Acylated- and unacylated ghrelin during an oral glucose tolerance test in humans at risk for type 2 diabetes mellitus

BACKGROUND/OBJECTIVES

The orexigenic peptide hormone ghrelin has been implicated in the pathophysiology of obesity and type 2 diabetes mellitus through its effects on nutrient homeostasis. Ghrelin is subject to a unique post-translational acyl modification regulating its biochemical activity.

SUBJECTS/METHODS

In this study we aimed to investigate the relation of acylated (AcG) as well as unacylated ghrelin (UnG) with body weight and insulin resistance in the fasting (n = 545) and post-oral glucose tolerance test (oGTT) state (n = 245) in a metabolically well characterized cohort covering a broad range of BMI (17.95 kg/m²-76.25 kg/m²).

RESULTS

Fasting AcG (median 94.2 pg/ml) and UnG (median 175.3 pg/ml) were negatively and the AcG/UnG ratio was positively correlated with BMI (all p < 0.0001). Insulin sensitivity (ISI) correlated positively with AcG (p = 0.0014) and UnG (p = 0.0004) but not with the AcG/UnG ratio. In a multivariate analysis, including ISI and BMI, only BMI, but not ISI was independently associated with AcG and UnG concentrations. Significant changes of AcG and UnG concentrations were detectable after oGTT stimulation, with slight decreases after 30 min and increases after 90-120 min. Subject stratification into BMI-divergent groups revealed more pronounced AcG increases in the two groups with BMI < 40 kg/m².

CONCLUSION

Our data demonstrate lower concentrations for both AcG and UnG with increasing BMI as well as an increased proportion of the biologically active, acylated form of ghrelin giving point to pharmacologic intervention in ghrelin acylation and/or increase in UnG for treatment of obesity despite decreased absolute AcG levels.

Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry

Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18-55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55-27.3)] as older (56-75 years) non-obese and metabolically healthy patients [n = 339; OR 8.21 (95% CI 4.10-18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age.

Evaluation of parameters for fetal behavioural state classification

Fetal behavioural states (fBS) describe periods of fetal wakefulness and sleep and are commonly defined by features such as body and eye movements and heart rate. Automatic state detection through algorithms relies on different parameters and thresholds derived from both the heart rate variability (HRV) and the actogram, which are highly dependent on the specific datasets and are prone to artefacts. Furthermore, the development of the fetal states is dynamic over the gestational period and the evaluation usually only separated into early and late gestation (before and after 32 weeks). In the current work, fBS detection was consistent between the classification algorithm and visual inspection in 87 fetal magnetocardiographic data segments between 27 and 39 weeks of gestational age. To identify how automated fBS detection could be improved, we first identified commonly used parameters for fBS classification in both the HRV and the actogram, and investigated their distribution across the different fBS. Then, we calculated a receiver operating characteristics (ROC) curve to determine the performance of each parameter in the fBS classification. Finally, we investigated the development of parameters over gestation through linear regression. As a result, the parameters derived from the HRV have a higher classification accuracy compared to those derived from the body movement as defined by the actogram. However, the overlapping distributions of several parameters across states limit a clear separation of states based on these parameters. The changes over gestation of the HRV parameters reflect the maturation of the fetal autonomic nervous system. Given the higher classification accuracy of the HRV in comparison to the actogram, we suggest to focus further research on the HRV. Furthermore, we propose to develop probabilistic fBS classification approaches to improve classification in less prototypical datasets.

Magnetoencephalographic signatures of conscious processing before birth

The concept of fetal consciousness is a widely discussed topic. In this study, we applied a hierarchical rule learning paradigm to investigate the possibility of fetal conscious processing during the last trimester of pregnancy. We used fetal magnetoencephalography, to assess fetal brain activity in 56 healthy fetuses between gestational week 25 and 40, during an auditory oddball paradigm containing first- and second-order regularities. The comparison of fetal brain responses towards standard and deviant tones revealed that the investigated fetuses show signs of hierarchical rule learning, and thus the formation of a memory trace for the second-order regularity. This ability develops over the course of the last trimester of gestation, in accordance with processes in physiological brain development and was only reliably present in fetuses older than week 35 of gestation. Analysis of fetal autonomic nervous system activity replicates findings in newborns, showing importance of activity state for cognitive processes. On the whole, our results support the assumption that fetuses in the last weeks of gestation are capable of consciously processing stimuli that reach them from outside the womb.

Automated Detection of Fetal Brain Signals with Principal Component Analysis

Detection of fetal brain signals in fetal magnetoencephalographic recordings is - due to the low signal to noise ratio - challenging for researchers in this field. Up to now, state of the art is a manual evaluation of the signal. To make the evaluation more reproducible and less time consuming, an approach using Principal Component Analysis is introduced. Locations of the channels of most importance for the first three principal components are taken into account and their possibility of resembling brain activity evaluated. Data with auditory stimulation are taken for this analysis and trigger averaged signals from the channels selected as brain activity (manually & automatically) compared. Comparisons are done with regard to their average baseline activity, activity during a window of interest and timing and amplitude of their highest auditory event-related peak. The number of evaluable data sets showed to be lower for the automated compared to manual approach but auditory event-related peaks did not differ significantly in amplitude or timing and in both cases there was a significant activity change following the tone event. The given results and the advantage of reproducibility make this method a valid alternative.

Fully Automated Subtraction of Heart Activity for Fetal Magnetoencephalography Data

Fetal magnetoencephalography (fMEG) is a method to record human fetal brain signals in pregnant mothers. Nevertheless the amplitude of the fetal brain signal is very small and the fetal brain signal is overlaid by interfering signals mainly caused by maternal and fetal heart activity. Several methods are used to attenuate the interfering signals for the extraction of the fetal brain signal. However currently used methods are often affected by a reduction of the fetal brain signal or redistribution of the fetal brain signal. To overcome this limitation we developed a new fully automated procedure for removal of heart activity (FAUNA) based on Principal Component Analysis (PCA) and Ridge Regression. We compared the results with an orthogonal projection (OP) algorithm which is widely used in fetal research. The analysis was performed on simulated data sets containing spontaneous and averaged brain activity. The new analysis was able to extract fetal brain signals with an increased signal to noise ratio and without redistribution of activity across sensors compared to OP. The attenuation of interfering heart signals in fMEG data was significantly improved by FAUNA and supports fully automated evaluation of fetal brain signal.

Fully Automated R-peak Detection Algorithm (FLORA) for fetal magnetoencephalographic data

BACKGROUND AND OBJECTIVE

Fetal magnetoencephalography (fMEG) is a method for recording fetal brain signals, fetal and maternal heart activity simultaneously. The identification of the R-peaks of the heartbeats forms the basis for later heart rate (HR) and heart rate variability (HRV) analysis. The current procedure for the evaluation of fetal magnetocardiograms (fMCG) is either semi-automated evaluation using template matching (SATM) or Hilbert transformation algorithm (HTA). However, none of the methods available at present works reliable for all datasets.

METHODS

Our aim was to develop a unitary, responsive and fully automated R-peak detection algorithm (FLORA) that combines and enhances both of the methods used up to now.

RESULTS

The evaluation of all methods on 55 datasets verifies that FLORA outperforms both of these methods as well as a combination of the two, which applies in particular to data of fetuses at earlier gestational age.

CONCLUSION

The combined analysis shows that FLORA is capable of providing good, stable and reproducible results without manual intervention.

Agreement of driving simulator and on-road driving performance in patients with binocular visual field loss

PURPOSE

On-road testing is considered the standard for assessment of driving performance; however, it lacks standardization. In contrast, driving simulators provide controlled experimental settings in a virtual reality environment. This study compares both testing conditions in patients with binocular visual field defects due to bilateral glaucomatous optic neuropathy or due to retro-chiasmal visual pathway lesions.

METHODS

Ten glaucoma patients (PG), ten patients with homonymous visual field defects (PH), and 20 age- and gender-matched ophthalmologically normal control subjects (CG and CH, respectively) participated in a 40-min on-road driving task using a dual brake vehicle. A subset of this sample (8 PG, 8 PH, 8 CG, and 7 CH) underwent a subsequent driving simulator test of similar duration. For both settings, pass/fail rates were assessed by a masked driving instructor.

RESULTS

For on-road driving, hemianopia patients (PH) and glaucoma patients (PG) showed worse performance than their controls (CH and CG groups): PH 40%, CH 30%, PG 60%, CG 0%, failure rate. Similar results were obtained for the driving simulator test: PH 50%, CH 29%, PG 38%, CG 0%, failure rate. Twenty-four out of 31 participants (77%) showed concordant results with regard to pass/fail under both test conditions (p > 0.05; McNemar test).

CONCLUSIONS

Driving simulator testing leads to results comparable to on-road driving, in terms of pass/fail rates in subjects with binocular (glaucomatous or retro-chiasmal lesion-induced) visual field defects. Driving simulator testing seems to be a well-standardized method, appropriate for assessment of driving performance in individuals with binocular visual field loss.

Donning devices (foot slips and frames) enable elderly people with severe chronic venous insufficiency to put on compression stockings

OBJECTIVE/BACKGROUND

Compression therapy is highly effective in the treatment of post-thrombotic syndrome and venous leg ulcer. On average, 50-60% of the patients cooperate with compression therapy. Therefore, it is necessary to improve the user-friendliness. This prospective study investigated whether the use of donning devices can contribute to improving user-friendliness.

METHODS

Forty patients aged >65 years with severe chronic venous insufficiency (CVI; C4-C6) successively donned compression stockings in a randomized order: one 40 mmHg (CS40) or two superimposed 20 mmHg (CS20+20), each with open toe (CS-o-t) and closed toe (CS-c-t), using donning devices (three foot slips for CS-o-t; two foot slips and three frames for CS-c-t). The study endpoint was that the stocking was completely donned and correctly positioned on the patient's leg. The success rate and its association with age, sex, first time versus second time user, body mass index, abdominal circumference, ability to reach the forefoot with the hand, and hand grip strength were analyzed. Additionally, subjective evaluation by the patients was performed.

RESULTS

Without donning devices, success with CS40-c-t was 60% (24/40 patients) and with CS20+20-c-t 70% (28/40 patients) (p = .220). Using donning devices increased success rates significantly. With CS40-o-t the success rate was 88% (35/40 patients; p = .001) and with CS40-c-t it was 90% (36/40 patients; p = .002). With CS20+20-o-t and CS20+20-c-t, the success rate was 88% (35/40 patients; p = .016). The proportion of patients who successfully used either CS40 or CS20+20 increased from 73% to 93%. Relevant for the patients' success was the ability to reach the forefoot with the hand, and hand grip strength. Subjectively, donning with a device was rated significantly better than without.

CONCLUSION

Donning devices significantly improve the ability of elderly patients with CVI to don compression stockings successfully. However, there are differences in user-friendliness among the devices..

Homonymous Visual Field Loss and Its Impact on Visual Exploration: A Supermarket Study

PURPOSE

Homonymous visual field defects (HVFDs) may critically interfere with quality of life. The aim of this study was to assess the impact of HVFDs on a supermarket search task and to investigate the influence of visual search on task performance.

METHODS

Ten patients with HVFDs (four with a right-sided [HR] and six with a left-sided defect [HL]), and 10 healthy-sighted, sex-, and age-matched control subjects were asked to collect 20 products placed on two supermarket shelves as quickly as possible. Task performance was rated as "passed" or "failed" with regard to the time per correctly collected item (T_C -failed = 4.84 seconds based on the performance of healthy subjects). Eye movements were analyzed regarding the horizontal gaze activity, glance frequency, and glance proportion for different VF areas.

RESULTS

Seven of 10 HVFD patients (three HR, four HL) passed the supermarket search task. Patients who passed needed significantly less time per correctly collected item and looked more frequently toward the VFD area than patients who failed. HL patients who passed the test showed a higher percentage of glances beyond the 60° VF (P < 0.05).

CONCLUSION

A considerable number of HVFD patients performed successfully and could compensate for the HVFD by shifting the gaze toward the peripheral VF and the VFD area.

TRANSLATIONAL RELEVANCE

These findings provide new insights on gaze adaptations in patients with HVFDs during activities of daily living and will enhance the design and development of realistic examination tools for use in the clinical setting to improve daily functioning. (http://www.clinicaltrials.gov, NCT01372319, NCT01372332).

Binocular glaucomatous visual field loss and its impact on visual exploration--a supermarket study

Advanced glaucomatous visual field loss may critically interfere with quality of life. The purpose of this study was to (i) assess the impact of binocular glaucomatous visual field loss on a supermarket search task as an example of everyday living activities, (ii) to identify factors influencing the performance, and (iii) to investigate the related compensatory mechanisms. Ten patients with binocular glaucoma (GP), and ten healthy-sighted control subjects (GC) were asked to collect twenty different products chosen randomly in two supermarket racks as quickly as possible. The task performance was rated as "passed" or "failed" with regard to the time per correctly collected item. Based on the performance of control subjects, the threshold value for failing the task was defined as μ+3σ (in seconds per correctly collected item). Eye movements were recorded by means of a mobile eye tracker. Eight out of ten patients with glaucoma and all control subjects passed the task. Patients who failed the task needed significantly longer time (111.47 s ±12.12 s) to complete the task than patients who passed (64.45 s ±13.36 s, t-test, p < 0.001). Furthermore, patients who passed the task showed a significantly higher number of glances towards the visual field defect (VFD) area than patients who failed (t-test, p < 0.05). According to these results, glaucoma patients with defects in the binocular visual field display on average longer search times in a naturalistic supermarket task. However, a considerable number of patients, who compensate by frequent glancing towards the VFD, showed successful task performance. Therefore, systematic exploration of the VFD area seems to be a "time-effective" compensatory mechanism during the present supermarket task.

Driving with binocular visual field loss? A study on a supervised on-road parcours with simultaneous eye and head tracking

Post-chiasmal visual pathway lesions and glaucomatous optic neuropathy cause binocular visual field defects (VFDs) that may critically interfere with quality of life and driving licensure. The aims of this study were (i) to assess the on-road driving performance of patients suffering from binocular visual field loss using a dual-brake vehicle, and (ii) to investigate the related compensatory mechanisms. A driving instructor, blinded to the participants' diagnosis, rated the driving performance (passed/failed) of ten patients with homonymous visual field defects (HP), including four patients with right (HR) and six patients with left homonymous visual field defects (HL), ten glaucoma patients (GP), and twenty age and gender-related ophthalmologically healthy control subjects (C) during a 40-minute driving task on a pre-specified public on-road parcours. In order to investigate the subjects' visual exploration ability, eye movements were recorded by means of a mobile eye tracker. Two additional cameras were used to monitor the driving scene and record head and shoulder movements. Thus this study is novel as a quantitative assessment of eye movements and an additional evaluation of head and shoulder was performed. Six out of ten HP and four out of ten GP were rated as fit to drive by the driving instructor, despite their binocular visual field loss. Three out of 20 control subjects failed the on-road assessment. The extent of the visual field defect was of minor importance with regard to the driving performance. The site of the homonymous visual field defect (HVFD) critically interfered with the driving ability: all failed HP subjects suffered from left homonymous visual field loss (HL) due to right hemispheric lesions. Patients who failed the driving assessment had mainly difficulties with lane keeping and gap judgment ability. Patients who passed the test displayed different exploration patterns than those who failed. Patients who passed focused longer on the central area of the visual field than patients who failed the test. In addition, patients who passed the test performed more glances towards the area of their visual field defect. In conclusion, our findings support the hypothesis that the extent of visual field per se cannot predict driving fitness, because some patients with HVFDs and advanced glaucoma can compensate for their deficit by effective visual scanning. Head movements appeared to be superior to eye and shoulder movements in predicting the outcome of the driving test under the present study scenario.

Evidence that venous hypertension causes stasis dermatitis

A clinical model to examine the hypothesis that venous hypertension of the lower leg per se can cause lower leg stasis dermatitis is described. To prove this concept, we retrospectively studied a consecutive series of 38 patients with lower leg dermatitis who underwent phlebological examination at our consultation over a period of four years. Among those patients who had an insufficiency of the superficial veins only, without insufficiency of the deep veins, 22 had undergone patch testing to common allergens in phlebology. We found 10 patients with a stasis dermatitis of the lower leg and an incompetent great saphenous vein, six of whom had no detectable contact sensitization at all and another four exclusively to phlebologically irrelevant substances, e.g. nickel, cobalt, chromate or epoxid resin. All these 10 patients showed long saphenous vein incompetence from the groin to the medial aspect of the leg. All were operated by classical flush ligation and saphenectomy. Lower leg dermatitis healed in all 10 patients within 8–12 weeks and no recurrence was observed (1 year follow-up). These results support clinical experience that venous hypertension alone indeed can cause lower leg dermatitis.

Kompressionstherapie bei chronischer ven�ser Insuffizienz

Chronic venous insufficiency (CVI) has a significant socioeconomic impact. The existent venous hypertension and the subsequent capillary hypertension result in trophic skin damage culminating in an ulcer. Venous ulcers affect 1-3% of the adult population. Compression therapy provides the basis for noninvasive treatment of CVI. It can be applied alone or in combination with invasive strategies. A variety of materials are available for phlebological compression therapy in the form of compression bandages and compression hosiery. Knowledge of the different qualities of the compression materials and their mode of action is important in choosing the correct means of compression with regard to clinical findings and the patient's needs. As far as possible, the compression method applied should be monitored for any loss of effectivity during regular follow-up examinations of the patients. The following article deals with this topic. A new option for compression therapy of crural ulcers is presented and the possibility for checking the effectiveness of the compression stockings during outpatient

Nongenomic effects of aldosterone on phosphocreatine levels in human calf muscle during recovery from exercise

Nongenomic in vitro effects of aldosterone on the sodium-proton antiport and intracellular second messengers have been described in human mononuclear leukocytes, vascular smooth muscle cells, and endothelial cells. To test the potential physiological relevance of these effects, an in vivo 31P magnetic resonance spectroscopy study on the human calf at rest and during exercise was performed in 10 healthy volunteers receiving either 1 mg aldosterone or placebo iv in a double blind, randomized, cross-over trial. Spectra were analyzed for phosphocreatine, ATP, phosphomonoesters, inorganic intracellular phosphate, and intracellular pH. Resting values remained unchanged by aldosterone. After isometric contraction of the calf (50% body weight for 3 min), phosphocreatine recovered to significantly higher levels after application of aldosterone compared with placebo. Other parameters were not significantly changed by aldosterone. Effects appeared immediately after isometric contraction and, thus, occurred within 8 min of aldosterone administration. They are, therefore, likely to represent the first contemporary evidence of nongenomic in vivo effects of aldosterone in man. These findings also point to an involvement of aldosteron in the acute stress adaptation of cellular oxidative metabolism in human muscle physiology.

Further studies on immunoglobulin G- and albumin-binding properties of streptococci of serological group L

In this study, all 88 streptococci of serological group L isolated from cows, pigs, poultry and humans bound 125I-immunoglobulin G, and, in addition, 22 cultures interacted with 125I-albumin. IgG- and albumin-binding sites were solubilized from the streptococcal surface by heat extraction at an acid pH and also by mutanolysin treatment of the bacteria. Western blot analysis of these binding proteins revealed that almost identical protein bands were responsible for 125I-IgG and -albumin binding. Certain protein fractions of the cultures interacted exclusively with 125I-IgG, indicating that there are two groups of IgG receptors among streptococci of this serogroup.

Rapid aldosterone signaling in vascular smooth muscle cells: involvement of phospholipase C, diacylglycerol and protein kinase C alpha

Rapid in vitro effects of aldosterone (ALDO) on intracellular sodium, potassium and calcium, cell volume and the sodium-proton-antiport have been described in human mononuclear leukocytes and rat vascular smooth muscle cells (VSMC). These nongenomic effects are signaled through membrane receptors with a high affinity for aldosterone, but not for hydrocortisone. Effects of ALDO on the production of diacylglycerol (DAG) and protein kinase C alpha (PKC) were measured in VSCM by enzymatic assay and immunoblotting. DAG production was stimulated twofold by ALDO (> or = 1 nM) within 30 sec while hydrocortisone was inactive at concentrations of up to 1 microM. The inhibitors of phospholipase C, neomycin and U-73122 completely blocked this effect. PKC translocation from cytosol to membranes by ALDO occurred within 5 min, the extent of this effect was comparable to that of angiotensin II. These data demonstrate rapid intracellular signaling for ALDO in VSMC through phospholipase C, DAG and PKC in addition to calcium and inositol-1,4,5-trisphosphate as determined earlier.

Characteristic properties of streptococci of serological group L

This study was designed to characterize further 88 streptococci of serological group L, isolated from bovines, pigs, poultry and humans. Most group L streptococci from bovines grew as granular sediment with long chains in fluid media and with compact colonies in soft agar. Most group L streptococci from pigs grew with a uniform turbidity in fluid media, short chains, and with diffuse colonies in soft agar. The biochemical characteristics, determined with the Strepzym identification system, revealed no significant differences between the group L streptococci of various origins. A positive opacity factor reaction could mainly be observed with group L streptococci from bovines and humans, but was less pronounced with group L streptococci from pigs and poultry. In addition, 27 group L streptococci reacted with type antigen X or R and 9 cultures with M1 or M6 specific antiserum. The determination of antibiotic resistance patterns revealed that all group L streptococci were resistant to tetracycline and minocycline, part of the cultures were resistant to chloramphenicol, erythromycin and gentamicin, and all cultures were susceptible to penicillin, bacitracin, cefoxitin and nitrofurantoin. All these data allowed an individual characterization of group L streptococci, possibly useful for epidemiological studies.

Non-classical receptors for aldosterone in plasma membranes from pig kidneys

Rapid, nongenomic in vitro effects of aldosterone on intracellular electrolytes, cell volume and the sodium-proton antiporter have been found in human mononuclear leukocytes (HML), as have related membrane receptors. In the present study, binding of 125I-labeled aldosterone to plasma membrane preparations from pig kidneys was studied, since nongenomic in vitro effects of aldosterone have also been described in cultured kidney cells. In this preparation, binding of aldosterone shares important features with both functional and binding data in HML. These include a very low apparent Ki of approximately 0.1 nM for aldosterone, a high turnover rate and binding selectivity for aldosterone and fludrocortisone. Desoxycorticosterone acetate and corticosterone show intermediate affinity, with apparent Ki values of approximately 1 and 100 nM, with hydrocortisone even less active. Thus binding of aldosterone to kidney plasma membranes is compatible with the major features of its nongenomic renal effects.

CD40 molecules induce down-modulation and endocytosis of T cell surface T cell-B cell activating molecule/CD40-L. Potential role in regulating helper effector function

The T-BAM/CD40-L molecule on CD4+ T cells interacts with B cell CD40 molecules to deliver contact-dependent signals that drive B cell activation and Ig secretion. Cell surface T-BAM/CD40-L expression is transient and may be closely regulated in order to limit the activation and clonal selection of noncognate B cells. We demonstrate that B cells, but not non-B cells, rapidly and specifically down-modulate surface T-BAM/CD40-L expression in a contact-dependent and temperature-sensitive manner that renders T cells unable to activate resting bystander B cells. Because the ability to down-modulate T-BAM/CD40-L correlated with CD40 expression, the role of CD40 molecules in down-modulating its ligand was directly assessed. Anti-CD40 mAb, but not control mAb, block B cell-induced T-BAM/CD40-L down-modulation. Furthermore, CD40+ nonlymphoid transfectants specifically down-modulate surface T-BAM/CD40-L expression. B cells induce T-BAM/CD40-L internalization into cytoplasmic compartments in a process that is inhibited by cytochalasin B. Pretreatment of activated T cells with lysosomotropic agents does not affect CD40-induced down-modulation of surface T-BAM/CD40-L but results in a marked accumulation of T-BAM/CD40-L in cytoplasmic vesicles. Together, these studies strongly suggest that CD40 induced T-BAM/CD40-L down-modulation occurs, in part, by receptor-mediated endocytosis followed by lysosomal degradation and may represent a mechanism to regulate CD4+ T cell helper effector functions.

CD40 molecules induce down-modulation and endocytosis of T cell surface T cell-B cell activating molecule/CD40-L. Potential role in regulating helper effector function

The T-BAM/CD40-L molecule on CD4+ T cells interacts with B cell CD40 molecules to deliver contact-dependent signals that drive B cell activation and Ig secretion. Cell surface T-BAM/CD40-L expression is transient and may be closely regulated in order to limit the activation and clonal selection of noncognate B cells. We demonstrate that B cells, but not non-B cells, rapidly and specifically down-modulate surface T-BAM/CD40-L expression in a contact-dependent and temperature-sensitive manner that renders T cells unable to activate resting bystander B cells. Because the ability to down-modulate T-BAM/CD40-L correlated with CD40 expression, the role of CD40 molecules in down-modulating its ligand was directly assessed. Anti-CD40 mAb, but not control mAb, block B cell-induced T-BAM/CD40-L down-modulation. Furthermore, CD40+ nonlymphoid transfectants specifically down-modulate surface T-BAM/CD40-L expression. B cells induce T-BAM/CD40-L internalization into cytoplasmic compartments in a process that is inhibited by cytochalasin B. Pretreatment of activated T cells with lysosomotropic agents does not affect CD40-induced down-modulation of surface T-BAM/CD40-L but results in a marked accumulation of T-BAM/CD40-L in cytoplasmic vesicles. Together, these studies strongly suggest that CD40 induced T-BAM/CD40-L down-modulation occurs, in part, by receptor-mediated endocytosis followed by lysosomal degradation and may represent a mechanism to regulate CD4+ T cell helper effector functions.

[Autologous 131J-tagged human fibrinogen for early detection of venous thrombosis (preparation, biological and in vivo properties) (author's transl)]

A method for preparation of autologous 131J-tagged human fibrinogen is demonstrated. In vitro the preparation is characterized by content of fibrinogen, protein, plasminogen, clottability and molecular weight. Total plasma radioactivity, specific radioactivity, non-protein-bound radioactivity, biologic half-life and the local activity at the thrombus define the properties in vivo. With the above criteria autologous 131-J-tagged human fibrinogen was shown to be useful for early diagnosis of venous thrombosis.