The Wildbad Kreuth initiative: European current practices and recommendations for optimal use of blood components

With the aging population in Europe it is anticipated that the growing demand for blood products will not be met by the estimated supply. Therefore up-to-date recommendations for optimal administration of blood products in hemotherapy are needed. Ten years after the first meeting on optimal use of blood products at Wildbad Kreuth, Germany, a second symposium was organized to convene leading experts from the clinical, regulatory and economic perspective. The aim was to re-evaluate the existing state of hemotherapy, identify areas where further studies are needed, and to provide up-dated recommendations. A preparatory survey by questionnaire concerning guidelines, quality management in clinical use of blood products, provision of products in the individual countries and re-evaluation of the 1999 Wildbad Kreuth recommendations was completed in advance. The second Kreuth Meeting in April 2009 was attended by 110 experts in transfusion medicine, regulators and regulatory authorities from 38 countries. By consensus, 20 new recommendations were adopted. Most of the 1999 recommendations were found to still be valid 10 years later. But their realization and implementation on the levels of clinical practice, regulatory authorities and health policy decision makers is still lagging behind leaving an important task to accomplish. The Kreuth initiative toward optimal use of blood products should continue.     

Efficacy and accuracy of portable PIT-antennae when locating fish in ice-covered streams

Active tracking of passive integrated transponder (PIT)-tags using portable antennae is becoming an increasingly common technique in fish habitat studies in shallow rivers. We carried out “blind testing” to test the efficacy (% tags found) and accuracy (distance between predicted and true tag location) of a portable antenna system (Texas Instruments) in winter conditions using 23-mm PIT-tags. Up to 90 cm reading range was achieved and signals penetrated ice, rock, wood and water. In the “blind test” trials, a majority of the hidden tags (N = 12–30) were found indicating high tracking efficacy. PIT-tags that were oriented with their cylindrical axis parallel to the plane of the antenna coil inductor loop resulted in a bimodal detection field that had low detection range in the centre of the loop. The utilization of this bimodal detection field proved to be a very accurate method for identifying tag position (mean ± SE distance from predicted to true tag location 10.9 ± 1.4 cm) and thus well suited for microhabitat and activity studies in winter conditions. Aggregations of tags (multiple tags within 1 m²) and obstacles for the antenna maneuvering (e.g., boulders, logjams) reduced the pinpointing accuracy (mean ± SE 13.3 ± 1.8 cm), but the reduction in accuracy was statistically non-significant between the single and aggregated tags.     

Simple Method for Repurification of Endotoxins for Biological Use

A method for obtaining highly purified endotoxin (lipopolysaccharide [LPS]) in a few hours by repurification of commercial or laboratory preparations was devised. It avoids the use of phenol, which is not suitable for phenol-soluble lipopolysaccharides nor for some industrial purposes. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and matrix-assisted laser desorption ionization mass spectrometry analysis confirmed the integrity of the purified LPSs. The purified products did not activate Toll-like receptor 2 (TLR2), nuclear oligomerization domain 1 (NOD1), or NOD2 but did activate TLR4. Applied to different lipopolysaccharides, the method also improved their mass spectra, thus facilitating their structural analysis.     

Replacement of sulfide by selenide in the [4Fe-4S] clusters of the ferredoxin fromClostridium pasteurianum

The sulfur atoms of the two [4Fe-4S] clusters present in the ferredoxin from $\text{C. pasteurianum}$ have been replaced by selenium. The optical absorption spectrum of the Se-ferredoxin is slightly different from the spectrum of the native protein, but it displays the characteristic features of [4Fe-4X] ( X = S, Se) clustors. The reduced Se-ferredoxin can reduce hydrogenase, and the oxidized Se-ferredoxin can be reduced by hydrogenase in the presence of molecular hydrogen. This is the first report of sulfide substitution by selenide in an iron-sulfur protein containing [4Fe-4S] active sites.     

A serpin regulates dorsal-ventral axis formation in the Drosophila embryo

Extracellular serine protease cascades have evolved in vertebrates and invertebrates to mediate rapid, local reactions to physiological or pathological cues. The serine protease cascade that triggers the Toll signaling pathway in Drosophila embryogenesis shares several organizational characteristics with those involved in mammalian complement and blood clotting. One of the hallmarks of such cascades is their regulation by serine protease inhibitors (serpins). Serpins act as suicide substrates and are cleaved by their target protease, forming an essentially irreversible 1:1 complex. The biological importance of serpins is highlighted by serpin dysfunction diseases, such as thrombosis caused by a deficiency in antithrombin. Here, we describe how a serpin controls the serine protease cascade, leading to Toll pathway activation. Female flies deficient in Serpin-27A produce embryos that lack dorsal-ventral polarity and show uniform high levels of Toll signaling. Since this serpin has been recently shown to restrain an immune reaction in the blood of Drosophila, it demonstrates that proteolysis can be regulated by the same serpin in different biological contexts.     

Expression of urea transporter (UT-A) mRNA in papilla and pelvic epithelium of kidney in normal and low protein fed sheep

The identification and cloning of the urea transporter (UT) in papilla and upper pelvic epithelium of sheep kidney and the effect of a 5-week-lasting low protein diet on UT mRNAs expression in these structures are reported. Using degenerate primers we cloned by RT-PCR a 770-base pairs UT-A cDNA fragment. The deduced amino acid sequence shared 92% and 93% identity with UT-A2 protein from rabbit and rat, and from human, respectively. Quantification of UT-A mRNAs expression after LP diet was performed by quantitative RT-PCR using UT-A mutant cRNA. Compared to normal protein fed sheep, low protein diet was associated with a significant reduction of UT-A mRNA levels in pelvic epithelium (852+/-172 vs. 2024+/-260 molecules, P<0.01) and a tendency to its increase in papilla (7959+/-1741 vs. 5447+/-1040 molecules, NS). Functional studies confirmed that kidneys of low protein fed sheep increased their ability to reduce urea losses. The reduction of UT-A expression in the pelvic epithelium lining the outer medulla could be relevant for the renal conservation of urea in protein restricted sheep.     

Mechanical Signals Inhibit Growth of a Grafted Tumor In Vivo: Proof of Concept

In the past ten years, many studies have shown that malignant tissue has been “normalized” in vitro using mechanical signals. We apply the principles of physical oncology (or mechanobiology) in vivo to show the effect of a “constraint field” on tumor growth. The human breast cancer cell line, MDA MB 231, admixed with ferric nanoparticles was grafted subcutaneously in Nude mice. The magnetizable particles rapidly surrounded the growing tumor. Two permanent magnets located on either side of the tumor created a gradient of magnetic field. Magnetic energy is transformed into mechanical energy by the particles acting as “bioactuators”, applying a constraint field and, by consequence, biomechanical stress to the tumor. This biomechanical treatment was applied 2 hours/day during 21 days, from Day 18 to Day 39 following tumor implantation. The study lasted 74 days. Palpable tumor was measured two times a week. There was a significant in vivo difference between the median volume of treated tumors and untreated controls in the mice measured up to D 74 (D 59 + population): (529 [346; 966] mm³ vs 1334 [256; 2106] mm³; p = 0.015), treated mice having smaller tumors. The difference was not statistically significant in the group of mice measured at least to D 59 (D 59 population). On ex vivo examination, the surface of the tumor mass, measured on histologic sections, was less in the treated group, G1, than in the control groups: G2 (nanoparticles, no magnetic field), G3 (magnetic field, no nanoparticles), G4 (no nanoparticles, no magnetic field) in the D 59 population (Median left surface was significantly lower in G1 (5.6 [3.0; 42.4] mm², p = 0.005) than in G2 (20.8 [4.9; 34.3]), G3 (16.5 [13.2; 23.2]) and G4 (14.8 [1.8; 55.5]); Median right surface was significantly lower in G1 (4.7 [1.9; 29.2] mm², p = 0.015) than in G2 (25.0 [5.2; 55.0]), G3 (18.0 [14.6; 35.2]) and G4 (12.5 [1.5; 51.8]). There was no statistically significant difference in the day 59+ population. This is the first demonstration of the effect of stress on tumor growth in vivo suggesting that biomechanical intervention may have a high translational potential as a therapy in locally advanced tumors like pancreatic cancer or primary hepatic carcinoma for which no effective therapy is currently available.