Role of ACE and PAI-1 Polymorphisms in the Development and Progression of Diabetic Retinopathy

In the present study we determined the association of angiotensin converting enzyme (ACE) and plasminogen activator inhibitor-1 (PAI-1) gene polymorphisms with diabetic retinopathy (DR) and its sub-clinical classes in Pakistani type 2 diabetic patients. A total of 353 diabetic subjects including 160 DR and 193 diabetic non retinopathy (DNR) as well as 198 healthy controls were genotyped by allele specific polymerase chain reaction (PCR) for ACE Insertion/Deletion (ID) polymorphism, rs4646994 in intron 16 and PAI-1 4G/5G (deletion/insertion) polymorphism, rs1799768 in promoter region of the gene. To statistically assess the genotype-phenotype association, multivariate logistic regression analysis was applied to the genotype data of DR, DNR and control individuals as well as the subtypes of DR. The ACE genotype ID was found to be significantly associated with DR (p = 0.009, odds ratio (OR) 1.870 [95% confidence interval (CI) = 1.04–3.36]) and its sub-clinical class non-proliferative DR (NPDR) (p = 0.006, OR 2.250 [95% CI = 1.098–4.620]), while PAI polymorphism did not show any association with DR in the current cohort. In conclusion in Pakistani population the ACE ID polymorphism was observed to be significantly associated with DR and NPDR, but not with the severe form of the disease i.e. proliferative DR (PDR).     

TULIP study: Trail of Lurasidone in bipolar disorder in Pakistan

BackgroundThis study examined usefulness and efficiency of Lurasidone in appraisal with the placebo as for the treatment of Bipolar Disorders.MethodsSeven treatment centers in Pakistan were selected for the purpose of starting a six week-long control trial (randomized and double-blind placebo). 76 subjects, already diagnosed with Bipolar I or II based on DSM 5 diagnosis, were selected after randomization. Patients were allocated in one of the two groups. Primary efficacy of the drug was measured using Young Mania Rating Scale. Positive response of the drug was defined as 50% reduction in symptoms from the baseline/13 point less than the baseline score on Young Mania Rating Scale. Efficacy and safety of the drug was assessed using variety of markers such as administering extra-pyramidal symptoms rating scale, adverse side effects reported, electrocardiograms, body weight, vital signs changes, and laboratory investigations.ResultsPatients treated with Lurasidone showed enhanced improvement in their overall health and symptoms manifestation in comparison to patients who were given placebo. Lurasidone treated patients showed a better response to the drug (66%), in comparison with the placebo treated patients (42%).LimitationsStudy was conducted on small scale due to complexity.ConclusionPatients treated with Lurasidone showed reduction in bipolar symptoms and tolerate the drug well.     

Antiangiogenic properties of Koetjapic acid, a natural triterpene isolated from Sandoricum koetjaoe Merr

Background

Angiogenesis, the formation of new blood vessels, has become an important target in cancer therapy. Angiogenesis plays an important role in tumor growth and metastasis. Koetjapic acid (KA) is a seco-A-ring oleanene triterpene isolated from S. koetjape. The solvent extract of this plant species was shown previously to have strong antiangiogenic activity; however the active ingredient(s) that conferred the biological activity and the mode of action was not established. Given the high concentration of KA in S. koetjape, an attempt has been made in this study to investigate the antiangiogenic properties of KA.

Results

Treatment with 10-50 μg/ml KA resulted in dose dependent inhibition of new blood vessels growth in ex vivo rat aortic ring assay. KA was found to be non-cytotoxic against HUVECs with IC₅₀ 40.97 ± 0.37 μg/ml. KA inhibited major angiogenesis process steps, endothelial cell migration and differentiation as well as VEGF expression.

Conclusions

The non-cytotoxic compound, KA, may be a potent antiangiogenic agent; its activity may be attributed to inhibition of endothelial cells migration and differentiation as well VEGF suppression.     

Phytohormones and microRNAs as sensors and regulators of leaf senescence: Assigning macro roles to small molecules

Ageing or senescence is an intricate and highly synchronized developmental phase in the life of plant parts including leaf. Senescence not only means death of a plant part, but during this process, different macromolecules undergo degradation and the resulting components are transported to other parts of the plant. During the period from when a leaf is young and green to the stage when it senesces, a multitude of factors such as hormones, environmental factors and senescence associated genes (SAGs) are involved. Plant hormones including salicylic acid, abscisic acid, jasmonic acid and ethylene advance leaf senescence, whereas others like cytokinins, gibberellins, and auxins delay this process. The environmental factors which generally affect plant development and growth, can hasten senescence, the examples being nutrient dearth, water stress, pathogen attack, radiations, high temperature and light intensity, waterlogging, and air, water or soil contamination. Other important influences include carbohydrate accumulation and high carbon/nitrogen level. To date, although several genes involved in this complex process have been identified, still not much information exists in the literature on the signalling mechanism of leaf senescence. Now, the Arabidopsis mutants have paved our way and opened new vistas to elucidate the signalling mechanism of leaf senescence for which various mutants are being utilized. Recent studies demonstrating the role of microRNAs in leaf senescence have reinforced our knowledge of this intricate process. This review provides a comprehensive and critical analysis of the information gained particularly on the roles of several plant growth regulators and microRNAs in regulation of leaf senescence.     

Mechanisms of Action of Bcl-2 Family Proteins

The Bcl-2 family of proteins controls a critical step in commitment to apoptosis by regulating permeabilization of the mitochondrial outer membrane (MOM). The family is divided into three classes: multiregion proapoptotic proteins that directly permeabilize the MOM; BH3 proteins that directly or indirectly activate the pore-forming class members; and the antiapoptotic proteins that inhibit this process at several steps. Different experimental approaches have led to several models, each proposed to explain the interactions between Bcl-2 family proteins. The discovery that many of these interactions occur at or in membranes as well as in the cytoplasm, and are governed by the concentrations and relative binding affinities of the proteins, provides a new basis for rationalizing these models. Furthermore, these dynamic interactions cause conformational changes in the Bcl-2 proteins that modulate their apoptotic function, providing additional potential modes of regulation.Apoptosis was formally described and named in 1972 as a unique morphological response to many different kinds of cell stress that was distinct from necrosis. However, despite the novelty and utility of the concept, little experimental work was performed during the following 20 years because no tools existed to manipulate the process. In the early 1990s, two seminal observations changed the landscape. First, as the complete developmental sequence of the nematode Caenorhabditis elegans was painstakingly elucidated at the single-cell level, it was noted that a fixed, predictable number of “intermediate” cells were destined to die, and that this process was positively and negatively regulated by specific genes. Second, a novel gene called B-cell CLL/lymphoma 2 (Bcl-2; encoded by BCL2) that was discovered as a partner in a reciprocal chromosomal translocation in a human tumor turned out to function not as a classic oncogene by driving cell division, but rather by preventing apoptosis. When it was discovered that the mammalian BCL2 could substitute for CED-9, the C. elegans gene that inhibits cell death, the generality of the process was recognized, and the scientific literature exploded with now well over 10⁵ publications on apoptosis. However, it is ironic to note that after a further 20 years of intensive investigation, it is clear that the mechanism of action of Bcl-2 is quite distinct from Ced-9, which sequesters the activator of the caspase protease that is the ultimate effector of apoptosis. In contrast, Bcl-2 works primarily by binding to other related proteins that regulate permeabilization of the mitochondrial outer membrane (MOM).This review examines how apoptosis is regulated by the members of the (now very large) Bcl-2 family, composed of three groups related by structure and function (illustrated in Fig. 1): (1) the BH3 proteins that sense cellular stress and activate (either directly or indirectly); (2) the executioner proteins Bax or Bak that oligomerize in and permeabilize the MOM, thereby releasing components of the intermembrane space that activate the final, effector caspases of apoptosis; and (3) the antiapoptotic members like Bcl-2 that impede the overall process by inhibiting both the BH3 and the executioner proteins. To understand the consequence of the interactions among the three subgroups, several models have been proposed (“direct activation,” “displacement,” “embedded together,” and “unified” models; illustrated in Fig. 2) that are briefly described here before a more detailed discussion of the Bcl-2 families.Open in a separate windowFigure 1.Schematic overview of the Bcl-2 family of proteins. The family is divided into two subgroups containing proteins that either inhibit apoptosis or promote apoptosis. The proapoptotic proteins are further subdivided functionally into those that oligomerize and permeabilize the MOM, such as Bax and Bak, or those that promote apoptosis through either activating Bax or Bak or inhibiting the antiapoptotic proteins, such as tBid, Bim, Bad, and Noxa. Proteins are included in the Bcl-2 family based on sequence homology to the founding member, Bcl-2, in one of the four Bcl-2 homology (BH) regions. All the antiapoptotic proteins, as well as Bax, Bak, and Bid, have multiple BH regions, are evolutionarily related, and share a three-dimensional (3D) structural fold. The BH3 proteins contain only the BH3 region, are evolutionarily distant from the multiregion proteins, and are intrinsically unstructured. Most members of the Bcl-2 family proteins contain a membrane-binding region (MBR) on their carboxyl termini in the form of a tail anchor, mitochondrial-targeting sequence, or as a hydrophobic amino acid sequence that facilitates binding and localization of these proteins to the MOM or to the endoplasmic reticulum (ER) membrane.Open in a separate windowFigure 2.Schematics of the core mechanisms proposed by various models for the regulation of MOMP by Bcl-2 proteins. (↑) Activation; (⊥) inhibition; (⊥↑) mutual recruitment/sequestration. Paired forward and reverse symbols indicate the model makes explicit reference to equilibria. (A) The direct activation model divides the different BH3 proteins by qualitative differences in function. The BH3 proteins with high affinity for binding and activating Bax and Bak are termed as “activators,” whereas those that only bind the antiapoptotic proteins are termed “sensitizers.” The activator BH3 proteins directly interact with and activate Bax and Bak to promote MOMP. The antiapoptotic proteins inhibit MOMP by specifically sequestering the BH3 activators. The BH3 sensitizer proteins can compete for binding with the antiapoptotic proteins, thus releasing the BH3 activator proteins to avidly promote MOMP through activation and oligomerization of Bax and Bak. (B) The displacement model categorizes the BH3 proteins solely based on their affinities of binding for the antiapoptotic proteins (hence, does not recognize them as activators). In this model, Bax and Bak are constitutively active and oligomerize and induce MOMP unless held in check by the antiapoptotic proteins. Therefore, for a cell to undergo apoptosis, the correct combination of BH3 proteins must compete for binding for the different antiapoptotic proteins to liberate Bax and Bak and for MOMP to ensue. (C) The embedded together model introduces an active role for the membrane and combines the major aspects of the previous models. The interactions between members of the Bcl-2 family are governed by equlibria and therefore are contingent on the relative protein concentrations as well as their binding affinities. The latter are determined by posttranslational modifications, fraction of protein bound to the membrane, and cellular physiology. At membranes, the activator BH3 proteins directly activate Bax and Bak, which then oligomerize, inducing MOMP. Both activator and sensitizer BH3 proteins can recruit and sequester antiapoptotic proteins in the membrane. The antiapoptotic proteins inhibit apoptosis by sequestering the BH3 proteins and Bax and Bak in the membrane or by preventing their binding to membranes. At different intracellular membranes, the local concentrations of specific subsets of Bcl-2 family members alter the binding of Bcl-2 proteins to the membrane and the binding equilibria between family members. As a result, Bcl-2 family proteins have distinct but overlapping functions at different cellular locations. (D) The unified model builds on the embedded together model by proposing that the antiapoptotic proteins sequester the activator BH3 proteins (mode 1) and sequester Bax and Bak (mode 2). It differs in that in the unified model, inhibition of apoptosis through mode 1 is less efficient (smaller arrow in panel D) and therefore easier to overcome by sensitizer BH3 proteins. In addition, the unified model extends the role of Bcl-2 family proteins and the regulation of MOMP to mitochondria dynamics (not shown).     

‘We Keep It Secret So No One Should Know’ – A Qualitative Study to Explore Young Schoolgirls Attitudes and Experiences with Menstruation in Rural Western Kenya

Background

Keeping girls in school offers them protection against early marriage, teen pregnancy, and sexual harms, and enhances social and economic equity. Studies report menstruation exacerbates school-drop out and poor attendance, although evidence is sparse. This study qualitatively examines the menstrual experiences of young adolescent schoolgirls.

Methods and Findings

The study was conducted in Siaya County in rural western Kenya. A sample of 120 girls aged 14–16 years took part in 11 focus group discussions, which were analysed thematically. The data gathered were supplemented by information from six FGDs with parents and community members. Emergent themes were: lack of preparation for menarche; maturation and sexual vulnerability; menstruation as an illness; secrecy, fear and shame of leaking; coping with inadequate alternatives; paying for pads with sex; and problems with menstrual hygiene. Girls were unprepared and demonstrated poor reproductive knowledge, but devised practical methods to cope with menstrual difficulties, often alone. Parental and school support of menstrual needs is limited, and information sparse or inaccurate. Girls’ physical changes prompt boys and adults to target and brand girls as ripe for sexual activity including coercion and marriage. Girls admitted ‘others’ rather than themselves were absent from school during menstruation, due to physical symptoms or inadequate sanitary protection. They described difficulties engaging in class, due to fear of smelling and leakage, and subsequent teasing. Sanitary pads were valued but resource and time constraints result in prolonged use causing chafing. Improvised alternatives, including rags and grass, were prone to leak, caused soreness, and were perceived as harmful. Girls reported ‘other girls’ but not themselves participated in transactional sex to buy pads, and received pads from boyfriends.

Conclusions

In the absence of parental and school support, girls cope, sometimes alone, with menarche in practical and sometimes hazardous ways. Emotional and physical support mechanisms need to be included within a package of measures to enable adolescent girls to reach their potential.     

Protective effects of dietary EPA and DHA on ischemia–reperfusion-induced intestinal stress

The immunoregulatory effects of dietary omega-3 fatty acids are still not fully characterized. The aim of this study was to determine whether dietary eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake limits intestinal ischemia–reperfusion (IR) injury. To test this, rats were fed either control or EPA/DHA supplemented diet for 3 weeks following which they underwent either a sham or an IR surgical protocol. A significant reduction in mucosal damage was observed after EPA/DHA supplemented diet as reflected by maintenance of total protein content. To address the underlying mechanisms of protection, we measured parameters of oxidative stress, intestinal and serological cytokines and intestinal eicosanoids. Interestingly, EPA/DHA fed animals displayed a higher activity of oxidative stress enzyme machinery, i.e., superoxide dismutase and catalase in addition to a reduction in total nitrate/nitrite content. While no changes in cytokines were observed, eicosanoid analyses of intestinal tissue revealed an increase in metabolites of the 12-lipoxygenase pathway following IR. Further, IR in EPA/DHA fed animals was accompanied by a significant increase of 17,18-epoxyeicosatetraenoic acid, 8-Iso prostaglandin F_3α and thromboxane B₃, by more than 12-, 6-, 3-fold, respectively. Thus, the data indicate that EPA/DHA supplementation may be able to reduce early intestinal IR injury by anti-oxidative and anti-inflammatory mechanisms.     

A Study on the Transfer of Iron in Soil–Plant–Animal Continuum Under Semi-arid Environmental Conditions in Sargodha,Pakistan

The present investigation on the iron (Fe) transfer from soil to plant and in turn to animal (cows), as a function of sampling periods was conducted at the Livestock Experimental Station Sargodha, Pakistan which falls under semi-arid conditions. Although the iron transfer from soil to forage increased consistently, the forage Fe content decreased progressively with increase in sampling period. Highest Fe transfer from forage to cow blood plasma was observed during October and lowest during January. The transfer of Fe from forage to animal milk was maximum during the months of October and January and minimum during December. The transfer of Fe to plasma and milk was found to be dependent variably on the growth stage of forage in this investigation. Based on the findings of the present study, it is evident that mineral supplementation with higher Fe availability is urgently warranted to the animals particularly during the months of December and January to enhance plasma Fe in the cows being reared at that livestock farm during the entire grazing period. Thus, obligatory supplementation of Fe to the ruminants is highly recommended. Since the processes involved in iron management system in humans, animals, and plants are basically similar, appropriate elemental management must be provided to the living organisms, otherwise deficient or excessive levels of iron may deteriorate the developing cells of the organisms.