[Scavenging effect of lazaroids U78517F, U74389F, U74500A on oxygen free radicals produced by stimulated human polymorphonuclear leucocytes and by chemical method] / Effetto scavenger dei lazaroidi U78517F, U74389F, U74500A sui radicali liberi dell'ossigeno prodotti da polimorfonucleati umani stimolati e mediante metodo chimico.

Authors investigated the scavenger capability of lazaroids, a new group of compounds (21-aminosteroid) that are reported in the literature to have interesting anti-lipid peroxidation properties. Authors tested the degree of scavenger activity related to the oxygen derived free radicals (ODFR) with different methods: 1) chemiluminescence; 2) production of superoxide anion from activated polymorphonuclear cells; 3) production of hydroxyl radical through a chemical procedure. Results showed a global scavenger activity of the three lazaroids (U78517F, U74389F, U74500A) in all the various tests, but differences of intensity of their action were noted among in each compound. We can thus attribute to these compounds a scavenger activity on the oxygen free radicals; this activity may facilitate their already known anti-lipid peroxidation action. Therefore, clinical use of lazaroids can be hypothesized for the diseases in which inflammation plays an important pathogenetic role via the production of oxygen free radicals and the resulting lipid peroxidation associated with tissue damage.

Seroprevalence of hepatitis C in a sample of middle class substance abusers.

Hepatitis C (HCV) is an indolent and often fatal disease affecting four million Americans commonly associated with low socioeconomic status. We assessed its prevalence in a sample of 334 consecutively admitted middle class substance abusers in a private urban hospital, and ascertained risk factors for its transmission. We found that the point prevalence rate for HCV was 27.7% among all substance abusers, and 76.7% among intravenous drug users. Using logistic regression, we found risk factors associated with HCV were intravenous drug use, needle sharing, prior liver disease, opioid dependence, HIV infection, and benzodiazepine dependence. Not found to increase infective risk were lower social class, male gender, African-American race, male homosexuality, unemployment, and the absence of private health insurance. Multiple viral genotype types were identified in this sample, suggesting diverse sources of transmission in the sample. This study documents an epidemic of HCV in an American middle class sample.

TGF-beta isoforms in alcoholic liver disease.

The increased deposition of extracellular matrix proteins in the liver is a key factor in the morbidity and mortality of alcoholic liver disease (ALD). This increased fibrosis may be due to a superabundance of profibrogenic factors such as transforming growth factor-beta (TGF-beta). The original peptide is now called TGF-beta 1, and two other isoforms have been recognized in humans (TGF-beta 2 and TGF-beta 3). It was the aim of the present study to determine the expression of the TGF-beta isoforms in different stages of ALD. Thirty patients with ALD had percutaneous liver biopsies performed for diagnostic purposes. They were grouped by clinical findings and by liver histology into four groups: I, steatosis; II, fibrosis; III, hepatitis; and IV, cirrhosis. An unused portion of each biopsy sample was used to evaluate the gene expression of TGF-beta 1, TGF-beta 2, and TGF-beta 3 by reverse transcription polymerase chain reaction (RT-PCR). The expression of all isoforms from patients was significantly greater than their expression in controls. No significant correlation was determined between TGF-beta isoform expression and liver function test results. When the different isoforms were grouped by histology, increased expression with more severe disease was found; however, differences existed among the isoforms. In ALD, all TGF-beta isoforms were increased and their expression was significantly greater in patients with more active and advanced disease. RT-PCR is an effective method for evaluating gene expression in clinical samples which often provide a limited amount of tissue.

An outbreak of intrafamiliar hepatitis A associated with clam consumption: epidemic transmission to a school community.

An outbreak of hepatitis A is described involving thirteen cases in a town in central-northern Italy. The consumption of infected clams, caught in a polluted coastal area of the Adriatic Sea, caused hepatitis A in all five members of a family consisting of mother, father and children, two of whom attended primary school. The epidemic subsequently spread to the primary school with a secondary attack rate of 7.9%, 0 for female pupils and 18.9% for males. The epidemiological and environmental investigations showed that the critical exposure took place in the boys' toilet in the primary school (OR: 32.79, 95% CI: 6.83-157.45). To prevent the spreading of contagion, extra disinfection was carried out in the whole school and health education campaigns were mounted. The good basic hygienic conditions of the homes, together with the cooperation of school staff in surveillance and providing information, allowed the epidemic to be controlled.

Does total hip arthroplasty mean sensorial and proprioceptive lesion? A clinical study.

Total hip arthroplasty means sacrificing the joint capsule and the mechanoreceptors contained therein. Recent neurophysiological experiences seem to redefine the sensorial and proprioceptive role of the joint capsule in favor of the activity of the muscular mechanoreceptors, particularly in the area of the coxofemoral joint. The authors have examined the sensorial lesion caused by total hip arthroplasty in a group of 20 patients. Clinical testing was conducted prior to surgery, 7 and 40 days later. The tests were aimed at exploring the perceptive and proprioceptive activity of the hip, and showed marked decrease in all of the receptorial activity one week after surgery. After 40 days perceptive function was completely recovered, as the scores for tests conducted were the same as those obtained prior to surgery: proprioceptive activity was instead considerably improved, with significant changes in most parts of the tests. The authors conclude by observing that total hip arthroplasty does not cause permanent lesion of the perception of joint movement; furthermore, renewed coxofemoral mechanics allow for a better proprioceptive response with strengthening of static and dynamic antigravitational reactions.

Expression of TA1, a rat oncofetal cDNA with homology to transport-associated genes, in carbon-tetrachloride-induced liver injury.

TA1, a novel rat oncofetal cDNA, is the predicted homolog of the human lymphocyte activation gene E16. The encoded peptides share high homology with transport-associated and uncharacterized sequences in distant species, suggesting an important and conserved function in cellular homeostasis. Moderate steady-state levels of TA1 RNA were induced following acute and chronic CCl4-mediated liver injury. TA1 expression was either greatly reduced or absent in livers of animals receiving injury-protective doses of vitamin E in conjunction with CCl4. In contrast to the in vivo data, acute in vitro exposure of hepatocytes to CCl4 did not induce TA1 RNA. Our results indicate that TA1 is spatially and temporally associated with liver injury in vivo and may play an adaptive role in the hepatic response to environmental toxicants.

The effects of cigarette smoke on the progression of septic pseudarthrosis of the tibia treated by Ilizarov external fixator.

The authors conducted a study to evaluate the effects of cigarette smoke on the healing of septic pseudarthrosis of the tibia treated by ilizarov external fixator. A total of 31 patients of both sexes were chosen, and the healing time in relation to the habit of smoking was examined. The results have shown that the healing time in non-smokers as compared to smokers was shorter by 33%. The difference is highly significant. This shows that abstention from smoking during treatment should be given maximum importance in prevention.

Vitamin E therapy of acute CCl4-induced hepatic injury in mice is associated with inhibition of nuclear factor kappa B binding.

Oxidative stress, with reactive oxygen intermediate formation, may represent a common mechanism by which liver injury is induced by diverse etiologies. Oxidative stress enhances nuclear factor kappa B (NF-kappa B) activity, and NF-kappa B activity has been shown to enhance the expression of cytotoxic cytokines. Acute hepatic injury caused by reactive oxygen intermediate production was induced by an intraperitoneal injection of CCl4 in mice. This injury was significantly inhibited by intravenous pretreatment of the mice with a water-soluble emulsion of alpha-tocopherol. Alpha-tocopherol treatment of the mice given the CCl4 also reduced the NF-kappa B binding to levels approaching those found in normal mice. In vitro treatment of a monocyte/macrophage cell line with CCl4 led to enhanced NF-kappa B binding and an increase in tumor necrosis factor-alpha (TNF-alpha) messenger RNA levels. Liver specimens taken from patients with acute fulminant hepatitis had markedly increased NF-kappa B binding activity in comparison with the binding of normal livers. These data demonstrate that abolishing acute hepatic injury with alpha-tocopherol, a free radical scavenger, also eliminated increased NF-kappa B binding. It is tempting to speculate that enhanced NF-kappa B expression caused by free radical production/oxidative stress may modulate liver injury, perhaps through an effect on cytotoxic cytokine synthesis.

Gene expression of transforming growth factor beta 1 and extracellular matrix proteins in murine Schistosoma mansoni infection.

BACKGROUND/AIMS: The study of Schistosoma-induced hepatic fibrosis in murine Schistosoma mansoni infection has elucidated the nature of hepatic fibrosis in humans. In the present study, fibrogenic gene expression was determined in murine S. mansoni infection during primary infection, after chemotherapy with praziquantel, and during secondary infection. METHODS: Both histomorphometric analysis and Northern blot profiles were performed. RESULTS: Histomorphometric analysis of granulomatous inflammation showed smaller hepatic fibrotic granulomata after chemotherapy and during secondary infection. Albumin gene expression remained relatively constant throughout primary infection, chemotherapy, and secondary infection. Fibronectin gene expression in primary infection was comparable with the level observed in noninfected mice and was reduced by chemotherapy. Reinfection resulted in augmented expression levels equal to primary infection levels. Osteonectin gene expression was active in primary infection, was reduced by chemotherapy, and was actively reexpressed in secondary infection. Interstitial matrix macromolecules, types I and III collagen, and basement membrane collagen showed high levels of gene expression in primary infection, were virtually terminated by chemotherapy, and were reexpressed on reinfection. The gene expression of transforming growth factor beta 1, a major, fibrogenic cytokine, paralleled collagen expression. CONCLUSIONS: Chemotherapy of schistosomiasis initiated a dramatic decrease in steady-state messenger RNA levels of major proteins associated with fibrosis; reinfection resulted in a reexpression of these genes.

Inhibition of carbon tetrachloride-induced liver injury by liposomes containing vitamin E.

We tested a variety of antioxidants as possible therapeutic agents in an acute CCl4 mouse model of hepatotoxicity. Liver damage, gauged by the amount of serum aminotransferase released into the blood, morphological changes, lethal dose response, and presence of thiobarbituric acid-reactive substances (TBARS), were significantly inhibited in a dose-dependent manner by liposomes containing vitamin E (LVE) or by Rocavit E, a water-soluble emulsion of alpha-tocopherol. Serum aminotransferase levels in LVE- or Rocavit E-treated animals were always > 10-fold lower than levels in corresponding CCl4 controls. Other liposome-associated antioxidants, butylated hydroxytoluene, vitamin E succinate, catalase, desferoxamine, superoxide dismutase, and ascorbic acid 6-palmitate, were also able to elicit a decrease in damage; however, they were substantially less effective. Intravenous therapy with LVE decreased mortality by nearly 90% when a lethal dose of CCl4 was given. When the biodistribution of the liposomes was examined, it was determined that the vast majority were localized in the Kupffer cell population. This approach of delivering nontoxic therapeutic agents selectively to the liver offers a variety of clinical applications in humans.

Effect of vitamin E on reoxygenation injury experienced by isolated rat hepatocytes.

The pathogenic role of lipid peroxidation in the reperfusion injury of the liver is still controversial. This study was performed to determine whether the damage caused by oxygen free radicals during reoxygenation in perfused rat hepatocytes is related to lipid peroxidation. Superoxide anion was detected by lucigenin-enhanced chemiluminescence. Lipid peroxidation and cell injury were assessed by the release of malondialdehyde and lactic dehydrogenase. Upon reoxygenation following 2.5 h of anoxia, isolated hepatocytes generated considerable amount of O2-. Following O2- formation, a significant increase in malondialdehyde release was measured. Cell injury was temporally delayed relative to O2- generation, but preceded the occurrence of a significant lipid peroxidation. Treatment with Vitamin E abolished lipid peroxidation but had no effect upon superoxide anion formation and cell injury. These results suggest that in perfused rat hepatocytes non-peroxidative mechanisms are more important than peroxidative mechanisms in the pathogenesis of the early phases of reoxygenation injury.

Hepatic fibrosis and gene expression changes induced by praziquantel treatment during immune modulation of Schistosoma japonicum infection.

In the present study fibrogenic gene expression was determined in murine Schistosoma japonicum infection during the progression of immune modulation of infection and following chemotherapy during the course of immune modulation. Histomorphometric analysis of granuloma size and collagen deposition revealed peak granuloma size in acute infection (5 weeks) and peak hepatic collagen content at 16 weeks of infection. Peak Type I collagen gene expression was concomitant with TGF-beta 1 gene expression at 8-11 weeks. Chemotherapy during either acute (9 weeks) or chronic (24, 28 weeks) infection resulted in increased collagen deposition and increased gene expression of Type I collagen and TGF-beta 1. However, chemotherapy at 14-16 weeks resulted in decreased levels of TGF-beta 1 gene expression and essentially minimal change in Type I collagen deposition and gene expression. These data indicate that chemotherapy of schistosomiasis japonica does not reverse hepatic fibrogenesis when administered in acute infection-when granuloma size is maximal-or in chronic infection. However, a beneficial effect on hepatic fibrogenesis is seen when chemotherapy is administered at 14-16 weeks post-infection, a time of decreasing granuloma size and maximal hepatic collagen content. Thus the ability to reverse schistosomal-induced hepatic fibrogenesis by chemotherapy may depend on disease stage.

Two rat models of hepatic fibrosis. A morphologic and molecular comparison.

We present a morphologic and molecular comparison of two models of hepatic fibrosis. Immune complexes are the source of insult in one model. In the other model, CCl4 induces fibrosis. For the immune complex model, rats were immunized intraperitoneally over the course of 4 weeks with human albumin, then injected through a tail vein three times a week for at least 5 more weeks with the same albumin. Seventy-five percent of all treated animals developed fibrosis characterized by fine collagen bands. There was a mild degree of hepatocyte trapping and necrosis as well as some bile duct hyperplasia and tissue eosinophilia. However, there was no significant Kupffer cell hyperplasia or inflammatory reaction. Quantification of specific mRNA species was determined by Northern blot hybridization analysis of total RNA. In comparison with CCl4-induced fibrosis in rats, a hepatotoxin-mediated model with a much greater inflammatory response, this immune complex model showed a less pronounced increase in type I procollagen mRNA, but a relatively greater increase in types III and IV procollagen mRNA. Whereas transforming growth factor-beta 1 mRNA levels were markedly increased in CCl4-induced fibrosis, there was only a slight increase in this cytokine, known to stimulate type I collagen synthesis, in the immune complex model. A comparison of the two model systems indicates that a variety of mechanisms may be involved in the process of hepatic fibrogenesis. It appears that an inflammatory response and elevated transforming growth factor-beta 1 levels are associated with a marked increased synthesis of type I collagen in a hepatotoxin model while other, as yet undefined, mediators may be responsible for the increase in types III and IV procollagen mRNA species found in the immune complex model.

Correlation between Ito cells and fibrogenesis in an experimental model of hepatic fibrosis. A sequential stereological study.

The relationship between Ito cells and hepatic fibrogenesis has been investigated in an experimental model: intraperitoneal injection of heterologous serum in rats leads to the appearance of fibrous septa within 5 weeks. Groups of rats were sacrificed at various intervals (from 2.5 to 20 weeks), saline-injected rats being used as controls. Liver fragments were prepared for light and electron microscopy and determination of hydroxyproline. Ito cells were identified by defined morphological criteria on 1 micron sections. The volume density (VD) of Ito cells and fibrous septa, and the Ito cell index were determined. Ito cells represent a very relevant component of early septa. In later stages, the VD of cells with morphological features of Ito cells falls to very low values. This might be related to modulation of Ito cells to fibroblasts. The increase of tissue hydroxyproline is delayed with respect to the peak VD of septal Ito cells, actually corresponding to the fall in the VD of septal Ito cells. The striking increase in the VD of total Ito cells cannot be related to a theoretically possible increase in the volume of single Ito cells, as VD always parallels the Ito cell index. These data suggest a hyperplastic reaction, possibly associated with a cellular migration from the lobules to early septa.