Two distinct human myeloma cell lines originating from one patient with myeloma

Two distinct cell lines (OPM-1 and OPM-2) were established from the peripheral blood of a 56-year-old female myeloma patient at the stage of terminal leukemic evolution associated with loss of cytoplasmic immunoglobulin heavy chain (G lambda----lambda). The lines grew in suspension with a doubling time of 36-42 hr and 30-36 hr, respectively. EBNA was absent from both lines. The lines synthesized cytoplasmic lambda-chain, but had no detectable surface immunoglobulins. Fc receptors and complement receptors could not be detected in either line. The lines had very complex chromosomal abnormalities, but the patterns of chromosomes differed greatly between the two lines. The two lines, together with the RPMI 8226 line established by Matsuoka et al. (1967), were analyzed for phenotypic expression as defined by a panel of monoclonal antibodies to B cells (B1, BA-1, BA-2, BA-3, OKIa-1 and OKT10/BMA0100). Neither OPM-1 nor OPM-2 reacted with any of the antibodies tested except OKT10. OPM-1 cells reacted weakly (less than 30%) with OKT10/BMA0100, while OPM-2 cells showed a fluctuating reactivity, ranging from 40 to 80%, with OKT10/BMA0100. In contrast, RPMI 8226 reacted strongly with OKT10 and BA-2. These results demonstrate the presence of phenotypic heterogeneity in all 3 myeloma cell lines, suggesting that the lines might represent different stages of terminal B-cell development.

T-cell abnormalities in patients with idiopathic thrombocytopenic purpura: the presence of OKT4+8+ cells

40 patients with idiopathic thrombocytopenic purpura (ITP) were studied for T-cell abnormalities using a panel of monoclonal antibodies (McAbs). These patients showed a tendency to have a decreased OKT4+:OKT8+ ratio compared with normal subjects and a significant increase was observed in OKT10-positive cells in ITP patients. Further analyses were made utilizing McAbs of different subclasses in combination (BMA040 mouse IgG1 McAb, helper/inducer T and BMA081 mouse IgG2 McAb, suppressor/cytotoxic T). An increased proportion of cells reactive with both BMA040 and BMA081 McAbs (double-labelled cells) was demonstrated in patients with ITP compared with the normal controls. Furthermore, there was an inverse correlation between the proportion of "double-labelled cells" and the platelet counts. These data suggest that abnormalities of the T-cell subsets in the peripheral blood may play an important role in the pathogenesis of ITP.

Intraorgan pressure changes in rejecting kidney, liver, and heart transplants in the rat

Intraorgan pressure was measured in DA kidneys, livers, and hearts after transplantation into Lewis rats. Recordings were obtained by passing a fine needle into the graft and measuring the resistance to the flow of saline. Rats with organ isografts (Lewis-to-Lewis) were used as controls, and a further control group comprised Lewis rats that had undergone left ureteric ligation. Following transplantation a rise in pressure was recorded from some of the isografts, it returned to base line levels by the second or third day. Similar changes were observed in the organ allografts, except that a second, much greater (P less than .05) rise soon followed. This was observed from day 3 onward in the case of the kidney and liver transplants, and from day 4 in the cardiac transplants. Control experiments showed that ligation of the ureter (as performed in all the kidney transplants) did not influence intrarenal pressure. It is concluded that a rise in intraorgan pressure is an early feature of rejection, and that pressure monitoring might be useful in patients with cardiac or liver transplants--in addition to those with kidney transplants in whom the test has been shown to be of value.

Acceleration of fibrinolysis by the N-terminal peptide of alpha 2-plasmin inhibitor

When blood plasma containing the NH2-terminal 12-residue peptide (N-peptide) of alpha 2-plasmin inhibitor (alpha 2PI; alpha 2-antiplasmin) was clotted in the presence of calcium ions, the N-peptide and alpha 2PI were cross-linked to fibrin by activated coagulation factor XIII. The amount of N-peptide cross-linked to fibrin was proportional to the concentration of N-peptide present in plasma. On the other hand, the amount of alpha 2PI cross-linked to fibrin was decreased by the presence of N-peptide, and the decrease was in reverse relationship to the increase of cross-linking of N-peptide. Spontaneous fibrinolysis or fibrinolysis induced by tissue plasminogen activator was accelerated by the presence of N-peptide, and the acceleration was dependent on the concentrations of N-peptide and directly proportional to inhibition of alpha 2PI cross-linking exerted by N-peptide. The acceleration was more pronounced when the clot was compacted by platelet-mediated clot retraction or by a squeeze. Fibrinolysis of an alpha 2PI-deficient or a factor XIII-deficient plasma clot was not accelerated by N-peptide. These findings were substantiated in a purified system and support the previous proposal that alpha 2PI is cross-linked to fibrin at the glutamine residue that is next to the NH2-terminus of alpha 2PI, and this factor XIII-mediated cross-linking of alpha 2PI is significant in inhibition of physiologically occurring endogenous fibrinolysis.

Effects of angiotensin I-converting enzyme inhibitor (SA-446) on renal function in dogs

The effects of an orally active inhibitor of angiotensin-converting enzyme (SA-446) on systemic arterial pressure, renal function and renin release were examined in anesthetized dogs. Intrarenal infusion of the larger dose of SA-446 (0.1 mg/min) caused an increase in RBF, urine flow and renin release and caused a fall in blood pressure. The smaller dose of SA-446 (0.02 mg/min) did not affect the blood pressure, but it increased the urine flow. However, the same dose of SA-446 in combination with probenecid caused a significant fall in blood pressure. The potentiation of SA-446 with probenecid may be explained by the elevation in plasma SA-446 concentration via the inhibition of its tubular secretion by probenecid.

Effects of a synthetic human atrial natriuretic polypeptide on regional blood flow in rats

The effects of alpha-hANP on systemic hemodynamics and regional blood flow were examined in conscious WKY and SHR. An intravenous infusion of alpha-hANP (3 micrograms/kg per min) resulted in a rapid and marked fall of blood pressure and of total peripheral resistance but with no change in cardiac output in both strains. alpha-hANP decreased vascular resistance in most organs and there was a redistribution of renal blood flow. Thus, the acute hypotensive effect of alpha-hANP is probably related to a vasodilator action.

Spinal cord monitoring: basic principles and experimental aspects

Spinal cord monitoring, based on spinal cord potentials recorded close to the conus medullaris and evoked by stimulating rostral spinal cord, has been extensively used clinically in Japan. To understand how such spinal cord evoked potentials (SCEP) reflect injurious effects on the spinal cord, we carried out the following animal experiments. The effects of spinal cord distraction, compression, and combined compression and hypotension or hypoxia were examined. We found that there is a critical point of compression or distraction of the spinal cord at which SCEP amplitude decreases significantly. Acute hypotension concomitant with moderate compression increases the risk of insult to the cord. Accordingly, we believe that repetitive monitoring and rapid feedback to the surgeon are indispensable to intraoperative spinal cord monitoring. Furthermore, hypotension should be carefully avoided whenever symptoms of spinal cord compression occur. A comparative study of SCEP and spinal SEP indicates that both potentials can substitute for each other, although the sensitivity of the SCEP for detecting hazardous effects is higher.

Tubuloreticular inclusions and paired cisternae induced in human lymphocytes cultured with Staphylococcus aureus Cowan 1

Tubuloreticular inclusions (TRI) and paired cisternae (PC) were induced in lymphocytes of normal individuals after incubation with Staphylococcus aureus Cowan 1. TRI were initially detected in lymphoid cells on day 2 (48-h culture). The frequency of TRI-positive cell sections on day 5 increased about twofold over those on days 2-4. On day 7, TRI were predominantly seen in lymphoplasmacytoid cells or plasmacytoid cells, with an incidence of up to 18% of sections. The regions in these cells were most extensive and anastomosed with the cisternae of adjacent well-developed rough endoplasmic reticulum (RER). TRI formation appears not to be essential for mitogen-induced B-cell differentiation to plasmacytoid cells, because pokeweed mitogen (PWM) failed to induce TRI. The diverse expressions of TRI induction between these two mitogens may be due to a difference in B-cell activation mechanisms. Paired cisternae were observed in a great majority of mitotic cells at various stages. These were encountered most frequently on day 4. PC were also seen in the PWM-stimulated culture. Our observations suggest that PC formation may be related to new formation of RER as well as to reconstruction of the nuclear envelope.

Redundant nerve roots in patients with degenerative lumbar spinal stenosis

Extensive fundamental and clinical investigations have been performed concerning redundant nerve roots (RNR) and the pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). These investigations consisted of (1) anatomic observations on RNR in 117 fixed cadaveric specimens, (2) myelographic study in 117 patients with or without DLCS, (3) operative observation on neural elements with special reference to the cauda equina in 56 DLCS patients (including a postoperative follow-up), and (4) electrophysiologic tests using spinal cord action potential recording under walking load preoperatively and intraoperative measurement of nerve conduction velocity of RNR. The RNR have neuronal losses resulting from a longer duration stenosis that suggests a sort of friction neuritis. Complicated factors contribute to the pathogenesis of CEC and the development of root gripping, such as the magnitude of RNR, the extent of the stenosis, a narrowed sac, age-dependent axial shortening of the spinal canal, and dynamic or postural factors. In cases with severe RNR, satisfactory operative results can be obtained only after thorough decompression with dural incision.

Helper T-cell lymphoma with marked plasmacytosis and polyclonal hypergammaglobulinemia. A case report

A case of malignant lymphoma with a helper activity of neoplastic cells is reported. On admission, a significant number of plasma cells of polyclonal nature were seen in the peripheral blood, and polyclonal hypergammaglobulinemia was seen. The biopsied lymph node showed poorly differentiated lymphocytic lymphoma with marked proliferation of plasma cells. At the terminal stage, the patient became leukemic in contrast with the disappearance of plasma cells from the peripheral blood. Although the leukemic cells failed to form sheep erythrocyte rosettes, they were considered to be of T-cell origin morphologically. Cytochemically, they had a "dot"-like pattern of alpha-naphthyl acetate esterase and acid phosphatase activity. Ultrastructurally, they had highly convoluted nuclei, and cytoplasmic clustered dense bodies. They showed marked helper activity on pokeweed mitogen-induced B-cell differentiation in vitro. This case may provide a novel view concerning the cause of hypergammaglobulinemia induced by lymphoproliferative disorders.

Spinal cord monitoring as a clinical utilization of the spinal evoked potential

For the purpose of monitoring spinal cord function, evoked spinal cord potential was observed by recording electrodes in the subarachnoid space at the level of the conus medullaris and stimuli delivered to the rostral spinal cord from the epidural space. A specially designed, flexible tube-type electrode was used for both recording and stimulating. The spinal cord evoked potential consisted of an initial spike followed by polyphasic waves. The peak amplitude change was considered to be the main indicator of events that would potentially be hazardous to spinal cord function. Two hundred and twenty-nine operations were monitored by the recording electrode. Six of the patients experienced postoperative neurologic complications. During operation, the peak amplitudes of the evoked potentials diminished to less than 50% of the control values. Simultaneous monitoring of evoked potential revealed that this method was more sensitive than the wake-up test. No complications resulted from the application of this method. Thus, monitoring is a sufficiently sensitive, safe, and reliable method to be useful during aggressive surgery in the spine and spinal cord.

The fine structure of cytoplasmic inclusions in brain and other visceral organs in Sandhoff disease

This paper describes an 11-month-old male who died of Sandhoff disease. Diagnosis was based on detection of cherry red spots and total deficiency of hexosaminidase A and B activities. Sections of the brain revealed swollen neuronal cells and their degeneration and disappearance, leaving a distorted cortical architecture. Ultrastructurally, numerous inclusions showing concentric lamellar or stacked lamellar profiles were found in ballooned neuronal cells, astrocytes and histiocytes. The parafoveal retina in the region of the cherry red spot contained ballooned ganglion and amacrine cells filled with PAS and LFB positive granules. Electron microscopically, these cells showed a greater accumulation of inclusions with stacked lamellar profiles, than the concentric lamellar ones, of classically membranous cytoplasmic bodies (MCB). Hepatocytes and Kupffer cells and epithelial cells of renal glomeruli contained pleomorphic inclusions. Biochemical analysis by thin-layer chromatography of lipid extracts from the cerebral cortex showed a marked increment of the GM2 fraction, without an increase in globoside.

Surface expression of human myeloma cells: an analysis using a panel of monoclonal antibodies

Neoplastic cells of 18 patients with multiple myeloma were studied using a panel of 6 monoclonal antibodies to B cells and monospecific antisera against the light chain types of immunoglobulin. OKT10 bound to the myeloma cells of all the patients, although only a small percentage of the cells reacted in 3 instances. Monoclonal sIg was present in 5 patients. HLA-DR antigen detected with OKIa-1 was found in 5 patients. B1 bound to a small percentage of the myeloma cells only in 2 patients who had received treatment. The B1+ cells were always sIg+. In 3 patients, BA-2 reacted with the myeloma cells. BA-1 and BA-3 invariably did not react with the cells. Myeloma cells with B cell markers were found more frequently in treated patients than in untreated patients. The RPMI8226 line was also studied and found to react with OKT10 and BA-2. The results of this study show the presence of phenotypic variety in myeloma cells.

A case of T-cell chronic lymphocytic leukemia (T-CLL) expressing a peculiar phenotype (E+, OKM1+, Leu 1+, OKT3- and IgG EA-)

A case of chronic leukemia is reported. Malignant cells had the morphology of lymphocytes and an affinity for skin. Cytochemically, they were peroxidase negative, and NaF-resistant alpha-naphthyl esterase positive. The peripheral mononuclear cells formed E-rosettes and reacted with Leu 1 and OKM1. They were unreactive with OKT3, OKT4, OKT6, OKT8, and OKIa1. The cells did not possess surface IG, C3b receptors, or IgG Fc receptors (EAIgG). They responded weakly to phytohemagglutinin, and did not respond to concanavalin A. The cells did not adhere to Petri dishes or phagocytose latex beads. It is concluded that it was a case of OKT3-, OKM1+, EAIgG- T-cell chronic lymphocytic leukemia. This suggests that OKT3 does not recognize all peripheral T-cells, and that OKM1 is not specific for the monocyte-myeloid lineage. These cells may be useful in the characterization of E+, OKM1+ subset of peripheral mononuclear cells.

Alteration of T cell subsets and immunoglobulin synthesis in vitro during high dose gamma-globulin therapy in patients with idiopathic thrombocytopenic purpura

T cell subsets of peripheral lymphocytes were studied using monoclonal antibodies (OKT3, OKT4, OKT8) and immunoglobulin (IgG, IgM, IgA) synthesis in vitro by peripheral mononuclear cells stimulated with pokeweed mitogen was studied in adult patients with idiopathic thrombocytopenic purpura before and after high-dose intravenous intact gamma(gamma-)globulin therapy, at a daily dose of 0.4g/kg body weight for 5 consecutive days. A transient increase in platelet count which reached a peak on the 1st to 2nd days after the end of the therapy was observed in four of five patients. Immunoglobulin synthesis in vitro was suppressed remarkably following therapy in all cases: the mean reduction of IgG, IgM and IgA was 78, 66 and 48%, respectively. Titres of various autoantibodies, TGHA, MCHA, ANF and anti-DNA antibody, also decreased following therapy. In correspondence to this, phenotypic analysis in T cell subsets showed a decrease of OKT4+:OKT8+ ratio following therapy, without a change in the proportion of OKT3+ cells. These data indicate that the intravenous gamma-globulin preparations suppressed synthesis of antibodies non-specifically and caused a relative increase of OKT8+ suppressor T cells.

A human B lymphocyte antigen (P-76) shared by B-cell chronic lymphocytic leukemia cells and hairy cell leukemia cells

A membrane antigen with an apparent specificity to B lymphocytes was detected with immunochemical techniques and its properties were analyzed. Anti-B-CLL serum was raised in a rabbit by immunization with B-cell chronic lymphocytic leukemia (B-CLL) cells. This anti-B-CLL serum was absorbed with erythrocytes, liver homogenate and insolubilized immunoglobulins. After further absorption with T-CLL cells, chronic myelocytic leukemia (CML) cells and acute myelocytic leukemia (AML) cells, the anti-B-CLL serum still reacted with peripheral blood B lymphocytes, B-CLL cells and hairy cell leukemia (HCL) cells. In contrast, no reactivity was seen with peripheral blood T lymphocyte or monocytes, or leukemia cells of non-B cell origin. An immunoprecipitation of radiolabeled cell surface proteins was attempted using the anti-B-CLL serum in the presence of Staphylococcus Aureus Cowan 1 (SaCl), and the precipitates were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A membrane antigen with an apparent molecular weight of 76,000 daltons (P-76) was immunoprecipitated with the anti-B-CLL serum from the lysates of normal B lymphocyte, B-CLL cells and HCL cells. The antigen (P-76) is not composed of disulfide-linked subunits and has no structural relationship with HLA-DR (Ia-like) antigens or other known antigens. These results suggest that this antigen is B-lymphocyte specific, and favour the B-lymphocyte nature of HCL cells.

Factor XIII-mediated cross-linking of NH2-terminal peptide of alpha 2-plasmin inhibitor to fibrin

The NH2-terminal 12-residue peptide of alpha 2-plasmin inhibitor, Asn-Gln-Glu-Gln-Val-Ser-Pro-Leu-Thr-Gly-Leu-Lys-NH2 . AcOH, was found to be a good substrate for plasma transglutaminase (activated blood coagulation factor XIII) and rapidly incorporated into fibrin by the enzyme. A high concentration of the peptide inhibited the enzyme-mediated cross-linking of alpha 2-plasmin inhibitor to fibrin probably by competing with the inhibitor for the same site of fibrin alpha-chain.

Heavy chain loss after treatment with Melphalan in a patient with "nonsecretory" myeloma

A case of "nonsecretory" myeloma is described. The patient had typical osteolytic lesions and marked infiltration of myeloma cells in the bone marrow, and plasma cell leukemia. A good partial remission was obtained with Melphalan, but the patient relapsed and died one year later. Immunofluorescent and immunoelectroscopic studies on the myeloma cells demonstrated the presence of cytoplasmic gamma-and kappa-chains at the initial stage and of only kappa-chains at a relapse. The electron microscopic method for polysome analysis indicated that both L-and H-chains were synthesized on membrane-bound polysomes initially, but the ability to produce H-chain was missing at the relapse.

Ultrastructure of normal human T cell subpopulations. Parallel tubular arrays in T gamma lymphocytes and clustered dense bodies in T mu lymphocytes

Ultrastructures of normal T-cell subpopulations, T gamma and T mu cells, were studied. T gamma cells were isolated and identified by repeating the rosetting method; firstly, by E rosette formation with neuraminidase-treated sheep red blood cells (SRBC), and next by EA gamma-rosette formation with ox red blood cells coated with IgG antibody (EAox). Before EAox rosetting, SRBC on isolated T cells were lysed by autologous plasma instead of ammonium chloride solution. Normal T gamma cells were heterogeneous with regard to their granules; the majority of T gamma cells had parallel tubular arrays (PTA) and a few had electron-dense granules. When ammonium chloride solution was employed to lyse SRBC, PTA were never observed; PTA in normal T gamma cells and in chronic lymphocytic leukemia cells with T gamma character both seemed to change into electron-dense granules after ammonium chloride treatment. In contrast to T gamma cells, T mu cells were characterized by clustered dense bodies, i.e. focal aggregates of electron-dense granules.