Upregulation of non-β cell-derived vascular endothelial growth factor A increases small clusters of insulin-producing cells in the pancreas

Pancreatic β cell-derived vascular endothelial growth factor A (VEGF-A) contributes to normal β cell function. We therefore hypothesized that non-β cell-derived VEGF-A may affect its properties in adult mice.We generated transgenic mice expressing human VEGF-A (hVEGF-A) in a visceral smooth muscle cell (SMC)-dominant manner under the control of the transgelin (Tagln/SM22α) promoter via a tamoxifen-induced Cre/loxP recombination system (SM-CreER(T2)/hVEGF mice).SM-CreER(T2)/hVEGF mice received tamoxifen orally followed by microscopic examination of their pancreas 4 weeks after the hVEGF-A induction. The number of clusters of insulin-producing cells (IPCs) in islets, pancreatic ducts, and individual IPCs were counted.The number of small IPC clusters (100-215 μm(2)) in the pancreas increased significantly in SM-CreER(T2)/hVEGF mice compared with SM-CreER(T2)(Ki) mice (473 out of 1 992 counts vs. 199 out of 976 counts, p<0.05), although total IPC area and the number of pancreatic duct IPCs, in proportion to exocrine area, were similar between the 2 groups. Although most small IPC clusters observed in SM-CreER(T2)/hVEGF mice were not accompanied by α and/or δ cells, some were attached to a single or a few α cells. An STZ-induced diabetic state in SM-CreER(T2)/hVEGF mice was slightly ameliorated, with only one point of significance 12 weeks after STZ administration, compared with SM-CreER(T2)(Ki) mice.Upregulation of non-β cell-derived VEGF-A may alter the composition of pancreatic IPCs by increasing the number of small IPC clusters. These findings provide new information on the role of non-β cell-derived VEGF-A to IPC regeneration and insulin production.

Taurine uptake by glial cells in the bullfrog sympathetic ganglia

Taurine uptake was studied in the bullfrog sympathetic ganglia. High- and low-affinity components were detected after subtraction of nonsaturable influx from total uptake in a concentration range from 34 nM to 8mM. Taurine uptake was strictly sodium dependent and the sodium dependency curve was sigmoidal, with a Hill number of 1.6, indicating that at least two sodium ions are required for the transport of one taurine molecule. External sodium ion affected both K(m) and V(max) for taurine uptake. Taurine uptake was inhibited by ouabain, but not by tetrodotoxin. These results suggest that sodium concentration gradient across plasma membrane may be the main driving force for taurine uptake. Electron and light microscopic autoradiography showed that glial cells were heavily labeled by [(3)H]taurine while ganglion cells were slightly labeled. The present data suggest that glial uptake may contribute to terminating the effect of taurine in the bullfrog sympathetic ganglia.

1,5-Anhydroglucitol attenuates cytokine release and protects mice with type 2 diabetes from inflammatory reactions

1,5-anhydroglucitol (1,5-AG) decreases in diabetic patients and is used as a marker of glycemic control. Type 2 diabetic patients are susceptibile to lipopolysaccharides (LPS), which stimulate macrophages to release large quantities of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6. This study examines the effects of 1,5-AG on lung inflammation induced by LPS and consequent systemic inflammation to determine whether the decrease of 1,5-AG concentration induces susceptibility to LPS. Before the challenge with LPS (1 mg/kg in vivo and 500 ng/ml in vitro), we pretreated db/db mice and RAW264.7 cells with 1,5-AG at 38.5 mg/kg and 500 microg/ml, respectively. The levels of IL-6, TNF-alpha, macrophage chemoattractant protein (MCP)-1 and IL-1beta in the serum and in the cell supernatants were measured. We also measured macrophage recruitment and the expression of inducible nitric oxide synthase (iNOS) in pulmonary tissues. We found that 1,5-AG attenuated serum cytokine release and protected db/db mice from LPS-induced pulmonary inflammation. In addition, 1,5-AG suppressed cytokine release and iNOS expression by suppressing Akt/NF-kB activity in RAW264.7 cells. These results suggest that 1,5-AG may be a mediator in, as well as marker for diabetes, and 1,5-AG intake may confer tolerance to LPS in patients with type 2 diabetes.

Genetic variation of pancreatic esterase isozyme in Japanese quail

A genetic variation was found in pancreatic esterases of Japanese quail which appeared to be arylesterase. It was found on the cathode side in the agar gel electrophoresis. Three phenotypes, A,B and AB, were observed. These phenotypes were shown to be controlled by one autosomal locus, designated as Es-4, with co-dominant alleles Es-4A and Es-4B. Es-4 esterase isozymes were detected in all the individuals from about 4 days of age, but the activity was very weak. However, it gradually increased to reach a level almost the same as that of a mature quail from about 15 days of age.

Trends in heterozygosity in the process of producing inbred strains of Japanese quail

Trends in heterozygosity in the process of producing inbred strains of Japanese quail were examined through the characterization of protein polymorphisms based on gene freqencies of 7 polymorphic loci. The average heterozygosity (Ho) at generation 1 was 0.472 and it decreased with increasing inbreeding coefficient (F) to 0.214 at generation 5 when F was 0.594. In all generations, the observed heterozygosities of the surviving families tended to be higher than those of the families that did not survive. The frequency of heterozygotes of the Es-4 locus in surviving families was higher than that of the extinct families in each generation and the difference became conspicuous in generation 4. These results suggest that a heterozygote advantage of Es-4 locus is revealed by inbreeding.

Measles virus receptors

Measles virus (MV) has two envelope glycoproteins, the hemagglutinin (H) and fusion protein, which are responsible for attachment and membrane fusion, respectively. Signaling lymphocyte activation molecule (SLAM, also called CD150), a membrane glycoprotein expressed on immune cells, acts as the principal cellular receptor for MV, accounting for its lymphotropism and immunosuppressive nature. MV also infects polarized epithelial cells via an as yet unknown receptor molecule, thereby presumably facilitating transmission via aerosol droplets. Vaccine and laboratory-adapted strains of MV use ubiquitously expressed CD46 as an alternate receptor through amino acid substitutions in the H protein. The crystal structure of the H protein indicates that the putative binding sites for SLAM, CD46, and the epithelial cell receptor are strategically located in different positions of the H protein. Other molecules have also been implicated in MV infection, although their relevance remains to be determined. The identification of MV receptors has advanced our understanding of MV tropism and pathogenesis.

Serum VEGF increases in diabetic polyneuropathy, particularly in the neurologically active symptomatic stage

AIM

To identify the relationship between vascular endothelial growth factor (VEGF) and diabetic polyneuropathy (DPN).

METHODS

Two hundred and twenty diabetic patients participated, 113 with DPN and 107 without DPN. All patients were also classified according to the four stages of DPN (no neuropathy: stage 0; asymptomatic neuropathy: stage 1; symptomatic neuropathy: stage 2; disabling neuropathy: stage 3). Serum VEGF concentration was measured using an enzyme-linked immunosorbent assay (ELISA) and levels between the patients with and without DPN and also between the different stages of DPN, were compared.

RESULTS

The mean serum VEGF level in all patients was 264.6 +/- 218.8 pg/ml. The mean serum VEGF level was higher in patients with DPN (310.1 +/- 224.3 pg/ml) than in the patients without DPN (216.5 +/- 204.0 pg/ml, P = 0.0014). Serum VEGF was higher in the 'symptomatic' stage (stage 2, 364.8 +/- 225.9 pg/ml) in comparison with the 'asymptomatic' (stage 1, 256.7 +/- 224.4 pg/ml, P = 0.015) and 'disabling' (stage 3, 180.3 +/- 109.4 pg/ml, P = 0.042) stages. The mean serum VEGF level in patients with diabetic retinopathy (261.1 +/- 210.6 pg/ml) and in patients with diabetic nephropathy (241.5 +/- 185.7 pg/ml) was not increased.

CONCLUSIONS

The serum VEGF level is increased in patients with DPN, particularly in patients in the neurologically active 'symptomatic' stage.

High-mobility group box 1 protein promotes development of microvascular thrombosis in rats

BACKGROUND

Sepsis is a life-threatening disorder resulting from systemic inflammatory and coagulatory responses to infection. High-mobility group box 1 protein (HMGB1), an abundant intranuclear protein, was recently identified as a potent lethal mediator of sepsis. However, the precise mechanisms by which HMGB1 exerts its lethal effects in sepsis have yet to be confirmed. We recently reported that plasma HMGB1 levels correlated with disseminated intravascular coagulation (DIC) score, indicating that HMGB1 might play an important role in the pathogenesis of DIC.

OBJECTIVES

To investigate the mechanisms responsible for the lethal effects of HMGB1, and more specifically, to explore the effects of HMGB1 on the coagulation system.

METHODS

Rats were exposed to thrombin with or without HMGB1, and a survival analysis, pathologic analyses and blood tests were conducted. The effects of HMGB1 on the coagulation cascade, anticoagulant pathways and surface expression of procoagulant or anticoagulant molecules were examined in vitro.

RESULTS

Compared to thrombin alone, combined administration of thrombin and HMGB1 resulted in excessive fibrin deposition in glomeruli, prolonged plasma clotting times, and increased mortality. In vitro, HMGB1 did not affect clotting times, but inhibited the anticoagulant protein C pathway mediated by the thrombin-thrombomodulin complex, and stimulated tissue factor expression on monocytes.

CONCLUSIONS

These findings demonstrate the procoagulant role of HMGB1 in vivo and in vitro. During sepsis, massive accumulation of HMGB1 in the systemic circulation would promote the development of DIC.

Highly accumulated platelet vascular endothelial growth factor in coagulant thrombotic region

BACKGROUND

Vascular endothelial growth factor (VEGF) is an endothelial cell-specific potent mitogen that induces angiogenesis and microvascular hyperpermeability. Recently, it has been reported that megakaryocytes and platelets contain VEGF in their cytoplasm.

OBJECTIVES

To elucidate and confirm the bioactivity and role of VEGF in platelets (platelet VEGF), which may be closely related to vascular thrombosis and atherosclerosis.

METHODS

The VEGF localization in megakaryocytes on bone marrow smears was analyzed by immunofluorescence and confocal laser scanning microscopic analysis. The intracellular VEGF expressed in platelets was determined by flow cytometric analysis. Platelet-rich plasma and washed platelets were used to analyze the secretion of VEGF during platelet aggregation by thrombin or gelatinase A (matrix metalloproteinase-2) stimulation. Immunohistochemical studies for VEGF in the thrombotic region were performed.

RESULTS AND CONCLUSIONS

Megakaryocytes and platelets are a very rich source of circulating VEGF. Gelatinase A, which is closely associated with vascular remodeling, enhances the VEGF levels released from platelets. VEGF was clearly detected in the fibrin nets of a thrombus. Taken together, platelet VEGF is bioactive as a direct angiogenic growth factor, and may play a very important role in wound healing and atherosclerosis in conjunction with other platelet cytokines such as platelet-derived growth factor, platelet-derived endothelial cell growth factor, transforming growth factor (TGF)-alpha, and TGF-beta.

The agonist of the protease-activated receptor-1 (PAR) but not PAR3 mimics thrombin-induced vascular endothelial growth factor release in human smooth muscle cells

Thrombin, a serine protease generated by the activation of the blood coagulation cascade following vessel injury, induces vascular endothelial growth factor-(VEGF) release. However, the molecular mechanism of thrombin-induced VEGF release is largely unknown. Anagonist of protease-activated receptor-i (PARI), SFLL-RNPNDKYEPF, mimicked thrombin-induced VEGF release in human vascular smooth muscle (HVSM) cells, as determined by enzyme-linked immunosorbent assay, reverse transcriptase-polymerase chain reaction, and Northern blotting. In contrast, the agonist of PAR3, TFR- GAP, did not affect VEGF release or expression. SFLL-RNPNDKYEPF, but not TFRGAP, up-regulated [Ca2-]i.Moreover, the calcium ionophone A23187 was found to trigger VEGF release in HVSM cells. Thrombin-inducedVEGF release was blocked by anti-thrombin, heparin, a synthetic thrombin receptor inhibitor E5510, the calcium chelator BAPTA, the protein kinase C inhibitor calphostin C, and the MEK1/2 inhibitor U0126. Thus, our data show that thrombin caused VEGF release via PARI activation in a manner dependent on [Ca2+]i and p44/42 downstream from the receptor activation.

Frequency response of nonlinear oscillations of air column in a tube with an array of Helmholtz resonators

Nonlinear cubic theory is developed to obtain a frequency response of shock-free, forced oscillations of an air column in a closed tube with an array of Helmholtz resonators connected axially. The column is assumed to be driven by a plane piston sinusoidally at a frequency close or equal to the lowest resonance frequency with its maximum displacement fixed. By applying the method of multiple scales, the equation for temporal modulation of a complex pressure amplitude of the lowest mode is derived in a case that a typical acoustic Mach number is comparable with the one-third power of the piston Mach number, while the relative detuning of a frequency is comparable with the quadratic order of the acoustic Mach number. The steady-state solution gives the asymmetric frequency response curve with bending (skew) due to nonlinear frequency upshift in addition to the linear downshift. Validity of the theory is checked against the frequency response obtained experimentally. For high amplitude of oscillations, an effect of jet loss at the throat of the resonator is taken into account, which introduces the quadratic loss to suppress the peak amplitude. It is revealed that as far as the present check is concerned, the weakly nonlinear theory can give quantitatively adequate description up to the pressure amplitude of about 3% to the equilibrium pressure.

Morphological and biochemical studies of human beta-mannosidosis: identification of a novel beta-mannosidase gene mutation

BACKGROUND

There are seven well-known lysosomal storage diseases that produce angiokeratoma corporis diffusum clinically. beta-Mannosidosis (MANB1; OMIM248510), first reported in humans in 1986, is a rare hereditary lysosomal storage disease caused by a deficiency of the enzyme beta-mannosidase. Since then, 13 cases of beta-mannosidase deficiency in ten families have been described. A human beta-mannosidase mutation has been reported only by Alkhayat et al. in 1998.

OBJECTIVES

To clarify its pathogenesis we did electron microscopic, biochemical and molecular biological investigations of a Japanese patient with beta-mannosidosis.

METHODS

Ultrastructural analyses, enzyme assays, cell culture and mRNA and genomic DNA were sequenced to find mutations in the beta-mannosidase gene.

RESULTS

Electron microscopy of skin biopsy specimens from the patient showed cytoplasmic vacuolation of lysosomes in blood and lymph vessels, endothelial cells, fibroblasts, secretory portions of eccrine sweat glands, neural cells and basal keratinocytes in the epidermis. This vacuolation was also observed in cultured keratinocytes and fibroblasts. Assays of seven enzyme activities in plasma and cultured skin fibroblasts showed a marked decrease of beta-mannosidase activity. Sequencing the beta-mannosidase cDNA revealed a four-base (ATAA) insertion between exons 7 and 8, resulting in a frameshift at codon 321 and termination at codon 325. Analysis of the patient's genomic DNA revealed a novel homozygous A(+1)-->G splice site mutation in intron 7.

CONCLUSIONS

To our knowledge, this is the first case of beta-mannosidosis reported in Japan and the second report in which a gene mutation is identified. The biological importance of beta-mannose moieties in glycoproteins in basal keratinocytes is suggested.

Novel mutations in GJB2 encoding connexin-26 in Japanese patients with keratitis-ichthyosis-deafness syndrome

BACKGROUND

Germline missense mutations in the GJB2 gene that encodes connexin-26 (Cx26) have recently been found to be the cause of the keratitis-ichthyosis-deafness (KID) syndrome.

OBJECTIVES

To define the GJB2 mutations in three Japanese patients with KID syndrome.

METHODS

Genomic DNA was extracted from peripheral blood and used to amplify the GJB2 gene. Direct sequencing and endonuclease digestion were used for mutation analysis and DNA-based diagnosis.

RESULTS

We identified two heterozygous mis-sense mutations (D50Y, D50N) in the GJB2 gene in three Japanese patients with KID syndrome. All mutations were located on the first extracellular domain of Cx26.

CONCLUSIONS

These data expand the GJB2 mutation database and show that a dominant mutation of Cx26 can cause KID syndrome in Japanese patients.

Reassessment of the diagnostic value of selective lumbosacral radiculography

In nerve root infiltration (NRI) consisting of neural blockage and radiculography, response to the nerve root block has usually been thought to be diagnostically significant. However radiculography has not been statistically evaluated. The purpose of this paper is to assess the value of selective radiculography of patients with group 1 response (typical pain reproduced by needle placement and then relieved by nerve root block) according to Dooley's criteria. We studied selective radiculography in a consecutive series of 88 patients with lumbo-sacral radicular pain who showed group 1 response in NRI. The accuracy of the preoperative nerve root block and radiculography in 88 nerve roots (L5,S1) were correlated with the intraoperative findings. Selective radiculograms were classified into three groups; normal (absence of block), partial block, and complete block. The tilting angle of all nerve roots was measured. We found the symptomatic root at the same level of the nerve root block in all 88 patients. Selective radiculograms showed five normal roots, 15 roots with incomplete block and 63 roots with complete block. Fifteen radiculograms had abnormal tilting angles. The accuracy of radiculography was 84% in the canal zone and 100% in the intra and extraforaminal zones. If the L5 nerve root angle was more than 60(o), an intra or extraforaminal lesion was strongly suggested (P<0.01). Radiculography of patients with group 1 response is useful for detecting compressed sites in the symptomatic nerve root, particularly for detecting lesions in the intra and extraforaminal zones.

[Vascular endothelial growth factor and Crow-Fukase syndrome]

Serum vascular endothelial growth factor (VEGF) is highly elevated in patients with Crow-Fukase syndrome (CFS) and is well correlated with the clinical manifestations of CFS. In circulating blood, VEGF is specifically stored in platelets and released during platelet aggregation. To clarify the role of VEGF in the pathomechanism of CFS, we transplanted VEGF secretion tumors in nude mice and studied the pathological findings in these mice. Prominent edema with elevated serum VEGF were found. Organomegaly was also found in liver, spleen and kidney. Pathological findings in these organs were similar to those found in autopsies of CFS patients. In peripheral nerve, mild intraneural edema was seen, however, neuropathy was not prominent. These findings suggest that elevated VEGF may be closely correlated with generalized edema (anasarca). However, it is also important to consider factors such as cytokines and other T cell functions that, in association with VEGF, may be the cause of neuropathy in CFS.

Expression of vascular endothelial growth factor in pulmonary aspergilloma

OBJECTIVE

Vascular endothelial growth factor (VEGF), a cytokine associated with malignant neoplasms, is increased in a number of inflammatory and infectious disorders. But little is known about VEGF in pulmonary aspergilloma (PA). In order to clarify the predictive value of VEGF in PA, we examined serum VEGF levels in PA patients as well as expression of VEGF in the PA lesion. Patients Twenty-one patients with PA (6 with hemoptysis and the rest without hemoptysis) were investigated.

METHODS

In all patients, serum VEGF levels were measured by enzyme-linked immunosorbent assay. We examined the statistical correlations of serum VEGF levels with the ratio of affected area to total lung volume and VEGF with PaO2 levels. In patients with hemoptysis, we measured the serum VEGF levels three months after the initiation of therapy. We examined the expression of VEGF in the resected lung tissue of 4 patients with PA using immunohistochemistry.

RESULTS

Serum VEGF levels showed a significant positive correlation with the ratio of affected to total lung area and a significant negative correlation with PaO2 levels. Serum VEGF levels in patients with hemoptysis were significantly higher than in those without hemoptysis. The serum levels of VEGF in patients with hemoptysis decreased significantly in parallel with the alleviation of hemoptysis. Immunohistochemical staining demonstrated the expression of VEGF in alveolar macrophages in the lesion of PA patients.

CONCLUSION

We suggest that VEGF can be used as a serum marker to determine the extent of the lesion, hypoxia and hemoptysis in PA.

Frameshift mutation in the collagen VI gene causes Ullrich's disease

Patients with Ullrich's disease have generalized muscle weakness, multiple contractures of the proximal joints, and hyperextensibility of the distal joints. Recently, we found a deficiency of collagen VI protein in two patients with Ullrich's disease. In this study, we detected a homozygous 26 bp deletion in exon 14 of the collagen VI alpha 2 gene (COL6A2) in one patient. This mutation causes a frameshift and a premature termination codon, and results in a truncated collagen VI alpha 2 chain. Our data suggest that at least some cases of Ullrich's disease result from recessive mutations in COL6A2.

Aberrant brain activation following motor skill learning in schizophrenic patients as shown by functional magnetic resonance imaging

BACKGROUND

Motor skill learning may be impaired in schizophrenia. While functional brain imaging studies have shown reduced activation during motor task performance in schizophrenic patients, brain activity changes with motor skill learning in these patients have not been studied by functional imaging.

METHODS

A sequential complex motor task involving the right hand was performed by nine medicated schizophrenic patients and 10 age-matched healthy controls. Functional magnetic resonance images were obtained using a gradient echo, echoplanar imaging (EPI) pulse sequence before and after 1 week of training in performing the task.

RESULTS

Bilaterally, patients showed significantly less blood oxygenation level-dependent (BOLD) signal response in the premotor area (PMA) before beginning motor training than controls. BOLD signal response increased in the left PMA of schizophrenic patients after 1 week of motor training; in contrast, the signal decreased in the left PMA of control subjects. Training effects concerning the number of finger movement sequences achieved did not differ between groups. Daily neuroleptic dose did not significantly affect changes with training in BOLD signal response in the PMA.

CONCLUSIONS

These preliminary results suggest that schizophrenic patients have dysfunction of neural networks in areas including the PMA that are involved in executing a complex motor task. In terms of brain activity, motor learning may be less efficient or slower in the patients than in healthy subjects.

Simultaneous measurement of anandamide and 2-arachidonoylglycerol by polymyxin B-selective adsorption and subsequent high-performance liquid chromatography analysis: increase in endogenous cannabinoids in the sera of patients with endotoxic shock

Anandamide (ANA) and 2-arachidonoylglycerol (2-AG), two endogenous cannabinoids, can be generated by activated macrophages and platelets, respectively, in the context of endotoxic shock, and are proposed to play a crucial role in the induction of the shock-related hypotension. Taking advantage of our recently discovered function of polymyxin B (PMB) binding to ANA and 2-AG, we developed a new method for measuring ANA and 2-AG by applying PMB-immobilized beads to selectively adsorb them in biological fluids, instead of organic solvent extraction. The eluate from beads can be directly fractionated by reverse-phase high-performance liquid chromatography (HPLC), and the fractionations corresponding to authentic ANA and 2-AG are collected and derivatized with fluorogenic reagent and subsequently quantified by HPLC with fluorometric detection. The calibration graphs of ANA and 2-AG were linear over a range of 1 to 500 pmol/ml. The limits of detection for ANA and 2-AG were 20 and 50 fmol, respectively. Intraassay precision was 2.24-4.25 and 3.47-5.44%, and interassay was 4.05-6.14 and 4.92-7.28% for ANA and 2-AG, respectively. Using this method, we first determined a 4-fold and 3-fold higher level of ANA and 2-AG, respectively, in the sera of patients with endotoxic shock than in normal serum. This finding should help in elucidating the role of the endogenous cannabinoids in the hypotension of human endotoxic shock. This method is rapid, sensitive, and reliable for simultaneously quantifying ANA and 2-AG in biological fluids, and has potential for clinical usage.

Elevation of N-(carboxymethyl)valine residue in hemoglobin of diabetic patients. Its role in the development of diabetic nephropathy

OBJECTIVE

Advanced glycation end products (AGEs) are a risk factor for diabetic complications. We have developed an assay method for N-(carboxymethyl)valine (CMV) of the hemoglobin (CMV-Hb), which is an AGE generated from HbA1c. Herein we describe the clinical utility of CMV-Hb measurement for the diagnosis of diabetic nephropathy

RESEARCH DESIGN AND METHODS

BALB/c mice were immunized with carboxy-methylated Hb and monoclonal antibody raised against CMV-Hb. This antibody was characterized by a surface plasmon resonance. We developed a latex immunoassay using the antibody and measured CMV-Hb from erythrocytes in type 2 diabetic patients and healthy control subjects (age 64.6 +/- 12.0 vs. 61.1 +/- 13.2 years, NS: HbA1c 69 +/- 1.5 vs. 5.2 +/- 0.4%, P < 0.0001).

RESULTS

A monoclonal antibody against CMV-Hb beta-chain NH2-terminal and an assay method for measurement for CNMV-Hb were both developed in our laboratory. CMV-Hb levels were significantly greater in the diabetic patients than in the control subjects (18.2 +/- 6.9 vs. 12.7 +/- 0.9 pmol CMV/mg Hb, P < 0.0001). No correlation was found between CMV-Hb and HbA1c or CMV-Hb and glycated albumin. Levels of CMV-Hb increased as the diabetic nephropathy progressed.

CONCLUSIONS

We established an assay method for CMV-Hb and confirmed the presence of CMV-Hb in circulating erythrocytes. CMV-Hb was more prevalent in diabetic patients than in healthy subjects. Furthermore, it was significantly higher in patients with diabetic nephropathy, suggesting that the presence of CMV-Hb may be a valuable marker for the progression of diabetic nephropathy.

Expression of vascular endothelial growth factor in tuberculous meningitis

The pathogenesis of tuberculous meningitis is still unclear. Recently, vascular endothelial growth factor (VEGF) was found to be associated with inflammatory diseases and we found the increased serum level of VEGF in pulmonary tuberculosis. We hypothesized that VEGF might be associated with the pathogenesis of tuberculous meningitis and measured serum and cerebrospinal fluid (CSF) levels of VEGF in 28 patients with tuberculous meningitis and 31 non-tuberculous infectious meningitis patients (13 bacterial meningitis patients, eight fungal meningitis patients and 10 patients with viral meningitis) before therapy. We examined the CSF VEGF levels 3 months after in 12 tuberculous meningitis patients. The serum and CSF levels of VEGF were significantly higher in tuberculous meningitis than in other meningitis. The decrease in titer of CSF VEGF paralleled the clinical improvement of tuberculous meningitis. Immunohistochemical staining of autopsied brains demonstrated the presence of VEGF in the inflammatory mononuclear cells of the dense fibroconnective tissue both in the subarachnoid space and surrounding the vasculitis lesion. We found the expression of VEGF in tuberculous meningitis and think that VEGF reflects its activity.

Circulating levels of MMP-1, -2, -3, -9, and TIMP-1 are increased in POEMS syndrome

The authors quantitatively measured levels of matrix metalloproteinases (MMP), tissue inhibitor of metalloproteinases (TIMP), and vascular endothelial growth factor (VEGF) in blood samples of POEMS syndrome. Circulating levels of MMP-1, -2, -3, -9, and TIMP-1 were more increased in patients with POEMS syndrome than in patients with other neurologic disorders or in healthy controls. Serum levels of VEGF and TIMP-1 were strongly correlated with each other. Increased circulating levels of MMP-1, -2, -3, -9, and TIMP-1 may lead to a better understanding the pathogenesis of POEMS syndrome.

VEGF is causative for pulmonary hypertension in a patient with Crow-Fukase (POEMS) syndrome

We report a case of Crow-Fukase (POEMS) syndrome associated with pulmonary hypertension (PH). In this case, the concentration of vascular endothelial growth factor (VEGF) was extremely high in the serum, and the levels of IL-1beta, IL-6, TNF-alpha, and thiamine, which were thought in past reports to be mediators of PH in Crow-Fukase syndrome, were normal. After prednisolone therapy, PH disappeared with a dramatic decrease in serum VEGF. Our results suggest that VEGF is closely correlated with PH in Crow-Fukase syndrome.

Three cases of polyarteritis nodosa cutanea and a review of the literature

We describe three cases of polyarteritis nodosa cutanea (PNC) showing necrotizing arteritis and only cutaneous lesions without systemic symptoms or visceral involvement for eleven, six, and three years after the onset of the disease. Since it was first described, there has been continuous controversy as to whether PNC progresses to systemic PN. Some cases have been described which had begun with a cutaneous lesion and progressed to the systemic form 19 and 18 years after the onset of the disease, so we believe that long term follow-up of this disease is essential.

Serum levels of vascular endothelial growth factor dependent on the stage progression of lung cancer

STUDY OBJECTIVE

In lung cancer, vascular endothelial growth factor (VEGF) is an important cytokine and is correlated with tumor vessel density, malignant pleural effusions, and coagulation-fibrinolysis factors in vitro. We investigated the correlation between serum VEGF level and stage progression in lung cancer to study the predicted value of VEGF level. We also studied whether coagulation-fibrinolysis factors and PaO(2) levels, which are also important factors for the prediction of the clinical course, are correlated with VEGF.

METHODS

Forty-nine patients with lung cancer were investigated prospectively. VEGF levels of sera and malignant effusions, and plasma concentrations of coagulation-fibrinolysis factors were measured by enzyme-linked immunosorbent assay. We measured PaO(2) levels in all patients at rest.

RESULTS

Serum levels of VEGF were increased significantly according to stage progression. Additionally, plasma concentrations of D dimer, thrombin-antithrombin complex (TAT), and tissue plasminogen activator/plasminogen activator inhibitor type I complex were elevated significantly according to stage progression. The serum VEGF level had a significant positive correlation with the TAT and D dimer levels. Serum VEGF levels had a significant negative correlation with PaO(2) levels. The incidence of cerebral vascular disorder was significantly higher in the patients with systemic hypoxemia than in those without (p<0.05). Mean VEGF levels in malignant effusions in eight patients (five with pleural effusions, two with pericardial effusions, and one with both) were extremely high, especially in pericardial effusions ([mean +/- SD] pleural effusions, 531.9+/-285.4 pg/mL; pericardial effusion, 3,071.6+/-81.3 pg/mL).

CONCLUSION

We predict that in lung cancer, VEGF production and the abnormality of the coagulation-fibrinolysis system differ depending on the stage of progression of disease. Serum VEGF levels would be affected by PaO(2) levels in lung cancer.

Increased serum level of vascular endothelial growth factor in pulmonary tuberculosis

Pulmonary tuberculosis, one of the granulomatous diseases, has few serological markers for its activity. Recently, an increased serum level of vascular endothelial growth factor (VEGF) was detected in patients with Crohn's disease, also a granulomatous disease. We hypothesized that VEGF might be associated with the pathogenesis of pulmonary tuberculosis. We investigated the serum level of VEGF in 43 patients with active pulmonary tuberculosis, 29 patients with old tuberculosis, and 25 patients with acute bronchitis. We were able to examine the serum VEGF levels every 3 mo for a period of 6 mo in seven patients with active pulmonary tuberculosis. We examined the presence of VEGF in the resected lungs of three patients with active pulmonary tuberculosis by immunohistochemistry. The serum levels of VEGF were significantly higher in patients with active pulmonary tuberculosis than in patients with old tuberculosis and acute bronchitis. The decrease in titer of serum VEGF paralleled the clinical improvement of patients with pulmonary tuberculosis. Immunohistochemical staining of the resected lungs demonstrated the presence of VEGF in alveolar macrophages surrounding the lesion. Therefore, VEGF may be associated with the pathogenesis of pulmonary tuberculosis.

Highly concentrated vascular endothelial growth factor in platelets in Crow-Fukase syndrome

We report a marked difference in concentration of vascular endothelial growth factor (VEGF) between serum and plasma in patients with Crow-Fukase syndrome (CFS). The serum/plasma VEGF levels in 4 CFS patients were 8,634/152, 5,203/176, 3,724/127, and 868/13 pg/ml, respectively. We also showed that platelets were a major source of this VEGF and that VEGF was released during platelet aggregation by physiological stimulation. It is suggested that in CFS, local VEGF concentration is markedly elevated by aggregation of platelets containing excessive VEGF and their adhesion to vascular walls, resulting in excessive physiological activities of VEGF. Our findings provide important information for developing more effective therapeutic trials.

Marked increase of matrix metalloproteinase 9 in cerebrospinal fluid of patients with fungal or tuberculous meningoencephalitis

Matrix metalloproteinases (MMPs) are believed to play an essential role in the breakdown of the extracellular matrix macromolecules in the blood-cerebrospinal fluid barrier and blood-brain barrier (BBB). In this study, the levels of MMP-2 and MMP-9 and their common tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2) were measured in the cerebrospinal fluid (CSF) from patients with various meningitides including aseptic, fungal and tuberculous ones. MMP-9 production level in CSF was more increased in subacute meningitis including fungal and tuberculous meningitis than in acute aseptic meningitis and non-inflammatory neurological diseases (NIDs). Enhanced production of MMP-9 was associated with high proteolytic activity detected by gelatin zymography. The MMP-2 and TIMP-1 levels in CSF of subacute meningitis were also higher than those of NIDs. In contrast, the TIMP-2 levels in CSF of either acute aseptic or subacute meningitis were not up-regulated compared with those of NIDs. The central nervous system (CNS) complications (i.e. disturbance of consciousness, psychiatric symptoms, urinary disturbance, etc.) during the course of meningitis showed good correlation with the enhanced production of MMP-9 in CSF. Immunohistochemical studies in tuberculous meningitis demonstrated that the infiltrating mononuclear cells in the meninges were immunoreactive for both MMP-2 and MMP-9. However, the infiltrating mononuclear cells into CNS parenchyma had immunoreactivity for MMP-9, but not for MMP-2. Taken together, those data suggest that MMP-9 in CSF may be a useful marker of encephalitogenecity during the course of subacute meningitis.

Medial plantar nerve conduction velocities among patients with vibration syndrome due to chain-saw work

OBJECTIVE

The present study examined the effect of the vibration syndrome (VS) on the peripheral nervous system in the lower extremities.

METHODS

Thirty-eight patients with VS due to previous exposure to vibration from chain-saw work and 55 age-matched controls were examined for sensory nerve conduction velocities in the medial plantar nerve (SCV-P). The patient group was divided into two subgroups, one with (n=19) and the other without vibration-induced white finger (VWF; n=19).

RESULTS

Analysis of variance of SCV-P for the three groups showed significant difference (F(2,89)=10.65, P < 0.0001). A significant difference was found between the controls and the VWF(+) group (P < 0.0001) but not between the controls and the VWF(-) group (P=0.0508) by multiple comparison using Scheffe's method.

CONCLUSION

These findings suggest that VS affects the peripheral nervous system function in the lower extremities via mediation of circulatory disturbance manifested as VWF.

Haloperidol improves membrane phospholipid abnormalities in temporal lobes of schizophrenic patients

Using 31P magnetic resonance spectroscopy, we examined changes in the levels of phosphorus metabolites in the temporal lobes of 13 schizophrenic patients before and 12 weeks after initiating haloperidol treatment. Spectra were obtained from a volume of interest positioned in each temporal lobe. Findings were compared with those in 13 age- and gender-matched healthy subjects. Prior to treatment the patients showed higher levels of phosphodiesters (PDE) in both temporal lobes than healthy subjects. Haloperidol administration significantly reduced the excess of PDE in the left temporal lobe, although the PDE concentration remained somewhat higher bilaterally than in controls. Treatment was associated with a decline in the total symptom score according to the Brief Psychiatric Rating Scale and the score for positive symptoms showed a relatively high correlation with reduction in PDE level in the left temporal lobe. These preliminary results suggest that haloperidol may partially normalize disturbed metabolism or abnormalities in components of membrane phospholipids in the left temporal lobe of untreated schizophrenic patients, paralleling symptom alleviation.

Distribution of nifedipine- and omega-conotoxin GVIA-sensitive Ca2+ channels in cultured rat neocortical neurons

L- and N-type voltage-dependent calcium channels are widely distributed in neurons of the CNS. To investigate their subcellular distributions on CNS neurons, intracellular calcium concentration ([Ca2+]i) increase in response to high potassium ([K+]) solution was detected in primary cultured rat neocortical neurons using the calcium indicator dye Oregon Green with a confocal laser scanning microscope. Extracellular application of 90 mM [K+] solution induced fluorescence increase in a manner dependent on extracellular [Ca2+]. The increase was partially blocked by 10 microM nifedipine, and the reduction was higher in cell bodies compared to dendritic processes. In contrast, omega-conotoxin GVIA reduced the 90 mM [K+] induced fluorescence increase more in the dendritic processes. The results demonstrated the heterogeneous distribution of nifedipine- and omega-conotoxin GVIA-sensitive calcium channels, which may suggest a functional difference in nifedipine- and omega-conotoxin GVIA-sensitive channels in cultured neocortical neurons.

Changes in levels of phosphorus metabolites in temporal lobes of drug-naive schizophrenic patients

OBJECTIVE

The authors examined phospholipids and high-energy phosphorus metabolism in the temporal lobes of drug-naive schizophrenic patients.

METHOD

In vivo 31P magnetic resonance spectroscopy was performed on 17 first-episode, drug-naive schizophrenic patients and 17 age- and gender-matched healthy subjects.

RESULTS

Patients showed higher levels of phosphodiesters and lower levels of phosphomonoesters than the comparison group. Phosphocreatine levels were increased in the left temporal lobes of patients.

CONCLUSIONS

The results suggest disturbed membrane phospholipid metabolism in both temporal lobes and decreased energy demands in the left temporal lobes of drug-naive schizophrenic patients.

Wear of alumina ceramics prosthesis

To investigate the process of wear in the total knee prosthesis consisting of alumina ceramics (Al-ceramics) and ultra-high molecular weight polyethylene (UHMWP) in vivo, we observed the fine structures of the articular surface of the prostheses used for four patients with osteosarcoma of the distal femur. We also examined the wear debris in the surrounding soft tissues. The prostheses were extracted at autopsy between 13 and 48 months after surgery. An increase of pores, indicating where Al-ceramics grains fell off, and many streaks on the UHMWP running parallel to the gliding direction of the joint were observed on the articular surface. The streaks had similar widths to the Al-ceramics grains. Al-ceramics debris was detected in the soft tissues around the joint mixed with UHMWP debris. We concluded that the wear of UHMWP in Al-ceramics prosthesis was promoted by interposition of Al-ceramics debris.

Cell-substratum adhesion is suppressed by high pressure

The effects of high pressure (0.1-80 MPa) on cell adhesion were examined using Chinese hamster ovary cells. The cells detached by EDTA or trypsin were cultured for 4 h at atmospheric pressure. In each case, the rate of the adhesive cells was about 85%. Upon the addition of cycloheximide, such cell adhesion was almost completely inhibited in trypsin-treated cells but less affected in EDTA-treated cells. When the EDTA-detached cells were subjected to high pressures and cultured at atmospheric pressure, the cell adhesion was unaffected up to 40 MPa, but was suppressed significantly at higher pressures although the integrins were expressed on the plasma membranes. The suppressive effects induced by high pressure (80 MPa) were marked in trypsin-treated cells, in which the integrins were digested. Furthermore, actin stress fibers in spread cells disappeared due to cell rounding upon exposure to 80 MPa, and such rounded cells were partially detached from the substratum. These results suggest that the retardation of adhesion by high pressure in EDTA-detached cells may be due to the perturbed interactions between integrin and its associated proteins, whereas that of trypsin-detached cells is due to the delayed expression of integrins toward the membrane surface, in addition to the cause seen in the case of EDTA.

Anti-emetic effects of a novel NK-1 receptor antagonist HSP-117 in ferrets

We have developed a non-peptide compound, HSP-117, antagonist of the tachykinin NK-1 receptor. Binding of 3H-substance P (SP) to the membranes of IM-9 cells was inhibited by the antagonists HSP-117 and CP-99,994, the inhibitory activity of HSP-117 being about 50-fold that of CP-99,994. The SP-induced firing responses of single neuron activity in slices of the nucleus tractus solitarius of ferrets were inhibited by 10 microM HSP-117. Intracerebroventricular injection of HSP-117 significantly inhibited retching and vomiting induced by copper sulphate and morphine and the inhibitory effect of HSP-117 on emesis was greater than that of CP-99,994. These results indicate that (1) HSP-117 is a potent anti-emetic agent, blocking NK-1 receptors in the nucleus tractus solitarius and (2) NK-1 receptors in the nucleus tractus solitarius play an important role in emesis induced by broad-spectrum emetic stimuli.

Evaluation of the topical delivery of a prednisolone derivative based upon percutaneous penetration kinetic analysis

Prednisolone (PN) and an esterified derivative (PND) were evaluated in pharmacological and pharmacokinetic studies. The pharmacological study was performed using a rat croton-oil induced ear edema model. The results for the topical effect in skin and the systemic effect through multiple topical applications showed that PN and PND were equally potent in suppressing edema, and that PN caused a reduction in thymus weight, whereas PND had little effect. The concentration of these steroids in hairless mouse skin was estimated from an in vitro percutaneous absorption study using the computer simulation program MULTI(FILT). PND was found to be poorly absorbed. In fact, the PND concentration in the viable skin remained low (0.79 microg/cm2), even after 7 d. However, the estimated concentration of PND in the viable skin appears to be in excess of the threshold for effective topical effect during the pharmacological evaluation. In contrast, in the case of PN, the estimated PN concentration increased gradually after application and reached a level of 10.22 microg/cm2 at day 7, suggesting that this increase in PN concentration in the viable skin could result in a systemic effect. The difference between PN and PND concentration in the skin during the time course could be due to the metabolism of PND to PN in the viable skin. Consequently, the difference between the pharmacological study is reflected from the results of the pharmacokinetics of PN and PND in the skin.

Affected segments of the median nerve detected by fractionated nerve conduction measurement in vibration-induced neuropathy

Peripheral neuropathy in the hand has often been reported in workers using hand-held vibrating tools. But the affected location in the hand is not clearly demonstrated. To elucidate the impaired segment of the median nerve within the hand, fractionated median sensory nerve conduction velocity (SCV) was measured in the digital, finger-to-palm, palm-to-wrist and wrist-to-elbow segments. Subjects were 56 patients with hand-arm vibration syndrome and 43 healthy controls of similar age. SCV in the digital and the wrist-to-palm segments was significantly slower in the patients than the controls. Slowed SCV in the digital segment was encountered in 36% of the patients, while the slowing in SCV in the wrist-to-palm segment (across the carpal tunnel) was found in 20% of them. The slowing in the digital segment was more frequently encountered in the advanced stage of the Stockholm sensorineural (SN) stage for hand-arm vibration syndrome: 10% in 0SN (no neurological symptoms) while 56% in 3SN (severe stage). The present study has demonstrated that vibration-induced nerve impairments dominantly exist both in the digits and across the carpal tunnel. Careful neurophysiological assessment is important to confirm the impaired location within the hand.

Correlation between antifungal activity and hydrophobicity of imidazole antifungal agents

To examine the effects of the affinity of antifungal imidazole agents to cell membranes on the in vitro antifungal activity, the correlation between antifungal activity and hydrophobicity of these drugs was investigated. The capacity factor (k') in HPLC was used as a parameter of hydrophobicity, and the minimum inhibitory concentration (MIC) as a parameter of antifungal activity. Consequently, a significant portion correlation was noted in the case of Candida albicans. However, no obvious correlation was noted for Trichophyton mentagrophytes and Trichophyton rubrum. Therefore, the mechanism of action of imidazole derivatives for Candida albicans was considered to mainly consist in the membrane action.

Metabolite changes with age measured by proton magnetic resonance spectroscopy in normal subjects

To determine whether there are metabolite changes in the left medial temporal and frontal lobes with aging, we performed proton magnetic resonance spectroscopy in 36 normal subjects. The N-acetylaspartate/creatine-phosphocreatine ratio in the medial temporal lobe tended to be decreased in subjects over 60 years of age. The ratio decrease in the frontal lobe related to aging was lower than that in the medial temporal lobe. There were no significant differences in the metabolite ratios between males and females. These findings suggest that structures in the medial temporal lobe may be more susceptible to neuronal dysfunction associated with aging than those in the frontal lobe.