The early and clinically occult spread of viable tumour cells throughout the body is increasingly considered as a hallmark of cancer progression, because recent data suggest that these cells are precursors of subsequent distant relapse. Using monoclonal antibodies to epithelial cytokeratins or tumour-associated cell-membrane glycoproteins, individual carcinoma cells can be detected in cytological bone marrow preparations at frequencies of 10-5 to 10-6. Prospective clinical studies have shown that the presence of these immunostained micrometastatic cells in bone marrow, as a frequent site of overt metastases, is prognostically relevant with regard to relapse-free period and overall survival. This screening approach might therefore be used to improve tumour staging and to guide stratification of patients for adjuvant therapy in clinical trials. Another promising clinical application is the use of these micrometastatic cells to monitor response to adjuvant therapies, which at present can be assessed only retrospectively after an extended period of clinical follow-up. This review summarises current data on the clinical significance of occult metastatic breast cancer cells in bone marrow.

The parasitic protozoan Toxoplasma gondii and its relatives (e.g. Plasmodium spp., which cause malaria) constitute a major global health problem. In recent years, the elucidation of biological processes in these parasites has accelerated with the application of genetic and genomic methodologies. Genetic analyses in T. gondii have revealed a remarkably stable 87 Mb (megabase) nuclear genome consisting of 11 chromosomes showing little variation across strains. Population studies demonstrate that the small amount of variation defines three clonal lineages where phenotypes such as virulence are associated with a single lineage. The random generation of cDNA (complementary DNA) sequences derived from different strains and developmental stages has highlighted the genetic differences underlying observed phenotypic variation. T. gondii also contains an extrachromosomal 35 kb (kilobase) circular DNA within an organelle with plastid-like properties. The limited coding capacity of the 35 kb organellar genome suggests that proteins responsible for organelle function(s) must be encoded by the nucleus. Scrutiny of T. gondii nuclear cDNA sequences has uncovered a number of proteins thought to carry out essential roles in the organelle (e.g. fatty acid biosynthesis). The synergism between these seemingly unrelated genomic studies has provided a greater understanding of parasite pathogenesis and has identified several new targets for chemotherapy.

Pancreatic adenocarcinoma is a major cause of cancer deaths in the industrialised world. Recent work has focused on the genetics of pancreatic cancer with a goal of finding an early detection marker that might allow for greater rates of survival than are currently possible. The breast cancer 2 gene (BRCA2) is one of numerous genes implicated in familial pancreatic cancer. Carriers of germline mutations of the BRCA2 gene have an increased risk of several cancers, among them pancreatic adenocarcinoma. During pancreatic carcinogenesis, bi-allelic inactivation of BRCA2 occurs as a late event, suggesting that other genetic events must occur before neoplastic cells can tolerate loss of BRCA2.

Toxoplasma gondii is a protozoan parasite that is uniquely adapted for penetrating and surviving within a wide range of host cells. This parasite invades mammalian cells by an active actin-dependent mechanism, and after entry establishes a vacuole with the assistance of products secreted by the parasite's apical organelles. Simultaneously, Toxoplasma sets about gaining access to cellular nutrients by forming pores in the vacuolar membrane. In this manner it enjoys a rich and comfortable lifestyle at the host cell's expense. Understanding the Toxoplasma–host interaction may reveal unusual mechanisms for exploiting host cell pathways and diverting host organelle functions. These novel modifications could also be potential targets for new drugs.

Kaposi's sarcoma (KS) is the most common neoplasm in acquired immune deficiency syndrome (AIDS) patients, with up to 20% of individuals infected with human immunodeficiency virus 1 (HIV-1) afflicted with this multifocal, systemic disease. For many years, scientists have striven to understand the complex pathogenesis of KS. Although experts generally agree on several key points [such as human herpesvirus 8 (HHV-8) being necessary but not sufficient for the development of KS], many questions still remain unanswered. This review summarises current theories on the molecular pathogenesis of KS, including the role of HHV-8, HIV-related proteins and growth factors in the initiation and progression of AIDS-related KS.

Preventing the destruction of articular cartilage has long been a goal in the treatment of arthritic diseases, in which a combination of cytokines and growth factors affect the catabolic state of cells within the joint. Normal tissue turnover can be viewed as a balance between degradation and synthesis of the macromolecules that constitute the extracellular matrix. This process is tightly regulated such that highly degradative proteinases are controlled at several levels, including synthesis and secretion, activation and inhibition. Tissue destruction occurs when proteinase-mediated degradation exceeds synthesis, and this is markedly influenced by cytokines and growth factors that stimulate matrix synthesis as well as the production of proteinases and/or their endogenous inhibitors. This review outlines current knowledge of factors that influence cartilage biology, with particular emphasis on chondrocytes and synovial fibroblasts. Recent findings from the delivery of cytokines to affected tissues are also summarised, and the potential impact these observations might have on new therapies for arthritic diseases is discussed.

Over the past decade, the prevailing view for the molecular and cellular pathogenesis of Alzheimer's disease (AD) has centred on the β-amyloid (Aβ) peptide that accumulates in vulnerable brain areas in the disease. The amyloid cascade hypothesis postulates that the build up of Aβ in the brain causes damage to neurons, leading to dysfunction and loss of neurons, and the clinical phenotype of the amnestic dementia characteristic of AD. All known mutations that result in autosomal dominant forms of early-onset familial AD cause increased production of Aβ42, a form of Aβ that is particularly relevant in AD. Other proteins that are crucial to the pathogenesis of AD are the presenilins 1 and 2, which are intimately involved with Aβ production and when mutated in familial forms of AD cause increases in Aβ42. Currently, challenges in AD research include determining the earliest pathological effects of Aβ42, how the important AD risk factor apolipoprotein E affects the disease process, whether presenilin is the elusive γ-secretase, and how levels of Aβ can be effectively reduced therapeutically.

Chemokines are small, chemotactic cytokines that direct migration of leukocytes, activate inflammatory responses and participate in many other pleiotropic functions, including regulation of tumour growth. Chemokines modulate tumour behaviour by three important mechanisms: regulation of tumour-associated angiogenesis, activation of a host tumour-specific immunological response, and direct stimulation of tumour cell proliferation in an autocrine fashion. All of these mechanisms are promising points of cancer intervention, and preclinical mouse models suggest that chemokine antagonists and agonists could become important in the development of new anticancer therapies.

Endometriosis originates in the uterine lining and affects ~20% of reproductive-age women. The disease often causes chronic pelvic pain, affects ovulatory function and influences fertility. Although laparoscopic diagnosis of uterine endometriosis is quite specific, direct visualisation can be difficult or inaccurate in some circumstances, and it is not useful for diagnosing extra-abdominal disease. Laparoscopy is an invasive procedure, has significant morbidity and cannot be carried out frequently to monitor efficacy of therapy and the possibility of recurrence. Thus, a specific, non-invasive diagnostic test is required. One intriguing area of research uses the technology of radioimmunotargeting, which has previously been used for cancer detection. This technique could have potential for the specific detection and eventual treatment of endometriosis. A marker, eosinophil peroxidase (EPO), has been identified that is expressed in ~90% of endometriosis specimens, and is not expressed or only weakly expressed in normal endometrium. The US Food and Drug Administration has approved a monoclonal antibody to EPO for investigation as an immunoimaging agent in cancers that exhibit eosinophilia. EPO targeting using this antibody could be useful for detecting and/or treating endometriosis.

Breast cancer is one of the most common causes of cancer-related mortality in women. It affects more than one in nine women over their lifetime. Although most breast cancers are sporadic, the genetics and molecular biology of the heritable forms of breast cancer have provided valuable insights into not only breast cancer but also cancers in general. Among the mutations linked to heritable breast cancers, the mutations in the breast cancer 1 (BRCA1) gene are the best characterised. The BRCA1 gene encodes a nuclear protein that is important for maintaining genome integrity. However, a growing list of BRCA1-associated proteins suggests that BRCA1 has diverse and unexpected functions.

It was suggested by Ronald Fisher in 1931 that genes that benefit the male (including those required for spermatogenesis) would accumulate on the Y chromosome. Following the discovery that microdeletions of the Y chromosome were associated with diverse spermatogenic phenotypes, at least three intervals that contain one or more genes controlling male germ-cell differentiation have been identified in humans. These intervals, named AZFa, AZFb and AZFc, have been mapped, cloned and examined in detail for the presence of functional genes. In this review, I have discussed the genes that map to the AZF intervals and the evidence indicating which ones are the most likely candidates underlying Y-linked male infertility. In addition, I have considered the analysis of key intervals on the mouse Y chromosome, where it provides comparative data supporting the role of a candidate gene in an infertility phenotype.