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Biomedical subjects

N Agarwal

Publications and source records attributed to N Agarwal.

At least 19 recordsLinked to original sources

A conserved retina-specific gene encodes a basic motif/leucine zipper domain.

Using subtraction cloning, we have isolated a human cDNA, AS321, which is expressed in retina and retinoblastoma cell lines but not in any other tissue or cell line tested. AS321 mRNA is detected in all cells of neural retina, with a high level of expression in photoreceptors. The polypeptide sequence deduced from the cDNA reveals consensus phosphorylation sites for protein kinase A and proline-directed protein kinase. Its C-terminal region contains a basic motif and a leucine zipper domain similar to the DNA binding proteins of the jun and fos oncoprotein family, and it shows a strong similarity to the product of an avian retroviral oncogene, v-maf. The gene for AS321 is conserved during evolution and is expressed in vertebrate retina. We propose to name the gene NRL (neural retina leucine zipper.

Amino Acid Sequence

Maintenance of opsin and S-antigen gene expression in RCS dystrophic rats following RPE transplantation.

The effects of retinal pigment epithelium (RPE) transplantation in rescuing photoreceptor cells (PRC) were studied in RCS rats bearing the rdy mutation. RPE preparations from Long-Evans rats were transplanted into the subretinal space of post-natal (P) 17-19-day-old RCS rats. Age-matched RCS animals in the control group received injections of the transplantation vehicle buffer alone. The animals were killed at various post-natal ages after RPE transplantation. Immunocytochemical studies using antibodies to opsin and S-antigen indicated intact photoreceptor cells in the transplanted retinas. In contrast age-matched sham-injected animals did not show any rescue of photoreceptor cells at P90. Single RPE transplantation of 60,000 cells in each eye resulted in restoration of near normal mRNA levels for opsin, and S-antigen proteins. Comparisons of mRNA levels of two visual proteins using cDNA probes demonstrated a therapeutic effect of RPE transplantation in preventing a progressive decline in mRNA levels due to retinal degeneration. In contrast, P109 sham-injected controls showed no detectable mRNA levels for these proteins. In vitro protein synthesis in RPE-transplanted retinas implied further competence of these retinas. These data suggest that RPE transplantation not only rescues photoreceptors from degeneration, but more importantly, it allows normal transcription and translation in these cells rendering them capable of participating in the visual and signal transduction cascade.

Animals

Expression of opsin and IRBP genes in mutant RCS rats.

The retinal pigment epithelium of RCS rats bearing the autosomal recessive rdy mutation fails to ingest shed rod outer segment tips. Accumulation of disk debris in the subretinal space of the maturing mutant retina causes a secondary degeneration of photoreceptor cells. Two hypotheses have been offered as possible explanations of the death of photoreceptor cells in this disorder: (1) photoreceptors are starved for amino acids, retinal, oxygen, etc; and (2) that IRBP levels and synthesis may be decreased and interfere with retinal transport and this deficiency is lethal to these cells. To test these hypotheses, we have studied the effect of this mutation on the levels of expression of opsin and IRBP genes, and gene products and on rates of synthesis at various ages in dystrophic RCS p+ rats and compared the results to those obtained with normal Long Evans rats. The mutant rats and normal controls had comparable amounts of opsin and IRBP mRNA transcripts and rates of synthesis up to post-natal day 45 (P45) but opsin transcripts were barely detectable at P60 and thereafter. IRBP mRNA levels were also very low after P62 although somewhat higher than opsin mRNA. Opsin could be detected immunochemically, albeit at lower levels, at all the ages studied up to P310, but IRBP levels fell below detection after P45. We localized opsin and IRBP in the retina by post-embedding EM immunocytochemical procedures and found that opsin is present in the remnants of rod outer segment debris, even at P390, long after detectable opsin synthesis had ceased. These data suggest that expression of opsin and IRBP genes is not influenced by the shape and state of the outer segments, and that the rdy mutation does not influence the expression of the opsin and IRBP in these retinas until the photoreceptor cells are profoundly damaged. Thus, neither hypothesis about the causes of cell death in this disorder is supported.

Aging

Functional heterogeneity of mutant rhodopsins responsible for autosomal dominant retinitis pigmentosa.

Thirteen mutant rhodopsins responsible for autosomal dominant retinitis pigmentosa (ADRP) have been produced by transfection of cloned cDNA into tissue culture cells. Three mutants [class I: Phe-45----Leu, Gln-344----termination (deletion of C-terminal positions 344-348), and Pro-347----Leu] resemble wild-type rhodopsin in yield, regenerability with 11-cis-retinal, and plasma membrane localization. Ten mutants [class II: Thr-17----Met, Pro-23----His, Thr-58----Arg, Val-87----Asp, Gly-89----Asp, Gly-106----Trp, Arg-135----Leu, Arg-135----Trp, Tyr-178----Cys, and Asp-190----Gly] accumulate to significantly lower levels, regenerate with 11-cis-retinal variably or not at all, and are transported inefficiently to the plasma membrane, remaining primarily in the endoplasmic reticulum. These data suggest that there are at least two distinct biochemical defects associated with different rhodopsin mutants in ADRP.

Blotting, Western

Differential expression of novel Gs alpha signal transduction protein cDNA species.

The Gs alpha guanine nucleotide-binding signal transduction protein is part of a heterotrimeric complex that is involved in the stimulation of adenylate cyclase upon activation of membrane receptors. We report the characterization of 16 Gs alpha cDNA clones isolated from the human adult retina and fetal eye libraries. Molecular heterogeneity in the 5'-region defines four novel Gs alpha cDNA species which are generated either by alternate splicing or by using alternative promoter. The novel exons upstream of exon 2 interrupt the highly conserved 'region A' in the Gs alpha polypeptide. Non-AUG codons in the novel 5'-exon can initiate translation of these Gs alpha species in vitro. Reverse transcription of total RNA coupled with polymerase chain reaction (RTPCR) using specific primers and in situ hybridization to mRNA in baboon tissue sections with a specific oligonucleotide probe show a high level of expression of these species in retina and brain but not in liver. Differential expression of alternatively spliced Gs alpha species suggests novel signal transducing pathways.

Aged

Arrestin mRNA expression, biosynthesis, and localization in degenerating photoreceptors of mutant rds mice retinas.

The retinal photoreceptors of the mutant rds mouse are unable to form normal outer segments. Eventually the abnormal cells die in the months following birth. The genetic defect in the rds mouse was recently localized to the peripherin gene that encodes a protein in the outer segment disc margin. Although this mutation may explain the morphogenetic defect, i.e., the failure to form outer segments, the reason for subsequent cell death is not clear. Previously, we demonstrated that the capability to synthesize opsin, an outer segment integral membrane protein, is not compromised by the morphogenetic defect although the opsin steady-state content is considerably reduced, since it is not incorporated into an organized outer segment. We have now studied arrestin, a cytoplasmic protein that is part of the phototransduction cascade and appears to shuttle between the inner and outer segment during the light/dark cycle. Since rds mice lack outer segments, it was of interest to determine the effects of the photoreceptor abnormality on arrestin gene expression. Arrestin mRNA levels and protein synthetic rates were high in young rds retinas. When corrected for cell loss, the steady-state arrestin content per cell in the rds retina was comparable to normal. However, in the absence of an outer segment, the total amount of arrestin is concentrated in the remaining inner segment. Consequently, a relatively high level of arrestin is present in the rds inner segment throughout the light/dark cycle. We suggest that the morphogenetic defect indirectly precipitates secondary effects such as the persistent presence of high levels of arrestin or other soluble proteins in the abnormal photoreceptor inner segment, nucleus, and synaptic terminal. This condition, if toxic to the cells, may compromise photoreceptor viability in the rds retina.

Animals

Sequence analysis, expression and chromosomal localization of a gene, isolated from a subtracted human retina cDNA library, that encodes an insulin-like growth factor binding protein (IGFBP2).

The metabolic functions of insulin-like growth factors (IGFs) I and II are modulated by a family of binding proteins which are present in biological fluids and are synthesized by a variety of cell types. A cDNA clone, isolated at random from a subtracted human retina library, has been identified to code for a novel IGF-binding protein (IGFBP2) by its sequence homology to the peptide sequence of IGF binding proteins purified from bovine MDBK and rat BRL-3A cells. The complete nucleotide sequence of the IGFBP2 cDNA is 1406 bp long, contains 66% G-Cs and an open reading frame of 328 amino acids with a putative signal or pro-peptide of 39 residues. The mature polypeptide of 289 amino acids has 18 cysteines, a putative ATP-binding site and an RGD tripeptide. The 1.4 kb IGFBP2 transcript is expressed in several human tissues including fetal eye and fetal brain, but not in the human lymphoblastoid cell line against which the retinal cDNA library was subtracted. In situ hybridization to sections of mouse retina localized the mRNA for IGFBP2 primarily in the outer nuclear layer of photoreceptors. Southern blot analysis of DNA from human x rodent and mouse x rodent somatic cell hybrids assigned the gene for IGFBP2 to human chromosome 2q33-qter and mouse chromosome 1 in a known conserved syntenic region.

Aged

Use of serum prolactin for monitoring the therapeutic response in ovarian malignancy.

Serum prolactin level was estimated in 20 women with ovarian malignancy. High prolactin level was observed in 13 out of 20 women. However, no correlation was seen between prolactin level and the stage of the disease. Serial measurement of prolactin showed a correlation of prolactin level with tumor mass in three patients in which serial tumor mass volume measurements were available. A rise in serum prolactin level was observed in women who had recurrence of the disease. Although the current study is based on a relatively small number of patients, it may be concluded that serum prolactin level might be used as a tumor marker to monitor the therapeutic response in cases of ovarian malignancy.

Adolescent

Analyses of preventable deaths by mechanism of injury among 13,500 trauma admissions.

Preventable deaths (PD) were evaluated by mechanism of injury for 13,500 trauma admissions to eight hospitals over 2 years. There were 42 (3.3%) hospital deaths. Preventable deaths were analyzed by time of death, anatomic site of injury, and mechanism; penetrating (PEN) and blunt with low fall (LF) injuries were considered separately. Preventability of death for patients with probability of survival of less than 0.5, "unexpected deaths," after penetrating and blunt injuries, was determined by consensus of three trauma surgeons. Twelve per cent of deaths were found to be possibly preventable. The incidence of preventable deaths did not differ significantly across groups. Factors in preventable deaths varied by injury cause; delays in operation, PEN (50%), and blunt injury patients (48%); management errors, blunt (52%) and LF (84%); and technical errors, PEN (37.5%). Median times to death were significantly different by cause of injury: PEN, 3 hours; blunt, 13 hours; and LF, 3975 hours. Problems were identified in the hospital care of patients, especially those with LF, leading to sepsis and multiple organ failure.

Accidental Falls

Limitations of the TRISS method for interhospital comparisons: a multihospital study.

The value of the TRISS method for interhospital comparisons of trauma care was studied using data for 5,616 consecutive patients from three trauma centers and five community hospitals. Z-scores were used to compare mortality rates. Three limitations of the method were documented: 1) the lack of homogeneity within the patient subcategory of penetrating injuries, specifically between patients with gunshot versus stab wounds; 2) the inability of the TRISS method to predict the survival rate of patients suffering low falls; and 3) the inability of the TRISS method to account for multiple severe injuries to a single body part. Remedies to the first two of these limitations can be addressed within the present TRISS method. A remedy for the third requires a new method.

Abbreviated Injury Scale

Repair of a traumatic noncircumferential hepatic bile duct defect using a vein patch: case report.

Injury to the bile ducts secondary to blunt trauma is a rare but potentially fatal condition that presents a difficult diagnostic and treatment challenge. Various treatment options exist for repair. Vein patch repairs have been criticized because of reports of subsequent fibrosis and stricture formation. This case report describes the successful repair of a traumatic, noncircumferential defect of a hepatic bile duct with a vein patch, and stresses the importance of an adequate duration of stenting.

Adolescent

Renal cyst formation and multifocal neoplasia in transgenic mice carrying the simian virus 40 early region.

Simian virus 40 early region transgenic mice develop characteristic pathological abnormalities of the brain, kidney, and thymus, due to expression of large-T antigen. Earlier studies have indicated that the most consistent effect of large-T antigen expression is the formation of choroid plexus papillomas in the brain and that thymic hyperplasia and various kidney abnormalities are less frequently observed. The renal lesions reportedly consist of numerous glomerular abnormalities and tubular proliferation. Surprisingly, an analysis of 21 simian virus 40 early region transgenic mice, which were produced for this study, revealed a much higher incidence of polycystic kidney disease as well as earlier development of T-antigen-induced abnormalities. In marked contrast to earlier observations, there is an apparent reduction in the glomerular number in the affected kidneys, whereas the remaining glomeruli appear normal. The most striking feature of the T-antigen-induced renal abnormalities was extensive hyperplasia of tubular epithelial cells which was most marked in the distal tubules; all tubule segments are involved in the most severely affected animals. In most cases, cysts lined with hyperplastic epithelium were observed and papillary structures protruding from the cyst lining were evident. Multiple areas of focal neoplasia were apparent, and, in the most severely affected animals, there were areas in which tumor had replaced normal renal parenchyma. These results strongly suggest that T-antigen-induced renal cyst and tumor formation are part of the same pathological process which is initially manifested as tubular epithelial hyperplasia.

Animals

Dietary cholesterol induced changes in lipid profile in patients with nephrotic syndrome and chronic renal failure.

Fifteen patients with nephrotic syndrome (9 aged below 30 years), 6 patients with chronic renal failure and 26 healthy males (14 below 30 years) were studied. After estimating the basal serum levels of total cholesterol (STC), triglycerides (STG), high density lipoprotein (HDL) and low density lipoprotein (LDL), the patients were given a high cholesterol and high fat breakfast (containing 32 g fat and 527 mg cholesterol) for 7 days. Lipoprotein levels were again estimated on days 8 and 16. In the basal state, all patients with nephrotic syndrome had markedly elevated levels of STC and LDL. In patients aged below 30 years, STG and VLDL levels were also elevated, while HDL levels were similar in both the groups in comparison to their respective age group controls. In patients with renal failure, basal levels of all lipoproteins were similar to levels in controls. After the high cholesterol fat diet, there was an insignificant rise in all lipoprotein values in patients with nephrotic syndrome and renal failure. However, HDL levels rose significantly in patients with nephrotic syndrome aged below 30 years. Patients with nephrotic syndrome and chronic renal failure can safely be given high cholesterol and high fat diet despite abnormalities in lipid lipoprotein metabolism.

Adolescent

High density lipoprotein.

High density lipoprotein (HDL) is a discoidal particle comprising phospholipid, cholesteryl esters and several apolipoproteins. It serves in transporting cholesterol from the periphery to the liver by the process of "reverse cholesterol transport". Compatible with this is the finding that the mass of the tissue cholesterol pools is inversely related to plasma HDL concentration. The plasma levels of components of HDL are determined by various physiological and pathological factors. The serum HDL levels are lower with advancing age, male sex, and in genetically predisposed, obese, sedentary persons. The effect of diet on serum HDL levels is not established; mild to moderate alcohol intake is associated with high serum HDL level. The main diseases affecting serum HDL levels are uncontrolled diabetes mellitus, uraemia and hyperthyroidism. Anabolic steroids, sex hormones, oral contraceptives, hypocholesterolaemics and beta blockers have been shown to affect serum HDL level variably. There is increasing epidemiological evidence to show that high levels of HDL are protective against coronary heart disease (CHD). A low serum HDL cholesterol concentration (less than 35 mg/dl) is associated with a significant increase in coronary risk in both men and women. Guidelines published by the National Cholesterol Education Programme do not recommend routine measurement of HDL cholesterol and adaptation of therapeutic modalities aiming to raise the low HDL levels. They recommend hygienic means (i.e. smoking cessation, aerobic exercises and weight loss) to raise the HDL cholesterol levels.

Female

Assessment of severity in acute pancreatitis.

Assessment of severity of acute pancreatitis (AP) is a key determinant in the management of a patient. This review evaluates the various methods of assessment: clinical assessment, biochemical tests, Ranson's and Imrie's multiple prognostic criteria, simplified prognostic criteria, APACHE II, peritoneal lavage, and computed tomography. Although all of the above criteria can identify most of the seriously ill patients, each has some drawbacks. Individual preference and available institutional facilities greatly influence the method used for prognostic assessment in AP. However, some type of predictive assessment is possible in any hospital, and should be used in the management of patients with AP.

Acute Disease

Opsin gene expression during early and late phases of retinal degeneration in rds mice.

Opsin mRNA levels, opsin synthetic rates and localization of opsin were studied throughout the photoreceptor's life span in the rds mice. Mutant mice 11 days to 11 months old were investigated. Opsin mRNA levels were studied by means of northern blot analysis. Opsin synthesis was measured by incorporation of [35S]methionine into newly synthesized opsin in vitro. Distribution of opsin in the retina was determined by immunoelectron microscopy. Opsin mRNA was detected in young as well as old retinas, and opsin synthesis could be detected at early phases of degeneration but not in late phases. The absence of opsin synthesis in older rds mice might be due to translational down-regulation or some other defect in the capacity to synthesize opsin. In young mice, opsin was detected in the subretinal space in opsin-laden vesicular membranes: such membranes were absent from retinas of older mice. This disappearance parallels the cessation of opsin synthesis and the consequent failure to deliver opsin to the subretinal space in retinas from older mice. Immunochemical analysis revealed the presence of small amounts of opsin in all retinas up to 11 months of age. Immunoelectron microscopy localized the residual opsin, mostly to the plasma membrane which envelops the nuclei and synaptic terminals. These opsin molecules might be a consequence of very low levels of opsin synthesis, too low to be detected by our assays, or may have been synthesized at an earlier age and retained in the plasma membrane of the old mutant photoreceptors.

Animals

A study of dietary cholesterol induced changes in serum lipid lipoproteins in healthy male children, adolescents and middle aged volunteers.

The present study comprised of 16 healthy male subjects of 8-12 years (Group A), 18 adolescent males (13-19 years) (Group B) and 20 middle aged volunteers (45-55 years) (Group C), who were fed a high cholesterol high fat diet (HCFD) consecutively for seven days. The serum lipid changes were noted. The diet was then withdrawn. Seven days later the lipid changes were again recorded. At basal stage, serum total cholesterol (STC), high density lipoprotein (HDL) and low density lipoprotein (LDL) were significantly higher in group C in comparison to Group A. LDL/HDL ratio was significantly lower in Group C than that of Group A. Seven days after feeding of HCFD significant elevations occurred in all the lipid subfractions of Groups AB. The rise in STC was mainly because of predominant rise in HDL leading to a significant fall in LDL/HDL ratio. In Group C, elevations occurred in all the lipid fractions except HDL that showed an insignificant rise. LDL/HDL ratio was insignificantly affected. After withdrawal of HCFD, all the lipid levels returned to normal except in Group A, where STC and LDL remained elevated. The LDL/HDL ratio again increased significantly. In conclusion, the serum lipid lipoprotein behaviour in response to HCFD is qualitatively different in young persons as compared to middle aged persons.

Adolescent