Effect of ethanol on liver antioxidant defense systems: Adose dependent study

Alcohol induced oxidative stress is linked to the metabolism of ethanol. In this study it has been observed that administration of ethanol in lower concentration caused gain in body and liver weight. while higher concentration of ethanol caused lesser gain in body and liver weight. Ethanol treatment enhanced lipid peroxidation significantly, depletion in levels of hepatic glutathione and ascorbate, accompanied by a decline in the activities of glutathione peroxidase and glutathione reductase, and increased in hepatic glutathione s-transferase activity. Interestingly catalase activity increases in lower concentration of ethanol exposure, and decreased in higher concentration. Superoxide dismutase activity was also increased on ethanol exposure. But, ethanol feeding did not show any effect on glucose-6-phosphate dehydrogenase activity. Ethanol ingestion perturbs the antioxidant system in a dose and time dependent manner.

Biochemical diagnosis of alcoholism

Medically diagnosed alcoholics can be differentiated reliably from non-alcoholics using clinically laboratory tests. In the present study, patients with liver diseases either due to alcohol or without alcohol compared with a group of normal healthy persons. Heavy drinkers showed significantly lower body weight and percent body fat, and low BMI compared with other groups. The percentage of hemoglobin and total number of RBC were found to be significantly decreased, whereas mean corpuscular volume (MCV) significantly increased in alcoholic liver disease (ALD). Hyperbilirubinemia, hyperuricemia and hypoalbuminemia correlate with alcohol intake. Albumin/globulin ratio significantly decreased in ALD. In acute liver injury AST/ALT ratio is ≤1.0, whereas in alcoholic hepatitis it is always >1.0. Moderately elevated level of ALP and high GGT values are good discriminator of alcoholic patients. Alcohol-induced liver injury is linked to oxidative stress as observed by decreased level of reduced glutathione and ascorbic acid, and increased level of thiobarbituric acid reactive substances.

Inhibition of lipid peroxidation by botanical extracts of Ocimum sanctum: In vivo and in vitro studies

Ocimum sanctum, the Indian holy basil, has significant ability to scavenge highly reactive free radicals. Shade dried leaf powder of the plant was extracted with water and alcohol, and then fractionated with different solvents. Both extracts and their fractions have in vitro anti-lipidperoxidative activity at very low concentrations. In vivo, hypercholesterolemia-induced erythrocyte lipid peroxidation activity was inhibited by aqueous extracts of Ocimum in a dose-dependent manner in male albino rabbits. Aqueous extract feeding also provided significant liver and aortic tissue protection from hypercholesterolemia-induced peroxidative damage.

Should we use carbohydrate deficient transferrin as a marker for alcohol abusers?

Carbohydrate deficient transferrin (CDT) is one of the conventional markers for chronic alcohol consumption, is used by researchers and clinicians. A number of enzymes are affected by ethanol intake. The induction or inhibition of sialyl transferase and plasma sialidase may be involved in the CDT level elevation. An alteration of protein transport during post-translational modification could be a primary mechanism in the impairment of protein metabolism associated with chronic alcohol abuse. Transferrin being a steroid responsive protein, sex-based hormonal variations might contribute to the lower sensitivity of CDT. Varying hormonal statuses such as pregnancy, use of contraceptives, menopause/ menstrual cycle can alter iron homeostasis in women. CDT levels are markedly affected by iron homeostasis. Several CDT assay methods appeared promising, but it is not readily apparent which technique is the most accurate. Moreover, false-positive results of CDT have been reported in non-alcohol related hepatic failure and in rare conditions. Therefore clinical interpretation of CDT needs careful assessment in patients with alcohol-related or non-alcohol-related health disorders.

p53 expression in oral cancer: observations of a South Indian study

Oral cancers constitute a significant proportion of hospital admissions among cancer patients in India. The aim of this study was to elucidate the role of tumour suppressor gene p53 in the pathogenesis of oral squamous cell carcinoma by immunohistochemistry. Though extensive studies on p53 alterations in oral cancers have been done in Western countries and some Asian countries, only a few studies have emerged from India, especially the Southern states. This study would therefore be helpful in providing an Indian perspective, with particular reference to South Indian states. A total of 110 cases of oral squamous cell carcinoma, 35 dysplastic lesions, 15 hyperplastic lesions, and 50 samples of normal mucosa were assessed for p53 expression. Out of 110 cases of oral carcinoma, 40 (36%) were p53 positive. Among 35 cases of dysplastic lesions studied, 6 (17%) showed p53 positive staining. None of the hyperplastic lesions and normal oral lesions showed any evidence of p53 positivity. However, in 9 out of 40 (23%) cases of positive infiltrating squamous cell carcinomas, the adjacent or overlying non-tumourous epithelium demonstrated focal areas of p53 positive staining in the basal and parabasal layers of the epithelium. In addition, in 7 out of 110 (6%) cases, cytoplasmic staining was observed. In these samples, nuclei were not stained. Our results indicate that p53 over-expression may be involved in only a certain proportion of oral carcinomas. The fact that 6% of the dysplastic lesions were p53 positive, and adjacent non-tumourous epithelium of 23% infiltrating squamous cell carcinomas showed positive staining for p53 in the progenitor compartment of the epithelium indicates that p53 immunoreactivity could be used to detect early tumours as well.

Biochemical markers for alcohol consumption

A variety of laboratory tests are available to assist in the diagnosis of alcohol consumption and related disorders. The levels of intake at which laboratory results become abnormal vary from person to person. Laboratory tests are particularly useful in settings where cooperativeness is suspected or when a history is not available. Several biochemical and hematological tests, such as γ-glutamyltransferase (GGT) activity, aspartate aminotransferase (AST) activity, high-density lipoprotein cholesterol (HDL-C) content of serum, and erythrocyte mean corpuscular volume (MCV) are established markers of alcohol intake. Their validity as markers is based largely on correlations with recent intake at a single time point and on decreases in elevated values when heavy drinkers abstain from alcohol. These readily available laboratory tests provide important prognostic information and should be integral part of the assessment of persons with hazardous alcohol consumption. There are several other markers with considerable potential for more accurate reflection of recent alcohol intake. These include carbohydrate deficient transferrin, β-hexosaminidase, acetaldehyde adducts and the urinary ratio of serotonin metabolites, 5-hydroxytryptophol and 5-hydroxyindoleacetic acid. These markers provide hope for more sensitive and specific aids to diagnosis and improved monitoring for intake.

Possible role of Granulocyte Macrophage Colony Stimulating Factor receptor (GM-CSF R) in malaria

Malaria has been reportedly increasing in incidence on the globe. Evidence from clinical studies supports a role for cytokines in the pathogenesis of cerebral malaria. Given the stimulatory effect of the ligand GM-CSF on the synthesis and release of the pyrogenic cytokine TNF alpha, the present study has been undertaken to investigate a possible role of GMCSF receptor in the pathogenesis of both Plasmodium vivax and Plasmodium falciparum malaria. An enzyme immunoassay developed by us at our laboratory for the quantitation of GM-CSF receptor has been used. No changes in the concentration of the receptor have been indicated either at the time of diagnosis or after treatment. In addition, an intercomparison of the receptor concentration between the P. vivax and P. falciparum groups does not show any significant difference. The results suggest that GM-CSF receptor has no significant role in the pathogenesis of either type of malaria.

Activity of Ocimum sanctum (the traditional Indian medicinal plant) against the enteric pathogens

Aqueous & alcoholic extracts of O. sanctum were prepared. Two concentrations of these extracts (30 mg & 60 mg) were tried against the enteric pathogens & candida albicans by Agar diffusion method. Wide zones of inhibition were observed at 60 mg concentration of extract. Aqeous extract showed wider zone of inhibition when compared to alcoholic extract. Aqueous extract showed wider zones of inhibition for Klebisella, E. Coil, Proteus & Staphylococcus aureus. Alcoholic extract showed wider zone for vibrio cholerae.

Evaluation of serum glycoproteins in oral carcinoma

The present study was conducted on thirty untreated oral cancer patients proved by clinical and histopathological evidence and thirty healthy control subjects. The levels of glycoprotein-associated carbohydrates such as hexose, hexosamine, fucose and sialic acid were found to be elevated significantly as compared to control subjects. There was a progressive rise in these markers as the stages of oral cancer advanced.

Enhancement of myeloperoxidase activity in WBCS in oral cancer patients treated with Granulocyte Macrophage Colony Stimulating Factor (GM-CSF)-A pilot study

In a pilot study with five oral cancer patients undergoing radiotherapy (RT) three were given Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) as a protective agent to reduce the mucosal inflammation during radiotherapy. The myeloperoxidase (MPO) enzyme activity in WBC was quantitated. The three patients showed a significant increase in the MPO activity when compared with two untreated controls indicating the efficacy of GM-CSF as a protective agent. It is suggested that further detailed studies with larger number of patients would be useful.

Viruses in human oral cancers

The role of viruses in the etiology of human oral cancer is critically reviewed. Available evidences show a positive correlation for human oral cancer with human papilloma virus (HPV), herpes simplex virus (HSV) and human herpes virus type-6 (HHV-6), having strongest association with HPV. These viruses may act alone or in combination with other carcinogens in the genesis of head and neck malignancies.

Defective interleukin-2 R gene expression in gastric carcinoma patients

Peripheral blood T lymphocytes from 15 patients with gastric carcinoma and 6 normal healthy controls were evaluated for Interleukin-2 R gene expression. Total RNA was extracted from T cell-enriched fractions of patients as well as from control peripheral blood lymphocytes, with or without mitogenic stimulation. The presence of mRNA for IL-2 R alpha evaluated by Northern blot analysis revealed that unstimulated T cells expressed lower levels of IL-2 R mRNA than PHA stimulated T cells. Expression of both IL-2 R alpha transcripts (3.5 and 1.5 Kb) were either not detectable or only weakly detectable on T lymphocytes from patients even after mitogenic stimulation. In contrast, a significant rise in the expression of both IL-2 R alpha transcripts was observed on T cells from normal controls followed by mitogenic challenge. This paper reports on the defective IL-2 R alpha gene expression in gastric carcinoma patients, which may explain one of the causes of immunodeficiency associated with neoplastic transformation and progression.

Augmentation of murine natural killer cell and antibody dependent cellular cytotoxicity activities by Phyllanthus emblica, a new immunomodulator

When administered orally, Phyllanthus emblica, an excellent source of vitamin C (ascorbate), has been found to enhance natural killer (NK) cell activity and antibody dependent cellular cytotoxicity (ADCC) in syngeneic BALB/c mice, bearing Dalton's lymphoma ascites (DLA) tumor. P. emblica elicited a 2-fold increase in splenic NK cell activity on day 3 post tumor inoculation. Enhanced activity was highly significant on days 3, 5, 7 and 9 after tumor inoculation with respect to the untreated tumor bearing control. A significant enhancement in ADCC was documented on days 3, 7, 9, 11 and 13 in drug treated mice as compared to the control. An increase in life span (ILS) of 35% was recorded in tumor bearing mice treated with P. emblica. This increased survival was completely abrogated when NK cell and killer (K) cell activities were depleted either by cyclophosphamide or anti-asialo-GM1 antibody treatment. These results indicate: (a) an absolute requirement for a functional NK cell or K cell population in order that P. emblica can exert its effect on tumor bearing animals, and (b) the antitumor activity of P. emblica is mediated primarily through the ability of the drug to augment natural cell mediated cytotoxicity.

WR-1065 as a chemoprotector in Adriamycin chemotherapy

The protective effect of WR-1065 against the side effects of Adriamycin was studied in tumor bearing mice. It has been noticed that WR-1065 pretreatment improved the Adriamycin toxicities such as increased enzyme levels, pathological lesions in lung, liver and heart and increased rate of lipid peroxidation, without reducing its anticancer property.

Prognostic significance of karyotype analysis in children with acute lymphoblastic leukemia

Chromosome studies, using bone marrow samples of 26 pretreated children (below 15 years of age) with Acute Lymphoblastic Leukemia were carried out to explore the potentialities of applying chromosomal findings as a prognostic indicator in these patients. Abnormal karyotype was identified in 15 patients (57.6 per cent). The chromosomes frequently involved in non-random numerical abnormalities were Nos. 8, 18 and 21. Structural chromosome changes observed consisted of deletion 6q- and translocation t (4;11). After karyotype analysis, patients were grouped into subsets on the basis of the karyotype pattern observed. They were followed up to evaluate their prognosis and survival period. Patients showing hyperdiploid clone with greater than 51 chromosomes had the best prognosis. Patients with normal karyotype and patients with deletion of the long arm of chromosome 6 showed intermediate prognosis whereas patients showing t (4;11), trisomy 8, trisomy 18, trisomy 21, and hypodiploid karyotype were associated with worst prognosis. Thus, karyotype analysis before treatment helps to classify ALL patients as poor, intermediate and good prognosis groups and on this basis therapy can be designed accordingly.

Ackerman's tumour (Verrucous carcinoma) of the oral cavity: a histopathologic study of 426 cases

Salient histopathological features of four hundred and twenty six (426) cases of verrucous carcinoma of the oral cavity reported jointly by the Department of Oral Pathology, Dental College and Department of Pathology, Medical College, Trivandrum, during the period from January 1975 to December 1984 were evaluated. They constituted 5.27% of 7,988 primary malignant neoplasms of the oral cavity detected during the period. Locally aggressive behaviour with bone, muscle and salivary gland invasion occurred in 53% of cases. Examination of the neighbouring areas of the lesion, which showed some light on the natural evolution of the disease, is described. The gradual transformation of a hyperplastic verrucous lesion into carcinoma is appraised. Evidence suggestive of a distant metastatic spread of the tumour could not be detected.

Presence of a receptor for the active component of Iscador in ascites fluid of tumour bearing mice

Tumour bearing mice exhibit a specific "receptor" in the ascites fluid which binds with the active component isolated from Iscador. This "receptor" was found to be a protein which inhibited the cytotoxicity of Iscador and its isolated active component at low concentration. The receptor protein was also found in the sonicates of tumour cells which are susceptible to the action of Iscador but not in lymphocytes which were not susceptible to Iscador or its isolated active component. The receptor was separated on a Sephadex G-50 column. Activity was lost upon heat denaturation and dialysis.

An alternative pathogenetic pathway for oral submucous fibrosis (OSMF)

Oral submucous fibrosis is a potent pre-cancerous condition which occurs almost exclusively in Indians but cases have been reported from several countries. The definite aetiology of OSMF is still unknown and there is no known treatment for it. Chilles, tobacco use, vitamin deficiencies and betel quid chewing have been implicated. Ramanathan is of the view that OSMF seems to be the Asian version of sideropenic dysphagia. He suggests that OSMF appears to be an altered oral mucosa following prolonged period of chronic deficiency of iron and/or vitamin "B" complex especially folic acid. This changed state of the oral mucosa subsequently appears to develop more easily a hypersensitivity to oral irritants such as spices especially chillies and to the betel quid. We hold that the hypersensitivity caused by local irritants and the resultant persistent juxta epithelial inflammatory response noted in OSMF (in a host system already primed by an intrinsic genetic defect) act as the initiating factor leading to a defective inflammatory--reparative response, culminating in fibrotic healing. The role of iron and "B"complex together with others may be contributory (promotor) to this pre-existing pathologic response of the lamina propria.

Jack fruit lectin binding pattern in benign and malignant lesions of the breast

N-acetyl D-galactosamine specific lectin was isolated from Jack fruit (Artocarpus integrifolia) and conjugated to horse radish peroxidase type VI. The purified conjugate was used for the study of tissue binding properties on benign and malignant lesions of the breast using diaminobenzidine as substrate on dewaxed tissue sections. Forty mammary carcinomas, 10 cystic hyperplasias of the breast and 10 normal breast tissues were used for the study. Neoplastic cells showed increased affinity to the lectin. The lectin binding was focally strong in neoplastic cells compared to the normal as well as the hyperplastic tissues. The stroma of the cancer tissues showed an intense strong binding where elastosis was present. The use of the lectin as a histochemical reagent is discussed.

Isolation and identification of a tumour reducing component from mistletoe extract (Iscador)

Using a combination of gel filtration and paper chromatography, a tumour reducing component from mistletoe extract (Iscador) was isolated and identified to be a peptide of approximate molecular weight 5000. The isolated peptide reduced the solid tumour induced by Dalton's lymphoma ascites tumour cells (DLA cells) in mice. The isolated component was very cytotoxic to the DLA cells but was not cytotoxic to normal lymphocytes, indicating a cell dependent specificity.

Preliminary studies on the immunopotentiating action of some ayurvedic preparations

Ten healthy controls, 9 Rheumatoid Arthritis patients and 5 cancer patients were studied for T and B cells in peripheral circulation. T cell count in cancer patients showed a slight enhancement after receiving Ayurvedic Treatment; but the B cell count remained the same. In Rheumatoid Arthritis patients no significant change was noticed either in T cell or cell count.

Serum immunoglobulins in patients with carcinoma of the oral cavity, uterine cervix and breast

Serum immunoglobulin levels (IgG, IgA, IgM, IgD and IgE) were estimated in 196 patients with carcinoma of the oral cavity, 172 patients with cervical cancer and 166 patients with breast cancer. The values were compared with those of 50 patients with benign lesions of the breast and cervix and 100 healthy adult controls. Only the serum IgE levels were found to be elevated in the benign group. Serum IgA, IgD and IgE levels were found to be elevated in all the three types of cancers and the levels were found to increase with clinical stage. In carcinoma of uterine cervix IgG levels were also found to be elevated. Immunoglobulins A and D returned to normal after clinical cure whereas IgE remained slightly elevated. IgD and IgE remained high in patients who had residual cancer.

High affinity rosette forming cells in carcinoma of the oral cavity, uterine cervix and breast

Total rosette forming cells (TRFC) and high affinity rosette forming cells (HARFC) were enumerated in 534 patients with carcinoma of oral cavity, uterine cervix or breast, and the results were compared with adult controls. The HARFC levels were found to be significantly decreased in cancer patients, and this decrease was more pronounced in advanced clinical stages. The HARFC levels returned to normal in patients who had a clinical cure but remained low in patients having residual disease. Enumeration of HARFC may therefore be useful in assessing the cell mediated immunity in cancer patients.

Leucocyte adherence inhibition assay (LAI) in cancer of the oral cavity

Antitumor immunity to oral cancer was assessed in 46 patients suffering from squamous cell carcinoma of the oral cavity using a leucocyte adherence inhibition assay (LAI). The response shown by the leucocytes of oral cancer patients to the oral cancer antigen was compared to that shown by the leucocytes from 10 normal age- and sex-matched healthy controls and 43 patients suffering from other types of cancers. Seventy-six percent of the oral cancer patients showed a high degree of leucocyte adherence inhibition in the presence of the antigen. The specificity of this test was further assessed using combinations of the leucocytes from oral cancer patients with extracts from seven cancers occurring at various other sites and extracts of normal oral tissue. The test was highly specific and the leucocytes of oral cancer patients showed significant inhibition only in the presence of oral cancer extract. The inhibition was between 0 and 30% with most other cancer extracts except in the case of extract from cancer of the cervix, where 4/10 patients showed above 30% inhibition. Specific blocking of the LAI response was observed on addition of sera from oral cancer patients to leucocyte-antigen mixtures from oral cancer patients. This effect was not observed on addition of these sera to specific leucocyte-antigen mixtures from other cancer patients. These observations point towards the usefulness of this test in monitoring antitumor immunity in oral cancer patients.

Quantitation of Fc receptor-bearing T-lymphocytes (TG and TM) in oral cancer

The lymphocytes from the peripheral blood of 30 untreated patients with oral cancer and 15 apparently healthy normal controls were studied for quantitation of T-cell subsets. When compared to age-matched controls, the patients as a group showed a significant increase in the proportion and number of TG cells (IgG Fc receptor-bearing T-cells) and a significant reduction in the TM cells (IgM Fc-bearing T-cells). The levels of total lymphocytes, T-cells, and B-cells remained in the control range. The discrepancy in the TG subset was evident in the early stages of the disease, while in TM cells, it was evident only in the advanced stages.

Abnormal Cutaneous Response to Mosquito Bites in Cancer Patients

A skin eruption simulating 'papular urticaria' was observed in 6% of 500 patients with cancer. Twenty seven of them had carcinoma affecting different organs, while 3 had lymphoma. Direct observation revealed that the skin lesions were the result of bites by the mosqmtoes. There was direct correlation between mosquito bite reaction and the response to iadermal tests with mosquito antigen , (MSA). The leucocytee migration inhibition test usmg MSA revealed the existence of cell mediated immunity to MSA in these patients with 'papular urticaria'. Specific treatment for malignancy apparently influenced the pattern of reaction to ID test as well as to mosquito bites. The histopathologic studies revealed non-- specific changes in the delayed papules after mosquito bites. The MAS test papules closely simulated morphologically and histologically, te delayed papules of mospuito bites. None of the 12 attendants of cancer patients who were exposed to similar environment as that of cancer patient, while in the ward or at home, developed similar reaction either to MSA or to direct mosquito bite. None of the healthy volunteers or patients with diseases other than cancer, developed similar reaction either to MSA or to direct bites by mosquities. The role of irradiation and malignancy in the abolition of 'Suppressor T cell" activity in the aetiology of these skin eruptions is discussed.

Renal involvement in leprosy

Renal involvement in 13 non-lepromatous and 17 lepromatous leprosy patients were assessed by routine urinalysis, detailed biochemical analysis of blood and urine and by renal histopathological studies and compared with 10 normal healthy controls. The presence of RBC and pus cells were detected in the urinary deposit of only one lepromatous leprosy patient in reactional phase. A reversal of albumin/globulin ratio was observed in 17.6% of non-lepromatous and 15.3% of lepromatous patients. 24 hours urinary excretion of sodium, potassium, chloride and aminonitrogen of the patients were within the normal range. Forth seven percent of the non-lepromatous and 46% of the lepromatous patients had proteinuria. Even though the mean serum creatinine values of the patients showed no difference from that of the normals, the creatinine clearance was low in 82.3% of the non-lepromatous and in all of the lepromatous patients. Serum phosphorus, serum uric acid, urinary phosphate excretion and the renal tubular reabsorption of phosphorus of the patients were normal. Twenty one percutaneous renal biopsy specimens showed nonspecific pathological changes such as nephritis of various varieties in 71.4% of the specimens. Among the lepromatous group renal involvement was observed in 5 out of 9 cases (55.6%) and in the non-lepromatous group 10 out of 12 cases (83.3%). No acid fast bacilli, amyloid and granuloma were seen in any of the renal tissues studied. There was no definite correlation between the type of renal pathology and biochemical changes. None of the patient showed any clinical evidence of renal involvement.

Liver in leprosy--I. Functional changes

Liver function tests were carried out in 79 leprosy patients, out of which 28 patients were being treated and 42 patients were not receiving any treatment. The rest 9 patients were clinically quiescent. In the untreated group there were 28 tuberculoid and 14 lepromatus cases. The 28 patients receiving treatment were composed of equal number of lepromatus and tuberculoid groups. The liver function tests of 10 of the untreated tuberculoid patients were repeated after six months of specific therapy with D.D.S. The values of liver function tests of these patients were compared with that of 20 normal adults. The most important abnormality observed in the patients were a reversal of albumin/globulins ratio which was more common in the lepromatus group than in the tuberculoid group. Treatment with D.D.S. has resulted in the reduction of the serum globulin. There were no changes in transaminases and alkaline phosphatase activities in the untreated patients. But however a rise in the above enzymes were observed in patients on treatment. The mean serum cholesterol values of the patients were lower than that of the controls.