No Evidence of Sexual Risk Compensation in the iPrEx Trial of Daily Oral HIV Preexposure Prophylaxis

Objective

Preexposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) reduced HIV acquisition in the iPrEx trial among men who have sex with men and transgender women. Self-reported sexual risk behavior decreased overall, but may be affected by reporting bias. We evaluated potential risk compensation using biomarkers of sexual risk behavior.

Design and methods

Sexual practices were assessed at baseline and quarterly thereafter; perceived treatment assignment and PrEP efficacy beliefs were assessed at 12 weeks. Among participants with ≥1 follow-up behavioral assessment, sexual behavior, syphilis, and HIV infection were compared by perceived treatment assignment, actual treatment assignment, and perceived PrEP efficacy.

Results

Overall, acute HIV infection and syphilis decreased during follow-up. Compared with participants believing they were receiving placebo, participants believing they were receiving FTC/TDF reported more receptive anal intercourse partners prior to initiating drug (12.8 vs. 7.7, P = 0.04). Belief in receiving FTC/TDF was not associated with an increase in receptive anal intercourse with no condom (ncRAI) from baseline through follow-up (risk ratio [RR] 0.9, 95% confidence interval [CI]: 0.6–1.4; P = 0.75), nor with a decrease after stopping study drug (RR 0.8, 95% CI: 0.5–1.3; P = 0.46). In the placebo arm, there were trends toward lower HIV incidence among participants believing they were receiving FTC/TDF (incidence rate ratio [IRR] 0.8, 95% CI: 0.4–1.8; P = 0.26) and also believing it was highly effective (IRR 0.5, 95% CI: 0.1–1.7; P = 0.12).

Conclusions

There was no evidence of sexual risk compensation in iPrEx. Participants believing they were receiving FTC/TDF had more partners prior to initiating drug, suggesting that risk behavior was not a consequence of PrEP use.     

IVIg Immune Reconstitution Treatment Alleviates the State of Persistent Immune Activation and Suppressed CD4 T Cell Counts in CVID

Common variable immunodeficiency (CVID) is characterized by defective B cell function, impaired antibody production, and increased susceptibility to bacterial infections. Here, we addressed the hypothesis that poor antibody-mediated immune control of infections may result in substantial perturbations in the T cell compartment. Newly diagnosed CVID patients were sampled before, and 6–12 months after, initiation of intravenous immunoglobulin (IVIg) therapy. Treatment-naïve CVID patients displayed suppressed CD4 T cell counts and myeloid dendritic cell (mDC) levels, as well as high levels of immune activation in CD8 T cells, CD4 T cells, and invariant natural killer T (iNKT) cells. Expression of co-stimulatory receptors CD80 and CD83 was elevated in mDCs and correlated with T cell activation. Levels of both FoxP3+ T regulatory (Treg) cells and iNKT cells were low, whereas soluble CD14 (sCD14), indicative of monocyte activation, was elevated. Importantly, immune reconstitution treatment with IVIg partially restored the CD4 T cell and mDC compartments. Treatment furthermore reduced the levels of CD8 T cell activation and mDC activation, whereas levels of Treg cells and iNKT cells remained low. Thus, primary deficiency in humoral immunity with impaired control of microbial infections is associated with significant pathological changes in cell-mediated immunity. Furthermore, therapeutic enhancement of humoral immunity with IVIg infusions alleviates several of these defects, indicating a relationship between poor antibody-mediated immune control of infections and the occurrence of abnormalities in the T cell and mDC compartments. These findings help our understanding of the immunopathogenesis of primary immunodeficiency, as well as acquired immunodeficiency caused by HIV-1 infection.     

Structural evidence for the evolution of xyloglucanase activity from xyloglucan endo-transglycosylases: biological implications for cell wall metabolism

High-resolution, three-dimensional structures of the archetypal glycoside hydrolase family 16 (GH16) endo-xyloglucanases Tm-NXG1 and Tm-NXG2 from nasturtium (Tropaeolum majus) have been solved by x-ray crystallography. Key structural features that modulate the relative rates of substrate hydrolysis to transglycosylation in the GH16 xyloglucan-active enzymes were identified by structure-function studies of the recombinantly expressed enzymes in comparison with data for the strict xyloglucan endo-transglycosylase Ptt-XET16-34 from hybrid aspen (Populus tremula x Populus tremuloides). Production of the loop deletion variant Tm-NXG1-DeltaYNIIG yielded an enzyme that was structurally similar to Ptt-XET16-34 and had a greatly increased transglycosylation:hydrolysis ratio. Comprehensive bioinformatic analyses of XTH gene products, together with detailed kinetic data, strongly suggest that xyloglucanase activity has evolved as a gain of function in an ancestral GH16 XET to meet specific biological requirements during seed germination, fruit ripening, and rapid wall expansion.     

Fatty acid mobilization in voles--model species for rapid fasting response and fatty liver

Factors regulating fatty acid (FA) composition of small herbivores are poorly known. Because of the fast response to food deprivation, the tissue FA profiles of voles could be rapidly modified. The selectivity of incorporating dietary FA into tissue total lipids and mobilizing tissue FA was examined in two Microtus vole species either fed or fasted for 12-18 h. The FA composition of the tissues reflected the dietary lipids, but FA were selectively incorporated depending on their structure. The FA profiles of white and brown adipose tissues were different and contained more saturated and monounsaturated FA and less polyunsaturated FA (PUFA) than the diet. The essential PUFA precursors with smaller tissue percentages were likely converted into longer-chain derivatives for structural lipids. The FA composition of the vole tissues was selectively modified by food deprivation. The preferences for retention or loss were tissue-specific and related to the FA structure. Livers displayed steatosis with characteristic accumulation of triacylglycerols, while FA prevalent in membrane phospholipids decreased in proportion. Hepatic FA could be partly derived from lipids hydrolyzed in fat depots. The FA profiles of the vole tissues reflect the dietary lipids and are rapidly and selectively modified by food deprivation.     

In vitro effect of pulsed 900 MHz GSM radiation on mitochondrial membrane potential and motility of human spermatozoa

Ejaculated, density purified, human spermatozoa were exposed to pulsed 900 MHz GSM mobile phone radiation at two specific absorption rate levels (SAR 2.0 and 5.7 W/kg) and compared with controls over time. Change in sperm mitochondrial membrane potential was analysed using flow cytometry. Sperm motility was determined by computer assisted sperm analysis (CASA). There was no effect of pulsed 900 MHz GSM radiation on mitochondrial membrane potential. This was also the case for all kinematic parameters assessed at a SAR of 2.0 W/kg. However, over time, the two kinematic parameters straight line velocity (VSL) and beat-cross frequency (BCF) were significantly impaired (P < 0.05) after the exposure at SAR 5.7 W/kg and no exposure by time interaction was present. This result should not be ascribed to thermal effects, due to the cooling methods employed in the RF chamber and temperature control within the incubator.     

Setup and dosimetry for exposure of human skin in vivo to RF-EMF at 900 MHz

The aim of this study was a dosimetrical analysis of an experimental setup used in the exposure of 10 female volunteers to GSM 900 radiation. The exposure was carried out by irradiating a small region of the right forearms of the volunteers for 1 h, after which biopsies were taken from the exposed skin for protein analysis. The source of irradiation was a half-wave dipole fed with a computer controlled GSM phone. The specific absorption rate (SAR) induced in the skin biopsy was assessed by computer simulations. The numerical model of the arm consisted of a muscle tissue simulating cylinder covered with thin skin (1 mm) and fat (3 mm) layers. The simulation models were validated by measurements with a homogeneous cylindrical liquid phantom. The average SAR value in the biopsy was 1.3 W/kg and the estimated uncertainty +/-20% (K = 2). The main source of error was found to be variations in the distance of the forearm from the dipole (10 +/- 1 mm). Other significant sources of uncertainty are individual variations of the fat layer and arm thicknesses, and the uncertainty of radio frequency (RF) power measurement.     

Plasmid and chromosomal DNA recovery by electroextraction of cyanobacteria

Abstract High voltage electroporation has been investigated as a method for rapid recovery of plasmid and chromosomal DNA from the cyanobacteria Nostoc PCC 7121, Synechococcus PCC 7002, and Anabaena PCC 7120. Pulses of 18 kV/cm and higher applied to concentrated Nostoc cells carrying a shuttle plasmid (pRL25) resulted in copious release of nucleic acids and phycobiliproteins into the suspending medium. Small portions of these supernatants, when electroporated with Escherichia coli , gave rise to hundreds of E. coli transformants which contained pRL25. Electroporation of Synechococcus carrying plasmid pAQE19 did not cause detectable release of macromolecules but did reveal a low-level, voltage independent 'leakage' of pAQE19 into the medium. Electroextraction of Nostoc or Anabaena followed by addition of E. coli and delivery of a second high-voltage pulse permitted direct, one-cuvette transfer of shuttle plasmids from these cyanobacteria into E. coli . Electroextraction of single cyanobacterial colonies, as shown for Nostoc , also released sufficient chromosomal DNA for amplification of specific sequences by the polymerase chain reaction.     

Pulmonary blood flow redistribution by increased gravitational force

This study was undertaken to assess theinfluence of gravity on the distribution of pulmonary blood flow (PBF)using increased inertial force as a perturbation. PBF was studied inunanesthetized swine exposed toG_x (dorsal-to-ventraldirection, prone position), where G is the magnitude of the force ofgravity at the surface of the Earth, on the Armstrong LaboratoryCentrifuge at Brooks Air Force Base. PBF was measured using 15-µmfluorescent microspheres, a method with markedly enhanced spatialresolution. Each animal was exposed randomly to 1, 2, and3 G_x. Pulmonary vascularpressures, cardiac output, heart rate, arterial blood gases, and PBFdistribution were measured at each G level. Heterogeneity of PBFdistribution as measured by the coefficient of variation of PBFdistribution increased from 0.38 ± 0.05 to 0.55 ± 0.11 to0.72 ± 0.16 at 1, 2, and 3G_x, respectively. At 1G_x, PBF was greatest in theventral and cranial and lowest in the dorsal and caudal regions of thelung. With increased G_x,this gradient was augmented in both directions. Extrapolation of thesevalues to 0 G predicts a slight dorsal (nondependent) region dominanceof PBF and a coefficient of variation of 0.22 in microgravity. Analysisof variance revealed that a fixed component (vascular structure)accounted for 81% and nonstructure components (including gravity)accounted for the remaining 19% of the PBF variance across the entireexperiment (all 3 gravitational levels). The results are inconsistentwith the predictions of the zone model.

     

Comparison of HPLC method and commercial ELISA assay for asymmetric dimethylarginine (ADMA) determination in human serum

The performance of a new ELISA assay kit (DLD Diagnostika GmbH, Hamburg, Germany) for the determination of asymmetric dimethylarginine (ADMA) was evaluated against a reversed phase HPLC method. ADMA concentrations of 55 serum samples were measured with both methods. The intra-assay CV for ADMA-ELISA was 19% (n=10). Inter-assay CVs for ADMA-ELISA were 9% for kit control 1 (0.410+/-0.037 microM) and 14% for kit control 2 (1.174+/-0.165 microM). The intra- and inter-assay CVs for HPLC assay for ADMA were 2.5% (0.586+/-0.015 microM) and 4.2% (0.664+/-0.028 microM), respectively. There was no correlation between these two methods (R(2)=0.0972). The effect of storage conditions of the samples on ADMA concentrations was investigated by HPLC. ADMA concentration was stable after four freezing and thawing cycles. Overall, the HPLC method offered better sensitivity, selectivity and, very importantly, simultaneous determination of ADMA, SDMA, l-homoarginine and l-arginine.