Correlation of HPV16 L1 capsid protein expression in cervical dysplasia with HPV16 DNA concentration, HPV16 E6*I mRNA and histologic outcome.

OBJECTIVE: To determine whether the absence ofHPV1i6 LI capsid protein is a prognostic parameter for the histologic outcome of cervical intraepithelial neoplasia (CIN) 2+ in cytologically diagnosed cervical dysplasia. STUDY DESIGN: Papanicolaou-stained microscopic slides of 95 HPV16-positive cervical samples that had a cytologic diagnosis of cervical dysplasia or borderline cytology were immunostained using an HPV16-specific anti-L1 viral capsid antibody. In parallel to the cytologic examination, HPV16 DNA and E6*I mRNA were quantitated using real-time polymerase chain reaction. Expression of L1 protein was correlated with relative levels of HPV16 DNA and E6*I mRNA as well as histologic diagnoses/cytologic follow-up. RESULTS: Thirty-five cases with a histologic diagnosis of CIN 2+ (61%) were negative for HPV16 L1 protein; 22 (39%) were positive. Of the cases that either were CIN 1 or regressed to normal cytology, 10 cases (26%) were positive for HPV16 L1 protein, while 28 (74%) were negative. L1-negative and L1-positive cases showed no statistically significant difference (p = 0.22) in their histologic diagnosis/cytologic follow-up. The positive predictive value for CIN 2+ was 56% if L1 protein was absent; the negative predictivre value for CIN 1/regression to normal cytology was 31% if L1 protein was present. HPV16 Ll-positive cases had significantly higher HPV16 DNA concentrations than L1-negative cases (p < 0.001), while levels of HPV16 E6*I mRNA were comparable in both types of cases (p = 0.36). CONCLUSION: The expression of HPV16 L1 capsid protein is correlated with viral DNA load but does not predict the histologic outcome of HPV16-positive cervical dysplasia.

Brain aluminum, magnesium and phosphorus contents of control and Alzheimer-diseased patients.

A study was undertaken to determine Al, Mg and P concentrations in 5 different brain regions of 3 control and 3 Alzheimer-diseased patients. One of the aims of this work was to evaluate the performance of applied analytical techniques. The digested samples were analyzed by inductively coupled plasma atomic emission spectrometry for Al, Mg and P. The dried samples were measured by instrumental neutron activation analysis for Al and Mg. The determination of human brain Al levels is complicated by the interfering reaction of P. We have previously worked out an analytical method which can eliminate this interference. The accuracy of the measured data was investigated by the analysis of biological standard reference materials. Our second goal was to study the possible elemental concentration changes in Alzheimer-diseased patients. Significantly higher Al and lower Mg and P values were found in some AD brain regions compared to the controls.

Rapid second-tier molecular genetic analysis for congenital adrenal hyperplasia attributable to steroid 21-hydroxylase deficiency.

BACKGROUND: Neonatal screening for steroid 21-hydroxylase (CYP21) deficiency is performed to identify congenital adrenal hyperplasia (CAH). The immunologic assay for 17alpha-hydroxyprogesterone (17-OHP) has a high rate of false positives. We assessed the potential for increasing the specificity for CAH by use of a second step involving analysis of the CYP21 gene. METHODS: Between January 1999 and December 2003, a total of 810,000 newborns were screened. Of these, 7920 had to be retested because their 17-OHP values were above the cutoff of the assay. Sixty-one had positive 17-OHP values in their recall samples and were diagnosed as having CAH. We used a rapid assay for common mutations of the CYP21 gene to analyze these 61 samples. In a prospective study, 198 consecutive samples that had increased 17-OHP and 100 samples that had normal 17-OHP concentrations were genotyped. RESULTS: Fifty-nine of 61 cases diagnosed as having CAH were confirmed genetically as CYP21 deficiencies. One patient had a 3beta-hydroxysteroid dehydrogenase deficiency, and one patient carried no CYP21 mutations. The 198 increased 17-OHP results were designated as false positives after immunologic testing of recall samples. None of these samples exhibited the genetic pattern consistent with CYP21 deficiency. CONCLUSIONS: If samples with increased 17-OHP values were screened genetically, the number of retests would decrease by approximately 90%, but the overall sensitivity of CAH screening would remain the same. Adding a second-tier genetic step would require a modest increase in costs, but is counterbalanced by fewer recalls, less clinical follow-up, and a reduction in unnecessary worry for families.

Type-specific detection of human papillomaviruses in a routine laboratory setting--improved sensitivity and specificity of PCR and sequence analysis compared to direct hybridisation.

Human papillomaviruses (HPV) are known to cause cervical dysplasia and cervical carcinoma. We used a 3-step PCR protocol that allows rapid type-specific HPV testing in a routine laboratory setting: HPV-16-positive samples were determined using a specific LightCycler PCR; HPV-16-negative samples were amplified by nested PCR and typed by sequence analysis. During a period of 7 months, 1275 PCR-based HPV tests were performed. Of the 1275 samples, 829 samples tested negative for HPV and 446 tested positive, including 124 positives found in the initial HPV-16-specific LightCycler assay. Sequence analysis of 132 samples detected 18 HPV types that are not included in the widely used Hybrid Capture II assay. For comparison, the first 100 cervical specimens were tested in parallel using PCR and direct hybridisation (Hybrid Capture II assay). PCR detected HPV DNA in 23 samples that tested negative in the Hybrid Capture assay. Four out of 37 samples that tested positive for HPV in the Hybrid Capture test may be false positives, because sequence analysis detected HPV types not included in the probe mixtures. As rare and novel HPV types may also confer an oncogenic risk, highly sensitive and specific PCR assays will help in understanding cervical HPV infection and cervical cancer of unknown causes.