Uptake of acetylated low density lipoprotein (ac-LDL) by synovial cells

Acetylated low density lipoprotein (ac-LDL) is known to be incorporated into monocyte/macrophages. We examined the uptake of fluorescence-labeled ac-LDL as well as the surface expression of CD14 using flow cytometry, in order to identify macrophage-like type A synoviocytes in the synovium of patients with rheumatoid arthritis (RA) (n = 15) and osteoarthritis (OA) (n = 5). The mean (+/- SD) percentage of ac-LDL uptake cells in RA synoviocytes (38.3 +/- 19.9%) was relatively higher than that in OA synoviocytes (16.6 +/- 8.7%) (p < 0.05). Also the proportion of ac-LDL incorporating cells paralleled, but was higher than, that of CD14 positive cells (r = 0.91, p < 0.001). This method is helpful in determining macrophage-like type A synoviocytes, and the presence of CD14-negative macrophage-like synoviocytes has been revealed.

Induction and characterization of mast cell colonies by culture supernatant of retinoic acid-treated mouse keratinocytes

The retinoic acid-stimulated mouse-transformed epidermal cell line Pam 212 generated soluble mediators (RA-Pam sup) which showed mast cell-proliferating activity and induced mast cell-like colonies from bone marrow cells. Both mucosal-type and connective tissue-type mast cells were demonstrated on histochemical analysis. The 3T3 fibroblast cell line or human trichilemmomal cell line (TL1) also generated similar molecules on retinoic acid stimulation. Anti-stem cell factor antibody presented a rather more potent inhibitory activity on RA-Pam sup-dependent mast cell colony formation than did anti-IL3 and -IL4 antibodies. RA-Pam sup only induced mast cell colonies in semisolid culture and failed to promote mast cell growth in a suspension culture. In addition, mast cell colonies showed close contact with fibroblast-like cells on the methylcellulose plate, but this finding was not observed in culture without RA-Pam sup.

Down-regulation of murine contact sensitivity by hapten-amino acid derivatives

The low responsiveness of contact sensitivity (CS) in sensitized and challenged mice was induced by using hapten-amino acid derivatives. Subcutaneous injection of trinitrophenyl (TNP)-lysine or oxazolone-glycine inhibited ear swelling responses in mice that received rechallenge. The inhibitory effect was long-lasting and antigen-specific. TNP-lysine blocked the transfer of CS in vivo and the binding of immune lymph node cells to antigen in vitro. Thus, the suppression was mediated by inhibition of effector cells, but not associated with the generation of efferent limb-acting suppressor cells. The tool reported herein seems to be quite useful for controlling ongoing murine CS to simple chemicals.

The role of metal allergy and local hyperhidrosis in the pathogenesis of pompholyx

Pompholyx (Dyshidrosis) is a disease of unknown etiology presenting as symmetrical, vesicular hand and foot dermatitis. To clarify the pathogenetic role of sweat and metal allergy, twenty five patients with pompholyx were examined with respect to their perspiration volume using equipment that continuously recorded the local perspiration volume. Patients were also examined for metal allergy by patch testing and oral challenge tests. The perspiration volumes were measured using recently developed equipment for continuous recording of local perspiration volume (Kenz-Perspiro oss-100). The perspiration volume of pompholyx patients was found to be 2.5 times higher than that of age-matched normal controls. Twenty percent of the patients showed sensitivity to chromate, 16% to cobalt, and 28% to nickel on patch testing. Six patients with positive results were challenged orally in a controlled trial with 2.5 mg nickel, 1 mg cobalt, or 2.5 mg chromium. Four of them (67%) showed vesicular reactions on their hands with challenge testing. These results indicated a sensitivity to metal compounds which, in combination with local hyperhidrosis, may contribute to the development of vesicular lesions in pompholyx.

Xeroderma pigmentosum: recent clinical and photobiological aspects

In Japan, more than 400 patients with xeroderma pigmentosum (XP) have been registered. The major groups are XP-A and variant, while clinically mild types of XP with intermediate levels of unscheduled DNA synthesis (UDS) have recently been increasing. The classical type of XP-A and some of the XP-D patients exhibit neurologic abnormalities. XP individuals display a marked increase in the frequency of skin malignancy. Development of skin malignancies appears to be related to the level of DNA repair capacity; the lower the capacity, the earlier and more frequently the skin tumors develop. Furthermore, the incidence of internal malignancy in XP patients is at least ten times higher than that for the Japanese general population over the age of 40 years. Cultured fibroblasts from XP patients exhibit higher sensitivity not only to UVC but also to UVB. The cellular sensitivity to UVB may correlate to photosensitivity in vivo from a study on a group E patient who showed age-related changes in photosensitivity and cellular sensitivity to UVB. We have also reviewed current status of molecular genetics in XP.

Accumulation of multiple T cell clonotypes in the synovial lesions of patients with rheumatoid arthritis revealed by a novel clonality analysis

T cell activation in the characteristic synovial lesions of rheumatoid arthritis may play a major role in the pathogenesis of this autoimmune disease. Analysis of T cell clonal diversity in these sites remains equivocal. Using the PCR and subsequent single-strand conformation polymorphism analysis it is possible to assess the degree of junctional diversity in the TCR with minimal selection bias. Concentrating on the beta-chain of the TCR, a paucity of clonotypic T cell expansion is demonstrated in the peripheral blood of healthy individuals. After polyclonal stimulation in vitro (with concanavalin A or phytohemagglutinin) this pattern does not change. In contrast, some T cell clonotypes appear following in vitro stimulation with purified protein derivative. Analysis of the peripheral blood, synovial fluid, and synovial tissue of patients with rheumatoid arthritis indicated many dominant T cell clonotypes. These data argue for a clonally diverse T cell response in the affected tissues of rheumatoid arthritic subjects.

Detection of myeloid precursors (granulocyte/macrophage colony forming units) in the bone marrow adjacent to rheumatoid arthritis joints

Various cytokines were recently found to be involved in the pathogenesis of rheumatoid arthritis (RA) and particularly, cytokines with hematopoietic activity have been detected in synovial tissues. We counted the number of myeloid precursors in terms of granulocyte/macrophage colony forming units (CFU-GM) and the number of stromal cell progenitors in terms of fibroblast colony forming units (CFU-F) in the tibial bone marrow adjacent to the joints affected by RA (n = 21), osteoarthritis (OA) (n = 10), and trauma (n = 2) using the colony formation unit assay. We also quantitated the amounts of interleukin 1 beta (IL-1 beta), IL-6, and granulocyte/macrophage colony stimulating factor (GM-CSF) in the culture supernatant of synovial tissue explants of these patients by enzyme linked immunosorbent assay (ELISA). The mean number (+/- SEM) of CFU-GM in patients with RA (7.4 +/- 4.9) was greater than that in patients with OA (0.5 +/- 0.2), while CFU-GM was not detected in trauma patients. The number of CFU-GM in the tibial bone marrow of patients with RA correlated well with the amount of IL-1 beta (r = 0.64, p < 0.01), but not with GM-CSF or with IL-6 from synovial tissues. These findings suggest that active bone marrow is present adjacent to the affected joints in patients with RA and that hematopoietic activity is influenced by IL-1 beta produced in nearby synovial tissues.

Resistance of hippocampal CA-1 noradrenergic fibers to five minutes of transient cerebral ischemia in the gerbil

We examined changes in the tyrosine hydroxylase (TH)-immunoreactive fibers following 5 min of cerebral ischemia in gerbils using an immunohistochemical method 1, 3 and 30 days after ischemia. Almost all CA-1 pyramidal neurons were lost 3 days after ischemia, whereas noradrenergic fibers were maintained 30 days after ischemia. The present study demonstrated that TH-immunoreactive fibers and cells were resistant to transient ischemia, and that there was no sprouting or hyperactivity in noradrenergic systems after ischemia.

Severe progressive erosive arthritis in multicentric reticulohistiocytosis: possible involvement of cytokines in synovial proliferation

A case of multicentric reticulohistiocytosis complicated by severe progressive erosive arthritis in a 40-year-old man is described. The diagnosis was confirmed by biopsies of the cutaneous nodule and the synovial tissue of the right knee joint. Destructive changes in the multiple joints rapidly progressed and resulted in severe progressive erosive arthritis. Immunohistochemical staining revealed that the histiocytes reacted positively to interleukin 1 beta and platelet derived growth factor B, leading to the speculation that these cytokines may play a role in the synovial proliferation seen in patients with multicentric reticulohistiocytosis.

Enhancing effects of fluorescein on beta-lactam rash. I: High incidence of cefclidin rashes in an ophthalmological volunteer trial

Disseminated maculopapular eruptions were frequently observed in a volunteer trial of cefclidin's use in ophthalmological and neurological examinations (8/12; 67%) It appeared at 8-12 days (mean +/- SD, 9.6 +/- 1.1 days) from the initiation of the trial and subsided within 1-2 days (mean +/- SD, 1.8 +/- 0.4 days). Patch testing with cefclidin produced a +/- reaction in 1 of 8 cases, and the drug-induced lymphocyte stimulation test (DLST) elicited a positive response (SI: 2.8) in 1 of 8 and a weakly positive response (1.8 < or = SI < 2) in 2 of 8. From these findings, it seems likely that the eruptions may be partially mediated by delayed type hypersensitivity (DTH) reactions to cefclidin. No such eruption was observed in the phase II trial of cefclidin where only 2.8% of 1.122 volunteers developed the eruption. The volunteers were given both fluorescein and oxybuprocain in their eyes to measure ocular tension on days -1, 0, 1, 3, 5, 7, 9, 11, 13 and weeks 3, 5, 7 after the initiation of cefclidin. Fluorescein and/or oxybuprocain may affect cefclidin to induce these abnormal reactions in the volunteers.

Polyamines in human and rat milk and in infant formulas

Polyamines are ubiquitous compounds known to be involved in cell proliferation and differentiation in many tissues. Enteral administration of these compounds has been shown to produce effects in suckling and adult animals. Using HPLC techniques, we verified the presence of putrescine, spermidine, and spermine in human milk and quantitated their concentration in samples collected from the first week up to 4 mo of lactation. Mean values of these compounds ranged (per liter) from 0 to 615 nmol putrescine, from 73 to 3512 nmol spermidine, and from 722 to 4458 nmol spermine. Polyamine concentrations in infant formulas were dependent on the protein source, the particular polyamine, and the protein concentration of the formula. Concentrations of these three compounds in rat milk over the first 3 wk of lactation were higher than in human milk, with spermidine being the polyamine most elevated compared with human milk (almost 20-fold higher). An artificial formula used for the rearing of suckling rats contained trace to immeasurable amounts of polyamines. Our study identifies milk as one vehicle for polyamine delivery to the intestinal mucosa of suckling animals.

Absence of early destructive changes of cytoskeletal proteins after transient ischemia in the rat

We examined the changes in immunoreactivity of microtubuli-associated protein (MAP) 2 in dendrites by immunohistochemical analysis following 20 min of cerebral ischemia in the rat. A decrease of immunoreactivity of MAP 2 in dendrites in the CA1 subfield of the hippocampus was observed on days 3 and 7 but not on day 1 after ischemia. Early destructive changes of this protein were not observed, a finding which was confirmed by polyacrylamide gel electrophoresis analysis. We elucidated one factor which indicated that destruction of the dendrites of CA1 pyramidal neurons would not take place any earlier than the destruction of the neurons themselves after ischemia in rats.

Substituting ornithine for arginine in total parenteral nutrition eliminates enhanced tumor growth

Total parenteral nutrition (TPN) may enhance the growth of some tumors: this enhanced growth is associated with an increase in the erythrocyte polyamine levels. The effect of arginine in TPN on tumor growth was compared with ornithine using rats with a transplantable Ward colon tumor. The relationship of circulating arginine, ornithine, glutamine, and polyamines with tumor growth was investigated. For rats fed chow ad libitum, increasing tumor weights were associated with a linear decrease in the plasma arginine levels which was consistently lower than that of age-matched non-tumor bearing (NTB) rats; ornithine and lysine levels were not affected. Subsequent experiments suggest that plasma glutamine levels were also lower in tumor bearing rats. Pair-fed NTB rats had reduced arginine but not glutamine levels in plasma. TPN regimens with arginine or with ornithine substituted for arginine at two levels (equimolar [Orn-Em] or isonitrogenous [Orn-IN]) were given to colon tumor bearing rats for 8 days. The final tumor weight of rats which received the arginine-containing regimen (19.8 +/- 5.7 g, n = 4) (P less than 0.05) was significantly greater than the tumor weight of rats fed chow ad libitum (12.1 +/- 3.3 g, n = 6). The final tumor weights of Orn-EM (11.2 +/- 2.6 g, n = 4) or Orn-IN (11.6 +/- 0.8 g, n = 6) were similar to the chow-fed controls. The plasma arginine levels were elevated, compared with the control, when arginine was present in the regimen. The plasma arginine levels of rats which received Orn-EM or Orn-IN were lower than the controls. The plasma ornithine levels were not affected by arginine in the regimen but were elevated with increasing levels of ornithine in TPN. Plasma glutamine levels were decreased when arginine was present in the regimen but were elevated when ornithine was substituted for arginine. Erythrocyte putrescine was increased when either arginine or ornithine was included in the TPN regimens. These results demonstrate that while arginine in a parenteral regimen stimulates tumor growth, substituting ornithine for arginine in TPN does not enhance the growth of a transplantable colon tumor.

Ingrown toenails: an evaluation of elevating the nail bed-periosteal flap

Many procedures to correct ingrown toenails are available; however, they cannot avoid recurrence and nail deformities. We have performed a procedure which corrects ingrown toenail without reducing the width of the nail plate by elevating the nail bed-periosteal flap. Sixty patients were observed for longer than six months and exhibited excellent results. Only two cases of incurvated nails (2) required re-operation.

Pigmentary dysplasias and chromosomal mosaicism: report of 9 cases

Chromosomes were studied in 9 individuals with pigmentary dysplasias of the skin and other abnormalities. Of the 9 individuals, 5 were chromosomal mosaics in both blood lymphocytes and skin fibroblasts (46,XY/47,XY, + 13;46,XX/47,XX, + 14;46,XY/47,XY, + 18;46,XX/47,XX, + 18;46, XX/47,XX, + mar), while the other 4 individuals were chromosomally normal in both tissues studied. The pigmentary dysplasias involved hypo- or hyperpigmented patches/flecks or lines/whorls. The latter ran along Blachko lines on the back, abdomen and the limbs. These patterns varied not only between individuals but also between different regions of an individual. The possibility of chimerism was studied but ruled out (1/32 to 1/256) in 7 individuals, using chromosomal heteromorphisms in the patients and their parents as markers.

[A case of small cell lung cancer with Waldenstrom's macroglobulinemia]

Waldenstrom's Macroglobulinemia is characterized by a proliferation of cells of the reticuloendothelial system associated with a monoclonal increase in serum levels of gamma globulins of immunoglobulin M class. We report a case of lung cancer with Waldenstrom's macroglobulinemia. A 68-year-old man was admitted to our hospital for abnormal mass shadow on chest X-P during chemotherapy for macroglobulinemia. Pathological diagnosis was small cell carcinoma by transbronchial lung biopsy. Right middle and lower lobectomy with mediastinal lymph nodes dissection were performed. Postoperative staging was stage II (t1n1m0). Chemotherapy for the lung cancer and plasmapheresis for hyperviscosity syndrome were carried out, after surgical treatment. This patient has been followed for three years and has no evidences of recurrence of the lung cancer.

Photosensitivity in atopic dermatitis: demonstration of abnormal response to UVB

It is a well-known fact among clinicians that sunlight may exacerbate atopic dermatitis (AD), but little is known beyond that. In a preliminary study investigating this phenomenon, 19 patients with AD were selected for phototests. All of them had a normal minimal erythema dose (MED). However, 3 patients (15.7%) demonstrated abnormal cutaneous responses 24-72 h after provocation with ultraviolet light B (UVB). None of the patients had a positive response to pure ultraviolet light A (UVA) irradiation of up to 9 J/cm2. The photobiological results of this study confirm the existence of photosensitivity in AD and indicate that UVB wavelengths are responsible for it.

Aberrant cytokine production from tenosynovium in dialysis associated amyloidosis

Culture supernatants of tenosynovial tissues from patients with carpal tunnel syndrome undergoing chronic haemodialysis contained interleukin (IL) 1-like and IL6-like activity. These culture supernatants also induced active proliferation of rheumatoid synovial cells. Immunohistochemical analysis of teno-synovial tissues showed the accumulation of mononuclear cells bearing CD14 and HLA-DR antigens adjacent to the deposition of amyloid protein (beta 2 microglobulin). These cells also reacted with antibodies to IL1 and IL6 respectively. These data suggest that multiple cytokines, including IL1 and IL6, produced from tenosynovial tissues in patients with dialysis associated amyloidosis might induce the proliferation of synovial cells that, together with deposition of amyloid protein, might cause carpal tunnel syndrome.

[Incidence of hepatitis C in chronic liver diseases following tattooing]

The seroprevalence of hepatitis C virus (HCV) was investigated in 16 tattooed men with chronic liver diseases using the Ortho-Chiron HCV antibody ELISA system. In 11 out of the 16 men, the result was positive, which was significantly higher as compared with that of presumably healthy blood donors in the Tokyo area, i. e., 1.14% of 2470 donors tested. These results suggest that HCV infection occurred at the time of tattooing in these 11 patients.

IgE, IgG, and IgG4 antibody titers to fractionated house dust mite antigens in nasal allergy patients

Using 6 fractions differing in molecular weight of Dermatophagoides pteronyssinus (Dp)-antigen, we measured by enzyme-linked immunosorbent assay (ELISA) the titers of specific IgE, IgG and IgG4 antibodies against Dp antigen in sera of allergic subjects who were sensitive to house dust mite. We intended to evaluate which Dp fraction acts as the major antigenicity for allergic subjects. Results were as follows: 1) In comparison with normal controls, the titer of IgE antibody specific to crude Dp antigen was evaluated, but no significant difference was found among the titers of IgE antibody against each Dp fraction. 2) The titer of IgG antibody against the fraction with a high molecular weight (190 KD, 95 KD) was significantly higher than the titer of the 15 KD fraction in the nasal allergy patients. 3) The 15 KD fraction induced significant elevation of the titer of IgG4 antibody. It suggests that the low molecular weight fraction may act as the major allergenicity of Dp-antigen for inducing both IgE and competitive IgG4 antibodies, although other fractions induce significant IgE responses in patients with nasal allergy.