Characteristics and sequence of the recurrent patterns after curative esophagectomy for squamous cell carcinoma

BACKGROUND

A large number of patients with esophageal cancer experience recurrence, even when a curative operation is performed. The purpose of this study was to clarify the characteristics of recurrence after a curative esophagectomy.

METHODS

The patterns and the time of recurrence after curative esophagectomy were examined in 187 cases of thoracic esophageal cancer. Ninety-five of these patients died of evident recurrence. The recurrence patterns were classified into lymphatic, hematogenic, mixed type (lymphatic and concomitant hematogenic), and intramural recurrences.

RESULTS

The number of cases in each recurrence group were 46, 23, 22, and 4, respectively. The disease free intervals were fairly closely correlated with pTNM stage in the lymphatic and mixed type groups whereas they were within 2 years in all cases of the hematogenic group. Among the 22 cases of the mixed type, hematogenic recurrence preceded lymphatic recurrence in only one case. Furthermore, 17 of 20 cases with either cervical or mediastinal lymph node recurrence of the mixed type were accompanied with lung recurrence, whereas the remaining two cases with abdominal lymph node recurrence had liver recurrence.

CONCLUSIONS

These findings suggest that most mixed type recurrences and most lymphatic ones are primarily caused by lymph node metastases; thus the importance of a radical lymphadenectomy was supported. On the other hand, a careful examination for hematogenic recurrence is essential soon after operation.

[Granulocyte colony-stimulating factor treatment (G-CSF) of antithyroid drug-induced granulocytopenia: granulocyte count measurement after 4 hours of G-CSF injection is useful for the detection of recovery from granulocytopenia]

The primary objective of this study was to ascertain the usefulness of granulocyte count measurement after 4 hours of granulocyte colony-stimulating factor (G-CSF) injections for the detection of recovery from granulocytopenia. Four Graves' patients with antithyroid drug-induced granulocytopenia (granulocyte count between 500 and 1000/mm3) and three Graves' patients with antithyroid drug-induced agranulocytosis (granulocyte count < 500/mm3) each received a daily dose of 75 mu g of G-CSF administered subcutaneously. In all granulocytopenic patients, after 4 hours of G-CSF injection the granulocyte counts increased to 5623, 4050, 8923 and 4647/mm3, and the granulocyte count after 24 hours of G-CSF injection was 3008, 4634, 4854, 4200/mm3. In one of the three agranulocytic patients, the granulocyte count increased from 238/mm3 to 5982/mm3 after 4 hours of G-CSF injection, and the granulocyte count after 24 hours of G-CSF injection was 4800/mm3. Although the granulocyte counts before G-CSF injection of the remaining two agranulocytic patients were 138 and 126/mm3, the granulocyte counts after 4 hours of G-CSF injection were 837 and 59/mm3 and those after 24 hours of G-CSF injection were 817 and 0/mm3. These results indicated that granulocyte count measurement after 4 hours of G-CSF injection was useful for detecting the recovery from granulocytopenia and agranulocytosis.

Eosinophilic leukaemia with a t(2;5) (p23;q35) translocation

Although the diagnosis of rare eosinophilic leukaemia is possible based on cytogenetic abnormalities, the chromosomal aberrations reported are diverse. We found a t(2;5) (p23;q35) translocation on bone marrow cells of a patient with chronic eosinophilia who suffered from multiple pustular folliculitis but lacked the clinical symptoms commonly observed in hypereosinophilic syndrome. No morphological abnormalities in an eosinophilic series were apparent and other haemopoietic cells were well preserved. A therapeutic trial with interferon-alpha failed after a 2-month period, and the patient is currently undergoing a combination therapy with interferon and intermittent administrations of hydroxyurea.

Thyroglobulin and lactic dehydrogenase isozymes in cystic fluid of thyroid nodules

Although fine needle aspiration biopsy (FNAB) is most valuable in the diagnosis of thyroid cancer, it is hampered by the fact that no specimen suitable for cytological examination can be collected from all cystic lesions. Often inadequate aspirates, consisting only of fluid or a few foamy cells and lacking the necessary epithelial cells, are all that an aspirationist is able to collect. Therefore an alternative method of determining the benign or malignant characteristics of cyst fluid is of vital importance. In this study we examine thyroglobulin (Tg) concentrations and lactic dehydrogenase (LDH) isozyme patterns of cyst fluid and discuss how these variables help us estimate the probability of malignancy. Fifty-three differentiated cancers (39 papillary and 14 follicular carcinomas) and 72 surgically resected benign thyroid nodules (40 adenomas, 19 colloid goiters, and 13 cysts) were analyzed. Only 28 (53%) of 53 malignant lesions were correctly diagnosed by FNAB. The mean logarithmic value for the Tg concentration (log10 Tg) was significantly lower in malignant cyst fluid than it was in benign nodules (mean +/- SD: 5.8 +/- 1.0 vs. 6.8 +/- 1.0; P < 0.001). The LDH 1 and 2 isozyme percentage was greater in the malignant group than in the benign group (49.1 +/- 12.7% vs. 38.1 +/- 16.9%; P < 0.01). In multiple logistic regression analysis, log10 Tg and the total of LDH 1+2 percentage was significant in estimating the probability of malignant nodules. The results of our study suggest that determining the Tg concentration and the LDH isozyme patterns of cyst fluid could provide new information for the evaluation of cystic thyroid nodules.

[Clinicopathological study of 4 patients with idiopathic BOOP, interstitial type on chest X-ray]

We studied four patients with idiopathic Bronchiolitis Obliterans Organizing Pneumonia (BOOP) diagnosed by open lung biopsy. All of four presented with acute onset and a rapid course with progressive dyspnea. Their chest X-ray films showed ground-glass opacities with reduced volumes in the bilateral lower lobes. Their chest CT revealed marked increases in lung density with air bronchograms. Radiologically, it was difficult to distinguish these cases from patients with acute interstitial pneumonia. Histologically, in the uninflated specimens, the collapse of alveoli and alveolar spaces filled with foamy macrophages and proteinous exudates were observed. The organizing tissues were present predominantly in the alveolar ducts, but varied in extent among cases. We considered the reduced lung volumes on chest X-ray films and the marked increases in lung density on chest CT to reflect alveolar collapse. Proliferation of type II pneumocytes was remarkable in all cases, but reactivity to antisurfactant protein-A antibody staining was decreased in the collapsed alveoli. It was suggested that the alveolar collapse was caused, in part, by decreased pulmonary surfactant in addition to obstruction of the alveolar ducts. The rapid responses to of these patients corticosteroid therapy may be due to improvement of the alveolar collapse.

Transmission at the squid giant synapse was blocked by tetanus toxin by affecting synaptobrevin, a vesicle-bound protein

1. The effect of whole tetanus toxin (TeTX) and of its light chain (TeTX L-chain) on transmitter release was determined by presynaptic pressure-injection in the squid giant synapse. 2. The results indicate that whole TeTX does not modify transmission while the L-chain blocks transmission within 20-30 min. This block does not involve changes in the sodium or potassium conductances responsible for spike generation or the voltage-dependent presynaptic calcium current responsible for transmitter release. 3. Western blotting of protein fractions from the squid optic lobe demonstrated the presence of a protein which reacted with specific antibodies against mammalian synaptobrevin, a vesicular protein. In addition, this protein was enzymatically cleaved by the L-chain component of the toxin in a similar fashion to its mammalian counterpart. 4. These results demonstrate that TeTX L-chain toxin acts directly on a squid synaptobrevin and prevents synaptic release probably by interfering with the docking-fusion synaptic vesicles at the active zone.

Novel mechanism of glucocorticoid-mediated gene repression. Nuclear factor-kappa B is target for glucocorticoid-mediated interleukin 8 gene repression

A glucocorticoid, dexamethasone, inhibited the production of a leukocyte chemotactic cytokine, interleukin 8 (IL-8), as well as mRNA expression by a glioblastoma cell line, T98G, stimulated with interleukin 1 (IL-1). Dexamethasone also inhibited IL-8 promoter-driven chloramphenicol acetyltransferase (CAT) activities induced by IL-1, suggesting that dexamethasone inhibited IL-8 production mainly at the transcriptional level. Moreover, CAT assay revealed that the nuclear factor-kappa B (NF-kappa B) binding site was the crucial cis-element required for conferring IL-1 responsiveness in conjunction with the CCAAT enhancer binding protein/nuclear factor-IL-6 (NF-IL6) and/or the AP-1 binding site(s). Mutation of either the AP-1 or NF-IL6 binding site did not abolish IL-8 gene repression by dexamethasone, suggesting that these sites were not targets for dexamethasone. Trimerized kappa B sequence in the IL-8 gene was enough for conferring the induction by IL-1 and inhibition by dexamethasone of CAT activity. Finally, dexamethasone diminished the IL-1-induced formation of NF-kappa B complexes, which were identified immunochemically to consist of p50 and p65, without reducing the amount of translocated factors. Collectively, dexamethasone interfered with the binding of the most essential transcription factor, NF-kappa B, to its cognate cis-element, thereby suppressing the transcription of IL-8 gene.

Identification of autoantibodies to a pancreatic antigen in patients with idiopathic chronic pancreatitis and Sjögren's syndrome

A serum autoantibody to a pancreatic antigen was identified in patients with idiopathic chronic pancreatitis and Sjögren's syndrome by radioimmunoassay and Western immunoblotting. Antigen from porcine and human pancreas extracts was partially purified using a monoclonal antibody, SP3-1, which recognizes the antigen in duct cells of various exocrine organs. Solid phase radioimmunoassay of the pancreatic antigen showed a positive result in 6 of 20 patients with idiopathic chronic pancreatitis (30%), 3 of 11 patients with Sjögren's syndrome (27%), and 1 of 15 patients with alcoholic chronic pancreatitis (7%). Among seven patients with stone-related chronic pancreatitis, six patients with autoimmune thyroiditis, and 14 normal controls, none showed evidence of autoantibodies to the pancreatic antigen. Western immunoblotting showed that serum antibody commonly reacted with a 60-kD molecule of either porcine or human pancreatic antigen, with which SP3-1 also reacted. These results show the existence of the autoantibodies to pancreas, especially to an antigen expressed in ductal cells of exocrine glands, in idiopathic chronic pancreatitis and Sjögren's syndrome, and suggest the possibility of an autoimmune mechanism in the pathogenesis of idiopathic chronic pancreatitis.

Beta-adrenoceptor-G protein-adenylate cyclase complex in rat hearts with ischemic heart failure produced by coronary artery ligation

We examined the role of the myocardial beta-adrenoceptor-G protein-adenylate cyclase complex in 10-week-old Wistar rats with ischemic heart failure produced by ligating the left coronary artery (l) and in sham-operated control rats (C). We determined the number of beta-adrenoceptors (Bmax), the dissociation constant (Kd) using a binding assay and adenylate cyclase activity. Levels of mRNA encoding for the alpha subunit of the stimulatory guanine nucleotide-binding protein (Gs alpha) and the alpha subunit of the inhibitory guanine nucleotide-binding protein (Gi alpha) were measured by Northern blot analysis. The amounts of Gs alpha and Gi alpha were measured by Western blot analysis. Bmax and Kd did not differ significantly between the two groups: Bmax: l, 14.7 +/- 1.3 v C, 13.4 +/- 0.9 f mol/mg protein; Kd: l, 345 +/- 31 v C, 340 +/- 28 pM (mean +/- standard error, S.E.). There were no significant differences in Gs alpha and Gi alpha concentrations between the two groups as measured by Northern blot analysis (Gs alpha: l, 91.6 +/- 4.5 v C, 96.5 +/- 2.3%; Gia; l, 95.4 +/- 3.6 v C, 90.0 +/- 3.0%) or by Western blot analysis (Gs alpha: l, 95.2 +/- 2.0 v C, 94.5 +/- 2.6%; Gi alpha: l, 91.5 +/- 3.0 v C, 95.1 +/- 2.9%). Activity of basal and MnCl2-stimulated adenylate cyclase did not differ significantly in the two groups: basal: l, 7.5 +/- 0.7 v C, 8.1 +/- 0.5 pmol cAMP/mg protein/min; MnCl2 l, 80.8 +/- 5.8 v C, 86.4 +/- 6.7 pmol cAMP/mg protein/min. Sodium fluoride and forskolin-stimulated adenylate cyclase activity were significantly lower in the hearts with ischemic failure compared with controls (sodium fluoride: l, 68.5 +/- 5.6 v C, 103 +/- 4.8 pmol cAMP/mg protein/min; forskolin: l, 84.6 +/- 6.5 v C, 117.1 +/- 5.6 pmol cAMP/mg protein/min). These data suggest the presence of myocardial Gs alpha dysfunction in ischemic heart failure. We conclude that such a dysfunction in Gs alpha may contribute to the contractile abnormalities in ischemic heart failure.

Cold-sensitive phenotype of Escherichia coli cells harboring a plasmid carrying the kil gene of phage lambda brought under control of cI857 gene promoters

A plasmid (pI-14), containing part of the phage lambda control region (EcoRI-D fragment of lambda cI857) with a large deletion between genes rex and kil, confers a cold-sensitive (cs) phenotype on the host bacteria, whereas the parent plasmid (pMM200) without the deletion made the host bacteria (Escherichia coli strain DOO) high-temperature sensitive. This phenomenon could be explained on the basis of the sequence analysis of the deletion. Upon this deletion, the lambda kil gene, which was originally under the control of the pL promoter, was brought under the control of the lambda cI promoters, resulting in the reversal of the host cell response to temperature. This example shows that gene circuits showing diametrically opposite responses to environmental factors (in this case, temperature) can be constructed from the same elements when the effector gene (here, kil) is connected in different ways to the sensor gene (here, cI857). This cold-dependent killing activity was also dependent on the crp+ state of the host.

Intracellular processes associated with vesicular transport from endoplasmic reticulum to Golgi and exocytosis: ethanol-induced changes in membrane biogenesis

Membrane biogenesis, expressed in endoplasmic reticulum (ER) by formation of transport vesicles, was studied in the liver of ethanol-fed and pair-fed rats. In ER of ethanol-fed animals, the endogenous synthesis of phosphatidylcholine (PC) and its contribution to ER transport vesicles were reduced by 50%, as compared to that in pair-fed controls. Reduction of PC synthesis and of its presence in ER-transport vesicles was also observed in pair-fed controls when the native cytosol was replaced with that from ethanol-fed animals. In contrast, preincubation of ER membranes from ethanol-fed animals with cytosol from controls led to the stimulation of PC synthesis in ER and its contribution to ER-transport vesicles. Analysis of water soluble metabolites of [methyl-14C]choline phosphate revealed the accumulation of CDP-choline precursor in samples derived from ethanol-fed rats. Concomitantly, the endogenous synthesis of phosphatidylinositol (PI) in the ER of ethanol-fed animals was stimulated up to 400-500%, but declined when the cytosol from ethanol-fed rats was replaced with that from the controls. The restoration of PC synthesis, the normalization of PI synthase activity, and, similar to control, the contribution of PC to ER-transport vesicles in ethanol-fed animals was achieved when ER membranes were preincubated with diglycerides or the cytosol was treated with ethylene glycol bis (beta-aminoethyl ether) N,N'-tetraacetic acid (EGTA). Conversely, addition of CaCl2-EGTA buffer containing 3 microM free Ca2+ to control samples, led to a reduction in PC synthesis. The studies on the effect of free Ca2+ on PI synthase and phosphatidic acid (PA) phosphatase activity established that in the presence of 1-3 microM free Ca2+, PI synthase activity remained constant, whereas that of PA phosphatase was reduced by 40% at 1 microM Ca2+, and no activity was detected when free Ca2+ was adjusted to 3 microM. The results suggest that modified membrane biogenesis in the liver of ethanol-fed rats is connected to the elevated free Ca2+ in the cytosol, which appears to regulate phosphatase activity. Accumulation of CDP-choline, decreased activity of PA phosphatase, and increased contribution of PI lipids to ER-transport vesicle membrane suggest that in ethanol-fed animals diglycerides are depleted and PA is utilized in a CDP-diacylglycerol pathway, thus leading to the generation of a different group of phospholipids and consequently modified ER-transport vesicle membrane.

Contact invasion by a polypoid pseudosarcomatous carcinoma of the esophageal wall: report of a case

We present herein the interesting case of a 43-year-old man in whom a rapidly growing polypoid tumor of the esophagus was histologically proven to be pseudosarcomatous carcinoma. Of particular interest was the unusual type of invasion displayed by this tumor, whereby the head of the polyp came into contact with and directly invaded the esophageal wall at the distal end of the pedicle to the submucosal layer, while invasion near the stalk was restricted to the mucosa. This style of invasion is considered to be caused by the mechanical pressure produced by the rapid growth of the tumor in the narrow esophageal lumen.

[Validity of non-invasive deep body thermometry to evaluate thermoregulation]

We evaluated, as an index of thermoregulation and hemodynamics, the validity of deep body thermometry that measures deep tissue temperature transcutaneously by creating an area under an insulated thermistor probe of zero thermal flow between skin and subcutaneous tissue in 27 patients undergoing cardiac surgery. Deep body temperatures (DBT) were measured at the forehead (FH) and palm (P), and the DBT gradients (DBTFH-P) were compared with simultaneously measured mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance (SVR), the gradients (TESODBTP, TRECDBTP) of the esophageal and rectal temperatures and palm DBT during a three hour period after discontinuing cardiopulmonary bypass. Among the body temperature and hemodynamics measurements, the closest linear relationship was found between DBTFH-P and TESODBTP [0.35 + 0.95 x TESODBTP (degrees C), r = 0.98, SEE = 0.45, P < 0.0001]. There were no correlations between DBTFH-P and MAP, CI and SVR. We conclude that the measurement of DBTFH-P is useful as a reliable non-invasive method of monitoring core and shell temperature to evaluate thermoregulation.

Increased serum immunoreactive parathyroid hormone-related protein levels in chronic hypocalcemia

To elucidate possible negative feedback regulation of circulating PTH-related protein (PTHrP) by serum calcium levels, we measured serum immunoreactive PTHrP (iPTHrP) by a specific RIA for PTHrP-(1-34) in patients with hypocalcemia due to PTH deficiency or resistance. Serum iPTHrP levels were not detectable (< 4 pmol/L) in 9 of 11 patients with postoperative hypocalcemia who presented with transient tetany, in 1 patient with hypocalcemia due to hypomagnesemia induced by cisplatin treatment, in normal subjects (n = 60), or in 1 normocalcemic patient with pseudopseudohypoparathyroidism. In contrast, the other 2 patients with postoperative hypocalcemia who had had hypocalcemic symptoms for longer periods (6 months and 3 yr, respectively) showed increased iPTHrP levels (6.3 and 5.3 pmol/L). All 6 patients with idiopathic hypoparathyroidism showed undetectable or low PTH, but increased iPTHrP, ranging from 6.5-19.5 pmol/L (mean +/- SD, 10.8 +/- 4.8 pmol/L). Elevated serum iPTHrP levels (7.4 and 8.1 pmol/L) were also found in both patients with pseudohypoparathyroidism type I. When chronic and profound hypocalcemia in these patients was normalized by treatment with 1 alpha-hydroxyvitamin D3, the elevated serum iPTHrP levels were normalized (undetectable, < 4 pmol/L) in all 6 patients examined. These results suggest that chronic and profound hypocalcemia and/or vitamin D deficiency can stimulate endogenous PTHrP secretion via a negative feedback mechanism, although elevated iPTHrP does not normalize the decreased serum calcium levels.

Retention behavior of conjugated metabolites of vitamin D and related compounds in high-performance liquid chromatography

The retention behavior of sulfates or glucuronides of provitamin D, vitamin D, and 25-hydroxyvitamin D3, together with its fluorescent derivatives, are examined with reversed-phase high-performance liquid chromatography. Inclusion chromatography using cyclodextrin as a mobile-phase additive is also used for this purpose. Conventional reversed-phase high-performance liquid chromatography clearly separates the positionally isomeric conjugates of 25-hydroxyvitamin D3. The addition of the host compound to the mobile phase is effective in separating the pairs of fluorescent derivatives of vitamin-D3 and -D2 conjugates or provitamin-D3 and -D2 conjugates.

Activation of arachidonoyl phospholipase A2 in prostaglandin-mediated action of sucralfate

1. The mechanism of sucralfate-induced gastric mucosal prostaglandin generation was investigated using mucosal cells labeled with [14C]choline and [3H]arachidonic acid. 2. In comparison to the controls, the cells maintained in the presence of sucralfate showed a concentration dependent increase in lysophosphatidylcholine (LPC) synthesis and PGE2 generation. The maximal effect was attained at 25 microM sucralfate giving a 45.7% increase in LPC and 70% increase in PGE2. 3. Pretreatment with indomethacin prior to sucralfate, while causing inhibition in PGE2 generation, had no effect on LPC production and led to accumulation of free arachidonic acid. In the case of pretreatment with NDGA, the sucralfate caused increased LPC synthesis accompanied by enhanced PGE2 generation without free arachidonic acid accumulation. 4. The stimulatory effect of sucralfate on LPC synthesis and PGE2 generation was inhibited by phospholipase A2 inhibitors, mepacrine and BPB. The inhibitory effect was concentration dependent and attained maximum at 40 microM for BPB and 80 microM for mepacrine. 5. The results for the first time demonstrate that the enhancement in gastric mucosal prostaglandin generation by sucralfate results from the stimulation of mucosal phospholipase A2 for arachidonic acid release.

Cloning and characterization of the cDNA encoding the HA protein of a hemagglutination-defective measles virus strain

cDNA clones corresponding to the mRNA for the hemagglutinin of the hemagglutination-defective strain AK-1 of measles virus were isolated and characterized. Compared with the prototype Edmonston strain, 60 nucleotide substitutions that resulted in 18 amino acid changes were detected. An additional potential N-linked glycosylation site was added by point mutation, which was supported by the observation that the hemagglutinin of the AK-1 strain was stained more heavily after NaDodSO4-PAGE and periodic acid-Schiff (PAS) staining than the Edmonston strain. Computer-assisted analysis revealed that three reverse turns in the secondary structure had disappeared in the hemagglutinin of the AK-1 strain. Moreover, one of these structural changes occurred in the closely glycosylated region at amino acid residues 168-240, which appeared to be a biologically important functional domain. The isoelectric point calculated from the predicted amino acid sequence became about 1 pH unit more basic in the AK-1 strain than the Edmonston strain. This present study is the first sequence analysis of the hemagglutinin gene in a hemagglutination-defective strain of the measles virus.

K+ ionophores inhibit nerve growth factor-induced neuronal differentiation in rat adrenal pheochromocytoma PC12 cells

Incubation with a K+/H+ ionophore nigericin attenuated the nerve growth factor (NGF)-induced neurite outgrowth in rat pheochromocytoma PC12 cells. However, a Na+/H+ ionophore monensin and a Ca2+ ionophore A23187 did not inhibited the neurite outgrowth. Nigericin also inhibited the NGF-caused induction of acetylcholinesterase and suppression of cell proliferation. These changes were dependent on the amount of the ionophore added to the culture. In addition, a distinct K+ ionophore, valinomycin, similarly inhibited the NGF-induced neuronal differentiation. These results suggest the presence of the K+ ionophore-sensitive mechanism in the NGF-induced differentiation system in PC12 cells.

A cytosolic peptide potentiates the GTP effect on beta-adrenergic response of adenylate cyclase

A cytosolic peptide-GTP complex that stimulates l-isoproterenol-responsive adenylate cyclase activity was identified in the rat liver. The peptide component was purified and characterized with regard to its interaction with GTP. The peptide was isolated as a complex form with GTP on a Sephadex G-25 column in 1 mM NaHCO3, and was purified as a dissociated form, with relative molecular weight (M(r)) approximately 3,000 and GTP-binding ability, in 200 mM ammonium acetate. The purified peptide alone displayed little stimulatory effect on adenylate cyclase activity, but its reassociated form with GTP clearly enhanced the effect of GTP on the enzyme activity. The isoproterenol competition curve using l-[3H]dihydroalprenolol as an antagonist ligand shifted to lower affinity by the addition of the peptide reassociated with GTP (16.5-fold shift), whereas the same concentration of GTP (1 microM) or the peptide alone had little or no effect (1.5- or 0.9-fold shift, respectively). Furthermore, the peptide enhanced the GTP effect in response to l-isoproterenol but not to glucagon, prostaglandin E1, or fluoride. These results suggest that the cytosolic peptide potentiates the effect of GTP on the agonist-beta-adrenergic receptor-stimulatory guanine nucleotide-binding regulatory component of the adenylate cyclase ternary complex.

Inflammatory cytokines up-regulate intercellular adhesion molecule-1 expression on primary cultured mouse hepatocytes and T-lymphocyte adhesion

We investigated the effect of inflammatory cytokines on the intercellular adhesion molecule-1 expression on primary cultured murine hepatocytes. Tumor necrosis factor-alpha, interferon-gamma and interleukin-1 alpha up-regulated the intercellular adhesion molecule-1 expression on hepatocytes in a dose-dependent fashion; however, interleukin-6 did not. On the basis of kinetic analysis, the expression level reached a peak 24 hr after stimulation, and both cycloheximide and actinomycin D inhibited the expression. Furthermore, T lymphocytes bind more to interferon-gamma-stimulated hepatocytes than to unstimulated hepatocytes. The binding was dependent on the concentration of interferon-gamma. The binding was also up-regulated by stimulating T lymphocytes with phorbol myristate acetate. Tumor necrosis factor-alpha and interleukin-1 alpha demonstrated the same effect as interferon-gamma, whereas interleukin-6 did not increase T-lymphocyte adhesion to the hepatocytes. The adhesion induced by interferon-gamma or tumor necrosis factor-alpha was inhibited by antibody against either intercellular adhesion molecule-1 or lymphocyte function-associated antigen-1, a ligand for intercellular adhesion molecule-1, but was not inhibited by CD44 antibodies. These results demonstrate that inflammatory lymphokines enhance the T-lymphocyte adhesion to primary cultured hepatocytes by up-regulating the intercellular adhesion molecule-1 expression on the stimulated hepatocytes by activating the de novo pathway. This mechanism may play an important role in the pathogenesis of hepatitis.