The influence of free 3-nitrotyrosine and saliva on the quantitative analysis of protein-bound 3-nitrotyrosine in sputum

BACKGROUND

We have recently developed a new technique for quantitatively measuring protein-bound 3-nitrotyrosine (3-NT), a footprint of nitrosative stress, utilizing high-performance liquid chromatography with an electrochemical detection (HPLC-ECD) system. Using this system, we showed that 3-NT formation was upregulated in the sputum of both COPD and asthmatic patients. However, in order to improve the accuracy of the measurement system, We have to resolve some problems which were the influence of free amino acid form of 3-NT and of salivary contamination.

OBJECTIVES

We initially investigated the amount of the free amino acid form of 3-NT in induced sputum and compared with that of protein-bound 3-NT. Next, we evaluated the concentration of protein-bound 3-NT in saliva and compared with that in induced sputum by means of HPLC-ECD.

METHODS

Five male COPD patients were enrolled. Induced sputum and saliva were obtained from the patients. The free amino acid form of 3-NT in sputum and saliva was measured by HPLC-ECD, and the protein-bound 3-NT and tyrosine in sputum and saliva were enzymatically hydrolyzed by Streptomyces griseus Pronase and measured for the protein hydrolysate by HPLC-ECD.

RESULTS

The mean value of the amount of protein-bound 3-NT was 65.0 fmol (31.2 to 106.4 fmol). On the other hand, the amount of the free amino acid form of 3-NT was under the detection limit (<10 fmol). The levels of both 3-NT (sputum: 0.55 +/- 0.15 pmol/ml, saliva: 0.02 +/- 0.01 pmol/ml, p < 0.01) and tyrosine (sputum: 0.81 +/- 0.43 micromol/ml, saliva: 0.07 +/- 0.04 micromol/ml, p < 0.01) in saliva were significantly lower than in sputum. The percentage of 3-NT in saliva to that in sputum was about 3.1%, and that of tyrosine was about 9.0%.

CONCLUSION

The free amino acid form of 3-NT does not affect the measurement of protein-bound 3-NT. Furthermore, the influence of salivary contamination on the measurement of protein-bound 3-NT in induced sputum by means of HPLC-ECD was very small and could be negligible.

The Influence of Free 3-Nitrotyrosine and Saliva on the Quantitative Analysis of Protein-Bound 3-Nitrotyrosine in Sputum

Background

We have recently developed a new technique for quantitatively measuring protein-bound 3-nitrotyrosine (3-NT), a footprint of nitrosative stress, utilizing high-performance liquid chromatography with an electrochemical detection (HPLC-ECD) system. Using this system, we showed that 3-NT formation was upregulated in the sputum of both COPD and asthmatic patients. However, in order to improve the accuracy of the measurement system, We have to resolve some problems which were the influence of free amino acid form of 3-NT and of salivary contamination.

Objectives

We initially investigated the amount of the free amino acid form of 3-NT in induced sputum and compared with that of protein-bound 3-NT. Next, we evaluated the concentration of protein-bound 3-NT in saliva and compared with that in induced sputum by means of HPLC-ECD.

Methods

Five male COPD patients were enrolled. Induced sputum and saliva were obtained from the patients. The free amino acid form of 3-NT in sputum and saliva was measured by HPLC-ECD, and the protein-bound 3-NT and tyrosine in sputum and saliva were enzymatically hydrolyzed by Streptomyces griseus Pronase and measured for the protein hydrolysate by HPLC-ECD.

Results

The mean value of the amount of protein-bound 3-NT was 65.0 fmol (31.2 to 106.4 fmol). On the other hand, the amount of the free amino acid form of 3-NT was under the detection limit (<10 fmol). The levels of both 3-NT (sputum: 0.55 ± 0.15 pmol/ml, saliva: 0.02 ± 0.01 pmol/ml, p < 0.01) and tyrosine (sputum: 0.81 ± 0.43 μmol/ml, saliva: 0.07 ± 0.04 μmol/ml, p < 0.01) in saliva were significantly lower than in sputum. The percentage of 3-NT in saliva to that in sputum was about 3.1%, and that of tyrosine was about 9.0%.

Conclusion

The free amino acid form of 3-NT does not affect the measurement of protein-bound 3-NT. Furthermore, the influence of salivary contamination on the measurement of protein-bound 3-NT in induced sputum by means of HPLC-ECD was very small and could be negligible.

Inhibition of reactive nitrogen species production in COPD airways: comparison of inhaled corticosteroid and oral theophylline

BACKGROUND

Reactive nitrogen species (RNS) are thought to be one of the important factors in the pathogenesis of chronic obstructive pulmonary disease (COPD). A study was undertaken to examine the effects of theophylline and fluticasone propionate (FP) on RNS production in subjects with COPD.

METHODS

Sixteen COPD subjects participated in the study. Theophylline (400 mg/day orally) or FP (400 mug/day inhalation) were administered for 4 weeks in a randomised crossover manner with a washout period of 4 weeks. Induced sputum was collected at the beginning and end of each treatment period. 3-nitrotyrosine (3-NT), which is a footprint of RNS, was quantified by high performance liquid chromatography with an electrochemical detection method as well as by immunohistochemical staining.

RESULTS

Theophylline significantly reduced the level of 3-NT in the sputum supernatant as well as the number of 3-NT positive cells (both p<0.01). FP also reduced 3-NT formation, but the effect was smaller than that of theophylline. Theophylline also significantly reduced the neutrophil cell counts in the sputum (p<0.01), while FP treatment had no effect on the number of inflammatory cells in the sputum, except eosinophils.

CONCLUSIONS

Theophylline reduces nitrative stress and neutrophil infiltration in COPD airways to a larger extent than inhaled corticosteroid.

Two cases of asthma in handicapped elderly persons in which assisted inhalation therapy was effective

BACKGROUND

Chronic airway inflammation is a basic pathology of bronchial asthma and it is important to control the inflammation by anti-inflammatory therapy mainly with steroids. However, in asthma in the elderly, there are cases where physicians hesitate to introduce the inhaled corticosteroid (ICS) therapy based on the diagnosis that the use of inhalants is difficult due to the existence of a functional lesion accompanying asthma.

METHODS & RESULTS

In cases where self-administrated inhalation therapy is difficult to execute due to the accompaniment of a functional lesion and in cases where sufficient curative effects of steroids are not produced in self-inhalation, administration of assisted inhalation resulted in improvement of clinical symptoms and pulmonary function and was proven effective.

CONCLUSIONS

Assisted inhalation therapy is expected to be useful in general and also in terms of expanding the application of ICS in the asthma in the elderly.

Survival study by organ disorders in 306 Japanese patients with systemic lupus erythematosus: results from a single center

Survival rate and causes of death according to the period of diagnosis and four accompanying organ disorders were analyzed in 306 Japanese patients with systemic lupus erythematosus. The survival rate was gradually improved, and the survival rate during 5- and 10-year periods of the patients diagnosed in 1990-2004 was 94 and 92%, 20-year period of those in 1980-1989 was 77%, 30-year period of those in 1975-1979 was 71%, respectively. Survival rate of those with serositis, pulmonary hypertension, and positive family history tended to be reduced, while that of the cases with neuropsychiatric disorder and renal disorder was significantly reduced. Overlapping of these organ disorders was an important factor for a poor prognosis. Bronchopneumonia and cerebrovascular accidents were frequent causes of death, and treatment for anti-phospholipid antibody syndrome and life-style diseases such as hypertension and arteriosclerosis was thought to be important for a good outcome.

Airway cytokine expression measured by means of protein array in exhaled breath condensate: correlation with physiologic properties in asthmatic patients

BACKGROUND

Simultaneous monitoring of airway inflammation and physiology might be useful for asthma management.

OBJECTIVE

We examined the upregulated molecules in asthmatic airways. Furthermore, we investigated the relationship between these molecules and the airway physiologic properties of asthma.

METHODS

Ten nonsmoking healthy subjects and 16 steroid-naive asthmatic patients were enrolled. Exhaled breath condensate (EBC) sampling, spirometry, and methacholine inhalation challenge were performed on one occasion in this cross-sectional study. Peak expiratory flow was also measured for 4 weeks. Airway cytokine-chemokine-growth factor production was analyzed with a protein array.

RESULTS

The expressions of IL-4, IL-8, IL-17, TNF-alpha, RANTES, IFN-gamma-inducible protein 10, TGF-beta, and macrophage inflammatory protein 1alpha and 1beta were significantly upregulated in asthmatic airways compared with those of nonsmoking healthy subjects. Among the upregulated molecules, RANTES expression was significantly correlated with the parameters that represent airway caliber, FEV(1) and respiratory resistance values. In addition, the levels of both TNF-alpha and TGF-beta were significantly correlated with the methacholine threshold and peak expiratory flow variability for the week.

CONCLUSION

Inflammatory molecule analysis with EBC appeared to be useful for monitoring the asthmatic airway condition.

CLINICAL IMPLICATIONS

Measurements of cytokine levels in EBC might be a promising approach to assess the efficacy of pharmacologic interventions and to investigate the pathophysiology of asthma.

Modulation of Na+ transport and epithelial sodium channel expression by protein kinase C in rat alveolar epithelial cells

Although the amiloride-sensitive epithelial sodium channel (ENaC) plays an important role in the modulation of alveolar liquid clearance, the precise mechanism of its regulation in alveolar epithelial cells is still under investigation. Protein kinase C (PKC) has been shown to alter ENaC expression and activity in renal epithelial cells, but much less is known about its role in alveolar epithelial cells. The objective of this study was to determine whether PKC activation modulates ENaC expression and transepithelial Na+ transport in cultured rat alveolar epithelial cells. Alveolar type II cells were isolated and cultured for 3 to 4 d before they were stimulated with phorbol 12-myristate 13-acetate (PMA 100 nmol/L) for 4 to 24 h. PMA treatment significantly decreased alpha, beta, and gammaENaC expression in a time-dependent manner, whereas an inactive form of phorbol ester had no apparent effect. This inhibitory action was seen with only 5-min exposure to PMA, which suggested that PKC activation was very important for the reduction of alphaENaC expression. The PKC inhibitors bisindolylmaleimide at 2 micromol/L and Gö6976 at 2 micromol/L diminished the PMA-induced suppression of alphaENaC expression, while rottlerin at 1 micromol/L had no effect. PMA elicited a decrease in total and amiloride-sensitive current across alveolar epithelial cell monolayers. This decline in amiloride-sensitive current was not blocked by PKC inhibitors except for a partial inhibition with bisindolylmaleimide. PMA induced a decrease in rubidium uptake, indicating potential Na+-K+-ATPase inhibition. However, since ouabain-sensitive current in apically permeabilized epithelial cells was similar in PMA-treated and control cells, the inhibition was most probably related to reduced Na+ entry at the apical surface of the cells. We conclude that PKC activation modulates ENaC expression and probably ENaC activity in alveolar epithelial cells. Ca2+-dependent PKC is potentially involved in this response.

Partial photoneutron cross sections for the isomeric state 180Tam

Photoneutron cross sections for (181)Ta(y, n) (180)Ta(m) were determined from simultaneous measurements of total cross sections (sigma(tot) and ground-state cross sections (sigma(gs)) for (180)Ta in photodisintegration of with laser Compton-backscattered rays. Techniques of direct neutron counting and photoactivation were used for the measurement of sigma(tot) and sigma(gs), respectively. The partial cross sections for the isomeric state serves as a novel probe of the nuclear level density of (180)Ta. Implications for the p- and s-process nucleosynthesis of (180)Ta(m) are given.

Agents against cytokine synthesis or receptors

Various cytokines play a critical role in pathophysiology of chronic inflammatory lung diseases including asthma and chronic obstructive pulmonary disease (COPD). The increasing evidence of the involvement of these cytokines in the development of airway inflammation raises the possibility that these cytokines may become the novel promising therapeutic targets. Studies concerning the inhibition of interleukin (IL)-4 have been discontinued despite promising early results in asthma. Although blocking antibody against IL-5 markedly reduces the infiltration of eosinophils in peripheral blood and airway, it does not seem to be effective in symptomatic asthma, while blocking IL-13 might be more effective. On the contrary, anti-inflammatory cytokines themselves such as IL-10, IL-12, IL-18, IL-23 and interferon-gamma may have a therapeutic potential. Inhibition of TNF-alpha may also be useful in severe asthma or COPD. Many chemokines are also involved in the inflammatory response of asthma and COPD through the recruitment of inflammatory cells. Several small molecule inhibitors of chemokine receptors are now in development for the treatment of asthma and COPD. Antibodies that block IL-8 reduce neutrophilic inflammation. Chemokine CC3 receptor antagonists, which block eosinophil chemotaxis, are now in clinical development for asthma therapy. As many cytokines are involved in the pathophysiology of inflammatory lung diseases, inhibitory agents of the synthesis of multiple cytokines may be more useful tools. Several such agents are now in clinical development.

The beneficial effects of treatment with all-trans-retinoic acid plus corticosteroid on autoimmune nephritis in NZB/WF mice

Corticosteroids are highly effective anti-inflammatory or immunosuppressive drugs used commonly to treat human systemic lupus erythematosus (SLE). All-trans-retinoic acid (ATRA), which belongs to a class of retinoids that exert immunomodulatory and anti-inflammatory functions, can also suppress the development of lupus nephritis in an animal model. However, both agents can inflict serious adverse effects. Here, we have asked whether ATRA can serve as a steroid-sparing drug in the treatment of lupus nephritis. To examine the efficacy of combining predonisolone (PSL) with ATRA, we treated intraperitoneally New Zealand black/white F1 (NZB/W F1) mice with PSL, ATRA or both agents. Survival rate and proteinuria were determined once a month. Cytokine and anti-DNA antibody production were determined by enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR). Renal histopathology was observed by haematoxylin and periodic acid Schiff (PAS), immunoperoxidase and immunohistochemical assay. Survival rate and proteinuria were improved in all experimental groups, and were much improved in the mice receiving the combination of ATRA and PSL (P <0.05). A single administration of ATRA reduced the Th1 [interleukin (IL)-2, interferon (IFN)-gamma and IL-12], and a Th2 (IL-4) cytokine level, as effectively as administration of PSL. ATRA also suppressed the expression of inducible nitric oxide synthetase (iNOS) and monocyte chemoattractant protein-1 (MCP-1) in the kidney. The combination of PSL and ATRA significantly reduced IgG2 (especially IgG2b)-specific anti-DNA antibody levels in comparison with administration of either agent alone. These data suggest that ATRA might have the potential to act as a new therapeutic and steroid-sparing drug against lupus nephritis.

[New forceps for thoracoscopic needle biopsy]

INTRODUCTION

When the diagnosis cannot be established preoperatively but malignant lung tumor is suspected, we frequently perform thoracoscopic wedge resection in order to perform rapid histodiagnosis on the specimen. If the diagnosis is malignancy, we extend the surgery to lobectomy for complete resection in many cases. However, cartridges of linear endoscopic staplers used for wedge resection are useless in such cases. This economic loss is expensive. Thoracoscopic needle biopsy is economic, but the technique is difficult and there is a risk of damage to important blood vessels when the needle penetrates deeper than is needed. Therefore, we developed forceps for thoracoscopic needle biopsy.

METHOD

We changed the tip shape of endoscopic grasping forceps, fixed a guide for inserting a biopsy needle and prevented the biopsy needle from going through the grasping extension for safety. We made 3 types of forceps, small, middle, and large sized forceps that could adapt the various sizes of tumors.

RESULT

We used the small forceps for 23 cases: the middle forceps for 13 cases; the large forceps for 7 cases; for a total of 43 cases, and succeeded in diagnosing 35 cases. The reason for failure in 6 cases using the small forceps was the exceeding softness of the lesion in 1 case, failure of rapid histodiagnosis in 1 case, and mal-adaptation between the forceps and tumor size in the remaining cases. The reason for failure in 2 cases using middle forceps was failure of rapid histodiagnosis in both cases. There was no complication due to biopsy. All bleeding after the puncture was quickly stopped. There was no dissemination or recurrence in the thoracic lumen.

CONCLUSION

During surgery for palpable visible lung tumors with an uncertain histological diagnosis, thoracoscopic needle biopsy is very easy and economic. It is also useful for avoiding unnecessary lung lobectomy, and is a minimally invasive method, contributing to medical economy.

[Traumatic lung cyst]

INTRODUCTION

Traumatic lung cysts have been reported to be comparatively rare. However, we diagnosed 11 cases to have traumatic lung cyst over the past 6 years. We mainly present the most characteristic 3 cases and also discuss our findings for the 11 cases of traumatic lung cyst. CASE 1: A 17-year-old male, who was injured on his left chest after falling from a height of 7 m. He presented in a state of shock and was immediately resected the left lung because of massive bleeding from a damage of pulmonary vein. However, he finally died due to disseminated intravascular clotting (DIC). We recognized a large traumatic lung cyst, which went from the upper lobe to lower lobe thoroughly the resected lung. CASE 2 : A 19-year-old male, who was injured on his left chest in traffic accident. We recognized a wide contusion, cysts and hemorrhage in the left upper lobe on computed tomography (CT) findings. We performed an emergency left upper lobectomy because of the intrabronchial bleeding. CASE 3: An 11-year-old boy, suffered trauma on his right chest when he fell while walking. We recognized minor redness and subcutaneous emphysema in the injured are, in addition to a contusion and cyst in the right lower lobe on CT findings. He was conservatively observed, and both the cyst and contusion gradually contracted.

CONCLUSION

Regarding traumatic lung cysts, a quick diagnosis and timely selection of the optimal treatment are important. When a pulmonary injury is serious, then quick surgical treatment is necessary, and a close follow-up is necessary in case undergoing conservative treatment.

Angioimmunoblastic lymphadenopathy with dysproteinaemia accompanied by pleural effusion

Angioimmunoblastic lymphadenopathy with dysproteinaemia (AILD) is a rare lymphoproliferative disorder characterized by systemic lymphadenopathy, hepatosplenomegaly, loss of body weight, fever, skin eruption, and polyclonal hypergammaglobulinaemia. Occasionally, pulmonary involvement, including pleural effusion, has also been observed. Two cases of AILD accompanied by pleural effusion are reported here. When thoracentesis was performed, an exudative effusion was obtained and there was an increase in soluble interleukin-2 receptor and immunoglobulin G, A, and M in the pleural fluid. Cytologically, atypical plasma cells, and T-cell predominant lymphocytes were also present. These findings are likely to be characteristic of pleural effusions associated with AILD and may prove to be a useful marker for diagnosis.

A case of pulmonary intravascular lymphomatosis diagnosed by thoracoscopic lung biopsy

Intravascular lymphomatosis with primary pulmonary lesion is an extremely rare disease. Although the major clinical symptoms include fever, cough, dyspnea and loss of body weight, these are not diagnostic. Chest radiograph findings are also nonspecific and include bilateral reticular shadow, reticulonodular shadow, ground-glass opacity or wedge-shaped subpleural opacities. Therefore, the antemortem diagnosis is relatively difficult. It is considered that intravascular lymphomatosis is a high-grade malignant lymphoma. However, it has been shown recently that a good response and long-term survival may possibly be obtained through systemic combination chemotherapy. We report a case of intravascular lymphomatosis with primary pulmonary lesion where an early diagnosis was obtained through thoracoscopic lung biopsy and subsequent systemic chemotherapy proved to be quite effective. Because the clinical symptoms or chest radiograph findings are usually nonspecific, it was thought that thoracoscopic lung biopsy could be a useful procedure for early and reliable diagnosis of primary pulmonary intravascular lymphomatosis and that it might contribute to an improved prognosis.

A Case of Primary Lung Cancer Producing Alpha-Fetoprotein

A case of lung carcinoid showing elevated plasma alpha-fetoprotein (AFP) level is reported. A 44-year-old man who complained of the development of bloody sputum had a left hilar lung mass on chest radiograph. The serum level of AFP was markedly increased to 8438 ng/mL. After resection, it was diagnosed as an atypical carcinoid, and the tumour cells were positive for cytoplasmic AFP. AFP is one of the most useful tumour markers for the diagnosis of hepatic cell carcinoma or germ cell tumours. It has also been reported that some primary lung tumours produce AFP. However, these tumours are mainly poorly differentiated adenocarcinomas or large cell carcinomas. A lung carcinoid that produces AFP is extremely rare.