Difference in time to x ray with similar time to treatment decision leads to differences in waiting times of patients with hip fracture in a crowded emergency department.

OBJECTIVE: Crowding of patients is common in emergency departments. The number of hip fracture patients not regarded as urgent builds up and patients wait for treatment. In this paper, we present the causes of waiting time and provide some suggestions to improve patient flow in emergency departments. METHODS: We undertook a retrospective review of emergency department records. Included in this study were 112 hip fracture patients seen between January 2005 and January 2007 at an urban, academically affiliated trauma centre. We recorded time to admission, to x ray, and to a definitive treatment decision. Patients were divided into two groups based on time to x ray of < or = 5 min, or > 5 min. RESULTS: There was no difference in the time between taking the x ray and the definitive decision on treatment in the two groups. CONCLUSIONS: We may reduce total waiting time for hip fracture patients by taking an x ray during triage. There are many patients in crowded emergency departments whose symptoms of hip contusion and hip pain, and with a clear history of a fall, are known at admission. Taking an x ray during triage when a patient presents with a typical history and symptoms can reduce total waiting time. We hope that further evaluation could confirm this point.

Late feeding of dietary fish oil alleviates disease severity and affects macrophage function in autoimmune NZB/W F1 mice.

To investigate the influence of different saturations of dietary fat on autoantibody production and disease courses, autoimmune NZB/NZW F1 (NZB/W F1) mice were fed diets containing 20% palm oil, lard/soybean oil, soybean oil, canola oil or fish oil at 5 months of age. Sera levels of anti-DNA antibodies, proteinuria and life span were followed regularly. In addition, peritoneal resident cells were isolated and mediators such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E2 (PGE2) and NO production were measured. The results show that mice fed a diet containing with fish oil had significantly decreased immunoglobulin G (IgG) anti-single strand (ss) or double strand (ds) DNA antibody levels, lessened proteinuria and prolonged life span compared to mice fed diets containing other types of dietary fat. TNF-alpha and PGE2 levels in mice fed a diet containing fish oil were significantly lower compared to the other dietary groups. IL-6 and NO produced by peritoneal resident cells were significantly higher in mice fed a diet containing lard/soybean oil in comparison with mice of the other groups. Hepatic ex vivo PGE2 level was significantly lower in mice fed fish oil compared to mice of the other dietary groups. These data suggested that dietary fish oil might affect either autoantibody production or macrophage function, contributing to alleviation of the autoimmune process in autoimmune-prone NZB/W F1 mice.

Dietary fish oil increases CD8+ T-cells and decreases autoreactive T-cell activity in autoimmune NZB/W F1 mice.

To further elucidate the effect of different dietary fats on the pathogenesis of autoimmune diseases, five groups of New Zealand black/white (NZB/W) F1 mice were fed diets containing 200 g of different dietary fats including palm oil, lard-soybean oil (1:1, w/w), soybean oil, canola oil or fish oil. Serum levels of anti-DNA antibodies, proteinuria were followed every month and life span of the mice was determined. After 5 months of the respective diets, mice were killed at the age of 7 months and phenotypic analysis of splenic cells and peritoneal resident cells was performed. The pattern of production of cytokines in splenic T-cells was also investigated. The peritoneal resident cells were isolated for measurement of prostaglandin E2 (PGE2) levels. Significantly lower immunoglobulin G (IgG) anti-single-stranded DNA (ssDNA) and anti-double-stranded DNA (dsDNA) antibody levels were associated with less severe proteinuria and prolonged life span in mice fed dietary fish oil compared to mice fed other dietary oils. Phenotypic analysis of spleen cells showed increased CD8+ T-cells in the mice fed dietary fish oil compared to mice of the other dietary groups, and the percentage of natural killer (NK) cells in the mice fed dietary fish oil was also higher compared to the other dietary groups. The peritoneal resident cells produced lower PGE2 in mice fed fish oil compared to mice in the other dietary groups. To further investigate the effect of fish oil on autoreactive T-cells, splenic T-cells purified using a nylon wool column were stimulated with non-T-cells of young NZB/W F1 mice. Our data suggest that the anti-DNA antibody augmentation ability of T-cells in mice fed dietary fish oil was significantly decreased compared to mice in the other dietary groups. These data indicate that dietary fish oil might maintain the existence of CD8+ T-cells, decrease autoreactive T-cell activity and alleviate subsequent autoimmune processes in autoimmune prone NZB/W F1 mice.

IL-1 and IL-6 mediate increased production and synthesis by hepatocytes of acute-phase reactant mouse serum amyloid P-component (SAP).

Primary mouse hepatocytes exposed to the inflammatory cytokines IL-1 and IL-6 in vitro displayed an increase in the production of the major acute-phase reactant, serum amyloid P-component (SAP). Antiserum to recombinant human IL-6 selectively neutralized the SAP-inducing activity secreted by human diploid fibroblasts. Purified mouse interferon-beta (IFN-beta), but not IFN-alpha, also induced SAP production. Addition of 0.05 ng/ml of recombinant mouse IL-1 alpha induced a 10-fold increase in SAP production, whereas recombinant human and recombinant mouse IL-6 displayed optimal SAP-inducing activity of four-fold and seven-fold at 10 ng/ml and 1 unit/ml/2 x 10(5) mouse hepatocytes, respectively. The SAP-inducing activity was neutralized by antibodies to each of the recombinant cytokines. The kinetics of the SAP response in vitro was similar for all of the cytokines. Addition of a mixture of IL-1 and IL-6 to the hepatocytes resulted in SAP production that was not synergistic, but additive, over a range of concentrations for each cytokine. The increase in SAP production mediated by the cytokines was in part the result of an increase in the level of SAP mRNA. Metabolic incorporation of [35S]methionine into mouse SAP occurred in response to both IL-1 and IL-6. Therefore, mouse SAP should be classified among the subset of acute-phase proteins that can be induced by the direct action of either IL-1 or IL-6 on hepatocytes.

The efficacy of triclabendazole (Fasinex) against immature and adult Fasciola hepatica in experimentally infected cattle.

Eighteen Chinese cattle were experimentally infected with metacercariae of Fasciola hepatica and randomly assigned to 6 groups. Five groups of cattle were treated with a single oral dose of triclabendazole at a dose rate of 12 mg kg-1. At necropsy, the reduction in fluke burden compared with the untreated group was 85, 99.6, 99.8, 100 and 100% for cattle treated 2, 6, 8, 12 and 16 weeks after infection, respectively. Data are also presented on body weight changes during the experimental period and on serum gamma-GT activity in cattle from selected groups. Triclabendazole is considered to be safer and more efficacious than currently available fasciolicides in China.

Association between folate status, diabetes, antihypertensive medication and age-related cataracts in elderly Taiwanese.

OBJECTIVE: To evaluate possible risk factors for cataract in elderly Taiwanese, and to investigate whether the relationship between age and cataract in older persons is modified by other cataract-associated risk factors. PARTICIPANTS: A cross-sectional study of 661 males and 645 females aged ≥ 65 yrs was conducted as part of the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT). METHODS: Self-reported cataracts were defined as any incidence of cataract that was diagnosed by a physician and treated by anticataractic drugs based on the medical history section of the Elderly NAHSIT. Potential risk factors for cataract were determined by multiple logistic regression analysis of data obtained from the health examination, blood biochemistry and interviewer-administered questionnaires. RESULTS: Results showed that the prevalence of self-reported cataract increased with age and was significantly higher in older women than in older men. Cataracts were associated with age, diabetes, antihypertensive medication and folate insufficiency in older men, and with age and antihypertensive medication in older women. Folate insufficiency remained associated with cataract in older men who had adequate vitamin B2, B6 and B12 status. Folate insufficiency was associated with cataract after adjustment for other risk factors in older men aged ≥ 75 yrs, while in older men aged 65-74 yrs, only diabetes and antihypertensive medication remained associated with cataract. In addition, age ≥ 75 yrs remained a risk factor for cataract in those without diabetes, not taking hypertensive medication and with normal folate status. Further analysis showed that the strength of the association between age ≥ 75 yrs in older men and cataracts was increased about 1.5-fold when combined with folate insufficiency (interaction p= 0.0198), and increased about 1.8-fold when combined with use of antihypertensive medication (interaction p = 0.0214). CONCLUSION: Our results suggest that the combination of age ≥ 75 yrs in older men with either folate insufficiency or use of antihypertensive medication had an additive effect on the risk of cataract. Maintenance of good folate status should be emphasized to reduce the risk of cataract in the Taiwanese elderly, especially men.

The ethyl acetate extract of alfalfa sprout ameliorates disease severity of autoimmune-prone MRL-lpr/lpr mice.

Previous study showed that soy isoflavone supplement alleviates disease severity in autoimmune-prone mice. As the ethyl acetate extract of alfalfa sprout (AS) has selective oestrogenic and anti-inflammatory activity, this study evaluated the effects of alfalfa sprout ethyl acetate extract (ASEA) on disease severity of systemic lupus erythematosus, using autoimmune-prone female MRL-lpr/lpr mice. In Experiment 1, five groups of 12-week-old female mice were per oral treated with vehicle (control), lyophilized AS (550 mg wt/kg BW), ASEA (ASEA, 25 mg/kg BW), coumestrol (CUM, 0.075 mg/kg BW) and tamoxifen (TAM, 0.375 mg/kg BW) as the positive control. The onset of proteinuria was delayed, and the life span was significantly longer in the ASEA and TAM groups but neither in the AS nor in the CUM groups, compared to the control. To examine the changes in the immunological parameters related to disease process, three more groups of MRL-lpr/lpr female mice (control, ASEA and TAM) were fed in a similar manner for 6 weeks in the Experiment 2. Flow cytometric analysis of splenocytes showed a significantly lower percentage of activated T cells in the ASEA and TAM groups. The ex-vivo interferon-gamma and interleukin (IL)-4 production from splenocytes and tumour necrosis factor-alpha and IL-1beta production from peritoneal exudate cells were also significantly lower in the ASEA group compared with the control. The ASEA group also had less severe glomerulonephritis. Thus, ASEA attenuated cytokine and inflammatory responses of self-reactive lymphocytes, decreased the disease severity, increased survival and life span of the autoimmune-prone MRL-lpr/lpr mice, suggesting a potential of ASEA in the treatment of autoimmune diseases.

Expression of Escherichia coli folylpolyglutamate synthetase in the Chinese hamster ovary cell mitochondrion.

Chinese hamster ovary (CHO) cell transfectants expressing Escherichia coli folylpoly-gamma-glutamate synthetase (FPGS) activity solely in their cytosol lack mitochondrial folylpolyglutamates and are auxotrophic for glycine. Addition of a mammalian mitochondrial leader sequence targeted E. coli FPGS to the mitochondria of these cells. Mitochondrial expression of FPGS restored mitochondrial folylpolyglutamate pools and overcame the glycine requirement. Pteroyltriglutamates functioned as effectively as the longer glutamate chain length folates found in wild type CHO cells in the metabolic cycle of glycine synthesis provided they were located in the mitochondria. Although folypolyglutamates cannot enter the mitochondria, mitochondrial folylpolyglutamates can be released without prior hydrolysis and CHO transfectants expressing E. coli FPGS activity solely in the mitochondria possessed normal cytosolic folylpolyglutamate pools. The proportion of cellular folate in the mitochondrion is governed by competition between mitochondrial and cytosolic FPGS activities.

Regulation of folate and one-carbon metabolism in mammalian cells. III. Role of mitochondrial folylpoly-gamma-glutamate synthetase.

Wild-type Chinese hamster ovary (CHO) cells and CHO cell transfectants expressing human folylpoly-gamma-glutamate synthetase (FPGS) activity contain mitochondrial FPGS activity of higher specific activity than the cytosolic isozyme. Expression of mitochondrial FPGS activity is required for folate accumulation by mitochondria. The mitochondrial folate pool in CHO cells is not in equilibrium with the cytosolic pool and contains folylpolyglutamates of longer glutamate chain length than cytosolic folates. The inability of AUX-coli, a CHO cell expressing high levels of Escherichia coli FPGS activity and containing pteroyltriglutamate, to support glycine synthesis is due to a lack of mitochondrial FPGS activity. AUX-coli cells lack mitochondrial folate despite containing high levels of cytosolic folate.

Dietary frying oil influences immune regulation in autoimmune-prone NZBxNZW F1 mice.

To further elucidate the role of dietary frying oil in the pathogenesis of autoimmune diseases, two groups of NZB/W F1 mice were fed with diets containing 20% fresh oil and frying oil, respectively. All these mice were followed up serum anit-DNA antibody levels, proteinuria and life span regularly. Our data suggested: 1) higher IgG anti-ss, dDNA antibody levels were noted in mice fed with fresh oil compared to those of the frying oil group; 2) lipopolysaccharide (LPS)-stimulated spleen cells of mice fed with frying oil produced higher IL-10 compared to that of fresh oil group; 3) IL-6, TNF-alpha and PGE2 produced by macrophages of dietary frying oil group were higher, although not statistically significant, than those of fresh oil group. Different degree of deterioration of dietary oil has been found to affect immune response in autoimmune mice.

Dietary oxidized oil influences the levels of type 2 T-helper cell-related antibody and inflammatory mediators in mice.

The aim of this present study was to investigate the effect of amount and degree of oxidation of dietary oil on type 2 T-helper cell (TH)-related immune responses. Four groups of BALB/c mice were fed either 50 g soyabean oil/kg (50-S), 50 g oxidized oil/kg (50-O), 150 g soyabean oil/kg (150-S) or 150 g oxidized oil/kg (150-O). After 14 weeks consuming the experimental diets, the mice were immunized with ovalbumin (OVA) plus Al and antigen-specific immunoglobulin (Ig)E, IgG1 and IgG2a, inflammatory mediators such as prostaglandin (PG) E2 and leukotriene (LT)B4 were determined. Higher hepatic microsomal cytochrome P450 was noted in mice fed 150 g oxidized oil/kg compared with those of other groups. OVA-specific IgG1 and IgE were higher in mice fed 150 g oxidized oil/kg compared with those of the other groups. The data suggested the interleukin (IL)-4: interferon (IFN)-gamma ratio was higher in mice fed 50 g dietary oxidized oil/kg compared with that of the 50-S group. The IL-5:IFN-gamma ratios were higher in the 150-S and 150-O groups than in the 50-S and 50-O groups. PGE2 and LTB4 produced by macrophages stimulated by lipopolysaccharide were highest in mice in the 150 g oxidized oil/kg group. The data suggested that an increased intake of oxidized oil might exert an unfavourable effect on the TH2 response involved in allergic disease.

Interaction of recombinant IL-1 and recombinant tumor necrosis factor in the induction of mouse acute phase proteins.

Recombinant mouse and human IL-1 (alpha and beta forms), as well as rTNF-alpha when administered in vivo, induced the production of the mouse acute phase reactants: serum amyloid P-component (SAP), C3, and fibrinogen. The SAP response to all three rIL-1 proteins reached a maximum at a dose of 10(4) U/mouse, which corresponds to 1 to 10 micrograms of protein. The maximum in vivo response consisted of a 10-fold increase in SAP levels, a 2-fold increase in C3 levels, and a 3-fold increase in fibrinogen concentration. By contrast, rTNF-alpha induced a much smaller acute phase (AP) protein response (4-fold increase in SAP) when administered in vivo. Administration of a combination if rIL-1 and rTNF resulted in an AP response that was additive for SAP, synergistic for fibrinogen, but resulted in only the same amount of C3 induced by IL-1 alone. Both recombinant monokines induced new SAP synthesis by isolated hepatocytes in vitro with an optimal response occurring with either 1 U of rIL-1/ml per 2 x 10(5) hepatocytes or 10(-3) U/ml of rTNF. The hepatocyte response to IL-1 was of the same magnitude as the response of intact mice; however, the response to TNF was approximately 10(4) times more efficient in vitro. A mixture of the monokines induced an in vitro SAP response that was additive when suboptimal doses of rIL-1 were combined with optimal amounts of rTNF-alpha. Overall, the findings indicate that both monokines directly trigger hepatocyte synthesis of SAP and that their combined effect probably accounts for a substantial portion of the synthesis of these AP proteins in mice.

Dietary fat affects lipids and anti-cardiolipin antibody levels in autoimmune-prone NZB/W F1 mice.

Studies in autoimmune-prone NZB/W F1 mice have demonstrated that the amount of dietary fat can affect autoantibody production and the disease course of autoimmune diseases. Anti-cardiolipin antibodies have been found to play a major role in thrombus formation and the increase of abortion rate in both human lupus patients and murine lupus. The present study investigated further the effect of dietary fat on lipid and anti-cardiolipin antibody production in autoimmune-prone mice. Two groups of NZB/W F1 mice were fed on diets containing 200 g dietary fat/kg and 50 g dietary fat/kg respectively, the fat being composed of equal amounts of lard and soyabean oil. Serum levels of lipids, immunoglobulin (Ig) anti-single stranded DNA and anti-cardiolipin antibodies were followed regularly every month and mice were killed for in vitro experiments after 5 months on the experimental diets. The results showed that serum triacylglycerol concentration was lower in mice fed on the high-fat diet than in those fed on 50 g fat/kg. There was no significant difference in hepatic lipid contents; however, the fatty acid contents were different between these two groups. Hepatic linoleic acid (18:2n-6) and arachidonic acid (20:4n-6) concentrations were higher in mice fed on the high-fat diet. There were no significant differences in serum IgM concentrations or IgM anti-cardiolipin antibody levels between these two groups. However, IgG anti-cardiolipin antibody levels were higher in mice fed on the high-fat diet at the age of 3-4 months. Total serum IgG concentration was noted to be higher, but in contrast, serum IgA was lower, in the high-dietary-fat group. These findings suggest that high dietary fat may affect lipid metabolism and autoantibody levels in autoimmune diseases.

Tamoxifen alleviates disease severity and decreases double negative T cells in autoimmune MRL-lpr/lpr mice.

Previous study suggested that MRL-lpr/lpr mice treated with tamoxifen (TAM) had less severe proteinuria, reduced serum titre of anti-dsDNA autoantibodies and an increased survival rate. To investigate further the regulatory mechanisms of TAM on MRL-lpr/lpr female mice, a total dose of 200 microg per mice (5.5 mg/kg) was given every 2 weeks subcutaneously, while the control mice were injected with oil only. After being treated with TAM four times, the mice were killed and cellular functions were evaluated. The TAM-treated groups had smaller sized spleen and lymph nodes. Flow cytometric analysis of splenocytes had a significantly lower percentage of cell number of T cells and double negative T cells (CD4- CD8- T cells). There was no difference in cytokine production (interleukin (IL)-2, IL-4, IL-5, IL-10 and interferon-gamma (IFN-gamma)) from splenocytes stimulated with concanavalin A (Con A) or cytokines (IL-6) secreted by peritoneal exudate cells when stimulated with lipopolysaccharide (LPS). However, IL-2 from lymph node cells was significantly higher on TAM-treated mice. Finally, splenocytes or purified T cells stimulated with anti-CD3 antibody plus cross-linking immunoglobulin G (IgG) of the TAM-treated group had higher 3H-incorporation of proliferation assay compared with that of control groups. In vitro study further demonstrated that IL-2-activated proliferation of lymph node double negative (DN) T cells can be inhibited by TAM treatment in a dose-dependent manner. Our finding demonstrated that TAM may potentially influence T cells and modulate the immune function, which offers a novel approach to explore the feasibility of hormone therapy for autoimmune diseases.

Dietary fat influences Ia antigen expression, cytokines and prostaglandin E2 production of immune cells in autoimmune-prone NZB x NZW F1 mice.

To elucidate further the influences of dietary fat on autoimmune diseases, two groups of NZB/W F1 mice were fed with diets containing 200 g dietary fat/kg and 50 g dietary fat/kg (control) respectively. The difference in energy intake between these two groups was compensated with carbohydrate. Mice were bled regularly every month and some of them were killed for in vitro experiments after 5 months experimental diets. Higher immunoglobulin (Ig)M and IgG anti-double stranded DNA antibody levels, shortened life span and worsened proteinuria were noted in mice fed on the high-fat diet compared with those fed on 50 g dietary fat/kg. Phenotypic analyses of spleen cells and peritoneal exudate cells showed that the percentage of CD5+ B cells and the mean fluorescent intensity of major histocompatibility molecules on the surface of both types of cells were higher in mice fed on the high-fat diet. In general, higher type 2 T-helper cell activity was noted in mice fed on the high-fat diet. In addition, cytokines such as interleukin-6, tumour necrosis factor-alpha and prostaglandin E2 (PGE2) produced by lipopolysaccharide-stimulated peritoneal exudate cells were also higher in the high-dietary-fat group. These studies suggest that high dietary fat and its related PGE2 level might have a critical effect on the frequency of CD5+ B cells, cytokine production, macrophage function and subsequent autoimmune regulation in autoimmune mice.

Different dietary fats influence serum and tissue lipids and anti-cardiolipin antibody levels in autoimmune-prone NZB/W F1 mice.

To investigate the influence of different dietary fats on lipids and anti-cardiolipin antibody levels, autoimmune NZB/W F1 mice were fed on diets containing 200 g dietary fat as palm oil, lard-soyabean oil (1:1, w/w), soyabean oil, rapeseed oil or fish oil/kg. In addition, each dietary fat group was divided into an early-feeding group with feeding from 2 months of age, and a late-feeding group with feeding from 5 months of age. Serum levels of triacylglycerol, phospholipid, cholesterol and anti-cardiolipin antibody were measured at regular intervals, and mice were killed at the age of 7 months for analysis of hepatic lipid and fatty acids. The results showed that hepatic triacylglycerol and cholesterol contents were lower in mice fed on fish oil than in those fed on palm oil. In contrast, hepatic phospholipid content was higher in mice of the fish oil group than in those of the other four dietary fat groups. Composition profiles for both hepatic and renal oleic acid (18: 1n-9), linoleic acid (18: 2n-6) and eicosapentaenoic acid (20: 5n-3) were similar to those of the dietary fats in mice of both early-feeding and late-feeding groups. Fish oil intake decreased arachidonic acid (20: 4n-6) concentration in kidney tissue but not in liver tissue. Serum triacylglycerol, cholesterol and phospholipid levels were lower in mice fed on fish oil than in those fed on palm oil. Immunoglobulin (Ig) M anti-cardiolipin antibody was lower for the fish oil group than for the other groups. The IgG anti-cardiolipin antibody level was significantly lower in mice fed on fish oil compared with that of the palm oil group only in the early-feeding group. There was a positive correlation between serum IgM anti-cardiolipin antibody and phospholipid levels (early-feeding group r 0.902, P < 0.05; late-feeding group r 0.894, P < 0.05). These findings suggest dietary fish oil may affect both lipid levels and anti-cardiolipin antibody, contributing to alleviation of the autoimmune process in autoimmune-prone NZB x NZW F1 mice.

A synthetic peptide corresponding to the phosphorylcholine (PC)-binding region of human C-reactive protein possesses the TEPC-15 myeloma PC-idiotype.

C-reactive protein (CRP) is a major acute phase reactant in most mammalian species. CRP molecules from all species display Ca2(+)-dependent binding to phosphorylcholine (PC). The conserved PC-binding region of CRP corresponds to amino acids 51-66 within the human CRP sequence. A synthetic peptide composed of residues 47-63 of human CRP was previously shown to possess PC binding activity. The charged amino acids at positions 57, 58, 60, and 62 of this synthetic peptide were critical for PC-binding based on lower binding activity of synthetic peptides containing uncharged residues at these positions. The PC-binding peptide was used to generate mouse mAb that were tested for reactivity with intact CRP and with the TEPC-15 (T-15) mouse myeloma protein that also binds PC. The PC-binding peptide of CRP was recognized by two mAb specific for the T-15 Id. One of the mAb generated against the PC-binding peptide of CRP (IID6.2) recognized an epitope on the T-15 protein that was also recognized by the near-binding site-specific mAb (F6) to the T-15 PC-Id. Binding of IID6.2 to T-15 myeloma protein was not inhibited by PC and did not require Ca2+; however, binding was inhibited by the synthetic PC-binding peptide itself. Recognition of synthetic peptides containing uncharged amino acid substitutions by mAb F6 and IID6.2 was greatly reduced indicating that the shared epitope on T-15 and CRP was composed of similar charged residues. Therefore, CRP displays the same idiotope as an antibody that shares its specificity for the hapten, PC.

Tamoxifen decreases renal inflammation and alleviates disease severity in autoimmune NZB/W F1 mice.

It has been documented that sex hormone may play a role in the pathogenesis of murine lupus. To determine the effect of tamoxifen (TAM) on NZB/W F1 female mice, a total dose of 800 microg (22 mg/kg body weight) of TAM was administered subcutaneously every 2 weeks. The control mice were injected with peanut oil only. After treatment with TAM for 5 months, the mice were killed and immunological parameters were evaluated. The results suggest that NZB/W F1 mice treated with TAM had less severe proteinuria and increased survival rate compared to controls. Flow cytometric analysis of splenocytes revealed a significantly lower percentage of B cells and CD5+ B cells in the TAM-treated group. There was a significantly lower serum level of soluble tumour necrosis factor (TNF) receptor I and II molecules in the TAM-treated mice. Immunohistological study showed that control mice had severe immune complex deposition in the kidney. In contrast, TAM-treated mice had much less pathological change. In summary, this study demonstrated that TAM treatment might be able to alleviate the symptoms of lupus nephritis, influence B-cell count, modulate the expression of cytokine receptors and thereby subsequently affect immune function. Further studies to determine the cellular mechanisms in lupus nephritis may increase our understanding of this complex disease and provide additional targets for therapeutic intervention.

Regulation of folate and one-carbon metabolism in mammalian cells. II. Effect of folylpoly-gamma-glutamate synthetase substrate specificity and level on folate metabolism and folylpoly-gamma-glutamate specificity of metabolic cycles of one-carbon metabolism.

The effect of folylpoly-gamma-glutamate synthetase (FPGS) levels on folate accumulation was investigated in Chinese hamster ovary cells expressing various levels of human and Escherichia coli FPGS activity. At low medium folate concentrations, folate accumulation was limited by influx and was independent of FPGS activity except in cells expressing extremely low levels of FPGS. Essentially all transported folate was metabolized to retained polyglutamate derivatives, the chain length of which varied with the level of FPGS activity. As medium folate concentration increased through the physiological to the pharmacological range, cellular folate accumulation became proportional to FPGS activity and the chain length of intracellular folates decreased. At high folate concentrations, competition between substrates for FPGS limited the extent of polyglutamylation and less than 5% of transported folate was retained by the cell. Pteroyltriglutamates functioned as effectively as the longer chain length polyglutamates normally found in mammalian cells in the metabolic cycles of de novo purine and thymidylate biosynthesis but were unable to support glycine and methionine synthesis. Transfectants expressing human FPGS and containing folates of glutamate chain length ranging from four to eight were equally effective at supporting glycine synthesis, and transfectants expressing higher levels of FPGS were able to grow in the absence of methionine. Growth in the absence of methionine required high (nonphysiological) intracellular folate levels and longer chain length polyglutamates.

Molecular biology in nutrition research: modeling of folate metabolism.

Model CHO cells obtained by transfecting CHO mutants with the E. coli and human folylpolyglutamate synthetase genes have proven useful for assessing the role of folylpolyglutamates in one carbon metabolism and for delineating how folate intracellular stores are regulated. Cells expressing enzymes in specific subcellular compartments, expressing enzymes with different substrate specificity's, and expressing enzyme activity at different levels, all in a common background, in this case the CHO cell, has allowed the development of kinetic models for assessing the role of folypolyglutamate synthetase in folate retention and in the cytotoxicity of antifolates.