Maintenance treatment with esomeprazole following initial relief of non-steroidal anti-inflammatory drug-associated upper gastrointestinal symptoms: the NASA2 and SPACE2 studies

Non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclo-oxygenase-2 (COX-2) inhibitors, cause upper gastrointestinal (GI) symptoms that are relieved by treatment with esomeprazole. We assessed esomeprazole for maintaining long-term relief of such symptoms. Six hundred and ten patients with a chronic condition requiring anti-inflammatory therapy who achieved relief of NSAID-associated symptoms of pain, discomfort, or burning in the upper abdomen during two previous studies were enrolled and randomly assigned into two identical, multicentre, parallel-group, placebo-controlled studies of esomeprazole 20 mg or 40 mg treatment (NASA2 [Nexium Anti-inflammatory Symptom Amelioration] and SPACE2 [Symptom Prevention by Acid Control with Esomeprazole] studies; ClinicalTrials.gov identifiers NCT00241514 and NCT00241553, respectively) performed at various rheumatology, gastroenterology, and primary care clinics. Four hundred and twenty-six patients completed the 6-month treatment period. The primary measure was the proportion of patients with relapse of upper GI symptoms, recorded in daily diary cards, after 6 months. Relapse was defined as moderate-to-severe upper GI symptoms (a score of more than or equal to 3 on a 7-grade scale) for 3 days or more in any 7-day period. Esomeprazole was significantly more effective than placebo in maintaining relief of upper GI symptoms throughout 6 months of treatment. Life-table estimates (95% confidence intervals) of the proportion of patients with relapse at 6 months (pooled population) were placebo, 39.1% (32.2% to 46.0%); esomeprazole 20 mg, 29.3% (22.3% to 36.2%) (p = 0.006 versus placebo); and esomeprazole 40 mg, 26.1% (19.4% to 32.9%) (p = 0.001 versus placebo). Patients on either non-selective NSAIDs or selective COX-2 inhibitors appeared to benefit. The frequency of adverse events was similar in the three groups. Esomeprazole maintains relief of NSAID-associated upper GI symptoms in patients taking continuous NSAIDs, including selective COX-2 inhibitors.     

Phosphoinositide-regulated retrograde transport of ricin: crosstalk between hVps34 and sorting nexins

The plant toxin ricin is transported from the plasma membrane via early endosomes and the Golgi apparatus to the endoplasmic reticulum. From this compartment, it enters the cytosol and inhibits protein synthesis. Lipid phosphorylation is an important regulator of vesicular transport, and in the present study we have investigated the role of the phosphatidylinositol (PI) 3-kinase hVps34 in retrograde transport of ricin. Our data demonstrate that transport of ricin from endosomes to the Golgi apparatus in human embryonic kidney cells (HEK 293) is dependent on PI(3)P. By using PI 3-kinase inhibitors, by sequestering the hVps34 product PI(3)P and by expressing mutants of hVps34 or small interfering RNA targeted against its messenger RNA, we show that hVps34 and its product PI(3)P are involved in transport of ricin from endosome to Golgi apparatus. Furthermore, we identify two effector proteins in the hVps34-dependent pathway, namely sorting nexin (SNX) 2 and SNX4. Knockdown of SNX2 or SNX4 inhibits ricin transport to the Golgi apparatus to the same extent as when hVps34 is perturbed. Furthermore, inhibition or knockdown of hVps34 redistributes these proteins. Interestingly, knocking down both SNX2 and SNX4 results in a better inhibition than knocking down only one of them, suggesting that they may act on separate pathways.     

Long-term Patterns of Shifts between Clear and Turbid States in Lake Krankesjön and Lake Tåkern

During the past century, Lake Tåkern and Lake Krankesjön, southern Sweden, have shifted repeatedly between a state of clear water and abundant submerged vegetation, and a state of turbid water and sparse vegetation. Long-term empirical data on such apparently alternative stable state dynamics are valuable as complements to modeling and experiments, although the causal mechanisms behind shifts are often difficult to identify in hindsight. Here, we summarize previous studies and discuss possible mechanisms behind the shifts. The most detailed information comes from monitoring of two recent shifts, one in each lake. In the 1980s, L. Krankesjön shifted to clear water following an expansion of sago pondweed, Potamogeton pectinatus. Water clarity increased when the pondweed was replaced by characeans. Zooplankton biomass in summer declined and the concentration of total phosphorus (TP) was reduced to half the previous level. The fish community changed over several years, including an increasing recruitment of piscivorous perch (Perca fluviatilis). An opposite directed shift to turbid water occurred in Lake Tåkern in 1995, when biomass of phytoplankton increased in spring, at the expense of submerged vegetation. Consistent with the findings in L. Krankesjön, phyto- and zooplankton biomass increased and the average concentration of TP doubled. After the shift to clear water in L. Krankesjön, TP concentration has increased during the latest decade, supporting the idea that accumulation of nutrients may lead to a long-term destabilization of the clear water state. In L. Tåkern, data on TP are inconclusive, but organic nitrogen concentrations oscillated during a 25-year period of clear water. These observations indicate that intrinsic processes cause gradual or periodic changes in system stability, although we cannot exclude the possibility that external forces are also involved. During such phases of destabilization of the clear water state, even small disturbances could possibly trigger a shift, which may explain why causes behind shifts are hard to identify even when they occur during periods of extensive monitoring.     

<Emphasis Type="Italic">Helicobacter pylori</Emphasis> genome variability in a framework of familial transmission

Background  

Helicobacter pylori infection is exceptionally prevalent and is considered to be acquired primarily early in life through person-to-person transmission within the family. H. pylori is a genetically diverse bacterial species, which may facilitate adaptation to new hosts and persistence for decades. The present study aimed to explore the genetic diversity of clonal isolates from a mother and her three children in order to shed light on H. pylori transmission and host adaptation.     

RNA quality in frozen breast cancer samples and the influence on gene expression analysis – a comparison of three evaluation methods using microcapillary electrophoresis traces

Background  

Assessing RNA quality is essential for gene expression analysis, as the inclusion of degraded samples may influence the interpretation of expression levels in relation to biological and/or clinical parameters. RNA quality can be analyzed by agarose gel electrophoresis, UV spectrophotometer, or microcapillary electrophoresis traces, and can furthermore be evaluated using different methods. No generally accepted recommendations exist for which technique or evaluation method is the best choice. The aim of the present study was to use microcapillary electrophoresis traces from the Bioanalyzer to compare three methods for evaluating RNA quality in 24 fresh frozen invasive breast cancer tissues: 1) Manual method = subjective evaluation of the electropherogram, 2) Ratio Method = the ratio between the 28S and 18S peaks, and 3) RNA integrity number (RIN) method = objective evaluation of the electropherogram. The results were also related to gene expression profiling analyses using 27K oligonucleotide microarrays, unsupervised hierarchical clustering analysis and ontological mapping.     

Effects of ration size and hypoxia on specific dynamic action in the cod

We present the first data on the effect of hypoxia on the specific dynamic action (SDA) in a teleost fish. Juvenile cod (Gadus morhua) were fed meals of 2.5% and 5% of their wet body mass (BM) in normoxia (19.8 kPa Po(2)) and 5% BM in hypoxia (6.3 kPa Po(2)). Reduced O(2) availability depressed the postprandial peaks of oxygen consumption, and to compensate for this, the total SDA duration lasted 212.0+/-20 h in hypoxia, compared with 95.1+/-25 h in normoxia. The percentage of energy associated with the meal digestion and assimilation (SDA coefficient) was equivalent between the different feeding rations but higher for fish exposed to hypoxia. Comparing peak oxygen consumption during the SDA course with maximum metabolic rates showed that food rations of 2.5% and 5% BM reduced the scope for activity by 40% and 55%, while ingestion of 5% BM in hypoxia occupied 69% of the aerobic scope, leaving little energy for other activities.