Proviral status of HTLV-1 integrated into the host genomic DNA of adult T-cell leukemia cells

Human T-cell leukemia virus type-1 (HTLV-1) is the etiological agent of adult T-cell leukemia (ATL), and leukemic cells always carry the proviral genome monoclonally integrated into their host genomes at the same sequence site, designated as the monoclonal integration. Using Southern blot hybridization (SBH) and sequenced tagged site polymerase chain reaction assays, we examined the proviral status in 558 clinical specimens from 350 patients who are suspected to have ATL. A total of 321 specimens (57.5%) from 241 patients showed positive results for the monoclonal integration according to SBH, using EcoR1 and Pst1. The 241 patients consisted of 136 patients (56.4%) with the complete provirus (C-type), 62 patients (25.7%) with a defective provirus (D-type), and 43 patients (17.8%) with multibands (M-type). The incidence of the D- and M-types were in the order of smoldering, chronic, and acute subtypes of ATL, suggesting that such an aberrant proviral status is generated on the way to multistep carcinogenesis and is subsequently clinically important for the malignant behavior of the disease. Moreover, our data showed that the partial deletion of the proviral genome is initiated first at the site of the gag region and spreads into the sites of the pol and env regions, whereas the long terminal repeats and pX regions are almost always conserved. These results suggest that analysis of the proviral status provides useful diagnostic and virologic-oncological information about ATL and HTLV-1 pathology, especially the important role of pX gene in tumorigenesis.

Microbial hydrogen production from sweet potato starch residue

Clostridium butyricum could produce hydrogen from a sweet potato starch residue upon supplementation of nitrogen sources. A repeated batch culture using a mixed culture of C. butyricum and Enterobacter aerogenes produced hydrogen with a yield of 2.4 mol H2/mol glucose under a controlled culture pH of 5.25 in a medium consisting of the sweet potato starch residue and 0.1% Polypepton without addition of any reducing agents. Rhodobacter sp. M-19 produced hydrogen from the supernatant of the culture broth obtained in the repeated batch culture containing C. butyricum and E. aerogenes when 50 microg/l Na2MoO4.2H2O and 20 mg/l EDTA were added to the supernatant and it was cultured under a controlled culture pH of 7.5. A high yield of hydrogen of 7.0 mol H2/mol glucose from the starch remaining in the starch residue was attained in two-step repeated batch cultures containing C. butyricum and E. aerogenes, and by Rhodobacter sp. M-19.

Serum lipid levels and factors affecting atherogenic index in Japanese children

An evaluation was made of the serum lipid levels and factors relating to atherogenicity in schoolchildren in Akita, Japan, in order to determine actual conditions and promote awareness of health. The subjects were 2878 boys and 2729 girls aged 9, 12 and 15 years, who lived in cities, towns and villages in the Akita prefecture. Physical and lifestyle data including serum lipids were collected from the subjects in their schools under the direction of the prefectural board of education. Total cholesterol levels were found to be nearly equal to those currently representative for Japanese children, ethnically situated between blacks and whites in the United States of America. Atherogenic indices (AIs) were lower than those in all other countries owing to the elevated high-density lipoprotein (HDL) cholesterol levels observed in this study. According to data obtained from the questionnaires that were part of the study, regularly taking breakfast and exercising in sports clubs seems connected to maintaining lower atherogenicity in childhood.

Long term prognosis of children born to lupus patients

OBJECTIVE

To determine the long term prognosis of children of patients with systemic lupus erythematosus (SLE).

METHODS

Children of patients with SLE were invited to attend our clinic for physical examination and laboratory tests. A total of 195 children (aged 4 months to 26 years; male = 82, female = 113) were examined in 1991, 1995, 1997, and 1998.

RESULTS

Two cases were diagnosed as SLE at the first visit and were excluded from the second visit. A significantly higher percentage (52/195 (27%)) of patients were positive for antinuclear antibodies (ANA) at a cut off serum dilution of 1/40 compared with controls (4/57 (7%)). ANA were detected more frequently in female subjects than in men (p<0.05). Forty four subjects were examined on more than two occasions. Nine of the 10 patients who were positive for ANA at the second visit were girls aged 4-8 years. The incidence of anti-DNA and antiphospholipid antibodies in children of patients with SLE was similar to that in the controls.

CONCLUSIONS

The finding that children, especially girls, born to maternal lupus patients had a high positive rate for ANA suggests that a genetic factor is involved in SLE pathogenesis. Longitudinal observation of these patients may provide important clinical information and clues to the pathogenesis of SLE.

High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis

OBJECTIVE

We investigated the rheumatoid arthritis (RA) diagnostic performances of anti-cyclic citrullinated peptide antibody (anti-CCP) and antifilaggrin antibody (AFA) in comparison with RF and matrix metalloproteinase-3 (MMP-3).

METHODS

We used a second generation enzyme-linked immunosorbent assay (ELISA) kit for the detection of anti-CCP. We constructed recombinant human filaggrin, which was citrullinated in vitro by human peptidylarginine deiminase, and subsequently used it as the coating antigen for AFA-ELISA. A total of 549 RA patients and 208 other rheumatic disease patients were included in the study.

RESULTS

The specificities of anti-CCP (88.9%) and AFA (94.7%) were superior to those of RF (81.7%) and MMP-3 (49.5%). The sensitivity of anti-CCP (87.6%) was superior to all others. However, the sensitivity of AFA (68.7%) was inferior to those of RF (69.8%) and MMP-3 (75.7%). Furthermore, receiver operating characteristic curves of anti-CCP and AFA passed closer to the upper left corner than those of RF and MMP-3, and the areas under the curves (AUC) of AFA and anti-CCP were significantly larger. In addition, the AUC of anti-CCP was significantly larger than that of AFA.

CONCLUSION

ELISA detection of antibodies to citrullinated antigens, especially a second generation anti-CCP, showed higher discriminative ability than other assays, including RF, and would be useful to aid the diagnosis of RA in clinical practice.

Ideal body shape in young Japanese women and assessment of excessive leanness based on allometry

The present study is aimed to clarify the degree of leanness desired by contemporary young Japanese women using questionnaires and to use allometry to define the body weight boundary between the excessively lean and the others for a given height. Questionnaires on ideal body shape were distributed to female college students living in Akita and the suburbs of Tokyo. Data for 578 respondents, aged 18 to 21 years-old, were analyzed. The questionnaire asked the subjects to report their current and ideal body shape and to make a qualitative self-assessment of their weight. On average, the perceived ideal weight was 5.2 kg lower than the current weight. The results also revealed that young women have a tendency to misunderstand their body shape and to regard themselves as heavier than they really were. Meanwhile, we defined leanness as a state of insufficient lean body mass (LBM, kg) in relation to height (Ht, cm). Allometric equation of LBM on Ht and the standard error of estimate (SEE) were calculated as LBM=3.87 x 10(-3) x Ht(1.826) and 1.09, respectively. The LBM boundary between the excessively lean and the others was determined using these values according to a statistical procedure comparing normal and abnormal values. The corresponding total body weight was estimated from the boundary LBM in the literature. Subsequently the body weight boundary for each height was tabulated in order to make young women reconsider weight control. The subjects were asked to assess the body weight boundary for their own height. The boundary values were found to be consistent with the sense of the subjects.

Ethnic Differences in the Relationship between Bioelectrical Impedance and Body Size

The present study compared the regression equations of bioelectrical impedance on body size among various groups to investigate potential differences due to ethnicity. Data consisted of 30 Japanese and 28 Caucasoid subjects, and other groups of Aborigines, Danes, Melanesians and Polynesians from literature. The relationship between impedance and body weight fot the groups showed the ethnic difference. In the regression equations for Japanese and Caucasoid, a statistically significant difference was observed between both groups. The regression equation for Japanese was lower in the elevation. This seemed to be attributable to differences in the volume of fat-free mass for the same body build, configuration of the body, and fat-free mass density.

Activated peripheral blood mononuclear cells detected in lupus patients using cDNA coding for proliferating cell nuclear antigen

Abstract The expression of proliferating cell nuclear antigen (PCNA) mRNA in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) was measured by dot blot hybridization using a PCNA cDNA, and correlated with the percentage of PCNA-positive cells detected immunohistochemically using a monoclonal anti-PCNA antibody. PCNA-positive PBMCs were detected in 72.2% of SLE patients (n = 36), which is significantly more than among healthy controls. In addition, among those in whom PCNA expression was detected, the percentage of PBMCs expressing PCNA was significantly higher in SLE patients (mean 2.5% vs. 0.15%). The level of PCNA mRNA was increased in PBMCs from 83.3% of SLE patients, and was significantly correlated with the percentage of PCNA-positive cells (r = 0.54, P < 0.01) and with the disease activity score (r = 0.56, P < 0.01). A longitudinal study of two SLE patients confirmed that PCNA mRNA expression and the percentages of PCNA-positive cells varied in parallel with disease activity. Thus, an analysis of activated PBMCs from SLE patients using PCNA cDNA may be a useful method by which to estimate SLE disease activity.

Flocculation properties of pectin in various suspensions

Pectin had a flocculating activity and its flocculating activities in various suspensions were investigated. Flocculating activity of pectin in a kaolin suspension was markedly stimulated by the addition of Al3+ and Fe3+ to the suspension. Optimum temperature for flocculating activity of pectin in the kaolin suspension was around 30 degrees C and high flocculating activity was obtained when 30 mg/l of pectin and 0.2 mM Fe3+ were added to the suspension. Other inorganic suspensions of activated carbon and acid clay were flocculated by pectin in the presence of Al3+ or Fe3+. Flocculation of organic suspensions such as cellulose and yeast by pectin occurred when 0.1-0.2 mM Fe3+ was present in the suspensions.

Anti-Ki antibodies recognize an epitope homologous with SV40 nuclear localization signal: clinical significance and reactivities in various immunoassays

Abstract We studied the characteristics of anti-Ki antibodies that react with a synthetic peptide (KILT) which has homology with SV40 large T antigen nuclear localization signal (SV40 T NLS). Immunoreactivity of antibodies to KILT was tested by enzyme-linked immunosorbent assay (ELISA), and this reactivity was compared with results obtained by immunoblotting using purified Ki and ELISA using purified or recombinant Ki antigen. The clinical significance of anti-KILT antibodies in lupus patients was also studied. Twenty percent of anti-Ki sera reacted with KILT, and all sera that reacted with KILT recognized both purified and recombinant Ki antigen in all our assay systems. A significant correlation was observed between reactivities in ELISA using KILT and with these using purified and recombinant Ki. Some sera with low titers by double immunodiffusion (DID) reacted with KILT, whereas high-titer anti-Ki sera showed a tendency to react with Ki antigen in different assays. The prevalence of discoid rash and sicca complex was higher in the anti-KILT-positive group. The amino acid sequence homologous to SV40 T NLS is an immunologically active epitope on the Ki antigen; reactivity to this epitope is associated with characteristic clinical features allied with anti-Ki antibodies in lupus patients.

Serum levels of interleukin 15 in patients with rheumatic diseases

OBJECTIVE

The role of the cytokine interleukin 15 (IL-15) in rheumatic disease is unclear. We examined serum levels of IL-15 in patients with various rheumatic diseases.

METHODS

Serum levels of IL-15 were determined by sandwich ELISA.

RESULTS

Serum levels of IL-15 were significantly increased in patients with polymyositis/dermatomyositis, polyarteritis nodosa, and systemic sclerosis; and significantly increased as well in disease complicated by interstitial pneumonitis (IP), hemophagocytic syndrome (HPS), and/or vasculitis. Patients with serum IL-15 levels < or = 5 pg/ml showed significantly high rates of survival.

CONCLUSION

IL-15 is related to the pathogenesis of IP, HPS, and/or vasculitis. Serum IL-15 level could possibly be used as a marker of prognosis.

Transient right phrenic nerve palsy associated with central venous catheterization

An 85-yr-old woman with advanced sigmoid colon cancer developed right phrenic nerve palsy following central venous catheterization for preoperative nutritional and fluid balance improvement. The central venous catheter was successfully placed via the left subclavian vein at the first attempt. Blood returned freely through the catheter. The chest x-ray film taken immediately after the catheterization showed the proper placement of the catheter, but it revealed a significant right hemidiaphragmatic elevation indicating phrenic nerve palsy. A chest computed tomography scan and bronchoscopy were normal. As the patient did not complain of dyspnoea and vital signs were normal, tumour resection was performed. The operative and postoperative course was uneventful. The chest x-ray film after the surgery still showed the elevation of the right hemidiaphragm. It resolved completely within 3 days of withdrawing the central venous catheter by 3 cm on the fourth postoperative day. We concluded the likely cause of the phrenic nerve palsy was that the catheter tip impinged upon the thin venous wall and compressed the phrenic nerve running alongside the superior vena cava.

[Therapeutic plasmapheresis for the prevention of congenital complete heart block associated with anti-SS-A/Ro antibody and anti-SS-B/La antibody]

OBJECTIVES

Neonatal lupus erythematosus is characterized by transient lupus abnormalities, various systemic and hematological abnormalities, and congenital complete heart block (CCHB). It is well known that anti-SS-A/Ro antibody (52 kD/60 kD) and anti-SS-B/La antibody are associated with CCHB. This study was conducted to evaluate the effects of the removal of anti-SS-A/Ro antibody (52 kD/60 kD) and anti-SS-B/La antibody from plasma in pregnant women whose fetuses are at a high risk of developing CCHB.

MATERIALS & METHODS

Fifteen pregnant patients positive for anti-SS-A/Ro antibody and anti-SS-B/Laantibody were subjected weekly to double filtration plasmapheresis to remove both antibodies. Antibody titers were measured by double immunodiffusion (DID) and ELISA.

RESULTS

As a result, all women gave birth to live babies, but CCHB was recognized in one baby. No transient lupus abnormalities were recognized in any of the babies. Fourteen patients showed decreased antibody titers by ELISA during plasmapheresis. However, the patient who was delivered of a baby with CCHB showed an increase of antibody titers by ELISA while the DID method showed a decrease of antibody titers.

CONCLUSION

Our study suggested that plasmapheresis prevents CCHB associated with anti-SS-A/Ro and anti-SS-B/La antibody. Also, it is important to monitor the antibody titer regularly during the course of pregnancy, because it may increase due to worsening of the mother's primary disease.

[A clinical study of the usefulness of assessing dyspnea in healthy elderly subjects]

Dyspnea is a major clinical symptom of various respiratory diseases. However, no objective assessment of dyspnea on exertion (DOE) in elderly subjects has been established yet. Furthermore, the factors which may influence DOE in healthy elderly subjects have not yet been precisely elucidated. An oxygen cost diagram (OCD), which was originally developed by McGavin (1978), is one of the methods of assessing dyspnea on exertion in a semi-quantitative way, although it is still uncertain which factor (s) might influence the changes in OCD values. The present study was, therefore, undertaken to study; 1) whether OCD values are useful for the assessment of DOE in elderly subjects, and 2) the possible factors (s) which might contribute to changes in OCD values in these patients. The total number of subjects which were enrolled in the present study was 818, consisting of 355 men and 463 women, whose mean age was 76.4 years old, was studied. Spirometry, arterial blood gases and OCD values were measured on the same day. The OCD value and FEV(1.0) declined linearly with advanced aging. It was found that the factors which significantly reduce OCD values were as follows: aging, vital capacity, FEV(1.0), and maximal voluntary ventilation (MVV). The odd ratio which contributes to changes in OCD values was calculated. It appeared that there was a gender difference: when the odd ratio of OCD values of less than 70 was taken as 1 in the men, the odd ratio in women was calculated as 1.42. The odd ratio increased with advancing age; when the value in the 65~69 year-old group was 1, the odd ratios in the 85~89 year-old and 90~94 year-old groups were in approximately 6 and 8, respectively. Similarly, the odd ratio increased parallel with reduction in MVV. From these results, we conclude that the OCD value is reliable, simple and the best method of evaluating dyspnea in elderly subjects semi-quantitatively, and both the minute ventilatory volume and age are closely related with changes in OCD values.

Reactivity of anti-proliferating cell nuclear antigen (PCNA) murine monoclonal antibodies and human autoantibodies to the PCNA multiprotein complexes involved in cell proliferation

Proliferating cell nuclear Ag (PCNA) occurs as a component of multiprotein complexes during cell proliferation. We found the complexes to react with murine anti-PCNA mAbs, but not with anti-PCNA Abs in lupus sera. The complexes were purified from rabbit thymus extract by affinity chromatography using anti-PCNA mAbs (TOB7, TO17, and TO30) and analyzed by ELISA, immunoprecipitation, immunoblotting, and HPLC gel filtration. That PCNA was complexed with other proteins was demonstrated by its copurification with a group of proteins excluded by an HPLC G3000 SW column. Although immunoblot analysis showed the mAbs to react exclusively with the 34-kDa PCNA polypeptide, they nonetheless immunoprecipitated the same group of proteins, confirming the interaction of the isolated PCNA with other proteins. Anti-PCNA sera, including AK, which reacts with biologically functional sites on PCNA, did not react with complexed PCNA, but did react with it once it was dissociated from the complexes. PCNA complexes in turn reacted with murine anti-DNA mAbs, as well as with Abs against p21, replication protein A, DNA helicase II, cyclin-dependent kinases 4 and 5, and topoisomerase I. These findings suggest that the PCNA complexes purified using anti-PCNA mAbs comprise the "protein machinery" for DNA replication and cell cycle regulation. They also suggest that anti-PCNA mAbs are useful tools with which to characterize the protein-protein interactions within PCNA complexes, as well as the autoimmune responses to proteins interacting with PCNA, which may shed light on the mechanisms of autoantibody production in lupus patients.

Purification and characterization of mannose isomerase from Agrobacterium radiobacter M-1

A mannose isomerase from Agrobacterium radiobacter M-1 (formerly Pseudomonas sp. MI) was purified to electrophoretic homogeneity and characterized. A cell-free extract was separated by ammonium sulfate fractionation, Butyl-Toyopearl 650M, DEAE-Sepharose and hydroxylapatite column chromatography. Its molecular mass was estimated to be 44 kDa by SDS-PAGE and 90 kDa by gel filtration, in which the enzyme is most likely a dimer composed of two identical subunits. The purified enzyme had an optimum pH at 8.0, an optimum temperature at 60 degrees C, a pI of 5.2 and a Km of 20 mM, and specifically converted D-mannose and D-lyxose to ketose. The N-terminal amino acid sequence was identified.

Phosphorylation of vimentin head domain inhibits interaction with the carboxyl-terminal end of alpha-helical rod domain studied by surface plasmon resonance measurements

The amino-terminal head domain of vimentin is the target site for several protein kinases and phosphorylation induces disassembly of the vimentin intermediate filaments in vivo and in vitro. To better understand molecular mechanisms involved in phosphorylation-dependent disassembly, we examined domain interactions involving the head domain and the effect of phosphorylation on the interaction, using surface plasmon resonance. We observed that the head domain binds to the carboxyl-terminal helix 2B in the rod domain, under physiological ionic strength. This interaction was interfered with by A-kinase phosphorylation of the head domain. Deletion of the carboxyl-terminal 20 amino acids of helix 2B resulted in loss of the interaction. Furthermore, peptide representing the carboxyl-terminal 20 residues of helix 2B had a substantial affinity with the head domain but not with the phosphorylated one. These findings support the idea that the interaction between the head domain and the last 20 residues of helix 2B is essential for association of vimentin tetramers into the intermediate filaments and that the phosphorylation-dependent disassembly is the result of loss of the interaction.

Effect of immune complexes in serum from patients with rheumatoid vasculitis on the expression of cell adhesion molecules on polymorphonuclear cells

OBJECTIVE

Immune complexes (IC) are frequently detected in patients with rheumatoid vasculitis (RV). To explore the pathogenic role of IC in the development of vasculitis among patients with rheumatoid arthritis (RA), we examined the effect of IC on the expression of cell adhesion molecules (CAM) on polymorphonuclear cells (PMN).

METHODS

PMN from healthy volunteers were incubated with the sera from 26 patients with RA including 9 patients with RV, and the expression of CAM on the PMN was assessed by flow cytometry.

RESULTS

We found that 67% (6/9) of the serum samples from RV patients and 18% (3/17) of the samples from RA patients without RV revealed up-regulated CD11b expression. On the other hand, 89% (8/9) of the samples from RV patients and 12% (2/17) of the samples from RA patients without RV revealed up-regulated CD18 expression. However, the expression of CD11a was not affected. Up-regulation of CD11b and CD18 on PMN was also induced by the immunoglobulin G (IgG) fraction of the sera of RV patients. Moreover, L-selectin expression on PMN was down-regulated by the sera or IgG of some patients with RV. These changes in CAM expression on PMN induced by IgG of RV patients were not observed when PMN were incubated with the IgG of RV patients from which the IC formed by IgG had been removed.

CONCLUSION

These results suggest that IC formed by IgG in patients with RA are involved in the development of vasculitis by affecting the expression of CAM on PMN.

[Objective evaluation of treatment for sleep apnea syndrome]

CPAP treatments for sleep apnea syndrome (SAS) are being established; however, there is no established evaluation method to scale the long-lasting effectiveness of the treatment. The only available method is to judge the results from each patient's subjective symptoms. We therefore tested a self-contained microcomputer with an acceleration sensor (Lifecorder) in an attempt to evaluate the effectiveness of treatments objectively. Fifteen patients with OSAS were the subjects. We keep the records of Lifecorders that were worn by the subjects a month before and a month after nasal CPAP treatment. We also assessed their daily physical activity levels; the number of steps taken, calories consumed, intensity of each activity along with improvement in their subjective symptoms. The number of steps taken in a day increased as did the calories consumed after treatment in 9 subjects. Moderate and intensive activities also increased among those 9 subjects. Our results indicate that evaluation with a Lifecorder, which is simple and inexpensive, can provide objective indicators to assess the effectiveness of treatments in patients' daily activities.

[Polysomnography]

Polysomnography(PSG) is essential for the diagnosis of all pathophysiologic conditions due to both any types of sleep disordered breathing and to any types of sleep disturbance. Since this issue's objection is to describe the outline of PSG, we will explain here about when PSG is needed, what type of measurements are necessary for PSG, and how it should be interpreted from the result of the PSG tracing for the diagnosis for sleep apnea syndrome, etc.

Repair of the inferior alveolar nerve with a forearm cutaneous nerve graft after ablative surgery of the mandible

PURPOSE

A method of autologous nerve grafting for repair of the inferior alveolar nerve after mandibular resection using a forearm cutaneous nerve is described.

PATIENTS AND METHODS

The lateral cutaneous nerve of forearm served as the donor nerve, and the graft was inserted microsurgically using an epineurial nerve suture technique in 6 subjects. Return of sensation in these 6 patients was measured by the use of Semmes-Weinstein method.

RESULTS

Sensibility of the lower lip and chin recovered after about 10 months in all 6 subjects.

CONCLUSION

The lateral branch of the forearm cutaneous nerve is a useful graft for repair of the inferior alveolar nerve after mandibular resection in which a forearm flap is used as part of the reconstruction.