Infrared Thermal Analysis and Individual Differences in Skin Temperature Asymmetry in Rett Syndrome

PURPOSE

We evaluated the feasibility of using a portable infrared thermal camera to quantify the degree of thermal dysregulation (cold hands/feet) and test for naturally occurring within-patient skin temperature asymmetry in Rett syndrome.

PROCEDURES

Infrared thermal images were acquired passively from 15 patients (mean age = 13.7 years, range 4-47) with clinical diagnoses of Rett. Images were acquired using a FLIR T400 infrared thermal camera (still images recorded at 5 Hz, resolution of 320 × 240 pixels, thermal sensitivity = 0.05 °C; capture session lasted approximately 3 minutes). The infrared thermal camera was orthogonal to the body part (hands, feet) and positioned approximately 1 meter from the skin's surface.

RESULTS

There were large intraindividual left/right differences in temperature. Seven (47%) and eight (53%) patients had statistically significant (P <0.05) left/right asymmetries between hands (mean difference = 0.87 °C, standard deviation = 1.21) and feet (mean difference = 1.73 °C, standard deviation = 3.03), respectively. Coders were reliable (intraclass correlations 0.97-0.99) on temperatures and selection of anatomical regions of interest.

CONCLUSIONS

The degree of thermal asymmetry may reflect prolonged activity of the sympathetic nervous system and individual differences in sympathetic regulation. As clinical trials emerge and endpoints are considered, portable infrared thermal camera may provide one noninvasive means of evaluating changes in sympathetic regulation.

Expression of VACM-1 protein in cultured rat adrenal endothelial cells is linked to the cell cycle

The vasopressin-activated calcium-mobilizing (VACM-1) protein is a unique arginine vasopressin (AVP) receptor which shares sequence homology with the cullins, genes involved in the regulation of cell cycle transitions. Unlike either cullins or AVP receptors, however, VACM-1 is expressed exclusively in the vascular endothelial cells and in the renal collecting tubule cells. In order to test the hypothesis that the expression of VACM-1 might be correlated with the cell cycle, and to establish an endothelial cell model for the VACM-1 receptor, we examined VACM-1 expression in rat adrenal medulla endothelial cells (RAMEC). Northern and Western blot analyses of mRNA and protein from RAMEC identified presence of 6.4 kb mRNA and a Mr 81 kDa protein, respectively. Immunostaining of RAMEC with anti-VACM-1 antibodies and Western blot analyses indicated that in RAMEC, VACM-1 protein expression is dependent on the cell cycle. VACM-1 protein virtually disappears during the S phase and localizes to the cytosol during cell division and to the cell membrane at the completion of cytokinesis. Furthermore, pretreatment of RAMEC with anti-VACM-1 specific antibodies increased basal levels of Ca2+and attenuated the AVP-dependent increase in cytosolic Ca2+. In summary, these results indicate that VACM-1 protein expression in RAMEC membrane is linked to the cell cycle, and consequently, VACM-1 may be involved in the regulation of cell division.

Interleukin 2 activation of natural killer cells rapidly induces the expression and phosphorylation of the Leu-23 activation antigen

IL-2 potentiates both growth and cytotoxic function of T lymphocytes and NK cells. Resting peripheral blood NK cells can respond directly to rIL-2, without requirement for accessory cells or cofactors, and enhanced cytotoxicity can be measured within a few hours after exposure to this lymphokine. In this study, we describe an activation antigen, Leu-23, that is rapidly induced and phosphorylated after IL-2 stimulation of NK cells and a subset of low buoyant density T lymphocytes. Previously, it has been uncertain whether all NK cells or only a subset are responsive to IL-2. Since within 18 h after exposure to IL-2, essentially all NK cells express Leu-23, these findings indicate that all peripheral blood NK cells are responsive to stimulation by IL-2. The Leu-23 antigen is a disulfide-bonded homodimer, composed of 24-kD protein subunits with two N-linked oligosaccharides. Appearance of this glycoprotein on NK cells is IL-2 dependent and closely parallels IL-2-induced cytotoxicity against NK-resistant solid tumor cell targets.

Characterization of a T-cell determinant defined by a monoclonal antibody (TH5.2) which is involved in the interleukin-2-producing and proliferative capabilities of T cells

Utilizing an OKT-4-positive human T-cell lymphoma cell line as immunogen, we have produced a monoclonal antibody (MAb), designated TH5.2, which is capable of augmenting the interleukin-2 (IL-2) production and proliferation of antigen-activated T cells. TH5.2 MAb by itself is not mitogenic for T cells; the enhanced IL-2 production and proliferation requires costimulation with either antigen or mitogen. TH.2 MAb recognizes all peripheral blood T cells at varying intensities, but does not react with monocytes. Using dual-color fluorescence analysis, it was determined that TH5.2 MAb reacts at a higher intensity on Leu-3a-positive T cells compared to Leu-2a-positive cells. Sorting T cells on the basis of fluorescent intensity with TH5.2 MAb demonstrated that the T cells reacting at high TH5.2 intensity were able to respond to mitogen at a higher rate (5-10X), as well as produce higher concentrations of IL-2 in response to mitogen as compared to the low IL-2 intensity cells. Cytotoxically treating peripheral blood mononuclear cells (PBMC) with TH5.2 MAb plus complement, which resulted in an approximate 8% decrease in the total population, significantly reduced the ability of the cells to proliferate to both mitogen and antigen. Addition of recombinant IL-2 to the cultures was able to restore the proliferative capability of the cells. In further analyzing the ability of TH5.2 MAb to augment the proliferative capability of PBMC to antigen and mitogen stimulation in vitro, it was determined that TH5.2 MAb was capable of acting synergistically with antigen or mitogen in increasing the Il-2-producing capability of T cells. Taken together the data suggest that the TH5.2 determinants is involved in the proliferative capability of T cells and is functioning at the level of IL-2 synthesis and/or secretion.

Assessment of the mechanism of the leukocyte adherence inhibition test

This study was designed to elucidate the mechanism of the leukocyte adherence inhibition (LAI) test in man. To identify the reactive cell types, enriched leukocyte populations (dextran-separated leukocytes and Hypaque-Ficoll-isolated mononuclear cells and neutrophils, as well as rosette-isolated B- and T-lymphocytes) were tested for leukocyte adherence in the absence of serum to tumor-specific antigens. LAI reactivity was not restricted to any of the enriched populations, suggesting the involvement of multiple cell types. Attempts to demonstrate soluble lymphocyte factors in the LAI mechanism have been uniformly negative. In contrast, factors in serum of immune donors were able to arm naive cells to be specifically responsive. This suggests a role for serum factors in the mechanism of LAI reactivity and partially explains the participation of multiple cell types in the responses observed. In additional studies, we could not document a correlation between the magnitude of the dermal test (delayed cutaneous hypersensitivity) and the magnitude of the LAI response in patients with squamous cell carcinoma of the head and neck. In 34 of 54 of these patients, there was agreement between the two tests (both positive, 27 of 54; both negative, 7 of 54). In the remaining 20 patients, the dermal test was greater than 5 mm while the LAI test was negative (less than 30% inhibition).