Disorder of collagen metabolism in a patient with osteogenesis imperfecta (lethal type): increased degree of hydroxylation of lysine in collagen types I and III

Types I, II and III collagen were isolated from calvarium, skin and cartilage from a patient with recessive lethal osteogenesis imperfecta. the distribution of the various collagen types was normal in all three tissues. The alpha-chains were purified by molecular sieve and ion-exchange chromatography and were found to differ from the corresponding alpha-chains of age-matched controls only in that the alpha 1(I), alpha 2 and alpha 1(III) chains contained higher amounts of hydroxylysine with proportionally less lysine. alpha 1(II) was normal. The excess hydroxylysine residues were all glycosylated in the case of alpha 1(I) chains, but only partly so for the alpha 2 chains. Similar observations were made with collagen from fetuses at various stages of development. In these fetuses, however, the increase in the degree of hydroxylation of lysine in alpha 1(I), alpha 2 and alpha 1(III) varied with age, being highest in the youngest fetus. Seen in the context of embryonic development, the collagen of the patient would correspond to that of a fetus younger than 18 weeks, and one could speculate that the defect seen in this patient is the result of a disturbed process of maturation of connective tissue.

Palmar fibromatosis-"Dupuytren's contracture". A comparison of light electron and immunofluorescence microscopic findings

A comparison of light, immunofluorescence and electron microscopic findings in palmar fibromatosis (Dupuytren's disease) revealed that the three morphologic phase of Luck; I. proliferative, 2. involutional, and 3. residual, corresponded for the most part to I. fibroblastic, 2. myofibroblastic or 3. fibrocytic lesions, respectively. The spectrum between proliferative phase and residual phase appeared immunohistochemically as a decrease in collagen type III, and an increase of collagen type I. Myosin was found in substantial quantities only during the involutional phase, distinguished by myofibroblasts, presumably with contractile capabilities. Thus, the clinical presence of contractures with palmar fibromatosis might also be explained in the absence of distinct fiber formation.

[Experimental study on tissue and cell reactions after implantation of xenogeneic collagen sponges (author's transl)]

164 inbred Wistar rats received subcutaneous and intraperitoneal implants of xenogeneic collagen sponges and were examined by light- and electron microscopy as well as immunohistologically, to establish tissue and cell reactions and the time of collagen reabsorption. 4 to 5 weeks after implantation the xenogeneic collagen sponge was completely absorbed. All the inflammatory and reparative reactions were non-specific. Granulation tissue appeared soon (3 days after implantation) with new synthesis of fine collagen fibrils, mainly of type III, followed by type I collagen fibers. Myofibroblasts, with intracellular evidence of myosin and collagen (Type I and III) were sporadically present in the granulation tissue after day 5 and regularly after day 10. Small scar granulomas without xenogenic collagen were detectable even 4 to 6 months after collagen implantation. Reabsorption and regression of collagen granulomas occurred faster after xenogeneic collagen implantation than after using surgical cat sutures. From the morphological point of view, there is no indication of specific sensitization against xenogeneic collagen or of a specific immunologic process.

Immunhistochemical demonstration of different collagen types in the normal epiphyseal plate and in benign and malignant tumors of bone and cartilage

Several benign and malignant tumors of bone and cartilage were examined by means of type-specific collagen antibodies in connection with indirect immunofluorescence technique in order to determine wether there is a positive correlation between cell morphology and gene expression as refered to the synthesis of tissue- or cell-specific collagen. In general benign bone and cartilage tumors show the collagen type corresponding to the original maternal tissue. In malignant osteogenic tumors a strong positive correlation was found between morphologic differentiation of osteosarcoma cells and tissue specific collagen synthesarcomas. Unrelated to the grade of differentiation and the type of malignant tumor, collagen type III could be demonstrated in all tumors investigated, occurring rather from vascular stroma than from the tumor cell itself.

Immunohistological study on collagen in cartilage-bone metamorphosis and degenerative osteoarthrosis

Synthesis of collagen by chondrocytes was studied by immunofluorescence using antibodies specific for type I, II and III collagen. The following tissues and culture conditions were chosen for this immunohistological study: normal articular cartilage, epiphyseal growth cartilage, cartilage undergoing osteoarthrotic degeneration, suspension culture and monolayer culture. While type II collagen is the unique collagen all over hyaline cartilage, type I collagen is produced by hypertrophic chondrocytes in the growth plate. In addition, chondrocytes in osteoarthrotic areas of articular cartilage synthesize type I collagen. Under in vitro culture conditions, chondrocytes initially product type II collagen and synthesize later on type I collagen. The change of synthesis from type II to type I collagen is more rapid in monolayer than in suspension culture. It is concluded that the presence of matrix compounds and the cellmatrix interaction as well are necessary to maintain synthesis of type II collagen in chondrocytes. Alterations in the cell-matrix interactions are shown to occur in the hypertrophic zone of the epiphyseal growth plate, in cartilage undergoing osteoarthrotic degeneration as well as in chondrocytes grown in culture. Thus, change in the control of gene activity may subsequently lead to change in collagen synthesis. It is possible that the synthesis of type I collagen, which cannot fulfil the physiological function of a structural element in cartilageneous tissue, is a crucial factor in the process of osteoarthrosis.

[Effects of short time extreme hemodilution with and without hypothermia on hemodynamic and biochemical parameters in the pig (author's transl)]

Extreme hemodilution as "Total Body Washout" (TBW) is a feasible method for the clinical therapy of endo- or exogenous intoxication. This method was modified for a simple and quick setup. Landrace pigs were hemodiluted with a special heart-lung-machine. Within 4 minutes the hematocrit was lowered to less than 1%. The rectal temperature fell hereby in a normothermic group (n = 15) to 35, 1 +/- 1, 1 degrees C and in a hypothermic one (n = 13) to 31,1 +/- 1,3 degrees C. The TBW was followed by a total exchange transfusion. Most of the parameters that were studied did not show significant differences between cold and warm perfusion. The proceeding was well tolerated by the animals, they were observed up to 6 weeks. Disadvantages of initial surface cooling may be avoided by extreme hemodilution with exclusive extracorporal cooling, when cardiac arrest in hypothermia is intended.

Galactosemia with endogenous production of galactose-1-phosphate and with cystic fibrosis-like appearance at autopsy

In an infant with galactosemia high levels of galactose-1-phosphate in red blood cells and of blood galactose were observed under a "galactose-free'' diet. The child did not thrive and developed a liver cirrhosis. At the age of 5 months he died unexpectedly. Post mortem examination revealed in the pancreas and the small intestine changes suggestive of a cystic fibrosis. Since the exogenous administration of galactose by diet could be excluded the endogenous production of significant amounts of galactose-1-phosphate has to be considered.

[Bence-Jones proteinemia and amyloidosis (author's transl)]

In a 55-year-old patient with Pattern I amyloidosis it was possible to detect a Lambda-Bence-Jones protein in plasma by means of CAF and immunelectrophoresis and column chromatography, but not in urine because of possible polymerisation.

Immunohistochemical evidence for the presence of collagen type III in human arterial walls, arterial thrombi, and in leukocytes, incubated with collagen in vitro

Sections of arterial walls and of thrombi and smears of leukocytes previously incubated in vitro with collagen type III were examined by immunohistochemical technique for the presence of collagen types I, II and III. In arterial walls collagen type III was detected immediately underlaying the endothelial cell layer and in the tissue between tunica elastica interna and adventitia. Collagen type I was not shown in the subendothelial layer. Fresh thrombi contained occasionally collagen, but only of type III. This was associated with leukocytes. Leukocytes were capable in vitro to associate and/or phagocytose collagen type III and this could be visualized immunohistochemically. The data show that collagen type III in vivo may play a crucial role in the initiation of thrombus formation.

[Immunohistochemical characterization of collagen in liver cirrhosis (author's transl)]

Using indirect immunofluorescence technique, 21 cases of hepatic cirrhosis of differing etiology were studied with type-specific antibodies to collagen type I, II, and III. In all cases the fibrous septa and portal tracts showed an increase in type III collagen. No fluorescence could be observed with antibodies to collagen type I and II. Thus, biochemical studies are supported which show, in addition to type III collagen, a new, as yet undescribed type of collagen in liver cirrhosis that is similar to type I collagen electronmicroscopically, but differs from type I collagen biochemically and immunologically. No correlation between the etiology of cirrhosis and the pattern of different collagen types could be found. The origin of different collagen types in liver cirrhosis is briefly discussed.

Liver cirrhosis: immunofluorescence and biochemical studies demonstrate two types of collagen

Pepsin solubilization of small and large noduled liver cirrhosis yielded two types of collagen (precipitated at 1.7 and 2.5 M NaCl concentrations) as demonstrated by electronmicroscopy. The 1.7 M NaCl precipitate was identified as type III collagen using an immunofluorescence technique. The 2.5 M NaCl precipitate appeared to be type I in the electronmicroscope. However, immunofluorescent and biochemical studies indicated that it was not type I but a type of collagen not yet described.