NS5A mutations predict biochemical but not virological response to interferon-alpha treatment of sporadic hepatitis C virus infection in European patients.

The NS5A region of the hepatitis C virus (HCV) genome has been reported by Japanese but not European investigators to be a significant factor in predicting interferon (IFN) response patients with HCV of genotype 1. We correlated the NS5A region with treatment outcome in patients with sporadic HCV infection. Twenty-eight patients (10 men, 18 women, mean age 60 +/- 2 years) with histologically proven HCV chronic hepatitis, genotype 1b, were treated with 6 MU IFN-alpha for 6 months. The 6954-7073 area of the NS5A region was directly sequenced for nucleotide and amino acids mutations and the results were related to biochemical and virological response. None of the patients had a strain with nucleotide sequence identical to the Japanese HCV-J. However, in five strains the nucleotide mutations led to synonymous amino acids and the amino acid sequences were identical to the prototype Japanese strain. Only 2/28 patients had four or more amino acid mutations (mutant strains) while 21 demonstrated an intermediate type and five belonged to the wild-type. The most frequent non-synonymous substitution was at position 6982 (A-->G) corresponding to an amino acid change at codon 2218 (His-->Arg). All patients with the wild-type were biochemical nonresponders while the two patients with the mutant strains had a sustained biochemical response. Twenty-three percent of the intermediate type had a sustained biochemical response. NS5A mutations predict the biochemical but not the virological response of patients. Virological response was poor and unrelated to the type of HCV strain. Biochemical responders had significantly lower amino acid mutations (1.14 +/- 0.19) compared with nonresponders (2.57 +/- 1.4, P < 0.003) as well as lower aminotransferase values (P < 0.01). Hence, mutational analysis of the NS5A region showed that our patients have a mutational profile similar to the European studies with a wild-type that is slightly different from the Japanese HCV-J sequence. The biochemical, but not the virological response to IFN-alpha is similar to the Japanese studies, with no response of the patients with wild-type sequence, a good response in the limited number of patients with mutant strains and 23% response rate in the patients with intermediate type sequences.

High-throughput methods for detection of genetic variation.

Understanding human genetic variation is currently believed to reveal the cause of individual susceptibility to disease and the large variation observed in response to treatment. In this review, we will focus on different approaches to identify and visualize genetic alterations. The various approaches for allele discrimination are formally systematically divided into (i) enzymatic approaches, in which the properties of different enzymes to discriminate between nucleotides are used (restriction enzymes type II, Cleavase and Resolvase, DNA polymerase, and ligase); (ii) electrophoretic methods, in which the allele discrimination is based on the difference in mobility in polymeric gels or capillaries (single- and double-stranded conformation assays, heteroduplex analysis, and DNA sequencing); (iii) solid-phase determination of allelic variants, including high-density oligonucleotide arrays for hybridization analysis, minisequencing primer extension analysis, and fiberoptic DNA sensor array; (iv) chromatographic methods such as denaturing high-performance liquid chromatography (DHPLC); (v) other physical methods of discrimination of allelic variants such as mass spectrometry (mass and charge) or fluorescence exchange-based techniques; and (vi) in silico methods such as high-throughput analysis of expressed sequence tag data. The most frequently used techniques and instrumental settings applied in different combinations are described, and other methods that are less broadly used but have interesting potentials are discussed.

Kinetics of PAF transfer, distribution and metabolism in human blood in vitro.

The transfer kinetics of PAF (0.1-100 nM), deposited as a thin film on a plastic surface, to human blood were studied under conditions of physiological significance. Almost all (83-87%) available PAF was solubilized in two waves. Initially, 40-50% of the available PAF was transferred to blood very fast in less than 15 seconds while the rest, 30-45%, obeyed first order kinetics, 0.0226 < k(app) < 0.0319 sec(-1). Blood cells following a parallel to whole blood binding time course bound 20-25% of the solubilized PAF. Dilution of blood up to 1:9 with 0.15M NaCl did not affect PAF transfer parameters favouring an aqueous phase diffusion mechanism. Blood-bound PAF was allocated mainly to plasma, 67 +/- 4%, erythrocytes, 18 +/- 1% and platelets, 5 +/- 1%. These data indicated the role of the high affinity binding sites in human platelets versus the low affinity binding by erythrocytes, although the latter, due to their number, dominated cell bound PAF. Even at 100 nM there were no saturation signs for the transfer of PAF to blood or blood cells. PAF hydrolysis did not affect its binding to the blood elements. Given infinite time only 62 +/- 1% of the blood bound PAF would be metabolised by the rather slow acting, 11.5 > t(1/2) > 6.5 min, PAF-acetylhydrolase.

PGF2alpha-induced signaling events in glomerular mesangial cells.

Of the various arachidonate cyclooxygenation eicosanoids synthesized in the normal and injured renal glomerular capillary, prostaglandin F2alpha (PGF2alpha) is the most abundant and potent in eliciting signaling events and biologic responses including contraction and proliferation of glomerular capillary pericytes known as mesangial cells. The regulation of PGF2alpha-induced signaling in these cells is unknown. The present studies assessed two key signaling events in response to PGF2alpha in mesangial cells; activation of phospholipase C (PLC) and protein kinase C (PKC). Mechanisms regulating PLC activation were also explored. Incubation of cultured growth arrested rat mesangial cells with PGF2alpha (1 microM) resulted in activation of a phosphatidyl inositol-specific phospholipase C (PI-PLC) assessed as increased generation of polyphosphates in myo-[3H]-inositol-labeled cells and as increased diacylglycerol (DAG) mass levels measured by a radioenzymatic assay. Generation of both inositol 1,4,5-trisphosphate and inositol 1,3,4-trisphosphate occurred, the former constituting 70% of total inositol trisphosphates. Enhanced generation of inositol 1,4-bisphosphate (IP2) also occurred and was greater than that of inositol 1,4,5-trisphosphate (IP3), indicating that PI-PLC utilized the phosphatidyl inositol monophosphate (PIP) to a greater extent than the phosphatidyl inositol bisphosphate (PIP2) substrate. Generation of DAG in response to PGF2alpha occurred in a biphasic pattern characterized by an early transient rise that peaked concomitantly with IP3 at 15 sec, and a late sustained increase at 2, 5, and 15 min that was not associated with an increase in IP3. PGF2alpha also activated PKC assessed as translocation of enzyme activity from cytosolic to membrane fractions. Inhibition of PKC using H-7 enhanced PGF2alpha-induced generation of IP3 at 15 sec but attenuated generation of DAG at 15 min. A more selective PKC inhibitor, Calphostin C, dose-dependently increased basal IP3 generation and also attenuated generation of DAG in response to PGF2alpha. This indicates that PKC negatively modulates PGF2alpha-induced PI-PLC activation, and that the late sustained DAG generation in response to PGF2alpha is regulated by a PKC-dependent phospholipase other than PLC. The mechanisms of PI-PLC stimulation in response to PGF2alpha were further explored using inhibitors of protein tyrosine phosphorylation and of guanine nucleotide-binding (G) protein activation. Inhibition of protein tyrosine phosphorylation using genistein had no effect on IP3 or DAG generation. ADP ribosylation of Gi using pertussis toxin (PTx) had no effect on IP3 generation in response to PGF2alpha. The inhibitor of receptor-coupled PI-PLC activation aminosteroid compound U-73122 that blocks G(PLC) was also ineffective. The observations indicate that PGF2alpha stimulates a PI-PLC which is under negative feedback regulatory control by PKC, and a phospholipase other than PLC which is under positive regulatory control by PKC. PGF2alpha-induced PI-PLC activation is independent of protein tyrosine phosphorylation and of PTx-sensitive G proteins.

Eicosanoid-induced growth and signaling events in rat glomerular mesangial cells.

Renal glomerular injury frequently results in proliferation of a specialized supporting cell of the glomerular capillary known as the mesangial cell. In various forms of renal injury there is enhanced glomerular synthesis of specific eicosanoids of the arachidonic cyclooxygenase and lipoxygenase pathways including prostaglandin (PG) F2 alpha, thromboxane (Tx) A2, the hydroxyeicosatetraenoic acids 12-HETE and 5-HETE, and the leukotrienes LTB4 and LTD4 and attempts have been made to link these eicosanoids with injury-induced mesangial cell growth. In this study, the growth promoting effect of these eicosanoids on glomerular mesangial cells was correlated with activation of two growth regulatory enzymes: phospholipase C (PLC) and protein kinase C (PKC). PGF2 alpha, and TxA2 endoperoxide analog U-46619, and LTD4 significantly enhanced DNA synthesis [(as assessed by [3H]thymidine (TdR) incorporation)] in relatively quiescent (0.5% serum) mesangial cells, activated PLC [as assessed by increased 1,4,5-inositol tris-phosphate (IP3) generation and diacylglycerol (DAG) synthesis], and activated PKC (as assessed by translocation of the enzyme activity from the cytosol to the membrane). The effect of PGF2 alpha on IP3 generation was not blocked by the TxA2 receptor antagonist, SQ-29,548. PGF2 alpha was the most effective eicosanoid in inducing all three events, and concentrations that enhanced TdR incorporation (1 microM) also activated PLC and PKC. In contrast, concentrations of U-46619 and LTD4 which enhanced TdR incorporation (1 microM), also activated PLC, but were insufficient to also activate PKC. Our observations indicate that the growth-promoting effect of PGF2 alpha, U-46619, and LTD4 can best be correlated with PLC activation. In addition, PGF2 alpha does not mediate PLC activation through binding to the TxA2 receptor.

Modulatory effects of eicosanoids on mesangial cell growth in response to immune injury.

In a rat model of glomerular mesangial cell immune injury induced by a monoclonal antibody (ER4) against the mesangial cell membrane antigen Thy 1.1 and in which mesangial cell proliferation is a prominent feature, we examined the role of arachidonate 5- and 12-lipoxygenation (LO) eicosanoids and of thromboxane (Tx) in modulating the proliferative response. Significant increments in glomerular cell proliferation, assessed by counting glomerular cells positive for the Proliferating Cell Nuclear Antigen (PCNA) and by the incorporation of [3H]thymidine ([3H]TdR) in mesangial cell outgrowths from explanted glomeruli, occurred during the mesangioproliferative phase of injury. This event was abrogated in animals depleted of leukocytes or platelets prior to administration of ER4 and in animals pretreated with the arachidonate 5-LO inhibitor MK886. Pretreatment with the Tx synthase inhibitor, Furegrelate, or the arachidonate 12-LO inhibitor, Baicalein, had no effect, indicating that eicosanoids of arachidonate 5-LO but not those of 12-LO or Tx modulate mesangial cell proliferation following immune injury. We further identified those 5-lipoxygenation eicosanoids with growth modulatory effects on cultured mesangial cells. Leukotriene (LT)C4 and D4 but not LTB4 or 5-hydroxyeicosatetraenoic (HETE) acid enhanced [3H]TdR incorporation in growth-arrested mesangial cells. This effect of LTC4 and LTD4 was abrogated by the specific protein kinase C (PKC) inhibitor calphostin C, indicating a PKC-dependent mechanism. LTC4 and LTD4 but not 5-HETE or LTB4 also increased mesangial cell mass levels of the endogenous PKC activator diacylglycerol. The observations indicate that leukocyte-derived arachidonate 5-LO eicosanoids modulate mesangial cell proliferation following immune injury. Of these LTC4 and LTD4 are the likely candidates as they promote mesangial cell growth via a PKC-dependent mechanisms.

In vivo responses of mouse blood cells to platelet-activating factor (PAF): role of the mediators of anaphylaxis.

Intravenous injection of platelet-activating factor (PAF) (0.36 mumol/kg b.w.) in mice induced severe hemoconcentration, leucopenia, thrombocytopenia and finally the death of 85% of the tested animals. Combined inhibition of histamine and serotonin by promethazine and chlorpromazine, 6.24 and 3.12 mg/kg b.w. subcutaneously, protected the mice from PAF in part, reducing the death rate to 43%. These drugs did not protect the mice against the PAF-induced hemoconcentration, leucopenia and thrombocytopenia. Sulfinpyrazone (100 mg/kg b.w.) intravenously was the most effective both in protecting mice from PAF-induced death, reducing the death rate to 17%, and from thrombocytopenia, although hemoconcentration persisted. These results indicated that an important component of the PAF-induced systemic effects is mediated by reactions which can be inhibited by sulfinpyrazone. Furthermore, PAF-induced thrombocytopenia is not a direct PAF effect since it can be inhibited by sulfinpyrazone.

Study of digoxin as inhibitor of the in vivo effects of acetyl glyceryl ether phosphorylcholine (AGEPC) in mice.

Acetyl glyceryl ether phosphorylcholine (AGEPC) and the cardiac glycoside digoxin were administered intravenously through the tail vein into ether-anesthetized SWR mice (two months old). The administered doses were 0.18 nmol AGEPC/g b.w. (a lethal one) and 75 or 125 ng digoxin/b.w. Digoxin ameliorates the effects of the lethal dose of AGEPC showing maximum activity when given 5 or 10 min after AGEPC administration to female and male animals respectively. Digoxin shows also a protective action towards the effects of AGEPC and maximum activity appears when it is given 10 min before AGEPC administration. In agreement with the picture of increased survival in digoxin pretreated animals, are our findings on life prolongation of mice which finally die from AGEPC, the amelioration of the expected fall in blood platelet counts after AGEPC administration as well as the improved performance of the animals in a series of physical tests.