Cerebellar peduncle damage in Langerhans cell histiocytosis-associated neurodegenerative disease revealed by diffusion tensor imaging

PURPOSE

To confirm the hypothesis that brain white matter damage is involved in the pathogenesis and disease progression of Langerhans cell histiocytosis (LCH)-associated neurodegenerative disease (ND), we aimed to analyze pediatric patients with LCH using diffusion tensor imaging (DTI).

METHODS

We enrolled 33 patients with LCH and obtained 33 DTI datasets. Using DTI-based tractography, fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD) were measured in the cerebral and cerebellar white matter tracts. The participants were divided into three groups-non-ND, ND without clinical symptoms (r-ND), and ND with clinical symptoms (c-ND)-according to their clinical status during the examination with DTI. We compared the DTI parameters in white matter tracts were compared among the three groups.

RESULTS

In the order of non-ND, r-ND, and c-ND groups, the FA in superior cerebellar peduncle (SCP) and middle cerebellar peduncle (MCP) significantly decreased, the ADC, AD, and RD of MCP, and the RD of SCP were significantly elevated (FA-SCP; p < 0.001, FA-MCP; p = 0.026, ADC-MCP; p < 0.001, AD-MCP; p = 0.002, RD-MCP; p = 0.003, and RD-SCP; p = 0.018). Furthermore, in the simple linear regression analysis, the FA, ADC, AD, and RD values in the MCP and the FA value in the SCP were significantly influenced by the presence of neurological symptoms and ND findings on MRI (all p < 0.001).

CONCLUSION

In LCH-ND, we identified microstructural damage in the SCP and MCP. DTI parameters in these tracts may help monitor LCH-ND; therefore, future studies are required to validate these results in a large cohort.

Low-grade IVH in preterm infants causes cerebellar damage, motor, and cognitive impairment

BACKGROUND

Few studies have examined the effect of low-grade intraventricular hemorrhage (IVH) on the white matter in the cerebellum and its association with neurodevelopment. We evaluated cerebellar white matter at term-equivalent age (TEA) in preterm infants with low-grade IVH. Furthermore, we assessed neurodevelopmental outcomes at 3 years of age to examine the influence of low-grade IVH on neurodevelopment.

METHODS

Thirteen infants with low-grade IVH and 26 without IVH, born at <30 weeks' postmenstrual age (PMA), were enrolled in this study. Diffusion tensor imaging (DTI) parameters, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in the middle and superior cerebellar peduncles (SCP), were measured. Neurodevelopmental outcomes at three years of age were assessed and the correlation between DTI parameters and developmental quotient (DQ) was analyzed.

RESULTS

Preterm infants with IVH showed lower FA values (P < 0.01) and higher ADC values (P < 0.05) in the SCP at TEA than the no-IVH group. Lower Postural-Motor and Cognitive-Adaptive DQ at 3 years of age were observed in the IVH compared to the no-IVH group. A significant correlation between the FA values in the SCP at TEA and the Posture-Motor DQ was observed at three years of age (P = 0.043, r = 0.50).

CONCLUSIONS

These data suggest that low-grade IVH in preterm infants affects the SCP at TEA and that impaired cerebellar white matter correlates with poor motor development at three years of age.

Analgesic effect of voluntary exercise in a rat model of persistent pain via suppression of microglial activation in the spinal cord

In this study, we employed a rodent model for persistent allodynia and hyperalgesia to determine whether voluntary exercise could exert analgesic effects on these pain symptoms. Rats were subcutaneously injected with formalin into the plantar surface of the right hind paw to induce mechanical allodynia and hyperalgesia. We assessed the analgesic effects of a voluntary wheel running (VWR) using the von Frey test and investigated microglial proliferation in the dorsal horn of the spinal cord. We also determined the effect of formalin and VWR on the protein expression levels of brain-derived neurotrophic factor (BDNF), its receptor TrkB, and K⁺-Cl^- cotransporter 2 (KCC2), which play a key role in inducing allodynia and hyperalgesia. Rats with access to the running wheels showed beneficial effects on persistent formalin-induced mechanical allodynia and hyperalgesia. The effects of VWR were elicited through the suppression of formalin-induced microglial proliferation, TrkB up-regulation, and KCC2 down-regulation in the spinal cord. BDNF, however, might not contribute to the beneficial effects of VWR. Our results show an analgesic effect of voluntary physical exercise in a rodent model with persistent pain, possibly through the regulation of microglial proliferation and TrkB and KCC2 expression in the spinal cord.

Simple blood test for diagnosis of gastrointestinal and pancreas cancer using surface-enhanced Raman scattering

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Background: Surface-Enhanced Raman Scattering (SERS) has been widely applicated in industrial microanalysis, and researched to apply for various fields, for example biological research. We tried to detect the SERS spectra from blood samples obtained from patients with cancers or benign diseases by using a low intensity laser beam, and compared the SERS spectra pattern among the samples from the patient group. Methods: Blood samples were obtained from patients with gastric cancer (n=30), colorectal cancer (n=20), pancreas cancer (n=5) and benign diseases (n=20). All blood samples were centrifuged at 1600g for 7 minutes, and serum samples were extracted. The serum samples were placed on the phosphor bronze chip with silver nanoscale hexagonal columns (NHCs), and SERS spectra was detected by using low intensity helium-neon red laser beam with 633 nm as wavelength. Results: SERS spectra were detected in all samples within 4 minutes from irradiation. Limiting dilution of detecting SERS was 1/1000 of serum. SERS spectra patterns were different between cancer and benign disease patients, and maximum peak level of the SERS in the samples from cancer patients were significantly higher than those from benign disease patients. There was a difference on the wavelength of Raman shifting at the peak intensity and the pattern of the SERS spectra between the samples from the patients with cancers and benign diseases. And furthermore, there was a difference on the SERS spectra pattern among the samples from the patients with gastric, colon and pancreas cancer. Additionally, it was suggested that the elements combined with the silver NHCs were histone-and-DNA complex. Conclusions: Our data suggest that our simple blood test using SERS is useful for diagnosis of gastrointestinal and pancreas cancer. We have been trying molecular analysis of the element combined with the silver NHCs by next-generation sequencer. Clinical trial information: UMIN000009818.

[A single administration of morphine suppresses the reduction of the systemic immune activity caused by acute inflammatory pain in rats]

BACKGROUND

Pain accompanying various diseases as well as invasion and postoperative pain reduce immune activities, and affect the prognosis of diseases and recovery after surgery (metastasis and relapse). While, some anesthetics and synthetic narcotics used to reduce pain are reported to suppress immune activities depending on the kind of medication and the dosing strategy. However, it is not clear how the single use of narcotics affects the immune activity at the acute stage of severe inflammatory pain. This study is undertaken to examine the effect of a single administration of morphine on the splenic NK cell activity in the acute inflammatory pain model rats.

METHODS

Rats received a 50 microl s.c. injection of 4% formaldehyde into the plantar surface of the right hindpaw. The spleen was removed 2 hours later and the splenic NK-cell activity was measured by 51Cr release assay.

RESULTS

Acute pain significantly reduced the splenic NK cell activity, but the single administration of morphine suppressed its reduction.

CONCLUSIONS

It was indicated that the single administration of morphine could suppress the reduction of the systemic immune activity caused by acute inflammatory pain.

Modulation of eosinophil survival by epinastine hydrochloride, an H1 receptor antagonist, in vitro

The influence of epinastine hydrochloride (EP) on eosinophil survival was examined by an in vitro cell culture technique. Nasal epithelial cells (NECs) were stimulated with 25 ng/ml TNF-alpha in the presence of EP (10 to 30 ng/ml). After 24 h, the culture supernatants were obtained and used as conditioned media of NECs (CM). Eosinophils (1 x 10(3) cells/ml) prepared from healthy human peripheral blood were incubated with 25% CM and eosinophil survival was assessed by trypan blue dye exclusion test 48 h later. CM prepared from NEC cultures pre-treated with TNF-alpha and EP caused a decrease in eosinophil survival as compared with that from NEC cells pre-treated with TNF-alpha alone. The minimum concentration of EP that caused a significant decrease in eosinophil survival was 25 ng/ml. The addition of EP into eosinophil cultures did not cause inhibition of eosinophil survival, which was prolonged by stimulation with granulocyte-macrophage colony-stimulating factor (GM-CSF), even when 40 ng/ml EP was added to cell cultures. We then examined the levels of GM-CSF in CM by ELISA. Treatment of NECs with EP at more than 25 ng/ml, reduced the ability of NECs to produce GM-CSF in response to TNF-alpha stimulation. These results may suggest that EP suppresses eosinophil survival through the suppression of GM-CSF production from NECs induced by inflammatory stimulation and that this suppressive effect contributes, in part, to the therapeutic mode of action of EP on allergic diseases.

Promoter polymorphism in the macrophage migration inhibitory factor gene is associated with obesity

OBJECTIVE

To explore the association of promoter polymorphisms of macrophage migration inhibitory factor (MIF) gene with obesity.

SUBJECTS

In total, 213 nondiabetic Japanese subjects. They were divided into three groups according to World Health Organization definitions: lean (body mass index (BMI) <25 kg/m2), overweight (25 < or = BMI < 30 kg/m2) and obese (BMI> or = 30 kg/m2).

METHODS

We examined two polymorphic loci in the MIF gene in the subjects: a single-nucleotide polymorphism at position -173 (G/C) and a CATT-tetranucleotide repeat polymorphism at position -794, which both can affect promoter activity in different cells.

RESULTS

We detected four alleles: 5-, 6-, 7- and 8-CATT at position -794. Genotypes without the 5-CATT allele (X/X, X refers to 6-, 7- or 8-CATT alleles) were more common in obese subjects than in lean or overweight groups (P = 0.013). The X-CATT allele was more frequent in obese subjects than in lean or overweight subjects (P = 0.030). In contrast, -173G/C was not associated with obesity. Among the haplotypes of the two promoter polymorphisms, G/5-CATT ((-173G/C)/(-794[CATT](5-8))) was associated with a decreased risk of obesity (P = 0.025) and G/6-CATT with an increased risk of overweight (P=0.028).

CONCLUSION

Promoter polymorphism in the MIF gene is linked with obesity.

Increased glomerular cytosolic phospholipase A2 activity of OLETF rats with early diabetes

In view of the potential role of prostaglandins (PGs) in development of glomerular hyperfiltration leading to diabetic nephropathy, we studied the temporal relationship of the activity of cytosolic phospholipase A2 (cPLA2), a rate-limiting enzyme for eicosanoid biosynthesis, with hyperfiltration and the histological changes in glomeruli using OLETF rats, a model for non-insulin-dependent diabetes mellitus (NIDDM). Diabetes mellitus and associated histopathological changes, which developed spontaneously by 30-46 weeks after birth of OLETF rats, were accompanied by approximately 65% increase in glomerular cPLA2 activity that showed significant correlations with elevated plasma glucose levels and creatinine clearance. Moreover, mesangial cells cultured for 5 days with high glucose exhibited approximately 2-fold higher cPLA2 activity than those cultured with physiologic level of glucose. These data suggest that increased glomerular cPLA2 activity leads to production of PGs, which may promote the progression of early diabetic glomerular hyperfiltration and subsequent diabetic nephropathy.

Regulation of macrophage migration inhibitory factor (MIF) expression by glucose and insulin in adipocytes in vitro

BACKGROUND

It has been reported that macrophage migration inhibitory factor (MIF) stimulated insulin secretion from pancreatic islet beta-cells in an autocrine manner, which suggests its pivotal role in the glucose metabolism. According to this finding, we evaluated MIF expression in cultured adipocytes and epididymal fat pads of obese and diabetic rats to investigate its role in adipose tissue.

MATERIALS AND METHODS

The murine adipocyte cell line 3T3-L1 was used to examine MIF mRNA expression and production of MIF protein in response to various concentrations of glucose and insulin. Epididymal fat pads of Otsuka Long-Evans Tokushima fatty (OLETF) and Wistar fatty rats, animal models of obesity and diabetes, were subjected to Northern blot analysis to determine MIF mRNA levels.

RESULTS

MIF mRNA of 3T3-L1 adipocytes was up-regulated by costimulation with glucose and insulin. Intracellular MIF content was significantly increased by stimulation, whereas its content in the culture medium was decreased. When the cells were treated with cytochalasin B, MIF secretion in the medium was increased. Pioglitazone significantly increased MIF content in the culture medium of 3T3-L1 cells. However, MIF mRNA expression of both epididymal fat pads of OLETF and Wistar fatty rats was down-regulated despite a high plasma glucose level. The plasma MIF level of Wistar fatty rats was significantly increased by treatment with pioglitazone.

CONCLUSION

We show here that the intracellular glucose level is critical to determining the MIF mRNA level as well as its protein content in adipose tissue. MIF is known to play an important role in glucose metabolism as a positive regulator of insulin secretion. In this context, it is conceivable that MIF may affect the pathophysiology of obesity and diabetes.

Tumor necrosis factor-alpha regulates the gene expression of macrophage migration inhibitory factor through tyrosine kinase-dependent pathway in 3T3-L1 adipocytes

Macrophage migration inhibitory factor (MIF) has been rediscovered as a proinflammatory cytokine, pituitary hormone, and glucocorticoid-induced immunoregulator. We have recently identified the expression of MIF in adipocytes and found that tumor necrosis factor (TNF)-alpha stimulates its secretion from 3T3-L1 adipocytes. Since adipocytes are regarded as a potential source of various biologically active substances, we examined in more detail the effect of TNF-alpha on MIF expression in 3T3-L1 adipocytes in the present study. We found that TNF-alpha induced MIF mRNA in dose- and time-dependent manners. After stimulation with TNF-alpha, the amount of intracellular MIF protein was unchanged or slightly decreased, concomitant with increased release of this protein into the extracellular space. This observation indicates that TNF-alpha stimulates MIF secretion from the constitutively expressed intracellular pool of 3T3-L1 adipocytes and promotes de novo synthesis of MIF. From evaluation of the mechanism of MIF gene expression, we found that tyrosine kinase inhibitors, either genistein or herbimycin A, suppressed the MIF mRNA induction by TNF-alpha. The results suggest the possibility that upregulation of MIF mRNA expression by TNF-alpha is mediated by a tyrosine kinase-dependent pathway. Taken together, the present observations shed light on the role of MIF in the metabolism of obesity and diabetes.

Identification of macrophage migration inhibitory factor in adipose tissue and its induction by tumor necrosis factor-alpha

Macrophage migration inhibitory factor (MIF) has been rediscovered as a proinflammatory cytokine, pituitary hormone, and glucocorticoid-induced immunoregulator. A survey of tissue distribution revealed that MIF expression is not limited to T lymphocytes, but exists in several other tissues; however, its presence in adipose tissue has never been investigated. In this study, we examined the expression of MIF in adipose tissue using the rat epididymal fat pad and murine 3T3-L1 adipocytes. Northern and Western blot analyses revealed the expression of MIF mRNA and MIF protein, respectively, in both the fat pad and the adipocyte cell line. In immunohistochemistry, a positive staining reaction with an anti-rat MIF antibody was detected largely in the cytosol of adipocytes of the epididymal fat pad. To examine the production and release of MIF by adipocytes, we examined its content in the culture medium of the 3T3-L1 adipocytes. The results showed that MIF content was 1.6 +/- 0.48 ng/ml (mean +/- SD) after 24 hr culture, and the content was increased up to 9.7 +/- 2.8 ng/ml by stimulation with TNF-alpha (50 nM). Since TNF-alpha produced in adipocytes is known to induce insulin resistance, the results suggest the possibility that MIF plays an important role in the mechanism of insulin resistance often observed in obesity and diabetes via regulation of TNF-alpha expression.

[A case of IgG-kappa type multiple myeloma complicated by Fanconi syndrome]

Fanconi syndrome is characterized by some absorptive defects of proximal renal tubules. It is observed either primarily, or secondarily to various diseases. A case of multiple myeloma complicated by Fanconi syndrome is reported. The patient was a 62-year-old female. The serum total protein was elevated, and monoclonal IgG-kappa protein was found on serum immunoelectrophoresis. Urinary Bence Jones protein was positive. Bone marrow aspiration disclosed increased dysplastic plasma cells, which led to the diagnosis of multiple myeloma. A diagnosis of Fanconi syndrome was based on renal glycosuria, hypophosphatemia, hypokalemia, and panaminoaciduria due to abnormal excretion from the kidney, and metabolic acidosis. After chemotherapy for multiple myeloma, serum IgG level and urine sugar decreased, and serum potassium level was corrected.

[Clinical significance of alpha(1----3)-L-fucosyltransferase activities in sera from patients with malignant diseases with a special reference to a potential tumor marker]

We measured alpha(1----3)-L-fucosyltransferase (alpha 13FT) activity in human plasma samples obtained from a group of 111 patients with malignant diseases, 86 patients with benign diseases, and 58 healthy controls using a newly developed assay method (Clin. Chem., 37: 2081-2086, 1991). The cutoff value was arbitrarily set at 73 units/ml (mean +/- 3SD of results for healthy controls). Forty-one of the 111 (36.9) plasma samples from patients with cancer showed high enzyme activity, and twelve of the 86 (13.6%) samples from patients with benign diseases were above the cutoff value. The levels of alpha 13FT were considerably high in samples obtained from the patients with esophagus, lung, liver and pancreatic and biliary cancer, and corresponding positive rates were 66.7, 64.7, 62.5 and 62.5%, respectively. The elevation of the enzyme activity was found in many samples from advanced cancer, whereas samples from patients with gastric and colon cancer in the clinical stage I showed high positive rates. No correlation was observed between the level of alpha 13FT and tumor--associated antigens such as carcinoembryonic antigen, CA19-9, and sialyl Tn (STN). These results suggest that alpha 13FT activity measured by the present assay method could have a potentiality for a new type of tumor marker.

[Hormone receptors (ER, PgR) as a prognostic factor in breast cancer]

To investigate the significance of the hormonal receptors (ER: estrogen receptors; PgR: Progesterone receptors) as prognostic factors in breast cancer, 213 patients with breast cancer (stages I-III) who were examined for both receptors and had not received adjuvant hormonal therapy have been studied so as to determine a disease-free survival rate. In stage I, the status of the hormonal receptors failed to show any statistically significant differences with regard to the disease-free curve. However, in patients in advanced stage, the presence of either PgR or both receptors positively correlated with the disease-free survival curve. In comparing the ER with the PgR as prognostic factors, the presence of the PgR seemed to be more important than the presence of the ER. These data suggest that the status of the hormonal receptors is considered to have prognostic significance.