Use of a proline-specific endopeptidase to reintroduce gluten in patients with non-coeliac gluten sensitivity: A randomized trial.

BACKGROUND: A gluten-free diet (GFD) is the main therapy for non-coeliac gluten sensitivity (NCGS). However, the availability of novel enzymes with the ability to digest gluten could represent a therapeutic opportunity for NCGS patients to avoid a GFD. AIMS: To evaluate the controlled reintroduction of gluten with or without the endopeptidase P1016 in NCGS patients. METHODS: This is a randomized, double-blind, placebo-controlled monocentric study, Registered under ClinicalTrials.gov Identifier no. NCT01864993. Gluten was reintroduced incrementally over a 3-week period under nutritional control. NCGS patients were randomized into two groups and administered P1016 or placebo during gluten reintroduction. We evaluated symptoms (visual analogue scale, VAS), quality of life (SF-36) and mental health symptoms (SCL-90) on a weekly basis. RESULTS: We enrolled a total 23 patients who were allocated to a placebo group (n = 11, age 38.4 ± 2.9) or an intervention group (n = 12, age 39.5 ± 3.1). No effect of P1016 on symptoms was found. During gluten reintroduction, patients reported a significant increase in abdominal pain and a worsening of stool consistency. Furthermore, no differences were found between the groups regarding SCL-90 and SF-36 scores. CONCLUSIONS: Our results demonstrate a lack of effect of P1016 in the management of NCGS patients and the possible reintroduction of gluten.

Are the dietary habits of treated individuals with celiac disease adherent to a Mediterranean diet?

BACKGROUND AND AIMS: The only treatment for celiac disease (CD) is strict, lifelong adherence to a gluten-free (GF) diet. To date, there are contrasting data concerning the nutritional adequacy of GF products and diet. There have been no studies that have assessed the adherence of individuals with CD to a Mediterranean diet (MD), a protective dietary regimen against major non-communicable diseases (NCDs). Therefore, we examined the adherence to an MD of a group of Italian individuals with CD and compared it with that of a healthy control group. METHODS AND RESULTS: In a cross-sectional study, a sample of individuals with CD and a group of healthy subjects were included. The dietary habits of all participants were recorded using a validated food frequency questionnaire, and the adherence to an MD was determined using the Italian Mediterranean Index. Typical Mediterranean food consumption was not significantly different between individuals with CD and the healthy participants, except for fruits (P = 0.017). However, individuals with CD consumed significantly higher amounts of potatoes (P = 0.003) and red and processed meat (P = 0.005) than healthy participants. The resulting mean Italian Mediterranean Index was significantly higher in healthy participants than in individuals with CD (P < 0.001). CONCLUSION: The results raise questions concerning the food choices of individuals with CD, suggesting the need of encouraging them to make better food choices more in line with an MD, which would improve their nutritional status and better protect them from NCDs at long term. PROTOCOL REGISTRATION: ClinicalTrials.gov (ID NCT01975155) on November 4 2013.

Plasma oxidative stress biomarkers, nitric oxide and heat shock protein 70 in trained elite soccer players.

The physiological response to the physical exercise involves a number of changes in the oxidative balance and in the metabolism of some important biological molecules, including nitric oxide (NO) and heat shock proteins (Hsp 70). With the aim to optimise previous laboratory diagnostic panels, we measured the plasma concentration of reactive oxygen metabolites (ROMs), total antioxidant status (TAS), glutathione reductase (GR) activity, and NO and Hsp 70 levels in 44 elite, antioxidant-supplemented and trained soccer players and in 15 sedentary controls. Although no statistically significant difference between athletes and controls was detected in the plasma level of ROMs and TAS, soccer players showed a significantly higher plasma GR activity, NO and Hst 70 levels than those of sedentary controls. These findings suggest that the measuring of relatively novel biomarkers in sport medicine, like GR, NO and Hsp 70, in addition to the well-known and reliable assays (d-ROMs test and TAS) may be useful to a clinician to better assess and evaluate the benefits of training and/or supplementation programs.

Early and delayed reproductive death in human cells exposed to high energy iron ion beams.

The aim of this research was to determine the biological effectiveness for early and delayed effects of high energy, high linear energy transfer (LET) charged particles. Survival and delayed reproductive death were measured in AG1522 human fibroblast cells exposed to Fe-ion beams of energies between 0.2 and 1 GeV/n, 0.97 GeV/n Ti-ion and 0.49 GeV/n Si-ion beams. The cells were irradiated at the HIMAC accelerator in Chiba, Japan (0.2 and 0.5 GeV/n Fe and 0.49 GeV/n Si) and at the NASA Space Radiation Laboratory in Brookhaven, USA (1 GeV/n Fe and 0.97 GeV/n Ti ions). The dose-effect curves were measured in the dose range between 0.25 and 2 Gy. For comparison cells were exposed to 60Co gamma rays. Analysis of the dose-effect curves show that all the heavy ion beams induce inactivation and delayed reproductive death more effectively than 60Co gamma rays. The only exception is the 0.2 GeV/n Fe-ion beam at low doses. The progeny of the irradiated cells show delayed damage in the form of reproductive death with all the heavy ion beams with the 1 GeV/n Fe-ion beam being the most effective. The relative biological effectiveness at low doses of the iron beams is highest for LET values between 140 and 200 keV/micrometers with values of 1.6 and 3 for early and delayed reproductive death, respectively. Analysis of the fluence-effect curves shows that the cross-sections for early and delayed inactivation increase with increasing LET up to 442 keV/micrometers.

Differential effectiveness of solar UVB subcomponents in causing cell death, oncogenic transformation and micronucleus induction in human hybrid cells.

PURPOSE: (1). To determine the biological effectiveness of two solar ultraviolet (UVB) spectra with different lower wavelength thresholds for oncogenic transformation and micronucleus induction in CGL1 cells; (2). to investigate whether the action spectra for short- and long-term effects are similar; and (3). to investigate possible links between transformation and other delayed effects. MATERIALS AND METHODS: Two spectra were derived from a solar UV simulator by using two filters: the first transmitted radiation with lambda > 284 nm, the second with lambda > 293 nm. The resulting spectra have the same UVA, but different UVB components (lambda between 284 and 320 nm, 19 W m(-2), and lambda between 293 and 320 nm, 13 W m(-2)). CGL1 cells were irradiated with 466 J m(-2) with lambda > 284 nm and 1582 J m(-2) with lambda > 293 nm. These doses were approximately equilethal. The endpoints examined were oncogenic transformation, and centromere-positive and -negative micronucleus frequencies in the directly irradiated cells and in transtheir progeny. RESULTS: At equilethal doses, the oncogenic transformation frequency in the directly irradiated cells was greater by a factor of at least 7 for lambda > 284 nm irradiation compared with lambda > 293 nm. The micronucleus induction frequency was also significantly higher with the lambda > 284 spectrum. Consistent with our previous findings, no delayed micronucleus formation was found in the progeny of cells exposed to lambda > 293 nm, while a threefold elevation above controls was seen in the progeny of cells exposed to lambda > 284 nm irradiation. This was also the case for formation of micronuclei with a centromere. CONCLUSIONS: It was found that: (1). for equilethal doses the lambda > 284 nm spectrum was more biologically effective than the lambda > 293 nm spectrum for induction of oncogenic transformation and micronucleus formation; and (2). the higher effectiveness of the lambda > 284 nm spectrum found at equilethal doses for delayed effects in the progeny of irradiated cells resembles that found for transformation. The results suggest that the UVB action spectrum for cell killing is different from that of some delayed effects, and from that of transformation.

Multicolor FISH in chronic lymphocytic leukemia. An interphase study of patients with early-onset disease.

Trisomy 12 and deletions of 13q14.2 and 14q32 are the most common chromosome abnormalities in patients with B-chronic lymphocytic leukemia (B-CLL), but whether specific chromosomal defects influence the course of B-CLL is still a matter of discussion. The aim of our study was to assess the possible correlation between cytogenetic findings and clinical characteristics. Thirty patients with previously untreated early-onset B-CLL were recruited. The incidence of trisomy 12, and observations of 13q14.2 and 14q32 was analyzed in unstimulated bone marrow cells by means of multicolor interphase FISH. No correlation was found between trisomy 12 and the patients' clinical characteristics. The analysis of the patients with trisomy 12 and observations of 13q14.2 and 14q32 revealed heterogeneity of the leukemic cell population, thus indicating that these chromosomal abnormalities are probably a secondary event in CLL leukemogenesis. The finding of RB1 gene nullisomy and 14q32 deletions in patients at an advanced clinical stage suggests a possible correlation between these rearrangements and disease progression. Multicolor FISH analysis in B-CLL provides important diagnostic, clinical, and prognostic information that may help in assessing prognosis and making treatment decisions.

Trisomy 4 leading to duplication of a mutated KIT allele in acute myeloid leukemia with mast cell involvement.

A G-->T transversion at nucleotide 2467 of the c-KIT gene leading to Asp816-->Tyr (D816Y) substitution in the phosphotransferase domain has been previously identified in a patient with rapidly progressing AML-M2 and mast cell involvement; the patient's blasts had a 47,XY, +4,t(8;21)(q22;q22) karyotype. Herein we confirm the simultaneous presence of both major chromosomal changes by multicolor fluorescence in situ hybridization (FISH) on interphase CD34+ mononuclear cells. By setting up culture leukemic blasts, spontaneous differentiation of adherent cells with mast-cell like features was proved by histochemical and immunoenzymatic analyses. Fluorescence in situ hybridization evidence of trisomy 4 confirmed the origin of differentiated cells from the leukemic blasts. Semiquantitative polymerase chain reaction (PCR) and phosphoimage densitometry of wild-type and mutated KIT alleles on bone marrow blasts made it possible to demonstrate that chromosome 4 trisomy led to a double dosage of the mutated KIT allele. This finding, and that of trisomy 7 and MET mutation in hereditary renal carcinoma represent the only cases of human tumors in which an increased number of chromosomes carrying an oncogene activated by point mutation have been detected.

GKLF in thymus epithelium as a developmentally regulated element of thymocyte-stroma cross-talk.

Gut-enriched Krüppel-like factor (GKLF) is a transcriptional regulator expressed in differentiated epithelia. We identified GKLF transcript as a regulated element in thymic epithelium of recombinase-deficient mice during thymus development induced by anti-CD3 antibody injection. This treatment recapitulates the organogenetic process depending on productive rearrangement of T cell receptor (TCR) beta gene with thymocytes expansion and acquisition of the CD4+8+ double positive phenotype. In wildtype mice, GKLF is expressed very early in embryogenesis and becomes intensely up-regulated in thymus epithelium at day 18 of gestation when TCR beta expressing cells have selectively expanded and express both CD4 and CD8. The results presented here suggest that thymocytes may regulate GKLF transcriptionally in the cortical epithelium at the developmental check-point controlled by TCR beta gene rearrangement. Furthermore, GKLF expression in hematopoietic stroma might suggest the thus far uncharacterised participation of this factor in hematopoiesis.

A rare chromosome 5 heterochromatic variant derived from insertion of 9qh satellite 3 sequences.

A rare chromosome 5 heterochromatic variant not linked to any clinical sign was identified in a three-generation family. After performing conventional cytogenetics characterization, fluorescence in situ hybridization of D9Z1 indicated that the unusually large qh region of chromosome 5 originated from 9qh, whereas the centromere of the variant chromosome was 5-specific as demonstrated by primed in situ DNA labelling. FISH of probes targeting satellite 3 and beta-satellite sequences of 9qh showed that only satellite 3 sequences were present in the variant 5qh region.

Localization of fos, jun, kit and SCF mRNA in human placenta throughout gestation using in situ RT-PCR.

The expression pattern of c-fos, c-jun, c-kit and stem cell factor (SCF) has been investigated in developing human placenta using the highly sensitive technique of in situ reverse transcriptase-polymerase chain reaction (RT-PCR). Specific transcripts of all genes under study were observed in first-trimester placenta sections. c-fos, c-jun, c-kit and SCF transcripts were localized in cells of the villous stroma; fos, jun and kit-specific mRNAs were also found in endothelial cells; fos, kit and SCF mRNAs were detected in villous trophoblast cells. In mid-trimester and term placenta specimens only SCF transcripts were observed, restricted to trophoblast cells. The lack of c-fos transcripts in placenta from the second and third trimesters is a finding that contrasts with data from the literature obtained using extractive techniques. Parallel immunocytochemistry of placenta specimens from the three pregnancy stages under study revealed the fos protein only in first-trimester placenta, in agreement with the in situ RT-PCR findings. We conclude that the in situ RT-PCR technique is most suitable for gene expression studies because of its high level of sensitivity in correctly assigning the signal to specific cell types in complex tissues.

Characterization of a cytogenetic 17q11.2 deletion in an NF1 patient with a contiguous gene syndrome.

We report on a rare patient screened as a putative carrier of a contiguous gene syndrome on the basis of a complex phenotype characterized by sporadic neurofibromatosis type 1 (NF1), dysmorphism, mental retardation and severe skeletal anomalies. A cytogenetically visible 17q11.2 deletion was detected in the patient's karyotype by high-resolution banding and confirmed by fluorescence in situ hybridization with yeast artificial chromosomes targeting the NF1 region. Analysis of the segregation from parents to proband of 13 polymorphic DNA markers, either contiguous or contained within the NF1 gene, showed that the patient is hemizygous at sites within the NF1 gene-the AAAT-Alu repeat in the 5' region of intron 27b, the CA/GT microsatellite in the 3' region of intron 27b, and the CA/GT microsatellite in intron 38- and at the extragenic D17S798 locus, distal to the 3' end of NF1. The patient may be an important resource in the identification of genes downstream of NF1 that may contribute to some of his extra-NF1 clinical signs.

An improved procedure for in situ RTPCR.

Direct in situ RTPCR has been successfully applied to paraffin-embedded human placental specimens. The expression of stem cell factor (SCF) mRNA visualized in cytotrophoblast and stromal cells is validated by the lack of any specific signal in parallel specimens where reverse transcription is omitted.

Expression pattern of c-sis, c-fos and c-jun in human placenta and embryofetal organs.

The expression pattern of c-sis, c-fos and c-jun was investigated in placenta and embryofetal organ specimens from the first trimester. Northern analysis of the placentae showed c-sis transcripts and c-fos expression. Northern analysis of the same genes in embryofetal organs pointed to the brain as the only organ where consistent transcriptional activity could be observed. RT-PCR analysis of c-fos and c-jun in placentae, staged at four different time periods in pregnancy, allowed to detect the expected fragments in all cases. The same was true when c-fos and c-jun were analyzed at the 13th week of gestation in all the embryofetal organs.

High spontaneous chromosomal damage in lymphocytes from patients with hereditary megaduodenum.

Chromosomal aberration and micronucleus assays were used to investigate the extent of cytogenetic damage in peripheral blood lymphocytes from four patients in two unrelated families with hereditary megaduodenum. The frequencies of total chromosomal aberrations, which significantly correlated with those of micronuclei, were higher in the patients than in sex- and age-matched controls, with no overlapping between the two groups. The considerable chromosomal fragility in patients with hereditary megaduodenum may be a genotypic marker for preclinical diagnosis predictive of increased cancer risk.

Identification of chromosomal rearrangements in the human myeloid leukemia cell line GF-D8 by dual-colour fluorescence in situ hybridization.

Fluorescence In Situ Hybridization (FISH) studies with chromosome-specific libraries and repetitive probes were performed on the human acute myeloid leukemia cell line GF-D8 in order to define the complex chromosomal rearrangements observed by conventional cytogenetic analysis. Two-colour FISH with whole chromosome painting probes 8 and 11 showed that the add(8) chromosome had an 11-derived region inserted at q24, whereas the add(11) chromosome had an 8-derived region translocated onto q23. It also demonstrated that no normal chromosome 11 is present in GF-D8 cells, since a translocation involving chromosomes 11 and 17q was detected in addition to the add(11). The der(7) chromosome with extra material in its long arm, identified by QFQ and GTG banding, turned out to have a chromosome 15-derived segment translocated to q22. The deletion of 7q was proved to be interstitial, as the 7q-specific telomere as well as a tiny 7-specific band were observed on an unknown chromosome. Fine mapping of the breakpoints involved in the multiple chromosomal rearrangements of the GF-D8 cell line might provide insights into the mechanisms of myeloid leukaemogenesis.

Three-way and two-way rearrangements involving chromosomes 10, 2, 5 and 5, 2 in two marker chromosomes of a human melanoma cell line.

Two marker chromosomes (mar1 and mar2), provided with two closely spaced heterochromatic bands, were observed in the 14932 cell line established from a human metastatic melanoma. Fluorescence in situ hybridization (FISH) with the alphoid sequence p82H common to all human centromeres showed strong signals over the double C-bands of mar1 and mar2. These were recognized by a chromosome 2-specific alphoid probe, although chromosome in situ suppression (CISS) hybridization with a chromosome 2 library failed to reveal any painting along mar1 and mar2. The centromere of mar1 was identified by a chromosome 10-specific alphoid sequence and the marker chromosome was decorated from pter to a region proximal to the interpolated C-band by a chromosome 10 library. The centromere of mar2 could not be recognized by any chromosome-specific alphoid probe, but the whole mar2 was decorated by a chromosome 5 library. This library also painted the distal q arm of mar1, which was not painted by the chromosome 10 library, as well as a small band proximal to the double C-band. Identification of the two marker chromosomes reveals their common origin and indicates a role for chromosomes 2, 5 and 10 in the genesis and/or progression of the 14932 melanoma. Alteration to the chromosome-specific alphoid sequence in the centromere of mar2 provides evidence for rearrangement of constitutive heterochromatin alphoid sequences in human tumours.

Expression of the c-ski proto-oncogene in human melanoma cell lines.

The aim of this study was to establish whether the expression of proto-oncogene c-ski in melanoma might be related to alterations of chromosome 1q involving the native location of the gene. Six melanoma cell lines, including two carrying marker chromosomes derived from breakage at 1q12-q21, were studied. Expression of c-ski was observed in all cell lines, with very high levels in five of them. However no alteration in c-ski structure or dosage was found in any of the melanoma cell lines, including those with non-random breakpoints near the gene. c-ski Transcripts were detected in cell cultures from normal melanocytes, but at a much lower level than that observed in melanoma cell lines. Transcripts of c-myb and the beta-NGF gene were not detectable in any of the melanoma cell lines, whereas sis- and epidermal growth factor (EGF) receptor gene-specific transcripts were present in two and four melanoma cell lines, respectively. The constant expression of c-ski in the melanoma-derived cell lines at a level of expression much higher than that of normal melanocytes suggests that this proto-oncogene may play a role in melanocyte transformation.

Prenatal diagnosis of an extranumerary i(22p) with normal phenotype.

A DA-Dapi and AgNOR-negative extranumerary chromosome was identified prenatally in a male fetus and also found in his normal father. Fluorescence in situ hybridization using repetitive DNA probes showed that the minute marker was positive at both ends for beta-satellite sequences, while its centromere was recognized by a 22 alphoid probe. It is concluded that the non-mosaic familial marker represents a 22p isochromosome.

Different phenotypes in two cases of an apparently identical familial (Yq;13p) translocation.

A chromosome 13 with extra material on the short arm was observed in a 17-year-old boy showing defects in skeletal growth, an altered hormone profile and asthenoteratozoospermia, and in a 46 XX fetus subjected to prenatal diagnosis. The abnormal chromosome 13 had been transmitted from phenotypically normal parents who were the mother (case 1) and the father (case 2). The extra material on the abnormal chromosome 13 was brightly fluorescent after Q-banding, and positive in C-banding (CBG) and distamycin A-Dapi (DA-Dapi) banding. Staining of the nucleolus organizer region indicated its retention. In-situ hybridization of a Yq-specific repetitive DNA probe to chromosomal spreads from both cases demonstrated that the der(13) chromosome contains sequences of the Yq heterochromatic region. However, the apparently identical unbalanced (Y;13) translocation may either interfere (case 1) or not (father of case 2) with meiotic or postmeiotic sperm cell development.

Loss of Y chromosome with retention of Y heterochromatin in a marker chromosome from a human melanoma.

A single copy of a der 15 chromosome (m3) characterized by a C- and distamycin A-Dapi-positive region was observed in the -Y hyperploid karyotype of a primary human melanoma (Me 1402). The heterochromatic region was located pericentromerically, adjacent at one end to the NOR region of chromosome 15, and at the other to an unclassifiable chromosomal piece. We established that the C-positive block in the marker chromosome originated from Y heterochromatin by high-stringency in situ hybridization with a DNA probe for the 2.1 Hae III Y-specific repeat. Loss of the Y chromosome in tumors has been considered to be a secondary event associated with malignant evolution. It is significant that Me 1402 cells, which are highly malignant, lack the Y chromosome, but retain its heterochromatic portion in the rearranged m3 chromosome.