Transglutaminase Type 2 is Involved in the Hematopoietic Stem Cells Homeostasis

Type 2 transglutaminase (TG2) is a multifunctional protein involved in various biological processes playing a key regulatory role in cell homeostasis such as cell death and autophagy. New evidence is emerging that support an important role of autophagy in regulating normal hematopoiesis. Prompted by these findings, in this study we investigated in vivo involvement of TG2 in mouse hematopoiesis under normal or nutrient deprivation conditions. We found that the number and rate of differentiation of bone marrow hematopoietic stem cell was decreased in the TG2 knockout mice. We present evidence showing that these effects on hematopoietic system are very likely due to the TG2-dependent impairment of autophagy. In fact, stimulation of autophagy by starvation is able to rescue the block of the differentiation of stem cells progenitors in the TG2 KO mice. It was also shown that the RhoA/ERK½ pathway, known to be essential for regulation of the bone marrow progenitor cells homeostasis, was significantly impaired in the absence of TG2. Hence, this study expanded our knowledge about TG2 discovering a role of this enzyme in regulation of hematopoiesis.

Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 10⁴ cells/mL) compared to control (69.6 ± 7.1 × 10⁴ cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h⁻¹·mL⁻¹), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h⁻¹·mL⁻¹, 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM.

Splenectomy increases mortality in murine Trypanosoma cruzi infection

The spleen is a secondary lymphoid organ that harbours a variety of cells such as T and B lymphocytes and antigen-presenting cells important to immune response development. In this study, we evaluated the impact of spleen removal in the immune response to experimental Trypanosoma cruzi infection. C57BL/6 mice were infected with Y strain of the parasite and infection was followed daily. Mice that underwent splenectomy had fewer parasites in peripheral blood at the peak of infection; however, mortality was increased. Histological analysis of heart and liver tissues revealed an increased number of parasites and inflammatory infiltrates at these sites. Spleen removal was associated with reduction in IFN-γ and TNF-α production during infection as well as with a decrease in specific antibody secretion. Haematological disorders were also detected. Splenectomized mice exhibited severe anaemia and decreased bone marrow cell numbers. Our results indicate that spleen integrity is critical in T. cruzi infection for the immune response against the parasite, as well as for the control of bone marrow haematological function.

Protein-energy malnutrition halts hemopoietic progenitor cells in the G0/G1 cell cycle stage, thereby altering cell production rates

Protein energy malnutrition (PEM) is a syndrome that often results in immunodeficiency coupled with pancytopenia. Hemopoietic tissue requires a high nutrient supply and the proliferation, differentiation and maturation of cells occur in a constant and balanced manner, sensitive to the demands of specific cell lineages and dependent on the stem cell population. In the present study, we evaluated the effect of PEM on some aspects of hemopoiesis, analyzing the cell cycle of bone marrow cells and the percentage of progenitor cells in the bone marrow. Two-month-old male Swiss mice (N = 7-9 per group) were submitted to PEM with a low-protein diet (4%) or were fed a control diet (20% protein) ad libitum. When the experimental group had lost about 20% of their original body weight after 14 days, we collected blood and bone marrow cells to determine the percentage of progenitor cells and the number of cells in each phase of the cell cycle. Animals of both groups were stimulated with 5-fluorouracil. Blood analysis, bone marrow cell composition and cell cycle evaluation was performed after 10 days. Malnourished animals presented anemia, reticulocytopenia and leukopenia. Their bone marrow was hypocellular and depleted of progenitor cells. Malnourished animals also presented more cells than normal in phases G0 and G1 of the cell cycle. Thus, we conclude that PEM leads to the depletion of progenitor hemopoietic populations and changes in cellular development. We suggest that these changes are some of the primary causes of pancytopenia in cases of PEM.

Endogenous glucocorticoids control neutrophil mobilization from bone marrow to blood and tissues in non-inflammatory conditions

BACKGROUND AND PURPOSE

We have shown that endogenous glucocorticoids control neutrophil mobilization in the absence of inflammation. In this study the role of the glucocorticoid receptor (GR) in the physiological control of neutrophil mobilization was investigated, focusing on the specific mechanisms for mature neutrophils in bone marrow, circulating neutrophils and endothelial cells.

EXPERIMENTAL APPROACH

Male Wistar rats were treated with RU 38486 or adrenalectomized. Cell numbers in bone marrow and circulation were morphologically quantified and expressions of L-selectin determined by flow cytometry. Expressions of P-selectin, E-selectin, PECAM-1, VCAM-1 and ICAM-1 were measured by immunohistochemistry on vessels of cremaster muscle and their mRNA levels quantified in primary cultured endothelial cells. NF-kappaB activity in neutrophils and endothelium was quantified by EMSA.

KEY RESULTS

RU 38486 treatment altered the maturation phases of neutrophilic lineage and reduced expression of L-selectin in mature neutrophils from bone marrow; increased the number of neutrophils in the circulation and elevated the expression of L-selectin in these cells. P-selectin and E-selectin expression in endothelial cells was unchanged by adrenalectomy or RU 38486 treatment. Membrane expressions, mRNA levels of ICAM-1, VCAM-1 and PECAM-1 and NF-kappaB translocation into the nucleus were higher in the endothelium of adrenalectomized and RU 38486 treated rats.

CONCLUSIONS AND IMPLICATIONS

Endogenous glucocorticoids, through activation of GR on neutrophils, physiologically control the rolling behaviour of these cells and, by modulating endothelial functions, affect their adhesiveness. The molecular mechanism induced by activated GR is different in each cell, as NF-kappaB translocation was only altered in endothelial cells.

Protein-energy malnutrition alters histological and ultrastructural characteristics of the bone marrow and decreases haematopoiesis in adult mice

Protein-energy malnutrition (PEM) decreases resistance to infection by impairing a number of physiological processes, including haematopoiesis. The aim of this study was to evaluate the microanatomical aspects of bone marrow (BM) in mice that were subjected to PEM, in particular, with respect to the components of the local extracellular matrix and the proliferative activity of haematopoietic cells. For this, histological, histochemical, immunohistochemical and ultrastructural techniques were used. Two-month old male Swiss mice were fed with a low-protein diet containing 4% protein and control mice fed a 20% protein diet. When the experimental group had attained a 25% loss of their original body weight, we collected the different biological samples. Malnourished mice had presented severe BM atrophy as well as a reduction in proliferating cell nuclear antigen and gelatinous degeneration. The malnourished mice had more fibronectin accretion in paratrabecular and endosteal regions and more laminin deposition in perisinusal sites than controls. Endosteal cell activation and hyperplasia were found, suggesting their participation in the process. Additionally, we have observed a decrease in the capacity of malnourished haematopoietic stroma to support the growth of haematopoietic stem cells (CD34+) in vitro. These findings point to a structural impairment of the haematopoietic microenvironments in mice with PEM, possibly hampering the interactions between cells and cellular signalling.

Cytotoxicity analysis of EDTA and citric acid applied on murine resident macrophages culture

AIM

To assess the ex vivo cytotoxicity of EDTA and citric acid solutions on macrophages.

METHODOLOGY

The cytotoxicity of 17% EDTA and 15% citric acid was evaluated on murine macrophage cultures using MTT-Tetrazolium method [3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide]. A total of 5 x 10(5) cells were plated in medium culture with 17% EDTA or 15% citric acid. Fresh medium was used as a control. Toxicity values were analysed statistically by anova and Tukey's test (P<0.05) at short (0, 6, 12, 24 h) and medium periods (1, 3, 5, 7 days), using ELISA absorbance.

RESULTS

On the short term, both EDTA (0.253 nm) and citric acid (0.260 nm) exhibited cytotoxic effects on macrophage cultures (P<0.05). On the medium term, statistical differences were observed (P<0.05) between the groups. EDTA (0.158 nm) and citric acid (0.219 nm) were cytotoxic when compared with the control group; EDTA-reduced macrophage viability significantly more than citric acid (P<0.05).

CONCLUSIONS

Both EDTA and citric acid had effects on macrophages cells ex vivo, but citric acid was less toxic in periods from 1 to 7 days of use.

Effect of in vivo phenol or hydroquinone exposure on events related to neutrophil delivery during an inflammatory response

Phenol (PHE) and hydroquinone (HQ) are metabolites of benzene that affect leukocytes after solvent intoxication. Hence, we investigated the effects of PHE or HQ exposure on neutrophil mobilization during an inflammatory response. Male Wistar rats received intraperitoneal injections of PHE, HQ or vehicle only and assays were performed 24 h after the last dose. Quantifications of bone marrow or circulating leukocytes showed that only HQ exposure induced neutrophilia, probably due to the accelerated mobilization from the bone marrow compartment, since reduced numbers of segmented cells in the last phase of maturation were detected there. Intravital microscopy showed that circulating leukocytes of HQ-exposed rats increased their rolling behavior and adherence to the mesenteric postcapillary venule wall in vivo. The enhanced leukocyte-endothelium interaction was not dependent on microvascular reactivity or perivascular mast cell degranulation. Instead, it was the result of neutrophil activation, demonstrated by a decrease in L-selectin and an increase in beta2 integrin expression on neutrophil membranes. This pattern of neutrophil activation may have contributed to the higher number of neutrophils in the subcutaneous inflammatory response of HQ-exposed rats after oyster glycogen injection. Taken together, our results indicate that HQ exposure alters neutrophil mobilization, which results in an exacerbated response after an injury. Although PHE is endogenously metabolized to HQ, PHE exposure only induced an increment in rolling behavior, which was not sufficient to alter the inflammatory response.

Chronic blockade of nitric oxide biosynthesis in rats: effect on leukocyte endothelial interaction and on leukocyte recruitment

INTRODUCTION

Previous studies showed that animals chronically treated with NG-nitro-L-arginine methyl ester (L-NAME) have a reduced inflammatory reaction. Now the role of L-NAME treatment (20 mg/Kg/day/14 days) on leukocyte mobilisation was assessed in rats.

METHODS

In vivo leukocyte recruitment evoked by Bothrops jararaca venom (BjV) and nitrite/nitrate (NO2-/NO3-; Griess reaction) were evaluated in the air pouch cavity. Haematological parameters were evaluated in the bone marrow and in the peripheral compartment. Microcirculatory blood flow, number of rolling and adhered leukocytes, vascular reactivity and mast cell activity were studied by intravital microscopy. Blood pressure was measured by the tail-cuff method. L-selectin and beta(2) integrin expressions on peripheral and bone marrow leukocytes were quantified by flow cytometry.

RESULTS

When compared with control rats (D-NAME) L-NAME treated rats had reduced PMN cell infiltrate (50%) and NO2-/NO3- (27%) in the air pouch cavity. Rolling leukocytes were decreased (70%) in L-NAME-treated animals, which was reversed by topical application of NO donor (SIN-1). BjV stimulation increased the number of rolling and adhered leukocytes only in control rats. Systemic blood pressure, microcirculatory blood flow and microvascular reactivity was not altered by the treatment. Only the vessel response to acetylcholine was delayed in treated rats. Peripheral PMN cells were increased by L-NAME treatment (100%), but the number of bone marrow cells was not altered. The treatment reduced L-selectin expression on circulating leukocytes, by either with (16%) or without (26%) stimulation with BjV; PMN cells were more affected (32-37%). Impairment of L-selectin expression was also verified in bone marrow cells under stimulation with BjV.

CONCLUSIONS

Results show that this schedule of L-NAME treatment promotes a decrease on L-selectin expression. This effect may promote the standstill of leukocytes in the blood compartment and may be responsible, at least in part, for the observed deficient leukocyte-endothelium interactions with subsequent impairment of leukocyte migration to the inflammatory site.

Crotalus durissus terrificus snake venom regulates macrophage metabolism and function

In the present study, we examined the effect of Crotalus durissus terrificus venom on rat macrophage metabolism and function. Two hours after subcutaneous injection of the venom, peritoneal resident (unstimulated), elicited (thioglycollate-stimulated), and activated Mycobacterium bovis strain bacille Calmette Guérin (BCG) macrophages were collected, and their functional and metabolic parameters were analyzed. The venom inhibited spreading and phagocytosis of macrophages. On the other hand, this treatment increased H(2)O(2) and NO production, candidacidal activity, and the activities of key enzymes of glycolysis and glutaminolysis. We also investigated whether the venom could affect macrophage activation by thioglycollate or BCG. The administration of venom 2 h before injection of thioglycollate and BCG or 2 or 3 days after injection of the thioglycollate or BCG, respectively, did not modify the previous observations. These findings suggest that crotalic venom leads the macrophage to an activated state, with high production of oxygen- and nitrogen-reactive species. This cell activation state does not include inflammatory properties of spreading and phagocytosis.

Experimental study of induced inflammation in the Brazilian Boa (Boa constrictor constrictor)

The objective of this work was to identify the cellular types present in inflammatory processes in the Brazilian snake, Boa constrictor constrictor. Blood smears were first made from three normal snakes and stained by several methods to identify the cell types present, thus facilitating the identification of cells in inflammatory processes induced in 16 further snakes by the subcutaneous implantation of cotton suture threads and circular coverslips. Implanted threads induced migration of heterophils and monocytes after 4 h, more intense monocyte migration after 24 h, an intense granulocytic migration inside and around the thread after 48 h, heterophilic granulocytes, macrophages and giant cells after 7 days, and giant cells with a typical granuloma response and persistence of heterophilic cells after 15, 69 and 117 days. The cell population attached to the implanted coverslips after 4 h was composed of heterophils, thrombocytes, erythrocytes and macrophages; after 24 and 48 h heterophils predominated, and after 7 days heterophils, macrophages and giant cells predominated.

Hand preference in Italian students

Italian undergraduates (N = 2326) were administered the Italian revised version of Edinburgh Handedness Inventory (Salmaso & Longoni, 1985). Left-handedness was documented in relation to sex, university faculty, geographic origin and handedness pressure. A greater proportion (7.9%) of left-handedness was found compared to previous works on Italian samples. Additional results indicated a difference in left-handedness incidence among Southern, Central and Northern Italian regions. Results are discussed in terms of social and cultural influence.

Protein malnutrition: some aspects of the in vitro adhesion of peritoneal mouse macrophages

Protein calorie malnutrition and disease are frequently associated. Protein malnutrition modifies both the specific and nonspecific resistance of the organism to infectious agents. The exact mechanisms underlying these findings are not clear. Cellular adhesion is a crucial step in the process of phagocytosis as well as cellular migration. The effect of a low-protein diet on adhesion of macrophages was studied using an experimental murine model. We used malnourished mice that had lost 30% of their initial body weight. We then injected them with a suspension of sodium caseinate and harvested the peritoneal macrophages after 5 days. The cells were then allowed to adhere to cover slips in the presence or absence of 10% fetal calf serum (FCS) in the medium for time periods of 30, 60, 90 and 120 min. Macrophage adhesion to glass slips whose surface had been covered with type I collagen was performed only for 90 min. The expression of fibronectin was studied using an immunohistochemical technique only in the 90-min assay. The results indicate that (1) protein malnutrition impairs the activation potential of macrophages, decreasing their adhesion and expression of fibronectin; (2) when FCS is present in the medium, there is a decrease in the number of adhered cells.

Alterations in proteins of bone marrow extracellular matrix in undernourished mice

The objective of the present study was to determine the effect of protein malnutrition on the glycoprotein content of bone marrow extracellular matrix (ECM). Two-month-old male Swiss mice were submitted to protein malnutrition with a low-protein diet containing 4% casein as compared to 20% casein in the control diet. When the experimental group had attained a 20% loss of their original body weight, we extracted the ECM proteins from bone marrow with PBS buffer, and analyzed ECM samples by SDS-PAGE (7.5%) and ECL Western blotting. Quantitative differences were observed between control and experimental groups. Bone marrow ECM from undernourished mice had greater amounts of extractable fibronectin (1.6-fold increase) and laminin (4.8-fold increase) when compared to the control group. These results suggest an association between fluctuations in the composition of the hematopoietic microenvironment and altered hematopoiesis observed in undernourished mice.

Acute Trypanosoma cruzi infection is associated with anemia, thrombocytopenia, leukopenia, and bone marrow hypoplasia: reversal by nifurtimox treatment

In the present work we show that acute infection of C3H mice with the CL strain of Trypanosoma cruzi is characterized by an exponential growth of parasites and high mortality accompanied by anemia, thrombocytopenia, leukopenia, and bone marrow hypoplasia. Administration of nifurtimox, a trypanocydal drug currently in clinical use at different days postinfection, modulates parasitemia and prevents mortality. More importantly, none of blood and bone marrow alterations were observed in nifurtimox-treated animals when treatment was initiated early in infection, one or seven days postinoculation. The bone marrow alterations were characterized by a decrease in the total number cells as well in the number of megakaryoblasts and erythroblasts. Transfer experiments of bone marrow cells from infected mice to noninfected lethally irradiated recipients revealed a poor marrow-repopulating activity. The colony forming units-spleen assay confirmed the depression of committed clonal progenitors cells and revealed a decreased number of granulocyte/macrophage, megacariocyte and erythrocyte colonies. In summary, this is the first report showing that acute T. cruzi infection results in profound alterations of the hematopoietic system and that these alterations can be prevented by nifurtimox treatment.

Unusual horizontal and vertical root fractures of maxillary molars: an 11-year follow-up

Intra-alveolar root fractures of posterior teeth are rare when compared with other dental injuries. This case report describes one vertical and two horizontal root fractures of teeth 3, 14, and 15. The teeth all tested normal to cold and electric pulp tests. The patient reported no history of accidental trauma, and no signs of scarring were found. These fractures were discovered during a routine full-mouth radiographic survey. All teeth were asymptomatic and in good function. During the 11 yr that followed, there was no dental treatment, except for routine periodontal maintenance. The patient had one abscess that occurred after 9 yr on tooth 3, which had to be extracted. The upper left molars are surprisingly still in function and asymptomatic. Either occlusal or lateral trauma may be the cause of these fractures. This would strongly suggest night guard appliances for patients who clench or grind. A psychological evaluation of the patient might reveal neurosis, anxiety, or stress situations affecting teeth.

Reimplantation or explantation in the treatment of septic prosthetic loosening

Indications for the surgical treatment of septic loosening of hip arthroplasty vary depending on different parameters. Explantation is indicated when patients are elderly, in generally poor condition, when there are veterate infections, particularly if these were caused by gram negative bacteria, and when there is severe skeletal injury. Reimplantation is instead indicated in patients whose general conditions are good, and who are young and motivated.

The surgical treatment of spondylolisthesis

The authors report the results obtained in 244 patients submitted to anterior interbody fusion. The method involves preoperative reduction in plaster (when necessary) and anterior surgical stabilization, facilitated by improvement in the anatomical and biomechanical conditions obtained with reduction. This method obtained excellent results in 85% of the cases, with fusion and absence of symptoms, and good results in 10% of the cases, with occasional symptoms and/or fibrous. Results were unsatisfactory in 5% of the cases because of residual radiculopathy (4 cases), non-union of the fusion (3 cases), retrograde ejaculation (2 cases), loosening of the graft (1 case) or unthreading of a screw (1 case). It is our opinion that anterior interbody fusion is the best surgical method for the stabilization of Meyerding grades III, IV and V spondylolisthesis. Posterolateral fusion is used to treat some cases with slippage equal to less than 25% (grade I) and cases where more than one level is involved.

Surgical treatment of unresolved Osgood-Schlatter lesion

The Osgood-Schlatter lesion is considered a traction apophysitis. Treatment is generally conservative, and only rarely does a surgical treatment become necessary for the persistence of pain and swelling over the tibial tubercle. The most widely used procedure consists of the excision of all intratendinous ossicles with or without removal of the prominent tibial tubercle. In 15 cases treated in this manner compared with 11 cases treated with various procedures before 1975, the results were clearly better with the former. There was only one fair and no poor results. Removal of all loose intratendinous ossicles associated with prominent tibial tubercles is the procedure of choice, both from the functional and the cosmetic point of view.

Quality criteria for pure titanium casting, laboratory soldering, intraoral welding, and a device to aid in making uncontaminated castings

Procedures for casting, laboratory soldering, and intraoral welding of titanium for dental restorations are described and illustrated. Pure titanium and titanium 6A1-4Va alloy castings may be used for virtually any prosthodontic rehabilitation as well as for implants, with the proper equipment and technique.

Early and long-term results of pneumatic dilation in the treatment of oesophageal achalasia

Between 1967 and 1989, 60 patients underwent pneumatic dilation of the cardia at our institution. Of these, 33 had not undergone any previous treatment (group 1), whereas 27 presented with recurrent dysphagia after a failure of surgical treatment (group 2). In this series there was no procedure-related mortality and a perforation occurred only in 1 patient who was treated conservatively. The mean follow-up was similar in both groups (44 and 49 months, respectively). The results of pneumatic dilation were either excellent or good in 61% of group 1 patients, and in 76% of group 2 patients. Reflux oesophagitis requiring medical therapy occurred in 1 group 2 patient. We conclude that pneumatic dilation is a safe and relatively effective procedure in patients with achalasia. Patients with a failed Heller myotomy seem to respond better than patients without previous surgery. However, the risk of gastro-oesophageal reflux after pneumatic dilation should not be underestimated.

[Delayed consolidation and pseudarthrosis in posttraumatic pathology of the carpal scaphoid. A magnetic resonance study]

Delayed unions and fibrous or sclerotic non-unions of the carpal scaphoid are frequent sequelae of non-diagnosed or not properly treated fractures. The most important cause of abnormal unions is ischemic necrosis, due to the terminal vascularity of the carpal scaphoid. Conventional X-rays, scintigraphy, and CT do not yield sufficient information for a complete diagnosis; at present, MR imaging represents a valuable alternative, for it is a noninvasive technique able to provide a "biological imaging" of bone. Fourteen patients underwent surgical/nonsurgical treatment, based on the findings supplied by MR imaging. MR reliability was evaluated in relation to the therapeutic results obtained. The study proved MR imaging to provide important information as to therapy planning; in case of surgical treatment, MR imaging helped in choosing the most appropriate location for the insertion of bone graft or screw.

[Use of a latissimus dorsi myocutaneous flap in locally advanced breast cancer]

Locally advanced breast cancer has a poor prognosis. Skin infiltration, ulceration and invasion of the chest wall, in the absence of distant metastases, worsen dramatically the quality of life. The Authors report 4 cases of one time wide resection and reconstruction using a pedicled myocutaneous flap of latissimus dorsi. This technique allowed good and rapid palliation of local symptoms.

Immunological features of endemic goiter

Some immune aspects of simple endemic goiter have been studied through a comparison of IgG, IgA, IgM, kappa and lambda chains, and C3 and C4 in the peripheral blood of 59 patients operated on for goiter and the peripheral blood of 49 normal controls. The median IgM was lower in the goiter blood. The incidence of thyroglobulin (Tg) and microsomal (Mi) antibodies (Abs) was 20.3% in goiter blood and that of nonthyroid autoAbs was 37%. Active and total rosetted blood lymphocytes were counted and OKT3, OKT4, OKT8, Leu 1, Leu3a, Leu2b, T DR+, and NK cell populations were classified. Helper T cells were occasionally decreased when goiter was associated with lymphocytic thyroiditis. The NK percentage was sometimes higher in goiter blood, whereas the T DR+ percentage was not significantly different in the two groups. Lymphocyte infiltration (LI) was noted in 32% of goiters (about 5% with a diffuse and nodular pattern). A prevalence of helper/inducer cells was observed among the infiltrating T cells. HLA-DR antigen (Ag) positive epithelial cells were seen, not only in LI areas. Granular deposits of IgG, IgA, IgM, and C3 on the follicular basal membrane were stained in 6.7% of goiters Patterns histologically and immunologically similar to those in Hashimoto's thyroiditis may therefore be observed in long-standing simple endemic goiter, suggesting that an autoimmune mechanism may be involved in its pathogenesis.