Antibodies to human gastric epithelial cells and heat shock protein 60 in Helicobacter pylori positive mucosa associated lymphoid tissue lymphoma

BACKGROUND

Development of gastric mucosa associated lymphoid tissue (MALT) lymphoma is thought to be closely associated with host immune reactions to Helicobacter pylori.

AIM

To investigate humoral immune responses in patients with MALT lymphoma to antigens shared by H pylori and human gastric epithelial cells.

METHODS

Sera were obtained from H pylori positive patients with MALT lymphoma (n = 11) or other gastroduodenal diseases (peptic ulcer, n = 40; non-ulcer dyspepsia, n = 20) and from H pylori negative healthy control subjects (n = 10). Antibodies to HGC-27 human gastric epithelial cells and human recombinant heat shock protein (Hsp) 60 were examined using an enzyme linked immunosorbent assay (ELISA) and immunoblotting.

RESULTS

Antibody titres to HGC-27 cells were significantly elevated in H pylori positive patients with MALT lymphoma when compared with titres in patients with other gastroduodenal diseases and in healthy subjects. Immunoblotting of sera from patients with MALT lymphoma often detected a band with a molecular mass corresponding to Hsp60, and both ELISA and immunoblotting showed elevated antibody titres to the recombinant human Hsp60. Antigenic similarity between Hsp60 and H pylori HspB was documented by immunoblotting experiments.

CONCLUSIONS

Autoantibodies reactive with host gastric epithelial cells are often increased in MALT lymphoma, and Hsp60 is a major target antigen. Immune responses induced by immunological cross reactivity between H pylori HspB and human Hsp60 in gastric epithelium may be involved in the development of MALT lymphoma.

Tonic regulation of the activity of noradrenergic neurons in the locus coeruleus of the conscious rat studied by dual-probe microdialysis

In the present study, receptor specific compounds were infused via a microdialysis probe in the vicinity of the right locus coeruleus (LC). During the infusion of these compounds, the extracellular content of noradrenaline was recorded in the ipsilateral medial prefrontal cortex (mPFC) with a second microdialysis probe. Agonists and antagonists of various subtypes receptors that have been described to be localized on LC cells, were infused near the LC. The receptors investigated were: alpha2-adrenergic, muscarinic, nicotinic, GABAergic (GABAA and GABAB), glutamatergic (NMDA and non-NMDA). The compounds infused were: clonidine (100 microM), idazoxan (50 microM), bicuculline (50 microM), muscimol (50 microM), baclofen (50 microM), CGP52432 (100 microM), NMDA (300 microM), CPP (300 microM), kainate (100 microM), DNQX (500 microM), oxotremorine (100 microM), atropine (10 microM), nicotine (100 microM) and mecamylamine (100 microM). Evidence was provided that GABAA, NMDA, non-NMDA glutamate, and muscarinic cholinergic receptors in the LC played roles in controlling the activity of noradrenaline neurons. The LC noradrenergic neurons were not tonically excitated by glutamatergic or cholinergic afferent neurons, and were not tonically inhibited by alpha2 autoreceptors. Tonic inhibition was evident for GABAergic neurons, acting via GABAA receptors.

Contribution of P-glycoprotein to bunitrolol efflux across blood-brain barrier

In this study, we investigated the mechanism of the blood-brain barrier (BBB) transport of bunitrolol (BTL), as a model of beta-blocker, in vivo and in vitro. In order to define the contribution of P-glycoprotein (P-gp) to the active efflux of BTL from brain to blood, we examined the in vivo brain distribution of BTL in mdr1a(-/-) mice with a disrupted mdr1a gene. After intravenous administration of BTL to mdr1a(-/-) mice, the brain concentration and Kp value of BTL were significantly increased as compared with those in mdr1a(+/+) mice. Next, the contribution of the mdr1a P-gp to in vitro uptake of BTL was compared in LV500 cells and L cells (mouse mdr1a-expressing cells and host cells, respectively). The intracellular accumulations of [3H]vinblastine and BTL by LV500 cells were lower than those by L cells, but were significantly increased by verapamil, a P-gp inhibitor. Furthermore, the BTL uptake by KB-VJ300 cells, which express human P-gp, was also significantly lower than that by KB host cells, and was increased by verapamil. The steady-state uptake of BTL by LLC-GA5-COL300 cells, expressing human P-gp, was significantly increased in the presence of 20 microM cyclosporin A (another P-gp inhibitor), which had no effect in the LLC-PK1 host cells. On the other hand, the steady-state intracellular accumulation of BTL by MBEC4 cells, which express mdr1b P-gp instead of mdr1a P-gp, was not significantly changed in the presence of verapamil. This finding suggested that BTL is not a good substrate for mdr1b P-gp. In conclusion, our results suggest that BTL is transported from brain to blood by mdr1a P-gp in mice and by MDR1 in humans, and this presumably accounts for the low brain distribution of BTL.

Infected abdominal aortic aneurysm: early CT findings

We describe computed tomographic (CT) findings at the early stage of infected abdominal aortic aneurysm in three patients. Periaortic mass and increased fat density were the characteristic findings of early aortic infection on CT. Similar findings caused by other diseases may be difficult to differentiate by imaging alone, but these findings should be used to trigger close follow-up for patients with suspected infected abdominal aortic aneurysm.

Spectrum and clinical significance of autoantibodies against transfer RNA

OBJECTIVE

To characterize the clinical features of patients who have autoantibodies against transfer RNA (tRNA) or tRNA-associated proteins.

METHODS

Sera from 1,472 patients with suspected systemic rheumatic disease were screened by RNA immunoprecipitation of HeLa cell extracts. The specificities of the antibodies that precipitated tRNAs were further analyzed by immunoprecipitation using deproteinized RNAs and 35S-methionine-labeled HeLa cell extracts, followed by immunoblotting.

RESULTS

Forty-one serum samples (2.8%) were found to immunoprecipitate tRNAs. Thirteen patients were identified as having previously defined anti-aminoacyl-tRNA synthetase antibodies (anti-histidyl-tRNA synthetase in 4 patients, anti-threonyl-tRNA synthetase in 1, anti-alanyl-tRNA synthetase in 3, anti-glycyl-tRNA synthetase in 4, and anti-isoleucyl-tRNA synthetase in 1). All 13 patients had myositis and/or interstitial pneumonitis. Sera from the remaining 28 patients immunoprecipitated previously unidentified tRNAs, including 13 serum samples that bound deproteinized cognate tRNA; 24 of the 28 patients met criteria for either systemic lupus erythematosus (SLE) or Sjögren's syndrome (SS). In addition, nonerosive polyarthritis, leukocytopenia, rheumatoid factor, and characteristic annular or papulosquamous recurrent erythema were noted in these patients; however, renal involvement was rare. Sera from 16 of these 28 patients also contained anti-Ro/SSA and/or anti-La/SSB antibodies. While 189 patient sera precipitated Ro/SSA and/or La/SSB-associated RNAs but not tRNA, only 12 of the patients (6.3%) developed skin lesions (P=0.0009, odds ratio 8.85).

CONCLUSION

Novel autoantibodies against tRNAs or tRNA-associated proteins were identified in 28 sera. These autoantibodies appear to be distinct from anti-aminoacyl-tRNA synthetase antibodies and are associated with SLE and SS. The presence of anti-Ro/SSA and/or anti-La/SSB along with anti-tRNA antibodies is more strongly associated with recurrent erythema than is the presence of anti-Ro/SSA or anti-La/SSB alone.

Inhibition by lysophosphatidylcholine of nitric oxide production in interleukin 1 beta-stimulated vascular smooth muscle cells

In vascular smooth muscle cells (VSMC), inflammatory cytokines such as interleukin 1 beta(IL-1 beta) stimulated nitric oxide (NO) production via the expression of an inducible type of NO synthase (iNOS). Lysophosphatidylcholine (LPC) is a major phospholipid component of atherogenic oxidized low density lipoprotein (Ox-LDL). In this study, we examined the effect of LPC on IL-1 beta-stimulated NO production in cultured. VSMC. LPC by itself did not stimulate the production of nitrite, a stable metabolite of NO, but dose-dependently inhibited IL-1 beta-stimulated nitrite production. LPC inhibited IL-1 beta-stimulated iNOS protein expression, whereas LPC did not inhibit IL-1 beta-stimulated iNOS mRNA expression. Analysis of iNOS protein degradation rate revealed that LPC had no effect on degradation rate of iNOS protein, suggesting that LPC inhibited iNOS translation. Moreover, Ox-LDL inhibited IL-1 beta-stimulated NO production by inhibiting iNOS protein expression without affecting iNOS mRNA expression. These results indicate that Ox-LDL negatively modulates IL-1 beta-induced NO production through the action of LPC, probably by blocking translation of iNOS mRNA.

P-glycoprotein-mediated transport of itraconazole across the blood-brain barrier

The mechanism for the accumulation of itraconazole (ITZ) in its elimination from the brain was studied in rats and mice. The concentration of ITZ in liver tissue declined in parallel with the plasma ITZ concentration until 24 h after intravenous injection of the drug (half-life, 5 h); however, the ITZ in brain tissue rapidly disappeared (half-life, 0.4 h). The time profiles of the brain/plasma ITZ concentration ratio (Kp value) showed a marked overshooting, and the Kp value increased with increasing dose; these phenomena were not observed in the liver tissue. This finding indicates the occurrence of a nonlinear efflux of ITZ from the brain to the blood. Moreover, based on a pharmacokinetic model which hypothesized processes for both nonlinear and linear effluxes of ITZ from the brain to the blood, we found that the efflux rate constant in the saturable process was approximately sevenfold larger than that in the nonsaturable process. The Kp value for the brain tissue was significantly increased in the presence of ketoconazole or verapamil. The brain Kp value for mdr1a knockout mice was also significantly increased compared with that of control mice. Moreover, the uptake of vincristine or vinblastine, both of which are substrates of the P glycoprotein (P-gp), into mouse brain capillary endothelial cells was also significantly increased by ITZ or verapamil. In conclusion, P-gp in the brain capillary endothelial cells participates in a process of active efflux of ITZ from the brain to the blood at the blood-brain barrier, and ITZ can be an inhibitor of various substrates of P-gp.

Detection of Helicobacter pylori associated antigen and heat shock protein 60 on follicular dendritic cells in the germinal centres of low grade B cell lymphoma of gastric mucosa associated lymphoid tissue (MALT)

AIMS

To investigate the localisation of Helicobacter pylori antigens and the expression of human heat shock proteins (HSP) in stomachs affected by MALT lymphoma.

METHODS

Surgically resected stomachs from 24 patients with MALT lymphoma were immunostained with anti-H pylori rabbit antibodies (ORP-1 and ORP-2) and anti-human HSP60 mouse monoclonal antibodies (mAb) (LK-1 and LK-2).

RESULTS

Follicular dendritic cells of germinal centres in the stomachs affected by MALT lymphoma were immunostained with anti-H pylori polyclonal antibodies and with anti-human HSP60 mAb, as were the epithelial cells. None of the lymph node samples reacted.

CONCLUSIONS

Human HSP60, which cross reacts with anti-H pylori polyclonal antibodies, is often expressed on follicular dendritic cells in gastric MALT lymphoma tissues and may be aetiologically relevant to lymphomagenesis of MALT lymphoma.

Tyrosine phosphorylation and association of p130Cas and c-Crk II by ANG II in vascular smooth muscle cells

In cultured vascular smooth muscle cells (VSMC), angiotensin II (ANG II) stimulated tyrosine phosphorylation of multiple proteins including a 130-kDa protein. This 130-kDa protein was identified as a Crk-associated substrate, p130Cas. ANG II-stimulated tyrosine phosphorylation of p130Cas was rapid, concentration dependent, and inhibited by the AT1-receptor antagonist CV-11974. Neither downregulation of protein kinase C by long exposure of cells to phorbol 12,13-dibutyrate nor blockade of Ca2+ mobilization by 1,2-bis(2-aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid acetoxymethyl ester had an effect on ANG II-stimulated tyrosine phosphorylation of p130Cas. Stimulation with ANG II enhanced the specific association of p130Cas with c-Crk II. The time course of the association of p130Cas and c-Crk II was similar to that of tyrosine phosphorylation of p130Cas. c-Crk II was also tyrosine phosphorylated in response to ANG II. These results indicate that ANG II induces tyrosine phosphorylation of p130Cas and c-Crk II and their specific association, suggesting a potential role of the p130Cas-c-Crk II complex in ANG II signal transduction in VSMC.

[The Leydig cell tumor and combined germ cell tumor in the unilateral testis. A case report]

The simultaneous occurrence of germ cell tumors and stromal tumor in the unilateral testis is extremely rare. We report a case of Leydig cell tumor and combined germ cell tumor in the right testis on a 24-year-old man. Histopathology revealed seminoma, embryonal carcinoma, choriocarcinoma and Leydig cell tumor.

Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings

PURPOSE

The objective was to assess the efficacy of fast spin-echo (FSE) imaging in the detection of articular cartilage abnormality in osteoarthrosis of the knee.

MATERIAL AND METHODS

We studied 356 articular surfaces in 73 knees that had been examined by both MR imaging and arthroscopy. The MR images were obtained with FSE imaging (TR/TE 4200/100) on a 0.5 T unit. The surface abnormalities of the articular cartilage that were detected by MR imaging were compared with the arthroscopic findings.

RESULTS

The overall sensitivity and specificity of MR in detecting chondral abnormalities were 60.5% (158/261) and 93.7% (89/95) respectively. MR imaging was more sensitive to the higher grade lesions: 31.8% (34/107) in grade 1; 72.4% (71/98) in grade 2; 93.5% (43/46) in grade 3; and 100% (10/10) in grade 4. The MR and arthroscopic grades were the same in 46.9% (167/356), and differed by no more than 1 grade in 90.2% (321/356) and 2 grades in 99.2% (353/356). The correlation between arthroscopic and MR grading scores was highly significant with a correlation coefficient of 0.705 (p < 0.0001).

CONCLUSION

FSE sequence was less sensitive to mild cartilage abnormality but useful in detecting moderate to severe abnormality and in evaluating the degree of articular cartilage abnormality.

Clinical evaluation of temporomandibular joint disorders (TMD) in patients treated with chin cup

The purpose of this manuscript was twofold: (1) to provide more information on the incidence of temporomandibular joint disorders (TMD) in chin cup-treated patients during and after active treatment; and (2) to evaluate results of functional analysis for one orthodontically treated chin cup patient with temporomandibular joint (TMJ) pain and difficulty of maximum mouth opening. Eighty-six out of a total of 160 chin cup patients responded to our questionnaire and were checked for pain, clicking, and maximum mouth opening. Twenty-eight of the chin cup subjects showed one or more symptom(s) of TMD. Spontaneous pain was found most often during active treatment but clicking (sound) occurred more often during the retention phase. One retreated patient showed remarkable improvement of TMD symptoms.

Drastic genetic instability of tumors and normal tissues in Turcot syndrome

Turcot syndrome is characterized by an association of malignant brain tumors and colon cancer developing in the patient's teens. Since the mechanism of carcinogenesis in Turcot syndrome is still unclear, we analysed genetic changes in tumors from a Turcot patient with no family history of the condition. All tumors, including one astrocytoma, three colon carcinomas, and two colon adenomas, exhibited severe replication error (RER), and all colon tumors showed somatic mutations at repeated regions of TGFbetaRII, E2F-4, hMSH3, and/or hMSH6 genes. Somatic APC mutations were detected in three of three colon carcinomas, and somatic p53 mutations were detected in the astrocytoma and two of three colon carcinomas, both of which showed two mutations without allele loss. We also found that normal colon mucosa, normal skin fibroblasts and normal brain tissue from this patient showed respective high frequencies of RER, in contrast to usual HNPCC patients in which RER was very rare in normal tissues. These results suggest that extreme DNA instability in normal tissues causes the early development of multiple cancer in Turcot syndrome. A missense mutation (GAG to AAG) at codon 705 of hPMS2 gene was detected in one allele of this patient, which was inherited from his mother without tumors. Additional unknown germline mutation may contribute to the genetic instability in normal tissues.

[Clarifying the nursing care and its process for patients with intractable illness]

The objective of this study was to clarify the nursing care and its process for patients with intractable illness. An inductive qualitative study was conducted by using a grounded theory approach. Subjects were seven nurses who cared patients with intractable illness at two hospitals in Japan. The qualitative data was collected by participant observations and interviews to the subjects, and analyzed by the constant comparative analysis. Results revealed four categories of nursing care and its process for patient with intractable illness. Four categories were named as "to accept his/her emotion", "to respect his/her existence", "to develop his/her potentiality", and "to support his/her autonomy". Category 1: "To accept his/her emotion" is a nursing care to make the patient express his/her emotion freely, to understand him/her, and to communicate that everyone could feel so if situated as him/her. Category 2: "To respect existence" is a nursing care to communicate the patient that the existence of him/her is respectable regardless with his/her ability or evaluation. Category 3: "To develop potentiality" is a nursing care to develop the patient's potentiality for his/her life with safety and high-quality through changing or creating the way of life. Category 4: "To support autonomy" is a nursing care to support and expand the patient's life activities through the ways of life acquired by him/her. This study also revealed some definite actions of nurses who cared for patients with intractable illness.

Arginine vasopressin increases nitric oxide synthesis in cytokine-stimulated rat cardiac myocytes

We investigated the effects of arginine vasopressin (AVP) on nitric oxide (NO) synthase activity in cardiac myocytes by measuring the production of nitrite, a stable metabolite of NO, and the expression of inducible NO synthase (iNOS) mRNA and protein. Incubation of cultured neonatal rat cardiac myocytes for 24 hours with interleukin-1beta (IL-1beta) caused a significant increase in NO production. Both AVP and V1a receptor agonist [Phe2,Ile3,Orn8]vasopressin augmented NO synthesis in IL-1beta-stimulated, but not in unstimulated myocytes, in a dose-dependent manner. The V1a receptor antagonist [d(CH2)[5]1,O-Me-Tyr2,Arg8]vasopressin completely inhibited the effect of AVP. The AVP-induced NO production by IL-1beta-stimulated cells was accompanied by increased iNOS mRNA and protein accumulation. AVP caused a significant increase in cytosolic free Ca2+ levels of cardiac myocytes, whereas it showed no effect on cytosolic cAMP levels. After protein kinase C activity was functionally depleted by treating cells with phorbol 12-myristate 13-acetate for 24 hours, AVP did not augment IL-1beta-induced NO production. The effect of AVP was also inhibited in the presence of the protein kinase C inhibitor calphostin C. The addition of AVP increased protein kinase C activity in cardiac myocytes, and its effect was significantly inhibited in the presence of calphostin C. These results support the hypothesis that the heart may be a target organ for AVP and that AVP modulates IL-1beta-induced iNOS expression in myocytes through the V1a receptor, which is mediated at least partially via activation of protein kinase C.

Electrocardiographic features differentiating dilated cardiomyopathy from hypertrophic cardiomyopathy

To determine the usefulness of electrocardiographic (ECG) features in differentiating between hypertrophic cardiomyopathy with features mimicking dilated cardiomyopathy (D-HCM) and true dilated cardiomyopathy (DCM), we compared ECGs of 52 consecutive patients (11 with D-HCM, 41 with DCM). Left atrial dimension, left ventricular internal dimension, and septal and posterior wall thickness were employed as echocardiographic indexes, while QRS duration, amplitude of RV5 or V6 + SV1, number of abnormal Q waves, P-terminal force in V1, and frontal plane QRS axis were used as ECG parameters. The patients with D-HCM demonstrated a larger number of abnormal Q waves (P < .0001), greater prolongation of QRS duration (P < .0001), and lower amplitude of RV5 or V6 + SV1 (P < .0001). In all cases of D-HCM, atrial overload was observed and abnormal QRS axis in 9 (82%) of the 11 patients. These features were noted in 21 (51%) and 17 (41%), respectively, of the 41 DCM patients (P < .005 and P < .05, respectively). Despite significant differences in the echocardiographic parameters between D-HCM and DCM, excluding left ventricular end-diastolic dimension, ECG abnormalities were more significant between the two groups. The results indicate that ECG features are extremely useful in differentiation between DCM and D-HCM.

A subepidermal blistering disease with histopathological features of dermatitis herpetiformis and immunofluorescence characteristics of bullous pemphigoid: a novel subepidermal blistering disease or a variant of bullous pemphigoid?

A 64-year-old man presented with a bullous eruption which clinically and histopathologically resembled dermatitis herpetiformis. However, direct immunofluorescence analysis showed IgG deposits at the basement membrane zone, indicating a relationship with bullous pemphigoid or epidermolysis bullosa acquisita. Indirect immunofluorescence studies on salt-split skin showed binding of IgG mainly on the dermal side of the blister. Immunoblot analysis revealed a novel 200 kDa dermal antigen that could be associated with a major pathogen in this blistering disease. The histopathological similarity to dermatitis herpetiformis and the immunofluorescence findings indicating bullous pemphigoid or epidermolysis bullosa acquisita seem typical of a distinct subepidermal blistering disease characterized by this 200 kDa antigen. However, the pathogenetic role of autoantibodies against this antigen should be further elucidated before confirming whether this case represents a novel subepidermal blistering disease or a special variant of bullous pemphigoid.

The locus coeruleus noradrenergic system in the rat brain studied by dual-probe microdialysis

A dual-probe microdialysis technique was applied to the locus coeruleus (LC) and prefrontal cortex (PFC) of the brain of conscious rats. One probe was implanted close to the LC and was used to apply receptor-specific compounds by retrograde microdialysis. The effects of the LC infusions were recorded by a sampling noradrenaline by a second probe that was implanted in the ipsilateral prefrontal cortex. Infusion of sodium channel blocker tetrodotoxin (1 microM; 90 min) into the LC decreased extracellular noradrenaline in the PFC to approximately 20% of control values. Infusion of alpha2-adrenoceptor agonist clonidine (100 microM, infused during 15 or 45 min) near to the LC, decreased extracellular noradrenaline in the PFC to 35 and 20% of controls, respectively. These results indicate that > 80% of the extracellular levels of noradrenaline in the PFC is derived from LC innervation, and confirms the importance of alpha2-autoreceptors on noradrenergic neurons in the LC. Infusion of the cholinergic receptor agonist, carbachol (100 microM, 45 min) near to the LC increased extracellular noradrenaline in the PFC to approximately 150% of controls. Infusions of the excitatory amino-acid agonists NMDA and kainate into the LC caused marked increases in extracellular noradrenaline in the PFC to 240 and 200% of controls, respectively. The experiments with clonidine, carbachol, NMDA and kainate were repeated in anesthetized rats. Clonidine and carbachol were similarly effective as in conscious animals but the effects of NMDA and kainate on extracellular noradrenaline in the PFC were clearly suppressed: 145 and 130% of controls, respectively. These results suggest that increased arousal or behavioural activation might have contributed to the increases in extracellular noradrenaline that was seen after infusion of the glutamate agonists. These results also provide evidence for localization of cholinergic-, NMDA-, non-NMDA-receptor on noradrenergic neurons in the LC. Finally it is concluded that dual-probe microdialysis is a useful method to further investigate the pharmacology of LC-noradrenergic neurons. Carbachol and clonidine are suitable tools for a rapid and reversible stimulation or inhibition, respectively, of noradrenergic LC neurons.

Relationship between the glutamate production and the activity of 2-oxoglutarate dehydrogenase in Brevibacterium lactofermentum

Enzyme activities of 2-oxoglutarate dehydrogenase complex and glutamate dehydrogenase of wild type Brevibacterium lactofermentum, one of the typical glutamate-producing coryneform bacteria, were investigated by using cells cultured under glutamate-productive and glutamate-non-productive conditions. Significant reduction of the former enzyme activity was observed in the cells under the several glutamate-productive conditions, namely, in the cells cultured in media containing a) limited concentrations of biotin, b) sub-lethal amounts of penicillin, and c) sub-optimal amounts of a surface-active agent, as compared with those under the non-productive conditions. The activity of the latter enzyme was essentially unchanged in every condition. The relationship between glutamate production and the enzyme activities as well as permeability of glutamate through cell membrane was discussed from the results obtained.