ABSTRACT
Manifestations of climate change in the Arctic include an increase in water temperatures and massive loss of sea ice enabling more light penetration. Yet to understand tempo and scale of these parameters change over time, constant monitoring is needed. We present 16-yr long-term datasets of sea water temperature and relative light intensity at two depth strata (8 and 14 ± 1 m) of two hard-bottom sites in southern Isfjorden proper (Spitsbergen, 78°N). The high temporal resolution of the datasets (every 30 min, between 2006-2022) makes them suitable for studying changes at a local scale, correlating environmental variability with observed processes in benthic assemblages, and serving as ground-truth for comparison with, for example, remotely sensed or mooring data. These datasets serve as baseline for long-term investigations in the shallows of a high-Arctic fjord undergoing severe environmental changes.
ABSTRACT
Diamond-Blackfan anemia (DBA) is a rare, inherited bone marrow failure syndrome that is both genetically and clinically heterogeneous. The diagnosis of DBA has changed over time, with advancements in our understanding of the varied genetic etiologies and phenotypic manifestations of the disease. We present a rare case of a patient who never developed erythroid precursor hypoplasia, adding to the understanding of atypical manifestations of DBA. Our patient had spontaneous remission followed by subsequent relapse, both atypical and poorly understood processes in DBA. We highlight important considerations in diagnostically challenging cases and review major outstanding questions surrounding DBA.
Subject(s)
Anemia, Diamond-Blackfan , Humans , Anemia, Diamond-Blackfan/complications , Anemia, Diamond-Blackfan/genetics , Anemia, Diamond-Blackfan/diagnosis , Bone Marrow Failure Disorders , Ribosomal Proteins/geneticsABSTRACT
This study provided new data on shell mineralogy in 23 Arctic bivalve species. The majority of examined species had purely aragonitic shells. Furthermore, we measured concentrations of Al, Ba, Ca, Fe, K, Mg, Mn, Na, P, S, Sr and Zn in 542 shells representing 25 Arctic bivalve species. Species-related differences in concentrations of specific elements were significant and occurred regardless of locations and water depths. This observation implies the dominance of biological processes regulating elemental uptake into the skeleton over factors related to the variability of abiotic environmental conditions. Analysis of the present study and literature data revealed that the highest concentrations of metals were observed in bivalves collected in the temperate zone, with intermediate levels in the tropics and the lowest levels in polar regions. This trend was ascribed mainly to the presence of higher anthropogenic pressure at temperate latitudes being a potential source of human-mediated metal pollution.
Subject(s)
Bivalvia , Trace Elements , Animals , Humans , Metals/analysis , Calcium Carbonate/analysis , Arctic Regions , Environmental Monitoring , Trace Elements/analysisABSTRACT
Dysfunctional mitochondria are linked to several neurodegenerative diseases. Metabolic defects, a symptom which can result from dysfunctional mitochondria, are also present in spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease, the most frequent, dominantly inherited neurodegenerative ataxia worldwide. Mitochondrial dysfunction has been reported for several neurodegenerative disorders and ataxin-3 is known to deubiquitinylate parkin, a key protein required for canonical mitophagy. In this study, we analyzed mitochondrial function and mitophagy in a patient-derived SCA3 cell model. Human fibroblast lines isolated from SCA3 patients were immortalized and characterized. SCA3 patient fibroblasts revealed circular, ring-shaped mitochondria and featured reduced OXPHOS complexes, ATP production and cell viability. We show that wildtype ataxin-3 deubiquitinates VDAC1 (voltage-dependent anion channel 1), a member of the mitochondrial permeability transition pore and a parkin substrate. In SCA3 patients, VDAC1 deubiquitination and parkin recruitment to the depolarized mitochondria is inhibited. Increased p62-linked mitophagy, autophagosome formation and autophagy is observed under disease conditions, which is in line with mitochondrial fission. SCA3 fibroblast lines demonstrated a mitochondrial phenotype and dysregulation of parkin-VDAC1-mediated mitophagy, thereby promoting mitochondrial quality control via alternative pathways.
Subject(s)
Machado-Joseph Disease , Ataxin-3/genetics , Ataxin-3/metabolism , Humans , Machado-Joseph Disease/genetics , Machado-Joseph Disease/metabolism , Mitochondria/genetics , Mitochondria/metabolism , Ubiquitin-Protein Ligases/genetics , Ubiquitin-Protein Ligases/metabolism , Voltage-Dependent Anion Channel 1/genetics , Voltage-Dependent Anion Channel 1/metabolismABSTRACT
Spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph Disease, is a progressive neurodegenerative disorder characterized by loss of neuronal matter due to the expansion of the CAG repeat in the ATXN3/MJD1 gene and subsequent ataxin-3 protein. Although the underlying pathogenic protein expansion has been known for more than 20 years, the complexity of its effects is still under exploration. The ataxin-3 protein in its expanded form is known to aggregate and disrupt cellular processes in neuronal tissue but the role of the protein on populations of immune cells is unknown. Recently, mast cells have emerged as potential key players in neuroinflammation and neurodegeneration. Here, we examined the mast cell-related effects of ataxin-3 expansion in the brain tissues of 304Q ataxin-3 knock-in mice and SCA3 patients. We also established cultures of mast cells from the 304Q knock-in mice and examined the effects of 304Q ataxin-3 knock-in on the immune responses of these cells and on markers involved in mast cell growth, development and function. Specifically, our results point to a role for expanded ataxin-3 in suppression of mast cell marker CD117/c-Kit, pro-inflammatory cytokine TNF-α and NF-κB inhibitor IκBα along with an increased expression of the granulocyte-attracting chemokine CXCL1. These results are the beginning of a more holistic understanding of ataxin-3 and could point to the development of novel therapeutic targets which act on inflammation to mitigate symptoms of SCA3.
Subject(s)
Machado-Joseph Disease , Neurodegenerative Diseases , Animals , Ataxin-3/genetics , Ataxin-3/metabolism , Humans , Machado-Joseph Disease/genetics , Machado-Joseph Disease/metabolism , Machado-Joseph Disease/pathology , Mast Cells/metabolism , Mice , Nerve Tissue Proteins/genetics , Nerve Tissue Proteins/metabolismABSTRACT
Spinocerebellar ataxia type 3 (SCA3) is a rare neurodegenerative disorder resulting from an aberrant expansion of a polyglutamine stretch in the ataxin-3 protein and subsequent neuronal death. The underlying intracellular signaling pathways are currently unknown. We applied the Reverse-phase Protein MicroArray (RPMA) technology to assess the levels of 50 signaling proteins (in phosphorylated and total forms) using three in vitro and in vivo models expressing expanded ataxin-3: (i) human embryonic kidney (HEK293T) cells stably transfected with human ataxin-3 constructs, (ii) mouse embryonic fibroblasts (MEF) from SCA3 transgenic mice, and (iii) whole brains from SCA3 transgenic mice. All three models demonstrated a high degree of similarity sharing a subset of phosphorylated proteins involved in the PI3K/AKT/GSK3/mTOR pathway. Expanded ataxin-3 strongly interfered (by stimulation or suppression) with normal ataxin-3 signaling consistent with the pathogenic role of the polyglutamine expansion. In comparison with normal ataxin-3, expanded ataxin-3 caused a pro-survival stimulation of the ERK pathway along with reduced pro-apoptotic and transcriptional responses.
Subject(s)
Ataxin-3/physiology , Machado-Joseph Disease/physiopathology , Nerve Tissue Proteins/physiology , Peptides/metabolism , Phosphoproteins/physiology , Signal Transduction/physiology , Animals , Apoptosis , Ataxin-3/genetics , Cell Line , Fibroblasts , Glycogen Synthase Kinase 3/physiology , HEK293 Cells , Humans , Mice , Mice, Transgenic , Phosphatidylinositol 3-Kinases/physiology , Protein Array Analysis , Proto-Oncogene Proteins c-akt/physiology , TOR Serine-Threonine Kinases/physiologyABSTRACT
BACKGROUND AND AIMS: As mast cells (MC) serve as a link between mucosal immune activity and the nervous system, it is likely they also play a role in the pathogenesis of irritable bowel syndrome (IBS). This connection might be an important factor in the development of IBS-related symptoms. METHOD: This overview comprises 36 case-control studies published from 2000 to 2018 that investigated MC in bowel biopsies of IBS patients and controls. The studies were selected from PubMed, EMBASE, Central, SemanticScholar by an electronic search, performed using RISMed R package. RESULTS: Significantly increased mucosal MC counts/or density in IBS patients compared to controls was observed in 30 studies. Five studies reported no differences and only one of the studies found a decreased amount of MC in an IBS patient. Furthermore, 15 studies made a statement regarding the correlation between the amount of MC and IBS associated symptoms. A significant positive correlation between MC count and IBS-associated symptoms was found in six investigations. A negative correlation was not reported. CONCLUSION: The results support the idea that MC are involved in IBS pathophysiology as key players in the interplay between psychological factors and the frequency and severity of IBS symptoms.
Subject(s)
Irritable Bowel Syndrome/immunology , Mast Cells/immunology , Biopsy , Case-Control Studies , Cell Count , Humans , Immunity, Mucosal , Intestinal Mucosa/immunology , Intestinal Mucosa/pathology , Irritable Bowel Syndrome/pathologyABSTRACT
NOD-like receptors (NLR) are critical regulators of innate immune signaling. The NLR family consists of 22 human proteins with a conserved structure containing a central oligomerization NACHT domain, an N-terminal interaction domain, and a variable number of C-terminal leucine-rich repeats. Most NLR proteins function as cytosolic pattern recognition receptors with activation of downstream inflammasome signaling, NF-κB, or MAPK activation. Although NLRP10 is the only NLR protein lacking the leucine rich repeats, it has been implicated in multiple immune pathways, including the regulation of inflammatory responses toward Leishmania major and Shigella flexneri infection. In this study, we identify Abin-1, a negative regulator of NF-κB, as an interaction partner of NLRP10 that binds to the NACHT domain of NLRP10. Using S. flexneri as an infection model in human epithelial cells, our work reveals a novel function of NLRP10 in destabilizing Abin-1, resulting in enhanced proinflammatory signaling. Our data give insight into the molecular mechanism underlying the function of NLRP10 in innate immune responses.
Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Apoptosis Regulatory Proteins/metabolism , DNA-Binding Proteins/metabolism , Dysentery, Bacillary/immunology , Epithelial Cells/physiology , Inflammation/immunology , Shigella flexneri/physiology , Animals , Apoptosis Regulatory Proteins/genetics , HEK293 Cells , Humans , Immunity, Innate , Inflammasomes/metabolism , Mice , Mice, Knockout , NF-kappa B/metabolism , Protein Binding , Protein Stability , Signal TransductionABSTRACT
Allergic diseases are known to vary in the severity of their symptoms throughout the day/night cycle. This rhythmicity is also observed in mast cell function and responsiveness. Mast cells are key effector cells of allergic reactions and release cytokines, chemokines, and important inflammatory mediators such as histamine, which have been shown to display diurnal variation. Recent research clarified that mast cells are controlled by their internal clock-which is regulated by a specific set of clock genes-as well as external factors such as light sensed by the suprachiasmatic nuclei, hormonal status, or diet. Here, we give an overview of the connections between circadian clock, mast cells, and allergic disease. Further work aimed at studying the role of chronotherapy/chronomedicine should take into account this rhythmic nature of not only mast cells but also the immune responses generated by mast cell signaling.
ABSTRACT
Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder caused by a CAG expansion in the ATXN3 gene leading to a polyglutamine expansion in the ataxin-3 protein. The nuclear presence and aggregation of expanded ataxin-3 are critical steps in disease pathogenesis. To identify novel therapeutic targets, we investigated the nucleocytoplasmic transport system by screening a collection of importins and exportins that potentially modulate this nuclear localization. Using cell, Drosophila, and mouse models, we focused on three transport proteins, namely, CRM1, IPO13, KPNA3, and their respective Drosophila orthologs Emb, Cdm, and Kap-α3. While overexpression of CRM1/Emb demonstrated positive effects in Drosophila, KPNA3/Kap-α3 emerged as the most promising target, as knockdown via multiple RNAi lines demonstrated its ability to shuttle both truncated and full-length expanded ataxin-3, rescue neurodegeneration, restore photoreceptor formation, and reduce aggregation. Furthermore, KPNA3 knockout in SCA3 mice resulted in an amelioration of molecular and behavioral disturbances such as total activity, anxiety, and gait. Since KPNA3 is known to function as an import protein and recognize nuclear localization signals (NLSs), this work unites ataxin-3 structure to the nuclear pore machinery and provides a link between karyopherins, NLS signals, and polyglutamine disease, as well as demonstrates that KPNA3 is a key player in the pathogenesis of SCA3.
Subject(s)
Active Transport, Cell Nucleus/genetics , Ataxin-3/genetics , Machado-Joseph Disease/genetics , alpha Karyopherins/genetics , Animals , Ataxin-3/metabolism , DNA Repeat Expansion , Disease Models, Animal , Drosophila , Female , HEK293 Cells , Humans , Machado-Joseph Disease/metabolism , Male , Mice , Mice, Knockout , Peptides , alpha Karyopherins/metabolismABSTRACT
BACKGROUND & AIMS: Spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease (MJD), is an autosomal dominantly inherited neurodegenerative disorder and the most common form of SCA worldwide. It is caused by the expansion of a polyglutamine (polyQ) tract in the ataxin-3 protein. Nuclear localization of the affected protein is a key event in the pathology of SCA3 via affecting nuclear organization, transcriptional dysfunction, and seeding aggregations, finally causing neurodegeneration and cell death. So far, there is no effective therapy to prevent or slow the progression of SCA3. METHODS: In this study, we explored the effect of divalproex sodium as an HDACi in SCA3 cell models and explored how divalproex sodium interferes with pathogenetic processes causing SCA3. RESULTS: We found that divalproex sodium rescues the hypoacetylation levels of histone H3 and attenuates cellular cytotoxicity induced by expanded ataxin-3 partly via preventing nuclear transport of ataxin-3 (particularly heat shock-dependent). CONCLUSION: Our study provides novel insights into the mechanisms of action of divalproex sodium as a possible treatment for SCA3, beyond the known regulation of transcription.
Subject(s)
Active Transport, Cell Nucleus/drug effects , Ataxin-3/metabolism , Neuroprotective Agents/pharmacology , Repressor Proteins/metabolism , Valproic Acid/pharmacology , Acetylation/drug effects , Animals , CHO Cells , Cell Survival/drug effects , Cell Survival/physiology , Cricetulus , HEK293 Cells , Heat-Shock Response/drug effects , Heat-Shock Response/physiology , Histones/metabolism , Humans , Protein Aggregates/drug effectsABSTRACT
Mammalian Nod-like receptor (NLR) proteins contribute to the regulation and induction of innate and adaptive immunity in mammals, although the function of about half of the currently identified NLR proteins remains poorly characterized. Here we analyzed the function of the primate-specific NLRP11 gene product. We show that NLRP11 is highly expressed in immune cells, including myeloid cells, B cells, and some B cell lymphoma lines. Overexpression of NLRP11 in human cells did not trigger key innate immune signaling pathways, including NF-κB and type I interferon responses. NLRP11 harbors a pyrin domain, which is responsible for inflammasome formation in related NLR proteins. However, NLRP11 did not interact with the inflammasome adaptor protein ASC, and it did not trigger caspase-1 activation. By contrast, expression of NLRP11 specifically repressed NF-κB and type I interferon responses, two key innate immune pathways involved in inflammation. This effect was independent of the pyrin domain and ATPase activity of NLRP11. siRNA-mediated knockdown of NLRP11 in human myeloid THP1 cells validated these findings and revealed enhanced lipopolysaccharide and Sendai virus-induced cytokine and interferon responses, respectively, in cells with reduced NLRP11 expression. In summary, our work identifies a novel role of NLRP11 in the regulation of inflammatory responses in human cells.
Subject(s)
B-Lymphocytes/metabolism , Down-Regulation , Gene Expression Regulation , Immunity, Innate , Intracellular Signaling Peptides and Proteins/metabolism , Myeloid Cells/metabolism , NLR Proteins/metabolism , Amino Acid Substitution , B-Lymphocytes/cytology , B-Lymphocytes/drug effects , B-Lymphocytes/immunology , Cell Line, Transformed , Cell Line, Tumor , Down-Regulation/drug effects , Female , Gene Expression Regulation/drug effects , Genes, Reporter/drug effects , Humans , Immunity, Innate/drug effects , Interferon Type I/agonists , Interferon Type I/antagonists & inhibitors , Interferon Type I/metabolism , Intracellular Signaling Peptides and Proteins/antagonists & inhibitors , Intracellular Signaling Peptides and Proteins/chemistry , Intracellular Signaling Peptides and Proteins/genetics , Lipopolysaccharides/toxicity , Male , Mutation , Myeloid Cells/cytology , Myeloid Cells/drug effects , Myeloid Cells/immunology , NF-kappa B/agonists , NF-kappa B/antagonists & inhibitors , NF-kappa B/metabolism , NLR Proteins/genetics , Neoplasm Proteins/antagonists & inhibitors , Neoplasm Proteins/chemistry , Neoplasm Proteins/genetics , Neoplasm Proteins/metabolism , Organ Specificity , Peptide Fragments/antagonists & inhibitors , Peptide Fragments/chemistry , Peptide Fragments/genetics , Peptide Fragments/metabolism , RNA Interference , Recombinant Fusion Proteins/chemistry , Recombinant Fusion Proteins/metabolismABSTRACT
Seeds of plants from Ipomoea genera contain numerous ergot alkaloids, including psychoactive ergine and ergometrine, and are often abused as so-called "legal highs." In this work, an analytical method for determination of ergine and ergometrine, and identification of other alkaloids was developed, optimized, and validated. Three extraction techniques, ultrasound-assisted extraction in bath, or with sonotrode, and microwave-assisted extraction were evaluated, and it was concluded that ultrasonic bath is the most suitable technique for extraction of ergot alkaloids. The extraction method was later optimized using a Doehlert experimental design with response surface methodology and used together with the optimized LC-Q-TOF-MS method. The analytical procedure was validated in terms of recovery and matrix effect, repeatability, and intermediate precision. Limits of detection and quantification were 1.0 and 3.0 ng mL(-1), respectively, and were sufficient for determination of ergot alkaloids in Ipomoea seeds. The analysis revealed that from five kinds of seeds purchased from different vendors, only three contained ergot alkaloids. Concentration of alkaloids and their relative abundance was similar in samples representative for whole seeds packs; however, when single seeds were analyzed, significant discrepancies in ergine and ergometrine concentrations were detected.
Subject(s)
Ergot Alkaloids/analysis , Ipomoea/chemistry , Chromatography/methods , Limit of Detection , Mass Spectrometry/methods , Reproducibility of ResultsABSTRACT
The chicken major histocompatibility complex (MHC) has strong genetic associations with resistance and susceptibility to certain infectious pathogens. The cell surface expression level of MHC class I molecules varies as much as 10-fold between chicken haplotypes and is inversely correlated with diversity of peptide repertoire and with resistance to Marek's disease caused by an oncogenic herpesvirus. Here we show that the average thermostability of class I molecules isolated from cells also varies, being higher for high-expressing MHC haplotypes. However, we find roughly the same amount of class I protein synthesized by high- and low-expressing MHC haplotypes, with movement to the cell surface responsible for the difference in expression. Previous data show that chicken TAP genes have high allelic polymorphism, with peptide translocation specific for each MHC haplotype. Here we use assembly assays with peptide libraries to show that high-expressing B15 class I molecules can bind a much wider variety of peptides than are found on the cell surface, with the B15 TAPs restricting the peptides available. In contrast, the translocation specificity of TAPs from the low-expressing B21 haplotype is even more permissive than the promiscuous binding shown by the dominantly expressed class I molecule. B15/B21 heterozygote cells show much greater expression of B15 class I molecules than B15/B15 homozygote cells, presumably as a result of receiving additional peptides from the B21 TAPs. Thus, chicken MHC haplotypes vary in several correlated attributes, with the most obvious candidate linking all these properties being molecular interactions within the peptide-loading complex (PLC).
Subject(s)
Cell Membrane/metabolism , Histocompatibility Antigens Class I/metabolism , Membrane Transport Proteins/metabolism , Peptides/metabolism , Temperature , Amino Acid Sequence , Animals , Biological Transport , Chickens , Epitopes/metabolism , Erythrocytes/metabolism , Haplotypes , Heterozygote , Homozygote , Molecular Sequence Data , Peptides/chemistry , Protein Stability , Substrate Specificity , beta 2-Microglobulin/metabolismABSTRACT
The history of polyglutamine diseases dates back approximately 20 years to the discovery of a polyglutamine repeat in the androgen receptor of SBMA followed by the identification of similar expansion mutations in Huntington's disease, SCA1, DRPLA, and the other spinocerebellar ataxias. This common molecular feature of polyglutamine diseases suggests shared mechanisms in disease pathology and neurodegeneration of disease specific brain regions. In this review, we discuss the main pathogenic pathways including proteolytic processing, nuclear shuttling and aggregation, mitochondrial dysfunction, and clearance of misfolded polyglutamine proteins and point out possible targets for treatment.
Subject(s)
Nerve Degeneration/pathology , Peptides/metabolism , Signal Transduction , Animals , Humans , Mitochondria/metabolism , Protein Aggregation, Pathological , ProteolysisABSTRACT
We present a case of a female neonate, born at 36 weeks of gestation from a monochorionic, diamniotic spontaneous twin pregnancy with congenital epulis, 2.5 cm in size, protruding from the oral cavity. Histopathology revealed a typical granular cell lesion. The other twin, also female, was prenatally diagnosed with congenital heart defect: pulmonary stenosis. The tumor was typically located in the maxillary alveolar ridge and unidirectional. The child underwent a successful surgery on the first day after birth. The course of the procedure and recovery was uneventful.
Subject(s)
Gingival Neoplasms/pathology , Gingival Neoplasms/surgery , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Female , Humans , Infant, Newborn , Maxilla/pathology , Maxilla/surgery , Treatment Outcome , TwinsABSTRACT
In most mammals, the MHC class I molecules are polymorphic and determine the specificity of peptide presentation, whereas the transporter associated with antigen presentation (TAP) heterodimers are functionally monomorphic. In chickens, there are two classical class I genes but only one is expressed at a high level, which can result in strong MHC associations with resistance to particular infectious pathogens. However, the basis for having a single dominantly expressed class I molecule has been unclear. Here we report TAP1 and TAP2 sequences from 16 chicken lines, and show that both genes have high allelic polymorphism and moderate sequence diversity, with variation in positions expected for peptide binding. We analyze peptide translocation in two MHC haplotypes, showing that chicken TAPs specify translocation at three peptide positions, matching the peptide motif of the single dominantly expressed class I molecule. These results show that coevolution between class I and TAP genes can explain the presence of a single dominantly expressed class I molecule in common chicken MHC haplotypes. Moreover, such coevolution in the primordial MHC may have been responsible for the appearance of the antigen presentation pathways at the birth of the adaptive immune system.
Subject(s)
ATP-Binding Cassette Transporters/genetics , Chickens/genetics , Evolution, Molecular , Histocompatibility Antigens Class I/genetics , Animals , Antigen Presentation/genetics , Molecular Sequence Data , Protein TransportSubject(s)
Chromosomes, Human, Pair 10 , Chromosomes, Human, Pair 12 , Leukemia, Myeloid, Acute/genetics , Proto-Oncogene Proteins c-ets/genetics , Repressor Proteins/genetics , Translocation, Genetic , Adult , Bone Marrow Cells/cytology , Female , Humans , Immunophenotyping , In Situ Hybridization, Fluorescence , Karyotyping , Treatment Outcome , ETS Translocation Variant 6 ProteinABSTRACT
BACKGROUND AND PURPOSE: To analyse acute mucosal reactions in patients treated with continuous accelerated postoperative irradiation (p-CAIR) compared to conventionally fractionated postoperative radiotherapy (p-CF). PATIENTS AND METHODS: The patients were randomly assigned to receive 63 Gy in 1.8 Gy fractions 7-days-a-week given over a period of 5 weeks (n=88), or 63 Gy in 1.8 Gy fractions given 5-days-a-week over 7 weeks (n=87). It represents 65% of an overall trial size. Acute mucosal reactions were scored using modified Dische system. Polychotomous logistic regression was used to estimate the influence of the selected variables on maximum grade of mucositis, and percent of the body weight loss during radiotherapy. RESULTS: The average maximum Dische score and percent of the patients with confluent mucositis were higher in patients treated with p-CAIR, compared to p-CF (13.3 vs. 10.8 and 54 vs. 27%). Polychotomous logistic regression analysis revealed that fractionation scheme and tumour site have significantly influenced maximum Dische score. Tumour site (laryngeal vs. other) had even stronger influence on maximum Dische score than fractionation scheme. The average residual Dische score 8 weeks after radiotherapy was higher in p-CAIR compared to p-CF (2.1 vs. 1.4), and was, most frequently, related to persistent mucosal erythema (70 vs. 57% of pts.). No severe consequential toxicity of radiotherapy was observed, so far, in the trial. CONCLUSIONS: While the incidence, intensity and duration of mucosal reactions was higher in p-CAIR than in p-CF the accelerated treatment can be considered tolerable with respect to acute toxicity. In both arms of the trial slight or moderate mucosal erythema was the most frequent acute side effect, which did not completely subside within 8 weeks after irradiation.