Multiple ulcerations and perforation in the small intestine after steroid treatment in eosinophilic granulomatosis with polyangiitis: a case report and literature review.

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly called Churg-Strauss syndrome, is an uncommon disease with pathological features consisting of systemic necrotizing vasculitis, eosinophilic infiltration, and granulomatous or nongranulomatous extravascular eosinophilic inflammation. EGPA preferentially affects certain organ systems, including the airways, peripheral nerves, heart, kidney, and gastrointestinal tract. Although gastrointestinal involvement, such as ulcerations, is common in EGPA, gastrointestinal perforation is relatively uncommon and is associated with a poor prognosis. Ulceration, perforation, and stenosis of the gastrointestinal tract are assumed to be the result of ischemia caused by vasculitis. The histological finding in the biopsy specimens of EGPA is generally only eosinophil infiltration, and vasculitis is not often seen. Therefore, in biopsy specimens, it is difficult to distinguish eosinophilic gastroenteritis from the gastrointestinal involvement of EGPA. In addition, in general, steroid therapy is the first-choice treatment for EGPA, but some reports have described the frequent occurrence of acute ulcer or perforation of the gastrointestinal tract in association with steroid treatment. We herein report an EGPA patient who was treated with steroid therapy and subsequently developed perforation of the small intestine.

Clusters of proliferating endothelial cells and smooth muscle cells in rabbit carotid arteries.

Schwarz and Benditt found clustering of replicating cells in aortic endothelium in 1976 and discussed how homeostasis of the arterial wall is maintained through this nonrandom distribution of replicating cells. However, it is still unclear how cells of vascular walls turnover. In order to address this issue, we evaluated distribution of the cells in mitotic cycle, labeled by Ki67-immunostaining, in serial histological sections of twelve carotid arteries of six adult male Japanese rabbits. As a result, a total of 1713 Ki67-positive endothelial cells (ECs) and 1247 Ki67-positive smooth muscle cells (SMCs) were identified. The Ki67-positivity rate in ECs and SMCs were about 0.048% and 0.0027%, respectively. Many of the Ki67-positive cells clustered in two (EC, 37%; SMC, 33%), three to four (EC, 8%; SMC, 28%), and five to eight cells (EC, 5%; SMC, 10%). Clusters having more than eight cells were not found. Thus, it can be speculated that the cell division of proliferating ECs and SMCs occur four times at most. These novel findings offer great insights for better understanding of the mechanism that underlies cell number regulation of the blood vessel.

Cytological Analysis of Low-grade Squamous Intraepithelial Lesion with a Histodiagnosis of Cervical Intraepithelial Neoplasia 3 (Severe Dysplasia) Prospectively.

OBJECTIVE: To reanalyze the cytological features of the first cytological specimens of cervical intraepithelial neoplasia 3 (CIN3) (severe) cases that were initially cytodiagnosed as LSIL and followed up for up to 5 years. STUDY DESIGN: Among 14,556.patients in 2009, 236 (1.6%) were cytodiagnosed with low-grade squamous intraepithelial lesion (LSIL). Among those, 128 cases could be histologically diagnosed from 2009 to 2013. Among those 128 cases, 16 were diagnosed as CIN3 (severe). The first cytological specimens of those 16 cases were reanalyzed morphologically. RESULTS: The first cytological specimens of the 16 cases diagnosed as LSIL and histodiagnosed as CIN3 (severe) showed a few small atypical cells in 13 and a cluster of small atypical cells in 1 case. Atypical cells indicating CIN1 were predominant in 14 LSIL cases and there were a few small atypical cells in these cases (LSIL, cannot exclude high-grade squamous intraepithelial lesion [LSIL-H]). CONCLUSION: We show the existence of LSIL-H (LSIL, cannot exclude HSIL) cases, for which biopsy with colposcopy should be applied actively.

The avoidance and aggregative movements of mesophyll chloroplasts in C(4) monocots in response to blue light and abscisic acid.

In C(4) plants, mesophyll (M) chloroplasts are randomly distributed along the cell walls, whereas bundle sheath chloroplasts are located in either a centripetal or centrifugal position. It was reported previously that only M chloroplasts aggregatively redistribute to the bundle sheath side in response to extremely strong light or environmental stresses. The aggregative movement of M chloroplasts is also induced in a light-dependent fashion upon incubation with abscisic acid (ABA). The involvement of reactive oxygen species (ROS) and red/blue light in the aggregative movement of M chloroplasts are examined here in two distinct subtypes of C(4) plants, finger millet and maize. Exogenously applied hydrogen peroxide or ROS scavengers could not change the response patterns of M chloroplast movement to light and ABA. Blue light irradiation essentially induced the rearrangement of M chloroplasts along the sides of anticlinal walls, parallel to the direction of the incident light, which is analogous to the avoidance movement of C(3) chloroplasts. In the presence of ABA, most of the M chloroplasts showed the aggregative movement in response to blue light but not red light. Together these results suggest that ROS are not involved in signal transduction for the aggregative movement, and ABA can shift the blue light-induced avoidance movement of C(4)-M chloroplasts to the aggregative movement.

The chloroplastic 2-oxoglutarate/malate transporter has dual function as the malate valve and in carbon/nitrogen metabolism.

Transport of dicarboxylates across the chloroplast envelope plays an important role in transferring carbon skeletons to the nitrogen assimilation pathway and exporting reducing equivalent to the cytosol to prevent photo-inhibition (the malate valve). It was previously shown that the Arabidopsis plastidic 2-oxoglutarate/malate transporter (AtpOMT1) and the general dicarboxylate transporter (AtpDCT1) play crucial roles at the interface between carbon and nitrogen metabolism. However, based on the in vitro transport properties of the recombinant transporters, it was hypothesized that AtpOMT1 might play a dual role, also functioning as an oxaloacetate/malate transporter, which is a crucial but currently unidentified component of the chloroplast malate valve. Here, we test this hypothesis using Arabidopsis T-DNA insertional mutants of AtpOMT1. Transport studies revealed a dramatically reduced rate of oxaloacetate uptake into chloroplasts isolated from the knockout plant. CO(2) -dependent O(2) evolution assays showed that cytosolic oxaloacetate is efficiently transported into chloroplasts mainly by AtpOMT1, and supported the absence of additional oxaloacetate transporters. These findings strongly indicate that the high-affinity oxaloacetate transporter in Arabidopsis chloroplasts is AtpOMT1. Further, the knockout plants showed enhanced photo-inhibition under high light due to greater accumulation of reducing equivalents in the stroma, indicating malfunction of the malate valve in the knockout plants. The knockout mutant showed a phenotype consistent with reductions in 2-oxoglutarate transport, glutamine synthetase/glutamate synthase activity, subsequent amino acid biosynthesis and photorespiration. Our results demonstrate that AtpOMT1 acts bi-functionally as an oxaloacetate/malate transporter in the malate valve and as a 2-oxoglutarate/malate transporter mediating carbon/nitrogen metabolism.

Differential positioning of C4 mesophyll and bundle sheath chloroplasts: aggregative movement of C4 mesophyll chloroplasts in response to environmental stresses.

In C(4) plants, mesophyll (M) chloroplasts are randomly distributed along the cell walls, while bundle sheath (BS) chloroplasts are typically located in either a centripetal or centrifugal position. We investigated whether these intracellular positions are affected by environmental stresses. When mature leaves of finger millet (Eleusine coracana) were exposed to extremely high intensity light, most M chloroplasts aggregatively re-distributed to the BS side, whereas the intracellular arrangement of BS chloroplasts was unaffected. Compared with the homologous light-avoidance movement of M chloroplasts in C(3) plants, it requires extremely high light (3,000-4,000 micromol m(-2) s(-1)) and responds more slowly (distinctive movement observed in 1 h). The high light-induced movement of M chloroplasts was also observed in maize (Zea mays), another C(4) species, but with a distinct pattern of redistribution along the sides of anticlinal walls, analogous to C(3) plants. The aggregative movement of M chloroplasts occurred at normal light intensities (250-500 micromol m(-2) s(-1)) in response to environmental stresses, such as drought, salinity and hyperosmosis. Moreover, the re-arrangement of M chloroplasts was observed in field-grown C(4) plants when exposed to mid-day sunlight, but also under midsummer drought conditions. The migration of M chloroplasts was controlled by actin filaments and also induced in a light-dependent fashion upon incubation with ABA, which may be the physiological signal transducer. Together these results suggest that M and BS cells of C(4) plants have different mechanisms controlling intracellular chloroplast positioning, and that the aggregative movement of C(4) M chloroplasts is thought to be a protective response under environmental stress conditions.

Differential positioning of C(4) mesophyll and bundle sheath chloroplasts: recovery of chloroplast positioning requires the actomyosin system.

In C(4) plants, bundle sheath (BS) chloroplasts are arranged in the centripetal position or in the centrifugal position, although mesophyll (M) chloroplasts are evenly distributed along cell membranes. To examine the molecular mechanism for the intracellular disposition of these chloroplasts, we observed the distribution of actin filaments in BS and M cells of the C(4) plants finger millet (Eleusine coracana) and maize (Zea mays) using immunofluorescence. Fine actin filaments encircled chloroplasts in both cell types, and an actin network was observed adjacent to plasma membranes. The intracellular disposition of both chloroplasts in finger millet was disrupted by centrifugal force but recovered within 2 h in the dark. Actin filaments remained associated with chloroplasts during recovery. We also examined the effects of inhibitors on the rearrangement of chloroplasts. Inhibitors of actin polymerization, myosin-based activities and cytosolic protein synthesis blocked migration of chloroplasts. In contrast, a microtubule-depolymerizing drug had no effect. These results show that C(4) plants possess a mechanism for keeping chloroplasts in the home position which is dependent on the actomyosin system and cytosolic protein synthesis but not tubulin or light.

Atomic structure of plant glutamine synthetase: a key enzyme for plant productivity.

Plants provide nourishment for animals and other heterotrophs as the sole primary producer in the food chain. Glutamine synthetase (GS), one of the essential enzymes for plant autotrophy catalyzes the incorporation of ammonia into glutamate to generate glutamine with concomitant hydrolysis of ATP, and plays a crucial role in the assimilation and re-assimilation of ammonia derived from a wide variety of metabolic processes during plant growth and development. Elucidation of the atomic structure of higher plant GS is important to understand its detailed reaction mechanism and to obtain further insight into plant productivity and agronomical utility. Here we report the first crystal structures of maize (Zea mays L.) GS. The structure reveals a unique decameric structure that differs significantly from the bacterial GS structure. Higher plants have several isoenzymes of GS differing in heat stability and catalytic properties for efficient responses to variation in the environment and nutrition. A key residue responsible for the heat stability was found to be Ile-161 in GS1a. The three structures in complex with substrate analogues, including phosphinothricin, a widely used herbicide, lead us to propose a mechanism for the transfer of phosphate from ATP to glutamate and to interpret the inhibitory action of phosphinothricin as a guide for the development of new potential herbicides.

Differentiation of dicarboxylate transporters in mesophyll and bundle sheath chloroplasts of maize.

In NADP-malic enzyme-type C(4) plants such as maize (Zea mays L.), efficient transport of oxaloacetate and malate across the inner envelope membranes of chloroplasts is indispensable. We isolated four maize cDNAs, ZmpOMT1 and ZmpDCT1 to 3, encoding orthologs of plastidic 2-oxoglutarate/malate and general dicarboxylate transporters, respectively. Their transcript levels were upregulated by light in a cell-specific manner; ZmpOMT1 and ZmpDCT1 were expressed in the mesophyll cell (MC) and ZmpDCT2 and 3 were expressed in the bundle sheath cell (BSC). The recombinant ZmpOMT1 protein expressed in yeast could transport malate and 2-oxoglutarate but not glutamate. By contrast, the recombinant ZmpDCT1 and 2 proteins transported 2-oxoglutarate and glutamate at similar affinities in exchange for malate. The recombinant proteins could also transport oxaloacetate at the same binding sites as those for the dicarboxylates. In particular, ZmpOMT1 transported oxaloacetate at a higher efficiency than malate or 2-oxoglutarate. We also compared the activities of oxaloacetate transport between MC and BSC chloroplasts from maize leaves. The K(m) value for oxaloacetate in MC chloroplasts was one order of magnitude lower than that in BSC chloroplasts, and was close to that determined with the recombinant ZmpOMT1 protein. Southern analysis revealed that maize has a single OMT gene. These findings suggest that ZmpOMT1 participates in the import of oxaloacetate into MC chloroplasts in exchange for stromal malate. In BSC chloroplasts, ZmpDCT2 and/or ZmpDCT3 were expected to import malate that is transported from MC.

Molecular characterization of His-Asp phosphorelay signaling factors in maize leaves: implications of the signal divergence by cytokinin-inducible response regulators in the cytosol and the nuclei.

Genes for histidyl-aspartyl (His-Asp) phosphorelay components (His-containing phosphotransfer proteins, HP, and response regulators, RR) were isolated from Zea mays L. to characterize their function in cytokinin signaling. Six type-A RRs (ZmRR1, ZmRR2, ZmRR4-ZmRR7), 3 type-B RRs (ZmRR8-ZmRR10), and 3 HPs (ZmHP1-ZmHP3) were found in leaves. All type-A RR genes expressed in leaves were up-regulated by exogenous cytokinin. Transient expression of fusion products of the signaling modules with green fluorescent protein in epidermal leaf cells suggested cytosolic and nuclear localizations of ZmHPs, whereas type-B ZmRR8 was restricted to the nucleus. Type-A RRs were localized partly to the cytosol (ZmRR1, ZmRR2, and ZmRR3) and partly to the nucleus (ZmRR4, ZmRR5, and ZmRR6). In the yeast two-hybrid assay, ZmHP1 and ZmHP3 interacted with both cytosolic ZmRR1 and nuclear type-B ZmRRs. In vitro experiments demonstrated that ZmHPs function as a phospho-donor for ZmRRs; turnover rates of the phosphorylated state were tenfold lower in ZmRR8 and ZmRR9 than in ZmRR1 and ZmRR4. These results suggest that the His-Asp phosphorelay signaling pathway might diverge into a cytosolic and a nuclear branch in leaves of maize, and that the biochemical nature of ZmRRs is different in terms of stability of the phosphorylated status.

Ultrastructure of endothelial cells under flow alteration.

Endothelial cells are stable and quiet in normal animals. They arrange regularly and have a smooth lumen surface and thin endothelial wall. According to Thoma's principle (1893) and Kamiya and Togawa's principle (1980) on the relationship of the vascular diameter to flow alteration, blood flow is in equilibrium to the diameter and in a physiological state. That is to say, there is no fast flow or slow flow. To understand the nature of the endothelial cells, we should investigate endothelial cells under flow alteration to break the equilibrium state. Endothelial cells under increased flow were studied in arteries with an arteriovenous fistula or in the capillaries of myocardium with volume-overloaded hearts or of the skeletal muscle by electrical stimulation. Those under decreased flow were studied by the closure of the fistula or by ceasing the stimulation. Endothelial cells in the coarctation of the arteries were also observed. Endothelial cells were activated by increased flow in the arteries and capillaries, while they were inactivated by decreased flow. Endothelial activation is characterized as lumen protrusions, increase of cytoplasmic organelles, abluminal protrusions, basement membrane degradation, internal elastic lamina degradation in the arteries, and sproutings in the capillaries. These are ultrastructurally comparable to angiogenesis. Endothelial inactivation is characterized by the decrease of endothelial cell number with apoptosis, which is ultrastructurally comparable to angioregression. We assume that endothelial cells respond to increased flow by angiogenesis and to decreased flow by angioregression.

Accumulation of maize response regulator proteins in mesophyll cells after cytokinin treatment.

The maize response regulator genes ZmRR1 and ZmRR2 respond to cytokinin, and the translated products seem to be involved in nitrogen signal transduction mediated by cytokinin through the His-Asp phosphorelay. To elucidate the physiological function of the proteins, we examined the temporal and spatial distribution in maize leaves by immunochemical analysis and use of transgenic plants. ZmRR1 and ZmRR2 polypeptides could be distinctively detected by western blotting. The polypeptides accumulated in leaves within 5 h of the supply of nitrate to nitrogen-depleted maize, and the accumulation was transient. The extent of induction was larger in the leaf tip, which is rich in photosynthetically matured cells, than elsewhere. In leaves, the polypeptides accumulated mostly in mesophyll cells. Histochemical analyses of transgenic maize harboring a ZmRR1 promoter-beta-glucuronidase fusion gene also showed most of the expression to be in these cells. These results suggest that ZmRR1 and ZmRR2 are induced in mesophyll cells and function in nitrogen signal transduction mediated by cytokinin.

Identifying and characterizing plastidic 2-oxoglutarate/malate and dicarboxylate transporters in Arabidopsis thaliana.

We characterized three Arabidopsis genes, AtpOMT1, AtpDCT1 and AtpDCT2, localized on chromosome 5 and homologous to spinach chloroplastic 2-oxoglutarate/malate transporter (OMT) gene. The yeast-expressed recombinant AtpOMT1 protein transported malate and 2-oxoglutarate but not glutamate. By contrast, the recombinant AtpDCT1 protein transported 2-oxoglutarate and glutamate at similar affinities in exchange for malate. These findings suggested that AtpOMT1 is OMT and AtpDCT1 is a general dicarboxylate transporter (DCT). The recombinant proteins could also transport oxaloacetate at the same binding sites for dicarboxylates. In particular, the AtpOMT1 had a K(m) value for oxaloacetate one order of magnitude lower than those for malate and 2-oxoglutarate. Although the transcripts for the three genes were accumulated in all tissues examined, the expression of the genes in leaf tissues was light inducible. The expression of the three genes was also induced by nitrate supplement but the induction was most prominent and transient in AtpOMT1 similar to nitrate reductase gene. These findings lead to a proposition that AtpOMT1 functions as an oxaloacetate transporter in the malate-oxaloacetate shuttle across chloroplast membranes. We identified T-DNA insertional mutants of AtpOMT1 and AtpDCT1. Although the AtpOMT1 mutants could grow normally in normal air, the AtpDCT1 mutants were non-viable under the same conditions. The AtpDCT1 mutants were able to grow under the high CO2 condition to suppress photorespiration. These findings suggested that at least AtpDCT1 is a necessary component for photorespiratory nitrogen recycling.

Expression of tissue factor, the clotting initiator, on macrophages in Plasmodium falciparum-infected placentas.

The expression of tissue factor (TF), the initiator of the clotting system, was investigated by immunohistochemical staining for its role in clotting mechanisms of Plasmodium falciparum-infected placenta. Most mononuclear cells in the intervillous space of infected placentas stained with an anti-TF monoclonal antibody (MAb) and were positive for antimacrophage MAb. The intervillous space of infected placentas had significant fibrin deposition. In contrast, only small amounts of leukocytes, TF-positive cells, and fibrin were seen in the intervillous space in noninfected placentas. These results indicate that macrophages accumulated in infected placentas express TF and that subsequent perivillous fibrin clot formation leads to a narrowing and plugging of the intervillous space and disturbance of the blood supply. Macrophage TF expression in placentas could be associated with retarded placental growth and low birth weight in malaria infection and should be further investigated.

Identification and characterization of a gene encoding drought-inducible protein localizing in the bundle sheath cell of sugarcane.

We have identified a drought-inducible gene, designated as SoDip22, in sugarcane leaves. The cDNA encoded a hydrophilic protein with a calculated molecular mass of 15.9 kDa and the amino acid sequence was similar to that of ABA, stress and ripening-inducible protein from various plant species. ABA or mannitol-treatment of the detached leaves also induced SoDip22 expression. Stepwise homogenization of the stressed leaves showed that SoDip22 is localized in bundle sheath cells. These results suggest that SoDip22 functions to adapt to drought stress in the bundle sheath cell, and that the signaling pathway for the induction is, at least in a part, mediated by ABA.

Multiple routes communicating nitrogen availability from roots to shoots: a signal transduction pathway mediated by cytokinin.

In higher plants, inorganic nitrogen has crucial effects on growth and development, providing cellular components and modulating gene expression. To date, not only nitrogen assimilatory genes but also a substantial number of genes with other functions have been shown to be selectively regulated by the availability of nitrogen. In terms of the communicating substance(s) between root and shoot, accumulating evidence suggests that nitrate itself is the primary signal molecule triggering the activation of transcription of nitrate assimilation and related genes. On the other hand, some of the genes involved in photosynthesis, cell cycling and translation machinery are also regulated, at least in part, by nitrate and other nitrogen sources and, in some cases, the effect can be mimicked by cytokinin treatment. Spatial and temporal studies on the accumulation levels and the translocation of cytokinin in response to nitrate replenishment in maize showed subsequent accumulation of various cytokinin species in the roots, xylem sap and leaves. In Arabidopsis thaliana, trans-zeatin riboside-5'-monophosphate and/or trans-zeatin riboside also accumulated in the roots in response to nitrate resupply. These studies suggest that cytokinin metabolism and translocation could be commonly modulated by nitrogen availability in higher plants. Thus, in addition to nitrate, cytokinin could be another root-to-shoot signal communicating nitrogen availability.

Physiological angiogenesis in electrically stimulated skeletal muscle in rabbits: characterization of capillary sprouting by ultrastructural 3-D reconstruction study.

Physiological angiogenesis occurs in electrically stimulated skeletal muscles. It is known to start as capillary sproutings, but has not yet been well characterized as ordinary angiogenesis. To characterize the sprouting process during physiological angiogenesis, we carried out an ultrastructural 3-D reconstruction study for the extensor digitorum longus of three adult rabbits under electrical stimulation for 7 days. In addition, hemodynamic and morphological studies were carried out after stimulation for 3, 7, and 14 days. The electrical stimulation induced a twofold increase in femoral artery blood flow and tissue blood flow. This was associated with an increase in capillary density of the muscle by more than twofold at 7 and 14 days. Sproutings frequently appeared at 7 days (4.3 +/- 1.4 x 10(3) sproutings per mm3, 13.3 +/- 6.9 microm in length). All sprouting tips consisted of endothelial cytoplasmic protrusions (ECP). Besides sproutings, there were communicating networks consisting segmentally of ECP (11.6 +/- 5.6 x 10(3) networks per mm3). Endothelial cytoplasmic protrusions began to appear at 3 days, were frequent at 7 days, and disappeared at 14 days, which corresponded well to the changes in blood flow and capillary density. We consider that in physiological angiogenesis, sproutings start as ECP, which contact other capillaries to form networks and become hollowed to form new capillary networks.