Enzyme replacement with transferrin receptor-targeted α-L-iduronidase rescues brain pathology in mucopolysaccharidosis I mice.

Mucopolysaccharidosis I (MPS I), a lysosomal storage disease caused by dysfunction of α-L-iduronidase (IDUA), is characterized by the deposition of dermatan sulfate (DS) and heparan sulfate (HS) throughout the body, which causes several somatic and central nervous symptoms. Although enzyme-replacement therapy (ERT) is currently available to treat MPS I, it does not alleviate central nervous disorders, as it cannot penetrate the blood-brain barrier. Here we evaluate the brain delivery, efficacy, and safety of JR-171, a fusion protein comprising humanized anti-human transferrin receptor antibody Fab and IDUA, using monkeys and MPS I mice. Intravenously administered JR-171 was distributed in major organs, including the brain, and reduced DS and HS concentrations in the central nervous system and peripheral tissues. JR-171 exerted similar effects on peripheral disorders similar to conventional ERT and further reversed brain pathology in MPS I mice. We found that JR-171 improved spatial learning ability, which was seen to deteriorate in the vehicle-treated mice. Further, no safety concerns were noted in repeat-dose toxicity studies in monkeys. This study provides nonclinical evidence that JR-171 might potentially prevent and even improve disease conditions in patients with neuronopathic MPS I without serious safety concerns.

Phase Separation and Collection of Annular Flow by Phase Transformation.

A polyethylene glycol/citrate mixed solution was fed into a single channel of a Y-type micro-channel on a microchip as an aqueous two-phase system. A phase separation multi-phase flow with a liquid-liquid interface was generated due to a phase transformation. An annular flow, one of the flow types in the phase separation multi-phase flow, was observed through bright-field microscopy. The flow consisted of citrate-rich inner and polyethylene glycol-rich outer phases. We attempted to separate and collect the two phases in the single channel into two separate Y-type channels. When the pressure losses for the separated channels were not very different, we observed symmetric flow in the Y-type channel. When the pressure losses were quite different, the polyethylene glycol-rich phase with higher viscosity was selectively distributed to the separated channel with lower pressure loss. Thus, the polyethylene glycol-rich phase was successfully and intentionally collected from the chosen Y-type channel via the creation of annular flow in the single channel.

High Titer of Acquired Factor V Inhibitor Presenting with a Pseudo-deficiency of Multiple Coagulation Factors.

Acquired coagulation factor inhibitor is a rare coagulation disorder. We herein report a patient with acquired factor V inhibitor showing a decrease in multiple coagulation factor activities. A high titer of factor V inhibitor presumably led to a marked inhibition of factor V activity in the specific factor-deficient plasma used in coagulation factor activity assays based on either an activated partial thromboplastin time (APTT) or prothrombin time (PT) clotting assay, resulting in false low values of the coagulation activity. We re-examined the coagulation factor activity using several dilutions of the patient's plasma and confirmed that the high factor V inhibitor titer had caused an apparent decrease in multiple coagulation factor activities.

Acute compartment syndrome as the initial manifestation of chronic-phase chronic myeloid leukemia: a case report and review of the literature.

BACKGROUND: Acute compartment syndrome is an orthopedic emergency requiring urgent fasciotomy to prevent irreversible damage. In hematological malignancies, acute compartment syndrome caused by severe soft tissue bleeding is extremely rare. We present a patient with chronic-phase chronic myeloid leukemia who had acute compartment syndrome caused by severe soft tissue bleeding in her right forearm. CASE PRESENTATION: A 72-year-old Japanese woman was referred to our hospital with swelling and pain of her right forearm without a previous history of trauma. She was diagnosed with chronic-phase chronic myeloid leukemia. Extreme thrombocytosis was present, although no evidence of acquired von Willebrand disorder was found. Compartment syndrome caused by soft tissue bleeding was confirmed. An emergency fasciotomy for decompression was conducted. However, sustained postoperative bleeding occurred and required massive red cell concentrate transfusion. As her platelet count decreased by cytoreductive therapy, complete hemostasis was achieved. CONCLUSIONS: Patients with an extremely high platelet count might be at high risk for severe bleeding complications even without acquired von Willebrand disease. For the control of severe bleeding complications in patients with myeloproliferative disorder, the importance of thrombocyte reduction should be recognized.

Structural and mutational analysis of amino acid residues involved in ATP specificity of Escherichia coli acetate kinase.

Acetate kinase (AK) generally utilizes ATP as a phosphoryl donor, but AK from Entamoeba histolytica (PPi-ehiAK) uses pyrophosphate (PPi), not ATP, and is PPi-specific. The determinants of the phosphoryl donor specificity are unknown. Here, we inferred 5 candidate amino acid residues associated with this specificity, based on structural information. Each candidate residue in Escherichia coli ATP-specific AK (ATP-ecoAK), which is unable to use PPi, was substituted with the respective PPi-ehiAK amino acid residue. Each variant ATP-ecoAK had an increased Km for ATP, indicating that the 5 residues are the determinants for the specificity to ATP in ATP-ecoAK. Moreover, Asn-337 of ATP-ecoAK was shown to be particularly significant for the specificity to ATP. The 5 residues are highly conserved in 2625 PPi-ehiAK homologs, implying that almost all organisms have ATP-dependent, rather than PPi-dependent, AK.

Conferring the ability to utilize inorganic polyphosphate on ATP-specific NAD kinase.

NAD kinase (NADK) is a crucial enzyme for production of NADP⁺. ATP-specific NADK prefers ATP to inorganic polyphosphate [poly(P)] as a phosphoryl donor, whereas poly(P)/ATP-NADK utilizes both ATP and poly(P), and is employed in industrial mass production of NADP⁺. Poly(P)/ATP-NADKs are distributed throughout Gram-positive bacteria and Archaea, whereas ATP-specific NADKs are found in Gram-negative α- and γ-proteobacteria and eukaryotes. In this study, we succeeded in conferring the ability to utilize poly(P) on γ-proteobacterial ATP-specific NADKs through a single amino-acid substitution; the substituted amino-acid residue is therefore important in determining the phosphoryl-donor specificity of γ-proteobacterial NADKs. We also demonstrate that a poly(P)/ATP-NADK created through this method is suitable for the poly(P)-dependent mass production of NADP⁺. Moreover, based on our results, we provide insight into the evolution of bacterial NADKs, in particular, how NADKs evolved from poly(P)/ATP-NADKs into ATP-specific NADKs.

Potent suppressive activity of fresh and dried peels from Satsuma mandarin Citrus unshiu (Marcorv.) on hydroperoxide generation from oxidized linoleic acid.

The effects of various extracts prepared from fresh and dried peels of Satsuma mandarin (Citrus unshiu Marcov.) on hydroperoxide generation from oxidized linoleic acid were compared under different extraction conditions. The cold-and hot-water extracts of fresh peels showed significant suppressive activity against hydroperoxide generation in a dose-dependent manner. However, the methanol or acetone extract of fresh peels did not exhibit significant suppressive effects. The commercially available ascorbic acids equivalent to their concentrations in the water extracts of fresh peels showed roughly equal antioxidative activities compared with those of the water extracts of fresh peels. Although the cold- and hot- water extracts of dried peels indicated a considerable reduction of ascorbic acid concentration, they exhibited much higher antioxidative activities than those of the fresh peels. The methanol extract of dried peels also showed significant antioxidative activities, but did not contain significant ascorbic acid. These results suggest that the fresh peels of Satsuma mandarin have potential antioxidant activities, and the drying treatment of fresh peels caused an enhancement of the antioxidant activity. The pharmacological significance of this finding is discussed.