Chronic cyclosporin A nephrotoxicity, P-glycoprotein overexpression, and relationships with intrarenal angiotensin II deposits

P-glycoprotein (P-gp) expels hydrophobic substances from the cell, including chemotherapeutic agents and immunosuppressants such as cyclosporin A (CsA) and FK506. Exposure of cultured renal tubular cells to CsA induces P-gp overexpression in cell membranes. Angiotensin II has recently been implicated as the principal factor responsible for progression of interstitial fibrosis induced by CsA. To investigate the in vivo relationships between histological lesions, P-gp overexpression, and intrarenal angiotensin II deposits, we developed a model of chronic CsA toxicity in Sprague-Dawley rats treated with 25 mg/kg/day CsA for 28 and 56 days and fed either a standard maintenance diet or a low-salt diet. Immunohistochemical methods were used to study the expression of P-gp in renal tubular cells and the appearance of intrarenal angiotensin II deposits. Rats treated with CsA developed chronic nephrotoxicity lesions that were more evident in the group fed the low-salt diet. Treatment with CsA induced overexpression of P-gp in tubular cells of the kidney that increased with time. We found that immunohistochemical expression of P-gp was slightly more severe in rats fed a low-salt diet. Intrarenal deposits of angiotensin II were more evident in rats treated with CsA; these deposits also increased with time. This finding was also more relevant in rats given the low-salt diet. The up-regulation of P-gp was inversely related to the incidence of hyaline arteriopathy (r = -0.65; P < 0.05), periglomerular (r = -0.58; P < 0.05) and peritubular fibrosis (r = -0.63; P < 0.05), and intrarenal angiotensin H deposits in animals with severe signs of nephrotoxicity (r = -0.65; P < 0.05). These results support the hypothesis that the role of P-gp as a detoxicant in renal cells may be related to mechanisms that control the cytoplasmic removal of both toxic metabolites from CsA and those originating from the catabolism of signal transduction proteins (methylcysteine esters), which are produced as a result of ras activation in presence of angiotensin II.

Long-term cultured CD40-activated B lymphocytes differentiate into plasma cells in response to IL-10 but not IL-4

We compared the effects of IL-10 and IL-4 on the functions of B lymphocytes triggered through their CD40. During the initial phase, IL-10 was as potent as IL-4 in inducing the expansion of viable B cells. Then, cellular expansion slowed down and after approximately 3 weeks the number of B cells started to decline. While the combination of IL-10 and IL-4 was synergistic during the first 2 weeks of culture, B cell recovery declined after 3 weeks, indicating that IL-10 prevails over IL-4. Those effects were not restricted to a specific B cell subset as both sIgD+ B cells and sIgD- B cells behaved in a similar way, though the latter population responded with a slightly accelerated kinetic. Inverted microscope examination and scanning electron microscopy showed that in response to IL-10, CD40-activated B cell cultures were heterogeneous with loose aggregates of cells as well as free floating large ovoid cells. In contrast, in the presence of IL-4, CD40-activated B cell cultures were essentially composed of tight cell clumps. IL-10 progressively induced all B cells to differentiate into non-replicating cells with intracytoplasmic Ig that secreted Ig at a high rate. Cytologic analysis indicated that IL-10 cultured cells display a basophilic cytoplasm with an arcoplasm and a low nucleus/cytoplasm ratio. Transmission electron microscopy demonstrated that when IL-10 was added to the culture, B cells displayed structures for excretion with extended endoplasmic reticulum and dilated cisternae containing paracrystalline structures, typical of plasmablasts cells. Taken together, these results indicate that IL-10 acts as a plasma cell differentiation factor for CD40-activated B cells.

Malignant large cell calcifying Sertoli cell tumor of the testis

An otherwise normal 48-year-old man had malignant large cell calcifying Sertoli cell tumor of the testis. There were lymph node involvement and albugineal invasion at orchiectomy, and pulmonary metastases developed despite radiotherapy and chemotherapy. Our case and, to our knowledge, the only other reported case of malignant large cell calcifying Sertoli cell tumor had clinical and histopathological features related to aggressiveness, such as unusual patient age, large tumor size, cellular pleomorphism, high mitotic rate, necrosis and aneuploid deoxyribonucleic acid. Such characteristics are not found in benign large cell calcifying Sertoli cell tumors. Associated findings included granular change of the epididymal lining, probably due to compression by the large tumor.

Adenocarcinoma of the renal pelvis. A report of two cases

Two cases of intestinal-type adenocarcinoma of the renal pelvis (ARP) in 48- and 63-year-old females are presented. Both had a previous history of urinary obstructive disease, one secondary to staghorn calculus and the other to postirradiation stenosis following treatment for carcinoma of the cervix. Immunohistochemical findings revealed marked positivity to epithelial membrane antigen and focal positivity to cytokeratins and carcinoembryonic antigen. Chronic irritation of the renal pelvis plays an important role in the pathogenesis of ARP. In one of our cases of multicentric origin, the synergistic effect of pelvic irradiation and cyclophosphamide chemotherapy in a patient with a previous squamous cell carcinoma of the cervix, may be responsible for the pathogenesis of the ARP.

Partial characterization of an external polysaccharide of Helicobacter pylori by using an immunoglobulin M monoclonal antibody

A monoclonal immunoglobulin M antibody, HP15/36, was produced by a hybridoma cell line prepared by fusion of mouse myeloma cell line Sp2/O with spleen cells of mice immunized with Helicobacter pylori D273 (French strain). Immunoelectron microscopy of whole bacteria and ultrathin sections showed that the determinant was located outside the bacterial cell, possibly in the outermost areas. This external reactivity was observed by immunofluorescence and immunoperoxidase assays and was confirmed by immunogold study at the ultrastructural level. The reactive epitope was formol and picric acid resistant and allowed the detection of the bacterium on fixed tissue biopsy specimens. The reactive component was extracted with phenol-water. Immunoblotting with such an antigen exhibited a clearly positive reactivity at a molecular mass between 50 and 120 kDa. This reactivity was suppressed by periodate oxidation, suggesting a carbohydrate epitope. The diagnostic value and significance of this polysaccharide in microbe-host interactions remain to be determined.

[Congenital prepubic sinus: blind epispadial duplication of the urethra]

Presentation of one case of congenital epispadial urethral duplication in a 1-year old child. The malformation consisted on one normal urethra and the other one a prepubic epispadial accessory urethra, with the proximal end finishing blind into the anterior side of the bladder. The mictional cystography performed showed normal bladder and urethra, while the retrograde urethrography through the dorsal sinus showed a 3 cm long tract with no communication to the urethra or the bladder. Treatment consisted in total exeresis of the accessory urethra by way of suprapubic approach, with no symphysiotomy. Up to the present date, the patient remains asymptomatic.

Isolation of two morphologically distinct cell lines from rat arterial smooth muscle expressing high tumorigenic potentials

Smooth muscle cell proliferation is an important feature of atherogenesis. Some works have hypothesized that a transformation of smooth muscle cells could arise during this pathological process. The present paper describes two spontaneously transformed cell lines of arterial smooth muscle cells (SMC) established from aortic media of adult rat. The cell lines have been designated V6 and V8; some of their morphologic, growth, and metabolic characteristics are described and compared to their parent cells. The two cell lines appeared distinct by their morphology and by their degree of transformation. V6 cells appeared as elongated spindle-shaped cells whereas V8 cells were spread cells with a cobblestone pattern. Karyotypes of both cell lines showed a high polyploidy level. V6 and V8 cell lines were immortalized and showed growth characteristics of transformed cells: low requirement of serum to grow, ability to form colonies in soft agar and tumorigenicity in nude mice; V8 cells presented a higher malignancy than V6 cells. Both V6 and V8 cells exhibited characteristics of cultured arterial SMC: ultrastructure, alpha actin expression at the protein and mRNA level, prostacyclin production. The remarkably different morphologies of the V6 and V8 lines and their transformed phenotype suggest that these cell lines could be useful models to study SMC differentiation and proliferation with respect to atherosclerotic or hypertensive vascular diseases.

Characterization of an immunoreactive species-specific 19-kilodalton outer membrane protein from Helicobacter pylori by using a monoclonal antibody

Immunoblotting experiments on hyperimmune rabbit serum and sera from patients with Helicobacter pylori gastritis showed a consistent antibody response to a 19-kDa outer membrane protein antigen. A monoclonal antibody, designated HP 40, which reacted by Western immunoblotting with this protein was produced. It was shared by all H. pylori strains tested (D 273, NCTC 11637, and 24 wild strains) but not by the thermophilic Campylobacter species, Campylobacter fetus, Helicobacter mustellae, or Helicobacter fennelliae. Immunogold staining suggested that the 19-kDa antigen was exposed on the outer surface of the bacteria. Its functional role and effectiveness as a serological diagnostic tool are under study.

Desmin expression in fibroblasts of murine periovular granuloma during liver Schistosoma mansoni infection

We have studied the expression of the desmin gene, a muscle-specific intermediate filament protein in the granuloma cells of mouse liver infected with Schistosoma mansoni. In situ hybridization using a desmin DNA probe showed that fibroblastic cells in the granuloma strongly expressed desmin mRNAs, while in normal liver these cells did not express this mRNA to a detectable degree. The quantitative analysis of total RNAs demonstrated that the proportion of specific desmin mRNA increased from 14 to 18 weeks after infection and decreased at 20 weeks. The analysis of collagen gene expression indicated that the amount of type III collagen mRNAs was still increasing after 18 weeks from infection; in contrast, the amount of type I collagen mRNAs remained unchanged at that stage. A good correlation was observed between the detection of the specific mRNAs and the detection of both desmin and collagen molecules. Therefore, these data point to a coordinate induction of desmin and collagen gene expression during Schistosomal granuloma formation. They also suggest that the expression of the myofibroblast phenotype involves the induction of both genes.

Localization of phosphophoryn in rat incisor dentin using immunocytochemical techniques

We studied the distribution of the phosphophoryn present in rat incisors by immunolocalization and histochemical techniques. The polyclonal antibody used reacts with both phosphorylated and de-phosphorylated phosphophoryn. Technical problems encountered in immunostaining and in preparing sections from mineralized dentin were resolved by use of peroxidase-conjugated protein A as the "second antibody" in indirect immunostaining reactions and by surface etching of partially demineralized sections. Staining with anti-rat incisor alpha-phosphophoryn antibody showed light staining over the odontoblasts and proximal odontoblastic processes, no stain over the predentin, dense staining over the intertubular dentin, and no stain over the mantle dentin. In the intertubular dentin the stain intensity was directly related to the distribution of mineral. These findings were directly corroborated by staining with Stains All. The mineralization of dentin and the distribution of phosphophoryn within the dentin may be much less uniform than previously supposed.

Histopathological and ultrastructural alterations in the aorta in experimental Solanum malacoxylon poisoning

A histopathological and electron microscopic study of the aortic wall of rabbits intoxicated with Solanum malacoxylon was performed. Histological examination showed local loss of the normal waviness of the elastic fibers and calcium deposits. Electron microscopic study of the corresponding areas showed a modified aspect of the smooth muscle cells with loss of some of their differential characteristics, especially their intracytoplasmic fibrils and densifications. The neighbouring elastic fibers showed an electron-dense peripheral band and sometimes a crystal deposit. X-ray microanalysis revealed the presence of a large amount of calcium in these crystals. Collagen fibers played no apparent role in this calcification. These findings support the idea that a local cellular alteration is necessary prior to elastic calcification. Two hypothetical mechanisms are proposed.