Does the p75 neurotrophin receptor mediate A beta-induced toxicity in Alzheimer's disease?

Alzheimer's disease is characterized by the over-production and accumulation of amyloidogenic A beta peptide, which can induce cell death in vitro. It has been suggested that the death signal could be transduced by the pan neurotrophin receptor (p75NTR). p75NTR is well known for its ability to mediate neuronal death in neurodegenerative conditions and is inextricably linked with changes that occur in Alzheimer's disease. Moreover, A beta binds to p75NTR, activating signalling cascades. However, the complexity of p75NTR-mediated signalling, which does not always promote cell death, leaves open the possibly of A beta promoting death via an alternative signalling pathway or the regulation of other p75NTR-mediated actions. This review focuses on the interactions between A beta and p75NTR in the context of the broader p75NTR signalling field, and offers alternative explanations for how p75NTR might contribute to the aetiology of Alzheimer's disease.

Choroidal osteoma: evidence of progression and decalcification over 20 years

Choroidal osteoma is a rare, benign, ossifying tumour of the choroid of unknown aetiology. In contrast to other types of intraocular ossification, choroidal osteoma is found typically in young healthy females in the second or third decades of life with no history of systemic or ocular disease. Choroidal osteoma is a deep, pale yellow lesion with distinct geographic borders at the juxtapapillary or macular region, with branching 'spider' vessels on the surface of the tumour. These features should help differentiate choroidal osteoma from other types of intraocular tumour and the diagnosis can be confirmed with ultrasonography and computerised tomography. Here we report an initially unilateral case of choroidal osteoma, which decalcified over 20 years but during the same period the fellow eye also developed a choroidal osteoma to become a bilateral case. Despite the benign nature of the tumour, vision may be compromised by gradual atrophy of the overlying retina, serous retinal detachment, accumulation of sub-retinal fluid and sub-retinal haemorrhage associated with choroidal neovascularisation. Frequent examinations are recommended for patients with choroidal osteoma, for early detection of a subretinal neovascular membrane and potential treatment with laser photocoagulation.

Dietary and nutritional aspects of tooth wear

There is a general perception that the problem of tooth wear is increasing due to elements of the modern diet and due to increased retention of dentition into older age. Tooth wear encompasses erosion, abrasion and attrition of dental tissues – these often co-exist – yet in general, erosion is of more significance to the young and attrition is of more significance to the older population. Diet plays a significant role in the aetiology of tooth wear and likewise advanced tooth wear in older age may impose dietary restrictions with consequences for dietary intake and nutritional status. There is a need to increase the awareness of the disease of tooth wear and the associated nutritional problems. At present, the aetiology of tooth wear is poorly understood – especially with respect to the role of diet. Clearer information on how best to measure and monitor the incidence and prevalence is needed in order to obtain longitudinal data on trends in tooth wear and to monitor the factors that contribute to this condition. These issues will be addressed in the following presentations: 1) What is tooth wear? Aetiology, measurement and monitoring, 2) The role of diet in the aetiology of dental erosion, 3) Groups at increased risk of tooth wear: Eating disorders, ‘dieters' sportsmen and those with impairments, 4) Tooth wear in older adults: nutritional implications. In summary this symposium seeks to: 1) increase awareness of the disease of tooth wear, and its associated nutritional problems 2) increase understanding of the aetiology of tooth wear, especially the dietary role, 3) provide information on how to measure and monitor tooth wear, 4) highlight future research requirements in the area of tooth wear and diet.

AVALIAÇÃO DE SINTOMAS DEPRESSIVOS E DA QUALIDADE DE VIDA EM PACIENTES COM SÍNDROME FIBROMIÁLGICA

Fibromialgia é uma síndrome de etiologia desconhecida com dor difusa, generalizada e crônica. O diagnóstico da fibromialgia deve ser feito de acordo com o critério do American College of Rheumatology (ACR) 1990. O paciente deve apresentar dor difusa por mais de três meses e relatar dor à palpação em pelo menos 11 de 18 pontos sensíveis, chamados de tender points , caracaterizando assim a síndrome. A maioria dos pacientes acometidos são mulheres, e o pico de incidência etária na ocasião do diagnóstico está entre 40 e 50 anos. A dor crônica promove um impacto na qualidade de vida dessas pessoas, diminuindo sua auto-estima, isolando-as do convívio social e fazendo com que percam o controle dos seus pensamentos e sentimentos. Sintomas depressivos podem ser o resultado da disfunção orgânica, associada às condições de limitação das atividades diárias.Este estudo tem como objetivo investigar a presença dos sintomas depressivos e analisar o impacto dos mesmos sobre a qualidade de vida das pacientes com SF. Foram selecionadas 30 mulheres com diagnóstico de SF, em atendimento no período de outubro a novembro de 2005, as quais responderam a dois questionários: Inventário de Depressão de Beck, para investigar a presença de sinto- mas depressivos e o SF-36 Medical Outcome Survey Short Form -36, para avaliar a qualidade de vida. Os resultados obtidos na estatística pelo programa SPS demons- tram que os sintomas depressivos são responsáveis pelo impacto na qualidade de vida dessas pessoas, principalmente nos domínios: aspectos físicos, aspectos sociais, saú- de mental, vitalidade e saúde geral. A análise dos dados sugere que os sintomas depressivos podem influenciar negativamente a qualidade de vida das mulheres fibromiálgicas, pois aumenta a sensação de incapacidade física, diminui a qualidade das relações sociais, aumenta o pessimismo, a fadiga e o desânimo

Laminar distribution of the pathological changes in sporadic and variant Creutzfeldt-Jakob disease

The laminar distributions of the pathological changes in the cerebral cortex were compared in the prion diseases sporadic Creutzfeldt-Jakob disease (sCJD) and variant CJD (vCJD). First, in some cortical regions the vacuolation (‘spongiform change’) was more generally distributed across the cortex in sCJD. Second, there was greater neuronal loss in the upper cortex in vCJD and in the lower cortex in sCJD. Third, the ‘diffuse’ and ‘florid’ prion protein (PrPsc) deposits were more frequently distributed in the upper cortex in vCJD and the ‘synaptic’ deposits in the lower cortex in sCJD. Fourth, there was a significant gliosis mainly affecting the lower cortex of both disorders. The data suggest that the pattern of cortical degeneration is different in sCJD and vCJD which may reflect differences in aetiology and the subsequent spread of prion pathology in the brain.

Investigation of dyslexia and SLI risk variants in reading- and language-impaired subjects

Dyslexia (or reading disability) and specific language impairment (or SLI) are common childhood disorders that show considerable co-morbidity and diagnostic overlaps and have been suggested to share some genetic aetiology. Recently, genetic risk variants have been identified for SLI and dyslexia enabling the direct evaluation of possible shared genetic influences between these disorders. In this study we investigate the role of variants in these genes (namely MRPL19/C20RF3, ROBO1, DCDC2, KIAA0319, DYX1C1, CNTNAP2, ATP2C2 and CMIP) in the aetiology of SLI and dyslexia. We perform case–control and quantitative association analyses using measures of oral and written language skills in samples of SLI and dyslexic families and cases. We replicate association between KIAA0319 and DCDC2 and dyslexia and provide evidence to support a role for KIAA0319 in oral language ability. In addition, we find association between reading-related measures and variants in CNTNAP2 and CMIP in the SLI families.

A spirochete isolated from a case of severe virulent ovine foot disease is closely related to a Treponeme isolated from human periodontitis and bovine digital dermatitis

The isolation of spirochetes from severe ovine foot disease has been reported recently by our research group. In this study we describe the preliminary classification of this spirochete based on nucleotide sequence analysis of the PCR-amplified 16S rRNA gene. Phylogenetic analysis of this sequence in comparison with other previously reported 16S rRNA gene sequences showed that the spirochete belonged to the treponemal phylotype Treponema vincentii which has been associated with bovine digital dermatitis and human periodontal disease. Further work is required to define the common virulence determinants of these closely related treponemes in the aetiology of these tissue destructive diseases.

The serological diagnosis of staphylococcal infective endocarditis

Objectives: Establishing the diagnosis of infective endocarditis (IE) can be difficult when blood cultures remain sterile or echocardiography is inconclusive. Staphylococcus aureus is a common aetiological microorganism in IE and is associated with severe valvular destruction and increased mortality. Early diagnosis using culture and antibiotic independent tests would be preferable to allow prompt antibiotic administration. We have developed and evaluated 2 serological assays for the rapid identification of a staphylococcal aetiology in infective endocarditis. The assays measure IgG against whole cells of S. aureus and IgG against lipid S, a novel extracellular antigen released by Gram-positive microorganisms. Methods: Serum was collected from 130 patients with IE and 94 control patients. IgG against whole cells of S. aureus and against lipid S was measured by enzyme linked immunosorbent assay (ELISA). Results: Anti-lipid S IgG titres were higher in IE caused by Gram-positive microorganisms than in controls (p < 0.0001) and higher in staphylococcal IE than in both controls and IE caused by other microorganisms (p = 0.0003). Anti-whole cell staphylococcal IgG was significantly higher in serum from patients with staphylococcal IE than in IE caused by other microorganisms and control samples (p < 0.0001). Conclusion: High anti-whole cell IgG titres are predictive of a staphylococcal aetiology in IE. Elevated serum anti-lipid S IgG titres are predictive of Gram-positive infection compared to controls, very high titres being associated with staphylococcal IE. © 2005 The British Infection Society.

Chronic administration of an aluminium-enriched diet impairs spatial orientation in a sub-group of C57BL6 female mice

Disturbances of spatial orientation are an early clinical component of senile dementia of the Alzheimer type (SDAT). since it has been suggested that an elevated aluminium intake associated with chronic nutritional deficiencies of calcium and magnesium may play an important role in the aetiology of SDAT, we have investigated the effect of such a dietary regime on the spatial orientation abilities of female C57BL6 mice using the Morris swimming pool test. Statistical analysis of the performances of control and experimental groups indicate that the ability to orientate towards a submerged and thus invisible platform is conistently and markedly impaired in the experimental group. The ability to orientate towards a visible platform is also significantly impaired although to a lesser extent. Analysis of the performances of individual animals demonstrate that this impairment of orientation in the experimental group only occurs in a sub-group of animals: the remainder display normal orientational ability.

Vergence analysis reveals the influence of axial distances on accommodation with age and axial ametropia

Despite numerous investigations, the aetiology and mechanism of accommodation and presbyopia remains equivocal. Using Gaussian first-order ray tracing calculations, we examine the contribution that ocular axial distances make to the accommodation response. Further, the influence of age and ametropia are also considered. The data show that all changes in axial distances during accommodation reduce the accommodation response, with the reduction in anterior chamber depth contributing most to this overall attenuation. Although the total power loss due to the changes in axial distances remained constant with increasing age, hyperopes exhibited less accommodation than myopes. The study, therefore, enhances our understanding of biometric accommodative changes and demonstrates the utility of vergence analysis in the assessment of accommodation.

A novel and rational approach towards designing aluminium chelators

Aluminium (Al) is known to be neurotoxic and has been associated with the aetiology of Alzheimer's Disease. To date, only desferrioxamine (DFO), a trihydroxamic acid siderophore has been used in the clinical environment for the removal of Al from the body. However, this drug is expensive, orally inactive and is associated with many side effects. These studies employed a theoretical approach, with the use of quantum mechanics (QM) via semi-empirical molecular orbital (MO) calculations, and a practical approach using U87-MG glioblastoma cells as a model for evaluating the influence of potential chelators on the passage of aluminium into cells. Preliminary studies involving the Cambridge Structural Database (CSD) identified that Al prefers binding to bidentate ligands in a 3:1 manner, whereby oxygen was the exclusive donating atom. Statistically significant differences in M-O bond lengths when compared to other trivalent metal ions such as Fe3+ were established and used as an acceptance criterion for subsequent MO calculations. Of the semi-empirical methods parameterised for Al, the PM3 Hamiltonian was found to give the most reliable final optimised geometries of simple 3:1 Al complexes. Consequently the PM3 Hamiltonian was used for evaluating the Hf of 3:1 complexes with more complicated ligands. No correlation exists between published stability constants and individual parameters calculated via PM3 optimisations, although investigation of the dicarboxylates reveals a correlation of 0.961 showing promise for affinity prediction of closely related ligands. A simple and inexpensive morin spectrofluorescence assay has been developed and optimised producing results comparable to atomic absorption spectroscopy methods for the quantitative analysis of Al. This assay was used in subsequent in vitro models, initially on E. coli, which indicated that Al inhibits the antimicrobial action of ciprofloxacin, a potent quinolone antibiotic. Ensuing studies using the second model, U87-MG cells, investigated the influence of chelators on the transmembrane transport of Al, identifying 1,2-diethylhydroxypyridin-4-one as a ligand showing greatest potential for chelating Al in the clinical situation. In conclusion, these studies have explored semi-empirical MO Hamiltonians and an in-vitro U87-MG cell line, both as possible methods for predicting effective chelators of Al.

Metal binding to transferrin and immune reactions in Parkinson's disease

The binding of iron (59Fe) and gallium (67Ga) to the plasma protein transferrin (Tf) was investigated by G75 gel filtration chromatography in control patients and treated and untreated patients with Parkinson's disease (PD). Fe-Tf binding was 100% in all controls and PD patients suggesting that a defect in Fe-Tf binding was not involved in the aetiology of PD. Ga-Tf binding was significantly reduced in both untreated and treated PD patients compared to controls. In addition, treated PD patients had significantly higher Ga-Tf binding than untreated patients. A reduction in metal binding to Tf could result in the increase of a low molecular weight species which may more readily enter the CNS. Alternatively, it could lead to a decrease in the transport of essential metals into the brain via the Tf receptor system. A significant elevation in neopterin was demonstrated within the plasma of untreated PD patients compared to controls suggesting the activation of a cellular immune response. Furthermore, plasma neopterin was lower in treated compared to untreated PD patients, although the difference was not significant. There was no evidence for the activation of the humoral immune response in untreated or treated PD patients as measured by circulating immune complex (CIC) levels within the plasma. An inverse relationship between Ga-Tf binding and neopterin was observed in untreated PD patients. The addition of oxidants in the form of potassium permanganate and activated manganese dioxide reduced Ga-Tf binding in control plasma. However, relatively little response was observed using monocyte preparations. The results suggest that oxidants produced by activation of the cellular immune system could damage the Tf molecule thereby reducing its ability to bind metals.

The effect of genetically-mediated taste acuity for 6-N-propylthiouracil (PROP) on food choice and diet-related disease

Taste acuity for the bitter taste of 6-n-propylthiouracil (PROP) is a heritable trait. Some individuals perceive concentrated levels of PROP to taste extremely bitter (supertasters) or moderately bitter (medium tasters), whereas others detect only a mild taste or none at all (non-tasters). Heightened PROP acuity has been reported to be associated with greater acuity for a variety of compounds found in ordinary foods, although there are some inconsistent findings. The extent to which these compounds are perceived may affect food likes/dislikes and dietary intake. The majority of studies have tended to measure food likes and intake using questionnaires or laboratory preparations of a single taste quality. The present study used food diaries and sensory responses to real foods to be better able to generalise to real eating situations. There was no substantial evidence that genetically mediated taste acuity for PROP had a direct influence on food likes/dislikes or intake, although there was evidence that dietary restraint could have influenced these findings among the female samples. However; investigation of PROP tasting among individuals with coronary heart disease (CHD) and a control group suggested that PROP acuity could function as a genetic taste marker for heart disease and potentially other diet-related conditions. CHD was associated with decreased PROP acuity among men. This is consistent with the findings that decreased PROP acuity tended to be associated with increased likelihood to be a smoker and higher body mass index. It is concluded that there is not a simple and direct relationship between PROP tasting ability and food choice. An interaction between PROP acuity and other mediating factors may be involved in a more complex model of food choice. The evidence that PROP taste acuity may function as a genetic taste marker for coronary heart disease could have wide implications for understanding the aetiology, and ultimately the prevention, of diet-related disease.

Serodiagnosis of staphylococcal sepsis

The coagulase-negative staphylococci are the most frequent cause of sepsis associated with indwelling intravascular catheters. Current microbiological investigations to support the diagnosis of catheter-related sepsis (CRS) include the culture of blood and catheter tips, however positive results may reflect specimen contamination, or colonisation of the catheter rather than true sepsis. Previous serological approaches to assist in the diagnosis of CRS based on cellular staphylococcal antigens have been of limited value. In this current study, the serodiagnostic potential of an exocellular antigen produced by 7 strains of coagulase-negative staphylococci cultured in brain heart infusion broth was investigated. Antigenic material isolated by gel permeation from liquid culture was characterised by immunological techniques and chemical analysis. Characterisation of the exocellular antigen revealed a novel glycerophosphoglycolipid, termed lipid S. which shared antigenic determinants with lipoteichoic acid, but differed by comprising a glycerophosphate chain length of only 6 units. In addition, lipid S was immunologically distinct from diphosphatidyl glycerol, a constituent cell membrane phospho lipid. An indirect enzyme linked immunosorbent assay (ELISA) based on lipid S was subsequently developed and used to determine serum antibody levels (IgM and IgG) in 67 patients with CRS due to staphylococci, and 67 patients with a central venous catheter (CVC) in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the lipid S IgG ELISA was 75% and 90% respectively whilst the IgM assay had sensitivity and specificity of 52% and 85%. The addition of GullSORereagent to the EL1SA procedure to remove competing serum IgG and rheumatoid factor did not significantly improve the performance of the IgM assay. The serological response in serial serum samples of 13 patients with CRS due to staphylococci was investigated. Elevated levels of antibody were detected at an early stage of infection, prior to the isolation of microorganisms by standard culture methods, and before the clinical presentation of sepsis in 3 patients. The lipid S ELISA was later optimised and a rapid 4-hour assay developed for the serodiagnosis of CRS. Serum IgG levels were determined in 40 patients with CRS due to staphylococci and 40 patients with a CVC in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the rapid IgG assay was 70% and 100% respectively. Elevated serum antibody levels in patients with endocarditis, prosthetic joint infection and pyogenic spondylodiscitis due to Gram-positive cocci were also detected with the lipid S ELISA suggesting that the assay may facilitate the diagnosis of these infections. Unexpected increased levels of anti-lipid S IgG in 31% of control patients with sciatica suggested a possible microbial aetiology of this condition. Further investigation of some of these patients by culture of microdiscectomy tissue removed at operation, revealed the presence of low-virulent microorganisms in 37% of patients of which Propionibacterium aeries accounted for 85% of the positive culture isolates. The results suggested a previously unrecognised association between P. acnes and sciatica, which may have implications for the future management of the condition.

An investigation into the pharmacology of tics and tic-like movements

The study of tic-like movements in mice has demonstrated close parallels both in characteristics and in pharmacology with the tics which occur in TS. Head-shakes and/or other tic-like behaviours occurring spontaneously or induced by the selective 5-HT2/1C agonist DOI, alpha-melanocyte stimulating hormone, adrenocorticotrophic hormone (1-39), thyrotropin releasing hormone, or RX336-M were blocked when tested with neuroleptics such as haloperidol and/or the alpha-2 adrenoceptor agonist clonidine. The selective dopamine D1 antagonists SCH23390 and SCH39166 dose-dependently blocked spontaneous and DOI head-shakes but the selective dopamine D2 antagonists sulpiride and raclopride were ineffective. The 5-HT1A receptor agonists 8-OH-DPAT, ipsapirone, gepirone, MDL 73005EF and buspirone (i.p) dose-dependently blocked DOI head-shakes, pindolol blocked the inhibitory effect of 8-OH-DPAT on DOI head-shakes. Parachlorophenylalanine blocked the inhibitory effect of 8-OH-DPAT and buspirone, suggesting that the 5-HT1A receptor involved is located presynaptically. The alpha-2 adrenoceptor antagonists yohimbine, idazoxan, 1-PP and RX811059 prevented the inhibitory effect of 8-OH-DPAT on DOI head-shakes suggesting that this 5-HT1A - 5-HT2 receptor interaction is under the modulatory control of adrenoceptors. Because kynurenine has previously been found to potentiate head-shaking, plasma kynurenine concentrations were measured in seven TS patients and were significantly higher than controls, but neopterin and biopterin were unchanged. The relationship between tic-like movements in rodents and their implications for understanding the aetiology and treatment of TS is discussed.