The loss of recombinant human granulocyte colony-stimulating factor and recombinant human TNF-alpha priming effects on the superoxide-generating response in exudated neutrophils is associated with a decrease in their receptor affinities

Several cytokines are known to enhance FMLP-stimulated superoxide generation in human circulating blood neutrophils through binding to their specific receptors, a process referred to as the priming effect. The priming effects produced by recombinant human granulocyte CSF (rhGCSF) and TNF-alpha (rhTNF-alpha) on FMLP-stimulated superoxide production in human and rabbit blood neutrophils were compared with their effects in their respective tissue neutrophils, i.e., human salivary and rabbit peritoneal neutrophils. The receptor binding characteristics of rhGCSF and rhTNF-alpha were also compared between the two types of neutrophils. Both rhGCSF and rhTNF-alpha produced dose-dependent priming effects on FMLP-stimulated superoxide production in human blood neutrophils, whereas they failed to produce any priming effects in human salivary neutrophils. Similar results were obtained for the priming effects by rhGCSF in rabbit blood and peritoneal neutrophils. A decrease in receptor binding affinity, but not in receptor density, in tissue neutrophils was demonstrated by analyzing the binding of [125I]rhGCSF and [125I]rhTNF-alpha. These findings suggest that tissue neutrophils are less responsive to rhGCSF and rhTNF-alpha in the modulation of FMLP-stimulated superoxide generation. This is due at least in part to the lower affinities of GCSF and TNF-alpha to their receptors in tissue neutrophils. This marked difference in priming effects by cytokines between blood and tissue neutrophils may represent an early step in the defensive responses against invading microorganisms or Ags.

The loss of recombinant human granulocyte colony-stimulating factor and recombinant human TNF-alpha priming effects on the superoxide-generating response in exudated neutrophils is associated with a decrease in their receptor affinities

Several cytokines are known to enhance FMLP-stimulated superoxide generation in human circulating blood neutrophils through binding to their specific receptors, a process referred to as the priming effect. The priming effects produced by recombinant human granulocyte CSF (rhGCSF) and TNF-alpha (rhTNF-alpha) on FMLP-stimulated superoxide production in human and rabbit blood neutrophils were compared with their effects in their respective tissue neutrophils, i.e., human salivary and rabbit peritoneal neutrophils. The receptor binding characteristics of rhGCSF and rhTNF-alpha were also compared between the two types of neutrophils. Both rhGCSF and rhTNF-alpha produced dose-dependent priming effects on FMLP-stimulated superoxide production in human blood neutrophils, whereas they failed to produce any priming effects in human salivary neutrophils. Similar results were obtained for the priming effects by rhGCSF in rabbit blood and peritoneal neutrophils. A decrease in receptor binding affinity, but not in receptor density, in tissue neutrophils was demonstrated by analyzing the binding of [125I]rhGCSF and [125I]rhTNF-alpha. These findings suggest that tissue neutrophils are less responsive to rhGCSF and rhTNF-alpha in the modulation of FMLP-stimulated superoxide generation. This is due at least in part to the lower affinities of GCSF and TNF-alpha to their receptors in tissue neutrophils. This marked difference in priming effects by cytokines between blood and tissue neutrophils may represent an early step in the defensive responses against invading microorganisms or Ags.

Clinical characteristics of three patients with UVs syndrome, a photosensitive disorder with defective DNA repair

Recently, we established a new category of photosensitive disorder termed UVs syndrome. Cells from patients with UVs syndrome have a similar UV sensitivity as xeroderma pigmentosum (XP) cells, but have a normal level of unscheduled DNA synthesis (UDS) unlike XP. UVs syndrome is distinct from Cockayne syndrome (CS) or XP including XP variant (XP-V), as determined by studies of genetic factors using cell fusion, microinjection, and postreplication repair assays. In this study, we identified three Japanese patients with UVs syndrome: an 11-year-old girl, a 17-year-old male, and an 8-year-old boy. The first two patients were siblings, while the third was a case from a different family. All of these patients exhibited acute recurrent sunburn. Common clinical manifestations of these patients were slight erythema and dryness, a number of freckles on sun-exposed areas, and slight telangiectasia only seen on the cheek and nose. Patient 3 showed a lowered minimal erythema dose between 280 and 300 nm. The patients' fibroblasts showed similar characteristics to those in CS, such as UV sensitivity, and a failure of RNA synthesis (RRS) after UV irradiation, despite a normal level of UDS. Thus, UVs syndrome is a new hereditary photosensitive disorder with clinical manifestations similar to a mild form of XP but showing the cellular characteristics of CS.

[Study of cockroach allergy in asthmatic children. The positive rates and antigenicity of cockroach allergen]

The specific IgE antibodies to 4 species of cockroach were measured in sera from 51 asthmatic children 6 to 16 years old by RAST and CAP system. Positive rates of RAST to Periplaneta fuliginosa, Blattela germanica, Periplaneta americana and Periplaneta japonica were 17.6%, 29.4%, 19.6% and 15.7%, respectively and those of CAP system to Periplaneta fuliginosa and Blattela germanica were 15.7%, respectively. Among those with positive RAST to 4 species of cockroach there were significant correlations. Significant correlations were observed also between the RAST titer for the whole bodies and feces of Periplaneta fuliginosa and Blattela germanica and immunoblotting analysis of sera obtained from two cockroach-positive patients revealed common sensitive fraction between whole body and feces. Immediate bronchial response was detected by bronchial provocation test. RAST inhibition study indicated no cross-reacting allergenicity between cockroach and mite. Collectively, cockroach is one of important inhalent allergens in asthmatic children.

A case report of colonic ileus due to eosinophilic nodular lesions caused by Gnathostoma doloresi infection

Gnathostomiasis is primarily a disease of the skin characterized as creeping eruption or mobile erythema. However, larval Gnathostoma sometimes migrate into an unexpected site to elicit serious illness. Here we describe a case of colonic ileus caused by Gnathostoma doloresi. The patient was a 57-year-old man living in Miyazaki Prefecture, Japan, which is known as an area endemic for this parasite. One week after having eaten a few slices of the flesh of a snake (Agkistrodon halys), he developed severe abdominal pain. An abdominal radiograph revealed multiple gas-fluid levels with a distended bowel of an inverted U shape. A barium enema revealed a tumor in the ascending colon near the hepatic flexure that was surgically removed by simple colonic resection. An oblique section of a parasite surrounded by massive infiltration of eosinophils was found by postoperative histopathologic examination. The entire body of the advanced third-stage larva of G. doloresi was dissected from a specimen-embedded paraffin block.

[Airborne Japanese cedar allergens studied by immunoblotting technique using anti-Cry j I monoclonal antibody--comparison with actual pollen counts and effect of wind speed and directions]

We collected airborne particles of Japanese cedar pollen with Burkard's sampling tape in Toyama from February to April 1992. The tape was cut into two pieces in parallel to time axis. The one of piece of the tapes was stained with glycerin-jerry and stained pollens were counted with a microscope. The other piece was treated according to the immunoblotting technique. The airborne pollen allergens, reacting with anti-Cry j I monoclonal antibody, were stained as blue spots. The spots were classified by diameter into two groups, large spots (> 50 microns) and small spots (< 50 microns). There were significant correlations found between the airborne Cry j I allergen spots (in large and small) and actual pollen counts obtained with the Burkard's sampler and the Durham's sampler (r = 0.729, 0.586 in large spots and r = 0.676, 0.489 in small spots, p < 0.001). The counts of small spots stayed in high level even in April when actual pollen counts decreased. We concluded that this discrepancy was caused by allergenic crushed cedar pollen particles staying floating longer than actual pollens. Secondly we set a gauge of wind speed and direction at the same point as the samplers. The actual pollen counts and large spots counts were significantly larger in the wind (SE wind in Toyama city) from cedar trees blooming area than other areas. However small spots counts did not differ significantly according to wind directions. Wind speed did not effect on actual pollen counts, large spots counts and small spots count.

[Bronchial hypersensitivity and development of bronchial asthma in children with atopic dermatitis]

Using histamine inhalation tests, we followed changes in bronchial hypersensitivity in 48 children with atopic dermatitis (AD) who were nonasthmatic on their initial visit. Twenty-three of these subjects became asthmatic during the follow-up period. The respiratory thresholds to histamine RT-Hist) of children with AD were widely distributed, ranging from 156 to more than 5000 micrograms/ml. There was a statistical difference in RT-Hist, as those who became asthmatic showed lower levels (< or = 625 micrograms/ml) at 2-6 yr of age. The percentage of peripheral eosinophil counts and IgE level was significantly elevated in those who became asthmatic. Subjects who developed asthma were more likely to have had positive D.p. RAST when they were less than 2 yr of age. The development of asthma in children with AD showed no significant relationship with family history of bronchial asthma.

[Bronchial hypersensitivity to histamine in asthmatic children longitudinal study from first visit to remitted state]

In order to examine the changes in bronchial hypersensitivity, histamine inhalation tests were evaluated in 27 asthmatic children who remitted. The respiratory threshold to histamine (RT-Hist) 2-3 yrs after remission was higher than in the initial test, in their worst periods of the asthma and just before remission (p < 0.001, p < 0.001, p < 0.005, respectively). Eleven subjects (40.7%), showed no improvement of bronchial hypersensitivity 2-3 yrs after remission (RT-Hist was 1250 micrograms/ml or lower). In this group, the asthma score per year two and three years before symptom-free state was higher than in the group with improved bronchial hypersensitivity (p < 0.05). There was no significant difference between % fall of FEV1.0 in RT-Hist in the worst periods of the asthma and 2-3 yrs after remission. FEV1.0/VCP, %V50, %V25 and V25/Ht 2-3 yrs after remission were higher than those in the worst periods of the asthma.

[A case of anaphylaxis caused by sunflower seed]

A 14 years old boy experienced an anaphylactic reaction of dyspnea, vomiting, urticaria and hypotension after he ate sunflower seeds. Specific IgE-mediated hypersensitivity to sunflower seen extract was demonstrated by skin tests and radioallergosorbent test (RAST). By immunoblotting test analysis (SDS-PAGE, Western blotting method), the allergenic activity of sunflower seem were shown to be in the MW range of 13.5 Kd.

[Evaluation of the Magic Lite SQ specific IgE kit]

The new IgE specific antibody assay kit (Magic Lite SQ) was evaluated by comparing its results with those obtained by the Phadebas RAST and the skin prick tests. Sera from allergic children were used in the tests. The correlation coefficients between the Magic Lite SQ and the Phadebas RAST were as follows: 0.87 for D.p., 0.89 for D.f., 0.87 for HD1, 0.55 for HD2, 0.76 for orchard grass, 0.93 for cat dander, 0.78 for Alternaria, 0.88 for egg white, 0.75 for egg york, 0.81 for milk, 0.75 for say bean, and 0.60 for shrimp. The concordance rate of the two methods was high, except on the case of HD2. The sensitivity and specificity of Magic Lite SQ to the skin prick test was high, except on the case of HD2 and orchard grass. Dilution tests using samples from D.f. positive patients showed a good linearity and excellent quantitativeness. When mite allergen was added to D.f. positive pool serum, mite specific IgE antibody yielded an excellent inhibition curve of up to a maximum of 96%. Since the Magic Lite SQ requires only a small sample of serum and can completed the test in a short time, it is a useful and specific IgE antibody assay kit.

[Airborne Japanese red cedar allergens studied by the immunoblotting technique--comparison with pollen counts obtained by Durham sampling and effect of weather]

We collected airborne particles with Burkard's sampling tape in Toyama from March to July. According to the immunoblotting technique (Takahashi et al, 1990), the airborne pollen allergens were reacted with anti-Cry j I polyclonal antibody and were stained as blue spots. The areas of these spots were measured with a color image analyzer (CIA) and a densitometer. There were significant correlations between the airborne Cry j I allergen spots (CIA and densitometer) and the pollen counts obtained with a Durham sampler (r = 0.624, 0.555, p < 0.001). The airborne Cry j I allergens however, tended to maintain a higher level than the pollen counts (Durham) in May. We theorized that this discrepancy is caused by cross reactivity with other pollen or crushed cedar pollen particles have allergenicity. There was a negative correlation between the Cry j I spots and rainfall. The pollen counts had a negative correlation with rainfall, and a positive correlation with average wind speed. These results suggest that this method is useful in evaluating fluctuations in airborne Cry j I allergen.

Intraoperative radiation-therapy combined with hyperthermia for pancreatic-carcinoma

Seventeen patients with pancreatic carcinoma were treated with intraoperative radiation therapy (IORT) combined with hyperthermia. Their treatment results were compared with those of 56 patients treated with the IORT alone (control group). The pain relief rate and the local tumor control rate of the hyperthermia group were slightly better than the control group. The survival rate of all patients was 13.7% at one year, 1.4% at two years (median, 5.0 months). The survival of the hyperthermia group was marginally better than that of the control group. Only 29% of the patients of the hyperthermia group was successfully heated, and if hyperthermia were given successfully to all patients, their prognoses would have been possibly improved.

[Efficacy of continuous isoproterenol inhalation therapy for severe asthma attacks in younger children]

The aim of this study was to evaluate the efficacy of continuous isoproterenol inhalation therapy for severe asthma attacks in younger children, compared with its efficacy in older children. We used l-body isoproterenol (Proternol L) in 31 children with 42 episodes of severe attacks. They were divided into two group according to age: 20 cases under 6 years old (Group A), and 22 cases over 7 years old (Group B). All of the patients except for one in Group B, eventually improved with this therapy. Wood's clinical scores for Group A were significantly higher than those for group B (p < 0.01). In 22 cases whose scores were 5-6, their SpO2 values at the onset of this therapy were 90.8 +/- 3.17 in group A and 92.4 +/- 3.82% in group B. The improvement time of group A (13.6 +/- 16.2 hours) was significantly longer than that of group B (2.5 +/- 5.66, p < 0.01). The nebulized isoproternol doses for group A were 0.47 +/- 0.168 and for group B 0.26 +/- 0.096 mg/kg/saline 500 ml. The dose for group A was significantly higher than that for group B (p < 0.01). We concluded that continuous isoproterenol inhalation therapy was effective even in younger children. But the degree of efficacy was slightly lower in younger children, although they inhaled higher doses of isoproterenal than older children.

[Efficacy of early use of continuous isoproterenol inhalation therapy for severe asthma attacks in children]

The aim of this study was to evaluate the efficacy and safety of continuous isoproterenol inhalation therapy for asthma attacks in children. We used l-body isoproterenol (Proternol L) in 22 children with 32 episodes of severe attacks. One of them did not respond to this therapy, and two had complications (atelectasis and pneumothorax). Twenty-nine cases were divided into three subgroups according to their clinical scores; A) scores less than or equal to 4, which meant that they were in the early stage of severe attack (n = 9), B) scores 5-6, which meant impending respiratory failure (n = 17), C) scores greater than or equal to 7, which meant respiratory failure (n = 3). The values of SpO2 at the start of this therapy were 94.8, 91.5, 82.0%, respectively. The more severe their attacks were, the lower their SpO2 levels were. The periods until their scores became zero were 0.78, 6.3, 17.2 hours, respectively. There were significant differences between each period respectively (p less than 0.001, p less than 0.01). Heart rates decreased when their symptoms improved, and other adverse effects were not detected. These results suggest that this therapy is effective and safe for children with severe asthma attacks, especially in the early stage.

Longitudinal study of bronchial hyperreactivity in preschool children with bronchial asthma

Forty asthmatic children aged 4 to 6 years performed histamine inhalation tests over 2 to 3 years. We used a previously reported method for examining bronchial hyperreactivity; measuring the transcutaneous oxygen pressure to evaluate whether bronchial hyperreactivity in younger children with bronchial asthma changed, and which potential factors affected changes in bronchial hyperreactivity. Although there was no significant relationship between the severity of asthma and respiratory threshold to histamine (RT-Hist) at the initial test, RT-Hist results in the severely asthmatic group were significantly lower than those of the remission and mild groups at the final test (P less than .01), respectively. RT-Hist significantly decreased in only the group whose asthma worsened (P less than .05). In the remission and improvement groups, RT-Hist did not improve despite their favorable clinical courses. When divided into two subgroups according to the extent of their RT-Hist, a high responder group had significantly more subjects who family histories of asthma than the low-responder group (P less than .05). There was no difference, however, in family history of allergic diseases between the two groups. We conclude that bronchial hyperreactivity in younger asthmatic children is influenced by multiple factors that may be congenital or acquired.

[Immunochemical quantification of the airborne chironomid allergens]

We collected airborne particles in the air using a high-volume air sampler, and measured chironomid allergen in the air-filter extract by use of RAST inhibition assay. The results obtained were as follows: 1) The assay revealed the presence of chironomid allergen in the air varying from 6.8 to less than 0.3 ng/m3. 2) In Toyama, seasonal fluctuations of airborne chironomid allergen demonstrated some large peaks in summer (June to August), and showed a tendency to decrease in winter. 3) There were significant correlations between airborne chironomid allergen and dry weight of chironomid midges, collected by using light traps, in all period of a week just before, 1 to 2 weeks before, 2 to 3 weeks before, or 3 to 4 weeks before air sampling. There were not significant correlations between airborne chironomid allergen and weathers (temperature, wind speed and precipitation) during or just before air sampling. 4) In Toyama, the frequency of asthma attacks in the asthmatic children with positive C.p. RAST was much increased in summer compared with that of the negative, in which the amount of airborne chironomid allergen was increased. These results show that there is large amount of chironomid allergen in the air from spring to autumn, especially large in summer, and it is related for some asthmatics to the increase of the frequency of asthma attack.

[Nationwide intradermal test with chironomid midge extract in asthmatic children in Japan]

Chironomidea (Insecta) is recently considered one of the most common inhalant antigen in Japan. Intradermal tests with Chironomus plumosus (CP) extract were undertaken on seven hundred and eighteen asthmatic children aged from 6 to 15 years in 10 areas (11 medical institutions) in Japan. The number of cases who showed positive intradermal tests with CP extract was 200 (27.9%) and the positive rate increased in proportion to their age (p less than 0.005). In each of the 11 medical institutions the positive rates ranged from 12.6% in Akita to 45.5% in Okinawa. There were no significant correlations between the results of the intradermal test with CP and those of RAST, prick test and intradermal test with mite, HD and silk, whereas correlation was noted in the prick test with silk (p less than 0.01). The CP positive asthmatics had significantly more attacks than the CP negative ones in the summer (p less than 0.01). The positive rate of asthmatics living near paddy or farm fields was significantly higher than that of those in urban residential areas (31.3% vs 23.8%, p less than 0.05). Chironomid midge is one of the most common and important allergen in Japan.

Nutritional characteristics of a neoglycoprotein, casein modified covalently by glucose

Glucose was combined covalently with the epsilon-amino groups of lysyl residues of bovine casein in the presence of sodium cyanoborohydride as a reducing reagent by reductive alkylation, forming stable secondary amine linkages. Solubility characteristics and nutritional values of the neoglycoprotein were examined. The degree of modification (%) of the glucosylated casein was 82.5. Solubility of the modified casein was increased by the attachment of glucose. The modification did not disturb the digestion of casein by pepsin or trypsin. Rat feeding experiments using 10% protein diets demonstrated that the protein efficiency ratio (PER) of the modified casein was 0.35 +/- 0.33 compared with 2.99 +/- 0.29 for the unmodified casein. When the modified casein was supplemented with L-lysine to equal the level of total lysine of unmodified casein, the PER value was increased to 2.21 +/- 0.29. Nitrogen balance experiments showed that the modified casein was digested completely. On the other hand, biological value and net protein utilization of the modified protein were shown to be considerably lower than those of the unmodified casein.

Measurement of bronchial hyperreactivity in infants and preschool children using a new method

We report a new method for examination of bronchial reactivity by measuring transcutaneous oxygen pressure (tcPO2) during the inhalation of histamine in stepwise incremental concentrations. The correlation between changes in tcPO2 and those in PEFR or FEV1 was high (P less than .001). When the fall in PEFR or FEV1 was more than 20% compared with baseline, the fall in tcPO2 was more than 10%. We also measured the dose of radiolabeled aerosol (99mTc-DTPA) inhaled into the lung using a scintillation camera. When aerosol is inhaled during tidal breathing, there are adequate correlations between the dose of aerosol in the lung and both the age and height of the patients (P less than .001). When aerosol was inhaled during crying, little deposit within the lung was shown. When the inhalation challenge test was done during a sleeping period for children aged under 2 years, the loading dose of aerosol in the lung was sufficient. The geometrical means of respiratory threshold of histamine (RT-Hist) among 106 asthmatic and 11 control children, aged 2 to 6 years, were 1182 and 4414 micrograms/mL, respectively. The means of RT-Hist in 17 children with bronchial asthma, nine with atopic dermatitis, five with respiratory disease, and nine controls, aged under 2 years, were 1152, 964, 544, and 3402 micrograms/mL, respectively.

[Expression of nerve growth factor-receptor in normal skin and melanocytic tumor]

Immunohistochemical localization of nerve growth factor (NGF) receptor in normal skin and melanocytic tumor was analysed using monoclonal antibody. In normal skin and fetal skin NGF receptor was good marker for cutaneous nerve sheath and schwann cells. In melanocytic lineage, the NGF receptor was not expressed in fetal, normal and dermal melanocyte and weakly positive in only small part of nevus cell nest. Positive staining was seen in primary and metastatic melanoma lesion and restricted to melanoma cell membrane. The distribution of the receptor suggests that the NGF-receptor may be involved in the control of proliferation and malignant transformation in melanocytic lineage.