Transepidermal elimination of lepromatous granuloma: a mechanism for mass transport of viable bacilli

A 35-year-old male with lepromatous leprosy showed significant progression of the disease on initial examination. Along with typical lepromatous skin lesions, many scar-forming lesions were present, mainly on his extremities. Some lesions showed erosive surfaces. From clinicopathological findings, these lesions were suspected to be due to the partial excretion of intradermal lepromatous granulomata by 'transepidermal elimination'. Increased local volume, which might be due mainly to rapidly growing lepromatous infiltration before chemotherapy, is suspected of triggering this phenomenon. There is no doubt that many fresh Mycobacterium leprae were included in these excretions. After the initiation of chemotherapy, no new scar-forming lesions were observed.

Expression and regulation of monocyte chemoattractant protein-1 by human eosinophils

Several recent studies have identified eosinophils as a cellular source of various cytokines, indicating that eosinophils play not only an effector role, but also a regulatory role within the allergic inflammatory cell network. In this study, we demonstrate that eosinophils can generate and secrete monocyte chemoattractant protein-1 (MCP-1), a prototype of C-C chemokines. Eosinophils generated immunoreactive MCP-1 in response to such diverse stimuli as C5a, formyl-methionyl-leucyl-phenylalanine (FMLP) and ionomycin, but MCP-1 production was not induced by interleukin (IL)-1 or tumor necrosis factor-alpha. C5a- and FMLP-induced eosinophil MCP-1 production was absolutely dependent on pretreatment with cytochalasin B. Eosinophils elaborated significantly more MCP-1 than neutrophils. Immunoreactive MCP-1 was detected at 6 h of incubation with C5a or FMLP. Expression of MCP-1 mRNA reached a maximum within the first 3 h after stimulation and then declined rapidly to a very low and stable level by 18 h. Pretreatment with IL-5 markedly amplified C5a-induced MCP-1 production, and the enhancement occurred at the pretranslational level. Eosinophil-active chemokines such as eotaxin failed to induce MCP-1 generation, even when eosinophils were primed by IL-5. Since MCP-1 exerts a potent histamine-releasing effect on human basophils, our results indicate that eosinophils may regulate basophil mediator release with possible consequent contribution to the pathogenesis of allergic inflammation via a paracrine mechanism.

Eosinophilopoietic factors prime eosinophils for increased interleukin-8 generation

Recent studies have identified eosinophils as a cellular of various cytokines, indicating that eosinophils play not only an effector role but also a regulatory role within the allergic inflammatory cell network. Because eosinophilopoietic factors are known to stimulate various functions of eosinophils, we examined the effect of interleukin (IL)-5 on chemoattractant-induced IL-8 generation from eosinophils. Although IL-5 alone induced little or no IL-8 production from eosinophils, short-term preincubation with IL-5 markedly enhanced the eosinophil IL-8 generation caused by C5a plus cytochalasin B (CB). IL-3 also potentiated C5a-induced IL-8 generation. Both factors were active at picomolar concentrations. Furthermore, competitive polymerase chain reaction (PCR) experiments revealed that the enhancement occurred at the pretranslational level. Since eosinophils in allergic inflammation are believed to be activated by these eosinophilopoietic factors, eosinophil-derived cytokines may play more important roles in the allergic inflammatory cell network than has been previously supposed.

Analysis of mitogenic substances in Bupleurum chinense by ESR spectroscopy

The polyphenolic substance(s) in the hot water extract of Bupleurum chinense (PSF) showed strong mitogenic activity. In this paper, we analyzed PSF by using ESR spectroscopy, and found that i) PSF showed a strong ESR signal on g = 2.005 which was similar to the commercially available lignin; ii) Sho-saiko-to, which contains an extract of B. chinense, also showed similar signals on ESR; iii) Powdered B. chinense also showed similar signals on g = 2.005. Peroxidase activity, essential for producing polyphenolic substances, was detected in the cold water extract of B. chinense. In addition, the signal intensity of the ESR spectrum of B. chinense was increased after boiling. The data of the ESR spectra of the model reactions using lignin, arginine, proline and maltose also strongly suggested that a certain chemical modification proceeded during the hot water extraction to increase the percentage of the stable free radical. These facts strongly suggested that the mitogenic substance in B. chinense is a polyphenolic substance extracted by hot water, and the structure was modified during the extraction to increase the stable free radical components.

Consecutive evaluation of immunoglobulin M and G antibodies against hepatitis E virus

Hepatitis E virus (HEV) infection is sporadic in the Guangzhou city southern China. However, the evaluation of antibodies to HEV during consecutive time periods after infection has not been reported. We utilized enzyme immunosorbent assay (ELISA) to defect IgM and IgG anti-HEV in consecutive serum specimens from patients with acute hepatitis E and compared that data with detection rates of IgM and IgG anti-HAV in patients with acute hepatitis A. IgM anti-HEV can be detected as early as 4 days after onset of disease symptoms in some patients. The detection rate of IgM anti-HEV is significantly higher in specimens collected within 4 weeks (95%) of onset than in those specimens collected 4 to 18 weeks after onset (67.6%) (P < 0.005). IgM anti-HEV had a similar pattern to IgM anti-HAV and can be used as a marker of acute HEV infection. In contrast with IgG anti-HAV, 56.8% of the specimens did not contain detectable levels of IgG anti-HEV (P < 0.005). One should be cautioned against making a diagnosis of HEV infection solely by the currently available assays for IgG anti-HEV. In conclusion, IgM anti-HEV can be used as a reliable and sensitive marker for recent HEV infection, but serum specimens should be collected within 4 weeks after onset of symptoms to avoid false-negative results. In contrast, we should be aware of the failure to develop IgG anti-HEV in some patients. These patients carry the risk of reinfection.

Voluntary contraction shortens peripheral conduction time in response to transcranial magnetic stimulation of the brain

We investigated the effects of voluntary contraction on peripheral conduction time in response to transcranial magnetic stimulation (TMS) of the brain in 10 normal subjects. We obtained surface recordings of compound muscle action potentials (CMAP) from the abductor digiti minimi muscle (ADM) and nerve action potentials (NAP) from the ulnar nerve, at rest and during contraction (10% of maximal voluntary contraction) in response to TMS delivered at 100% output using a coil shaped like a figure 8. The distance between the two recording electrodes was 10 cm. The distal latency in response to TMS was calculated by subtracting the NAP latency from the CMAP latency. Distal latency was also measured by recording ADM responses to supramaximal electrical stimulation (ES) 10 cm proximal to the recording electrode. TMS-induced distal latency was significantly shorter during voluntary contraction than at rest (P < 0.0001). There was no significant difference between TMS-induced distal latency during contraction and ES-induced distal latency. TMS-induced distal latencies at rest and during contraction were correlated with the ES-induced distal latencies (r2 = 0.468, P = 0.028 and r2 = 0.769, P = 0.0009, respectively). Our results showed that the peripheral conduction time in response to TMS was related to the activity of the target muscle and to the fastest conduction velocity of the target nerve. Voluntary contraction reduced the peripheral conduction time in response to TMS.

Alpha 1b-adrenoceptor-mediated calcium oscillation is specific for the S phase in cell cycle and dependent on the extracellular calcium

Using Chinese hamster ovary cells stably expressing alpha 1b-adrenoceptor (alpha 1bAR) as a model, we examined the effect of the cell cycle on the agonist-promoted intracellular [Ca2+]i oscillation. In cells synchronized into either the G1 state or the M phase, no oscillatory behavior was observed under any extracellular Ca2+ concentrations ([Ca2+]o < or = 3 mM), whereas in cells synchronized into the S phase, norepinephrine caused [Ca2+]i oscillation in a [Ca2+]o-dependent manner, indicating that alpha 1AR-mediated [Ca2+]i oscillation is specific for the S phase in cell cycle and dependent on [Ca2+]o. The S phase-specific occurrence of alpha 1AR-mediated [Ca2+]i oscillation is not associated with changes in alpha 1AR density. As the cells consistently developed [Ca2+]i oscillation in the S phase, the cells would provide a valuable system to study further the biochemical mechanism for agonist-induced [Ca2+]i oscillation phenomenon.

Reciprocal inhibition in the forearm during voluntary contraction and thinking about movement

The regulatory mechanism for the interaction of agonist and antagonist muscles is not still clear. In these studies we investigated reciprocal inhibition during voluntary contraction and thinking about movement by using transcranial magnetic stimulation (TMS) and the H reflex technique. Magnetic stimuli, with intensities 10% above threshold, were delivered at the scalp under 3 experimental conditions; at rest, during voluntary isometric weak contraction and during thinking about movement. Surface EMG responses were taken from extensor carpi radialis (ECR) and flexor carpi radialis (FCR) muscles in 14 normal subjects. Inhibitions of antagonist muscles induced by thinking about agonist movement occurred in 8 ECR and 10 FCR muscles, but most of them were not statistically significant. H reflexes were obtained from the FCR muscles in 10 normal subjects under the same conditions. Voluntary wrist extension and thinking about wrist extension produced inhibition of the H reflex in the FCR muscles. Reciprocal inhibition of antagonist muscles may occur at the cortical and spinal cord levels. The excitability of motoneurons has effects on the H reflex amplitude. Motor evoked potential (MEP) response to TMS might be affected by the combination of input from the motor cortex and the spinal cord. TMS may evoke simultaneous facilitatory and inhibitory volleys to antagonist muscles. This may explain why the inhibitions in the TMS study were weaker than those in the H reflex study.

A serologic Mycobacteria leprae gelatin particle agglutination (MLPA) in the diagnosis of leprosy: comparison with conventional enzyme-linked immunoassay and bacterial index

A gelatin particle agglutination test (MLPA) for the detection of anti-phenolic glycolipid-1 (PGL-1) antibodies was compared with the slit skin smear method in the diagnosis of leprosy. MLPA and BI tests showed a good agreement rate of 88.1% and MLPA and ELISA tests showed an excellent agreement rate 96.2%. This MLPA test is simple and reliable, it will be very convenient for the medical practitioners, it would be of great benefit for leprosy patient as well because this test would look like a routine blood examination compared with slit skin smear method which is widely known diagnostic tool for leprosy.

Coagulation factor V levels as a prognostic indicator in fulminant hepatic failure

Data reported by Bernuau et al. have strongly supported the measurement of coagulation factor V as the best prognostic indicator in fulminant hepatic failure (FHF) and as the test on which selection for urgent liver transplantation should be made. In this study, we have measured plasma factor V in 110 patients with FHF, in grades I-IV coma, in 88 of whom the etiology was acetaminophen overdose. On admission, patients who did not survive had significantly lower factor V levels (median, 5%; range, 1-27; n = 49), compared with those who did (median, 10%; range, 2-70; P < .001). In the 81 patients with acetaminophen-induced FHF who did not receive a transplant, there was no cutoff level of factor V that clearly separated the patients. On statistical analysis, a positive predictive value (the mortality in patients predicted to have a poor prognosis) of 0.49 was calculated for factor V <20% and 0.57 for factor V < 10%. If the prognostic criteria included deep coma (grades III and IV) as well as factor V <20%, a positive predictive value of 0.73 was calculated. This compared with a value of 0.92 for the well-established King's prognostic criteria based on pH, and a combination of international normalized ratio (INR), renal failure, and coma. In the 17 mixed, nonacetaminophen group of patients who did not receive a liver graft, the positive predictive value was 0.85 for a factor V level <20% and 1.00 for factor V <10%, compared with 0.93 for the King's criteria for that etiologic group. This study demonstrates that the predictive accuracy of plasma factor V level is much less effective than the well-validated King's criteria in the selection of patients with acetaminophen-induced FHF needing liver grafting, although it may be useful in patients with FHF due to other causes.

Significantly increased frequency of the apolipoprotein E epsilon 4 allele in elderly non-demented leprosy patients

Apolipoprotein E (apo E) genotypes in 350 leprosy patients were examined and compared with those of 870 age-matched controls. The allelic frequencies of the apo E gene did not differ between demented patients with leprosy and controls. However, the frequency of apo E epsilon 4 allele was significantly higher in non-demented leprosy patients than in controls (P < 0.001). Of special interest is that the prevalence of E3/4 genotype in non-demented leprosy patients increased significantly with age, being 14.1%, 24.4%, and 28.3% in the 60s, 70s, and 80s, respectively (P < 0.05). These data suggest that apo E epsilon 4 is not a risk factor for senile dementia in elderly leprosy patients, and there exist factors to overcome the risk of apo E4 in leprosy patients.

Ovariectomy-evoked increase in gonadotropin releasing hormone receptor parallels its messenger RNA level, but does not correlate with stimulated gonadotropin release

The amount of gonadotropin releasing hormone receptor (GnRH-R) in the anterior pituitary changes during the rat estrous cycle; in addition, it is chronically increased for several weeks in response to ovariectomy. The present study was undertaken to investigate these changes in relation to the concentrations of GnRH-R mRNA, gonadotropins and luteinizing hormone-beta (LH-beta) subunit in serum and the pituitary gland, as well as hypothalamic GnRH. GnRH-R concentrations on the day of estrus were significantly lower than that at diestrus (30% lower during 2 d), its mRNA decreased even further (by 60%), but there were no significant changes in gonadotropin. Ovariectomy increased GnRH-R significantly (by 30% during 2 wk) in parallel with receptor mRNA and with pituitary LH and LH-beta, but induced an earlier increase in serum gonadotropins. Our results suggest that transcriptional activity is more intimately linked to the number of GnRH-R in the long-term increase after ovariectomy than in the short-term change during the estrous cycle, and that the increased GnRH-R is not a major factor in ovariectomy-stimulated gonadotropin release.

Keratinocyte growth factor and its receptor in the rhesus macaque placenta during the course of gestation

Keratinocyte growth factor (KGF) is synthesized and secreted exclusively by mesenchymal cells, and acts through its receptor (KGFR) to stimulate epithelial proliferation. In vivo, KGF and KGFR comprise a mesenchymal-epithelial cell paracrine system that can mediate epithelial cell mitosis. In preliminary work, we noted that KGF was expressed in the rhesus monkey placenta, and we now report on the expression of placental KGF and KGFR mRNAs during the course of gestation in this species. In-situ hybridization revealed that during early gestation, KGF mRNA was strongly expressed in placental mesenchymal cells. These cells, which were also immunoreactive for vimentin, were mainly located on the periphery of the mesenchymal cores of both anchoring and floating villi. KGFR mRNA was expressed in the adjacent trophoblastic epithelium, which was immunoreactive for cytokeratin. In-situ hybridization revealed that KGF mRNA expression was very high in the youngest placentae (34-days gestation) and decreased gradually to minimal levels by late gestation (157 days). Northern blot analysis indicated also that the KGF MRNA signal was strongest in early gestation samples and weakest by late gestation. Analysis for KGFR mRNA by a reverse transcriptase-polymerase chain reaction technique showed that KGFR mRNA expression could be detected at all stages. However, in-situ hybridization indicated that KGFR mRNA expression was highest in early gestation placentae and least in the oldest placentae. Autoradiographs of frozen sections of placenta that had been incubated with [125I]KGF to detect receptor binding showed that grain density over the trophoblast was highest in the youngest and least in the oldest placentae. PCNA and Ki-67 expression followed this same temporal trend. We conclude that the KGF/KGFR system may be important in proliferation of the placental trophoblast during early- to mid-pregnancy in rhesus monkeys.

FR901483, a novel immunosuppressant isolated from Cladobotryum sp. No. 11231. Taxonomy of the producing organism, fermentation, isolation, physico-chemical properties and biological activities

FR901483, a novel immunosuppressant, has been isolated from the fermentation broth of Cladobotryum sp. No. 11231. The molecular formula of FR901483 has been determined as C20H31N2O6P. FR901483 exerts a potent immunosuppressive activity in vitro and significantly prolongs graft survival time in the rat skin allograft model. This compound has an intriguing tricyclic structure possessing a phosphate ester in its molecule. The ester residue may play an important role in exerting immunosuppressive activity because the desphosphoryl compound is devoid of activity. It is thought that the primary target of immunosuppression by this compound is inhibition of purine nucleotide biosynthesis.

Molecular cloning and characterization of cDNA for insect biogenic peptide, growth-blocking peptide

Growth-blocking peptide (GBP) is an insect biogenic peptide that prevents the onset of metamorphosis from larva to pupa. A cDNA coding for GBP is described. Mixed oligonucleotides derived from a GBP peptide sequence were used to generate amplified DNA by the polymerase chain reaction (PCR). Based on the sequence of the amplified DNA, a 41 bases oligonucleotide was designed for screening a cDNA library which was constructed from the armyworm Pseudaletia separata larvae parasitized with the parasitic wasp Cotesia kariyai. The cloned cDNA for GBP was 809 base pairs in length. An open reading frame of 429 base pairs encodes a pre-pro-peptide of 143 amino acid residues in which GBP is localized at the C-terminal region, and other three peptides including a putative signal peptide and appropriate processing sites for endoproteolytic cleavage precede the GBP sequence. Northern blot analyses demonstrate the presence of a 800-base mRNA transcript in fat body and 2.5-kilobase transcript in brain and nerve cord, suggesting the possibility that the transcription of GBP gene is regulated in a tissue-dependent manner. This interpretation was supported by isolating a GBP cDNA fragment from cDNA pool of brain-nerve cords. GBP mRNA is constantly expressed in both parasitized and non-parasitized last instar larvae and there is no difference in the levels of the mRNA between both larvae, thus indicating that parasitism may effect on translational or posttranslational level to elevate plasma GBP concentration.

Evaluation of the Mycobacterium leprae particle agglutination (MLPA) test as a tool in the epidemiology of leprosy in high prevalence village in South Sulawesi, Indonesia

This study reports on the usefulness of an IgM phenolic glycolipid-1 (PGL-1) Mycobacterium leprae particle agglutination (MLPA) test for serodiagnosis of leprosy in a prospective longitudinal community survey in a high prevalence village in South Sulawesi, Indonesia, IgM PGL-1 MLPA has simple and limited value as a screening method for detection of transmission of leprosy in the community. Many normal persons in the community in a high prevalence area had increased IgM anti PGL-1 antibodies, presumably as a consequence of early subclinical infection. In conclusion, this study demonstrated that the MLPA test can only reliably detect anti-PGL-1 antibodies in the community and may be useful for follow-up study of subclinical infection of leprosy among individuals living the an endemic area.

[Uveitis in leprosy patients]

We examined 24 dermatologically cured leprosy patients with ongoing uveitis (UV+) and 22 age and type matched controls (UV-) to study the late phase leprous UV. All patients have been skin smear negative for more than 10 years. The history of chemotherapy, 5 years before and after a accomplishing bacterial negativity, was evaluated and represented by "SCORE". It was found that anti-PGL-I and anti-LAM-B antibodies were significantly higher in UV+ group compared to the controls. The mean SCORE of chemotherapy in UV+ group was significantly lower than in the controls. Iris pearls were seen in 10 cases or 42% out of 24 UV+ patients. No iris pearls were seen in control group. These results suggest that insufficient chemotherapy and consequent incomplete elimination of bacilli are the risk factors for leprous UV in the quiescent stage of the disease.

Graded exercise in three cases of heart rupture after acute myocardial infarction

Despite advances in the study of exercise for acute myocardial infarction (AMI) patients, few studies on exercise for post-AMI heart rupture patients have been reported. We assessed three cases of heart rupture (of the left ventricular free wall in two cases and of the ventricular septum in one case) in post-AMI patients who underwent three-graded exercise. Two of the three patients were operated on, whereas one patient was managed conservatively for heart rupture. Two of the three cases had also suffered cerebral infarction post-AMI. The exercise program was composed of three grades, slow level walking (grade 1), mild reconditioning and activities of daily living (ADL) exercises (grade 2), and optional endurance training using machines below 75% of predicted maximal heart rate (grade 3). Electrocardiograms and blood pressure were monitored during all exercises. All patients had muscle weakness, poor endurance capacity, as well as low cardiac function (28-47% of left ventricular ejection fraction). Two patients underwent grades 1 and 2 exercise programs, and the other performed grades 1, 2, and 3 exercise programs over a 3- to 10-wk period. We observed improvement in the double product, work capacity, and ADL without congestive heart failure, ischemic attack, or serious arrhythmias. However, the youngest patient, who underwent the grade 3 exercise program, died from a cardiac event 10 mo after onset of AMI. We conclude that post-AMI heart rupture patients should undergo delayed, gradual, low-level graded exercise (4-6 metabolic equivalents), with monitoring of blood pressure and electrocardiograms to improve work capacity, ADL, and the quality of life. However, daily activity and exercise intensity should be promptly supervised for those with severely deteriorated cardiac functions to prevent sudden cardiac event.

The fat body cell-free system for tissue-specific transcription of plasma protein gene of Bombyx mori

A nuclear extract was prepared for the larval fat body of the silkworm, Bombyx mori, and a homologous in vitro system was developed for the transcription of major plasma protein gene of B.mori. The gene for SP1, a storage protein of B.mori, and adenovirus 2 major late (AdML) gene were faithfully transcribed under relatively high template concentrations in the nuclear extract prepared from the fat body of female fifth instar larvae. Complete inhibition of gene transcription by a low concentration of alpha-amanitin indicated that the reaction is catalyzed by RNA polymerase II. At low template concentration (0.6 nM) the fat body nuclear extract transcribed the homologous SP1 gene with high efficiency, while AdML gene and larval cuticle protein gene were only barely transcribed in the same extract. The SP1 gene deleted upstream of the TATA box sequence showed little effect on transcription, whereas mutations that destroy TATA sequence totally abolished the gene transcription. These results suggested that the core promoter region of SP1 gene spanning between positions -44 and +16 is essential for the fat body specific transcription in vitro.