Effect of bucillamine on the rat trinitrobenzene sulfonic acid induced model of colitis

Salicylazosulphapyridine and corticosteroids are the only remedies for inflammatory bowel disease currently in clinical use. They do not, however, necessarily bring about satisfactory therapeutic benefits, so that new agents are needed. In this study, we evaluated the effect of bucillamine, a new antirheumatic agent, in experimental rat colitis induced by trinitrobenzene sulfonic acid enema. Wistar rats were given vehicle alone (n = 16) or treated with 50 (n = 20) or 150 (n = 20) mg/kg of bucillamine daily for three weeks after induction of colitis. Conventional histological sections of the colon stained by haematoxylin and eosin were prepared and observed under a light microscope to determine colonic damage scores. The determinations were significantly lower in the group treated with 50 mg/kg of bucillamine and tended to be lower in the group treated with 150 mg/kg of bucillamine than in the untreated group, which implied that the experimentally induced colonic inflammatory changes and ulcerations were alleviated by bucillamine. Blood tests showed no abnormal values at the end of the treatment. The present observations suggest that bucillamine should be developed further as a possible therapy for inflammatory bowel disease.

Immunophenotypic features and configuration of immunoglobulin genes in hairy cell leukemia-Japanese variant

Immunophenotypes and Ig gene rearrangements were investigated in 12 patients with a variant form of hairy cell leukemia (HCL) termed HCL-Japanese variant (HCL-J), and in an HCL-J-derived cell line. The leukemic cells of HCL-J characteristically showed the phenotype of CD20+, CD5-, CD10-, CD11c+, CD22+, CD24- and CD25-. Ig light (L) chain was undetected in nine cases, and the remaining four cases expressed kappa chain. Expression of Ig heavy (H) chain was studied in nine cases. In addition to Igkappa+ cases showing expression of predominantly gamma H chain isotype, alpha chain was detected in one case without expression of L chain. Rearranged bands in Ig heavy chain (JH) genes were recognized in all 12 cases tested. Rearranged bands in kappa chain genes and germline configuration in chi chain genes were seen in all three Igkappa+ cases tested. Four of nine cases without expression of L chain had a rearranged chi chain gene. The other three cases had chi chain genes in the germline configuration and rearranged and/or deleted kappa chain genes. In the remaining two cases, no rearrangement in either kappa or chi chain genes was detected. The Ig gene configuration and expression in HCL-J, partially overlapping with those described for immature B cell leukemia, were dissociated from the cytological features and CD20+, membrane CD22+ phenotype characteristic of mature B cells.

Adenovirus-mediated gene transfer using ex vivo perfusion of the heart graft

A replication-deficient adenovirus was used for ex vivo gene transfer into rat heart grafts under conditions simulating clinical transplantation. The adenoviral vector, AdHCMVsp1LacZ, containing an expression cassette of Escherichiae coli lacZ, was used to perfuse heart grafts during cold ischemia before transplantation. Heart grafts were perfused with University of Wisconsin (UW) solution containing either 0 pfu, 5 x 10(10) pfu, or 1 x 10(11) pfu of viral vector, and were preserved for either 2 or 4 h and then transplanted into syngeneic recipients. The animals were killed at 1, 7, and 14 days after transplantation. The infection rate was assessed by histochemical staining for beta-galactosidase. Using polymerase chain reaction (PCR), viral DNA presence was confirmed in every graft perfused with viral vectors. The protein production from the transfected gene was confirmed by a functional protein assay. An efficient gene transfer was achieved with an infection rate of 1%-1.5% for all cardiac myocytes, as assessed by 5-bromo-4-chloro-indolyl-beta-D-galactopyranoside (X-gal) staining. All studies were negative in the control grafts. Gene expression persisted for at least 10 days after transplantation. We thus conclude that an efficient adenovirus-mediated gene transfection and expression of gene products can be achieved in ex vivo perfusion of the heart graft during cold preservation.

[Chronic active EB virus infection and granular lymphocytes proliferative disorders in Japan]

To clarify the characteristics of chronic active EB virus infection (CAEBV) in Japan, and to investigate the relation between granular lymphocytes proliferative disorder (GLPD) and EB virus, we conducted a survey through a questionnaire conducted throughout Japan. Among 17 registered patients with CAEBV, 9 developed various types of lymphoproliferative disorders (LPDs), and 6 patients died of LPD. Among 72 cases of GLPD, 43 were CD3-positive and 27 were CD3-negative. EB viral DNA was detected in the peripheral mononuclear cells in 6 of 7 CD3-negative and 1 of 4 CD3-positive cases. These data suggest that EB virus-associated LPDs frequently derive from patients with CAEBV. However, some GLPD patients without CAEBV, especially for CD3-negative GLPD, are associated with EB virus infection. Therefore detection of EB viral DNA is very important to understand the pathogenesis of GLPD.

[Early intervention for very-low-birth-weight infant]

In order to establish an early intervention (EI) system for very-low-birth-weight infants, we designed a randomized trial at multiple institutions in Japan. We also reviewed the concept and history of early intervention in USA. Eight medical institutions in different locations were selected for participation. Sixty-two EI group patients and 48 controls without neurological abnormalities (age 2 years) were selected for study. The developmental quotient (DQ) by the revised Kyoto-K method and 15 questionnaire items were monitored twice, at the age of 2 and after one year of EI (3 years). Improvements in behavioral problems, circadian rhythm, and speech were significantly greater in the EI group than in the control group. (P < 0.01). Data on all patients are being collected, and further evaluation and analysis of DQ are planned. The most effective EI method in each specific location and the financial support of its official institutions are required for the success of the EI program for very-low-birth-weight infants.

Deficiency of blood coagulation factor XIII in Crohn's disease

OBJECTIVE

Refractory fistula formation is one of most intractable complications in Crohn's disease. Recently, the role of blood coagulation Factor XIII has been recognized as an important wound-healing factor. We investigated the plasma concentration and functional activity of blood coagulation Factor XIIIa, active subunit of the Factor XIII, in patients with Crohn's disease and in healthy volunteers.

METHODS

Peripheral blood was obtained from 24 patients with Crohn's disease and from 10 healthy volunteers. The functional activity of Factor XIIIa was measured by its transglutaminase activity, and plasma concentration was measured by the immunoelectrophoresis method.

RESULTS

The differences in Crohn's disease patients and healthy volunteers were not significant. However, Crohn's disease patients with fistula had significantly lower functional activity than Crohn's disease patients without fistula.

CONCLUSIONS

The deficiency in this wound-healing factor might be one reason for refractory fistulas in Crohn's disease, and supplementation of the factor might be useful therapeutically.

Age-related changes in surface antigens on peripheral lymphocytes of healthy children

The age-related changes in proportion of various subsets within lymphocytes were investigated in cord blood and peripheral blood from healthy children and adults. The percentages of T and B cells did not show age-related changes, whereas natural killer (NK) cells increased significantly with age. Within lymphocytes or the CD3+ T cell population the proportion of CD45RAbright+ lymphocytes decreased and that of CD45RO+ cells increased, while that of CD45RAdim+ cells showed no age-related change. Within lymphocytes, the percentage of CD45RAbright+ CD4+ cells decreased, together with a decline of that of CD4+ cells. The proportions of CD45RAbright+ CD8+ cells and S6F1bright+ CD8+ cells increased with age, and the age-dependent increase of the proportion of CD8+ cells seems to be mainly attributable to the increases in these subsets. The CD45RAdim+ CD4+ and CD45RAdim+ CD8+ cells co-expressing CD45RO at a low level nevertheless showed no age-related changes. In gamma delta T cells, both delta TCS1+ and delta TCS1- T cells increased with age, but the delta TCS1- gamma delta T cells increased more than the delta TCS1+ subset. Among lymphocytes, the percentages of CD20+, CD21+ and CD22+ cells remained similar, with no age-related changes, but the proportion of CD5+ cells within lymphocytes or B cells decreased. The proportions of CD16+ NK cells among lymphocytes increased with age, and this change was attributable to the increase of CD56+ cells.

CD33+ B-cell precursor acute lymphoblastic leukemia in children: a distinct subgroup of B-cell precursor acute lymphoblastic leukemia

Clinical and laboratory features associated with CD33 expression were analysed in 123 children with B-precursor acute lymphoblastic leukemia (ALL), including 85 at onset, 34 at relapse and four in a refractory state to induction therapy. CD33 was demonstrated in 13 patients (15.3%) at onset, and it was associated with coexpression of T-cell and multipotential hematopoietic cell-associated antigens, i.e. CD2, CD4 and CD7, which were observed in four of 11 analysed patients (P < 0.01). Patients with CD33 expression were older than those without CD33 (P < 0.01). Although CD33 was the strongest predictor of a poor outcome (event-free survival, 44% for CD33+ and 75% for CD33-patients; P = 0.0041) in univariate analysis, multivariate analysis did not demonstrate significance (P = 0.0645). Fourteen of 38 patients (36.8%) at relapse or in a refractory state showed CD33 expression. Analysis of CD33 expression had also been performed at onset in 16 of these patients and showed acquisition of CD33 in six of 13 patients who had been negative for this antigen at onset. Thus, it seems that CD33+ B-precursor ALL is derived from undifferentiated cells minimally committed to B-cell lineage and more homogeneous than so-called My+ B-precursor ALL with regard to the clinical and biological features. The frequent expression of CD33 on the cells which acquired resistance to chemotherapy may have resulted from expansion of a CD33+ original minor clone or clonal evolution.

Low frequency of the p53 gene mutations in neuroblastoma

BACKGROUND

The p53 gene frequently is affected by point mutations, rearrangements, or deletions that contribute to the genesis or progression of a wide variety of human adult solid tumors; however, to the authors' knowledge, this gene alteration has not been analyzed in neuroblastoma.

METHODS

Genomic DNA samples from 20 children with neuroblastoma, including 16 patients with advanced disease, were screened for the presence of mutations in exons 5-9 of the p53 gene, where over 90% of mutations have been reported to be located in human cancer. The screening technique employed polymerase chain reaction/single-strand conformation polymorphism analysis followed by direct DNA sequencing.

RESULTS

Heterozygous mutations were detected in 2 of the 20 cases. A silent mutation (T to G transversion) at codon 172 and a missense mutation (G to T transversion) at codon 259 were found in patients with Stage II and Stage IV disease, respectively. Thus, p53 mutations were found to occur in neuroblastoma, but at a low frequency (2 of 20).

CONCLUSIONS

Our data suggest that in a minority of neuroblastomas, p53 gene mutations may play a contributing role in tumorigenesis, but other genes presumably play a major role in this tumor.

Phenotypic characteristics of acute megakaryocytic leukemia and transient abnormal myelopoiesis

By immunophenotyping and ultrastructural cytochemistry, the disorders involving megakaryocytic lineage cells have been clarified. These disorders are termed acute megakaryocytic leukemia (AMKL) and transient abnormal myelopoiesis (TAM). The characteristics of blasts in these disorders have been extensively investigated from various standpoints including cytochemistry, cytogenetics, ultrastructure and in vitro-colony differentiation. The target cells of AMKL and TAM are immature cells close to stem cells which are capable of differentiating into lineage cells such as megakaryocytes, erythrocytes and myeloid cells. Phenotypically, these blasts frequently express antigens appearing at an early stage in the hematopoietic differentiation pathway. They thus often emerge as mixed phenotypes as seen in mixed lineage leukemia of immature cell origin.

CD8+ lymphocyte counts and the risk of death in advanced HIV infection

BACKGROUND

Mortality related to human immunodeficiency virus (HIV) infection occurs predominantly in patients with CD4+ lymphocyte counts of less than 50 cells/mm3. We followed 133 HIV-infected patients with enrollment CD4 counts of less than 50 cells/mm3 to determine if the risk of death during a 1-year period could be predicted by a single enrollment CD8+ lymphocyte count.

METHODS

Enrollment data including age, sex, T-cell subset counts, p24 antigen status, antiretroviral use, and preexisting HIV-related illnesses were collected on a cohort of 133 consecutive patients with enrollment CD4 counts of less than 50 cells/mm3. The cohort was followed for 1 year, and survival data were analyzed in relation to enrollment variables.

RESULTS

The mean enrollment CD8 count of those patients alive at 1 year was 600 cells/mm3, compared with a mean enrollment CD8 count of only 370 cells/mm3 in patients who had died prior to 1 year (P < .001). For every 100-cell decline in the enrollment CD8 count, the risk of death increased by 16% (95% confidence interval [CI], 5% to 22%), independent of other enrollment variables, including CD4 counts and p24 antigen status. A significant CD8 count warning level of 415 cells/mm3, irrespective of the presence of other enrollment variables, was associated with death within 1 year. The Kaplan-Meier estimated chance of death within 1 year was 54% (95% CI, 42% to 66%) for patients with CD8 counts of less than 415 cells/mm3 compared with only 25% (95% CI, 14% to 36%) for patients with CD8 counts greater than 415 cells/mm3.

CONCLUSIONS

This study finds that a single CD8 count has important prognostic significance in patients with advanced HIV infection and suggests that potential therapies to enhance CD8 counts might be beneficial to patients with advanced HIV infection.

Transient abnormal myelopoiesis in Down's syndrome

Recent data have elucidated the pathogenesis of transient abnormal myelopoiesis (TAM) to a great extent. TAM is a monoclonal disorder which resolves spontaneously and the target cell in this disorder is a multipotent stem cell which is capable of differentiating into megakaryocytes. The pathogeneses of TAM/AMKL (acute megakaryoblastic leukemia) appears to be closely associated with abnormal quality and quantity of a gene located on chromosome 21. AMKL developing after the regression of TAM appears to come from the same clone as the TAM, which apparently experiences some kind of genetic alterations. It seems that the gene responsible for TAM will soon be cloned in the near future. However, the mechanism of spontaneous regression of TAM has as yet not been clarified. The expanding clone in the transient physiological immunodeficient state, during the perinatal period, might be eliminated with the maturation of more mature immunosurveillance. Alternatively, the TAM clone might be destined to undergo spontaneous death, which is called "programmed cell death" (apoptosis). The mechanism of this phenomenon awaits further elucidation.

Immunization of the elderly and patients with collagen vascular diseases with live varicella vaccine and use of varicella skin antigen

Elderly subjects and patients with collagen vascular diseases were immunized with a live varicella vaccine to assess the vaccine's potential for preventing herpes zoster. An improved varicella-zoster virus (VZV) skin test antigen was then used to assess cell-mediated immunity to VZV. The antigen was prepared from culture fluid of VZV-infected cells and had far less protein content than crude antigen prepared by sonication of infected cells. In 11 of 12 patients with ophthalmic zoster and 17 of 21 with dermal zoster, the skin reaction was negative at the beginning of the disease but became positive later. After two doses of VZV vaccine, 8 of 12 elderly subjects (greater than 60 years old) and 4 of 6 patients with collagen vascular diseases, who were VZV-skin test negative but purified protein derivative tuberculin test-positive, became VZV skin test-positive.

Mixed phenotype of blasts in acute megakaryocytic leukaemia and transient abnormal myelopoiesis in Down's syndrome

Blasts from eight cases with acute megakaryoblastic leukaemia (AMKL) and seven with transient abnormal myelopoiesis in Down's syndrome (TAM) were investigated to clarify their phenotypic characteristics. CD41 and CD7 were the most frequently expressed in both disorders. CD41 was positive in six TAM and five AMKL cases, and CD7 was positive in five TAM and five AMKL cases, respectively. CD33 was detected in four TAM and five AMKL cases. Other myeloid-lineage associated antigens such as CD13 and CD11b could not be found in TAM but were expressed in five AMKL cases. Interestingly, CD56, a neural adhesion molecule, was expressed in three of four TAM and one of five AMKL cases. Cytoplasmic CD3 antigen was also noted in three of five examined cases. A short-term culture study was conducted on blasts from two TAM cases and five AMKL cases. In two cases in which CD41 was not expressed before culture, the expression of CD41 was enhanced after culture with or without 12-O-tetradecanoyl-phorbol-13-acetate (TPA). The expression of CD7 remarkably was depressed, while that of CD13 was enhanced after culture with TPA. These findings suggest that blasts of TAM and AMKL originate from very immature cells and represent a mixed phenotype. In the present study, distinction of phenotypical differences between blast in TAM and AMKL was not possible.

T-cell receptor alpha and delta gene assembly in B-cell precursor acute lymphoblastic leukemia

The status of the TCR-alpha/delta genes in B-precursor ALL and the rearrangement patterns of these gene loci are discussed in this review. Although most of these rearrangements have been characterized, some still remain to be clarified. Almost all rearrangements of the TCRs in B-precursor ALL are incomplete and may reflect early recombinational steps during the TCR differentiation processes in normal T-lineage cells. In addition, even in T-cell malignancies, it is rarely possible to obtain clonal cell populations with TCR rearrangements arrested in very early recombinational steps. Therefore, studies of these as yet uncharacterized rearrangements may lead to the discovery of additional gene segments playing important roles in the TCR recombinational processes and may provide useful information for understanding the processes of T-cell differentiation.

[Phenotypic and genotypic analysis of acute leukemia--current status of lineage specific classification]

More detailed identification and understanding of the heterogeneity of leukemias using a broad panel of markers seems to be essential for the successful design of more sophisticated and effective treatments. Based on the FAB system, immunological phenotypes using a panel of monoclonal antibodies, and rearrangements of immunoglobulin and T-cell receptor genes, acute leukemia can be divided into six subtypes such as B-lineage, T-lineage, AML, NK-lineage, AUL and mixed lineage leukemia. The definition of B-lineage and T-lineage cells, a new classification for mixed lineage leukemia, incidence of dual rearrangements and their clinical significance are discussed.

Monocytes appearing repeatedly after chemotherapies had an identical rearrangement pattern of immunoglobulin with leukemic blasts in a patient with CD13+ acute lymphoblastic leukemia

We recently encountered a patient with acute lymphoblastic leukemia (ALL) who showed temporal monocytosis of an unusually high cell count (5,000-30,000 monocytoid cells/microliter) five times after treatment with different chemotherapies. The leukemic cells expressed B-cell-associated antigens, CD19 and CD10, E-rosette receptor, CD2 and monocyte/myeloid antigen, CD13 simultaneously. They were peroxidase-negative. One week after the initiation of conventional chemotherapy for ALL, the leukemic blasts had disappeared. Alternatively, monocytoid cells appeared along with the recovery from nadir status. They showed several features of monocytes; they were weakly dot-positive for nonspecific esterase, reactive with CD14 and CD13 and Fc gamma-receptor-positive. Furthermore, they migrated into a fungally infected joint space. Features incompatible with normal monocytes were the absence of peroxidase reactivity, the expression of B-cell-associated antigens, CD19 and CD10 and E-rosette receptor, CD2. Southern blot hybridization analysis revealed an unexpected result that HindIII digested DNA from both leukemic blasts and monocytoid cells had the same rearranged band of IgH. Thus, an identical clonality of monocytoid cells, temporally appearing after chemotherapies and leukemic lymphoblasts, was determined in this patient with CD13+ ALL.

Clinical significance of CD7-positive stem cell leukemia. A distinct subtype of mixed lineage leukemia

Ten leukemia cases with mixed phenotype were investigated in terms of clinical characteristics and cellular origin. Three patients were infants and six patients were older children. Six of them had a high leukocyte count and a mediastinal mass was found in three cases. All but one showed hepatosplenomegaly and/or lymphoadenopathy. In spite of intensive chemotherapy, most of them responded poorly. Cytochemical analysis of their leukemic cells revealed a low percentage of positivity for myeloperoxidase reactivity (less than 25%) in two cases and electron microscopic platelet peroxidase reactivity was found in one of three analyzed cases. Phenotypically, these cells all expressed CD7, and other T-lineage-associated, B-lineage-associated, and/or myeloid-associated antigens were also detected to some extent. In addition, three cases expressed CD41 and one case expressed CD56. The T-cell receptor (TCR) genes and immunoglobulin gene were in the germline configuration in seven cases. In three rearranged cases, two showed only the TCR-delta gene rearrangement, and one had both TCR-gamma and delta gene rearrangements. Cell culture studies with 12-0-tetradecanoyl-phorbol-13-acetate (TPA) revealed differentiation to the T-lineage in two cases and to a myeloid lineage in one case. Megakaryocytic differentiation was detected in two cases in culture without TPA. These results suggest that the cells from these cases arose from stem cells capable of both lymphoid and nonlymphoid differentiation. Although the cells were heterogeneous with regard to their potency of differentiation, they have similar clinical characteristics. Because of poor prognosis, it is important to identify this type of leukemia, and allogenic or autologous bone marrow transplantation should be considered.

Differential usage of delta recombining element and V delta genes during T-cell ontogeny

We analyzed the usage of the delta recombining element (delta Rec) and six V delta genes in cell samples from 15 patients with CD3- and 10 patients with CD3+ T-cell acute lymphoblastic leukemia in an attempt to define the hierarchy of genetic events that is associated with the T-cell receptor (TCR) alpha/delta gene complex during T-cell ontogeny. Based on the deletion patterns of these genes, we surmised their relative order on chromosome 14 to be as follows: 5'-V delta 4, V delta 6, V delta 1, V delta 5, delta Rec, V delta 2, D delta 1-3, J delta 1-3, C delta, V delta 3-3'. In agreement with previous reports, V delta 1 was found to be preferentially rearranged in CD3+ samples. In CD3- samples, V delta 2 and V delta 3 rearrangements were observed at a high frequency. Incomplete V delta D delta rearrangements using V delta 2 or V delta 3, which are closest to C delta, were observed in three patients with CD3- and one patient with CD3+. These results suggest that V delta 2- and V delta 3-(Dn)D delta 3 recombinations are among the earliest recombinational events. Delta Rec was observed to be rearranged to phi J alpha on one allele. In addition, delta Rec rearrangements to J delta 1 and J alpha close to phi J alpha were also demonstrated on three alleles and one allele, respectively. Delta Rec rearrangements to J delta and J alpha other than phi J alpha also inhibit expression of the TCR delta locus. Approximately half of the alleles with J delta rearrangements showed no involvement of known V delta or delta Rec, indicating the existence of other, yet-uncharacterized V delta or delta Rec-like segments.