Expression of three cell proliferation-associated antigens, DNA polymerase alpha, Ki-67 antigen and transferrin receptor in nodal and cutaneous T-cell lymphomas

We studied the expression of three cell proliferation-associated antigens: DNA polymerase alpha, Ki-67 antigen, and transferrin receptor, in 35 T-cell lymphomas of nodal origin (T-NL) and 40 cutaneous T-cell lymphomas (CTCL). Immunohistochemical staining was carried out on frozen tissue sections of these specimens using three monoclonal antibodies, DAKO-PC, CL22-2-42B (DNA polymerase alpha), and OKT9. The proportion of cells positive for CL22-2-42B, DAKO-PC, or OKT9 among all tumor cells was correlated with four histologic subtypes: malignant lymphoma (ML), diffuse, small; mixed; large; and large cell immunoblastic in both T-NL and CTCL. A strong correlation was noted between positivity for CL22-2-42B and that for DAKO-PC or OKT9. On the other hand, no difference in the expression of these three antigens was noted between T-NL and CTCL in the high, intermediate or low grade-malignancy group. In CTCL as well as in T-NL, cells positive for CL22-2-42B, DAKO-PC or OKT9 were significantly more numerous in the high-grade group than the intermediate-grade group, and in the intermediate-grade group than the low-grade group. Furthermore, a significant correlation between survival period and the number of CL22-2-42B-positive cells was noted when the T cell malignancies, CTCL and T-NL were considered (t value = 2.015, p less than 0.05). Thus, the expression of DNA-polymerase alpha, Ki-67 antigen or OKT9 seems to well reflect the biological behavior and/or clinical prognosis of T-cell lymphoma.

Antagonism by propyl-beta-carboline-3-carboxylate of passive avoidance impairment induced by diazepam

We investigated the effects of propyl-beta-carboline-3-carboxylate (beta-CCP) on learning and memory tasks in a passive avoidance test in mice to clarify whether beta-CCP is an agonist or antagonist at benzodiazepine (BZP) receptors. At doses up to 10 mg/kg i.v., beta-CCP had no effect on mice in the passive avoidance test. Diazepam impaired passive avoidance behavior and methyl-beta-carboline-3-carboxylate(beta-CCM) enhanced it. beta-CCP blocked these effects of diazepam and beta-CCM in a dose-dependent manner similar to the effect of Ro15-1788. These effects of beta-CCP, which are thought to be mediated by BZP receptors, indicate that beta-CCP is an antagonist in the passive avoidance test.

Pharmacological profile of a potential anxiolytic: AP159, a new benzothieno-pyridine derivative

AP159 [N-cyclohexyl-1,2,3,4-tetrahydrobenzo(b)thieno(2,3c)pyridine]-3- carboamide,hydrochloride) showed clear anti-conflict activity in rats in the absence of effects on muscle relaxation, potentiation of anesthesia (in mice) or anticonvulsant activity (in mice). This anti-conflict effect was antagonized by treatment with Ro15-1788. By contrast with the deficits produced by diazepam, AP159 did not impair passive avoidance. The latter drug also improved scopolamine-induced amnesia in the same task. AP159 did not inhibit 3H-flunitrazepam binding, but potently inhibited 3H-8OH-DPAT binding. This compound increased serotonin and 5HIAA content of the midbrain raphe nuclei and of the amygdala centralis. AP159 has been shown to be a novel non-BZP anxiolytic agent with no side effects in laboratory animals; it could be a clinically effective anxiolytic agent.

Comparative study of cutaneous T-cell lymphoma and adult T-cell leukemia/lymphoma. Clinical, histopathologic, and immunohistochemical analyses

An important disease entity distinct from cutaneous T-cell lymphoma (CTCL) in Japan is adult T-cell leukemia/lymphoma (ATL), which usually shows the same phenotype as CTCL, i.e., a helper/inducer T-cell phenotype (CD4+CD8-), and usually involves the skin. Clinically, both CTCL and ATL are heterogeneous in nature. In this study, we demonstrated differences between CTCL and ATL in terms of clinical and immunopathologic cell surface features. In patients with ATL, the predominant clinical findings were peripheral lymph node involvement, skin lesions, hepatosplenomegaly, leukemic manifestations, and an aggressive course. In patients with CTCL, by contrast, only skin lesions predominated at the onset of the disease and a relatively good prognosis was demonstrated. Phenotypic heterogeneity of ATL in the skin, i.e., CD4-CD8-, CD4+CD8-, and CD4-CD8+, was demonstrated. Expression of Leu8, CD7 (Leu9), and CD45RA (2H4) was high in both the skin-infiltrating ATL cells and peripheral blood and lymph node ATL cells compared with that in the skin-infiltrating CTCL cells. Expression of CD25 (IL-2R), CD71 (OKT9), HLA-DR, and HLA-DQ was higher in the skin-infiltrating ATL cells than in CTCL cells. Expression of CD29 (4B4) was high, and that of CD45RA (2H4) was low in both the skin-infiltrating ATL and CTCL cells compared with the peripheral blood and lymph node ATL cells. Expression of CD45RO (UCHL-1) was not significantly high in the skin-infiltrating CTCL cells compared with that in ATL cells. The most significant phenotypic difference between ATL cells and CTCL cells was the expression of Leu8 (lymph node homing receptor), CD7 and CD25 antigens on the cell surface, and the main phenotypic difference between skin-infiltrating ATL and CTCL cells and peripheral blood and lymph node ATL cells was the expression of CD29 and CD45RA. These findings confirm that the difference in antigen expression on the cell surface might reflect the clinical features of ATL and CTCL, and suggest that the predominant phenotype of peripheral blood and lymph node ATL cells is that of naive, relatively immature or activated T-cells, and that CTCL cells are previously activated (memory) T-cells. In other words, CTCL cells do not share the same origin as ATL cells. These observations support the concept that ATL is a disease distinct from CTCL.

Treatment of cutaneous T-cell lymphomas (CTCL) with extracorporeal photochemotherapy--preliminary report

Since August of 1988, we have treated seven CTCL patients with extracorporeal photochemotherapy, including two with tumor-stage mycosis fungoides (MF) showing mucinous degeneration, two with plaque-stage MF, and two with erythrodermatous MF. One was withdrawn just after the first trial. For each patient, the phenotypes of peripheral blood lymphocytes were analyzed by flow cytometry in terms of the percentages of OKT11, OKT3, OKT4, Leu9, OKT8, B1, Tac, OKT9, OKIa1, Leu7, Leu3a/4B4, and Leu3a/2H4 cells. These parameters were compared with the clinical responses according to skin score. The two patients with tumors died, but the five patients without tumors did not. Three of the 6 patients responded to the treatment. Side effects that are often associated with standard chemotherapy, such as bone marrow suppression, gastrointestinal symptoms and hair loss, were not observed. One cardiovascular event (1 patient) occurred. No significant changes in T-cell subsets were seen during the course of therapy. These preliminary data suggest that extracorporeal photochemotherapy may be effective for CTCL other than tumor-stage MF.

Potent anticonflict activity and lessening of memory impairment with a series of novel [1]benzothieno[2,3-c]pyridines and 1,2,3,4-tetrahydro[1]benzothieno[2,3-c]pyridines

[1]Benzothieno[2,3-c]pyridines (10a-c, 11, 12a-t, and 13a,b) and 1,2,3,4-tetrahydro[1]benzothieno[2,3-c]pyridines (3a-c, 7, 8a-c, and 9) were synthesized. The compounds are bioisosteres of beta-carbolines and 1,2,3,4-tetrahydro-beta-carbolines where the indole nitrogen is replaced by sulfur. Their pharmacological activity was evaluated in a water lick conflict test in rats and a passive avoidance test in mice. In the 1,2,3,4-tetrahydro[1]benzothieno[2,3-c]pyridine series, the presence of ethyl ester (3b) or cyclohexyl carboxamide (7) groups at C-3 conferred good anticonflict activity and lessening of memory impairment, while N-acylation of 3b abolished activity. In the [1]benzothieno(2,3-c]pyridine series, the aminoethyl carboxamide (12a) group at C-3 also conferred activity, but other amides studied were not active. The most potent compounds (3b, 7, and 12a) were also administered orally and had potent anticonflict and antiscopolamine amnesia-reversal activity. These compounds did not bind to the BZP receptor in spite of having structures similar to those of beta-carbolines. Compound 7 bound strongly to 5-HT1A receptors and would be expected to be a novel anxiolytic.

beta-CCM inhibits muricide induced by olfactory bulbectomy in rats

Intravenous administration of beta-CCM (methyl-beta-carboline-3-carboxylate) at doses ranging from 0.3 to 10 mg/kg dose-dependently inhibited muricide in olfactory bulbectomized rats. beta-CCM elicited a decrease of locomotor activity at doses ranging from 0.3 to 3 mg/kg, and it impaired rotarod performance at doses of 1 and 3 mg/kg. The inhibition of muricide induced by beta-CCM was antagonized by intraperitoneal administration of Ro15-1788 at 10 mg/kg or diazepam at 3 mg/kg. However, the hypolocomotor activity and impairment of rotarod performance induced by beta-CCM were not antagonized by diazepam at 3 mg/kg. These results indicated that beta-CCM exerts an inhibitory effect on muricide through benzodiazepine receptors and this inhibitory effect was not solely caused by its sedative or motor incordinating activity at the dose ranges used in this study.

[Choroid plexus involvement in malignant lymphoma. Case report]

Involvement of the choroid plexus by malignant lymphoma is rare. This case showed mass lesions at the choroid plexus in the first stage of systemic non-Hodgkin's malignant lymphoma. A 53-year-old female was admitted with headache, diplopia, and gait disturbance. The patient was alert but had left supraclavicular and axially lymph node swelling. Computed tomography scan revealed enhanced masses at the lateral and fourth ventricles. The lymph node biopsy disclosed non-Hodgkin's malignant lymphoma, diffuse large cell type. The immunological marker was the B-cell type. At surgery, there was highly vascular white tumor at the choroid plexus of the right lateral ventricle. The tumor also involved adjacent brain tissue. Pathological examination revealed infiltration of lymphoma cells to the choroid plexus. The subependymal and perivascular spaces of the choroid plexus were filled with lymphoma cells. Virchow-Robin space and white matter of adjacent brain tissue were also involved by lymphoma. After surgery, whole brain irradiation of 35 Gy and chemotherapy were performed. However, 14 months after initial diagnosis, the patient expired because of systemic involvement by the lymphoma.

Phenotypic heterogeneity of lymphoma of the skin

We studied surface markers present in 56 cases of lymphoma of the skin by immunohistochemical staining, using the ABC (avidin-biotin-peroxidase complex) and PAP (peroxidase-antiperoxidase complex) methods. Of these cases, 49 were T-cell lymphoma and 7 were B-cell lymphoma. Ten of the 49 cases of T-cell lymphoma were adult T-cell leukemia/lymphoma (ATL). Twenty-five of 31 cases of T-cell lymphoma except ATL analyzed by the ABC method showed a helper/inducer phenotype (Leu2a-,Leu3a+), two cases showed a suppressor/cytotoxic phenotype (Leu2a+, Leu3a-), one case showed Leu2a+Leu3a+, one case showed an inducer phenotype (Leu2a-, Leu3a+, Leu9+), and one case showed OKT11+, Leu2a-, Leu3a-, Leu1-, Leu9+, CD25+, Leu10+, CD30+. One CD8+ lymphoma was Pagetoid reticulosis, and a CD4+, CD8+ lymphoma was lymphomatoid papulosis with erythematous plaque. Cutaneous T-cell lymphoma (CTCL), previously described by Edelson et al., is defined as a helper T-cell lymphoma with marked affinity for the skin. In our study, 5 cases of T-cell lymphoma of the skin were not CTCL as described by Edelson et al. These results show that T-cell lymphoma of the skin is heterogeneous in nature. In other words, CTCL is one type but represents a major proportion of T-cell lymphomas of the skin.

[Kimura's disease--immunohistochemistry using monoclonal and polyclonal antibodies]

We report a case of Kimura's disease of the external ear occurring in a 30-year-old woman. Subcutaneous masses removed from auricular lesions showed histologic features of Kimura's disease including many lymphoid follicles in the dermis, around which marked infiltrations of tissue eosinophils and mast cells, fibrosis, and vascular proliferation were seen. Immunohistochemical study by peroxidase-anti-peroxidase complex method showed IgE deposition in the lymph follicles. Infiltrating cells of extrafollicular lesions were also shown to include many mast cells which were IgE-positive in cell membranes and Giemsa-positive on cytoplasmic granules. In addition, we tried to examine the distribution of IgE Fc receptor (Fc epsilon R) by avidin-biotin-peroxidase complex (ABC) method with specifically reacting monoclonal antibody to Fc epsilon R (H107). In the germinal centers of the lymph follicles, Fc epsilon R distributed with a lacynetwork pattern. The staining pattern of dendritic reticulum cells (DAKO-DRC) was similar to that of H107. These findings indicate that Fc epsilon R on follicular dendritic cells have a close relationship to the IgE immune response and also play an important role in the pathogenesis of Kimura's disease.

Direct observation of immunoreactive sites and antibody molecules by ultrahigh-resolution scanning electron microscope

Using an ultrahigh-resolution scanning electron microscope (SEM), an attempt was made to directly visualize antibody molecules at antigenic sites in rat pancreas or on silicone plates. Although individual antibody molecules could not be discerned, a fluffy meshwork, probably indicating several molecules, was seen. With further improvements in specimen preparation, the high-resolution SEM promises to be an important tool in examining individual antibody-antigen sites without the need of an electron-dense label such as colloidal gold.

[T-cell lymphoma of the skin--clinicopathological relationships, therapy and survival]

We investigated the pretreatment characteristics and prognosis of T-cell lymphomas, including mycosis fungoides (MF), T-cell lymphoma of the skin other than MF (CTL), adult T-cell leukemia/lymphoma (ATL), immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma and angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), as well as B-cell lymphoma of the skin (CBL) and analyzed the prognostic factors for skin T-cell lymphoma when the skin was the organ initially or predoienantly involved. Twenty-eight cases of erythematous-stage MF, ten cases of plaque-stage MF, eleven cases of tumor-stage MF, twelve cases of ATL, eleven cases of IBL-like T-cell lymphoma/AILD, and eight cases of CBL were studied. CTCL patients were treated by photochemotherapy with topical 8-methoxypsoralen (8-MOP) followed by VUA irradiation, electron-beam irradiation, or systemic chemotherapy. Complete remission (CR) was obtained with all of these therapies. However induction of CR was not a major prognostic factor in skin T-cell lymphoma, and the clinical stage was more valuable in this respect. No cases of death occurred among erythematous-stage MF patients, but eight out of 11 patients with tumor-stage MF died (mean survival rate, 38 months). The prognosis for tumor-stage MF was better than that of ATL (19 months) or IBL-like T cell lymphoma/AILD (28 months), but worse than those of erythematous-a plaque-stage MF. TNM staging of CTCL was also a useful factor for prognosis.

The effect of agonists at the GABA-benzodiazepine-receptor-complex on the proconflict effect induced by beta-CCM and pentetrazol in rats

The effect of anxiolytics, benzodiazepine (BZP), diazepam (DZP), non-BZP zopiclone (ZOP) and phenobarbital (PBT), on the proconflict effect induced by methyl-beta-carboline-3-carboxylate (beta-CCM) or by pentetrazol (PTZ) was investigated. The proconflict effect of beta-CCM and PTZ was reduced by these anxiolytics and aminooxyacetic acid (AOAA). In addition, isoniazid produced proconflict activity. Therefore, it is suggested that anxiolytics facilitate the GABA-ergic function, causing the inhibition of the proconflict effect. Although both propyl-beta-carboline-3-carboxylate (beta-CCP) and Ro15-1788 did not produce proconflict activity, they reduced the proconflict effect induced by beta-CCM but not by PTZ. These data clearly show that beta-CCM exerts the proconflict effect through interaction with BZP receptor and that there are behavioral similarities between beta-CCP and Ro15-1788. In this study, we additionally observed the time latency until the rat began to drink the water. beta-CCM and PTZ prolonged this latency in a dose-dependent manner. However, AOAA could not reduce the prolonged latency induced by beta-CCM and by PTZ, and anxiolytics and beta-CCP could not reduce the prolonged latency induced by beta-CCM. The mechanism of the prolongation of latency induced by beta-CCM and PTZ seems to be different from that of the proconflict effect.

The effect of agonists at the GABA-benzodiazepine receptor complex on the duration of immobility of mice in the forced swimming test

In the present study, we examined the effect of various agents which affect in a different manner the GABA-benzodiazepine receptor-chloride ionophore complex system in relation to the immobile behavior of mice in the forced swimming test. The benzodiazepines diazepam and flurazepam, the barbiturates pentobarbital and phenobarbital, zopiclone and beta-CCP (propyl-beta-carboline-3-carboxylate) enhanced the immobile behavior in a dose-dependent manner. In the doses used here, these agents produced almost no muscle relaxant action. Ro15-1788 and beta-CCM (methyl-beta-carboline-3-carboxylate) themselves had no effect on the duration of immobility. However, Ro15-1788 and beta-CCM reversed the enhancing effect produced by all 6 drugs. These results indicate that the enhancement of the duration of immobility of mice may be somehow correlated to the anxiolytic action but not to the muscle relaxant action. The effect may be mainly mediated by the benzodiazepine receptor, which forms a part of the GABA-benzodiazepine receptor-chloride ionophore complex. Furthermore it is suggested that there were behavioral similarities in the effects of beta-CCP and benzodiazepines.

Establishment of T cell hybridomas which produce suppressor factors specific to the hen egg-white lysozyme (HEL)

The T cell hybridoma (#5104-2) which produces a suppressor factor to suppress the hen egg-white lysozyme (HEL) specific T cell proliferative response in an antigen specific manner was developed in our laboratories. Suppression by this suppressor factor require an I-J subregion matching between suppressor factor donor and donor of HEL-specific proliferative T cells. The Igh restriction between this suppressor factor donor and HEL-primed responder cell donor has not yet been observed in our experimental system. This suppressor factor has binding activity to HEL and is bound to anti-I-J antibody columns. It was also found to suppress the HEL specific delayed type hypersensitivity (DTH) responses when administered at the induction phase.

The effect of diazepam and of agents which change GABAergic functions in immobility in mice

When mice are forced to swim a restricted space, they will cease attempts to escape and adopt a characteristic immobile posture. In this study, this immobility was reduced by antidepressants and monoamineoxidase inhibitors. We found that diazepam had the ability to enhance this immobility. It is well known that diazepam exerts its pharmacological effect at least in part through GABAergic functions. Muscimol and aminooxyacetic acid enhanced the immobility. In addition, semicarbazide, bicuculline, picrotoxin and pentylenetetrazol reduced the immobility and pretreatment with bicuculline decreased this enhancement with muscimol, aminooxyacetic acid and diazepam. It seems that GABAergic functions play some role in the mechanism of this immobility.