Elevation of circulating interleukin 6 after surgery: factors influencing the serum level

To investigate the effect of surgical trauma and other factors on the postoperative elevation of serum interleukin 6 (IL-6), we examined changes in IL-6 concentration after major thoracoabdominal surgery. Serum IL-6 levels reached the maximum concentration on the first postoperative day in all 38 patients, with peak ranging from 1400.8 +/- 383.4 pg/ml (mean +/- SEM) to 29.8 +/- 3.8 among six groups who underwent surgery at different sites. The IL-6 peak was significantly correlated with surgical trauma as defined by the operation length and the volume of blood loss during surgery (r = 0.554, P < 0.01 and r = 0.427, P < 0.01, respectively). The peak concentration of serum IL-6 in patients undergoing esophagectomy was significantly higher than in those undergoing pancreaticoduodenectomy (P < 0.05), despite a similar degree of surgical trauma defined by the operation length and volume of blood loss during surgery. Peak IL-6 concentration observed in a patient who underwent esophagectomy was about 100-fold greater in fluid drained from the thorax than in the peripheral blood. IL-6 mRNA was demonstrated in leukocytes from thoracic and abdominal exudate at 6, 24 and 48 h after surgery. In contrast, IL-6 mRNA could not be detected in leukocytes from the peripheral blood. Similar findings were also observed for interleukin 8 (IL-8). However, interleukin 1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha) were detected only once after surgery in the drainage fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

[Some consideration about cerebellar ataxia and crossed cerebellar diaschisis in Dejerine-Roussy syndrome]

We report a 68-year-old right-handed male who exhibited Dejerine-Roussy syndrome including a persistent cerebellar ataxia following the left thalamic hemorrhage with special reference to the evolution of crossed cerebellar diaschisis (CCD) measured with positron emission tomography (PET). The initial PET studies performed 50 days after onset revealed a mild reduction of blood flow and glucose metabolism in the right cerebellar hemisphere in addition to the severe reduction in the left thalamus. Even in the chronic stage when the motor weakness almost disappeared, he persistently showed a cerebellar ataxia in his right extremities. The cerebellar blood flow and metabolism became normalized without laterality in the follow-up PET studies which were performed 29 months after onset, although the left thalamus and left cerebral cortices were still severely involved. The cerebellar ataxia with preserved cerebellar blood flow and metabolism following the thalamic hemorrhage was possibly associated with damage to the efferent fibers from the cerebellum, whereas the CCD observed in the early stage probably was caused by a transient involvement of the cortico-ponto-cerebellar tract at the level of the internal capsule.

[The inhibitory effect of mouse monoclonal IgM antibody E5 against endotoxin on limulus activity of various lipopolysaccharides]

The anti-endotoxin activity of mouse monoclonal IgM antibody E5 was determined against various lipopolysaccharides (LPSs) derived from Escherichia coli J5, E. coli O111:B4, Klebsiella pneumoniae and Pseudomonas aeruginosa by measuring limulus activity by endospecy method. In general, above 0.2 microgram/ml of E5 reduced almost dose-dependently the limulus activities of all LPSs tested, although the degree of reduction in limulus activity somewhat varied among bacterial species. The limulus activities of LPS from E. coli J5, E. coli O111:B4, K. pneumoniae and P. aeruginosa decreased by 72%, 50%, 44%, and 58%, respectively, by exposure to 5.0 micrograms/ml of E5 for 2 hrs.

Platelet-activating factor (PAF) acetylhydrolase activity, type II phospholipase A2, and cytokine levels in patients with sepsis

Platelet activating factor acetylhydrolase (PAF-AH) activity was measured in patients with sepsis, and its relationships with various cytokines and endotoxin were evaluated. PAF-AH activity was significantly higher (p = 0.0136) in 17 patients who died than 13 patients who survived. PAF-AH activity showed significant correlations with the plasma endotoxin, TNF-alpha, and IL-8 levels. These findings suggest that PAF-AH activity reflects the severity of the pathological condition.

Group II phospholipase A2 in invasive gastric cancer cell line is induced by interleukin 6

To investigate the role of group II phospholipase A2(PLA2) in cancer, we examined the expression and secretion of group II PLA2 in response to the stimulation of interleukin 6(IL-6) in human gastric cancer cells in vitro. Group II PLA2 determined by a specific radioimmunoassay was constitutively produced in culture supernatant of KATO III (signet ring cell carcinoma) and MKN28 (well differentiated adenocarcinoma). This production in KATO III significantly increased with a treatment of IL-6, whereas that in MKN28 remained at a same level. Moreover, the quantitation by reverse transcription-polymerase chain reaction(RT-PCR) demonstrated the IL-6 inducible overexpression of group II PLA2 mRNA in KATO III. This transcription was mediated by NF-IL6, the same as in hepatocytes. These results suggest two possible mechanisms of group II PLA2 production by cancer cells in vivo, that is, cytokine-induced production and constitutive production.

Kinetics of active efflux via choroid plexus of beta-lactam antibiotics from the CSF into the circulation

To examine the role of the choroid plexus in eliminating organic anions from the cerebrospinal fluid (CSF), a kinetic study was performed both in in vivo and in vitro experiments using [3H]benzylpenicillin (PCG) as a model compound. In vivo, after intracerebroventricular administration, [3H]PCG was eliminated from the CSF much more rapidly than [14C]mannitol. Analysis of the elimination clearance from the CSF revealed that 12 and 24% of the disappearance of [3H]PCG can be accounted for by convective loss at a rate equivalent to CSF turnover, and by diffusional loss across the ependymal surface into the brain extracellular space, respectively. Approximately two-thirds of [3H]PCG elimination was due to a saturable process [Michaelis constant (Km) = 43.0 +/- 17.8 microM, maximum velocity (Vmax) = 619 +/- 286 pmol.min-1 x rat-1]. These kinetic parameters obtained in vivo were comparable to those determined previously in vitro, i.e., [3H]PCG was accumulated by the isolated rat choroid plexus via an active transport mechanism (Km = 58 microM, Vmax = 504 pmol.min-1 x rat-1; H. Suzuki, Y. Sawada, Y. Sugiyama, T. Iga, and H. Hanano, J. Pharmacol. Exp. Ther. 242: 660-665, 1987). Furthermore, other organic anions (probenecid, ampicillin, cefodizime, cefotaxime, and ceftriaxone) reduced the transport of [3H]PCG in a dose-dependent manner both in vivo and in vitro. A good correlation was observed between the log inhibition constant (Ki) values obtained for these ligands in vivo and in vitro (r = 0.94, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Glucocorticoid independence of acute thymic involution induced by lymphotoxin and estrogen

Acute thymic involution is known to be induced under conditions of physical stress, bacterial infections, and malignancies. It is speculated that glucocorticoids, tumor necrosis factor (TNF), and other factors may act as mediators for the thymic involution under such conditions. It was herein investigated whether either lymphotoxin (TNF beta) or estrogen could induce thymic involution without the help of glucocorticoids. Interestingly, both lymphotoxin or estrogen alone induced profound thymic involution even in adrenalectomized mice. In contrast to glucocorticoids, which induce lymphocytopenia throughout the organs, lymphotoxin and estrogen did not induce lymphocytopenia in the peripheral organs. More importantly, lymphotoxin and estrogen rather stimulated extrathymic T cells in the liver and other organs. These results suggest that lymphotoxin and estrogen per se might be important regulators of immune systems.

PCPA reduces both monoaminergic afferents and nonmonoaminergic synapses in the cerebral cortex

In order to examine the possible trophic, nontransmitter role of monoaminergic fibers in the adult CNS, synaptic structures were examined in different laminae of the somatosensory cortex of the rat following a p-chlorophenylalanine (PCPA)-induced decrease of monoamine. Synaptic densities were reduced in a dose-dependent fashion by 30-50% in the target area of monoamine fibers following four injections of PCPA made over a 1-week period. Although serotonin- and tyrosine hydroxylase-immunopositive profiles were frequently observed in all laminae of the cerebral cortex, only a few such profiles had the morphology of synapses. Therefore, virtually all of the reduction in synaptic structures following PCPA treatment involved nonmonoaminergic fibers.

Molecular cloning and analysis of the yeast flocculation gene FLO1

The DNA sequence of the flocculation gene FLO1 of Saccharomyces cerevisiae, which is located on chromosome I (Watari et al., 1989) was determined. The sequence contains a large open reading frame (ORF) of 2586 bp and codes for a protein of 862 amino acids. However, further study (genomic Southern and polymerase chain reaction analyses) indicated that the gene we cloned was not the intact FLO1 gene but a form with an approximately 2 kb deletion in the ORF region. The intact FLO1 gene was then cloned and its nucleotide sequence determined. The sequence revealed that the ORF of the intact gene is composed of 4611 bp which code for a protein of 1537 amino acids. A remarkable feature of the putative Flo1 protein is that it contains four families of repeated sequences composed of 18, 2, 3 and 3 repeats and that it has a large number of serines and threonines. In the deleted FLO1 form, a large part of these repeated sequences was missing. The N- and C-terminal regions are hydrophobic and both contain a potential membrane-spanning region, suggesting that the Flo1 protein is an integral membrane protein and a cell wall component.

Negative regulation of early B lymphopoiesis by interleukin 3 and interleukin 1 alpha

We recently developed a two-step methyl cellulose culture system for murine lymphohemopoietic progenitors that are capable of differentiation along the myeloid and B-lymphoid lineages. In this system, two-factor combinations, which include steel factor plus interleukin (IL) 6, IL-11, or granulocyte colony-stimulating factor effectively supported the lymphomyeloid potential of primary colonies. Interestingly, IL-3 could neither replace nor act synergistically with steel factor in maintaining the B-lymphoid potential of the primary colonies although the frequency of colony formation was the same with IL-3 and steel factor. We now report that addition of IL-3 or IL-1 alpha to a permissive system suppresses the B-lymphoid potential of primitive progenitor cells in primary culture in dose-dependent fashion. In vivo transfer of the primary colonies to scid mice confirmed the suppressive effects of IL-3 and IL-1 alpha. In addition, IL-1 alpha inhibited pre-B-cell colony formation in the secondary culture. Once pre-B-cell colonies had formed in secondary culture, neither factor affected the proliferation of the pre-B cells. These results suggest negative regulatory roles for IL-3 and IL-1 alpha in early stages of B lymphopoiesis.

[Laboratory and clinical study on combined effects of fosfomycin plus sulbactam/cefoperazone for mixed infections of MRSA and Pseudomonas aeruginosa]

Pseudomonas aeruginosa has been a major bacterial partner when MRSA (Methicillin-resistant Staphylococcus aureus) is isolated clinically. Hence, we studied the in vitro combined effect of fosfomycin (FOM) plus sulbactam/cefoperazone (SBT/CPZ) against mixed infections of MRSA and P. aeruginosa. The combined effect of FOM plus SBT/CPZ was observed through an FIC index using the checkerboard method, log reduction of colony counts on the time killing curve, and morphological changes observed using scanning electron micrography. Under serum concentration at 3 hours after administration in consider of pharmacokinetics, the combination effect was also evaluated. Furthermore, we evaluated a time-lag combination therapy in which FOM is administered 60 minutes before SBT/CPZ administration for mixed infections. Synergistic effects of FOM plus SBT/CPZ were clearly observed against mixed infections of MRSA and P. aeruginosa. Log reduction of colony counts on the time killing curve seemed to be an appropriate indicator in the evaluation of synergistic effects.

Enrichment for primitive hemopoietic progenitors of marrow cells from 5-fluorouracil-treated mice and normal mice

Study of the mechanisms regulating stem cells would be significantly facilitated if a purified population of stem cells were available. During the last 4 years, our laboratory has been engaged in enrichment of murine marrow cells for primitive hemopoietic progenitors. We primarily used marrow cells from mice treated with 150 mg/kg of 5-fluorouracil (5-FU), and our assay for the primitive progenitors was formation of multilineage colonies supported by a combination of interleukin-3 (IL-3) and IL-6. First, we found that post-5-FU marrow cells with a density of 1.0631-1.0770 g/cm3, negative for lineage-specific markers and positive for Ly-6A/E are routinely enriched for multipotential progenitors by approximately 800-fold. We then observed that J11d.2 and c-kit are additional useful markers for further enrichment of the primitive hemopoietic progenitors. Cell cycle-dormant primitive progenitors are primarily in the J11d.2+ fraction, whereas more mature progenitors are J11d.2-. The primitive progenitors express relatively low levels of c-kit, while more mature, actively cycling progenitors express high levels of c-kit. Combinations of these markers may be useful in enrichment of marrow cells of normal mice for primitive hemopoietic progenitors.

Cytokine regulation of early B-lymphopoiesis assessed in culture

Lymphohemopoietic progenitors that are capable of expressing B-cell and myeloid lineages may be cultured from bone marrow cells of adult mice by using a two-step methylcellulose culture system. In this system, the primary colonies expressing myeloid lineages are plated in secondary culture for B-lymphoid colony formation. We have observed that combinations of two factors based on steel factor (SLF), such as SLF plus interleukin (IL)-6, SLF plus granulocyte colony-stimulating factor (G-CSF), and SLF plus IL-11 support the differentiation and proliferation of B-cell progenitors from the lymphohemopoietic progenitors. Surprisingly, IL-3 failed to support B lymphopoiesis either alone or in combination with other factors. In addition, when added to permissive culture conditions, IL-3 and IL-1 independently inhibited the B-cell potential of the primary colonies. The inhibitory effects of IL-3 and IL-1 observed in this in vitro system may be significant in the selection of cytokine combinations for in vitro expansion of hemopoietic stem cells.

Acute suppurative thyroiditis in an asymptomatic woman: an atypical presentation simulating thyroid carcinoma

Patients with acute suppurative thyroiditis usually have pain or tenderness in the anterior part of the neck associated with erythema and dysphagia. A 26-year-old Japanese woman with none of these symptoms presented with a left anterior cervical mass. Since physical examination and laboratory studies showed a firm and irregular tumour located in the left lobe of the thyroid without any inflammatory signs, we made a diagnosis of thyroid carcinoma. After surgery, histological examination of the thyroid specimen revealed various changes of severe inflammation, and a barium swallow demonstrated a left pyriform sinus fistula. We describe here a unique case of acute suppurative thyroiditis in an asymptomatic woman.

Synergistic interaction between interleukin-12 and steel factor in support of proliferation of murine lymphohematopoietic progenitors in culture

We have investigated the effects of interleukin (IL)-12 (natural killer cell stimulatory factor/cytotoxic lymphocyte maturation factor) on the proliferation of murine myeloid and lymphohematopoietic progenitors in methylcellulose culture. In the presence of erythropoietin (Ep), IL-12 alone failed to support colony formation by mononuclear and enriched marrow cells of normal mice. Steel factor (SF) alone supported primarily formation of granulocyte/macrophage (GM) colony formation. However, the combination of the two cytokines yielded a significant number of multilineage colonies. When tested on marrow cells from 5-fluorouracil (5-FU)-treated mice, the combination of IL-12 and SF, but not the single factors, was effective in support of formation of various types of colonies. Approximately 25% of these colonies yielded pre-B-cell colonies when replated in secondary culture containing SF and IL-7, indicating that IL-12 can interact with SF in supporting the development of primitive lymphohematopoietic progenitors. These results demonstrate that IL-12, a cytokine believed to be involved in the development of cell-mediated immune responses, has a wider range of activity, including committed myeloid and multipotent lymphohematopoietic progenitors.

[Studies on the combined effect of fosfomycin with sulbactam/cefoperazone on methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa]

We studied the combined effect of fosfomycin (FOM) with sulbactam/cefoperazone (SBT/CPZ) on clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA, 246 strains) and Pseudomonas aeruginosa (190 strains) in vitro. In ratio of mixed serum concentration of antibiotics at three hours after intravenous administration, the combination of FOM with SBT/CPZ and alone of arbekacin showed over 90% in cumulative percentage of MIC against MRSA and P. aeruginosa. The effect of the combination of FOM and SBT/CPZ was observed in MRSA strains of > 16 micrograms/ml of SBT/CPZ MIC and > 256 micrograms/ml FOM MIC. As well as in P. aeruginosa strains, the effect of the combination of FOM and SBT/CPZ was observed in strains of > 16 micrograms/ml of SBT/CPZ MIC and < 256 micrograms/ml FOM MIC, but it was not remarkable in strains of > 256 micrograms/ml FOM MIC. These results suggests that the combination treatment of FOM and SBT/CPZ may be effective for mixed infection of MRSA and P. aeruginosa.

Altered cerebral energy metabolism in Alzheimer's disease: a PET study

In an effort to better understand the metabolic basis for the reported decreases in regional cerebral cortex glucose metabolism in patients with Alzheimer's disease, glucose utilization oxygen consumption and regional cerebral blood flow were examined.

METHODS

Nine patients with Alzheimer's disease and nine age-matched normal controls were imaged using 18F-labeled deoxyglucose and 15O-labeled gases.

RESULTS

Regional analysis of the cerebral metabolic rate of glucose (CMRglu), cerebral metabolic rate of oxygen (CMRO2) and cerebral blood flow (CBF) revealed that these values were significantly low in the frontal, parietal and temporal regions. The parietotemporal region had an abnormally high metabolic ratio (CMRO2/CMRglu), while the frontal, sensorimotor and occipital visual cortices had a metabolic ratio similar to that of the normal controls.

CONCLUSIONS

These findings suggest that the abnormal parietotemporal metabolism in Alzheimer's disease involves a metabolic shift from glycolytic to oxidative metabolism. This impairment of glucose degradation may be the basis for synoptic dysfunction underlying the impairment observed in Alzheimer's disease.

Characterization of nicotinamide methyltransferase in livers of mice bearing Ehrlich ascites tumors: preferential increase of activity

There was a 2- to 7-fold increase in nicotinamide methyltransferase activity in the livers of mice and rats bearing seven different kinds of tumors compared with the respective control normal livers, while activity in the tumors themselves was hardly detectable. The activity in the liver started to increase markedly 3-7 days after i.p. transplantation of Ehrlich ascites tumors into the mice, maintaining a plateau up to death. Metabolic conversion of 14C-nicotinamide to 14C-N1-methylnicotinamide was 3-fold higher in the slices of the ascites tumor host liver than in the normal liver, but the conversion to other radioactive metabolites was not significantly different. Nicotinamide methyltransferase was finally purified 20,000-fold with a yield of 4% from the cytosolic fraction of the ascites tumor host liver by means of five purification steps. At every purification step, only one enzyme fraction was detected. The enzyme finally isolated exhibited a single protein band in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, with a molecular weight of 26,000. As for the compounds investigated, including the substrates for methyltransferases other than nicotinamide methyltransferase, only quinoline could be the substrate for enzyme activity. It is suggested that the increase in enzyme activity in the tumor host liver probably derived from the endogenous enzyme preexisting in the liver before tumor transplantation.

Production of immunoreactive polymorphonuclear leucocyte elastase in human breast cancer cells: possible role of polymorphonuclear leucocyte elastase in the progression of human breast cancer

Breast cancer cells are known to express various proteolytic enzymes, which make them invasive and favour their dissemination to distant sites. However, it is unclear whether breast cancer cells have the ability to produce polymorphonuclear leucocyte elastase (PMN-E). We measured immunoreactive (ir) PMN-E content in the conditioned medium of two breast cancer cell lines, MCF-7 and ZR-75-1, and two normal breast epithelial cell lines, HBL-100 and Hs 578Bst, using a highly specific and sensitive enzyme immunoassay. Furthermore, ir-PMN-E content was determined in tissue extracts from 62 human breast cancers. ir-PMN-E content in the culture medium of MCF-7 cells and ZR-75-1 cells increased as a function of time, regardless of the presence or absence of oestradiol. On the other hand, no detectable ir-PMN-E was secreted into the culture medium of HBL-100 and Hs 578Bst cells. ir-PMN-E was detectable in 59 of 62 tissue extracts prepared from human breast cancers, the concentration ranging from 0.12 to 19.17 micrograms per 100 mg of protein. When 62 breast cancer specimens were categorised into four groups in terms of clinical stage, ir-PMN-E content in breast cancer tissue was significantly higher in stage III (8.90 +/- 5.13 micrograms 100 mg-1 protein) and stage IV (12.19 +/- 5.44 micrograms 100 mg-1 protein) patients than in stage I (1.64 +/- 1.54 micrograms 100 mg-1 protein) and stage II (4.23 +/- 3.74 micrograms 100 mg-1 protein) patients. Breast cancer patients with high levels of ir-PMN-E showed significantly shorter disease-free survival and overall survival than those with low levels of ir-PMN-E at the cut-off point of 8.99 micrograms 100 mg-1 protein. In the multivariate analysis, ir-PMN-E content was found to be a significant prognostic factor for disease recurrence and death in human breast cancer.