Lack of evidence for local immune activity in oral hairy leukoplakia and oral wart lesions.

BACKGROUND: Oral warts, caused by human papillomavirus (HPV), and oral hairy leukoplakia (OHL) caused by Epstein-Barr virus (EBV), are common oral manifestations in HIV-infected persons. Although both conditions occur most often with reduced blood CD4+ T-cell numbers, oral warts and OHL rarely occur simultaneously, suggesting that dysfunctions in other secondary local immune parameters are also involved. The present study evaluated tissue-associated proinflammatory and T-helper cytokine and chemokine mRNA expression and the presence of T cells in each lesion. METHODS: Biopsies were taken from lesion-positive and adjacent lesion-negative sites of HIV+ persons with oral warts or OHL and lesion-negative sites from HIV+ persons who were oral HPV or EBV DNA-positive (matched controls). Cytokine/chemokine mRNA expression was quantified by real-time polymerase chain reaction. CD3, CD4, and CD8 cells were identified by immunohistochemistry. RESULTS: No differences were detected in tissue-associated cytokine/chemokine mRNA expression in warts or OHL when compared to lesion-negative sites. Immunohistochemical analysis of T cells showed CD8+ cells exclusively, but few cells were present in either lesion. No differences were detected between lesion-positive and -negative control sites of each pathologic condition. CONCLUSION: Little evidence was found for local immune reactivity to either oral warts and OHL, suggesting that CD4+ T cells are a primary host defense against both oral warts and OHL, but with nonimmune factors potentially responsible for the divergent prevalence of each.

Intrarenal distribution of exchangeable calcium in HgCl2-induced acute tubular necrosis.

We used autoradiography to localize 45Ca accumulated in vitro by rat kidney that had been injured by HgCl2 in vivo. HgCl2, 1 mg/kg, was administered IV to male Sprague-Dawley rats and nephrectomies were performed from 15 min-30 days later. Kidney slices were incubated in KRB buffer containing 2 mM 45Ca at 25 degrees C for 180 min. The 45Ca slice-to-medium concentration ratio (S/M) increased significantly from a control mean of 0.8 +/- 0.04 SD (n = 4) to 1.6 +/- 0.3 (n = 4) after 1 day and reached 4.6 +/- 4.2 (n = 6) after 3 days. The serum creatinine increased more rapidly, from a control mean of 0.4 +/- 0.1 mg/dl to 0.7 +/- 0.1, 3.3 +/- 0.2, 7.2 +/- 1.6 after 4 hr, 1 day, and 3 days, respectively. Autoradiographic localization of 45Ca was first evident in necrotic proximal tubule (PT) straight segments after 1 day and was maximal at 3 days. 45Ca uptake was increased by slice incubation with N2 instead of O2, but anoxia did not alter the intrarenal distribution pattern. Necrotic PTs showing 45Ca by autoradiography were also positive by the von Kossa stain. Autoradiographs prepared from paraffin or Epon sections showed the same intrarenal distribution of 45Ca as section freeze-dry autoradiographs. Increased tissue 45Ca was due primarily to uptake by nephrocalcinotic PT segments; 40Ca accumulated in vivo exchanged for 45Ca during in vitro incubation. The exchangeable intrarenal calcium observed in this autoradiographic study was due to HgCl2-induced nephrocalcinosis.

Multiorgan crystal deposition following intravenous oxalate infusion in rat.

Deposition of calcium oxalate is responsible for the pathologic manifestations of oxalosis and may contribute to multiorgan dysfunction in uremia and to the progression of renal damage after renal failure is established. We have developed a rat model of oxalosis using a single intravenous injection of sodium oxalate, 0.3 mmol./kg. body weight, in rats. Polarized light microscopy and section freeze-dry autoradiography were used to identify 14C-oxalate within the renal parenchyma and in extrarenal organs. 14C-oxalate crystals under three mu in length were identified within one min. of injection in proximal tubule lumens. Section freeze-dry autoradiography showed occasional minute crystals within glomeruli, heart, lung and liver at one hr. In contrast to concentrative cellular uptake demonstrated in rat renal cortical slices in vitro, intracellular accumulation of 14C-oxalate could not be detected in vivo. Within the first 24 hr., renal oxalate retention reached a maximum of 25 +/- 4 per cent of the injected dose/gm. kidney compared to a maximum of only 7 +/- 3 per cent/gm. kidney after intraperitoneal administration. Although less than one per cent dose/gm. kidney remained after one week, crystal fragments were scattered throughout the cortex and medulla, often surrounded by foci of interstitial nephritis. The retention of crystals in kidney and other body organs following i.v. oxalate provides a model of oxalosis which stimulates pathophysiologic events in a variety of clinical situations characterized by transiently or persistently elevated serum oxalate.

Renal tubular transport of delta-aminolevulinic acid in rat.

delta-Aminolevulinic acid (ALA) interferes with cell membrane and metabolic functions in a variety of tissues. To determine if ALA interacts with renal tubular transport functions, we examined concentrative transport of this heme precursor in rat kidneys. ALA was accumulated against a concentration gradient in rat renal cortical slices. Section freeze-dry autoradiography demonstrated selective accumulation in cells of proximal tubules. Concentrative uptake of ALA was inhibited by KCN, probenecid and p-aminohippurate (PAH). ALA inhibited slice uptake of PAH but failed to block slice accumulation of galactose, cycloleucine, lysine, glycine, proline, or alpha-aminoisobutyric acid and did not alter O2 utilization. Massive intraperitoneal injection of ALA did not increase 24 hr fractional excretion of amino acids in vivo. Concentrative transport of ALA in proximal tubules does not lead to generalized renal tubular transport defects but ALA appears to share the organic acid secretory system in rat kidney.

Oxalate accumulation in rat renal cortical slices.

Tubular transport of oxalate is thought to be an energy-mediated process which may contribute to the renal deposition of calcium oxalate in a variety of pathologic states. In order to examine this possibility, the renal handling of oxalate was investigated in rat renal cortical slices in vitro. Slices incubated in vitro with 1 microM [14C]oxalate in Krebs-Ringer bicarbonate buffer at 25 degrees C for 180 min achieved a mean slice to medium ratio of 2.8 +/- 0.08 (SEM) and a mean tissue concentration of 7.7 +/- 0.2 mumol/kg dry wt (N = 64). Section freeze-dry autoradiographs demonstrated maximum uptake within proximal tubule cells but no crystals were evident. Substituting N2 for O2, adding KCN, or removing Ca2+ increased uptake of 14C-oxalate. Dinitrophenol (DNP) and iodoacetamide (IoAc), however, significantly decreased, and O degrees C eliminated slice uptake. Slices incubated with 100 microM [14C]oxalate showed a further increase in tissue accumulation and the appearance of [14C]oxalate crystals. Crystals formed in vitro were deposited throughout the tissue. Oxalic acid did not appear to share the organic acid by renal cortical slices in vitro is largely independent of energy-mediated mechanisms.

Transport of gentamicin in rat proximal tubule.

The intrarenal distribution of tritiated gentamicin (GM) was determined in rat by combined immunofluorescence and section freeze-dry autoradiography, techniques that permit subcellular localization before and after diffusional redistribution. Tissue from these kidneys was also examined by electron microscopy. After parenteral administration of 4 to 100 mg/kg, GM accumulates in S1 and S2 but not S3 segments of proximal tubules. Within 10 minutes, autoradiography demonstrates 3H-GM in the lumina of proximal and distal tubules; a subapical distribution consistent with pinocytotic uptake is prominent in many proximal cells. After 1 hour, 3H-GM is diffusely distributed within the cytoplasm in section freeze-dry autoradiographs with minimal evidence of intracellular sequestration. At this time, 3H-GM is presumably within endocytotic vacuoles, and electron microscopy reveals only rare vacuoles containing single myeloid bodies. Subsequently, section freeze-dry autoradiography shows sequestration of the aminoglycoside, but this intracellular localization is lost during tissue processing for fluorescent microscopy up to 6 hours after injection. At 6 hours large cytoplasmic vacuoles containing multiple well-organized myelin figures first appear in S1 and S2 segments. By 48 hours, 3H-GM is firmly bound in these vacuoles and is maintained in situ in both section freeze-dry autoradiographs and immunofluorescent preparations in association with increased numbers of vacuoles containing multiple myeloid bodies by electron microscopy. These studies thus demonstrate diffusible 3H-Gm within the cell which is available to initiate nephrotoxicity 1 to 6 hours after administration.