Expression of somatostatin receptor subtype 2 mRNA in human lymphoid cells

We analyzed the mRNA expression of somatostatin receptor subtypes 1 to 5 (SSTR1-5) in human lymphoid cell lines, human peripheral blood lymphocytes (PBL), and human lymphatic leukemia cells, using the reverse transcription-polymerase chain reaction method. In human lymphoid cell lines, SSTR2 mRNA expression was clearly detectable, and there was no evidence of SSTR1 mRNA expression. SSTR2 mRNA was barely detectable in PBL from healthy individuals but was clearly detectable in EB virus-transformed lymphocytes. Lymphocytes from some of the leukemic patients showed elevated SSTR2 mRNA expression. SSTR2 mRNA expression in PBL was upregulated upon stimulation by PHA. SSTR3 mRNA was also observed in all the cell lines examined, although in one cell line, the expression was weak. Some cell lines showed little or no SSTR4 or 5 mRNA expression. The expression pattern of SSTR2 mRNA suggests that this receptor may have some important roles in lymphocyte activation, development, and/or tumorgenesis.

Factor VII and fibrinogen levels examined by age, sex, and other atherosclerotic risk factors in a Japanese population. The Jichi Medical School Cohort Study

Factor VII coagulant activity (FVIIc) and fibrinogen (Fbg) levels have been investigated as cardiovascular risk factors. We studied these two factors with stratification for age, sex and blood pressure, and the relation with other atherosclerotic risk factors in a Japanese general population. The subjects were 3,139 Japanese (1,315 males and 1,824 females) aged 30 to 89 in 1992 and 1993. A linear increase with age was observed in the levels of Fbg in both men and women, but no differences were observed between men and women in each age group. A linear increase with age was also seen in the levels of FVIIc in women, but the levels of FVIIc in men were significantly higher for the age group 40-49 years than for any other age group. The levels of FVIIc in women were significantly higher than in men at age > or = 60 years. As concerning the effect of alcohol intake status, Fbg had a tendency to decrease with alcohol intake. Fbg and FVIIc levels were associated with an increase in smoking status in men, but no association was seen in women in either Fbg or FVIIc. FVIIc was positively correlated with age, body mass index, total cholesterol, triglycerides and fasting insulin level. Fbg was positively correlated with age, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL-cholesterol and triglycerides in women, but Fbg had few positive correlations with risk factors in men. A comparison with previous Western studies showed that the Fbg levels of our Japanese population were lower than those of the Caucasians studied, but the present FVIIc levels were nearly the same level or slightly higher than theirs. The association of Fbg and FVIIc and with other cardiovascular risk factors in Japanese was similar to those observed in Caucasians.

Glioependymal cyst in the posterior fossa

A large cyst filled with clear fluid was resected from the cerebellum of a 29-year-old man. By light microscopy the cyst was lined by flat epithelial cells. These epithelial cells abutted on a glial layer and immunohistochemical staining revealed that some of them expressed glial fibrillary acidic protein. Corpora amylacea were noted within the glial layer. Ultrastructurally, 2 types of cells lining the cyst were identified. One was characterized by electron-dense cytoplasm, cytoplasmic vacuoles, microvilli without surface-coated material, cilia, and basal bodies. The other was a cell with a smooth cytoplasmic membrane, round nucleus, and clear cytoplasm. Zonulae adherentes was observed between cyst lining cells and the cyst lining cells were shown to rest directly on the glial layer. Surprisingly, myelinated axons were identified in the glial layer, although nerve cells were not identified. These findings are compatible with those of a glioependymal cyst. The origin of glioependymal cysts of the posterior fossa is not understood, but possibilities include neuroglial heterotopia, persistent Blake's pouch (diverticulum of the roof of fourth ventricle), and remnants of a tela chorioidea. The location of the cyst and the presence of myelinated axons in the cyst wall may be best explained by an origin from neuroglial heterotopia.

Lupus erythematosus profundus around the salivary glands: a case resembling submandibular salivary gland disease

In a 29 year old Japanese woman with SLE, a bilateral submandibular mass was detected. Computed tomographic (CT) scan suggested inflammatory changes around the submandibular glands. Histological findings of the deep skin biopsy showed typical changes of lupus erythematosus profundus (LEP). LEP should be considered in the differential diagnosis of an unexplained submandibular mass in a subject with SLE.

The effect of labor force participation on coronary heart disease risk factors among middle-aged women: A cross-sectional study in a Japanese rural district

This study examined labor force participation as a risk factor for coronary heart disease. The participants were 224 women aged 45 to 64, residing in a rural district in Japan. The working women spent a significantly greater number of working hours (paid and unpaid) and had a more "Westernized" food preference than homemakers. After adjusting for physical, psychosocial, and behavioral covariates, working women had significantly lower systolic blood pressure and blood glucose levels than homemakers. The "healthy worker effect" did not explain these differences. Middle-aged rural Japanese women who worked outside the home were slightly healthier than homemakers, despite their less healthy lifestyle. Total working hours were positively associated with systolic and diastolic blood pressures and total cholesterol in multiple regression analyses, which suggests that work overload has a harmful effect. A more suitable social environment is required if f Japanese working women are to enjoy a healthier life.

Symptomatic hypertrophic pacchionian granulation mimicking bone tumor: case report

OBJECTIVE AND IMPORTANCE

Osteolytic lesions can be seen in various diseases, and they also resemble the markings normally found on the cranium. We present a rare case of symptomatic hypertrophic pacchionian granulation mimicking bone tumor in the calvaria.

CLINICAL PRESENTATION

A 46-year-old woman suffered from a small hump accompanied by pain in the right frontoparietal region. A plain radiograph revealed two punched-out lesions. Precontrast-enhanced computed tomographic scans demonstrated hypodense masses, with partial defect of the outer table of the cranium. Magnetic resonance imaging demonstrated hypointense masses in the T1-weighted image and hyperintense masses in the T2-weighted image, with capsule-like contrast enhancement by gadolinium diethylenetriamine penta-acetic acid.

INTERVENTION

The masses were totally resected with attached bone and dura. One of them had destroyed the outer table of the cranium. The affected portions of the masses lacked the dura and partially adhered to the brain surface. Histologically, hypertrophic pacchionian granulation was diagnosed.

CONCLUSION

The patient has had no recurrence for 2 years. This case suggests the need to include hypertrophic pacchionian granulation in the differential diagnosis of punched-out lesions.

Leiomyosarcoma of the vaginal wall causing difficulty in micturition: a case report

A 52-year-old woman was admitted because of a vaginal-wall tumor adjacent to the external urethral orifice. The tumor had been causing disturbances in micturition for the past year. Magnetic resonance imaging and computed tomography images indicated a 6 x 3 cm solid mass in the anterior vaginal wall. The tumor was enucleated surgically through a median longitudinal incision of the anterior vaginal wall. Micturitional disturbances were rectified after surgery. Histologically, the tumor was a mixture of a high-cellularity area with a mitosis rate of 7 per 30 high-power fields, and a less cellular area without mitosis. Immunohistochemical staining was performed for both areas. The prognostic implications of the tumor are discussed.

Antibodies to beta 2-glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

OBJECTIVE

To investigate whether anticardiolipin antibodies (aCL) in patients with systemic lupus erythematosus (SLE) bind to beta 2-glycoprotein I (beta 2GPI), and to search for a relationship between the presence of IgG and/or IgM anti-beta 2GPI antibody and clinical manifestations in SLE patients.

METHODS

IgG and IgM anti-beta 2GPI in 308 Japanese SLE patients were measured using phospholipid-independent enzyme immunoassays. Relationships to clinical histories and to various laboratory data were examined.

RESULTS

The values of anti-beta 2GPI and aCL, as measured by conventional enzyme immunoassay, showed a strong correlation, but the anti-beta 2GPI assay was more useful in distinguishing beta 2GPI-dependent aCL from beta 2GPI-independent aCL. The presence of IgG anti-beta 2GPI was associated with an increased frequency of a history of thrombosis. Comparisons of various laboratory data suggested that the titer of anti-beta 2GPI may fluctuate with disease activity.

CONCLUSION

The results suggest that pathogenic aCL is directed against structurally altered beta 2GPI and that enzyme immunoassay for anti-beta 2GPI may prove useful in evaluating the risk of thrombosis and monitoring the clinical course in patients with SLE.

Preoperative embolization of highly vascular brain tumors: clinical and histopathological findings

This report concerns the clinical and histopathologic findings in five patients with meningioma and two with hemangioblastoma who underwent embolization with polyvinyl alcohol (PVA) particles before surgery. Angiography revealed loss of tumor stain from the main feeders in all seven patients, with markedly decreased contrast enhancement of computed tomography (CT) and magnetic resonance imaging (MRI) in six of them. Tumor excision was readily accomplished in all instances, with minimal bleeding from the tumor. In the patient operated 1 day after embolization there were almost no necrotic lesions, even though hemorrhage, presumably due to the surgical procedure was noted. Necrotic lesions and island-like residual tumor cells around the vessels were seen in the patient operated two days after embolization. Extended necrotic lesions were noted among patients who underwent surgery at day 4 and thereafter. Revasculization was not found, even in the patient operated one week after embolization. Massive bleeding (due presumably to the surgical procedure, suggesting recanalization) was noted in the tissue of a hemangioblastoma patient who underwent surgery 13 days after embolization, even though tumor excision was easy. In the patient subjected to the surgical procedure 694 days following embolization, the CT and MRI performed 2 months later, revealed contrast enhancement similar to that seen before the operation. Moreover, angiography, done after 5 months, demonstrated tumor stain as had been noted before embolization. The histopathologic examination of this case reveal the presence of extended necrotic lesions, a large number of macrophages that contained PVA particles, and destruction of the walls of the onceoccluded vessels. In addition, there were many blood-filled vessels that had achieved recanalization. These findings suggest that it is desirable to operate within 7 days after embolization, since recanalization occurs during this period, even though PVA particles remain unabsorbed for a long time.

Characteristics of the insulin resistance syndrome in a Japanese population. The Jichi Medical School Cohort Study

We investigated the relationships between hyperinsulinemia (a major indicator of the insulin resistance syndrome), blood pressure, dyslipidemia, and coagulation factors in 2606 community-dwelling Japanese individuals as part of the Jichi Medical School Cohort Study. An age-related decrease of the fasting insulin level was found in men but not in women. Body mass index, systolic and diastolic blood pressure, triglyceride and fasting glucose levels, and factor VII activity all increased in both sexes as the insulin level became higher, while the HDL cholesterol level decreased. In addition, total cholesterol and LDL cholesterol levels increased as the insulin level became higher and lipoprotein(a) levels decreased in the men. Fibrinogen levels were not related to the insulin level in either sex. Multiple logistic regression analysis revealed that fasting insulin levels were positively correlated with body mass index and fasting glucose and factor VII activity levels, whereas they were negatively correlated with HDL cholesterol in both sexes. In addition, fasting insulin levels were positively correlated with LDL cholesterol levels in men and with triglyceride levels in women. Our results indicate that hyperinsulinemia is associated with high factor VII activity in a general Japanese population as well as with high blood pressure and dyslipidemia. The accumulation of these cardiovascular risk factors in hyperinsulinemic subjects appears to contribute to cardiovascular events in the Japanese as well as in westerners.

Experimental and clinical studies on balloon laserthermia using Nd: YAG laser for uterine endometrial cancer

BACKGROUND AND OBJECTIVE

No conservative therapy for endometrial cancer exists. We therefore evaluated the new balloon laserthermia for such cases.

STUDY DESIGN/MATERIAL AND METHODS

Experimental and clinical study. We examined experimentally porcine kidney and stomach, human resected uterus and clinically on 12 patients with endometrial cancer and two patients with hyperplasia.

RESULTS

Temperatures were safely kept at the balloon surface. Laser irradiation should be performed for at least 10-15 min, 65-70 degrees C to produce a suitable degeneration, experimentally. Clinically, necrosis and degeneration to a depth of 4-6 mm was histologically observed. Eight patients with carcinoma and hyperplasia for which laserthermia was effective showed that the surface of cancer was smooth and the depth of invasion was in most cases up to 1/4 of muscle layer.

CONCLUSION

Balloon laserthermia may be effective in early endometrial cancer or precancerous lesions. Its clinical usefulness should be investigated further.

Duct-acinar-islet cell tumor of the pancreas

A case of a rare pancreatic tumor, duct-acinar-islet cell tumor is presented. The tumor was incidentally found in the pancreatic body on computed tomography of a 21 year old male suffering from mumps. It was well demarcated from surrounding pancreas, and spherical in shape, measured 2.5 cm in diameter. Histologic and immunohistochemical examinations showed the tumor to consist of three distinct cell populations: duct, acinar and islet cells. Small cell nests consisting of these cellular components, either solely of one cell type or mixed of the three cell types, were separated by broad desmoplastic stroma. Islet (endocrine) cells, which were most predominant, were arranged in a trabecular pattern or small cell nests. Most of them were positive for glucagon, and a few cells expressed insulin, somatostatin, serotonin or pancreatic polypeptide. These cells were distributed randomly within the cell nests. Ducts, some of which contained goblet cells, were found among the endocrine cell nests. Duct-islet complexes were also observed. The acinar cells were the least conspicuous component. They expressed pancreatic alpha-amylase. An electron microscopic examination revealed duct cells with intercellular attachments and interdigitations, endocrine cells containing secretory granules, and acinar cells with zymogen granules. No definite evidence suggesting malignancy could be obtained.

[A case of melorheostosis with linear sclerodermatous skin changes]

A 69-years old Japanese woman complained of pain in the left elbow joint and thickened skin over the left upper limb. The pain had been present for 20 years, and the thickened area of the skin gradually enlarged during this period. Her left elbow joint showed some limitation of motion. There was no record of any similar condition in her family history. Radiographs of the left limb showed cortical hyperostosis extending from the middle of the left humerus to the distal end of the radius. Radiographs of the other limbs were normal. A technetium 99m-methylene diphosphonate bone scintigraphy revealed increased uptake in the areas of radiographic hyperostosis. The diagnosis of melorheostosis was made. Skin biopsy of thickened area was performed. The epidermis was normal, and proliferation of normal-appearing collagen fibers into the subcutaneous fat was noted. No inflammatory changes were found. The cause of sclerodermatous skin changes was thought to be not by linear scleroderma but by melorheostosis. In cases of linear sclerodermatous changes, melorheostosis as its origin should be considered.

[A case of mixed connective tissue disease with acute interstitial pneumonitis]

A 43-years-old woman was admitted to the Hokkaido University Hospital because of high fever, muscle weakness and dyspnea in May 1993. She had has muscle weakness of upper extremities since December 1992. She had developed swollen hand, polyarthralgia and Raynaud's phenomenon. High fever and severe dyspnea developed in May 1993. Chest roentogenogram was normal in April 1993. Physical examination showed Velcro rales in both lower lung fields. Her laboratory data showed increased muscle enzymes, high titers of anti-nuclear-antibody (1: 1280) and anti-RNP-antibody (index 199.4 (normal < 7)). Anti-DNA, anti-Sm and anti-Jo-1-antibodies were all negative. Blood gas analysis showed severe hypoxemia. Chest roentogenogram revealed diffuse bilateral interstitial infiltrates prominent in the bases. Diagnosis of mixed connective tissue disease with acute interstitial pneumonitis was made. She was treated with steroid pulse therapy (methylprednisolone 1 g x 3 days) followed by high dose oral prednisolone (60 mg/day), and diffuse interstitial infiltrates disappeared within one week. Prednisolone could be tapered to 17.5 mg/day without relapse. Acute interstitial pneumonitis is a rare complication of mixed connective tissue disease, but may be life threatening. In such cases, high dose steroid therapy should be started without delay.

[The association of the disease activity of rheumatoid factor positive vasculitis and the level of rheumatoid factor]

Rheumatoid factor (RF), an autoantibody against the Fc portion of denatured IgG, has long been recognized as an important biologic marker not only for rheumatoid arthritis but also for other auto-immune diseases. In this study, we measured the level of serum RF in four patients with RF positive systemic vasculitis using laser nephelometry. Three patients were diagnosed as polyarteritis nodosa and the other patient was diagnosed as systemic vasculitis without the finding of typical necrotizing vasculitis from biopsies. In the result, we found that the level of RF paralleled the disease activity in these cases. When active phase of the disease, the level of RF showed very high, and after the treatment combined with plasmapheresis, corticosteroid and immunosuppressive agent, the level of RF decreased in accordance with CRP, ESR and clinical features. These suggested that RF was the disease specific marker for RF positive vasculitis and beneficial informations for proper diagnosis and better treatment could be provided by measurement of the level of RF in patients with RF positive systemic vasculitis.

Lipoprotein(a) levels in the Japanese population: influence of age and sex, and relation to atherosclerotic risk factors. The Jichi Medical School Cohort Study

The authors studied the distribution of lipoprotein(a) (Lp(a)) levels with stratification for age and sex, as well as the relation between Lp(a) and atherosclerotic risk factors in a large Japanese population between 1992 and 1993. The subjects were 1,235 males and 1,762 females over 30 years old. Lp(a) was measured by an enzyme-linked immunosorbent assay. Lp(a) levels were higher in females than in males. The increase in Lp(a) with age was statistically significant, and the proportion of subjects with Lp(a) levels > 30 mg/dl also increased with age. In the obese subjects (body mass index (BMI) (kg/m2) > 26), Lp(a) levels were lower than in the non-obese subjects (BMI < or = 26) (p < 0.01 in males; p < 0.05 in females). Male alcohol drinkers had lower Lp(a) levels than nondrinkers (p < 0.05). Age, low density lipoprotein subtracting Lp(a) cholesterol [Lp(a) x 0.3], and fibrinogen level were all positively correlated with Lp(a) in both sexes. Alcohol consumption (g/day) and triglycerides were inversely correlated with Lp(a) in males, while total cholesterol subtracting Lp(a) cholesterol [Lp(a) x 0.3], high density lipoprotein, and factor VII were positively correlated in females. Multiple logistic regression analysis showed that triglycerides in males and BMI and fibrinogen in females were significant independent variables. The authors conclude that Lp(a) level is affected by various factors, such as alcohol drinking, BMI, sex, and age, and is not only correlated with lipid levels but also with hemostatic factors such as fibrinogen and factor VII.

Genetic determinants of plasma factor VII activity in the Japanese

We investigated the frequency of the factor VII Gln353 (FVII Gln353) allele in Japan, where coronary artery disease is much less common and factor VII coagulant activity (FVIIc) is lower than in Western countries. Japanese males (n = 144) aged 40-59 years living in 2 different districts were studied, and the FVIIc and activated factor VII (FVIIa) levels were measured with human (FVIIa Hum) and bovine soluble tissue factor (FVIIa Bov). The frequency of the FVII Gln353 allele in the 2 districts was 0.026 and 0.052 (combined: 0.034), which was about one third of that in a European population. Thus, the lower FVIIc level in Japanese is not due to the effect of FVII Gln353 allele. Ten individuals with the Gln353 allele showed a 39% decrease of FVIIa Hum levels and a 29% decrease of the FVIIa Bov level compared with 134 individuals homozygous for the FVII Arg353 allele. These decreases of FVIIa were greater than the decrease of FVIIc (17%), suggesting that FVII Gln353 may be difficult to activate in vivo. The marked decrease of FVIIa levels in individuals with the FVII Gln353 allele suggests that they are genetically protected against cardiovascular disease irrespective of ethnic background, by virtue of their decreased FVIIa level.

Up-regulated expression of Fas antigen (CD95) by peripheral naive and memory T cell subsets in patients with systemic lupus erythematosus (SLE): a possible mechanism for lymphopenia

Fas antigen (CD95) is a membrane-associated molecule that mediates apoptotic cell death and may play a role in the induction and maintenance of T cell tolerance. To elucidate the involvement of Fas antigen in human autoimmune diseases, we analysed Fas antigen expression by peripheral T cells from patients with SLE and rheumatoid arthritis (RA), using three-colour flow cytometry. Both CD4+ and CD8+ T cells from SLE patients expressed Fas antigen in a higher density than did these cells from healthy donors and from RA patients. Enhancement of Fas antigen density was noted in Fas+CD45RO+ memory T cells from SLE patients. More remarkably, a significant expression of Fas antigen was observed in CD45RO- naive T cells from SLE patients. CD4+CD45RO- T cells from SLE patients co-expressed Fas antigen and early to intermediate activation antigens such as CD25 and CD71, and late activation antigen HLA-DR in only FashiCD4+ naive T cells. Such up-regulation of Fas antigen expression in SLE patients seems to be clinically meaningful, because mean fluorescence intensity (MFI) of Fas antigen on CD4+ T cell subsets inversely correlates with the absolute size of CD4+ T cell subsets in peripheral blood of SLE patients. These results suggest that T cells with increased Fas antigen expression may be highly susceptible to apoptotic cell death, in vivo. A putative mechanism for lymphopenia in SLE patients is discussed.

[Development of a perceived social support scale: for a Japanese population]

Social support is increasingly attracting interest in as a factor in epidemiological research of disease risks. However, at present, few methods for measuring social support that can be credited as having reliability and validity exist in Japan. Therefore a perceived social support scale was developed in relation to a population study of a town in Fukuoka prefecture. A method for measuring functional support from several external sources was designed consisting of a self-administered test provided with only two available response options--yes & no. Pretests were conducted twice in order to evaluate content validity and adjust the number of determinants and resulted in spouse, family members, and friends being selected to be primary sources of support. A factor analysis was applied to select 10 conditions with high internal consistency for each of the sources. Responses were scored 0 or 1, for 'no' or 'yes,' respectively. Subsequently each set of 10 variables was summed into an index ranking social support conditions for each of the three sources. The three highest ranking indicators from each of the respective sources were then integrated into a single comprehensive total social support score of the individuals. The inquiry method was applied on 277 adults, aged from 40 to 69 years, in the town. Intercorrelation between the indicators of support derived from the three sources was low and coefficients of reliability ranged from 0.892 to 0.978. The score of each set of the 10 variables were incorporated into a principal components analysis in order to determine factorial validity. All of the first factor loadings of the items measuring support from both spouse and family were greater than 0.7 and high eigenvalues were obtained. Therefore the methods applied to spouse and family were considered adequate to measure a given construct. The items measuring support from friends were divided into two factors, emotional support and tangible support.

Infrared studies of interaction between metal ions and Ca(2+)-binding proteins. Marker bands for identifying the types of coordination of the side-chain COO- groups to metal ions in pike parvalbumin (pI = 4.10)

Metal-ligand interactions in the Ca(2+)-binding sites of pike parvalbumin (pI = 4.10) have been examined by Fourier-transform infrared spectroscopy. The region of the COO- antisymmetric stretch provides useful information on the types of coordination of the COO- groups to the metal ions in the Mg(2+)-, Mn(2+)-, and Ca(2+)-bound forms. In the spectrum of the Ca(2+)-bound form, two bands are observed at 1,582 and 1,553 cm-1, whereas, in the spectra of the Mg(2+)- and Mn(2+)-bound forms, bands are observed only in the region around 1,582 cm-1 and no band is found in the region around 1,553 cm-1. The 1,553-cm-1 band of the Ca(2+)-bound form reflects the bidentate coordination of the COO- groups of both Glu-62 in the CD site and Glu-101 in the EF site to the Ca2+ ions, which has been made clear by X-ray analysis as a feature of the Ca(2+)-bound form. Absence of such a band in the spectrum of the Mn(2+)-bound form is consistent with the X-ray structure of this form where both of the two COO- groups are unidentate. These unidentate COO- groups of Glu-62 and Glu-101 in the Mn(2+)-bound form seem to give rise to a band at 1,577-1,574 cm-1. The spectrum of the Mg(2+)-bound form is also consistent with the 'pseudo-bridging' coordination of the COO- group of Glu-101 reported in the X-ray structure of a form where the Mg2+ ion occupies only the EF site, and the same spectrum is further indicative of the 'pseudo-bridging' coordination of the COO- group of Glu-62.

Extradural extension of primitive neuroectodermal tumor--case report

A 13-year-old boy presented with a primitive neuroectodermal tumor (PNET) with unusual extracranial extension. Precontrast computed tomography showed the tumor as a ring-shaped high-density area which was enhanced postcontrast, with a low-density center. Magnetic resonance imaging showed the tumor as a low-intensity area on the T1-weighted images with marked enhancement by gadolinium-diethylenetriaminepentaacetic acid, and high intensity on the T2-weighted images. The central area appeared as high intensity on both images, suggesting free methemoglobin. The tumor was subtotally removed. Histological examination demonstrated PNET. Despite irradiation (20 Gy) to the surgical site, and further tumor removal, he died 6 months later. This case showed PNET can extend extracranially. Diagnosis and treatment of such a tumor located extracranially and intracranially require careful consideration.

Calcineurin activates transcription from the GM-CSF promoter in synergy with either protein kinase C or NF-kappa B/AP-1 in T cells

Two cis-acting elements GM-kappa B/GC-box and CLE0, of the granulocyte-macrophage colony-stimulating factor (GM-CSF) gene are required for maximal induction in Jurkat T cells by costimulation with phorbol-12-myristate acetate (PMA) and Ca2+ ionophore (A23187). The GM-kappa B sequence is recognized by NF-kappa B, which is mainly induced by PMA. The CLE0 sequence interacts with factors, related to a PMA-induced AP-1 and a PMA/A23187-induced NF-AT. We examined whether signal transducing components in T cells can activate transcription of the GM-CSF gene. Cotransfection of NF-kappa B (p50/p65)- or AP-1 (c-Jun/c-Fos)-expression vectors into Jurkat cells with a luciferase reporter containing the GM-CSF promoter did not stimulate transcription from the GM-CSF promoter. In contrast, cotransfection with a combination of NF-kappa B and AP-1 significantly augmented transcription from the GM-CSF promoter containing the GM-kappa B/GC-box and the CLE0 (AP-1/NF-AT). Expression of a constitutively active calcineurin (CN), a Ca2+/calmodulin-dependent protein phosphatase, potentiated by two fold the transcriptional activation by NF-kappa B/AP-1. Both constitutively active forms of CN and protein kinase C (PKC) synergistically activated transcription from the GM-CSF promoter. These results suggest that cooperation among NF-kappa B-, AP-1- and NF-AT-binding sequences is required for induction of the GM-CSF gene through PKC- and Ca2+-signaling pathways downstream of T cell activation.