Membrane damage and the Ca(2+)-paradox in the perfused rat kidney

Lactate dehydrogenase (LDH) leaks from the perfused rat kidney under the artificial conditions of a Ca(2+)-paradox protocol, namely Ca(2+)-repletion following a 20 minute period of Ca(2+)-depletion. LDH leakage was markedly suppressed by perfusion at 25 degrees C or with 0.1 mM dibucaine or 2 mM lidocaine. Lidocaine inhibited leakage only during Ca(2+)-depletion. Lowering the perfusion rate significantly reduced LDH escape. No LDH loss occurred if the osmotic pressure of the perfusion fluid was raised by 420 mOsm during either Ca(2+)-depletion or Ca(2+)-repletion. Amiloride (2 mM) significantly reduced LDH leakage to 43%. Reduction of the pH of the perfusion fluid to 6.8 significantly inhibited LDH loss, and at pH 6.4 this leakage was almost completely suppressed. LDH loss was equally suppressed at pH 6.4 only during Ca(2+)-depletion, whereas pH 6.4 was markedly less effective when perfused only during Ca(2+)-repletion. Ouabain (5 x 10(-6) M) had only a limited effect in exacerbating LDH leakage. Raising [K+]o significantly protected against LDH leakage, which fell to 36% at 16 mM [K+]. These features correspond with the Ca(2+)-paradox of the perfused rat heart an it is suggested that: (i) a Ca(2+)-paradox can be produced in the rat kidney; (ii) a similar mechanism governs the release of cytosolic proteins in these two preparations; and (iii) the damage mechanism of the plasmalemma is a transmembrane oxidoreductase-diaphorase molecular complex which generates H+ when activated by Ca(2+)-depletion.

The plague in Penrith, Cumbria, 1597/8: its causes, biology and consequences

Using a family reconstitution study the biology of the plague in Penrith, Cumbria in 1597/8 is described in detail; it was an explosive epidemic that spread rapidly within families and 606 individuals died of the plague, some 40% of the population. The age-specific mortality corresponded with the calculated age structure of the population and infection appeared to be random. The sex ratio of victims was 1.37 females to 1 male. The plague spread from the northeast via Richmond and then exploded in the Eden valley, appearing almost simultaneously in Penrith, Kendal and Carlisle. The details of the epidemics and the location and the climate of these widely separated small market towns show that bubonic plague was not the causative agent, and the possibility that anthrax was responsible for the drastic mortality is briefly considered. The population rapidly built up after the plague, largely by immigration and not by increased fertility, and steady-state conditions were re-established within 5 years and continued for 150 years. This severe mortality crisis of the plague had a profound effect on the population at Penrith, triggering long wavelength oscillations in both baptisms and burials in this population living under marginal conditions and maintained in steady-state by density-dependent factors.

Protective effect of lidocaine on cell damage in the perfused rat heart

The effect of lidocaine (2 mM) on cell damage in the perfused rat heart is compared in three experimental protocols: the Ca(2+)-paradox, the O2-paradox and perfusion with caffeine. Lidocaine protected against creatine kinase (CK) release when perfused throughout or only during the priming stage in all three protocols. Lidocaine also protects against CK release in the Ca(2+)-paradox when present only during Ca(2+)-reperfusion. Lidocaine protects against myofilament damage in the Ca(2+)-paradox but not in the O2-paradox and caffeine protocols, even though CK release is inhibited. Analysis of these different effects of lidocaine on the priming and full activation stages in the three protocols suggests the sequence of the underlying biochemical events of the two separate damage pathways associated with the release of cytosolic proteins and the degradation of the myofilament apparatus.

The protective effect of lowered temperature on the oxygen paradox in the rat heart

The isolated rat heart was completely protected against creatine kinase (CK) release in the standard Ca2+ or O2 paradoxes when perfused at 28 degrees C instead of 37 degrees C, as previously reported. Hearts subjected to the O2 paradox at 28 degrees C recovered normal contractile activity, and electron microscopy revealed normal, undamaged ultrastructure. The mitochondria remained contracted and showed no signs of Ca2+ uptake following a rise in Ca2+ concentration in the cytosol that would be expected following the prolonged period of anoxia. It is concluded that the rise in [Ca2+]i that results from a perturbation of Ca2+ homeostasis during anoxic perfusion in the O2 paradox is not sufficient to cause either CK release or myofilament degradation which follow only on reoxygenation in the second phase of the paradox. Since both the Ca2+ and O2 paradoxes are completely protected when the first stage is carried out at 28 degrees C, it is concluded that the initial activation of the sequence of damage events is prevented at this temperature.

Infant mortality and famine: a study in historical epidemiology in northern England

OBJECTIVE

To examine whether periodic variations in annual infant mortality were associated with malnutrition and the poor quality of the food supply available to the community.

DESIGN

Retrospective study of historical epidemiology of infant mortality by time series analysis and family reconstitution of parish registers of burials and baptisms.

SETTING

Penrith, Cumbria, England, 1557-1812.

SUBJECTS

A total of 17,500 births during 1557-1812.

RESULTS

This community in the Eden Valley, Cumbria, close to the Scottish borders, was living under marginal conditions with high mortality and low fertility. Clear oscillations in infant mortality synchronise with the oscillations in the wheat price index which is regarded as a measure of the availability of food to the community, and to pregnant and nursing mothers in particular. Input-output analysis showed that the relationship between the wheat price index (input) and infant mortality (output) was highly significant (p < 0.001). Events during the famine of 1623 have been analysed in detail: high wheat prices during pregnancy caused subsequent severe infant mortality but did not have indirect effects on the subsequent mortality of the surviving children over the age of 1 year. Non-stationary oscillations in neonatal and post neonatal mortality were strongly coherent (p < 0.001) with the wheat price index throughout the period.

CONCLUSIONS

Infant mortality is particularly sensitive to famine and also to the quality of the food supply available to pregnant and nursing mothers. The lags between neonatal and post-neonatal mortalities and wheat prices, together with the analysis of the famine of 1623, support the hypothesis that neonatal mortality was related to malnutrition in pregnancy whereas post-neonatal mortality was primarily directly dependent on exogenous causes in the first year of life.

The action of phenazine methosulphate in causing cellular damage in the isolated mouse soleus muscle preparation

Exposure of the isolated mouse soleus preparation to 1.0 mM phenazine methosulphate (PMS) caused (i) a slow and modest release of creatine kinase (CK) that was exacerbated by removal of extracellular Ca2+, (ii) a specific type of ultrastructural damage, namely a characteristic spacing of the myofibrils, (iii) swelling of the mitochondria, indicating a modest rise in [Ca2+]i, and (iv) swelling of the sarcoplasmic reticulum (SR). It is suggested that PMS (i) activates a sarcolemma oxidoreductase which synergistically interacts with raised [Ca2+]i to cause modest CK efflux and (ii) activates an oxidoreductase on the SR, thereby generating electrons which directly modify the integrity and organisation of the contractile apparatus.

Modelling the different smallpox epidemics in England

Time series analysis has revealed two different patterns of smallpox epidemics in Britain in the seventeenth and eighteenth centuries: in large conurbations (exemplified by London) the disease was endemic whereas medium-sized rural towns (exemplified by Penrith, Cumbria) suffered from 5 year epidemics with no cases of smallpox in the inter-epidemic years. The oscillations (epidemics) persisted for over 150 years and it is suggested that both systems were pumped up by regular fluctuations in susceptibility (delta beta). Modelling suggests that: (i) the natural frequency of oscillations in large cities is two years and the system is pumped up by a 1 year, seasonal input; (ii) it takes five years to build up a pool of susceptibles in medium-sized towns by new births and epidemics are then triggered by a 5 year input. The equations represent a system that has two components, a basic linear element with the remainder of the system being nonlinear; modelling a progressive increase in delta beta in London illustrates theoretically how a predominantly linear response changes to a nonlinear response and ultimately to chaos. A variation in susceptibility is a theoretical condition for inducing chaos; the undriven system cannot become chaotic. Modelling populations of progressively increasing size/density and applying a 1 year or 5 year sinusoidal oscillation in delta beta illustrates the fundamental distinction in the response of medium-sized rural towns and large cities.

Ultrastructural changes in rat kidney mitochondria in response to the oxygen- or calcium-paradox

Isolated, perfused rat kidney released lactate dehydrogenase in response to the protocol of a standard oxygen-paradox or calcium-paradox. The results are comparable to those found with rat heart. The mitochondria of the proximal tubule cells at the end of the calcium-paradox were swollen, had mitochondrial bars and were subdivided with internal septa; after the oxygen-paradox they exhibited, in addition, many myelin figures. Such ultrastructural changes were characteristic of the mitochondria of skeletal and cardiac muscles damaged by a rise in [Ca2+]i. It is concluded (i) that typical calcium- and oxygen-paradoxes can be produced in kidney, (ii) that these are associated with a rise in [Ca2+]i and (iii) the proximal tubules, in particular, are damaged.

Are oxygen radicals implicated in the calcium paradox of the rat heart?

No reduction in creatine kinase (CK) release during standard Ca2+ paradox in the Langendorff-perfused rat heart was afforded by anoxic perfusion, nor by addition of the radical scavengers superoxide dismutase (150,000 U/L), catalase (150,000 U/L), mannitol (15 or 50 mM), dimethylthiourea (DMTU, 10 mM), the antioxidant vitamin E (0.25 or 0.75 mM), or the iron chelator desferrioxamine (0.8 mM). Even under mild Ca(2+)-paradox conditions, achieved by (a) reducing the duration of the Ca(2+)-free period, (b) increasing [Ca2+]0 during the "Ca(2+)-free" period, or (c) reperfusing with 0.1 mM Ca2+, no protection was achieved by mannitol, DMTU, or desferrioxamine. Perfusion with N2 did not cause a reduction in CK release caused by caffeine or dinitrophenol or Ca2+ paradox. We conclude that no evidence supports the hypothesis that oxygen radicals are implicated in release of CK in Ca2+ paradox.

The dynamics of smallpox epidemics in Britain, 1550–1800

Time-series analysis, a valuable tool in studying population dynamics, has been used to determine the periodicity of smallpox epidemics during the seventeenth and eighteenth centuries in two contrasting representative situations: 1) London, a large city where smallpox was endemic, and 2) Penrith, a small rural town. The interepidemic period was found to be two years in London and five years in Penrith. Equations governing the dynamics of epidemics predict 1) a two-year periodicity and 2) that oscillatory epidemics die out quickly. It is suggested that epidemics were maintained by a periodic variation in susceptibility linked either to a five-year cycle of malnutrition or to an annual cycle. Computer modeling shows how the very different patterns of epidemics are related to population size and to the magnitude of the oscillation in susceptibility.

Biochemical pathways of cell damage during the oxygen paradox of the rat heart

1. The standard O2-paradox has been studied in the Langendorff-perfused rat heart. 2. Perfusion of glucose-free saline under anoxia did not cause release of creatine kinase (CK) although, it is suggested, there was a progressive rise in [Ca2+]i. 3. Ca(2+)-depletion after anoxia caused CK release. 4. Prolonged anoxic perfusion (55 min) produced a markedly reduced release of CK on Ca(2+)-depletion because, it is suggested, of the reduction in substrates for the release mechanism. 5. No protection against the O2-paradox was found with oxygen radical scavengers and inhibitors. 6. Lowering [Ca2+]o during reoxygenation to 0.1 mM did not reduce CK release. 7. Neither 1 mM amiloride (Na+/H+ antiporter inhibitor) nor 2 x 10(-6) M 1-(5-isoquinolinesulphonyl) piperazine (protein kinase C inhibitor) reduced CK release, unlike their effects in the Ca(2+)-paradox. 8. An hypothesis for events in the O2-paradox in presented: anoxia causes a loss of Ca(2+)-homeostasis and a rise in [Ca2+]i thereby activating a transmembrane NAD(P) oxido-reductase/diaphorase (stage 1); the return of O2 synergistically activates this molecular complex and causes CK release (stage 2).

The dynamics of smallpox epidemics in Britain, 1550-1800

Time-series analysis, a valuable tool in studying population dynamics, has been used to determine the periodicity of smallpox epidemics during the seventeenth and eighteenth centuries in two contrasting representative situations: 1) London, a large city where smallpox was endemic, and 2) Penrith, a small rural town. The interepidemic period was found to be two years in London and five years in Penrith. Equations governing the dynamics of epidemics predict 1) a two-year periodicity and 2) that oscillatory epidemics die out quickly. It is suggested that epidemics were maintained by a periodic variation in susceptibility linked either to a five-year cycle of malnutrition or to an annual cycle. Computer modeling shows how the very different patterns of epidemics are related to population size and to the magnitude of the oscillation in susceptibility.

Does the protein kinase C pathway modulate sarcolemma damage and the release of cytosolic proteins in the rat heart?

1. The release of creatine kinase (CK) in the Langendorff-perfused rat heart during the Ca(2+)-paradox, was critically dependent on the duration and [Ca2+]o of the initial Ca(2+)-depletion phase. 2. When [Ca2+]i was raised by perfusion with caffeine or under N2, activation of the protein kinase C pathway (PKC) produced a small but significant release of CK. PKC stimulation is therefore able to substitute for the Cao(2+)-depletion of the Ca(2+)-paradox. 3. The PKC inhibitor, 1-(5-isoquinolinyl sulphonyl)-2-methyl piperazine, (2 x 10(-6) M) inhibited both the Ca(2+)-paradox and caffeine-induced release of CK. 4. It is concluded that the PKC pathway has a regulatory role for the damage system of the sarcolemma that is responsible for the release of cytosolic proteins.

Cellular damage in the rat heart caused by caffeine or dinitrophenol

1. Langendorff-perfusion of rat hearts with either 10 mM caffeine or 1 mM 2,4-dinitrophenol (DNP) caused severe ultrastructural damage to the myofilaments and mitochondria that was similar to that found in a standard Ca(2+)-paradox. 2. This damage occurred in the presence and absence of extracellular Ca2+. 3. Creatine kinase (CK) release (indicative of sarcolemma breakdown) was not recorded unless the caffeine- or DNP-perfusion was preceded by Ca(2+)0-depletion. 4. It is concluded that: (i) the pathways leading to damage to the myofilaments and sarcolemma are independent; (ii) the CK release mechanism requires dual activation of Ca(2+)0-depletion plus a rise in [Ca2+]i; and (iii) current theories concerning the mechanisms underlying the genesis of the Ca(2+)-paradox are incorrect or incomplete.

An hypothesis for the periodicity of smallpox epidemics as revealed by time series analysis

Parish registers have been studied by time series analysis to detect smallpox epidemics in England during 1600-1800. Confirmatory evidence was provided by the seasonality of child mortality. A 5-year cycle in smallpox epidemics was detected in medium-sized, rural towns. Consideration of the mathematics of the dynamics of viral diseases suggests that the true interepidemic period where smallpox is endemic should be 2-3 years and it is concluded that, in the towns studied, the disease was not endemic but that the oscillations were established by 5-year cycles of periods of famine associated with high wheat prices. The cross-correlation function between the two cycles shows zero lag and the input-output function shows significant coherence. Another epidemic follows only when a sufficient density of susceptibles has been established by births, so that the cycles become phase-locked. It is predicted that smallpox (i) was endemic in London and other large cities, with 2-3 year epidemics, (ii) was epidemic with a 5-year oscillation in rural towns, (iii) did not reach epidemic proportions in scattered communities.

Interaction of H2O2 and dithiothreitol and the genesis of cellular damage in the perfused rat heart

1. H2O2 (0.3 mM) causes release of creatine kinase (CK) from the perfused rat heart, but only when activated by removal of extracellular Ca2+. 2. Dithiothreitol (DTT), 2 mM, provides partial protection against this damage induced by artificially-introduced O2 radicals. 3. Paradoxically, DTT triggers CK release by H2O2 in the presence of extracellular Ca2+. The interaction of these agents in stimulating and protecting against this damage to the sarcolemma is discussed.

Fra(X) prenatal diagnosis: are endoreduplicated and polyploid cells useful diagnostic criteria?

Cytogenetic and molecular protocols for prenatal ascertainment of the fragile X syndrome and the associated fragile site at Xq27.3 are relatively reliable. Any new diagnostic method which becomes available still elicits much interest. Kimchi-Sarfaty et al. [1991] reported an increase in frequency of endoreduplication and polyploidy in fra(X) lymphoblasts and amniocytes when cultured with methotrexate (MTX) or fluorodeoxyuridine. Recently we analyzed the endoreduplication/polyploidy system using amniotic fluid, chorionic villus, and fibroblasts from fra(X) positive abortus cell cultures and from control samples. We observed no increased expression of endoreduplicated or polyploid cells in fra(X) positive amniocytes after exposure to MTX. The data presented here clearly dispute the value of endoreduplication/polyploid scoring as a diagnostic aid in prenatal fra(X) analysis.

Dialyzed fetal bovine serum increases cytogenetic fragile X expression

Short-term whole blood cultures from 9 unrelated male individuals with the fragile X [fra(X)] syndrome were exposed to 5-fluorodeoxyuridine (FUdR). The fra(X) frequency was higher in 8 of 9 cases where the complete medium contained dialyzed fetal bovine serum (DFBS). In 3 of the cases, the fra(X) frequency nearly tripled (e.g., 12/100 to 33/100) while in 2 others, it nearly doubled (e.g., 15/100 to 29/100). When DFBS cultures from 2 other fra(X) individuals were exposed to increasing folic acid concentrations ranging from 2 to 4,000 x 10(-6) M, there was virtually no change in fra(X) expression. In 6 of 9 DFBS cultures, the mitotic index decreased, and it increased in 3. Therefore, although the fra(X) frequency increased, in most DFBS cultures the mitotic index decreased. Whether the reduction in mitotic index indicates an inverse correlation between reduced mitotic index and increased fra(X) expression, at least in cultures from some individuals, will be determined by additional studies.

IN CONCLUSION

(1) medium supplementation with dialyzed fetal bovine serum should be considered when using FUdR for fra(X) identification in order to avoid potentially false negative results; (2) there appears to be no direct correlation between increased mitotic index and increased fra(X) expression in whole blood cultures; (3) increased folic acid concentrations do not affect fra(X) expression when FUdR fra(X) induction is employed; therefore requesting people to refrain from taking vitamins, including folic acid, before fra(X) testing (a practice that still persists in some places) appears unnecessary.

Fra(X)(q27.2), the common fragile site, observed in only one of 760 cases studied for the fragile X syndrome

Cell cultures from 760 whole blood, amniotic fluid, chorionic villus sample, and peripheral umbilical blood sample specimens were exposed to multiple fra(X)(q27.3) induction systems (none had aphidicolin). Fifty-three exhibited the rare fragile site, fra(X)(q27.3) or FRAXA, none of which demonstrated the common fragile site or FRAXD at band Xq27.2. Only one cell in one of the negative whole blood FUdR-treated cultures from a mentally retarded male showed FRAXD. Therefore, it appears that FRAXD occurs very rarely in cultures treated to induce FRAXA since only one positive cell was observed in over 88,000 analyzed. It appears that very low frequencies of fra(X)(q27) can be accounted for only in part by the presence of the common fragile site since only one of 9 cases, each with one fra(X)(q27) positive cell, exhibited FRAXD and the others were FRAXA. After confirmation of FRAXA with direct DNA testing in a large number of low frequency cases, it should be possible to rely on the detection of very low frequencies of fra(X)(q27.3), e.g., 1% with at least 2 positive cells.

SV40-transformed fragile (X) amniocytes

We report SV-40 transformation of female and male fragile X [fra(X)] amniocytes. In the transformants, fra(X) (q27.3) was detected in the 7th passage (9 cell generations) in fra(X) female amniocytes. It was conserved until at least the 20th passage (42 cell generations) although the frequency was reduced or became difficult to detect due to karyotypic evolution in the later generations. Similarly, for the male fra(X) amniocyte line, fra(X) was demonstrated at the 2nd passage (3 cell generations) and persisted until at least the 13th passage (29 cell generations). The prolonged period of reproductive potential of these transformed lines ranging from at least 29-42 generations suggests that the cryopreservation of significant quantities of early passage fra(X) transformed amniocytes will assure a reliable and continuous supply of positive control cells. These lines may be used for fra(X) prenatal diagnostic studies thereby improving the ability to quality control the particular fra(X) induction system being used.