Functional study of T lymphocyte responsiveness in patients with dementia of the Alzheimer type

The autologous mixed lymphocyte reaction (AMLR) was used to study T lymphocytes in a group of patients with dementia of the Alzheimer type (DAT) in order to confirm the observation that their T cell proliferation in AMLR was greater than in age-matched controls, and to investigate other pathways of T cell activation, searching for correlations between immunologic and clinical findings in DAT. The mean proliferative response in AMLR was increased in patients with DAT. No differences between patients and age-matched controls were detected when other pathways of T cell activation were investigated. The degree of response in the AMLR varied among patients with DAT. This fits with the suggestion that the disorder may be a heterogeneous syndrome.

IgG paraproteinemias: a comparative CSF and serum study

In 10 neurologic patients routine isoelectric focusing of CSF and serum revealed monoclonal IgG paraproteinemia (3 multiple myelomas and 7 benign monoclonal gammopathies). Quantitative protein study showed blood-brain barrier damage in 7 out of 10 patients; 2 patients had intrathecal synthesis of IgG measurable by Reiber's formula. Each case showed identical monoclonal IgG pattern in CSF and serum at isoelectric focusing and immunofixation. We suppose that monoclonal IgG detectable in the CSF usually derive from the serum across the intact or damaged barrier. The occurrence of quantifiable intrathecally synthesized IgG in 2 patients, both with skeletal lesions close to the subarachnoid spaces, and the identical patterns of IgG in CSF and serum suggest that tumoral plasma cells secrete monoclonal IgG into blood and CSF from the bone location.

Genetic aspects of variation of protein amounts in maize and pea

Using high-resolution two-dimensional polyacrylamide gel electrophoresis we studied the polymorphism of protein amounts in some genotypes of maize and pea. This type of variability seems to be rather common and insensitive to environmental conditions, as attested by the comparison of the patterns of two maize lines harvested in two different years. A large-scale experiment involving 5 lines, 7 of their hybrids, and 6 organs (or physiological stages) of maize allowed us to examine numerous polypeptides regarding their genetic variability, their amount differences between organs and the inheritance of their abundance. Genetic and organ variations are not independent: polypeptides whose amount varies from one organ to another are, for the most part, genetically variable (59%), while the stable polypeptides are not often genetically variable (18%). We found a striking organ specificity for (i) the extent of quantitative variability (from 2.3-15.4% of the polypeptides), (ii) the occurrence and the type of variation for a given polypeptide (an intensity difference seen in an organ can disappear or even be reversed in another one), (iii) the kind of inheritance (additive/non-additive): combining the 6 organs and the 7 hybrids we found 101 cases of non-additivity (4% of the total) which concern as many as 72 different spots, that is to say that in most cases a polypeptide displaying nonadditivity in an organ seems to display additivity in the other ones. Moreover, for most of the polypeptides with nonadditive inheritance the hybrid spot presents an intensity similar to that of the most intense parental spot.(ABSTRACT TRUNCATED AT 250 WORDS)

Multiple polymorphic sites in factor X locus

The structure of factor X (FX) gene was analyzed in five FX deficient pedigrees with four different variants of the disease, as well as in 50 normal subjects. Genomic DNA from the deficient patients and the normal controls was digested with 12 restriction endonucleases and hybridized with a FX cDNA probe. The results seemingly exclude gross gene deletions or rearrangements in the deficient patients. A variety of polymorphic sites (ie, EcoRI, HindIII, PstI, PvuII, TaqI) was observed within the FX locus and their relative frequency was established. Intriguingly, a highly polymorphic region for the PvuII endonuclease was identified and located approximately 3 kilobases (kb) from the last 3' exon. These polymorphisms allowed us to analyze the allelic segregation in a FX deficient family and to identify a homozygous subject.

Oligoclonal and polyclonal synthesis of IgG in the central nervous system: an isoelectric focusing study

The IgG pattern in isoelectric focusing (IEF) has been studied in 90 paired samples of cerebrospinal fluid (CSF) and sera obtained from patients in which intrathecal synthesis of IgG without barrier damage was detectable by Reiber's graph and formula (1980, J. Neurol. 224, 89). Thirty patients were affected by multiple sclerosis (MS), 30 by other inflammatory nervous diseases (OID), and 30 by noninflammatory nervous diseases (NID). At IEF two distinct pathological patterns of CSF IgG were detected: oligoclonal bands (OB), prevailing in the MS group (83% of cases), and a "polyclonal"--i.e., diffuse, uniform--increase of CSF IgG, prevailing in the NID (90%). The OID group was intermediate, 57% of cases with OB and 43% with polyclonal CSF IgG patterns. Overall, only 45 of 90 patients synthesizing IgG in the CNS had CSF OB. This suggests that the CNS immune response can imply either the synthesis of IgG of restricted heterogeneity (i.e., OB) or a polyclonal IgG synthesis, giving in IEF a serum-like pattern to the CSF.

Cerebrospinal fluid and neuropathological study in Devic's syndrome. Evidence of intrathecal immune activation

Cerebrospinal fluid (CSF) was studied in 2 cases of Devic's syndrome (DS). In one of these cases autopsy was carried out. The main CSF feature in DS is the association of blood-brain barrier damage and intrathecal IgG synthesis. These findings are in keeping with our neuropathological observation of diffuse central nervous system vasculitis and leptomeningitis. As a whole, our CSF and neuropathological findings in DS are consistently different from those in multiple sclerosis.

Hereditary thrombophilia: identification of nonsense and missense mutations in the protein C gene

The structure of the gene for protein C, an anticoagulant serine protease, was analyzed in 29 unrelated patients with hereditary thrombophilia and protein C deficiency. Gene deletion(s) or gross rearrangement(s) was not demonstrable by Southern blot hybridization to cDNA probes. However, two unrelated patients showed a variant restriction pattern after Pvu II or BamHI digestion, due to mutations in the last exon: analysis of their pedigrees, including three or seven heterozygotes, respectively, with approximately 50% reduction of both enzymatic and antigen level, showed the abnormal restriction pattern in all heterozygous individuals, but not in normal relatives. Cloning of protein C gene and sequencing of the last exon allowed us to identify a nonsense and a missense mutation, respectively. In the first case, codon 306 (CGA, arginine) is mutated to an inframe stop codon, thus generating a new Pvu II recognition site. In the second case, a missense mutation in the BamHI palindrome (GGATCC----GCATCC) leads to substitution of a key amino acid (a tryptophan to cysteine substitution at position 402), invariantly conserved in eukaryotic serine proteases. These point mutations may explain the protein C-deficiency phenotype of heterozygotes in the two pedigrees.

1-(2-pyridinyl)piperazine derivatives with antianaphylactic, antibronchospastic, and mast cell stabilizing activities

New 1-(2-pyridinyl)piperazine derivatives were synthesized and tested as inhibitors of the reaginic passive cutaneous anaphylaxis in the rat (PCA), of the histamine-induced bronchospasm in the guinea pig, and of the rat mesenteric mast cell degranulation induced by compound 48/80. On the basis of test results, a series of N-(substituted phenyl)-omega-[4-(2-pyridinyl)-1-piperazinyl]alkanamides was prepared. The nature of substituents at the anilide ring strongly influenced mast cell stabilizing activity, whereas it was less determining in the case of the other two tests. No clear correlation between the most common physicochemical parameters (pi, sigma, Vw volume) of substituents and activity could be detected. With regard to the position of substituents at the anilide ring, the rank order of potency, in the PCA and bronchoconstriction tests, was para greater than meta greater than ortho. Introduction of substituents in the 1-(2-pyridinyl)piperazinyl moiety of the N-(substituted phenyl)propanamide derivatives hardly affected activity, or the effect was deleterious. Some of the new compounds exhibited a simultaneous remarkable activity in all the three assays employed.

Evidence of T-lymphocyte functional impairment in Huntington's disease

Huntington's Disease (HD) is a degenerative neurological disorder with autosomal dominant transmission. Although immunological defect(s) have been postulated, no confirmed laboratory evidence for this exists. In the present study we observed activated T cells in the peripheral blood of HD patients (using 4F2 monoclonal antibody), whereas the percentage of T cells bearing T-cell activation markers such as HLA-DR and MLR4 antigens was normal. We then studied T cells of HD patients in some functional assays. Since it has been suggested that autologous mixed lymphocyte reaction (AMLR) includes several immune mechanisms in which distinct cell subsets interact and perform distinct regulatory functions, it is conceivable that the remarkable deficiency of AMLR herein observed in HD patients results from some abnormal immune regulation which may contribute to the pathology of this condition. Additional experiments demonstrated a defect of AMLR in three asymptomatic young sibs of HD patients, and coculture experiments between T cells of patients (as responders) and non-T cells of their sibs (as stimulators), and vice versa, produced no proliferative response. Subnormal responsiveness in allogeneic MLR was also observed. Normal or enhanced PHA-induced production of both IL-2 and IFN-gamma in vitro was detected. These experimental data suggest a cellular branch of the immune system in HD; however, they do not indicate if this defect is primary or secondary to the disease itself.

Thalamic dementia: report of a case with unusual lesion location

Thalamic dementia usually results from a bilateral paramedian thalamic infarction. We report a case with typical clinical and neuropsychological features of thalamic dementia, but with CT evidence of an unusual and asymmetrical location of ischemic lesions. Somatosensory evoked potential recordings were consistent with a left medial thalamic infarction, associated with a contralateral lesion, possibly at lemniscal level. This case suggests that thalamic dementia may develop following a unilateral paramedian thalamic infarction.

Hemophilia B with inhibitor: molecular analysis of the subtotal deletion of the factor IX gene

The structure of factor IX gene was analyzed in a hemophilia B patient with inhibitor. Genomic DNA, digested with a variety of restriction endonucleases, was hybridized with the cDNA and various genomic factor IX probes. A large subtotal deletion of the gene was observed. The borders of the deletion span from a approximately 125 nucleotide region within the last exon to an unknown domain at least 7.5 kb upstream from the first exon: it thus involves approximately 33 kb of the factor IX locus. The abnormal gene was inherited by the daughter of the propositus, who showed both the normal and the deleted allele.

A simple method to detect intrathecal production of specific antimeasles antibodies in cerebrospinal fluid during subacute sclerosing panencephalitis

The intrathecal production of antimeasles antibodies was studied using the enzyme-linked immunosorbent assay in eight specimens of serum and cerebrospinal fluid (CSF) from patients with clinical signs of subacute sclerosing panencephalitis (SSPE). The test was performed using a 1:5 dilution of CSF and a 1:2000 dilution of serum (ratio 1:400) in order to nullify the physiological gradient of immunoglobulins across the blood brain barrier (BBB). This procedure allowed a rapid and accurate assessment of the synthesis of specific immunoglobulins in the CSF and a good evaluation of the permeability of the BBB. A diagnosis of SSPE was provided in five out of eight patients with clinical signs of the disease. Clinical follow-up confirmed the diagnosis of SSPE in the group of patients with clear evidence of intrathecal synthesis of antimeasles antibodies.

Intragenic Factor IX restriction site polymorphism in hemophilia B variants

This study includes 47 normal subjects and 25 hemophilia B patients without inhibitor(s), showing different factor IX coagulant activity and antigen levels. Genomic DNA, digested with various restriction endonucleases, was hybridized with two different factor IX probes, ie, the cDNA and the subgenomic probe for the intragenic TaqI polymorphic site. cDNA restriction patterns suggest absence of gross rearrangements and/or deletions in all hemophilic patients. The frequency of the X chromosome bearing the TaqI polymorphic site is 0.32 +/- 0.09 in hemophilic subjects v 0.36 +/- 0.06 in normal control subjects, the latter value being comparable to that reported for the normal British population. No association between this polymorphism and hemophilia B variants has been observed, thus indicating that a wide spectrum of mutations underlies this blood-clotting disorder and particularly each of its variants.

The integrity of the blood-brain barrier in Alzheimer's type and multi-infarct dementia evaluated by the study of albumin and IgG in serum and cerebrospinal fluid

Albumin and IgG have been determined in the serum and cerebrospinal fluid (CSF) of 64 patients affected by Alzheimer's disease and senile dementia of Alzheimer type (SDAT/AD), 17 multi-infarct dementia (MID) patients and 52 controls. The concentrations of albumin and IgG in the serum and CSF have been taken into account to evaluate the integrity of the blood-brain barrier (BBB) and the occurrence of intrathecal immunological activation in demented patients. Clear-cut signs of BBB damage have been shown only in the group of patients affected by MID, whilst none of the two groups of patients displayed signs of immunological activation, expressed by an increase in IgG index, nor abnormally low CSF/serum ratios for IgG, previously suggested as expressive of a "consumption" of IgG by the brain parenchyma.

[New 2,4-dibromo-6-(N-cyclohexyl-N-methyl)-aminomethylanilides of derivatives of cysteine and cystine with expectorant activity]

New 2,4-dibromo-6-(N-cyclohexyl-N-methyl)aminomethylanilides of N-acetylcysteine and N-acetyl-S-carboxymethylcisteine derivatives, N-benzyloxycarbonylcysteine and N,N'-bisbenzyloxycarbonylcystine were synthesized. The compounds were tested for the expectorant activity in rabbit and mouse. N,N'-Bisbenzyloxycarbonylcystin-bis [2,4-dibromo-6-(N-cyclohexyl-N-methyl)aminomethyl]anilide (XIX) was selected for further investigations.

Periodic lateralized discharges in Creutzfeldt-Jakob disease: serial electroencephalographic studies

Serial EEG recordings in 12 cases of Creutzfeldt-Jakob disease were analyzed. Focal abnormalities, consisting of unspecific slowing of the rhythm or periodic lateralized discharges (PLD), were observed in 50% of cases in the prodromal stage. As the disease progressed, conversion of unspecific focal alterations into PLD and of these into generalized periodic patterns was seen. This evolution and the correlation between PLD and focal epileptic phenomena suggest that the discharges are cortical in nature.

Cerebrospinal fluid (CSF) findings in amyotrophic lateral sclerosis

The cerebrospinal fluid (CSF) was examined in 90 amyotrophic lateral sclerosis (ALS) patients and in 50 age-matched normal controls. Total protein concentration was significantly higher in ALS patients than in normal controls. CSF IgG and albumin, quantitatively determined by single radial immunodiffusion, were significantly increased in ALS. No difference in serum concentrations was observed between ALS patients and normal controls. On isoelectric focusing a clearcut "fingerprint" pattern was observed in 11 of 12 cases. These findings support the hypothesis that blood-brain barrier damage occurs in ALS. The finding of a higher mononuclear cell count in young ALS patients is briefly discussed in the light of the hypothesis that an exogenous agent might be of some relevance in pathogenesis. An alteration of at least one of the CSF parameters considered was found in 45.5% of ALS cases.

[Indolin-2,3-dione-3,N-alkylamino- and 3,N-piperazinoacetylhydrazones, new substances with anti-ulcer and antisecretory activity]

New indolin-2,3-dione-3,N-alkylamino- and 3,N-piperazinoacetylhydrazones were synthesized and the gastric antisecretory activity was tested. Most of the active products were selected to evaluate the inhibition of peptic ulcer induced by phenylbutazone or by stress (restraint and cold).

[Synthesis of benzofuran derivatives with H2 antagonist activity]

N-[2-(7-Dimethylaminomethyl-5-methyl-2-benzofuranmethylthio)ethyl]-N'-methyl-2-nitro-1,1-ethenediamine (III) and N-cyano-N'-[2-(7-dimethylaminomethyl-5-methyl-2-benzofuranmethylthio)ethyl]-N"-methylguanidine (IV) were synthesized. The direct transformation of 2,2-dicarbethoxy-3-hydroxy-5-methyl-7-dimethylaminomethylcoumaran (VII) and of 2,2-dicarbethoxy-3-hydroxycoumaran (XVI) to the corresponding ethyl 2-benzofurancarboxylates (IX) and (XV) is also reported. A mechanism for this reaction is proposed. Compounds (III) and (IV) showed hystamine H2 receptor antagonist activity, but were less potent than cimetidine and ranitidine.

Extravasation of pertechnetate in cranial extracerebral tissues during first pass across the cerebral vasculature

By evaluating regional cerebral first pass curves following Pertechnetate administration in common, internal and external carotid artery, it has been shown that about 20% of the injected dose of Pertechnetate extravasates in cranial extracerebral tissues during the first pass. This extravasation may lead to an overestimation of about 1 sec in the determination of regional cerebral mean transit time by intravenous radionuclide Angiography.

Relationships between moment of monitored time-activity curves and regional cerebral mean transit time following common carotid administration of a non diffusible tracer

By intravenous Radionuclide Angiography it is possible to estimate a whole path regional Arm-Brain mean transit Time as the first moment of monitored activity about injection time. This time is composed by an input mean transit time or transit time in the vein-inflow cerebral path and a circulation time within the monitored cerebral space. By evaluating this last by means of common carotid administration it was concluded that, although calculated by residue detection and not from outflow curves, this time is not far from regional cerebral mean transit time.

Skin fibroblasts in Huntington's disease. An electron microscopic study

Cultured skin fibroblasts of 3 patients with Huntington's disease (HD) and of 3 normal individuals have been examined by electron microscopy during the log phase of growth and at confluence. Though HD fibroblasts achieve higher maximal densities than controls, this is not associated with abnormal ultrastructural aspects of the cells. In particular, microfilaments and microtubules are identical in HD and normal fibroblasts.

[Durene derivates. IV. N-((2,3,5,6-tetramethylbenzoyl)alkyl)imidazoles and N-((beta-(2,3,5,6-tetramethylphenyl)-beta-hydroxy)ethyl)imidazoles with anticonvulsant activity]

A series of N-[(2,3,4,6-tetramethylbenzoyl)alkyl]imidazoles and of N-([beta-(2,3,5,6-tetramethylphenyl)-beta-hydroxy]ethyl)imidazoles has been synthesized. All compounds were tested in mice for anticonvulsant activity against electroshock and pentylenetetrazole convulsions. These durene-derivatives showed good activity, whereas the corresponding benzene-derivatives were inactive.

Synthesis and anticonvulsant activity of N-(benzoylalkyl)imidazoles and N-(omega-phenyl-omega-hydroxyalkyl)imidazoles

A novel series of N-(benzoylalkyl)imidazoles and N-(omega-phenyl-omega-hydroxyalkyl)imidazoles was synthesized and evaluated for anticonvulsant activity in mice against maximal electroshock induced seizures. Some of the compounds showed an activity comparable to or better than phenytoin and phenobarbital. The N-[beta-[4-(beta-phenylethyl)phenyl]-beta-hydroxyethyl]imidazole (38) was selected for further studies; preclinical toxicology and additional efficacy evaluations are in progress. Structure-activity relationships are discussed.

Thickening of the basement membrane of cortical capillaries in Alzheimer's disease

Data concerning width and surface of the basement membrane of cortical capillaries in three patients with Alzheimer's disease and five age-matched controls, have been submitted to statistical analysis to ascertain the role of the aging process upon thickening of the basement membrane itself. The analysis showed that there was a significant difference between patients with Alzheimer's disease and controls (P less than 0.01) as to both width and surface of the basement membrane, so suggesting that in these patients aging was not the only factor which thickening of the basement membrane of cortical capillaries was related to.

Loss of striatal neurons in Parkinson's disease: a cytometric study

By means of a cell-counting technique, it has been shown that patients with Parkinson's disease underwent decreased density of striatal nerve cell population. Large cells were more severely affected than small cells. These findings support the view that striatal involvement, although not severe enough to be easily recognized by conventional neuropathological examination, might be responsible of the progressive loss of benefit that most patients experience during chronic L-dopa treatment.

Research on durene derivatives. Note I - hypertensive activity of 2-(2,3,5,6-tetramethylbenzyl)imidazoline and related compounds

A series of substituted 2-(2,3,5,6-tetramethylbenzyl)imidazolines and related compounds have been synthesized to study the steric and hydrophobic effects on the vasoactivity of the introduction of four methyl groups on the phenyl moiety. The 2-(2,3,5,6-tetramethylbenzyl)imidazoline (I) showed a high hypertensive activity, whereas the 2-benzylimidazoline possesses an adrenolytic activity. The 2-(2,3,5,6-tetramethylphenoxy)methylimidazoline (XVII) retained the hypertensive activity, whereas the corresponding thioether (XIX) was inactive. Some structure-activity relationships with regard to the presence of substituents in the 4-position of the phenyl moiety and on the benzylic CH2 are reported.

Tendency to periodic recurrence of EEG changes in Lafora's disease. Case report

A young male patient affected with Lafora's disease and concomitant mental deterioration, myoclonic jerks and epileptic seizures is reported. A cerebral biopsy showed round PAS-positive myoclonus bodies in nerve cells and neuropile. A tendency to periodic recurrence of paroxysmal activity in the EEG tracings, an unusual finding in Lafora's disease, is briefly discussed.

Early degeneration of the cerebellar cortex, particularly the granular cells

An 8 month old infant, who died of severe gastroenteritis, presented a degeneration of the cerebellar cortex involving cells arising from the outer granular layer as well as Purkinje and Golgi II cells. Residual Purkinje cells showed vacuolar change of the cell body and dendritic abnormalities. Related lesions were atrophy of the inferior olives and degeneration of the mossy fibers.

[Reaction of ortho-ortho-dimethylphenacyl-halides with formamide. Formation of 4(5)-(ortho-ortho-dimethylbenzoyl)imidazoles]

Reaction of 2,3,5,6-tetramethylphenacyl halides with formamide did not produce the expected 4(5)-(2,3,5,6-tetramethylphenyl)imidazole, but 4(5)-(2,3,5,6-tetramethylbenzoyl)imidazole (VII) was isolated as the major product together with 5-(2,3,5,6-tetramethylphenyl)oxazole (III), alpha-formylamino-2,3,5,6-tetramethylacetophenone (IV) and alpha-chloro-beta-amino-vinyl 2,3,5,6-tetramethylphenyl ketone (IX) as by-products. The corresponding mesitylene derivatives gave analogous results, whereas 4(5)-(2-methylphenyl)imidazole was obtained from 2-methylphenacyl bromide as expected according to the Bredereck's reaction. The structure of the isolated compounds were elucidated by element analysis, mass, I.R., U.V. and N.M.R. spectra, and by chemical reactivity.

Nerve cell loss with aging in the putamen

A significant correlation between age and decrease in the number of nerve cells has been found in the putamen. Both small and large cells in this nucleus were proportionally involved. A possible relationship with the outfall of cells in other structures of the brain, with which the putamen is connected, in order to balance the activity of the extrapyramidal system has been suggested.

Primary immunodeficiency with early encephalopathy in two siblings. An anatomo-clinical study

The authors describe two siblings affected by an immunodeficiency state characterized by low IgA and IgM levels in serum, and an early encephalopathy with infantile spasms and hypsarrhythmia. The nosography of this unusual association and the relationship to ataxia telangiectasia and allied disorders are briefly discussed.