Cardiac muscle lesions associated with chronic administration of methamphetamine in rats

Cardiovascular complications associated with methamphetamine abuse have increasingly been reported. However, chronic cardiotoxicity of methamphetamine is not experimentally well documented. In this study, methamphetamine (1 mg/kg/day) was subcutaneously injected into 5-week-old male Wistar Kyoto rats (n = 30). Age- and sex-matched Wistar Kyoto rats served as controls (n = 30). After 14 and 56 days, hearts were examined by light and electron microscopy. Foci of myocytic degeneration and necrosis appeared in the sub-endocardial areas on day 14 of methamphetamine exposure. Myocytic degeneration and necrosis became more extensive on day 56. At this stage, myocytolysis, contraction bands, atrophied myocytes, and spotty fibrosis were patchily distributed throughout the myocardium in most of rats treated with methamphetamine. The accompanying ultrastructural features included marked degeneration of cardiac mitochondria with fractured and disrupted cristae, hypercontraction of myofibrils, and loss of myofilament. In contrast, cardiac myocyte lesions were not observed in control rats. These myocardial lesions in rats treated with methamphetamine for 56 days resemble the cardiomyopathy associated with methamphetamine abuse in humans.

Fatigue evaluation of lumbar muscles during repeated dynamic trunk exercise

Muscle fatigue in the lumbar muscles for five normal subjects was investigated during repeated dynamic trunk exercise using a lumbar extension machine which is designed to isolated lumbar extension functions. The electromyogram (EMG) signal from erector spinae muscles at lumbar 1 (L1), lumbar 3 (L3) and lumbar 5 (L5) spinal level was detected by bipolar Ag-AgCl surface electrodes. Subjects were required to perform one set of variable resistance lumbar extensions through a 72 degrees range of motion (ROM) with a weight load (50% maximal voluntary contraction) that allowed 13 repetitions of fatigue contraction. Median frequency (MF) of EMG power spectrum was analyzed to compare the difference of fatigability between each lumbar muscle. The experimental results indicated: 1) each lumbar muscle has characteristic MF, especially at the beginning of the trunk exercise (i.e., L1 = 86 Hz, L3 = 96 Hz and L5 = 106 Hz); 2) Significant differences (P < 0.001) in MF between the beginning and the end of trunk exercise for all lumbar muscle sites; 3) Significant differences in the decreasing ratios of MF between L1, L3 and L5. Based on the theory that the decreasing ratio of MF is proportional to fatigability, L5 was more fatiguable than L1 and L3.

Serum antibodies to carbonic anhydrase I and II in patients with idiopathic chronic pancreatitis and Sjögren's syndrome

BACKGROUND & AIMS

Patients with idiopathic chronic pancreatitis and Sjögren's syndrome show immune responses against a 60-kilodalton protein isolated from human pancreas extracts. Monoclonal antibody SP3-1, raised against the 60-kilodalton protein, reacts with ductal cells in several exocrine organs and cross-reacts with human carbonic anhydrase II. The present study evaluated serum from patients with these diseases for antibodies to human carbonic anhydrase I and II.

METHODS

An enzyme-linked immunosorbent assay was used to quantify serum antibody against carbonic anhydrase I and II.

RESULTS

Serum antibodies against carbonic anhydrase I and II were detected in 7 and 11 of 33 patients with idiopathic chronic pancreatitis, respectively, and in 8 and 13 of 21 patients with Sjögren's syndrome, respectively. The positive prevalence rates of patients with antibodies of carbonic anhydrase II were significantly different among patients with idiopathic chronic pancreatitis and Sjögren's syndrome compared with normal patients (1 of 21). There were no significant differences in the prevalence rates of patients with alcoholic chronic pancreatitis (3 of 20), gallstone-related chronic pancreatitis (0 of 7), and primary biliary cirrhosis (1 of 11).

CONCLUSIONS

The results suggest that carbonic anhydrase II is one candidate target antigen recognized during the autoimmune pathophysiology observed in idiopathic chronic pancreatitis and Sjögren's syndrome.

Immunoreactivity of antimitochondrial autoantibodies in Japanese patients with primary biliary cirrhosis

The incidence and prevalence of primary biliary cirrhosis show wide geographic differences. The frequency of this disease in Japan is lower than in Northern Europe. To elucidate the immunoreactivity of serum with enzymes of the 2-oxo-acid dehydrogenase complex (2-OADC) and the M2 mitochondrial antigenic complex in Japanese patients, we examined sera from 107 patients with primary biliary cirrhosis from three geographically different regions of Japan. The sera were assayed by immunofluorescence on frozen tissue sections, immunoblotting on bovine heart mitochondria and recombinant E2 subunit of branched chain oxo-acid dehydrogenase complex (BCOADC-E2), ELISA using recombinant E2 subunit of human pyruvate dehydrogenase complex (PDC-E2) and purified porcine 2-oxoglutarate dehydrogenase complex (OGDC), and enzyme inhibition assay using procine PDC and OGDC. Of the 107 sera, 95 (88%) reacted by immunofluorescence, 102 (95%) by immunoblotting with at least one of the M2 autoantigens, although only 78 (73%) reacted with PDC-E2; 72 (67%) by ELISA with PDC-E2; and 81 (76%) with PDC by the enzyme inhibition assay. Thus, the frequency of reactivity with PDC-E2 by all assays was lower for Japanese than the reported frequency for Caucasian patients with primary biliary cirrhosis, whereas the frequency of reactivity by immunoblotting and ELISA against 2-OADC enzymes other than PDC was relatively higher. The relative frequency of reactivity of autoantibodies to the M2 autoantigens was similar for the three different regions of Japan. The different autoantibody profiles for Japanese and Caucasian patients with primary biliary cirrhosis point to immunogenetic and environmental determinants of this disease, which should provide new insights into its autoimmune origins.

Hepatic sinusoidal endothelial cells can store and metabolize serum immunoglobulin

Sinusoidal inclusion-containing endothelial cells in the liver were investigated with particular interest in their capacity of metabolizing immunoglobulin. Formalin-fixed deparaffinized liver specimens were used for immunohistochemistry, and pronase digestion was proved to be effective for antigen retrieval of immunoglobulin. The inclusions in sinusoidal endothelial cells were strongly immunostained with anti-immunoglobulin (Ig)G, IgA, and IgM antibodies in predigested sections. The complements were not identified immunohistochemically in the inclusions even after pronase treatment. Two women with autoimmune liver disease, who initially represented high levels of serum gamma globulin and abundant inclusion-containing endothelial cells, were studied. The subsequent biopsy after effective corticosteroid therapy demonstrated significant histological improvement as well as the disappearance of inclusion-containing endothelial cells (ICECs). During and after treatment, their serum gamma globulin levels were drastically reduced. In conclusion, the hepatic sinusoidal endothelial cells can take up serum immunoglobulin, probably through a receptor-mediated pathway, and its excessive storage results in the formation of cytoplasmic inclusions that are easily recognized by a light microscope. The stored immunoglobulin may be degraded in the cytoplasm, and the inclusions would disappear in association with the reduction of sinusoidal gamma globulin content. In other words, the intralobular density of inclusion-containing endothelial cells is a morphological predictor for the serum gamma globulin level.

The power spectral analysis of heart rate variability in athletes during dynamic exercise--Part I

In this study, the effects of long-term physical training on autonomic function in athletes and the response of the autonomic nervous system to dynamic exercise were investigated in nonathletes and athletes with power spectral analysis of heart rate variability (HRV). This study was performed on 13 healthy subjects (5 athletes and 8 non athletes). Electrocardiographic (ECG) signals were continuously recorded during (1) 15 min of rest in a sitting position on a bicycle ergometer, (2) the dynamic exercise test to the point of exhaustion, and (3) a 15 min postexercise period. After the recorded ECG signals were sampled at 500 samples/s, the instantaneous HRV signal was constructed from the detected R peaks and then resampled at 4 Hz in order to obtain an evenly spaced time series applicable to power spectral analysis. After linear trends were removed by the robust locally weighted regression algorithm, the power spectrum of HRV was estimated for contiguous records of 512 samples by Burg's maximum entrophy method. HRV was quantified by determining the spectral area (power) in two frequency bands, low-frequency power (LF power: 0.05-0.15 Hz) and high-frequency power (HF power: 0.15-0.8 Hz), and their ratio. The comparison between athletes and nonathlete was performed in terms of the above-mentioned parameters. Although both groups showed similar trends in heart rate (HR) at all stages of protocols, HR in athletes was significantly lower than that in nonathletes during rest and postexercise. In athletes and nonathletes, LF and HF powers gradually decreased with exercise. As recovery progressed, they continued to increase gradually, but remained below resting level. During rest and postexercise, HF power in athletes was significantly (p < 0.05) higher than than in nonathletes. Also, the recovery of HR and HF powers during early recovery (PO1) was more rapid in athletes than in nonathletes. Both groups showed an attenuation of LF and HF powers during dynamic exercise. It is likely that, in athletes, the lower HR during rest and the more rapid recovery of HR postexercise was due to a high level of HF power, indicating that vagal activity was enhanced by the adaptive changes in neural regulation produced by long-term physical training.

Autoantibody against 70 kD heat shock protein in patients with autoimmune liver diseases

BACKGROUND/AIMS

It has recently been suggested that heat shock proteins are implicated in the pathogenesis and teh pathophysiology of various immunological disorders, and the presence of antibodies against heat shock proteins has been reported in several autoimmune diseases.

METHODS

We investigated autoantibodies against the two major human heat shock proteins (hsp70 and hsp90) in sera from patients with primary biliary cirrhosis and autoimmune hepatitis, the two major autoimmune liver disease. Reactivity with human heat shock proteins obtained from phytohemagglutinin stimulated cells was investigated by immunoblots with sera at 1:20 dilution.

RESULTS

Reactivity with human hsp90 was not found in any sera from patients or normal controls. In contrast, reactivity with human hsp70 was found in 16 of 35 (45.7%) primary biliary cirrhosis patients and in 9 of 17 (52.9%) autoimmune hepatitis patients, but similar reactivity was found in only 2 of 15 patients with chronic hepatitis B and 1 of 13 patients with chronic hepatitis C. All the normal controls showed a negative reaction. Two-dimensional immunoblots and immunoabsorption experiments established that the autoantibody recognized only human hsc70 (73 kD/pI 5.5), a constitutive form of the hsp70 family.

CONCLUSIONS

Although the pathological significance of the autoantibody against hsc70 in these autoimmune liver diseases remains unknown, the serum autoantibody detected in primary biliary cirrhosis patients is closely related to clinical variables including serum total bilirubin, alanine aminotransferase, IgG, IgM, titers of antimitochondrial antibodies, and major symptoms (pruritus and/or icterus). These observations may suggest that the anti-hsc70 antibody is an indicator for the disease activity of primary biliary cirrhosis.

Cardiac lesions and their reversibility after long term administration of methamphetamine

In order to clarify the effect of methamphetamine (MA) on myocardium, histological, immunohistochemical and electron microscopic changes in the myocardium of rats were examined following daily intraperitoneal administration of MA at a dose of 1 mg per kg body weight for 4, 8, and 12 weeks before sacrifice. Normal saline (NS) was similarly injected for the same period before sacrifice to constitute a control group. Light microscopic changes found in the myocardium of the MA-treated group included atrophy, hypertrophy, patchy cellular infiltration, eosinophilic degeneration and disarray, edema myolysis, fibrosis, and the appearance of vacuoles. Ultrastructurally, nuclei and normal mitochondria had various shapes and there were dilated T tubules and sarcoplasmic reticulum, the accumulation of glycogen granules and fat droplets. Intra- and extra-cellular edema and intramyocytic vacuoles were often found. Withdrawal of MA at the twelfth week in another group of rats evidenced gradual recovery of the myocardial changes, commencing at 3 weeks after withdrawal. Optimism is therefore generated about the possibility of the affected hearts in MA-abuse patients returning towards the normal state if they give up the drug.

The arterial ketone body ratio and serum alpha-fetoprotein level in patients with acute hepatic failure

Hepatocyte regeneration is essential for recovery in acute hepatic failure, although it requires a large amount of energy. The ratio of acetoacetate to beta-hydroxybutyrate in arterial blood has been reported to reflect the cellular energy charge of hepatocytes, and we proposed that the recovery of the ratio in the early days of acute hepatic failure is essential for survival. However, there is no report on any marker of regeneration to confirm this hypothesis. In this study, we have assessed this ratio and the serum alpha-fetoprotein level sequentially in 26 patients with acute hepatic failure. Ten patients recovered and 16 died. The arterial blood ketone body ratio 3 days after the onset of hepatic encephalopathy of grade II or more was below 0.6 in 15 of the 16 nonsurvivors, whereas that in the 10 survivors was above 0.6. There was a positive correlation between the arterial blood ketone body ratio and the maximal concentration of alpha-fetoprotein (r = 0.465, p < 0.02 by Student's t-test). These data indicate that the arterial blood ketone body ratio is a marker for the capacity of the liver to regenerate and for the prognosis in patients with acute hepatic failure: effective hepatocyte regeneration may be impossible if these metabolic changes in acute hepatic failure impair the hepatocyte energy charge severely.

Humoral and cellular immune responses to dihydrolipoamide dehydrogenase (E3): lack of specificity for primary biliary cirrhosis

Immune responses to dihydrolipoamide dehydrogenase, the E3 subunit which is a common component of 2-oxoacid dehydrogenase complexes, have been suggested to be associated with the etiology of primary biliary cirrhosis (PBC). However, since an antibody to E3 could be detected in Caucasian patients with PBC, but was not specific for the disease, the proposal is not evident at the antibody level. We have identified the antibody also in Japanese patients with PBC by immunoblotting with sera at a 1:100 dilution and have assessed cellular immune responses to E3 by proliferation assay of peripheral blood lymphocytes. Anti-E3 antibody was detected more frequently in 25 of 43 PBC (58.1%) than in normal controls (p < 0.01) and in chronic liver diseases (p < 0.05), but the antibody was not specific for PBC as reported in Caucasian PBC. Anti-E3 antibody-positive sera of PBC patients or normal controls and their IgG fraction did not inhibit the enzyme activity of E3. Lymphocyte blastogenesis to E3 in PBC was significantly greater than normal controls (p < 0.05), but was not significant as compared with chronic liver disease or non-hepatic autoimmune diseases. Thus, these data do not support the hypothesis that the immune response to the E3 subunit is associated with etiology of PBC.

Exacerbation of primary biliary cirrhosis during interferon-alpha 2b therapy for chronic active hepatitis C

A 60-year-old woman with chronic active hepatitis C was treated with 6 million units of rIFN-alpha 2b daily for two weeks and subsequently three times weekly for several months. Histological examination proved a severe form of chronic active hepatitis C unexpectedly complicated with primary biliary cirrhosis (PBC). Before treatment, levels of serum alkaline phosphatase (ALP) or gammaglutamyltranspeptidase (GGT) had remained within normal limits over six months, although anti-mitochondrial antibody (AMA) was shown to be positive. After eight weeks of therapy, the daily dose of rIFN was reduced to 3 million units because of a marked increase of ALP and GGT, although the serum alanine aminotransferase (ALT) was normalized. Four months later, IFN treatment was suspended because of continuous elevation of the ALP and GGT levels, and administration of ursodeoxycholic acid was substituted. Two months later, the ALP and GGT levels returned to the normal range, although ALT was not normalized and HCV-RNA remained positive. This is the first report case that demonstrates IFN treatment potentially exacerbates PBC associated with chronic active hepatitis C. It is important for treating physicians to keep this association in mind.

Effect of calcium antagonist, nicardipine, on cerebral blood flow in postasphyxial newborn piglets

An experiment was carried out in nine piglets within 24 h after birth (control group: four, nicardipine group: five) for the purpose of evaluating the effects of a calcium antagonist, nicardipine, on cerebral blood flow changes induced by asphyxia neonatorum. Under respiratory control with a mechanical ventilator, the animals were exposed to hypoxia. The inspiratory oxygen level was lowered at 15 min intervals from 0.08 to 0.06 and then to 0.05. When bradycardia (heart rate; 60/min or less) was observed, 100% oxygen, adrenaline, and sodium bicarbonate were administered for resuscitation. Nicardipine was administered at a dosage of 10 micrograms/kg via bolus injection 30 min after the resuscitation. It was administered thereafter at a rate of 10 micrograms/kg per h. The cerebral blood flow was measured using a laser Doppler velocimeter. The cerebral blood flow, electroencephalograph (EEG), blood pressure, and heart rate were continuously measured for 120 min after the resuscitation. In the control group, the mean arterial pressure 35 min after the resuscitation was 60 mmHg or more. However, the cerebral blood flow was lower than the prehypoxia value in the animals with a mean arterial pressure of 75 mmHg or less. In the nicardipine group, the mean arterial pressure was lower, but the cerebral blood flow was higher than the prehypoxia value and cerebral ischemia was not induced. The mean arterial pressure 120 min after the resuscitation was 72.0 +/- 8.2 mmHg in the control group, while it was 56.7 +/- 7.5 mmHg in the nicardipine group. It was significantly lower in the latter.(ABSTRACT TRUNCATED AT 250 WORDS)

T cell autoreactivity against a 28 kD biliary protein (B1-p28) in primary biliary cirrhosis

BACKGROUND/AIMS

Cellular immune responses against biliary epithelial cells are important in understanding the pathogenesis of primary biliary cirrhosis. We previously reported a biliary antigen B1 which stimulated peripheral T lymphocytes of primary biliary cirrhosis as a possible, non-mitochondrial target of biliary epithelial cells. Further characterization of B1 was performed.

METHODS

To confirm localization of B1 in biliary epithelial cells, a mouse monoclonal antibody was raised against B1. As B1 could be separated into two main components by SDS-PAGE under reducing condition, these components were individually cut out from Western blots and converted into antigen-bearing particles for a proliferation assay to detect the antigenic component responsible for stimulating lymphocytes. The relation of this proliferation to HLA DR antigens was also analyzed.

RESULTS

Immunohistochemically, B1 was shown to be specifically expressed on biliary epithelial cells of human liver tissue. Of two components from B1 under reducing condition, prominent proliferation against B1-p28, a 28 kD component of B1 was detected in primary biliary cirrhosis. The reactivities were significantly higher than chronic liver diseases (p < 0.001) or normal controls (p < 0.001). Furthermore, high responders to B1-p28 were observed frequently in primary biliary cirrhosis patients with HLA DR8 (p < 0.02), which was susceptible to the development of primary biliary cirrhosis.

CONCLUSIONS

These data suggest B1-p28 expressed on biliary epithelial cells is a candidate for the target antigen of primary biliary cirrhosis in addition to mitochondrial autoantigens. Further characterization of B1-p28 may provide new insight into the autoimmune mechanisms of primary biliary cirrhosis.

Pathological changes of myocardial cytoskeleton in cardiomyopathic hamster

Immunocytochemical investigation was performed on the cytoskeletal proteins in cardiac tissue of the cardiomyopathic hamster. Male cardiomyopathic UM-X7.1 hamsters at 180 days of age (n = 8) and age- and sex-matched normal BIO-RB hamsters (n = 8) were used in this study. Immunofluorescence microscopy using monoclonal antibodies against desmin, alpha-actinin, titin, and vincullin was employed. The heart weight to body weight ratio was significantly increased in the heart of cardiomyopathic hamster compared with that of normal hamster. In cardiomyopathic hamster, the left ventricular cavity was markedly dilated. Light microscopically, hypertrophy and atrophy of myocytes and myocardial fibrosis were prominently observed in cardiomyopathic myocardium. Immunocytochemically, desmin, alpha-actinin and titin showed the cross striations along the myofibers in normal myocardium. In contrast, in cardiomyopathic myocardium, desmin was irregularly distributed in myocytes and the amount of desmin was increased. Loss of cross striations of alpha-actinin and titin were frequently observed. Immunofluorescence against vinculin was not significantly altered. We conclude that the alterations of cytoskeletal proteins in myocardial cells may relate to decreased myocardial function in cardiomyopathic hamster failing heart.

Relation between grip strength and radial bone mineral density in young athletes

In this study, we evaluated the relationship between bone mineral density (BMD) and muscle strength in young athletes who had not yet experienced age-related bone loss. Radial BMD and grip strength were measured in 10 male college wrestlers, 16 female college basketball players, and 12 female college tennis players. Radial BMD was measured in the distal and middle radius by dual energy x-ray absorptiometry (DEXA). Isometric grip strength was assessed with a hand-held dynamometer. The dominant forearm was examined in the amateur wrestlers and basketball players for grip strength and BMD. Both forearms were examined in the tennis players. A significant positive correlation was found between radial BMD and grip strength in the dominant forearm, and between radial BMD and body weight. Moreover, to eliminate a possible effect of body weight on radial BMD, we compared radial BMD with grip strength in both the dominant and nondominant arm of 12 college tennis players. Grip strength in the dominant forearm was significantly greater than in the nondominant forearm. The midradial BMD of the dominant forearm was also significantly higher than in the nondominant forearm. Based on these findings, we conclude that grip strength is one of the determinant factors of radial BMD in the dominant forearm of young college athletes.

Sequential changes in human Ito cells and their relation to postnecrotic liver fibrosis in massive and submassive hepatic necrosis

To examine the relationship of Ito cells to postnecrotic liver fibrosis, liver specimens, obtained at autopsy from 17 patients with acute massive necrosis (AMN) and acute submassive hepatic necrosis (ASMN), were examined immunohistochemically. In normal adult livers, Ito cells positive for alpha-smooth muscle actin isoform (ASMA) were rarely seen, scattered along hepatic sinusoids. In contrast, in AMN the Ito cells in necrotic areas became strongly positive for ASMA. They were swollen with elongated cytoplasmic processes along collapsed sinusoidal walls. Around these ASMA-positive Ito cells, there were numerous infiltrated macrophages and lymphocytes present. There was no significant alteration of fibroblasts in the portal tracts. In the middle and late stages of ASMN, the spindle-shaped ASMA-positive Ito cells formed a continuous cellular network. New fibre formation was predominantly around them. In this immediate postnecrotic fibrosis, ASMA-positive stromal cells of Ito cell origin were distributed irregularly and were closely associated with reticulin and newly-formed collagen fibres. Regenerative nodules were surrounded by dense layers of ASMA-positive stromal cells. Throughout the stages of ASMN, portal fibroblasts remained negative for ASMA. We believe that Ito cells in necrotic areas show myofibroblastic transformation and play a central role in the postnecrotic liver fibrosis. Portal fibroblasts play no significant part in this type of fibrosis.

Assessment of training-induced autonomic adaptations in athletes with spectral analysis of cardiovascular variability signals

The purpose of this study was to assess the adaptive effects of endurance training on autonomic functions in athletes with spectral analysis of cardiovascular variability signals. Continuous ECG, arterial blood pressure (ABP), and respiratory signals were recorded from 15 athletes (VO2max > 55 ml/(kg.min)) and 15 nonathletes (VO2max < 45 ml/(kg.min)) in the sitting position during controlled respiration (tidal volume 700 ml and 15 cycles/min). The autonomic functions were assessed by the normalized low-frequency power (LF power: 0.06-0.14 Hz) and high-frequency power (HF power: the region of the respiratory frequency based on respiratory spectrum) obtained from the autospectra of the RR interval, systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) variability signals. The spontaneous baroreflex sensitivity (BRS) was evaluated by the moduli, BRSLF and BRSHF, of the transfer function between the RR interval and SAP variability in LF and HF bands. The resting HR in athletes was significantly lower than that in nonathletes. In the case of RR interval spectra, the HF power was significantly higher in athletes than in nonathletes, whereas the LF power was significantly lower in athletes than in nonahtletes. These differences might reflect an alteration of sympathovagal interaction with a predominance of parasympathetic activity. However, there was no significant difference in the LF power of SAP and DAP autospectra, reflecting the sympathetic vascular control. The BRSLF and BRSHF were significantly higher in athletes as compared with nonathletes. These results indicate that endurance training induces autonomic imbalance (i.e., the enhanced vagal activities/the attenuated sympathetic tone), which may in part contribute to the resting bradycardia and an increase in the spontaneous BRS in athletes.

Longitudinal characteristic curve of liver disease

A longitudinal characteristic curve of chronic liver disease (LCC-LD) is derived for the first time by a new method of time series data analysis, where a hospital information system is utilized as a clinical research application of the database. It describes a typical pattern of development of disease from the beginning of chronic hepatitis to the final stage of cirrhosis. The LCC-LD is obtained by effectively using patient data with various stages of developments of liver disease and the present method is applicable to derive the LCC of other diseases. The obtained LCC-LD may be useful for a clinical decision making support such as the prospective assessment (for example, the onset time of cirrhosis) of liver disease in individual patients, an evaluation of drug effect, etc.