Induction of human cutaneous mast cell degranulation by opiates and endogenous opioid peptides: evidence for opiate and nonopiate receptor participation

In order to examine the capacity of pharmacologically useful opiates to stimulate human mast cell secretion, subjects were skin tested with morphine, codeine, or meperidine hydrochloride. All three agents acted equipotently in eliciting positive immediate skin reactions from all subjects tested. Each agent demonstrated 10 mm of net whealing at 5 to 10 micrograms base (16.7 to 40.4 nmol) injected intradermally. The ability to elicit immediate skin test reactions with endogenous opioid peptides was examined with the use of dynorphin, [D-Ala, 2-D-Leu5] enkephalin, beta-endorphin, and morphiceptin . All four compounds induced wheal-and-flare reactions with the order of potency: dynorphin, greater than beta-endorphin, and greater than [D-Ala, 2-D-Leu5] enkephalin approximately equal to morphiceptin at dose ranges of 0.3 to 8.45 nmol. The inhibition of reactivity by hydroxyzine and the demonstration of mast cell degranulation by electron microscopy suggest that the immediate skin responses to opioid stimulation occur as a consequence of mast cell degranulation. Experiments with the opioid receptor antagonist, naloxone, suggest that both opioid and nonopioid receptors may be involved. These results imply that endogenous opioid peptides possibly may play a role in mast cell function and/or degradulation .

Dopamine inhibition of histamine-mediated cutaneous responses

Several patients receiving dopamine for hypotension were skin tested for possible penicillin sensitivity. Not only were the penicillin skin tests negative but also the histamine control. On the possibility that dopamine might affect cutaneous histamine responses, we examined the effect of dopamine on histamine, antigen, morphine, and compound 48/80 skin responses. Both intradermal and intravenous dopamine selectively inhibited histamine but not antigen, morphine, or compound 48/80 skin responses, and the inhibition was in a dose-related fashion. This observation indicates that histamine should not be used to demonstrate dermal reactivity in patients receiving dopamine. The results of this study also suggest that histamine may not be the sole mast cell-derived mediator involved in the wheal-and-flare reaction characteristic of immediate-type skin tests since dopamine did not affect skin reactions caused by endogenous mast cell degranulation. Finally, the possible use of dopaminergic drugs in diseases with histamine-associated symptoms is discussed.

Concomitant pulmonary aspergillosis and nocardiosis in a patient with chronic granulomatous disease of childhood

Chronic granulomatous disease is characterized by recurrent infections with microorganisms which produce catalase, an enzyme that detoxifies endogenous or exogenous hydrogen peroxide to water and oxygen. Among 245 patients with CGD reviewed by Cohen et al, (7)20.4% had a history of fungal infection. The frequency with which fungal infections occur in patients with CGD emphasizes the importance of the phagocyte in defense against these pathogens. Our case of concomitant pulmonary aspergillosis and nocardiosis in a 15-year-old boy with CGD who had previous infections with both of these organisms illustrates several important points: (1) Aggressive diagnostic approaches (eg, open lung biopsy) are often required to make the diagnosis of fungal infections in patients with CGD; (2) patients with CGD can have multiple simultaneous infections with catalase-positive organisms; and (3) acute infections with Aspergillus or Nocardia do not provide lasting immunity in patients with CGD.

Preparation of a human lung purified plasma membrane fraction: confirmation by enzyme markers, electron microscopy, and histamine H1 receptor binding

A simple and rapid method of isolating plasma membranes from human peripheral lung tissue is described. The method involves homogenization of tissue in 0.25 M sucrose-buffered medium followed by differential and sucrose density gradient centrifugation. Enzymatic and morphological characterization of the plasma membrane fraction revealed minimal contamination by nonplasma membrane fragments. The isolated plasma membranes showed an 18-fold purification of 5'-nucleotidase activity compared to the original homogenate. Electron-microscopic studies of the plasma membrane fraction revealed the presence of small membrane vesicles having a trilaminar membrane structure. To further examine the purity of the plasma membrane preparation, the binding of the H1 receptor antagonist, 3H pyrilamine, to the plasma membrane-enriched fraction was compared to the binding to crude membrane preparations. Both the plasma membrane-enriched fraction and the crude membrane preparation had similar Kd's for the histamine antagonist, but the plasma membrane-enriched fraction had a threefold greater binding capacity, reflecting the relative enrichment of plasma membranes of the preparation. Thus, a method has been developed for the isolation of plasma membranes from human peripheral lung which should provide material for a variety of biochemical and pharmacological studies.

The role of the autonomic nervous system in allergic diseases

The autonomic nervous system plays a significant role in the pathogenesis of allergic diseases, especially asthma. This paper details the components of the autonomic nervous system, defines the role that these individual components play in allergy and details the abnormalities found in the autonomic nervous system in allergic subjects that may contribute to the disease state.

Detection of beta-adrenergic receptors on rabbit mononuclear cells isolated free of significant contamination by other cell types

In order to study rabbit mononuclear cell surface receptors, it was necessary to develop a procedure to isolate mononuclear cell preparations that are free of significant contamination by other cell types, especially platelets. Centrifugation of dextran-sedimented, anti-coagulated whole blood through Hypaque (density 1.060) at 600 X g for 5 min at 22 degrees C eliminated greater than 93% of starting platelets. A second 5-min Hypaque centrifugation of Hypaque-Ficoll-isolated mononuclear cells (MNC) (approximately 80% lymphocytes) at 450 X g for 5 min at 22 degrees C reduced platelet contamination to less than one platelet per three MNC, and resulted in the overall removal of greater than 99.5% of starting platelets. These relatively pure MNC which were isolated in less than 2 hr were identified as having beta-adrenergic receptors by radioligand binding techniques using [125I]iodohydroxybenzylpindolol [( 125I]IHYP). Binding of [125I]IHYP to intact rabbit MNC was a saturable, stereospecific, and rapid process with a dissociation constant (KD) of 0.53 +/- 0.18 nM and a binding capacity of 3,461 +/- 235 sites/cell.

Mast cells and asthma. The role of mast cell mediators in the pathogenesis of allergic asthma

Upon a specific allergic reaction mediators released from mast cells found free in the bronchial lumen or in the epithelial surface loosen the interepithelial cell tight-junctions allowing the entrance of more allergen to deeper mast cells. The primary and secondary mediators thereby generated induce further increased vascular permeability which leads to the entrance of plasma proteins and platelets. The other immediate responses induced by mediator release are smooth muscle constriction, mucus secretion and leukocyte chemoattraction. Vagal afferent and reflex efferent stimulation are induced by histamine and probably other mediators which might contribute both to the bronchospasm as well as mucous gland secretion. Subacute responses include increased cellular infiltrates, mucosal edema, desquamation, basement membrane thickening, goblet cell hyperplasia and mucus secretion. These responses may occur because of the continued release of primary and secondary mediators as well as effects caused by the mast cell granule matrix-derived factors. It can thus be seen that many of the pathologic features of asthma may be attributed to mast cell degranulation.

A rapid method for isolation of human mononuclear cells free of significant platelet contamination

In order to obtain mononuclear cells from peripheral human blood for the study of cell surface receptors, it was necessary to effectively eliminate contaminating platelets. The usual Hypaque-Ficoll isolation procedures were found to produce mononuclear cells contaminated with 10-1000 platelets per mononuclear cell (by phase microscopy). Multiple slow speed centrifugations reduced the contamination to 5-10 platelets per mononuclear cell. However, centrifugation of EDTA-anticoagulated blood through Hypaque (D20(20) 1.060) at 400 X g for 5 min at 22 degrees C followed by the usual Hypaque-Ficoll gradient reduced platelet contamination to less than 1 platelet per 2 mononuclear cells. Thus, a rapid and simple gradient procedure is capable of significantly reducing platelet contamination of mononuclear cell preparations and should facilitate the analysis of mononuclear cell receptors and functions.

Chronic granulomatous disease of childhood and Chromobacterium violaceum infections in the southeastern United States

Patients with chronic granulomatous disease are predisposed to infections by catalase-positive organisms in the environment. Chromobacterium violaceum is a catalase-positive bacterium whose saprophytic source in this country is the subtropical soil and water of the southeastern United States. Two patients with chronic granulomatous disease, followed at the National Institutes of Health in Maryland, acquired C. violaceum infections in Florida. All 10 cases previously reported were acquired in Florida and Louisiana, and reports for which dates were available showed that all infections were acquired from June to September. Seven of 10 patients died; one patient was studied and found to have chronic granulomatous disease. Thus, at least three of the 12 known patients have had underlying chronic granulomatous disease. We suggest that C. violaceum infections occur with unusual frequency in patients with a common underlying predisposing disorder; C. violaceum poses a potential threat to patients with chronic granulomatous disease living in or visiting the endemic states.

Aplastic anemia: the disease and its management

Aplastic anemia is a disease characterized by pancytopenia with hypocellular bone marrow. There are multiple etiologic agents, in particular, physical and chemical agents such as benzene and chloramphenicol (Chloromycetin). Pathogenetically, the disease may represent a stem-cell defect, a hostile microenvironment, or an autoimmune phenomenon. The diagnosis is made by history, physical examination, review of peripheral blood smear findings, and bone marrow aspiration and biopsy. Therapy is both supportive and specific, using multiple modalities; immunosuppression and bone marrow transplantation are particularly promising.