Two into One Won’t Go: Conceptual, Clinical, Ethical and Legal Impedimenta to the Convergence of CAM and Orthodox Medicine

The convergence of complementary and alternative medicine (CAM) and evidence-based medicine (EBM) is a prominent feature of healthcare in western countries, but it is currently undertheorised, and its implications have been insufficiently considered. Two models of convergence are described – the totally integrated evidence-based model (TI) and the multicultural-pluralistic model (MP). Both models are being incorporated into general medical practice. Against the background of the reasons for the increasing utilisation of CAM by the public and by general practitioners, TI-convergence is supported and MP-convergence is rejected. MP-convergence is epistemologically and clinically incoherent, and it cannot be regulated. It is also inconsistent with developments in the legal determination of the standard of care for both diagnosis/treatment and disclosure. These claims concerning MP-convergence are justified by the fact that science is not a member of the group of perspectives or world-views which postmodernism treats as equally valid, and this is especially important for healthcare.     

Caveolin-1 mutants P132L and Y14F are dominant negative regulators of invasion, migration and aggregation in H1299 lung cancer cells

Caveolin-1 is an essential protein constituent of caveolae. Accumulating evidence indicates that caveolin-1 may act as a positive regulator of cancer progression. In this study, we investigated the function of caveolin-1 in human lung cancer cells. Caveolin-1 knockdown inhibited cell proliferation and reduced focal adhesion kinase (Fak) phosphorylation. Matrix invasion and cell migration as well as expression and activity of matrix metalloproteases were attenuated following caveolin-1 RNAi-mediated knockdown or overexpression of Y14F and P132L mutants, demonstrating dominant-negative activity of these mutants. Time-lapse fluorescence microscopy revealed that caveolin-1 and its mutants P132L and Y14F are localized to the trailing edge of migrating cells during both random and directed cell movement, implying an active role of caveolin-1 in the migration process. Suppression of caveolin-1 function greatly elevated the percentage of H1299 cells exhibiting focal adhesions. In addition, cell aggregation was increased by wild type caveolin-1 and attenuated by both P132L and Y14F mutants. Overexpression of wild type caveolin-1 increased caveolae density, however, P132L and Y14F mutants did not affect caveolae formation, suggesting that in this respect that the mutants do not act in a dominant negative manner, and that effects of caveolin-1 on caveolae and cell invasion, migration, focal adhesion and aggregation, are separable. Our data provide novel mechanistic insights into the role of caveolin-1 in cell motility, invasiveness and aggregation, therefore, expanding our understanding of the tumor-promoting activities of caveolin-1 in advanced-stage cancer.     

The Relation Between Activity of Phosphoenolpyruvate Carboxykinase and Photosynthesis in Aloe vera Leaves

The chlorophyllous layer of leaf of a PEP-CK type CAM plant Aloe vera was stripped tiff from the colorIess water storage tissue and used to stuly the interrelation between the activity of decarboxylating enzyme phosphoenolpyruvate carboxykinase (PEPCK) and photosynthesis. Oxaloacetate, malate+ADP, and NaHCO3 were found to stimulate photosynthetic oxygen evolution. During the period from 6:00 to 18:00 of the day time, a diurnal fluctuation was observed in both PEPCK activity and the rate of oxygen evolution. The maximum of photosynthesis appeared at 10-12:00, but the maximum PEPCK activity appeared at 14:00. The PEPCK activity and photosynthetic rate in leaf discs increased with temperature from 10 to 35℃, then decreased at 45℃. Similar decline of both parameters was found in the leaf discs stressed by different concentration of PEG-6000 solution for 4.5 h. At light intensity of 900 mol m-2 s-1 and 25℃, the PEPCK activity and photosynthetic rate of leaf discs rised with the illumination time, then a slight inhibition followed at the time of 30 min (Pn) or 40 min (PEPCK). The strong response of PEPCK activity to high light intensity in leaf discs, and a progressive increase of PEPCK activity in direct illumination of crude enzyme extractm the range of 0-55 min, indicated that light s likely to be an activator for PEPCK. Leaf discs were infiltrated with 3-(3,4-dichlorophenyl)-l, 1-dimethylurea, DL-glyceraldehyde and 2,4-dimitrophenol resulted in the partial inhibition of light-ependent photosynthesis and decarboxylation of C4 acid. The activity of PEPCK was also stimulated by Mg2+ or Mg2++ATP infiltrated into the leaf discs in the dark. The evidence presented here suggested that PEPCK activity of CAM plants showed a close interrelation with photosynthesis. Both of them were regulated by the environmental changes. The activity of PEPCK might be coupled to electron trsnsport and photophosphorylatiou.     

Changes in levels of phosphoenolpyruvate carboxylase with induction of Crassulacean acid metabolism (CAM)-like behavior in the C4 plant Portulaca oleracea

Changes in levels of phosphoenolpyruvate carboxylase (PEPC, EC 4.1.1.31, orthophosphate: oxaloacetate carboxy-lyase, phosphorylating) were followed in leaves and stems of CAM-expressing and non-expressing Portulaca oleracea L. plants. CAM expression was induced by growing plants under an 8-h photoperiod and water stress conditions (SD-WS). Leaves and stems of these plants (designated CAM) expressed nocturnal acidification with an oscillation pattern and an amplitude characteristic of CAM plants. Generally, PEPC activity increased by ca 3-fold during the period of CAM induction. Over the day/night cycle. PEPC activity oscillated in a pattern typical of CAM plants. Treatment of the other plant group (designated as non-CAM) by growth under a 16-h photoperiod and well-watered conditions (LD-WW) did not induce expression of the tested criteria of CAM in plants. In these plants, nocturnal acidification as well as changes in the magnitude of PEPC, activity and fluctuation pattern were undetectable. SDS-PAGE of leaf extracts of the CAM-expressing plants and the corresponding densitometric scans show progressive increase in the amount of PEPC subunit protein (ca 95 kDa) during the period of CAM induction. These results show that induction of CAM-like characteristics in the C₄ plant Portulaca oleracea is also accompanied by increased PEPC activity, which may be partly due to an increase in enzyme synthesis.     

Toward a Better Knowledge of the Molecular Evolution of Phosphoenolpyruvate Carboxylase by Comparison of Partial cDNA Sequences

To get deeper insight into the evolution of phosphoenolpyruvate carboxylase we have identified PEPC fragments (about 1,100 bp) of another 12 plants species not yet investigated in this context. The selected plants include one Chlorophyta, two Bryophyta, four Pteridophyta, and five Spermatophyta species. The obtained phylogenetic trees on PEPC isoforms are the most complete ones up to now available. Independent of their manner of construction, the resulting dendrograms are very similar and fully consistent with the main topology as it is postulated for the evolution of the higher terrestrial plants. We found a distinct clustering of the PEPC sequences of the prokaryotes, the algae, and the spermatophytes. PEPC isoforms of the archegoniates are located in the phylogenetic trees between the algae and spermatophytes. Our results strengthen the view that the PEPC is a very useful molecular marker with which to visualize phylogenetic trends both on the metabolic and organismic levels. Received: 23 December 1996 / Accepted: 22 April 1997     

CAM and carbon isotope composition: Origin of the constitutive carbon in young leaves of Bryophyllum daigremontianum Berger

Abstract. The export of assimilates from mature leaves towards the young leaves was investigated: 100% and 65% of constitutive matter of leaves of rank 0 (the youngest leaves at the top of the plant) and of rank 1, respectively, originated from other parts of the plant. Photosynthesis of a particular leaf covers the total carbon requirement of that leaf only when it reaches about two-thirds of its mature size. When pairs of mature leaves were excised, the young leaves increased their own autotrophic growth while the level of assimilates exported by the remaining leaves remained unchanged. The existence of permanent pools in the leaves that export the assimilates was demonstrated; about 50% of the carbon, both in the soluble and insoluble fractions of mature and senescent leaves (ranks 5 to 8 from the apex), was not renewed by turnover. It is shown that the ¹³C-enrichment of the components of the starch-malate sequence in young leaves results, at least in part, from the incorporation of imported carbon chains. The significance of the δ¹³C diagnosis in CAM determination is discussed in relation to the origin of the constitutive carbon of the leaves.     

XIAP is essential for shear stress-enhanced Tyr-576 phosphorylation of FAK

In endothelial cells, X-chromosome linked inhibitor of apoptosis protein (XIAP) regulates cell survival, migration and adhesion. We have recently found that XIAP recruits focal adhesion kinase (FAK) into integrin-associated focal adhesions, controlling cell migration. However, little is understood about the molecular mechanisms by which FAK modulation is controlled by XIAP. In this study, we show that XIAP modulates FAK activity through the control of FAK phosphorylation. In bovine aortic endothelial cells (BAEC), phosphorylation of Tyr-576 in FAK is elevated by laminar shear stress. This elevated phosphorylation appears to be responsible for shear stress-stimulated ERK activation. We found that XIAP knockdown reduces shear stress-enhanced phosphorylation of Tyr-576 and induces shear stress-triggered translocation of FAK into nucleus. Nuclear translocation of FAK reduces contact between FAK and Src, a kinase which phosphorylates Tyr-576. This spatial segregation of FAK from Src decreases Tyr-576 phosphorylation and thus shear-stimulated ERK activation. Taken together, our results demonstrate that XIAP plays a key role in shear stress-stimulated ERK activation by maintaining the Src-accessible location of FAK.