Four Cases of Phytolacca Esculenta Van Houtte Intoxication due to Misidentification as a Ginseng

Poisoning by Phytolacca esculenta commonly occurs by misidentification as other edible plants. The root of Phytolacca esculenta is similar to other roots, such as kudzu, balloon flower, codonopsis lanceolata, and ginseng. The author experienced four cases of Phytolacca esculenta intoxication due to misidentification as a ginseng. We report on these cases with a review of the literature.

Clinical Features of Pokeweed Intoxication Experienced in a University Hospital

PURPOSE: Although Pokeweed intoxication is relatively less severe, thereis little data onthe clinical presentation ofPokeweed intoxication in Korea. This study examined the clinical aspectsto providebasic data for evaluating Pokeweed intoxication. METHODS: A retrospective study by a chart review was performedon 19 patients who ingested Pokeweed and presented to anacademic emergency department with an annual census of 40,000 between March 2012 and May 2012. RESULTS: Nineteen patients were identified. All patients wereintoxicated unintentionally. The most common symptoms were vomiting with diarrhea and abdominal pain. The onset time varied, but occurs 30 minutes to 5 hours post ingestion of Pokeweed. All patients were discharged without fatal complications. CONCLUSION: Compared to previous reports, mostpokeweed poisoning patients complain of gastrointestinal symptoms. Supportive care is the mainstay of the management of pokeweed intoxication. All symptoms were resolved over a 24 to 48 hour period.

Exploración del efecto de altas diluciones sucusionadas (medicamento homeopático) de phytolacca americana sobre linfocitos humanos. Fase III / Exploration of the effect of high dilutions succussed (homeopathic medicine) of phytolacca americana on human lymphocytes. Phase III

Phytolacca americana es una planta que preparada bajo el método homeopático se ha usado para el manejo de enfermedades que cursan con adenopatías, sabemos que in Vitro exhibe un efecto sobre la proliferación de células mononucleares de sangre periférica, principalmente linfocitos y sobre la producción de diversas citoquinas. El objetivo de este trabajo fue la exploración del efecto de Phytolacca americana sobre la proliferación de células mononucleares de sangre periférica y sobre la producción de TNFα, en diluciones consecutivas entre la 12 CH y la 18 CH. Para la evaluación de la viabilidad celular se usó el método MTT (Bromuro de 3(4,5 dimetil-2-tiazoil)-2,5- difeniltetrazólico) y para la cuantificación de la producción de TNFα el método ELISA, se analizaron muestras de sangre periférica de 10 individuos sanos. Se encontró de manera general aumento máximo de la proliferación celular 48 horas posterior a la exposición a Phytolacca, y un aumento en la producción de TNF α para la dilución 14 CH. Concluimos que Phytolacca americana produce un aumento de la proliferación de células mononucleares de sangre periférica y que en las diluciones 13, 14 y 18 CH se estimula la producción de TNFα, sin embargo, para el resto de diluciones, el efecto varía de manera individual.

Chromosome study on chronic lymphocytic leukemia using CpG-oligodeoxynucleotide as immunostimulant agent / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate whether CpG-oligodeoxynucleotide (CpG-ODN) can improve the detection rate of the karyotypic abnormalities in chronic lymphocytic leukemia (CLL).</p><p><b>METHODS</b>The bone marrow (BM) or peripheral blood (PB) cells from 57 cases of CLL were collected and cultured with CpG-ODN DSP30+interleukin-2 (IL-2), phytohemagglutinin (PHA), pokeweed (PWM) or IL-2, respectively. Five days later cells were harvested for chromosome preparation. Karyotypic analysis was done using R banding technique. Panel fluorescence in situ hybridization (FISH) was carried out on 19 cases of CLL with normal karyotypes using the following probes: Cen12, D13S25, Rb1, ATM, p53, MYB and IgH. Genomic DNA from 21 cases of them was extracted from BM or PB leukocytes. The immunoglobulin variable heavy chain (IgVH) was amplified by polymerase chain reaction (PCR) and sequenced. CD38 and ZAP70 expressions in the leukemic cells were determined by flow cytometry (FCM).</p><p><b>RESULTS</b>The detection rate of karyotypic abnormalities in the CpG-ODN+IL-2 group (43.85%) was obviously higher than that in the PHA (15.09%), PWM (17.31%) and IL-2 (3.13%) groups (P<0.01). Fifty-two types of karyotypic abnormalities were found. Among them, trisomy12 (+12) or +12 with other abnormalities were the most common, while translocations were the most frequent structural abnormalities including 3 unbalanced and 11 balanced translocations, among them 7 had rearrangements involving 14q32. Thirteen cases showed one or more abnormalities on FISH including trisomy 12 and p53 deletion each in one case, IgH rearrangement and partial deletion each in one case, 13q14.3 deletion in 11 cases of which 5 cases also had Rb1 deletion, 1 case had Rb1 partial deletion. No case with ATM or MYB deletions was found. PCR detected IgVH mutations in 10/21 cases. FCM showed 10/45 cases were CD38 positive, but 35 /45 were CD38 negative, 11/27 cases expressed ZAP70, but 16/27 did not. Among the 26 cases examined for CD38 and ZAP70 expressions simultaneously, 5 cases were CD38+ZAP70+, 13 were CD38-ZAP70-, 6 were CD38-ZAP70+, and 2 were CD38+ZAP70-, respectively. Statistic analysis showed a correlation between complex karyotype and IgVH without mutation, but no association between karyotype and CD38 or ZAP70 expression was observed.</p><p><b>CONCLUSION</b>CpG-ODN immunostimulation can obviously raise the detection rate of abnormal karyotypes, especially translocations in CLL. FISH is an important complement to conventional karyotypic analysis. The combination of both methods can provide more comprehensive genetic information for CLL.</p>

Two Cases of Phytolacca Americana Intoxication with Confusion and Abdominal Cramping

Phytolacca americana poisoning is a benign plant intoxication that causes gastrointestinal symptoms, including abdominal cramps, vomiting, diarrhea, and gastrointestinal bleeding. Other signs and symptoms include diaphoresis, salivation, visual disturbance, and seizures or mental changes. We report two cases of patients who experienced confusion and abdominal pain, vomiting, and hematemesis after oral ingestion of pokeweed. A 60-year-old female with confusion and a 67-year-old female with abdominal pain, vomiting, and diarrhea were admitted to the emergency department after pokeweed poisoning. After supportive treatment of hydration and gastrointestinal medication, the two patients showed full recovery within 24 h and were discharged from the hospital.

Co-stimulatory molecules on peripheral blood mononuclear cells and tissue infiltrating cells of skin wart and in vitro poke weed mitogen stimulation.

BACKGROUND: Skin wart is a lesion caused by human papilloma viruses (HPVs) that can infect both male and female. OBJECTIVE: Quantify the number of CD28+, CD86+, CD152+ and gammadelta+ in peripheral blood mononuclear cells (PBMCs) of subjects with skin wart. Identify CD86+ and gammagamma+ cells in skin wart cryosections. MATERIAL AND METHOD: Sixteen subjects with skin warts on face, hand, finger, knee, foot or plantar, both male and female, aged between 19-59 years-old, were recruited from Ramathibodi Hospital, Mahidol University, Bangkok. RESULTS: CD86 and CD152, on peripheral blood mononuclear cells (PBMCs) of subjects with skin wart are significantly lower compared to controls. Tissue cryosection staining for CD86+ and gammadelta+ cells showed no difference among subjects with skin wart and control. Proliferative response to poke weed mitogen of subjects with skin wart is significantly lower than control subjects. CONCLUSION: There was no difference in the number of subjects positive for CD28 and CD86 cell between normal and skin wart subject, but an increase in skin wart subjects with gammadelta+ cells.

Cloning and expression of pokeweed antiviral protein-II gene from the summer leaves of Phytolacca amercana / 生物工程学报

The cDNA sequence encoding pokeweed antiviral protein-II was cloned from the fresh summer leaves of phytolacca amercana by RT-PCR. The recombinant PAP-II was subcloned into the expression vector pET-28a(+) and expressed in E. coli BL21 after IPTG induction. SDS-PAGE analysis showed that the expressed PAP-II existed in the form of inclusion bodies. The purified fusion protein was obtained after a series of steps including cell break, inclusion body solubilization, protein refolding and purification through BBST NTA resin column. The non-radioactive ELISA-based HIV-1 integrase assay showed that the recombinant pokeweed antiviral protein-II and RTA were able to inhibit HIV-1 integrase to some extent (IC50 = 303 microg/mL, 220 microg/mL respectively). MTT assay showed that cytotoxicity of pokeweed antiviral protein II for HEP-G2 cells and Hela cells was in a dose-dependent manner with IC50 s of 93 microg/mL and 102 microg/mL, respectively. The results suggested that pokeweed antiviral protein-II is a potent anti-tumor candidate. The finding of integrase inhibitory activity and the discovery of cytotoxicity provide more insights into the anti-HIV and the anti-tumor activities of PAP-II.

Human Immunodeficiency Virus-Infected T Cells Are Selectively Killed by Monoclonal Anti-gp120 Antibody Coupled to Pokeweed Antiviral Protein

A murime monoclonal antibody (mAb) specific for the envelope glycoprotein gp120 of human immunodeficiency virus type-I (HIV-1) was chemically coupled to pokeweed antiviral protein (PAP) from Phytolacca americana. The immunotoxin was purified by FPLC using 5200 colum. The purified immunotoxin efficiently bound to HIV-infected T cells as evidenced by fluorescence-activated cell sorter analysis. The immunotoxin selectively killed human T lymphoid lines infected with HIV-lIIIB at less than 250 pM of the immunotoxin cells, while PAP or mAb alone did not have any significant effect on infected cells. The uninfected control T cell lines were not affected. Human cells infected with HIV-2 or other HIV-1 strains were not killed, suggesting that the killing depends completely on the antibody used for coupling. These in vitro results suggest that the PAP-mAb conjugate may be used to selectively remove cells expressing viral antigens from individuals infected with HIV.

Immunologic Alterations of Peripheral Mononuclear Cells by Intravenous Immunoglobulin in the Acute Stage of Kawasaki disease

PURPOSE: High dose intravenous immunoglobulin (IVIG) therapy is effective in reducing the incidence of coronary artery aneurysm in Kawasaki disease (KD) patients, however, the precise mechanisms by which IVIG reverses the immune activation is unknown. METHODS: The sera and peripheral mononuclear cells (PBMCs) were obtained from 10 KD patients in the acute stage (24 hrs before) and 24 hrs after one dose of IVIG (2g/kg) treatment. We measured serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) and compared them to the messenger RNA expression of the PBMCs by reverse transcription polymerase chain reaction. We also investigated the cytokines' or immunoglobulins' production of PBMCs which were stimulated with phytohemagglutinin-P (PHA-P) or pokeweed mitogen (PWM, without in vitro IVIG treatment) by enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-6 and TNF-alpha decreased significantly after IVIG treatment. However, the gene expression of IL-6 and TNF-alpha showed no significant difference after IVIG treatment. IL-6 and TNF-alpha productions of PBMCs stimulated with PHA-P decreased significantly after IVIG treatment, however, IL-4 and IFN-gamma production showed no significant differences. IL-6 production of PBMCs stimulated with PWM also decreased significantly after IVIG treatment, but TNF-alpha did not change significantly. The synthesis of IgG, IgM, IgA and IgG1 after IVIG treatment showed a significant decrease, and that of IgG2 showed a slight decrease, but was not statistically significant. CONCLUSION: The results demonstrate that the administration of IVIG in the acute stage of KD resulted in the alterations of activated immunologic abnormalities, especially in monocytes and B cells.

Effect of Mercury Chloride on Humoral and Cell-mediated Immune Responses in Mice / 예방의학회지

The in vivo and in vitro humoral and cell-mediated immune responses of lymphocytes of BALB/c mouse exposed to mercury chloride(HgC12) were investigated. In vitro exposure of the splenocytes to mercury chloride produced overt cytotoxicity in 3 hours period. The IC50(the concentration required to inhibit a splenocyte viability by 50%) for mercury chloride was >0.1mM for cytotoxicity. In vivo mercury chloride exposed mice were significantly depressed delayed type hypersensitivity(DTH) response to sheep red blood cells(SRBC) in a dose-dependent manner compared with control group. Mercury chloride inhibited the proliferative responses of splenocytes to lipopolysaccharide. pokeweed mitogen, concanavalin A and phytohemagglutinin in a dose-dependent manner. Hemagglutinin response to SRBC in mercury chloride exposed mice was significantly depressed in a dose-dependent manner compared with control group. After 7 weeks of mercury chloride exposure in vivo. mercury chloride induced an increase of nonspecific serum IgG1 and IgE levels in BALB/c mice.

HgCl2 Dysregulates the Immune Response of Balb/c Mice / 예방의학회지

The studies reported here were undertaken to investigate the effects of mercury chloride on immune system of Balb/c mouse employing a flexible tier of in vitro and in vivo assays. Mercury chloride inhibited the proliferative responses of spleen cells to lipopolysaccharide, pokeweed mitogen, and phytohemagglutinin as a dose-dependent manner. This inhibitory effect was observed not only when HgCl2 was added 2nd or 3rd day of 3 days culture period but also when spleen cells was pretreated with HgC12 for 2 hours. Mercury chloride, however, potentiated the production of IgM and IgG from spleen cells. During the HgCl2 administration by drinking for 3 weeks, the weight gain of mice was significantly blunted than that of control group mice, while no overt signs related to mercury toxicity were noted in any mice of experimental group. There was no change in thymus and spleen weights, and in histological findings of kidney, bone marrow of femur, thymus, spleen, and politeful lymph node after 3 weeks of mercury exposure. However, HgC12 induced a significant increase of total serum IgM, IgG including IgG1, IgG2a and IgG2b, and IgE in Balb/c mice. Treatment in vivo with anti-IL-4 monoclonal antibody significantly abrogated the HgCl2-induced increase in total serum IgG1 and IgE. Whereas HgCl2 potentiated total serum IgM and IgG, there was, there was no difference in total serum hemagglutinin to SRBC(Sheep Red Blood cell) between experimental and control group mice when these mice were immunized with SRBC. All these findings observed in Balb/c mice suggest that mercury perturbates well-orchestrated regulation of immune responses before developing histopathological changes in lymphoid tissues.

Effects of Inhalation Anesthetics on Lymphocyte Transformation / 대한마취과학회지

Anesthesia and operation may impair the immune system so that bacterial growth and tumor cells spread can occur more rapidly and host response to transplanted tissue may be altered. In order to evaluate the influence of inhalation anesthetics on immune function, mitogen induced lymphocyte transformation and colony formation of T lymphoctye of peripheral blood in rats were studied. The experimental animals were divided into 4 groups according to inhaled anesthetics such as control, 0.8% halothane, 1.65% enflurane and 1.05% isoflurane 6 hours inhaled group. One day after inhalation of anesthetics, 5 ml of blood was sampled from inferior vena cava and the lymphocytes were isolated and cultured. Spontaneous and phytohemagglutinin (PHA) or pokeweed mitogen (PWM) induced lymphocte transformation were measured by the titration of H-thymidine uptake and the number of colony forming unit-T lymphocyte (CFU-TL) were counted. The results were as follows: Spontaneous lymphocyte transformation was increased by halothane and decreased by enflurane significantly but not differed by isoflurane compared with the control group. Lymphocyte transformation were decreased significantly before and after PHA stimulation in all of the anesthetic groups respectively compared with the control group. 3) Lymphocyte transformation by PWM stimulation also decreased in all of the anesthetic groups. 4) The numbers of CFU-TL cluster and colony decreased in all of the anesthetic groups compared with the control group. In conclusion, inhalation anesthetics such as halothane, enflurane and isoflurane decreased immune competence and that halothane was the most, isoflurane was the least immunosuppressive among these three inhalation anesthetics.

Suppression of B- and T-cell Immunity by Protein Fractions of Human Seminal Plasma / 대한비뇨기과학회지

It has been postulated that seminal plasma contains a potent immunosuppressive factor(s) which play a critical role h preventing sensitization of females to sperm antigens after insemination. It has been shown that human seminal plasma (HuSePl) inhibited phytohemagglutinin(PHA) and Concanavalin A(ConA) induced blast transformation of normal peripheral blood lymphocytes. To analyze protein fractions of HuSePl and to observe suppression of cell-mediated immune response by each fraction, the authors performed the Sephadex G-100 chromatography and the lymphocyte transformation with parameters of purified PHA(PHA-P) and pokeweed mitogen(PWM) stimulation test. The results were as follows; 1. Sephadex G-100 chromatography of HuSePl yielded five fractions(Fr. 1-5). 2. The molecular weight of each fraction, assessed by sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS.PAGE), was from 14,000 daltons(D) to more than 85,000 D in Fr. 1, 42,000 D and 33,000 D in Fr. 2, 43,000 D in Fr. 3, 20,000 D in Fr. 4 and 19,000 D in Fr. 5. 3. The mean percentages .of suppression in PHA-P stimulation test by fractions isolated from HuSePl in male (n=I3) were 59.8+10.1% in Fr. 1, 59.5+23.0% in Fr. 2, 84.2+9.4% in Fr. 3, 60.9+/-2l.4% in Fr. 4, 49.4+/-23.2% in Fr. S(F=6.=8, P 0.05). The results revealed that the Fr. 3 has the strongest suppressive effect on lymphocyte transformation activity and these observations support the concept that a local immune response against sperm in the female reproductive tract is actively suppressed by a component in seminal plasma.