The comparison of characteristics between membrane-active antifungal peptide and its pseudopeptides

By the introduction of various amide surrogates, novel pseudopeptides corresponding to a membrane active depsipeptide were synthesized and their native characteristics compared with that of the peptide. The pseudopeptides had more resistance to serum proteases than the peptide and similar antimicrobial activities to that of the peptide without hemolytic activity. The pseudopeptides like the peptide were active against current drug resistant fungi and pathogenic fungi isolated from patients, and also had a strong synergism with current antifungal drugs against Candida albicans. The leakage assay suggested that the pseudopeptides also acted on the lipid membrane of pathogenic cells. These results indicated that the novel pseudopeptides had advantages over the peptide as a candidate for a novel antifungal drug and backbone modifications can be a tool in the development of a novel antifungal agent from membrane-active peptides isolated from natural sources or chemically synthesized.

Life stress, mood disturbance, and elevated interleukin-6 in healthy older women

BACKGROUND

Although adverse effects of severe chronic stress on immunocompetence and physical well-being in older adults have been reported, the immune response to less severe life stress among healthy older adults, particularly among women, is not well understood. Interleukin-6 (IL-6) has been considered a good overall indicator of immune functioning in older adults because of its contribution to the pathogenesis of several age-related conditions such as osteoporosis. Regulation of IL-6 is impaired in elderly adults, and levels of IL-6 increase with stress and depression. This research cross-sectionally examined levels of IL-6 in three groups of healthy older women with varying levels of life stress and mood disturbance and a healthy group of young women.

METHODS

Subjects included 18 caregivers of Alzheimer's patients, 17 older women assessed one month before relocation of their residence, 15 nonmoving and noncaregiving older women, and 20 younger women. Subjects completed the Profile of Mood States (POMS) and had early morning blood draws.

RESULTS

Alzheimer's caregivers reported significantly greater distress than women of all other groups. IL-6 levels in caregivers were significantly higher than those of all other women. The older women had significantly higher IL-6 than young controls, but there were no significant differences in IL-6 between movers and older controls. Among all women, greater depression and distress were related to higher levels of IL-6.

CONCLUSIONS

These findings suggest that in older women, chronic stressors are associated with significant elevations in IL-6 over and above the elevations associated with normal aging, but that moderate stressors may not be related to appreciable elevations in IL-6.

Inducible nitric oxide synthase inhibitors from Melia azedarach var. japonica

In bioassay-guided search for inducible nitric oxide synthase (iNOS) inhibitory compounds from higher plants of South Korea, two beta-carboline alkaloids, 4-methoxy-1-vinyl-beta-carboline (1) and 4,8-dimethoxy-l-vinyl-beta-carboline (2) have been isolated from the cortex of Melia azedarach var. japonica. The structures of these compounds were elucidated on the basis of spectroscopic data. Compounds 1 and 2 showed marked inhibitory activity of iNOS on LPS- and interferon-gamma-stimulated RAW 264.7 cells.

Design, synthesis and characterization of antimicrobial pseudopeptides corresponding to membrane-active peptide

To obtain active and metabolically stable analogues, peptide backbone modifications have been incorporated into many biologically active peptides. In this study, we designed and synthesized pseudopeptides corresponding to the antimicrobial peptide that acted on the lipid membrane of the pathogen. Most pseudopeptides exhibited a longer half-life than the peptide in the presence of serum as well as a considerable activity against test bacteria and fungi. Circular dichroism spectra and retention times of the pseudopeptides helped us to elucidate the effect of the incorporation of backbone modifications on the structural parameters necessary for the activity, indicating that alpha-helical structure was the most important factor for the activity and hydrophobicity had a considerable effect on the activity. Backbone modifications employed in this study can be a useful tool for structure-activity relationship studies and the development of therapeutic agents from membrane-active antimicrobial peptides.

Influence of 5,10-methylenetetrahydrofolate reductase gene polymorphism on plasma homocysteine concentration in patients with end-stage renal disease

The purpose of this study is to observe the influence of the methylenetetrahydrofolate reductase (MTHFR) gene (677C-->T substitution) on plasma homocysteine levels in end-stage renal disease (ESRD) patients who received a relatively large amount of folate (2 mg/d) and are undergoing hemodialysis. A cross-sectional study of plasma homocysteine, vitamin B(12), and folate was performed in patients with ESRD. The study population for the MTHFR gene study included 312 healthy subjects and 106 patients with ESRD undergoing hemodialysis. The C677T transition in the MTHFR gene was detected by HinF 1 restriction enzyme analysis and subsequent electrophoresis in a 3% agarose gel. The genotype of the MTHFR gene in 106 patients with ESRD was homozygous C677T mutation (VV) in 17 patients (16.1%) and heterozygous (AV) in 63 patients (58.4%); 26 patients (24.5%) did not carry this mutation (AA). The mean levels of homocysteine, vitamin B(12), and folate in the patients with ESRD were 23.3 +/- 14.0 mmol/L, 620.2 +/- 98.5 pmol/L, and 138.6 +/- 55.6 nmol/L, respectively. There was no significant difference in homocysteine levels among the three genotypes: 28.2 +/- 19.4 mmol/L for VV, 22.7 +/- 14.9 mmol/L for AV, and 23.4 +/- 11.1 mmol/L for AA genotype (P > 0.05). There was no difference in genotype distribution between the patient groups of less than 25th and greater than 75th percentiles, classified according to plasma homocysteine levels (P = 0.47). In conclusion, with high-dose folate supplementation, the hyperhomocysteinemia in patients with ESRD does not seem to be caused by the 677C-->T mutation in the MTHFR gene.

In vitro antifungal activity and cytotoxicity of a novel membrane-active peptide

In the present study, we investigated the antifungal activity and cytotoxicity of a novel membrane-active peptide, KKVVFKVKFKK (MP). MP inhibited the growth of various pathogenic fungi isolated from patients and of fluconazole-resistant fungi at concentrations of 2 to 32 microg/ml. MP had potent fungicidal activity; the minimal fungicidal concentrations of the peptide were no more than fourfold greater than the MICs. Time course experiments of MP-induced killing of Candida albicans ATCC 36232 showed that the rate of killing was rapid and depended on the concentration of MP. MP had a strong synergism with other antifungal drugs; the fractional inhibitory concentration index values of MP with amphotericin B and fluconazole for C. albicans were 0.16 and 0.02, respectively. The 50% inhibitory concentrations of MP for NIH 3T3 and Jurkat cells were approximately 100 times higher than the MIC for C. albicans ATCC 36232, indicating that MP had high selectivity between the fungal and mammalian cells. These results suggest that MP has great advantages in the development of antifungal agents.

An endogenous proteinacious inhibitor for S-adenosyl-L-methionine-dependent transmethylation reactions; identification of S-adenosylhomocystein as an integral part

A proteinacious inhibitor with a molecular weight of 1,600 Da which inhibits S-adenosyl-L-methionine-dependent transmethylation reactions was purified from porcine liver to homogeneity by procedures including boiling, Sephadex G-25 column chromatography and repeated HPLC. Employing both Nuclear Magnetic Resonance (NMR) and Fast Atom Bombardment-Mass (FAB-Mass) spectroscopy, S-adenosylhomocysteine was conclusively identified as an integral part of the inhibitor. The purified S-adenosylhomocysteine was competitive with S-adenosyl-L-methionine with Ki value of 6.3x10(-6) M towards protein methylase II.

Structure-activity relationship study: short antimicrobial peptides

Many short antimicrobial peptides (< 18mer) have been identified for the development of therapeutic agents. However, Structure-activity relationship (SAR) studies about short antimicrobial peptides have not been extensively performed. To investigate the relationship between activity and structural parameters such as an alpha-helical structure, a net positive charge and a hydrophobicity, we synthesized and characterized diastereomers, scramble peptides and substituted peptides of the short antimicrobial peptide identified by combinatorial libraries. Circular dichroism (CD) spectra and in vitro activity indicated that an alpha-helical structure correlated with the antimicrobial activity and a beta-sheet structure also satisfied a structural requirement for antimicrobial activity. Most peptides consisting of L-amino acids lost antifungal activity in the presence of heat-inactivated serum, while active diastereomers and a scramble peptide with the beta-sheet structure retained antifungal activity in the same condition.

NO/cGMP pathway is involved in exocrine secretion from rat pancreatic acinar cells

The enzyme responsible for the synthesis of nitric oxide (NO) from L-arginine in mammalian tissues is known as nitric oxide synthase (NOS) (EC.1.14.13.39). In the present study, the role of NO in the regulation of exocrine secretion was investigated in rat pancreatic acinar cells. Treatment of rat pancreatic acinar cells with cholecystokinin-octapeptide (CCK-OP) resulted in an increase in the arginine conversion to citrulline, the amount of NOx, the release of amylase, and the level of cGMP. Especially, CCK-OP-stimulated increase of arginine to citrulline transformation, the amount of NOx and cGMP level were completely counteracted by the inhibitor of NOS, NG-monomethyl-L-arginine (MMA), by contrast, that of amylase release was partially reduced. Furthermore, MMA-induced decrease of NOS activity and amylase release showed dose-dependent pattern. The data on the time course of CCK-OP-induced citrulline formation and cGMP rise indicate that NOS and guanylate cyclase were activated by treatment of CCK-OP. However, the mechanism of agonist-stimulated guanylate cyclase activation in acinar cells remains unknown. Therefore, activation of NOS is one of the early events in receptor-mediated cascade of reactions in pancreatic acinar cells and NO, not completely, but partially mediate pancreatic enzyme exocrine secretion.

Synthesis and structure-function study about tenecin 1, an antibacterial protein from larvae of Tenebrio molitor

Tenecin 1, an inducible antibacterial protein secreted in the larvae of Tenebrio molitor, has a long N-terminal loop and common structural feature of insect defensin family corresponding to cysteine stabilized alpha/beta motif. To study the function of the N-terminal loop and disulfide bridges, N-terminal loop deleted tenecin 1, reduced tenecin 1 and tenecin 1 were chemically synthesized and their activities were measured. N-terminal loop deleted tenecin and reduced tenecin 1 did not show antibacterial activity. Circular dichroism (CD) spectroscopy data revealed that the alpha-helical content of tenecin 1 and the other proteins increased in the presence of 50% (v/v) trifluoroethanol (TFE) and the alpha-helical content of tenecin 1 was much higher than that of the other proteins in buffer with or without 50% (v/v) TFE. These results suggest that disulfide bridges are necessary for the activity structure and the N-terminal loop plays an important role in the increase of alpha-helix in the membrane mimetic environment and the activity.

Identification and characterization of novel antimicrobial decapeptides generated by combinatorial chemistry

Novel combinatorial libraries consisting of simplified amino acid sequences were designed to screen for peptides active against the Candida albicans membrane. A novel decapeptide, KKVVFKVKFK, that had a unique primary amino acid sequence was identified in this work. This peptide irreversibly inhibited the growth of C. albicans and showed a broad range of antibacterial activity but no hemolytic activity. Circular dichroism spectra revealed that the predominant secondary structure of this peptide strongly depended on the membrane-mimetic environments; the peptide preferred to form an amphipathic alpha-helical structure in the presence of 50% trifluoroethanol, while it preferred to adopt a distorted alpha-helical structure in the presence of sodium dodecyl sulfate micelles. Experiments in which dye was released from vesicles indicated that this novel antimicrobial peptide killed microorganisms through the action on the membrane as its primary target. Replacement of amino acids in this active decapeptide on the basis of information from the libraries could provide unique information about factors affecting its antimicrobial activity such as its secondary structure, net positive charge, and hydrophobicity.

Structure-activity analysis of brevinin 1E amide, an antimicrobial peptide from Rana esculenta

Brevinin 1E, consisting of 24 amino acid residues, from Rana esculenta has potent antimicrobial and hemolytic activity. From a structural point of view, this peptide has a N-terminal hydrophobic region, a proline hinge region in the middle and a C-terminal loop region delineated by an intra-disulfide bridge, which is a common structural feature of antimicrobial peptides from Rana species. To investigate the structural features for antimicrobial and hemolytic activity, truncated and linearized brevinin 1E amides were synthesized and characterized. A deletion of three amino acids from the N-terminal region did not greatly affect antimicrobial activity but dramatically reduced hemolytic activity. The contribution of the intra-disulfide bridge to antimicrobial and hemolytic activity was somewhat different between brevinin 1E amide and truncated fragments. In brevinin 1E amide, the elimination of the intra-disulfide bridge did not greatly affect antimicrobial and hemolytic activity whereas the elimination of the intra-disulfide bridge in the truncated fragments did not decrease antimicrobial activity but did decrease hemolytic activity. Circular dichroism spectra and the retention time on the C18 reverse phase column revealed that the intra-disulfide bridge (i, i+6) formed an amphipathic loop which increased hydrophobicity and helped to induce the alpha-helical structure in the membrane-mimetic environment. Even though the intra-disulfide bridge and the N-terminal region were responsible for the alpha-helical structure and hydrophobicity, these two structural features were not essential for antimicrobial activity. The hemolytic activity of brevinin 1E amide and its analogs also correlated well with the retention time rather than the alpha-helicity.

Identification and characterization of the antimicrobial peptide corresponding to C-terminal beta-sheet domain of tenecin 1, an antibacterial protein of larvae of Tenebrio molitor

An active fragment was identified from tenecin 1, an antibacterial protein belonging to the insect defensin family, by synthesizing the peptides corresponding to the three regions of tenecin 1. Only the fragment corresponding to the C-terminal beta-sheet domain showed activity against fungi as well as Gram-positive and Gram-negative bacteria, whereas tenecin 1, the native protein, showed activity only against Gram-positive bacteria. CD spectra indicated that each fragment in a membrane-mimetic environment might adopt a secondary structure corresponding to its region in the protein. The leakage of dye from liposomes induced by this fragment suggested that this fragment acts on the membrane of pathogens as a primary mode of action. A comparison between the structure and the activity of each fragment indicated that a net positive charge was a prerequisite factor for activity. To the best of our knowledge this is the first report in which the fragment corresponding to the beta-sheet region in antibacterial proteins, which consists of alpha-helical and beta-sheet regions, has been identified as a primary active fragment.

Methylesters of L-arginine and N-nitro-L-arginine induce nitric oxide synthase in Staphylococcus aureus

The presence of L-arginine methylester (AME), L-arginine ethylester (AEE), or N-nitro-L-arginine methylester (NAME) in the growth media of Staphylococcus aureus increased the nitric oxide synthase (NOS) activity approximately 5- to 14-fold. The increase of NOS activity was confirmed by two assay methods, namely assaying the formation of L-[3H] citrulline from L-[3H] arginine and NO formation. The increase of NOS activity was most likely due to increased de novo synthesis, demonstrated by Western immunoblot analysis. The addition of methanol to the culture medium also increased the NOS activity as much as that found with the above three compounds. Evidence is presented to show that AME, AEE, or NAME gave rise to the formation of methanol in vivo by the action of intracellular esterase(s) and that methanol is subsequently involved in the induction of NOS in this bacterial system.

Nitric oxide synthase from bovine pancreas: purification and characterization

Nitric oxide synthase, NOS (EC.1.14.13.39), was purified from bovine pancreas over 5,500-fold with a 7.6% yield using 30% ammonium sulfate precipitation, and 2',5'-ADP-agarose and calmodulin-agarose affinity chromatography. The purified bovine pancreatic NOS (bpNOS) showed a single band on SDS-PAGE corresponding to an apparent molecular mass of 160 kDa, whereas it was 320 kDa on non-denaturating gel-filtration. This indicated a homodimeric nature of the enzyme. The specific activity of the purified bpNOS was 31.67 nmol L-citrulline fored/mtn/mg protein and apparent K(m) for L-arginine was 15.72 microM. The enzyme activity was dependent on Ca2+ and calmodulin, and to a lesser extent on NADPH, FAD and FMN. H4B was not required as a cofactor for the activity. In an inhibition experiment with L-arginine analogues, NG-nitro-L-arginine (NNA) had the most potent inhibitory effect on bpNOS, and NG, NG'-dimethyl-L-arginine (symmetric; sDMA) did not have any inhibitory effect. Immunohistochemical analysis of the bovine pancreas using brain type NOS antibody (anti-bNOS antibody) revealed that acinar cells showed strong immunoreactivity against the antibody.

Comparison of plasma amino acid concentrations in end-stage renal disease patients on hemodialysis and peritoneal dialysis

OBJECTIVES

Recent reports have suggested that patients treated by CAPD have a relatively increased risk of death compared to patients undergoing HD, although the cause of this discrepancy is poorly understood. Protein malnutrition is an important risk factor in ESRD. Also, amino acid concentrations, for which the physiological function differs from that of protein, may be an independent risk factor in ESRD. There is no doubt concerning the prevalence of low amino acid levels in both HD and CAPD patients. But the difference in plasma amino acid levels between these two groups has not been well defined. The purpose of this study is to compare plasma amino acid levels between patients with ESRD on HD and CAPD.

METHODS

A cross sectional study of overnight fasting plasma amino acid concentrations was performed on 12 CAPD and 45 HD patients with ESRD, matched by age, sex and body mass index. The levels of individual plasma amino acid and TAA, EAA, NEAA and BCAA were compared for the HD and CAPD groups. In order to measure losses during HD and CAPD, amino acid and protein concentrations were measured from 10 dialysates obtained from 10 HD patients and 12 peritoneal dialysis solutions from 12 CAPD patients.

RESULTS

All of the measured amino acid concentrations were found to be lower in the CAPD group compared to the HD group. Furthermore, the levels of TAA (2017.3 +/- 781.1 vs. 903.3 +/- 316.1 mumole/L), EAA(1201.8 +/- 492.6 vs. 567.6 +/- 223.2 mumole/L), NEAA(815.5 +/- 308.6 vs. 335.7 +/- 100.2 mumole/L); and BCAA (315.0 +/- 146.0 vs. 145.2 +/- 65.0 mumole/L), were all lower in the CAPD group than in the HD group. The protein loss was 2.0 +/- 0.2 g/L in the peritoneal dialysate but was not detectable in the hemodialysates. TAA loss over a one week period was about 61.8 +/- 13.0mmole for the HD group and 38.0 +/- 13.0 mmole for the CAPD group.

CONCLUSIONS

Our results show that amino acid concentrations are lower in ESRD patients on CAPD than on HD. It seems likely that protein loss in the peritoneal dialysate is a contributing factor to lowered plasma amino acid concentrations in ESRD patients on CAPD than on HD. We believe that the lowered amino acid concentrations observed in CAPD patients may worsen the clinical outcome compared to HD patients.

Antimicrobial activity and conformation of gaegurin-6 amide and its analogs

A function of the intra-disulfide bridge located at the C-terminal of Rana peptides has not been extensively studied. To investigate the function of the disulfide bridge related to the activity and the structure, we chose Gaegurin-6, isolated from Rana rugosa as a model peptide and synthesized linear analogs. The reduction of the disulfide bridge resulted in the complete loss of antimicrobial activity while replacements of cysteines by serines retained antimicrobial activity. Circular dichroism spectra from a titration of the peptides in sodium dodecyl sulfate indicated that the disulfide bridge of Gaegurin-6 might stabilize the induction of an alpha helical structure in lipid membranes and the alpha helical forming propensity of the peptides correlated with antimicrobial activity.

The relationship between plasma homocysteine and amino acid concentrations in patients with end-stage renal disease

OBJECTIVE

Observe the relationship between homocysteine and other amino acids in patients with end-stage renal disease (ESRD).

DESIGN

A cross-sectional study of amino acids and homocysteine and comparison of the correlations between ESRD and control group.

SETTING

Nephrology unit of Soonchunhyang University hospital in Chunan, Korea.

PARTICIPANTS

Forty-five ESRD patients and 30 control volunteers.

MAIN OUTCOME MEASURES

Plasma amino acids and homocysteine.

RESULTS

Concentrations of asparate, proline and cysteine were higher and serine, tyrosine, valine, isoleuline, leucine, and lysine levels were lower in the ESRD group than in control group. The branched chain amino acids (BCAAs) and essential amino acid were lower in the ESRD group than in the control group, but there was no difference in non-essential amino acid and total amino acid between the two groups. The mean plasma total homocysteine concentrations were 6 +/- 1 mmol/L in the control group and 14 +/- 4 mmol/L in the ESRD group (P < .001). In the ESRD group, homocysteine concentrations showed a direct correlation with the concentration of histidine (R2: .403, P < .001), valine (R2: .324, P < .01), leucine (R2: .400, P < .01), isoleucine (R2: .351, P < .005), cysteine (R2: .287, P < .001), methionine (R2: .256, P < .01), BCAA (R2: .50, P < .01), and essential amino acid (R2: .416, P < .01). In the control group, no correlation between the homocysteine and amino acid concentrations was found.

CONCLUSIONS

Contrary to the control group, the homocysteine concentrations showed a direct correlation with the concentration of valine, leucine, isoleucine, methionine, and histidine levels in the ESRD group. Altered essential amino acid metabolism, specifically BCAAs and histidine, influence hyperhomocysteinemia in ESRD. Further study is needed to confirm this theory.

Dextromethorphan alters the reinforcing effect of cocaine in the rat

Dextromethorphan (DM) at supra-antitussive doses produces psychotomimetic effects in humans. In order to achieve a better understanding of the pharmacological mechanisms responsible for the behaviors induced by DM, we examined the effects of DM on the intravenous self-administration of cocaine in the rat. The effects of DM (40 mg/kg, p.o.) on responding for 0.5, 0.25, 0.125, 0.06 and 0.03 mg/kg/infusion of cocaine was assessed. DM decreased the rate of responding for higher doses of cocaine (0.5, 0.25 and 0.125 mg/kg/infusion), and increased the rate of responding for lower doses of cocaine (0.06 and 0.03 mg/kg/infusion), suggesting that DM shifted the dose-response curve for cocaine self-administration to the left. Therefore, our results indicate that the sensitivity to cocaine's behavioral effects appears to be enhanced by DM.

Identification of nitric oxide synthase in Staphylococcus aureus

The presence of nitric oxide synthase (NOS) in Staphylococcus aureus ATCC6538P was established by western blot analysis. The identity of citrulline formed from L-arginine by the NOS was confirmed by both TLC and HPLC and the other product, NO, by directly measuring the production of nitrogen oxides (NOx) in the reaction mixture. The activity was inhibited by typical NOS inhibitors such as N-nitro-L-arginine methylester and NG,NG-dimethyl-L-arginine with the IC50 of 4.9 x 10(-4) and 2.5 x 10(-4) M, respectively. The NOS activity was maximum at pH 6.5 and at 47.5 degrees C. These results indicate that the NOS of S. aureus ATCC6538P is an isoform distinct from mammalian NOS.

Unusually stable helical kink in the antimicrobial peptide--a derivative of gaegurin

The structure of an active analog of the antibacterial peptide gaegurin was investigated by CD and NMR spectroscopy. The NOE connectivities showed that 21 out of 24 residues formed an a-helix despite the presence of a central proline. CD and NMR analysis indicates that the helix is in fast equilibrium with random coil. From chemical shift analysis of the amide protons, the distances of hydrogen bonding in the helix were calculated, and manifested obvious periodicity which implied a kink in the middle of the helix. 1D amide proton exchange experiments provided further evidence of an exceptionally stable kink. It is inferred that this kink is important not only to the function of the peptide but also to the early stage of the folding as a nucleation site.

Effect of deamino-8-D-arginine desmopressin in uremic bleeding

OBJECTIVES

This study is designed to evaluate the clinical outcome of uremic bleeding treated with DDAVP. DDAVP was given intravenously in nine ESRD patients who had undergone A/V fistula surgery and showed oozing of the operation site for more than one hour.

METHODS

Hemostasis was observed by removing the blood from the wound site with a piece of filter paper for 3 hours after DDAVP administration. vWF, t-PA antigen, t-PA activity, total fibrinolytic activity in euglobulin fraction, fibrinopeptide A and FDP were measured before and after DDAVP administration.

RESULTS

Cessation of the oozing did not occur within 3 hours after DDAVP administration in all of the cases. vWF levels and t-PA antigen were significantly increased after DDAVP administration peaked at 30 min for vWF and 60 min for t-PA antigen. t-PA activity increased in 6 cases and euglobulin fibrinolytic activity increased in 7 cases, respectively. These values fell towards pre-administration levels 120 min after the administration. There was no difference in fibrinopeptide A levels before and after DDAVP administration. FDP became positive in 4 cases after DDAVP administration.

CONCLUSION

DDAVP increased both vWF and t-PA levels and cessation of the oozing from post-operative AV-fistula wounds did not occur within 3 hours after DDAVP administration in all of the cases. These results suggest that the effect of DDAVP should be reassessed in the treatment of uremic bleeding.

Enhanced effectiveness of dimethyl-4,4'-dimethoxy-5,6,5',6'-dimethylene dioxybiphenyl-2,2'-dicarboxylate in combination with garlic oil against experimental hepatic injury in rats and mice

The present study was designed to evaluate the effects of dimethyl-4,4'-dimethoxy-5,6,5',6'-dimethylene dioxybiphenyl-2,2'-dicarboxylate (PMC) in combination with garlic oil against chemical-induced hepatic injury in rats and mice. Rats insulted with carbon tetrachloride were concomitantly treated with PMC and/or garlic oil (50 and 100 mg kg-1, respectively) for four weeks. Whereas treatment of animals with garlic oil alone was ineffective in suppressing carbon tetrachloride-induced hepatotoxicity, administration of PMC in combination with garlic oil more effectively protected the liver against the carbon tetrachloride-induced insult than PMC alone, as monitored by serum aminotransferase activity. Hepatoprotective effects of the formulation were further supported by the changes in the numbers of Kupffer cells and dead hepatocytes. Although prior treatment of rats with PMC for three days failed to protect hepatotoxicity elicited by allyl alcohol, the formulation of PMC and garlic oil was capable of blocking allyl alcohol-induced hepatotoxicity by approximately 40%. To further examine the effect of the agents on lipid metabolism in the liver, hepatic triglycerides and cholesterol contents were assessed in mice after a diet containing PMC and/or garlic oil for one week followed by a single dose of carbon tetrachloride. Garlic oil appeared to be more effective in bringing hepatic lipid levels to those of control than PMC alone. Treatment of animals with PMC in combination with garlic oil synergistically improved chemical-induced impairment of hepatic triglycerides and cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)

Paraquat poisoning of the lung: thin-section CT findings

PURPOSE

To describe thin-section computed tomographic (CT) findings in paraquat poisoning of the lung.

MATERIALS AND METHODS

Thin-section CT scans of the lungs in 16 patients with paraquat poisoning were reviewed. The patients were nine male and seven female persons whose ages ranged from 16 to 74 years (mean, 29 years). Follow-up CT scans were available for seven patients.

RESULTS

The most common pattern on initial scans was ground-glass attenuation, present alone or as part of a mixed pattern in 13 patients. It was bilateral and diffuse in distribution. Consolidation was present in six patients, irregular lines in three, and nodules in two patients. On follow-up scans, the ground-glass attenuation had changed to consolidation with bronchiectasis. Additional irregular lines and traction bronchiectasis also were observed.

CONCLUSION

CT findings in paraquat poisoning of the lung begin with ground-glass attenuation, which leads to consolidation with bronchiectasis or irregular lines.

Lipoprotein(a) levels and fibrinolytic activity in patients with nephrotic syndrome

Recently there has been a renewed interest in the possibility that lipoprotein(a)--Lp(a)--may be important in the pathogenesis of thrombosis-related disease. In nephrotic syndrome, hyperlipidemia is a common finding, and thrombosis is a major complication. With this regard, if Lp(a) levels increase concomitantly with low-density lipoprotein and/or very-low-density lipoprotein levels in nephrotic syndrome, this may be considered a thrombogenic factor. To probe this possibility and to corroborate the relationship between Lp(a) and fibrinolytic profiles, we measured the Lp(a) levels in patients with nephrotic syndrome (n = 43), in patients with chronic glomerulonephritis with less proteinuria than in nephrotic syndrome (n = 28), and in healthy controls (n = 50) and observed the relation between Lp(a) levels and tissue-type plasminogen activator (t-PA) activity, euglobulin fibrinolytic activity, and t-PA antigen. The Lp(a) levels were significantly higher in the patients with nephrotic syndrome as compared with both patients with chronic glomerulonephritis and healthy controls (p < 0.001). There was a direct correlation with serum cholesterol level (r = 0.780; p = 0.0001), triglyceride level (r = 0.445; p = 0.0001), and urine protein level (r = 0.675; p = 0.0001) and a reverse correlation with serum albumin levels (r = 0.566; p = 0.0001). The Lp(a) levels showed a reverse correlation with t-pA activity (r = 0.627; p = 0.0001), total fibrinolytic activity in euglobulin fraction (r = 0.458; p = 0.0001), and t-PA activity divided by the t-PA antigen (r = 0.567; p = 0.0001), but no correlation with t-PA antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pathological study on placenta from pregnancies with systemic lupus erythematosus]

Pathological study on the placenta of 18 cases of pregnancy complicated with systemic lupus erythematosus (SLE) and 23 cases of normal pregnancy was done. The average weight and placenta-villi area ratio of the placenta from pregnancy with SLE were significantly lower than those of the normal (P < 0.05). Scanning under electron microscope showed the placental villi of the SLE group slender and branching little, with their ends bean-sprout looking and the surface covered with pin-point holes, even slitted masses. Immunohistologic examination indicated deposition of IgG, IgA, IgM, C3 on the villi capillary wall surface, which suggested damage of the placental function of the SLE gravidae by the immunologic compounds.

[Correlation between outcome of pregnancy and condition of disease at conception in systemic lupus erythematosus women]

Thirty four pregnant patients with systemic lupus erythematosus (SLE) were divided into 3 groups: (1) primigravida, (2) previous history of spontaneous abortion, and (3) previous history of induced abortion. Outcomes of these pregnancies showed that the average birth weight in primigravida group was significantly higher than that in the other 2 groups (P < 0.05). Grouping by clinical status of SLE at conception, there were 4 kinds of situation: (1) remission, (2) controlled, (3) active, and (4) first onset. Patients with SLE of active stage had the lowest birth weight and gestational age babies (P < 0.05). The best time for conception in SLE women was at the time of remission or controlled stage, i.e. patients treated with prednisone in a dose of 5-15 mg/day for more than 6 months or without any medication for at least 1 year.

Increasing prevalence of antimicrobial resistance among organisms isolated from blood culture in a Singapore hospital

The blood culture isolates obtained over the period 1985-1990 in a general teaching hospital were reviewed to determine trends in the prevalence of resistance to antimicrobial drugs. The percentages of Staphylococcus aureus isolates resistant to methicillin increased each year. Resistance among coagulase negative staphylococci also increased in prevalence: by 1990 approximately 50% of such isolates were resistant to methicillin, erythromycin, co-trimoxazole and gentamicin, 24% were resistant to clindamycin, 20% to fucidic acid but only 0.5% to vancomycin. Isolates of Enterobacteriaceae, excluding community-acquired salmonellae, showed increasing prevalence of resistance to beta-lactams, as did Acinetobacter spp isolates to gentamicin, co-trimoxazole and ceftriaxone. The isolates of Pseudomonas aeruginosa were exceptional, having no evident increase in the prevalence of resistance during the period. The rapid increases observed in relation to the other pathogens indicate the need for an antibiotic policy based on continuous surveillance of susceptibility patterns in the hospital.

Plasma t-PA and PAI-1 antigen concentrations in non-insulin dependent diabetic patients: implication for diabetic retinopathy

Parameters of fibrinolysis, including basal plasma tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) antigen levels were studied in 49 non-insulin dependent diabetic patients (23 men, 26 women: ages 51.3 +/- 14.9 years) and 16 age matched non-diabetic subjects (9 men, 7 women ages 49.8 +/- 12.2 years) as a control group. Compared to a control group, the diabetic patients had a significantly higher mean plasma t-PA antigen (4.94 +/- 2.68 vs 3.20 +/- 2.30 ng/ml) and PAI-1 antigen (34.86 +/- 16.71 vs. 17.60 +/- 15.36 ng/ml) levels (P < 0.05). Significant univariate correlations were observed between t-PA and body mass index (BMI) (P = 0.0009, r = 0.7217), and PAI-1 were positively correlated with BMI and FBS (fasting blood sugar) in the total diabetic patients (P = 0.0003, r = 0.7217; P = 0.0477, r = 0.2858, respectively). In diabetic patients with proliferative diabetic retinopathy, both PAI-1 and t-PA antigen levels were significantly lower than those of diabetic patients with negative or background retinopathy (P = < 0.05). There were no significant differences of the plasma t-PA and PAI-1 levels between diabetic patients with micro- and macroproteinuria. This study conducted on non-insulin dependent diabetic patients suggests that they have significantly higher t-PA and PAI-1 antigen levels than do control subjects, and these findings appear to correlate negatively with proliferative retinopathy observed among the patients studied.

Insulin levels and fibrinolytic activity in patients with end-stage renal disease

Considering that PAI-1 is an important factor modulating the systemic fibrinolytic activity, the abnormal insulin metabolism frequently seen in end-stage renal disease (ESRD) may cause decreased fibrinolytic activity in concert with PAI-1. To study this possibility, we measured insulin levels and compared it with the fibrinolytic profiles in ESRD patients. Fasting blood sugar, insulin, and C peptide levels were higher in ESRD patients than in the control group. In the ESRD patients, the insulin levels showed a positive correlation with C peptide (r = 0.612, p = 0.0001), fasting blood sugar (r = 0.334, p = 0.044), and PAI-1 antigen (r = 0.474, p = 0.0001) and a reverse correlation with euglobulin fibrinolytic activity (r = 0.5, p = 0.005), but no correlation with t-PA antigen. The euglobulin fibrinolytic activity showed a reverse correlation with PAI-1 antigen (r = 0.289, p = 0.0144), but no correlation with t-PA antigen. Our results suggest that abnormal insulin metabolism and/or insulin resistance, which occur frequently in ESRD, may play an important role in the decrease in systemic fibrinolytic activity by the regulation of the PAI-1 concentration.

Fibrinolytic activity in end-stage renal disease

Recently, we described that in the physiologic state, urokinase concentration is higher in the renal vein than in the renal artery which suggests that the kidney is the essential organ providing urokinase to the systemic circulation. In end-stage renal disease (ESRD) patients, urokinase provided by the kidney may be decreased, and this might be the cause of decreased systemic fibrinolytic activity seen in ESRD. To study this possibility, we measured fibrinolytic profiles including urokinase, tissue plasminogen activator (t-PA) and fibrinolytic activity in the euglobulin fraction of ESRD patients and compared the results with those of two control groups consisting of renal transplantation patients and age- and sex-matched healthy controls. The euglobulin fibrinolytic activity was 92.2 +/- 14.8 BAU in the ESRD group, 108.7 +/- 13.5 BAU in the kidney transplantation (KT) group and 101.5 +/- 8.0 BAU in the healthy control group. Although it was lower in the ESRD than in the KT (p < 0.005) and the healthy control group (p < 0.005), there was no difference between the KT and the healthy control group. t-PA antigen was 1.2 +/- 1.3 ng/ml in the ESRD group, 3.5 +/- 1.7 ng/ml in the KT group and 3.1 +/- 2.1 ng/ml in the healthy control group. It was lower in the ESRD compared to the KT (p < 0.001) and the healthy control group (p < 0.001) but there was no difference between the KT and the healthy control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma t-PA and PAl-1 antigen concentrations in non-insulin dependent diabetic patients: effects of treatment modality on fibrinolysis

Basal plasma tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAl-1) antigen levels were studied in 49 non-insulin dependent diabetic patients (23 men, 26 women: ages 51.3 +/- 14.9 years) and 16 age matched non-diabetic subjects (9 men, 7 women: ages 49.8 +/- 12.2 years) as a control group. Compared to a control group, the diabetic patients had a significantly higher mean t-PA antigen (5.15 +/- 3.02 vs 3.20 +/- 2.30 ng/ml) and PAl-1 antigen (35.89 +/- 18.59 vs 17.60 +/- 15.36 ng/ml) levels (p < 0.05). Plasma t-PA antigen level was not influenced by each treatment modality. There was a significant decrease of plasma PAl-1 antigen level after Metformin administration compared to that of before Metformin administration (39.74 +/- 19.39 vs 25.14 +/- 16.18 ng/ml) (p < 0.05), and the insulin-treated group showed a tendency for a decrease of plasma PAl-1 antigen levels after insulin administration but this did not reach statistical significance (29.93 +/- 15.37 vs 17.32 +/- 10.60 ng/ml). Sulfonylurea did not change both plasma t-PA and PAl-1 antigen levels. In conclusion, diabetic patients have high t-PA and PAl-1 antigen levels. Biguanide reduced plasma PAl-1 antigen levels, which might play some helpful role in the improvement of chronic complications in NIDDM.

Effect of periodic transfusion on erythropoietin concentration in end stage renal disease

BACKGROUND

It has been reported that a feedback circuit exists between erythropoietin (EPO) concentration and the degree of anemia even in end stage renal disease (ESRD), and growing experience with subcutaneous EPO administration confirms that only slight increases in EPO levels are required to correct renal anemia. Keeping in mind these findings, if a small portion of reserved EPO production could be reactivated in ESRD, it might be biologically significant and vice-versa. From this viewpoint, it is conceivable that periodic long term transfusion might suppress EPO production in ESRD.

METHODS

In order to see whether periodic transfusion influences the EPO concentration in ESRD, a cross-sectional retrospective study was undertaken by reviewing medical records of 28 non-transfusion patients and 22 transfusion patients with ESRD undergoing hemodialysis.

RESULTS

The EPO concentration of the ESRD group (29.1 +/- 8.0 mU/ml) but only about one twentieth of the control group (578.8 +/- 69.1 mU/ml). In ESRD group, It was 27.9 +/- 8.0 mU/ml in transfusion group and 30.6 +/- 7.9 mU/ml in non-transfusion group. EPO concentration at varying hematocrit (Hct) levels did not differ between the non-transfusion group and transfusion group. There was an inverse relationship seen in the non-transfusion group (p < 0.05) but no relationship was seen between the EPO concentrations and varying Hct levels in the transfusion group. The EPO concentration at equal levels of Hct did not differ between the non-transfusion group and transfusion group. The relationship between EPO concentration and the changes in Hct during the observation period did not differ between the non-transfusion group and transfusion group. Both the total amount of transfusion and the frequency of transfusions did not influence EPO concentration.

CONCLUSION

periodic long term transfusion does not seem to decrease the sensitivity of the EPO producing cell to the degree of anemia in ESRD.

The effect of dilution, pH and ionic strength of plasma on t-PA precipitation in euglobulin fraction

In order to evaluate the influence of dilution, pH and ionic strength on the precipitation of t-PA and PAI-1 during euglobulin precipitation, we measured t-PA Ag, PAI-1 Ag and fibrinolytic activity in the euglobulin fraction made of pooled plasma from liver cirrhosis patients, under various conditions by changing pH, ionic strength and degree of dilution. The precipitation of t-PA Ag in the euglobulin fraction was enhanced by decreasing the ionic strength and greatest at pH 6.0. The fibrinolytic activity in the euglobulin fraction showed consistent changes with t-PA Ag under varying pH and ionic strength. The precipitation of t-PA Ag was not influenced by the dilution factor but the larger the dilution factor, the greater the PAI-1 and the smaller the fibrinolytic activity in the euglobulin fraction. PAI Ag in euglobulin fraction showed consistent changes with t-PA Ag in the euglobulin fraction regardless of the changes in ionic strength and pH. The amount of precipitation of t-PA and PAI-1 was increased by the presence of dextran sulfate, under varying pH, ionic strength and dilution conditions. Our results show that the currently used conditions for standard euglobulin precipitation are the most favorable for t-PA precipitation into the euglobulin fraction. The fibrinolytic activity exerted in the euglobulin fraction seems to depend on the amount of t-PA-PAI-1 complex rather than minimized protease inhibitor in the euglobulin fraction.

Urokinase concentration in the renal artery and vein

To compare the fibrinolytic activity between the renal artery and vein and the systemic circulation, we measured tissue-type plasminogen activator (t-PA), urokinase and total fibrinolytic activity in the blood samples from both the left and right renal artery and vein and the anterior cubital vein of 7 kidney donors. Englobulin fibrinolytic activity was significantly higher in the renal vein [106.6 +/- 5.6 blood activator units (BAU)] than in the renal artery (90.6 +/- 4.1 BAU; p less than 0.001) and cubital vein (94.3 +/- 6.3 BAU, p less than 0.005), but there was no difference between renal artery and cubital vein. t-PA Ag was 2.9 +/- 1.1 ng/ml in the renal vein, 2.6 +/- 1.0 ng/ml in the renal artery and 2.6 +/- 1.1 ng/ml in the cubital vein. There was no difference between renal artery, renal vein and cubital vein. Urokinase was significantly higher in the renal vein (3.3 +/- 0.4 ng/ml) than in the renal artery (2.4 +/- 0.4 ng/ml; p less than 0.001) and cubital vein (2.6 +/- 0.4; p less than 0.005), but there was no difference between the renal artery and cubital vein. In all cases, there was no difference in the fibrin(ogen) degradation product concentration between the renal artery and vein and the cubital vein. These findings suggest that the kidney may be an essential organ for providing urokinase to the systemic circulation.

Euglobulin fibrinolytic activity in NIDDM patients

The euglobulin fibrinolytic activity was measured in 56 non-insulin-dependent diabetics and 118 age-matched healthy controls before and after venous occlusion for 5 min at 100 mmHg of the left antecubital vein. In the basal state, fibrinolytic activity was impaired in diabetics compared with controls (93.1 +/- 6.7 vs 101.6 +/- 0.9 BAU) (P less than 0.05) and plasma fibrinogen level was increased but this did not reach statistical significance (467.3 +/- 264.1 vs 359.2 +/- 200.2 mg/dl). In diabetics, stimulated fibrinolysis following venous occlusion was depressed compared with controls (110.6 +/- 3.9 vs 121.6 +/- 1.9 BAU) (P less than 0.05). No relation of fibrinolytic activity to age, duration of diabetes, obesity, serum triglyceride, HbA1c, or 24 h proteinuria was demonstrated. In the diabetic retinopathy group, the fibrinolytic activity was lower than in the non-retinopathy group. Diabetics with long-standing diabetes (10 years or more) who remained free from retinopathy had significantly increased fibrinolytic activity than the diabetics with short-standing diabetes (less than 10 years) who have developed retinopathy (P less than 0.05). These findings imply a poor fibrinolytic activity, not in all diabetics, but only in those with retinopathy, and this may play a role in the development of diabetic retinopathy.

[Clinical effects and immune regulation of musk-moxa-string therapy in 39 patients with scrofula]

Immunological function and lymphocytic subsets of peripheral blood mononuclear cell (PBWC) from 39 patients with scrofula were investigated before and after treatment with musk-moxa-string therapy. The results showed that the percentage of CD3+, CD4+ cells and the ratio of CD4+/CD8+ cells were markedly decreased in the patients than normal control (P less than 0.001). On the contrary, the numbers of B lymphocytes and DR+ cells were increased. But the response of PBWC to phytohemagglutin in (PHA) stimulation markedly decreased in the patients than the normal control. After treatment with musk-moxa-string therapy, the percentage of CD3+, CD4+ cells and the ratio of CD4/CD8 were increased (P less than 0.001) and blastogenic response to mitogen stimulation with PHA recovered to normal. Meanwhile, the symptoms was improved and swell lymph node disappeared or was reduced markedly in size and the ulcer was healed completely. These findings suggest that the effect of musk-moxa-string therapy is caused by the enhancement of immunological capacity of the patients.

The urine urokinase concentration in end stage renal disease with acquired renal cyst

To see whether there was any difference in the urine urokinase concentration between acquired cystic kidney disease (ACKD) group and control (non cyst) group in end stage renal disease patients (ESRD), we evaluated fifty ESRD patients who had been maintained on chronic hemodialysis for various period. The urine urokinase concentration was higher in the ACKD group (17.5 +/- 14.7 unit/ml, range 13.5-47.0 unit/ml, n = 9) than the control group (4.1 +/- 3.4 unit/ml, range 0.5-12.0 unit/ml, n = 36) (p less than 0.001), and polycyst group (2.6 +/- 1.8 unit/ml, range 1.0-5.1 unit/ml, n = 5) (p less than 0.01). But there was no difference between the control group and polycyst group. In the control group and the ACKD group, there was a direct relation between the dialysis duration and the urokinase concentration and the longer the dialysis duration, the higher the urine urokinase concentration (r squared = 0.424, p = 0.0001). The hemodialysis duration was longer in the ACKD group (42 +/- 17.0 months) than the control group (20.0 +/- 12.5 months) (p less than 0.005). These findings suggest that urokinase may be responsible for cystogenic degeneration in ESRD.

Effect of 1,25-dihydroxyvitamin D3 on mesangial cell proliferation

We have studied the effect of 1,25-dihydroxyvitamin D3 (1,25, (OH)2D3) on mesangial cell growth. Previous studies have shown that the monocyte-macrophage is the principal effector cell in immune-mediated nephritis; this cell infiltrates the glomerular mesangium, and its products may have important effects on the physiology of the mesangial cell. One of the substances produced by the activated macrophage is 1,25,(OH)2D3. We have investigated the effect of 1,25,(OH)2D3 on mesangial cell growth and found that this vitamin D metabolite suppresses the proliferation of mouse mesangial cells as assessed by mesangial cell tritiated thymidine uptake and by cell counts; this substance also antagonizes the mitogenic effect of epidermal growth factor on mesangial cell growth. By comparison, the vitamin D metabolite 25 hydroxyvitamin D3 has no significant suppressive effect on the proliferation of mesangial cells. It has also been possible to demonstrate that 1,25,(OH)2D3 could suppress the growth of mesangial cells that had been committed to proliferate by the prior addition of epidermal growth factor. The results of these studies are relevant to our understanding of the pathogenesis of the cellular abnormalities that occur in immune-mediated nephritis, and especially in subjects who have concurrent hypertension, because a segment of subjects with hypertension have demonstrable abnormalities in the levels of circulating 1,25,(OH)2D3.

Immunoregulatory effects of phospholipase A2 (PLA2) on the proliferation of human lymphocytes

Extracellular phospholipase A2 (PLA2) is a proinflammatory enzyme found especially in the inflammatory exudate to modulate blood flow to areas of antigen stimulation. In this study we found that PLA2 exerted a biphasic effect on the proliferation of phytohemagglutinin (PHA)-stimulated human mononuclear cells (PHA MNC). At low concentrations range from 0.001 to 1 U/ml, PLA2 enhanced the proliferation of PHA MNC (maximal increase was 37.0 +/- 5.67%). Conversely, at concentrations over 10 U/ml, PLA2 markedly suppressed the PHA-induced MNC proliferation (maximal decrease was 88.86 +/- 2.89%). PLA2 was non-toxic to lymphocytes after three days culture, unless the concentration was higher than 100 U/ml. The membrane polarization of PHA-stimulated lymphocytes was also increased by PLA2 at a low concentration. In addition, PLA2 displayed a similar effect on the proliferation of streptokinase-streptodornase (SK/SD) or allogeneic cell stimulated lymphocytes. The change of lymphocyte proliferation by PLA2, was parallel to the change of percentage of helper T cells. Furthermore--a CD4-rich population was proved more susceptible to PLA2 effect than a CD8-rich population. Para-bromophenacyl bromide (pBPB), an irreversible inhibitor of PLA2, abrogated the biphasic effect of PLA2 on PHA MNC proliferation. These results suggest that PLA2 plays a regulatory role on immune reactions by modulating the percentage of helper T cells.

Circulating HBsAg/IgG complexes in idiopathic chronic glomerulonephritis

We measured HBsAg/IgG complexes (CX) quantitatively by ELISA from HBsAg positive serum of 35 liver disease patients, 15 patients with glomerular diseases (8 membranous glomerulonephritis (MGN) 7 membranoproliferative glomerulonephritis (MPGN), and 50 healthy carriers of HBsAg. HbsAg/IgG CX was detected in 26 out of 35 liver disease patients (74.3%), 5 out of 50 healthy carriers (10%), and one of both 8 MGN patients (12.5%) and 7 MPGN patients (14.3%). HBsAg/IgG CX was big in size and wide spread in the liver disease groups but negligible in the healthy carrier group (41 +/- 2.6 ng/ml, n = 5) and MGN (50 ng/ml, n = 1) and MPGN (42 ng/ml, n = 1) group. In the liver disease group, no one suffered from glomerulopathy even with a wide spectrum of HBsAg/IgG CX. These results suggest that HBsAg/IgG CX in plasma is non causative of MGN and MPGN.

Immunomodulation of musk-moxa-string therapy in patients with scrofula

The effects of musk-moxa-string therapy on the immune system in man were investigated in 39 patients with scrofula. Before treatment, the numbers of peripheral blood (PB) CD3+ and DC4+ cells and the ratio CD4+/CD8+ were found to be lower in patients with scrofula than in normal subjects, while those of B cells and DR+ cells were higher. Response of peripheral blood mononuclear cells (PBMC) to phytohemagglutinin (PHA) diminished in patients with scrofula. At month 2-6 of musk-moxa-string therapy the number of PB CD8+ cells showed slight diminution along with significant increases in CD3+ and CD4+ cells and CD4+/CD8+ ratio in total lymphocytes (P less than 0.001). In vitro a marked increased blastogenic response to mitogen stimulation with PHA was observed in PBMC of patients with scrofula after treatment (P less than 0.001). In contrast, B lymphocytes, monocytes, DR+ cells and blastogenic response to concanavalin A and pokeweed mitogen were not influenced by musk-moxa-string therapy.

A simple quantitative assay of vascular plasminogen activator--not only stimulated fibrinolytic activity but also basal fibrinolytic activity are correlated with venous fibrinolytic activity

A simple method for the quantitative assay of vascular plasminogen activator is described. From 24 chronic renal failure patients who were undergoing surgery for A/V fistular or shunt construction, small pieces of artery (mean 7.8 mg, range 3.0-18.5 mg) and vein (mean 4.5 mg, range 3.0-8.8 mg) were used. The fibrinolytic activity was assayed on a well-controlled fibrin plate by only distilled water immersion and incubation at 37 degrees C. Basal fibrinolytic activity was correlated with venous fibrinolytic activity (r = 0.773, p less than 0.0001) and with arterial fibrinolytic activity (r = 0.55, 0.005 less than p less than 0.01). The increment of fibrinolytic activity by venous occlusion was correlated to venous fibrinolytic activity (r = 0.849, p less than 0.0001) but not to arterial fibrinolytic activity (r = 0.34, 0.1 less than p less than 0.25).

Urinary plasminogen activator activity in progressive renal failure

The purpose of this study was to discover how functional nephrons produce the plasminogen activator as renal function progresses to renal failure. Urine Plasminogen activator (U-PA) activity was measured by the fibrin plate method in 73 patients with various degrees of renal function deterioration from various underlying diseases and in one healthy individual in order to evaluate the plasminogen activator activity of remnant nephrons. The plasminogen activator activity of the 12 consecutive urine samples from the healthy individual showed that is varied according to the time of day, but there was no circadian rhythm. The urine plasminogen activator activity correlated with the osmolality (r = 0.51, P less than 0.001) and creatinine (r = 0.56, P less than 0.001) of the urine, suggesting that it is concentrated at distal nephrons. The fractional sodium excretion rate (FeNa) increased abruptly when GFR decreased below 25 L/day. This pattern was very similar with the relation between total U-PA activity/GFR and GFR. The correlation between total U-PA activity and FeNa was not significant, but there was a significant direct correlation between total U-PA activity/GFR and FeNa (r = 0.775, P less than 0.0001). There was no relationship between the 24-hour urine protein and total U-PA activity or total U-PA activity/GFR.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of serum urokinase on urine fibrinolytic activity

The purpose of this study was to see if the serum level of urokinase might influence the urine fibrinolytic activity. Serum fibrinolytic activity precipitated in dextran sulfate euglobulin fraction was measured on the plasminogen-rich plate before, during, and after the urokinase infusion. The fibrinolytic activity of euglobulin increased during urokinase infusion by dose-dependent pattern (n = 4, mean: 230%, range: 173-333% of basal level) and decreased below the basal level after cessation of urokinase (n = 4, mean: 18%, range: 0-27% of basal level). There was inverse correlation between the urine fibrinolytic activity and serum fibrinolytic activity in all cases (r = -0.75, 0.01 less than p less than 0.02 in case 2; r = -0.88, 0.0001 less than p less than 0.005 in case 3; r = -0.74, 0.05 less than p less than 0.10 in case 1a and r = 0.59, 0.05 less than p less than 0.10 in case 1b). This finding suggests that the urine fibrinolytic activity production was under control of the serum urokinase level with feedback mechanism.