Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study

Introduction

Chronic inflammation combined with glucocorticoid treatment and immobilization puts juvenile idiopathic arthritis (JIA) patients at risk of impaired growth and reduced bone mineral density (BMD). Conventional methods for evaluating bone age and BMD are time-consuming or come with additional costs and radiation exposure. In addition, an automated measurement of bone age and BMD is likely to be more consistent than visual evaluation. In this study, we aimed to evaluate the feasibility of an automated method for determination of bone age and (cortical) bone mineral density (cBMD) in severely affected JIA patients. A secondary objective was to describe bone age and cBMD in this specific JIA population eligible for biologic treatment.

Methods

In total, 69 patients with standard hand radiographs at the start of etanercept treatment and of calendar age within the reliability ranges (2.5 to 17 years for boys and 2 to 15 years for girls) were extracted from the Dutch Arthritis and Biologicals in Children register. Radiographs were analyzed using the BoneXpert method, thus automatically determining bone age and cBMD expressed as bone health index (BHI). Agreement between measurements of the left- and right-hand radiographs and a repeated measurement of the left hand were assessed with the intraclass correlation coefficient (ICC). Regression analysis was used to identify variables associated with Z-scores of bone age and BHI.

Results

The BoneXpert method was reliable in the evaluation of radiographs of 67 patients (radiographs of 2 patients were rejected because of poor image quality). Agreement between left- and right-hand radiographs (ICC = 0.838 to 0.996) and repeated measurements (ICC = 0.999 to 1.000) was good. Mean Z-scores of bone age (−0.36, P = 0.051) and BHI (−0.85, P < 0.001) were lower compared to the healthy population. Glucocorticoid use was associated with delayed bone age (0.79 standard deviation (SD), P = 0.028), and male gender was associated with a lower Z-score of BHI (0.65 SD, P = 0.021).

Conclusions

BoneXpert is an easy-to-use method for assessing bone age and cBMD in patients with JIA, provided that radiographs are of reasonable quality and patients’ bone age lies within the age ranges of the program. The population investigated had delayed bone maturation and lower cBMD than healthy children.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-014-0424-1) contains supplementary material, which is available to authorized users.     

Inhibition of Calcineurin-mediated Endocytosis and ��-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptors Prevents Amyloid �� Oligomer-induced Synaptic Disruption

Synaptic degeneration, including impairment of synaptic plasticity and loss of synapses, is an important feature of Alzheimer disease pathogenesis. Increasing evidence suggests that these degenerative synaptic changes are associated with an accumulation of soluble oligomeric assemblies of amyloid β (Aβ) known as ADDLs. In primary hippocampal cultures ADDLs bind to a subpopulation of neurons. However the molecular basis of this cell type-selective interaction is not understood. Here, using siRNA screening technology, we identified α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunits and calcineurin as candidate genes potentially involved in ADDL-neuron interactions. Immunocolocalization experiments confirmed that ADDL binding occurs in dendritic spines that express surface AMPA receptors, particularly the calcium-impermeable type II AMPA receptor subunit (GluR2). Pharmacological removal of the surface AMPA receptors or inhibition of AMPA receptors with antagonists reduces ADDL binding. Furthermore, using co-immunoprecipitation and photoreactive amino acid cross-linking, we found that ADDLs interact preferentially with GluR2-containing complexes. We demonstrate that calcineurin mediates an endocytotic process that is responsible for the rapid internalization of bound ADDLs along with surface AMPA receptor subunits, which then both colocalize with cpg2, a molecule localized specifically at the postsynaptic endocytic zone of excitatory synapses that plays an important role in activity-dependent glutamate receptor endocytosis. Both AMPA receptor and calcineurin inhibitors prevent oligomer-induced surface AMPAR and spine loss. These results support a model of disease pathogenesis in which Aβ oligomers interact selectively with neurotransmission pathways at excitatory synapses, resulting in synaptic loss via facilitated endocytosis. Validation of this model in human disease would identify therapeutic targets for Alzheimer disease.     

人呼吸道合胞病毒兰州株基因组全长cDNA克隆的构建及鉴定

目的构建用于呼吸道合胞病毒(respiratory syncytial virus,RSV)体外拯救的RSV基因组全长cDNA克隆,并进行鉴定。方法根据RSV Long株基因组序列设计并合成引物,利用RT-PCR技术分6段扩增RSV LZ01/09基因组序列并构建克隆载体;测序后,利用重叠PCR与酶切连接技术,根据基因组序列选择特异性酶切位点,引入Kpn I、Xma I和Sal I酶切位点,构建成4个亚克隆载体;将亚克隆载体的插入片段连接至经过改造且包含T7启动子、锤头状核酶、多克隆位点、丁肝核酶、T7终止子的p RSV1载体中,构建RSV基因组全长cDNA克隆;对克隆全长cDNA序列进行测定,与亲本RSV LZ01/09基因组进行同源性比对分析,并与RSV实验参比株进行系统进化树分析。结果测序结果显示,RSV LZ 01/09的基因组全长为15 204 bp,与GenBank公布的RSV基因组序列长度相当,将完整的序列提交GenBank,登录号为KY782635;酶切及测序结果显示,用于RSV全长cDNA克隆构建的基本载体p BSKS-MCS(简称p RSV1)与预期相符,RSV全长基因组cDNA克隆质粒(简称转录载体p RSV1-4F)酶切片段大小与预期一致;同源性比对结果显示,全长cDNA序列与亲本RSV LZ01/09基因组序列同源性高达99.83%;系统进化树分析结果显示,其与RSV-A亚型序列同属于一个分支。结论测序及酶切分析结果表明已成功构建RSVLZ01/09基因组全长cDNA克隆,为建立拯救RSV重组病毒的反向遗传学系统平台奠定了基础。     

一种新的制备多克隆抗体的方法

用亲和色谱纯化的rhEPO作为抗原免疫KM小鼠和Bal b/c小鼠,然后腹腔注射S180细胞或SP2/0细胞。S180细胞可刺激KM小鼠产生腹水,腹水量大,抗体效价高。而直接注射SP2/0细胞既未能使KM小鼠产生腹水,也未能使Bal b/c小鼠产生腹水。实验提供了一种新的简便、快速、经济地制备高效价多克隆抗体的方法。     

Experimental infection of white-tailed deer with rinderpest virus.

White-tailed deer (Odocoileus virginianus) succumbed to experimental infection with virulent rinderpest (RP) virus that was also lethal to cattle and goats. The deer developed clinical signs typical of RP and died 5 and 6 days post-inoculation. Infection was confirmed by recovery of virus from blood before death, from lymph node tissue after necropsy, and demonstration of specific complement fixing antigen in those tissues. Electron micrographs of infected Vero cell cultures revealed extracellular virions and intracytoplasmic and intranuclear inclusions made of randomly distributed fibrillar strands.     

Daily changes in the sensitivity of wax-moth larvae, Galleria mellonella, to cooling stress

ABSTRACT. Sensitivity to cooling stress in the last instar larvae of Galleria mellonella was measured as (a) the number of extra larval moults, (b) the number of larvae retaining the ability to secrete silk, and (c) the number showing arrested development. With respect to (a) and (b) there were considerable differences in sensitivity across the day. A relationship was observed between the number of additional larval moults induced by chilling and the ability of prepupal larvae to spin silk: the periods during the 24 h when the most larvae passed through additional larval moults were periods characterized by the smallest number of larvae capable of spinning, and vice versa. These daily changes were apparently partly independent of developmental age. Daily variations in sensitivity also occurred when larvae of the same age were cooled at different times of day. It is suggested that these rhythms in cold-sensitivity are related to a cold-sensitive rhythm in juvenile hormone secretion, or hormone sensitivity in the tissues.