Pitfall of stiff shoulder: inveterated posterior dislocation

The authors relate the observation of an inveterated bilateral posterior dislocation, occurring during a generalized epileptic attack and mimicking a painful stiff shoulder. The clinical signs (i.e. aetiologic circumstances causing a forced internal rotation, limitation or absence of external rotation) and radiological data, especially the necessity of a profile X-ray, which lead to the diagnostic are reiterated. The interest of computerized tomography in the pre-operative assessment is underscored.

High prevalence of hepatitis B, C, and E markers in young sexually active adults from the Central African Republic

The Central African Republic is located in tropical Africa, where both the human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are highly endemic. The exact prevalence of hepatitis C virus (HCV) and hepatitis E virus (HEV) markers in this country is unknown. The aim of the study was to determine, according to HIV and HBV serostatus, the prevalence of these markers in young sexually active adults in the Central African Republic. One hundred and fifty-seven consecutive patients attending the National Centre for Sexually Transmitted Diseases in Bangui were included. The following serological markers were examined: (i) anti-HIV1 and anti-HIV2 antibodies; (ii) markers of HBV infection; (iii) anti-HCV antibodies; (iv) anti-HEV antibodies. Anti-HIV1 antibodies were found in 31 of the 157 patients (20%). The prevalence of anti-HBc antibodies, reflecting exposure to HBV, was 140/157 (89%) and 45 had detectable anti-HBs antibodies. Twenty-two patients (14%) were chronic carriers of hepatitis B surface antigen (HBsAg), but only one was HBe antigen-positive. Anti-HCV antibodies were found in 8 persons (5%) and anti-HEV antibodies in 38 (24%). No difference was found in the prevalence of these markers according to the presence or absence of anti-HIV antibodies. This study confirms the high rate of HIV infection, HBV exposure and chronic carriage of HBsAg in sexually active young adults in the Central African Republic. A high prevalence of HCV markers was found in this population, similar to that reported in neighbouring countries, together with a high rate of HEV markers, suggesting that HEV is endemic in this region.

Characterization of the vasorelaxant activity of tyramine and other phenylethylamines in rat aorta

We recently reported that tyramine caused concentration-dependent relaxation of rat aorta, which was endothelium independent and was not exerted via alpha 1-adrenoceptors (AR), alpha 2AR, beta 1AR, beta 2AR, or receptors for 5-hydroxytryptamine, histamine, and adenosine. The present studies were done on endothelium-denuded strips to determine structure-vasorelaxant activity after blockade of beta AR by propranolol plus irreversible blockade of alpha 1AR with benextramine. Vasorelaxation under these conditions was limited to noncatecholamines, and their vasorelaxant potencies were methoxyphenamine > tyramine > p-hydroxyephedrine > L-amphetamine > L-ephedrine > phenylethylamine > synephrine > methoxamine > octopamine. beta 3AR agonists (BRL 37344 and CGP 12177A) did not produce vasorelaxation, although tyramine could compete for cyanopindolol binding to murine L cells expressing human beta 2AR or beta 3AR. There was no significant specific binding of [3H]tyramine to aortic membrane preparations after the inhibition of monamine oxidase. Yohimbine, which has a high affinity for Drosophila tyramine receptors, also caused dose-dependent vasorelaxation like tyramine. It is concluded that tyramine and several other phenylethylamines produce relaxation of rat aorta, which does not involve any of the known adrenoceptors but may be exerted via novel tyramine receptors.

CT and MRI evaluation of tenosynovitis of the rheumatoid hindfoot

Thirty-nine patients with rheumatoid arthritis who had presented with tarsitis before, were investigated at the level of the rearfoot. The first 17 patients had CT with previous tenography when it was possible; the following 22 patients had MRI with gadolinium injection. Tendon involvement appeared in 52.9% of the cases on CT, and in 90% of the feet on MRI; therefore, in case of clinical or radiological signs of tarsitis, it appears that tendon involvement must be suspected. With the two procedures the tibialis posterior tendon lesions were very predominant. In the majority of the patients (31/39), there was associated involvement of two or more tendons. If there is a ruptured tendon, the authors think that one must be cautious with surgical tendinous transfer; indeed, the long-term results of this surgical procedure present a strong probability of being compromised in rheumatoid arthritis which is a progressive disease.

Functional effects of long-term activation on human beta 2- and beta 3-adrenoceptor signalling

The functional effects of long-term activation of beta-adrenoceptors were investigated by measuring adenylyl cyclase activity, cyclic AMP accumulation and cyclic AMP-dependent protein kinase activity in CHW and L cells expressing either human beta 2- or beta 3-adrenoceptors. Pre-incubation of CHW and L cells expressing beta 2-adrenoceptors with 10 microM isoprenaline for 24 h produced a marked reduction in the total receptor number and dramatically reduced the capacity of the receptor to stimulate adenylyl cyclase maximally. In contrast, the ability of beta 3-adrenoceptors number was observed in L but not in CHW cells. Maximal levels of intracellular cyclic AMP concentrations were reached during the first hour of receptor activation with isoprenaline in all four cell lines. In the absence of phosphodiesterase inhibitors, cyclic AMP decreased to basal levels within 24 h of continuous stimulation. This phenomenon occurred more rapidly in cells expressing the beta 2- than the beta 3-adrenoceptors. These results confirm that, at the level of adenylyl cyclase stimulation and cyclic AMP accumulation, the beta 3-adrenoceptor is more resistant than the beta 2-adrenoceptor to long-term desensitization. However, when cyclic AMP-dependent protein kinase activity was considered, a 24 h stimulation of beta 2- and when cyclic AMP-dependent protein kinase activity was considered, a 24 h stimulation of beta 2- and beta 3-adrenoceptor expressing cells led to the desensitization of the kinase in L but not in CHW cells. In conclusion, long-term desensitization may have distinct functional effects on cell signalling depending on the receptor subtype and the cell type considered. These findings might have practical implications for future strategies involving long-term therapies with receptor agonists.

Characterization, expression, and hormonal control of a thymic beta 2-adrenergic receptor

In the present study, we have characterized the beta 2-adrenergic receptor (beta 2-AR)-adenosine 3',5'-cyclic monophosphate (cAMP) system of the rat thymus gland and examined the hormonal regulation of the thymic beta 2-AR gene expression under physiological or pharmacological conditions accompanied by marked alterations of the sex steroid hormone milieu. We report here that membrane preparations of female rat thymic tissue contain iodocyanopindolol binding sites that exhibit pharmacological properties typical of a beta-AR. Detailed analysis by computer modeling of the binding potencies of a large series of beta 1- and beta 2-adrenergic agonists and antagonists revealed predominantly the beta 2-AR subtype (78%) in rat thymus. This inference from radioligand binding studies was corroborated functionally by the rank order of potencies of a series of adrenergic agonists to stimulate the production of cAMP. Northern blot analysis, using a human beta 2-AR cDNA as a probe, revealed the presence of a mRNA of 2.3 kb, which is consistent with the size of the beta 2-AR mRNA found in other rat tissues. Physiological regulation of specific beta 2-AR in the rat thymus was indicated by significant increases in both receptor concentration and steady-state levels of beta 2-AR mRNA during the diestrous 2 and proestrous phases of the rat estrous cycle and pregnancy, whereas castration sharply reduced beta 2-AR numbers and transcript levels within the thymus. The modulation of the thymic beta 2-AR-cAMP signaling system by the preexisting sex steroid milieu, coupled with the sex-dependent adrenergic modulation of thymic cell-mediated immune response, may contribute to the various sex-related alterations in immune responsiveness and could play a role in sexually related immune disorders.

Beta-adrenergic receptor desensitization in the early stage of hereditary cardiomyopathy in hamsters

The beta-adrenergic receptor (beta AR)/adenylyl cyclase signalling pathway was examined in cardiac membranes from cardiomyopathic Syrian hamsters. Three stages were examined during the progression of this hereditary cardiomyopathy (30 days old, prenecrotic phase; 60 days old, necrotic phase; and 120 days old, compensatory phase). Isoproterenol-stimulated adenylyl cyclase activity was decreased by 32 +/- 16% in 30-day-old cardiomyopathic hamsters, compared with age-matched controls. This was not accompanied by any change in the fluoride- or forskolin-stimulated activities, suggesting that the decrease reflects a perturbation of the receptor-mediated stimulation. Neither the density nor the subcellular distribution of the beta AR, as assessed by [125I]iodocyanopindolol binding assays, was affected in these animals. However, the agonist binding properties of the beta AR were significantly affected. Indeed, the effect of guanyl nucleotides on isoproterenol binding was decreased in 30-day-old cardiomyopathic hamsters. Given that guanyl nucleotide sensitivity is correlated with the ability of the beta AR to productively interact with Gs protein, these results suggest that the decreased beta-adrenergic-stimulated adenylyl cyclase activity results from a functional uncoupling of the beta AR with no change in receptor density. The desensitization of the beta-adrenergic-stimulated adenylyl cyclase was transient, since no change in isoproterenol-stimulated adenylyl cyclase was detected in 60- and 120-day-old hamsters, compared with age-matched controls. Similarly, the receptor number and distribution were not affected at those ages.(ABSTRACT TRUNCATED AT 250 WORDS)

Importance of peptide amino and carboxyl termini to the stability of MHC class I molecules

An influenza virus matrix peptide in which either the charged amino or carboxyl terminus was substituted by methyl groups promoted folding of the class I human histocompatibility antigen (HLA-A2). A peptide modified at both termini did not promote stable folding. The thermal stability of HLA-A2 complexed with peptides that did not have either terminus was approximately 22 degrees C lower than that of the control peptide, whereas matrix peptide in which both anchor positions were substituted by alanines had its stability decreased by only 5.5 degrees C. Thus, the conserved major histocompatibility complex class I residues at both ends of the peptide binding site form energetically important sites for binding the termini of short peptides.

Cell-specific down-regulation of the beta 3-adrenergic receptor

Previous studies have shown that beta 3-adrenergic receptors, in contrast to the beta 1 and beta 2 subtypes, do not undergo desensitization following short term activation (minutes) with agonists. Longer activation (hours) has been shown to induce desensitization of the beta 3-adrenergic receptor in some, but not all, cases, suggesting that cell- or species-specific mechanisms may be involved. We investigated the contribution of the cell type to the pattern of beta 3-adrenergic receptor long term desensitization by studying, in parallel, two cell lines (Chinese hamster fibroblasts and murine Ltk- cells) expressing the human beta 3-adrenergic receptor. Sustained agonist-promoted down-regulation of the beta 3-adrenergic receptor could be induced in Ltk- cells, whereas only a transient and weak reduction of receptor number was observed in Chinese hamster fibroblasts. The half-life of the beta 3-adrenergic receptor was not affected by the agonist activation in either cell line, indicating that in contrast to the beta 2-adrenergic receptor, degradation of preexisting receptor protein does not contribute to down-regulation. Sustained reduction of receptor RNA levels, monitored by reverse transcriptase polymerase chain reaction, was exclusively shown in Ltk- cells and probably accounted for most of the observed down-regulation. Differences in the ability of the receptor to stimulate adenylyl cyclase activity in the two cell lines may be responsible for the distinct patterns of beta 3-adrenergic receptor down-regulation.

Effects of trandolapril on the sympathetic tone and reactivity in systemic hypertension

Hemodynamic and autonomic evaluations were carried out after 2-3 weeks of treatment with placebo and at the end of 4 weeks of treatment with an angiotensin converting enzyme (ACE) inhibitor, trandolapril, 2 mg/day in 18 hypertensive patients (average age, 48 +/- 2 years) of either sex. This treatment lowered the mean arterial pressure in the whole group from 112 to 105 mm Hg (p < 0.05) without significant changes in basal heart rate or norepinephrine (NE) and epinephrine plasma levels. Based on daytime ambulatory blood pressure monitoring, the patients were separated into 2 equal groups of 9 patients: the better responders (R), with an average decrease in mean arterial pressure of 12 mm Hg, and the lesser responders (NR), with an average fall of mean arterial pressure of 2 mm Hg. Before treatment, the R group had a higher resting heart rate, a lower cardiac output (-16%), and a higher peripheral resistance (+22%) than the NR group (difference not significant). Moreover, the R group was also observed to have a 33% higher plasma NE level (p < 0.05) in the supine position, associated with a 52% higher NE response to standing (p < 0.05), and a 40% lower number of beta-adrenergic receptors on lymphocytes, suggesting a higher sympathetic tone and reactivity in that group. Following treatment with the ACE inhibitor, heart rate and plasma NE levels were not altered significantly in either group, suggesting a blunting of the baroreflex response concomitant with the lowered blood pressure, especially in the R group.(ABSTRACT TRUNCATED AT 250 WORDS)

Desensitization, phosphorylation and palmitoylation of the human dopamine D1 receptor

The regulation and post-translational modifications of the human dopamine D1 receptor were studied in the baculovirus-eukaryotic cell expression system. Baculovirus constructs containing either the DNA encoding the dopamine D1 receptor or a DNA encoding a c-myc epitope tagged dopamine D1 receptor (c-myc-dopamine D1 receptor) were used to infect Spodoptera frugiperda (Sf9) insect cells. Expressed dopamine D1 and c-myc-dopamine D1 receptors bound agonists and antagonists with affinities and a rank order of potency characteristic of a classical dopamine D1 receptor pharmacological profile. In membrane preparations from cells expressing c-myc-dopamine D1 receptor, the photoaffinity label [125I](3-methyl-2-[4'-azidophenyl]-2,3,5-tetrahydro-2H-3-benzazepine) ([125I]MAB) bound specifically upon photolysis. A major broad band of approximately 48 kDa was detected. This species was identified in immunoblots by the monoclonal antibody raised against the c-myc epitope of c-myc-dopamine D1 receptor was isolated by immunoprecipitation from whole cells and was shown to be post-translationally modified by phosphorylation and palmitoylation. Exposure of cells expressing c-myc-dopamine D1 receptor to dopamine for 15 min resulted in a reduction in the maximal dopamine stimulated adenylyl cyclase activity, which was accompanied by an increased phosphorylation of the receptor and a rapid redistribution of surface c-myc-dopamine D1 receptor as detected by in situ immunofluorescence. Dopamine exposure also resulted in an increased level of incorporation of [3H]palmitic acid into the receptor. Thus, we provide the first evidence that the human dopamine D1 receptor undergoes agonist-dependent desensitization, phosphorylation and palmitoylation.

Inverse agonist activity of beta-adrenergic antagonists

Agonist-independent properties of the human beta 2-adrenergic receptor (beta 2AR) were studied using the baculovirus expression system in Sf9 cells. In the absence of agonist but in the presence of GTP, membranes from cells expressing the beta 2AR exhibited higher levels of cAMP production than did membranes from uninfected cells or from cells infected with wild-type baculovirus. The increase in cAMP production was proportional to the number of beta 2AR expressed, up to 40 pmol/mg of membrane protein, and it could be inhibited in a dose-dependent manner by beta AR antagonists. The increase and its reversal both were independent of the possible presence of contaminating catecholamines in the culture medium and thus appear to reflect spontaneous beta 2AR activity and direct antagonist-receptor interactions, respectively. The maximal level of inhibition varied among the beta AR ligands tested, to yield the following rank order of "inverse efficacy"; timolol > or = propranolol > alprenolol > or = pindolol > labetalol > dichloroisoproterenol. The same rank order was observed using membranes prepared from Chinese hamster fibroblasts expressing beta 2AR. The effect of timolol was partly blocked by labetalol and dichloroisoproterenol, in an apparently competitive manner. The intracellular cAMP content of Sf9 cells cultured in serum-free medium was also increased by the expression of beta 2AR, and that increase was reversed by timolol and propranolol, consistent with observations in membrane preparations. The properties revealed by the expression of the beta 2AR in Sf9 cells suggest two agonist-independent traits of G protein-linked receptors, i.e., 1) that unliganded receptors are able to activate G proteins both in membrane preparations and in whole cells and 2) that antagonists may mediate their effects not only by preventing the binding of agonists but also by decreasing the propensity of the receptor to assume an active state.

Ethical issues involved in establishing a registry for familial Alzheimer's disease

In January 1992, the IMAGE Project extended the establishment of its registry of familial Alzheimer cases to all areas of the province of Quebec, for collection of epidemiological and clinical data, as well as biological samples. The aim is to study genetic transmission patterns of Alzheimer's disease (AD) and to provide a sampling framework for further etiologic and risk factor studies. The IMAGE registry already includes data of a population-based study in the Saguenay-Lac-St-Jean area; the project to collect data on familial AD (FAD) cases across the province of Quebec is known as the ALGENE Initiative. The registry is thus a collection of "AD families" for both familial and sporadic cases. The establishment of the registry involves several steps in the field work: recruitment and selection of families; collection of information on family medical history; selection of informative families and genetic testing for AD/FAD by linkage analysis. As AD is not homogeneous in its etiology and since we do not know if, in the event that genetics is involved in AD whether or not penetrance of the gene(s) is high, we must be aware of the "genetic horizons" of AD in collecting and conserving data on families of cases, and in the genetic testing for AD/FAD by linkage analysis. Families who choose genetic testing must be aware of the implications of our undertaking, assured of the confidentiality of the test and, at the same time, they must understand its limitations. The experimental nature of our research project raises ethical dilemmas. This article examines these initial considerations of the field work involved in developing a registry pertaining to genetic testing for AD/FAD by linkage analysis and offers some preliminary observations on the experience of the first year of this project.

Human serotonin1B receptor expression in Sf9 cells: phosphorylation, palmitoylation, and adenylyl cyclase inhibition

Analysis of the primary protein structure of the human serotonin1B (5-HT1B) receptor reveals consensus sites for phosphorylation and a putative site for palmitoylation. To investigate these posttranslational modifications, we have expressed a c-myc epitope-tagged 5-HT1B (m5-HT1B) receptor in Sf9 cells. This strategy enabled receptors to be detected by immunoblot analysis and purified by immunoprecipitation using a monoclonal antibody, 9E10, specific for the c-myc epitope. Agonist radioligand [3H]5-HT binding studies showed that the expressed 5-HT1B and m5-HT1B receptors displayed the characteristic pharmacological profile of the neuronal 5-HT1B receptor. The expressed receptors displayed both high- and low-affinity states for [3H]5-HT, suggesting that the receptors were coupled to endogenous G-proteins. Indeed, agonist binding to the high-affinity receptor state was regulated in the presence of GTP gamma S, Gpp(NH)p, and pertussis toxin. [32P]ADP-ribosylation experiments identified a major approximately 41-kDa ADP-ribosylated protein present in Sf9 membranes that comigrated with partially purified bovine brain Gi alpha/G(o) alpha subunits. Measurements of adenylyl cyclase activity in membranes from cells expressing m5-HT1B receptors showed that serotonergic agonists mediated the inhibition of adenylyl cyclase activity with a rank order of potency comparable to their affinity constants. Immunoblot analysis of membranes prepared from cells expressing m5-HT1B receptors and photoaffinity labeling of the immunoprecipitated material revealed photolabeled species at approximately 95 and at approximately 42 kDa.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellular characterization of the pharmacological selectivity and tachyphylactic properties of denopamine for the human beta adrenergic receptors

The pharmacological properties of the cardiotonic agent denopamine toward human beta-1 and beta-2 adrenergic receptors (AR) were assessed in a heterologous expression system. In whole cells radiolabeled with the nonselective beta antagonist [125I]iodopindolol, denopamine displayed a 7-fold lower inhibition constant for the beta-1 than for the beta-2 AR. Similarly, denopamine exhibited a 7-fold greater potency to stimulate the adenylyl cyclase activity in cells expressing the beta-1 AR than in cells expressing the beta-2 subtype, which confirmed the subtype selectivity of this drug. The maximal stimulation of adenylyl cyclase activity by denopamine was less than 10% of that produced by isoproterenol at both receptor subtypes, which indicated that denopamine is a weak partial agonist. The extent of beta-1 AR desensitization induced by denopamine was then compared with that induced by the full agonist isoproterenol. By contrast with isoproterenol, preincubation with denopamine for 20 min did not induce any decrease in the responsiveness of the receptor to subsequent stimulation nor did it promote any sequestration of the receptor. A 24-hr pretreatment with denopamine produced a time-dependent reduction in the number of beta-1 AR with a rate of down-regulation slower than that produced by isoproterenol. These data therefore indicate that denopamine is a beta-1 adrenergic selective agonist with low intrinsic activity that is less prone than full agonists to cause desensitization. This may explain the long-lasting cardiotonic effects of denopamine compared with those of full agonists.

Mutation of tyrosine-350 impairs the coupling of the beta 2-adrenergic receptor to the stimulatory guanine nucleotide binding protein without interfering with receptor down-regulation

Long-term stimulation of the beta 2-adrenergic receptor (beta 2AR) leads to an internalization and degradation of the receptor. This down-regulation of the beta 2AR number contributes to the desensitization of the adenylyl cyclase activity induced by chronic exposure to agonists. It was proposed that two tyrosine residues (Tyr-350 and Tyr-354) located in the cytoplasmic tail of the beta 2AR play a crucial role in agonist-induced down-regulation. In addition to perturbation of the down-regulation, the substitution of these tyrosines for alanines also led to a functional uncoupling of the receptor from Gs [Valiquette et al. (1990) Proc. Natl. Acad. Sci. U.S.A. 87, 5089-5093]. To further characterize the relative contribution of Tyr-350 and Tyr-354 to the receptor interaction with Gs and agonist-promoted down-regulation, both tyrosines were individually replaced by alanines and mutant receptors expressed in CHW cells. We show here that mutation of Tyr-350 but not that of Tyr-354 significantly decreased the ability of the beta 2AR to be functionally coupled to Gs and thereby to stimulate the adenylyl cyclase. Moreover, in contrast to the double tyrosine mutation, neither of the single-point mutations affected the agonist-induced down-regulation pattern. These data suggest that the presence of either Tyr-350 or Tyr-354 is sufficient to maintain normal agonist-induced down-regulation whereas the integrity of Tyr-350 is required for an appropriate coupling to Gs.(ABSTRACT TRUNCATED AT 250 WORDS)