Prophylactic treatment of migraine with beta-blockers and riboflavin: differential effects on the intensity dependence of auditory evoked cortical potentials

OBJECTIVE

To investigate the influence of different pharmacological treatments on the intensity dependence of auditory evoked cortical potentials in migraineurs.

BACKGROUND

Between attacks, patients with migraine show abnormalities in cortical information processing and decreased brain mitochondrial energy reserve. Both are most probably relevant for migraine pathogenesis, and they could be differentially modified by prophylactic drug therapy. Design.-The intensity dependence of the auditory evoked cortical potentials is, on average, increased in migraine. We have studied this intensity dependence in 26 patients before and after a 4-month period of prophylaxis with beta-blockers (n = 11, all migraine without aura; metoprolol or bisoprolol) or riboflavin (n = 15, migraine without aura: 13, migraine with aura: 2). Recordings were performed at least 3 days before or after an attack.

RESULTS

After the treatment with beta-blockers, the intensity dependence of the auditory evoked cortical potentials was significantly decreased (before: 1.66+/-1.02 microV/10 dB; after: 0.79+/-1.06 microV/10 dB, P=.02). The decrease in intensity dependence was correlated significantly with clinical improvement (r = .69, P = .02). There was no change in intensity dependence after riboflavin treatment (before: 1.80+/-0.81 microV/10 dB; after: 1.56+/-0.83 microV/10 dB, P = .39), although the majority of patients showed improvement.

CONCLUSIONS

These results confirm that beta-blockers and riboflavin act on two distinct pathophysiological mechanisms. Combining both treatments might enhance their efficacy without increasing central nervous system side effects.

Immunohistochemical expression of BerEP4, a new epithelial antigen, in endometrial carcinoma: correlation with clinical parameters

OBJECTIVE

To assess the immunochemical expression of BerEP4, a new epithelial antigen in endometrial carcinoma.

METHODS

We studied 45 cases of endometrial carcinoma in which the BerEP4, CEA and TAG-72 antigens were searched by an immunohistochemical method. We evaluated the correlations among the immunohistochemical positivity and the grading, histotype, stage and receptorial status of the neoplasia.

RESULTS

CEA was positive in 29 out of 45 cases (64.4%), TAG-72 in 17 out of 45 cases (37.7%) and BerEP4 in 31 out of 45 cases (68.9%). Both TAG-72 and CEA were inversely related to the grading while, with regard to the histotype, CEA resulted as highly positive in the 5 cases of adenoacanthoma.

CONCLUSION

BerEP4 did not show any correlation with grading, histotype, stage of disease or receptorial status of the carcinoma.

Impairment of neuromuscular transmission in a subgroup of migraine patients

Neuronal voltage-dependent P/Q Ca2+ channels are genetically abnormal in many cases of familial hemiplegic migraine and possibly associated with the more common forms of migraine with and without aura. Besides the brain, these channels are found in motor nerve endings where they control stimulation-induced acetylcholine release. Using single fiber EMG recordings we were able to demonstrate subclinical abnormalities of neuromuscular transmission in a subgroup of patients suffering from migraine with aura. This could be related to genetic abnormalities of P/Q Ca2+ channels in certain patients suffering from migraine with aura, which needs to be explored by proper genetic analyses.

[The rationalization of the follow-up of hormonal replacement treatment in menopause]

BACKGROUND

Decision making about the opportunity of starting or continuing hormone replacement therapy (HRT) in menopause should rely on an overall evaluation of its risks and benefits for the women's health; the evaluation of HRT cost-benefit ratio, however, should include its possible outcomes from an economical point of view. In this view, and with the certainty that menopausal patients should be protected by proper treatments, our case series has been evaluated in order to improve the quality of our clinical schedules for both their access to HRT and the treatment follow-up.

METHODS

Two groups of patients have been considered the first one consisted of 560 women observed during '97 for climacteric symptoms and candicated to begin HRT. The second one consisted of 100 women on HRT for 1 to 6 years. In the first group we considered which test and with which frequency were responsible for stopping or delay the beginning of therapy; while in the second group we evaluated the reasons for stopping treatment.

RESULTS AND CONCLUSIONS

On the basis of our experience, the exams required before starting HRT seem to be the following: patient history, mammography, densitometry and endometrial sample as well as the parameters of glucose lipidic, coagulative and hepatic metabolism. Densitometry is useful in the annual follow-up only in patients with bone alterations from the beginning. The same exams seem required for the follow-up, with the exception of bone densitometry which should be performed yearly only in patients with bone demineralization.

"Gating" of human short-latency somatosensory evoked cortical responses during execution of movement. A high resolution electroencephalography study

The present study aimed at investigating gating of median nerve somatosensory evoked cortical responses (SECRs), estimated during executed continuous complex ipsilateral and contralateral sequential finger movements. SECRs were modeled with an advanced high resolution electroencephalography technology that dramatically improved spatial details of the scalp recorded somatosensory evoked potentials. Integration with magnetic resonance brain images allowed us to localize different SECRs within cortical areas. The working hypothesis was that the gating effects were time varying and could differently influence SECRs. Maximum statistically significant (p<0. 01) time-varying gating (magnitude reduction) of the short-latency SECRs modeled in the contralateral primary motor and somatosensory and supplementary motor areas was computed during the executed ipsilateral movement. The gating effects were stronger on the modeled SECRs peaking 30-45 ms (N30-P30, N32, P45-N45) than 20-26 ms (P20-N20, P22, N26) post-stimulus. Furthermore, the modeled SECRs peaking 30 ms post-stimulus (N30-P30) were significantly increased in magnitude during the executed contralateral movement. These results may delineate a distributed cortical sensorimotor system responsible for the gating effects on SECRs. This system would be able to modulate activity of SECR generators, based on the integration of afferent somatosensory inputs from the stimulated nerve with outputs related to the movement execution.

The value of serum CA 125 and association CA 125/CA 19-9 in endometrial carcinoma

One hundred and twelve women with endometrial carcinoma were studied with serum sampling to determine preoperative and postoperative levels of CEA, CA 15-3, CA 19-9, TPA and CA 125. After surgical treatment 88 patients had stage I, 8 stage II, 14 stage III and 2 stage IV disease. Before treatment the sensitivity of CEA, CA 15-3, CA 19-9, TPA and CA 125 was 22.3% (25/112), 32.1% (36/112), 22.3% (25/112), 45.5% (51/112), 33.9% (38/112), respectively. According to pathological stage a statistically significant difference between intrauterine (96 cases) and extrauterine disease (16 cases) was noted only for CA 125 (28.1% vs. 68.7%) and CA 15.3 (28.1% vs. 56.2%). In relation to histological grading CA 125 rises progressively from well-differentiated cases to poorly-differentiated tumors. During the follow-up the most reliable marker was CA 125: values more than 35 U/ml of this marker resulted positive in 50% of relapsed cases and only in 5.1% of disease-free cases, thus demonstrating a high specificity. The association of various markers during the follow-up allowed us to reveal interesting results only for the CA 125/CA 19-9 combination. In fact the combined use of these markers permitted a high sensitivity (83.3%), with only 12.8% false positive cases, so with a high specificity.

Nitrite and nitrate levels in cerebrospinal fluid of normal subjects

In order to evaluate the involvement of nitric oxide in neurologic disorders it is important to generate controlled values of its metabolites nitrite and nitrate in human cerebrospinal fluid (CSF). Samples of CSF obtained from 14 patients without neurologic diseases were analysed for nitrite and nitrate concentration by reverse phase chromatography with ultraviolet (UV) detection. For comparison, the levels of nitrite in the same samples were also measured by reverse phase chromatography coupled with electrochemical detection and those of nitrate by ion chromatography coupled with UV detection. A good correlation was found for the concentration values of both ions obtained with the two procedures. Then, 10.41 +/- 0.47 ng/ml of nitrite and 2.92 +/- 0.37 ng/ml of nitrate could be regarded as reliable values in control subjects. No correlation between age and levels of nitrite and nitrate was observed.

Responses of human primary sensorimotor and supplementary motor areas to internally triggered unilateral and simultaneous bilateral one-digit movements. A high-resolution EEG study

We modelled the responses of human primary sensorimotor areas and supplementary motor area to simple, self-initiated unilateral and simultaneous bilateral middle finger movements using a novel high-resolution electroencephalography technology. The results support the view that these cortical motor areas are involved in parallel and present similar activity in the preparation, initiation, and execution of the contralateral and bilateral movements. Furthermore, the left primary sensorimotor area (dominant hemisphere) appears to be activated more than the right primary sensorimotor area during the preparation and performance of the ipsilateral movements.

Human short latency cortical responses to somatosensory stimulation. A high resolution EEG study

Human short-latency cortical responses to median nerve stimulation were investigated with a new high resolution electroencephalography technology that markedly enhanced spatial details of somatosensory-evoked potentials (SEPs). Maximum amplitude potentials were estimated over contralateral and/or frontal-mesial scalp regions about 20, 22, 24, 26, 30, 32 and 45 ms following the stimulation. Frontal-lateral P20-N24-N30-P45 and parietal-lateral N20-P24-P30-N45 showed dipolar patterns, whereas frontal-mesial N24-N30-P45 and central-lateral P22-N26-N32-P45 presented no clearcut dipole counterpart. Plausibly, the spatially enhanced frontal-parietal SEP components were generated (tangential dipoles) within the lateral central sulcus cortex, and anticipated the central-lateral and frontal-mesial components generated (radial dipoles) from the crown of the pre- and/or post-central gyri and the supplementary motor area, respectively.

Changes in nitric oxide metabolite levels in stimulated substantia nigra neurons

Simultaneous quantification of the two major nitric oxide (NO) metabolites, nitrite and nitrate, was performed on mouse mesencephalic neurons in vitro, in basal conditions or after excitatory stimuli. Measurements were made using both extracellular medium and cytosolic extracts. Basal metabolite levels were stable up to 5 min. Depolarization by high levels of potassium promptly increased extracellular nitrite (270% of basal, peak at 10s) leaving intracellular levels unchanged. Glutamate receptor agonists caused a rapid increase in intracellular, but not extracellular, nitrite levels (240% of basal, peak at 30s). Intracellular nitrate levels raised slowly after addition of potassium (215% of basal at 1 min) or N-methyl-D-aspartate (230% of basal at 5 min), but not after quisqualate. The different dynamic variations of the two NO metabolites point to the specificity of the activated metabolism according to the type of excitatory stimulus.

Topography of spatially enhanced human short-latency somatosensory evoked potentials

In the present study modern high resolution electroencephalography (EEG) was used to spatially enhance human median nerve short-latency somatosensory evoked potentials (SEPs). It was shown that the spatially enhanced N30 consisted of two frontal subcomponents, one located in the frontal-lateral area of the scalp, the other located in the frontal-mesial area. Both of these subcomponents were most reduced in amplitude (or disappeared) during concomitant hand movement ipsilateral to the stimulus, but were differentially influenced by executed contralateral movement and imagined ipsilateral movement. These results support the hypothesis of an involvement of the frontal-mesial cortex (including the supplementary motor area) in the generation of the frontal N30.

Pupillometric evaluation and analysis of light reflex in healthy subjects as a tool to study autonomic nervous system changes with aging

To assess the relationships between aging and autonomic control of pupillary functions, TV-pupillometry and light reflex evaluation were performed in 52 healthy volunteers in the age range 15-75 years, grouped into four age classes (group 1: 15-29 years, Group 2: 30-44 years, Group 3: 45-59 years, Group 4: 60-75 years). Baseline light pupil diameter was found to be age-dependent, together with light reflex contraction velocity, which presented a linear correlation with age. Light reflex amplitude and half-redilatation velocity were reduced in older subjects, but presented only a weak linear correlation with age, while latency, contraction time and half-redilatation time percent of secondary dilatation and redilatation at 5 seconds did not show significant changes with age. These results confirm that there are important age-dependent changes in the mechanisms involved in pupillary autonomic functions, regarding both sympathetic and parasympathetic components. These changes appear to be easily detectable by making use of a sensitive and non-invasive technique such as TV-pupillometry.

Cyclic GMP inhibition of metabotropic glutamate receptor-induced phosphoinositide hydrolysis in mesencephalic neurons

The effect of cGMP on metabotropic glutamate receptor-induced stimulation of phosphoinositide hydrolysis in mesencephalic neuronal cultures was evaluated by cell incubation with the stable analogue dibutyryl-cGMP (10 microM). A complete blockade of (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid- or quisqualate-induced inositol phosphate formation was observed. Ionotropic glutamate receptors in mesencephalic neurons activate cGMP formation and, through this intracellular messenger, they might control mGluR activity.

Metabotropic glutamate receptors negatively coupled to adenylate cyclase inhibit N-methyl-D-aspartate receptor activity and prevent neurotoxicity in mesencephalic neurons in vitro

The functional effects of G protein-linked glutamate receptor activation have been studied in mouse mesencephalic neurons in vitro. We have been able to identify two receptor classes, one linked to phosphoinositide hydrolysis and another that inhibits adenylate cyclase. The agonist (1S,3R)-aminocyclopentane-1,3-dicarboxylate (ACPD) affected the two responses with similar potency (EC50 = 2 and 7 microM, respectively). In contrast, (2S,3S,4S)-alpha-(carboxycyclopropyl)glycine selectively decreased adenylate cyclase activity (EC50 = 150 nM), without interfering with the phosphoinositide pathway. Activation of ion channel-linked glutamate receptors in mesencephalic neurons leads to cGMP formation. In this study, we demonstrate that cell pretreatment with ACPD or (2S,3S,4S)-alpha-(carboxycyclopropyl)glycine prevented, in a dose-dependent fashion, N-methyl-D-aspartate (NMDA)-induced cGMP formation but not the kainate-stimulated response. The pharmacological profile suggests that receptors that are negatively coupled to adenylate cyclase are responsible for this effect. Coexposure of neurons to ACPD and Ba2+, a K+ channel blocker, counteracted the ACPD-induced blockade of NMDA receptors, suggesting that activation of K+ conductances could be involved in the post-transduction events triggered by metabotropic receptors in the mesencephalon. Neuronal treatment with NMDA for 10 min caused a reduction in mitochondrial activity. Direct inhibition of nitric oxide synthase with the inhibitor NG-nitro-L-arginine or removal of extracellular nitric oxide with reduced hemoglobin did not prevent this metabolic impairment, thus excluding a role for nitric oxide in this test for excitotoxicity. On the contrary, the mitochondrial function was maintained when neurons exposed to NMDA were preincubated with metabotropic receptor agonists. To summarize, our results suggest that metabotropic receptors that are negatively coupled to adenylate cyclase exert modulatory control specifically on NMDA receptor activity. This event could also contribute to the reduction of neurotoxic effects due to NMDA receptor hyperactivity.

The effect of N-acyl ethanolamines on phosphatidylethanolamine phase transitions studied by laurdan generalised polarisation

The effect of N-lauroylethanolamine (N-LEA) and N-oleoylethanolamine (N-OEA) on the thermal behaviour of fully hydrated egg phosphatidylethanolamine (TPE) was investigated by the steady-state fluorescence of 2-dimethylamino-(6-lauroyl)-naphtalene (laurdan) and 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH). The parameter generalised polarisation (GP), calculated by exciting laurdan at 340 and 410 nm, revealed the gel to liquid crystalline lamellar (L alpha) as well as the L alpha to inverse hexagonal (HII) phase transitions of TPE. The L alpha to HII phase transition was not detected in TPE/N-OEA system, probably because of the formation of an intermediate Q224 cubic phase. The formation of Q224 phase in TPE/N-OEA and TPE/N-LEA systems was previously demonstrated by X-ray diffraction, but neither laurdan generalised polarisation nor TMA-DPH steady-state fluorescence anisotropy measurements revealed the presence of this phase. It is suggested that the lack of detection of the cubic phase is probably due to the similarity in dynamic characteristics and hydration levels of phospholipid headgroups in the bilayer and cubic phases.

Glutamate receptor-induced cyclic GMP formation in primary cultures of mesencephalic neurons

The link between excitatory amino acid (EAA) receptor activation and the nitric oxide/cyclic GMP intracellular pathway was investigated in primary cultures of mouse mesencephalic neurons. L-glutamate, N-methyl-D-aspartate (NMDA), kainate (KA) and alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate were able to induce cyclic GMP formation. NMDA and KA were the most effective and their action could be blocked, besides the specific antagonists 2-amino-5-phosphonopentanoate and 6-cyano-7-nitroquinoxaline-2,3-dione, by NG-nitro-L-arginine, a nitric oxide synthase inhibitor. This finding demonstrates that nitric oxide generation is necessary for EAA-induced cyclic GMP formation and provides indirect evidence for nitric oxide synthase activity in mesencephalic neurons. GMP increase induced by NMDA or KA was potentiated by carbachol or by exogenous activation of protein kinase C with phorbol esters. A clarification of the early intracellular events that follow EAA receptor activation may be important for understanding the physiological and excitotoxic events linked to these receptors in the mesencephalon.

N-acylethanolamines as membrane topological stress compromising agents

The effect of different N-acylethanolamines on the phase behaviour of fully hydrated egg phosphatidylethanolamines is reported. In particular, in the presence of N-acylethanolamines, the transition from the liquid-crystalline lamellar (L alpha) to the inverse hexagonal (HII) phase is observed at higher temperature with respect to the temperature transition of pure phosphatidylethanolamine. Moreover, in correspondence of this transition, an intermediate Q224 (space group Pn3m) cubic phase has been detected. Since the structure of this cubic phase presents unique topological analogies with the lipid bilayer organization, these data suggest the possible role of N-acylethanolamines in stabilizing the biological membranes by avoiding a sudden change to a non-bilayer phase in those tissues which undergo stress conditions.

Effect of N-acylethanolamines with different acyl-chains on DPPC multilamellar liposomes

The influence of N-acylethanolamines with different acyl-chains on the physico-chemical state of neutral phospholipids was investigated using dipalmitoyl phosphatidylcholine (DPPC) multilamellar liposomes. The thermal dependence of steady state fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene (DPH) and its charged derivative 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) was recorded. The N-acylethanolamines modified the DPPC phase transition temperature and broadened the transition temperature range in different ways depending on the N-acylethanolamines acyl chain characteristics. Our data suggest that the N-acylethanolamine acyl chain length and unsaturation play an important role in the interaction of these compounds with model membranes. The results show that long-chain-N-acylethanolamines interact largely with DPPC model membranes while a similar effect is not observed for the short ones.

[Role of endoscopy in the diagnosis and follow-up of bleeding lesions of the colon]

Considering the results of the centre of colonoscopy we can draw some considerations about the irreplaceable role of endoscopy in the diagnosis of bleeding colonic lesions and about its greater security in comparison with the traditional radiologic exam, about its possibilities to be sometimes resolutive even for the therapy and about its great importance in the follow-up of patients treated for lesions of this kind.

Purified unitary kainate/alpha-amino-3-hydroxy-5-methylisooxazole-propionate (AMPA) and kainate/AMPA/N-methyl-D-aspartate receptors with interchangeable subunits

We have purified and characterized two vertebrate excitatory amino acid ionotropic receptors from the Xenopus central nervous system. Each is a unitary receptor (i.e., having more than one class of excitatory amino acid agonist specificity within one protein oligomer). The first is a unitary non-N-methyl-D-aspartate (non-NMDA) receptor and the second is a unitary NMDA/non-NMDA receptor. The specific agonist-activated channel activity and pharmacology of each type were recognized by patch-clamping lipid bilayers in which the isolated protein was reconstituted. In the second case, the NMDA and the non-NMDA sites could not be physically separated and exhibited functional interaction. Parallel evidence for this was obtained when poly(A) RNA from Xenopus brain was translated in oocytes: a noncompetitive inhibition of the response to L-kainate is produced by NMDA to a maximum depression of 30% at 1 mM NMDA. Each isolated oligomer contains 42-kDa subunits of the non-NMDA ligand binding type, but the second type has an additional NMDA-receptor-specific 100-kDa subunit. Thus, a subunit-exchange hypothesis can account for the known multiplicity of excitatory amino acid receptor types.

Effect of the fungicides tributyltin acetate and tributyltin chloride on multilamellar liposomes: fluorescence studies

The influence of tri-n-butyltin acetate (TBTA) and tri-n-butyltin chloride (TBTC) on the physico-chemical state of charged and neutral phospholipids was investigated using multilamellar liposomes. The thermal dependence of steady state fluorescence polarization of DPH and its charged derivative TMA-DPH was recorded. The two fungicides lowered DPPC phase transition temperature and broadened the temperature range of the transition in different ways. The effects were concentration-dependent. The results show that TBTC interacts more effectively with DPPC model membranes rather than TBTA. Moreover, TBTC broadens and shifts the main phase transition (Tm) more effectively in DPPC rather than in DMPC liposomes. Below Tm, TBTC decreases fluorescence polarization (P) in all phospholipids used. Above Tm P is almost constant in phospholipids with saturated acyl chains, except for DMPG. In fact, an increase of P is detectable in this lipid as in PLs with unsaturated acyl chains. It is suggested that the effects of TBT on liposomal membranes are dependent on the anion moiety and phospholipids characteristics.

AMPA and kainate-operated channels reconstituted in artificial bilayers

Cationic channels which can be activated by alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) and kainate play a key role in the generation of excitatory postsynaptic potentials in the brain of all vertebrates. On a protein carrying binding sites for both these ligands, affinity-purified from the Xenopus nervous system, electrical measurements have been performed to investigate its functional properties after the pure complex had been incorporated into planar lipid bilayers. Domoate, AMPA or kainate added to the reconstituted protein activated cationic channels, which were blocked by typical antagonists for this neurotransmitter system. These data suggest that the reconstituted protein is an ionotropic receptor of the unitary non-NMDA subtype.

Interaction of the herbicide atrazine with model membranes. II: Effect of atrazine on fusion of phospholipid vesicles

The effect of atrazine on Ca2+ induced fusion of cardiolipin(CL) and phosphatidylserine (PS) vesicles is studied by Tb3+/dipicolinic acid fluorescence and turbidity measurements. The interaction of herbicide with CL and PS membranes is studied by DPH fluorescence polarization. At low concentrations the pesticide partially inhibits fusion, especially in CL vesicles. Higher concentrations of atrazine decrease inhibition of fusion in CL, while fusion is slightly increased in PS. The Ca2(+)-induced increase of turbidity is not affected by atrazine in both PS and CL aggregation experiments. DPH polarization measurements show a perturbation only of the membrane hydrophobic core of PS, in presence of Ca2+. It is hypothesized that this biphasic effect shown by low and high atrazine concentrations on Ca2(+)-induced fusion of vesicles is due to a different localization of the pesticide in the membrane.

Interaction of the herbicide atrazine with model membranes. I: Physico-chemical studies on dipalmitoyl phosphatidylcholine liposomes

Atrazine (2-chloro-4 ethylamino-6-(isopropylamino)-s-triazine) is one of the most widely used herbicides. Fourier transform infrared spectroscopy, differential scanning calorimetry and fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene (DPH) and of its derivative 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) were used to study the interaction of atrazine with dipalmitoyl phosphatidylcholine liposomes used as a model for biological membranes. The results show that atrazine does not perturb the hydrophobic core of the lipid bilayer and suggest that the herbicide localizes near the glycerol backbone of the lipid.

Differential scanning calorimetry characterization of oxidized egg phosphatidylcholine liposomes

Differential scanning calorimetry has been used to characterize liposomes made from mixtures of unoxidized and singlet oxygen oxidized egg phosphatidylcholine. Cooling scans reveal that trapped water decreases when the oxidized phosphatidylcholine content is increased in the liposomes. Liposomes made from mixtures containing more than 50% by weight of oxidized phosphatidylcholine do not show trapped water.

Evidence for a single glutamate receptor of the ionotropic kainate/quisqualate type

The kainate (KA) and the quisqualate (QUIS) receptors that activate cation channels in the central nervous system have previously been defined as two of the major glutamate receptor types. In amphibian brain, an exceptionally rich source of these sites, they can be coextracted by octylglucoside and shown to behave as one entity in all analyses made in solution. When partly purified by lectin affinity, ion-exchange chromatography or by sucrose gradient centrifugation, the two activities comigrate in a 1:1 ratio. When the QUIS component is bound to an immobilized specific QUIS agonist, the KA component is extracted in parallel with it. There are equivalent numbers of the QUIS and KA sites and the two sites show a single affinity series for the binding of glutamatergic agonists. We deduce that KA or QUIS select different conformations of a single KA/QUIS receptor binding site, leading thus to the different channel-opening events that have been reported for these two agonists.

Muscarinic and quisqualate receptor-induced phosphoinositide hydrolysis in primary cultures of striatal and hippocampal neurons. Evidence for differential mechanisms of activation

Several neurotransmitters activate polyphosphoinositide (PPI) hydrolysis in CNS neurons as the first step of a transmembrane signalling cascade that may lead to neuronal circuit modulation. Muscarinic and quisqualate receptor-triggered PPI hydrolysis was investigated in neuronal primary cultures. A clear increase in inositol phosphates (Ins-Ps) was detected as early as 15 s after the agonist addition; at this time, the increases of inositol 1,4,5-trisphosphate (measured by HPLC) were relatively larger with respect to the other Ins-Ps. Ins-P accumulation was maintained in part in a Ca2+-free medium, excluding that Ca2+ entry is the fundamental step of the receptor-induced PPI hydrolysis. Acute cell pretreatment with phorbol dibutyrate, an activator of protein kinase C, was able to inhibit 50% of the response to carbachol, and almost completely the quisqualate effect, suggesting a negative feedback modulation by the enzyme. Finally, pertussis toxin failed to inhibit muscarinic responses, whereas it blocked greater than 70% of the quisqualate stimulation. The two receptors therefore appear coupled to phosphodiesterase by two different G proteins. The comparison of the results obtained by stimulating the two receptor systems suggests that the generation of the same intracellular signal at two distinct receptor types may occur by different coupling mechanisms, and be differently regulated even in the same neuronal preparations.

Second-messenger control of catecholamine release from PC12 cells. Role of muscarinic receptors and nerve-growth-factor-induced cell differentiation

The role of various intracellular signals and of their possible interactions in the control of neurotransmitter release was investigated in PC12 cells. To this purpose, agents that affect primarily the cytosolic concentration of Ca2+, [Ca2+]i (ionomycin, high K+), agents that affect cyclic AMP concentrations (forskolin; the adenosine analogue phenylisopropyladenosine; clonidine) and activators of protein kinase C (phorbol esters) were applied alone or in combination to either growing chromaffin-like PC12-cells, or to neuron-like PC12+ cells differentiated by treatment with NGF (nerve growth factor). In addition, the release effects of muscarinic-receptor stimulation (which causes increase in [Ca2+]i, activation of protein kinase C and decrease in cyclic AMP) were investigated. Two techniques were employed to measure catecholamine release: static incubation of [3H]dopamine-loaded cells, and perfusion incubation of unlabelled cells coupled to highly sensitive electrochemical detection of released catecholamines. The results obtained demonstrate that: (1) release from PC12 cells can be elicited by both raising [Ca2+]i and activating protein kinases (protein kinase C and, although to a much smaller extent, cyclic AMP-dependent protein kinase); and (2) these various control pathways interact extensively. Activation of muscarinic receptors by carbachol induced appreciable release responses, which appeared to be due to a synergistic interplay between [Ca2+]i and protein kinase C activation. The muscarinic-induced release responses tended to become inactivated rapidly, possibly by feedback desensitization of the receptor mediated by protein kinase C. Muscarinic inactivation was prevented (or reversed) by agents that increase, and accelerated by agents that decrease, cyclic AMP. Agents that stimulate release primarily through the Ca2+ pathway (ionomycin and high K+) were found to be equipotent in both PC12- and PC12+ cells, whereas the protein kinase C activator 12-O-tetradecanoyl-phorbol 13-acetate was approx. 10-fold less potent in PC12+ cells, when administered either alone or in combination with ionomycin. In contrast, the cell binding of phorbol esters was not greatly modified by NGF treatment. Thus control of neurotransmitter release from PC12 cells is changed by differentiation, with a diminished role of the mechanism mediated by protein kinase C.

HIV-related malignant lymphoma: a report of 46 cases observed in Italy

We report 36 patients with non-Hodgkin's lymphomas (NHL) and 10 patients with Hodgkin's disease (HD), predominantly intravenous drug abusers (IVDA; 35 patients), diagnosed in 16 different Italian centers. The group of NHL has a median age of 26 years (range 16-64): 26 were IVDA, 3 polytransfused, 3 IVDA and homosexual men, 2 homosexual men and 2 without apparent risk for AIDS but carrying HIV antibodies. 81% of the evaluable patients had high-grade NHL (32% Burkitt's type) according to the Working Formulation, 15% intermediate and 4% low-grade. Out of 23 patients with stage reported, 16 (70%) were stage IV, 2 (9%) stage III, 1 (4%) stage II and 4 (17%) stage I (CNS involvement). The group with HD has a median age of 25 years (range 20-40), 9 were IVDA and 1 IVDA and homosexual. Of the 7 patients with subtype reported, 4 patients had nodular sclerosis and 3 mixed cellularity subtype. Stage III and IV were reported in 66% of the patients. The median survival is 4 months for NHL and 10 months for HD. The most common cause of death is opportunistic infection in 86% of the evaluable cases.

Activation of a muscarinic receptor selectively inhibits a rapidly inactivated Ca2+ current in rat sympathetic neurons

Sympathetic neurons dissociated from the superior cervical ganglion of 2-day-old rats were studied by whole-cell patch clamp and by fura-2 measurements of the cytosolic free Ca2+ concentration, [Ca2+]i. Step depolarizations in the presence of tetrodotoxin and hexamethonium triggered two Ca2+ currents that differed in the voltage dependence of activation and kinetics of inactivation. These currents resemble the L and N currents previously described in chicken sensory neurons [Nowycky, M. C., Fox, A. P. & Tsien, R. W. (1985) Nature (London) 316, 440-442]. Treatment with acetylcholine resulted in the rapid (within seconds), selective, and reversible inhibition of the rapidly inactivated, N-type current, whereas the long-lasting L-type current remained unaffected. The high sensitivity to blocker drugs (atropine, pirenzepine) indicated that this effect of acetylcholine was due to a muscarinic M1 receptor. Intracellular perfusion with nonhydrolyzable guanine nucleotide analogs or pretreatment of the neurons with pertussis toxin had profound effects on the Ca2+ current modulation. Guanosine 5'-[gamma-thio]triphosphate caused the disappearance of the N-type current (an effect akin to that of acetylcholine, but irreversible), whereas guanosine 5'-[beta-thio]diphosphate and pertussis toxin pretreatment prevented the acetylcholine-induced inhibition. In contrast, cAMP, applied intracellularly together with 3-isobutyl-1-methylxanthine, as well as activators and inhibitors of protein kinase C, were without effect. Acetylcholine caused shortening of action potentials in neurons treated with tetraethylammonium to partially block K+ channels. Moreover, when applied to neurons loaded with the fluorescent indicator fura-2, acetylcholine failed to appreciably modify [Ca2+]i at rest but caused a partial blunting of the initial [Ca2+]i peak induced by depolarization with high K+. This effect was blocked by muscarinic antagonists and pertussis toxin and was unaffected by protein kinase activators. Thus, muscarinic modulation of the N-type Ca2+ channels appears to be mediated by a pertussis toxin-sensitive guanine nucleotide-binding protein and independent of both cAMP-dependent protein kinase and protein kinase C.

Activation of muscarinic receptors in PC12 cells. Correlation between cytosolic Ca2+ rise and phosphoinositide hydrolysis

The intracellular signals generated by carbachol activation of the muscarinic receptor [release of inositol phosphates as a consequence of phosphoinositide hydrolysis and rise of the cytosolic Ca2+ concentration ([Ca2+]i, measured by quin2)] were studied in intact PC12 pheochromocytoma cells that had been differentiated by treatment with nerve growth factor. When measured in parallel samples of the same cell preparation 30 s after receptor activation, the release of inositol trisphosphate and of its possible metabolites, inositol bis- and mono-phosphate, and the [Ca2+]i rise were found to occur with almost superimposable carbachol concentration curves. At the same time carbachol caused a decrease in the radioactivity of preloaded phosphatidylinositol 4,5-bisphosphate, the precursor of inositol trisphosphate. Neither the inositol phosphate nor the [Ca2+]i signal was modified by preincubation of the cells with either purified Bordetella pertussis toxin or forskolin, the direct activator of adenylate cyclase. Both signals were partially inhibited by dibutyryl cyclic AMP, especially when the nucleotide analogue was applied in combination with the phosphodiesterase inhibitors RO 201724 and theophylline. The latter drug alone profoundly inhibited the carbachol-induced [Ca2+]i rise, with only minimal effect on phosphoinositide hydrolysis. Because of the diverging results obtained with forskolin on the one hand, dibutyryl cyclic AMP and phosphodiesterase inhibitors on the other, the effects of the latter drugs are considered to be pharmacological, independent of the intracellular cyclic AMP concentration. Two further drugs tested, mepacrine and MY5445, inhibited phosphoinositide hydrolysis at the same time as the 45Ca2+ influx stimulated by carbachol. Taken together, our results concur with previous evidence obtained with permeabilized cells and cell fractions to indicate phosphatidylinositol 4,5-bisphosphate hydrolysis and [Ca2+]i rise as two successive events in the intracellular transduction cascade initiated by receptor activation. The strict correlation between the carbachol concentration curves for inositol trisphosphate generation and [Ca2+]i rise, and the inhibition by theophylline of the Ca2$ signal without major effects on inositol phosphate generation, satisfy important requirements of the abovementioned interpretation.

Muscarinic receptor-induced phosphoinositide hydrolysis at resting cytosolic Ca2+ concentration in PC12 cells

In PC12 cells, cultured in the presence of nerve growth factor to increase their complement of muscarinic receptors, treatment with carbachol induces muscarinic receptor-dependent rises in free cytosolic Ca2+ as well as hydrolysis of membrane phosphoinositides. Experiments were carried out to clarify the relationship between these two receptor-triggered events. In particular, since inositol-1,4,5-trisphosphate (the hydrophilic metabolite produced by the hydrolysis of phosphatidylinositol-4,5-bisphosphate) is believed to mediate intracellularly the release of Ca2+ from nonmitochondrial store(s), it was important to establish whether it can be generated at resting cytoplasmic concentration of Ca2+ (approximately 0.1 microM). Cells incubated in Ca2+-free medium were depleted of their cytoplasmic Ca2+ stores by pretreatment with ionomycin. When these cells were then treated with carbachol, their cytosolic concentration of Ca2+ remained at the resting level, whereas inositol-1,4,5-trisphosphate generation was still markedly stimulated. Our results demonstrate that an increase in the concentration of cytosolic Ca2+ is not a necessary intermediate between receptor activation and phosphoinositide hydrolysis, and therefore support the second-messenger role of inositol-1,4,5-trisphosphate.

Tumor promoter phorbol 12-myristate, 13-acetate inhibits phosphoinositide hydrolysis and cytosolic Ca2+ rise induced by the activation of muscarinic receptors in PC12 cells

Preincubation of PC12 cells (used both before and after differentiation by NGF) with phorbol myristate acetate (PMA) was without effect on the basal concentration of inositol phosphates (metabolites of phosphoinositide hydrolysis) and of free cytosolic Ca2+, but inhibited considerably the increases induced by the cholinergic agonist carbachol via the activation of the muscarinic receptor. Inasmuch as binding was unaffected, this inhibition might occur at the level of receptor coupling to its transduction mechanism(s). Inhibition appeared within 1 min and was maximal after 3 min. The concentrations of PMA needed (10(-9)-10(-8)M) were in the range believed to cause specifically the activation of protein kinase C. The muscarinic receptor, via the hydrolysis of phosphoinositides and the generation of diacylglycerol, participates in the regulation of the latter enzyme. Our data suggest therefore that the receptor operates under stringent feedback control by the metabolites generated as a consequence of its activation.

[Chemical and pharmacological research on pyran derivatives. XV. Phenyl-substituted 2-(dialkylamino)chromones]

Some 2-(dialkylamino)chromones phenyl substituted in position 6 or 7 or 8 were synthesized by reaction of N,N-dialkylethoxycarbonylacetamides with 4- or 3- or 2-biphenylol, respectively, in the presence of phosphorus oxychloride. The pharmacological activity of these compounds was then evaluated and compared with that shown by naphthopyran derivatives of structures (I), (II), and (III). With this same purpose also 6- and 8-benzyl derivatives of 2-(dialkylamino)chromones were prepared by using in the reaction 4- or 2-benzylphenol. Pharmacological screening showed that 6-phenyl substituted 2-(dialkylamino)chromones maintained the antireserpine and antimetrazole acti-activities which were possessed by the 1H-naphtho[2,1-b]pyran derivatives (I) and the 4H-naphtho[2,3-b]pyran derivatives (II), whereas 7-phenyl substituted compounds were devoid of any activity. 8-Phenyl substituted 2-(dialkylamino)chromones maintained to some extent the antiamphetamine activity which was clearly shown by the 4H-naphtho[1,2-]pyran derivatives (III). Furthermore, the compounds bearing the benzyl substituent both in the 6 or 8 position showed only antimetrazole activity.