Environmental and anthropic variabilities at Guanabara Bay (Brazil): A comparative perspective of metal depositions in different time scales during the last 5,500 yrs

The determination of age-dated metal sediment accumulation rates in a representative South American bay is able to portray the dimension of human impacts during the colonial occupation and industrial periods. Many studies have assessed metal distribution and chronology at Guanabara Bay, in Brazil. However, understanding natural variabilities associated to paleoclimatic changes and comparing these natural variabilities to anthropogenic processes are not well established to date. Accurate geochronological control integrating ages determined by ²¹⁰Pb and ¹⁴C chronologies through an exponential spline fit model allowed for a precise definition of changes associated to the holocene marine transgression, as well as the colonial period, leading to intense land use changes, and the industrial period. The reference values of the system were defined based on their concentrations and the accumulation rates of ecotoxicologically important metals. Al, Ba, Fe, Cd, Cu, Cr, Li, Ni, Mn, Pb, Si, Ti, V, and Zn distributions were determined in a Guanabara Bay core (BG-28) by the EPA 3051 method. Elemental distribution profile assessment allowed for the identification of variabilities associated to weathering processes, predominantly of lithogenic origin, mainly for Al, Ba, Fe, Li, Si, and V. Weathering processes occurred simultaneously to land use changes in the drainage basin since the colonial period, at 400 cal yr BP, and during the industrial period, mainly after the 1960s, denoted by Cd, Cr, Cu, Mn, Pb and Zn increases. The highest average metal enrichment values metals associated to industrial processes reached 5.95, with 119.1-fold higher accumulation rates than the background accumulation values observed between 4200 and 500 cal yr BP.

Spatial distribution of six managed tree species is influenced by topography conditions in the Central Amazon

In tropical forests, the spatial distribution of trees may present random, uniform, or grouped patterns that can simultaneously be affected by site and species characteristics. In Central Amazon, topographic gradients and soil water levels drive differences in tree species distribution and in forest dynamics at local scales. Knowing this kind of information can be useful for a forest manager to plan harvesting operations considering the microhabitat preference of merchantable species to reduce the disturbances caused by logging activities. Thus, the spatial variation of tree species is an important information to be considered to support the planning process of forest logging. The present study aims to evaluate the spatial distribution pattern of six species and analyze the relationship between the topography and the population densities and stem size of those species. The study was carried out in a forest production compartment managed by a private company located in the municipality of Silves, state of Amazonas, Brazil. The spatial pattern of the six species was characterized by Ripley's K function. Spatial distribution of diameter at breast height (DBH) and tree density based on kernel incidence calculation were evaluated for topographic classes of slope, elevation, and distance from streams, which were mapped using geographic information systems (GIS). The means of DBH and density of each species were compared among topographic classes by ANOVA and Tukey's test. The results demonstrated the predominance of the aggregate distribution pattern for the six species up to 1105 m (p < 0.01). The tree species Minquartia guianensis Aubl., Protium puncticulatum J.F.Macbr, Manilkara elata (Allemão ex Miq.) Monach, and Caryocar glabrum Aubl. Pers showed an increase in the tree density as the distance from the streams and elevation increased, standing spatially incident on plateaus. Kernel densities of Dinizia excelsa Ducke and Goupia glabra Aubl. were higher closer to streams. The DBH averages followed similar trends of population density for M. guianensis, M. elata, and C. glabrum, and the opposite pattern for D. excelsa, which presented larger individuals in less densely populated areas. P. puncticulatum and G. glabra mean DBH distribution was not affected by the topographic variables analyzed. Topography-related variables showed effects on variations of density and tree size, suggesting that species may be spatially sensitive to the habitat variability available in the study area. In view of logging planning, spatial distribution must be considered in decisions related to cutting down trees and maintenance of remaining trees, especially because some species are more aggregated in smaller scales. Moreover, as topographic variations affect the spatial distribution of size and density, the timber yield will vary spatially in the area, bringing implications for planning logging intensities, roads, skid trails and forest operations. Finally, the procedures and information generated in this study can be reproduced and applied to other species and managed areas to support the planning toward minimizing impacts on the spatial structure of commercial species, as well as to increase the chances of future stock recovery of managed forests in the Amazon.

Geographical Distribution of Schizotetranychus hindustanicus and Associated Mites in Roraima, Brazil

The Hindustan citrus mite, Schizotetranychus hindustanicus Hirst (Acari: Tetranychidae), is a quarantine pest present in the state of Roraima, Brazil. This mite, which was described in India in 1924, was reported in 2002 in Venezuela and spread to Roraima, where it was reported in 2008, and to Colombia, where it was reported in 2010. Its possible spread to other regions of Brazil is a threat to Brazilian citriculture. This study reports the current distribution of S. hindustanicus and potential predators of this pest and other mites associated with citrus in Roraima. A survey was conducted in August and September 2015 in the 15 municipalities of the state. In each municipality, orchards and citrus plants in backyards and public areas along highways and in urban areas were sampled. Samples of leaves and fruits were collected to identify the mite and its natural enemies. Schizotetranychus hindustanicus was found in all 15 municipalities in the state of Roraima. In total, 308 associated mites were found, with S. hindustanicus being the most abundant phytophagous mite, followed by Brevipalpus yothersi Baker. Amblyseius aerialis (Muma) was the most abundant predator, followed by Iphiseiodes zuluagai Denmark and Muma and Euseius concordis (Chant). The broad dispersal of S. hindustanicus in Roraima increases the risks of this pest reaching the main citrus-producing regions in Brazil.

An unusual case of dental infection by Pseudomonas aeruginosa causing a brain abscess: case report

A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23 year old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis. Antibiotics and analgesics were prescribed to treat the disease. However, after 10 days, she returned to the emergency room, presenting with proptosis of the right eyeball, subconjunctival haemorrhage, ophthalmoplegia and intense pain in the right orbit, in addition to headaches. After computed tomography was performed, she was diagnosed with a brain abscess in the frontal lobe with the involvement of the maxillary right first molar, the maxillary sinus, the ethmoid sinus and the orbital cavity. With culturing of the secretion, the growth of Pseudomonas aeruginosa colonies was evident. Treatment consisted of a craniotomy to drain the brain abscess, a Caldwell-Luc procedure to drain the right maxillary sinus, dental extraction and aggressive antibiotic therapy. After 6 weeks, the patient was discharged with no neurological sequelae.

Cardiac magnetic resonance assessment of takotsubo cardiomyopathy

Takotsubo cardiomyopathy is an important condition that can be difficult to differentiate from acute coronary syndrome on the basis of clinical, electrocardiogram, and cardiac enzyme assessment alone. Although coronary angiography remains important in the acute assessment of patients with suspected takotsubo cardiomyopathy, cardiac magnetic resonance (CMR) has emerged over the last decade as an important non-invasive imaging tool in the diagnosis and follow-up of this condition. We present a review highlighting the CMR features of takotsubo cardiomyopathy and its complications with particular focus on differentiating this condition from acute myocardial infarction and myocarditis.

Atomic force microscopy as a novel pharmacological tool

With the advent of the atomic force microscope (AFM), the study of biological samples has become more realistic because, in most cases, samples are not covered or fixed, which makes it possible to observe them while the cells are alive. This advantage of the AFM allowed the advent of a new invention: nanobiosensors using the cantilever (probe) of the AFM and, in this case, it is possible to observe the entering or exiting of specific molecules (including medications) from living cells. This is the smallest biosensor in the world, measuring about 100 microm long (about the width of a hair). Beyond sensing the area of interest with this biosensor, it is also possible to see the area and exactly what is occurring on it, in real time. This new tool will be very useful for several areas: molecular pharmacology, enzymology, physiology, molecular biology, biotechnology, biophysics, physical chemistry, analytical chemistry, and organic chemistry. This article discusses, mainly, the applications of this new technique to the field of pharmacology.

The use of Gd-DTPA as a marker of myocardial viability in reperfused acute myocardial infarction

At present, accurate assessment of the extent of myocardial viability after acute myocardial infarction is limited due to the spatial resolution of currently available imaging modalities. MR cardiac imaging, with its superior spatial resolution, would be used if viable and infarcted tissue could be separated based on signal intensity. In infarcted tissue, cell membrane breakdown allows the entry of the MR contrast agent Gd-DTPA which is normally extracellular. The increased space for Gd-DTPA distribution (partition coefficient, lambda) in this infarcted tissue results in increased Gd-DTPA concentration and hence increased signal intensity on T1-weighted MR images. In a canine model of ischemia/reperfusion injury, the partition coefficient in infarcted tissue increased as early as 1 min post reperfusion. lambda in infarcted tissue stayed increased over that in normal tissue for at least 8 weeks. The accuracy of contrast-enhanced MRI was confirmed by results of 201Tl SPECT and a cine MRI dobutamine wall motion study in a patient 1 week after an acute myocardial infarction. Thus, contrast-enhanced MRI shows great promise for the non-invasive determination of myocardial viability after acute myocardial infarction.

Gd-DTPA bolus tracking in the myocardium using T1 fast acquisition relaxation mapping (T1 FARM)

MRI methods currently used for bolus tracking in the myocardium, such as saturation recovery turbo-fast low-angle shot (FLASH) (srTFL), are limited by signal intensity (SI) saturation at high contrast agent (CA) concentrations. By using T1 fast acquisition relaxation mapping (T1 FARM), a Gd-DTPA bolus (0.075 vs. 0.025 mmol/kg) may be injected without causing saturation. This study tested the feasibility of in vivo T1 FARM bolus tracking under rest/stress conditions in seven beagles with multiple permanently occluded branches of the left anterior descending (LAD) coronary artery. Although it underestimated the myocardial perfusion reserve (MPR) measured ex vivo using radioactive microspheres (mean +/- SEM; 3.60 +/- 0.26), the MPR determined upon application of the modified Kety model (1.86 +/- 0.10) enabled distinction between normal and infarcted tissue. The partition coefficient (lambda) estimated at rest and stress using the modified Kety model underestimated ex vivo radioactive measurements in infarcted tissue (0.25 +/- 0.01 vs. 0.26 +/- 0.01 vs. 0.79 +/- 0.08 ml/g, P < 0.0001) yet was accurate in normal tissue (0.28 +/- 0.01 vs. 0.30 +/- 0.01 vs. 0.33 +/- 0.01 ml/g, P = NS). Thus, although unsuitable for myocardial viability assessment, T1 FARM bolus tracking shows potential for assessment of myocardial perfusion.

Examining a canine model of stunned myocardium with Gd-DTPA-enhanced MRI

It has previously been shown that the distribution volume of Gd-DTPA (lambda) in infarcted, canine myocardium is higher than that of normal tissue. The purpose of this study was to determine whether stunned myocardium exhibits increased lambda. Stunning was produced in beagles by means of 30 min LAD occlusion followed by 3 weeks (n = 4) reperfusion. Gd-DTPA was infused at each imaging session and lambda determined in vivo using a saturation recovery turboFLASH sequence; cine imaging was used to assess ventricular wall thickening (%WT). (201)Tl uptake was used as an independent assessment of viability. %WT data confirmed that the brief insult caused prolonged, yet reversible, regional contractile dysfunction in each animal. %WT was not significantly different from baseline values by 3 weeks post-reflow. Normal (201)Tl uptake confirmed the absence of infarction. The lambda of stunned tissue (lambda = 0.381 +/- 0.030 ml/g) was not elevated above that of normal tissue (lambda = 0.398 +/- 0.027 ml/g, P = NS), at any time point studied, in vivo. These data suggest that an increase in lambda is a specific indicator of irreversible damage.

Clinical assessment of myocardial viability using MRI during a constant infusion of Gd-DTPA

This study assessed the accuracy and feasibility of magnetic resonance imaging (MRI) during a constant infusion of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) for the determination of myocardial viability in patients with recent acute myocardial infarction (AMI). Nine patients were studied within 10 days of AMI. Rest-redistribution 201Thallium (201Tl) single photon emission computed tomography (SPECT) was used as a gold standard for viability. Using MRI, regional perfusion was assessed using dynamic imaging during a bolus injection of Gd-DTPA and viability was assessed during a continuous infusion. Finally, cine MR images were acquired at baseline, during low-dose dobutamine infusion and after recovery. To assess viability, the left ventricle was divided into 16 segments and signal intensity in corresponding MRI and redistribution SPECT segments were compared. Wall thickening index (WTI) was determined at each step during the dobutamine study. The results revealed that in five patients, reduced perfusion in infarcted regions was observed qualitatively during dynamic first pass imaging. There was a significant inverse correlation between 201Tl uptake and MRI signal intensity, i.e. infarcted tissue (low 201Tl uptake) had increased MR signal intensity. Segments were separated into normal (201Tl uptake > 90%) and infarcted (< 601%). lnfarcted MRI segments had greater signal intensity than normal segments (179 +/- 50 vs. 102 +/- 14%; P < 0.0001). WTI in normal segments increased by 18 +/- 8.5% (P < 0.0001) from baseline to 10 microg/kg per min of dobutamine while infarcted tissue WTI decreased 2.8 +/- 7.2% (P = 0.17). Thus regions of myocardium that were infarcted as defined by reduced 201Tl uptake and absent contractile reserve showed greatly increased MRI signal intensity during a constant infusion of Gd-DTPA. The use of MRI during a constant infusion of Gd-DTPA is accurate and feasible for the determination of myocardial necrosis in a clinical setting.

Contrast-enhanced MRI for the assessment of myocardial viability after permanent coronary artery occlusion

Previous studies in a model of ischemia/reperfusion using a constant infusion of Gd-DTPA have shown that distribution volume (lambda) is increased in infarcted myocardial tissue. This study examined this technique in the setting of permanent coronary artery occlusion. Ten beagles underwent permanent occlusion of a coronary artery for 2 days (N = 3), 1 week (N = 4), or 3 weeks (N = 3). Imaging was performed at 2 days and, depending on the length of occlusion, 1 week, 2 weeks, and 3 weeks to follow changes in lambda in vivo. At sacrifice, (201)Tl was injected and the extent of the hyperenhanced region was compared to pathology. lambda was increased in infarcted tissue by 2 days post occlusion and this increase persisted for 3 weeks. At sacrifice, lambda correlated strongly with (201)Tl uptake (r = -0.86 to -0.95, P < 0.05; i.e., lambda increased in infarcted tissue) and the size of the hyperenhanced region was comparable to pathological infarct size (slope 1.006, r = 0.96, P < 0.0001). Thus, beyond 2 days after coronary occlusion, MRI, during a constant infusion of Gd-DTPA, can assess myocardial viability regardless of the success of reperfusion. Magn Reson Med 44:309-316, 2000.

One-year treatment of chronic urticaria with mizolastine: efficacy and safety. URTOL study group

AIM

To assess the long-term safety and efficacy of the H1-receptor antagonist mizolastine in the symptomatic treatment of chronic urticaria (CU).

BACKGROUND

Mizolastine is a novel second generation antihistamine with additional anti-inflammatory properties which has been shown to be effective in this condition as well as in allergic rhinitis. As the drug is used for chronic treatment, a detailed study of its efficacy and safety over a prolonged period was warranted.

METHODS

This open label multicentre trial recruited 211 patients suffering from CU (67% female; mean age 40+/-13 years), with > or = 1 episode/week if untreated. After a 7-day placebo run-in period, patients received mizolastine (10 or 15 mg) for 12 months. Efficacy was assessed by the patient using daily diary cards and overall condition evaluation at study visits. Clinicians also assessed the same parameters at each visit, and gave a global assessment at study termination. Safety was assessed by monitoring adverse events and laboratory parameters. Cardiac safety was monitored every 4 months using 12-lead ECGs, with particular attention to QT intervals.

RESULTS

The trial was completed by 127 patients. Mizolastine reduced overall discomfort from the second week of therapy, and reduced itching and the number and size of wheals, as assessed by the patients. The clinician's assessment of the proportion of patients with > 10 wheals decreased from 42% to 28% after 2 months. Clinical assessment also indicated that itch intensity and angioedema were improved by mizolastine, and the improvement was sustained throughout the trial. The investigators estimated that 70% of patients benefited from therapy. There were no drug-related serious adverse events during the study. The cardiac repolarization assessed according to the QTc intervals was not modified during prolonged administration.

CONCLUSION

Mizolastine improves CU symptoms, and these improvements are sustained over 12 months with no loss of drug sensitivity. No specific side-effects are associated with its long-term use in the current study.

Assessment of myocardial viability using MRI during a constant infusion of Gd-DTPA: further studies at early and late periods of reperfusion

It was previously shown in a canine model of ischemia/reperfusion injury that the partition coefficient of gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) (lambda) increases in infarcted tissue. That previous study used a non-magnetic resonance imaging (MRI) method to measure lambda and only investigated reperfusion times from 2 hr to 3 weeks. This study presents evidence suggesting that lambda starts to increase as early as 1 min after reperfusion of a 2 hr occlusion and continues to rise for up to 2 hr or more; lambda stays increased as late as 8 weeks, reaching peak values at 1-11 days and subsequently decreasing. It was also demonstrated that lambda can be accurately measured in vivo using a saturation recovery turbo fast low-angle shot (FLASH) sequence. The results of this study show that MRI during a constant infusion of Gd-DTPA has great potential for the non-invasive determination of myocardial viability as early as 1 min to as late as 8 weeks following reperfusion of acute myocardial infarction.

Improved contrast agent bolus tracking using T1 FARM

Current MRI bolus tracking techniques, such as saturation recovery Turbo-FLASH (srTFL), suffer from signal saturation at high contrast concentrations. In this study T1 Fast Acquisition Relaxation Mapping (T1 FARM) was compared to srTFL. In phantoms, T1 FARM maps were linear with [Gd-DTPA] up to 7.0 mmol/L while srTFL images saturated above 2.0 mmol/L. In the canine left ventricle, blood concentration curves determined from T1 FARM saturated with bolus injections exceeding 0.075 mmol/kg, while srTFL curves saturated above 0.025 mmol/kg of Gd-DTPA. Also, T1 FARM improved contrast-to-noise ratio in tissue concentration curves since higher contrast concentrations could be measured without saturating.

Substance P binding to peripheral blood mononuclear leukocytes in atopic dermatitis

Substance P has various immunomodulatory effects, including in vitro modification of lymphocyte proliferation and cytokine release. Elevated levels of substance P and increased staining of substance P-positive nerve fibres have been reported in atopic dermatitis patients. We examined fluoresceinated substance P binding to a range of lymphocyte subsets and compared the results in atopic dermatitis, non-atopic psoriasis patients and normal controls. Fluoresceinated substance P and phycoerythrin-labelled monoclonal antibodies to CD3, CD4, CD8, CD57, CD19 and CD14 were incubated in duplicate with Ficoll-Hypaque separated peripheral blood mononuclear leukocytes. With flow cytometry the fluoresceinated substance P-positive cells were identifiable as a peak of positively fluorescent cells, and the percentages of positive cells were measured. We have demonstrated binding of fluoresceinated substance P to all subsets examined, with significantly less binding to atopic dermatitis CD3-, CD8- and CD57-positive cells. This may affect cytokine release and hence be important in the pathogenesis of atopic dermatitis.

[Measurement of arteriovenous oxygen difference in the monitoring of patients with subarachnoid hemorrhage due to cerebral aneurysm]

The arterious venous oxygen difference (AVDO2) due to the close relationship with cerebral metabolic rate of oxygen and cerebral blood flow shows metabolic alterations that occur in some pathological situations in the brain including subarachnoid haemorrhage. The AVDO2 was calculated by the Fick equation and the results evaluated by the Glasgow outcome scale. Measurements of arteriojugular oxygen difference were carried out in 30 patients with subarachnoid haemorrhage due to rupture of intracranial aneurysms, as an attempt to monitor the relationship between changes in AVDO2, clinical picture, and evolution of the patients. The subarachnoid haemorrhage was diagnosed by CT scan in 17 patients and by lumbar punction in 13 and the diagnosis of arterial vasospasm was carried out by clinical evaluation and confirmed by four vessels angiogram in only eight patients. Eighteen patients were admitted with Hunt & Hess (H&H) I/II, seven with H&H III and five with H&H IV/V. Nineteen patients had AVDO2 normal and this group had three deaths; five patients had AVDO2 continuously low with three deaths; and six patients had AVDO2 continuously high with two deaths. The patients with normal AVDO2 had better prognosis and clinical evolution than the patients with abnormal values of AVDO2. In conclusion, AVDO2 measurements could not be correlated with the diagnosis of vasospasm, but was useful in the early identification of metabolic changes that occur after subarachnoid haemorrhage and could be used as an supplementary monitoring in the clinical evaluation of patients with this pathology.

The determination of myocardial viability using Gd-DTPA in a canine model of acute myocardial ischemia and reperfusion

The partition coefficient of Gd-DTPA was thought to vary with the amount of cellular membrane damage after an acute myocardial infarction. The relationship between the partition coefficient of Gd-DTPA (lambda) and the uptake of 201Tl (as a marker of tissue viability) was studied 2 h to 3 weeks after reperfusion of a 2-h occlusion to the left anterior descending coronary artery in a canine model. Gd-DTPA was infused as a bolus followed by a prolonged constant infusion, and this infusion protocol was optimized such that the concentration of Gd-DTPA was directly related to lambda. After this infusion, MR images of excised hearts showed regions of increased signal intensity corresponding to increased Gd-DTPA concentration. At all time points, lambda and 201Tl uptake were strongly negatively correlated indicating that lambda is an accurate indicator of myocardial viability. Furthermore, lambda in the infarcted regions was increased relative to normal regions after 2 h of reperfusion and stayed elevated up to 3 weeks. At all time points, lambda in the infarcted and normal regions were significantly different. As well, this data showed a trend that lambda in infarcted regions decreased monotonically from 1 day to 3 weeks. This trend was confirmed with MR imaging by examining the change in signal intensity of in vivo images from 4 days to 3 weeks in two animals. These results suggest that MRI with Gd-DTPA could be used to measure the extent of myocardial damage after an acute myocardial infarction.

[Acute traumatic subdural haematomas: study of 110 cases]

We report a series of 110 patients with acute traumatic subdural hematoma (ASDH) admitted at HBDF emergency within 1994 (January 1st to December 1st). All patients were treated according to the same protocol. There was a predominance of males (79%), with ages ranging from 14 to 70, being car accidents (20%) and car-pedestrian accidents (34%) the most frequent causes. The majority of patients (85.7%) was admitted in very serious condition, with a score of 8 points on the Glasgow Coma Scale (GCS) or lesser, which directly influenced the mortality rates. CT scan was the diagnostic procedure of choice, and it showed contusion and brain swelling to be the most frequent associated intracranial lesions. Surgery was carried out in 45.1% of cases and, in most instances, through an ample fronto-temporo-parietal craniotomy, with hematoma drainage and dural reconstitution. In 54.9% of cases, clinical conditions did not allow surgery and in this group, 69.6%.

Laboratory indicators for monitoring HIV disease

Immunological monitoring of disease progression following HIV infection and seroconversion illness, latency and AIDS, not only helps in the basic investigation of the natural history of the viral infection in man, but also can assist in prognosis and treatment of AIDS-defining illnesses. However, outside clinical trials, these tests should be selected and used in clinical practice only if they are validated as relevant and effective. The absolute CD4+ T-helper lymphocyte count, measured by flow cytometry, has emerged as the best available investigation, but needs care in sampling due to diurnal and circadian rhythms, effects of age, pregnancy, therapy, intercurrent infections and technique. Sampling should provide a baseline and trends-monthly intervals initially, then quarterly in uncomplicated cases. Thresholds may be given for counts (e.g. 200/microliter) below which prophylaxis against pneumocystis pneumonia should be administered, and repeating persistently low counts (e.g. below 50/microliter) is seldom helpful in practice. Serum levels of beta-2 microglobulin, neopterin and immunoglobulins rarely add information. Physicians and laboratories should have testing guidelines based on clinical audit of best practice, based in turn on scientific understanding of the immunological processes involved.

Lipid peroxidation: the role of Ca2+ and protection by calcinine

When calcinine (A-23187) (2 microM), a known Ca2+ ionophore, is present, a significant protection is observed to a mitochondrial suspension undergoing lipid peroxidation by Fe(2+)-citrate complex. A-23187 can remove Ca2+, which seems to have an important role in the lipid peroxidation process, from its 'lesive sites' and consequently preventing the damage. This information has importance in terms of knowing the mechanisms and avoiding the damages of lipid peroxidation that occur in some pathological cases such as tumor promotion and hemochromatosis.

Protective effect of safranine on the mitochondrial damage induced by Fe(II)citrate: comparative study with trifluoperazine

In this study, we show that safranine at the concentrations usually employed as a probe of mitochondrial membrane potential significantly protects against the oxidative damage of mitochondria induced by Fe(II)citrate. The effect of safranine was illustrated by experiments showing that this dye strongly inhibits both production of thiobarbituric acid-reactive substances and membrane potential decrease when energized mitochondria were exposed to Fe(II)citrate in the presence of Ca2+ ions. Similar results were obtained with the lipophylic compound trifluoperazine. It is proposed that, like trifluoperazine, safranine decreases the rate of lipid peroxidation due to its insertion in the membrane altering the physical state of the lipid phase.

In vitro cytokine profiles and their relevance to rejection following renal transplantation

Graft rejection remains an important cause of renal allograft failure, despite improvements in immunosuppression and HLA typing. Although HLA matching is beneficial, ensuring an exact match it is often impractical. Thus, a reliable in vitro method for quantitating and qualitating alloreactivity is an important goal. In this study, we measured in vitro the cytokine secretion profiles of mononuclear cells from patients prior to renal transplantation by stimulating with anti-CD3 monoclonal antibody and suppressing with cyclosporine. Mononuclear cells from patients who subsequently developed acute cellular rejection secreted higher mean levels of interleukin (IL)-2 and gamma-interferon (IFN-gamma) than those from patients who had no rejection episodes. IFN-gamma secretion was significantly associated with rejection (P = 0.002), whereas IL-2 secretion did not quite reach statistical significance. There was no significant correlation between IL-4 levels and rejection. Although cyclosporine suppressed the secretion of both IL-2 and IFN-gamma, there was no difference in sensitivity to suppression between rejectors and nonrejectors. These results further emphasize the importance of the TH1 lymphocyte subset in renal allograft rejection. The IFN-gamma secretory capacity of alloreactive T cells may influence the outcome of a renal allograft by (1) activating graft infiltrating macrophages and/or (2) up-regulating HLA molecules on the graft.

gamma-interferon production in atopic dermatitis shows differential modification by phosphodiesterase and prostaglandin inhibition

Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear leucocytes (MNL) is reduced in atopic dermatitis (AD) patients. This may be related to abnormalities in second messenger systems, and increased prostaglandin E2 (PGE2) release from monocytes. We compared the effects of manipulating the second messenger activity using the phosphodiesterase (PDE) inhibitor Ro 20-1724, dibutyryl cyclic adenosine monophosphate (cAMP), and cyclooxygenase inhibition of PGE2, on IFN-gamma production by cultured MNL from AD patients (n = 9) and normal controls (n = 10). Ficoll-Hypaque-separated MNL were cultured for 48 h with OKT3 stimulation, and cAMP, Ro 20-1724, or indomethacin. Supernatants were analysed for IFN-gamma by ELISA. Basal IFN-gamma was lower in AD patients, and the increase in IFN-gamma production with OKT3 was 6.5-fold greater in control subjects than patients with AD. Culture with indomethacin significantly enhanced OKT3-stimulated IFN-gamma production in both groups, whereas OKT3-stimulated IFN-gamma production was abolished with dibutyryl cAMP. IFN-gamma production was significantly lower with Ro 20-1742 in AD than in normal controls. We have shown reduced IFN-gamma release from unstimulated and stimulated MNL in AD patients compared with normal controls. The addition of indomethacin increased IFN-gamma production in both groups, although the increase was less in AD patients, suggesting an intrinsic cellular defect. IFN-gamma release from AD MNL was more sensitive to the inhibitory effects of PDE, and this may be due to increased PDE activity, or the hyperdynamic cAMP system present in atopics.

Limiting dilution analysis of the allo-MHC anti-paternal cytotoxic T cell response. I: Normal primigravid and multiparous pregnancies

Anti-paternal cytotoxic T lymphocyte precursor frequencies (CTLpF) were determined by limiting dilution analysis (LDA) in the peripheral blood of eight primigravid and seven multiparous women during the three trimesters of pregnancy. In five of these women the responses to cord blood lymphocytes (CBL) and paternal lymphocytes were also determined at the time of delivery and at 6 weeks post delivery. As controls, CTLpF against unrelated third party donors were determined. A wide range of CTLpF against all three groups of targets was found in both the primigravid and multiparous women, reflecting the wide range of frequencies found in random populations. These frequencies remained fairly constant during and 6 weeks after the pregnancy. Splitwell analysis demonstrated that the responses generated in our culture system were specific to the stimulator. The LDA data conform to single-hit kinetics, indicating that only cytotoxic T cells were limiting in the assay. Proliferative responses of maternal lymphocytes to paternal, cord blood and third party MHC antigens also remained unchanged as determined by time-course mixed lymphocyte reactions (MLR). Our data suggest that there is no significant allo-stimulation or suppression of the maternal immune system during normal pregnancy. The mother remains immunocompetent and is capable of both cytotoxic and proliferative responses to paternally-derived fetal MHC antigens. Our findings confirm that in normal pregnancy the trophoblast, which is devoid of classical MHC antigens, forms an effective immune barrier which prevents interaction of the maternal and fetal immune systems.

Limiting dilution analysis of the allo-MHC anti-paternal cytotoxic T cell response. II: Recurrent spontaneous abortion and the effect of immunotherapy

Using limiting dilution analysis (LDA) we determined anti-paternal cytotoxic T lymphocyte precursor (CTLp) frequencies in the peripheral blood of 10 women with unexplained recurrent spontaneous abortion (RSA) before and after immunization with paternal lymphocytes. The women and their partners were HLA tissue-typed and none of the women had anti-paternal cytotoxic antibodies (APCA) before immunization. All other known causes of RSA were excluded. All 10 women were found to have high frequencies of specific anti-paternal cytotoxic T cells before immunization (range 1/1030 to 1/9574). Splitwell analysis showed that these cytotoxic cells were specific to paternal MHC antigens. These frequencies rose significantly following immunization (range 1/683 to 1/4652). The cytotoxic T lymphocyte frequencies against an HLA-mismatched third party varied from woman to woman, but were not affected by the immunization. The LDA data conformed to single-hit kinetics, indicating that only cytotoxic T cells were limiting in the assay. Our data are in sharp contrast to the previously held view that women with RSA may be hyporesponsive to paternal MHC antigens. Immunizing such women with paternal leucocytes further sensitizes them. These findings cannot be reconciled with a favourable outcome in the treatment of RSA with immunotherapy. We would argue that this treatment is at best of unproven value, and may even be harmful. That these women may sometimes have successful pregnancies following immunotherapy testifies to the effectiveness of the classical MHC antigen-deficient trophoblast as an immunological barrier between mother and fetus.

Protective effect of trifluoperazine on the mitochondrial damage induced by Ca2+ plus prooxidants

Isolated rat liver mitochondria undergo extensive swelling and disruption of membrane potential when they accumulate Ca2+ in the presence of a prooxidant such as diamide or t-butylhydroperoxide. The phenothiazinic drug trifluoperazine, at concentrations (15-35 microM) which do not inhibit respiration or the influx of Ca2+ into mitochondria, significantly protected mitochondria against the deleterious effects of Ca2+ plus a prooxidant. In contrast, at concentrations higher than 100 microM the drug potentiated these deleterious effects of Ca2+ and prooxidants and had a damaging effect per se on the inner mitochondrial membrane. It is proposed that the protection conferred by the drug is mediated by changes in membrane protein structure that decrease the production of protein thiol cross-linkings which occur when mitochondria accumulate calcium under oxidant stress conditions.

Effect of 17 beta-oestradiol on lymphocyte subpopulations, delayed cutaneous hypersensitivity responses and mixed lymphocyte reactions in post-menopausal women

High-dose steroids are known to be potent modulators of the immune response. We accordingly investigated the effect of therapeutic doses of 17 beta-oestradiol (E2) on cellular immune responses in post-menopausal women. Fifteen (15) healthy women who had undergone a natural menopause were treated with E2 in the form of 100 mg estraderm patches applied twice weekly for 3 out of every 4 weeks over a 3-month period, followed by combined oestrogen and progestogen formulations as long-term therapy. Blood samples were taken on two occasions prior to treatment and at weeks 1, 3, 4, 7, 9, 12 and 24 after commencing therapy. Lymphocyte subsets (CD2, CD4, CD8, CD19, HLA-DR and NK) were studied in each blood sample using a monoclonal antibody kit and a two-colour fluorescence flow-cytometer. One-way mixed lymphocyte reactions (MLRs) were performed using the same stimulator throughout. Delayed hypersensitivity skin tests (DHTs) were carried out twice before treatment and at weeks 3, 4, 12 and 24 using Multitest 7-antigen kits (Institut Mérieux). Lymphocyte subsets did not change significantly with treatment, but both the MLRs and the DHTs were significantly depressed, maximally so by the third week of treatment. We conclude that therapeutic doses of E2 modulate certain immune responses. The significance of this is discussed in the light of the increasing use of long-term oestrogen replacement therapy.

HLA and immunoglobulin allotypes in mixed connective tissue disease

A group of patients with mixed connective tissue disease (MCTD) were HLA and immunoglobulin allotyped. We found that the incidence of DR4 in the patient group was increased compared with that in the normal controls, but the increase was restricted to the subgroup of patients with arthritis. The age at onset of MCTD was lower in patients with DR4 and higher in patients with DR2 compared with patients who did not have these antigens. A1, B8, and DR3 were more frequent, but not significantly so, in the MCTD patient group. We also found that there was a significant perturbation of the Gm allotype frequencies in patients with MCTD.

Synovial amyloid in chronic haemodialysis contains beta 2 microglobulin

A case of amyloid arthropathy occurring in a patient receiving long term chronic haemodialysis treatment is reported. He was found to have raised serum beta 2 microglobulin (beta 2M). and beta 2M was detected in the synovial amyloid deposits.

A strong association between null alleles at the C4A locus in the major histocompatibility complex and systemic sclerosis

Allotyping of the major histocompatibility complex (MHC)-linked complement component C4 has revealed a strong association of the null allele, C4A*Q0, with systemic sclerosis (SSc). Sixty-four percent of patients with SSc carried the C4A*Q0 allele, compared with 17% of the control group. Twenty-five patients and their families were typed for HLA antigens (A, B, Cw, and DR) and the MHC-linked complement components C4 and factor B to identify haplotypes in the MHC linkage group and C4 null alleles. Strong allelic association of HLA-B8 and DR3 with C4A*Q0 probably explains the previously reported association of SSc with the extended haplotype carrying HLA-B8 and DR3. Ninety-two percent of the patients had either C4A*Q0 or DR5; 31% of the controls had either C4A*Q0 or DR5.

Antinuclear antibodies in the relatives and spouses of patients with systemic sclerosis

The families of 65 patients with systemic sclerosis were examined clinically and serum samples from each subject were tested for antinuclear antibodies (ANA) by immunofluorescence on HEp2 cells and for precipitating antibodies to soluble cellular antigens including Scl-70. Of 217 blood relatives, 58 (27%) had ANA (42 speckled, 13 nucleolar, one centromere, two homogeneous); 22 (10%) had precipitins, one anti-Scl-70, one anti-PM-Scl, one anti-nRNP, two anti-Ro(SSA), the remainder unidentified). Family members tended to share ANA patterns. Of 38 spouses, nine (24%) had ANA (all speckled) and two showed unidentified precipitins. This compares with an incidence of ANA and precipitins in a control population of 8% and 1% respectively. Antibodies were more common in female than male relatives (particularly in mothers and sisters of probands). Twenty one of the 58 family members with ANA had clinical features of connective tissue disease; the remainder were asymptomatic. The presence of genetic factors influencing autoimmunity is suggested by the incidence of autoantibodies in first degree relatives. Similar observations in spouses, however, indicate that environmental factors may also have a role in these immune abnormalities.

Sister chromatid exchange frequencies in patients with scleroderma and their relatives

Sister chromatid exchange (SCE) analysis is a sensitive measure of chromosome damage induced by many agents which damage DNA. These agents have been reported to be present in the serum of patients with scleroderma. Chromosome aberrations are thought to be more common in cells of these patients and their relatives than in cells of controls. We have observed that the SCE frequencies in blood lymphocytes of patients with scleroderma and their relatives do not differ from those of controls.

Antibodies to collagen types I-VI in Dupuytren's contracture

Sera from 16 patients with Dupuytren's contracture were tested for IgG and IgM antibodies to native and denatured human collagen types I, II, III, IV, V and VI. IgG antibody to at least one collagen type was found in 11/16 (69%) of these patients, compared with 27/96 (28%) normal adult blood donor controls. The prevalence of antibody to denatured type II collagen was raised, and although there was no overall increase in HLA-DR4 compared with a control population, this antibody was associated with HLA-DR4 in this patient group.

Antibodies to collagen types I-VI in Dupuytren's contracture

Sera from 16 patients with Dupuytren's contracture were tested for IgG and IgM antibodies to native and denatured human collagen types I, II, III, IV, V and VI. IgG antibody to at least one collagen type was found in 11/16 (69%) of these patients, compared with 27/96 (28%) normal adult blood donor controls. The prevalence of antibody to denatured type II collagen was raised, and although there was no overall increase in HLA-DR4 compared with a control population, this antibody was associated with HLA-DR4 in this patient group.

Autoantibodies in childhood scleroderma

The clinical presentation of scleroderma in childhood is even more varied than in adult life. This study of 19 children shows that antinuclear antibodies (ANA) detected on the HEp2 cell substrate are just as common as in the adult disorders. All seven children with diffuse scleroderma or acrosclerosis were ANA positive, as were eight of the 12 with more localised disease. Antinucleolar antibodies were particularly frequent (58% overall), but anticentromere antibody was not observed. Enzyme-linked immunosorbent assays (ELISAs) for antibodies to collagen types I-V, in contrast to adult scleroderma, gave normal results in all childhood cases.

Persistent immunoglobulin deficiency after prednisolone and antiepileptic therapy in a C2 deficient patient with lupus-like syndrome

A homozygous C2 deficient patient with a lupus-like syndrome developed hypogammaglobulinemia soon after treatment with prednisolone together with phenytoin, replaced subsequently by carbamazepine. She suffered from recurrent chest infections and her lupus symptoms continued unabated. In vitro tests of immunoglobulin production by her Epstein Barr virus transformed B cells showed typical patterns of reduced IgA and IgG production seen in common variable hypogammaglobulinemia. An opsonisation defect to Hemophilus influenzae was also demonstrated which could be reversed by the addition of pooled human gammaglobulin. Serum IgM and IgG levels returned to normal 2 years after withdrawal of phenytoin and prednisolone, but 3 years later, she remained IgA deficient and the in vitro abnormalities persisted.

Acquired basophil and eosinophil deficiency in a patient with hypogammaglobulinaemia associated with thymoma

A 55-year-old male with a history of recurrent bacterial and viral infection was found to have hypogammaglobulinaemia in association with a benign thymoma. The patient lacked eosinophils and was deficient in basophils in both the peripheral blood and bone marrow. The absence of eosinophils in a skin challenge known to recruit these cells, and below normal total peripheral blood leucocyte histamine content further suggests a deficiency of eosinophils and basophils respectively. Abnormal suppressor T cell function was documented both phenotypically, using OKT monoclonal antisera, and functionally in pokeweed mitogen stimulated cultures. This patient is the first reported with a deficiency of both eosinophils and basophils occurring in the presence of hypogammaglobulinaemia and thymoma; these abnormalities may be related to the abnormal suppressor T cell function that is present.

Effects of cyclosporin A on immunoglobulin production by EB virus stimulated lymphocytes

Cyclosporin A (Cy A) enhances immunoglobulin (Ig) production by EB virus stimulated peripheral blood lymphocytes from normal subjects with prior immunity to EB virus. In 11 normal adults, this enhancement of Ig production correlated with T cell-mediated cytotoxic regression. Cultures from normal healthy adults without prior immunity showed a diminution of Ig production when Cy A was added. However, Cy A had no effect on Ig production by cord blood lymphocytes in the first week of culture but there was definite enhancement after 3 weeks. Cy A thus inhibits both the early phase of T cell help (which is lymphokine- or interferon-mediated) and the later phase of cytotoxicity manifested as regression. Furthermore, Cy A tended to inhibit IgG and IgA production in T depleted cultures, and had little effect on IgM or IgD, suggesting a differential effect on B cell subsets. These reactions to EB virus in vitro were investigated in two diseases in which EB virus immunity may be relevant. Six of 14 adult patients with primary hypogammaglobulinaemia showed no T cell-mediated regression nor Cy A enhancement, probably because of an underlying defect in both T and B cells. Regression was variable in 12 cases of rheumatoid arthritis, but Cy A initially diminished and later enhanced immunoglobulin production in all cases, suggesting a defect in the normal early response to EB virus in vitro.

Simple hanging drop (20 microliter) double antibody radioimmunoassay of human IgM, IgG, IgA, IgD and IgE

A simple hanging drop radioimmunoassay has been developed for different classes of human immunoglobulin from serum and culture supernatant samples. The immune precipitate was formed in inverted Terasaki plates (20 microliter per well) using 4 aliquots (5 microliter) as follows: (A) a standard or unknown sample; (B) rabbit antisera to the appropriate immunoglobulin class; (C) 125I-labelled human immunoglobulin of the appropriate class; (D) a developing goat-anti rabbit serum. The immune precipitate in the hanging drop was harvested and washed without centrifugation with a simple Terasaki plate harvester. The method gives a great saving both in time and in sample and reagent volumes in comparison with an established double antibody assay in tubes (4 X 100 microliter aliquots).