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Biomedical subjects

R Iyer

Publications and source records attributed to R Iyer.

At least 37 records · Page 2Linked to original sources
PubMed1999

Genetic diversity of Borrelia burgdorferi in lyme disease patients as determined by culture versus direct PCR with clinical specimens.

Two hundred seventeen isolates of Borrelia burgdorferi originally cultured from skin biopsy samples or blood of early Lyme disease patients were genetically characterized by PCR-restriction fragment length polymorphism (RFLP) typing of the 16S-23S ribosomal DNA intergenic spacer. Three major RFLP types were observed. Of the cultured isolates, 63 of 217 (29.0%) were type 1, 85 of 217 (39.2%) were type 2, and 58 of 217 (26.7%) were type 3; mixtures of two RFLP types were obtained in 6.0% (13 of 217) of the cultures. Comparison of typing of B. burgdorferi performed directly on 51 patient skin specimens with typing of cultures originally isolated from the same tissue revealed that a much larger proportion of direct tissue samples had mixtures of RFLP types (43.1% by direct typing versus 5.9% by culture [P < 0.001). In addition, identical RFLP types were observed in only 35.5% (11 of 31) of the paired samples. RFLP type 3 organisms were recovered from blood at a significantly lower rate than were either type 1 or type 2 strains. These studies demonstrate that the genetic diversity of B. burgdorferi patient isolates as determined by cultivation differs from that assessed by PCR performed directly on patient tissue.

Bacteriological Techniques↗
PubMed1999

MRP3, a new ATP-binding cassette protein localized to the canalicular domain of the hepatocyte.

Bile secretion in liver is driven in large part by ATP-binding cassette (ABC)-type proteins that reside in the canalicular membrane and effect ATP-dependent transport of bile acids, phospholipids, and non-bile acid organic anions. Canalicular ABC-type proteins can be classified into two subfamilies based on membrane topology and sequence identity: MDR1, MDR3, and SPGP resemble the multidrug resistance (MDR) P-glycoprotein, whereas MRP2 is similar in structure and sequence to the multidrug resistance protein MRP1 and transports similar substrates. We now report the isolation of the rMRP3 gene from rat liver, which codes for a protein 1522 amino acids in length that exhibits extensive sequence similarity with MRP1 and MRP2. Northern blot analyses indicate that rMRP3 is expressed in lung and intestine of Sprague-Dawley rats as well as in liver of Eisai hyperbilirubinemic rats and TR- mutant rats, which are deficient in MRP2 expression. rMRP3 expression is also transiently induced in liver shortly after birth and during obstructive cholestasis. Antibodies raised against MRP3 recognize a polypeptide of 190-200 kDa, which is reduced in size to 155-165 kDa after treatment with endoglycosidases. Immunoblot analysis and immunoconfocal microscopy indicate that rMRP3 is present in the canalicular membrane, suggesting that it may play a role in bile formation.

ATP-Binding Cassette Transporters↗
PubMed1998

Management of cardiac pacemaker in a patient with spinal cord stimulator implant.

Spinal cord stimulation reduces pain of critical ischaemia in patients with severe inoperable coronary artery and peripheral vascular disease by increasing microvascular flow. Patients with cardiac pacemaker may be denied a spinal cord stimulator (SCS) implant because of the risk of compromising pacemaker function by inhibition or reversion to asynchronous noise-pacing mode. We describe the management of a patient with an SCS implant for lower limb ischaemia who required a pacemaker. We suggest that with modern pacemakers it is safe to implant a spinal cord stimulator simultaneously with a pacemaker provided adequate precautions are taken to prevent interdevice interference.

Aged↗
PubMed1998

The human arginases and arginase deficiency.

Arginase is the final enzyme in the urea cycle. Its deficiency is the least frequently described disorder of this cycle. It results primarily in elevated blood arginine, and less frequently in either persistent or acute elevations in blood ammonia. This appears to be due to a second arginase locus, expressed primarily in the kidney, which can be recruited to compensate, in part, for the deficiency of liver arginase. The liver arginase gene structure permitted study of the molecular pathology of patients with the disorder and the results of these studies and the inferences about the protein structure are presented. The conserved regions among all arginases allowed the cloning of AII, the second arginase isoform. It has been localized to the mitochondrion and is thought to be involved in ornithine biosynthesis. It shares the major conserved protein sequences, and structural features of liver arginase gene are also conserved. When AI and AII from various species are compared, it appears that the two diverged some time prior to the evolution of amphibians. The evidence for the role of AII in nitric oxide and polyamine metabolism is presented and this appears consonant with the data on the tissue distribution.

Amino Acid Metabolism, Inborn Errors↗
PubMed1998

Decline in rates of seropositivity for measles, mumps, and rubella antibodies among previously immunized children treated for acute leukemia.

We prospectively determined the measles-mumps-rubella (MMR) antibody status of 39 previously vaccinated children before and after administering protocol-directed chemotherapy for acute leukemia. At diagnosis the seropositivity rates for measles and mumps-specific immunoglobulin G were > or = 90%, while the seropositivity rate for rubella was 85%. After treatment, rates of seropositivity for measles antibody declined by 13% (90% of patients to 77%; P = .13); for mumps antibody, by 18% (97%-79%; P = .02); and for rubella antibody, by 21% (85%-64%; P = .03). These findings suggest that some survivors of acute leukemia during childhood have an increased susceptibility to MMR viruses and would benefit from posttreatment evaluation of their immune statuses and from possible revaccination.

Acute Disease↗
PubMed1998

Thymic sarcoma in childhood.

Sarcoma of the thymus is exceedingly rare, especially in children. We report a case of thymic sarcoma in a child, including the imaging findings which have not been previously described.

Child↗
PubMed1997

Complex inhibition of OmpF and OmpC bacterial porins by polyamines.

The effects of four polyamines (putrescine, cadaverine, spermidine, and spermine) on the activity of bacterial porins OmpC and OmpF were investigated by electrophysiology. Membrane vesicles made from the outer membrane of Escherichia coli strains expressing only OmpC or OmpF were reconstituted into liposomes probed by patch clamp. The channel activity was recorded in control solutions and in the presence of increasing concentrations of a specific polyamine. In all cases, concentration- and voltage-dependent inhibitory effects were observed. They include both the suppression of channel openings and the enhancement of channel closures as well as the promotion of blocked or inactivated states. OmpF and OmpC, although highly homologous, have distinct sensitivities to modulation, especially by spermine. This compound inhibits OmpF in the nanomolar range, which is in agreement with its potency on eukaryotic channels. Putrescine was the least effective (upper millimolar range) and also had inhibitory effects qualitatively distinct from those exerted by the other polyamines. The compounds appear to bind to at least two distinct binding sites, one of which resides within the pore. The potencies to this site are lower when the polyamines are applied from the extracellular side than from the periplasmic side, suggesting an asymmetric binding site.

Binding Sites↗
PubMed1997

Thymidine kinase (TK) gene-transduced human lymphocytes can be highly purified, remain fully functional, and are killed efficiently with ganciclovir.

A graft-versus-leukemia (GVL) effect has been considered a major factor responsible for cures in patients with hematologic malignancies undergoing allogeneic bone marrow transplantation; however, associated graft-versus-host disease (GVHD) results in significant morbidity and mortality. T-cell depletion reduces the incidence and severity of GVHD but eliminates, at least partially, the GVL effect. Reinfusion of donor T lymphocytes at relapse posttransplantation can induce a potent antitumor response, but GVHD still occurs in the majority of patients. Prior transduction of T lymphocytes with the suicide gene, the viral thymidine kinase (TK), permits specific cell kill on administration of ganciclovir (GCV). Therefore, infusion of TK-transduced T lymphocytes may induce GVL effect and allow for their subsequent selective elimination in case GVHD develops. To evaluate the efficacy and feasibility of this promising approach, anti-CD3-stimulated primary human lymphocytes cultured in interleukin-2 were TK-transduced by a retroviral vector carrying both TK and neomycin-resistance genes. After selection in G418, more than 90% of the cells contained the TK gene as shown by a semiquantitative polymerase chain reaction. In addition, 1 to 5 days of GCV exposure, at clinically achievable concentrations of 20 to 50 micromol/L, induced > or = 90% killing of G418-selected cells without affecting nontransduced cells. Correlation of the extent of T-cell kill and the proportion of TK-gene-transduced cells is consistent with the absence of a bystander effect. Transduced cells were CD3+ and either CD8+ or CD4+ and retained functional properties of untransduced cells. In vivo administration of GCV prevented tumor development after subcutaneous injection of TK-transduced murine myeloma cells (MOPC-11), whereas such an effect was not observed on injection of untransduced cells into the opposite flank. Our studies provide critical information that (1) adequate numbers of TK-transduced lymphocytes can be selected efficiently with > or = 90% purity, (2) selected cells remain functional, (3) 24 hours of exposure to GCV at clinically achievable concentration effects > or = 90% killing of selected cells, and (4) GCV is effective in vivo in killing TK-transduced cells. Based on these data, a clinical study has been initiated in patients with multiple myeloma with persistent or relapsing disease after T-cell-depleted allogeneic transplants.

Animals↗
PubMed1997

Involvement of the ICE family of proteases in silica-induced apoptosis in human alveolar macrophages.

Exposure to silica dust can result in lung inflammation that may progress to fibrosis for which there is no effective clinical treatment. The mechanisms involved in the development of pulmonary silicosis have not been well defined; however, most current evidence implicates a central role for alveolar macrophages in this process. We have previously demonstrated that fibrotic agents, such as asbestos and silica, induce apoptosis in human alveolar macrophages. The goal of this study was to identify molecular events in the silica-induced apoptotic process to better understand the mechanism by which fibrotic agents may be inducing apoptosis in human alveolar macrophages. To elucidate the possible mechanism by which silica causes apoptosis, we investigated the involvement of the interleukin-converting enzyme (ICE) family of proteases. Human alveolar macrophages were treated with silica in vitro and were examined for the involvement of ICE, Ich-1L, and cpp32beta in silica-induced apoptosis. Pretreatment of cells with 10 microM of the ICE inhibitor z-Val-Ala-Asp-fluoromethyl ketone and the cpp32beta inhibitor Asp-Glu-Val-Asp-fluoromethyl ketone completely blocked silica-induced apoptosis. Additionally, an increased formation of the active p20 fragments of ICE and Ich-1L as well as degradation of the inactive zymogen form of cpp32beta protein were observed in silica-treated human alveolar macrophages, indicating activation of these proteases. Furthermore, degradation of the nuclear protein poly(ADP-ribose) polymerase was observed within 2 h of silica treatment. These results suggest that silica-induced apoptosis involves activation of the ICE family of proteases and is the first step in elucidating the intracellular mechanism of particulate-induced apoptosis in human alveolar macrophages.

Adult↗
PubMed1996

Effects of 540C91 [(E)-3-[2-(4'-pyridyl)-vinyl]-1H-indole], an inhibitor of hepatic tryptophan dioxygenase, on brain quinolinic acid in mice.

Studies were undertaken to assess the role of the liver in the formation of the neurotoxin quinolinic acid in the brain. A selective and potent inhibitor of hepatic tryptophan 2,3-dioxygenase, 540C91 [(E)-3-[2-(4'-pyridyl)-vinyl]-1H-indole], largely prevented the elevation in mouse brain quinolinic acid resulting from parenteral injection of tryptophan (TRP). In contrast, 540C91 did not affect basal levels of the neurotoxin. Following induction of indoleamine dioxygenase with bacterial lipopolysaccharide, 540C91 was less effective in preventing the TRP-induced elevations in quinolinic acid. The data suggest that kynurenines, formed from tryptophan, by the liver and other extrahepatic organs can give rise to brain quinolinic acid.

Animals↗
PubMed1996

Silica-induced apoptosis mediated via scavenger receptor in human alveolar macrophages.

Exposure to silica dust can result in lung inflammation that may progress to fibrosis, for which there is no effective clinical treatment. The mechanisms involved in the development of pulmonary silicosis have not been well defined; however, most current evidence implicates a central role for alveolar macrophages (AM) in this process. We propose that the fibrotic potential of a particulate depends upon its ability to cause apoptosis in AM. In this study, human AM were treated with fibrogenic, poorly fibrogenic, and nonfibrogenic model particulates, such as silica (133 micrograms/ml), amorphous silica (80 micrograms/ml), and titanium dioxide (60 micrograms/ml), respectively. Cell were treated with these particulates in vitro for 6 and 24 hr and examined for apoptosis by morphological analysis, DNA fragmentation, and levels of cytosolic histone-bound DNA fragments (cell death ELISA assays). Treatment with silica resulted in morphological changes typical of apoptotic cells, enhanced DNA fragmentation (a characteristic feature of programmed cell death), and significant alveolar macrophage apoptosis as observed by cell death ELISA assays. In contrast, amorphous silica and titanium dioxide demonstrated no significant apoptotic potential. To elucidate the possible mechanism by which silica causes apoptosis, we investigated the role of the scavenger receptor (SR) in silica-induced apoptosis. Cells were pretreated with and without SR ligand binding inhibitor, polyinosinic acid (poly(I), 500 micrograms/ml), for 10 min prior to silica treatment. Pretreatment with poly(I) resulted in complete inhibition of silica-induced apoptosis as measured by cell death ELISA. Further, we examined the involvement of interleukin-converting enzyme (ICE) in silica-mediated apoptosis using an ICE inhibitor, Z-Val-Ala-Asp-fluoromethyl ketone. Z-Val-Ala-Asp-fluoromethyl ketone inhibited silica-induced apoptosis and IL-1 beta release. These results suggest that fibrogenic particulates, such as silica, caused apoptosis of alveolar macrophages and that this apoptotic potential of fibrogenic particulates may be a critical factor in initiating an inflammatory response resulting in fibrosis. Additionally, silica-induced apoptosis of alveolar macrophages may be due to the interaction of silica particulates with the SR, initiating one or a number of signaling pathways involving ICE, ultimately leading to apoptosis.

Adult↗
PubMed1995

The effects of a novel and selective inhibitor of tryptophan 2,3-dioxygenase on tryptophan and serotonin metabolism in the rat.

The effects of a novel inhibitor 680C91 ((E)-6-fluoro-3-[2-(3- pyridyl)vinyl]-1H-indole) of the key enzyme of tryptophan catabolism tryptophan 2,3-dioxygenase (TDO) (EC 1.13.11.11), were examined on tryptophan catabolism in vitro and in vivo and on brain levels of tryptophan, serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA). 680C91 was a potent (Ki = 51 nM) and selective TDO inhibitor with no inhibitory activity against indoleamine 2,3-dioxygenase (EC 1.13.11.17), monoamine oxidase A and B, 5-HT uptake and 5-HT1A,1D,2A and 2C receptors at a concentration of 10 microM. 680C91 had no effect on the binding of tryptophan to serum albumin in plasma and inhibited TDO competitively with respect to its substrate tryptophan. 680C91 inhibited the catabolism of tryptophan by rat liver cells and rat liver perfused in situ. The catabolism of L-[ring-2-14C]-tryptophan and a load dose of tryptophan (100 mg/kg) in vivo were inhibited by prior administration of 680C91. Administration of 680C91 alone produced marked increases in brain tryptophan, 5-HT and 5-HIAA. A load dose of tryptophan (100 mg/kg), producing increases in brain tryptophan 4-fold greater than that seen with 680C91, did not increase brain 5-HT and 5-HIAA to levels greater than those seen with 680C91 and produced a shorter-lasting increase in these parameters. These data therefore demonstrate the importance of TDO as a regulator of whole-body tryptophan catabolism and brain levels of tryptophan and 5-HT and suggest that a greater antidepressant efficacy might be achieved with inhibitors of TDO than tryptophan administration alone.

Animals↗
PubMed1995

The effects of an inhibitor of tryptophan 2,3-dioxygenase and a combined inhibitor of tryptophan 2,3-dioxygenase and 5-HT reuptake in the rat.

The effects of a novel inhibitor 680C91 ((E)-6-fluoro-3-[2-(3-pyridyl)vinyl]-1H-indole) of the key enzyme of tryptophan catabolism tryptophan 2,3-dioxygenase (TDO), and a novel inhibitor 709W92 ((E)-6-fluoro-3-[2-(4-pyridyl)vinyl]-1H-indole), of both TDO and 5-hydroxytryptamine (5-HT) reuptake, were examined on tryptophan catabolism, cerebrospinal fluid (CSF) concentrations of tryptophan and 5-HT and serotonergic-mediated physiology and behaviour in the rat. The catabolism of L-[ring-2-14C]tryptophan in vivo was completely inhibited by prior administration of 709W92. 709W92, but not 680C91, potentiated head-twitch produced by 5-hydroxytryptophan, prevented head-twitch and whole brain 5-HT depletion produced by p-chloroamphetamine and rapidly decreased dorsal raphe firing. Both 709W92 and 680C91 elevated CSF tryptophan by up to 260% of basal concentration. A maximally effective dose of 680C91 elevated a global measure of brain extracellular 5-HT (CSF 5-HT) to concentrations similar to those seen maximally after exogenous tryptophan administration (approx 170% of basal). Maximally effective doses of 709W92 increased CSF 5-HT to concentrations comparable to those seen after tryptophan and 5-HT reuptake inhibitor coadministration (approx 900% of basal) and to concentrations greater than those achieved maximally with serotonergically active antidepressant monotherapy (approx 500% of basal). 709W92 did not elevate CSF 5-HT to concentrations associated with the serotonin syndrome (approx 3000% of basal). The combined TDO inhibitor/5-HT reuptake inhibitor, 709W92, showed anxiolytic activity in the rat-pup vocalization model of anxiety. These results show that 709W92 (a novel inhibitor of both TDO and 5-HT reuptake), can produce an elevation of CSF 5-HT similar to that achieved with a serotonin reuptake inhibitor/tryptophan combination therapy but with a more sustained timecourse; such compounds may therefore have superior antidepressant efficacy in the clinic.

Animals↗
PubMed1995

Algorithm for managing a baby with dusky soles.

We have been using dusky colour of the sole in newborns as proxy to cyanosis. An algorithm for management of dusky soles was developed presupposing that a baby can have dusky soles due commonly to hypothermia, hypoxaemia, or hypotension in isolation or in combination. Fifty-one consecutive babies were managed according to a predetermined algorithm based largely on clinical signs. Forty babies were covered by these three broad groups and 37 of them could be managed successfully. Of the remaining babies two were found to have congenital malformations on autopsy and one died of hyperthermia. Algorithmic approach has simplified the management with low failure rate and can be useful when hi-tech neonatal care is unaffordable.

Algorithms↗
PubMed1994

Restriction of interferon gamma responsiveness and basal expression of the myeloid human Fc gamma R1b gene is mediated by a functional PU.1 site and a transcription initiator consensus.

The restricted expression of the human Fc gamma R1b gene to myeloid cells is likely to be regulated by a combination of transcription factors that may not be solely expressed in myeloid cells, but act together to restrict the expression of the gene to myeloid cells. Low basal expression of the human Fc gamma R1b gene is specifically upregulated by interferon gamma (IFN-gamma). A 181-bp region of 5' flanking sequence contains several key regulatory motifs that include the extended gamma response region (XGRR) and the PIE region. The XGRR contains the 39-bp gamma response region originally defined in the highly homologous Fc gamma R1a gene. The XGRR is in close proximity to the 21-bp PIE motif that is conserved in the promoters of some other myeloid genes. The PIE motif contains a consensus site for the macrophage and B cell transcription factor, PU.1, and is adjacent to the cluster of transcription start sites. An active transcription initiator, Inr, consensus spans the start sites and appears to direct transcription initiation of this TATA-less gene. In this study, we demonstrate that the PIE region contains a functional PU.1 site that binds a human PU.1-like protein and that associated factors present in myeloid extracts also bind in this PIE region. Mutational analysis reveals an absolute requirement for an intact PU.1 box for both basal and IFN-gamma inducible expression of this gene. In addition, mutations in the Inr greatly reduce basal and inducible transcription. Insertion of a strong TATA box downstream from the Inr or at -30 bp from the transcription start sites restores basal and inducible activity in the presence of a mutated PU.1 site. We also demonstrate that indeed, when the XGRR is positioned in the context of a heterologous TATA containing promoter, it is able to respond equivalently to either IFN-alpha or IFN-gamma. However, IFN-alpha responsiveness does not occur in the context of the physiological Fc gamma R1b TATA-less basal promoter. Our results suggest that a human PU.1-like factor acts as a "bridging factor" between the upstream IFN-gamma enhancer and the Inr dependent preinitiation complex. These findings indicate that the structure of the basal promoter in combination with restricted activators like PU.1 are important in regulating the expression of this gene.

B-Lymphocytes↗
PubMed1993

Structure of the murine Mac-2 gene. Splice variants encode proteins lacking functional signal peptides.

The murine Mac-2 gene is composed of six exons dispersed over 10.5 kilobases. S1 nuclease mapping showed multiple transcription initiation sites, clustered within a 30-base pair region. Sequence analysis revealed that a consensus initiator sequence is located in this area which lacks a TATA motif. The untranslated first exon contains an alternative splice donor site, confirming the existence of two cDNA species with the potential to encode proteins differing at their NH2 termini. In vitro expression and translocation experiments demonstrate that both of the alternatively spliced variants of Mac-2 encode proteins which lack a functional signal peptide. Subcellular fractionation studies indicate that most of the Mac-2 protein is present in the cytosol. These results support the view that Mac-2 is exported from the cell by an unusual mechanism which does not depend on the presence of a signal peptide.

Alternative Splicing↗
PubMed1993

Cystic retroperitoneal lymphangioma: CT, ultrasound and MR findings.

A case of cystic retroperitoneal lymphangioma complicated by hemorrhage is reported in a 7-year-old boy who presented with an abdominal mass. The mass which was partially obstructing the ureter was successfully resected. The imaging findings with emphasis on MR features are described.

Child↗