Ex vivo programmed macrophages ameliorate experimental chronic inflammatory renal disease

Macrophage infiltration of the kidney is a prominent feature associated with the severity of renal injury and progressive renal failure. To determine the influence of macrophages in renal disease models in the absence of endogenous T and B cells, we performed adoptive transfer of macrophages into severe combined immunodeficient (SCID) mice. In this study, macrophages were isolated from the spleens of BALB/c mice and stimulated with lipopolysaccharide to induce classically activated M1 macrophages or with interleukin-4 (IL-4) and IL-13 to induce alternatively activated M2 macrophages. These macrophages were then infused into SCID mice with adriamycin nephropathy; an in vivo model of chronic inflammatory renal disease analogous to human focal segmental glomerulosclerosis. Mice infused with M1 macrophages had a more severe histological and functional injury, whereas M2 macrophage-induced transfused mice had reduced histological and functional injury. Both M1 and M2 macrophages localized preferentially to the area of injury and maintained their phenotypes even after 4 weeks. The protective effect of M2 macrophages was associated with reduced accumulation and possibly downregulated chemokine and inflammatory cytokine expression of the host infiltrating macrophages. Our findings demonstrate that macrophages not only act as effectors of immune injury but can be induced to provide protection against immune injury.

A collectin-like protein from tunicates

Collectins are a sub-family of C-type lectins from mammals and birds that are characterized by their collagen-like domains. The mammalian collectin, mannose binding lectin, has attracted considerable interest because it can activate complement components via a lectin-mediated complement pathway that is independent of immunoglobulins. In this study, we have identified a calcium-dependent lectin from the invertebrate (tunicate), Styela plicata, that bears substantial similarities to mammalian collectins. The tunicate lectin, which was isolated by carbohydrate affinity chromatography, has a reduced apparent molecular mass of 43 kDa. The 43 kDa reduced polypeptide appeared as dimers, trimers and hexamers when analyzed by non-reducing and two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis, while gel filtration suggested that the native form of the protein was a nonamer. Amino acid sequence and amino acid composition analysis revealed obvious similarities between the tunicate lectin and mammalian collectins, notably the inclusion of a collagenous domain and a short, cysteine bearing N-terminal domain. The identification of a collectin-like protein in an invertebrate such as S. plicata, which does not express immunoglobulin, indicates that lectin-mediated complement pathways may predate the origin of antibodies.

The effect of chronic and acyclic elevation of circulating androstenedione or estrone concentrations on ovarian function in the rhesus monkey

The concept that chronically elevated blood androstenedione concentrations increase the incidence of anovulation in the primate and that acyclic elevated basal blood androgen and/or estrogen concentrations cause abnormal gonadotropin secretion was studied. Regularly menstruating female rhesus monkeys were implanted sc with Silastic tubing filled with androstenedione or estrone and compared with controls. Androstenedione implants increased the serum androstenedione concentrations from 1.6 +/- 0.1 (SE) ng/ml to 6.30 +/- 0.27 ng/ml. By peripheral conversion the testosterone concentration increased from control values of 279 +/- 10 (SE) pg/ml to 1280 +/- 41 pg/ml. The testosterone concentration in the estrone-treated monkeys was 247 +/- 9.7 pg/ml. The estrone concentrations were: controls, 63.2 +/- 3.1 (SE) pg/ml; androstenedione-treated monkeys, 63.2 +/- 3.1 pg/ml; and estrone-treated animals, 150 +/- 5.3 pg/ml. The corresponding estradiol concentrations were: control animals, 35.1 +/- 2.1 (SE) pg/ml; androstenedione animals, 30.9 +/- 1.8 pg/ml; and estrone-treated monkeys, 65.7 +/- 3.9 pg/ml. There was no difference in the morning serum cortisol concentrations between any of the three groups or between ovulatory or anovulatory months. The chronic elevation of either androstenedione or estrone caused an increased incidence of anovulation compared with the controls. Increased estrogen concentrations caused increased anovulation during both summer and winter months; however, increased androgen concentrations caused increased anovulation only during the summer months. However, LH concentrations were unaffected in either group but were lower during anovulation months in all three groups. An LH or FSH surge followed an estradiol bolus in three of four control animals and four of six androstenedione-treated but none of the estrone-treated monkeys. Histological examination of ovarian biopsies demonstrated thickening of the tunica albuginea ovarii in androgen-treated ovaries and an apparent increased number of atretic follicles. Corpora lutea were absent in the ovaries of the estrogen-treated monkeys, but otherwise these ovaries were similar to those of controls. It is concluded that chronic acyclic elevation of blood androstenedione (and resultant testosterone) increases seasonal anovulation in the rhesus monkey. Increased blood estrone (and resultant estradiol) leads to almost complete anovulation throughout the year and renders the central nervous system-pituitary axis insensitive to positive feedback effect of estradiol. Neither treatment caused an increase in basal LH concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

OBJECTIVE

To identify the prevalence of coronary risk factors among South Asian Indians in Australia and India.

DESIGN

Cross-sectional intercountry comparison.

SUBJECTS

Healthy volunteers aged 23-75 y recruited from the Indian community in Sydney Australia (n=125), and their nominated relatives in India, (n=125).

RESULTS

The two groups were of similar background with over 90% of the group in India being siblings, parents or relatives of the group in Australia. There was no difference in the populations between India and Australia with regard to mean age (40+/-11.5 vs 39+/-10.3 y), body mass index (BMI) (25+/-3.3 vs 25+/-3.5 kg/m(2)), lipoprotein (a) (178 vs 202 mg/l), total cholesterol (5.3+/-1.3 vs 5.3+/-1.2 mmol/l) or triglyceride (1.7+/-0.8 vs 1.7+/-0.8 mmol/l). The group in India had higher insulin (median values) (139 vs 83 pmol/l, P=0.0001), waist-to-hip ratio (WHR) (0.88+/-0.08 vs 0.85+/-0.09, P=0.01), exercise time (23.7+/-32.7 vs 17.2+/-23.2 h/week, P=0.07), lower waist (83+/-10.0 vs 85+/-11.1 cm, P=0.05) and high-density lipoprotein (0.9+/-0.3 vs 1.1+/-0.6 mmol/l, P=0.02). Women in India had lower BMI (22.7+/-2.9 vs 25.3+/-4.2 kg/m(2), P<0.001), higher insulin (182 vs 90 pmol/l, P<0.001), WHR (0.86+/-0.08 vs 0.77+/-0.06, P<0.001)) and prevalence of abdominal obesity (% WHR >0.8, 73 vs 23%, P<0.001; odds of waist >90 cm=2.3, P<0.05). Men in India had the same BMI, lower waist (85.5+/-8.8 vs 92.9+/-7.2 cm, P<0.001) and WHR (0.89+/-0.09 vs 0.93+/-0.05, P<0.01) but higher insulin (137 vs 76 pmol/l).

CONCLUSION

The group in Australia (especially women) have a more favourable disease risk profile than those in India. The fact that the groups are of such similar background and partly related, make it unlikely that changes due to migration have a strong genetic bias. In contrast to other studies, the absence here of excessive weight gain on migration may be a key factor in disease risk prevention.

Regular non-vigorous physical activity and cholesterol levels in the elderly

BACKGROUND

High-density lipoprotein cholesterol (HDL-C) is a powerful independent risk factor for coronary heart disease (CHD) among the elderly. Regular vigorous physical activity has been found to raise the concentration of HDL-C and thus reduce the risk of CHD. There is little data on the effect of non-vigorous activity on HDL-C in the elderly.

OBJECTIVE

The aim of this study was to compare CHD risk factors, especially HDL-C, in a group of elderly persons who engage in regular non-vigorous physical activity with a group of frail elderly examined in a previous study.

METHODS

Each subject (51 women and 19 men) had anthropometric measures taken and completed a questionnaire on lifestyle and medical history. Total cholesterol (TC), HDL-C and lipoprotein (a) were analysed. Results were compared with those of a frail group examined previously using similar methodology.

RESULTS

HDL-C, adjusted for age, body mass index (BMI) and waist-to-hip ratio (WHR), was greater among women (p < 0.01) and men (p < 0.05) who were engaged in a regular physical activity at least once a week. TC was higher among active women (p < 0.001), but there was also a trend towards a lower TC/HDL ratio. Therefore, although TC is higher in active women, this could be due to a higher proportion of the cholesterol fraction consisting of HDL-C. WHR was negatively associated with HDL-C in frail men (p < 0. 05), active men (p < 0.01) and active women (p < 0.05). BMI was negatively associated with HDL-C in frail women (p < 0.05).

CONCLUSIONS

This sample of elderly people who participate in regular weekly non-vigorous physical activity have a higher HDL-C than frail individuals who do little or no exercise. Since HDL-C is consistently reported to be inversely associated with CHD in the elderly, an elevation in HDL-C concentration may provide some protection to elderly persons who participate in regular nonvigorous physical activity compared to frail elderly individuals who are largely sedentary. Caution should be exercised in the interpretation of a TC only reading in active elderly women without an accompanying measure of HDL.

Low-density lipoprotein subclasses in children under 10 years of age

OBJECTIVE

To examine the prevalence of small dense low density lipoprotein (LDL) in a cohort of children under 10 years of age and to investigate the relationship to other biochemical variables and to measures of fatness. A preponderance of small dense LDL (pattern B), is associated with obesity, abdominal fat accumulation, insulin resistance and risk of heart disease in adults.

METHODOLOGY

LDL peak particle diameter (PPD) was determined by gel electrophoresis in 53 children under 10 years of age and in 65 of their parents: apoproteins A1 and B were determined by turbidimetry. Anthropometric variables, basic lipid profiles, insulin and leptin had been determined previously. Differences between patterns A (large light particles > 25.5 nm diameter) and B were examined by t-test, Chi-square, or Mann-Whitney test. Relationships between the variables were reported as Pearson correlation coefficients.

RESULTS

Pattern B (PPD of < or = 25.5 nm) prevalence was 7.5% in children and 11% in parents (17% in men and 5% in women). Most of the children (86%) who had PPD < or = 26.0 nm also had parents with PPD in this range. A strong association was found between children's and mother's PPD (r=0.60, P < 0.001), but this was somewhat less with fathers (r=0.40, P=0.02). Children in the lowest tertile of PPD had a tendency towards a higher body mass index, waist, fat mass and insulin.

CONCLUSIONS

The prevalence of small dense LDL is lower in children under 10 years of age than in their parents; fathers had a higher prevalence of pattern B than mothers and there is some evidence of a familial effect in the inheritance of pattern B.

Correlation of bone mineral density with biochemical markers in post menopausal women

To evaluate the magnitude of bone loss in postmenopausal women and to study the effect of a selective estrogen Receptor Modulator, raloxifene, on bone loss by quantitative ultrasound of calcaneus and serum bone specific alkaline phosphatase (BAP). Postmenopausal women with ostesopenia/osteoporosis were assigned randomly to receive placebo (n=30) or raloxifene (60mg/d, n=30) with calcium (500mg/day) and vitamin D (250 IU/day). The bone mineral density (BMD) and BAP levels were measured at the beginning of therapy and six months later. They were subjected to statistical analysis (t test, p value) using SPSS statistical package. 70% of postmenopausal women suffered from osteopenia/osteoporosis. After raloxifene therapy, there was improvement in the BMD but this was not statistically significant (p>0.05). There was a fall in the value of serum BAP by 26.6% (p<0.05). Raloxifene has a favourable effect on bone turnover as evident from changes in BMD and a significant fall in serum BAP.

Isolation of the 66-kilodalton polypeptide from promastigotes of Leishmania donovani as a ligand molecule for binding to macrophages

A 66-kDa major plasma membrane-associated molecule of promastigotes of Leishmania donovani (UR6) was purified by affinity chromatography. The immunoreactivity of the 66-kDa molecule was lost upon exposure to heat or treatment with trypsin. The metaperiodate oxidation significantly reduced its immunoreactivity. The 66-kDa molecule is, therefore, glycoprotein in nature. With a fluorescent probe, the 66-kDa molecule was found to be located on the tip of flagellum and on the kinetoplast. The exposure of promastigotes of L. donovani to monospecific anti-66-kDa antibodies significantly reduced the percentage of macrophages with attached promastigotes in the cultured cell line (J774G8). The data suggested that promastigotes of L. donovani utilize the 66-kDa molecule in recognizing and as ligand for binding to macrophages.

Cor triloculare biatriatum--A case report

Cor triloculare biatriatum or double inlet single ventricle is a congenital heart defect in which both atria are connected to a common or dominant ventricle. The present report presents an index case and describes the embryological basis and clinical aspects of this extremely rare anomaly. A three months old infant presented with extreme respiratory distress without cyanosis and repeated chest infections. The patient was diagnosed to be a case of single ventricle with both atria opening in the common ventricular chamber. The common ventricular chamber (single ventricle) was connected to a rudimentary outflow tract. The great arteries were in a position of d-transposition of great arteries. However, there was no pulmonary or aortic stenosis. A clear concept and awareness regarding this condition and its clinical manifestations is bound to facilitate timely intervention with improved success rates.

Anatomical variations and developmental insights of tendons in the first extensor compartment of the hand: Cadaveric study with surgical implications

Background

Anatomical variations in first extensor compartment play a role in the development of de Quervain's disease. This study delves into the detailed examination of these anatomical variations.

Methods

50 upper limbs (28 male and 22 female) from 25 for-malin-embalmed adult human cadavers were dissected to investigate variations in tendons of first extensor compartment.

Results

Accessory tendons to main tendon of abductor pollicis longus (APL) were reported in 49 (98%) cases, with 34% having two accessory tendons, 52% having three, and 12% having four. Terminal ends of these accessory tendons were generally consistent, except in one case where it split into two tendinous bands at insertion site, which was most commonly at base of first metacarpal. Extensor pollicis brevis (EPB) was found as a single tendon in 48 cases, with one case each of duplication and absence. In 19 cases (38%), muscle belly of EPB was fused with that of APL to some extent and it typically inserted at base of the proximal phalanx of the thumb. Average length of muscle belly, tendon, and muscle tendon ratio (MTR) of APL was 15.99±0.62 cm, 5.91±0.76 cm and 2.71 and of EPB was 6.39±0.29 cm, 9.15±0.74 cm and 0.70 respectively.

Conclusion

APL variations range from accessory tendons, splitting of tendons to various insertion points. Additionally, length and insertions points of these accessory tendons are key factors in deciding their usability as graft sources for tendon reconstruction and in surgical treatments of conditions like de Quervain's tenosynovitis.

Anti-66 kDa antileishmanial antibodies as specific immunodiagnostic probe for visceral leishmaniasis

A 66 kDa plasma membrane associated molecule of promastigotes of Leishmania donovani (MHOM/IN/1978/UR6) was affinity purified under acidic conditions. Employing purified 66 kDa antigen in micro ELISA, 36 (97.3%) of the 37 patients of visceral leishmaniasis (bone marrow aspirates positive for Leishman Donovan bodies) had detectable levels of anti 66 kDa anti leishmanial antibodies. The sera of the patients confirmed to have visceral leishmaniasis had significantly (P < 0.001) higher optical density values (0.636 +/- 0.230) as compared to sera (OD 0.185 +/- 0.131) from patients clinically suspected to have visceral leishmaniasis (bone marrow aspirates negative for Leishman Donovan bodies). None of the 35 sera from apparently healthy subjects from non endemic area had anti 66 kDa antibodies. However, sera from one (8.3%) of the 12 healthy subjects, who was a first degree relative of a patient of visceral leishmaniasis and residing in an area endemic for visceral leishmaniasis, had anti 66 kDa antibodies. It is felt that detection of anti 66 kDa antibodies in a micro ELISA assay provides a highly sensitive and specific tool for confirming ongoing visceral leishmaniasis.