The Dose and Duration of Effect of Levocabastine, A New Topical H1 Antagonist, on Nasal Provocation Reaction to Allergen

This study investigated the dose and duration of effect of topical levocabastine (LC) in patients with perennial allergic rhinitis as evaluated by the effect on nasal provocation test with house dust antigen. Three different doses (0.05, 0.1, and 0.2 mg) of LC were independently administered to evaluate the dose response and duration of effect. Reaction to nasal provocation was evaluated by a scoring system based on a combination of symptoms, such as number of sneezes, degree of nasal discharge, and nasal obstruction. The mean scores at 30 minutes postadministration of each of the three different doses of LC showed a significant decrease as compared with those of preadministration. The effect persisted for 4 hours with a dose of 0.05 mg and 0.1 mg of LC and for 12 hours with 0.2 mg of LC. In a comparison of the three doses potency of effect of LC, the highest dose (0.2 mg) demonstrated the strongest effect in the interval from 4 hours to 10 hours postadministration. These results indicate that LC has an immediate effect and its effect is dose dependent. The present study suggests that nasal symptoms in perennial allergic rhinitis could be relieved by topical application of 0.2 mg of LC, twice a day.

a-Si:H TFT Driven Linear Image Sensor

A new contact type linear image sensor, which has 8.5 inches in length and 300 dot/inch, has been developed. By using a thin film transistor (TFT) array as a switching device, it requires only one IC chip compared with 20 ICs in conventional sensor.

The new sensor integrates a-Si:H photodiode (PD) array, a-Si:H TFT array, multiplex circuits and an analog multiplexer on a single substrate. The TFT has an inverted staggered structure and amorphous silicon nitride (SiNx) is used as a gate insulator. The PD has a Cr/a-Si:H/ITQ sandwich structure and each PD is completely isolated by photolithography. In the multiplex circuits, a ground line is inserted between each signal line to reduce a capacitive coupling between them.

A new custom LSI has also been developed. It has 64-ch input terminals to detect small signal with amplification and 41-ch output terminals to control the gates of TFT array. The sensor with the new LSI has achieved 2MHz clock frequency operation and proved to be used as a high speed device.

Expression of inducible nitric oxide synthase (iNOS/NOS II) in the hydropic vestibule after injection of keyhole limpet hemocyanin into the endolymphatic sac of guinea pigs

This study was undertaken to examine the expression of inducible nitric oxide synthase (iNOS / NOS II) in the hydropic vestibule of guinea pigs. Animals were systemically sensitized with 500 microg of keyhole limpet hemocyanin. Two weeks after the first injection, keyhole limpet hemocyanin (100 microg/5 microl) was injected into the endolymphatic sac following the intradural approach, and the next day temporal bones were removed for the immunohistochemical examination. Endolymphatic hydrops was evidenced by the expansion of the Reissner's membrane in the cochlea after direct injection of keyhole limpet hemocyanin into the endolymphatic sac. Inducible nitric oxide synthase expression was increased in the sensory cells, supporting cells and vestibular ganglion cells, while temporal bones, where only phosphate buffered saline was injected, did not show any inducible nitric oxide synthase immunoreactivity. High levels of inducible nitric oxide synthase-catalyzed nitric oxide were detected prior to the development of the inner ear dysfunction. Our results suggest that the occurrence of inducible nitric oxide synthase immunoreactivity parallels the inner ear disturbance as seen in endolymphatic hydrops.

Th1: mediator lymphocytes in experimental autoimmune labyrinthitis

A previous study on experimental autoimmune labyrinthitis (EAL) consistently demonstrated transient infiltration of lymphocytes only into the inner ear of mice. To clarify the profile of lymphocytes in the initiation of EAL, the present study investigated cell surface antigens, as well as cytokines, from Day 4 to Day 35, using immunohistochemical techniques. Many CD4+ cells mainly infiltrated the endolymphatic sac as early as Day 4 and gradually spread to the rest of the inner ear. Infiltration peaked on Day 12 and persisted in most animals until Day 35, although the number of cells gradually decreased. In contrast, very few CD8+ cells were found to have appeared in the inner ear of all animals on Day 10, and the number of cells rapidly decreased. Many cells positive for IFN-gamma and IL-2 were identified in the endolymphatic sac on Day 4. These results suggest that helper T1 lymphocytes, rather than cytotoxic T lymphocytes, may play a central role in the initiation of EAL.

Apoptosis in the hydropic cochlea of guinea pigs following immune reaction of the endolymphatic sac: immunohistochemical analysis

Apoptotic change in the cochlea was studied by immunohistochemistry after the injection of keyhole limpet haemocyanin (KLH) into the right endolymphatic sac of guinea pigs. Apoptosis was examined with the specific antibody to single-stranded DNA (ssDNA). Endolymphatic hydrops became evident in the cochlea 1 day after the injection of KLH (n = 6). Increased ssDNA expression could be detected in the spiral ligament and the stria vascularis. The temporal bones in the control group did not show any ssDNA immunoreactivity (n = 6). Apoptosis is the process of the cell death. Our findings imply that apoptotic changes are involved in endolymphatic hydrops. These phenomena could lead to cochlear dysfunction as seen in endolymphatic hydrops.

Nanosized Ni/SiO2 catalyst prepared by homogeneous precipitation in wet silica gel

A Ni/SiO2 catalyst was prepared by homogeneous precipitation of nickel hydroxide in a sol-gel-derived wet silica gel. The preparation process consists of two successive steps: gelation of silica in the presence of nickel nitrate and urea at 50 degrees C, followed by aging at higher temperature, typically at 80 degrees C, to decompose the urea. The decomposition of urea increases the pH of the solution in the wet gel, leading to the concurrence of structural rearrangement of silica gel and deposition of nickel species. As a result, the structure of the silica changes from a ramified polymeric network into particle aggregates that entrap the nickel cations in the particles. The resulting Ni/SiO2 contains large mesopores that have high thermal stability up to 1000 degrees C and highly dispersed Ni metal particles with typical crystallite size of 4 nm even at high Ni content at 20 wt%.

Expression of Inducible Nitric Oxide Synthase in the Cochlea following Immune Response in the Endolymphatic Sac of Guinea Pigs

Immunohistochemical study for inducible nitric oxide synthase (iNOS or NOS II) in the cochlea of guinea pigs was performed after the injection of keyhole limpet hemocyanin (KLH) into the endolymphatic sac. Morphological changes were observed in the cochlea of all animals after the injection of KLH. Increased iNOS expression was detected in the lateral wall, organ of Corti and ganglion cells. It is known that high levels of nitric oxide can lead to inner ear dysfunction. Our results suggest that iNOS may mediate the inner ear disturbance as seen in endolymphatic hydrops.

Detection of single-stranded DNA in the hydropic vestibule after the direct injection of antigen into the endolymphatic sac of guinea pigs

Immunohistochemical study for single-stranded DNA (ssDNA) with vestibule of guinea pigs was performed after the injection of keyhole limpet hemocyanin (KLH) into the right endolymphatic sac. Endolymphatic hydrops became evident by expansion of the Reissner's membrane in the cochlea of all animals 1 day after the injection of KLH. Increased ssDNA expression was detected in the sensory epithelium and transitional area, while temporal bones in the control group did not show any ssDNA immunoreactivities. ssDNA is accompanied with the apoptotic change in the vestibule. Our results suggest that apoptotic changes could be involved in the hydropic vestibule and these phenomena lead inner ear disturbance as seen in endolymphatic hydrops.

Passive transfer of experimental autoimmune labyrinthitis

The aim of the present study was to establish an animal model of autoimmune labyrinthitis using heterologous inner ear antigen (IEAg) and to elucidate whether the experimentally induced labyrinthitis could be passively transferred. Cochlear and vestibular membranous labyrinthine tissues from bovine temporal bones were used as IEAg. Donor mice were inoculated intracutaneously at multiple sites with an emulsion consisting of equal parts of IEAg and complete Freund's adjuvant. After 10 days, mononuclear cells were collected from lymph nodes, spleen and blood of the donor mice and injected intravenously into naive recipient mice. Cellular infiltration was observed in the perilymphatic space of the cochlea of all donor and recipient mice. Endolymphatic hydrops was also observed in 63% of donor and 42% of recipient mice. These findings suggest that the experimentally induced labyrinthitis observed in this animal model was probably due to an autoimmune reaction to the IEAg and was passively transferred by a cell-mediated immune reaction.

Experimental autoimmune labyrinthitis induced by cell-mediated immune reaction

This study was designed to establish an experimental cell-mediated autoimmune labyrinthitis model in C57BL/6 mice, which could exhibit high reproducibility and be adopted for precise immunological analysis. Inner ear antigen (IEA) was prepared from bovine membranous labyrinth. Following pretreatment with cyclophosphamide (CP) and primary sensitization with IEA/FCA, many inflammatory cells infiltrated transiently into the perilymphatic and endolymphatic regions of the cochlea, vestibule and the endolymphatic sac, but not into the kidney, lung, brain or liver. This reaction occurred from day 7 and peaked on day 12 in all animals, and then rapidly reduced. This reaction occurred in all experimental mice during day 10 to day 12. The control mice showed no cellular reaction in the inner ear. These results suggest that the inner ear may possess cross-species organ-specific antigen and that a cell-mediated immune reaction may play an important role in the induction of autoimmune labyrinthitis.

A macrolide antibiotic, roxithromycin, inhibits the growth of nasal polyp fibroblasts

Recently, the efficacy of macrolide antibiotics in cystic fibrosis and bleomycin-induced lung injury was reported. Nasal polyposis is a chronic inflammatory disease of the upper airway characterized by structural abnormalities including stromal fibrosis. Fibroblasts are resident cells thought to play an important role in the development of fibrosis. Although the effect of Roxithromycin (RXM) on inflammatory cells is well known, there is no evidence on the effect of RXM on fibroblasts. The purpose of the present study was two-fold: to examine the effect of RXM on the growth of fibroblasts in vitro and to examine the effect of RXM on the proliferation of fibroblasts in vivo. Nasal polyp fibroblast lines were generated from untreated patients, and those who were treated with RXM (300 mg/day) for one month before biopsy. Nasal polyp fibroblast lines from untreated patients were cultured for 72 hours with or without RXM, and the direct effect of RXM on fibroblast growth in vitro was examined by cell counting and 3H thymidine uptake. Next, we examined the in vivo effect of RXM on nasal polyp fibroblasts (NPFs) by comparing the growth characteristics of NPF lines from RXM treated and untreated patients. Finally, we examined the proliferating rate of NPF lines from the same patient before and after treatment with RXM. NPF lines that were treated with RXM exhibited a lower proliferating rate in vitro as compared to those that were not treated with RXM. Treatment of NPF lines with RXM suppressed the proliferation of fibroblasts in a dose-dependent manner. In addition, NPF lines from patients treated with RXM exhibited a lower proliferating rate in vitro as compared to NPF lines from the same patient taken before RXM treatment. We demonstrated that RXM directly suppressed nasal polyp fibroblast proliferation, and that this effect of RXM on fibroblast growth was persistent, indicating that RXM may prevent the progression of nasal polyposis by inhibiting the development of fibrosis.

Intercellular adhesion molecule-1 expression in the inner ear of rats following secondary immune reaction in the endolymphatic sac

An immunological aetiology for inner ear diseases has long been proposed. The endolymphatic sac (ES) is the only immunoprivileged site in the inner ear with a resident population of immunocompetent cells. By keyhole limpet hemocyanin (KLH) challenge into the ES of systemically pre-immunized guinea pigs, we previously demonstrated an infiltration of inflammatory cells into the perilymphatic space of the cochlea. In order to understand the mechanisms involved in the recruitment of immunocompetent cells into the inner ear, and their relation to the development of endolymphatic hydrops (EH), we investigated the expression and time-kinetics of intercellular adhesion molecule 1 (ICAM-1) in the inner ear of systemically pre-immunized rats after antigen (KLH) challenge into the ES, its relation to cell infiltration in the cochlea and subsequent development of EH. By immunohistochemistry, strong ICAM-1 expression was detected in the spiral ligament, suprastrial region, spiral prominence, spiral modiolar veins, spiral collecting venules, surface membrane of the perilymphatic compartment, perilymphatic space and ES of immunized rats, but not of control rats. ICAM-1 expression was detected at 5-6 h, peaked at 10-15 h, and gradually reduced by 2 weeks. Cell infiltration into the cochlea started at 6-12 h and peaked at day one. By 6 h, 50% of challenged rats developed EH. This figure rose to 70% at 12 h, and then gradually reduced. However, immunoreactivity for KLH (antigen) was only detected in the ES. These results emphasize that the sac is the central immunological organ of the inner ear, and suggest that ICAM-1 may play a pivotal role in the aetiology of immune-mediated inner ear diseases through the recruitment of immunocompetent cells into the inner ear and subsequent development of EH.

Effective inhibition by beta-carotene of cellular DNA breaking induced by peroxynitrous acid

Peroxynitrous acid synthesized by reaction of hydrogen peroxide and nitrite and generated from 3-morpholinosydononimine (SIN-1) induced cellular DNA breaking of human promyelocytic leukemia HL-60 cells in phosphate buffer (pH 7.5) as assessed by alkaline single cell gel electrophoresis (comet) assay and quantification of comet types. Ascorbate and Trolox inhibited cellular DNA breaking induced by peroxynitrous acid, but the concentrations of these antioxidants required for effective inhibition was about 50-fold higher than that of peroxynitrous acid. beta-Carotene protected DNA breaking by peroxynitrous acid in 20% tetrahydrofuran-phosphate buffer (pH 7.5) much more effectively than ascorbate and Trolox. The concentrations of beta-carotene required for effective inhibition was lower than the concentration of peroxynitrous acid.

Effect of beta-carotene on the transformation of tyrosine by nitrogen dioxide and peroxynitrous acid

In the NO2-exposure of tyrosine in 70% dioxane/phosphate buffer (pH 7.4), beta-carotene enhanced the degradation of tyrosine and/or 3-nitrotyrosine produced, whereas alpha-tocopherol and ascorbyl palmitate inhibited the transformation of tyrosine into 3-nitrotyrosine. Generation of certain active species in the interaction of beta-carotene with NO2 was suggested. Ascorbyl palmitate effectively and alpha-tocopherol slightly inhibited the transformation of tyrosine in the NO2-exposure in the presence of beta-carotene. In the reaction of tyrosine with ONOO-/ONOOH, beta-carotene enhanced the degradation of 3-nitrotyrosine produced suggesting generation of certain active species, whereas alpha-tocopherol and ascorbyl palmitate completely suppressed the transformation of tyrosine into 3-nitrotyrosine.

[Antigen removal after inoculation into the endolymphatic sac of immunized guinea pigs]

Antigen removal in the endolymphatic sac (ES) was immunohistochemically examined. Forty-five adult female Hartley guinea pigs were used in this study. After keyhole limpet hemocyanin (KLH) systemic immunization, KLH was directly injected into the lumen of the right ES. The presence of KLH was detected in histological sections using immunohistochemistry. After KLH challenge into endolymphatic sac lumen, high concentrations of KLH were diffusely found within phagocytes in the endolymphatic lumen and peri-saccular tissue on day 2. After day 14, KLH disappeared from the immunized inner ear. The above results suggest that KLH is removed from the inner ear by diffusion through the endolymphatic epithelial cells which have altered permeability or by phagocytosis of the phagocytic cells. No KLH was observed in the left endolymphatic sac and bilateral cochlea as well as vestibular organ during 5 months of follow up. This study showed that the endolymphatic sac is capable of appropriately trapping macromolecule, KLH antigen (molecular weight: about 400 KDa), and removing antigens quickly from the inner ear.

Appearance of electron spin resonance signals in the interaction of dithiocarbamate-Fe(II) with nitrogen dioxide and nitrite

Whether dithiocarbamate-Fe(II) complexes used in the electron spin resonance (ESR) studies are specific for the detection of NO was investigated. It was found that the typical ESR signals of dithiocarbamate-Fe(II)-NO spin adducts appeared in the interaction of N-methyl-D-glucaminedithiocarbamate (MGD)-, bis(hydroxyethyl) dithiocarbamate (HED)- and diethyldithiocarbamate (DED)-Fe(II) complexes with the NO-derived nitrogen oxides, nitrogen dioxide (NO2) and nitrite ion (NO2-) in a prolonged incubation. Under the conditions of prolonged incubation, appearance of the ESR signals of the dithiocarbamate-Fe(II)-NO spin adducts may indicate the presence of not only NO but NO2 and NO2-.

In vivo metabolism of 24R,25-dihydroxyvitamin D3: structure of its major bile metabolite

In vivo metabolism of 24R,25-dihydroxyvitamin D3 (24,25-(OH)2D3) in female dogs has been studied thoroughly, and its major bile metabolite identified. After single oral administration of 24,25-(OH)2 [6,19,19-3H]D3 the plasma concentrations of radioactive metabolites were monitored for 504 h, and the metabolites in the bile collected and analyzed. The concentration of 24,25-(OH)2D3 in plasma reached a maximum after 6 h and decayed in two distinct phases; a fast-phase with a half-life of 17 h, followed by a slow-phase with a 17-day half-life. The area under the concentration/time curve (AUC) was 78-84% (0-504 h). The only detectable metabolite in the plasma was 25-hydroxy-24-oxovitamin D3 whose AUC was less than 5%. At 504 h, about 50% of administered radioactivity has been excreted, of which about 90% was found in the feces, indicating most of the administered 24,25-(OH)2D3 to be excreted in bile. A major metabolite, which constituted 23% of the total bile radioactivity at 504 h, was found in the bile. This metabolite was efficiently deconjugated by beta-glucuronidase to afford an aglycone which was identified as 23S,25-dihydroxy-24-oxovitamin D3 (23S,25-(OH)2-24-oxo-D3), by co-chromatography on HPLC with synthetic standards. The glucuronide was isolated from the bile of dogs given large doses of 24,25-(OH)2D3, and the structure determined being 23-(beta-glucuronide) of 23S,25-(OH)2-24-oxo-D3, by analyzing its negative ion mass spectrum and the positive ion mass spectrum of its derivatives. Thus it was concluded that, in dogs, 24,25-(OH)2D3 is a long lasting vitamin D metabolite, is mainly excreted in bile when metabolized to 23S,25-(OH)2-24-oxo-D3 and is conjugated at 23-OH as glucuronide.

beta-Carotene effectively scavenges toxic nitrogen oxides: nitrogen dioxide and peroxynitrous acid

beta-Carotene absorbed 2 equimolar amounts of NO2 accompanying the complete destruction of beta-carotene. Electron spin resonance study using 2-phenyl-4,4,5,5-tetramethylimidazoline-3-oxide-1-oxyl revealed that no significant amounts of NO were released by the interaction. Nitrogen atoms derived from NO2 were tightly bound to the beta-carotene molecules. Destruction of beta-carotene was inhibited little by alpha-tocopherol and polyunsaturated fatty esters, and slightly by ascorbyl palmitate, indicating that beta-carotene was a more effective scavenger of NO2. ONOOH/ONOO- and 3-morpholinosydononimine similarly destroyed beta-carotene. The results suggest that beta-carotene contributes to the prevention of cytotoxicity and genotoxicity of NO2 and ONOOH/ONOO- derived from NO.

Preliminary study of the role of endothelin-1 in the homeostasis of the inner ear

Endothelin (ET), originally characterized as a 21-residue vasoconstrictor peptide from endothelial cells, has been reported to act as a local hormonal regulator of pressure, fluid, ions, and neurotransduction. Our previous studies suggested an important role of ET-1 in the inner ear. The present study investigated the time kinetics of ET-1 in the epithelium of the endolymphatic sac (ES) of guinea pigs and its relation to the development of endolymphatic hydrops (EH) following locally mounted secondary immune reaction. In the duration between 12 h and day 1, ET-1-like activity completely disappeared from the epithelium of the ES and was associated with the accumulation of inflammatory cells in the ES and a rapid development of EH. On day 7, ET-1-like activity recovered as a consequence of the decrease of inflammatory cells and reduction of EH. These findings suggest that ET-1 may play an important role as one of the regulators maintaining the fluid balance.

Distribution of endothelin-1-like activity in the cochlea of normal guinea pigs

Distribution of endothelin-1 (ET-1) in the cochlea of normal guinea pigs was determined by immunohistochemistry. ET-1 activity was identified with the mouse anti-human ET-1 IgG1 monoclonal antibody. ET-1 activity was distributed in the modiolus, spiral ligament, stria vascularis, spiral prominence. Reissner's membrane, supporting cells of the organ of Corti and spiral ganglion cells. These findings suggest that ET-1 may be involved in the regulation of fluid volume and ions of the cochlea.

Regeneration of the damaged endolymphatic sac epithelium

The regeneration of endolymphatic sac (ES) epithelium after epithelial damage was examined using 5-bromo-2'-deoxyuridine (BrdUrd). Guinea pigs and anti-BrdUrd, antikeratin, and anti-basement membrane (BM) component antibodies were used. Animals were sacrificed at 3, 7, and 14 days following an immune injury of the ES. The animals were sacrificed after an administration of BrdUrd at the designated times. Decalcified temporal bones were examined immunohistochemically. At day 3, epithelial loss without subepithelial BM was seen in the region of marked cell infiltration. BrdUrd-positive cells could be detected in the epithelium at the edge of the wound. At day 7, cell infiltration decreased, and the epithelial lining with BM was repaired. These results reveal that the epithelium of the ES can regenerate within 7 days after an immune injury.

Fluctuating hearing loss following immune reaction in the endolymphatic sac of guinea pigs

This study has investigated immune injuries to the inner ear auditory system of guinea pigs. Following secondary antigen challenge to the endolymphatic sac, the mean hearing threshold significantly increased in the early phase from day 1 to day 3 and thereafter recovered. In the early phase, hearing threshold significantly increased simultaneously to the elevation of perilymph antibody levels. The size of hydrops was not the only factor that causes an increase in hearing loss as well as in AP/SP ratio. Scale-out hearing loss was seen in 2 animals with severe degeneration of the stria vascularis as well as the organ of Corti associated with the inflammatory cellular infiltration especially in the perilymphatic space, even in the absence of keyhole limpet hemocyanin antigen in the cochlea. On the other hand, control animals did not suffer hearing loss. These results suggest that an immune reaction in the endolymphatic sac is a possible pathogenic etiology of Ménière's disease or sudden deafness.

Distribution of endothelin-1 like activity in the endolymphatic sac of normal guinea pigs

Endothelin-1 (ET-1), originally characterized as a 21-residue vasoconstrictor peptide from endothelial cells, has been reported to act as a local hormonal regulator of pressure, fluid, ions as well as neuropeptides. The present study investigated the distribution of ET-1 in the endolymphatic sac and duct of normal guinea pigs, by immunohistochemistry. ET-1 like activity was identified in the epithelial cells and subepithelial connective tissue of the endolymphatic sac and duct. No significant difference was seen in the intermediate and proximal portions. These findings suggest that ET-1 may play an important role in the regulation of inner ear pressure, fluid volume, and ion balance.

Cell proliferation in the endolymphatic sac in situ after inner ear immunostimulation

Cell proliferation in the endolymphatic sac (ES) after immunostimulation was assessed immunohistochemically. Guinea pigs were employed as experimental animals and keyhole limpet hemocyanin was used as the antigen. After i.p. injection of 5-bromo-2'-deoxyuridine (BrdUrd), the BrdUrd+ cells were counted to assess the number of proliferating cells. In the secondary immune reaction of the ES, the IgG+ cell count in the perisaccular region was markedly increased on days 7-14. An increased number of BrdUrd+ cells was detected, peaking on day 3, and the localization of these cells in the ES was similar to that of the IgG+ cells. This suggests that some BrdUrd+ cells may differentiate into IgG- cells within the ES.

Vascular permeability of the stria vascularis and morphology of the endolymphatic sac in two types of experimental endolymphatic hydrops

We produced two kinds of experimental endolymphatic hydrops. One was induced by obliteration of the endolymphatic sac (ES), and the other was induced by both systemic keyhole limpet hemocyanin immunization and secondary keyhole limpet hemocyanin challenge into the ES. The vascular permeability of the stria vascularis in acute and chronic phases was compared between both models by light and electron microscopy using the tracer method of horseradish peroxidase. Both models showed that the number of strial capillaries showing horseradish peroxidase leakage was significantly higher in the acute phase than in the chronic phase. In the acute phase, the ES showed acute inflammation in both models. In the chronic phase, extensive fibrosis occurred in the ES obliteration model, whereas the ES appeared to have a normal shape in the immunologically induced model. The mechanism of hydrops formation will be compared between the two models.

Elevated serum levels of 3-deoxyglucosone, a potent protein-cross-linking intermediate of the Maillard reaction, in uremic patients

3-Deoxyglucosone (3-DG) has been identified as an intermediate of the Maillard reaction in vitro. We measured serum 3-DG levels using gas chromatography/mass spectrometry and found a marked elevation in serum 3-DG levels in uremic patients compared with healthy subjects. The uremic patients with diabetes showed significantly higher serum concentrations of 3-DG than those without diabetes. 3-DG was demonstrated to be a potent protein-cross-linking agent in the reaction with lysozyme, leading to browning, fluorescence formation and polymerization of the protein by formation of advanced glycation end products (AGE). The increase in serum 3-DG levels in the uremic patients suggests that 3-DG may be responsible for the development of uremic complications by promoting the formation of AGE.

Inner ear autoantibodies in patients with sensorineural hearing loss

In order to identify the inner ear autoantibodies, sera of 195 patients with sensorineural hearing loss and/or vertigo were reached with bovine inner ear antigen by western blotting method. Positive reaction was seen at several molecular weights, in which 33-35 kD, 42 kD and 68 kD were highly reactive. In moderate to severe hearing loss patients, positive reactions with 33-35 kD, 42 kD, 68 kD and others were 25.8%, 26.8%, 26.8% and 71.5% respectively. On the other hand, a positive rate did not clearly correlate with diagnostic entities. Further study to purify inner ear antigen may evaluate inner ear autoimmune disease.

[Free radicals in inner ear immune responses; immunohistochemical study of myeloperoxidase]

Previously, we reported that immune reactions in the endolymphatic sac of guinea pigs caused spontaneous nystagmus, a suppressed caloric response, and fluctuating hearing loss. In order to evaluate immune injury to the sensory organs of the inner ear, we conducted an immunohistochemical investigation of the distribution and time course of myeloperoxidase (MPO) following immune reaction in the endolymphatic sac. MPO staining can be seen in the endolymphatic sac, outer hair cells, stria vascularis and lateral canal (ampulla), from several hours to 3 weeks after a secondary KLH challenge, and its time course parallels the time course of neutrophil infiltration of the endolymphatic sac. This result indicates that free radicals in the MPO-H2O2-Cl system are responsible for the tissue damage and dysfunction resulting from inner ear immune reactions.

Gas chromatography/mass spectrometric analysis of 24R,25-dihydroxyvitamin D3 using 24R,25-dihydroxy[6,19,19-2H]vitamin D3 as internal standard

Gas chromatography/mass spectrometric (GC/MS) analysis of 24R,25-dihydroxyvitamin D3 (24,25-(OH)2D3, 1a) in rat serum is examined using 6,19,19-trideuterated derivative (24,25-(OH)2[6,19,19-2H]D3, 1c) as an internal standard. Pyro- and isopyro-24,25-(OH)2D3 (2a and 3a) are synthesized and the structures are determined unambiguously by their spectral data including nuclear overhauser enhancement study of the NMR spectra. The two peaks which appear on the total ion chromatogram of 24,25-cyclic n-butyl boronate-3-trimethylsilyl derivative of 24,25-(OH)2D3 are identified to be those of the pyro and isopyro isomers (2a and 3a) by direct comparison with the synthetic standards. Analysis of the GC/MS spectrum of 24,25-(OH)2[6,19,19-2H]D3 (1c) indicated that the CH3(19) is preferentially eliminated in the fragmentation giving rise to a base peak (M-TMSOH-Me)+. Thus the molecular ion peak, which is about 20% of the base peak, rather than the base peak is used for GC/MS assay of 24,25-(OH)2D3 in serum.

[Alterations in the distributions of the basement membrane components after secondary inner ear immune reaction in guinea pigs]

Alterations in the distributions of type IV collagen (C-IV), laminin (La), and fibronectin (Fib), which are important components of the basement membrane, in the inner ear following secondary endolymphatic sac immune response were studied immunohistologically using control animals for comparison. Endolymphatic hydrops developed following direct secondary keyhole limpet hemocyanin (KLH) challenge to the endolymphatic sac in systematically pre-sensitized animals. In the endolymphatic sacs of control animals, C-IV and La were localized continuously just under epithelial cells whereas Fib was present intermittently in subepithelial connective tissue. In the endolymphatic sac, following secondary KLH challenge, linear subepithelial localizations of C-IV and La were interrupted, thinner and more loosely aggregated with numerous inflammatory cellular infiltrates on days 2-4. Following these changes, endolymphatic hydrops in the cochlea developed and peaked on days 4-7. On days 1-7, Fib was strongly but sporadically localized in subepithelial cells. These results suggest that C-IV and La may play important roles in the regulation of endolymph whereas Fib may be related to the restoration of injured endolymphatic sac tissue in animals exposed to a secondary challenge.

Immunological approach to Ménière's disease: vestibular immune injury following immune reaction of the endolymphatic sac

Following direct antigen challenge to the endolymphatic sac (sac), the relation of caloric test results and spontaneous nystagmus to the histological changes of the sensory epithelium of the vestibular organ and perilymph antibody levels was investigated in the guinea pig. In a secondary keyhole limpet hemocyanin (KLH) challenge to the sac, irritative nystagmus was followed by paralytic nystagmus and a suppression of caloric reaction. These findings correlated well with the degree of degeneration of the sensory epithelium of the vestibular organ and the levels of perilymph antibody. On the other hand, neither phosphate-buffered saline inoculation nor primary KLH challenge to the sac nor a secondary KLH challenge to the intradural space resulted in a disturbance of the vestibular function. These results suggest that the immune response of the sac may possibly be an important key to the pathogenesis of Ménière's disease.

Presence of 3-deoxyglucosone, a potent protein crosslinking intermediate of Maillard reaction, in diabetic serum

3-Deoxyglucosone, a potent protein crosslinking intermediate of the Maillard reaction, was first detected in diabetic serum using gas chromatography/mass spectrometry. Serum concentration of 3-deoxyglucosone was elevated in diabetic patients as compared with healthy subjects. More notably, diabetic patients with nephropathy showed higher serum concentration of 3-deoxyglucosone than those without nephropathy. The increased serum concentration of 3-deoxyglucosone in the diabetic patients suggests that 3-deoxyglucosone may be responsible for the development of diabetic complications such as diabetic nephropathy by promoting the formation of advanced glycation end products.

Immunological pathogenesis of endolymphatic hydrops and its relation to Menière's disease

This study was designed to investigate an immunologically induced endolymphatic hydrops (ELH) and to focus on the issue of its pathogenesis in relation to Menière's disease. The time course of ELH was evaluated by light microscopy in a 2-hour to 7-month period following direct antigen challenge to the endolymphatic sac (ELS) in systemically pre-sensitized guinea pigs. ELH began to appear in the vestibule and the basal turn 5-7 hours after inner ear challenge and developed gradually. During the interval from the second day to the first week, ELH rapidly developed in all the cochlear turns and reached a maximum size. During the period from the second week to the eighth week, ELH gradually reduced. After 9 weeks, ELH of the saccule and the cochlea gradually recurred. During the interval from the first week to the eighth week, the time course of ELH correlated well with the grade of cellular infiltration of the perisaccular tissue. These results suggest that recurrent immunological reaction in the ELS may result in disorders of the ELS which finally lead to the onset of Menière's disease.

[Vestibular immune injury related to perilymph antigen specific antibody levels in the guinea pig]

This study demonstrates that degeneration of vestibular sensory cells depends on the integrity of immune responses in the endolymphatic sac (ES). Degeneration of the saccule occurred nearly twice as often as degeneration of the utricle and ampulla. Perilymph antibody levels were assessed following direct antigen (KLH) challenge to the endolymphatic sac in systemic presensitized guinea pigs. Mean perilymph antibody levels were significantly elevated in ears showing degeneration as compared to those which did not. Serum anti-KLH antibody levels were also significantly elevated in the ears with degeneration as compared to those without. Whether degeneration or recovery occurs, is largely dependent on the level of systemic immunization and perilymph antibody level within one week of antigen challenge to the ES.

[Cochlear immune injury following direct antigen challenge to the endolymphatic sac]

Following direct KLH antigen challenge to the endolymphatic sac (e. sac) in guinea pigs, degeneration of the cochlea was examined histologically by light microscopy. Degeneration was seen in 21 out of 140 animals presensitized systemically from day 1 to 5 weeks post secondary KLH challenge to the e. sac. Degeneration of the organ of Corti, stria vascularis and spiral ganglion cells was seen from day 1 in 19, 17 and 7 animals, respectively. There was no increase in these degenerative processes during the time course. In the period from day 1 to day 4, severe bleeding in the perilymphatic space occurred simultaneously with cochlear deterioration. Three animals showed perilymphatic fibrosis which was noted after the first week post KLH secondary challenge. In contrast, animals primarily challenged with KLH (locally administered to the e. sac) showed no cochlear degeneration. These results suggest that a locally mounted immune response in the e. sac can cause direct immune injury to cochlear tissues.

[Development of endolymphatic hydrops following immune response in the endolymphatic sac of guinea pigs--long-term observation]

We report findings for endolymphatic hydrops in specimens obtained 5 to 28 weeks after a direct challenge with secondary KLH antigen to the endolymphatic sac (ES) of guinea pigs. Following gradual disappearance of endolymphatic hydrops (EH) in the period between the 5th and 8th weeks, the inferior labyrinth EH gradually developed again from the 3rd month onward in the saccule and from the 4th month onward in the cochlea. Many lymphocytes and plasma cells infiltrated into the perisaccular space for up to 7 months. These results suggest that an immune response in the ES may ultimately induce chronic dysfunction of the ES and thereby lead to progressive EH.

Endolymphatic hydrops induced by immune response of the endolymphatic sac: relation to perilymph antibody levels

This study investigated the effect of a secondary immune response in the endolymphatic sac on the development of endolymphatic hydrops in guinea pigs. Following secondary keyhole limpet hemocyanin (KLH) challenge directly to the sac in systemically presensitized animals, hydrops rapidly developed within 1 week, then gradually reduced by 4 weeks. After 5 weeks, hydrops gradually recurred and developed again. Mean perilymph anti-KLH antibody levels rose from day 1 to 4 weeks and then decreased. The elevation of perilymph anti-KLH antibody levels on day 2 was due to an increased vascular permeability and there was a local regeneration by the challenge of the sac after day 7. The development of hydrops correlated well with mean perilymph anti-KLH antibody levels in the period from day 1 to day 7. After 2 weeks, there was no correlation between them. These results suggest that an immune response of the sac may induce an excess secretion of endolymph in the initial stage and may further lead to irreversible dysfunction of the sac at a later stage.

[Immuno-injury to the inner ear auditory system following secondary endolymphatic sac immune response]

This study investigated immuno-injury to the inner ear auditory system following inner ear immune response in the guinea pig. The endolymphatic sac (ES) was directly challenged with keyhole limpet hemocyanin (KLH). Auditory brainstem response with click sound stimulation was assessed pre and post KLH challenge of the ES. In systematically presensitized animals, secondary KLH challenge to the ES produced significant elevation of the mean threshold level on day 3 and 17 as compared to that of pre challenge levels. However, no significant prolongation of the latency (N1-N3) was observed. On the other hand, neither phosphate buffered saline injection into the ES nor primary KLH challenges of the ES were capable of elevating the threshold level and changing the latency. These results indicate that elevation of threshold was apparently induced by a secondary immune response of the ES, not by nonspecific mechanical damage to the ES, the central auditory system or KLH toxicity to the inner ear, suggesting that local immune response of the ES is a possible pathogenesis of sensorineural hearing loss.

[Effects of inner ear immune responses on auditory function in guinea pigs]

Following direct challenge with KLH antigen primary or secondary (after systemic immunization) to the ES (endolymphatic sac) in guinea pigs, ECoG (electrocochleograms) were recorded from the round window induced by click and tone pips. The recordings were carried out on the 2nd, 7th and 21st days after local antigen challenge. There were no abnormal findings in the ECoG of the primary antigen challenged animals. On the other hand, prolongation of latencies, decrease in amplitudes of APs (compound action potentials) and increases in SP/AP ratios were observed in the 2nd day recordings of the secondary antigen challenged animals. However, all parameters of ECoG in the 7th day recordings were normal. Decreases in AP amplitudes were again found in the 21st day recordings. The ECoG findings with click and tone pip stimulation showed similar results. From these findings, in conjunction with morphological observations, it is speculated that these ECoG findings are caused by immuno-injury to the ES and cochlea, as well as the resultant endolymphatic hydrops which develops acutely and gradually subsides after secondary challenge.

Feasibility study on quality-of-life questionnaires for patients with advanced lung cancer

In order to evaluate quality-of-life (QOL) questionnaires, we studied the reliability and validity of the self-rating forms: A, comprising 16 questions; B, comprising 39 questions (Table II and III), in a special study supported by the Ministry of Health and Welfare. Sixty-four patients with inoperable lung cancer and 50 patients with chronic, non-malignant disease were entered into the study. Form A was translated and modified to Japanese culture from Schipper's Functional Living Index-Cancer, and Form B was of our own design. The internal consistency of the forms was examined by Cronbach's alpha coefficient. Both forms except for aspects of physical and social concern on form B, had alpha values greater than 0.65. A concurrent validity with performance status was shown over all aspects of concern (Pearson's correlation, r greater than 0.27, P less than 0.05) except for social (forms A and B) and psychological (form B). Analysis of variance of the QOL scores revealed significantly lower scores for the cancer patients than for the non-malignant-disease patients, except for the social aspect of concern (P less than 0.001). Factor analysis, using the principal component method, identified four major factors to account for 60 and 42% of the total variance on forms A and B, respectively. The factors were: patient's mood, anxiety over disease and treatment, relationships with other people, physical capability. In conclusion, this has been the first feasible study to show that QOL forms from the West could be used in Japan with some modifications. We are at present studying successive changes in QOL for advanced lung cancer patients in clinical trials.

Development of endolymphatic hydrops following immune response in the endolymphatic sac of the guinea pig

The present study investigated immune injury associated with endolymphatic hydrops (e.hydrops) following locally mounted immune reaction in the endolymphatic sac (e.sac) of guinea pigs. E.hydrops occurred, progressing rapidly within the first week post secondary Keyhole limpet hemocyanin (KLH) challenge in the e.sac and developed into two phases, acute and chronic. On the other hand, primary KLH challenge of the e.sac, PBS inoculation into the e.sac or intradural secondary KLH challenge were incapable of inducing e.hydrops. These results indicate that reversible and irreversible e.hydrops are induced by the immune response of the e.sac, suggesting that local immunological events of the e.sac may provide an animal model of Meniere's disease.

[Mechanisms of development of endolymphatic hydrops following secondary immune response in the endolymphatic sac of guinea pigs]

Previously the author reported the immediate development of endolymphatic hydrops (e. hydrops) following direct challenge of secondary antigen to the endolymphatic sac (ES) in guinea pigs, during the early phases of postchallenge, ranging from 1 to 5 weeks. The present study reports the results of specimens taken up to 10 weeks postchallenge, and correlation of e.hydrops to perilymph in antigen-specific antibody levels. From the present results, mechanisms of e.hydrops induced ES immune reaction are suggested as follows. 1) In the early stage of e.hydrops, an acute inflammatory reaction in the ES may produce endolymph by an increased vascular permeability of the inner ear and may impair endolymph absorption from the ES. 2) In the latter stage of e.hydrops, the moderate cellular infiltration in the ES may cause chronic impairment of endolymph absorption in the ES.

[Effect of inner ear immune response on vestibular function in guinea pigs]

We examined vestibular dysfunction and histological damage caused by direct antigen challenge to the endolymphatic sac in guinea pigs. We observed spontaneous nystagmus every eight hours and performed caloric testing every week following endolymphatic sac secondary KLH challenge. Spontaneous nystagmus was seen in 12 of 18 animals, and nystagmus in all directed toward the unchallenged ear (paralytic). The caloric response time courses were classified into two types, which were irreversible type and reversible type after endolymphatic sac KLH challenge. The immune injury of animals with irreversible type was thought to be stronger than that of these with reversible type. The spontaneous nystagmus of irreversible type animals was longer than that of reversible type animals. The temporary vestibular dysfunction was thought to be similar to that observed in Meniere's disease.

[Development of acute endolymphatic hydrops following secondary endolymphatic sac immune response. I: Short-term observation]

The development of endolymphatic hydrops (e. hydrops) following secondary e. sac immune response was investigated in Hartley guinea pigs, for a period of 5 weeks. E. hydrops immediately developed to a maximum from day 2 to day 7 and then gradually reduced in the next 4 weeks. In the e. sac, numerous inflammatory cellular infiltrates, mainly polymorphonuclear cells and macrophages, were seen from day 1 to day 2. Lymphocytes and plasma cells appeared from day 3 and increased to a maximum by day 7 and then gradually decreased in the next 4 weeks. Neither primary e. sac KLH challenge nor e. sac PBS inoculation could derive e. hydrops. Development of e. hydrops was considerably parallel to the grade of immune reaction within the e. sac, suggesting that immuno-pathological reaction of the e. sac has an important effect on regulation of the endolymph volume.