Immunomodulation by an adenylate cyclase activator, NKH477, in vivo and vitro

Cyclic adenosine monophosphate (cAMP) is an intracellular second messenger which modulates T cell function. NKH477 is a direct adenylate cyclase activator derived from forskolin and now under clinical investigation as a positive inotropic agent. While the immunosuppressive effects of forskolin on lymphocytes have been reported, little is known about its effects in vivo. In this study, we investigated whether NKH477 has immunosuppressive effects in mice, namely on cardiac allograft survival, and on the generation of cytotoxic T lymphocytes (CTL), T cell proliferation in mixed lymphocyte reaction (MLR), and production of interleukin-2 (IL-2) in MLR and in mitogen response. We assessed the effects of standard immunosuppressant cyclosporin A (CsA) on IL-2 production and on allograft survival to estimate the intensity of rejection in this acute rejection model. Saline-treated C57BL/6 (H-2b) mice rejected DBA/2 (H-2d) cardiac allografts with a median graft survival time of 10 days. In contrast, median graft survival was prolonged to 12 and 15 days in mice treated with NKH477 at 1 and 3 mg/kg/day, respectively (P < 0.01 vs control). The equivalent dose of CsA (40 mg/kg/day) to the maintenance dose after clinical cardiac transplantation prolonged median graft survival time to 15.5 days, indicating that high dose of NKH477 was as efficacious as lower dose of CsA. Addition of NKH477 to the culture medium suppressed the generation of CTL, T cell proliferation in MLR, and production of IL-2 in MLR and in mitogen response. These results suggest that NKH477 exerts a beneficial effect on murine cardiac allograft survival by modulating T cell function.

[Stage IIIa endometrial carcinoma: MR findings]

[PURPOSE]: An attempt was made to evaluate the ability of magnetic resonance (MR) imaging to diagnose stage IIIa endometrial carcinoma. [MATERIALS AND METHODS]: Thirty-three patients with endometrial carcinoma underwent MR imaging and surgery. Surgical staging was classified as I in 21 patients, II in 3 patients and III in 9 patients. The MR images of each patient were retrospectively reviewed by three radiologists. Only the clinical diagnosis of endometrial carcinoma was previously notified. Segmental disruption of the full thickness of the myometrium was considered serosal invasion. Intraperitoneal metastasis was diagnosed according to three criteria (intraperitoneal solid mass of isointensity compared with endometrial lesion, cystic mass excluding benign ovarian cysts, ascites). These evaluations were compared with the surgical findings and analyzed by the kappa statistic. [RESULTS]: The rates of sensitivity and positive predictive value (PPV) for serosal invasion were 33% and 6%, respectively. False positive evaluation frequently occurred when thickness of the intact myometrium was less than 5mm. The rates of sensitivity and PPV for intraperitoneal metastasis were 86% and 72%, respectively. The reason for false negative evaluation was small foci of intraperitoneal metastasis. Overall, sensitivity and PPV for stage IIIa were 86% and 69%, respectively. [CONCLUSION]: MRI was useful in detecting intraperitoneal metastasis of endometrial carcinoma with the exception of diagnosing serosal invasion. It is difficult to detect small foci of peritoneal metastasis. It is necessary to differentiate adnexal metastasis from benign adnexal masses.

Preparation of an activity-inhibiting monoclonal antibody against human placental aromatase cytochrome P450

We produced a murine monoclonal antibody (MAb) to human placental aromatase cytochrome P450. This MAb, designated MAb3-2C2, was selected on its ability to suppress aromatase activity. The specificity of this MAb was assessed by selective immunoprecipitation of 125I-labeled aromatase cytochrome P450 as well as by the identification of a 55-kDa protein, which was enriched and purified by immunoaffinity chromatography on a MAb-coupled Sepharose 4B column. The MAb was able to suppress both human placental and ovarian microsomal aromatase. Species differences of aromatase were recognized by MAb3-2C2 on the basis of differential immunosuppression of aromatase activity. The antibody had no effect on non-aromatase cytochrome P450s. MAb3-2C2 gave negative results with human placental aromatase P450 in the Western blot analysis. The data presented indicate that MAb3-2C2 is specific for aromatase cytochrome P450 and that its epitope is located in a fragile tertiary conformation of the enzyme, thus making it capable of sensitively affecting catalysis.

Characteristic immunological tolerance in intrahepatic lymphocytes induced by bacterial superantigen SEB

We have reported that the liver is closely associated with the hematolymphoid system and that the liver, as a lymphoid organ, may play an important role in the differentiation of lymphocytes and oral tolerance. To investigate the relevance of the liver to immunological tolerance, we compared the response pattern to Staphylococcus enterotoxin B (SEB) in intrahepatic lymphocytes (IHL) with those of spleen cells (SPC) and mesenteric lymph node cells (mLNC) during tolerance induction. Tolerance was induced by i.v. injections of SEB in all three organs. IHL had a distinct pattern from the other cells in the induction of unresponsiveness to SEB. While SPC and mLNC have a proliferation phase before the reduction of DNA synthesis, IHL become tolerant immediately without this phase. When IHL became tolerant in the early period after SEB injection, their nylon-wool column non-adherent (NW-NA) IHL were not recovered from unresponsiveness in vitro in spite of the addition of irradiated normal SPC as accessory cells. NW-NA IHL did not secrete IL-2 during this process, indicating that NW-NA IHL were in a state of functional anergy soon after the i.v. administration of SEB. Phenotypic analysis revealed that the characteristic changes of IHL during the induction of unresponsiveness might be associated with the kinetic modulation of CD4+ V beta 8+ T cells. These results suggest that the liver may hold a different mechanism for the induction of tolerance to SEB from that of SPC and mLNC.

Metabolic effects of glibenclamide in isolated rat hepatocytes in the absence of extracellular Ca2+

We examined the metabolic effects of glibenclamide, a potent second-generation sulfonylurea, in isolated rat hepatocytes incubated in the absence of extracellular Ca2+. We first demonstrated in the present study that glibenclamide caused a significant increase in basal glucose release and lactate production without any modification of intracellular Ca2+ concentration or cAMP levels in isolated rat hepatocytes. Furthermore, glibenclamide inhibited the noradrenaline-induced increase in cAMP accumulation, while activation of glycogenolysis by noradrenaline was not suppressed by this agent. Our data indicate that glibenclamide exerts its metabolic effects independent of intracellular Ca2+ mobilization and cAMP accumulation.

Molecular analysis of mutations induced by 2-chloroacetaldehyde, the ultimate carcinogenic form of vinyl chloride, in human cells using shuttle vectors

Vinyl chloride (VC) is a carcinogen associated with human and animal cancers. The ultimate carcinogenic form of VC, 2-chloroacetaldehyde (CAA), has been suspected to be mutagenic and we confirmed the mutagenicity of CAA using a modified shuttle vector plasmid. Base sequence analyses of 109 mutant plasmids with mutations in the supF gene, which were treated with CAA and propagated in the cultured human cells, revealed that more than half of the single base substitutions were G:C to A:T transitions with eight hotspots. The majority of the mutations involving G:C base pairs were in 5'-AAGG-3' or 5'-CCTT-3' sequences suggesting that these sequences are the main targets of mutagenesis caused by CAA.

Beneficial effect of amrinone on murine cardiac allograft survival

Amrinone is a non-glycoside positive inotropic agent with an inhibitory effect on a cyclic adenosine monophosphate (AMP) phosphodiesterase isoenzyme. In the present study, we examined the immunosuppressive action of amrinone, since several other cyclic AMP-elevating agents have been shown to suppress T lymphocyte activation. First, the in vivo effects of amrinone were investigated. Oral amrinone treatment, at 40 mg/kg per day, significantly prolonged median cardiac allograft survival compared with non-treated controls (22.0 days versus 10.5 days, P < 0.01) when DBA/2 mouse hearts (H-2d) were heterotopically transplanted into C57B1/6 mice (H-2b). Histopathological examination showed that there was less prominent cellular infiltration in the amrinone-treated than in the non-treated allografts. Plasma amrinone concentrations of mice after a single oral dose of 40 mg/kg were within the range of clinical relevance. To clarify the mechanism of action, in vitro studies were done. The generation of specific cytotoxic T lymphocytes after mixed lymphocyte culture was significantly suppressed by addition of amrinone to the culture medium at 5 micrograms/ml. The production of IL-2 and the interferon-gamma during mixed lymphocyte culture was also suppressed by amrinone at 5 micrograms/ml. However, the level of intracellular cyclic AMP in mouse splenic lymphocytes was not affected significantly by the same dose of amrinone. In conclusion, amrinone has immunosuppressive actions at the therapeutic doses, and it may be a beneficial agent for therapy against acute cardiac allograft rejection.

[Histopathological and immunohistochemical evaluation of lymph node metastasis in superficial esophageal cancer--with reference to the expression of E-cadherin and alpha-catenin]

We compared node-negative patients (13 cases) with node-positive patients (17 cases) with submucosal cancer of the esophagus, to assess the relationship between clinicopathological factors and lymph node metastasis. We also investigated the expression of E-cadherin, an intercellular adhesion molecule (27 cases), and alpha-catenin, an undercoat protein of adherence junction (16 cases) by immunohistochemical staining to evaluate the association between intercellular adhesiveness and lymph node metastasis in superficial esophageal cancer. There was no significant difference between the node-negative and node-positive groups in other clinicopathological factors and tumor size, while the frequency of lymphatic invasion in the node-positive group was statistically higher than that in the node-negative group (p < 0.05). The frequency of lymph node metastasis in 14 cases with preserved expression of E-cadherin was significantly lower than that in 13 cases with reduced or negative expression (7.1% vs. 46.2%: p < 0.05). Moreover, all three patients with negative expression of alpha-catenin had lymph node metastasis, while only one of 13 patients with preserved or reduced expression of alpha-catenin had lymph node metastasis (100% vs. 7.7%: p < 0.01). In conclusion, we have found that the evaluation of both E-cadherin and alpha-catenin expression might be of great value in predicting lymph node metastasis in superficial esophageal cancer.

Assessment of working skeletal muscle oxygenation in patients with chronic heart failure

Patients with chronic heart failure (CHF) are frequently limited by muscle fatigue resulting from impaired skeletal muscle blood flow. Accordingly, we assessed working skeletal muscle oxygenation in such patients using near-infrared (NIR) spectroscopy. Nine normal subjects (mean age 52 years) and 12 patients with CHF (mean age 60 years) were studied. NIR spectroscopy was used to monitor relative changes in oxygenated hemoglobin (Hb) and myoglobin (Mb) (oxy Hb/Mb), deoxygenated Hb and Mb (deoxy Hb/Mb), and total (oxy + deoxy) Hb and Mb (total Hb/Mb) contents in the vastus lateralis muscle at rest, during warm-up (0 W, 30 cycles/min for 3 min), incremental maximal supine bicycle exercise (ramp protocol, 15 W/min, 50 cycles/min), and recovery. At peak exercise the patients exhibited reduced heart rate, systolic blood pressure, peak exercise oxygen consumption (VO2; 15 +/- 3.0 ml/kg/min vs 32 +/- 8.5 ml/kg/min), and workload (99 +/- 23.4 W vs 183 +/- 68.4 W) as compared with the normal subjects. The respiratory quotient was comparable in both groups. In the normal subjects, oxy Hb/Mb was increased from the warm-up period to the early phase of exercise, followed by a progressive decrease to peak exercise. In the recovery phase, oxy Hb/Mb was increased abruptly. For these patients, change in oxy Hb/Mb followed a pattern similar to that seen in normal subjects, and oxy Hb/Mb was decreased earlier in contrast to that in the normal subjects. There was a significant difference in the change of oxy Hb/Mb during warm-up, early phase exercise, and recovery between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Quantitation of IL-1 beta mRNA by a combined method of RT-PCR and an ELISA based on ion-sensitive field effect transistor

A method for quantitative RT-PCR using ELISA detection was developed and applied to the quantitation of IL-1 beta mRNA in clinical samples. To compensate for the 'tube effect' of RT-PCR, a synthetic RNA, pRSET RNA, was added to sample solutions as an internal standard and co-amplified with IL-1 beta mRNA. Sense primers for IL-1 beta and pRSET were labeled with digoxigenin and FITC, respectively, while anti-sense primers for both were labeled with biotin. Double-stranded PCR products were captured by two solid-phase pipettetips. One was coated with an anti-digoxigenin antibody and another with an anti-FITC antibody, and sandwiched by avidin-urease, and their activities were measured by coupling them with a pH-FET in a pH-measuring cell containing urea solution. The ratio of the signal intensity for IL-1 beta to that for pRSET was used to quantify the concentration of IL-1 beta mRNA. A calibration curve was obtained by using a known amount of AW 109 RNA as an external standard of IL-1 beta RNA. It was found that 10(2)-10(6) copies of IL-1 beta mRNA were measurable by the present method. Expression levels of IL-1 beta mRNA in clinical samples, such as monocytes of peripheral blood or synovial cells from patients with RA or OA, were determined.

Isolation of a full-length cDNA clone for human GTP cyclohydrolase I type 1 from pheochromocytoma

Although the existence of three different cDNA forms of human GTP cyclohydrolase I (GCH I) have been reported (Togari et al., 1992), the full-length sequence of any human GCH I cDNA involving poly (A) tail has not yet been documented. In the present study, we first isolated a full-length cDNA clone encoding human GCH I type 1 from human pheochromocytoma cDNA library. The length of the cDNA insert was 2,921 base pairs including poly (A) tail. RNA blot analysis showed a single mRNA species of 4.0 kb in human pheochromocytoma tissue.

Effect of epidermal growth factor on cadherin-mediated adhesion in a human oesophageal cancer cell line

Epidermal growth factor (EGF) mediates many pleiotrophic biological effects, one of which is alteration of cellular morphology. In the present study, we examine the possibility that this alteration in cell morphology is caused in part by the dysfunction of cadherin-mediated cell-cell adhesion using the human oesophageal cancer cell line TE-2R, which expresses E-cadherin and EGF receptor. In the presence of EGF, TE-2R changed its shape from round to fibroblastic and its colony formation from compact to sparse. Vanadate, a tyrosine phosphatase inhibitor, further potentiated the EGF response, whereas herbimycin A, a tyrosine kinase inhibitor, interfered with it. Moreover, EGF enabled the cells to invade in organotypic raft culture. These phenomena were accompanied not by decreased expression of the E-cadherin molecule but by a change in its localisation from the lateral adhesion site to the whole cell surface. Both alpha- and beta-catenin, cadherin-binding proteins, were also expressed at the same level throughout these morphological changes. Finally, we examined tyrosine phosphorylation of E-cadherin and alpha- and beta-catenin, and observed tyrosine phosphorylation of beta-catenin induced by EGF. These results suggest that EGF counteracts E-cadherin-mediated junctional assembly through phosphorylation of beta-catenin and modulates tumour cell behaviour to a more aggressive phenotype.

Detachment of desmosomes in a microcystic meningioma

This report demonstrates the detachment of desmosomes in the microcystic area of a frontal convexity meningioma removed from a 69-year-old woman. Well-developed interdigitations of the tumor cell processes with numerous desmosomes and with narrow extracellular spaces were characteristic features of the solid area of the meningioma. By contrast, the microcystic area of the tumor had markedly distended extracellular spaces. Various stages in the separation of desmosomal attachments were seen in this area. The observed configurations ranged from the widening of opposing junctions to the formation of large cavities where hemidesmosome-like structures were evident. The latter lacked basal lamina, and are considered to represent a transition leading to the loss of desmosome, and thus involved in the enlargement of the extracellular space in microcystic meningiomas.

Dilated cardiomyopathy defines serum autoantibodies against G-protein-coupled cardiovascular receptors

In order further to identify the prevalence of anti-receptor autoantibodies in the sera of patients with dilated cardiomyopathy (DCM), we attempted to detect autoantibodies against a series of G-protein-coupled cardiovascular receptors in a well-defined population of DCM patients from Japan. Peptides corresponding to the sequences of the second extracellular loops of the human beta 1 and beta 2 adrenoceptors, alpha 1 adrenoceptors, M2 muscarinic acetylcholine receptors and angiotensin II-1 (AT1) receptors were used as antigens in an enzyme immunoassay to screen the sera from patients with DCM (n = 28). Nine sera from patients with DCM (32%) and 2 sera from healthy subjects (9%) recognized the beta 1 adrenoceptor peptide. Ten sera from patients (36%) and 3 sera from healthy subjects (13%) recognized the M2 receptor peptide. Thirty-six per cent of the patients with autoantibody against the beta 1 adrenoceptor peptide. Ten sera from patients (36%) and 3 sera from healthy subjects (13%) recognized the M2 receptor peptide. Thirty-six per cent of the patients with autoantibody against the beta 1 adrenoceptor had autoantibody against the M2 receptor. However, no significantly high frequencies of autoantibodies against the beta 2 adrenoceptor, alpha 1 adrenoceptor and AT1 receptor were found in DCM patients. Our results demonstrate that a subgroup of patients with DCM have a specific spectrum of autoantibodies which are specifically directed against the second extracellular loops of the beta 1 adrenoceptors and M2 muscarinic receptors rather than other cardiovascular receptors.

Detection of the products of polymerase chain reaction by an ELISA system based on an ion sensitive field effect transistor

An ELISA system was developed using a pH sensitive ISFET (pH-FET) as a detector, a pipette tip as a solid phase, and urease as a detecting enzyme. Double stranded PCR products with digoxigenin and biotin at both terminals were obtained by using digoxigenin- and biotin-labeled primers. 1 microliters of the PCR solution was directly introduced into the end part of a pipette tip coated with anti-digoxigenin antibody. Biotin-labeled PCR products captured at the solid phase were detected with avidin-urease, of which the activity was measured by a pH-FET in a pH-measuring cell containing urea solution. The assay was used to detect HTLV-I provirus gene integrated in the genome of a human MT-1 cell, and it was found that 100 pg of the genomic DNA of MT-1 cell was specifically detectable after 35 cycles of PCR. Also the detection limit of the present ELISA system itself was determined by using known amounts of purified PCR product labeled with digoxigenin and biotin, and it was found that 10 amol of the labeled DNA in 1 microliter of sample was detectable.

[A case of severe pneumonia in an elderly man, caused by Citrobacter freundii suspected to have a low susceptibility to imipenem/cilastatin sodium]

An 80-year-old blind man with lepromatous leprosy suffered from right femoral neck and humeral neck fractures on July 9, 1993. Because of fever (38.6 degrees C), difficult expectoration and diffuse bilateral perihilar infiltrates with consolidation in the left lower lung field on his chest radiograph, severe pneumonia was diagnosed. With intravenous hyperalimentation, imipenem/cilastatin (IPM/CS), ceftazidime, minocycline, gentamicin (GM), and human immunoglobulin were administrated. On July 29, hip screw-plate fixation was done. Citrobacter freundii was isolated from the sputum and its susceptibility was IPM/CS+, GM3+. Multi-drug therapy with GM and other antibiotics improved the patients' condition, but Citrobacter freundii were still detected and 43 days of medication were needed. According to a report by the Ministry of Health and Welfare in 1992, the resistance rate of IPM/CS against Citrobacter freundii is only 0.7%, and IPM/CS is more effective than beta-Lactams. This is a very rare case of severe pneumonia in an elderly patient caused by Citrobacter freundii that was suspected to have low susceptibility to IPM/CS.

Immunolocalization of a fibronectin-binding proteoglycan (PG-P1) immunologically related to HSPG2/perlecan in normal and fibrotic human liver

Immunolocalization of a fibronectin-binding proteoglycan (PG-P1) in relation to fibronectin, type IV collagen and laminin, in normal and fibrotic human liver was investigated by light and electron microscopy. HS-42, which is a monoclonal antibody to PG-P1 and is reported to recognize a heparan sulfate proteoglycan named HSPG2/perlecan, was used for this purpose. Light microscopy in the human liver with minimal changes revealed that PG-P1 was present along the hepatic sinusoids as well as fibronectin and type IV collagen, whereas laminin was only weakly detected. In portal areas, PG-P1 was only localized on basement membranes around bile duct systems and blood vessels, as well as laminin and type IV collagen, while fibronectin was scarcely detected in basement membranes. In the fibrotic liver, fibronectin was abundant in necrotic and/or newly fibrosing areas, while PG-P1 was absent in these regions. Using immunoelectron microscopy, PG-P1 was localized in the space of Disse in nearly normal livers and was only detected on basement membranes in portal tracts. In fibrotic livers, PG-P1 in the space of Disse occasionally showed a basement-membrane-like deposition in parallel with the increased light microscopical deposition of laminin in this area, suggesting the positive participation of PG-P1 in the sinusoidal capillarization. Most capillary and sinusoidal endothelial cells, and rarely bile epithelial cells revealed the reaction products of PG-P1 in their rough endoplasmic reticulum and small vesicles. Thus, it was suggested that these cell types are mainly, if not wholly, responsible for PG-P1 production.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunosuppression by lymphokine-activated murine killer cell line with B-lymphoblast-lytic activity in vitro

The in vitro immunosuppressive effect caused by a murine lymphokine-activated killer cell line with B-lymphoblast-lytic activity was studied. The cloned cells (named BC-1.10, phenotype Thy 1.2+, LFA-1+, TCR-alpha beta-, TCR-gamma delta-, Fc gamma RII-, CD2-, CD3 epsilon-, CD4-, CD8- and express mRNA of zeta chain) suppressed LPS-induced Ig synthesis by B lymphoblasts previously stimulated with LPS. Phase-contrast microscopy indicated disappearance of B lymphoblasts at 24 h after the addition of BC-1.10 cells. This suppressive effect was reduced when BC-1.10 cells were pretreated with anti-LFA-1 mAb, which inhibits cytotoxicity of this clone. These data suggest that the immunosuppressive effect of BC-1.10 is due to an elimination of B lymphoblasts, and that one of the physiological functions of lymphokine-activated killer (LAK) cells, which are induced as a consequence of immune reactions, might be immunosuppression.

Periodic lateralized epileptiform discharges in EEG during recovery from hyponatremia: a case report

PLEDs were observed in a case of undifferentiated schizophrenia, transiently during the course of recovery from hyponatremia, and diffuse EEG slowing remained even after the serum sodium had returned to normal range. It was considered that PLEDs had occurred transiently in relation to hemispheric ischemic disturbance induced by hyponatremia. The characteristics of PLEDs associated with hyponatremia will need to be studied further in more patients with hyponatremia.