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Biomedical subjects

A D Friedman

Publications and source records attributed to A D Friedman.

At least 73 records · Page 4Linked to original sources

Identification of two polypeptide segments of CCAAT/enhancer-binding protein required for transcriptional activation of the serum albumin gene.

We used molecular genetic methods to generate systematically altered forms of CCAAT/enhancer-binding protein (C/EBP). The aim of our experiments was to identify regions of C/EBP that contribute to its capacity to activate transcription from the promoter of the serum albumin gene in cultured hepatoma cells. Earlier experiments had shown that the DNA-binding domain must remain intact for C/EBP to activate albumin transcription. We now provide evidence of two additional elements of C/EBP that are required for its gene-activating role. One such element occurs within a 28-residue region located close to the amino terminus of the protein. The other maps to a broader, more internal region of the protein and appears to exhibit functional redundancy. These newly defined elements of C/EBP exhibit two characteristics of "activation" domains delineated in studies of other gene regulatory proteins. First, they play no obvious role in the capacity of C/EBP to bind to its DNA substrate. Second, they retain function after being appended onto the DNA-binding domain of a different protein. Neither of these putative activating elements is characterized by overt distinction in either charge or preponderance of any particular amino acid. The more amino-terminal element does, however, exhibit several features suggesting that it may assume an alpha-helical structure. These studies offer observations and reagents that will be valuable for future studies concerning the physiologic function of C/EBP.

Amino Acid Sequence↗

CCAAT/enhancer binding protein activates the promoter of the serum albumin gene in cultured hepatoma cells.

An expression vector capable of encoding full-length CCAAT/enhancer-binding protein (C/EBP) has been constructed and tested in transient transfection assays for its capacity to activate transcription from the promoter of the serum albumin gene. When tested in cultured hepatoma cells, the C/EBP expression vector achieved potent trans-activation of the albumin promoter. Less substantial activation was observed when the same experiment was conducted using cultured mouse fibroblasts. Expression vectors that encoded defective forms of C/EBP failed to activate the albumin promoter. Moreover, mutated variants of the albumin promoter that lack the C/EBP-binding site failed to be trans-activated. The data are consistent with the interpretation that C/EBP is a bona fide transcription factor. During the course of these experiments it was noted also that C/EBP is more than an order of magnitude less concentrated in cultured hepatoma cells than it is in adult liver cells. Given these findings, we speculate that C/EBP may play a general role in establishing and maintaining the differentiated, nonproliferative state.

Animals↗

Differentiation-induced gene expression in 3T3-L1 preadipocytes: CCAAT/enhancer binding protein interacts with and activates the promoters of two adipocyte-specific genes.

Previous studies have shown that differentiation of 3T3-L1 preadipocytes leads to the transcriptional activation of a group of adipose-specific genes. As an approach to defining the mechanism responsible for activating the expression of these genes, we investigated the binding of nuclear factors to the promoters of two differentiation-induced genes, the 422(aP2) and stearoyl-CoA desaturase 1 (SCD1) genes. DNase I footprinting and gel retardation analysis identified two binding regions within the promoters of each gene that interact with nuclear factors present in differentiated 3T3-L1 adipocytes. One differentiation-induced nuclear factor interacts specifically with a single binding site in the promoter of each gene. Competition experiments showed that the interaction of this nuclear factor with the SCD1 promoter was prevented specifically by a synthetic oligonucleotide corresponding to the site footprinted in the 422(aP2) promoter. Several lines of evidence indicate that the differentiation-induced nuclear factor is CCAAT/enhancer binding protein (C/EBP), a DNA-binding protein first isolated from rat liver. Bacterially expressed recombinant C/EBP binds to the same site at which the differentiation-specific nuclear factor interacts within the promoter of each gene. Northern analysis with RNA from 3T3-L1 cells shows that C/EBP mRNA abundance increases markedly during differentiation. Transient cotransfection studies using a C/EBP expression vector demonstrate that C/EBP can function as a trans-activator of both the 422(aP2) and SCD1 gene promoters.

Adipose Tissue↗

Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin.

Ninety-seven patients with impetigo were prospectively enrolled in a study to determine the comparative efficacy of systemic and topical antibiotic therapy. After obtaining a bacterial culture from a representative lesion, the children were randomized to receive seven days of either oral erythromycin or topical mupirocin administered three times daily. Staphylococcus aureus alone was isolated from 51% and in association with group A beta-hemolytic streptococci (GABS) from 29%; GABS alone was isolated from 4% of patients. Of 48 children who received erythromycin, 43 (90%) were clinically improved or cured, and 11 of 17 were bacteriologically cured. Of 49 children who received mupirocin, 47 (96%) were clinically improved or cured, and 10 of 14 were bacteriologically cured. At three-week follow-up, clinical cure rates and number of secondary household cases of impetigo were equivalent in both treatment groups. Mupirocin appears to be a well-tolerated, albeit expensive, alternative to erythromycin for the treatment of impetigo.

Administration, Oral↗

Expression of a truncated viral trans-activator selectively impedes lytic infection by its cognate virus.

A virion protein of herpes simplex virus type 1 (HSV-1) specifically and potently activates transcription of the viral immediate early genes. Appropriate function of this protein, termed VP16, depends on an acidic transcriptional activation domain located within the 78 carboxyl-terminal amino acids of the protein. Mutated forms of the protein lacking this acidic domain lose the ability to activate transcription, and can dominantly interfere with the trans-activation function of native VP16 (ref. 1). We have prepared stably transformed mouse L cells that constitutively express a form of VP16 lacking its acidic activating domain. In this report we show that these cells are selectively impaired in their capacity to support the lytic infectious cycle of HSV-1, and that this impairment results from their inability to support immediate early transcription.

Animals↗

Impetigo contagiosa: a comparison of erythromycin and dicloxacillin therapy.

One hundred patients with impetigo were prospectively enrolled in a study to determine the current etiology and comparative therapeutic efficacy of two oral antimicrobial agents active against both group A beta-hemolytic streptococci (GABS) and Staphylococcus aureus. After obtaining a bacterial culture from a representative impetiginous lesion, the children were randomized to receive 10 days of either erythromycin (40 mg/kg/day) or dicloxacillin (25 mg/kg/day). S. aureus alone was isolated from 46 children, and in association with GABS from 25 children. GABS alone was isolated from nine patients. Of the 59 evaluable children with S. aureus isolates, 28 of 29 treated with erythromycin and 29 of 30 treated with dicloxacillin were cured or improved on follow-up examination. Thus, we conclude that erythromycin is the drug of choice for impetigo in our midwestern locale because of its high efficacy and relatively low cost.

Adolescent↗

An atypical presentation of Kawasaki syndrome in an infant.

Kawasaki syndrome (KS) is a vasculitis of childhood, the etiology of which is unknown. Diagnosis is based on the Center for Disease Control (CDC) criteria in which skin and mucous membrane findings play a key role. Coronary artery involvement can be fatal. Prompt diagnosis and initiation of therapy can reduce the risk of cardiac complication. Autopsy findings of patients with KS who did not fit CDC criteria for symptoms have been reported. Infants, in particular, may have an atypical clinical course resulting in delayed diagnosis and initiation of treatment. This case presents an infant with fever and an atypical rash who did not fit diagnostic criteria. Differential diagnosis of infants with prolonged fevers and rash, who do not fit into other diagnostic categories, should include KS and an appropriate cardiac examination including consideration of an echocardiogram.

Age Factors↗

Impetigo: a reassessment of etiology and therapy.

Traditional concepts regarding the bacteriology and therapy of nonbullous impetigo have been reexamined. Although in the United States the disease is considered primarily of streptococcal origin and amenable to penicillin therapy, we found that Staphylococcus aureus was the most common isolate in 71 patients studied. Only two patients yielded pure cultures of group A beta-hemolytic streptococci. All but two isolates of S. aureus were resistant to penicillin; one of these two isolates was also resistant to erythromycin. Erythromycin appeared to be more efficacious than penicillin for the treatment of impetigo.

Child, Preschool↗

Value of rapid diagnosis of respiratory syncytial virus infection on management of small infants.

Respiratory syncytial virus (RSV) is a common cause of infection in infancy and early childhood. A presumptive diagnosis of RSV infection can frequently be made on clinical grounds. Confirmation can be made by viral culture, which may take 3 to 7 days. Immunofluorescent assay (IFA) is a specific and sensitive test that can provide laboratory confirmation of RSV infection the same day. Rapid diagnosis of RSV infection may have implications regarding prevention of nosocomial spread of RSV, early initiation of anti-viral therapy, use of antibiotics, and duration of hospital stay. Data are presented regarding the use of RSV-IFA and its effect on patient management.

Anti-Bacterial Agents↗

Coronaviruslike particles in human gastrointestinal disease. Epidemiologic, clinical, and laboratory observations.

Coronaviruslike particles (CVLPs) were visualized by direct electron microscopy (EM) of diarrheal stools in 49 of 126 infants and children between 1 month and 12 years of age during a three-year observation period. The clinical and epidemiologic features of these patients were analyzed and compared with patients with diarrhea who were shedding rotaviruses, or whose stools were negative for enteric viruses by EM. Seasonal and age distributions for CVLP shedding were similar to those for rotaviruses (in most cases less than 1 year of age; peak months were September through January), as were the symptoms and median durations of illness. Prospective studies of three subsequent patients suggest that the duration of shedding in acute illness is five to at least 25 days. Multiple attempts to cultivate the CVLPs were unsuccessful. In addition, partial purification of CVLPs from stool specimens was performed, and immunologic analysis by immunoelectron microscopy and radial immunodiffusion showed no antigenic relatedness to prototype human (OC43 and 229E) or animal (bovine and canine) coronaviruses. These findings suggest that CVLPs may be an important cause of acute gastrointestinal illness in infancy, and may represent a virus antigenically unrelated to known human and animal coronaviruses.

Child↗

Determination of the hemoglobin F program in human progenitor-derived erythroid cells.

The absolute adult and fetal hemoglobin (HbF) contents of the erythroid cells derived from the differentiation of normal human and simian erythroid progenitors and of the peripheral blood erythroid burst-forming units (BFU-E) of patients with nondeletion hemoglobinopathies have been measured with a sensitive radioligand immunoassay. The HbF content varied between 0.13 and 2.96 pg/cell, representing between 0.7% and 19.6% of the total hemoglobin with a mean value of 7.0%. The absolute content of HbF was indistinguishable in the well-hemoglobinized progeny of marrow erythroid colony-forming units, marrow or blood BFU-E, or of mixed colony-forming units. The term HbF program refers to this inherent capacity to produce fetal hemoglobin (HbF) in the erythroid cells derived from these progenitors in vitro. The HbF content of marrow erythroblasts as determined by the same radioligand immunoassay was similar to that found in the peripheral blood, suggesting that the switch off of gamma-chain production occurs after the erythroid colony-forming unit stage of maturation. Increasing concentrations of a crude erythropoietin-containing preparation induced higher numbers of erythroid colonies, which were larger in size, but the HbF program was unaffected. In contrast to the hemoglobin accumulation in human progenitor-derived colonies, simian progenitor-derived colonies produced considerably more HbF, and the amount of HbF was strongly influenced by progenitor maturity. Assays of the HbF content of erythroblasts derived from culture of the peripheral blood BFU-E of patients with nondeletion hemoglobinopathies and their parents showed that the HbF program in the progenitors of such patients is highly variable. Some produce only a slight excess of HbF in progenitor-derived erythroblasts, whereas others have extraordinarily high HbF programs. The molecular basis of this variability is presently unknown.

Animals↗

Towne-vaccine-induced prevention of cytomegalovirus disease after renal transplants.

91 renal transplant candidates were randomised to receive Towne strain cytomegalovirus (CMV) vaccine or placebo at least 8 weeks before transplantation. The vaccine was well tolerated and there was no vaccine virus excretion. Serological and cellular immune responses developed in most vaccines but were lower in the transplant patients than in healthy volunteers and some of the seronegative patients failed to mount responses. CMV infection occurred in most of the seronegative vaccine-treated or placebo-treated patients who received kidneys from seropositive donors, but the illnesses were less severe in the vaccines than those in similarly exposed placebo-treated patients. Vaccine-treated patients who received kidneys from seronegative donors did not excrete virus, and therefore the vaccine virus was not reactivated from a putative latent state despite immunosuppression at the time of transplantation.

Antibodies, Viral↗