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Y Liu

Publications and source records attributed to Y Liu.

At least 361 records · Page 20Linked to original sources

Interlocked feedback loops contribute to the robustness of the Neurospora circadian clock.

Interlocked feedback loops may represent a common feature among the regulatory systems controlling circadian rhythms. The Neurospora circadian feedback loops involve white collar-1 (wc-1), wc-2, and frequency (frq) genes. We show that WC-1 and WC-2 proteins activate the transcription of frq gene, whereas FRQ protein plays dual roles: repressing its own transcription, probably by interacting with the WC-1/WC-2 complex, and activating the expression of both WC proteins. Thus, they form two interlocked feedback loops: one negative and one positive. We establish the physiological significance of the interlocked positive feedback loops by showing that the levels of WC-1 and WC-2 determine the robustness and stability of the clock. Our data demonstrate that with WC-1 being the limiting factor in the WC-1/WC-2 complex, the greater the levels of WC-1 and WC-2, the higher the level of the FRQ oscillation and the more robust the overt rhythms. Our data also show that, despite considerable changes in the levels of WC-1, WC-2, and FRQ, the period of the clock has been limited to a small range, suggesting that the interlocked circadian feedback loops are also important for determining the circadian period length of the clock.

Circadian Rhythm↗

Cooperative multipoint recognition of organic dyes by bis(beta-cyclodextrin)s with 2,2'-bipyridine-4,4'-dicarboxy tethers.

A series of novel 6,6'-bis(beta-cyclodextrin)s linked by 2,2'-bipyridine-4,4'-dicarboxy tethers; that is, 2,2'-bipyridine-4,4'-dicarboxy-bridged bis(6-O-beta-cyclodextrin) (2) and N,N'-bis(2-aminoethyl )-2,2'-bipyridine-4,4'-dicarboxamide-bridged (3), N,N'-bis(5-amino-3-azapentyl)-2,2'-bipyridine-4,4'-dicarboxamide-bridged (4) and N,N'-bis(8-amino-3,6-diazaoctyl)-2,2'-bipyridine-4,4'-dicarboxamide-bridged bis(6-amino-6-deoxy-beta-cyclodextrin) (5), has been synthesized as cooperative multipoint-recognition receptor models. The inclusion complexation behavior of 2-5 with organic dyes; that is, ammonium 8-anilino-1-naphthalenesulfonate, Brilliant Green, Methyl Orange, Acridine Red, and Rhodamine B, has been investigated in aqueous phosphate buffer solutions (pH 7.20) at 25 degrees C by means of ultraviolet, fluorescence, and circular dichroism spectrometry as well as by fluorescence lifetime measurements. The spectral titrations gave the complex stability constants (Ks) and Gibbs' free energy changes (deltaG degrees) for the inclusion complexation of 2-5 with the organic dyes and other thermodynamic parameters (deltaH degrees and deltaS degrees) for the inclusion complexation of 2-4 with the fluorescent dyes Acridine Red and Rhodamine B. Bis(beta-cyclodextrin)s 2-5 displayed higher binding abilities toward most of the examined dye molecules than native beta-cyclodextrin 1; this is discussed from the viewpoints of the size/shape-fit concept, the induced-fit interaction, and cooperative, multipoint recognition by the bridging chain and the dual hydrophobic cavities. Thermodynamically, the inclusion complexation of 2-4 with Acridine Red is totally enthalpy driven with a negative or minor positive entropic contribution, but the inclusion complexation with Rhodamine B is mainly entropy-driven with a mostly positive, but occasionally negative, enthalpic contribution; in some cases this determines the complex stability.

Journal Article↗

Expression, purification, characterization and homology modeling of active Akt/PKB, a key enzyme involved in cell survival signaling.

Akt is a serine/threonine kinase that plays a critical role in cell survival signaling and its activation has been linked to tumorigenesis. Up-regulation of Akt as well as its upstream regulator phosphatidylinositol-3 kinase (PI3K) has been found in many tumors and the negative regulator of this pathway PTEN/MMAC is a tumor suppressor. As a target for drug discovery, we have expressed and purified an active Akt1 enzyme from a recombinant baculovirus-infected Sf9 cell culture. Coexpression of Akt1 with the catalytic subunit of PI3K or treatment with okadaic acid during expression was found to generate an active enzyme in the insect cell culture system. We have optimized the kinase activity and developed a simple quantitative kinase assay using biotinylated peptide substrates. Using the purified active enzyme, we have characterized its physical, catalytic and kinetic properties. Since Akt is closely related to protein kinase C (PKC) and protein kinase A, the issue of obtaining selective inhibitors of this enzyme was addressed by comparison of the structures of catalytic domains of Akt and PKC, derived by homology modeling methods. A number of amino acid differences in the ATP binding regions of these kinases were identified, suggesting that selective inhibitors of Akt can be discovered. However, the ATP binding regions are highly conserved in the three isoforms of Akt implying that the discovery of isoform-selective inhibitors would be very challenging.

Amino Acid Sequence↗

[The role of cyclin-dependent kinase inhibitors in hyperplasia and hypertrophy of vascular smooth muscle cells].

OBJECTIVE: To investigate the role p27, p21, and p57, different cyclin-dependent kinase inhibitors (CKIs), play in the hyperplasia and hypertrophy of vascular smooth muscle cells (VSMCs) stimulated with platelet-derived growth factor (PDGF-BB) and angiotensin II (Ang II). METHODS: VSMCs from rat aorta were cultured. PDGF-BB and Ang II were added into the serum-free media at the concentrations of 10 - 6 M and 20 ng/ml respectively. VSMCs were harvested after 6h, 12h, and 24 h or stimulation. The protein levels of p27, p21 and p57 in VSMCs were examined with Western blot analysis. RESULTS: The protein levels of p27, p21, and p57 in the Ang II-stimulated VSMCs were similar to those in the quiescent cells (P > 0.05). The protein levels of p21 and p57 in the PDGF-BB-stimulated VSMCs increased along with the time course of stimulation, the former being at its peak value at the 24th hour, and were significantly higher than those in Ang II-stimulated VSMCs. However, the p57 protein level was high in the quiescent cells. A remarkable decrease of the p57 protein level was found in the PDGF-BB-stimulated VSMCs (P < 0.01). CONCLUSION: p27, p21, and p57 proteins play important roles in regulating hyperplasia and hypertrophy of VSMC. P21 and p57 prevent the overplasia of VSMCs. P27 is the most important regulator of hyperplasia and hypertrophy of VSMC stimulated by PDGF and Ang II.

Angiotensin II↗

Non-Fermi-liquid behaviour in La4Ru6O19.

Understanding the complexities of electronic and magnetic ground states in solids is one of the main goals of solid-state physics. Transition-metal oxides have proved to be particularly fruitful in this regard, especially for those materials with the perovskite structure, where the special characteristics of transition-metal-oxygen orbital hybridization determine their properties. Ruthenates have recently emerged as an important family of perovskites because of the unexpected evolution from high-temperature ferromagnetism in SrRuO3 to low-temperature superconductivity in Sr2RuO4 (refs 1, 2). Here we show that a ruthenate in a different structural family, La4Ru6O19, displays a number of highly unusual properties, most notably non-Fermi-liquid behaviour. The properties of La4Ru6O19 have no analogy among the thousands of previously characterized transition-metal oxides. Instead, they resemble those of CeCu6-xAux-a widely studied f-electron-based heavy fermion intermetallic compound that is often considered as providing the best example of non-Fermi-liquid behaviour. In the ruthenate, non-Fermi-liquid behaviour appears to arise from just the right balance between the interactions of localized electronic states derived from Ru-Ru bonding and delocalized states derived from Ru-O hybridization.

Journal Article↗

Both cyclooxygenase-1 and cyclooxygenase-2 mediate osteoblast response to titanium surface roughness.

Previous studies suggest that the enhanced expression of the osteoblastic phenotype exhibited by MG63 osteoblast-like cells on rough Ti surfaces (R(a) 4-5 microm) involves increased production of prostaglandin. Inhibition of prostaglandin synthesis by indomethacin blocks surface-roughness-dependent decreases in cell proliferation and increases in alkaline phosphatase activity and the production of osteocalcin and TGF-beta1. This study examined the hypothesis that the increase in expression of the osteoblastic phenotype noted in MG63 cells cultured on rough Ti surfaces is mediated by inducible cyclooxygenase-2 (Cox-2) whereas Cox-1 modulates prostaglandin production and phenotypic expression of the cells under standard conditions and on smooth Ti surfaces. MG63 cells were cultured on tissue culture plastic, smooth Ti (PT, R(a) = 0.60 microm), and two rough Ti surfaces with differing morphologies (SLA, R(a) = 3.97 microm and TPS, R(a) = 5.21 microm). At 24 h after plating, media were replaced with media containing the general Cox inhibitor indomethacin (10(-7)M), the Cox-1 inhibitor resveratrol (1 or 10 microM), or the Cox-2 inhibitor NS-398 (1 or 10 microM). Media were changed again after 48 h. Five days after plating, osteocalcin, PGE(2), and TGF-beta1 content of the conditioned media were determined. Cell numbers were assessed in the same cultures used for determination of osteocalcin production. Cell layer protein and alkaline phosphatase specific activity were assessed in cultures used to measure PGE(2) and TGF-beta1. Indomethacin, resveratrol, and NS-398 had no effect on cell number. Indomethacin blocked the surface-roughness-dependent increase in PGE(2) production by up to 80%. Similarly, resveratrol inhibited up to 50% of the PGE(2) production on smooth surfaces and up to 80% on rough surfaces. In contrast, NS-398 had no effect on PGE(2) production by cells on smooth surfaces but caused a 60% reduction in cultures on rough surfaces. Indomethacin reduced alkaline phosphatase on all surfaces below basal levels. However, neither resveratrol nor NS-398 had an effect. Indomethacin blocked the stimulatory effect of surface roughness on osteocalcin production while resveratrol only partially reduced osteocalcin production, and NS398 completely blocked the surface-dependent increase. TGF-beta1 production on rough surfaces was blocked by indomethacin. The effects of resveratrol and NS-398 were dose dependent, but neither agent caused total inhibition of the increase noted on SLA, and only resveratrol blocked the increase on TPS. These results indicate that both Cox-1 and Cox-2 are involved in the response of osteoblasts to surface roughness with respect to production of PGE(2), TGF-beta1, and osteocalcin. While prostaglandin mediates the effects of surface roughness on alkaline phosphatase, neither Cox-1 nor Cox-2 appears to be involved, at least with respect to the two inhibitors used.

Alkaline Phosphatase↗

Unique fluorescence behavior of rhodamine B upon inclusion complexation with novel bis(beta-cyclodextrin-6-yl) 2,2'-bipyridine-4,4'-dicarboxylate.

Newly synthesized bis(beta-cyclodextrin-6-yl) 2,2'-bipyridine-4,4'-dicarboxylate was found to induce an unusual fluorescence enhancement of Rhodamine B (RhB) upon complexation. This effect is attributable to the equilibium shift of RhB to the highly fluorescent carboxylate ion form, which is induced by the cooperative binding by two appropriately preorganized cyclodextrin units in the bis(beta-cyclodextrin). This sandwich complexation behavior was investigated by means of the fluorescence and 2D NMR spectroscopy.

Cyclodextrins↗

Discordance between the binding affinity of mitogen-activated protein kinase subfamily members for MAP kinase phosphatase-2 and their ability to activate the phosphatase catalytically.

MKP-2 is a member of the mitogen-activated protein (MAP) kinase phosphatase family which has been suggested to play an important role in the feedback control of MAP kinase-mediated gene expression. Although MKP-2 preferentially inactivates extracellular signal-regulated kinase (ERK) and c-Jun NH(2)-terminal kinase (JNK) MAP kinase subfamilies, the mechanisms underlying its own regulation remain unclear. In this report, we have examined the MKP-2 interaction with and catalytic activation by distinct MAP kinase subfamilies. We found that the catalytic activity of MKP-2 was enhanced dramatically by ERK and JNK but was affected only minimally by p38. By contrast, p38 and ERK bound MKP-2 with comparably strong affinities, whereas JNK and MKP-2 interacted very weakly. Through site-directed mutagenesis, we defined the ERK/p38-binding site as a cluster of arginine residues in the NH(2)-terminal domain of MKP-2. Mutation of the basic motif abrogated its interaction with both ERK and p38 and severely compromised the catalytic activation of MKP-2 by these kinases. Unexpectedly, such mutations had little effect on JNK-triggered catalytic activation. Both in vitro and in vivo, wild type MKP-2 effectively inactivated ERK2 whereas MKP-2 mutants incapable of binding to ERK/p38 did not. Finally, in addition to its role as a docking site for ERK and p38, the MKP-2 basic motif plays a role in regulating its nuclear localization. Our studies provided a mechanistic explanation for the substrate preference of MKP-2 and suggest that catalytic activation of MKP-2 upon binding to its substrates is crucial for its function.

Amino Acid Substitution↗

Kinetic preference for oriented DNA binding by the yeast TATA-binding protein TBP.

In solution, the TATA box binding protein from S. cerevisiae (yTBP) is only minimally oriented when bound to the adenovirus major late promoter (AdMLP) and the yeast CYC1 promoter. At equilibrium, approximately 60% of the complexes are assembled in the orientation observed within crystal structures; 40% are assembled in the opposite orientation. Here we use stopped-flow fluorescence resonance energy transfer (FRET) to study the association kinetics of the two TBP.TATA box orientational isomers. Kinetics were determined by monitoring FRET between a unique tryptophan residue engineered into either the C- or the N-terminal stirrup of the conserved C-terminal subunit of yeast TBP (yTBPc) and an aminocoumarin moiety appended either upstream or downstream of the TATA box. Together, these constructs permitted a simultaneous yet independent monitor of the kinetics of TBP binding in both orientations. Not only did our results provide an independent confirmation of the free energy difference between the two orientational isomers, but they also showed that the orientational binding preference at equilibrium is a result of a faster association rate when TBP binds DNA in the orientation observed in the crystal structure.

Coumarins↗

Crystal structure of the SarR protein from Staphylococcus aureus.

The expression of virulence determinants in Staphylococcus aureus is controlled by global regulatory loci (e.g., sarA and agr). The sar (Staphylococcus accessory regulator) locus is composed of three overlapping transcripts (sarA P1, P3, and P2, transcripts initiated from the P1, P3, and P2 promoters, respectively), all encoding the 124-aa SarA protein. The level of SarA, the major regulatory protein, is partially controlled by the differential activation of the sarA promoters. We previously partially purified a 13.6-kDa protein, designated SarR, that binds to the sarA promoter region to down-modulate sarA transcription from the P1 promoter and subsequently SarA expression. SarR shares sequence similarity to SarA, and another SarA homolog, SarS. Here we report the 2.3 A-resolution x-ray crystal structure of the dimeric SarR-MBP (maltose binding protein) fusion protein. The structure reveals that the SarR protein not only has a classic helix-turn-helix module for DNA binding at the major grooves, but also has an additional loop region involved in DNA recognition at the minor grooves. This interaction mode could represent a new functional class of the "winged helix" family. The dimeric SarR structure could accommodate an unusually long stretch of approximately 27 nucleotides with two or four bending points along the course, which could lead to the bending of DNA by 90 degrees or more, similar to that seen in the catabolite activator protein (CAP)-DNA complex. The structure also demonstrates the molecular basis for the stable dimerization of the SarR monomers and possible motifs for interaction with other proteins.

Amino Acid Sequence↗

Preliminary X-ray crystallographic analysis of a Ca2+-binding protein human S100A1.

S100A1, a Ca(2+)-binding protein from the S100 protein family, has been crystallized by the vapour-diffusion method using polyethylene glycol 4000 as the precipitant at pH 8.5. The crystal belongs to space group P6(3). The unit-cell parameters are a = b = 57.3, c = 104.7 A. There appear to be two S100A1 molecules in the asymmetric unit. The crystals were stable during exposure to X-rays and diffract to 2.6 A resolution in-house.

Calcium-Binding Proteins↗

Lesions of the vomeronasal organ disrupt mating-induced pair bonding in female prairie voles (Microtus ochrogaster).

The prairie vole (Microtus ochrogaster) is a highly social, monogamous species and displays pair bonding that can be assessed by the presence of selective affiliation with the familiar partner versus a conspecific stranger. In female prairie voles, exposure to a male or to male sensory cues is essential for estrus induction, and the subsequent mating facilitates pair bond formation. In the present study, we examined the role of the vomeronasal organ (VNO) in estrus induction and pair bonding in female prairie voles. VNO lesions did not alter olfaction mediated by the main olfactory system, but did prevent male-induced estrus induction. We by-passed the necessity of the VNO for estrus induction by estrogen priming the females. Despite the fact that all subjects displayed similar levels of mating, social contact and locomotor activities, VNO lesioned females failed to show mating-induced pair bonding whereas intact and sham-lesioned females displayed a robust preference for the familiar partner. Our data not only support previous findings that the VNO is important for estrus induction but also indicate that this structure is crucial for mating-induced pair bonding, suggesting an important role for the VNO in reproductive success in prairie voles.

Animals↗

Identification of a novel structural variant of the alpha 6 integrin.

The alpha(6) integrin is a 140-kDa (nonreduced) laminin receptor. We have identified a novel 70-kDa (nonreduced) form of the alpha(6) integrin called alpha(6)p for the latin word parvus, meaning small. The variant was immunoprecipitated from human cells using four different alpha(6)-specific monoclonal antibodies but not with alpha(3) or alpha(5) antibodies. The alpha(6)p integrin contained identical amino acid sequences within exons 13--25, corresponding to the extracellular "stalk region" and the cytoplasmic tail of the alpha(6) integrin. The light chains of alpha(6) and alpha(6)p were identical as judged by alpha(6)A-specific antibodies and electrophoretic properties. The alpha(6)p variant paired with either beta(1) or beta(4) subunits and was retained on the cell surface three times longer than alpha(6). Reverse transcription/polymerase chain reaction analysis revealed a single polymerase chain reaction product. The alpha(6)p variant was found in human prostate (DU145H, LnCaP, PC3) and colon (SW480) cancer cell lines but not in normal prostate (PrEC), breast cancer (MCF-7), or lung cancer (H69) cell lines or a variant of a prostate carcinoma cell line (PC3-N). Protein levels of alpha(6)p increased 3-fold during calcium-induced terminal differentiation in a normal mouse keratinocyte model system. A novel form of the alpha(6) integrin exists on cell surfaces that contains a dramatically altered extracellular domain.

Amino Acid Sequence↗

AP-1 blockade inhibits the growth of normal and malignant breast cells.

We have previously demonstrated that basal AP-1 transcriptional activity is high in normal human mammary epithelial cells, intermediate in immortal breast cells, and relatively low in breast cancer cells. In this study we investigated whether differences in AP-1 transcriptional activity reflect differences in breast cells' dependence on AP-1 for proliferation. The cJun dominant negative, TAM-67, was used to determine the effect of AP-1 blockade on the growth of normal, immortal and malignant breast cells. We first showed that TAM-67 inhibits AP-1 activity in normal and malignant breast cells. We then determined whether this AP-1 inhibitor affected colony forming efficiency of the immortalized and malignant breast cells. The AP-1 inhibitor reduced colony formation of immortal breast cells by over 50% (by 58% in 184B5 cells and 62% in MCF10A cells), and reduced colony formation in the breast cancer cell line MCF7 by 43%, but did not reduce colony formation in the other breast cancer cell lines (T47D, MDA MB231 and MDA MB 435). We also determined the effect of AP-1 blockade on the growth of normal breast cells using a single cell proliferation assay. Using this assay, the growth of normal breast cells was extremely sensitive to AP-1 blockade, while immortal breast cells were moderately sensitive. We next directly tested the effect of TAM-67 expression on the growth of MCF7 breast cancer cells, using cells stably transfected with TAM-67 under the control of a doxycycline-inducible promoter. Upon induction, TAM-67 was expressed and AP-1 activity was inhibited in these cells. We then measured the growth of these cells in the presence or absence of TAM-67. The results of these studies show that the growth of MCF7 cells was suppressed by the AP-1 inhibitor, TAM-67. These results demonstrate that normal and immortalized breast cells, and some breast cancer cells (such as MCF7), require AP-1 to transduce proliferative signals, while other breast cancer cells (such as T47D, MDA MB 231 and MDA MB 435) do not. These studies suggest that the AP-1 transcription factor is a potential target for future agents for the prevention or treatment of breast cancer.

Breast↗

Characterization of DNA damage-stimulated self-interaction of Saccharomyces cerevisiae checkpoint protein Rad17p.

Saccharomyces cerevisiae Rad17p is necessary for cell cycle checkpoint arrests in response to DNA damage. Its known interactions with the checkpoint proteins Mec3p and Ddc1p in a PCNA-like complex indicate a sensor role in damage recognition. In a novel application of the yeast two-hybrid system and by immunoprecipitation, we show here that Rad17p is capable of increased self-interaction following DNA damage introduced by 4-nitroquinoline-N-oxide, camptothecin or partial inactivation of DNA ligase I. Despite overlap of regions required for Rad17p interactions with Rad17p or Mec3p, single amino acid substitutions revealed that Rad17p x Rad17p complex formation is independent of Mec3p. E128K (rad17-1) was found to inhibit Rad17p interaction with Mec3p but not with Rad17p. On the other hand, Phe-121 is essential for Rad17p self-interaction, and its function in checkpoint arrest but not for Mec3p interaction. These differential effects indicate that Rad17p-Rad17p interaction plays a role that is independent of the Rad17p x Mec3p x Ddc1p complex, although our results are also compatible with Rad17p-mediated supercomplex formation of the Rad17p x Mec3p x Ddc1p heterotrimer in response to DNA damage.

Amino Acid Sequence↗

Developmental and cell-cycle regulation of Caenorhabditis elegans HCF phosphorylation.

HCF-1 is a mammalian protein required for cell proliferation. It is also involved in transcriptional activation of herpes-simplex-virus immediate-early gene transcription in association with the viral transactivator VP16. HCF-1 and a related protein called HCF-2 possess a homologue in Caenorhabditis elegans that can associate with and activate VP16. Here, we demonstrate developmental regulation of C. elegans HCF (CeHCF) phosphorylation: a hyperphosphorylated form of CeHCF is present in embryos, whereas a hypophosphorylated form is present in L1 larvae. The phosphorylation patterns of endogenous CeHCF in worms and ectopically synthesized CeHCF in mammalian cells are remarkably similar, suggesting that the way CeHCF can be recognized by kinases is conserved in animals. Phosphorylation-site mapping of endogenous CeHCF, however, revealed that phosphorylation occurs at four clustered sites in the region of the protein that is not highly conserved among HCF proteins and is not required for VP16-induced complex formation. Indeed, phosphorylation of either CeHCF or human HCF-1 appears to be dispensable for association with VP16. All four CeHCF phosphorylation sites match the consensus recognition site for the cell-cycle kinases CDC2 and CDK2. Consistent with this similarity and with the developmental phosphorylation of CeHCF in C. elegans embryos, CeHCF phosphorylation is cell-cycle-regulated in mammalian cells.

Alanine↗

Expression and estrogen regulation of brain-derived neurotrophic factor gene and protein in the forebrain of female prairie voles.

Brain-derived neurotrophic factor (BDNF) has been linked to the development, differentiation, and plasticity of the central nervous system. In the present study, we first used a highly specific affinity-purified antibody and a cRNA probe to generate a detailed mapping of BDNF immunoreactive (BDNF-ir) staining and mRNA labeling throughout the forebrain of female prairie voles. Our data revealed that (1) BDNF-ir cells were present essentially in the brain regions in which BDNF mRNA-labeled cells were found; (2) BDNF-ir fibers were distributed extensively throughout many forebrain regions; and (3) BDNF mRNA was also detected in some thalamic regions in which BDNF-ir fibers, but not immunostained cells, were present. With few exceptions, the distribution pattern of BDNF in the vole brain generally resembled the pattern found in rats. In a second experiment, we examined the effects of estrogen on BDNF expression. Ovariectomized prairie voles that were treated with estradiol benzoate had a higher level of BDNF mRNA labeling in the dentate gyrus and CA3 region of the hippocampus, as well as in the basolateral nucleus of the amygdala, than did ovariectomized voles that were treated with vehicle. In addition, estrogen treatment increased the density of BDNF-ir fibers in the lateral septum, dorsolateral area of the bed nucleus of the stria terminalis, and lateral habenular nucleus. These data suggest that estrogen may regulate BDNF at the level of gene and protein expression, and thus, BDNF may be in a position to mediate the effects of estrogen on the brain of the prairie vole.

Animals↗

[Mycophenolate mofetil in the treatment of primary nephrotic syndrome].

OBJECTIVE: To investigate the efficacy and safety of mycophenolate mofetil (MMF) on treating refractory primary nephrotic syndrome. METHODS: Forty-one patients with refractory nephrotic syndrome confirmed by renal biopsy, 19 with minor lesion (minimal lesion nephropathy and mesangial proliferative glomerulonephritis), 18 with membranous nephropathy (MN), 3 with focal segmental glomerulosclerosis (FSGS), and one with mesangioproliferative glomerulonephritis (MPGN), were treated by MMF combined with prednisone. The initial dosage of MMF was 1.0 - 2.0 g/d for three months and then the dosage was tapered gradually. The duration of MMF treatment was at least six months. Prednisone at the dose of 20 - 60 g/d was used at the beginning of the combined treatment and then the dosage was tapered gradually. Follow-up interview was conducted regularly. Four patients were rebiopsyed by the end of observation. RESULTS: The combined treatment of MMF/prednisone decreased the urine protein and elevated the serum albumin significantly among patients with minor lesion and MN (P < 0.001). All patients with minor lesion achieved clinical remission. Eleven of the nineteen cases responded within four weeks, and twelve of them obtained complete clinical remission. The dosage of prednisone could be tapered smoothly among the steroid dependent patients. Thirteen of the eighteen patients with MN achieved remission, however only six responded within four weeks and only three of them achieved complete clinical remission. During the treatment, four patients experienced transient increase of urine protein due to infection and recovered spontaneously without alteration of treatment. Side effects were tolerable except one case was withdrawn due to the decrease of hemoglobin. Renal function remained stable during the treatment. No obvious alteration could be found in renal biopsy by the end of treatment among four patients. CONCLUSION: MMF is an effective and safe immunosuppressive agent for refractory nephrotic syndrome.

Adolescent↗