Type VI collagen in mouse masseter tendon, from osseous attachment to myotendinous junction

BACKGROUND AND METHODS

The association of masseter tendon type VI collagen with other extracellular matrix (ECM) components was examined from osseous attachment to myotendinous junction by immunohistochemistry and transmission electron microscopy with ATP treatment and enzyme digestion.

RESULTS

In the tendon proper, fibrocytes extended their processes among bundles of striated collagen fibrils and associated with adjacent cells through amorphous materials, thus forming a three-dimensional network. The amorphous or filamentous material was observed around the fibrocyte cell body and along the cell processes, where the localization of type VI collagen was confirmed by immunohistochemistry using anti-type VI collagen antibody. After treatment with 20 mM adenosine 5'-triphosphate (ATP), 100 nm periodic fibrils, an aggregated form of type VI collagen, were formed in the place where amorphous or filamentous material was present before the treatment. In myotendinous junction, the ATP-aggregated periodic fibrils were observed to associate with the external lamina of the muscle cells as well as among junctional tendon collagen fibrils. In the tendon-bone boundary, ATP-aggregated periodic fibrils were observed around fibrocartilage-like cells in the uncalcifying area but not in the calcification front. Prolonged ATP treatment or hyaluronidase predigestion caused the formation of type VI collagen periodic fibrils in the area near the calcified matrix.

CONCLUSIONS

The distribution of type VI collagen in mouse masseter tendon is different in different anatomical position. This may reflect the different functional demand for this collagen.

Monoclonal anticardiolipin autoantibodies established from the (New Zealand white x BXSB)F1 mouse model of antiphospholipid syndrome cross-react with oxidized low-density lipoprotein

OBJECTIVE

Autoimmunity-prone (New Zealand white x BXSB)F1 ([NZW x BXSB]F1) mice have been shown to be useful as a model of antiphospholipid syndrome with myocardial infarction. The aim of this study was to examine the cross-reactivity of anticardiolipin antibody (aCL) derived from (NZW x BXSB)F1 mice with oxidized low-density lipoprotein (ox-LDL), which is closely associated with atherosclerosis.

METHODS

Six monoclonal antibodies (MAb) against CL were established from (NZW x BXSB)F1 mice, and reactivity of aCL with ox-LDL was examined by micro-enzyme-linked immunosorbent assay.

RESULTS

Higher titers of anti-ox-LDL autoantibodies were found in adult (NZW x BXSB)F1 mice compared with other autoimmunity-prone mouse strains (P < 0.01) or a control strain (P < 0.005). There was a significant positive correlation between titers of aCL and those of anti-ox-LDL in (NZW x BXSB)F1 mice (r = 0.79, P < 0.001). Of the 6 MAb against CL, 2 clones that showed beta 2-glycoprotein 1-dependent reactivity also cross-reacted with ox-LDL. Binding of monoclonal aCL to solid-phase cardiolipin was inhibited by ox-LDL, but not by native LDL.

CONCLUSION

We confirmed that aCL derived from (NZW x BXSB)F1 mice can cross-react with ox-LDL. This result suggests that aCL, which is closely associated with lupus-associated thrombosis, may also play an important role in atherosclerotic complications in patients with systemic lupus erythematosus.

Type VI collagen periodic fibrils in the synovium of the mouse temporomandibular joint

Immunohistochemical staining with anti-type VI collagen antibody was strongly positive in the intimal layer and moderately positive in the subsynovium. After treatment with 20 mM ATP, numerous structures with a periodicity of 100 +/- 10 nm (type VI collagen fibrils) appeared around the synovial cells. As the periodic dark bands were stained by ruthenium red, proteoglycan(s) or glycosaminoglycan(s) were probably associated with the type VI collagen fibrils. When the tissue was digested with testicular hyaluronidase before ATP treatment, the periodic fibrils were not found, and only a filamentous network of 100-nm interval was seen around the cells. Thus, type VI collagen is abundant in the synovium of the mouse mandibular joint and is associated with proteoglycans or glycosaminoglycans, which might have a role in its formation.

Increased spontaneous production of IL-8 in peripheral blood monocytes from the psoriatic patient: relation to focal infection and response to treatments

To evaluate the contribution of peripheral blood monocytes (PBMC) to epidermotropic inflammatory reactions in psoriasis, using an enzyme-linked immunosorbent assay we measured spontaneous interleukin-8 (IL-8) production in PBMC obtained from patients with psoriasis. IL-8 production in the psoriatic PBMC was significantly higher than that in normal control PBMC. Plasma IL-8 levels in psoriatic patients were also moderately increased compared to normal control levels. IL-8 production in PBMC was closely related to the clinical severity of psoriasis and to the response to treatment, including systemic methotrexate (MTX) treatment and tonsillectomy. IL-8 production in PBMC was also positively related to the production of interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in these cells. We speculate that the chemotactic cytokine IL-8 contributes to the development of psoriatic skin lesions, and mediates inflammatory reactions from the inflammatory focus to the psoriatic lesions.

Gastrointestinal vasculitis in autoimmune-prone (NZW X BXSB)F1 mice: association with anticardiolipin autoantibodies

Gastrointestinal vasculitis is a fatal aspect of systemic lupus erythematosus. Whether lupus-prone strains of mice develop gastrointestinal vasculitis, and whether it is accompanied by elevated titres of anticardiolipin autoantibody is not known. Lupus-prone (NZW X BXSB)F1 (W/BF1) mice, and other strains were examined immunohistologically. Levels of anticardiolipin autoantibody and circulating immune complexes were determined by microELISA. Reciprocal haploidentical marrow transplantations between W/BF1 and autoimmune-resistent B6C3F1 mice were made. Young adult W/BF1 mice had the highest incidence of gastrointestinal vasculitis (61%), and the highest mean titre of anticardiolipin autoantibody. Lesions consisted of subintimal fibrinoid degeneration in arterioles of the duodenum, jejunum and ileum, and were prevented, or alternatively induced by reciprocal marrow transplantations between W/BF1 and B6C3F1 mice. Mice engrafted with W/BF1 marrow which developed vasculitis had higher titres of anticardiolipin autoantibodies than engrafted mice free of vasculitis (P < 0.005). This represents the first report of gastrointestinal vasculitis as an aspect of systemic autoimmunity in lupus-prone mice. The concurrent elevation of anticardiolipin autoantibody and development of vasculitis suggests that anticardiolipin autoantibodies, and their proposed thrombogenic and vascular injury consequences, contribute to development of microvasculitis in lupus-prone mice.

Effects of highly hydrogenated soybean oil and cholesterol on plasma, liver cholesterol, and fecal steroids in rats

We investigated the relationship between dietary highly hydrogenated soybean oil (HSO) and cholesterol transport in rats. In the first study, to examine the effects on cholesterol transport of different concentrations of HSO in dietary oil, rats were given one of the three diets containing 0, 25, or 50% HSO in dietary oil with cholesterol (5 g/kg diet) or a diet without HSO and cholesterol for 22 d. Feeding the high concentration of HSO prevented the increase in plasma total cholesterol, hepatic total lipids, and cholesterol and the decrease in high-density lipoprotein-cholesterol, which were caused by dietary cholesterol. Moreover, HSO increased the fecal excretion, fecal lipids, and steroids in a dose-dependent manner. In the second study, to examine the effects on cholesterol transport of redistribution of steric acid in the triacylglycerol species contained in HSO, rats were given one of the six diets containing HSO (distearoylmonoacylglycerol and tristearoylglycerol)-rich, monostearoylglycerol-rich, or palmitic acid-rich oil with/without cholesterol (5 g/kg diet), for 30 d. Whereas the accumulation of cholesterol in the body was reduced, cholesterol excretion was enhanced effectively in rats given the HSO-rich diet compared with rats given the monostearoylglycerol-rich diet. These results suggested that not only the high concentration of stearic acid but also its uneven distribution in HSO-triacylglycerol contributed to the reduction in intestinal cholesterol absorption in rats.

Antiallergic constituents from oolong tea stem

The antiallergic constituents of oolong tea stem were examined. The stem extracts inhibited the 48 h homologous passive cutaneous anaphylaxis (PCA) reactions or rats in a dose-dependent manner and showed the same extent of inhibitory activity as ketotifen. All antiallergic constituents from the stem were concentrated into chloroform and ethyl acetate fractions, when extracted by various solvents. These fractions were treated with polyvinylpolypyrrolidone (PVPP), which resulted in the elimination of antiallergic activity in the ethyl acetate fraction, suggesting that one of the antiallergic constituents may be tea catechins. Then, six kinds of catechins, (-)-epigallocatechin gallate (EGCG), (-)-epigallocatechin (EGC), (-)-epicatechin gallate (ECG), -epicatechin (EC), (+)-catechin (C) and (-)-gallocatechin gallate (GCG), were isolated from the ethyl acetate fraction, and the inhibitory activity of these catechins on histamine release from rat peritoneal mast cells passively sensitized with anti-egg albumin (EA) IgE antibody was investigated. Among these catechins, significant inhibitory activity was observed in all the catechins except for EC. In addition, the inhibitory activity of GCG was greater than that of EGCG, which is well known to be an antiallergic constituent in tea. These results suggest that GCG may be a novel antiallergic constituent among tea catechins, and also the most potent.

Sinus arrest developed during gastric cancer operation in a progressive systemic sclerosis patient

We report a case of progressive systemic sclerosis (PSS) who suddenly developed sinus arrest during an operation for gastric cancer under general anesthesia. No abnormalities in her cardiac, respiratory or renal functions had been detected before surgery. The cardiac functions evaluated by echocardiogram before and after pacemaking eliminated heart muscular involvement. We speculated that the operation stress induced by general anesthesia altered the asymptomatic fibrotic sinus into apparent sinus dysfunction. Care should be taken in general anesthesia for scleroderma patients who are free from detectable cardiac manifestations.

Primary Sjögren's syndrome and psoriasis vulgaris in a case of OKT4 epitope deficiency

We report a 29-year-old female OKT4 epitope deficiency patient with primary Sjögren's syndrome and psoriasis vulgaris. Immunological investigations during the prolonged clinical course of her herpes zoster revealed that she has OKT4 epitope deficiency and primary Sjögren's syndrome. She had been treated for psoriasis vulgaris for 17 years without systemic immunosuppressive therapy. Flow cytometric study revealed that her OKT4 deficiency is heterogeneous and excluded interference with the OKT4 epitope by anti OKT4 autoantibodies. The rare coexistence of primary Sjögren's syndrome and psoriasis implicates an immune disturbance due to an unusual phenotype of CD4.

Nodular scleroderma: focally increased tenascin expression differing from that in the surrounding scleroderma skin

Nodular scleroderma is a rare variant of the disease, whose pathogenesis is uncertain. Tenascin is a recently cloned extracellular matrix protein which is thought to be a marker for tissue remodelling. To further investigate the pathogenesis of nodular scleroderma, we have followed up a case of this disease and studied tenascin expression in the nodular lesions and surrounding progressive systemic sclerosis skin. Previously, we demonstrated a long-lasting intermediate level of dermal tenascin expression in progressive systemic sclerosis; morphea and hypertrophic scar lesions showed strong but short-lived tenascin expression. In our current patient, high levels of tenascin were found in the nodules, which rapidly resolved. Thus, the time course of the clinical and histopathological findings together with the tenascin expression were more suggestive of hypertrophic scar than progressive systemic sclerosis. These findings imply that nodular scleroderma has a supplementary pathogenesis, such as itching, in addition to the proceeding systemic sclerosis.

Contrast-enhanced dynamic MR imaging of postmolar gestational trophoblastic disease

Conventional spin-echo (SE) and contrast-enhanced dynamic MR imaging were performed on a 1.5 T superconductive unit for evaluation of myometrial lesions in postmolar gestational trophoblastic disease (GTD) in 10 women. MR imaging was done at the time of the initial examination (n = 10), during (n = 6), and after repeated courses of chemotherapy (n = 10). The T2-weighted SE image revealed an enlarged uterus (n = 7), disappearance of zonal anatomy (n = 6), and heterogeneous signal intensities (n = 8) with prominent flow voids (n = 7). However, these abnormalities remained after repeated courses of chemotherapy, when the S-beta-HCG level returned to the normal range. Myometrial lesions characteristically had marked enhancement with areas of unenhancement on dynamic MR images in patients with highly elevated S-beta-HCG. Areas of contrast enhancement correlated with changes in S-beta-HCG level. The enhancement was reduced with decrease in S-beta-HCG level after repeated courses of chemotherapy. Six of 8 masses seen on T2-weighted images proved to be active trophoblastic lesions and 2 masses proved to be hematoma or necrosis. In 2 patients, abnormal myometrial lesions were detected only on contrast-enhanced dynamic MR imaging. These preliminary data indicate that contrast-enhanced dynamic MR imaging more clearly demonstrates myometrial involvement of postmolar GTD than conventional SE imaging.

Activated (HLA-DR+) T-lymphocyte subsets in cervical carcinoma and effects of radiotherapy and immunotherapy with sizofiran on cell-mediated immunity and survival

A prospective randomized trial on 312 patients with locally advanced cervical carcinoma (FIGO stages IB-IV) was carried out. The 5-year survival in 90 patients treated with radiotherapy and antitumor polysaccharide sizofiran, an extract from the culture broth of Schizophyllum commune Fries, in combination was significantly (P = 0.045) better than that in 82 patients treated with radiotherapy alone. Treatment with sizofiran and 5-fluorouracil in combination improved (P = 0.003) the 5-year survival in 60 patients treated with radiotherapy. In 244 cervical carcinoma patients, the percentage of activated CD8+ (CD8+HLA-DR+) T cells in the CD8+ T-cell subsets in peripheral lymphocytes increased significantly as the disease progressed. A similar tendency was observed in the percentage of activated CD4+ (CD4+HLA-DR+) T cells in the CD4+ T-cell subsets. These immunologic parameters were significantly increased by radiotherapy, but not by surgery. Sizofiran accelerated a recovery in the activated CD8+ T cells in the CD8+ T-cell subsets compared with that of sizofiran nontreated patients after radiotherapy. Our data show that possible immune impairment in cervical carcinoma may be caused by disturbances in cell-mediated immunity, and that sizofiran is an effective immunotherapeutic agent for cervical carcinoma because it stimulates a rapid recovery of the immunologic parameters impaired by radiotherapy.

Adnexal masses: accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging

PURPOSE

To determine the accuracy of transvaginal ultrasound (TVUS) and of precontrast and contrast material-enhanced magnetic resonance (MR) imaging in the differentiation of adnexal masses.

MATERIALS AND METHODS

Five blinded readers analyzed images of 80 masses in 72 patients. MR and TVUS images were interpreted in separate sessions. Findings were confirmed at surgery or laparoscopy.

RESULTS

Higher diagnostic accuracy was attained with MR imaging in mature cystic teratomas and endometriomas. However, better accuracy was achieved with contrast-enhanced MR imaging and TVUS in simple cysts, cystadenomas, and malignant tumors because internal details could be visualized. Receiver operating characteristic study indicated that observer confidence was significantly higher with contrast-enhanced MR imaging than with precontrast MR imaging (P = .011) or TVUS (P = .002) in the differentiation of benign and malignant masses.

CONCLUSION

Contrast-enhanced MR imaging is superior to precontrast MR and TVUS imaging in the characterization and differentiation of adnexal masses.

Remission of pustular psoriasis after cholecystectomy: role of focal infection in pustularization of psoriasis

We report an 81-year-old male with long lasting psoriasis with exacerbation who showed remission of skin lesions after cholecystectomy. He consulted our clinic for impetiginous skin lesions and was treated with oral antibiotics without improvement. Several days later, he developed right hypochondralgia and was diagnosed with acute cholecystitis with gallstones. After cholecystectomy, the skin lesions significantly improved and disappeared within three weeks. Laboratory examination data indicated that acute inflammatory parameters normalized simultaneously. Although the role of focal infection in psoriasis is obscure, our case emphasizes the importance of focal infection in the pathogenesis of unstable psoriasis.

Functional and immunoreactive thrombomodulin expressed by keratinocytes

In an immunohistopathologic study using two monoclonal antibodies that recognize independent epitopes on human thrombomodulin, we detected expression of thrombomodulin on Malpighian-layer keratinocytes, but not on the basal or upper granular-layer keratinocytes. Western blotting and thrombomodulin-specific enzyme-linked immunosorbent assay performed on both shaved skin and cultured SV40-transformed keratinocytes showed the expression of full-length thrombomodulin, indistinguishable from endothelial thrombomodulin. Thrombomodulin was expressed by keratinocytes in 1 mM calcium but not in reduced calcium. A functional assay for thrombomodulin revealed that epidermal-derived thrombomodulin possessed cofactor activity for thrombin-catalyzed protein C activation. The limited pattern of expression of thrombomodulin in epidermis implies that this molecule may be a differentiation marker of keratinocytes in addition to being a potent anticoagulant in the skin.

Conversion of antinuclear antibody specificity as a marker of deterioration of cutaneous lupus erythematosus into lupus nephritis

A 34-year-old male systemic lupus erythematosus patient (SLE) with cutaneous vasculitis developed renal failure after switching anti-nuclear antibody (ANA) specificity. He developed cutaneous lupus erythematosus with homogeneous and speckled type ANA and a high titer of anti-DNA antibody without renal involvement at 21 years of age. After developing lupus nephritis at the age of 27, the original ANA disappeared gradually. Two years later, a discrete speckled type ANA titer elevated abruptly to as high as 1:640 with low complementemia and without DNA antibody. Within five years, he suffered renal failure. This case of SLE suggests a direct correlation with ANA pattern and organ involvement.

Detection of interleukin-1 receptors in human epidermis. Induction of the type II receptor after organ culture and in psoriasis

Normal human epidermis is a rich source of biologically active interleukin-1 alpha (IL-1 alpha). Keratinocytes both synthesize this cytokine and respond to it via cell surface receptors (IL-1R), suggesting that the IL-1 system may play an important role in normal epidermal physiology and inflammation. In this study, we have examined the expression of IL-1R in normal and psoriatic epidermis, as judged at a functional level by the capacity to bind 125I-labeled IL-1 alpha (the principal IL-1 species present in epidermis) and by immunostaining with antibodies specific for each species of IL-1R. IL-1R was not readily detectable by either technique in normal, freshly isolated human epidermis. However, in lesional psoriasis or normal epidermis after 24 hours of organ culture, expression of IL-1R was dramatically induced, especially in basal keratinocytes. Immunostaining and antibody blocking studies demonstrated the induced IL-1R to be the type II species, a nonsignal transducing molecule previously demonstrated only on leukocytes. The Ka of this receptor was comparable to that previously demonstrated in vitro. mRNA for both species of IL-1R could be demonstrated by reverse transcriptase-polymerase chain reaction in fresh and cultured epidermis. These in vivo findings were confirmed in culture, where normal human keratinocytes expressed few IL-1R at rest but large numbers of type II IL-1R after activation by phorbol ester or interferon-gamma. We conclude that under resting conditions, epidermal expression of IL-1R is low. However, the potential for keratinocytes in vivo to express large numbers of the nonsignal transducing type II IL-1R is evident from both organ cultured and psoriatic epidermis. The in vitro induction of keratinocyte IL-1R by interferon-gamma suggests that this cytokine may be involved in the induction of type II IL-1R in inflammatory skin disease. The presence of bioactive IL-1 in epidermis, coupled with the inducible expression of the decoy type II IL-1R, indicates the existence of a highly regulated system of autocrine stimulation of keratinocytes by IL-1.

Magnetic resonance imaging of pseudomalignant osseous tumor of the hand

Noninfectious, nonneoplastic reactive processes of the hand, such as myositis ossificans circumscripta, pseudomalignant osseous tumor of soft tissue, and florid reactive periostitis, appear similar radiologically and histologically and are often difficult to differentiate. Magnetic resonance (MR) findings in two such lesions are reported. The extensive reactive change in the extraosseous soft tissue and the bone marrow and the relatively small extent of ossification may be characteristic. Although low-grade infection and small osseous neoplasms with reactive changes, such as osteoid osteoma, may still remain possible causes, MR imaging provides essential evidence for including noninfective, nonneoplastic reactive processes of uncertain cause in the list of differential diagnoses.

Energy restriction prevents and reverses immune thrombocytopenic purpura (ITP) and increases life span of ITP-prone (NZW x BXSB) F1 mice

Male (NZW x BXSB)F1 (W/BF1) mice develop immune thrombocytopenic purpura (ITP), which involves antiplatelet autoantibodies and shortened platelet life span. To determine whether reduction of dietary energy can prevent the development or reverse the progression of ITP, male W/BF1 mice were separated into five experimental groups and either given free access to semipurified diet (designated Group A, n = 50) or consumed 32% less energy from an otherwise comparable diet (Group B6, n = 20), or were initially allowed free access to diet then switched to energy restriction at ages 14, 17 or 22 wk (Groups B14, n = 10; B17, n = 20; B22, n = 20). Thrombocytopenia was prevented by energy restriction in Group B6 mice. Platelet-associated IgG (PAIgG) autoantibody levels and the number of splenic antiplatelet antibody-forming cells were low (P < 0.01) and the survival of injected IgG-coated RBC was extended in energy-restricted Group B6 mice (P < 0.01) compared with mice in Group A. Group A mice became progressively thrombocytopenic, with platelet counts as low as 34 x 10(10)/L. Progression of thrombocytopenia was reversed when energy restriction was initiated in Groups B14, B17 and B22, with platelet counts > or = 88 x 10(10)/L and reduction of PAIgG. Life span was extended among early onset energy-restricted Group B6 and Group B14 mice (P = 0.0001 and P = 0.005) but not among late onset energy-restricted Group B17 and Group B22 mice (P = 0.06 and P = 0.35) compared with Group A mice.(ABSTRACT TRUNCATED AT 250 WORDS)

Neural blockade, urokinase and prostaglandin E1 combination therapy for acute digital ischemia of progressive systemic sclerosis

To treat severe painful digital ulcers on progressive systemic sclerosis (PSS) patients, we developed a new combination therapy which included neural blockade, intravenous urokinase, and prostaglandin E1 infusion. All of these are already recognized treatments for circulatory disturbances in PSS. Although each of them alone has a limited effect on the painful ischemic attack in PSS; in stepwise combination, neural blockade for release of vascular spasm and pain, prostaglandin E1 for further vasodilatation, and urokinase for thrombolysis were effective in the treatment of digital ischemia in two PSS patients. This therapy reduced the necrotic areas predicted before therapy and saved fingers from amputation. It also relieved the intolerable digital pain and effected the recovery of digital function.