The modification and expression of 21-hydroxylase gene in normal human adrenal gland and adrenal cancer

Genomic DNA and total RNA from three adrenal cancer tissues were analyzed by hybridization with human 21-hydroxylase gene. Southern blot analysis with restriction enzyme Eco RI revealed major fragments at 18, 13 and 9 kilobase (kb) in normal adrenal glands. In two of three adrenal cancers, however, the band at 18 kb was either absent or decreased and the 9 kb fragment showed an increase in its intensity. Normal liver, kidney and leucocytes has only 18 and 13 kb while lacking the 9 kb fragment. Using Taq I, Bam HI or Bgl II, we found no difference in restriction fragment patterns between adrenal cancer and normal tissues. Cleavage with Hpa II after digestion with Bgl II showed that significantly more DNA was digested into low-molecular weight fragments in adrenal cancer and the normal adrenal gland than those in other normal tissues. By Northern blot analysis, there was difference of signal intensity of hybridizing mRNA between the adrenal cancers and normal adrenal glands. These results suggest that the Eco RI site in the flanking region of the 21-hydroxylase gene may be modified in adrenal cancer tissue, and that inadequate 21-hydroxylase is present in some forms of adrenal cancers.

[Effect of endotoxin on plasma angiotensin-converting enzyme in dogs]

We calculated angiotensin converting enzyme (ACE) index (ACE/CO) to exclude the influence of pulmonary perfusion and investigated the relationship among ACE, ACE index, hemodynamic changes in 6 endotoxin dogs. Systemic arterial pressure and cardiac output (CO) decreased significantly after 3 mg.kg-1 of endotoxin administration, but neither pulmonary arterial pressure nor pulmonary arterial wedge pressure changed. Lung wet/dry ratio was higher. Although endotoxin administration caused the pulmonary capillary endothelial damage in this experiment, plasma ACE showed a nonsignificant increase. The main reason may be related to the reduction of surface area of pulmonary capillary endothelial cells caused by the decrease in cardiac output. The increased ACE index lasted for 15 to 90 min and began to return to baseline at 120 min after endotoxin administration. We conclude that ACE index is more useful than plasma ACE as an early marker of the pulmonary capillary endothelial damage induced by endotoxin.

Combined 17 alpha-hydroxylase/17,20-lyase deficiency due to a 7-basepair duplication in the N-terminal region of the cytochrome P45017 alpha (CYP17) gene

17 alpha-Hydroxylase deficiency is characterized by defects in either or both of the 17 alpha-hydroxylase/17,20-lyase activities. We have elucidated the molecular basis of the combined deficiency of these activities in a Japanese female who is genotypically male and the child of a consanguineous marriage. The complete exonic sequence of the patient's CYP17 (P45017 alpha) gene revealed a seven-basepair duplication (GCGCACA) in exon 2 which leads to a frame shift and, subsequently, a premature stop codon. Because this stop codon occurs N-terminal to the heme-binding sequence, the presence of this mutation leads to the absence of a functional P45017 alpha-protein in adrenal cortex and testis. This, in turn, leads to an absence of sex steroids and excessive secretion of steroids with mineralocorticoid activity and, consequently, female external genitalia and hypertension in this 46XY patient.

Pressure-supported ventilation for posterior fossa operation

To maintain enough gas exchange while using spontaneous respiration as a monitor of the normal brainstem function, we tried pressure-supported ventilation (PSV) with a Servo 900C ventilator (Siemens Elema AB, Sweden) on 12 otherwise healthy patients during posterior fossa operation. Ventilation mode was switched from controlled to PSV after the dura was open uneventfully in all cases but one. With a trigger level of -1 to -2 cm H2O, spontaneous respiration was triggered to start the inspiration. With supporting inspiratory pressure of 4-20 cm H2O, PaCO2 was kept at 31.7-45.9 mm Hg. The ventilatory level could be monitored breath by breath by ventilatory frequency, tidal volume, minute volume, and end-tidal CO2 concentration shown on the ventilator system. Apnea was observed in two cases during surgical manipulation around the brainstem. It was indicated immediately by the ventilator's alarm for decreased expiratory minute volume, and no sign of brainstem dysfunction was observed postoperatively. PSV was useful in maintaining adequate ventilation whereas spontaneous respiration was used as an indicator of normal brainstem function. The alarm system of the ventilator was sensitive enough to detect the surgical invasion of the brainstem at a very early stage.

Expression of c-fos and c-myc proto-oncogenes in human adrenal pheochromocytomas

We examined c-fos and c-myc expressions in pheochromocytoma tissues from six patients. All samples contained c-fos and c-myc transcripts, whereas mRNA from bovine adrenal medulla, as a control, did not contain these transcripts at detectable levels. Southern blot analysis revealed no amplification and no rearrangement of c-fos and c-myc genes. We also examined the gene expression of insulin-like growth factor-II (IGF-II), a mitogen for rat pheochromocytoma cells exerted by autocrine or paracrine fashion. All samples from the pheochromocytomas contained IGF-II transcripts as well as c-fos and c-myc transcripts. The constitutive expressions of c-fos and c-myc genes may be interpreted to mean that pheochromocytoma is in a state of growth stimulation in vivo by growth factors, including IGF-II.

[Cholesterol atheroembolic renal failure after arteriography. Report of a case diagnosed by renal biopsy]

A case of atheroembolic renal failure diagnosed by renal biopsy was presented. A 69-year-old man was referred because of progressive renal failure two months after major angiography for occlusive arterial disease of lower limbs. The physical examination on admission revealed an uncontrollable hypertension. The laboratory findings showed elevated serum creatinine (7.5 mg/dl) and eosinophilia (1022/mm3) with normal urinalysis findings. Renal biopsy disclosed a occlusive lesion of the arcuate artery which contained cholesterol clefts and foam cells, and showed ischemic renal parenchymal changes. These findings were compatible with cholesterol atheroembolic renal disease. In spite of the aggressive medical treatment, renal function had deteriorated progressively and the patient has been on regular hemodialysis. Atheroembolic renal failure after arteriography have been reported recently, but the case diagnosed by renal biopsy has been rare. Since there is no therapeutic way to reverse this type of renal failure, strict selection of patients for the angiographic examination and use of flexible catheter might be mandatory. Subacute course of renal failure after angiography and eosinophilia seem to be the important diagnostic clues for this disorder.

Deletion of a phenylalanine in the N-terminal region of human cytochrome P-450(17 alpha) results in partial combined 17 alpha-hydroxylase/17,20-lyase deficiency

Steroid 17 alpha-hydroxylase and 17,20-lyase activities reside within the same polypeptide chain (cytochrome P-450(17 alpha)), and consequently human 17 alpha-hydroxylase deficiencies are characterized by defects in either or both of these activities. Human mutants having these deficiencies represent an excellent source of material for investigation of P-450(17 alpha) structure-function relationships. The CYP17 gene from an individual having partial combined 17 alpha-hydroxylase/17,20-lyase deficiency has been characterized structurally and the homozygous mutation found to be the deletion of the phenylalanine codon (TTC) at either amino acid position 53 or 54 in exon 1. Reconstruction of this mutation into a human P-450(17 alpha) cDNA followed by expression in COS 1 cells led to production of the same amount of immunodetectable P-450(17 alpha) protein as found with expression of the normal human P-450(17 alpha) cDNA. However, 17 alpha-hydroxylase activity of this mutant protein measured in intact cells was less than 37% of that observed upon expression of the wild-type enzyme, whereas 17,20-lyase activity of the mutant was less than 8% of that observed with the normal enzyme. When estimated in intact cells, the Km for 17 alpha-hydroxylation of progesterone was increased by a factor of 2 in the mutant enzyme, whereas the Vmax was reduced by a factor of 3. In order to estimate the kinetic parameters for the 17,20-lyase reaction, microsomes were isolated from transfected COS 1 cells to enrich for this activity. Surprisingly, the specific activity of the mutant 17 alpha-hydroxylase in microsomes was 3-fold less than that observed in intact cells, indicating that the structure of mutant P-450(17 alpha) was dramatically altered upon disruption of COS 1 cells. Apparently the deletion of a single phenylalanine in the N-terminal region of P-450(17 alpha) alters its folding in such a way that both enzymatic activities are dramatically decreased, leading to the partial combined deficiency observed in this individual.

Combined 17 alpha-hydroxylase/17,20-lyase deficiency due to a stop codon in the N-terminal region of 17 alpha-hydroxylase cytochrome P-450

Steroid 17 alpha-hydroxylase (cytochrome P-450(17)alpha) mediates both 17 alpha-hydroxylase and 17,20-lyase activities. A relatively rare disease, 17 alpha-hydroxylase deficiency is characterized by defects in either or both of these activities. The molecular basis for variability of the defect is not well understood. We have determined the exonic sequence of the mutant P-450(17)alpha gene from one Japanese patient with combined 17 alpha-hydroxylase/17,20-lyase deficiencies. A stop codon (TGA) due to a single point mutation was found at the position of amino acid 17 in exon 1 of the P-450(17)alpha gene. The presence of a stop codon in the N-terminal region of this gene leads to the absence of a functional P-450(17)alpha protein in adrenal cortex and ovary, and consequently hypertension, primary amenorrhea and osteoporosis in this patient.

A case of glucocorticoid-suppressible hyperaldosteronism with aldosterone producing adenoma

A 34-yr-old woman with hypertension (142/102 mmHg), hypokalemia, high plasma and urinary aldosterone and low plasma renin activity was studied. A left adrenal tumor and enlarged right adrenal gland were demonstrated by adrenal venography. During administration of dexamethasone (2 mg daily, for 3 weeks), urinary aldosterone excretion decreased abruptly from 22.5 to 9-11 micrograms/day, serum potassium increased and blood pressure fell to 120-130/80-90 mmHg. After left adrenalectomy, all manifestations improved with no medication. The resected adrenal gland revealed clear cell adenoma and micronodular adrenocortical hyperplasia. The patient was considered to be a rare case of glucocorticoid-suppressible hyperaldosteronism with an aldosterone-producing adenoma.

Correlation of daily urinary excretion of met-enkephalin-like immunoreactivity and epinephrine in men

To investigate the source of urinary Met-enkephalin-like immunoreactivity (MELI), 24-h urinary excretion of MELI and catecholamines (CAs) were examined in normal subjects and patients with tuberculous Addison's disease. MELI was present in urine and 24-h urinary excretion of MELI averaged 813.8 +/- 446.9 ng/day in normal subjects (N = 33, Mean +/- SD). 24-h urinary excretion of MELI in normal subjects significantly showed positive correlation with 24-h urinary epinephrine (E) (R = 0.392, P less than 0.05) but no correlation with that of norepinephrine (NE) or dopamine (DA). In two patients with tuberculous Addison's disease, 24-h urinary excretion of MELI and that of E were significantly lower than those of normal subjects. These results indicate that the main source of urinary MELI may be adrenal medulla.

Preproenkephalin A-derived opioid peptides and mRNA of preproenkephalin A in human pheochromocytomas

Tissue contents of immunoreactive met-enkephalin (Met-Enk), leu-enkephalin (Leu-Enk) and met-enkephalin-Arg-Gly-Leu (Met-Enk-AGL) were determined by specific RIAs in 17 pheochromocytomas and the levels of preproenkephalin A mRNA were compared in some of these tissues by Northern blot hybridization. Remarkably wide distributions in the amounts of immunoreactive Met-Enk, Leu-Enk and Met-Enk-AGL were observed in 17 pheochromocytomas. Medullary pheochromocytomas contained significantly larger amounts of immunoreactive Met-Enk, Leu-Enk and Met-Enk-AGL than did the extramedullary ones. Significant positive correlations of tumor tissue immunoreactivities between Met-Enk and Leu-Enk (r = 0.97, P less than 0.01) and between Met-Enk and Met-Enk-AGL (r = 0.97, P less than 0.01) were observed. No difference in size of mRNA of preproenkephalin A was observed in the pheochromocytomas. Medullary pheochromocytomas contained higher amounts of preproenkephalin A mRA than did the extramedullary ones. The quantities of preproenkephalin A mRNA in nine pheochromocytoma tissues significantly correlated with those of immunoreactive Met-Enk in these tissues (r = 0.94, P less than 0.01). These results indicate that the remarkable difference in tissue immunoreactivities of preproenkephalin A-derived opioid peptides is decided at the transcriptional level but not at the posttranslational level.

Studies on adrenorphin in pheochromocytoma

We studied the secretion and tissue contents of adrenorphin in human pheochromocytomas. In 17 human pheochromocytomas from 11 patients, we found a remarkably wide distribution in immunoreactive adrenorphin levels (3-7771 pg/mg tissue). Adrenomedullary pheochromocytomas contained a significantly larger amount of immunoreactive adrenorphin (2295 +/- 1092 pg/mg, mean +/- SE) than did extramedullary ones (17.8 +/- 8.4 pg/mg). Gel chromatographic studies revealed that immunoreactive adrenorphin consisted largely of material emerging at the position of synthetic adrenorphin in both pheochromocytoma and normal adrenal medulla tissue. Nicotine (10(-5) M) significantly stimulated the secretion of immunoreactive adrenorphin as well as catecholamines from cultured human pheochromocytoma cells. Adrenorphin was a more potent inhibitor of catecholamine secretion evoked by 10(-5) M nicotine than was met-enkephalin in cultured human pheochromocytoma cells. The 50% inhibitory concentrations (IC50) were 1.1 X 10(-6) and 6.5 X 10(-5) M for adrenorphin and met-enkephalin, respectively. The effect of adrenorphin was much the same as that of dynorphin-(1-13) (IC50, 1.0 X 10(-6) M) and BAM-12P (IC50, 4.5 X 10(-6) M). These results indicate the presence and secretion of adrenorphin in human pheochromocytomas. Adrenorphin may play an important role in regulating catecholamine secretion in human pheochromocytoma.

Preproenkephalin B-derived opioid peptides in human phaeochromocytomas

We demonstrated the presence and the secretion in vivo and in vitro of immunoreactive preproenkephalin B-derived opioid peptides (alpha-neoendorphin, dynorphin and leumorphin) in human phaeochromocytomas. In seventeen human phaeochromocytomas and two human adrenal medullas, the tissue contents of immunoreactive preproenkephalin B-derived opioid peptides (alpha-neoendorphin, dynorphin and leumorphin) and leu-enkephalin were studied by specific RIAs. Compared with a remarkable wide distribution in amounts of immunoreactive leu-enkephalin (1063 +/- 437 pg/mg, mean +/- SE), small amounts of immunoreactive alpha-neoendorphin (22.6 +/- 6.4 pg/mg) and dynorphin (8.5 +/- 1.2 pg/mg) were detected in all seventeen human phaeochromocytomas and the two human adrenal medullas. Leumorphin-like immunoreactivity was detected in only four tumours. Gel chromatographic studies revealed the presence of preproenkephalin B-derived peptides and their high molecular forms. A significant positive correlation between the tumour tissue contents of immunoreactive alpha-neoendorphin and of dynorphin was observed. Nicotine (10(-5), 10(-4) mol/l) significantly stimulated the secretion of immunoreactive alpha-neoendorphin and dynorphin as well as leu-enkephalin and catecholamines from cultured human phaeochromocytoma cells. Administration of 1 mg of glucagon to a patient with medullary phaeochromocytoma induced a rapid increase in the plasma concentration of immunoreactive alpha-neoendorphin with a concomitant increase in plasma catecholamines. These results indicate the presence of preproenkephalin B-derived opioid peptides in human phaeochromocytomas and human adrenal medullas and their secretion in human phaeochromocytomas.

alpha-Neoendorphin-like immunoreactivity in medullary carcinoma of the thyroid

alpha-Neoendorphin-like immunoreactivities (alpha-NE-IR) were demonstrated in tissues from three patients with medullary carcinoma of the thyroid (MCT). A large amount of alpha-NE-IR was detected in the extracts of primary tumors and metastatic lymphatic tissues by a highly sensitive and specific radioimmunoassay (RIA). Gel filtration analyses showed two different molecular-weight forms of the alpha-NE-IR: One eluted at the void fraction and the other at the position of [125I]-alpha-NE on Sephadex (Pharmacia Fine Chemical, Uppsala, Sweden) G-50 chromatography. Immunohistochemical examination revealed the presence of alpha-NE-IR in the C-cell carcinoma. These data presumably reflect that alpha-NE, the opioid peptide derived from preproenkephalin B, is synthesized in the MCT.

Catecholamines and opioid peptides in human phaeochromocytomas

The tissue contents of catecholamines (CAs) and methionine-enkephalin-like immunoreactivity (Met-enk) were examined in 8 patients with phaeochromocytomas (Phs). In 6, Ph cells were cultured, and the modes of secretion of CAs and Met-enk were examined. Tissue contents of CAs and Met-enk varied from patient to patient, but larger amounts of Met-enk were found in medullary Phs than extramedullary ones, regardless of the secreting CA type. Three patients with extramedullary Phs had clinically showed a sustained hypertension, whereas five with medullary Phs were normotensive or had occasional paroxysmal hypertension. Nicotine (10(-7) M to 10(-4) M) stimulated simultaneous secretion of CAs and Met-enk from the cultured human Ph cells. Met-enk, however, was not secreted in proportion to either epinephrine (E), norepinephrine (NE) or total CAs (E + NE). Met-enk, FK33-824 (FK) (Met-enkephalin analogue), and dynorphin 1-13 (Dyn) significantly suppressed the secretion of CA evoked by 10(-5) M nicotine. The 50% inhibitory concentrations (IC50) of Met-enk, FK, and Dyn were 5 X 10(-6) M, 9.9 X 10(-5) M, and 9.0 X 10(-8) M, respectively, in one patient and 9.0 X 10(-6) M, 1.5 X 10(-7) M, and 1.4 X 10(-7) M in another. In one patient, 10(-5) M naloxone inhibited the CA secretion evoked by 10(-5) M nicotine and did not reverse the 10(-5) M FK-induced suppression of CA secretion in the presence of 10(-5) M nicotine. These results suggest that human Phs may be heterogeneous with regard to storage and secretion of CAs and opioid peptides.(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo evidence of regulation by pituitary-adrenal axis of urinary epinephrine excretion in men

The effect of the pituitary-adrenal axis on epinephrine synthesis in the human adrenal medulla was examined by the estimation of the 24-h urinary epinephrine level after treatment with glucocorticoids in four patients with systemic lupus erythematodes (SLE), one patient with rheumatoid arthritis (RA) and one patient with adrenal pheochromocytoma. 24-h urinary catecholamines (CAs) were measured by HPLC before and after glucocorticoid treatment, dexamethasone or prednisolone was orally given for more than seven days to patients with SLE, RA or isolated ACTH deficiency and five days to a patient with adrenal pheochromocytoma. In patients with isolated ACTH deficiency, the 24-h urinary epinephrine level was significantly lower than the normal range. In patients with SLE or RA, the 24-h urinary epinephrine level was normal and it was significantly suppressed by therapeutic doses of prednisolone 30-40 mg/day. In a patient with adrenal pheochromocytoma, 24-h urinary epinephrine was extremely high and it was significantly increased after dexamethasone 0.5 mg/day. These results suggest that epinephrine synthesis in the human adrenal medulla may be dependent on the pituitary-adrenal axis. But the increase in epinephrine synthesis due to dexamethasone in a patient with pheochromocytoma may reflect the direct effect via the feeding artery to the tumor, as previously shown in an in vitro culture system.

Mechanism of dissociation of cortisol and adrenal androgen secretion after removal of adrenocortical adenoma in patients with Cushing's syndrome

We investigated the mechanism of dissociation of cortisol and dehydroepiandrosterone sulfate (DHEA-S) secretion by the adrenal glands after the removal of an adrenal gland containing an adrenocortical adenoma in a patient with Cushing's syndrome. After removal of the adrenocortical adenoma, the serum cortisol rapidly decreased from 24.6 +/- 6.4 micrograms/dl (mean +/- SD, n = 6) to 0.7 +/- 0.5 micrograms/dl. Serum DHEA-S levels were 15 +/- 14 micrograms/dl and 6 +/- 9 micrograms/dl before and after surgery, respectively, and significantly lower than the control values. Serum cortisol levels reverted to normal levels 1.5 to 3 years after the surgery. On the other hand, DHEA-S levels reverted to normal 5 to 7 years after the serum cortisol levels had normalized. Monolayer cultures of normal human adrenal cells obtained at adrenalectomy in patients with advanced breast cancer and atrophic adrenal cells adjacent to the adrenocortical adenoma in patients with Cushing's syndrome were used to study the mechanism of the dissociation of cortisol and DHEA-S secretion. ACTH caused significant increases in the productions of pregnenolone (P5), progesterone (P4), 17-hydroxypregnenolone (17-OH-P5), 17-hydroxyprogesterone (17-OH-P4), DHEA, DHEA-S, androstenedione (delta 4-A), and cortisol. The amounts of 17-OH-P5 and 17-OH-P4 produced by ACTH in atrophic adrenal cells were significantly greater than those in normal adrenal cells. The amounts of DHEA, DHEA-S and delta 4-A produced by ACTH in atrophic adrenal cells were significantly smaller than those of normal adrenal cells. The conversion rate of 17-OH-[3H]P5 to 17-OH-[3H]P4 and 11-deoxy-[3H] cortisol was higher in atrophic adrenal cells than in normal adrenal cells, but the conversion rate to [3H]DHEA, [3H]DHEA-S and [3H]delta 4-A was significantly lower in atrophic adrenal cells than in normal adrenal cells. These results suggest that the dissociation of cortisol from DHEA-S after the removal of adrenocortical adenoma is a probably due to diminished C17,20-lyase activity in the remaining atrophic adrenal gland.

Probable ACTH-secreting pituitary tumour in association with Addison's disease

A 61 year old Japanese man with a diagnosis of Addison's disease was admitted to Kyushu University Hospital for further investigation of high ACTH levels and hyperpigmentation which 37.5 mg of cortisone acetate failed to alleviate. The basal level of plasma ACTH was 700-1000 pg/ml, and following 25-37.5 mg cortisone acetate or 1 mg dexamethasone the levels were 300-600 pg/ml. The general pigmentation showed little improvement with such medication. Radiographic studies revealed a double floor of the sella turcica and cisternal herniation. These observations suggested the existence of a pituitary ACTH-secreting tumour. Plasma ACTH showed a circadian rhythm ranging from 440 to 1570 pg/ml and it was not suppressed to a normal range by oral administration of dexamethasone, 8 mg/day or by continuous infusion of dexamethasone, 1.25 mg/h for 2 h. Plasma ACTH responses of 80% above basal level to lysine-vasopressin (LVP), and 12% above basal to synthetic ovine corticotrophin releasing factor (CRF) were observed. FK 33-824, a methionine-enkephalin analogue, suppressed plasma ACTH to 85% of basal level, while bromocriptine (CB-154) caused no significant change. These findings led to a diagnosis of pituitary ACTH-secreting adenoma (corticotropinoma) in association with Addison's disease. The persistent circadian rhythm of plasma ACTH suggested that this adenoma may not be completely free from regulation by the central nervous system. This case may be clinically significant for investigation of the pathogenesis of pituitary adenoma, particularly in Nelson's syndrome.

[The effects of metoclopramide and dopamine on aldosterone secretion in cultured adrenocortical adenoma cells and adjacent non-adenoma cells from patients with primary aldosteronism]

Several authors have reported that metoclopramide (MCP), a dopaminergic antagonist, stimulates aldosterone secretion and that dopamine (DA) inhibits the MCP-mediated aldosterone secretion in man. However, many controversial results have been reported relating to the direct effect of MCP and DA on the secretion of aldosterone by adrenocortical cells in in vitro experiments. The present studies were designed to determine whether or not MCP and DA exerts its effect directly on the cultured human adrenocortical adenoma cells and adjacent non-adenoma cells obtained from patients with primary aldosteronism. A bolus intravenous injection of 10 mg MCP significantly increased the plasma aldosterone concentration (PAC) from 255 +/- 57 pg/ml (mean +/- SD) to 386 +/- 98 pg/ml after 15 min in patients with primary aldosteronism. But MCP (10(10)-10(-6) M) failed to increase aldosterone secretion from both adenoma cells and non-adenoma cells in culture. DA (10(-9) and 10(-6) M) did not suppress the basal secretion and the enhanced secretion of aldosterone by A II or ACTH in cells of either culture. The analysis by HPLC showed that 57% of dopamine hydrochloride added in the medium was preserved after 60 min incubation. These results suggest that MCP and DA do not act directly on the human adrenal glomerulosa cells in the regulation of aldosterone secretion.

Epinephrine and norepinephrine syntheses are regulated by a glucocorticoid receptor-mediated mechanism in the bovine adrenal medulla

The bovine adrenal medulla was investigated regarding the presence of glucocorticoid binding protein and the increases in ornithine decarboxylase (ODC) activity and epinephrine and norepinephrine by dexamethasone. Scatchard analysis of specific cytosol [3H] dexamethasone-binding study indicated a single class of high affinity (kd, 35 +/- 5 nM) and limited binding sites (150 +/- 26 fmoles/mg protein). Competition studies of various steroids indicated a high affinity for dexamethasone and hydrocortisone. Sedimentation in sucrose density gradients revealed a 7.3 S binding peak in the cytosol. Dexamethasone caused an increase in ornithine decarboxylase (ODC) activity within 1 to 2 hours after which the norepinephrine and epinephrine contents increased 16 hours after the peak of ODC activity in a dose dependent manner of dexamethasone in bovine adrenal medullary chromaffin cells in primary monolayer culture. These data suggest that the bovine adrenal medulla is a target organ of glucocorticoid hormone and that norepinephrine and epinephrine syntheses are regulated by a glucocorticoid receptor-mediated mechanism.

Effect of angiotensin II on secretion of adrenal androgens

To assess the effect of angiotensin II (A II) on the secretion of human adrenal androgens (AA), plasma dehydroepiandrosterone (DHEA), DHEA sulfate (DS) and delta 4-androstenedione (delta 4-A) were measured in eight normal men 60 and 120 min after stimulation of endogenous A II by a bolus injection of 40 mg frusemide, and the direct effect of A II on the secretion of adrenal androgens was examined in cultured human adrenocortical cells in the presence of a low concentration of ACTH. The administration of frusemide led to a significant increase in the plasma DHEA and DS concentration as well as plasma renin activity (PRA) and aldosterone concentration (PAC), but did not change plasma cortisol and delta 4-A. In the culture of human adrenocortical cells, 10(-9)-10(-5) M A II or 10(-13) M ACTH alone did not stimulate the secretion of DHEA, DS and delta 4-A, while 10(-7) and 10(-5) M A II in the presence of 10(-13) M ACTH caused a significant increase in DHEA and DS secretion with no change in delta 4-A. These results suggest that the activated renin-angiotensin system stimulates the secretion of adrenal androgens by a direct effect of A II on adrenal cortical cells.

Dexamethasone increases both catecholamines and methionine-enkephalin in cultured bovine adrenal chromaffin cells and human extramedullary pheochromocytoma cells

The effect of dexamethasone on dispersed cells in primary monolayer culture from bovine adrenal medulla and human extramedullary pheochromocytoma was examined by estimating the level of catecholamines (CAs) and Methionine-enkephalin (Met-enk) in the medium and cells. In cultured bovine adrenal chromaffin cells, dexamethasone caused significant increase in Met-enk levels 18 hours after administration. There was no release of Met-enk and CAs in the medium 10 min after administration, although nicotine did cause a significant release of Met-enk and CAs. A dose response increase in the level of CAs and Met-enk in bovine adrenal chromaffin cells was obtained with doses varying between 0 and 10(-6)M dexamethasone 18 hours after administration. In cultured human extramedullary pheochromocytoma cells, dexamethasone significantly increased the levels of norepinephrine and Met-enk in a dose dependent manner 24 hours after administration. These results suggest that dexamethasone does not act as a secretagogue but may be related to the synthesis of Met-enk and CAs.

Hereditary spherocytosis associated with a variant of band 3 protein in the erythrocyte membrane

A 17-year-old woman with hereditary spherocytosis was found to be heterozygous for an unusual variant of the band 3 protein in erythrocyte membranes. The variant had a molecular weight of 95,000 daltons which was larger by about 3,000 daltons than the 92,000 m.w. normal band 3, and was phosphorylated less efficiently when intact cells were incubated with 32P-inorganic phosphate. It is discussed that this variant may affect the integrity of the membrane skeletons.

Distribution of alpha 2-macroglobulin in normal, inflammatory, and tumor tissues in rats

Distribution of uptake and catabolism of intravenously administered 125I-labeled rat alpha 2-macroglobulin(125I-alpha 2MG) were examined in normal, inflammatory, and tumor tissues of rats. Clearance of intravenously administered [125I]alpha 2MG from the circulation was rapid. Accumulation of this compound into inflammatory tissue was 2-3 times more extensive than in normal tissues. The accumulation into sarcoma tissue was much less. Radioactivity in TCA-PTA precipitates remained fairly constant for the first 12 h in inflammatory tissue and for the first 24 h in sarcoma. These patterns of accumulation were never observed in the normal tissues. As the kidney preferentially accumulated large amounts of [125I]alpha 2MG in the nondegraded form and its degradation products, the tissue may play a special role in the metabolism of alpha 2MG. Rapid clearance from the circulation and relatively small amounts of accumulation in tissues suggest that alpha 2MG may function as a protease inhibitor, mainly in the circulation rather than in the tissues.

Selective IgA deficiency: analysis of Ig production in vitro

The cellular basis of the pathogenesis of selective IgA deficiency (SIgAD) was investigated by examining surface immunoglobulin (SmIg) and in vitro pokeweed mitogen (PWM)-stimulated immunoglobulin (Ig) synthesis and by assaying in combination the counterpart lymphocytes from individuals with SIgAD and healthy donors. Peripheral blood lymphocytes (PBL) from 14 individuals with SIgAD synthesized normal amounts of IgG and IgM but did not synthesize normal amounts of IgA. Functional defects of lymphocytes for IgA synthesis were classified into four types: (i) B-lymphocyte dysfunction, (ii) increased function of suppressor T lymphocytes (Ts), (iii) decreased function of helper T lymphocytes (Th), and (iv) B-lymphocyte dysfunction and increased Ts function. The cells bearing SmIgG, SmIgM, and SmIgD were demonstrated at normal percentage ratios in all cases by immunofluorescent staining. The cells bearing SmIgA were at normal percentage ratios in the cases of T-lymphocyte dysfunction, while in the cases of B-lymphocyte defect SmIgA-bearing cells were reduced.

Erythroid colony forming cells in systemic lupus erythematosus

The incidence of erythroid progenitor cells in the bone marrow was studied in 9 patients with systemic lupus erythematosis (SLE) in the absence of corticosteroid or immunosuppressive therapy. The incidence of late erythropoietic precursors (CFU-E) was diminished in SLE. The colony formation of marrow CFU-E was inhibited by the addition of allogeneic and autologous T lymphocytes from SLE patients before the prescription of corticosteroid. These results suggest that the T cell mediated suppression of erythroid progenitor cells may play an important role in a pathogenesis of erythropoietic failure in SLE.

Multipotent hemopoietic progenitors (CFUMIX) in human fetal liver

Colony formation by multipotent hemopoietic precursors (CFUMIX) from human fetal liver was studied in a methylcellulose culture system containing erythropoietin (Ep) and media conditioned by leukocytes in the presence of phytohemagglutinin (PHA-LCM). The 15 fetal livers used were obtained from 13-23-week-old abortuses. Morphologic characteristics of the fetal mixed colonies were similar to those of colonies derived from adult marrow cells. The number of colonies reached a maximum at about 15-17 days. Fetal liver CFUMIX was apparently more sensitive to added Ep than progenitors from adult bone marrow. Frequency of fetal liver precursors was higher than frequency of adult marrow precursors. Number of mixed colonies tended to increase with fetal age from 13 to 23 weeks of gestation (r = 0.547, P less than 0.05).

Determination of the second component of complement (C2) by electroimmunoassay in sera from patients with systemic lupus erythematosus

The concentration of C2 was determined by electroimmunoassay in sera from healthy controls, patients with systemic lupus erythematosus (SLE), their relatives and patients with other diseases. Monospecific anti-human C2 serum was obtained by immunizing rabbits with purified human C2 and then absorbing the rabbit serum with inactivated normal human serum that was made insoluble. In addition, it was shown that human C2 could be purified by means of affinity chromatography on anti-C2 antibody coupled Sepharose. The serum concentration of C2 was 37.8 +/- 5.0 (s.d.) micrograms/ml in healthy controls (n = 133). In patients with SLE, the values were below normal in the active phase and were within normal limits in the inactive phase, showing good correlations with other complement parameters such as CH50, C4, C3 and factor B. C2 concentration was well correlated with C2 haemolytic activity in the inactive phase of SLE, but there was no relationship between the two in the active phase. The mean value of C2 concentration in the relatives of patients with SLE showed no significant difference from that in healthy controls. C2 concentration tended to be high in patients with scleroderma, polymyositis, rheumatoid arthritis, Behçet's disease and aortitis syndrome. However, the values were often low in patients with chronic liver diseases, suggesting a decrease of C2 production in the liver.

Granulopoiesis in systemic lupus erythematosus

The pathogenesis of granulopoietic failure in systemic lupus erythematosus (SLE) was studied. In 16 Japanese women with SLE, a decreased number of granulocyte/monocyte progenitor cells (CFU-C) in the bone marrow was demonstrated, and the number of CFU-C correlated significantly with the peripheral blood granulocyte/monocyte count. The peripheral and bone marrow T lymphocytes suppressed the colony formation of autologous or allogeneic bone marrow CFU-C. These findings suggest that the decreased marrow CFU-C may be due to suppression by T lymphocytes, an event that may play an important role in the pathogenesis of granulopoietic failure in SLE.

Structure of cloned delta-globin genes from a normal subject and a patient with delta-thalassemia; sequence polymorphisms found in the delta-globin gene region of Japanese individuals

The delta-globin genes of a normal Japanese and a Japanese patient with homozygous delta-thalassemia were cloned, and the nucleotide sequence of a region including the gene was determined. Comparison of the nucleotide sequences of these two individuals with that of pH delta 1, delta-globin clone from the gene library constructed by Maniatis et al., showed differences in the large intervening sequence (IVS 2), at positions 137, 151, 186, 188, 291, 292 and 540 as one base substitutions, at 339 and 823 as one base additions, at 548 as a one base deletion, and a 9 bp duplication between positions 651 and 659, and differences in the 3'-flanking sequence at 51 and 98 nucleotides 3' to the AATAAA sequence. However, in the region studied, no differences was observed in the nucleotide sequences of the normal subject and the patient with delta-thalassemia. Therefore, these differences may represent polymorphisms of the delta-globin gene present in Japanese individuals. These data suggest that IVS 2 is more divergent than other regions, and that a DNA region(s) other than the globin gene may affect expression of the gene.