Combination of cyclosporine and splene-ctomy suppresses interleukin-6 production and major histocompatibility complex class II expression and prolongs cardiac xenograft survival

Complications of splenectomy

Surgical removal of the spleen, splenectomy, is a procedure that has significantly decreased in frequency as our understanding of the infectious complications of the asplenic state increased. The full spectrum and details of splenic function, however, have yet to be fully outlined. As a result, our comprehension of the long-term consequences of splenectomy remains incomplete. We review the evidence relating to the effects of splenectomy on infection, malignancy, thrombosis, and transplantation. Perhaps the best-defined and most widely understood complication of splenectomy is the asplenic patient's susceptibility to infection. In response to this concern, novel techniques have emerged to attempt to preserve splenic function in those patients for whom surgical therapy of the spleen is necessary. The efficacy of these techniques in preserving splenic function and staving off the complications associated with splenectomy is also reviewed in this article.

Lipopolysaccharide administration increases acid and alkaline phosphatase reactivity in the cardiac muscle

The effect of lipopolysaccharide (LPS) administration on the in situ distribution of the reaction product of acid phosphatase (AcPase) and alkaline phosphatase (AlPase) activity was examined in the rat cardiac muscle using catalytical cytochemistry. Tissues of the heart were fixed and then incubated in reaction media for detection of AcPase and AlPase reactivity. In normal hearts, reaction product of AcPase activity was observed in lysosomes. AlPase reactivity was detected at the extracellular surface of the capillary endothelilal cells and in their caveolae. Following LPS administration, the number and the size of lysosomes possessing AcPase reactivity as well as their electron density significantly increased. Furthermore, they tended to form groups consisting of three to five lysosomes. Cytochemical reaction 2 and 24 hours after injection was similar. One week later, the reaction returned to its normal pattern. As in the case with AcPase, the first changes of the distribution of the reaction product of AlPase activity were detected 2 hours after injection. The changes included a remarkable increase of the number of enzymatically positive capillaries, intensified cytochemical reaction in endothelial cells, and an increased number of caveolae. Again, no noticeable differences in reactivity were observed 2 and 24 hours after injection and the reaction returned to normal one week later. Collectively, our data indicate that both cardiac AcPase and AlPase are affected early after injection of LPS. Although the pattern of cytochemical reaction of both phosphatases was restored one week later, it is believed that the altered distribution of their reactivity in early periods after LPS administration may be a factor contributing to the development of pathological changes in this organ at a later stage.

Tumor necrosis factor in the heart

The heart is a tumor necrosis factor (TNF)-producing organ. Both myocardial macrophages and cardiac myocytes themselves synthesize TNF. Accumulating evidence indicates that myocardial TNF is an autocrine contributor to myocardial dysfunction and cardiomyocyte death in ischemia-reperfusion injury, sepsis, chronic heart failure, viral myocarditis, and cardiac allograft rejection. Indeed, locally (vs. systemically) produced TNF contributes to postischemic myocardial dysfunction via direct depression of contractility and induction of myocyte apoptosis. Lipopolysaccharide or ischemia-reperfusion activates myocardial P38 mitogen-activated protein (MAP) kinase and nuclear factor kappa B, which lead to TNF production. TNF depresses myocardial function by nitric oxide (NO)-dependent and NO-independent (sphingosine dependent) mechanisms. TNF activation of TNF receptor 1 or Fas may induce cardiac myocyte apoptosis. MAP kinases and TNF transcription factors are feasible targets for anti-TNF (i.e., cardioprotective) strategies. Endogenous anti-inflammatory ligands, which trigger the gp130 signaling cascade, heat shock proteins, and TNF-binding proteins, also control TNF production and activity. Thus modulation of TNF in cardiovascular disease represents a realistic goal for clinical medicine.