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Biomedical subjects

A Kelly

Publications and source records attributed to A Kelly.

At least 127 records · Page 7Linked to original sources

Targeting signal and subcellular compartments involved in the intracellular trafficking of HLA-DMB.

Evidence suggests that peptide loading onto MHC class II molecules occurs in a specialized late endocytic compartment (MIIC) where HLA-DM predominantly resides and in which MHC class II transiently accumulates before transport to the cell surface. We examined the targeting signals and compartments involved in the intracellular trafficking of human HLA-DM by expressing hybrid molecules comprising the cytoplasmic domain of DMB and luminal and transmembrane domains of CD8 in HeLa cells. A tyrosine-based tetrapeptide motif present in the cytoplasmic domain of DMB targeted hybrid molecules to intracellular vesicles. Mutation of the tyrosine residue to alanine resulted in redistribution of hybrid molecules to the cell surface. Correct intracellular targeting of HLA-DM was crucial for normal function in B cells. Immunoelectron microscopy on ultrathin cryosections showed that CD8-DMB molecules accumulated in late endocytic compartments sharing characteristics with lysosomes, like MHC class II compartments in APCs. Thus far, the exit of DMB from the Golgi complex has not been elucidated. Interestingly, we found that although the mannose 6-phosphate receptor and CD8-DMB contain similar tyrosine signals, no co-localization was observed in the trans-Golgi network, suggesting that these proteins are differentially sorted at this site. Co-transfection of CD8-DMB, HLA-DR alpha, HLA-DR beta, and an invariant chain revealed that HLA-DR molecules accumulated together with CD8-DMB in these lysosomal compartments. The similarity of these lysosomal-like compartments in wild-type and transfected cells suggests that they are part of the normal endocytic pathway in non-APCs.

Amino Acid Sequence↗

Evolutionary dynamics of non-coding sequences within the class II region of the human MHC.

About 40% (350 kb) of the human MHC class II region has been sequenced and a coordinated effort to sequence the entire MHC is underway. In addition to the coding information (22 genes/pseudogenes), the non-coding sequences reveal novel information on the organisation and evolution of the MHC as demonstrated here by the example of a 200 kb contig that has been analysed for local and global features. In conjunction with cross-species comparisons, our results present new evidence on the structure of isochores, the evolutionary dynamics of repeat-mediated recombination and its effect on certain MHC encoded genes, and a higher than average degree of natural polymorphism that has implications for sequencing the human genome. We also report the finding of a class I-related pseudogene (HLA-ZI) in the middle of the class II region, which provides the first direct evidence for DNA exchange between these two related regions in man.

Amino Acid Sequence↗

Genetic evidence that glycolysis is necessary for gastrulation in the mouse.

Mouse embryos homozygous for the Gpi1-sa-m1H null allele (abbreviated to m) of glucose phosphate isomerase (GPI) die early in development. A histological study was undertaken to identify the earliest abnormalities attributable to the absence of this glycolytic enzyme. Two groups of embryos were produced and examined histologically from E6.5 to E9.5 days. Experimental embryos were produced by crossing heterozygous Gpi1-sa/m females with heterozygous Gpi1-sb/m males and compared with control embryos produced by crossing heterozygous Gpi1-sb/Gpi1-sb males. The first sign of abnormality attributable to homozygous m/m embryos appeared at 7.5 days when 32.2% of the embryos in the experimental group were histologically abnormal or retarded, compared to 8.3% in the control group. The putative homozygous m/m embryos had a range of abnormalities, but consistently the egg cylinder failed to be divided into the three cavities characteristic of normal 7.5-day embryos. This suggests that a deficiency in extraembryonic mesoderm formation resulted in the failure to form the amnion or chorionic mesoderm. At 8.5 and 9.5 days the abnormal embryos from the experimental cross had progressed little further. It is suggested that in the absence of GPI, energy production is impaired so that the embryo fails to develop beyond the egg cylinder stage and gastrulation has begun completed. Developmental failure may occur before gastrulation or once gastrulation has begun and produced some mesoderm. It is concluded that glucose phosphate isomerase and presumably, therefore, glycolysis is needed for normal gastrulation of mouse embryos.

Animals↗

A WHO Collaborative Study of Maternal Anthropometry and Pregnancy Outcomes.

OBJECTIVES: To evaluate to what degree anthropometric measurements are useful and efficient in predicting maternal and fetal outcomes in different country settings and to develop appropriate reference curves for maternal weight gain. METHODS: A meta-analysis of 25 data sets providing information on over 111,000 births worldwide. RESULTS: Attained weight indicators from pre-pregnancy (Pp) through 9 lunar months demonstrated high odds ratios (O.R.) for both low birth weight (LBW) and intra-uterine growth retardation (IUGR). The strongest effect size (O.R. = 4.0) was provided by attained weight at 7 lunar months for IUGR, when applied to women of below average pre-pregnancy weight. The study indicators showed only minor and inconsistent O.R. for preterm birth (PTB). The ability of study indicators to predict the three maternal outcomes was much weaker. Maternal height as a predictor of assisted delivery showed the highest positive O.R. (1.6), but did not meet the screening criteria. CONCLUSIONS: A single measurement of attained weight at 5 or 7 lunar months (16-20 or 24-28 weeks) is the most practical screening instrument for LBW and IUGR in most primary health care settings and provides warning of the need for intervention. The operational value of these findings should be demonstrated through their successful large-scale application in service settings.

Body Height↗

A 2-year study of lipid and lipoprotein changes in postmenopausal women with tibolone and estrogen-progestin.

OBJECTIVE: To assess changes in lipid-lipoprotein profile in postmenopausal women taking tibolone and estrogen-progestin, compared with untreated controls. METHODS: Sixty-three women were randomized to take a combined estrogen-progestin preparation (n = 31) or tibolone (n = 32), and 50 other women acted as controls. Fasting lipid-lipoprotein levels were measured over 96 weeks. RESULTS: The controls, who were older and postmenopausal longer than the therapy subjects, exhibited significant decreases in total (P < .05) and low-density lipoprotein (LDL) (P < .001) cholesterol and increases in triglyceride (P < .05) and lipoprotein (a) (P < .001) over the 96-week period of study. Lipoprotein (a) also decreased significantly in both treated groups (P < .001). Total and LDL cholesterol decreased and triglyceride increased in the estrogen-progestin group, but, compared with controls, these changes were not significant. Total cholesterol decreased in the tibolone group, although decreases in low- and particularly high-density lipoprotein (HDL) (P < .001) cholesterol and parallel decreases in apolipoprotein A1 (P < .001) and B (p < .01) were also observed. There was evidence of a reversion phenomenon in apolipoproteins A1 and B in all groups, and in lipoprotein (a) with tibolone. CONCLUSION: Some changes accompanying tibolone may be favorable and may counter its adverse effect on HDL cholesterol. Lowering of lipoprotein (a) was the only significant change found with estrogen-progestin.

Animals↗

Hairy polyp of the oropharynx: case report and literature review.

Hairy polyp of the oronasopharynx is an uncommon developmental malformation that is most frequently seen as a pedunculated tumor in the neonate. Derived from the ectoderm and mesoderm, this benign tumor generally has been classified as dermoid. The clinical presentation is dependent on the polyp's size and location. A full-term girl was evaluated for an oral mass that was first noted at the time of birth. Evaluation showed a 5- x 2.5-cm soft, nontender, skin-covered mass that protruded from the oral cavity. During surgery, it was noted that the stalk was attached to the superior pole of the left tonsil. The histology of the mass was consistent with a hairy polyp. Knowledge of this type of malformation facilitates early intervention and avoids significant morbidity.

Dermoid Cyst↗

Delayed articular cartilage slough: two cases resulting from holmium:YAG laser damage to normal articular cartilage and a review of the literature.

We present two cases referred from other physicians with chondral damage and cartilage slough secondary to use of the holmium:YAG laser during knee arthroscopy. The first patient had a partial lateral meniscectomy, which was done with a 20-W Ho:YAG laser. The patient never fully recovered and underwent a second arthroscopy that revealed full-thickness cartilage defects of the lateral femoral condyle. The second patient had debridement of Outerbridge grade III changes of the lateral tibial plateau and patella, as well as a partial lateral meniscectomy using a Ho:YAG laser. The patient developed recurrent symptoms, and when a second arthroscopy was performed, new degenerative changes to the lateral femoral condyle were noted with large areas of cartilage loss. A careful look needs to be taken at the limited use of lasers until further randomized prospective studies are carried out comparing patient outcomes, cost, and long-term complications.

Adult↗

The concept of the specialist community nurse.

This paper seeks to stimulate discussion on the concept of the specialist community nurse and to investigate the effectiveness or limitations of the role. The main arguments presented are that, although the role of the specialist community nurse will be exposed to constraints from both the medical and managerial culture and tensions within the profession regarding perceptions of professionalization may militate against progress towards specialist status, the concept is a worthy goal and can be underpinned by phenomenological concepts of professionalism.

Attitude of Health Personnel↗

Patterns of attachment loss in advanced periodontitis patients monitored following initial periodontal treatment.

2 main concepts seem to exist for the progression of periodontitis: (1) a slow continuous process of attachment loss; (2) periodic bursts of activity followed by quiescence or remission. This study addresses this problem and presents data for 69 sites having experienced a net loss of probing attachment amounting to > or = 3.0 mm over 42 months. The sites originated from 16 adult patients monitored after nonsurgical treatment of advanced chronic periodontitis. Probing attachment level recordings were obtained every 3rd month. The sequential probing attachment level data for each site were smoothed using cubic splines. Subjective evaluation of the raw and the smoothed data from the study sites suggested that the majority of the sites seemed to lose probing attachment in a continuous fashion, and over periods of 12 months or more. The smoothed curves were subjected to principal components analysis, which allowed the 69 sites to be ordered according to curve similarity. Nonparametric runs test failed to show that the shape of the curves for the sites was significantly associated with any of the following characteristics: patient, tooth type, tooth surface, initial probing depth, bleeding frequency, occurrence of suppuration, or a combination of inflammatory characteristics of sites.

Adult↗

DNA sequencing of the MHC class II region and the chromosome 6 sequencing effort at the Sanger Centre.

The human Major Histocompatibility Complex (MHC) is located on the short arm of chromosome 6 (6p21.3) and spans about 4 Mb. According to different gene families the MHC is subdivided into a class I, class II and class III region and many of its gene products are associated with the immune system and the susceptibility to various diseases. To date, we have sequenced about 40% (400 kb) of the class II region between HLA-DP and HLA-DQ and a coordinated effort to sequence the entire MHC is well underway. Analysis of the sequence revealed several novel genes and provides new insights into the molecular organisation and evolution of the MHC. All our data are publicly available via the MHC database (MHCDB) which allows rapid access, retrieval and display in the context of other MHC associated data. MHCDB is online available at (http:(/)/www.hgmp.mrc.ac.uk/) and, together with all our sequences also via anonymous ftp (ftp.icnet.uk/icrf-public).

Animals↗

Organisation and functions of class II genes and molecules.

The class II region of the human MHC contains all of the known class II genes: as well as antigen processing components and only one gene not obviously associated with the immune system, RING3. As an approach to understanding linkage disequilibrium and recombination in relation to polymorphism of the region we are cloning and sequencing the class II region. To date, the sequence of the DP-DQ region has almost been completed (see Report by S. Beck). Several sets of genes implicated in the immune system, especially in antigen processing and presentation, are clustered together in the MHC: class I (HLA-A, B, C etc) class II (DR, DQ, DP, DN, DO, DM) LMP2 and 7, TAP1 and 2, TNF, C2, C4, Bf, Hsp70. This situation has provoked speculation that the MHC behaves as a gene cluster in which allelic products of polymorphic genes are maintained on a haplotype so as to co-ordinate T cell repertoire development and deployment. The high levels of linkage disequilibrium across the region are consistent with this idea. Functions of the genes in the MHC are being investigated as a step towards gaining insight into antigen processing and presentation as well as understanding MHC-disease associations. We are concentrating on the functions of the class II-related genes, DM and DN/DO as well as the TAP/LMP cluster.

ATP-Binding Cassette Transporters↗

Women's experiences of general practitioner management of their vaginal symptoms.

BACKGROUND: Little is known about the management of vaginal symptoms despite their frequency. Most vaginal symptoms in non-menopausal women are managed as thrush, although bacterial vaginosis is commoner. AIM: The aim of this study was to measure the experiences of women attending their general practitioner with vaginal symptoms including self-reporting of symptoms, duration and severity, informal support, over-the-counter remedies, sources of information, gender of doctor, expected and actual vaginal examination, and explanations and knowledge of common vaginal infections. METHOD: A postal questionnaire survey was conducted of 490 patients presenting with vaginal symptoms aged between 18 and 48 years who had attended 10 general practices within the previous 3 months in the East Midlands of England. RESULTS: A total of 85% of patients had suffered a previous episode, with 39% having had three or more infections in the previous year. Overall, 68% consult with each episode, and most consult within 7 days of onset of symptoms (median = 4 days). In all, 68% discussed their symptoms with partners, families or friends, but 32% relied solely on their doctor. Some 33% bought over-the-counter remedies. A total of 65% informed themselves further from encyclopaedias, leaflets and women's magazines, but there was a strong request for more information. Out of those questioned, 75% expected a vaginal examination, whereas 57% had such an examination performed. Most were told their symptoms were caused by thrush (78%), but patients' ideas on causation were varied. Most believed sexual transmission played a role in transmission of symptoms. Women were socially embarrassed by their symptoms, with 46% admitting to having the condition on their minds all or most of the time. Twenty-eight per cent of women wished to see a female doctor, with gender being unimportant to the remainder. CONCLUSIONS: Vaginal symptoms were commonly recurrent, socially embarrassing and managed as candidiasis. Just over half the patients had a vaginal examination. There is a shortage of suitable information on vaginal infections available to patients, many of whom used over-the-counter medications.

Adolescent↗

Effects of treatment with topical ivermectin three and eight weeks after turnout on nematode control and the performance of second-season beef suckler cattle.

Two groups of yearling suckled beef calves born between January and May of the preceding year and another two groups of lighter and slightly younger calves born between the previous March and July were grazed during their second year on four separate paddocks known to be contaminated with infective larvae of gastrointestinal nematodes. One of the heavier and one of the lighter groups were treated with a topical formulation of ivermectin three weeks and eight weeks after turnout. The treatment of the heavier group had only relatively minor parasitological effects and no effect on weight gains, whereas the treatment of the lighter cattle resulted in increased weight gains due to effective nematode control. The paper highlights that small differences in previous performances, age and exposure to parasites can have a substantial impact on the benefits accrued from anthelmintic treatment.

Administration, Topical↗

Coordinate regulation of the human TAP1 and LMP2 genes from a shared bidirectional promoter.

Recently, four genes (TAP1, TAP2, LMP2, LMP7) involved or potentially involved in the processing and transport of major histocompatibility complex class I-associated antigen to the endoplasmic reticulum have been identified. We now report the initial characterization of the bidirectional promoter for the human transporter associated with antigen processing 1 (TAP1) and low molecular mass polypeptide 2 (LMP2) genes. These genes are divergently transcribed from a central promoter region of only 593 bp. Functional analysis using a bidirectional reporter system demonstrates the minimal 593-bp promoter is sufficient for concurrent expression in both directions. There is no TATA box homology at either end but there is a prevalence of GC boxes. Transcription is initiated at multiple sites for each gene without any of the TAP1 transcripts overlapping with the LMP2 transcripts. The region proximal to the TAP1 gene is required for maximal basal level expression of not only TAP1 but also LMP2. Furthermore, this region is necessary for tumor necrosis factor alpha (TNF-alpha) induction of both genes. Site-specific mutations of an NF-kappa B element in the TAP1 proximal region blocked induction by TNF-alpha in both the TAP1 and LMP2 directions. An adjacent GC box was required for basal expression of both genes as well as augmenting the TNF-alpha induction of the distal LMP2 gene. In vivo genomic foot-printing of this region revealed strong protein/DNA interactions at the NF-kappa B and GC box consensus sequences. In vitro binding studies confirmed the capacity of the NF-kappa B site to bind p50/p65 and p52/p65 heterodimers and of the GC box to bind Sp1. Thus, the promoter elements proximal to the TAP1 gene play a significant role in regulating basal and induced expression of both TAP1 and LMP2. The findings presented in this report clearly link LMP2 expression with TAP1 expression and provide additional suggestive evidence linking LMP2 to class I antigen presentation.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Genes encoded in the major histocompatibility complex affecting the generation of peptides for TAP transport.

The B cell line 721.174 has lost the ability to present intracellular antigens to major histocompatibility complex (MHC) class I-restricted cytotoxic T lymphocytes (CTL). This phenotype results from a homozygous deletion in the MHC that includes the peptide transporter genes TAP1 and TAP2, and the proteasome subunits LMP2 and LMP7. Recent work has shown that such cells transfected with TAP genes load their class I molecules with endogenous peptides, and present several viral epitopes to class I-restricted CTL. These data implied that the LMP2 and LMP7 genes were not required for the presentation of most epitopes through class I molecules. By contrast, while confirming the previous reports, we have identified several epitopes that appear to require genes in the MHC in addition to the TAP for their presentation. Further analysis localizes the defect to proteolysis in the cytosol. In one case, presentation could be partially restored by re-expression of full-length LMP7. Control experiments with LMP7, from which the putative pro-region had been removed, failed to restore presentation, and this lack of effect correlated with failure of the shortened LMP7 to incorporate into the proteasome. These results suggest a role for LMP7 in the generation of a viral epitope, but leave open the possibility that additional genes within the .174 deletion are required for full restoration of antigen presentation.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Restoration of endogenous antigen processing in Burkitt's lymphoma cells by Epstein-Barr virus latent membrane protein-1: coordinate up-regulation of peptide transporters and HLA-class I antigen expression.

Group I Burkitt lymphoma (BL) lines retaining the original BL tumor cell phenotype are unable to present endogenously expressed antigens to HLA class I-restricted cytotoxic T cells (CTL) but can be recognized if the relevant HLA class I/peptide epitope complex is reconstituted at the cell surface by exogenous addition of synthetic target peptide. Endogenous antigen-processing function is restored in BL lines that have undergone Epstein-Barr virus (EBV)-induced drift in culture to the group III phenotype typically displayed by EBV-transformed lymphoblastoid cell lines (LCL) of normal B cell origin. We compared group I versus group III cells for their expression of proteasome components, transporter proteins and HLA-class I antigens, all of which are thought to be involved in the endogenous antigen processing pathway. By Western blot analysis, there were not consistent differences in the low molecular mass protein subunits of proteasomes (lmp)-2, lmp-7 and delta, although the mb-1 proteasome subunit was regularly present at higher levels in group I BL lines relative to group III lines or LCL. By contrast there were marked differences in the expression of peptide transporter-associated proteins (Tap), with down-regulation of Tap-1 and Tap-2 in 8/8 and 7/8 group I BL lines, respectively. Surface levels of HLA class I antigens were also consistently lower in group I cells; this was not associated with an intracellular accumulation of free HLA heavy chains, such as is seen in the Tap-deficient T2 processing-mutant line, but instead reflected a reduced rate of HLA class I synthesis in group I cells. Analysis of EBV gene transfectants of the B lymphoma lines BJAB and BL41 showed that the virus-encoded latent membrane protein-1 (LMP1), which is one of several EBV antigens expressed in group III but not in group I cells, was uniquely able to up-regulate expression both of the Tap proteins and HLA class I. Furthermore, this was accompanied by a restoration of antigen-processing function as measured by the ability of these cells to present an endogenously expressed viral antigen to CTL. These effects of LMP1 were similar to those induced in the same cell lines by interferon-gamma treatment. The results implicate both Tap and HLA class I expression as factors limiting the antigen-processing function of BL cells, and suggest that the accessibility of other EBV-associated malignancies to CTL surveillance may be critically dependent upon their LMP1 status.

ATP Binding Cassette Transporter, Subfamily B, Mem↗