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Biomedical subjects

Henk van den Berg

Publications and source records attributed to Henk van den Berg.

15 recordsLinked to original sources

Construction of doxycyline-dependent mini-HIV-1 variants for the development of a virotherapy against leukemias.

T-cell acute lymphoblastic leukemia (T-ALL) is a high-risk type of blood-cell cancer. We describe the improvement of a candidate therapeutic virus for virotherapy of leukemic cells. Virotherapy is based on the exclusive replication of a virus in leukemic cells, leading to the selective removal of these malignant cells. To improve the safety of such a virus, we constructed an HIV-1 variant that replicates exclusively in the presence of the nontoxic effector doxycycline (dox). This was achieved by replacement of the viral TAR-Tat system for transcriptional activation by the Escherichia coli-derived Tet system for inducible gene expression. This HIV-rtTA virus replicates in a strictly dox-dependent manner. In this virus, additional deletions and/or inactivating mutations were introduced in the genes for accessory proteins. These proteins are essential for virus replication in untransformed cells, but dispensable in leukemic T cells. These minimized HIV-rtTA variants contain up to 7 deletions/inactivating mutations (TAR, Tat, vif, vpR, vpU, nef and U3) and replicate efficiently in the leukemic SupT1 T cell line, but do not replicate in normal peripheral blood mononuclear cells. These virus variants are also able to efficiently remove leukemic cells from a mixed culture with untransformed cells. The therapeutic viruses use CD4 and CXCR4 for cell entry and could potentially be used against CXCR4 expressing malignancies such as T-lymphoblastic leukemia/lymphoma, NK leukemia and some myeloid leukemias.

Anti-Bacterial Agents↗

Adamantinoma in childhood: report of six cases and review of the literature.

BACKGROUND: Adamantinoma is a rare slow-growing malignant bone tumour. OBJECTIVE: To describe the imaging appearances of six childhood cases and review the published literature. MATERIALS AND METHODS: The database of the Working Group on Paediatric Oncology, Academic Medical Centre/Emma Children's Hospital Amsterdam, was searched for cases of adamantinoma. Additionally a literature study was performed to identify cases of adamantinoma in childhood. RESULTS: We identified six local cases of adamantinoma of the long bones, two boys (age 3 and 8 years) and four girls (mean age 8.8 years, range 3.0-14.0 years). The location of the tumour was the tibia in five and the tibia and fibula in one patient. In two patients initially a different diagnosis was made, which led to a delay in appropriate treatment. None of the children showed pulmonary metastases and all underwent total gross resection. On follow-up (mean 6.1 years, range 1.6-12.0 years) all children remained disease-free. Besides a discussion of our six patients, imaging features, histopathology, surgical approach and a literature review of childhood adamantinomas is presented. CONCLUSION: Although the incidence of adamantinoma is low, it is important to recognize this rare bone tumour, since in the early stages of the disease adequate treatment will result in an excellent prognosis.

Adamantinoma↗

The Farmer Field School: a method for enhancing the role of rural communities in malaria control ?

Malaria has strong linkages with agriculture, and farmers in malarious regions have a central position in creating or controlling the conditions that favour disease transmission. An interdisciplinary and integrated approach is needed to involve farmers and more than one sector in control efforts. It is suggested that malaria control can benefit from a complementary intervention in rural development, the Farmer Field School (FFS) on Integrated Pest Management (IPM). This is a form of education that uses experiential learning methods to build farmers' expertise, and has proven farm-level and empowerment effects. The benefits of incorporating malaria control into the IPM curriculum are discussed. An example of a combined health-agriculture curriculum, labeled Integrated Pest and Vector Management (IPVM), developed in Sri Lanka is presented. Institutional ownership and support for IPVM could potentially be spread over several public sectors requiring a process for institutional learning and reform.

Agriculture↗

Construction of a minimal HIV-1 variant that selectively replicates in leukemic derived T-cell lines: towards a new virotherapy approach.

T-cell acute lymphoblastic leukemia is a high-risk type of blood-cell cancer. We analyzed the possibility of developing virotherapy for T-cell acute lymphoblastic leukemia. Virotherapy is based on the exclusive replication of a virus in leukemic cells, leading to the selective removal of these malignant cells. We constructed a minimized derivative of HIV-1, a complex lentivirus encoding multiple accessory functions that are essential for virus replication in untransformed cells, but dispensable in leukemic T cells. This mini-HIV virus has five deletions (vif, vpR, vpU, nef, and U3) and replicated in the SupT1 cell line, but did not replicate in normal peripheral blood mononuclear cells. The stripped down mini-HIV variant was also able to efficiently remove leukemic cells from a mixed culture with untransformed control cells. In contrast to wild-type HIV-1, we did not observe bystander killing in mixed culture experiments with the mini-HIV variant. Furthermore, viral escape was not detected in long-term cultures. The mini-HIV variant that uses CD4 and CXCR4 for cell entry could potentially be used against CXCR4-expressing malignancies such as T-lymphoblastic leukemia/lymphoma, natural killer leukemia, and some myeloid leukemias.

CD4 Antigens↗

Effect of folate-binding protein on intestinal transport of folic acid and 5-methyltetrahydrofolate across Caco-2 cells.

BACKGROUND: Milk products are a potential matrix for fortification with synthetic folic acid or natural 5-methyltetrahydrofolate (5-CH3-H4folate) to enhance the daily folate intake. In milk, folate occurs bound to folate-binding proteins (FBP). Our previous studies with an in vitro gastrointestinal model showed that 70% of the initial FBP content of the milk product was retained in the duodenal lumen. While folic acid remained bound to FBP after gastric passage, 5-CH3-H4folate was mainly present as free folate in the duodenal lumen. AIM OF THE STUDY: To investigate the effect of FBP on the absorption of folic acid and 5-CH3-H4folate from the intestinal lumen. METHODS: The transport of [3H]-folic acid and [14C]-5-CH3-H4folate across enterocytes was studied in the presence or absence of bovine FBP using monolayers of Caco-2 cells grown on semi-permeable inserts in a two-compartment model. The apparent permeability coefficients (P(app)) of folic acid and 5-CH3-H4folate were determined and compared with the permeability of reference compounds for low (mannitol) and high (caffeine) permeability. RESULTS: The transport from the apical to the basolateral side of the Caco-2 cells was higher (P < 0.05) for folic acid (P(app) = 1.7*10(-6) cm/s) than for 5-CH3-H4folate (P(app) = 1.4*10(-6) cm/s) after 2 h incubation to 1 microM folic acid or 5-CH3-H4folate test solutions (pH 7). The permeability of folic acid and 5-CH3-H4folate across Caco-2 monolayers appeared to be higher (P < 0.05) than that of mannitol (P(app) = 0.5*10(-6) cm/s) but lower (P < 0.05) than that of caffeine (P(app) = 34*10(-6) cm/s). The addition of FBP to the medium led to a lower (P < 0.05) intestinal transport and cellular accumulation of folic acid and 5-CH3-H4folate. CONCLUSIONS: Compared to the reference compounds, folic acid and 5-CH3-H4folate showed a moderate permeability across Caco-2 cells, which indicates that folate absorption from the intestinal lumen is not likely to be complete. The intestinal transport of folic acid and 5-CH3-H4folate was found to be dependent on the extent of binding to FBP at the luminal side of the cells.

Biological Transport↗

Rating of SPICES criteria to evaluate and compare curricula.

SPICES criteria (Student-centred, Problem-based, Integrated, Community-based, Electives, Systematic) are used to describe educational strategies applied in medical schools. Application of SPICES criteria often can be just a statement since various forms of teaching with large variations are incorporated in a curriculum. In this paper a system of rating SPICES criteria is presented in which also quantitative aspects (in respect of hours of scheduling of the various educational strategies) are considered. Application of this system provides a score on application of SPICES criteria for the curriculum as whole. In addition, comparison of various curricula can be done in a more objective manner.

Curriculum↗

Spontaneous remission in congenital leukemia is not related to (mosaic) trisomy 21: case presentation and literature review.

Congenital leukemia is seldomly diagnosed. Cases should be differentiated from transient leukemoid reaction, which is noted in Down syndrome. Outcome in congenital leukemia is poor, but spontaneous remissions have been described. The authors report on a female neonate with myeloid leukemia of the skin; no blood and bone marrow involvement was noted. Constitutional 47, XX, + 21 was excluded. In situ hybridization on a paraffin-embedded skin biopsy sample did not show trisomy 21 in the leukemia lesions. No antileukemia therapy was given. During follow-up, small nodules (diameter up to 3 mm) on the soles of both feet came and went over a 3-month period. The child is now 3.5 years old and well. To date, 18 cases of congenital leukemia showing spontaneous remission have been described in the literature, almost exclusively myeloid leukemia (FAB M4 and M5). Congenital leukemia confined to the skin was described in only 4 cases. On follow-up, 6 cases relapsed; only one of them initially had skin involvement only. The data from this patient and literature indicate that cytostatic treatment should start only if the malignancy interferes with vital parameters. In case of relapse or progression, initial postponement of chemotherapy in these frail neonates will result in less toxicity and probably a better survival.

Diagnosis, Differential↗

Synthetic and tomato-based lycopene have identical bioavailability in humans.

BACKGROUND: Bioavailability studies with lycopene have focused on natural sources. A synthetic source has recently become available. AIM OF THE STUDY: To determine the relative bioavailabilities of synthetic and tomato-based lycopene in free living volunteers in a single-blind, randomized, placebo-controlled, parallel trial. METHODS: Three groups (n=12/group) of healthy, normolipemic male and female subjects with a mean baseline serum lycopene concentration of 0.36 micro mol/L took a dose of 15 mg/day total lycopene for 28 days from either Lycovit 10% (beadlets, BASF, Germany) or Lyc-O-Mato (beads, LycoRed Natural Products, Israel) or a placebo (without lycopene) together with the main meal. The increase in serum lycopene from baseline was used as the parameter of bioavailability. RESULTS: Synthetic and tomato-lycopene resulted in significant increases above baseline of serum total lycopene by 0.58 and 0.57 micro mol/L, trans-lycopene by 0.34 and 0.41 micro mol/L, and total-cis-lycopene by 0.24 and 0.16 micro mol/L, whereas no significant changes were found in the placebo treatment. The mean serum total lycopene response to synthetic and natural lycopene was not significantly different. Neither lycopene source affected the other serum carotenoids, viz. alpha-carotene, beta-carotene, beta-cryptoxanthin, zeaxanthin and lutein. CONCLUSION: We conclude that synthetic and natural lycopene are equivalent sources of lycopene and that there is no interaction with other circulating carotenoids.

Adult↗

Incidence, medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodgkin's lymphoma in four European countries.

Hyperuricemia (HU) and tumour lysis syndrome (TLS) are complications of acute leukaemia and non-Hodgkin lymphoma (NHL) leading to increased morbidity and mortality. The objective of this study was to define incidence and calculate health care cost associated with HU and TLS. 788 acute leukaemia and NHL patients from Belgium, The Netherlands, Spain and UK were screened retrospectively for HU and TLS. Resource use related to HU and TLS was recorded and costs were calculated applying local unit costs. Results showed that HU occurred in 18.9% of patients, and 27.8% of them fulfilled TLS criteria. The cost of HU without TLS was 672 euros (SE 181), the cost of TLS 7,342 euros (SE 1,412). TLS requiring dialysis incurred an average cost of 17,706 euros. In conclusion, it is noted that the observed incidence rates were lower than earlier reports. In addition, some risk factors for HU and TLS (e.g. paediatric patients versus adults) were not associated with increased rates of HU or TLS as a consequence of higher rates of prevention. TLS cases incurred 11 times higher costs than HU cases in which TLS was absent. The main cost drivers in TLS are interventions requiring intensive care.

Acute Disease↗

Folic acid and 5-methyltetrahydrofolate in fortified milk are bioaccessible as determined in a dynamic in vitro gastrointestinal model.

Dairy products are a potential matrix for folate fortification to enhance folate consumption in the Western world. Milk folate-binding proteins (FBP) are especially interesting because they seem to be involved in folate bioavailability. In this study, folate bioaccessibility was investigated using a dynamic computer-controlled gastrointestinal model [TNO gastrointestinal model (TIM)]. We used both ultrahigh temperature (UHT)-processed milk and pasteurized milk, differing in endogenous FBP concentrations and fortified with folic acid or 5-methyltetrahydrofolate (5-CH(3)-H(4)folate). To study FBP stability during gastrointestinal passage and the effect of additional FBP on folate bioaccessibility, FBP-fortified UHT and pasteurized milk products were also tested. Folate bioaccessibility and FBP stability were measured by taking samples along the compartments of the gastrointestinal model and measuring their folate and FBP concentrations. Folate bioaccessibility from folic acid-fortified milk products without additional FBP was 58-61%. This was lower (P < 0.05) than that of the 5-CH(3)-H(4)folate-fortified milk products (71%). Addition of FBP reduced (P < 0.05) folate bioaccessibility from folic acid-fortified milk (44-51%) but not from 5-CH(3)-H(4)folate-fortified milk products (72%). The residual FBP levels in the folic acid- and 5-CH(3)-H(4)folate-fortified milk products after gastrointestinal passage were 13-16% and 0-1%, respectively, of the starting amounts subjected to TIM. In conclusion, milk seems to be a suitable carrier for folate, because both folic acid and 5-CH(3)-H(4)folate are easily released from the matrix and available for absorption. However, our results suggest that folic acid remains partly bound to FBP during passage through the small intestine, which reduces the bioaccessibility of folic acid from milk in this model.

Animals↗

Influence of lifestyle on vitamin bioavailability.

In this review the effects of lifestyle factors, especially alcohol consumption, on vitamin bioavailability are summarized and discussed. Alcohol effects are clearly dose-dependent. Excessive chronic alcohol intake is generally associated with vitamin deficiency (especially folate, thiamine, and vitamin B6) due to malnutrition, malabsorption, and ethanol toxicity. Effects of moderate alcohol use are mainly explained by a lower vitamin intake. In the case of vitamin A and beta-carotene, effects on post-absorptive (lipoprotein) metabolism have been demonstrated. In one diet-controlled crossover study, alcohol consumption resulted in an increase in the plasma vitamin B6 (PLP) content, especially after beer consumption (containing vitamin B6), but also after wine and spirit consumption (not containing vitamin B6). Smoking is also associated with a lower dietary vitamin intake. In the case of vitamin C, B12, folate, and beta-carotene, evidence has been presented for effects on postabsorptive metabolism, due to smoke-induced oxidative stress and/or vitamin inactivation. For vitamin E a direct effect of smoking on absorption has been demonstrated. There is no convincing evidence that low-fat diets negatively affect fat-soluble vitamin absorption, but cholesterol-lowering compounds (diets), or unabsorbable fat substitutes, may do so. Vitamin bioavailability may be compromised from certain vegetables (particularly raw), and/or from high-fiber foods, because of limited digestion and inefficient release of vitamins from the food matrix.

Alcohol Drinking↗

Comparison of LDL fatty acid and carotenoid concentrations and oxidative resistance of LDL in volunteers from countries with different rates of cardiovascular disease.

Within Europe there are differences in cardiovascular disease (CVD) risk between countries and this might be related to dietary habits. Oxidative modification of LDL is suggested to increase the risk of CVD and both the fatty acid and antioxidant content of LDL can affect its oxidation. In the present study, concentration of LDL fatty acid and antioxidant micronutrients (tocopherols and carotenoids) and ex vivo oxidative resistance of LDL (lag phase) was compared in volunteers from five countries with different fruit and vegetable intakes and reported rates of CVD. Eighty volunteers (forty males, forty females per centre), age range 25-45 years, were recruited from France, Northern Ireland, UK, Republic of Ireland, The Netherlands, and Spain, and their LDL composition and lag phase were measured. There were some differences in LDL carotenoid and alpha-tocopherol concentrations between countries. alpha-Tocopherol was low and beta- + gamma-tocopherol were high (P<0.001) in the Dutch subjects. Beta-Carotene concentrations were significantly different between the French and Spanish volunteers, with French showing the highest and Spanish the lowest concentration. LDL lycopene was not different between centres in contrast to lutein, which was highest in French (twofold that in the Dutch and Spanish and threefold that in Northern Ireland and the Republic of Ireland, P<0.001). However absolute LDL saturated, monounsaturated, polyunsaturated and total unsaturated fatty acid concentrations were different between countries (P<0.001, total unsaturated highest in Northern Ireland) there was little difference in unsaturated:saturated fatty acid concentration ratios and no difference in polyunsaturated:saturated fatty acid concentration ratios. LDL from the Republic of Ireland (a region with a high rate of CVD) had greater resistance to Cu-stimulated oxidation than samples obtained from volunteers in other countries. In conclusion, LDL composition did not predict resistance to Cu-stimulated oxidation, nor is there evidence that LDL from volunteers in countries with lower rates of CVD have greater resistance to oxidation.

Adult↗

A European multicentre, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene: analysis of serum responses.

Increased levels of oxidative stress have been implicated in tissue damage and the development of chronic diseases, and dietary antioxidants may reduce the risk of oxidative tissue damage. As part of a European multicentre project, several studies were undertaken with the aim of testing whether the consumption of foods rich in carotenoids reduces oxidative damage to human tissue components. We describe here the serum response of carotenoids and tocopherols upon supplementation with carotenoids from natural extracts (alpha-carotene+beta-carotene, lutein or lycopene; 15 mg/day) and/or with alpha-tocopherol (100 mg/day) in a multicentre, placebo-controlled intervention study in 400 healthy male and female volunteers, aged 25-45 years, from five European regions (France, Northern Ireland, Republic of Ireland, The Netherlands and Spain). Supplementation with alpha-tocopherol increased serum alpha-tocopherol levels, while producing a marked decrease in serum gamma-tocopherol. Supplementation with alpha- + beta-carotene (carotene-rich palm oil) resulted in 14-fold and 5-fold increases respectively in serum levels of these carotenoids. Supplementation with lutein (from marigold extracts) elevated serum lutein (approx. 5-fold), zeaxanthin (approx. doubled) and ketocarotenoids (although these were not present in the supplement), whereas lycopene supplementation (from tomato paste) resulted in a 2-fold increase in serum lycopene. The isomer distributions of beta-carotene and lycopene in serum remained constant regardless of the isomer composition in the capsules. In Spanish volunteers, additional data showed that the serum response to carotenoid supplementation reached a plateau after 4 weeks, and no significant side effects (except carotenodermia) or changes in biochemical or haematological indices were observed throughout the study. This part of the study describes dose-time responses, isomer distribution, subject variability and side effects during supplementation with the major dietary carotenoids in healthy subjects.

Adult↗