There is a paucity of community-based epidemiological data on nonalcoholic fatty liver (NAFL) among nonaffluent populations in developing countries. Available studies are radiological and/or biochemical and lack histological assessment, limiting their strength. We conducted a prospective epidemiological study comprising a 1:3 subsample of all adult (>18 years) inhabitants of a rural administrative unit of West Bengal, India. Subjects positive for hepatitis B virus and/or hepatitis C virus infection and consuming any amount of alcohol were excluded. Diagnosis of NAFL was by dual radiological screening protocol consisting of ultrasonographic and computed tomographic examination of the liver. Transient elastographic examination and liver biopsy were performed in a subset to identify significant liver disease. The risk factors of having NAFL were analyzed. A total of 1,911 individuals were analyzed, 7% of whom were overweight and 11% of whom had abdominal obesity. The prevalence of NAFL, NAFL with elevated alanine aminotransferase, and cryptogenic cirrhosis was 8.7%, 2.3%, and 0.2%, respectively. Seventy-five percent of NAFL subjects had a body mass index (BMI) <25 kg/m 2 , and 54% were neither overweight nor had abdominal obesity. The subjects with the highest risk of having NAFL were those with a BMI >25 kg/m 2 (odds ratio 4.3, 95% confidence interval 1.6-11.5). Abdominal obesity, dysglycemia (fasting plasma glucose >100 mg/dL or elevated homeostatic model assessment of insulin resistance), and higher income were the other risk factors. Even having a normal BMI (18.5-24.9 kg/m 2 ) was associated with a 2-fold increased risk of NAFL versus those with a BMI <18.5 kg/m 2

We report that chlorogenic acid (Chl) induces apoptosis of several Bcr-Ablpositive chronic myelogenous leukemia (CML) cell lines and primary cells from CML patients in vitro and destroys BcrAbl-positive K562 cells in vivo. In contrast, this compound has no effect on the growth and viability of Bcr-Abl-negative lymphocytic and myeloid cell lines and primary CML cells. Sodium chlorogenate (NaChl) exhibits 2-fold higher efficiency in killing K562 cells compared with Chl. NaChl also induces growth inhibition of squamous cell carcinoma (HSC-2) and salivary gland tumor cells (HSG), although at 50-fold higher concentration. NaChl inhibits autophosphorylation of p210 Bcr-Abl fusion protein rapidly. We demonstrate that p38 phosphorylation is increased in Bcr-Abl-positive cells after treatment with NaChl and closely paralleled the inhibition of Bcr-Abl phosphorylation. NaChl did not increase phosphorylation of p38 in Bcr-Abl-negative cells including HSC-2 and HSG that are responsive to this compound, indicating that p38 activation by NaChl is dependent on Bcr-Abl kinase inhibition. Inhibition of p38 activity by SB203580 significantly reduced NaChl-induced apoptosis of K562 cells, whereas activation of p38 by anisomycin augmented the apoptosis. These findings indicate that inhibition of BcrAbl kinase leading to activation of p38 mitogen-activated protein ( IntroductionChronic myelogenous leukemia (CML) is a malignant clonal disorder of hematopoietic stem cells leading to massive expansion of myeloid lineage cells. 1 The natural fate of CML is to progress from a benign chronic phase into the fatal blast crisis between approximately 3 and 5 years. Development of CML is associated with a specific chromosomal translocation known as the Philadelphia (Ph) chromosome that is detectable throughout the course of the disease. 2 Somatic mutation in Ph chromosome originates from reciprocal translocation between the long arms of chromosomes 9 and 22 and fuses Bcr with c-Abl genetic sequences. Both the Bcr-Abl fusion proteins p210 and p185 can cause CML or acute leukemia. 3,4 The p210 form of Bcr-Abl is seen in 95% of CML and in 20% of acute lymphocytic leukemia, whereas the p185 form is identified in about 10% of acute lymphocytic leukemia patients. 5,6 The Bcr-Abl fusion proteins are constitutively active non-receptor tyrosine kinases whose activity is essential for transforming abilities. 7 An almost universal presence of Bcr-Abl in CML patients made this fusion protein an attractive target for drug development. Bcr-Abl inhibitors, STI571, adaphostin, and PD173955, are capable of inducing a variable degree of apoptosis in human CML cells. [8][9][10] The signal transduction pathways involved in mediating apoptosis by Bcr-Abl inhibitors are poorly defined. In the current study, we describe a novel Bcr-Abl kinase inhibitor that triggers p38 mitogen-activated protein (MAP) kinase-dependent apoptosis of Bcr-Abl-positive CML cells. Materials and methods Cells and reagentsThe Ph chromosome ϩ CML cell line K562, 11 Ph chromosome-negative T-...

Sialic acids typically present as terminal sugars of oligo-saccharides are reported to be modified by O-acetylation at the C-9 position on lymphoblasts of childhood acute lymphoblastic leukemia (ALL) patients (Sinha et al., 1999a, Leukaemia, 13, 119-125). We now report high titers of IgG antibodies directed against O-acetylated derivatives of sialic acids (O-AcSA) in serum of ALL patients. These antibodies were purified using bovine submaxillary mucin (BSM) and the IgG distribution was confined to IgG(1)and IgG(2)subclasses; their binding was totally abolished with de-O-acetylation confirming their specificity towards O-AcSA determinants. Flow cytometry demonstrated binding of these antibody fractions to peripheral blood mononuclear cells (PBMC) of both T- and B-ALL patients having increased cell surface 9-O-AcSA determinants. Western blotting of membranes derived from PBMC of ALL patients confirmed binding of the antibody to O-acetylated sialoglycoconjugates corresponding to 144, 135, 120, 90, and 36 kDa whereas binding to PBMC from normal individuals corresponded to 144 and 36 kDa. Specificity of the antibody fraction towards 9-O-AcSA was substantiated by hemagglutination and hemagglutination-inhibition assays. The antibody purified from ALL serum selectively mediates complement dependent cytolysis of lymphoblasts expressing O-AcSAs and thereby possibly confers passive protection. The enhanced anti O-AcSA antibody levels allowed for development of a serodiagnostic assay (BSM-ELISA) specific for ALL. Minimal crossreactivity was observed with other hematological disorders like acute myeloid leukemia (n = 16), chronic myeloid leukemia (n = 6), chronic lymphocytic leukemia (n = 7) and non-Hodgkin's lymphoma (n = 3) as well as normal healthy individuals (n = 28). The BSM-ELISA therefore provides a simple, noninvasive alternative diagnostic approach for ALL and merits clinical consideration.

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