Monoterpenes as therapeutic candidates to induce fetal hemoglobin synthesis and up-regulation of gamma-globin gene: An in vitro and in vivo investigation.

Pharmacologically induced production of fetal hemoglobin (HbF) is a pragmatic therapeutic strategy for the reduction of globin chain imbalance and improving the clinical severities of patients with ß-hemoglobinopathies. To identify highly desirable new therapeutic HbF-inducing agents, we screened functionally diverse ten monoterpenes, as molecular entities for their potent induction and erythroid differentiation ability in human erythroleukemia cell line (K562) and transgenic mice. Benzidine hemoglobin staining demonstrated six compounds to have significantly induced erythroid differentiation of K562 cells in a dose and time-dependent manner. This induction paralleled well with the optimal accumulated quantity of total hemoglobin in treated cultures. The cytotoxic studies revealed that three (carvacrol, 3-carene, and 1,4-cineole) of the six compounds with their maximal erythroid expansion ability did not affect cell proliferation and were found non-toxic. Four compounds were found to have high potency, with 4-8-fold induction of HbF at both transcriptional and protein levels in vitro. Subsequently, an in vivo study with the three active non-cytotoxic compounds showed significant overexpression of the γ-globin gene and HbF production. Carvacrol emerged as a lead HbF regulator suggested by the increase in expression of γ-globin mRNA content (5.762 ± 0.54-fold in K562 cells and 5.59 ± 0.20-fold increase in transgenic mice), accompanied by an increase in fetal hemoglobin (F-cells) levels (83.47% in K562 cells and 79.6% in mice model). This study implicates monoterpenes as new HbF inducing candidates but warrants mechanistic elucidation to develop them into potential therapeutic drugs in ß-thalassemia and sickle cell anemia.

Guidelines for diagnosis and management of Beta-thalassemia intermedia.

Beta-thalassemia intermedia (ß-TI) is a genetic variant of beta-thalassemias with a clinical disorder whose severity falls between thalassemia minor and thalassemia major. Different genetic defects are involved in this disorder and, based on severity of disease, clinical complications like skeletal deformities and growth retardation, splenomegaly, extramedullary hematopoiesis, heart failure, and endocrine disorders may be present in untreated patients. Precise diagnosis and management are essential in these patients for prevention of later clinical complications. Diagnosis of TI is based on clinical and laboratory data. There are some treatment strategies like modulation of gamma-globulin chain production with hydroxyurea or other drugs, transfusion, splenectomy, and stem cell transplantation. Iron chelation therapy is also needed in many of these patients even if they are not transfused. The aim of this manuscript is to review the clinical manifestations, complications, genetic defects, and unmet treatments needs in TI.

PIPKIIα is widely expressed in hematopoietic-derived cells and may play a role in the expression of alpha- and gamma-globins in K562 cells.

Characterized for the first time in erythrocytes, phosphatidylinositol phosphate kinases (PIP kinases) belong to a family of enzymes that generate various lipid messengers and participate in several cellular processes, including gene expression regulation. Recently, the PIPKIIα gene was found to be differentially expressed in reticulocytes from two siblings with hemoglobin H disease, suggesting a possible relationship between PIPKIIα and the production of globins. Here, we investigated PIPKIIα gene and protein expression and protein localization in hematopoietic-derived cells during their differentiation, and the effects of PIPKIIα silencing on K562 cells. PIPKIIα silencing resulted in an increase in α and γ globins and a decrease in the proliferation of K562 cells without affecting cell cycle progression and apoptosis. In conclusion, using a cell line model, we showed that PIPKIIα is widely expressed in hematopoietic-derived cells, is localized in their cytoplasm and nucleus, and is upregulated during erythroid differentiation. We also showed that PIPKIIα silencing can induce α and γ globin expression and decrease cell proliferation in K562 cells.

Immunizations of human lymphocytes in vitro with a T-dependent antigen towards human monoclonal antibody production.

Human monoclonal antibodies have a plethora of applications, justifying the time and effort towards development of techniques for their efficient production. Attempts at establishing efficient reproducible techniques for activation of lymphocytes in culture have met with moderate success. In this study, human lymphocytes from peripheral blood and bone marrow were immunized in vitro with a T-dependent antigen--bovine gamma globulin. Whole blood, bone marrow and separated mononuclear peripheral blood cells were studied for the potential antibody secretory capabilities. The culture conditions included supplementation with heat treated autologous serum, spent medium from U-266 myeloma cell culture, which is known to contain B cell differentiation factors, and varied antigenic concentrations along with exposure duration. Although there was no appreciable difference in response between whole peripheral blood and whole bone marrow, there is a much better response when compared to isolated cell cultures; especially when culture conditions include antigenic withdrawal and supplementation with conditioned medium. However, lower antigenic concentration was required for whole bone marrow cultures. With optimal in vitro conditions for antigenic stimulation standardized, several options are available for the immortalization of such activated cells to obtain stable human hybridomas of interest.

DNA vaccination with the Aleutian mink disease virus NS1 gene confers partial protection against disease.

Aleutian disease virus (ADV) causes severe losses in mink. This happens in nature as well as in farms. In spite of several attempts to provide an efficient protective protein based vaccine, experiments have failed so far. Only partial protection has been obtained. The aim of this work was to construct and test a protective DNA vaccine based on the gene encoding for the ADV non-structural protein 1 (NS1) and to test this construct as a potential vaccine candidate against ADV infection or disease. First, the vaccine construct was tested by in vitro transfection studies. NS1 protein expression was found by immunofluorescent studies and the expected size of translated protein confirmed by Western blot. Then, 18 female mink were divided into three groups: a control group, a DNA vaccinated group, and a group which received DNA vaccine plus a boost with recombinant NS1 protein in the last immunization. After virus challenge, the two DNA vaccinated groups induced higher antibody levels in the first 23 weeks of the 32 week observation period. One month after virus challenge, the most interesting finding was, that the "DNA+protein" group exhibited a significantly higher percentage of CD8+ cells, when compared to the levels in the two other groups. This, we believe, indicate a memory CTL response created by the vaccination. Most CD8+ cells were found to contain interferon gamma as measured by FACS intracellular staining. Severity of Aleutian disease was judged by quantification of plasma gammaglobulin levels and mink death statistics. The findings let us to conclude, that the two DNA vaccinated groups of mink did show milder disease characteristics, but that the vaccine effect also in this trial could only be characterized as partial.

B cells expressing Bcl-2 and a signaling-impaired BAFF-specific receptor fail to mature and are deficient in the formation of lymphoid follicles and germinal centers.

The TNF family cytokine B cell-activating factor belonging to the TNF family (BAFF) (BLyS) plays a fundamental role in regulating peripheral B cell survival and homeostasis. A BAFF-specific receptor (BAFF-R; BR3) appears to mediate these functions via activation of the NF-kappaB2 pathway. Signaling by the BAFF-R is also required to sustain the germinal center (GC) reaction. Engagement of this receptor results in the induction of Bcl-2, suggesting that this antiapoptotic factor acts downstream of the BAFF-R and NF-kappaB2 pathway to promote peripheral B cell survival during primary and Ag-driven development. To test this idea, we created lines of mice coexpressing a Bcl-2 transgene and a signaling-deficient form of the BAFF-R derived from the B lymphopenic A/WySnJ strain. Surprisingly, although dramatically elevated numbers of B cells accumulate in the periphery of these mice, these B cells exhibit extremely perturbed primary development, formation of lymphoid microenvironments, and GC and IgG responses. Moreover, mice expressing the bcl-2 transgene alone display a loss of marginal zone B cells, an expansion of follicular B cells that appear immature, and alterations of the GC reaction. These results suggest that the BAFF-R and Bcl-2 regulate key and nonoverlapping aspects of peripheral B cell survival and development.

Anti-phlogistic and immunocompetent effects of acupuncture treatment in women suffering from chronic pelvic inflammatory diseases.

Thirty-nine women of reproductive age suffering from chronic pelvic inflammatory disease (PID) for at least two years, previously treated pharmacologically with no effect, were enrolled in a four-week therapeutic protocol consisting of 12 acupuncture treatments performed with the frequency of three per week. In each female patient at baseline and after the study, pain score and the following parameters in blood serum were evaluated: concentration of immunoglobulin M (IgM), albumins, alpha1-globulins, alpha2-globulins and gamma-globulins, erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. During the study, we obtained a significant drop in ESR and IgM levels together with a rise in gamma-globulin concentrations. A significant decrease (from 4.89 +/- 0.82 to 0.63 +/- 1.05) in pain score was obtained. The other parameters remained unchanged. These results suggest that acupuncture treatment of PID exhibits a clear anti-inflammatory and immunocompetent effect.

Expression of erythroid-specific genes in megakaryoblastic disorders.

Currently available data indicate that erythroid and megakaryocytic differentiation pathways are closely related to each other, and there may exist progenitor cells common to those two lineages may exist. Acute megakaryoblastic leukemia (AML-M7) and transient myeloproliferative disorder in Down's syndrome (TMD) are characterized by rapid growth of abnormal blast cells which express megakaryocytic markers. These blast cells express lineage-specific transcription factors such as GATA-1 common to these lineages and frequently express erythroid-specific mRNAs such as gamma-globin and erythroid delta-aminolevulinate synthase (ALAS-E), indicating that most of the blasts in M7 and TMD cases have erythroid and megakaryocytic phenotypes. These results suggest that blasts in M7 and TMD may correspond to progenitors of both erythroid and megakaryocytic lineages.

Acquisition of immunity in cattle against the blue tick, Boophilus decoloratus.

It is well known that ixodid ticks have the ability to induce immunity in their host. We demonstrate, for the first time, that the tick Boophilus decoloratus induced immunity in its bovine host, since the mean weight of engorged females fed on naive animals dropped from 201.5 mg, to 173.7 mg and 155.3 mg, for females fed on calves previously exposed once and twice; respectively, to B. decoloratus infestations. Ticks which had been transferred from one individual host to another one were able to complete their feeding period on a sensitive host. Such ticks were significantly heavier (mean 245.2 mg) than those fed on a naive (mean 201.5 mg) host for the entire normal feeding period. A negative correlation between the mean weight of the engorged female ticks and the level of serum gamma globulins in the host was also demonstrated.

Efecto de la gamaglobulina humana intravenosa sobre el cultivo mixto de linfocitos

Se estudio el efecto de la gamaglobulina humana intravenosa (GGHIV)(Sandoblogulin) sobre la reacción alogénica in vitro mediante el cultivo mixto de linfocitos (CML) en individuos normales. LA GGHIV en concentraciones superiores a 0.5 mg/ml inhibió en 61 por ciento y 99 por ciento la respuesta proliferativa. Se descartó que la inhibición fuese debida a factores citotóxicos presentes en la GGHIV comercial y/o deficit nutricional en los medios de cultivo. La incubación de los CML con 4 mg/ml de GGHIV durante 4 h/37 grados Centigrados produjo un 74 por ciento de inhibición. Se observó un efecto más acentuado al preincubar las células estimuladoras. La adición de GGHIV al CML, ocasionó una inhibición dependiente del tiempo de adición, mayor entre las 0 horas (h)(90 por ciento) y las 48 h (40 por ciento). El fenómeno inhibitorio no fue específico sobre la reacción alogénica puesto que también se encontró sobre la respuesta proliferativa a concavalina A (Con A) (63 por ciento), fitohematoglutinina A (PHA) (62 por ciento) y derivado protéico purificado (PPD) (84 por ciento). La inhibición sobre el CML, se revirtió parcialmente con la adición de 100 U de IL-2rH en las primeras 24h. La GGHIV redujo en un 79 por ciento la expresión del receptor de IL-2 al quinto día del CML. Los resultados de cuantificación de IL-1B en los sobrenadantes de CML con y sin GGHIV no arrojaron datos concluyentes. Se discuten los posibles mecanismos de acción y futuras utilidades de la GGHIV como inmunomoduladora en los transplantes de tejidos.

Studies on synthesis of interleukin-6 and gammaglobulin in peripheral blood mononuclear cells of patients with systemic lupus erythematosus.

Peripheral blood mononuclear cells (PBMC) from patients with systemic lupus erythematosus (SLE) proliferated spontaneously and secreted an elevated level of IgG compared with that of normal controls. However, the levels of interleukin-6 (IL-6) produced by PBMC from patients with SLE with or without pokeweed mitogen (PWM) stimulation showed no significant difference from those of normal controls. The levels of IL-6 secreted spontaneously from PBMC of SLE patients correlated inversely with the percent and the absolute number of CD19 positive cells in PBMC, but not with the levels of IgG and IgM secreted spontaneously from PBMC. There was no significant difference in the levels of IgG produced by PBMC stimulated with IL-6 and also in the levels of IL-6 synthetized by T and B cells between SLE patients and normal controls. These data suggest that IL-6 may not play an important role in the hypergammaglobulinemia in SLE.

Humoral immunodeficiency.

Humoral (or antibody) immunodeficiency syndromes may occur as apparent congenital or acquired abnormalities, with deficiencies in all or in only some classes of immunoglobulins. Most patients are recognized because of recurrent infections with high-grade extracellular encapsulated bacterial pathogens, but some with selective IgA deficiency or with transient hypogammaglobulinemia of infancy may have few or no infections. Although general population statistics are not available, most defects are thought to be rare; humoral immunodeficiency is more prevalent than cellular immunodeficiency, possibly due to early death from the latter defects. Disorders affecting B-cell function may be inherited as X-linked recessive or as autosomal traits. Although considerable information exists about such defects at a functional and cellular level, the primary biologic errors are as yet unknown for all of them. Apparent abnormalities of B-cell maturation and/or intrinsic B-cell malfunction are seen in a majority of these defects. The heterogeneity of B-cell morphology and function in large pedigrees of patients with X-linked agammaglobulinemia makes it unlikely that the defect is due to a distinct gene rearrangement abnormality at a specific stage of B-cell maturation. Early recognition of B-cell deficiency and institution of adequate immunoglobulin replacement therapy can prevent extensive damage to the lungs and other life-threatening problems from infection and allow a relatively normal childhood and adult life.

Thermal trauma-induced changes in the synthesis of rat serum proteins.

Infliction of non-lethal scalding was found to cause an increase in the rate of incorporation of 35S-methionine into albumin and globulin fractions of rat serum proteins, the the increase being remarkably higher for alpha- and beta-globulins than for albumin and gamma-globulins The most pronounced enhancement was associated with the 60- and 70-kd constituents of beta-globulins, the 34-, 55- and 136-kd polypeptides of alpha-2-globulins and the 50-, 60-, 125- and 145-kd polypeptides of alpha-1-globulins. The response of serum proteins to the heat shock was similar, though the changes were significantly less pronounced.

Lycurim (R-74) in the therapy of chronic lymphocytic leukaemia.

Lycurim was used in the therapy of 41 CLL patients, in 34 a positive clinical effect was found. The effect was marked in cases of CLL associated with autoimmune haemolytic anaemia. The immunodepressive property of Lycurim was confirmed by immunological investigation. It has been shown that the levels of IgG, IgA and IgM fall after Lycurim treatment of CLL patients. At the same time the T-lymphocyte count decreases and a tendency for EAC rosette-forming B-lymphocyte decrease is marked.

Modulation of the rats' immune status by monoassociation with anaerobic bacteria.

The capacity of a pure culture of anaerobic intestinal bacteria to influence the host's cellular and humoral immune systems was investigated with germfree, monoassociated, and conventionally reared rats. Monoassociation of germfree rats with Bacteroides fragilis stimulated the production of serum gamma globulin, agglutinating antibodies, and an apparent IgG (immunoelectrophoresis) band. A comparison of the in vitro blastogenic potential of lymphocytes (spleen cells and mesenteric lymph node cells) from germfree, monoassociated, and conventionally reared rats indicated the following: (1) the microbial flora had no obvious effect on the capacity of nonstimulated lymphocytes to incorporate [3H]thymidine; (2) spleen cells from conventionally reared rats responded to phytohemagglutinin, concanavalin A, or pokeweed mitogen better than splenocytes from germfree rats; (3) colonization of germfree rats with Fusobacterium necrophorum increased the responsiveness of splenocytes to photohemagglutinin and concanavalin A; and (4) monoassociation of germfree rats with B. fragilis, but not with F. necrophorum or propionibacterium acnes, increased splenocyte blastogenesis to homologous (i.e., colonizing) bacterial antigens. This study indicated that some intestinal bacteria can modulate the immune status of the host; the extent and nature of this modulation depended on the particular species of colonizing bacteria.

Identification of Anaplasmataceae (Haemobartonella) antigen and antibodies in systemic lupus erythematosus.

Free antigen related to Anaplasma marginale (AM) (Haemobartonella) was demonstrated in the glomeruli of one patient with lupus nephritis. Indirect fluorescent antibodies against this rickettsia were demonstrated in all of 22 lupus sera tested, with titers ranging from 1:20 to 1:1280. Geometric mean titer (GMT) was 116. Fifty-eight percent of 102 controls did not react to AM by indirect fluorescent antibody technique, and GMT of all controls was 10.7 Immunofluorescence was eliminated by neutralization and blocking techniques.

[Immunological studies demonstrating the enhancing effect of aristolochic acid on immunoreactions (author's transl)]. / Immunologische Untersuchungen zum Nachweis der abwehrsteigernden Wirkung von Aristolochiasäure.

In experimental studies it was shown that aristolochic acid is able to ameliorate or to stimulate immunoreactions. This was studied in vivo with cutaneous delayed hypersensitivity reactions and by measurement of the gamma-globulin formation of treated rabbits; the in vitro system used was the macrophage migration test.