OK432-activated human dendritic cells kill tumor cells via CD40/CD40 ligand interactions

In vivo, dendritic cells (DC) are programmed to orchestrate innate and adaptive immunity in response to pathogen-derived "danger" signals. Under particular circumstances, DC can also be directly cytotoxic against tumor cells, potentially allowing them to release tumor associated Ags from dying cells and then prime antitumor immunity against them. In this study, we describe the innate characteristics of DC (OK-DC) generated in vitro after exposure of immature human myeloid-derived DC to OK432, a penicillin-inactivated and lyophilized preparation of Streptococcus pyrogenes. OK-DC produced proinflammatory cytokines, stimulated autologous T cell proliferation and IFN-gamma secretion, expressed CCR7, and migrated in response to MIP-3beta. Moreover, OK-DC displayed strong, specific cytotoxicity toward tumor cell targets. This cytotoxicity was associated with novel, OK432-induced up-regulation of CD40L on the cell surface of OK-DC, and was absolutely dependent on expression of CD40 on the tumor targets. These data demonstrate that maturation of human DC with OK432, an adjuvant suitable for clinical use, induces direct tumor cell killing by DC, and describes a novel CD40/CD40L-mediated mechanism for specific DC antitumor cytotoxicity.     

Methods and criteria for deciding whether specific-locus mutation-rate data in mice indicate a positive,negative, or inconclusive result

The binomial approximation of the UMPU (uniformly most powerful unbiased) test for the equality of 2 binomial proportions is shown to be a highly accurate and easily applied method for testing the hypothesis that a given mouse specific-locus mutation frequency is not higher than the spontaneous mutation frequency (43 mutations in 801 406 offspring, for males). Critical sample sizes have been calculated that show at a glance whether P < 0.05.The first hypothesis that the mutation frequency (induced + spontaneous) of treated mice is not higher than the spontaneous mutation frequency is combined with the second hypothesis that the induced mutation frequency of treated mice is no less than 4 times the historical-control mutation frequency to produce a multiple decision procedure with 4 possible decisions: inconclusive result, negative result, positive result, and weak mutagen. Critical sample sizes for the second hypothesis, also with P < 0.05, are combined with those for the first hypothesis into a grid that permits rapid evaluation of data according to these criterea. The justification for using these criteria in reaching decisions, assuming a high level of exposure has been given, is the practical necessity of rapidly determining which chemicals are potent mutagens.Positive results can become apparent in relatively small samples. Larger samples, of at least 11 166 offspring, are required to obtain a negative result. If samples of 18 000 are routinely collected (unless positive results are found earlier), 75% of tests of chemicals that are non-mutagens will give a negative result. If the question being asked is not whether a chemical induces gene mutations but, rather, whether the exposure received by humans causes any important risk from gene mutations, a much smaller sample size may be acceptable, under certain conditions.A comparison of the relative efficiencies of the specific-locus test (for gene mutations and small deficiencies) and the heritable-translocation test (for transmissible chromosome rearrangements), in detecting the same proportional increases over the spontaneous frequencies of their respective types of genetic damage, shows that less work is involved in reaching a conclusive result in the specific-locus test. Proposed specific-locus tests using biochemical markers are at a considerable statistical disadvantage compared with the standard test (using 7 visible markers) for which there is available a very large historical control showing a very low mutation rate.     

A systematic analysis of the effects of increasing degrees of serum immunodepletion in terms of depth of coverage and other key aspects in top-down and bottom-up proteomic analyses

Immunodepletion of clinical fluids to overcome the dominance by a few very abundant proteins has been explored but studies are few, commonly examining only limited aspects with one analytical platform. We have systematically compared immunodepletion of 6, 14, or 20 proteins using serum from renal transplant patients, analysing reproducibility, depth of coverage, efficiency, and specificity using 2-D DIGE ('top-down') and LC-MS/MS ('bottom-up'). A progressive increase in protein number (≥2 unique peptides) was found from 159 in unfractionated serum to 301 following 20 protein depletion using a relatively high-throughput 1-D-LC-MS/MS approach, including known biomarkers and moderate-lower abundance proteins such as NGAL and cytokine/growth factor receptors. On the contrary, readout by 2-D DIGE demonstrated good reproducibility of immunodepletion, but additional proteins seen tended to be isoforms of existing proteins. Depletion of 14 or 20 proteins followed by LC-MS/MS showed excellent reproducibility of proteins detected and a significant overlap between columns. Using label-free analysis, greater run-to-run variability was seen with the Prot20 column compared with the MARS14 column (median %CVs of 30.9 versus 18.2%, respectively) and a corresponding wider precision profile for the Prot20. These results illustrate the potential of immunodepletion followed by 1-D nano-LC-LTQ Orbitrap Velos analysis in a moderate through-put biomarker discovery process.     

Progesterone,fluid, and electrolytes in premenstrual syndrome.

Changes in mood, plasma progesterone concentration, urinary volume, sodium excretion, sodium:potassium ratio, and body weight during the menstrual cycle were determined in 18 women with premenstrual syndrome and 10 symptomless (control group) women. Plasma progesterone concentration was higher in the women with symptoms during the postovulatory phase of the cycle, and the peak progesterone concentration appeared earlier. The changes in progesterone concentration were accompanied by a natriuresis and diuresis that fell towards preovulatory values in the premenstrual phase. Sodium retention was not confined to any definite period. Mood symptoms occurred after the changes in progesterone and electrolyte concentrations. Progesterone deficiency is probably not the cause of premenstrual syndrome. Thus treatment with progesterone is probably illogical unless a deficiency is detected. Treatment should be aimed at preventing the natriuretic effect of progesterone in the postovulatory phase and the sodium-retaining and water-retaining effects of aldosterone in the premenstrual phase.     

Study protocol: The Adherence and Intensification of Medications (AIM) study - a cluster randomized controlled effectiveness study

Background

Each year, worldwide about 530,000 women die from causes related to pregnancy and childbirth. Of the deaths 99% are in low and middle income countries. Obstetric haemorrhage is the leading cause of maternal mortality, most occurring in the postpartum period. Systemic antifibrinolytic agents are widely used in surgery to prevent clot breakdown (fibrinolysis) in order to reduce surgical blood loss. At present there is little reliable evidence from randomised trials on the effectiveness of tranexamic acid in the treatment of postpartum haemorrhage.

Methods

The Trial aims to determine the effect of early administration of tranexamic acid on mortality, hysterectomy and other morbidities (surgical interventions, blood transfusion, risk of non-fatal vascular events) in women with clinically diagnosed postpartum haemorrhage. The use of health services and safety, especially thromboembolic effect, on breastfed babies will also be assessed. The trial will be a large, pragmatic, randomised, double blind, placebo controlled trial among 15,000 women with a clinical diagnosis of postpartum haemorrhage. All legally adult women with clinically diagnosed postpartum haemorrhage following vaginal delivery of a baby or caesarean section will potentially be eligible. The fundamental eligibility criterion is the responsible clinician's 'uncertainty' as to whether or not to use an antifibrinolytic agent in a particular woman with postpartum haemorrhage. Treatment will entail a dose of tranexamic acid (1 gram by intravenous injection) or placebo (sodium chloride 0.9%) will be given as soon as possible after randomisation. A second dose may be given if after 30 minutes bleeding continues, or if it stops and restarts within 24 hours after the first dose. The main analyses will be on an 'intention to treat' basis, irrespective of whether the allocated treatment was received or not. Subgroup analyses for the primary outcome will be based on type of delivery; administration or not of prophylactic uterotonics; and on whether the clinical decision to consider trial entry was based primarily on estimated blood loss alone or on haemodynamic instability. A study with 15,000 women will have over 90% power to detect a 25% reduction from 4% to 3% in the primary endpoint of mortality or hysterectomy.

Trial registration

Current Controlled Trials: ISRCTN76912190 and Clinicaltrials.gov ID: NCT00872469     

Description of a new species of Haemogamasus (Mesostigmata, Laelapidae, Haemogamasinae) from Chubut, Río Negro and Neuquén Provinces, Argentina

A new species of Haemogamasus mites is described from Chubut, Neuquén and Río Negro Provinces, Argentina. It was collected primarily from rodents of the genus Abrothrix (65 of 77 collections): Abrothrix longipilis (63), Abrothrix olivaceus olivaceus (1) and Abrothrix olivaceus xanthorhinus (1). Additional collections were made from Geoxus valdivianus (5) and Loxdomtomys micropus (5). Possibly incidental or contaminate collections were recorded from Oligoryzomys longicaudatus (1) and Dromiciops gliroides (1). Most collections came from Río Negro Province (36), with 22 from Neuquén and 19 from Chubut. An identification key is provided to distinguish ♀s of this new species from ♀s of species from the western hemisphere, based on morphological characters.