Natural course of serum-specific immunoglobulin E and immunoglobulin G4 for a span of eight years in untreated patients with perennial allergic rhinitis

During the past two decades, considerable attention has been devoted to the clinical role of serum-specific IgE and IgG4 following immunotherapy. To definitely discuss the clinical role of serum-specific IgG4, we should know the natural course of serum-specific IgG4 in the untreated patient with allergic rhinitis. To our knowledge, however, no such kind of study can be found in the literature. Our present study focused on the long-term follow-up of serum-specific IgE and IgG4 in patients who were not treated with immunotherapy for perennial allergic rhinitis. They were scheduled to take no medication for their perennial nasal symptoms for 8 years. Serum-specific IgE and IgG4 in untreated patients with perennial allergic rhinitis never significantly change during the observation period. These data will be of great value for studies in serologic changes following active treatment for atopic diseases. Additionally, our study suggests that a reduction in serum-specific IgE and an increase in serum-specific IgG4 following immunotherapy are not the result of an immunotherapy-independent and age-related phenomenon but the result of active immunologic modulation by immunotherapy.

Serum level of soluble interleukin-2 receptor in patients with seasonal allergic rhinitis

The rate of release of the soluble form of interleukin-2 receptor (soluble IL-2R) reflects T cell activation in vivo. Since T lymphocytes play a central role in respiratory allergic disorders, the measurement of serum levels of soluble IL-2R may be useful in analysing the disease state of allergic disorders. The study has aimed at investigating the seasonal changes in serum soluble IL-2R in 81 patients with seasonal allergic rhinitis due to Japanese cedar pollens, with special reference to the effect of anti-allergic pharmacotherapy and immunotherapy. Serum samples were obtained twice from each patient, before and during the pollen season, and all the serum samples were simultaneously used for determination of soluble IL-2R and cedar pollen-specific immunoglobin E (IgE). Seasonal elevation in soluble IL-2R was not associated with the good clinical outcome but was associated with the poor clinical outcome, irrespective of pharmacotherapy or immunotherapy. Additionally, successful immunotherapy suppressed seasonal elevation of serum soluble IL-2R more strongly than successful pharmacotherapy, and seasonal increase rates in soluble IL-2R were inversely correlated with the duration of immunotherapy. Seasonal increase rates in soluble IL-2R were significantly correlated with seasonal increase rates in specific IgE in both the medication group and the immunotherapy patients. These results may suggest that seasonal changes in serum soluble IL-2R may serve as an indicator for clinical outcome of seasonal allergic rhinitis, that the magnitude of T cell activation could affect specific IgE production, and that T cell activation could be gradually modulated as immunotherapy proceeds. In conclusion, seasonal changes in serum soluble IL-2R may serve as an objective indicator for clinical outcome of seasonal allergic rhinitis.

Ethanol induces transient arrest of cell division (G2 + M block) followed by G0/G1 block: dose effects of short- and longer-term ethanol exposure on cell cycle and cell functions

To study the cytophysiological effects of ethanol systematically, L929 cells, a fibroblastic cell line derived from mouse connective tissue, were exposed to various concentrations of ethanol (12.5, 50, 100 and 200 mM) for short (3 and 6 h) and longer (24 or 26 h) durations. Ethanol-induced cellular responses were analysed by a combination of the following assays: number of cells, amounts of DNA and protein, MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay and cell cycle. Ethanol dose-dependently suppressed these cellular functions, except that 12.5 mM exposures for both 6 and 26 h increased the amount of protein in spite of almost no change in other cellular functions, compared to the control. The most marked dose-dependency was observed in a reduction of formazan product in an MTT assay after both 6 and 26 h exposures to ethanol, being independent of the number of cells and probably reflecting dose-dependent depression of mitochondrial respiration. A G2 + M block in the cell cycle, an inhibition of cell division, was induced after short-term exposures (3 and 6 h) to 100 and 200 mM ethanol, but the block was released before 24 h had passed. Alternatively, prolonged exposures (24 h) to 50-200 mM ethanol induced a G0/G1 block, resulting in a decrease in the amount of DNA below the control value. Moreover, the percentage of the S phase was decreased gradually and dose-dependently throughout the 24 h exposure. Thus, high concentrations of ethanol (50, 100 and 200 mM) perturbed the cell cycle progression by causing both a transient G2 + M block (an inhibition of mitosis) and a continuous G0/G1 block, though the latter was masked by the G2 + M block during short-term exposure. The cells seem finally to acquire some tolerance to ethanol so as to pass through mitosis, but much less tolerance to pass through the checkpoint from the G1 to the S phase, which results in a decline in proliferation.

In vitro conversion of 2,3-oxidosqualene into dammarenediol by Panax ginseng microsomes

(RS)-[3-3H]-2,3-Oxidosqualene (1) was converted into (20S)-dammarenediol (2) and not to (20R)-dammarenediol by a microsomal fraction prepared from the hairy root of Panax ginseng. The enzyme activity was highest at pH 6.0 and was not increased by the addition of any detergents. These properties differed significantly from those of other 2,3-oxidosqualene cyclases reported from higher plants and animals.

The effects of a simplified method for cryopreservation and thawing procedures on peripheral blood stem cells

A simplified method for cryopreservation at -80 degrees C of peripheral blood stem cells (PBSC) has been increasingly used for autologous PBSC transplantation in Japan. Although this method, using 6% hydroxyethyl starch (HES) and 5% dimethyl sulfoxide (DMSO) as a cryoprotectant without rate-controlled freezing, has several advantages over the conventional method using 10% DMSO with rate-controlled freezing, little is known about effects of long-term cryopreservation for years and thawing process on hematopoietic progenitors. We examined the recovery rates of BFU-E and CFU-GM in sample tubes cryopreserved by the simplified method under various conditions as follows: (1) long-term storage for 1-5 years; (2) DMSO exposure for 1 h after rapid thawing; and (3) thawing at a lower temperature other than 37 degrees C. In our study, we found that the recovery rates of BFU-E and CFU-GM were not affected by the length of cryopreservation period; they remained at more than 70% on average for 16-61 months. In our hands, a 1-h exposure to DMSO after rapid thawing was not toxic for hematopoietic progenitors. Furthermore, there was no significant difference in the recovery rates of BFU-E and CFU-GM between thawing at 37 degrees C and 20 degrees C. These observations indicate that PBSC cryopreserved for at least 5 years by the simplified method can be used clinically without losing hematopoietic activity, and suggest that hematopoietic activity of the thawed PBSC may be unaffected when PBSC are infused slowly within 60 min or even when PBSC are thawed gradually at room temperature.

[Survey of patients with intractable diseases. Analyses of patients receiving financial aid for treatment]

The Research Committee of Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) conducted a Nationwide survey of 34 intractable diseases with each of the 47 prefectural governments reporting information on all patients having any of 34 intractable diseases, and who received financial aid for the disease from April 1992 to March 1993. Information collected about each patient was the identification number, which included the disease code, sex, age, the code of the municipality where the patient lived, the medical institution which treated the patient, and the department where the patient was treated. The results can be summarized as follows: 1) The total number of patients who received financial aid for disease was 247,726 (Male 93,251 Female 154,274) for a sex ratio of 0.60, and 61.7% of patients were between 40 and 69 years of age. Of 109,387 patients whose status could be confirmed regarding either outpatient or inpatient, 13.5 percent were inpatients. Of the patients, 47,222 (53.0%) were treated in departments of internal medicine. 2) Of all 34 intractable diseases, the greatest number receiving aid were patients with systemic lupus erythematosus with 35,690 receiving aid between April 1992 and March 1993. Of new patients commencing financial aid between April 1992 and March 1993, the largest group was patients with ulcerative colitis with 5,361. 3) The numbers of patients and those who started receiving the aid in the observed one year was larger than those in 1984 and 1988. The increase in numbers between 25 and 34 years of age was remarkable. By age group, the largest number of patients became older within the 8 years from 1984 to 1992.

Multivariate evaluation of prognostic determinants for renal cell carcinomas which are metastatic at initial diagnosis

To clarify the relative importance of clinicopathological factors potentially affecting the survival of individuals initially diagnosed as having metastatic renal cell carcinoma (RCC), univariate and multivariate analyses using Cox's proportional hazards model were performed for 111 RCC patients who were admitted to four hospitals in Nagoya, Japan, between 1978 and 1993. Survival time was calculated from the date of diagnosis to the date of death or the end of May, 1995. Nineteen factors (17 clinically applicable before treatment and 2 histological in nature) were included for assessment. Univariate analysis revealed that 10 of the total 19 factors were significantly associated with patient survival. Multivariate analysis found 7 factors to be statistically significant determinants. Survival was further evaluated by categorizing the patients into three groups according to the number of the 7 factors. These groups showed clearly different survivals (log-rank test, p < 0.0001), confirming the importance of the 7 factors as definite determinants. They should therefore prove to be of advantage for classifying metastatic RCC patients when designing clinical prospective studies of immunotherapy and chemotherapy.

Partial purification and characterization of serum embryotrophic factor required for early postimplantation growth of rat embryos in culture

Serum embryotrophic factor (SEF) required for the growth of cultured postimplantation rat embryos was partially purified from rat serum. Rabbit serum was used as a basal medium for the embryo culture, and embryotrophic activity was measured as embryonic protein increase. For partial purification of SEF, the rat serum globulin fraction obtained by ultracentrifugation and (NH4)2SO4 precipitation was fractionated by gel filtration, diethylaminoethyl ion-exchange chromatography, and hydroxyapatite chromatography. Partially purified SEF was characterized by stability tests and affinity chromatography. SEF was inactivated by heat, acid, dithiothreitol reduction, or trypsin digestion. SEF bound to concanavalin A but not to heparin. These results indicated that SEF was an acid-labile acidic glycoprotein with disulphide bonds and no affinity for heparin. The M(r) of SEF was estimated to be about 180 x 10(3) by gel filtration. The specific activity (U/g protein) was increased about 25-fold with 9.4% recovery by the partial purification, when 1 U of SEF was defined as the amount giving 50% embryonic protein increase. By polyacrylamide gel electrophoresis, a protein most likely to be SEF was identified as a heterodimer composed of subunits of M(r) 116 x 10(3) and 62 x 10(3) linked by disulphide bonds, and was shown to be contained in the medium at micromolar concentrations. SEF appeared to be distinct from known protein embryotrophic factors, growth factors, or cytokines.

Successful foscarnet therapy for mucocutaneous infection with herpes simplex virus in a recipient after unrelated bone marrow transplantation

A 36-year-old Japanese man who received an unrelated bone marrow transplant (BMT) developed severe mucocutaneous infection with herpes simplex virus (HSV) type 1 during oral acyclovir prophylaxis. The lesions progressed despite treatment with intravenous acyclovir and vidarabine. The HSV isolates were sensitive acyclovir, vidarabine and foscarnet in vitro, but peripheral CD3- or CD19-positive cells were barely detectable even 4 months after transplant. A 12-day course of treatment with foscarnet led to a rapid improvement. Foscarnet therapy should be considered for all severe HSV infections following BMT, regardless of whether or not the HSV isolates are sensitive to acyclovir.

Unexplained increase in serum corticosteroid-binding globulin levels in a patient with chronic thyroiditis, pituitary adenoma and empty sella

Unexplained high serum corticosteroid-binding globulin (CBG) concentrations (mean +/- SD, 74.1 +/- 12.1 micrograms/dl; normal women, 32.5 +/- 5.6 micrograms/dl) were found in an unmarried women who was not pregnant or taking exogenous estrogens. She was also found to suffer from subclinical chronic thyroiditis, pituitary adenoma and empty sella. The increased serum CBG concentrations in this patient were not due to any of the factors known to increase CBG. Consistently high basal serum GH levels and unusual GH responses to GH-releasing factor (GRF) and L-dopa were also noted.

Indigenous bacterial flora of medicinal leeches and their susceptibilities to 15 antimicrobial agents

Surface bacterial flora, as well as homogenates, of medical leeches, Hirudo medicinalis and Hirudinaria manillensis, were surveyed and the susceptibility of these isolates to 15 antimicrobial agents was examined. Aeromonas spp. were isolated from all leeches, and Pseudomonas fluorescens and other glucose-non-fermenting gram-negative rods (NF-GNR) were frequent isolates. Isolates were highly resistant to cephalosporins but susceptible to carbapenems, aminoglycosides and ofloxacin. The results indicate that prophylaxis with antimicrobial agents active against Aeromonas spp. and NF-GNR is necessary to avoid opportunist infections caused by indigenous leech flora during medical leech therapy on immunocompromised patients.

[Combination chemotherapy with 5-FU and CDDP or CDDP analog for head and neck cancer]

Combination chemotherapy with CDDP and 5-FU is one of the effective regimens for head and neck cancer. We studied the difference in the effects and adverse effects between two kinds of schedules of CDDP administration for CDDP-5-FU combination chemotherapy. For 13 patients, CDDP was administered on 5 consecutive days from day 1 to day 5 at a daily dose of 16 mg/m2 (Regimen A). For 14 patients CDDP was administered 80 mg on day 1 (Regimen B). 5-FU was administered 700 mg/m2/ day as a continuous drip infusion for 120 hours from day 1 to day 5. For regimen A, the response rate was 77%; for regimen B, it was 64%. The pattern of adverse effects showed a difference. Regimen B was more toxic for renal function than regimen A. But regimen A showed toxicity for bone marrow function. Acute phase nausea and vomit appeared more frequently in regimen B. The difference in the adverse effect pattern, which depends on the schedule of CDDP administration, seems important in order to apply this regimen for head and neck cancer patients safely. The schedule of CDDP administration should be changes depending on the renal and bone marrow function of patients. In order to evaluate the efficacy of UFT as adjuvant chemotherapy, UFT was administered p.o. to patients with maxillary sinus carcinoma for more than one year after definitive treatment with surgery or radiotherapy. Fifteen patients with UFT adjuvant chemotherapy showed significantly better survival rates than patients without adjuvant chemotherapy. We also studied adjuvant chemotherapy with CBDCA and FT for patients with advanced head and neck cancer. Administration with UFT (600 mg/day) from day 1 to day 14 with CBDCA 350 mg/m2 at day 7 was repeated more than twice. This regimen showed low toxicity and better survival for nasopharyngeal cancer patients. More clinical trials with this regimen for adjuvant chemotherapy are needed.

[Commencement and discontinuance of receiving financial aid for intractable disease treatment]

Data concerning all patients receiving financial aid for 26 types of intractable diseases in 1984, 1988 and 1992 were individually linked. Proportions of patients who discontinued financial aid in 1988 or 1992 among patients who were receiving aid in 1984 (ratio of discontinuance per patients); and ratios of the numbers of patients newly commencing aid in 1988 or 1992 to the numbers of patients who were receiving aid in 1984 (ratio of commencement per patients) were calculated. The results were as follows; 1. Among patients receiving financial aid in 1984, ratios of discontinuance per 100 patients were 28 in 1985-88 and 43 in 1985-92. Ratios of commencement per 100 patients were 96 in 1985-88 and 203 in 1985-92. 2. Ratios of discontinuance and of commencement per 100 patients in 1985-92 among 26 intractable diseases were 27-96 and 31-1,068, respectively. 3. Ratios of discontinuance per patients were higher an age groups 0-19 year and 60 year and over than in other age groups. Ratios of commencement per patients were higher in age groups 20-29 year and 70 year and over than in other age groups. Both ratios were higher among males than among females. 4. Ranges of ratios of discontinuance per patients and of ratios of commencement per patients were smaller among 47 prefectures than among diseases and age groups. The number of patients receiving financial aid in 1984 per population among prefectures was inversely correlated to ratios of commencement per patients, and were not correlated with ratios of discontinuance per patients.

Inhibition by antipsychotic drugs of L-type Ca2+ channel current in PC12 cells

Inhibition by antipsychotic drugs of voltage-gated L-type Ca2+ channels was characterized in rat neuronal cell line pheochromocytoma PC12 cells. Under whole-cell voltage-clamp, haloperidol and chlorpromazine (1-100 microM) inhibited Ba2+ current permeating through Ca2+ channels. Fluspirilene and pimozide the Ba2+ current at lower concentrations (fluspirilene, 0.1 pM to 1 nM; pimozide 10 pM to 1 microM). Effects of dopamine receptor antagonists and calmodulin antagonists were tested because antipsychotic drugs are known to exhibit these pharmacological activities. Sulpiride (1 and 10 microM), an antagonist to dopamine D2 receptors, and SCH-23390 (R(+)-7-chloro-8-hydroxy-3-methyl-l-phenyl-2,3,4,5-tetrahydro-1H-3- benzazepine; 1 and 10 microM), an antagonist to dopamine D1 receptors, also inhibited the Ba2+ current. As for calmodulin antagonists, W-7 (N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide; 10 and 100 microM) as well as calmidazolium (10 nM to 1 microM) reduced the Ba2+ current. The inhibition by haloperidol or fluspirilene of the Ba2+ current was not affected when GTP in intracellular solution was replaced with GDP beta S. These properties of the Ca2+ channel inhibition are discussed by comparing with those of the K+ channel inhibition and in relation to therapeutic relevance.

Genetic linkage of the sarco(endo)plasmic reticulum Ca(2+)-dependent ATPase II gene to intracellular Ca2+ concentration in the spontaneously hypertensive rat

A cosegregation analysis of sarco(endo)plasmic reticulum Ca(2+)-dependent ATPase (SERCA) II genotype, systolic blood pressure and platelet intracellular Ca2+ concentration was performed to dissect polygenic hypertensive traits in spontaneously hypertensive rats. Backcross analysis between spontaneously hypertensive rats and normotensive. Donryu rats demonstrated the existence of an inferred single major gene locus (ht). Thrombin-stimulated intraplatelet Ca2+ concentration was significantly higher in the SERCA II homozygotes than in the heterozygotes. The SERCA II genotype did not cosegregate with the blood pressure level. The SERCA II gene was assigned to rat chromosome 12. These results suggest that the SERCA II gene on rat chromosome 12 contributes to increased thrombin-stimulated intraplatelet Ca2+ concentration and that the SERCA II gene is not identical to ht.

Evaluation of perospirone (SM-9018), a novel serotonin-2 and dopamine-2 receptor antagonist, and other antipsychotics in the conditioned fear stress-induced freezing behavior model in rats

We studied the effects of perospirone (SM-9018), a novel serotonin-2 (5-HT2) and dopamine-2 (D2) receptor antagonist (SDA), on conditioned fear stress (CFS)-induced freezing behavior in rats and compared its actions with those of other antipsychotics. Exposure of rats to the environment previously paired with foot shock induced marked freezing behavior, which was reduced by the anxiolytic diazepam (0.1-3 mg/kg, p.o.) or antidepressants, desipramine and imipramine (10-100 mg/kg, p.o.). Perospirone at 0.3-3 mg/kg, p.o. significantly attenuated the CFS-induced freezing behavior in a dose-dependent manner, while the effect was reduced at the higher dose of 6 mg/kg. Other SDA-type antipsychotics, clozapine (1-30 mg/kg, p.o.) and risperidone (0.03-1 mg/kg, p.o.), and selective 5-HT2 antagonists, ritanserin (0.1-1 mg/kg, p.o.) and ketanserin (0.3-1 mg/kg, p.o.), all reduced the freezing behavior with U-shaped dose-response curves. However, neither conventional antipsychotic, haloperidol (0.1-3 mg/kg, p.o.), chlorpromazine (3-100 mg/kg, p.o.), thioridazine (3-100 mg/kg, p.o.), mosapramine (3-100 mg/kg, p.o.) nor tiapride (30-1000 mg/kg, p.o.) reduced the CFS-induced freezing behavior. In addition, subacute treatment of rats with perospirone (1-10 mg/kg/day) or imipramine (30 mg/kg/day) for 2 weeks prevented the induction of the freezing behavior by CFS. These findings suggest that SDA-type antipsychotics including perospirone are effective for the treatment of mood disturbances such as anxiety and depressive mood associated with schizophrenia and have a broader efficacy profile as compared with the conventional antipsychotics.

Effects of SM-9018, a novel 5-HT2 and D2 receptor antagonist, on electrically-evoked [3H]acetylcholine release from rat striatal slices

1. Electrical stimulation (1 Hz) of striatal slices evoked Ca(+2)-dependent [3H]ACh release, which was inhibited by the D2 agonist quinpirole (QPL). 2. SM-9018 and other neuroleptics antagonized the QPL-induced inhibition of the evoked [3H]ACh release. The relative potencies of the neuroleptics in antagonizing the QPL action were nemonapride > haloperidol approximately equal to SM-9018 > > chlorpromazine > > SCH 23390, and the rank order, except for nemonapride, was consistent with their binding affinities to striatal D2 receptors. 3. SM-9018 was weaker than haloperidol in enhancing the [3H]ACh release evoked by higher frequency (3 Hz) stimulation, the enhancement being abolished by the depletion of endogenous dopamine with reserpine pretreatment. 4. The selective 5-HT2 antagonist LY 53857 significantly attenuated the stimulatory effects of haloperidol on the 3 Hz-evoked [3H]ACh release. 5. These findings suggest that SM-9018 is as potent as haloperidol in antagonizing the QPL action on [3H]ACh release at striatal D2 receptors, but is weaker than haloperidol in enhancing the [3H]ACh release under high-frequency stimulation. The 5-HT2 blocking activity of SM-9018 seems to be involved in the latter effects.