Facial palsy from temporal bone lesions

INTRODUCTION

Facial nerve palsy results in the loss of facial expression and is most commonly caused by a benign self-limiting inflammatory condition, known as Bell's palsy. However, there are other conditions which may result in injury of the seventh cranial nerve and the radiologist should be familiar with their imaging appearances.

MATERIALS AND METHODS

The relevant anatomy of the facial nerve and pathology which may affect the intratemporal portion of the nerve is described. The role of imaging and choice of imaging modality is also reviewed.

RESULTS

High-resolution computer tomography(HRCT) images of the temporal bone and magnetic resonance(MR) images of the facial nerve from 11 patients who presented with facial nerve palsy were used to illustrate how intratemporal facial nerve injury of other aetiologies can mimic Bell's palsy. The typical imaging appearance of Bell's palsy was also presented.

CONCLUSIONS

Most patients with suspected Bell's palsy do not require radiologic imaging. However, when symptoms progress, persist or when there is multiple cranial nerve involvement, recurrent symptoms or subacute onset of facial nerve palsy, causes other than Bell's palsy should be considered.

Retroviral delivery of peptide modulators of cellular functions

Stable transduction of genetic material, in combination with sensitive methodologies for in vivo study of cell physiology, provides an opportunity to efficiently evaluate the functions of regulatory proteins. To dissect the minimal therapeutic function of such proteins, we have stably expressed protein microdomains as fusions, composed of short peptides, and detected specific subfunctions distinct from holoprotein function, using flow cytometry and other techniques. We demonstrate that retroviral delivery of the 24-amino-acid proliferating cell nuclear antigen-binding motif (p21C), derived from the C-terminus of the cell cycle inhibitor protein, p21, is sufficient to induce cell cycle arrest. Cells expressing this peptide motif reversibly execute both G1- and G2-checkpoint controls that are normally activated subsequent to interference with DNA synthesis. The p21C effect is distinct from results obtained with an intact p21 protein that also binds cyclin-CDK complexes and arrested cells exclusively at the G1/S transition. Thus, microdomains can exert unique biological effects compared to the parental molecules from which they were derived. To further evaluate the peptide delivery strategy, we analyzed the role of various kinases in IgE-mediated stimulation of mast cell exocytosis. Primary bone marrow-derived mast cells were transduced with retroviral constructs encoding short-kinase inhibitor motifs and analyzed by flow cytometry for effects on exocytosis. We found that a specific protein kinase A (PKA) inhibitor peptide suppressed IgE-mediated stimulation of mast cell exocytosis. This anti-exocytotic effect was mimicked by a small molecule inhibitor of PKA (KT5720). Thus, the ability to express protein microdomains can be a powerful means to subtly perturb cellular physiology in manners that reveal new paths for therapeutic intervention. We believe that such approaches might allow for new forms of gene therapy to become available.

Quantitative measurement of mast cell degranulation using a novel flow cytometric annexin-V binding assay

BACKGROUND

Mast cells are primary mediators of allergic inflammation. Antigen-mediated crosslinking of their cell surface immunoglobulin E (IgE) receptors results in degranulation and the release of proinflammatory mediators including histamine, tumor necrosis factor-alpha, and leukotrienes.

METHODS

Mast cells were stimulated to degranulate by using either IgE crosslinking or ionophore treatment. Exogenously added annexin-V was used to stain exocytosing granules, and the extent of binding was measured flow cytometrically. Release of the enzyme beta-hexosaminidase was used for population-based measurements of degranulation. Two known inhibitors of degranulation, the phosphatidylinositol 3 kinase inhibitor wortmannin and overexpression of a mutant rab3d protein, were used as controls to validate the annexin-V binding assay.

RESULTS

Annexin-V specifically bound to mast cell granules exposed after stimulation in proportion to the extent of degranulation. Annexin-V binding was calcium dependent and was blocked by phosphatidylserine containing liposomes, consistent with specific binding to this membrane lipid. Visualization of annexin-V staining showed granular cell surface patches that colocalized with the exocytic granule marker VAMP-green fluorescent protein (GFP). Wortmannin inhibited both annexin-V binding and beta-hexosaminidase release in RBL-2H3 cells, as did the expression of a dominant negative rab3d mutant protein.

CONCLUSIONS

The annexin-V binding assay represents a powerful new flow cytometric method to monitor mast cell degranulation for functional analysis.