Regulation of transforming growth factor-beta subtypes by members of the steroid hormone superfamily

Transforming growth factor-beta s (TGF-beta s) are potent regulators of cell growth and differentiation. Expression of the closely related TGF-beta subtypes in vivo is differentially regulated both temporally and spatially. Members of the steroid hormone superfamily may play an important role in this gene- and tissue-specific regulation. We have shown that anti-estrogens induce the production of TGF-beta 1 in mammary carcinoma cells and fetal fibroblasts, whereas retinoic acid specifically induces TGF-beta 2 in primary epidermal keratinocytes. The induction of TGF-beta 2 by retinoids is accompanied by an increase in TGF-beta 2 mRNAs, but little change in transcription rates, suggesting an effect of retinoids on message stability or processing. In contrast, TGF-beta 1 mRNA levels are unchanged by anti-estrogen treatment, suggesting these compounds may regulate the translatability of the TGF-beta 1 message or some post-translational processing event. We have identified a stable stem-loop structure in the 5' untranslated region (UTR) of the TGF-beta 1 mRNA that inhibits translation of a heterologous reporter gene, and we are investigating the possibility that anti-estrogens may regulate the activity of this element, and hence the translatability of the TGF-beta 1 message. A significant fraction (25-90%) of the TGF-beta induced by retinoids and anti-estrogens is in the biologically active rather than the latent form. We have shown that active TGF-beta has a much shorter in vivo half-life than latent TGF-beta, suggesting that the TGF-beta induced by retinoids and steroids may act locally at the site of production. Since many tumor cells retain sensitivity to the growth inhibitory effects of active TGF-beta, the use of members of the steroid hormone superfamily for inducing this potent growth inhibitor locally at the tumor site may have therapeutic potential.

A contact study to evaluate the BCG vaccination programme in Seoul

A contact study was undertaken in Seoul to determine the protective effect of the BCG programme in children up to 5 years of age. There were 1993 contact children to 4484 smear-positive patients with pulmonary tuberculosis. 1223 completed the examination, 806 had evidence of BCG vaccination, 417 had not. In total, 129 or 126 children were considered cases of tuberculosis according to radiological/clinical classification or scoring system, respectively. For the unvaccinated the respective numbers of cases were 84 and 80 and for the vaccinated 45 and 46. The data were stratified for factors that could have distorted comparability: age and sex, relationship of index case, feeding habits, room occupancy, treatment history of index case and health centre that diagnosed the index case. Only age was found to have a small effect. Correcting for this, the observed level of protection was 74% with 95% confidence limits of 62% and 82%. It appeared to be the same for all types of disease observed.

Activation of the second promoter of the transforming growth factor-beta 1 gene by transforming growth factor-beta 1 and phorbol ester occurs through the same target sequences

Two distinct regions of the transforming growth factor-beta 1 (TGF-beta 1) promoter are responsive to autoregulation and activation by phorbol ester (12-O-tetradecanoylphorbol-13-acetate): sequences located between nucleotides -454 to -323 (first promoter) and between the two transcriptional start sites. We have now characterized in detail the induction of the second promoter (sequences between nucleotides + 1 to +271) of the TGF-beta 1 gene by both TGF-beta 1 and phorbol ester. By assaying progressively deleted mutations in the second promoter, we have found two regions responsible for the induction; each contains a phorbol ester-responsive element. In vitro transcription of the second promoter-chloramphenicol acetyltransferase chimeric genes using nuclear extracts of A-549 cells showed that deletion of the putative phorbol ester-responsive elements results in a 70-80% decrease in activity. DNase I footprinting and gel mobility shift assays showed that binding to an Sp1 site and the putative TRE elements are required for maximal expression of the second promoter region of the TGF-beta 1 gene. These results suggest that AP-1, which is capable of conferring phorbol ester or TGF-beta 1 responsiveness, is the major transcription factor involved in the second promoter-derived transcription of the TGF-beta 1 gene.

Transforming growth factor-beta production by synovial tissues from rheumatoid patients and streptococcal cell wall arthritic rats. Studies on secretion by synovial fibroblast-like cells and immunohistologic localization

The growth of synovial fibroblast-like cells from patients with rheumatoid arthritis and rats with streptococcal cell wall (SCW)-induced arthritis in vitro under anchorage-independent conditions is inhibited by transforming growth factor-beta (TGF-beta). Because this growth factor is present in rheumatoid synovial fluids, we studied whether this cytokine might be secreted by cells in rheumatoid synovial tissue. We show that synovial tissues from patients with rheumatoid arthritis and osteoarthritis, and rats with SCW-induced arthritis, contain TGF-beta-1 mRNA. TGF-beta, predominantly type 1, was spontaneously secreted in vitro by synovial tissue explants and synovial fibroblast-like cells. In addition, TGF-beta could be detected immunohistochemically in cells throughout rheumatoid and SCW-induced arthritic rat synovial tissues. Finally, exogenous TGF-beta induced collagen and inhibited collagenase mRNA levels by cultured synoviocytes. These data support an autocrine role for TGF-beta in the regulation of synoviocytes in rheumatoid arthritis and, in light of its demonstrated effects on the immune system, suggest that TGF-beta might also have important paracrine effects on infiltrating inflammatory cells.

Transforming growth factor-beta production by synovial tissues from rheumatoid patients and streptococcal cell wall arthritic rats. Studies on secretion by synovial fibroblast-like cells and immunohistologic localization

The growth of synovial fibroblast-like cells from patients with rheumatoid arthritis and rats with streptococcal cell wall (SCW)-induced arthritis in vitro under anchorage-independent conditions is inhibited by transforming growth factor-beta (TGF-beta). Because this growth factor is present in rheumatoid synovial fluids, we studied whether this cytokine might be secreted by cells in rheumatoid synovial tissue. We show that synovial tissues from patients with rheumatoid arthritis and osteoarthritis, and rats with SCW-induced arthritis, contain TGF-beta-1 mRNA. TGF-beta, predominantly type 1, was spontaneously secreted in vitro by synovial tissue explants and synovial fibroblast-like cells. In addition, TGF-beta could be detected immunohistochemically in cells throughout rheumatoid and SCW-induced arthritic rat synovial tissues. Finally, exogenous TGF-beta induced collagen and inhibited collagenase mRNA levels by cultured synoviocytes. These data support an autocrine role for TGF-beta in the regulation of synoviocytes in rheumatoid arthritis and, in light of its demonstrated effects on the immune system, suggest that TGF-beta might also have important paracrine effects on infiltrating inflammatory cells.

Platelet-derived growth factor and IL-1 interactions in rheumatoid arthritis. Regulation of synoviocyte proliferation, prostaglandin production, and collagenase transcription

We show that platelet-derived growth factor (PDGF) and IL-1 interact in both a synergistic and antagonistic manner to regulate synovial fibroblast-like cells (synoviocytes) derived from patients with rheumatoid arthritis. PDGF and IL-1 operated synergistically in vitro to stimulate synoviocyte proliferation in the presence of indomethacin. However, when these same cells were treated with PDGF and IL-1 in the absence of indomethacin, IL-1 inhibited PDGF-stimulated synoviocyte proliferation. Moreover, exogenous PGE2, a PG known to be produced in response to IL-1, dramatically inhibited synoviocyte proliferation induced by PDGF. PDGF also acted synergistically to markedly increase production of PGE2 stimulated by IL-1. This is in contrast to the antagonistic effect PDGF had on IL-1-stimulated collagenase transcription. IL-1 stimulated collagenase transcription, but PDGF did not. It in fact inhibited IL-1 stimulation of collagenase gene expression. These data differ somewhat from those reported for dermal fibroblasts. Our data further indicate that the effects of cytokines vary from one cell type to another, even amongst "fibroblasts," and illustrate the complexity of cytokine regulation of rheumatoid synoviocyte function.

Platelet-derived growth factor and IL-1 interactions in rheumatoid arthritis. Regulation of synoviocyte proliferation, prostaglandin production, and collagenase transcription

We show that platelet-derived growth factor (PDGF) and IL-1 interact in both a synergistic and antagonistic manner to regulate synovial fibroblast-like cells (synoviocytes) derived from patients with rheumatoid arthritis. PDGF and IL-1 operated synergistically in vitro to stimulate synoviocyte proliferation in the presence of indomethacin. However, when these same cells were treated with PDGF and IL-1 in the absence of indomethacin, IL-1 inhibited PDGF-stimulated synoviocyte proliferation. Moreover, exogenous PGE2, a PG known to be produced in response to IL-1, dramatically inhibited synoviocyte proliferation induced by PDGF. PDGF also acted synergistically to markedly increase production of PGE2 stimulated by IL-1. This is in contrast to the antagonistic effect PDGF had on IL-1-stimulated collagenase transcription. IL-1 stimulated collagenase transcription, but PDGF did not. It in fact inhibited IL-1 stimulation of collagenase gene expression. These data differ somewhat from those reported for dermal fibroblasts. Our data further indicate that the effects of cytokines vary from one cell type to another, even amongst "fibroblasts," and illustrate the complexity of cytokine regulation of rheumatoid synoviocyte function.

Promoter sequences of the human transforming growth factor-beta 1 gene responsive to transforming growth factor-beta 1 autoinduction

Two distinct regions of the transforming growth factor (TGF)-beta 1 promoter are responsive to autoregulation. Sequences located between nucleotides -454 to -323 and between the two major transcriptional start sites have positive regulatory activities and are induced by TGF-beta 1 in A-549 cells. The chloramphenicol acetyltransferase activity of the upstream human TGF-beta 1 promoter-chloramphenicol acetyltransferase gene is increased 8- to 10-fold by treatment of cells with TGF-beta 1, whereas that of the second promoter is increased approximately 3- to 4-fold. Using an S1 nuclease protection assay of chloramphenicol acetyl-transferase mRNA, we found that the steady-state expression of chloramphenicol acetyltransferase mRNA also is markedly increased. Seven distinct factors present in nuclear extracts from A-549 cells interact with the sequences between -454 and -323, strongly supporting the involvement of sequence-specific transcription factors in the transcriptional autoactivation of the human TGF-beta 1 gene.

Persistent right coronary flow reserve at low perfusion pressure

To determine whether right coronary (RC) flow reserve persists at perfusion pressures below the apparent autoregulatory range, the RC artery of 18 anesthetized dogs was cannulated and perfused at controlled pressures. RC blood flow (RCBF) fell from 65.3 +/- 6.1 to 33.7 +/- 2.3 ml.min-1.100 g-1 as RC perfusion pressure (RCPP) was reduced from 80 to 40 mmHg. At 40 mmHg, intracoronary adenosine increased RCBF by 97.9 +/- 10.6 ml.min-1.100 g-1 (P less than 0.001). RCBF fell to 9.5 +/- 1.7 ml.min-1.100 g-1 at 20 mmHg, and RCBF did not significantly increase during adenosine, although RC vasodilation was observed in four dogs. Regional right ventricular (RV) blood flows at RCPP of 80 and 40 mmHg were measured by radioactive microsphere technique. Before adenosine infusion, RCBF was distributed uniformly across the RV free wall at normal and low perfusion pressures. During adenosine infusion, blood flow in both regions increased significantly, but the flow reserve was greater in the subendocardial region at both normal and reduced pressures. RV myocardial O2 consumption (MVo2) was decreased significantly at 40 mmHg, however, there was no evidence of ischemia at this pressure, since the RV lactate extraction ratio was normal (n = 8). Thus RV O2 demand fell when RC O2 supply was reduced, although a flow reserve was available. RV MVo2 was restored to normal when right coronary flow reserve was mobilized by adenosine infusion. For RCBF from 65 to 365 ml.min-1.100 g-1, RC venous O2 content rose and RV MVo2 was essentially constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Multidisciplinary approach in the management of gestational trophoblastic tumor (GTT)

In summary of our 15 years experiences it is obvious that at least about 15% of GTT patients still do not get complete remission in spite of development of multiagent chemotherapy. To obtain better therapeutical result in unceasing problems should be solved and the improvement in newer methods of management as listed below is mandatory: (1) Prediction on risk factors and early diagnosis of the persistent GTT before and after molar evacuation (2) "Clinico-biochemical classification" based on more collective tumor markers (3) New chemotherapeutic agents (4) Regimen for prevention and/or modulation of drug resistance (5) Multimodality treatment including initial and adjuvant surgery, irradiation and immune response modifiers. (6) Remission consolidation

[Tegumental ultrastructures of Paragonimus iloktsuenensis according to the developmental stages]

A scanning electron microscopic study was performed to observe the tegumental ultrastructures of Paragonimus iloktsuenensis according to its developmental stages. The metacercariae were obtained from the liver of the brackish water crab, Sesarma dehaani. Juvenile and adult P. iloktsuenensis were recovered from the experimental rats on 2, 4 and 8 weeks after infection. The findings were summarized as follows: 1. The excysted metacercariae were characteristically gourd-shape, with their whole body surface beset with numerous spade-shape spines. The large, type II sensory papillae (non-ciliated round swellings) were arranged along the rim of the oral and ventral suckers, 11-12 and 6-8 in numbers respectively. 2. Two-week old juvenile worms, recovered chiefly from the liver of the experimental rats, were slender in body shape, with their ventral sucker near the anterior one-third level. The distribution of tegumental spines was less dense than in the excysted metacercariae. The spines were with 1-2 pointed tips and 3-4 longitudinal splits. Numerous ciliated knob-like, type I papillae were observed in both sides of the oral sucker, and 6 large, type II papillae were arranged along the rim of the ventral sucker. 3. Four-week old worms, recovered from the thoracic cavity and/or lung parenchyme of the experimental rats, were thicker than wide in body configuration, and their ventral sucker was located near the anterior one-fourth level. The tegumental spines at ventral surface were grouped, each group with 3-5 aggregated ones. The type I and type II papillae (small-sized) were distributed chiefly around the rim of two suckers. 4. Adult (eight-week old) worms, recovered from the capsules in the lung parenchyme, were very stout, and covered densely with bearfoot-like spines. At dorsal surface, cobblestone-like cytoplasmic processes were well-developed, with many tegumental spines embedded in them. It was observed in this study that the tegument of P. iloktsuenesis continued to change and differentiate as the worms grew to be adults.

Failure of sodium benzoate to alleviate plasma and liver ammonia in rats

The intraperitoneal administration of L-norvaline and L-methionine-SR-sulfoximine to rats caused an increase in the concentration of ammonia in plasma as well as in liver. These compounds interfere with urea and glutamine formation, respectively. Subsequent injection of sodium benzoate failed to alleviate ammonia levels, and on the contrary, caused a further increase. Sodium benzoate itself, when administered, resulted in higher levels of ammonia in plasma and liver of the rats. Administration of glycine to rats treated with benzoate did not lower ammonia levels indicating that other factors besides glycine may also be necessary for the removal of sodium benzoate.

Characterization of the promoter region of the human transforming growth factor-beta 1 gene

The 5'-end of the human transforming growth factor-beta 1 gene (TGF-beta 1) was isolated from a human leukocyte genomic DNA library. Analysis of the transcriptional start sites of human TGF-beta 1 mRNAs by S1 mapping and primer extension revealed two major start sites 271 nucleotides from one another; several minor sites were also identified. DNA sequence analysis showed that the promoter region contains neither a "TATA" box nor a "CAAT" box, is very G+C rich, and contains 11 CCGCCC repeats. Seven putative binding sites for the transcription factor Sp1 were also identified. To determine the location of sites that may be important for the function of the TGF-beta 1 promoter, we joined the 5'-end of the TGF-beta 1 gene to the coding region for chloramphenicol acetyltransferase. The chimeric gene produced high levels of chloramphenicol acetyltransferase activity in transfected HT-1080, AKR-2B, and A-549 cells. Sequences responsible for both promotion and inhibition of transcription were located in the region extending from 1400 to 300 base pairs upstream of the first major TGF-beta 1 transcriptional start site. The 130-base pair fragment located between 453 and 323 base pairs upstream of this start site contains positive regulatory activity in all cells tested. A second promoter activity was identified in the region between the two major transcriptional start sites. These findings revealed a complex pattern of regulation of human TGF-beta 1 gene expression.

Umbilical artery creatine kinase brain-band isozyme as a predictor of neonatal periventricular-intraventricular hemorrhage

In low-birth-weight neonates, an elevation in the percentage of creatine kinase brain-band isozyme in the umbilical artery was significantly correlated with future development of neonatal grade III and grade IV periventricular-intraventricular hemorrhage, when compared with levels in those neonates who did not show periventricular-intraventricular hemorrhage or who developed grade I and grade II periventricular-intraventricular hemorrhage (p = 0.025). In these neonates the relative levels in maternal venous, umbilical arterial, and umbilical venous samples indicated that the source of the isozyme was fetal.

Fibrinolytic response to standardized venous occlusion in different age groups

The purpose of this study was to find out the range and distribution of fibrinolytic response to standardized venous occlusion in healthy volunteers and to determine whether there were any differences according to age and sex. In 118 healthy volunteers (55 males, 63 females) of various age groups, the total fibrinolytic activity in euglobulin fractions was measured by a well controlled fibrin plate method before and after venous occlusion of 5 minutes at 100 mmHg. The difference between our method and previous methods is that we occluded for a relatively shorter duration than that of previous studies (15-20 minutes) at constant pressure (100 mmHg), instead of midway between systolic and diastolic pressure. This method was reliable and reproducible as a tool to qualify and assess the fibrinolytic activity capacity of individuals. The results showed that there was no difference in basal fibrinolytic activity and the response to stimuli in various age groups (p greater than 0.25) and in male and female groups (0.1 less than p less than 0.375).

Changes of tetanus specific IgG, IgM and IgG subclasses after DPT vaccination

We evaluated tetanus specific IgG, IgM, IgG subclasses after DPT vaccination in infants and children. Tetanus toxoid specific IgG, IgM IgG subclasses were measured to characterize the isotope profile of antibody against tetanus toxoid. The values of the tetanus specific IgG in the positive group were significantly increased compared to those of the control group, and were significantly increased after two inoculation. Tetanus specific IgG was very low in adults and neonates. In our tetanus specific IgG subclasses study, forty-five of 56 cases (80%) showed predominantly IgG1 antibody responses to tetanus toxoid, while twenty-five of 56 cases (45%) showed IgG4 responses. Both IgG1 and IgG4 responses were demonstrated in 17 cases (30%). So we suggest that IgG was mainly involved in humoral immune response after DPT vaccination, and IgG1 may play an important role among IgG subclasses. IgG4, alone or together with IgG1, can also play a role in immune response to tetanus toxoid.

Comparison of a daily and three intermittent retreatment regimens for pulmonary tuberculosis administered under programme conditions

One daily and 3 thrice weekly retreatment regimens given for 12 months under programme conditions were compared. The daily regimen was rifampicin and ethambutol (RE7). The three intermittent regimens also contained rifampicin and ethambutol: one of them, rifampicin and ethambutol throughout (RE3); the next one supplemented with pyrazinamide for the first 3 months (REZ3); the last one supplemented with prothionamide for the first 3 months (REPt3). The pyrazinamide containing regimen was subdivided into ordinary and high dose groups. The subjects for retreatment were those who have had, at least, more than 6 months of initial triple chemotherapy of isoniazid, PAS and streptomycin at the health centres, and failed to convert to bacteriologically negative status. Among 419 patients who were available for sensitivity tests before commencing retreatment, 393 (94.3%) were resistant to isoniazid. Six hundred and seventy-four patients (674) were allocated randomly to the regimens: 64 patients were excluded due to various pretreatment reasons and 109 did not complete 12 months of chemotherapy. There remain 501 patients who completed their retreatment. As assessed at 12 months, a bacteriologically favourable response was achieved in 68% of 135 RE7 patients, 62% of 129 RE3 patients, 74% of 132 REZ3 patients, and in 79% of 108 REPt3 patients. Adverse reactions were uncommon: 4% in RE7, 5% in RE3 and 9% in REZ3, but 32% in REPt3. Relapse rates during 2 years after termination of chemotherapy were 15% in RE7, 14% in RE3 and REZ3, and 26% in REPt3, as calculated by life table analysis.

In vivo release of beta human chorionic gonadotropin by luteinizing hormone releasing hormone stimulation and its clinical application as a remission criterion in patients with gestational trophoblastic disease

In vivo responses of trophoblasts to luteinizing hormone releasing hormone (LHRH) stimulation in 48 gestational trophoblastic disease patients were observed. Serum beta human chorionic gonadotropin (beta-hCG) levels after LHRH injection were significantly increased in patients with hCG values between 5 and 20 mIU/ml (minimal resistance group) but not in patients whose hCG levels were less than 5 mIU/ml (possible remission group). The sensitivity, specificity and the predictive values of LHRH stimulation test were 75.0, 91.3 and 95.5% in the possible remission group and 87.5, 20.0 and 77.8% in the minimal resistance group.

Peripheral embolization provides evidence for microvascular collaterals in hearts with chronic coronary artery occlusion

Macroscopic collateral vessels are widely regarded as the primary source of blood flow to collateral-dependent myocardium. Microscopic coronary collateral vessels have also been described, but their functional significance is controversial. Experiments were conducted in 18 anesthetized dogs with chronic coronary artery occlusions. Indices of collateral function demonstrated that all hearts were well-collateralized. The previously occluded coronary artery was cannulated distal to the obstruction for measuring retrograde flow before and after injection of either 13 microns or 84 microns emboli. Mean arterial pressure and heart rate were not altered by coronary embolization. Embolization with 13 micron spheres caused retrograde flow to increase by 43% (n = 11), whereas embolization with 84 micron spheres had no effect on retrograde flow (n = 7). Retrograde flow dislodged occlusive 84 micron spheres, since these spheres were found in the retrograde flow, and since antegrade flow increased by 250% after retrograde flow diversion. These findings demonstrate that collateral vessels less than 84 micron diameter contribute significantly to perfusion of chronically collateral-dependent myocardium.