Expression of MAGE and GAGE genes in the bronchogenic cancer tissues obtained by bronchoscopy / 대한내과학회지

BACKGROUND: There has been significant progress in the identification of tumor associated antigens. Among the tumor associated antigens, MAGE (melanoma antigen), BAGE, GAGE, PRAME, NY-ESO were named as cancer/testis specific antigens since they are only expressed in the testis or cancer cells. Because of their relative specificity, they have been considered as the appropriate targets for the specific immunotherapy, or the early diagnosis of several cancers. In bronchogenic cancer, these antigens would be useful as a promising candidate in the screening test or immunotherapy. This study was to investigate the expression of MAGE and GAGE genes in the bronchogenic cancer tissues obtained by bronchoscopy. METHODS: In five normal bronchial and 26 cancer tissues obtained by bronchoscopic biopsy from 26 bronchogenic cancer patients, total cellular mRNA was extracted. Then RT PCR was run in 35 cycles, with two different kinds of primers designed to detect the several subtypes of MAGE DNA simultaneously and the similar process to detect GAGE DNA was also done. Concurrently, DNA sequencing of the isolates was done in portion to prove the isolates are cloned MAGE and GAGE DNA. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blotting. Then the expression of MAGE or GAGE in the bronchogenic cancer tissues was evaluated by the tissue types and clinical staging. RESULTS: In the five controls, MAGE or GAGE was not detected in any specimen and beta actin was not expressed in 4 cases, suggesting the specimen might be too small to detect beta actin by 35 cycles of PCR. In the 26 cancer tissues, the expression rate of MAGE and GAGE was 42.3% (11/26) and 42.3% (11/26) respectively and MAGE or GAGE were expressed in 17 cases (65.3%). Neither clinical staging nor tissue types were associated with the expression of MAGE or GAGE. Beta actin was not detected in 11 cases of cancer specimen, but MAGE or GAGE were expressed in 10 cases of them. CONCLUSION: Using these primers in detection of MAGE or GAGE genes in the bronchoscopicbiopsy tissues seems to be effective or complimentary method in screening of bronchogenic cancer patients, who would be the candidate for the possible immunotherapy.

The Relationship between Graves' Disease and Serum Immunoglobulin-E / 대한내분비학회지

BACKGROUND: It is widely believed that Graves' disease is an autoimmune disorder characterized by the presence of the circulating TSH receptor antibody (TRAb). The majority of the activity of TRAb is of the immunoglobulin G (IgG) class. However, other immunoglobulin such as immunoglobulin E (IgE), may play a role in the activity. IgE accumulation has been reported to occur in the thyroid gland and ocular muscles of subjects with Graves' disease. Furthermore, it has been noted that recurrence of Graves' disease can be induced by an allergy to pollen. Because an allergy to pollen is commonly associated with IgE, IgE might play a role in the induction of Graves' disease. Therefore, investigated whether IgE was elevated in Graves' disease, and evaluated the potential relationship between the levels of TRAb and IgE Graves' disease. METHODS: Forty-six patients with Graves' disease, and 6 with chronic thyroiditis, diagnosed at the Kosin Medical Center between April, 2000 and July, 2000 were included in this study. Thirty-five persons without thyroid disease or a history of allergic rhinitis were used as normal controls. The level of TRAb was measured using thyrotropin binding inhibitory immunoglobulin (TBII). Serum total IgE was measured using an enzymeimmunoassay method. Test for thyroid function, TBII and total IgE were performed in all cases, and the results statistically analyzed. RESULTS: TBII, as IgG, and the serum IgE level were higher in the patients with Graves' disease, and the levels of the latter were 598.1+/-1112.9U/mL, 98.5+/-79.7U/mL and controls 161.7+/-194.4U/mL in the Graves' patients, those with thyroiditis and the controls, respectively (p<0.05). The prevalence of allergic rhinitis in Graves' disease was 10.9%. The serum IgE level in Graves' disease with, and without, allergic rhinitis were 903.1+/-1152.2U/mL and 560.8+/-1117.0U/mL, respectively, although there was no significancant difference between the two groups. According to the clinical stage, the serum TBII level was higher in the untreated Graves', and relapsed patients 49.9+/-23.9% and 21.1+/-3.1%, respectively, than in the treated group, 7.4+/-18.6% (p<0.05). The serum IgE level was higher in the untreated Graves' and relapsed patients 758.6+/-1250.2U/mL and 1198.5+/-1952.1U/mL, respectively, than in the treated group 233.8+/-432.7U/mL, although this was not significant. According to the duration of treatment, the serum TBII levels were higher in the untreated Graves' patients, and those treated for less than 1 year, than in those treated for more than 1 year, with values of 49.9+/-23.9, 24.8+/-3.8 and 2.22+/-1.97%, respectively (p<0.05). The serum IgE level was higher in the untreated Graves' disease (758.6+/-1250.2U/mL) than in the groups treated for less than 12 months (158.3+/-91.5U/mL) and more than 12 months (252.7+/-483.4U/mL), but the differences were not significant. CONCLUSIONS: The concentration of IgE was high in Graves' patients, and although not statistically significant, the serum IgE level in Graves' patients with allergic rhinitis was higher than those without. With regard to the clinical stage of Graves' disease, the change in the IgE level tended to follow that of the TBII. Further study will be required to define the possible role of IgE in the pathogenesis in Graves' disease.

Molecular Diagnosis of Recurrent Thyroid Cancer by Reverse Transcription-Polymerase Chain Reaction of Thyroglobulin Messenger Ribonucleic Acid in Peripheral Blood / 대한내분비학회지

BACKGROUND: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyroid ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluate the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. METHODS: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR, and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. RESULTS: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. CONCLUSION: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications.

Peak Expiratory Flow(PEF) Measured by Peak Flow Meter and Correlation Between PEF and Other Ventilatory Parameters in Healthy Children / 결핵

BACKGROUND: In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of FEV1 in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of FEV1 especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and FEV1 in healthy children. METHOD: PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children (age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of FEV1 by PEF were derived. RESULTS: 1. The regression equation for PEF(L/min) was:12.6×age(year)+3.4×height(cm)-263(R2=0.85) in boys, and 6×age(year)+3.9×height(cm)-293(R2=0.82) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for FEV1(ml) by PEF(L/min) was:7×PEF-550(R2=0.82) in boys, and 5.8×PEF-146(R2=0.81) in girls, respectively. CONCLUSION: This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for FEV1, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.