The effect of nicotine on basophil histamine release

BACKGROUND

Changes in the immune and inflammatory response are induced by smoking tobacco but underlying mechanisms remain to be elucidated.

OBJECTIVE

This study investigated the effect of nicotine agonists on histamine release from human basophils.

METHODS

Peripheral blood basophils were obtained from healthy volunteers. The effect of the nicotine agonists [-]-1-methyl-2-[3-pyridyl]pyrrolidine and (+)-nicotine di-p-toluoyltartrate salt on cell viability and anti-IgE induced histamine release was investigated.

RESULTS

Cell viability was not altered by preincubation with the agents for 15 min. Anti-IgE induced histamine release was significantly inhibited by preincubation (15 min, 37 degrees C) with [-]-1-methyl-2-[3-pyridyl]pyrrolidine at the highest concentration tested 10(-)3 M (p<0.01). Preincubation (15 min, 37 degrees C) with (+)-nicotine di-p-toluoyltartrate salt significantly inhibited anti-IgE induced histamine release at 10(-3)M and 10(-5) M (p<0.05).

CONCLUSIONS

This study has demonstrated that nicotine agonists inhibit histamine release from human basophils. Further studies examining the effect of smoking on basophil activation are required.

Arrhythmias occurring during intravenous urography

A low but significant fatality rate persists in intravenous urography. Fatalities are sudden and their cause is not understood. This trial assessed the arrhythmogenic effects of a common urographic contrast agent. Using standard bolus injection techniques, 12 patients out of 58 (20%) developed post-injection arrhythmias. Seven of these cases (12%) were considered to have significant or potentially serious arrhythmias. This group includes various paroxysmal tachycardias and a case of atrioventricular block. Arrhythmia post-injection was commoner in the male and in the older age groups. An abnormal control ECG was not found to be a predisposing factor to the development of arrhythmia. It is suggested that the findings reflect the high incidence of latent coronary heart disease in our older male population. No correlation was found with minor side-effects of contrast injection and the development of arrhythmia.

Prediction of risk for pseudoallergic reactions and histamine release in patients undergoing anaesthesia and surgery: a computer-aided model using independence-Bayes

A computer-aided model for the prediction of pseudoallergic reactions was developed using prospective data collected from 581 patients in a controlled clinical trial examining pseudoallergic reactions to the plasma substitute Haemaccel (outdated formulation). The multivariate analysis of 22 proposed risk factors was performed using Bayes theorem. This enabled the accurate prediction of 86% of the patients who had a systemic reaction. The clinical use of such system would enable a selection of patients to receive the effective prophylactic measure of pretreatment with H1 plus H2-receptor antagonists.

Acetylcholinesterase and Nissl staining in the same histological section

Acetylcholinesterase (AChE) enzyme histochemistry and Nissl staining are commonly utilized in neural architectonic studies. However, the opaque reaction deposit produced by the most commonly used AChE histochemical methods is not compatible with satisfactory Nissl staining. As a result, precise correlation of AChE and Nissl staining necessitates time-consuming comparisons of adjacent sections which may have differential shrinkage. Here, we have modified the Koelle-Friedenwald histochemical reaction for AChE by omitting the final intensification steps. The modified reaction yields a non-opaque reaction product that is selectively visualized by darkfield illumination. This non-intensified darkfield AChE (NIDA) reaction allows clear visualization of Nissl staining in the same histological section. This combined AChE-Nissl method greatly facilitates detailed correlation of enzyme and cytoarchitectonic organization.

HLA antigens in adults negative for antibody to Epstein-Barr virus (EBV)

Evidence for a genetic component in susceptibility to Epstein-Barr virus (EBV) infection was sought by comparing HLA A and B phenotypes of EBV antibody-negative Scottish medical students and randomly chosen antibody-positive controls. No statistically significant differences were observed, but three antigens, (A10, A29 and B15), were relatively underrepresented in the EBV seronegative group; findings which agree with data previously reported from a similar study in Los Angeles. A strong association between the HLA A1/Blank phenotype and EBV seronegativity, evident in the Los Angeles population, was not confirmed in the present study.

Effect of in vivo and in vitro lovastatin treatment on mast cell activation

The hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitor lovastatin is used to treat hyperlipidaemia. This agent prevents the isoprenylation of some proteins involved in signal transduction processes and inhibits IgE-receptor-linked mediator release from RBL-2H3 cells. In this study the effect of in vivo and in vitro administration of lovastatin on histamine release from rat peritoneal mast cells was examined. Lovastatin (4 mg/kg/day for 2 weeks) inhibited histamine release induced by concanavalin A (con A) from rat peritoneal mast cells of Hooded-Lister rats and both homozygous lean and obese Zucker rats. In contrast, release induced by antirat IgE (anti-IgE) was only significantly inhibited in cells derived from Hooded-Lister rats and that induced by compound 48/80 was not altered. Lovastatin (20 microM, 24 h, in vitro) caused a significant inhibition of the subsequent histamine release to con A, anti-IgE and compound 48/80 but not to the calcium ionophore A 23187. It is important to determine whether such inhibitory effects are also observed after the chronic, clinical administration of lovastatin and other HMG CoA reductase inhibitors.

Intravascular anti-IgE challenge in perfused lungs: mediator release and vascular pressor response

Intravascular application of goat anti-rabbit immunoglobulin E (IgE) was used to stimulate parenchymal mast cells in situ in perfused rabbit lungs. Sustained pulmonary arterial pressure rise was evoked in the absence of lung vascular permeability increase and lung edema formation. Early prostaglandin (PG) D2 and histamine release into the perfusate was documented, accompanied by more sustained liberation of cysteinyl leukotrienes (LT), LTB4, and PGI2. The quantities of these inflammatory mediators displayed the following order: histamine greater than cysteinyl-LT greater than PGI2 greater than LTB4 greater than PGD2. Pressor response and inflammatory mediator release revealed corresponding bell-shaped dose dependencies. Cyclooxygenase inhibition (acetylsalicylic acid) suppressed prostanoid generation, increased LT release, and did not substantially affect pressor response and histamine liberation. BW755 C, a cyclo- and lipoxygenase inhibitor, blocked the release of cysteinyl-LT and markedly reduced the liberation of the other inflammatory mediators as well as the pressor response. The H1-antagonist clemastine caused a moderate reduction of the anti-IgE-provoked pressure rise. We conclude that intravascular anti-IgE challenge in intact lungs provokes the release of an inflammatory mediator profile compatible with in situ lung parenchymal mast cell activation. Pulmonary hypertension represents the predominant vascular response, presumably mediated by cysteinyl-LT and, to a minor extent, histamine liberation.

The role of chymase in ionophore-induced histamine release from human pulmonary mast cells

Human pulmonary mast cells contain the serine proteases tryptase and chymase. Chymase is present in much smaller quantities than tryptase. The definite physiological role of both enzymes remains to be elucidated, angiotensin processing has been proposed as one possible function of chymase. A dose-dependent inhibition of A 23187-induced histamine release from dispersed human lung mast cells was observed after pretreatment with diisopropylfluorophosphate (DFP) or 1-1-tosyamide-2-phenylethyl chloromethyl ketone (TPCK) but not with N-2-p-tosyl-1-lysine chloromethyl ketone (TLCK). In contrast, no inhibition was observed under the same conditions with isolated rat peritoneal mast cells. These results indicate that a chymase is probably an important factor in a late phase of human lung mast cell activation. Current work focuses on the isolation of human lung chymase to further investigate this topic.

The effect of serine esterase inhibitors on ionophore-induced histamine release from human pulmonary mast cells

The serine proteases tryptase and chymase are present in human pulmonary mast cells. About 10-100 times more tryptase than chymase is found in these cells. However, a clear physiological role for both enzymes remains to be elucidated; angiotensin processing has been proposed as one possible function of chymase. A dose-dependent inhibition of A23187-induced histamine release from dispersed human lung mast cells was observed after pretreatment with the serine protease inhibitor diisopropylfluorophosphate (DFP) or the chymotrypsin-like enzyme inhibitor N-tosyl-L-phenylalanine chloromethylketone (TPCK) but not with the trypsin-like enzyme inhibitor N-tosyl-L-lysine chloromethylketone (TLCK). These results indicate that a chymase is probably an important factor in a late phase of human lung mast cell activation.

A comparison of three standard methods of identifying mast cells in endobronchial biopsies in normal and asthmatic subjects

Reported mast-cell counts in endobronchial biopsies from asthmatic subjects are conflicting, with different methodologies often being used. This study compared three standard methods of counting mast cells in endobronchial biopsies from asthmatic and normal subjects. Endobronchial biopsies were obtained from atopic asthmatic subjects (n = 17), atopic nonasthmatic subjects (n = 6), and nonatopic nonasthmatic control subjects (n = 5). After overnight fixation in Carnoy's fixative, mast cells were stained by the short and long toluidine blue methods and antitryptase immunohistochemistry and were counted by light microscopy. Method comparison was made according to Bland & Altman. The limits of agreement were unacceptable for each of the comparisons, suggesting that the methods are not interchangeable. Coefficients of repeatability were excellent, and not different for the individual techniques. These results suggest that some of the reported differences in mast-cell numbers in endobronchial biopsies in asthma may be due to the staining method used, making direct comparisons between studies invalid. Agreement on a standard method is required for counting mast cells in bronchial biopsies, and we recommend the immunohistochemical method, since fixation is less critical and the resultant tissue sections facilitate clear, accurate, and rapid counts.

A double-labeling method for AChE and fluorescent retrograde tracers

Staining for the degradative enzyme acetylcholinesterase (AChE) is an important tool in studying central cholinergic/cholinoceptive systems. AChE staining has also been useful in identifying the projections of AChE-containing neurons and codistribution of AChE with other neurotransmitters. The intensity and opacity of conventional AChE histochemical reaction products, however, pose problems for such double-labeling studies. Here, we have successfully combined a modified version (37) of the Koelle-Friedenwald AChE reaction with retrograde transport of the fluorescent tracer, Fluoro-Gold (FG). By omitting the final intensification steps of the Koelle-Friedenwald reaction, a translucent, light-stable reaction product is created. Viewed under darkfield illumination, this precipitate is of similar intensity and sensitivity to that produced by conventional AChE histochemical processing. Prior administration of an AChE-inhibitor yields preferential staining of AChE-positive neuronal somata. This nonintensified darkfield AChE (NIDA) histochemical method was compatible with visualization of retrogradely transported FG in AChE-positive neurons, allowing unambiguous identification of the projections of AChE-containing neurons.

Comparison of histamine release from peritoneal mast cells derived from diabetic and control rats

Clinical and experimental diabetes are associated with an increased number of mast cells and elevated tissue histamine concentrations. This study compared histamine release from peritoneal mast cells derived from diabetic and control rats. Experimental diabetes was induced by a single i.v. injection of streptozotocin (50 mg/kg body weight). Measurement of plasma glucose levels confirmed the diabetic state. Peritoneal mast cells were stimulated for 10 min with the lectin concanavalin A (0.5-100 micrograms/ml) in the presence or absence of phosphatidylserine, clinical dextran (0.6-1200 micrograms/ml) in the presence of phosphatidylserine, the calcium ionophore A23187 (0.1-1 microM) or the basic releasing agent compound 48/80 (0.1-10 micrograms/ml). Histamine release induced by these agents was similar in both populations. Further studies will compare the differences in histamine release from mast cells isolated from different tissues, e.g. heart and lung. In addition, physiological stimuli which are altered in the diabetic state (e.g. hyperosmolalar solutions and free radical generating systems) are under investigation.

A comparison of the determinants of safe injecting and condom use among injecting drug users

A sample of 582 injecting drug users were interviewed as part of an evaluation of an AIDS prevention programme for drug users. This paper examines the biographic and predispositional determinants of five HIV preventive behaviours--equipment sharing (not receiving and not giving) and and condom use (with regular partners, casual partners and sex clients). A two-stage sequential approach was adopted for a logistic regression analysis. Initially, to model each of the five preventive behaviours, biographical and drug use variables were entered. In a second set of models, behavioural predisposition factors were included. Age, drug use and prison experience correlate with variables in both models, although not consistently in the same direction. While a predisposition to reject sharing correlates with safer rejecting and condom use, the predisposition to safer sex only correlates with condom use. Needle exchange programmes that only target the individual would seem to be inadequate. To enhance targeted interventions changes in public and agency policy that create a social environment conductive to behaviour change are required.

On the mechanism of immunosympathectomy

The effects in vivo and in vitro of the antiserum to mouse nerve growth factor (NGF) are independent of the presence of complement. These results are consistent with the view that the antiserum acts by neutralizing endogenous NGF.

Liver fluke (Fasciola hepatica)-derived peptides activate rat peritoneal mast cells

Short peptides with sequences derived from those found in the tegumental antigen of Fasciola hepatica have been synthesised. Incubation of some of these peptides with rat peritoneal mast cells resulted in the degranulation of the cells as measured by a histamine release assay. This activity was shown to be associated with the proline-lysine-proline motif, which is responsible for the induction of mast cell degranulation by the mammalian bioactive peptide substance P. Studies on the mode of action of the fluke-derived peptide indicated that it was operating through the same biochemical pathways as substance P. The implications of these findings for the development of immune responses during parasite infections are discussed.

Isolation and purification of human mast cells and basophils

Mast cells were once thought to represent a single population of highly granulated secretory cells. However, with the development of mast cell isolation techniques for a diverse range of tissues, it became apparent that mast cells from different species and those from different tissues within the same species exhibit variations in their biochemical, histochemical, and functional properties. The functional heterogeneity of mast cells has important implications for studies of the response of mast cells to secretory stimuli, antiallergic drugs, or drugs that have the potential to produce adverse responses.

Abstract P1-16-03: Phase II randomized clinical trial (RCT) of metformin (MET) vs placebo (PLAC) in combination with chemotherapy (CXT) in refractory locally advanced (LABC) or metastatic breast cancer (MBC)

Background: MET treatment of diabetes is associated with improved BC outcomes. Hirsch et al (Cancer Res 2009;69:7505-7511) suggested MET may act synergistically with CXT in BC rodent models. We conducted a double-blind Phase II RCT of CXT plus MET vs placebo in LABC/MBC.

Methods: Non-diabetic BC patients (pts) about to commence 1st-4th line CXT (prespecified anthracycline, taxane, vinorelbine, platinum or capecitabine; HER2 Rx permitted) for MBC or refractory LABC (any ER, PgR, HER2) were eligible if (i) age 18-75, (ii) ECOG 0-2, (iii) adequate hepatic, renal, bone marrow, cardiac function and (iv) measurable or evaluable disease. Those with CNS metastases, recent MET use or radiotherapy to target lesions, intake of ≥ 3 alcoholic drinks/day, history of lactic acidosis or current/planned pregnancy or lactation were ineligible. Randomization was to MET 850 mg po bid (or identical PLAC bid) with a 2 day ramp up of one tablet/day; dose was reduced/drug discontinued in a pre-specified manner for grade 2-4 toxicity. Disease status and toxicity/HRQOL were assessed at baseline and q9 weeks until progression. Primary outcome was progression-free survival (PFS); secondary outcomes included survival (OS), response and toxicity. With 40 subjects and type one error 0.2 (1-sided), a PFS HR of 0.58 could be detected with 80% power. PFS was analyzed using Cox proportional hazards regression.

Results: 40 pts were randomized (22 MET, 18 PLAC). Mean age 55.4 vs 56.9 years; ER/PgR+ in 86.4 vs 83.3%; time from 1st metastases to randomization 297 vs 405 days, in MET vs PLAC respectively. MET pts were more likely to have visceral metastases (95.5% vs 72.2% PLAC) and less likely to be HER2+ (9.1% vs 23.5% PLAC). CXT was 1st line in 68.2% MET and 66.7% PLAC pts. Toxicity - # events: Gr 4: 0 MET vs 1 PLAC, Gr 3: 14 MET vs 14 PLAC; Gr 1 or 2: 193 MET (mainly GI) vs 53 PLAC. Best response: PR 18.2% MET vs 22.2% PLAC, SD 31.8% MET vs 11.1% PLAC, PD 45.4% MET vs 50.0% PLAC, P = 0.41. Mean PFS 164 days MET vs 192 days PLAC; HR (MET vs PLAC) 1.14 (95% CI 0.59-2.2), 1-sided p=0.65. Mean OS 645 MET vs 831 PLAC days; HR (MET vs PLAC) 1.6, 95% CI 0.72-3.54, 1-sided p=0.88.

Conclusion: In these BC pts receiving 1st-4th line CXT, MET (vs PLAC) did not improve response rates, PFS or OS. Gr 1 and 2 toxicity was higher with MET than PLAC. These results do not support use of MET with CXT in refractory LABC/MET BC. MA32, an adjuvant trial of MET vs PLAC in early BC will provide information on MET in the adjuvant setting.

Funded by the Breast Cancer Research Foundation (New York) and Hold'em for Life Charity (Toronto)

Citation Format: Goodwin PJ, Ennis M, Cescon DW, Elser C, Haq R, Hamm CM, Lohmann AE, Pimentel I, Chang MC, Dowling RJ, Stambolic V. Phase II randomized clinical trial (RCT) of metformin (MET) vs placebo (PLAC) in combination with chemotherapy (CXT) in refractory locally advanced (LABC) or metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-16-03.