Kinetic properties of Na+, K+ activated, Mg2+ -dependent ATP-hydrolysis of blood lymphocytes in patients with rheumatoid arthritis and ankylosing spondyloarthritis

The comparative analysis of the kinetic properties of ouabain-sensitive Na+, K+ -ATPase activity of saponin-perforated blood lymphocytes of donors and patients with rheumatoid arthritis (RA) and ankylosing spondyloarthritis (AS) was carried out. When analyzing the alterations in hydrolase activity of the examined enzyme it was shown that in the blood lymphocytes of patients with RA and AS the primary active transport of Na+ and K+ ions is less intensive in comparison with practically healthy donors, but it is characterized by almost the same capacity as in donors. The affinity constant of Na+, K+ -ATPase for ATP in the blood lymphocytes in patients with RA and AS is greater 3.1 and 2.5 times, respectively, in comparison with healthy donor. It was found that in conditions of rheumatic pathology in immunocompetent cells the inhibition of Na+, K+ -ATPase activity is not related to the reduction of maximum reaction rate, but is related to the decrease of Na+, K+ -ATPase affinity to ATP. However, Mg2+ -binding center of Na+, K+ -ATPase in patients with RA and AS remains native. It was identified that the affinity constant of Na+, K+ -ATPase to Na+ ions in the blood lymphocytes of patients with RA and AS is 2.75 times lower than its value in healthy donors. Na+, K+ -ATPase of the blood lymphocytes of patients with RA and AS retains its native receptor properties and sensitivity to ouabain does not change.     

长春瑞滨联合卡铂化疗治疗晚期肺癌的临床观察

目的:探讨长春瑞滨联合卡铂化疗对晚期肺癌的治疗效果和安全性。方法:选取我院肿瘤科收治的晚期肺癌患者60例,根据不同治疗方案分为实验组与对照组,每组各30例患者。比较两组患者治疗前后的CEA、CA50、CYFRA21-1水平、白细胞计数及T淋巴细胞亚群CD4+、CD8+水平的变化。结果:治疗前,两组患者的CEA、CA50、CYFRA21-1水平、白细胞计数及T淋巴细胞亚群CD4+、CD8+水平比较均无统计学差异(P0.05)。治疗后,实验组的CEA、CA50、CYFRA21-1、CD8+水平均明显低于对照组,而白细胞计数及T淋巴细胞亚群CD4+、CD4+/CD8+水平均显著高于对照组,差异均具有统计学意义(P0.05)。结论:与放疗相比,长春瑞滨联合卡铂化疗能显著提高晚期肺癌的疗效,且不降低患者的细胞免疫。     

Phenotype of peripheral blood leukocytes and survival of patients with metastatic colorectal cancer

Immune dysfunction is prevalent in metastatic cancer. Few patients with colorectal cancer metastases are cured, and among the strategies aimed at improving the therapeutic results in patients with metastatic colorectal cancer, immunotherapy is being increasingly investigated. We evaluated retrospectively the prognostic significance of peripheral blood leukocytes in 59 patients with metastatic colorectal cancer. The relative numbers of CD3+, CD3+CD4+, CD3+CD8+, NK (CD3-CD16+CD56+), CD3+DR+, CD3+CD25+, CD3+CD69+, CD19+, CD19+CD23+, CD8+CD28+, CD8-CD28+, CD8+CD57+, CD14+DR+ and CD14+CD16+ leukocytes were analyzed by two-color flow cytometry. A three-step approach was adopted to identify predictors of prognosis using regression analysis. Based on the results of univariate survival analysis, the absolute number of white blood cells, NK/CD3+CD69+ and NK/white cell count ratios were significant indicators of prognosis. In the multivariate regression analysis a model was obtained using a single parameter, the NK/CD3+CD69+ ratio, predicting the survival with 10-15% power of regression. The present results indicate that the NK/CD3+CD69+ ratio in peripheral blood may be an independent variable in a regression model predicting the overall survival of patients with colorectal cancer metastases to be tested in prospective studies.     

Deterioration of cellular immunity during aging. The relationship between age-dependent impairment of delayed-type hypersensitivity reactivity, interleukin-2 production capacity, and frequency of Thy-1+,Lyt-2- cells in C57BL/Ka and CBA/Rij mice

The effect of aging on the delayed-type hypersensitivity (DTH) to sheep red blood cells (SRBC) in vivo and the interleukin-2 (IL-2) production capacity in vitro by spleen cells from young (17 weeks) and old (125 weeks) CBA/Rij and C57BL/Ka mice were investigated. For both CBA/Rij and C57BL/Ka mice an age-related decline in the DTH response to SRBC and the IL-2 production capacity was observed. Both parameters are mediated by Thy-1+,Lyt-2- spleen cells. For both mouse strains the proportion of Thy-1+,Lyt-2- spleen cells declined less strongly with aging than the DTH reactivity and the IL-2 production capacity. From this it was concluded that not only a quantitative but also a qualitative decrease of T-cell function occurs during senescence. It was also investigated whether the proportion of Thy-1+,Lyt-2- peripheral blood lymphocytes can be used as a predictive value with regard to the decline of DTH with aging of the corresponding mouse. This was indeed found to be the case in CBA/Rij mice, but not in C57BL mice.     

Localization of Na+,K+-ATPase activity in the cardiac myocytes of white rats at the ultrastructural level

The localization of Na+,K+-ATPase in cardiomyocytes of white rats at the ultrastructural level and the dependence of enzyme activeness on electronic density of structures, were studied. Na+,K+-ATPase activity was revealed in plasmalemma, Z-membranes and in nuclei. The enzyme activity is distributed discretely both within the tissue and within separate cells. It is, probably, due to the heterogeneity of structural-functional condition of cells and their ultrastructures as revealed by means of electronic microscopy in terms of their different electronic density. The maximal Na+,K+-ATPase activeness was revealed at the average electronic density of structures.     

Assessment of the ability of mononuclear blood cells to produce IFN-gamma in patients with laryngeal cancer

The ability of mononuclear blood cells (PBMC), derived from patients with cancer of the larynx, to produce IFN-gamma in vitro was assessed in this paper. Thirty patients (27 male, 3 female) were qualified to the study. Their mean age was 65 (range: 41 to 78 years), tumour sizes found in the group were from T2 to T4, levels of pathologic malignancy G2 or G3. The percentage rates different blood cells phenotypes (CD3+, CD3+ HLADR+, CD4+, CD8+, CD14+ HLADR+, CD19+, CD56+) were evaluated by means of flow cytometry (Coulter EPICS XL). The control group consisted of 20 healthy blood donors. PBMC were derived by centrifugation of heparinized venous blood on Lymphoprep gradient according to Boyum method. Double cell cultures were performed for 24 hours with antibody anti-CD3 or recombinant interleukins 12 (rhIL-12) or 18 (rhIL-18). The statistic analysis was based on Student t and Mann-Whitney's test with significancy at p<0.05. A significant decrease in the production of IFN-gamma by PBMC in patients with laryngeal cancer after stimulation with antiCD3 (p=0.018), rhIL-12 (p=0.027), rhIL-18 (p=0.016) was found in comparison with the controls. The results suggest a decreased production of IFN-gamma in patients with cancer of the larynx.     

Inequality as a Powerful Predictor of Infant and Maternal Mortality around the World

Background

Maternal and infant mortality are highly devastating, yet, in many cases, preventable events for a community. The human development of a country is a strong predictor of maternal and infant mortality, reflecting the importance of socioeconomic factors in determinants of health. Previous research has shown that the Human Development Index (HDI) predicts infant mortality rate (IMR) and the maternal mortality ratio (MMR). Inequality has also been shown to be associated with worse health in certain populations. The main purpose of the present study was to determine the correlation and predictive power of the Inequality Adjusted Human Development Index (IHDI) as a measure of inequality with the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Early Neonatal Mortality Rate (ENMR), Late Neonatal Mortality Rate (LNMR), and the Post Neonatal Mortality Rate (PNMR).

Methods and Findings

Data for the present study were downloaded from two sources: infant and maternal mortality data were downloaded from the Global Burden of Disease 2013 Cause of Death Database and the Human Development Index (HDI) and Inequality-Adjusted Human Development Index (IHDI) data were downloaded from the United Nations Development Program (UNDP). Pearson correlation coefficients were estimated, following logarithmic transformations to the data, to examine the relationship between HDI and IHDI with MMR, IMR, ENMR, LNMR, and PNMR. Steiger’s Z test for the equality of two dependent correlations was utilized in order to determine whether the HDI or IHDI was more strongly associated with the outcome variables. Lastly, we constructed OLS regression models in order to determine the predictive power of the HDI and IHDI in terms of the MMR, IMR, ENMR, LNMR, and PNMR.Maternal and infant mortality were both strongly and negatively correlated with both HDI and IHDI; however, Steiger’s Z test for the equality of two dependent correlations revealed that IHDI was more strongly correlated than HDI with MMR (Z = 4.897, p < 0.001), IMR (Z = 2.524, p = 0.012), ENMR (Z = 2.936, p = 0.003), LNMR (Z = 2.272, p = 0.023), and PNMR (Z = 2.277, p = 0.023). Furthermore, side-by-side OLS regression models revealed that, when IHDI was used as the predictor variable instead of HDI, the R ² value was 0.053 higher for MMR, 0.025 higher for IMR, 0.038 higher for ENMR, 0.029 higher for LNMR, and 0.026 higher for PNMR.

Conclusions

Even when both the HDI and the IHDI correlate with the infant and maternal mortality rates, the IHDI is a better predictor for these two health indicators. Therefore, these results add more evidence that inequality is playing an important role in determining the health status of various populations in the world and more efforts should be put into programs to fight inequality.     

Effect of hypoosmotic stimulation of the gastrointestinal mucosa on the activity of NA+, K+-atpase of epithelial cells in the small intestine and kidney in rats]

The experiments on Wistar rats have shown that intragestral injection with mannitol hypotonic solution (20 mmol/l) causes the significant activation of Na+, K(+)-ATPase of duodenum and distal intestine epithelial cells, kidney cortex cells, but does not affect the brain cortex of Na+, K(+)-ATPase activity. Simultaneously the activator of enzyme (AE) enters blood serum of rats, its activity is revealed by blood serum addition to homogenates of tissues of control rats. It is assumed that AE is produced in duodenal and intestinal mucosa released to blood after stimulation of mucosal surface by hypotonic solutions and included into the osmoregulation processes on the Na+, K(+)-ATPase level.     

Chimeric drift in allophenic mice.

The composition of the immune system of 33 allophenic mice of four different types [C57BL/6 in equilibrium DBA/1, C57BL/6 in equilibrium (CBA X CBA/H-T6), C57BL/6 in equilibrium (A X SJL), DBA/1 in equilibrium (CBA X CBA/H-T6)] was studied. It was found that the parental composition of the peripheral white blood cells changed significantly during a two-month interval in 11/33 or 33% of the mice studied. This phenomenon has been termed chimeric drift. The animals were sacrificed between 9 and 16 months of age, and the parental composition of the peripheral white blood cells, spleen white blood cells, and thymocytes was determined on the day of sacrifice. It was foound that the peripheral white blood cell and spleen white blood cell compositions showed a high degree of correlation. However 8/33 or 24% of the mice studied showed discordance of the spleen and thymocyte cell populations. Seven of the 8 mice which showed spleen-thymocyte discordance, had also shown evidence of chimeric drift earlier in their lives. We suggest that this is evidence that chimeric drift may have an immunological basis.     

Immune status of Greek patients with beta-thalassemia major negative for anti-HIV

Patients with thalassemia who receive multiple blood transfusions are at risk for the acquired immunodeficiency syndrome. Peripheral blood lymphocyte subpopulations were studied in 22 multitransfused thalassemic patients; 10 patients were without splenectomy and 12 were studied after splenectomy. Both groups were negative for anti-HIV. Four additional patients who were found positive for anti-HIV and ten healthy controls were also included in this study. Patients without splenectomy compared to controls and to patients after splenectomy showed a significant decrease of both percentage (p less than 0.001) and absolute numbers (p less than 0.001) of Leu-7+ cells without significant abnormalities of T4/T8 ratio (1.56 +/- 0.4). Patients after splenectomy compared to controls and to patients without splenectomy showed a significant increase of the absolute numbers of lymphocytes and lymphocytes subsets T11+, T3+, T4+, T8+ and SmIg+ cells. In the seropositive patients for HIV only a significant increase of the absolute number of T8+ cells was observed while the T4/T8 ratio was 1.24 +/- 0.73. The decrease in the percentage of Leu-7+ cells in patients without splenectomy correlated inversely to the total amount of blood transfused. In conclusion patients with thalassemia had normal T4/T8 ratio and did not show the abnormal immunologic profile that has been reported in haemophiliacs.     

Impaired natural killer cell function in hemophiliacs with or without continuous substitution

In the present study, 28 hemophiliacs substituted continuously and 5 hemophiliacs who had received almost no blood products were investigated. Cells of OKT 3+, OKT 4+, and OKT 8+ subsets were counted. Percoll separated fractions of peripheral blood mononuclear cells were examined by morphological criteria and were tested for NK cell activity. We found that the NK cell activity of both groups of hemophiliacs was decreased on testing Ficoll separated cells or low density Percoll separated cells. Normal NK cell activity was found in medium density cells of hemophiliacs. Two possible explanations are discussed: first, the NK cell activity may be suppressed in hemophiliacs and secondly, there may be a block in maturation of NK cell activity. It is unlikely that chronic substitution by blood products counts for these alterations. The possible role of chronic infections is discussed.     

A case of dengue hemorrhagic fever in a Japanese child

A 6-year-old Japanese girl contracted a febrile illness with hemorrhagic manifestations when she traveled in Indonesia. A remarkable decrease in the numbers of platelets and white blood cells was observed in her acute-phase blood specimens. Her father, who accompanied her, showed dengue fever-like symptoms at almost the same time as her illness. It was determined by serological tests that they were infected with dengue virus type 1. Moreover, she showed a secondary antibody response to the flavivirus due to the pre-existing antibody to Japanese encephalitis virus. This is the first confirmed case of dengue hemorrhagic fever (DHF) in Japanese people.     

Effect of chronic ethanol consumption on emotional stress in the white rat

Chronic pain emotional stress (PES), paired action of the white noise and electric skin stimulation and chronic (during 7 months) ethanol consumption in white rats were shown to act in the same direction. Hypertension, decrease of respiratory rate and increase of Hildebrandt index were observed as a result of PES, ethanol consumption, and especially under PES during ethanol consumption. Ethanol consumption by the animals led to their growth retardation and increase of the spleen and heart mass. Accidental thymus involution was noted both under ethanol consumption and PES. Activation of lipid peroxidation and decrease of superoxide dismutase activity (of its mitochondrial form especially) as well as of Na+,K+-ATP-ase activity were observed in brain homogenates of the rats after PES, while the general ATP-ase activity remained unchanged. An increase of triiodothyronine level and the tendency to thyroxine level increase as well as a decrease of superoxide dismutase activity were observed in the blood serum of these animals. A tendency towards lipid peroxidation level decrease and to brain superoxide dismutase activity increase, as well as blood antioxidation activity increase (evaluated by transferrin and coeruloplasmin contents and by serum superoxide dismutase activity) and a decrease of thyroxine level were observed as a result of ethanol consumption. The mechanisms are discussed of the "anti-stress" action of short-term ethanol consumption and of the action of its chronic consumption, additive to PES.     

Mobilization of bone marrow-derived progenitor cells in acute coronary syndromes

Two hypotheses explain the role of adult progenitor cells in myocardial regeneration. Stem cell plasticity which involves mobilization of stem cells from the bone marrow and other niches, homing to the area of tissue injury and transdifferentiation into functional cardiomyocytes. Alternative hypothesis is based on the observations that bone marrow harbors a heterogenous population of cells positive for CXCR4 - receptor for chemokine SDF-1. This population of non-hematopoietic cells expresses genes specific for early muscle, myocardial and endothelial progenitor cells (EPC). These tissue-committed stem cells circulate in the peripheral blood at low numbers and can be mobilized by hematopoietic cytokines in the setting of myocardial ischemia. Endothelial precursors capable of transforming into mature, functional endothelial cells are present in the pool of peripheral mononuclear cells in circulation. Their number significantly increases in acute myocardial infarction (AMI) with subsequent decrease after 1 month, as well as in patients with unstable angina in comparison to stable coronary heart disease (CHD). There are numerous physiological and pathological stimuli which influence the number of circulating EPC such as regular physical activity, medications (statins, PPAR-gamma agonists, estrogens), as well as numerous inflammatory and hematopoietic cytokines. Mobilization of stem cells in AMI involves not only the endothelial progenitors but also hematopoietic, non-hematopoietic stem cells and most probably the mesenchymal cells. In healthy subjects and patients with stable CHD, small number of circulating CD34+, CXCR4+, CD117+, c-met+ and CD34/CD117+ stem cells can be detected. In patients with AMI, a significant increase in CD34+/CXCR4+, CD117+, c-met+ and CD34/CD117+ stem cell number the in peripheral blood was demonstrated with parallel increase in mRNA expression for early cardiac, muscle and endothelial markers in peripheral blood mononuclear cells. The maximum number of stem cells was found early in ST-segment elevation myocardial infarction (<12 hours) with subsequent decrease through the 7-day follow-up and with concomitant changes in the levels of cytokines involved in the inflammatory response and stem cell recruitment. Moreover, peak expression of cardiac muscle and endothelial markers occurred at the same time as the most significant increase in CD34/CXCR4+ stem cell number. The SDF-1/CXCR-4 axis seems particularly important in stem/muscle progenitor cell homing, chemotaxis, engraftment and retention in ischaemic myocardium. The significance of autologous stem cells mobilization in terms of cardiac salvage and regeneration needs to be proved in humans but it seems to be a reparative mechanism triggered early in the course of acute coronary syndromes.     

The activation processes of the immune system during low intensity exercise without relaxation

The activation processes of T-, B- and NK-cells were studied during 8-week low intensity strength training without relaxation. After the long-term training, no changes occurred in the peripheral blood contents of the main subpopulations of immunocompetent cells (CD3+, CD4+, CD8+, CD19+ and CD16+/CD56+ lymphocytes) and serum levels of immunoglobulin A, M, and G. At the same time, training was accompanied by positive activation of the immunocompetent cells which was evident from increased percentage of CD3+, CD19+ and /CD56+ cells expressing CD69 after activation (PHA, PW and II.2, respectively). The final period of the training course was also associated with a decrease in the level of lymphocyte apoptosis and increase of proliferative responses of lymphocytes.     

Cell numbers and in vitro responses of leucocytes and lymphocyte subpopulations following maximal exercise and interval training sessions of different intensities.

In vitro lymphocyte function and the mobilisation of peripheral blood leucocytes was examined in eight trained subjects who undertook an incremental exercise test to exhaustion and a series of interval training sessions. Venous blood samples were obtained before the incremental test, immediately after, and 30, 60, and 120 min after the test. Interval training sessions were undertaken on separate days and the exercise intensities for each of the different sessions were 30%, 60%, 90% and 120% of their maximal work capacity respectively, as determined from the incremental exercise test. There were 15 exercise periods of 1-min duration separated by recovery intervals of 2 min in each session. Venous blood samples were obtained immediately after each training session. Significant increases in lymphocyte subpopulations (CD3+, CD4+, CD8+, CD20+, and CD56+) occurred following both maximal and supramaximal exercise. This was accompanied by a significant decrease in the response of cultures of peripheral blood lymphocytes to Concanavalin A (ConA), a T-cell mitogen. The state of lymphocyte activation in vivo as measured by CD25+ surface antigen was not, however, affected by acute exercise. The total number of lymphocytes, distribution of lymphocyte subpopulations and in vitro lymphocyte response to ConA had returned to pre-exercise levels within half an hour of termination of exercise but serum cortisol concentrations had not begun to fall at this time. There was a significant decrease in the CD4+:CD8+ cell ratio following exercise; this was more the result of increases in CD3-CD8+ cells (CD8+ natural killer cells) than to CD3+CD8+ cells (CD8+ T-lymphocytes). Decreased responsiveness of T-cells to T-cell mitogens, postexercise, may have been the result of decreases in the percentage of T-cells in postexercise mixed lymphocyte cultures rather than depressed cell function. The cause of this was an increase in the percentage of natural killer cells which did not respond to the T-cell mitogen. The results indicated that while a substantial immediate in vitro "immunomodulation" occurred with acute exercise, this did not reflect an immunosuppression but was rather the result of changes in the proportions of reactive cells in mononuclear cell cultures. We have also demonstrated that the degree of the change in distribution of lymphocyte subpopulation numbers and responsiveness of peripheral blood mononuclear cells in in vitro mitogen reactions increased with increasing exercise intensity. Plasma volume changes may have contributed to some of the changes seen in leucocyte population and subpopulation numbers during and following exercise.     

Differences in the nitric oxide metabolism in streptozotocin-treated rats and children suffering from Type 1 diabetes

The relationship between diabetes mellitus Type 1 and nitric oxide (NO) synthesis was studied in multiple low-dose streptozotocin (STZ)-treated rats and diabetic children. The aim of our experimental work was to test the effect of hyperglycemic state on the level of urinary stable NO end products and on the expression of inducible nitric oxide synthase (NOS II) in white blood cells (WBC). It was also studied whether the measurements of these parameters were suitable to predict the presence of early diabetes before its onset. The occurrence of insulitis in streptozotocin-treated rats could not be clearly demonstrated. Urinary nitrite plus nitrate level significantly increased both in diabetic rats and in children compared to controls. However, the increase of the activity and the expression of inducible NOS II were only observed in rat white blood cells and this effect was prevented by insulin treatment. In human samples, less than 25% of children showed elevated NOS II expression in white blood cells without any correlation to the level of urinary NO end products and glycated hemoglobin in blood. Correlation was found only between the activity and expression of NOS II in white blood cells of patients whose white blood cells were positive for the presence of NOS II. Measurement of urinary nitrite plus nitrate content as well as the determination of NOS II expression of white blood cells in an early phase of diabetes are not suitable predictors in humans probably due to the basic differences in the mechanism of streptozotocin-induced rat and spontaneous human Type 1 diabetes.     

系统性红斑狼疮患者外周血单个核细胞中C-myc和ras癌蛋白的表达及NK亚群的状况

作者检测了系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中 C-myc.Ki-ras 和Ha-ras 三种癌蛋白的表达和自然杀伤细胞(NK)亚群状况。结果显示,SLE 患者血液淋巴细胞和单核细胞中上述三种癌蛋白的阳性率均显著高亍健康对照组(P<0.001);而 SLE 组 NK 总数和CD16~+.CD16~+.57~+亚群细胞数则显著低于对照组(P<0.001)。作者结合文献讨论了 SLE 患者PBMC 中癌基因激活的可能机制和重要意义,以及与 NK 细胞和其亚群改变之间的相互关系。     

Heterogeneity of stromal precursor cells isolated from rat bone marrow

Bone marrow stroma contains mesenchymal stem cells (MSC) which are precursor for at least mesenchyma-derived cells. Recent investigations revealed a lot of questions concerning MSC biology that should be further refined. The aim of this study was the comparative analysis of rat bone marrow stroma cells cultures. Mesenchymal precursor cells isolated from rat bone marrow were passed up to 50 times. Comparative morphological and immunophenotypical analysis of these cultures was carried out as well as their ability to osteogenic differentiation was studied. The isolated cultures contained morphologically different types of cells and thus showed a high heterogenity level. Morphology of these cell types was described. The heterogeneity level was reported to decrease over time. It was found out that subcultures isolated from different rats shared the same immunophenotype characteristics (CD90+, CD44+, CD54+, CD 106+, CD45-, CD11b-), but differed in their morphology as well as in ability to osteogenic differentiation. Thus MSC identification requires more specific marker and functional tests to be used.     

Breast Cancer Incidence in Black and White Women Stratified by Estrogen and Progesterone Receptor Statuses

Background

There is increasing evidence that breast cancer is a heterogeneous disease presented by different phenotypes and that white women have a higher breast cancer incidence rate, whereas black women have a higher mortality rate. It is also well known that white women have lower incidence rates than black women until approximately age 40, when rate curves cross over and white women have higher rates. The goal of this study was to validate the risk of white and black women to breast cancer phenotypes, stratified by statuses of the estrogen (ER) and progesterone (PR) receptors.

Methodology/Principal Findings

SEER17 data were fractioned by receptor status into [ER+, PR+], [ER−, PR−], [ER+, PR−], and [ER−, PR+] phenotypes. It was shown that in black women compared to white women, cumulative age-specific incidence rates are: (i) smaller for the [ER+, PR+] phenotype; (ii) larger for the [ER−, PR−] and [ER−, PR+] phenotypes; and (iii) almost equal for the [ER+, PR−] phenotype. Clemmesen''s Hook, an undulation unique to women''s breast cancer age-specific incidence rate curves, is shown here to exist in both races only for the [ER+, PR+] phenotype. It was also shown that for all phenotypes, rate curves have additional undulations and that age-specific incidence rates are nearly proportional in all age intervals.

Conclusions/Significance

For black and white women, risk for the [ER+, PR+], [ER−, PR−] and [ER−, PR+] phenotypes are race dependent, while risk for the [ER+, PR−] phenotype is almost independent of race. The processes of carcinogenesis in aging, leading to the development of each of the considered breast cancer phenotypes, are similar in these racial groups. Undulations exhibited on the curves of age-specific incidence rates of the considered breast cancer phenotypes point to the presence of several subtypes (to be determined) of each of these phenotypes.