In vitro exposure of human osteoarthritic chondrocytes to ELF fields and new therapeutic application of musically modulated electromagnetic fields: biological evidence

Osteoarthritis (OA) is the most frequently occurring rheumatic disease, caused by metabolic changes in chondrocytes, the cells that maintain cartilage. Treatment with electromagnetic fields (MF) produces benefits in patients affected by this pathology. Isolated human osteoarthritic (OA) chondrocytes were cultured in vitro under standard conditions or stimulated with IL-1beta or IGF-1, to mimic the imbalance between chondroformation and chondroresorption processes observed in OA cartilage in vivo. The cells were exposed for a specific time to extremely low frequency (ELF; 100-Hz) electromagnetic fields and to the Therapeutic Application of Musically Modulated Electromagnetic Fields (TAMMEF), which are characterized by variable frequencies, intensities, and waveforms. Using flow cytometry, we tested the effects of the different types of exposure on chondrocyte metabolism. The exposure of the cells to both systems enhances cell proliferation, does not generate reactive oxygen species, does not cause glutathione depletion or changes in mitochondrial transmembrane potential and does not induce apoptosis. This study presents scientific support to the fact that MF could influence OA chondrocytes from different points of view (viability, ROS production and apoptosis). We can conclude that both ELF and TAMMEF systems could be recommended for OA therapy and represent a valid non-pharmacological approach to the treatment of this pathology.

Preliminary study of gene expression levels in human T-cells exposed to cosmic radiations

Several experiments demonstrated the influence of microgravity on mitogenic activation of T cells at molecular level. To discriminate between effects of microgravity and cosmic radiations, in this work we studied the effects of high cosmic radiations on the genetic expression in human T cells boarded in a stratospheric balloon (BIRBA-1 mission, 22 hours of flight). The genetic expression was analyzed by the cDNA microarray hybridization technology, which allows the comparative and simultaneous estimate of hundreds of mRNAs Activated cells react to the ionizing stress by activating genes involved in cell cycle check-point, oxidative stress response, heat shock proteins production or by repressing genes involved in antigen recognition.

The sardinian autoimmunity study. 4. Thyroid and islet cell autoantibodies in sardinian pregnant women at delivery: a cross-sectional study

A high incidence of autoimmune Type 1 diabetes mellitus (DM) has been clearly established in Sardinia. Although systematic epidemiological studies are still not available, an increased prevalence of thyroid autoantibodies (ATA) has been documented in the Sardinian adult population as compared to other Italian regions, suggesting that thyroid autoimmune disease may also have increased. We carried out a preliminary study with the aim of determining the prevalence of serological markers of thyroid (anti-thyroperoxydase antibodies, TPOAb) and islet cell (ICA) autoimmunity in a large number (no.=2249) of sera obtained from cord-blood of Sardinian pregnant women at delivery. The prevalence of TPOAb was 11.9%, while ICA were detected in 59 cases (2.6%). A higher prevalence of TPOAb (6/17=35.3%) was found in sera with high ICA titers (> or = 20 JDF-U), as compared to sera with low ICA titers (5-19 JDF-U) and to ICA-negative sera (3/42=7,1%; chi2=5.4, p=0.02 and 258/2190=11,8%; chi2=6.8, p=0.009 respectively). Fourteen women (all ICA-negative) were diabetic: 4 had Type 1 and 10 had gestational DM; due to the low number, no correlation could be established between DM type and TPOAb prevalence and/or titer. These preliminary data indicate that ATA are frequently observed in the general population of Sardinian pregnant women at term. As a consequence, even the frequency of postpartum thyroiditis is expected to be high. Although ATA were not increased in women with clinical overt diabetes, a higher prevalence of ATA was found in women with high titers of circulating ICA. Our results also confirm that Sardinia represents, perhaps for its peculiar genetic characteristics, an ideal place to study organ-specific autoimmunity.

High frequency of antithyroid autoantibodies in pregnant women at increased risk of gestational diabetes mellitus

BACKGROUND

Thyroid autoantibodies (ThyAb) and subclinical hypothyroidism occur more frequently in pregnant women with insulin-dependent diabetes mellitus than in healthy pregnant women. Few studies have investigated the presence of ThyAb in women with gestational diabetes mellitus (GDM), and no significant association between diabetes in pregnancy and thyroid function has been reported.

OBJECTIVE

To assess the thyroid biochemical profile and estimate the prevalence of ThyAb in a group of pregnant women at increased risk of GDM due to family and personal risk factors, and to investigate the relationship between a positive family history of diabetes or thyroid diseases and the eventual presence of ThyAb during pregnancy.

METHODS

Oral glucose tolerance, serum ThyAb and thyroid function were evaluated in 181 pregnant women with increased risk for GDM (study group). Seventeen healthy pregnant women without risk factors for GDM and with a normal glucose tolerance were recruited as controls.

RESULTS

The women who developed GDM showed a mean free thyroxine concentration significantly lower than that observed in the healthy pregnant women and in those with impaired gestational glucose tolerance and normal glucose tolerance. Twenty-nine of the 181 women in the study group (16%) were ThyAb positive. However, the risk of being ThyAb positive during pregnancy was three times greater in the women with positive family history of both diabetes mellitus and thyroid disease than in those with no family history of these conditions.

CONCLUSIONS

This study showed that women with increased risk of GDM, mostly those with family history of diabetes mellitus and thyroid disease, also have an increased risk of being ThyAb positive during pregnancy. It also highlighted the importance of evaluating thyroid function in pregnant women with impaired glucose tolerance, in view of their increased risk of subclinical hypothyroidism.

Incidence and risk factors associated with cardiac arrhythmias during rehabilitation after coronary artery bypass surgery

OBJECTIVE

To evaluate the clinical relevance of cardiac arrhythmias during rehabilitation after coronary artery bypass graft (CABG) surgery.

DESIGN

Survey of consecutive patients admitted to an inpatient cardiac rehabilitation center.

SETTING

A rehabilitation center acting as a reference for cardiology clinics lacking this facility. The program was performed in the inpatient setting.

PATIENTS

Two hundred sixty patients undergoing elective CABG surgery for angina.

INTERVENTIONS

Four-week cardiac rehabilitation program. A 24-hour electrocardiographic examination was performed during the first 2 days and, subsequently, on a daily basis.

MAIN OUTCOME MEASURES

Incidence and type of cardiac arrhythmias during rehabilitation; identification of factors associated with an increased risk of cardiac arrhythmias.

RESULTS

Cardiac arrhythmias were recorded in 33.5% of the patients and were more frequent in patients with hypertension (47%), diabetes (42.4%), and hyperlipidemia (36.5%), compared with patients free from these diseases (15.5%) (p < .05). Arrhythmias were also recorded in patients older than 70 years (49%), compared with those younger (29.2%) (p < .01), and in patients who discontinued amiodarone (64.3%) compared with those who did not interrupt the drug (16%) (p < .005). Arrhythmias precluded rehabilitation in 5% of the patients and caused death in one patient.

CONCLUSION

Surveillance for the development of cardiac arrhythmias during cardiac rehabilitation after CABG surgery may allow the early detection and treatment of arrhythmias in a substantial number of patients.

Health status and internal radiocontamination assessment in children exposed to the fallout of the Chernobyl accident

The Chernobyl fallout caused release of radioisotope contaminants in a very large area that includes Belarus, the Ukraine, and the Russian Federation. In this study, the authors monitored the health status and level of internal contamination in 422 children who resided in the aforementioned areas and who were < or = 10 y of age at the time of the accident. The children came to Italy for a 1-mo period between 1991 and 1992. During this time, the children underwent pediatric checkups and biochemical, immunological, and thyroid analyses. All children underwent whole-body counter measurements, and urine radiotoxicological analysis was performed for 224 of them. The 24 children evacuated from Pripiat, a village very close to the Chernobyl reactor site, were selected for cytogenetic analysis. All of these children continue to have a detectable internal contamination of caesium radioisotopes. This condition is likely the result of ground and foodstuff contamination in the various areas. The children did not evidence overt pathologies related to ionizing radiation. However, minor alterations in immunological and thyroid parameters were observed in the group of the evacuated children. Traditional cytogenetic dosimetry was not possible, but the occurrence of acentric fragments was observed-indicating a persistent effect of continuous exposure to low doses of radiation.

Infection with Helicobacter pylori and leukocyte response in patients with myocardial infarction

To test whether Helicobacter pylori may contribute to the inflammatory response following myocardial infarction, the levels of IgG antibodies to Helicobacter pylori and some parameters of leukocyte activity were measured in 63 patients and 61 comparable controls. Helicobacter pylori-positive patients showed a significantly higher expression of the adhesion molecule LFA-1 on neutrophils than Helicobacter pylori-negative patients (433+/-29.0 vs. 398.8+/-38.9 mean fluorescence channels; P<0.0001), whereas no significant difference for any parameters tested was found in control subjects. These data suggest a role of Helicobacter pylori in inducing a leukocyte response following myocardial infarction.

Effect of hydrostatic pressure on morphological and ultrastructural aspects of normal and osteoarthritic human articular chondrocytes

In this work we studied the morphological and ultrastructural aspects of normal and osteoarthritic (OA) human articular chondrocytes cultivated in alginate gel for 48 hours. After this period the chondrocytes in Petri dishes were exposed to cyclic pressurization (minimum pressure 1 MPa and maximum pressure 5 MPa) at 0.25 Hz frequency for three hours. In other loading procedures the cells were exposed to continuous pressure (24 MPa) for three hours. Some dishes were not pressurised and these served as controls. The cells were then fixed for transmission electron microscopy (T.E.M.) and for scanning electron microscopy (S.E.M.). No ultrastructural changes were observed in normal chondrocytes exposed at physiological pressure. OA cells placed under physiological pressure showed a partial recovery on morphological and ultrastructural aspects. Normal and OA samples exposed to continuous pressure (24 MPa) showed a morphological worsening in both T.E.M. and S.E.M. studies.

Leucocyte rheological properties are altered in patients with diffuse atherosclerosis

To evaluate whether atherosclerosis may be associated with altered leucocyte rheology, we assessed leucocyte count (by Coulter counter), aggregation (by means of the leukergy test) and expression of adhesion molecules integrin LFA-1 and CD 44 (by means of immunofluorescence staining and flow cytometry) in 9 patients with carotid plus lower limb artery atherosclerosis (group A), 14 patients with carotid atherosclerosis only (group B) and 23 controls without atherosclerosis (group C). The level of LFA-1 (calculated as mean fluorescence channels-MFCs) on neutrophils, lymphocytes and monocytes was significantly higher (p < 0.05) in group A and B patients than in controls (group A-mean +/- SE: 383.77 +/- 9.42 vs 295.45 +/- 5.76; 474.22 +/- 8.86 vs 388.35 +/- 7.84; 457.66 +/- 12.03 vs 396.25 +/- 4.37. Group B: 322.42 +/- 6.36 vs 295.45 +/- 5.76; 421.42 +/- 7.21 vs 388.35 +/- 7.84; 415.71 +/- 7.73 vs 396.25 +/- 4.37, respectively); furthermore, the MFC of LFA-1 on neutrophils was significantly different (p < 0.05) between group A and B patients. The percentage of aggregated leucocytes was significantly higher (p < 0.05) in group A patients (4.46 +/- 1.07) than those in groups B (1.75 +/- 0.38) and C (1.43 +/- 0.25), whereas no significant difference was detected between groups B and C. Leucocyte number and expression of CD44 were not significantly different among the 3 groups. In conclusion, changes in leucocyte rheology are present in patients with atherosclerosis and may contribute to chronic ischaemia.

Dose-response of X-irradiated human and equine lymphocytes

We have investigated and compared DNA damage and cell killing induced in human and equine lymphocytes after in vitro X-irradiation. Our data show that the cytogenetic and the lethality effects are both greater in equine lymphocytes, but that the difference is wider for lethality. The ratios between doses inducing the same effect are 1.3, 1.7 and 9.4 for the number of binucleated cells with micronuclei, micronucleus frequency in binucleated cells and DNA synthesis inhibition, respectively. The very different radiosensitivity observed for the two mammalian species encourages us to use their lymphocytes in cell radiobiology studies.

Timing and course of leucocyte aggregation in myocardial infarction

In order to evaluate the pathophysiological relevance and clinical implications of leukocyte rheology in myocardial ischaemia we measured the percentage of aggregated leukocytes in 43 subjects with acute substernal pain before diagnosis. The percentage of aggregated leukocytes was significantly higher in 16 patients with subsequent diagnosis of myocardial infarction with respect to 11 with angina and 16 with non ischaemic chest pain (4.75 +/- 0.88, 3.43 +/- 0.65 and 1.52 +/- 0.32 respectively p < 0.01). The percentage of aggregated leukocytes was also evaluated in another group of 46 patients hospitalized for myocardial infarction. Among these, aggregated leukocytes were significantly higher in those with residual ischaemia, with respect to those without residual ischaemia (7.4 +/- 1.1 vs 3.5 +/- 0.6, p < 0.01). In conclusion, leukocyte aggregation is precociously increased after myocardial ischaemia. It may be a marker of residual ischaemia in patients with myocardial infarction.

Early detection of nephrotoxic effects in thalassemic patients receiving desferrioxamine therapy

Nineteen transfusion-dependent beta-thalassemia major patients were included in the study. Six of these patients underwent chelation therapy with desferrioxamine by subcutaneous infusion (50 mg/kg/12 hr) and 13 received intravenous infusion (50 mg/kg/6 hr or 100 mg/kg/24 hr). BUN, creatinine, creatinine clearance, beta 2-microglobulin, urinary beta 2-microglobulin and urinary growth hormone excretion were evaluated during desferrioxamine treatment. Thirteen out of nineteen patients presented tubular damage indicated by increased excretion of urinary beta 2-microglobulin. 85% (11 of 13) of these patients showed more serious tubular damage, as demonstrated by concurrent increased urinary growth hormone excretion. Moreover, a positive correlation between urinary growth hormone excretion and urinary beta 2-microglobulin was observed (P < 0.05).

Subarachnoid hemorrhage of unknown origin. A 44 cases study

44 cases (20 men and 24 women) of subarachnoid hemorrhage (SAH) of unknown origin were studied: the mean age was 54.1 yrs. Highest frequency of the disease was observed in 51-70 years old patients. There was only a slight involvement of consciousness (I-II grade of HESS and HUNT). Vascular hypertension was noticed in 45.5% of patients, but outcome did not differ in hypertensive and normotensive subjects. The CT findings showed a typical picture of SAH. 4 cases of perimesencephalic and peripontine hemorrhage were noticed. 24 patients underwent lumbar puncture. The angiographic study was normal in all patients. 14 subjects repeated four-vessel angiography. Transient hydrocephalus was found in 22.7% of patients. Approximately 70% of patients received antifibrinolytic therapy, either with or without calcium entry-blockers (nimodipine). Neither ischemic complications nor rebleeding were observed. Follow-up showed that all patients had survived 7-88 months after SAH. All subjects made a complete recovery and have since been able to resume work.

Leukocyte aggregation in patients with a previous cerebral ischemic event

BACKGROUND AND PURPOSE

The role of leukocyte aggregation in ischemic stroke is controversial. In this study we investigated this hemorheologic alteration in patients at risk for stroke.

METHODS

Leukocyte aggregation was evaluated with the leukergy test in 61 patients with a recent cerebral ischemic event and in 61 control subjects.

RESULTS

In patients leukocyte aggregation was significantly higher than in control subjects (3.8 +/- 3.4% versus 2.5 +/- 2.2%; P = .01). In control subjects, the presence of vascular risk factors was associated with values of aggregation similar to those observed in patients.

CONCLUSIONS

These findings suggest an association between altered leukocyte aggregation and cerebrovascular disease. Further investigations are needed to evaluate whether this hemorheologic alteration can be considered a marker of increased risk for stroke.

The National Register of infants with congenital hypothyroidism detected by neonatal screening in Italy

Neonatal screening for congenital hypothyroidism began in Italy in 1977 and then progressively developed covering 94% of live births in 1991. The National Register of infants with congenital hypothyroidism was established in 1987 as a project of the Health Ministry. The results of the Register provided valuable epidemiological information about congenital hypothyroidism in Italy and evidenced some aspects in the screening organization which had to be improved. Discussion of Register data during annual national meetings has recently allowed an improvement of the screening program with particular regard to the beginning of therapy with L-thyroxine and its dose.

Influence of acute and chronic smoking on leukocyte aggregation

The aim of the present study was to evaluate whether alterations of leukocyte aggregation are present before the development of smoking-associated diseases. Leukocyte aggregation, studied by means of the leukergy test, was significantly higher in 24 healthy smokers as compared to 18 healthy non-smokers (mean + SE) 4.4 +/- 2.2 vs 1.5 +/- 1.3; P < 0.02. Intermediate values were found in ex-smokers. A significant increase was observed in smokers who underwent the acute smoking of three cigarettes in 20 minutes (mean +/- SE) 3.5 +/- 1.9 vs 7.5 +/- 2.6; P < 0.02. These data indicate that changes of leukocyte aggregation induced by smoking are present in healthy subjects before the development of clinically evident diseases associated with smoking.

Proposal of a new method to avoid misinterpretations in the evaluation of the leukergy test

The leukergy test has been widely used in recent years to detect the phenomenon of leucocyte aggregation in various clinical conditions. It is performed by processing some drops of blood on a slide. According to the authors proposing this test, the leucocyte aggregation is expressed as the mean of the number of aggregates detected among 300 cells of a randomly chosen tract of two slides. We noted, however, that significant differences in the percentage of leucocyte aggregates were sometimes detected between two different slides prepared from the same patient, and hypothesized that an unequal distribution of aggregates along the slide could explain this finding. To test this hypothesis we analysed separately the leucocyte aggregates of three tracts of equal size of blood smears taken from 20 patients. Three slides, numbered 1, 2 and 3, were prepared from each patient. The first tract run by the drops when placing them in the slide showed a significantly lower percentage of aggregates than the remaining tracts (p less than 0.01 post hoc Tukey test). We conclude that the distribution of aggregated leucocytes is unequal along the slide and that the evaluation of the phenomenon of leukergy should always include the count of aggregates of the proximal, intermediate and distal tract of each slide.

Isoelectric focusing and immunoblotting analysis of thyroglobulin from different thyroid diseases

Thyroglobulins (Tgs) have been obtained from macro-microfollicular goiter, toxic adenomas, papillary carcinomas and metastatic lympho-node and chromatographed by gel filtration. The 19S Tgs so obtained have been characterized by isoelectric focusing (IEF) and immunoblotting. IEF showed microheterogeneity pattern of Tgs from normal tissue, macro-microfollicular goiter and toxic adenomas to be within pH range from 4.2 to 4.5, while that from papillary carcinomas and metastatic lympho-node showed a wider microheterogeneity. Passive blotting of focused Tgs and immunoreaction with rabbit anti-Tg peroxidase conjugated antibody have been carried out and a positive reaction for all examined samples have been evidenced. Also two bands, focused at more cathodic pH value (pH 4.7), observed in IEF patterns of Tgs from carcinomas and metastatic lympho-node, gave a positive reaction with anti-Tg conjugated antibody. These differences observed in IEF and immunoblotting patterns of Tgs from papillary carcinomas and metastatic lympho-node are discussed in this report.

Three years of experience of the congenital hypothyroidism National Register

Mental retardation caused by congenital deficiency of thyroid hormones can be prevented by early diagnosis and therapy which are assured by neonatal thyroid screening. Congenital hypothyroidism screening is performed in Italy by regional centres which in 1989 have screened more than 82% of neonatal population. Since 1987 a National Register of children affected by CH has been instituted. The results of the analysis of data collected in the first three years are reported.

Monoclonal autoantibody to thyroglobulin as a possible vector in immunodiagnosis and immunotherapy of differentiated thyroid cancer

Differentiated thyroid carcinoma synthetize and secrete thyroglobulin. During its biosynthesis this antigen becomes expressed in the microvilli-bearing surface of carcinoma cells. Attempts have been carried out to target, with specific antithyroglobulin antibodies, the membrane bound absorption thyroglobulin in cancer cells for in vivo diagnosis and therapy. In the serum of patients with autoimmune thyroid diseases a high concentration of antithyroglobulin antibodies is frequently found (1-3 mg/ml). Their purification by immunoabsorption and dissociation is hampered by a low recovery and partial denaturation. It has been recently reported that about 1% of sera from Hashimoto's thyroiditis bear in their electrophoretogram a "myeloma-like protein". In the present report we describe in the serum of a Hashimoto patient a myeloma-like IgG which is an antithyroglobulin autoantibody with restricted functional and structural properties. The serum concentration of this myeloma-like IgG was found to be 40 mg/ml with a capacity of 6.5 nM of human thyroglobulin/mg IgG. The light chain composition was determined to be mostly of the lambda type. The clonal analysis of this myeloma IgG carried out by isoelectrofocusing, immunoblotting and autoradiography resulted in the recognition of several distinct clones, two of which were prominent at pH 8.7 and 7.8. By this technique and in view of the high serum concentration of this myeloma-like IgG, single clones of antithyroglobulin autoantibody can be easily obtained in high yields and without denaturation from human serum. This reagent could offer an ideal immunovector to target membrane-bound thyroglobulin of cancer cells.

Influence of environmental iodine deficiency on neonatal thyroid screening results

During a multicentric pilot screening program for congenital hypothyroidism a comparison between the results obtained from Urbino, an area characterized by low iodine supply and endemic goiter, and Rome, a non-endemic area, has been made. The evaluation of neonatal urinary iodine excretion in the two areas showed significantly lower iodine urinary excretion levels in Urbino than in Rome. A shift of TSH at screening toward higher values as well as a higher percentage of recall in Urbino area than in Rome was observed. This finding, which well correlates with a low environmental iodine supply, emphasizes the importance of screening for congenital hypothyroidism as a suitable index of the presence and action of goitrogenic factors in the environment.

Relationship between maternal parity, basal prolactin levels and neonatal breast milk intake

Basal serum levels of prolactin (PRL) in 21 nursing mothers were measured by radioimmunoassay on the 2nd, 3rd and 4th days of the puerperium. The quantity of breast milk suckled during the 4th day of life was also evaluated by calculating the difference in the baby's weight before and after each feeding. During the first postpartum days, mean basal levels of PRL did not change. However these levels were noted to be significantly lower in the multiparas (p less than 0.05) than in the primiparas. In addition, the milk intake in neonates of multiparous mothers was significantly greater (p less than 0.05) than that in neonates of primiparous mothers. The author's hypothesis, based on the results of animal experimentation described in the literature, is that initiation of breast-feeding is facilitated in multiparas by the increased number of occupied PRL receptors in the mammary glands reflected by the lowered serum levels of the hormone.