Epstein-Barr virus latent membrane protein 1 activates nuclear factor-kappa B in human endothelial cells and inhibits apoptosis.

BACKGROUND: Although vascular changes and transplant vasculopathy have been described with cytomegalovirus, the impact of Epstein-Barr virus (EBV) on the vascular endothelium of the transplanted allograft is largely unknown. We recently reported that EBV (+) patients taken off immunosuppressive medications for periods of time had a low incidence of chronic rejection. In another report, we noted that there was expression of the "protective" antiapoptotic factor Bcl-2 in the vascular endothelium of transplant allografts from EBV (+) patients. In this report, we determined the effect of latent EBV infection on endothelial cell activation and apoptosis. METHODS: Cultured human umbilical vein endothelial cells (HUVEC) were either infected with EBV or transduced with EBV latent membrane protein 1 and examined for apoptosis, nuclear factor (NF)-kappaB activation, and expression of chemokines, cytokines, and adhesion molecules. RESULTS: EBV infection and latent membrane protein 1 expression in HUVEC resulted in NF-kappaB activation and increased expression of the cytokines interleukin (IL)-1alpha, IL-1beta, and IL-6; the chemokines IL-8, monocyte chemotactic protein-1, and RANTES; and the adhesion molecules intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin. There was increased expression of the antiapoptotic genes A1, c-IAP2, and TRAF1; inhibition of caspase 3; and protection from apoptosis. CONCLUSIONS: Latent EBV in HUVEC results in constitutive NF-kappaB activation, protection from apoptosis, and increased basal expression of inflammatory factors. The in vivo effect of latent EBV in the vascular endothelium of the transplanted allograft and its resultant impact on transplant vasculopathy are the subject of further investigations in our laboratory.

Knowledge and beliefs regarding type 2 diabetes mellitus in rural Mexico.

OBJECTIVE: To investigate adults with Type 2 diabetes mellitus (DM) in a rural area of Mexico in order to explore their knowledge and beliefs regarding diabetes. DESIGN: A pilot study was conducted in a rural town in Morelos, Mexico. Adults over the age of 40 were invited to participate in a screening program for DM, and those who had been previously diagnosed with Type 2 DM were invited for an interview to learn about their knowledge and beliefs regarding diabetes. RESULTS: The glucose screening project enrolled 521 participants, including 56 previously diagnosed with Type 2 DM. Interviews were conducted with 37 of those with previously diagnosed DM. Almost all individuals in the interview sample held causal explanations based on non-scientific beliefs. Home remedies were used by a majority, and most informants used one or more methods. Blood glucose monitoring was virtually non-existent. The most frequently reported source of social support was family members. Physicians appeared to be a less important source of support. CONCLUSION: Most respondents would like to improve management of their DM, and they try to do so with whatever resources they can afford; however, a lack of information and restricted economic resources appear to limit the availability of modern medical resources. Without the availability of glucose monitoring/screening programs and affordable medication, it appears unlikely that improved treatment of Type 2 DM will occur. Dietary changes and other management approaches may be best modified through family and community influence, instead of the individual lifestyle modification strategies described in the US Type 2 DM management model.