Nighttime administration of high-dose, sustained-release melatonin does not decrease nocturnal blood pressure in African-American patients: Results from a preliminary randomized, crossover trial.

OBJECTIVES: This preliminary study tested whether a high-dose, sustained-release form of melatonin reduced 24-hour blood pressure in African-Americans. DESIGN: Randomized, placebo-controlled, crossover pilot study of 40 self-defined African-American patients with essential hypertension. SETTINGS/LOCATION: Urban, academic medical center and associated outpatient clinics. INTERVENTIONS: Patients ingested either melatonin (high dose [24 mg], sustained-release formulation] or placebo in randomized order over a 4-week period. OUTCOME MEASURES: Mean nighttime and daytime systolic and diastolic blood pressures, as measured with 24-hour ambulatory blood pressure monitors. The primary outcome was mean nighttime systolic blood pressure. RESULTS: There were no statistically differences between melatonin and placebo conditions in mean nighttime or daytime systolic or diastolic blood pressures. CONCLUSIONS: In contrast with studies in other populations, this preliminary study showed that nighttime dosing of continuous-release melatonin had no significant effect on nocturnal blood pressure in African Americans with essential hypertension when compared to placebo.

The effect of two doses of dried plum on bone density and bone biomarkers in osteopenic postmenopausal women: a randomized, controlled trial.

UNLABELLED: Daily consumption of 50 g of dried plum (equivalent to 5-6 dried plums) for 6 months may be as effective as 100 g of dried plum in preventing bone loss in older, osteopenic postmenopausal women. To some extent, these results may be attributed to the inhibition of bone resorption with the concurrent maintenance of bone formation. INTRODUCTION: The objective of our current study was to examine the possible dose-dependent effects of dried plum in preventing bone loss in older osteopenic postmenopausal women. METHODS: Forty-eight osteopenic women (65-79 years old) were randomly assigned into one of three treatment groups for 6 months: (1) 50 g of dried plum; (2) 100 g of dried plum; and (3) control. Total body, hip, and lumbar bone mineral density (BMD) were evaluated at baseline and 6 months using dual-energy X-ray absorptiometry. Blood biomarkers including bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRAP-5b), high-sensitivity C-reactive protein (hs-CRP), insulin-like growth factor-1 (IGF-1), and sclerostin were measured at baseline, 3 months, and 6 months. Osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), calcium, phosphorous, and vitamin D were measured at baseline and 6 months. RESULTS: Both doses of dried plum were able to prevent the loss of total body BMD compared with that of the control group (P < 0.05). TRAP-5b, a marker of bone resorption, decreased at 3 months and this was sustained at 6 months in both 50 and 100 g dried plum groups (P < 0.01 and P < 0.04, respectively). Although there were no significant changes in BAP for either of the dried plum groups, the BAP/TRAP-5b ratio was significantly (P < 0.05) greater at 6 months in both dried plum groups whereas there were no changes in the control group. CONCLUSIONS: These results confirm the ability of dried plum to prevent the loss of total body BMD in older osteopenic postmenopausal women and suggest that a lower dose of dried plum (i.e., 50 g) may be as effective as 100 g of dried plum in preventing bone loss in older, osteopenic postmenopausal women. This may be due, in part, to the ability of dried plums to inhibit bone resorption. This clinical trial was registered at ClinicalTrials.gov: NCT02325895 .

Anthracycline-induced cardiotoxicity in adult hematologic malignancies.

Anthracyclines are a highly efficacious treatment for adult hematologic malignancies, including acute myeloid leukemia, acute lymphoblastic leukemia, multiple myeloma, Hodgkin's disease, and non-Hodgkin's lymphoma. The consequences of anthracycline-induced cardiotoxicity have obliged hematologists to set empirical dose limits, above which the cardiotoxic risk is deemed unacceptable. However, subclinical (and also clinical) cardiotoxicity occurs below these empirical doses and may begin to induce cardiac damage in an unpredictable and progressive manner after the first dose of treatment. As a result, treatment with anthracyclines may be withdrawn from patients prematurely or substituted with less efficacious alternative therapies. Through discontinuing further use of anthracyclines, relapsed patients previously treated with these agents may consequently be treated with second-line therapy that is less effective and possibly less well tolerated. Anthracycline-induced cardiotoxicity is potentially fatal and can significantly impair patients' quality of life, while also substantially increasing health care costs.

Pollen germinates precociously in the anthers of raring-to-go, an Arabidopsis gametophytic mutant.

Pollen hydration is usually tightly regulated and occurs in vivo only when desiccated pollen grains acquire water from the female, thus enabling pollen tube growth. Pollen tubes are easily visualized by staining with decolorized aniline blue, a stain specific for callose. We identified a mutant, raring-to-go, in which pollen grains stained for callose before anther dehiscence. When raring-to-go plants are transferred to high humidity, pollen tubes dramatically elongate within the anther. As early as the bicellular stage, affected pollen grains in raring-to-go plants acquire or retain water within the anther, and precociously germinate. Thus, the requirement for contact with the female is circumvented. We used pollen tetrad analysis to show that raring-to-go is a gametophytic mutation, to our knowledge the first gametophytic mutation in Arabidopsis that affects early events in the pollination pathway. To aid in identifying raring-to-go alleles, we devised a new technique for screening pollen in bulk with decolorized aniline blue. We screened a new M(1) mutagenized population and identified several additional mutants with a raring-to-go-like phenotype, demonstrating the usefulness of this technique. Further, we isolated other mutants (gift-wrapped pollen, polka dot pollen, and emotionally fragile pollen) with unexpected patterns of callose staining. We suggest that raring-to-go and these other mutants may help dissect components of the pathway that regulates pollen hydration and pollen tube growth.

The fallacy of evaluating biomaterial wear-rates with water as lubricant: a hip simulator study of alumina-PTFE nd CoCr-PTFE combinations.

Controversy surrounds wear data from hip-simulator studies, whether from the choice of lubricants or other parameters such as the particular biomaterial combinations used, and whether any such interactions could bias the resulting wear predictions. To investigate these phenomena, we studied the wear performance of CoCr and alumina femoral heads, in water and serum-based lubricants, using as our standard the polytetrafluoroethylene wear data derived clinically by Charnley. To model Charnley's clinical experience, PTFE acetabular cups were used in sets of three each with each size of femoral head for 22.25, 28, and 42-mm diameters in a nine-channel hip simulator. From the serum-based tests, the CoCr-PTFE wear data were consistently linear with duration of test, exhibited very large wear rates of 3,000-8,400 mm3/10(6), cycles had a precision within +/- 4% for each set of three cups, and copious amounts of small particulate were clearly seen circulating. The wear data clearly demonstrated Charnley's thesis that volume of wear increased with regard to size of femoral head. From the water-based tests, the CoCr-PTFE wear data were nonlinear with duration of test, had much reduced wear rates compared to the serum tests, lost the clinical relationship with ball size, and precision deteriorated to +/- 27% for each set. The wear debris appeared as 1-2 cm long ribbons which floated to the surface. For the alumina-PTFE combination in serum, the wear data appeared identical in performance to the CoCr-PTFE data in serum. Thus, the PTFE wear rates were not sensitive to the choice of femoral-head material. The most surprising outcome in this study was the zero-wear performance of the ceramic-PTFE combination in water. This contrasted remarkably with the large wear rates established for the same combinations run in serum. The zero-wear performance of the ceramic-PTFE combination in water was unexpected, but a similar phenomenon was noted in published simulator tests of ceramic-UHMWPE run in water. It now seems likely that such data may reflect the capricious behavior of water lubrication rather than any other variables under evaluation. The water-based experiments clearly favored the ceramic's superior tribological performance and placed metal bearings at a decided disadvantage. Therefore, for an in vitro simulation of materials wear-ranking of clinical relevance, it may be advisable to use a serum-based lubricant.

Cloning, sequence, and expression of a blood group B active recombinant alpha-D-galactosidase from pinto bean (Phaseolus vulgaris).

A cDNA encoding pinto bean alpha-D-galactosidase [E.C. 3.2.1.22] was obtained by amplification of cDNA using highly conserved sequences found in eucaryotic alpha-D-galactosidases. Subsequently a full length Phaseolus cDNA clone was obtained that is 1537 nt long and contains untranslated 5' and 3' sequences. The nucleotide sequence of the cDNA has a high degree of homology with other eucaryotic alpha-D-galactosidase genes. The recombinant alpha-D-galactosidase (rGal) was expressed in Escherichia coli and purified by ion exchange and affinity chromatography. Purified rGal was homogeneous by SDS-PAGE and had relative masses of 40.1 and 45.4 kDa under nonreducing and reducing conditions, respectively. The N-terminal sequence of the expressed protein contained the sequence GNGLGQTPPMG corresponding to that deduced from the cDNA sequence. The native molecular weight for rGal was determined to be 32.18 kDa by Sephacryl S-200 chromatography. The specific activity of the rGal was 349 mu moles of PNP-alpha-D-galactopyranoside hydrolyzed per mg of pure rGal per min. rGal was highly specific for alpha-D-galactosyl residues and degraded B oligosaccharide. No detectable hemagglutinin or protease activity was present in the preparations. Furthermore, rGal was active against the blood group B antigen on native human erythrocytes in cell suspension assays. The only detectable RBC phenotypic change was loss of the B and P1 epitopes. Recombinant Phaseolus vulgaris alpha-D-galactosidase may have useful biotechnical applications in the potential mass production of enzymatically converted, universally transfusable type O RBCs. alpha-D-galactosidase [E.C. 3.2.1.22] has been purified from a variety of procaryotic and eucaryotic species. Most alpha-D-galactosidases have similar low molecular weight substrate specificities, but activity against high molecular weight substrates is variable. Terminal alpha-D-galactoside residues are present in glycoproteins and glycolipids. Some alpha-D-galactosidases have activity against alpha-D-galactosyl residues on cell membrane glycoconjugates. Glycosidases with this property are useful for carbohydrate structural studies and biotechnical applications. Enzymes free of other glycosidase activities with activity near neutral pH are particularly useful for membrane modification studies on native cells. Complex sugar chains in glycolipids and glycoproteins have often been implicated in the growth and development of eucaryotes. In particular, complex sugar chains play an important role in the recognition of self in the immune system. Some alpha-D-galactosidases can modify certain carbohydrate membrane epitopes, thereby modulating the immune response. For example, the blood group B epitope expressed on erythrocytes contains a terminal alpha-D-galactosyl residue. Individuals lacking this antigen produce naturally occurring complement fixing antibodies to the B epitope. Hydrolysis of this terminal saccharide destroys the antigenic activity of the B determinant producing H antigen (blood type O) on erythrocytes. Only rare individuals produce clinically significant antibodies to the H antigen, and therefore, type O red blood cells are "universally" compatible and in great demand. Dhar purified alpha-D-galactosidase isozymes from Phaseolus vulgaris and characterized their activity. To our knowledge, our laboratory, in a brief report, is the first to describe the cloning of the gene and the use of recombinant enzyme for seroconverting blood type B to O cells. This paper describes the cloning, sequence, expression, purification, and characterization of recombinant alpha-D-galactosidase. Activity of the recombinant enzyme on the native human erythrocyte blood group B epitope is shown.

Anthracyclines in haematology: preclinical studies, toxicity and delivery systems.

The anthracyclines are widely used in the treatment of haematological and non-haematological malignancy and there is now more than 30 years' clinical experience with these agents but despite this, their mechanism of action is incompletely understood. The anthracyclines have been shown to intercalate with DNA and indirectly inhibit the activity of the enzyme topoisomerase II, resulting in DNA strand breaks. More recently, workers have focused on induction of apoptosis and have shown that daunorubicin stimulates production of the apoptotic mediator, ceramide and that the activity of doxorubicin can be blocked by inhibitors of CD95 (fas). One of the major problems with anthracycline therapy is the development of resistance which may be mediated by p-glycoprotein or by other mechanisms. Much recent research has concentrated on methods to modulate the drug-resistant phenotype and these include development of new analogues and use of specific reversal agents. The toxicity profile of the anthracyclines includes bone marrow suppression, severe local reaction following extravasation, radiation recall, alopecia, gastrointestinal and hepatic effects, development of secondary malignancies and significant cardiac toxicity. The risk factors for the development of anthracycline-related cardiac toxicity are well documented and several methods have been exploited in attempts at prevention. Finally, a number of drug delivery systems have been developed in order to improve therapeutic response and reduce toxicity to normal tissues, including the use of liposomal preparations.

Combined in situ hybridization and immunocytochemistry in the assay of pharmacological effects on tyrosine hydroxylase mRNA concentration.

An assay for tyrosine hydroxylase (TH) mRNA by in situ hybridization in combination with immunocytochemistry (ICC) for TH on the same section is described. The in situ hybridization protocol was optimized for [35S]cRNA (complementary RNA, i.e. anti-sense strand) probe concentration and time of hybridization. The specificity of hybridization was measured by several critera. The advantage of measuring grain density versus grains per cell is discussed for quantitation of in situ autoradiography. Finally, the reserpine-induced increase in adrenal TH mRNA was used to validate quantitative aspects of the in situ hybridization technique by comparison with blot hybridization. In contrast to the adrenal, reserpine did not increase TH mRNA in substantia nigra (s. nigra) neurons as measured by either technique.

Haematological reconstitution after autografting for chronic granulocytic leukaemia in transformation: the influence of previous splenectomy.

Peripheral blood values and bone marrow appearances were monitored in eight patients treated for chronic granulocytic leukaemia in transformation by cytotoxic drugs with or without total body irradiation followed by autografting with cryopreserved-thawed peripheral blood nucleated cells. One of the patients was 'autografted' on two occasions. Five patients had been splenectomized early in the first chronic phase and the other three patients had their spleens intact. Recovery of peripheral blood values was more rapid in the splenectomized than in the non-splenectomized patients. CFUc were present in the circulation immediately after autografting in each case but subsequently the pattern of CFUc changes differed between patients. The bone marrow was hypocellular at the time of autografting but the rate at which it returned to a typical chronic phase picture varied. Peripheral blood nucleated cells collected at the time of diagnosis include stem cells with the capacity to repopulate the marrow after 'ablative' therapy for transformation. Elective splenectomy in the chronic phase may promote more rapid recovery of peripheral blood values but its long-term importance is unknown.