Long-term peritoneal tissue response in rats to mould-release agents and lubricant powder used on surgeons' gloves

Following implantation of 50-mg samples of a starch powder used for glove lubrication, or of talc or calcium carbonate mould-release agents for gloves, in the peritoneal cavity of rats, the treated animals were killed in groups of ten after 2, 4, 8, 13, 26 and 52 wk and were examined. Groups of sham-operated animals were used as controls. Within each treatment group the frequency of peritoneal adhesions remained constant throughout the study. Talc produced significantly more adhesions than the other treatments and caused a more severe granulomatous reaction, which persisted. Calcium carbonate and starch powder produced similar numbers of adhesions and in both cases the residues became invested by a thin fibrous capsule. Calcium carbonate appeared a safer material than talc.

Differential metabolism of fenvalerate and granuloma formation. I. Identification of a cholesterol ester derived from a specific chiral isomer of fenvalerate

On a single po administration of the four chiral isomers of fenvalerate ([RS]-alpha-cyano-3-phenoxybenzyl [RS]-2-(4-cholorophenyl)isovalerate) to rats and mice at 2.5 mg/kg, the [2R, alpha S]-isomer showed relatively higher residues in all analyzed tissues as compared with the other three isomers. Similarly, this isomer showed higher tissue concentrations than other isomers when mice were fed a diet containing 500 ppm of the [2S, alpha S]-, and [2R, alpha R]-isomers for 2 weeks. The [2R, alpha S]-isomer produced a lipophilic metabolite in all the examined tissues on the basis of thin-layer chromatography analysis, but not for the other isomers. The amounts of lipophilic metabolite differed among tissues, being higher in adrenal, liver, and mesenteric lymph nodes following feeding to mice at 500 ppm of the [2R, alpha S]-isomer for 2 weeks. However, the amount did not increase proportionally with time and apparently reached a plateau within a rather short time. This metabolite was identified as cholesteryl [2R]-2-(4-chlorophenyl)isovalerate ([2R]-CPIA-cholesterol ester) on the basis of spectroanalysis and chromatographic behavior after purification on silica gel, Florisil, thin-layer, and high-pressure liquid chromatography. The presence of the same metabolite also was indicated in rat tissues. The CPIA-cholesterol ester was rapidly formed and found in all the analyzed tissues of mice 1 hr after a single po administration of the [2R, alpha S]-isomer.

Differential metabolism of fenvalerate and granuloma formation. II. Toxicological significance of a lipophilic conjugate from fenvalerate

Male mice of the ddY strain were fed a diet containing the [2S, alpha S]-, [2S, alpha RS]-, [2R, alpha S]-, and [2R, alpha R]-isomers of fenvalerate. Microgranulomatous changes were observed only in mice treated with the [2R, alpha S]-isomer at 125 and 1000 ppm for 1, 2, or 3 months. In contrast, the changes did not occur in mice treated with the [2R, alpha R]-isomer under the same conditions. Feeding of the [2S, alpha S]- and [2S, alpha RS]-isomers for 1 year did not cause the microgranulomatous changes at 500 or 1000 ppm. To clarify the causative agent of granuloma formation, cholesterol ester of 2-(4-chlorophenyl)isovaleric acid (CPIA), a lipophilic conjugate from the [2R, alpha S]-isomer of fenvalerate, was injected iv into ddY mice. Microgranulomatous changes were observed in the liver of mice treated with the [2R]-, [2S]-, or [2RS]-CPIA-cholesterol ester 1 week after a single treatment of 1, 10, or 100 mg/kg, as well as in liver of mice treated with a single dose of 10 or 30 mg/kg of the [2R]-CPIA-cholesterol ester and kept up to 26 weeks afterward. Histochemistry and microscopic autoradiography of the liver of mice demonstrated the presence of tritium derived from 3H-labeled[2R]-2-(4-chlorophenyl)isovalerate and cholesterol. Histochemistry also was positive for cholesterol ester in livers of mice treated with the [2R, alpha S]-isomer of fenvalerate. These results lend support for the hypothesis that CPIA-cholesterol ester is the causative agent of microgranulomatous changes induced by fenvalerate.

Ultrastructure of macrophages of carrageenan granuloma in the rat with data on gamma-glutamyltranspeptidase activity

The present study is an electron-microscopic investigation of granuloma induced in the rat by the subcutaneous injection of 1% lambda-carrageenan in 0.8% sodium chloride. We report on the presence of desmosome-like structures connecting neighbouring macrophages. They consisted of electron-dense plaques, which are closely applied to the cytoplasmic surfaces of the junction. Usually, no bundles of cytoplasmic filaments attached to the plaques were seen. At the intercellular space at the level of the junction, a dense material was observed that was sometimes arranged in a cross-bridge fashion. The lysosomal system was markedly developed and consisted mainly of secondary lysosomes containing a filamentous material that showed intense acid phosphatase activity, which was also demonstrated in Golgi cisternae. A membrane preparation obtained from rat carrageenan granuloma contained gamma-glutamyltranspeptidase activity (GGTP), which is a cell and lysosomal membrane-bound enzyme. The GGTP activity of a similar membrane preparation of guinea pig carrageenan granuloma was six times higher than that of the rat.

Fenvalerate-induced granulomatous changes in rats and mice

Wistar rats and ddY mice were fed diet containing 10 to 3000 ppm technical fenvalerate for the major portion of their life span. Microgranulomatous changes were observed in lymph nodes, liver and spleen of both rats and mice as well as in adrenals of rats. The no-effect level for microgranulomatous changes was 30 ppm for mice and 150 ppm for rats. Transmission electron microscopy of phagocytes in the granulomatous foci revealed needle- or rod-shaped crystalline bodies within the cytoplasm. To examine reversibility of the microgranulomatous changes, ddY mice were fed the diet containing technical fenvalerate at the levels of 1000 and 3000 ppm for 6 weeks, followed by rearing on the control diet for up to 12 months. The size and number of the microgranulomatous changes were reduced with time. The microgranulomatous changes were typical of foreign body granulomas; they did not have the appearance of granulomas formed in response to immunologic stimulus.

Allopurinol hypersensitivity syndrome as a cause of hepatic fibrin-ring granulomas

Hepatic fibrin-ring granulomas were found in a 35-yr-old man who developed fever, myalgias, rash, eosinophilia, and abnormal liver function tests 4 wk after the beginning of allopurinol treatment. All clinical and biochemical abnormalities spontaneously resolved within 6 wk after cessation of therapy. There was no evidence for Q fever or Hodgkin's disease, which are the recognized causes of hepatic fibrin-ring granulomas. It is suggested that allopurinol hypersensitivity might be an additional cause of these peculiar granulomas.

Pulmonary changes resulting from subchronic exposure to cadmium chloride aerosol

Fischer-344 rats were exposed to 0.0, 0.3, 1.0, or 2.0 mg Cd/m3 as CdCl2 aerosol for 6 h/d, 5 d/wk, for 62 exposure days. Exposure to 2.0 mg Cd/m3 resulted in rapid weight loss, and all of the animals died within the first 45 exposure days. As a group, female rats survived significantly longer than the males. Exposure to Cd resulted in dose-dependent increases in lung weight. The increased weight was the result of additional tissue mass rather than edema. Both connective-tissue components, elastin and collagen, were significantly increased in the 1.0-mg/m3 group when these components were expressed on the basis of dry weight. Dose-dependent changes at the terminal bronchioles consisted of hyperplasia and flattening of type II cells, inflammation, and the proliferation of fibroblasts. Exposure to Cd also resulted in the development of intralymphatic microgranulomas in the perivascular and peribronchiolar lymphoid tissues.

[Granuloma formation in test and treatment sites caused by intracutaneously administered, injectable collagen]

Within 24 h of intracutaneous administration of an injectable collagen implant, a 34-year-old woman developed reddish-yellow nodules at two test implantation sites as well as at treatment sites. These nodules have persisted for more than 8 months. Histological findings seem to be consistent with an allergic reaction of the granulomatous type (type V).

[Acne conglobata: unusual course in 13-cis-retinoic acid therapy]

Four weeks after the introduction of a therapeutic regimen with 80 mg 13-cis-retinoic acid/day, a 16-year-old male patient developed oozing hypergranulation with vulnerable masses within acne lesions. These local symptoms were accompanied by fever, fatigue, weight loss, polyarthralgia and myalgia, similar to acne fulminans. In spite of these unusual reactions treatment was continued. Local steroid ointments were additionally applied. Within a short period of time regression of granulations and normalization of the general health condition was observed. After 4 months, therapy was discontinued. The patient's acne had totally healed and did not relapse within an observation period of 2 years.

[Granulomatous hepatitis caused by nomifensine]

Four patients are described who developed granulomatous hepatitis 4-6 weeks after treatment with nomifensin. The granulomas were located both in the portal tract and the liver parenchyma, and contained eosinophils and a few polynuclear giant cells. Serum alkaline phosphatase, alanine aminotransferase and bilirubin were raised in three, two and one patient respectively. After medication was discontinued all abnormalities disappeared within 6-10 weeks. After oral intake of 25-50 mg nomifensin all patients experienced paroxysms of high body temperature for several hours. Reexposure in one patient resulted in another fever spike 6 hours after ingestion. No other cause of the fever or the granulomatous hepatitis was identifiable. The clinical data, especially the simultanous occurrence of drug fever and the histologic pattern, are compatible with an allergic mechanism of the liver granulomas. In the presence of high fever and abnormal liver tests in relation to nomifensin treatment, an allergic drug reaction should be considered.

Chemiluminescence monitoring of phagocyte oxidative metabolism in mice bearing polyacrylamide induced granulomas

A technical protocol was recently described by Fauve et al. (J. Immunol. Methods 1983, 64, 345) for inducing subcutaneous granuloma with polyacrylamide microbeads. The present study using this technique demonstrates that the capacity of host phagocytes to generate reactive oxygen species can be easily monitored by chemiluminescence, both locally in granuloma infiltrating cells and at sites remote from the inflammatory reaction, i.e., within microamounts of whole blood and in spleen cells. We observed that both resting and stimulated (zymosan or phorbol-myristate acetate) production by C57BL/6 mouse phagocytes are significantly higher in granulomas induced with high porosity polyacrylamide beads (P300) than in those induced with beads of low polyacrylamide porosity (P4). Since this selective modulation of phagocyte oxidative metabolism is also detectable within microamounts of whole blood and in spleen cells, it could serve as a model for investigating the role of reactive oxygen species in the inflammatory reaction.

Cutaneous Thorotrast granulomas and chronic lymphocytic leukemia following Thorotrast angiography

A patient underwent cerebral angiography with thorium dioxide (Thorotrast). Six years later, an acne-like eruption of the face and scalp occurred which persisted despite aggressive treatment. Twenty-six years after the angiography he developed chronic lymphocytic leukemia with massive lymphadenopathy. Review of three facial biopsies revealed collections of Thorotrast-laden histiocytes and free thorium dioxide within a background of chronic inflammation and dermal fibrosis. These changes are of the same type described in Thorotrast granulomas of the subcutaneous tissues. There is an increased incidence of myelogenous leukemia in Thorotrast-treated patients; lymphoproliferative disorders, however, are only rarely observed.

Evolution of foam cells in subcutaneous rabbit carrageenan granulomas. II. Tissue and macrophage lipid composition

This study describes the lipid composition of differentiating macrophage-derived foam cells in the inflammatory carrageenan granuloma. In this model, macrophages exposed in vivo to diet-induced hypercholesterolemia progressively accumulate electron-translucent lipid inclusions; and at 14 and 28 days, many assume the morphologic features of arterial plaque foam cells. Subcutaneous carrageenan granulomas were induced in 24 pellet-fed (NC) and 24 cholesterol-fed (HC) rabbits, and tissue was harvested at 4, 14, and 28 days. Total (TC) and free cholesterol (FC), cholesteryl esters (CEs), CE fatty acids, triglycerides (TGs), and phospholipids (PLs) were measured on lipid extracts from tissue. TC, FC, and CEs were also measured on isolated, cultured granuloma macrophages. Tissue TCs and FCs were significantly elevated in HC relative to NC rabbits at both 14 and 28 days (P less than 0.005 and P less than 0.01, respectively). CE accumulation in HC granuloma tissue was 80-fold greater at 14 days and 178-fold greater at 28 days (P less than 0.005), compared with NC granulomas. Oleic acid (18:1), the principal CE fatty acid in both NC and HC granulomas, accounted for significantly more (P less than 0.05) of the total CE fatty acids in HC (48%) relative to NC granulomas (37%). No net accumulation of TG was observed with time in NC or HC animals. Although diet did not influence tissue PL content, significant increases (P less than 0.05) were observed at 14 days in NC rabbits and at 14 and 28 days in HC rabbits relative to 4-day levels. CE accumulation was significantly greater in cultured macrophages isolated from HC granulomas at 14 days (P less than 0.001) and 28 days (P less than 0.01). These findings have demonstrated the significant accumulation of CEs in both HC granuloma tissue and in cultured HC macrophage/foam cells in vivo. The carrageenan granuloma model has, we believe, considerable potential for defining mechanisms responsible for CE accumulation in the differentiating macrophage-derived foam cell.

Granuloma formation by muramyl dipeptide associated with branched fatty acids, a structure probably essential for tubercle formation by Mycobacterium tuberculosis

Muramyl dipeptide, which does not induce epithelioid granuloma when injected alone dissolved in phosphate-buffered saline, could induce extensive granulomas in guinea pigs when chemically conjugated with branched, but not linear, fatty acids. Peptidoglycan fragments of Staphylococcus epidermidis could evoke epithelioid granulomas when incorporated in a water-in-oil emulsion. These findings suggest the importance of a lipid bound to muramyl dipeptide for granuloma formation. In view of the fact that mycobacteria uniquely contain large amounts of branched fatty acids, it was proposed that the complex of muramyl dipeptide and branched fatty acids, mostly mycolic acids, is a structure in tubercle bacilli responsible for tubercle formation.

A Paracoccidioides brasiliensis polysaccharide having granuloma-inducing, toxic and macrophage-stimulating activity

The occurrence of a polysaccharide fraction of Paracoccidioides brasiliensis cell wall with toxic, granuloma-inducing and macrophage-stimulating activities was demonstrated. After fractionation of the lipid-extracted wall with 1 M-NaOH, three fractions were obtained: (1) an alkali-insoluble fraction; (2) an alkali-soluble, acid-insoluble fraction and (3) an alkali-soluble, acid-soluble fraction. When the three fractions were injected into mice only fraction (1) was able to induce chronic lung inflammation, causing a marked loss in body weight and death at a dose of 6 mg per animal. Analysis of the stimulation of peritoneal macrophages of mice (measured by cell spreading on glass) after intraperitoneal injection of fraction 1 showed that 75% of the cells were able to spread even 20 d after inoculation.

Diltiazem and granulomatous hepatitis

A case of granulomatous hepatitis proven by biopsy and related to diltiazem use is described. Clinicians should be alert to the possible presence of this complication in patients who develop fever, laboratory abnormalities, or clinical evidence of hepatic injury while taking diltiazem.

Inhibition of plasmacytoma development in BALB/c mice by indomethacin

Indomethacin given continuously in the drinking water (20 micrograms/ml) to BALB/cAn pi mice during the latent period of pristane-induced plasmacytoma development dramatically reduced the plasmacytoma incidence from 34.9 to 2.2%. Additionally, indomethacin given from day 0 to 120 or begun as late as 60 d after a single injection of 1.0 ml pristane was also highly effective in reducing the development of plasmacytomas. Indomethacin treatment did not prevent the formation of a peritoneal inflammatory exudate or peritoneal oil granulomatous tissue, although it had a mild inhibitory effect on the intensity of the cellular inflammation, particularly after extensive treatment of greater than 100 d. Indomethacin treatment reduced the incidence of arthritis by 50%. A major effect of indomethacin treatment was a reduction in the appearance of microscopic plasmacytomas that appear in the oil granuloma before plasmacytomas can be detected by routine sampling of the peritoneal exudate. Between days 116 and 181, 16 of 20 mice given 0.5 ml pristane were found to have foci of plasmacytoma cells, while only 2 of 20 indomethacin-treated mice had foci-containing plasmacytoma cells. The number of mice with microscopic foci in the pristane-treated group greatly exceeded the expected incidence of plasmacytomas (22%) at this dose of pristane. The growth of primary plasmacytomas in transplant that is dependent on the pristane-conditioned peritoneal environment was not inhibited by indomethacin treatment. The role of indomethacin in inhibiting plasmacytoma development was not established; two possibilities are that it inhibits production of mutagenic and tissue destructive oxidants by inflammatory cells, and it inhibits prostaglandin synthesis and intracellular production of oxidant biproducts.