The Link between Type III Reg and STAT3-Associated Cytokines in Inflamed Colonic Tissues.

Reg (regenerating gene) family proteins are known to be overexpressed in gastrointestinal (GI) tissues under conditions of inflammation. However, the pathophysiological significance of Reg family protein overexpression and its regulation is still unclear. In the present study, we investigated the profile of Reg family gene expression in a colitis model and focused on the regulation of Reg IIIß and IIIγ, which are overexpressed in inflamed colonic mucosa. C57BL/6 mice were administered 2% dextran sulfate sodium (DSS) in drinking water for five days, and their colonic tissues were investigated histopathologically at interval for up to 12 weeks. Gene expression of the Reg family and cytokines (IL-6, IL-17, and IL-22) was evaluated by real-time RT-PCR, and Reg IIIß/γ expression was examined by immunohistochemistry. The effects of cytokines on STAT3 phosphorylation and HIP/PAP (type III REG) expression in Caco2 and HCT116 cells were examined by Western blot analysis. Among Reg family genes, Reg IIIß and IIIγ were alternatively overexpressed in the colonic tissues of mice with DSS-induced colitis. The expression of STAT3-associated cytokines (IL-6, IL-17, and IL-22) was also significantly increased in those tissues, being significantly correlated with that of Reg IIIß/γ. STAT3 phosphorylation and HIP/PAP expression were significantly enhanced in Caco2 cells upon stimulation with IL-6, IL-17, and IL-22. In HCT116 cells, those enhancements were also observed by IL-6 and IL-22 stimulations but not IL-17. The link between type III Reg and STAT3-associated cytokines appears to play a pivotal role in the pathophysiology of DSS-induced colitis.

Colonic M1 macrophage is associated with the prolongation of gastrointestinal motility and obesity in mice treated with vancomycin.

Gut microbiota plays a pivotal role in not only the gastrointestinal (GI) immune system but also GI motility and metabolism. Antibiotic treatments are likely to affect the gut flora and GI immune system, subsequently disturbing GI motility and body metabolism. In the present study, we investigated antibiotic­induced alterations of body metabolism and GI motility in association with the macrophage profile in the colon. Specific pathogen­free (SPF) mice (ICR; 6 weeks old; female) were orally administered vancomycin (0.2 mg/ml) in drinking water for 5 weeks, and subsequent changes in pathophysiology were observed. The expression of CD80 and CD163 was examined by immunohistochemistry and the expression of cytokines in colonic tissues was evaluated by reverse transcription­quantitative polymerase chain reaction. The gastrointestinal transit time (GITT) was measured by administration of carmine red (6% w/v) solution. In the vancomycin­treated SPF mice, significant increases in body weight, cecum weight and GITT were observed compared with the controls. The number of CD80­positive M1 macrophages and the expression of interferon­Î³ and interleukin­12 were significantly increased, whereas, the numbers of CD163­positive M2 macrophages in the mucosal and muscular layers were decreased in the colon of vancomycin­treated mice. GITT was positively correlated with the number of CD80­positive M1 macrophages in the colonic mucosa; however, was negatively correlated with the number of CD163­positive M2 macrophages in the mucosal and muscular layers. Therefore, it was suggested that antibiotic treatment affects body metabolism and GI motility, accompanied by alterations in macrophage polarization and cytokine profiles in the colon.

Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes.

Purpose: Most patients with Asherman's syndrome present with infertility and menstrual problems. In this retrospective clinical study, we analyzed patients with Asherman's syndrome who underwent hysteroscopic adhesiolysis to examine their associated symptoms, disease etiologies, and fertility outcomes. Methods: Twenty-seven patients with Asherman's syndrome that were diagnosed using hysteroscopy were recruited. The chief complaints were infertility, hypomenorrhea, and amenorrhea. Each case of Asherman's syndrome was classified according to the American Fertility Society classification. Hysteroscopic adhesiolysis was performed in all cases and concomitant transabdominal ultrasonography was conducted in cases with extensive and dense adhesions. Results: There were no complications associated with the hysteroscopic procedure. Normal menstrual cycles resumed in all cases. Of the 16 infertile patients, 9 conceived. Three patients achieved term deliveries and one patient is currently pregnant. None of the patients had obstetric complications. Two patients had spontaneous abortions, one had an ectopic pregnancy, one had an abortion at 16 weeks' gestation due to cervical incompetence, and one had a molar pregnancy and required uterine artery embolization for uncontrolled hemorrhaging during a dilatation and curettage procedure. Conclusions: Hysteroscopic adhesiolysis with transabdominal ultrasonography is a suitable treatment method for Asherman's syndrome. Subfertile patients with Asherman's syndrome undergoing adhesiolysis should be appropriately informed about the risk of associated life-threatening complications and preterm delivery.

Longitudinal changes in canal length at 16-35 weeks in normal twin pregnancies and twin pregnancies with preterm labor and delivery.

AIM: To describe the longitudinal changes in canal length at 16-35 weeks' gestation in cases of twin pregnancy with preterm labor and delivery. METHODS: We studied 22 cases of twin pregnancy that were delivered at < 36 weeks and/or that underwent preterm labor requiring tocolysis. We also studied 44 cases of twin pregnancy delivered at > or = 36 weeks without tocolysis (non-tocolysis twin pregnancy). Controls were 82 cases of normal singleton pregnancy. Canal length was longitudinally measured using transvaginal ultrasonography. The observational period of 16-35 weeks was divided into 4-week periods for analysis. RESULTS: From 28 to 31 weeks onwards the canal length of non-tocolysis twin pregnancies was shorter than that of normal singleton pregnancies (P < 0.05). The canal length of twin pregnancies with preterm labor and delivery was shorter than that of non-tocolysis twin pregnancies at 16-19 weeks and decreased rapidly until 24-27 weeks (P < 0.01). CONCLUSIONS: A short canal length at 16-19 weeks followed by rapid canal length shortening in the second trimester are specific characteristics in preterm labor and delivery of twin pregnancies. Sequential measurements of canal length in the second trimester starting at < 20 weeks may be a suitable parameter to predict preterm labor and delivery in twin pregnancies.

The efficacy of preoperative hormonal therapy before laparoscopic cystectomy of ovarian endometriomas.

AIM: The aim of this study was to investigate the influence of preoperative hormonal therapy before laparoscopic cystectomy of ovarian endometriomas. We identified differences in follicle loss and surgical difficulties with or without preoperative hormonal therapy. METHODS: Ninety-six patients with ovarian endometrioma underwent a laparoscopic cystectomy. Patients were divided into three groups: control group A (53 patients, 57 cysts) with no preoperative hormonal therapy; group B (34 patients, 40 cysts) who received gonadotropin-releasing hormone agonist therapy; and group C (9 patients, 11 cysts) who received danazol therapy before surgery. The medical and videotape records of all patients were retrospectively reviewed. The specimens of endometriomas were histologically evaluated. RESULTS: Mean diameters of endometriomas before hormonal therapy in groups B and C were significantly greater than those in the control group. There were no significant differences in the following: the mean diameter of removed cysts, the revised-American Society of Reproductive Medicine scores, the number of capsules containing follicle(s), and the mean number of follicles attached to a cyst. However, the number of capsules showing fibrosis significantly increased in the preoperative hormonal therapy groups (P < 0.001). Furthermore, the mean operation time of the preoperative hormonal groups was significantly longer than that of the control group (P < 0.01, P < 0.001). CONCLUSION: Our data suggested that preoperative hormonal therapy reduced the size of endometriomas. However, with similar revised-American Society of Reproductive Medicine scores, preoperative hormonal therapy did not contribute to the reduction of the loss of ovarian follicles. Fibrosis resulting from hormonal therapy appears to be responsible for these observations.

Investigation of beta(2)-adrenoceptor subtype selectivity and organ specificity for bedoradrine (KUR-1246), a novel tocolytic beta-adrenergic receptor stimulant.

OBJECTIVES: The aim of this study was to evaluate the beta-adrenergic receptor (beta-AR) selectivity, organ specificity and efficacy of delaying the onset of spontaneous delivery of bedoradrine (KUR-1246), a novel uterine relaxant. METHODS: beta-AR selectivity was evaluated in terms of the amount of cyclic adenosine monophosphate produced by bedoradrine, ritodrine and isoprenaline in Chinese hamster ovary cells expressing human beta(1)-, beta(2)-AR or beta(3)-AR. Inhibition of contractions of the atrium, trachea and proximal colon by bedoradrine were compared with those of the uterus in pregnant rats using an organ bath method. Finally, the delaying effect of bedoradrine on spontaneous labor was evaluated by an in vivo study using term pregnant rats. RESULTS: EC(50) values of bedoradrine for cyclic adenosine monophosphate production in Chinese hamster ovary cells via beta(1)-, beta(2)- and beta(3)-AR were 2400 +/- 30, 2.9 +/- 0.10 and 363 +/- 3 nmol/L, respectively, indicating that bedoradrine had 832- and 126-fold higher selectivity for beta(2)-AR than for beta(1)- and beta(3)-AR. EC(50) values of bedoradrine for the uterus, atrium, trachea and proximal colon were 1.01 +/- 0.27, 2300 +/- 356, 1610 +/- 299 and 219 +/- 23.5 nmol/L, respectively. Thus, bedoradrine was 2280-, 1590- and 217-fold more specific for the uterus than for the atrium, trachea and proximal colon, respectively. Bedoradrine delayed the spontaneous delivery of 21-day-pregnant rats in a dose-dependent manner. CONCLUSIONS: Bedoradrine is a promising drug for the treatment of preterm labor in obstetrical practice because it has better selectivity for beta(2)-AR and specificity for the uterus than currently used agents and may effectively delay spontaneous delivery.

A normal uterus communicating with a double cervix and the vagina: a müllerian anomaly without any present classification.

OBJECTIVE: To report a rare uterine anomaly consisting of a normal uterus, a double cervix, and a double vagina. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 28-year-old nulligravida patient referred for evaluation of primary infertility and a suspected müllerian anomaly. INTERVENTION(S): Clinical and surgical evaluation of the anomaly. MAIN OUTCOME MEASURE(S): Description and treatment for a rare uterine anomaly and a subsequent literature search. RESULT(S): Successful resection of vaginal septum and subsequent pregnancy. CONCLUSION(S): This extremely rare anomaly is not explained by classic embryologic teachings, and it does not fit into the classification system currently used to describe müllerian anomalies.

Amphiregulin is much more abundantly expressed than transforming growth factor-alpha and epidermal growth factor in human follicular fluid obtained from patients undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To identify the most important epidermal growth factor (EGF) receptor ligand in the LH or hCG signal pathway in human ovary. DESIGN: A retrospective clinical study. SETTING: Tertiary university hospital. PATIENT(S): Ninety-eight infertile patients who underwent IVF-embryo transfer. INTERVENTION(S): Sera and follicular fluid were collected at the time of oocyte retrieval. The levels of EGF, transforming growth factor-alpha (TGFalpha), and amphiregulin (AR) were measured in follicular fluid and sera by using ELISA. MAIN OUTCOME MEASURE(S): The relationships between the level of AR and level of hCG, fertilization rate, and embryo quality. RESULT(S): Amphiregulin was abundantly expressed in follicular fluid after hCG stimulation. Although large differences were found between AR and both EGF and TGFalpha in follicular fluid, no significant difference was detected in the levels of the three EGF receptor ligands in sera. The level of AR was inversely correlated with the fertilization rate and hCG level, whereas little significant association was observed between the level of AR and embryo quality. CONCLUSION(S): Amphiregulin was expressed most dominantly among EGF receptor ligands tested and may mediate the hCG signal in human oocyte maturation. Elaborate interaction between AR and hCG may be required for an optimal oocyte maturation.

Changes in lipid metabolism in postmenopausal Japanese women using hormone therapy evaluated by capillary isotachophoresis: a pilot study.

OBJECTIVE: The aim of this study was to clarify the changes in lipid metabolism in postmenopausal Japanese women during continuous combined hormone therapy (HT) in detail by using capillary isotachophoresis (cITP). DESIGN: Twenty-three postmenopausal Japanese women with climacteric symptoms were recruited. Blood samples were collected from all participants before HT and after 3 and 6 months of HT, and changes in total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein (apo) A-I, apoB, and lipoprotein(a) were assessed. The same blood samples were analyzed for charge-based lipoprotein subfractions using cITP. RESULTS: Total cholesterol (-8.5%), LDL-cholesterol (-16.2%), and lipoprotein(a) (-25.5%) decreased and apoA-I (9.5%) increased significantly from the baseline level at 6 months after starting continuous combined HT. HDL-cholesterol increased nonsignificantly (+2.4%). cITP revealed that the fast HDL subfraction (+24.7%), which contains apoA-I and may be antiatherogenic, significantly increased. Conversely, the fast LDL subfraction (+14.4%), which may possess atherogenic potential, increased during HT. CONCLUSIONS: The changes in lipid metabolism in postmenopausal Japanese women receiving HT are inconclusive regarding atherogenicity, ie, it increased fast HDL and simultaneously increased fast LDL. cITP is useful for clarifying the changes in lipid metabolism during HT.

Left ventricular outflow obstruction after mitral valve replacement preserving native anterior leaflet.

Left ventricular outflow obstruction may result from preserving the anterior leaflet after mitral valve replacement. A 79-year-old woman, who had a mitral valve replacement with the native mitral leaflets left intact 16 years before, was admitted to our hospital with severe dyspnea due to heart failure. Echocardiography showed systolic anterior motion of preserved anterior mitral leaflet, and continuous wave Doppler detected severe left ventricular outflow tract jets during systole without mitral chordal rupture. Surgical incising of the anterior mitral leaflet through the aortic root relieved the obstruction without removing the prosthetic mitral valve.

Identification and electrophysiological characteristics of isoforms of T-type calcium channel Ca(v)3.2 expressed in pregnant human uterus.

Electrophysiological characteristics were compared among four cloned human alpha1H isoforms transcripted by alternative splicings of exons 25B and 26 [Delta25B/+26 (native form; alpha1H-a), Delta25B/Delta?6 (alpha1H-b), +25B/Delta26, and +25B/+26] in the intracellular loop between domains III and IV (III-IV linker) of a human T-type calcium channel (Ca(v)3.2). The native isoform Delta25B/+26 predominated in ovary and non-pregnant uterus, while isoform Delta25B/Delta26 (alpha1H-b) predominated in pregnant uterus and testis. Expressions of the newly identified +25B/Delta26 and +25B/+26 isoforms were greater in the uterus at gestation than in the non-pregnant uterus. When expressed in Xenopus laevis oocytes, all isoforms produced transient inward currents with low voltage-dependent activation and inactivation characterized in typical T-type Ca2+ currents. Each isoform possessing exon 25B (+25B/?Delta26 or +25B/+26) showed current activation and inactivation at a more negative membrane potential than the respective isoform (Delta25B/Delta26 or Delta25B/+26) lacking it. Moreover, the current activation and inactivation rates were faster for the two isoforms possessing exon 25B than for the respective isoforms lacking it. By itself, exon 26 seemed not to affect any electrophysiological characteristics. Increasing the net positive charge (relative to the native form), as occurred in isoforms Delta25B/Delta26, +25B/Delta26, and +25B/+26, caused recovery from short-term inactivation to become faster. Our results show that molecular-structure variations within the III-IV linker influence the voltage-dependence and kinetics of both activation and inactivation. Although the role of T-type Ca2+ channels in uterine tissue remains unknown, changes in the uterine expression of these alpha1H isoforms may influence physiological functions during pregnancy.

Differential expression of L- and T-type calcium channels between longitudinal and circular muscles of the rat myometrium during pregnancy.

The aim of this study was to evaluate the difference in the expression of mRNA of two types of calcium channels between longitudinal and circular muscle layer of rat myometrium during pregnancy. Changes in the expressions of the mRNA encoding L-type (alpha1C) and T-type (alpha1G, alpha1H, and alpha1I) calcium channels in longitudinal and circular smooth muscle cells of the rat myometrium were examined using a comparative kinetic RT/PCR method. During the course of pregnancy, alpha1C mRNA expression showed an N-shaped change in longitudinal muscle, but simply increased after mid-pregnancy in circular muscles. The mRNAs for alpha1G and alpha1H, but not that for alpha1I, were expressed in both longitudinal and circular smooth muscle. In longitudinal muscle, the change in alpha1H mRNA was similar to that in alpha1C mRNA during gestation, but the expression of alpha1G mRNA changed significantly only at term (day 22). In circular muscle, alpha1H mRNA expression was stable at any stage during pregnancy, but alpha1G mRNA significantly increased on day 15 and at term. No relationship was observed between voltage-dependent calcium-channel mRNA expressions and either proliferation or hypertrophy of circular muscle during pregnancy. These results show (a) that during pregnancy, the expression levels of L-type channels change dynamically, and it may contribute directly to the regulation of cell excitability, and (b) that the T-subtype that increases during pregnancy differs between longitudinal and circular muscle cells, although their functions remain unclear.

Amino acid-permeable anion channels in early mouse embryos and their possible effects on cleavage.

Effects of several Cl(-) channel blockers on ionic currents in mouse embryos were studied using whole-cell patch-clamp and microelectrode methods. Microelectrode measurements showed that the resting membrane potential of early embryonic cells (1-cell stage) was -23 mV and that reduction of extracellular Cl(-) concentration depolarized the membrane, suggesting that Cl(-) conductance is a major contributor for establishing the resting membrane potential. Membrane currents recorded by whole-cell voltage clamp showed outward rectification and confirmed that a major component of these embryonic currents are carried by Cl(-) ions. A Cl(-) channel blocker, 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS), suppressed the outward rectifier current in a voltage- and concentration-dependent manner. Other Cl(-) channel blockers (5-nitro-2-[3-phenylpropyl-amino] benzoic acid and 2-[3-(trifluoromethyl)-anilino] nicotinic acid [niflumic acid]) similarly inhibited this current. Simultaneous application of niflumic acid with DIDS further suppressed the outward rectifier current. Under high osmotic condition, niflumic acid, but not DIDS, inhibited the Cl(-)current, suggesting the presence of two types of Cl(-) channels: a DIDS-sensitive (swelling-activated) channel, and a DIDS-insensitive (niflumic acid-sensitive) Cl(-) channel. Anion permeability of the DIDS-insensitive Cl(-) current differed from that of the compound Cl(-) current: Rank order of anion permeability of the DIDS-sensitive Cl(-) channels was I(-) = Br(-) > Cl(-) > gluconate(-), whereas that of the DIDS-insensitive Cl(-) channel was I(-) = Br(-) > Cl(-) >> gluconate(-). These results indicate that early mouse embryos have a Cl(-) channel that is highly permeable to amino acids, which may regulate intracellular amino acid concentration.

Diversity of inhibitory responses to beta2-stimulants shown by term-pregnant human myometria in vitro is partly due to differences in receptor density.

OBJECTIVE: The aims of this study were (1) to evaluate the usefulness of the new beta2-adrenergic stimulant KUR-1246 as a tocolytic agent and (2) to clarify the mechanisms that underlie the diverse inhibitory effects of beta2-stimulants that are seen in human myometria in vitro. STUDY DESIGN: The displacement of tritiated ([3H]) (-)CGP 12177 (0.4 nmol/L) by KUR-1246 and other beta2-stimulants was examined with human beta(1)- and beta2-receptors present on membrane fractions. The inhibitory effects of these beta2-stimulants on the term-pregnant human myometrium were compared with the use of isometric tension recording and microelectrode methods. Finally, the relationship between [3H]dihydroaloprenolol binding and the magnitude of the tocolytic effect of isoproterenol was examined. RESULTS: KUR-1246 was approximately 80 times and 7 times more selective for beta2-receptors than isoproterenol and ritodrine, respectively. The inhibitory effect of KUR-1246 was as strong as the inhibitory effect of the conventional beta2-adrenergic stimulants. A wide range of inhibitory effects was observed, even when high concentrations of isoproterenol or KUR-1246 were applied. There was a correlation between the degree to which isoproterenol suppressed contractions and the number of [3H]dihydroaloprenolol binding sites on the membrane in each muscle strip. CONCLUSION: KUR-1246 should be a very useful beta2-adrenergic stimulant for use as a tocolytic agent because of its high selectivity for the beta2-receptor and its potent inhibitory effect. The diversity of the inhibitory effects that are induced by beta2-stimulants is at least partly due to differences in beta2-receptor density among term-pregnant human myometria.