Involvement of peritoneal macrophage in the induction of cytotoxicity due to apoptosis in ascitic fluid associated with severe acute pancreatitis

The aim of this study was to assess the significance of peritoneal macrophage in inducing cytotoxicity in ascitic fluid associated with severe acute pancreatitis. The involvement of peritoneal macrophage was examined experimentally in rats by macrophage depletion with peritoneal lavage prior to the development of pancreatitis. More than 94% of the cellular components collected from peritoneal cavities by the lavage are macrophages. Although the ascitic fluid collected from the rats with necrotizing pancreatitis showed cytocidal effects via apoptosis on Madin-Darby canine kidney cells in a dose- and time-dependent manner, cytotoxicity or apoptosis-inducing activity almost disappeared from the ascitic fluid by the preceding peritoneal lavage. The ascitic fluid did not show significant differences by the lavage in osmolarity and in concentrations of albumin, bilirubin, amylase, and lipase. Although a slight reduction of tumor necrosis factor-alpha was noted with the lavage, tumor necrosis factor-alpha failed to induce apoptotic cell death in the cells, and the neutralization by antibody ameliorated neither cell death nor apoptosis. We conclude that peritoneal macrophages secrete apoptosis-inducing factor(s) into pancreatitis-associated ascitic fluid, other than tumor necrosis factor-alpha.

Fibrinolytic factors in endometriotic tissue, endometrium, peritoneal fluid, and plasma from women with endometriosis and in endometrium and peritoneal fluid from healthy women

OBJECTIVE

To determine whether there is a difference in fibrinolytic compounds in endometriotic tissue, endometrium, peritoneal fluid (PF), and plasma from women with endometriosis and in endometrium and PF from healthy women.

DESIGN

Prospective study.

SETTING

Two university clinics.

PATIENT(S)

Regularly menstruating women with and without endometriosis.

INTERVENTION(S)

Tissue samples, PF, and blood were collected at surgery performed for clinical reasons.

MAIN OUTCOME MEASURE(S)

The antigen concentrations of plasminogen activators and plasminogen activator inhibitors (PAls) in tissue homogenates, PF, and plasma were assayed by ELISA.

RESULT(S)

The concentrations of urokinase plasminogen activator (u-PA) and PAI-1 were higher in endometrium from women with endometriosis than in endometrium from controls and even higher in endometriotic tissue than in endometrium from both groups. In PF, the concentration of PAI-2 was higher in women with endometriosis than in controls.

CONCLUSION(S)

The high concentrations of u-PA and PAI-1 in endometrium from women with endometriosis might facilitate implantation of endometrial cells and the high concentration in endometriotic tissue might contribute to their invasive growth. The inflammatory reaction may contribute to the high concentration of PAI-2.

Paracrine changes in the peritoneal environment of women with endometriosis

During the past decade, macrophage-derived substances such as prostanoids, cytokines, growth factors and angiogenic factors have been detected in the peritoneal fluid of women with endometriosis. In particular, growth-promoting and angiogenic factors are considered to be substantially involved in the pathogenesis of endometriosis. In this study, vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta) and intercellular adhesion molecule 1 (ICAM-1), substances recently detected in the peritoneal fluid of women with endometriosis, were assessed with regard to their concentrations in different stages of endometriosis and changes of the peritoneal paracrine activity after medical treatment with a gonadotrophin releasing hormone agonist (GnRHa). Peritoneal fluid was obtained from patients with endometriosis during laparoscopy before and after a 4-month treatment with a GnRHa. VEGF, TGF-beta and ICAM-1 could be detected in all women presenting with various stages of active endometriosis. After GnRHa therapy, all patients showed significant decreases in mean concentrations of VEGF (194+/-77 pg/ml), TGF-beta (902+/-273 pg/ml) and ICAM-1 (157+/-52 ng/ml). Patients with stage III and IV endometriosis (according to the rAFS score) had much higher concentrations of VEGF and TGF-beta before treatment compared with those patients with mild endometriosis (rAFS stages I and II). The most striking decrease in concentration was for TGF-beta, from 902 pg/ml before to 273 pg/ml after therapy. These results indicate an important role for paracrine activity in the establishment and maintenance of endometriosis. Indeed, treatment with a GnRHa may reduce paracrine activity in the peritoneal cavity via hypo-oestrogenism and provide proof of successful therapy.

Tracing cellular and molecular mechanisms involved in endometriosis

The aetiology and pathogenesis of endometriosis, defined as the presence of endometrium-like tissue outside the uterine cavity, is largely unknown. In this paper we present and discuss possibilities to study the putative pathogenic properties of endometriotic cells in vitro. The current focus of our investigations is on the invasive phenotype of the disease, assuming that this might contribute to the pathogenesis of endometriosis. So far, we have shown that: (i) cytokeratin-positive and E-cadherin-negative endometriotic cells have an invasive phenotype in a collagen invasion assay in vitro similar to metastatic carcinoma cells; (ii) the invasiveness of endometriotic but not of eutopic endometrial cells can be stimulated by a heat-stable protein present in peritoneal fluid; and (iii) the endometriotic cell line EEC145T, which we established, may be a useful tool for the identification of gene products which are, positively or negatively, invasion-related. Finally, our studies suggest that the invasive phenotype in endometriosis shares aspects with tumour metastasis, but might also have unique mechanisms.

Endometriotic disease: the role of peritoneal fluid

Peritoneal fluid and the intraovarian milieu are a specific microenvironment. Peritoneal fluid originates mainly as an ovarian exudation product caused by increased vascular permeability, with cyclic variation in volume and steroid hormones which are always higher than in plasma. It contains large amounts of macrophages and their secretion products, and has a large exchange area with plasma through the peritoneum, which is highly permeable for small molecules. Diffusion becomes virtually zero for molecules with a molecular weight of >100000 Da. In women with the luteinized unruptured follicle (LUF) syndrome, concentrations of oestrogens and progesterone are much lower in the luteal phase. Endometriosis is associated with sterile low-grade inflammation, increased concentrations of activated macrophages and many of their secretions, such as cytokines, growth factors and angiogenic factors. Concentrations of CA-125 and of glycodelins are also increased, secreted locally by the endometrial cells. Natural killer (NK) cell function declines, possibly mediated by glycodelins or local intercellular adhesion molecule (ICAM) -1 shedding. The ovary is also a specific microenvironment, with steroid hormone concentrations 1000-fold higher in follicles than in plasma. Endometrial and superficially implanted cells are influenced by peritoneal fluid concentrations so that local environment, rather than inherent cellular differences could explain differences between superficial endometriosis and eutopic endometrium. Differences between superficial implants and endometriotic disease, deep infiltrating or cystic ovarian endometriosis, may thus arise via different endocrine environments. Superficial endometrial implants are regulated by peritoneal fluid factors, whereas deep endometriosis and cystic ovarian endometriosis are influenced by blood or ovarian factors. The endometriotic disease theory considers superficial endometriotic implants and their remodelling as a physiological process in most women, and concentrates on the causes of severe endometriosis such as differences in the eutopic endometrium from women with and without endometriosis (which may indicate hereditary differences), the invasiveness of some endometriotic cells in vitro, focal 'shielding' of endometriotic foci by adhesions, and inhibition of NK activity by ICAM-1 and glycodelins. Endometriotic disease is thus seen as a benign tumour. The type of cellular lesion, hereditary and immunological environments and local hormone concentrations in the ovary and in peritoneal fluid, will decide expression as cystic ovarian endometriosis, deep endometriosis or adenomyosis externa, and whether the latter is associated with adhesions.

Effects of endometrial stromal cells and peritoneal fluid on fertility associated with endometriosis

Endometriosis is one cause of infertility. The disease causes severe non-bacterial inflammation and adhesion in the ovarian tubes and/or referred reproductive organs, but a number of types of unexplained infertility without severe organic disorders also exist. In the present study, we investigated the effects of endometrial stromal cells (SC) and peritoneal fluid (PF) in endometriosis on the fertilization and embryonic development rates using mouse ova and embryos. In addition, we prepared endometriosis artificially in rats and investigated the effects of peritoneal perfusate on the fertilization and embryonic development rates. We also investigated the in vitro fertilization rate in these rats. The mouse ova, sperm, and two-cell embryos were cultured on SC isolated surgically from patients with uterine myoma (M) or endometriosis (E), and 24 hours later, the fertilization and embryonic development rates were investigated. To this co-culture system, PF from M or E patients was added, at varying concentrations, and the fertilization and embryonic development rates were investigated. Then, rats with experimental endometriosis were prepared. After confirmation of the presence of lesions, peritoneal perfusate was added, at varying concentrations, to the co-culture system, and the fertilization and embryonic development rates were investigated. In addition, the in vitro fertilization rate was investigated in these rats. Both the fertilization rate and the embryonic development rate were significantly lower for the co-culture system in the E group. In the PF addition system, PF decreased the fertilization and embryonic development rates at lower concentrations in the E group. In rats with artificial endometriosis, peritoneal perfusate from rats with lesions significantly decreased the fertilization and embryonic development rates at lower concentrations. The in vitro fertilization rate was significantly lower in rats with lesions. The above results strongly suggested that inhibitions of fertilization and embryonic development induced by SC and PF, and altered quality of the ovum itself, might be responsible for infertility in endometriosis.

The effect of lignocaine on sperm phagocytosis in the peritoneal fluid from women with or without endometriosis

The study was undertaken to investigate a possible mechanism for reducing the phagocytosis of spermatozoa by leukocytes in the peritoneal fluid from women suffering from endometriosis. Peritoneal fluids were collected during laparoscopy from women undergoing laparoscopic sterilization or from women under investigation for cause of infertility where the laparoscopic findings were endometriosis. Prepared spermatozoa from one healthy man were incubated in vitro with peritoneal fluid with or without lignocaine. Samples from the incubations were studied daily and the number of viable and dead spermatozoa were counted. The number of free spermatozoa, not adhered to leukocytes, was significantly increased when incubated in human peritoneal fluid supplemented with lignocaine. Thus lignocaine contributes to increasing the number of free spermatozoa and maintaining the possibility of fertilizing an oocyte. For patients with endometriosis, treatment with lignocaine might be a means of increasing the chances of conception. A clinical study is in progress to evaluate this effect in vivo and to search for alternative methods of assisting the fertilization process.

An evaluation of the clinical pathologic findings in experimentally induced urinary bladder rupture in pre-ruminant calves

The purpose of this project was to study the biochemical abnormalities that develop over time in preruminant calves with experimentally induced uroperitoneum. Uroperitoneum was produced by incising the bladder via a standing left flank laparotomy. Serum and peritoneal concentrations sodium, chloride, potassium, phosphate and creatinine were determined at 0, 2, 4, 8, 24, and 40 h. Serum creatinine concentration was increased by 8 h post-bladder rupture. Peritoneal concentrations of potassium and phosphate were significantly elevated 2 h after bladder rupture and peritoneal creatinine was significantly elevated by 4 h. Serum to peritoneal fluid ratios for potassium, phosphate and creatinine exceeded 2:1 within 2 h of bladder rupture. Pre-ruminant calves with experimentally induced uroperitoneum did not become hyperkalemic during the 40 h experiment.

An inhibitor of cell proliferation associated with adhesion formation is suppressed by N,O-carboxymethyl chitosan

Surgical adhesions are a major cause of morbidity and mortality. The ideal barrier agent will both minimize adhesions and provide a milieu for the regeneration of the mesothelium lining of the abdominal and thoracic cavities. N,O-Carboxymethylchitosan (NOCC), a derivation of chitin that markedly reduces adhesions, may function to modulate intracellular signals such as growth factors and cytokines in the inflammatory exudate. Since transforming growth factor-beta is implicated in the fibrotic process, we investigated the possibility that NOCC's effects on adhesion formation reflects a modulation of TGF-beta activity. Using a biological assay for inhibition of cell proliferation to detect TGF-beta activity, we demonstrate that NOCC suppresses the levels of an inhibitor of cell proliferation released into serum and peritoneal exudates after cecal abrasion in the rat. However, this activity was distinct from known forms of TGF-beta as determined using both TGF-beta-neutralizing antisera and a TGF-beta-resistant cell proliferation assay. Thus at least one potential effect of NOCC involves a mechanism distinct from TGF-beta inhibition.

The prevention of fatalities in cycloheximide challenged mice pretreated with a submicrogram dose of lipopolysaccharide or with a small volume of cell-free Ehrlich ascites tumour fluid

OBJECTIVE AND DESIGN

Therapeutic strategies were employed to better understand the pathogenesis of fatal cycloheximide (CX) intolerance in mice pretreated with a submicrogram dose of lipopolysaccharide (LPS) or with a small volume of cell-free Ehrlich ascites tumour fluid (EAF).

MATERIALS AND SUBJECTS

Inbred, male CBA-strain mice.

METHODS

Aminoguanidine (AMG), a selective inhibitor of inducible nitric oxide synthase (iNOS) was used to determine the role of nitric oxide (NO) in the fatalities. Dexamethasone (DEX) or nordihydroguaiaretic acid (NDGA) were used to assess possible involvement of tumour necrosis factor-alpha (TNF) in sensitisation to CX.

RESULTS

AMG protected CX challenged mice pretreated with LPS or with EAF. DEX, but not NDGA, protected the former animals; both DEX and NDGA protected the latter.

CONCLUSION

AMG protection indicates the essential role of iNOS in CX-precipitated fatalities. It is suggested that the pretreatments either directly or indirectly place iNOS expression under control of a labile protein repressor. In the case of EAF pretreated mice, a role for TNF could not be excluded, whereas in LPS pretreated animals TNF plays no part in sensitising to CX.

Effect of peritoneal fluid from patients with mild and severe endometriosis on endometrial stromal cell proliferation

The aim of this study was to evaluate and compare the mitogenic effect of peritoneal fluid (PF) from women with mild and severe endometriosis on the endometrial stromal cell proliferation. Increasing concentrations of PF from women with and without mild or severe endometriosis were added to primary endometrial stromal cell cultures and 3H-thymidine incorporation was used to assess DNA synthesis in these cultures. PF from women with mild endometriosis induced a statistically significant dose-dependent increase in stromal cell thymidine uptake ranged from 5.8 to 14.5 fold, whereas PF from women with severe endometriosis produced an average 51% inhibition of stromal cell proliferation of compared with cells exposed to non-endometriosis PF or exposed to nutrient medium supplemented with 2.5% calf serum alone. PF samples from patients with stage I endometriosis induced a statistically dose-dependent increase in stromal cell proliferation, whereas PF from patients with stage IV endometriosis caused a significant inhibition.

Highly malignant rat hepatoma AH66F cells respond to ascitic fluid

Rat ascites hepatoma (AH) 66F cells are more maligant than AH130 cells. AH66F cells grew faster than AH130 cells in media supplemented with both 5% fetal calf serum (FCS) and 5% ascites fluid (ASF), which is obtained from rats bearing these cells. The growth of AH66F cells was more accelerated in ASF than in FCS. The motility of AH66F cells was significantly increased by ASF, while the cells hardly moved in FCS. The growth and motility of AH130 cells were not different in FCS and ASF. Moreover, the adhesion ability of AH66F cells to mesothelial cells (M-cells) isolated from the mesentery was significantly higher than that of AH130 cells just after harvesting from the rats. The fresh AH66F cells adhered to M-cells at about 60%, and the adhesion rate of the cells decreased to about 47% after culturing with 5% FCS for 48 hours but was maintained in the presence of ASF. The adhesion ability of AH130 cells was not changed after incubation with both FCS and ASF. On the other hand, it has been reported that AH66F cells are unique in having leukocyte function-associated antigen-1 (LFA-1) on the outer cell membrane, adhering through interaction with intercellular adhesion molecule-1 (ICAM-1) on M-cells, although AH130 cells are not so efficient as other hepatoma cells. Consequently, the adhesion of AH66F cells to M-cells was inhibited by anti-LFA-1 beta-chain monoclonal antibody and anti-ICAM-1 antibody. When cells were cultured separately with FCS or ASF, and the adhesion molecules were analysed using flow cytometry, the expression of LFA-1 molecules on AH66F cells was not changed by eitherv FCS or ASF, but the ICAM-1 molecule on M-cells was increased time-dependently by ASF. From these results, the high malignancy of AH66F cells attributes to responsibility to ASF for tumor growth and motility and to irregular expression of LFA-1 on the membrane, in comparison to AH130 cells.

Peritoneal fluid from women with moderate or severe endometriosis inhibits sperm motility: the role of seminal fluid components

OBJECTIVE

To examine the mechanism of sperm motility inhibition by peritoneal fluid (PF) from women with endometriosis.

DESIGN

Prospective, randomized study.

SETTING

University-based andrology laboratory.

PATIENTS

Women with and without endometriosis.

INTERVENTIONS

Fresh semen or Percoll-purified sperm fractions were combined with PF from women with endometriosis (n = 20), from fertile women without endometriosis (n = 10), or with physiological saline.

MAIN OUTCOME MEASURE

Sperm motility parameters were determined with computer assisted semen analysis. Data were evaluated by the analysis of variance and the Student's t-test.

RESULTS

Peritoneal fluid from women with minimal or mild endometriosis did not inhibit sperm motility in semen. Peritoneal fluid from women with moderate or severe endometriosis caused approximately 40%, 50%, and 80% declines in sperm motility and in percent progressive motile sperm after 4,7, and 24 hours, respectively. Sperm velocity was inhibited by approximately 30% and 60% after 7 and 24 hours, respectively. However, in the Percoll-purified sperm fractions the same PF did not inhibit sperm motility within the 4- to 7-hour time frame, and only a 17% to 42% inhibition occurred after the overnight incubation. Sperm velocity was not affected.

CONCLUSION

Cellular components of seminal fluid appear to mediate the inhibitory action of PF. Assuming that the leukocyte components of semen and PF are common, the cell-mediated inhibition of sperm motility is a likely contributor to endometriosis related infertility.

Hydrogen peroxide generation by polymorphonuclear leukocytes exposed to peritoneal dialysis effluent

In the presence of peritoneal dialysis effluent (PDE), human polymorphonuclear leukocytes (PMN) showed reduced production of hydrogen peroxide and hypochlorous acid (H2O2 and HOCl, respectively) when at rest and when stimulated with both soluble (formylmethionyl-leucyl-phenylalanine and phorbol myristate acetate) and particulate (Staphylococcus epidermidis) agonists. This effect occurred in a concentration-dependent manner between 0 and 70%. (vol/vol) dialysis effluent. The inhibition of H2O2 and HOCl observed in resting, formy-methionylleucyphenyalanine-stimulated, and S. epidermidis-stimulated PMN was confined to a low-molecular-mass (< 10,000-Da) fraction of PDE, whereas the inhibition of the PMA response was equally dispersed throughout both low (< 10,000-Da)- and high-molecular-mass (> 10,000-Da) fractions. Human serum albumin, a major component of PDE, also inhibited H2O2 and HOCl production by PMN; however, results from cell-free systems suggested that human serum albumin was not wholly responsible for the inhibition of PMN function seen with PDE. The solute(s) responsible did not affect myloperoxidase but very rapidly scavenged H2O2 and HOCl. These data suggest that the factors capable of affecting H2O2 and HOCl production by PMN accumulate in uremia and are removed from the circulation into dialysis effluent.

Disturbed host defense in peritoneal cavity during CAPD: characterization of responsible factors in dwell fluid

In this study, the factors in overnight dwell fluid (8 to 10 hr dwell) depressing granulocyte (GC) NAD(P)H-oxidase dependent radical species production are characterized. At present, most studies have essentially focused on fresh, unspent dialysate and on peritoneal macrophages. The response to Staphylococcus aureus (Staph A) was dose-dependently depressed for both GC CO2 production (from 91.3 +/- 8.4 to 9.0 +/- 1.5 dpm/10(3) GC, P < 0.01) and chemiluminescence (CL) (peak from 7.3 +/- 0.8 to 1.6 +/- 0.8 cps x 10(3)/GC, P < 0.01). Stimulation with formyl-methionine-leucine-phenylalanine (f-MLP), phorbol myristic acid (PMA), Staphylococcus epidermidis (Staph Epi), E. coli, latex and zymosan revealed a parallel depression, pointing to an intrinsic metabolic defect, rather than failure of particle ingestion. The addition of glucose to the normal cell medium to obtain the same concentration as in the CAPD effluent (2.9 +/- 0.3 mg/dl) depressed function but not to the same extent as the genuine PD effluent. Opsonization of Staph A and E. coli induced a partial correction. No effect of pH or osmolality was observed. HPLC fractionation of CAPD effluent on a polarity based gradient revealed an elution of depressive factors in hydrophobic fractions with a nadir in F7 and F12. Analysis of the elution pattern of various uremic solutes revealed elution in F12 of p-cresol, a solute with known inhibitory effect on GC function. These events may be related to recent peritonitis (CL in response to Staph A 0.3 +/- 0.1 in effluent of 6 patients with recent peritonitis versus 2.6 +/- 0.8 cps x 10(3)/GC in 12 patients without recent peritonitis (P < 0.01). We conclude that the GC response is depressed in the presence of CAPD effluent due to excess glucose, lack of opsonization, and uremic solutes of which p-cresol is one of the responsible compounds.

Influence of changes in peritoneal fluid on body-composition measurements by dual-energy X-ray absorptiometry in patients receiving continuous ambulatory peritoneal dialysis

The effect of the presence of intraabdominal fluid on measurement of body composition by dual-energy X-ray absorptiometry (DXA) was determined by scanning 14 patients who were receiving continuous ambulatory peritoneal dialysis (CAPD) before and after the drainage of peritoneal dialysate, resulting in a mean (+/- SD) weight loss of 1.81 +/- 0.34 kg. DXA showed changes in whole-body soft tissue, which were correctly localized to the trunk region on regional analysis. Changes in DXA estimates of mean total lean tissue, 1.78 +/- 0.94 kg, and trunk lean tissue, 1.87 +/- 0.84 kg, were very similar to the actual change in body weight. However, the DXA estimate of change in total soft tissue, 2.11 +/- 0.44 kg, was significantly greater than the change in body weight by 0.3 kg (P < 0.005); the difference was accounted for by a tendency for a reduction in the estimate of body fat affecting the trunk region after drainage of dialysate. DXA was also less good at detecting changes in individual subjects. Estimates of total and regional bone mineral content and bone mineral density were not affected by the drainage of the dialysis fluid.

The effect of peritoneal fluid from patients with endometriosis on human sperm function in vitro

OBJECTIVE

Our purpose was to evaluate the effect of peritoneal fluid from women with endometriosis on sperm motility and function in an in vitro model.

STUDY DESIGN

Peritoneal fluid was collected at laparoscopy from patients with and without endometriosis. Human donor sperm was diluted with this fluid, and its effect on sperm function and motility was measured was measured with the zona-free hamster egg sperm penetration assay and computer-assisted semen analysis.

RESULTS

The mean number of eggs penetrated by the sperm mixed with peritoneal fluid from patients with endometriosis was significantly fewer than the number penetrated by the sperm mixed with fluid from control patients (22.9 +/- 5.31 vs 44.4 +/- 4.96, p < 0.01, Student t test, n = 20). When evaluated by computer-assisted semen analysis, sperm mixed with peritoneal fluid from patients with endometriosis showed a significant decrease in mean swimming velocity compared with sperm mixed with peritoneal fluid from control patients (54.0 +/- 1.77 vs 59.2 +/- 1.05, p = 0.02, Student t test, n = 20). A significant increase in the fraction of sperm swimming at slower velocities was also found. A trend toward a positive correlation between eggs penetrated and sperm velocity was seen, but statistical significance was not achieved (correlation coefficient 0.4392, p = 0.053, n = 20).

CONCLUSION

These data suggest that substances found in the peritoneal fluid of patients with endometriosis could contribute to infertility through impairment of both sperm function and motion kinematics.

Validation of the determination of the activity of adenosine deaminase in the body effusions of cats

In order to identify parameters differentiating exudative from transudative effusions, it was postulated that the activity of adenosine deaminase (AD) (EC 3.5.4.4) might be highly correlated with granulomatous inflammatory processes of the serosa, and the activity of the enzyme in body effusions and serum from cats was examined. The method of Slaats et al (1985) for the determination of the enzyme was evaluated by using an Hitachi 705 autoanalyser, and its activity was measured in body cavity effusions of 174 cats. The activity of AD was high in effusions from cats with infectious serositis and bacterial or feline infectious peritonitis (FIP). In cases of FIP the activity of AD was very significantly different from all other cases of thoracic (P = 0.004) and abdominal (P < 0.0001) effusions. The determination of AD in the serum of cats did not contribute to the aetiological differentiation of hydrops. The increases in the activity of AD appeared to originate from the body effusion, because the ratio of the activity of the enzyme in the effusion to its activity in serum was relatively high in cases of FIP.

Effect of peritoneal fluid from infertile women with endometriosis on ionophore-stimulated acrosome loss

The effect of peritoneal fluid (PF) from endometriosis patients was studied in spontaneous and stimulus-induced (Ca-ionophore; A23187) acrosome reactions. PF samples were obtained from 21 infertile women with endometriosis and five normal women (controls). Sperm acrosomes were examined by staining with Pisum sativum agglutinin labelled with fluorescein isothiocyanate. The incidence of spontaneous acrosome reaction after 1 and 6 h of incubation (6.7 +/- 1.6 and 6.9 +/- 1.4 respectively) was significantly (P < 0.001) lower when the incubation was performed with PF from endometriosis patients in comparison with spermatozoa incubated in PF from the control group (12.8 +/- 1.1 and 12.8 +/- 0.8). Similarly, the incidence of A23187-induced acrosome reaction after 1 and 6 h of incubation (19.8 +/- 2.7 and 20.0 +/- 2.4) was significantly (P < 0.001) lower when spermatozoa were incubated with PF from endometriosis patients in comparison with spermatozoa incubated with PF from the control group (34.6 +/- 9.8 and 34.4 +/- 1.1). The incidence of A23187-inducible acrosome reaction was also significantly (P < 0.001) lower when the incubation was performed with PF from endometriosis patients (13.1 +/- 2.8 and 13.1 +/- 2.4) when compared with that from the control group (21.8 +/- 2.6 and 21.6 +/- 1.5). No relationship was found between the stage of endometriosis and the incidence of acrosome loss. In conclusion, the PF from endometriosis patients decreased both spontaneous and stimulus-induced acrosome reaction. This may represent a mechanism for the detrimental effect of the PF from endometriosis patients on the spermatozoa-oocyte interaction and partially explain the aetiology of infertility in patients with endometriosis.

Cell free ascitic fluid prevents loss of cell surface sialic acid from Zajdela Ascitic Hepatoma cells in culture

In the Zajdela Ascitic Hepatoma (ZAH), a rat tumor, high levels of cell surface sialic acid residues are present which masked the immunogenicity of the cells. We have shown here that cell surface sialic acid level goes down rapidly when ZAH cells are put in culture. The reduction in surface sialic acid levels is due to a decrease in sialic acid residues on the major sialylated glycoprotein, gp 120, as well as a decrease in gp 120 polypeptide. The loss of sialic acid from the cultured cells is reduced if the cells are cultured in the presence of cell free ascitic fluid from ZAH tumor.

Peritoneal lavage fluids stimulate NIH3T3 fibroblast proliferation and contain increased tumour necrosis factor and IL-6 in experimental silica-induced rat peritonitis

Fibroblast proliferation is one of the earliest features of fibrosis, preceding collagen deposition in wound. The response to tissue injury is characterized by the infiltration of acute inflammatory cells, followed by persistence of macrophages. In vitro, macrophages are known to secrete monokines and growth factors which affect fibroblast proliferation and collagen synthesis. To investigate in vivo kinetics of fibroblast proliferating activity and monokine production in experimental peritonitis, silica was instilled intraperitoneally into rats, and peritoneal lavage fluids (PLF) and the culture supernatants of macrophages were analysed for NIH3T3 fibroblast proliferating activity and monokine production. NIH3T3 fibroblast proliferating activity in PLF was markedly elevated 3-5 days after intraperitoneal silica instillation, and peritoneal macrophages also spontaneously released these factors in vitro. Tumour necrosis factor (TNF) and IL-6 were also markedly increased after 3-5 days, and macrophages spontaneously released these monokines. PLF-induced fibroblast proliferation was blocked by anti-TNF antibody, and fibroblast proliferation was stimulated by the external addition of TNF or TNF and IL-6 in vitro. These results show high influx of fibroblast proliferating factors and monokines in peritoneal lavage fluid after 3-5 days of silica-induced experimental peritonitis, providing further evidence of involvement of macrophages, TNF, and possibly IL-6 in peritoneal fibrosis.

Influence of ascites on the chemotaxis of granulocytes in patients with cirrhosis

Spontaneous bacterial peritonitis is a specific infectious complication in liver cirrhosis. The reasons for the preferred location of infection on the peritoneum are not clear. The aims of the present study were to ascertain whether hepatogenic ascites fluid is chemotactically effective, what part is played by complement factor C3 and whether there are inhibitors of chemotaxis in ascites. Chemotaxis of granulocytes in serum and ascites fluid was measured in 18 patients with cirrhosis and ascites and in 18 healthy individuals using the Boyden chamber method. In the patients, the chemotactic effect of serum was reduced significantly. Ascites fluid had lower chemotactic activity than autologous serum (P < 0.01), directly correlated to C3 levels (P < 0.025). There was a significant correlation between chemotaxis in serum and in ascites fluid (P < 0.005). Adding ascites fluid to serum led to reduction of chemotactic activity only in the patients (P < 0.025). In conclusion, the chemotactic effect of ascites fluid is considerably lower than that of serum and is proportional to local concentrations of C3. Chemotaxis-inhibiting factors can also be identified in ascites fluid, their pathogenetic relevance being limited.

Tumor oncogenic expression in malignant effusions as a possible method to enhance cytologic diagnostic sensitivity. An immunocytochemical study of 87 cases

The diagnostic ability of cytological preparations can be hampered by specimen inadequacy and the presence of representative cells, which may result in a diagnostic accuracy of only 70%. An immunocytochemical battery (ICC), which included anti-p53, anti-c-erbB-2, and B72.3 MoAbs, was used to enhance sensitivity in 87 specimens of body effusions. Thirty-six cases were positive for malignancy using conventional cytology. Forty cases were negative and 11 cases were inconclusive or had an equivocal diagnosis. Sensitivity was 65%, and there was a negative predictive value (NPV) of 62%. p53 was expressed in 50 cases (56%, sensitivity = 83%, NPV = 73%), and B72.3 MoAb was positive in 36 cases (37%, sensitivity = 66%, NPV = 64%). Forty-eight cases (56%) displayed reactivity with anti-c-erbB-2 (sensitivity = 75%, NPV = 63%). The authors concluded that application of an ICC panel of anti-p53, B72.3 and c-erbB-2 to complement conventional cytology increases sensitivity to 98% (P < .0005) with an NPV of 96% (P = .001).

Peritoneal fluid and HCG influence on steroid production from ovarian tumor tissue, in vitro

Steroids are produced by malignant and benign epithelial ovarian tumor tissue in vitro, but the regulation is unknown. The effect of peritoneal fluid and beta-HCG on steroid production was analysed. Tissue from 17 malignant or benign epithelial ovarian tumors and 6 normal postmenopausal ovaries were incubated. In 11 cases tissue was incubated with and without addition of the patient's own peritoneal fluid (Part I). Tissue from 22 ovaries was incubated with and without HCG (100 IU/ml medium), (Part II). Furthermore, the release from tumorous and control ovaries of beta-HCG, progesterone, androstenedione and estradiol measured using radioimmunoassay (Part III). Peritoneal fluid stimulated the release of progesterone from both malignant and benign tissue and androstenedione or estradiol stimulated release from benign tissue (Part I). There was no stimulatory effect of HCG on steroid release from malignant tissue. HCG stimulated release of estradiol in benign tissue (Part II). All malignant tumors and 4 out of 6 benign tumors released beta-HCG (Part III). There seems to exist factors in peritoneal fluid which are able to stimulate steroid production from ovarian tumors.

Interaction between three subpopulations of Ehrlich carcinoma in mixed solid tumours in nude mice: evidence of contact domination

Clonal interaction between three subpopulations of Ehrlich carcinoma were studied during growth as mixed solid tumours and as ascites tumours in immune-incompetent nude NMRI mice. The tumour cell lines differed in DNA content as determined by DNA flow cytometry (FCM). Tumour growth was evaluated by tumour growth curves including calculation of tumour volume doubling times, tumour weight on day 14, cell cycle times (per cent labelled mitoses) and cell cycle distributions (FCM). Two subpopulations (E1.15 and E1.95) showed nearly identical growth characteristics during both solid and ascites tumour growth. The third subpopulation (E1.80) grew more slowly. FCM on fine-needle tumour aspirates was used to determine the relative proportions of the cell populations in mixed solid tumours in which E1.95 showed a growth-dominating effect on E1.15. No such effect was demonstrated during single-cell tumour growth in ascitic fluid in which the cells had no intimate contact. Ascitic fluid from E1.95-bearing animals or radiation-killed E1.95 cells had no effect on the growth of E1.15, and no remote effect was seen when the two cell lines were growing in opposite flanks. This indicates that only viable E1.95 cells in close in vivo contact were able to induce growth inhibition of the E1.15 subpopulation. Both the E1.95 and the E1.15 cells dominated the E1.80 cells, but in these cases cell kinetic differences may have played a role as the E1.95 and the E1.15 lines grew faster than the E1.80. The E1.80 cell line had no dominating effect on the E1.15 or E1.95. It is concluded that non-immunologically mediated cellular dominance in heterogeneous tumours may contribute to the evolution of these tumours and may be involved in fundamental tumour biological phenomena.