Bone resorbing activity in supernatant fluid from cultured human peripheral blood leukocytes

Psoriasis: a disease of abnormal Keratinocyte proliferation induced by T lymphocytes

Psoriasis affects 2% of the population in Western countries. Its aetiology and pathogenesis remain unknown but suggestions include abnormalities of blood vessels, neural components, epidermal cell cycle time or maturation of keratinocytes. More recently autoimmune reactions have been implicated involving stratum corneum antibodies(1) and antibodies to nuclei of basal epidermal cells(2). However, there is no convincing evidence that any of these abnormalities are of primary nature. In this article, Helgi Valdimarsson and his colleagues propose that the process leading to psoriatic lesions is triggered by T lymphocytes within the epidermal compartment. They envisage that psoratic lesions erupt where epidermal influx of antigen-carrying Langerhans cells and helper T lymphocytes overrides the normal epidermal suppressor mechanism.

Metabolic emergencies in cancer medicine

This article describes the many metabolic complications encountered in the management of cancer patients. Pathogenetic mechanisms and therapy are discussed, with special emphasis on hypercalcemia, the most common of these disorders.

Differentiation-inducing factor purified from conditioned medium of mitogen-treated spleen cell cultures stimulates bone resorption

Spleen cells treated with mitogens produce a potent bone-resorbing factor called osteoclast-activating factor (OAF). To examine the relationship between the bone-resorbing factor and other protein factors produced by spleen cells, the colony-stimulating factor (CSF), the differentiation-inducing factor (DIF), the macrophage fusion factor (MFF), and the macrophage growth factor (MGF) were purified from 2.68 liters of conditioned medium of mouse spleen cell cultures treated with concanavalin A. Purification was performed successively by DEAE-cellulose, Blue Sepharose, and Sephadex G-150 column chromatography and high-pressure liquid chromatography (HPLC). The DIF was successfully separated from CSF and MGF on HPLC. CSF coincided with MGF on HPLC, but MFF disappeared before application to HPLC. Only the DIF exhibited bone-resorbing activity, whereas CSF and MGF did not. The DIFs purified from L929 cells and Ehrlich ascites tumors similarly exhibited bone-resorbing activity. The DIFs purified from spleen cells and Ehrlich ascites tumor cells exhibited neither interleukin 1 (IL-1) activity nor tumor necrosis factor (TNF) activity, though the unfractionated conditioned medium from spleen cells did exhibit them. In the light of recent reports that IL-1 beta and TNF also stimulate bone resorption, the term OAF should refer to a generic activity rather than a single factor.

Cyclosporine A inhibits calcemic hormone-induced bone resorption in vitro

We have investigated the in vitro effects of cyclosporine (CsA), a potent immunosuppressive agent, on bone resorption induced by calcemic hormones. CsA inhibited parathyroid hormone (PTH), prostaglandin E2, 1,25-dihydroxy vitamin D3 (1,25(OH)2D3), and osteoclast-activating factor induced resorption of fetal rat limb bones in a dose-dependent manner. Established ongoing resorptive activity in bone was also inhibited by CsA. The CsA inhibition of bone resorption could be partially surmounted by higher concentrations of PTH and 1,25(OH)2D3. The inhibitory effects of CsA on limb bone resorption were reversible. Neither protein nor DNA synthesis were inhibited by treatment of limb bones with CsA. Thus, the inhibitory effect of this agent on bone resorption is not a cytotoxic one. These data could suggest that the induction of bone resorption by the calcemic hormones involves an immune cell derived mediator such as a lymphokine.

Advances in understanding cell interactions in tissue resorption. Relevance to the pathogenesis of periodontal diseases and a new hypothesis

Much of the connective tissue degradation that takes place in periodontal diseases is mediated by proteolytic enzymes. Previous studies have focused on the action of proteinases released by invading polymorphonuclear neutrophils and macrophages, and bacterial enzymes. In view of recent work establishing that resident connective tissue cells can be induced by cytokines to bring about the destruction of their own matrix, we propose a new hypothesis. In this we envisage that a critical step is the interaction of bacterial antigens with inflammatory cells, resulting in the production of a cytokine, interleukin-1. Our interpretation of in vitro evidence is that the loss of connective tissue attachment and bone matrix resorption in periodontal diseases is mediated by metalloproteinases such as collagenase and stromelysin released by cells of the periodontium. Such proteolytic destruction can be induced by interleukin-1, whose production may not be dependent on a specific microbial flora but may be triggered by a number of organisms. It is now clear that interleukin-1 has multiple actions on both immune and non-immune cells; these include the induction of lymphocyte differentiation and proliferation and the stimulation of bone and cartilage resorption, and prostaglandin and metalloproteinase synthesis by connective tissues. It seems likely that further knowledge about the production and function of this cytokine will have an increasing impact in many diseases that involve resorption, particularly since interleukin-1-like molecules can be produced by cell types other than monocytes/macrophages, including keratinocytes and fibroblasts.

Effects of human recombinant CSF-GM and highly purified CSF-1 on the formation of multinucleated cells with osteoclast characteristics in long-term bone marrow cultures

Several studies have suggested that the osteoclast is derived from a mononuclear precursor which is found in bone marrow. We have developed a system for studying the formation of osteoclast-like multinucleated cells in long-term bone marrow culture of baboon cells. Recombinant human CSF-GM and highly purified CSF-1, both of which stimulate the proliferation of monocyte/macrophage precursors, were found to increase the number of osteoclast-like cells formed in long-term bone marrow culture. CSF-GM stimulated multinucleated cell formation more consistently than CSF-1. The subsequent addition of 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) to cultures initially treated with CSF-GM or CSF-1 further increased multinucleated cell formation. Autoradiographic studies indicate that CSF stimulated multinucleated cell formation by increasing the proliferation of the precursor cell, and that the potentiating effect of 1,25-(OH)2D3 was caused by fusion of the increased numbers of precursors. These studies suggest that the interaction of locally produced colony-stimulating factors with circulating calcium regulating hormones may be important in the control of osteoclast formation and bone resorption.

The osteoclast and periodontitis

The osteoclast may play an important rŏle in the variable rate of osseous destruction seen in periodontitis. Current understanding of various aspects of the osteoclast may help explain this fact. This review paper will first look at two theories of cell origin of the osteoclast: the multipotential osteoprogenitor cell theory and the hemopoietic stem cell theory. Next, ultrastructural features characteristic to the cell such as the ruffled border, clear zone, and lysosomal system, will be discussed. Thirdly, current and proposed theories on the actual mechanism of bone degradation are considered. This includes the one-cell theory and the two-cell theory. Finally, elements which activate the osteoclast are enumerated and their delicate interplay is outlined. In the context of this information, pathways found in the periodontal lesion (microbial agents, inflammatory cells and their products) which attract and activate elements of the osteoclastic system are discussed.

Stimulation of bone resorption and inhibition of bone formation in vitro by human tumour necrosis factors

When leukocytes are exposed to mitogens or antigens in vitro, they release bone-resorbing activity into the culture supernatants which can be detected by bioassay. Like many lymphocyte-monocyte products, this activity has been difficult to purify because of its low abundance in activated leukocyte cultures and the unwieldy bioassay required to detect biological activity. Partially purified preparations of this activity inhibit bone collagen synthesis in organ cultures of fetal rat calvariae. Recent data suggest that both activated lymphocytes and monocytes release factors which could contribute to this activity. Recently, monocyte-derived tumour necrosis factor alpha (TNF-alpha) and lymphocyte-derived tumour necrosis factor beta (TNF-beta) (previously called lymphotoxin), two multifunctional cytokines which have similar cytotoxic effects on neoplastic cell lines, have been purified to homogeneity and their complementary DNAs cloned and expressed in Escherichia coli. As both of these cytokines are likely to be present in activated leukocyte supernatants, we tested purified recombinant preparations for their effects on bone resorption and bone collagen synthesis in vitro, and report here that both cytokines at 10(-7) to 10(-9) M caused osteoclastic bone resorption and inhibited bone collagen synthesis. These data suggest that at least part of the bone-resorbing activity present in activated leukocyte culture supernatants may be due to these cytokines.

Recombinant gamma-interferon inhibits prostaglandin-mediated and parathyroid hormone-induced bone resorption in cultured neonatal mouse calvaria

A role of gamma-interferon in the bone remodeling process can be implicated from its interference with bone resorptive processes in cultured neonatal mouse calvaria. The immune interferon is an efficient inhibitor of endogenous prostaglandin synthesis, particularly after stimulation by thrombin or arachidonic acid, and, in addition, has a calcitonin-like inhibitory effect on PTH-induced osteoclastic bone resorption.

Immunological function in osteoporosis

An imbalance of osteoblastic bone formation and osteoclastic bone resorption is thought to be responsible for the osteoporotic condition. The pathological events leading to this disorder are, in most instances, uncertain. A defect in the ability of osteoporotic patients to respond to foreign histocompatibility antigens in a mixed leukocyte reaction is reported here. The results further show that this defect is due both to a poorly responding lymphocyte population as well as to a suppressor factor in osteoporotic sera. In addition, there is a significant increase in the relative and absolute numbers of T cells in the patients' peripheral blood, while serum IgG, IgA, and IgM remain within the normal range. These findings are discussed in the light of a common immunopathological pathway regulating osteoclastic activity and leading to the osteoporotic condition.

Estrogens and antiestrogens stimulate release of bone resorbing activity by cultured human breast cancer cells

Patients with advanced breast cancer may develop acute, severe hypercalcemia when treated with estrogens or antiestrogens. In this study, we examined the effects of estrogens and related compounds on the release of bone resorbing activity by cultured human breast cancer cells in vitro. We found that the estrogen receptor positive breast cancer cell line MCF-7 releases bone resorbing activity in response to low concentrations of 17 beta-estradiol. Bone resorbing activity was also released in response to the antiestrogen nafoxidine. Other steroidal compounds had no effect on the release of bone resorbing activity. Estrogen-stimulated release of bone resorbing activity occurred with live bone cultures, but not with devitalized bones, indicating that the effect was bone cell mediated. The breast cancer cell line MDA-231, which does not have estrogen receptors, did not release bone resorbing activity in response to 17 beta-estradiol or nafoxidine. Release of the bone resorbing activity by MCF-7 cells incubated with 17 beta-estradiol was inhibited by indomethacin (10 microM) and flufenamic acid (50 microM), two structurally unrelated compounds that inhibit prostaglandin synthesis. Concentrations of 17 beta-estradiol and nafoxidine that caused increased release of bone resorbing activity by the breast cancer cells caused a four- to fivefold increase in release of prostaglandins of the E series by MCF-7 cells. These data may explain why some patients with advanced breast cancer develop acute hypercalcemia when treated with estrogens or antiestrogens, and why bone metastases are more common in patients with estrogen receptor positive tumors.

Lactate dehydrogenase activity in gingival crevicular fluid collected with filter paper strips: analysis in subjects with non-inflamed and mildly inflamed gingiva

A previous study of lactate dehydrogenase (LDH) in gingival crevicular fluid (GCF) suggested that the concentration is 10 to 25 times that of serum (means = 2300 international units/1 versus 100 IU/1 for serum). That study used capillary tubes to collect microliter amounts of GCF. Since invasive collection techniques can influence GCF flow, we evaluated LDH activity in GCF collected by filter strips. GCF was collected in a standardized fashion from 10 subjects with mild inflammation (GI = 0.5-1.0) and 10 subjects without evidence of gingival inflammation (GI = 0). Our results indicate that LDH volume activity was greater for subjects with GI = 0 (means = 105,529 IU/1) than for subjects with GI = 0.5-1.0 (means = 77,661 IU/1), but the difference was not significant. LDH total unit activity was significantly greater in subjects with GI = 0.5-1.0 versus GI = 0 (means = 0.048 IU versus means = 0.0242 IU, P less than 0.0001). The relationship of LDH volume activity to GCF volume, the regression lines fit to the data, and calculation of LDH total unit activity were important for analysis of enzyme activity in GCF.

Quantitative histologic studies on the pathogenesis of periarticular osteoporosis in rheumatoid arthritis

The pathogenesis of periarticular osteopenia in rheumatoid arthritis (RA) was investigated by histomorphometry on juxtaarticular bone removed during joint surgery. Twenty areas from 12 RA patients were compared with 14 areas from 6 osteoarthritis (OA) patients. There was no difference between the 2 groups in the percent of total bone volume. However, increased bone formation was suggested by an increase in the percent of active osteoid surface in RA compared with that in OA. Bone resorption was also increased in RA, as evidenced by increases versus OA in percent total resorptive surface, percent active resorptive surface, and number of osteoclasts. These results demonstrate increased turnover of bone in RA, especially in the resorptive phase of the periarticular trabecular bone. It is proposed that soluble factor(s) synthesized in the contiguous rheumatoid synovium may be transferred to the periarticular bone space, stimulating osteoclasts to resorb bone.

Patterns and mechanisms of localized bone invasion by tumors: studies with squamous carcinomas of the head and neck

Squamous carcinomas of the head and neck provide a useful model for analyzing patterns and mechanisms of tumor-associated bone destruction. Morphological studies show that a major part of the invasive process is mediated by local osteoclasts which erode bone in front of the advancing tumor. Functional studies indicate that both fresh tumors and tumor cell lines resorb calvarial bone in an in vitro test system, again by stimulating local osteoclasts. Prostaglandins of the E2 type are regularly released by the tumors, together with indomethacin-resistant, nonprostaglandin osteolysins. Control (nonneoplastic) tissues will resorb bone and release osteolytic factors, usually at lower levels of activity--such properties are thus tumor-associated rather than tumor-specific. Xenografts of squamous carcinomas resorb bone in vitro and synthesize osteolysins. They do not invade local bone in their hosts but some grafts regularly produce a systemic hypercalcemia. General implications are discussed, particularly for other human tumors which more frequently metastasize to bone. Possible pointers to the (partial) control of the destructive process are noted.

Caribbean T-cell lymphoma/leukemia

Caribbean T-cell lymphoma/leukemia (CATL) is a recently described neoplasm similar to Japanese adult T-cell leukemia/lymphoma, but it occurs in patients born in a different geographic region. Four adult Black West Indian women with CATL were studied using a multiparameter approach, including clinical, hematologic, pathologic, and immunologic investigations. The disease was usually characterized by adenopathy (with or without hepatosplenomegaly), peripheral blood involvement, hypercalcemia often in the absence of gross bony lesions, and a poor prognosis. The neoplastic cells were pleomorphic with marked nuclear irregularity of a multilobated or more cerebriform type. Lymph node biopsies demonstrated a diffuse pleomorphic lymphoma with variable degrees of nuclear irregularity and transformation. Marrow involvement consisted of focal nodules or, more commonly, scattered atypical lymphoid cells. Marrow biopsies also often demonstrated osteoclastic activity. Cases were all of T-cell origin, most commonly of T-helper phenotype, although there was some phenotypic heterogeneity. All patients had antibodies to the human T-lymphoma/leukemia virus.

Inhibition of parathormone-stimulated bone resorption by type I interferon

The effect of Type I interferon on bone resorption was studied by measuring its effect on parathormone-stimulated calcium release from neonatal murine calvaria in vitro. A pure human recombinant leukocyte interferon hybrid of the A and D subtypes was used, which has high antiviral activity on mouse cells. Calcium release was inhibited in a dose dependent fashion with 50% inhibition at about 10(-10) M or 600 U/ml, and the inhibition was reversible. The presence of interferon was required before or during the activation phase of the resorptive response, when the formation of osteoclasts from precursor cells would occur. When added to actively resorbing bone it had no effect. The data suggest that Type I interferon can inhibit the parathormone-regulated development of active osteoclasts, possibly by inhibiting osteoclast precursor differentiation.

Thymus-derived lymphocytes and their interactions with macrophages are required for the production of osteoclast-activating factor in the mouse

A bone-resorbing factor, comparable to the osteoclast-activating factor (OAF) produced from peripheral blood leukocytes, is shown to be produced by murine spleen cells activated with the T-cell mitogen Con A. Murine OAF is demonstrated here as being a product of the interaction between thymus-derived T lymphocytes and macrophages. Activation of T cells in the presence of macrophages with Con A yields culture supernatants with OAF activity. This OAF activity is not dialyzable and is not extracted by lipid solvents. Purified B cells in the presence or absence of macrophages and cocultured with Con A or activated with the B-cell-specific mitogen lipopolysaccharide yield culture supernatants with no detectable OAF activity. Similarly, macrophages cocultured with Con A or activated with lipopolysaccharide fail to yield culture supernatants with bone resorbing activity. These types of immune cell interactions are similar to that required for the production of lymphokines. These data support the hypothesis that one aspect of regulation of bone remodeling is through cells of the immune system.

Bradykinin stimulates bone resorption and lysosomal-enzyme release in cultured mouse calvaria

The effect of bradykinin on bone resorption was studied in cultures of newborn-mouse calvaria. Bradykinin (0.03 microM, 1 microM) stimulated the release of 45Ca2+ from bones dissected out from mice prelabelled in vivo with 45Ca. Bradykinin (1 microM) also augmented the release of stable calcium ( 40Ca ), Pi and the lysosomal enzyme beta-glucuronidase. The stimulatory effect of bradykinin on mineral mobilization and lysosmal -enzyme release could be blocked by indomethacin. It is speculated that concomitant generation of thrombin and bradykinin in areas of trauma and inflammation may induce resorption of nearby bone tissue.

Host responses in periodontal diseases

Great progress has been made in our understanding of the pathogenesis of periodontal disease, the primary role of bacteria as etiologic agents, and the critical modifying role of host responses. It is useful to consider several stages in the pathogenesis of periodontal disease - (a) colonization, (b) invasion, (c) destruction, and (d) healing - and to place into perspective the various host responses as they may affect each of these four stages (Table 5). With respect to colonization, although very little direct evidence is available, it is reasonable to suggest that antibodies, either secretory or serum-derived, acting by virtue of their ability to block attachment, could inhibit colonization by immune reduction of adherence mechanisms. With respect to invasion of the tissue, it appears that phagocytes, particularly the neutrophils, are important, acting in concert with opsonic antibody and complement in ingesting and killing the periodontal microflora before or during the early invasive process. A major advance in our understanding of the pathogenesis of periodontal diseases is the realization that the virulence of periodontopathic bacteria relates to their leukaggressive properties, allowing them to evade neutrophil protective mechanisms. Invasion of the periodontal tissues by bacterial products may be inhibited by the complexing of these products with antibody with the formation of antigen-antibody complexes that are phagocytosed and digested, particularly by scavenger phagocytes such as the macrophage. With respect to the destructive phase of periodontal disease, it is clear that the direct effect of lymphocytes mediated either through direct cytotoxic activity, or through biologically-active destructive lymphokines (such as alpha-lymphotoxin and osteoclast activating factor), can lead to tissue destruction. Macrophages, through the production of monokines, collagenase, and reactive oxygen species, can also lead to tissue destruction. The direct effects of bacterial toxins or enzymes which can lead to tissue destruction can be inhibited by complexing with antitoxic or enzyme-neutralizing antibodies. With respect to healing and fibrosis, very little direct information is available; however, it is possible that the lymphocytes and macrophages affect fibrosis by the production of chemotactic factors for fibroblasts which would be expected to bring them to the area of periodontal inflammation and also by production of fibroblast-activating factors, which then cause the fibroblasts to proliferate and produce collagen which replaces lost collagen or results in fibrosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Thymocyte activating factor(s) in human gingival fluids

Human gingival fluid contains a low-molecular-weight factor (10,000 to 25,000) which enhances the proliferation of murine thymocytes in the presence of suboptimal doses of mitogen. Although the gingival fluid has no Interleukin 2 (T cell growth factor) activity, as indicated by its inability to induce proliferation of an IL 2 dependent lymphocytic cell line, it is directly mitogenic for dermal fibroblasts. These studies suggest that the thymocyte and fibroblast growth-promoting properties of human gingival fluid may have important functions in regulating inflammatory responses in the human periodontal tissues.

Host response in experimental periodontal disease

Experiments were performed to determine the role of the immune response in rat periodontal disease. Germ-free rats were fed defined antigen-free liquid diets or a diet containing ovalbumin(OVA) as a prototype antigen. The OVA-fed rats demonstrated increased gingival lymphocytes (mainly T at early times), OVA-sensitized spleen cells, and increased periodontal bone loss. In further studies, rats pre-sensitized with OVA, and receiving OVA in the diet, showed elevated IgG antibody, sensitized spleen cells, and elevated periodontal bone loss scores. The concept that bone loss was due to mixed hypersensitivity reaction is consistent with the periodontal pathology. The effects of pre-immunization with A. actinomycetemcomitans (Aa) on periodontal bone loss in Actinobacillus (Aa) - infected rats was examined. Delayed hypersensitivity (DTH) was present in immunized rats throughout the experimental period. Sham-immunized rats showed DTH after 30 days of infection. In addition, immunized rats showed elevated bone loss scores. These experiments support the contention that a combination of hypersensitivity reactions (i.e., mixed hypersensitivity to Aa) could give rise to the periodontal pathology observed. Congenitally athymic rats (nude) were shown to have more periodontal bone loss than did normal littermates. However, bone loss in thymus-cell reconstituted nude rats was not different from that in control rats. Normal rats receiving Aa-sensitized T lymphocytes prior to infection with Aa demonstrated increased DTH and periodontal bone loss. These studies support the concept that T-cell functions and thymic regulation of immune responses can exert protective and/or destructive effects in periodontal disease. In order to modify disease, it will be necessary to enhance the protective aspects of the immune response and to minimize the detrimental aspects.

Increased ratio of helper to suppressor T cells in alopecia areata

We studied lymphocyte subsets in the blood of twenty-four patients with alopecia areata of various degrees of severity. There was an increase in the ratio of helper to suppressor cells that correlated with the extent of the disease, providing further evidence that the immune system may be involved in its pathogenesis.

An electron microscopic study of the synovial-bone junction in rheumatoid arthritis

The cellular characteristics of the rheumatoid synovial-bone junction (SBJ) were examined in the electron microscope. Large numbers of mononuclear inflammatory cells along the bone suggested the advance of the rheumatoid inflammatory lesion into bone tissue. The SBJ contained macrophage-rich and osteoclast-rich areas. The presence of the macrophage as a predominant cell type and the marked collagenolysis of the eroded bone matrix suggested that collagenase released by macrophages was responsible for a major portion of the bone erosion. The observation of osteoclasts with ruffled borders, containing free bone crystals in close contact with the bone, indicated that these osteoclasts were stimulated by the rheumatoid synovium. It seems likely that articular bone resorption depends upon the local host response to the macrophage and osteoclast in the rheumatoid joint.

The bone-resorbing activities in tissue culture of lipopolysaccharides from the bacteria Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Capnocytophaga ochracea isolated from human mouths

The activities of lipopolysaccharides (LPS) were assessed by measuring the calcium release from mouse calvaria in vitro and compared to that of LPS from Salmonella typhimurium. Stimulation of bone resorption was maximal at an LPS concentration of 10 micrograms/ml and at this dose all oral LPS preparations showed similar levels of activity and less than that of LPS from S. typhimurium. Only S. typhimurium LPS and B. gingivalis LPS retained bone-resorbing activity at 0.1 microgram/ml. No bone-resorbing activity was observed against killed bone and histochemical observations of stable acid phosphatase activity indicated both mononuclear and multinuclear cells participating in bone removal. Addition of indomethacin to the culture medium did not inhibit calcium release from the bones by any of the LPS preparations except for that from A. actinomycetemcomitans. Fetal calf serum completely blocked the activities of all the LPS preparations whereas human serum did not inhibit the action of B. gingivalis LPS. Thus this particular LPS could be important in mediating bone loss in chronic periodontitis.

Evidence for fibroblasts as the major source of prostacyclin and prostaglandin synthesis in dental cyst in man

Periodontal cysts synthesize large amounts of prostaglandins and collagenase which probably cause the localized bone destruction essential for intraosseous cyst growth. Fragments of cyst wall, and fibroblasts cultured from them, synthesized prostacyclin (PGI2) in addition to prostaglandin E2 (PGE2), PGF2 alpha and collagenase in vitro. Soluble products from cultures of unstimulated and phytohaemagglutinin-stimulated blood mononuclear cells enhanced the synthesis of these prostaglandins in monolayer cultures of cyst-wall fibroblasts. It is therefore proposed that cyst capsule fibroblasts are the major source of these bone-resorbing factors, acting under the stimulus of lymphocytes and monocytes in chronically inflamed cysts. Cysts which were not infiltrated by chronic inflammatory cells (follicular cysts, a keratocyst, an ameloblastoma, and an aneurysmal bone cyst) also produced prostaglandins and collagenase, indicating that the stimulatory mechanism for the production of bone-resorbing factors in these cysts may differ from that in periodontal cysts.

Identification of the receptor for antigen and major histocompatibility complex on human inducer T lymphocytes

Human T cell clones and monoclonal antibodies directed at their surface structures were used to define the receptor for the antigen and major histocompatibility complex on inducer T lymphocytes. The results indicated that the receptor is a single complex consisting of the monomorphic T3 molecule with a molecular weight of 20,000 to 25,000 and a clonotypic disulfide linked heterodimer Ti with a molecular weight of 90,000. Sepharose-bound monoclonal antibodies (anti-Ti4 or anti-T3) to the receptor could activate clonal proliferation and inducer function for B cell immunoglobulin secretion and thus substitute for the appropriate combination of major histocompatibility complex gene product and specific antigen.

An interleukin 1 like factor stimulates bone resorption in vitro

Many activities are now ascribed to the monokine interleukin 1 including enhancement of immune responses, stimulation of thymocyte proliferation, activation of B cells, stimulation of proteinase and prostaglandin production by connective tissue cells, stimulation of the production of acute phase proteins, induction of fever and the induction of neutrophilia. These activities were thought to be due to various different factors, but are now considered probably due to very similar, if not identical, molecules. The term interleukin 1 (IL-1) was coined to describe the factor released by monocyte/macrophages which acts on T and B lymphocytes. Only after this definition had been accepted was it shown that target cells other than lymphocytes were affected by IL-1. Products of human blood monocytes (mononuclear cell factor, MCF) have been implicated in the pathogenesis of inflammatory diseases such as rheumatoid arthritis and periodontal disease. Bone resorption is often a feature of such diseases, and monocytes are frequently found at sites of localized bone resorption. Preliminary experiments with monocyte-conditioned medium indicated that MCF could stimulate bone resorption. We therefore undertook this study to verify these observations and to determine whether purified IL-1 could stimulate connective tissue breakdown in vitro.

The effect of non-steroidal anti-inflammatory drugs on the metabolism of 14C-arachidonic acid by human gingival tissue in vitro

We investigated the effect of non-steroidal anti-inflammatory drugs on prostaglandins (PGs) and 12-hydroxyeicosatetraenoic acid (12-HETE) formation by inflamed human gingival tissues. Gingival tissue homogenates were incubated with 14C-arachidonic acid in the presence of indomethacin, piroxicam, or ibuprofen, and the organic solvent extracts were chromatographed on silica gel plates with standards for radiometric assay. There was a significant negative trend between the doses (10(-7)-10(-3) M) of each of indomethacin, piroxicam, and ibuprofen, and the amounts of PGF2 alpha, PGE2, PGD2, and 15-keto-PGE2 produced. All three drugs have a significant inhibitory effect on PGs and 12-HETE production at 10(-3) M when compared with the control. The rank order effectiveness of the drugs, at 10(-3) M, on PG inhibition was indomethacin greater than piroxicam greater than ibuprofen, and on 12-HETE inhibition was indomethacin greater than ibuprofen greater than piroxicam.

[Hypocalcemia in malignant diseases]

Hypercalcemia accompanies often malignant diseases. The majority of cases of malignancy complicated by hypercalcemia is induced by metastases involving bone, hypercalcemia may also accompany localised tumors. Various hormones have been implicated in the genesis of malignant hypercalcemia: ectopic secretion of parathyroid hormone by tumor or orthotopic secretion by concomitant primary hyperparathyroidism, prostaglandin activating osteoclasts, production of hypercalcemic factor other than these hormones. This review summarizes current knowledge about endocrine-mediated mechanisms which produce hypercalcemia and about its frequency and mechanism in different types of tumors.

Clinical course of retrovirus-associated adult T-cell lymphoma in the United States

We studied the clinical features of 11 patients with adult T-cell lymphoma associated with the human T-cell lymphoma virus. The patients were predominantly young, black, and born in the southeastern United States. They had an aggressive course, with the rapid onset of disseminated skin lesions or symptoms related to hypercalcemia and other metabolic disturbances, or both. Common findings included rapid enlargement of peripheral, hilar, and retroperitoneal lymph nodes, with sparing of the mediastinum; invasion of the central nervous system, lungs, or gastrointestinal tract; and opportunistic infections. A paraneoplastic syndrome characterized by increased bone turnover, abnormal bone scintigraphy, and hypercalcemia was present in all patients. Intensive combination chemotherapy produced prompt complete clinical remissions, which were generally of short duration. Similar features have been described in patients in Japan and the West Indies who had adult T-cell lymphoma, which is also associated with the human T-cell lymphoma virus. This syndrome should be suspected in patients presenting with the acute onset of widespread T-cell lymphoma in association with metabolic bone disease and hypercalcemia. The presence of the syndrome can be confirmed by appropriate serologic and virologic studies.

(Dichloromethylene)diphosphonate-induced impairment of T-lymphocyte function

The daily subcutaneous administration of (dichloromethylene)diphosphonate (clodronate) to 3-day-old normal inbred Wistar-Furth rats for 30 days produces osteopetrotic bone lesions resembling those of the osteopetrotic mutants. Furthermore, tooth eruption is prevented, growth slows down, and signs of runt disease appear. The weight of the thymus is decreased, and T cells from the thymus and spleen respond weakly to mitogens. These thymic disorders associated with defective bone resorption are very similar to those previously reported in the osteopetrotic mutant op rat and support the hypothesis of a link between the thymus and normal bone modeling and remodeling.

Bone formation by isolated calvarial osteoblasts in syngeneic and allogeneic transplants: light microscopic observations

Taking advantage of recently developed methods for osteoblast isolation, we used these cells to study bone morphogenesis in syngeneic and allogeneic intramuscular transplants. Syngeneic osteoblasts from fetal rat calvaria produced small islands of bone by the third day after transplantation. These islands increased in size and began to fuse after about 14 days. At the surface of the woven bone laid down first, lamellar bone developed. The amount of this bone increased, and in 56-day-old transplants solid blocks of bone were present. Osteoclasts were scarce, and the woven bone remained unresorbed. Bone marrow was absent. The structure of bone in transplants differed from that of mature calvarial bones in which only remnants of woven bone remained and bone marrow was well developed. The scarcity of osteoclasts in transplants could be caused by their relative paucity among the injected cells, since these cells responded strongly to added parathyroid hormone by increased production of cyclic adenosine monophosphate (cAMP) but only weakly to calcitonin. Osteoblasts isolated from the surface of calvarial lamellar bone of 28-day-old rats formed woven bone similar to the bone formed by fetal cells. This suggests that the type of bone produced does not depend on the intrinsic properties of the osteoblasts. Bone formed in an allogeneic system was surrounded by infiltrations containing lymphocytes, macrophages, and osteoclastlike cells in 14-day-old transplants. Osteoblasts at the bone periphery were destroyed and bone matrix was resorbed by infiltrating cells. Numerous bone lacunae were enlarged, suggesting the occurrence of osteocytic osteolysis. Isolated osteoblasts cultured for three population doublings or longer did not form bone after transplantation, although they retained some reactivity toward parathyroid hormone.

Orchestration of tooth movement

Recent advances in the art and mechanics of delivering orthodontic forces have achieved greater precision and control of tooth movement. The exact mechanism by which these forces orchestrate tooth movement is not thoroughly understood. An accurate understanding and precise control over the factors responsible for initiating and carrying out the tissue reaction will ultimately optimize the rate of tooth movement. An integrated hypothetical model for the mechanism of tooth movement is discussed here. This model is based on the most recent body of information available to explain how various stimuli affect bone cells. The roles played by piezoelectric responses, prostaglandin production, and biochemical factors are discussed, with particular emphasis on their importance and contribution in terms of maximizing the rate of tooth movement. The intelligent use of this knowledge will permit us to modify the orthodontic appliance and treatment regimen in order to achieve an optimum tissue response.

Thrombin, a stimulator of bone resorption

It is shown that thrombin (0.1-7 units/ml) stimulates calcium mobilization and bone matrix degradation, as indicated by release of [3H]proline, from cultured calvarial bones. The second finding in this paper, that indomethacin blocks the stimulating effect of thrombin on bone resorption, is consistent with the concept that prostaglandin synthesis may be involved in this process. It is suggested that thrombin is a potential mediator of bone resorption associated with inflammatory and malignant processes.

Induction of nonspecific tolerance to endotoxins reduces the alveolar bone resorption in ligature-treated rats

Previous experimental data from various laboratories indicate that endotoxin of gram-negative oral microorganisms might be one of the most important bacterial products involved in bone resorption during periodontitis. Immunologically nonspecific tolerance to endotoxins in rats was induced by repeated application of Serratia marcescens trichloroacetic acid-extracted endotoxin. Silk ligature was placed on the second maxillary molar of the endotoxin-tolerant rats as well as of control rats in which tolerance to endotoxin had not been induced. The animals were sacrificed 8 days later. The rats showed no specific immune response to the tolerance-inducing endotoxin as measured by passive hemagglutination and by the lymphoblast assays, but we found that bone resorption was significantly reduced in the endotoxin-tolerant rats as compared with ligature-treated animals in which tolerance to endotoxin had not been induced.

The hypercalcemia of malignancy: pathogenesis and management

The number of agents and treatment regimens which can be used in the medical treatment of hypercalcemia has increased markedly over the last 5 yr. As this list has increased, clinicians are anxious to know more about the humoral and cellular mechanisms which are responsible for the hypercalcemia of malignancy and to understand how these drugs work. Unfortunately there is no treatment available presently which is uniformally safe and effective, and the potential pathogenetic mechanisms responsible for hypercalcemia are hotly debated. In this review, we plan to summarize current views of the pathogenesis, clinical features and treatment of hypercalcemia associated with malignant disease.

Release of toxic microvesicles by Actinobacillus actinomycetemcomitans

Oral isolates of Actinobacillus actinomycetemcomitans (strain Y4) release spherical microvesicles in large numbers during normal growth. The biological activities of these products were studied, and it was estimated that approximately 1/10 of their dry weight was made up of heat- and proteolysis-resistant endotoxin. The chicken embryo lethality and bone-resorbing activity of the microvesicles were heat stable but proteolysis sensitive. Other laboratories have reported the presence of a heat- and proteolysis-sensitive leukotoxin in similar preparations. Accordingly, the microvesicles released by strain Y4 may contain, in addition to endotoxin, several potent substances which are highly toxic and active in bone resorption, and these may be significant factors in the pathogenesis of periodontal diseases.

The effect of force magnitude on extractable bone resorptive activity and cemental cratering in orthodontic tooth movement

The delay period in the orthodontic tooth movement cycle was studied with respect to the stimulation of an extractable bone resorptive activity and the degree of tissue damage at sites of greatest pressure. Total area of cemental cratering was used as a measure of tissue damage. Both bone resorptive activity and tissue damage were found to be significantly increased with moderate and high forces, a fact which supports the suggestion that bone resorptive activity is related to tissue damage.