The Journal of laboratory and clinical medicine最新文献

The purpose of this study was to characterize the effects of two new adenosine A2 agonists, 2-(p-(2-carboxyethyl)phenethyl amino)-5'-N-ethylcarboxamidoadenosine (CGS-21680) and N6-(2(3,5-dimethoxyphenyl)-2-(2-methylphenyl)ethyl)-adenosine (DPMA), on erythropoietin (EPO) production in vivo and in vitro. Intravenous injections of CGS-21680 (100 to 500 nmol/kg mouse/day) and DPMA (50 to 500 nmol/kg mouse/day) for 4 days produced significant increases in serum levels of EPO in exhypoxic polycythemic mice. CGS-21680 (10(-7) to 10(-6) mol/L) and DPMA (10(-8) to 10(-5) mol/L) also produced significant increases in medium levels of EPO in a cloned EPO-producing Hep3B hepatocellular carcinoma cell line after 18 hours of incubation in 1% O2. Both compounds also increased cellular cAMP levels significantly in a dose-dependent manner after 1 hour of incubation. A2 receptor binding assays with tritiated CGS-21680 revealed a single type of adenosine receptor binding site on Hep3B cell membranes with a dissociation constant of 132.9 nmol/L and a binding capacity of 270.6 fmol/mg protein. The Ki competition binding values versus tritiated CGS-21680 were 217 nmol/L for CGS-21680 and 86.8 nmol/L for DPMA. These results indicate that adenosine A2 receptor activation amplifies EPO production in response to hypoxia, both in vivo and in vitro.

Experiments were done in anesthetized rats to determine systemic hemodynamic and renal functional effects of isovolemic exchange transfusion with either 5% albumin or hemoglobin cross-linked with bis (3,5-dibromosalicyl) fumarate (XLHb) in volumes ranging from 1 to 6.3 ml.100 gm-1. Hematocrit decreased in proportion to increasing exchange volumes with either fluid. Exchange with increasing volumes of albumin led to progressive decreases in blood pressure. Exchange of 1 ml.100 gm-1 of XLHb was associated with an increase in blood pressure, whereas with larger exchanges, blood pressure returned to and was maintained at control values even for exchanges as large as 6.3 ml.100 gm-1. An increase of similar magnitude in glomerular filtration rate occurred with both fluids. Net and fractional sodium excretion (FENa) increased significantly with both transfusion fluids; the increase was significantly larger for XLHb than for albumin. Maximal FENa excretion with albumin was about 8% but exceeded 6% with XLHb. Pretreatment with indomethacin (5 mg.kg-1.day-1 for 3 days) did not blunt the diuresis that occurred with an exchange of 2 ml.100 gm-1 XLHb. It is concluded that 5% XLHb, as compared with 5% albumin, better supports systemic blood pressure, especially as exchange volume increases, possibly as a result of hemoglobin-induced increased vascular tone. Although a decrease in hematocrit may play a role in the diuresis observed with either fluid, the greater diuresis with XLHb must be due to some additional factor; the mechanism does not appear to involve prostaglandins.

Eighty-one women with a history of thrombosis were classified into three groups: group I (n = 29), women in whom thrombosis developed during oral contraception; group II (n = 33), those who used oral contraceptives (OC) without complications but experienced vascular occlusion in other risk situations; group III (n = 19), women who never used OC. The level of antibodies to anionic phospholipids (PLa), a response to activated protein C (APC), and the presence for the mutation in the coagulation factor V gene causing APC resistance were studied. In the studied groups, APC resistance was present in 14% to 42% of patients. PLa were elevated in about half of APC-resistant patients. The incidence of APC resistance correlated with the recurrency of the thrombotic events within the groups. In most cases it was tightly connected to the mutation in the factor V gene. Women in whom thrombosis developed while they were taking OC (group I) differed from the others, having a remarkable disagreement between the lowest incidence of APC resistance and a relatively increased number of the mutation (14% vs 38%, p < 0.025). This finding suggested that the APC response is flexible. An influence of OC that predisposes a reduction in APC response is discussed.

Folates play a vital role in cellular processes that are essential for fetal growth and viability. Thus the human placenta, which contains high-affinity membrane-associated placental folate receptors (PFRs), maintains a concentrative maternal-to-fetal flux of the vitamin under conditions of minimal dependence on variations of maternal dietary intake. To define transplacental folate transport and the role of PFRs in this mechanism, we utilized the isolated perfused human placental cotyledon. In closed system perfusions with 10 nmol/L 5-methyltetrahydrofolate, placental binding was rapid and extensive (47%), with a gradual maternal-to-fetal transfer of 5-methyltetrahydrofolate. Although hydrophilic PFRs were released into the fetal perfusate, PFR-bound folates constituted only a fraction of net transplacental folate transport. Transfer was bidirectional, not saturable, not inhibited by anion channel blockers, and dependent on perfusate levels. Placental binding far exceeded transfer, and pulsing the maternal circuit with tritiated 5-methyltetrahydrofolate, followed by washout of unbound radiolabel and rechallenge with unlabeled 5-methyltetrahydrofolate or folate, led to release of bound tritiated 5-methyltetrahydrofolate, illustrating reversible binding. Perfusion with the N-hydroxysuccinimide ester of folic acid eliminated essentially all 5-methyltetrahydrofolate binding to PFRs, while increasing net maternal-to-fetal transfer of the vitamin. Finally, because it has been suggested that impaired placental transport of folate may be linked to the fetotoxic effects of ethanol, the effect of this compound on the above processes was examined. An acute 6-hour exposure to ethanol (2.5 to 3.1 mg/ml) had no effect (p > 0.05) on net maternal-to-fetal transfer of 5-methyltetrahydrofolate. These studies suggest that net maternal-to-fetal transfer is a process consisting of two steps. First is the concentrative component in which circulating 5-methyltetrahydrofolate is bound to (captured by) PFRs on the maternally facing chorionic surface. Although kinetics favor binding, there is a dynamic state wherein a gradual release of 5-methyltetrahydrofolate from this pool can add to incoming circulating folates to generate an intervillous blood level approximately 3 times that in the maternal blood. In the second step, folates are passively transferred to the fetal circulation along a downhill concentration gradient. This unique mechanism for transplacental folate transport may be applicable to other small relative molecular mass ligand nutrients that bind to high-affinity placental receptors.

After influenza challenge, aged mice have prolonged viral shedding that correlates with lower splenic cytotoxic T lymphocyte (CTL) activity. To evaluate the age-related pulmonary cell-mediated immune response to influenza, pulmonary lymphocytes were obtained from young and aged mice at various days after respiratory tract infection with nonlethal influenza A/PC/1/73 (H3N2) virus. In young mice, pulmonary CTL activity peaked at 48% +/- 2% on day 7 after infection. Pulmonary CTL activity peaked 1 day later in aged mice and at about half the activity (24% +/- 5%). The majority of the cells recovered from the lungs in both age groups were CD3+, CD8+ T cells. Histologic examination of the lungs revealed that aged mice had significantly less inflammation than young mice. Therefore, after influenza challenge there was a large influx of lymphocytes into the lungs of both young and aged mice, but the cells from young mice were more active on a per-cell basis. In a further experiment, challenge with a more virulent strain of influenza produced higher mortality in young mice than in aged mice. Thus the higher CTL activity of young animals leads to more rapid virai clearance, but this may be at a price to the host--that is, more immunopathologic damage.

Histidine-rich glycoprotein (HRGP) is a potent inhibitor of T cell activation and production of cytokines such as (gamma-IFN). gamma-IFN released by activated T cells is increased during a short-term period at the onset of GvHD after allogeneic bone marrow transplantation. Therefore we investigated HRGP plasma levels in patients after BMT. Blood was collected from 20 children before and up to 6 weeks after BMT. In patients without GvHD, HRGP plasma levels decreased during the first week after BMT to 237 +/- 60 micrograms/ml, compared with 302 +/- 104 micrograms/ml before transplantation. However, no significant changes in mean HRGP plasma levels were observed during the following 5 weeks of the posttransplantation period. Acute GvHD occurred in 10 of 20 patients between the second and third week after BMT. HRGP levels (mean +/- SEM) in patients with GvHD dropped during the first week to 158 +/- 32 micrograms/ml, compared with pretransplant levels of 240 +/- 48 micrograms/ml). In contrast to results in patients without GvHD, a second and significant decrease was obtained between the second and third week after BMT in patients with GvHD (161 +/- 35 micrograms/ml vs 84 +/- 13 micrograms/ml; p < 0.01). In the third week after BMT, HRGP levels were significantly lower in patients with GvHD as compared with patients without GvHD (166 +/- 29 micrograms/ml; p < 0.01). The decrease in HRGP in the second and third posttransplantation week was not a result of steroid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

The development of a sensitive enzyme-linked immunosorbent assay (ELISA) for human metallothionein-1 is reported. Metallothionein was purified from postmortem human liver and used to raise high-titer antibodies in rabbits. The assay was specific for human metallothionein-1 (MT-1), and there was no significant cross-reaction with human metallothionein-2. The detection limit (sensitivity) of the assay was 5 ng/ml, and the added MT-1 could be fully recovered from plasma and urine. The normal reference range for MT-1 was 32 +/- 16 ng/ml in plasma and 10 +/- 6 ng MT-1 per micromole of creatinine in random samples of urine. No significant differences were found between the values for males and females. The concentration of MT-1 was greatly increased between 24 and 48 hours after surgery, indicating that the protein behaves like an acute phase reactant in human subjects.

Cell-free hemoglobin (Hb) and bacterial endotoxin (LPS) synergistically produce toxicity. To elucidate possible mechanisms, three groups of rabbits received LPS alone, LPS plus human serum albumin (HSA), or LPS plus Hb (Hb group). The intravascular retention of injected iodine 125-labeled LPS during the 30-minute period analyzed was significantly longer in the Hb group than in the LPS alone or HSA groups (p = 0.0007 and p = 0.03, respectively), especially during the initial 10 minutes. The intravascular half-life of LPS in the LPS control, HSA, and Hb groups was 2.8, 4.0, and 4.9 minutes, respectively; the area under the curve was 1369 +/- 483, 1594 +/- 360, and 1731 +/- 481, respectively (ng/ml x minutes, mean +/- SD); and the total body clearance was 24.7 +/- 9.2, 20.1 +/- 5.4, and 18.9 +/- 6.0 (ml/min, mean +/- SD), respectively. The proportion of LPS associated with blood cells was very small at the initial 1-minute time period, and this decreased even further during the 30-minute period analyzed (p = 0.0001). Over 96% of injected LPS was associated with the cell-free plasma, with 51% to 54% of LPS in the apoprotein fraction at the initial time point and 35% to 37% in the HDL fraction. The proportion of LPS increased significantly in the HDL fraction and decreased significantly in apoproteins during the 30-minute period analyzed (p = 0.0006 and p = 0.002, respectively). However, there were no differences between the three groups. The liver was the main distribution site (74%) of injected LPS among the six organs evaluated. In the Hb group the accumulation of 125I-labeled LPS in the spleen was significantly lower than that in the HSA group (p = 0.05). The synergism of the in vivo toxicity reported for LPS and Hb may be due, in part, to the decreased rate of intravascular clearance of endotoxin.

To identify potential intracellular mediators of mesangial cell fibronectin production, we examined the effect of cyclic adenosine monophosphate and protein kinase C on fibronectin biosynthesis in cultured human mesangial cells. We found that increasing intracellular cyclic adenosine monophosphate resulted in a 2.6-fold increase in fibronectin mRNA expression within 15 minutes; this reached a plateau after 1 hour and fell below control levels by 24 hours. Cyclic adenosine monophosphate significantly increased both immunoreactive fibronectin levels and the incorporation of [35S]-labeled methionine into fibronectin after 1 and 2 hours (251% +/- 3% and 157% +/- 18% of controls, respectively). The induction of protein kinase C with phorbol ester also increased fibronectin mRNA expression. The effect was time and dose dependent. Phorbol ester significantly increased both immunoreactive fibronectin levels and the incorporation of [35S]-labeled methionine after 1 and 2 hours (174% +/- 2% and 224% +/- 6% of controls, respectively). Inhibition of protein kinase C with calphostin C attenuated constitutive and phorbol ester induced fibronectin biosynthesis. These studies indicate that cyclic adenosine monophosphate and protein kinase C regulate mesangial cell fibronectin biosynthesis and that protein kinase C may contribute to control of constitutive fibronectin production.