Higher incidences of anti-SS-A/Ro and anti-SS-B/La autoantibodies in Japanese patients with autoimmune disorders--studies of antigens and antibodies using the immunoblotting method

A specific and sensitive assay was performed to detect both anti-SS-A/Ro and anti-SS-B/La antibodies in sera of patients with autoimmune diseases, including systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), Sjögren's syndrome (SS), discoid lupus erythematosus (DLE), mixed connective tissue disease (MCTD), generalized morphea (GM), and dermatomyositis (DM). The SS-A/Ro and SS-B/La antigens were prepared from human spleen (HSE) and cultured human cell line (KB cells, KBE), white rabbit thymus extract (RTE) was used as the SS-B/La antigen marker. The antigens were partially purified by DEAE cellulose column chromatography. Immunoblotting showed that the SS-A/Ro antibody reacts mainly with the 58-kDa peptide of the partially purified antigen. Sera containing both the SS-A/Ro and SS-B/La antibodies reacted with the 40-kDa peptide of RTE, and the 58-kDa, 42-kDa, and 40-kDa peptides of HSE and KBE. We found that some of the SS-A/Ro antisera could further react with the 64-kDa peptide of HSE and KBE. The 58-kDa peptide is rich in its cytoplasmic fraction of KB cells, and the 4-kDa peptide in nucleoplasmic fraction. The KB cell line is a better source of the antigens than human spleen extract. The immunoblotting method clearly showed that the positivity rates of SS-A/Ro and/or SS-B/La autoantibodies were higher in sera from Japanese patients with SLE compared with titers reported for Caucasians but not in sera from healthy volunteers.

Appearance of membranocystic lesion (Nasu)-like changes in Behçet's syndrome. An electron microscopic study of erythema nodosum-like lesions

Membranocystic lesion (Nasu)-like changes were seen in the subcutaneous fat tissues of erythema nodosum-like lesions in three of 18 patients with Behçet's syndrome. The membranocystic structures, which were derived from degenerative fat cells with a loss of the cell membrane, were observed in the edematous connective tissues accompanied by fibrin deposition and diapedesis of erythrocytes. Electron microscopic evaluation revealed two different patterns of peculiar membranous structures in the cytoplasm of the degenerative fat cells. One was proliferating membrane structures such as well developed Golgi-endoplasmic reticulum, and the other was minute tubular structures such as intracytoplasmic microvesicles. These degenerative fat cells are considered to be derived from abnormal fat cells which lack a cell membrane, but whose cellular and nuclear configurations appear to be normal morphologically, because the cytoplasm of these abnormal cells showed the same tubular structures as those seen in the characteristic architecture of membranocystic lesion-like change. The relation between the appearance of such abnormal cells and the pathologic conditions of erythema nodosum-like lesions in Behçet's syndrome was discussed.

Two human papillomavirus DNAs molecularly cloned from a patient with epidermodysplasia verruciformis: restriction maps

Two distinct human papillomavirus (HPV) DNAs (MY-1 and MY-2) were molecularly cloned from the benign skin lesions of a patient with epidermodysplasia verruciformis. The restriction map of MY-1 was the same as that of HPV 3a. The map of MY-2 appeared to be different from those of any HPVs reported in the literature. MY-2 did not cross-hybridize with MY-1 or the DNAs of HPV types 1, 2 and 4 under stringent conditions.

Electrophoretic and spectroscopic analyses of equine alpha 2-macroglobulin with cleavage of the thiol ester bonds by methylamine

Reaction of equine alpha 2-macroglobulin (alpha 2M) with methylamine caused generation of 3.7 mol of thiol groups per mole of the protein, and the second-order rate constant of the generation was calculated to be 3.5 M-1 s-1. The inhibitory profile of caseinolytic activity of trypsin indicated that one molecule of equine alpha 2M inhibited two molecules of trypsin, similar to human alpha 2M. The methylamine-treated equine alpha 2M, with complete cleavage of the thiol ester bonds, still inhibited the activity of trypsin, though human alpha 2M lost its inhibitory activity by treatment with methylamine. These results indicate that the mode of inhibition of trypsin by equine alpha 2M is substantially unperturbed by cleavage of the thiol ester bonds and that the intact thiol ester bonds per se are not essential for the ability of equine alpha 2M to bind the enzyme. Ultraviolet absorption difference, intrinsic fluorescence, and circular dichroism spectra of the methylamine-treated equine alpha 2M showed that this treatment caused only a small change in conformation of the protein. Reaction of the methylamine-treated protein with trypsin induced appreciable changes in the spectra, indicating a large change in conformation of the protein. These findings were consistent with the results obtained by electrophoresis: The band of methylamine-treated equine alpha 2M showed indistinguishable mobility from that of the unmodified protein, indicating that no appreciable change in conformation occurred, and distinctly different mobility from that of the unmodified or methylamine-treated equine alpha 2M when each had reacted with trypsin.

SSA/Ro antigen expression in simian virus 40-transformed human keratinocytes

SSA/Ro antigen is a soluble cellular component to which antibodies are frequently produced in patients with Sjögren's syndrome and systemic lupus erythematosus. Its exact location within the cell has yet to be determined. In this study we report the expression of SSA/Ro antigen in simian virus 40 (SV40)-transformed keratinocytes. The locations of SSA/Ro, U1RNP, and DNA antigens were studied by indirect immunofluorescence using monospecific antibodies. SSA/Ro antigen was detected in both the nucleus and cytoplasm of SV40-transformed keratinocytes tested with three monospecific sera. Primary cultured keratinocytes derived from adult human skin showed localized immunofluorescent staining within the nucleus. When Ca++ concentration of the medium was switched to 0.05 mM, these cells expressed cytoplasmic SSA/Ro antigens within 48 h. Depletion of the antibody activity with insolubilized human spleen extract abolished the staining. Surface expression of this antigen could not be detected in either primary or transformed cells. Localization of U1RNP and DNA was not altered. These results indicate that expression of SSA/Ro antigen in human keratinocytes is modulated by SV40 infection and that this antigen is expressed to a greater degree in cells that are less differentiated, transformed, or proliferating.

Ultrastructure of lymphocyte-mediated fat-cell lysis in erythema nodosum-like lesions of Behçet's syndrome

In this study, biopsy specimens from 18 patients with Behçet's syndrome were examined by electron microscopy with particular attention to the appearance of the lymphocyte-macrophage infiltrate into the interlobules of subcutaneous fat in erythema nodosum-like lesions. Electron microscopic evaluation revealed vacuolization changes of fat cells with detachment of their cell membrane from the basal lamina that permitted lymphocytes and macrophages to enter into this developed space. We believe that the detachment of fat cells from the basal lamina precedes invasion by lymphocytes which, in turn, attracts macrophages into the space. This eventually leads to fat-cell lysis accompanied by activation of macrophages, which causes further inflammation, completing the picture of panniculitis in the erythema nodosum-like lesions in Behçet's syndrome.

Flow cytometric analysis for assessing the malignant potential of breast cancer

Flow cytometric analysis was performed on 60 patients with breast cancer to investigate the relationship between DNA histogram and the malignant potential of breast cancer. DNA aneuploidy of breast cancer tended to increase with increasing stage and degree of nodal metastasis. The percent of cells in the S phase was significantly increased in the patients with metastasis compared to those without metastasis. Patients exhibiting percent S phase value of more than 20% showed a high frequency of metastasis even when breast tumors were small (T1, less than 2.0 cm in diameter). Thus, flow cytometric analysis may give additional information on biological characteristics and may be useful for predicting the prognosis of breast cancer in some patients.

Phosphorylation sites of bovine brain myelin basic protein phosphorylated with Ca2+-calmodulin-dependent protein kinase from rat brain

The phosphorylation sites of myelin basic protein from bovine brain were determined after phosphorylation with Ca2+-calmodulin-dependent protein kinase. Four phosphorylated peptides were selectively and rapidly separated by reversed-phase high-performance liquid chromatography. Partial sequencing of the phosphorylated peptides by automated Edman degradation revealed that Ca2+-calmodulin-dependent protein kinase phosphorylated serine-16, serine-70, and threonine-95 specifically, as well as serine-115, which is located on the experimental allergic encephalitogenic determinant of the protein. Of the four amino acid sequences determined, two sequences surrounding phosphorylated amino acids, -Lys-Tyr-Leu-Ala-Ser(P)16-Ala- and -Arg-Phe-Ser(P)115-Trp-Gly-, have both sides of each phosphoserine residue occupied by hydrophobic amino acids, and a basic amino acid, arginine or lysine, is located at the position 2 or 4 residues amino-terminal to the phosphoserine residue. In contrast, the two other sequences surrounding phosphorylated amino acids, -Tyr-Gly-Ser(P)70-Leu-Pro-Glu-Lys- and -Ile-Val-Thr(P)95-Pro-Arg-, have a basic amino acid at the position 2 or 4 residues carboxyl-terminal to the phosphoamino acid residue.

The pathogenesis of vascular changes in erythema nodosum-like lesions of Behçet's syndrome: an electron microscopic study

The probable sequence of microvascular changes affecting endothelial cells in erythema nodosum-like lesions was examined by electron microscopy in 18 patients with typical Behçet's syndrome. Dark endothelial cells in the superficial and deep dermis exhibited degeneration with contraction changes. Consequently, degenerated endothelial cells showed nuclear and cytoplasmic condensation, vacuolization in the cytoplasm, and rich ribosomes. Moreover, blood vessels which were enveloped by cuffs of lymphocytes simultaneously exhibited both endothelial cell hypertrophy and endothelial cell necrosis. The implied associations between perivascular lymphocytic cuffs and blood vessels exhibiting endothelial cell alterations indicate that microvascular changes in erythema nodosum-like lesions may be closely associated with the delayed-type hypersensitivity reaction.

[Synergistic effect of cell kinetics-directed chemo-endocrine therapy on experimental mammary tumors]

We tried to demonstrate that the cell kinetics-directed chemoendocrine therapy is more effective on hormone dependent breast cancer than empirical combination of the endocrine therapy and chemotherapy. Cell kinetics of each tumor was measured by flow cytometric analysis. Estrogen dependent human breast cancer cell line MCF-7 was used in vitro. In vivo, androgen dependent SC-115 carcinoma was transplanted to DDS mice. In vitro, tamoxifen was administered as the endocrine therapy. In vivo, we carried out testectomy on DDS mice. Effect of the endocrine therapy on the cell kinetics of the tumor was thought to be G1-S depression. High density 5FU was administered as the chemotherapeutic agents, whose content was 1 microgram/ml in vitro and 40 mg/kg in vivo. 5FU brought temporary decrease of cells in S phase. Only anteceding 5FU administration had synergistic effect in combination of 5FU and the endocrine therapy. 5FU was convinced to act more effectively on cells in S phase, so it was shown that cell kinetics-directed schedule was superior to the empirical treatment schedule in chemoendocrine therapy.

A histologic study on the fate of intradermally implanted epidermal cells in guinea pigs: a new method for evaluation of skin allograft survival

The fate of allogeneic (strains 13, 2, and JY-1) and autologous epidermal cell (EC) suspensions injected intradermally was investigated histologically in JY-1 strain guinea pigs. Epidermal cells were found to proliferate actively in the dermis and form EC nests with central keratinization. The significant reject reaction associated with necrosis of the epidermal structures was seen in due time in the animals implanted with allogeneic ECs. We attempted to assess the effect of cyclosporin A (CYA) on skin allograft survival by observing the fate of strain 13 ECs implanted intradermally into the CYA-treated JY-1. Successful prolongation of allograft survival with CYA was clearly demonstrated by this method. This is considered to be a useful experimental way for evaluation of skin allograft survival and to be suitable for routine use.

Ripple pigmentation of the neck in atopic dermatitis

Ripple pigmentary lesions of the neck were observed in 12 patients with atopic dermatitis. Biopsy specimens from three cases revealed no amyloid substances. From the review of cases with either atopic dermatitis or ripple pigmentation seen in our hospital, it was concluded that ripple pigmentation of the neck was always associated with atopic dermatitis and appeared in 1.7% of all 751 patients with atopic dermatitis. It is suggested that ripple pigmentation is not necessarily specific or diagnostic of amyloidosis, as is generally believed. Possible relationships involving ripple pigmentation, atopic dermatitis, and macular amyloidosis are also discussed.

Electron microscopic observation on dark endothelial cells in erythema nodosum-like lesions of Behçet's disease with ultrastructural X-ray spectroanalysis

We used electron microscopy and electron microscopic X-ray spectroanalysis to examine the biopsies taken from erythema nodosum-like lesions of 20 patients with Behçet's disease. Electron-dense degenerated endothelial cells were found in the microcirculatory beds of the dermis and subcutaneous fat. However, electron microscopic X-ray spectroanalysis failed to demonstrate the localization of either chlorine or base metals in those degenerated endothelial cells. Moreover, neither in ultrastructurally normal endothelial cells, nor in infiltrating macrophages of erythema nodosum-like lesions the positive deposit of chlorine or base metals could not be detected. The results of this analysis suggest that environmental factors do not play an etiologic role in this disease. Significance of the degeneration of endothelial cells is not clear present.

Differing lectin-binding patterns of malignant melanoma and nevocellular and Spitz nevi

The lectin-binding patterns of primary malignant melanoma, nevocellular nevus, and Spitz nevus were studied on formalin-fixed, paraffin-embedded sections using a series of biotinylated lectins--concanavalin A (ConA), Ricinus communis agglutinin-1 (RCA1), dolichos biflorus agglutinin (DBA), soybean agglutinin (SBA), maclura pomifera agglutinin (MPA), peanut agglutinin (PNA), wheat germ agglutinin (WGA), and Ulex europeus agglutinin-1(UEA1)--and employing the avidin-biotin-peroxidase complex method. In nevocellular and Spitz nevi, all of the nevus cells were positively stained with ConA and RCA1. No positive staining was observed, however, with the other lectins and no change in binding patterns occurred following neuraminidase pretreatment. In malignant melanoma, all of the melanoma cells were positively stained with ConA and RCA1, and some were also stained with MPA, PNA, and WGA. In addition, DBA, SBA, MPA, PNA, and WGA labeled all of the melanoma cells after neuraminidase pretreatment. No positive staining was observed with UEA1 despite neuraminidase pretreatment. The present results showed that malignant melanoma and nevocellular and Spitz nevi have different lectin-binding patterns and different responses to neuraminidase pretreatment. We, therefore, believe that the lectin staining on paraffin-embedded sections can be a useful probe for the differentiation of these diseases.

Delayed-type skin reaction to 2,4-dinitrophenylated epidermal cells in guinea pigs with contact sensitivity to 2,4-dinitrochlorobenzene

Contact sensitivity (CS) induced by hapten has been thought to be analogous to delayed-type hypersensitivity, such as the Mantoux reaction, because of outstanding similarities between the two phenomena. It can be suggested that animals with CS respond also to intradermal injection of the conjugate of hapten and protein as well as to epicutaneous application of hapten. However, evidence against this has been reported. In the present experiments, delayed-type skin reaction (DSR) was successfully obtained in JY1 strain guinea pigs sensitized by painting the skin with 2,4-dinitrochlorobenzene using in vitro dinitrophenylated epidermal cell suspension (DNP-EC) as antigen for a delayed intradermal test. The experiment using anti-Ia alloantiserum and complement showed that the elicitation of DSR is due to the presence of Ia-positive cells (presumably Langerhans cells) among DNP-ECs. The delayed intradermal test with the conjugates such as haptenated ECs in the animals with CS is considered to be an experimentally useful way of analysing the antigen in the sensitivity.

Expression of human lymphocyte antigen (HLA)-DR on tumor cells in basal cell carcinoma

Immunohistologic studies of eight patients with basal cell carcinoma were undertaken using a series of monoclonal antibodies. In all of the patients, the majority of dermal infiltrates reacted with OKT3 and OKIa1 (HLA-DR), with a slight predominance of OKT4+ helper/inducer T cells (the mean OKT4/OKT8 ratio was 1.8). Both OKT4+ and OKT8+ cells were seen infiltrating the tumor masses. In addition, in five cases, human lymphocyte antigen (HLA)-DR was demonstrated on some tumor cells close to a vast number of HLA-DR+ infiltrates surrounding the carcinoma, but not on epidermal keratinocytes and tumor cells devoid of the HLA-DR+ infiltrates. A considerable number of OKT6+ dendritic cells were also observed surrounding the carcinoma. Staining with OKB7 and OKM1 revealed negligible reactive cells, and virtually none of the dermal infiltrates reacted with Leu-7 (HNK-1). These findings suggest that in addition to varied immunologically competent cells, expression of HLA-DR antigen on tumor cells may participate in a cellular immune reaction, a defense mechanism against tumor cell proliferation in basal cell carcinoma.

[Experimental studies on the enhanced effects of chemoendocrine therapy in breast cancer]

The clinical response rate of chemotherapy or endocrine therapy for advanced or recurrent breast cancer has been described as being about 30%, regardless of steroid hormone status. However, the response rate for endocrine therapy is about double in patients with positive estrogen receptor. In order to obtain a higher response rate than that for single therapy, experimental attempts were made to combine cytotoxic agents, antiestrogenic agents, ablative therapy and immunotherapy from the viewpoints of tumor cell kinetics, natural killer activity and interferon activity of spleen cells. Tamoxifen and orchiectomy were shown by flow cytometry to produce a G1 block, increasing the G0, G1 phase and decreasing the S phase, in MCF-7 cells in vitro and in SC 115 cells, in vivo respectively, for a long period. On the other hand, 5-FU showed most effective cytotoxicity in the S phase of both types of tumor cells in vitro and in vivo, although the depressed S phase recovered within 24 hours. Therefore, any combined chemo-endocrine therapy should be devised so that the endocrine therapy maintains a G1 block for a long period and performed immediately following chemotherapy during the decreased S phase of the tumor cells. N K activity of spleen cells were enhanced, and interferon production in spleen cells was not changed by ovariectomy in C3H/He mice compared with sham-operated mice. It is suggested that endocrine therapy may affect the immunopotentiality of cancer patients.

Histological study on the fate of haptenated epidermal cells injected intradermally in guinea pigs

The percutaneous administration of in vitro haptenated epidermal cells (EC) has become established as a procedure to produce contact sensitivity (CS) in experimental animals for routine use. The cells have also been found to elicit a significant delayed-type skin reaction by intradermal test in the animals sensitized by painting the skin with the hapten. The fate of 2,4-dinitrophenylated (DNP) isogeneic epidermal cell suspensions (EC) injected intradermally was investigated histologically in intact or 2,4-dinitrochlorobenzene (DNCB)-sensitized strain 13 guinea pigs to study the role of the cells in CS. DNP-EC were found to proliferate actively in the dermis and formed EC nests with central keratinization and then elicited inflammatory reaction associated with necrosis of the epidermal structures 7 days after injection in the intact animals. DNP-EC injected intradermally into the animals which had received and reacted against DNCB underwent a suppression of EC proliferation. These findings are discussed in relation to the role of the haptenated EC in CS.

[Stewart-Bluefarb syndrome (kaposiform arteriovenous fistula with bone changes)]

In a 14-year-old female patient with arteriovenous shunts (Stewart-Bluefarb syndrome), fist-sized cutaneous swelling, venous dilatation, blue-brown pigmentation and painful subcutaneous fingertip-sized nodules were noted on the right lower thigh. In addition to an arteriovenous malformation, bone hypertrophy, bone atrophy and after bone defects were observed in the involved area on X-ray examination. Histological examination revealed increased vascularity and vascular cavernous structures with endothelial swelling and extravasation of erythrocytes, but no malignant changes.

Immunohistologic studies of squamous cell carcinoma: possible participation of Leu-7+ (natural killer) cells as antitumor effector cells

Immunohistologic studies of 8 patients with squamous cell carcinoma (SCC) were undertaken using a series of monoclonal antibodies. In all of the patients, over 70% of the dermal infiltrates reacted with OKT3 and OKIal (HLA-DR), with a slight predominance of the OKT8+ suppressor/cytotoxic T subset (the mean OKT4/OKT8 ratio was 0.85). Both OKT4+ and OKT8+ subsets could be seen in contact with individual cancer cells. The percentage of OKB7+ (B) cells was less than 29% of the dermal infiltrates. Some Leu-7+ cells (less than 9% of the infiltrates) were seen in close association with individual cancer cells and none of these cells was present apart from the cancer cells. Few OKT6+ cells were observed in the papillary dermis and these had no relation to cancer cells. In the epidermis, OKT6+ dendritic cells remained within normal proportions. Staining with OKM1 revealed sporadic reactive cells. These results strongly suggest that besides T and B lymphocytes, Leu-7+ (natural killer) cells participate in a significant defense mechanism against SCC proliferation.