Does HMGB1 predict occult neck lymph node metastasis in early tongue carcinoma? A case-control study of 26 patients.

OBJECTIVE: This study examined whether the occurrence of late neck metastasis in early tongue squamous cell carcinoma can be predicted by evaluating HMGB1 (high mobility group box 1) expression in the primary lesion. METHODS: A case-control study was conducted. The cases comprised 10 patients with late neck metastasis. The controls consisted of 16 patients without recurrence. All were examined immunohistochemically for HMGB1 protein expression. The odds ratio for late neck metastasis in relation to HMGB1 was estimated. RESULTS: RESULTS for HMGB1 were dichotomised into positive staining scores (score, 5-7) and negative scores (0-4). Six cases (60 per cent) and four controls (25 per cent) were HMGB1-positive. Although no significant result was seen, compared with HMGB1-negative patients the odds ratio for late neck metastasis in HMGB1-positive patients was 3.8 (95 per cent confidence interval, 0.6-26.5) after adjusting for other factors. CONCLUSION: In the present study, immunohistochemical study of HMGB1 in early tongue squamous cell carcinoma did not appear to be very useful for predicting occult neck metastasis. Further study is necessary to clarify the relationship between HMGB1 expression and late neck metastasis in early tongue squamous cell carcinoma.

Levels of interleukin 12, a cytokine of type 1 helper T cells, are elevated in sera from patients with systemic sclerosis.

OBJECTIVE: To determine serum levels and spontaneous production by peripheral blood mononuclear cells (PBMC) of interleukin 12 (IL-12), a potent inducer of type 1 helper (Th1) T cells, in patients with systemic sclerosis (SSc). METHODS: Serum IL-12 levels and spontaneous production levels of IL-12 in culture supernatants from PBMC were examined by ELISA. Serum levels of IL-4, IL-6. IL-10, and IL-13 and production levels by PBMC of IL-6 and IL-10 were also examined by ELISA. Renal vascular damage was determined as a pulsatility index (PI) by color flow Doppler ultrasonography of kidneys. RESULTS: Serum IL-12 levels were significantly elevated in patients with SSc (n = 62) compared with healthy controls (n = 20). Similarly, spontaneous production levels of IL-12 by PBMC in patients with SSc (n = 47) were higher than those in controls (n = 20). Serum IL-12 levels did not correlate with serum levels of any Th2-type cytokines such as IL-4, IL-6, IL-10, and IL-13. However, spontaneous production levels of IL-10 by PBMC significantly correlated with serum IL-12 levels in patients. Patients with elevated serum IL-12 levels had the increased PI values more frequently than those with normal IL-12 levels. Further, serum levels of IL-12 and production levels of IL-12 by PBMC correlated significantly with the PI values in patients with SSc. CONCLUSION: These results suggest that the increased levels of IL-12 may relate to the activation of Th1 cells in SSc and that IL- 12 overproduction may be associated with renal vascular damage.

Infective endocarditis-induced crescentic glomerulonephritis dramatically improved by plasmapheresis.

A 50-year-old woman was referred to our hospital because of skin purpura, anemia, high fever, and acute renal insufficiency. Five years ago, she had been diagnosed as having ventricular septal defect without any complications. A blood culture drawn during the hospitalization grew Streptococcus viridans. She was diagnosed as having infective endocarditis-induced crescentic glomerulonephritis (GN) according to echocardiography and renal biopsy results. Although antibiotic treatment alone showed no apparent efficacy, after the initiation of plasmapheresis, the high fever and acute renal insufficiency were dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment of infective endocarditis-induced crescentic GN. The possible mechanisms of this therapy are discussed.