Specific self-antigen-driven immune response in pericardial effusion as an isolated GVHD manifestation.

Pericardial effusion and cardiac tamponade have been described as GVHD manifestations in the post transplant period. Direct evidence of GVHD-related TCR or B-cell receptor clones in patients with pericardial effusion has never been described. Using several methods, including FACS and spectratyping analysis to assess T- and B-cell clonality and to quantify TCR excision circles to assess newly thymus-derived T cells, we were able to show expansion of oligoclonal T-cell populations and the possible presence of early/premature B cells in the pericardial effusion but not in peripheral mononuclear cells. This may explain the presentation of an isolated GVHD manifestation.

Chloride conductance in amphibian skin: regulatory control in the skin of Rana pipiens.

Chloride conductance across the isolated skin of Rana pipiens shows a voltage-activated component (G(Cl)(V)) which requires the presence of mucosal Cl. G(Cl)(V) is normally low or dormant. It is stimulated by elevated intracellular cAMP, irrespective whether originating from application of ss-adrenergic agonists (isoproterenol), stimulators of the adenylyl-cyclase (forskolin), inhibitors of the phosphodiesterases (isobutyl-methyl-xanthine) or membrane-permeable cAMP analogues (CPT-cAMP). Baseline G(Cl) under inactivating conditions increases also with cAMP dose-dependently. The data indicate that cAMP is a central regulator of the passive, conductive chloride transport across amphibian skin.

Review: intravenous immunoglobulin therapy and thromboembolic complications.

Intravenous immunglobulin (IVIg) is used to treat a number of immune-deficiences and autoimmune diseases. Safety concerns related to a number of reported thromboembolic complications prompted us to review the literature. These complications happened mainly in individuals that had risk factors for thromboembolism, like advanced age, previous thromboembolic diseases, bed-ridden, and in individuals in which high doses or high infusion rates of IVIg were administered. The mechanism responsible for these events seems to be a rise in plasma viscosity that can trigger a thromboembolic event, especially in cases in which there is an underlying circulation impairment. Complications can be minimized by using IVIg only in clear-cut indications, weighting risk versus benefit in patients who are at high risk for thromboembolism and by sticking to carefully monitored slow infusion rates. IVIg for the treatment of autoimmune disorders should be administered as a five-day course of 2 g/kg of body weight. Each daily dose of 400 mg/kg should be given in not less than eight hours.

Hypotonic-induced transport pathways in Xenopus laevis erythrocytes: taurine fluxes.

Taurine fluxes in Xenopus laevis red cells were studied in vitro in media of different tonicities. Both influx and efflux increased 3-10 times reversibly when dilution of the medium exceeded 30%. The absolute values of uptake ranged between 5 and 30 micromol/l cells.h at extracellular taurine concentration of 1 mmol/l, but is poorly selective as almost the same uptake was measured for choline and sucrose. Q(10) of 2.77 and an activation energy of 71.90+/-7.37 kJ/mol were calculated for the uptake process. Taurine uptake was reduced 50% in the absence of Cl(-), whereas the alkali cations (Na(+), K(+), Li(+) and Rb(+)) supported it similarly. Taurine uptake was greatly increased in Ca(2+)-free solution, and was inhibited by alkaline pH. The inhibitor of anion exchange protein, 4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid (IC(50)=25 microM) and the Cl(-) channel blockers 5-nitro-2-(3-phenylpropylamino) benzoic acid and [(dihydro-indenyl) oxy] alkanoic acid (IC(50)<20 microM) inhibited taurine uptake effectively. Isoproterenol did not affect taurine uptake in isotonic, nor in hypotonic solution. The uptake was reduced slowly to near the original, control level within 15-30 min in hypotonic solutions, indicating deactivation of the hypotonic-induced taurine pathway.

Effects of season and temperature acclimation on electrocardiogram and heart rate of toads.

Electrocardiogram (ECG) was recorded from unrestrained toads of two species, one resistant (Bufo viridis) and the other sensitive (B. regularis) to low temperatures. Although the temperature-sensitive species could not survive at temperatures below 7-8 degrees C, heart rate is linearly and similarly related to ambient temperature in the two species. In B. viridis, the cold resistant species, heart rate in winter was 25% lower than in summer, and the dependency of heart rate on temperature was reduced by 50% in toads acclimated to 10 degrees C in winter. It was not possible to disclose any effect of acclimation on heart rate in summer, due to the large variation in the recorded values. The QRS amplitude in the ECG was considerably reduced at low temperature only in B. viridis. It is concluded that differences in cardiac activity cannot account for the distinct difference in thermal relations of the two species, and that it should reside at other regulatory levels.

Structure-function relationships in the integument of Salamandra salamandra during ontogenetic development.

Morphological, cytological and transport properties of the integument of Salamandra salamandra were investigated during natural ontogenetic development, from birth to adult. Three stages were operationally defined: I, larvae, from birth to metamorphosis; II, metamorphosis (judged externally by the colour change and loss of the gills); and III, post-metamorphosis to adult. Pieces of skin were fixed at various stages for immunocytochemical examinations, and the electrical properties were investigated on parallel pieces. Distinct cellular changes take place in the skin during metamorphosis, and lectin (PNA, WGA and ConA) binding indicates profound changes in glycoprotein composition of cell membranes, following metamorphosis. Band 3 and carbonic anhydrase I (CA I) were confined to mitochondria-rich (MR)-like cells, and were detected only in the larval stage. CA II on the other hand, was detected both in MR-like and in MR cells following metamorphosis. The electrical studies show that the skin becomes more tight (transepithelial resistance increases) upon metamorphosis, followed by manifestation of amiloride-sensitive short-circuit current (I(SC)) indicating that functional Na+ uptake has been acquired. The skin of metamorphosed adults had no finite transepithelial Cl- conductance, and band 3 was not detected in its MR cells. The functional properties of MR-like and MR cells remain to be established.

Selective inhibition of Cl(-) conductance in toad skin by blockers of Cl(-) channels and transporters.

We compared the effects exerted by two classes of Cl(-) transport inhibitors on a Cl(-)-selective, passive anion transport route across the skin of Bufo viridis, the conductance (G(Cl)) of which can be activated by transepithelial voltage perturbation or high cAMP at short circuit. Inhibitors of antiporters (erythrosine, eosin) or cotransporters (furosemide) reduced voltage-activated G(Cl) with IC(50) of 6 +/- 1, 54 +/- 12, and 607 +/- 125 microM, respectively; they had no effect on the cAMP-induced G(Cl). The voltage for half-maximal activation of G(Cl) (V(50)) increased compared with controls, but effects on the maximal G(Cl) at more positive clamp potentials were small. Cl(-) channel blockers from the diphenylamino-2-carboxylic acid (DPC) family [dichloro-DPC, niflumic acid, flufenamic acid, and 5-nitro-2-(3-phenylpropylamino)benzoic acid] reduced the voltage-activated G(Cl) with IC(50) of 8.3 +/- 1.2, 10.5 +/- 0.6, 16.5 +/- 3.4, and 36.5 +/- 11.4 microM, respectively, and also inhibited the cAMP-induced G(Cl), albeit with slightly larger IC(50). V(50) was not significantly changed compared with controls; the maximal G(Cl) was strongly reduced. We conclude that the pathway for Cl(-) is composed of the conductive pore proper, which is blocked by the derivatives of DPC, and a separate, voltage-sensitive regulator, which is influenced by blockers of cotransporters or antiporters. This influence is partly overcome by increasing the clamp potential and removed by high concentrations of cAMP, which renders the pathway insensitive to voltage.

Posttreatment follow-up of Helicobacter pylori infection using a stool antigen immunoassay.

The Helicobacter pylori stool antigen enzyme immunoassay (HpSA) was evaluated during posttreatment follow-up of patients in a country with a very high prevalence of H. pylori infection. From among 273 dyspeptic individuals (18 to 55 years) initially recruited from a shantytown in Lima, Peru, 238 participants who met the inclusion criteria and were suspected to be H. pylori positive based on (14)C urea breath test (UBT) results underwent endoscopy. Participants with endoscopy-proven infections received standard eradication therapy and were monitored by UBT and HpSA at 1 month following treatment and at 3-month intervals for 9 months posttreatment. A second endoscopy was performed if UBT results showed evidence of treatment failure or H. pylori recurrence. Biopsy results were considered the "gold standard" in all analyses. Among patients who underwent endoscopy, HpSA had a pretreatment sensitivity of 93%. Two-hundred thirty patients completed the treatment regimen, of whom 201 (93%) were considered to have had successful treatment outcomes based on a negative follow-up UBT. Thirty-two patients with UBT-defined treatment failures or H. pylori recurrences at any point during the 9-month follow-up underwent a second endoscopy. In the posttreatment setting, HpSA had an overall sensitivity of 73% and a specificity of 67%. Agreement between UBT and HpSA diminished throughout the follow-up. Among 14 participants in whom HpSA remained positive at 1 month following treatment despite UBT evidence of treatment success, 12 (86%) became HpSA negative within 3 months posttreatment. Although this study confirmed the validity of the HpSA in the initial assessment of dyspeptic patients, the test demonstrated a reduced overall accuracy in the detection of treatment failures and H. pylori recurrences during 9 months of posttreatment follow-up. Furthermore, in some patients it may take up to 3 months after successful eradication for antigen shedding to diminish to levels within the negative HpSA range.

Transepithelial chloride conductance in amphibian skin: regulatory mechanisms and localization.

The transepithelial transport of Na+ by amphibian skin must be accompanied by the corresponding anion, Cl-, and much effort has been devoted to the characterization of Cl- transport. The transepithelial Cl- conductance, G(Cl), is activated by voltage and adenosine 3',5'-cyclic monophosphate (cAMP), shows rectification, requires the presence of Cl- in the pathway and is influenced by factors modifying intracellular signalling cascades and by metabolic poisons such as cyanide (CN-). Until recently, these findings were interpreted as strong evidence for a transcellular path, for which, given the impermeability of the principal cells for Cl-, the mitochondria-rich cells (MRC) are the only candidate. This was supported by the apparent parallelism between G(Cl) and the density of MRC (D(mrc)). Data accumulated in recent years, however, raise serious doubts as to the validity of this concept. The single-channel conductance derived from various techniques is too small by an order of magnitude to account for the observed G(Cl), the very slow time course of conductance activation is not reconcilable with any known membrane channel gating processes, a more thorough examination of the relationship between G(Cl) and D(mrc) fails to show any consistent pattern and analysis of current density immediately above the transporting epithelium using the vibrating voltage probe shows current peaks associated with only a small fraction of MRC, and even so, these current peaks account for about 20% of the transepithelial current. The remaining 80% of the current cannot be localized to specific structures. Given the increasing evidence for close cellular control of tight-junction function, the foregoing findings are equally consistent with an additional, major, paracellular pathway for Cl-. A comprehensive description of Cl- transport must await the final resolution of the transport pathway(s).

Chloride conductance across toad skin: effects of ionic acclimations and cyclic AMP and relationship to mitochondria-rich cell density.

The anionic conductance across toad (Bufo viridis) skin was studied using the voltage-clamp technique following long-term (more than 10 days) acclimation to NaCl and KCl solutions. The non-specific baseline conductance was approximately 0.6 mS cm(-)(2) and was similar in skins from all acclimation conditions. The voltage-activated Cl(-) conductance (G(Cl)) was maximal in skins from distilled-water- and KCl-acclimated toads (>3 mS cm(-)(2)) and was greatly reduced following acclimation to NaCl solutions. Cyclic AMP (EC(50)=13 micromol l(-)(1)) and isobutylmethyl xanthine (IBMX) (EC(50)=69 micromol l(-)(1)) exerted different effects on the activated conductance. IBMX only sensitized the activated conductance, whereas cyclic AMP (CPTcAMP) at high concentrations induced an increase in anionic conductance that was insensitive to electrical potential. Furthermore, external Cl(-) was not required for the stimulatory effect of cyclic AMP, and the conductive pathway had low selectivity. The effects of the two agonists were reversible and depended on the acclimation conditions. Following electrical measurements, the skin of the toads was removed and stained with silver to measure mitochondria-rich cell density (D(mrc)). There was no correlation between D(mrc) and Cl(-) conductance in the present study.

Mitochondria-rich cells in anuran amphibia: chloride conductance and regional distribution over the body surface.

The distribution and density (D(mrc)) of mitochondria-rich cells (MR cells) in skin epithelium, were determined over the whole body surface in nine species of anuran Amphibia that live in a variety of habitats. It was found that the more terrestrial species (beginning with Hyla arborea) have a higher density of MR cells in their pelvic region. In the skin of aquatic (Xenopus laevis) or fossorial (Pelobates syriacus) species, D(mrc) is evenly distributed over the whole body surface. In dorsal skin pieces of H. arborea that lack detectable MR cells, transepithelial voltage activation did not induce Cl(-) conductance as it did in ventral pieces. Skins from Bufo viridis and X. laevis, both have MR cells in their skin, differ markedly in their biophysical properties: a Cl(-) specific current conductance is predominant in the skin epithelium of B. viridis, and is absent in X. laevis. In the latter, anionic conductance is due to glandular secretion. The biophysical properties cannot therefore be related solely to the presence or density of MR cells. Mitochondria-rich cells are sites of Cl(-) conductance across the skin of those amphibians that show this property, but must have different function(s) in other species. It is suggested that the specific zonal distribution of MR cells in the species that were examined in this study could be due to ion exchange activity and water conservation in more terrestrial environments.

Cyanide inhibition of chloride conductance across toad skin.

The effect of cyanide (CN(-)) on voltage-activated or cAMP-induced passive chloride conductance (G(Cl)) was analyzed in isolated toad skin. Comparatively low concentrations of CN(-) inhibited G(Cl) almost completely and fully reversibly, regardless of whether it was applied from the mucosal or serosal side. The IC(50) was 180 +/- 12 microm for voltage-activated G(Cl) and 305 +/- 30 microm for the cAMP-inducted conductance. At [CN] <100 microm, the initial inhibition frequently declined partly in the continuous presence of CN(-). Inhibition was independent of the presence of Ca(2+). Inhibition was stronger at more alkaline pH, which suggests that dissociated CN(-) is the effective inhibitor. The onset of the inhibition of voltage-activated or cAMP-induced G(Cl) by CN(-) occurred with half-times of 34 +/- 10 sec, whereas reversibility upon washout was twice as fast (18 +/- 7 sec). If [CN(-)] <200 microm was applied under inactivating conditions (serosa -30 mV), the reduction of G(Cl) was stronger upon subsequent voltage-activation than under steady-state activated conditions. This effect was essentially complete less than 30 sec after apical addition of CN(-), but G(t) recovered thereafter partially in the continuous presence of CN(-). Dinitrophenol inhibited G(Cl) similarly, while omission of oxygen did not affect it. These observations, as well as the time course of inhibition and the full reversibility, suggest that interference of CN(-) with oxidative phosphorylation and subsequent metabolic depletion is not the reason for the inhibition of G(Cl). We propose that the inhibition is directly on G(Cl), presumably by competition with Cl(-) at a rate-limiting site in the pathway. Location and molecular nature of this site remain to be identified.

Lectin binding patterns in amphibian skin epithelium.

Seven lectins (PNA, DBA, WGA, UEA-I, RCA, SBA, Con A) were used to localize glycoconjugates in the skin of 10 species of Amphibia, 7 anurans (Bufo marinus, Bufo bufo, Rana ridibunda, Rana pipiens, Hyla arborea, Pelobates syriacus and Xenopus laevis) and 3 urodeles (Salamandra salamandra, Triturus vulgaris and Ambystoma mexicanum). It was found that every lectin has a specific binding pattern in the skin of each species. No common pattern could be established, either among frogs or toads, nor for a particular lectin. Each lectin bound specifically and selectively to a particular epithelial component, which differed from one species to the other. A number of lectins showed selective binding to mitochondria-rich cells, but, again, a pattern in positivity could not be found. It is concluded that lectin histochemistry does correlate with cellular function. Our data can be applied in studies of epithelium and skin development, and of changes that occur during adaptation to the environment by amphibian species.