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Shu-Jen Chen

Publications and source records attributed to Shu-Jen Chen.

At least 19 recordsLinked to original sources

Enhancing the utility of adeno-associated virus gene transfer through inducible tissue-specific expression.

The ability to regulate both the timing and specificity of gene expression mediated by viral vectors will be important in maximizing its utility. We describe the development of an adeno-associated virus (AAV)-based vector with tissue-specific gene regulation, using the ARGENT dimerizer-inducible system. This two-vector system based on AAV serotype 9 consists of one vector encoding a combination of reporter genes from which expression is directed by a ubiquitous, inducible promoter and a second vector encoding transcription factor domains under the control of either a heart- or liver-specific promoter, which are activated with a small molecule. Administration of the vectors via either systemic or intrapericardial injection demonstrated that the vector system is capable of mediating gene expression that is tissue specific, regulatable, and reproducible over induction cycles. Somatic gene transfer in vivo is being considered in therapeutic applications, although its most substantial value will be in basic applications such as target validation and development of animal models.

Animals↗

Synthesis, crystal structure, structure-activity relationships, and antiviral activity of a potent SARS coronavirus 3CL protease inhibitor.

A potent SARS coronavirus (CoV) 3CL protease inhibitor (TG-0205221, Ki = 53 nM) has been developed. TG-0205221 showed remarkable activity against SARS CoV and human coronavirus (HCoV) 229E replications by reducing the viral titer by 4.7 log (at 5 microM) for SARS CoV and 5.2 log (at 1.25 microM) for HCoV 229E. The crystal structure of TG-0205221 (resolution = 1.93 A) has revealed a unique binding mode comprising a covalent bond, hydrogen bonds, and numerous hydrophobic interactions. Structural comparisons between TG-0205221 and a natural peptide substrate were also discussed. This information may be applied toward the design of other 3CL protease inhibitors.

Animals↗

The early-immediate gene EGR-1 is induced by transforming growth factor-beta and mediates stimulation of collagen gene expression.

Transforming growth factor-beta (TGF-beta) stimulates collagen synthesis and accumulation, and aberrant TGF-beta signaling is implicated in pathological organ fibrosis. Regulation of type I procollagen gene (COL1A2) transcription by TGF-beta involves the canonical Smad signaling pathway as well as additional protein and lipid kinases, coactivators, and DNA-binding transcription factors that constitute alternate non-Smad pathways. By using Affymetrix microarrays to detect cellular genes whose expression is regulated by Smad3, we identified early growth response factor-1 (EGR-1) as a novel Smad3-inducible gene. Previous studies implicated Egr-1 in cell growth, differentiation, and survival. We found that TGF-beta induced rapid and transient accumulation of Egr-1 protein and mRNA in human skin fibroblasts. In transient transfection assays, TGF-beta stimulated the activity of the Egr-1 gene promoter, as well as that of a minimal Egr-1-responsive reporter construct. Furthermore, TGF-beta enhanced endogenous Egr-1 interaction with a consensus Egr-1-binding site element and with GC-rich DNA sequences of the human COL1A2 promoter in vitro and in vivo. Forced expression of Egr-1 by itself caused dose-dependent up-regulation of COL1A2 promoter activity and further enhanced the stimulation induced by TGF-beta. In contrast, the TGF-beta response was abrogated when the Egr-1-binding sites of the COL1A2 promoter were mutated or deleted. Furthermore, Egr-1-deficient embryonic mouse fibroblasts showed attenuated TGF-beta responses despite intact Smad activation, and forced expression of ectopic EGR-1 in these cells could restore COL1A2 stimulation in a dose-dependent manner. Taken together, these findings identify Egr-1 as a novel intracellular TGF-beta target that is necessary for maximal stimulation of collagen gene expression in fibroblasts. The results therefore implicate Egr-1 in the profibrotic responses elicited by TGF-beta and suggest that Egr-1 may play a new and important role in the pathogenesis of fibrosis.

Animals↗

Esophageal atresia with tracheoesophageal fistula: ten years of experience in an institute.

BACKGROUND: Esophageal atresia (EA), tracheoesophageal fistula (TEF), or both is a complicated problem. The purpose of this study was to evaluate the outcomes and postoperative complications in patients with EA/TEF who were admitted to our hospital. METHODS: In total, 15 patients were enrolled from 1994 to 2003, including 8 males and 7 females. Patient demographics, associated anomalies, and outcomes were analyzed. RESULTS: The most common variant was EA with a distal TEF (type C), which occurred in 12 patients (80%). The latter had associated congenital anomalies, and cardiac anomalies were the most frequent, occurring in 8 patients (53.3%). Of the 6 cases who had life-threatening anomalies, 4 (66.7%) died, and of the 9 cases who had no life-threatening-anomalies, 2 (22.2%) died. Tracheomalacia and/or stenosis were diagnosed in 8 patients (66.7%) postoperatively. Though 3 of the 4 cases who suffered from dying spell received intratracheal stent implantation, 2 cases still died. CONCLUSION: The survival rate of the patients with EA/TEF is influenced mainly by associated life-threatening anomalies. TMS combined with a history of dying spell may be the major fatal complication.

Esophageal Atresia↗

Adenoviral human telomerase reverse transcriptase dramatically improves ischemic wound healing without detrimental immune response in an aged rabbit model.

Chronic ischemic wounds are major clinical problems, and are especially prevalent in elderly patients. Management of these wounds costs billions of dollars annually in the United States. Because of the severe impairment in tissue repair, ischemic wounds among the aged are major challenges for physicians. For example, transforming growth factor-beta1 stimulates healing of young patients' ischemic wounds, but it is totally ineffective in treating the ischemic wounds of aged patients. Therefore, our goal is to develop a better therapeutic strategy for elderly patient ischemic wounds. Because human telomerase reverse transcriptase (hTERT) has emerged as having a role in promoting cell proliferation, we hypothesized that hTERT overexpression may improve ischemic wound healing in the elderly. We successfully tested this hypothesis by demonstrating for the first time that gene delivery of hTERT by adenovirus (Ad-hTERT) dramatically improved ischemic wound healing in an aged rabbit model. Importantly, our histological data indicate that no deleterious immune response was induced in the aged rabbits. This finding has broad implications for the field of gene therapy because the foremost obstacle in the use of adenoviral vectors for gene therapy is that they provoke strong innate and adaptive immune responses in the host. Moreover, Ad-hTERT significantly improved survival of primary rabbit dermal fibroblasts that were treated with hypoxia and hydrogen peroxide (oxidative stress). This model is clinically relevant because it simulates the ischemia cycle of an ischemia-reperfusion injury, which can lead to stroke, myocardial infarction, and other tissue injuries. We conclude that Ad-hTERT is an effective and novel approach to treating the ischemic wounds of elderly patients.

Adenoviridae↗

The diagnostic value of serum interleukins 6 and 8 in children with acute gastroenteritis.

OBJECTIVES: Early identification of the pathogen causing acute gastroenteritis in children helps the physicians managing the disease and prevents unnecessary antibiotic treatment. C-reactive protein (CRP), interleukin (IL) 6 and IL-8 play a major role in immune responses and have been studied in a large number of infectious and noninfectious inflammatory diseases. The purpose of this study was to determine the serum IL-6 and IL-8 concentrations early in the course of acute gastroenteritis to see if these cytokines were useful diagnostic markers in differentiating viral from bacterial gastroenteritis. METHODS: Interleukin 6, IL-8 and CRP were measured in 18 patients with bacterial gastroenteritis, 21 patients with viral gastroenteritis and 17 healthy children. RESULTS: Interleukin 6 and CRP concentrations in patients with bacterial gastroenteritis were significantly higher than those in patients with viral gastroenteritis and healthy controls (P < 0.001). IL-8 concentrations in patients with viral and bacterial gastroenteritis were both increased and were not statistically different. IL-6 and IL-8 levels had diagnostic sensitivities of 79% and 50% and specificities of 86% and 67%, respectively. The combination of IL-6 and CRP had a sensitivity of 94%, specificity of 71%, a positive predictive value of 74% and a negative predictive value of 93.75%. CONCLUSIONS: Serum IL-6 may be a useful marker for early differentiation of viral and bacterial gastroenteritis in children, especially in combination with CRP.

Acute Disease↗

Is urorectal septum malformation sequence a variant of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association? Report of a case and a review of the literature.

UNLABELLED: The urorectal septum malformation sequence (URSMS) consists of multiple systems anomalies including ambiguous genitalia, the absence of a perineal opening, an imperforate anus, and urogenital, colonic and lumbosacral anomalies. We describe a 3-day-old female infant with characteristic URSMS and review its clinical manifestations, outcomes and putative pathogenesis. We also compare its characteristics with those of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia (VATER) association. CONCLUSION: Although defects of the urorectal septum malformation sequence and the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association overlap, we believe that they are separate entities. Differentiating the urorectal septum malformation sequence from vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association is helpful to develop appropriate clinical investigations and search for the aetiology and pathogenesis of these diseases.

Abnormalities, Multiple↗

A longitudinal study of growth patterns in schoolchildren in one Taipei District. II: Sitting height, arm span, body mass index and skinfold thickness.

BACKGROUND: It has been suggested that longitudinal rather than cross-sectional growth standards be used to assess individual growth patterns. Thus, the aim of this study was to follow boys and girls throughout their pubertal years, so that a mixed longitudinal growth curve of height, weight, sitting height, arm span, skinfold thickness, body mass index (BMI), and the ratio of sitting height or arm span to stature, could be obtained. METHODS: A defined group of 1,139 healthy schoolchildren (570 boys and 569 girls) from the Shih-Pai district of Taipei were followed longitudinally for 4 years. Anthropometric measurements of height, weight, sitting height, arm span, skinfold thickness, and BMI, were obtained for each child. RESULTS: Peak sitting-height velocities of 6.1 cm/year (boys) and 6.3 cm/year (girls) were seen at 8.5 years. The second peak of sitting-height velocity occurred at a mean age of 12.5 years for boys and 11.5 years for girls. Sitting-height velocity for the whole year covering the second peak was 4.6 cm in boys and 3.2 cm in girls. Peak arm-span velocity was seen at 13.5 years for boys and 8.5 years for girls, and arm-span velocity for the whole year covering this peak was 8.4 cm/year for boys and 8.1 cm/year for girls. CONCLUSION: These data provide growth patterns for Chinese children aged 8-18 years living in a Taipei district, with percentile charts for sitting height, arm span, BMI, and skinfold thickness.

Adolescent↗

Tumor necrosis factor-alpha and interleukin-10 in viral and bacterial gastroenteritis in children.

BACKGROUND: Gastroenteritis is a common cause of hospitalization and is associated with high morbidity in children. C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) are primary mediators of inflammation, and have been implicated in many infectious and non-infectious inflammatory diseases. The main objective of this study was to identify serum markers in viral and bacterial gastroenteritis. METHODS: Thirty-one patients admitted to a pediatric infection ward with gastroenteritis and definite pathogens were enrolled in the study: 17 patients had viral gastroenteritis and 14 bacterial gastroenteritis. Serum levels of TNF-alpha, IL-10 and CRP were measured in these 31 patients, and in a control group of 15 healthy children. RESULTS: Serum concentrations of TNF-alpha and CRP were significantly greater in patients with bacterial gastroenteritis than in patients with viral gastroenteritis and healthy controls (p < 0.001). Concentrations of IL-10 were increased, but not significantly, in patients with viral or bacterial gastroenteritis (p = 0.577 vs controls). Regarding diagnosis, the measurement of TNF-alpha and CRP levels was 78.6% and 92.0% sensitive, respectively; and 88.2% and 58.8% specific, respectively. CONCLUSION: Serum TNF-alpha concentration may be a useful marker for distinguishing between viral and bacterial gastroenteritis.

Bacterial Infections↗

Serum interleukin-5 measurements for monitoring acute asthma in children.

Cytokine-mediated interactions among the inflammatory cells may play a role in the pathogenesis of bronchial asthma. Interleukin-5 (IL-5) is a major cytokine in the recruitment of neutrophils to the area of inflammation. Serum IL-5 is a marker of disease activity and treatment efficacy in bronchial asthma. To understand the role of IL-5 in disease activity in acute asthma, changes in serum concentrations of IL-5 elaborated by activated eosinophil before and after prednisolone therapy with clinical improvement were determined in the present study. Circulating levels of IL-5 in 16 normal control subjects and in sera from 22 allergic asthmatic children with acute exacerbation and in stable condition were determined by using commercially available assay kits. The mean concentration of serum IL-5 was higher in patients with acute exacerbation (6.30 +/- 2.21 pg/mL) and in stable asthmatics (5.55 +/- 2.23 pg/mL) compared to control group subjects (4.81 +/- 0.54 pg/mL; p > 0.05). However, the difference was not statistically significant between the acute exacerbation and stable asthmatics groups (p > 0.05). Serum IL-5 is a poor indicator of disease activity in acute asthma; therefore, monitoring serum IL-5 concentration is of limited value. The clinical value of serum IL-5 as a marker of disease activity remains to be established.

Acute Disease↗

Xanthogranulomatous pyelonephritis treated by partial nephrectomy.

Xanthogranulomatous pyelonephritis is an uncommon disease in children. We report of a 2-month-old girl with urinary tract infection and with a renal mass detected by ultrasound scan. The preoperative differential diagnoses were Wilms tumor, multicystic dysplastic kidney, renal abscess, and mesoplastic nephroma. The subsequent histopathological findings allowed the diagnosis of xanthogranulomatous pyelonephritis (XGP). Although XGP is rare at this age, it must be considered in the differential diagnosis of a child presenting with renal mass, either with or without associated urolithiasis, anemia, and elevated inflammatory markers. The long-standing mainstay of therapy for diffuse XGP has been nephrectomy. However, we report the successful preservation of renal mass with partial nephrectomy for diffuse XGP. The affected kidney grew normally and preserved residual function after the operation. Hence we strongly suggest parenchymal saving in pediatric cases of XGP to preserve renal function.

Antihypertensive Agents↗

Disruption of transforming growth factor beta signaling and profibrotic responses in normal skin fibroblasts by peroxisome proliferator-activated receptor gamma.

OBJECTIVE: In fibroblasts, transforming growth factor beta (TGF beta) stimulates collagen synthesis and myofibroblast transdifferentiation through the Smad intracellular signal transduction pathway. TGF beta-mediated fibroblast activation is the hallmark of scleroderma and related fibrotic conditions, and disrupting the intracellular TGF beta/Smad signaling may provide a novel approach to controlling fibrosis. Because of its potential role in modulating inflammatory and fibrotic responses, we examined the expression of the nuclear hormone receptor peroxisome proliferator-activated receptor gamma (PPAR gamma) in normal skin fibroblasts and its effect on TGF beta-induced cellular responses. METHODS: The expression and activity of PPAR gamma in normal dermal fibroblasts were examined by Northern and Western blot analyses, immunocytochemistry, flow cytometry, and transient transfections with reporter constructs. The same approaches were used to evaluate the effects of PPAR gamma activation by naturally occurring and synthetic ligands on collagen synthesis and alpha-smooth muscle actin (alpha-SMA) expression. Modulation of Smad-mediated transcriptional responses was examined by transient transfection assays using wild-type and dominant-negative PPAR gamma expression constructs. RESULTS: The PPAR gamma receptor was expressed and fully functional in quiescent normal skin fibroblasts. Whereas ligand activation of cellular PPAR gamma resulted in modest suppression of basal collagen gene expression, it abrogated TGF beta-induced stimulation in a concentration-dependent manner. This response was mimicked by overexpressing PPAR gamma in fibroblasts, and was blocked by a selective antagonist of PPAR gamma signaling or by transfection of fibroblasts with dominant-negative PPAR gamma constructs. Furthermore, PPAR gamma ligands abrogated TGF beta-induced expression of alpha-SMA, a marker of myofibroblasts. Stimulation of Smad-dependent transcriptional responses by TGF beta was suppressed by PPAR gamma despite the absence of a consensus PPAR gamma-response element in the targeted promoters. Ligand-induced activation of fibroblast PPAR gamma had no effect on protein expression of cellular Smad3 or Smad7. CONCLUSION: By abrogating of TGF beta-induced stimulation of collagen gene expression, myofibroblast transdifferentiation, and Smad-dependent promoter activity in normal fibroblasts, PPAR gamma may play a physiologic role in the regulation of the profibrotic response. Furthermore, our results suggest that PPAR gamma activation by pharmacologic agonists may represent a novel approach to the control of fibrosis in scleroderma.

Actins↗

Selective human enterovirus and rhinovirus inhibitors: An overview of capsid-binding and protease-inhibiting molecules.

The absence of effective vaccines for most viral infections highlights an urgent necessity for the design and development of effective antiviral drugs. Due to the advancement in virology since the late 1980s, several key events in the viral life cycle have been well delineated and a number of molecular targets have been validated, culminating in the emergence of many new antiviral drugs in recent years. Inhibitors against enteroviruses and rhinoviruses, responsible for about half of the human common colds, are currently under active investigation. Agents targeted at either viral protein 1 (VP1), a relatively conserved capsid structure mediating viral adsorption/uncoating process, or 3C protease, which is highly conserved among different serotypes and essential for viral replication, are of great potential to become antipicornavirus drugs.

Antiviral Agents↗

Targeted disruption of TGF-beta/Smad3 signaling modulates skin fibrosis in a mouse model of scleroderma.

Transforming growth factor-beta (TGF-beta) is a potent stimulus of connective tissue accumulation, and is implicated in the pathogenesis of scleroderma and other fibrotic disorders. Smad3 functions as a key intracellular signal transducer for profibrotic TGF-beta responses in normal skin fibroblasts. The potential role of Smad3 in the pathogenesis of scleroderma was investigated in Smad3-null (Smad3(-/-)) mice using a model of skin fibrosis induced by subcutaneous injections of bleomycin. At early time points, bleomycin-induced macrophage infiltration in the dermis and local TGF-beta production were similar in Smad3(-/-) and wild-type mice. In contrast, at day 28, lesional skin from Smad3(-/-) mice showed attenuated fibrosis, lower synthesis and accumulation of collagen, and reduced collagen gene transcription in situ, compared to wild-type mice. Connective tissue growth factor and alpha-smooth muscle actin expression in lesional skin were also significantly attenuated. Electron microscopy revealed an absence of small diameter collagen fibrils in the dermis from bleomycin-treated Smad3(-/-) mice. Compared to fibroblasts derived from wild-type mice, Smad3(-/-) fibroblasts showed reduced in vitro proliferative and profibrotic responses elicited by TGF-beta. Together, these results indicate that ablation of Smad3 is associated with markedly altered fibroblast regulation in vivo and in vitro, and confers partial protection from bleomycin-induced scleroderma in mice. Reduced fibrosis is due to deregulated fibroblast function, as the inflammatory response induced by bleomycin was similar in wild-type and Smad3(-/-) mice.

Actins↗

Pediatric lung abscess: a retrospective review of 23 cases.

Pulmonary abscess is a rare but critical problem in childhood. We did a retrospective review of 23 children with documented lung abscess who had been admitted and treated at the Taipei Veterans General Hospital over a 20-year period from April 1982 to April 2002. Among the 23 children, 11 cases were primary lung abscess, and 12 were secondary lung abscess. The pathogens were isolated in 16 patients (69.6%), and blood cultures yielded in only 3 patients (13.0%). The most common microorganism isolated in this series was Streptococcus pneumoniae. The 2 patients (8.7%) that died in our series had secondary lung abscess. We herein report the presenting symptoms, bacteriology, clinical management, and outcome of these 23 cases.

Adolescent↗

Neonatal bacteremia in a neonatal intensive care unit: analysis of causative organisms and antimicrobial susceptibility.

BACKGROUND: Infections cause significant mortality and morbidity in neonates, especially the premature ones. Although there are various antibiotics can be used to combat neonatal infection, resistant strains have subsequently emerged. In an epidemiological survey, we analyzed bacterial isolates and their antibiotic susceptibilities for cases of bacteremia in a neonatal intensive care unit (NICU) of a teaching hospital. METHODS: From November 1999 to October 2001, 623 neonates admitted to the NICU were enrolled. The incidence and incidence density of bacteremia, morbidity and mortality of sepsis, as well as antibiotic susceptibility, were investigated. RESULTS: Totally, 754 blood cultures were done on 623 patients. Fifty-eight patients experienced 85 episodes of bacteremia, with 87 isolates cultured. The incidence of bacteremia in our NICU was 9.31% (58/623) with an incidence density of 10.98/1000 patient-days. The overall mortality rate was 7.22%. The case fatality rate of bacteremia was 20.7% (12/58). The bacterial pathogens encountered, in order of frequency, were coagulase-negative Staphylococcus (29%), Staphylococcus aureus (22%), and Enterobacter cloacae (17%). All of the gram-positive bacteria were susceptible to vancomycin, while the gram-negative bacteria were susceptible to imipenem, amikacin and ciprofloxacin. Oxacillin-resistant S. epidermidis, oxacillin-resistant S. aureus, and multi-drug resistant enterobacteriae were the leading microorganisms causing bacteremia in our NICU. CONCLUSIONS: It is an endless struggle to combat neonatal infection. Periodic evaluation of bacterial antibiotic susceptibility is necessary. More judicious selection of antibiotics and rotating antibiotic regimens should be kept in mind to reduce the resurgence of multidrug resistant strains.

Anti-Bacterial Agents↗

A longitudinal study of growth patterns in school children in Taipei area I: growth curve and height velocity curve.

BACKGROUND: It has been pointed out that longitudinal rather than cross-sectional growth standards should be used to assess individual linear growth. The purpose of this study is to investigate the growth characteristics of school boys and girls living in Shih-Pai district in Taipei. METHODS: A defined group of 1,139 healthy school children (570 boys and 569 girls) from the Shih-Pai district of Taipei city were followed longitudinally for 3 to 4 years. Anthropometric measurement of height and weight and physical development in each child were obtained. The annual increments were calculated every 6 months to map the peak height velocity (PHV), height velocity curve (HVC), peak weight velocity (PWV) and weight velocity curve (WVC). RESULTS: The age at peak velocity was taken as 12.5 years for boys and 10.5 years for girls, and the whole year PHV as 8.0 cm/yr in boys and 7.0 cm/yr in girls. The mean PHV was less than 1 cm in boys and girls of about 17 years and 15 years, respectively, with mean heights of 170.8 cm and 158.7 cm, respectively. CONCLUSIONS: Our preliminary results were actually calculated from the combination of longitudinal data and cross-sectional data pools. Since this is only a pilot study design, we expect that a longer follow-up period of the same cohorts would give more exact growth characteristics.

Adolescent↗

Synthesis and biological evaluation of N-heterocyclic indolyl glyoxylamides as orally active anticancer agents.

A series of N-heterocyclic indolyl glyoxylamides were synthesized and evaluated for in vitro and in vivo anticancer activities. They exhibited a broad spectrum of anticancer activity not only in murine leukemic cancer cells but also in human gastric, breast, and uterus cancer cells as well as their multidrug resistant sublines with a wide range of IC(50) values. They also induced apoptosis and caused DNA fragmentation in human gastric cancer cells. Among the compounds studied, 7 showed the most potent activity of growth inhibition (IC(50) = 17-1711 nM) in several human cancer cells. Given orally, compounds 7 and 13 dose-dependently prolonged the survival of animals inoculated with P388 leukemic cancer cells. N-Heterocyclic indolyl glyoxylamides may be useful as orally active chemotherapeutic agents against cancer and refractory cancerous diseases of multidrug resistance phenotype.

Administration, Oral↗