HIV-1-Tat modulates the function of monocytes and alters their interactions with microvessel endothelial cells. A mechanism of HIV pathogenesis

Monocytes are major targets of HIV infection in patients with AIDS. In vitro infection of monocytes with HIV is associated with increased expression of beta 2 integrins, which increases both monocyte aggregation and monocyte/endothelial adhesion as well as monocyte metalloproteinase (MMP-9) expression. Treatment of primary monocytes with soluble HIV-Tat protein mimicked many of the properties of HIV infection of monocytes. Tat treatment up-regulated the expression of the beta 2 integrins, which was associated with the formation of large aggregates of monocytes and increased adhesion to endothelial monolayers. Treatment of monocytes with Tat increased their adhesion to both untreated and TNF-alpha-treated endothelial monolayers, and adhesion was inhibited by inclusion of anti-beta 2 and anti-ICAM-1 Abs. The increased adhesion of activated monocytes was accompanied by substantial disruption of the endothelial monolayers, with retraction or detachment of individual endothelial cells. Tat treatment of monocytes up-regulated the synthesis and release of the protease MMP-9, providing a potential mechanism to explain endothelial cell/basement membrane detachment. Thus, extracellular Tat is capable of activating monocytes even in the absence of HIV infection. Our studies demonstrate that many of the effects of HIV infection on monocyte homotypic and heterotypic adhesion, protease secretion, and disruption of the endothelium can be mimicked by treatment with HIV-Tat protein alone. These results suggest a mechanism where monocytes could be inappropriately activated by HIV-Tat, secreted by HIV-infected cells, causing them to extravasate into underlying tissues and ultimately contribute to tissue damage as seen during the progression of AIDS.

HIV-1-Tat modulates the function of monocytes and alters their interactions with microvessel endothelial cells. A mechanism of HIV pathogenesis

Monocytes are major targets of HIV infection in patients with AIDS. In vitro infection of monocytes with HIV is associated with increased expression of beta 2 integrins, which increases both monocyte aggregation and monocyte/endothelial adhesion as well as monocyte metalloproteinase (MMP-9) expression. Treatment of primary monocytes with soluble HIV-Tat protein mimicked many of the properties of HIV infection of monocytes. Tat treatment up-regulated the expression of the beta 2 integrins, which was associated with the formation of large aggregates of monocytes and increased adhesion to endothelial monolayers. Treatment of monocytes with Tat increased their adhesion to both untreated and TNF-alpha-treated endothelial monolayers, and adhesion was inhibited by inclusion of anti-beta 2 and anti-ICAM-1 Abs. The increased adhesion of activated monocytes was accompanied by substantial disruption of the endothelial monolayers, with retraction or detachment of individual endothelial cells. Tat treatment of monocytes up-regulated the synthesis and release of the protease MMP-9, providing a potential mechanism to explain endothelial cell/basement membrane detachment. Thus, extracellular Tat is capable of activating monocytes even in the absence of HIV infection. Our studies demonstrate that many of the effects of HIV infection on monocyte homotypic and heterotypic adhesion, protease secretion, and disruption of the endothelium can be mimicked by treatment with HIV-Tat protein alone. These results suggest a mechanism where monocytes could be inappropriately activated by HIV-Tat, secreted by HIV-infected cells, causing them to extravasate into underlying tissues and ultimately contribute to tissue damage as seen during the progression of AIDS.

Interferon-gamma inhibits HIV-induced invasiveness of monocytes

HIV-infected monocytes form highly invasive network on basement membrane matrix and secrete high levels of 92-kd metalloproteinase (MMP-9), an enzyme that degrades basement membrane proteins. In the present study, using matrigel as a model basement membrane system, we demonstrate that treatment of human immunodeficiency virus (HIV)-infected monocytes with interferon-gamma at 50 U/ml inhibited the ability of infected monocytes to form an invasive network on matrigel and their invasion through the matrigel matrix. These effects were associated with a significant reduction in the levels of MMP-9 produced by HIV-infected monocytes treated with interferon-gamma 1 day prior to infection with HIV as compared with that of untreated HIV-infected monocytes. Monocytes treated with interferon-gamma 1 day after HIV infection showed the presence of integrated HIV sequences; however, the levels of MMP-9 were substantially lower than those produced by monocytes inoculated with live HIV, heat-inactivated HIV, or even the control uninfected monocytes. Exposure of monocytes to heat-inactivated HIV did not result in increased invasiveness or high MMP-9 production, suggesting that regulation of metalloproteinase by monocytes was independent of CD4-gp120 interactions and required active virus infection. Furthermore, addition of interferon-gamma to monocytes on day 10 after infection inhibited MMP-9 production by more than threefold with no significant reduction of virus replication. These results indicate that the mechanism of interferon-gamma-induced down-regulation of MMP-9 levels and reduced monocyte invasiveness may be mediated by a mechanism independent of antiviral activity of IFN-gamma in monocytes. Down-regulation of MMP-9 in HIV-infected monocytes by interferon-gamma may play an important role in the control of HIV pathogenesis.

Birth weights of infants of first generation Asian women in Britain compared with second generation Asian women

OBJECTIVES

To compare birth weights of infants of first generation Asian women (women born in the Indian subcontinent) with those of infants of second generation Asian women (born in the United Kingdom).

DESIGN

Retrospective case note study.

SETTING

Bolton District General Hospital.

SUBJECTS

331 Asian women who gave birth between January 1989 and December 1989: 220 of these women were first generation Asians and 111 were second generation Asians.

MAIN OUTCOME MEASURE

Birth weights of babies born to first and second generation Asian women.

RESULTS

At all gestational ages at delivery, babies born to second generation Asian women were heavier than those born to first generation women. The mean birth weight for babies of second generation women was 3196 g, 249 g more than the mean birth weight of 2946 g of babies of first generation women (P < 0.001). After a stepwise multiple regression analysis was carried out the adjusted difference in birth weights was 280 g, greater than the crude difference.

CONCLUSION

Birth weights are important in relation to perinatal mortality, which is notoriously high among Asians. The results of this study indicate that there is hope for lowering of perinatal mortality and improving postnatal growth in babies of second generation Asians.

Interferon-gamma-induced downregulation of CD4 inhibits the entry of human immunodeficiency virus type-1 in primary monocytes

We have previously shown that the treatment of monocytes with interferon-gamma (IFN-gamma) prior to exposure with human immunodeficiency virus type-1 (HIV) results in complete inhibition of HIV infection of monocytes. In the present report, we have extended this study to obtain information on the mechanism(s) underlying IFN-gamma-induced inhibition of HIV infection of monocytes. To examine the effect of IFN-gamma on HIV entry, the first event in the infectious cycle of the virus, we amplified HIV-gag sequences in the genomic DNA and RNA of IFN-gamma treated monocytes, and found no evidence for the presence of either proviral DNA or HIV RNA sequences. These results were consistent with the absence of intracellular HIV particles either in the latent or actively replicating state as determined by flow-cytometric analysis of these cells. Furthermore, no HIV-induced cytopathic effects, such as multinucleated giant cell formation or cell death, were observed in IFN-gamma-treated monocytes after their exposure to HIV. Stimulation of IFN-gamma-treated monocytes 6 days postinfection with tumor necrosis factor-alpha (TNF-alpha), which is known to augment HIV replication in the infected cells, did not result in the induction of the HIV indicating the absence of latent HIV infection in IFN-gamma-treated monocytes. Treatment of monocytes with IFN-gamma, TNF-alpha, or with a combination of the two agents which is known to induce antimicrobial free radical nitric oxide (NO2- in the murine system did not induce NO2- production human monocytes suggesting the antiviral activity of IFN-gamma to be independent of NO2(-)-mediated killing of HIV or HIV-infected monocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

HIV-1 infection alters monocyte interactions with human microvascular endothelial cells

HIV infection of monocytes resulted in twofold elevation of adhesion molecule LFA-1 (both alpha L/CD11a and beta 2/CD18 subunits) and LFA-3 (CD58), with no apparent increase in LFA-2 (CD2) or various beta 1-integrins. Homotypic aggregation of monocytes was evident 2 h after exposure to virus and was inhibited by mAbs to both the alpha L- and beta 2-subunits of LFA-1. HIV-infected monocytes also showed a marked increase in adherence to human capillary endothelial cell monolayers derived from brain, lung, and skin. This adherence was inhibited by mAb to either LFA-1 subunit and by mAb to the counter-receptor intercellular adhesion molecule-1. Cocultivation of HIV-infected monocytes with endothelial cells increased permeability of endothelial cell monolayers to 125I albumin in transwell assay systems. The increased endothelial permeability induced by HIV-infected monocytes was associated with a substantial disruption of the endothelial cell monolayer. Morphologic disruption was not a direct toxic effect on endothelial cells, but appeared to be secondary to changes in endothelial cell-cell or cell-matrix interactions. Northern blot analysis showed increased expression of gelatinase B (92-kDa gelatinase), tissue inhibitor of metalloproteinase TIMP-1, and TIMP-2 in the HIV-infected monocytes. Consistent with these Northern analyses, secretion of gelatinase activity in culture fluids of HIV-infected monocytes was also increased and was dependent on the stage of virus replication. Incubation of HIV-infected monocytes with the proteinase inhibitors TIMP-1 and TIMP-2 inhibited the increased permeability of endothelial cell monolayers to 125I albumin. These results suggest possible mechanisms for extravasation of HIV-infected monocytes through vascular endothelium into tissue in early stages of HIV disease.

HIV-1 infection alters monocyte interactions with human microvascular endothelial cells

HIV infection of monocytes resulted in twofold elevation of adhesion molecule LFA-1 (both alpha L/CD11a and beta 2/CD18 subunits) and LFA-3 (CD58), with no apparent increase in LFA-2 (CD2) or various beta 1-integrins. Homotypic aggregation of monocytes was evident 2 h after exposure to virus and was inhibited by mAbs to both the alpha L- and beta 2-subunits of LFA-1. HIV-infected monocytes also showed a marked increase in adherence to human capillary endothelial cell monolayers derived from brain, lung, and skin. This adherence was inhibited by mAb to either LFA-1 subunit and by mAb to the counter-receptor intercellular adhesion molecule-1. Cocultivation of HIV-infected monocytes with endothelial cells increased permeability of endothelial cell monolayers to 125I albumin in transwell assay systems. The increased endothelial permeability induced by HIV-infected monocytes was associated with a substantial disruption of the endothelial cell monolayer. Morphologic disruption was not a direct toxic effect on endothelial cells, but appeared to be secondary to changes in endothelial cell-cell or cell-matrix interactions. Northern blot analysis showed increased expression of gelatinase B (92-kDa gelatinase), tissue inhibitor of metalloproteinase TIMP-1, and TIMP-2 in the HIV-infected monocytes. Consistent with these Northern analyses, secretion of gelatinase activity in culture fluids of HIV-infected monocytes was also increased and was dependent on the stage of virus replication. Incubation of HIV-infected monocytes with the proteinase inhibitors TIMP-1 and TIMP-2 inhibited the increased permeability of endothelial cell monolayers to 125I albumin. These results suggest possible mechanisms for extravasation of HIV-infected monocytes through vascular endothelium into tissue in early stages of HIV disease.

Interferon-gamma induces resistance in primary monocytes against human immunodeficiency virus type-1 infection

Treatment of monocytes with interferon-gamma 1 day before, or at the time of infection with human immunodeficiency virus type-1 (HIV-1) induced complete resistance in monocytes against HIV-1 infection. There was no evidence of viral RNA, proviral DNA, p24 antigen, or reverse transcriptase activity through 2 weeks after inoculation. Ultrastructural examination of these cells showed no detectable virus particles. When interferon-gamma was added to monocytes 1 to 3 days post-infection, virus integration occurred, but the viral expression was either ablated (1 day post-infection) or significantly inhibited (3 days post-infection). Treatment of monocytes with interferon-gamma before or after infection with HIV-1 produced significantly higher levels of tumor necrosis factor-alpha and interleukin-8 than untreated or uninfected monocytes. These results suggest that altered regulation of cytokines may mediate antiviral activity of interferon-gamma in monocytes.

Modulation of HTLV-II-associated spontaneous lymphocyte proliferation by beta 2 integrin CD11a/CD18 involves interaction with its cognate ligand, CD54

In vitro culture of lymphocytes from persons infected by human T-lymphocyte virus type II (HTLV-II) results in spontaneous proliferation in the absence of any exogenous stimuli. The present investigation examined the role of integrin molecules in spontaneous lymphocyte proliferation (SLP) in persons infected with HTLV-II (n = 18) and normal controls (n = 16). Phenotypic analysis of SLP cells on Day 8 demonstrated no change in the surface expression of CD29 (beta 1), CD49b,d,e, and f (alpha-chains) compared with cells from normal controls; however, there was an increase of CD29 expression on SLP cells on Day 8 (77.2 +/- 5.1%) compared with Day 0 (53.2 +/- 3.1%; P < 0.01). Furthermore, addition of extracellular matrix proteins, fibronectin, laminin, or collagen (beta 1 integrin ligands) did not alter either the proliferative responses or the adhesion clusters in either groups. Analysis of beta 2 integrins on SLP cells showed not only an increased cell surface density of both CD18 and CD11a but also differential expansion of CD8+ T-cells coexpressing CD18 (54.0 +/- 10.3%), CD11a (53.7 +/- 8.1%), and S6F1, an epitope of CD11a, (65.3 +/- 7.8%) on Day 8 compared with Day 0 (20.0 +/- 2.5%, 19.3 +/- 1.9%, and 38.0 +/- 7.0%, respectively). Monoclonal antibodies to CD18 and CD11a inhibited SLP by 55 +/- 6.3% in HTLV-II-infected persons in a dose-dependent manner. The inhibition of SLP by anti-beta 2 antibodies was not due to negative signaling, since these antibodies did not inhibit anti-CD3-stimulated proliferation of normal lymphocytes. Moreover, monoclonal antibodies to CD54, the ligand for CD11a, inhibited the SLP in the majority of HTLV-II-infected persons studied. Taken together, these data suggest that SLP by PBL from HTLV-II-infected individuals is mediated through increased expression of beta 2 integrins that can modulate cognate receptor/ligand interactions on the cell surface of autologous proliferating cells.

Long-term contraceptive effects of intrauterine neem treatment (IUNT) in bonnet monkeys: an alternate to intrauterine contraceptive devices (IUCD)

Antifertility effects of intrauterine neem treatment (IUNT) was studied in bonnet monkeys. A single administration of 1 ml of neem oil by an intrauterine insemination catheter blocked fertility for 7 to 12 months. The effect was, however, reversible as all the animals became pregnant subsequently and delivered normal babies. The neem oil treatment had no adverse effect on menstrual cyclicity and ovarian functions. The uterus of neem-treated animals showed normal morphology. Immunohistological studies, however, demonstrated a significant increase in the number of MHC-II antigen-positive cells in the uterine endometrium following neem treatment, indicating enhanced antigen-presenting ability of the uterus; a feature that may be related to the observed antifertility effect of neem oil. The present investigation demonstrates that an IUNT can be used for long-term, reversible contraception, without any apparent side effects, and that the method could provide an alternate to currently used intrauterine contraceptive devices (IUCD).

Increased expression of alpha 4 beta 1 and alpha 5 beta 1 integrins on HTLV-I-infected lymphocytes

T cells interact with the extracellular matrix via integrin receptors and these interactions affect both cellular localization and proliferation. The importance of these interactions in retrovirus-induced diseases, however, remains less clear. In the present study, we investigated changes in T cell adhesion to extracellular matrix proteins by HTLV-I expressing cell lines and human peripheral blood lymphocytes infected with HTLV-I by cocultivation. Cell lines and acutely infected primary peripheral blood lymphocytes demonstrated enhanced adhesion to fibronectin. Acute infection of peripheral blood lymphocytes increased the expression of alpha 5 beta 1 and alpha 4 beta 1 integrins. Antibodies to the alpha 4, alpha 5, and beta 1 subunits inhibited attachment of infected cells to fibronectin. We conclude that HTLV-I infection is associated with an increase in the expression of both the classical fibronectin receptor and the receptor for the alternatively spliced domain of fibronectin on peripheral blood lymphocytes. HTLV-I-related alterations in cell surface adhesion molecules may contribute to the abnormal proliferation of T cells in adult T cell leukemia (ATL) or to the abnormal localization of activated or infected T cells to the central nervous system of patients with tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM).

Antifertility effects of neem (Azadirachta indica) oil in male rats by single intra-vas administration: an alternate approach to vasectomy

An alternate approach to vasectomy for long-term male contraception following a single intra-vas application of a traditional plant (Azadirachta indica) product having immunomodulatory properties is described. Male Wistar rats of proven fertility were given a single dose (50 microliters) of neem oil in the lumen of the vas deferens on each side; control animals received the same volume of peanut oil. Animals were put on continuous mating 4 weeks after the treatment, with females of proven fertility. While the control animals impregnated the female partners, all males treated with neem oil remained infertile throughout the 8 months of observation period. Epididymal and vas histology were normal without any inflammatory changes or obstruction. The intra-vas administration of neem oil resulted in a block of spermatogenesis without affecting testosterone production; the seminiferous tubules, although reduced in diameter, appeared normal and contained mostly early spermatogenic cells. No anti-sperm antibody could be detected in the serum. Unilateral administration of neem oil in the vas resulted in a significant reduction of testicular size and spermatogenic block only on the side of application; the draining lymph node cells of the treated side also showed enhanced proliferative response to in vitro mitogen challenge. These results indicate that the testicular effects following intra-vas application of neem oil may possibly be mediated by a local immune mechanism.

Long-term follow-up of patients with diffuse fasciitis and eosinophilia associated with L-tryptophan ingestion

We describe the long-term follow-up of two patients who experienced diffuse fasciitis and eosinophilia while ingesting L-tryptophan for treatment of insomnia. This is one of the first reports in the dermatologic literature of the long-term follow-up of eosinophilic fasciitis in association with L-tryptophan ingestion. Both patients fit the Centers for Disease Control's criteria for eosinophilia-myalgia syndrome. The literature on the eosinophilia-myalgia syndrome is reviewed.

Immunomodulatory effects of neem (Azadirachta indica) oil

Immunomodulatory effects of neem oil were studied in mice. The animals were treated intraperitoneally (i.p.) with neem oil; control animals received the emulsifying agent with or without peanut oil. Peritoneal lavage, collected on subsequent days, showed a maximum number of leukocytic cells on day 3 following treatment with neem oil; peritoneal macrophages exhibited enhanced phagocytic activity and expression of MHC class-II antigens. Neem oil treatment also induced the production of gamma interferon. Spleen cells of neem oil-treated animals showed a significantly higher lymphocyte proliferative response to in vitro challenge with Con A or tetanus toxoid (TT) than that of the controls. Pre-treatment with neem oil, however, did not augment the anti-TT antibody response. The results of this study indicate that neem oil acts as a non-specific immunostimulant and that it selectively activates the cell-mediated immune (CMI) mechanisms to elicit an enhanced response to subsequent mitogenic or antigenic challenge.

Interactions between HIV-infected monocytes and the extracellular matrix: HIV-infected monocytes secrete neutral metalloproteases that degrade basement membrane protein matrices

The frequency of human immunodeficiency virus (HIV)-infected monocytes that spread on a model basement membrane was about twofold greater than that of an equal number of uninfected control cells through the initial 12 to 18 h of culture. By 24 h, virtually all HIV-infected and uninfected control cells spread on the basement membrane gel. The frequency of spread cells in the uninfected control population was less than 10% of total cells by 12 days. In contrast, 30 to 40% of HIV-infected monocytes remained spread through this time interval and formed a dense interdigitated network of cell processes on and into the gel matrix. Invasion of the basement membrane matrix by HIV-infected monocytes suggested increased secretion of proteases able to digest the gel. Indeed, levels of neutral protease activity in culture fluids from HIV-infected monocytes were significantly higher than those from equal numbers of uninfected control cells. High levels of protease activity in culture fluids of HIV-infected monocytes required productive virus infection and were not observed with cells exposed to T cell-tropic HIV isolates. The predominant protease activity in these cultures was a 92-kd neutral metallogelatinase. HIV-induced changes in monocyte metalloprotease activity may be important for extravasation of infected cells to tissue or for the development of AIDS-associated neuropathology, carcinogenesis, and opportunistic infection.

Interactions between HIV-infected monocytes and the extracellular matrix: increased capacity of HIV-infected monocytes to adhere to and spread on extracellular matrix associated with changes in extent of virus replication and cytopathic effects in infected cells

Monocytes express cell surface receptors for extracellular matrix (ECM) proteins of basement membranes. These receptors are engaged during extravasation of cells through capillary endothelium into tissue. The number of human immunodeficiency virus (HIV)-infected monocytes that adhered to ECM over 2 h was threefold higher than that of uninfected control cells. This difference was ECM specific and was not observed with a bovine serum albumin substrate. Enhanced adhesion to ECM was evident in monocytes by 4 days after HIV infection and increased through 10 days. Monocytes exposed to a T cell-tropic HIV strain that binds to but does not replicate in monocytes showed no changes in adherence to ECM. Thus, productive infection of monocytes by HIV induces a significant increase in the capacity of these cells to interact with ECM. Enhanced adhesion of HIV-infected monocytes to ECM was associated with increased spreading: at 12 h, sixfold more HIV-infected monocytes were spread on ECM than were uninfected control cells. Cell processes of HIV-infected monocytes formed a complex network on ECM: many of these cells expressed HIV proteins as detected by indirect immunofluorescence. HIV-associated cytopathic effects and levels of virion-associated reverse transcriptase activity depended on the substrate to which monocytes were attached. Virus replication and cytopathic effects in monocytes adhered to ECM, fibronectin, or plastic alone were comparable. In contrast, HIV-infected monocytes attached to laminin showed a significant increase in virus replication and in extent of cytopathic effects through 2 weeks after infection. The lowest levels of HIV replication and cytopathic effects were in monocytes attached to collagen IV. Interactions between monocytes and ECM profoundly affect the manner in which these cells control HIV infection: HIV infection changes the capacity of infected monocytes to attach and spread on ECM; attachment to ECM alters the extent of virus replication in infected cells.

The efflux of nor-epinephrine from platelets in genetic hypertension

Platelets have been used as a model of sympathetic neurons to study the storage of nor-adrenaline in normotensive individuals belonging to families with essential hypertension for at least two generations. The efflux and initial efflux rate (K) of noradrenaline was determined in 36 young relatives (mean age 29.2 years) and in 20 young controls with no family history of hypertension (mean age 26.5 years). From the groups of relatives all those with definite hypertension had been excluded. Efflux and efflux rate K was significantly higher in young relatives (50.82 +/- 3.84 and 28.2 +/- 6.3) than in the controls (39.2 +/- 0.71 and 15.2 +/- 4.8). Of the relatives 25.2% had higher K values than any of the controls.

Use of captopril as an isolated agent for the management of stable angina pectoris--a double blind randomised trial

In this double blind randomised placebo controlled study, we investigated the antianginal efficacy of oral captopril in 33 patients of angiographically documented coronary artery disease (chronic stable angina). Apart from sublingual nitrates, all other antianginal drugs were withdrawn. Patients were then evaluated both subjectively by questionnaire and objectively by treadmill stress test. No patient had more than mild hypertension and all patients had good left ventricular function. One group of patients received oral captopril while the other group was given placebo. A repeat assessment was done after six weeks and the results compared with baseline. Anginal attacks decreased from 20.11 +/- 1.86 per week on placebo to 9.92 +/- 1.38 (p < 0.01) on captopril as also the number of sublingual nitrates (18.84 +/- 3.01 to 11.14 +/- 2.94, p < 0.01). Assessment by the treadmill stress test showed that in comparison to the pretreatment test, captopril therapy resulted in a significantly increased exercise duration (6.26 +/- 0.21 to 6.98 +/- 0.31 minutes, p < 0.05), total work done (6.76 +/- 0.26 METS to 7.48 +/- 0.29 METS, p < 0.05). In addition there was a significant increase in time to angina (6.16 +/- 0.18 to 6.85 +/- 0.24 min, p < 0.05) and time to 1mm ST depression (5.18 +/- 0.26 to 6.46 +/- 0.30 min, p < 0.01). We conclude that captopril is an effective monotherapy for patients with chronic stable angina and has both antianginal as well as anti-ischemic effects, possibly secondary to direct coronary vasodilation.

Modified cephalic vein guide wire technique for permanent pacemaker implantation

This report describes a modified cephalic vein guide wire technique used for implantation of 18 consecutive pacemakers using bipolar leads. The modified technique appears to be a safe and simple procedure for single chamber permanent pacing. Its use may also be extended in implanting dual chamber pacemakers.

Factors influencing platelet serotonin uptake in essential hypertension

In a study of the mechanism(s) of platelet serotonin uptake alteration in essential hypertension, a total of 90 blood samples were analysed for platelet count and platelet serotonin uptake. These included 20 blood samples each of hypertensives, controls before and after cross-incubation experiments and 10 samples of hypertensives after control of blood pressure. It was observed that serotonin uptake was markedly reduced in hypertensive platelets. Diminished serotonin uptake in essential hypertension correlated directly with diastolic and mean arterial blood pressure and inversely with plasma total cholesterol values. In cross-incubation experiments using control platelets and hypertensive plasma, there was a significant reduction in platelet serotonin uptake (303.06 +/- 86.28 cpm/10(8) vs. 204.26 +/- 66.45 cpm/10(8); P less than 0.001), whereas hypertensive platelets when incubated with control plasma, showed increased serotonin uptake (233.50 +/- 75.19 cpm/10(8) vs. 312.64 +/- 79.54 cpm/10(8); P less than 0.01). Upon control of blood pressure, the platelet serotonin uptake improved significantly (205.45 +/- 70.0 cpm/10(8) vs. 266.77 +/- 61.68 cpm/10(8); P less than 0.05-0.01). From these results, it appears that reduced platelet serotonin uptake in essential hypertension is a reversible phenomenon probably governed by the presence of plasma factor(s) and/or altered platelet-membrane function.

The efflux of nor-epinephrine from platelets in essential hypertension

The precise role of sympathetic nervous system in initiation and/or maintenance of essential hypertension is unclear even today. Platelets have been used as a suitable model for studying neuronal turnover of biogenic amines. The present study comprised of hypertensive subjects (23) and normotensive controls (10). Hypertensive subjects exhibited significantly enhanced norepinephrine efflux from platelets at both 30 minutes and 60 minutes (p less than 0.001). The percent norepinephrine efflux from platelets correlated with diastolic (r = 0.66 and 0.76) and mean arterial blood pressure (r = 0.54 and 0.65) but not with systolic blood pressure. The norepinephrine efflux rate (K) similarly correlated with diastolic and mean arterial blood pressure in hypertensive subjects studied. From the above findings it appears that operative sympathetic nervous system activity is enhanced in essential hypertension. The enhanced efflux of norepinephrine from platelets may also indicate activated state of platelets in hypertension. Both could be important in genesis and complications of essential hypertension.