The co-localization of neuropeptides in the submucosa of the small intestine of normal Wistar and non-diabetic BB rats.

Immunocytochemical double and triple staining techniques were employed on whole mounts of the submucosal plexus from normal Wistar and non-diabetic BB rat jejunum and ileum, to determine the patterns of co-localization of vasoactive intestinal polypeptide-, peptide histidine-isoleucine-, somatostatin-, neuropeptide Y-, calcitonin gene-related peptide-, substance P-, and galanin-immunoreactive nerves. Neuropeptide Y immunoreactivity was found in 38% of submucosal plexus neurons, within the same neuronal elements as vasoactive intestinal polypeptide immunoreactivity (39% of submucosal plexus neurons) and peptide histidine-isoleucine immunoreactivity. A small population (1% of submucosal plexus neurons) containing vasoactive intestinal polypeptide- and peptide histide isoleucine-like immunoreactivity without NPY-like immunoreactivity was also observed. A significant population of fibers containing vasoactive intestinal polypeptide and galanin immunoreactivity were observed in the mucosa and submucosa, although no cell bodies were detected which contained both neuropeptides. Galanin-like immunoreactivity was seen in a small (2% of submucosal plexus neurons) population, not co-localized with any of the other neuropeptides examined. All somatostatin-immunoreactive neuronal elements (18% of submucosal plexus neurons) contained calcitonin gene-related peptide immunoreactivity, just over half of which also contained substance P immunoreactivity. An additional 25% of submucosal plexus neurons contained calcitonin gene-related peptide- without somatostatin-like immunoreactivity and 28% of submucosal plexus neurons contained substance P without somatostatin-like immunoreactivity. Some degree of co-localization was seen between calcitonin gene-related peptide- and substance P-like immunoreactivity, however, this could not be directly quantified.(ABSTRACT TRUNCATED AT 250 WORDS)     

N-methyl-D-aspartate evokes the release of somatostatin from striatal interneurons in primary culture.

Indirect immunocytochemistry of striatal neurons in primary culture, generated from the embryonic mouse brain, suggested that 2-4% of the neurons contained somatostatin-like immunoreactivity; the majority of these cells also contained neuropeptide Y immunoreactivity, characteristic of a subset of striatal interneurons. Although 10-15% of cultured striatal neurons showed moderate or intense immunoreactivity for calbindin-D28k, the majority of neurons with somatostatin-like immunoreactivity did not contain calbindin-D28k-like immunoreactivity; parvalbumin immunoreactivity was absent from the culture preparation. A highly sensitive radioimmunoassay was used to examine the actions of depolarizing agents and excitatory amino acids on the release of endogenous somatostatin-like immunoreactivity from striatal interneurons. During a 15 min incubation period, 47 +/- 10 fmol of somatostatin-like immunoreactivity were released from 14 days in vitro striatal neurons, cultured in 35 mm dishes. Depolarization with 56 mM KCl or 10 micrograms/ml veratrine resulted in an additional 105 +/- 9 and 56 +/- 5 fmol, respectively, of somatostatin-like immunoreactivity released; the release evoked by veratrine was blocked by 1 microM tetrodotoxin. In the presence of 100 microM N-methyl-D-aspartate, 112 +/- 21 fmol of somatostatin-like immunoreactivity (above basal) were released (+238%); the N-methyl-D-aspartate-evoked release was dose-dependent (EC50, 20 microM), attenuated in the absence of added Ca2+, potentiated in the absence of added Mg2+ and unaffected by the presence of 1 microM tetrodotoxin. The selective antagonists 2-amino-5-phosphonovalerate (100 microM) and MK-801 (1 microM) blocked the N-methyl-D-aspartate-evoked release of somatostatin-like immunoreactivity; KCl-evoked release was unaffected. Kainate was slightly more effective, yet five-fold less potent (EC50, 100 microM), than N-methyl-D-aspartate in evoking somatostatin-like immunoreactivity release; quisqualate was marginally effective. The results of this study suggest that N-methyl-D-aspartate and kainate receptors are present on striatal somatostatinergic interneurons in primary culture.     

DUODENAL SOMATOSTATINOMA Immunohistopathology and Review of Literature

A case of duodenal somatostatinoma is reported. The patient, a 54-year-old male, had complained of an epigastric pain due to gastric ulcer and a duodenal polyp was unexpectedly found at a gastrectomy. The polyp showed basically tubular adenocarcinoma, with negative argyrophil and argentaffin reactions. By an indirect immunofluorescent examination almost all of the tumor cells were revealed as somatostatin-immunoreactive. Big somatostatin was also positive. Radioimmunoassay of the tumor indicated 6400 pg of somatostatin-like immunoreactivity per milligram of wet tissue. This seems to be the second case of duodenal somatostatinoma, following the case reported by us previously.     

Tumor necrosis factor and disease severity in children with falciparum malaria

To investigate the role of tumor necrosis factor in Plasmodium falciparum infections, we measured serum concentrations of this cytokine in 65 Malawian children with severe falciparum malaria. Of these children (mean age, 5.3 years), 55 were unconscious and 10 had hypoglycemia at presentation. Although there was considerable overlap, the mean (+/- SEM) initial serum concentration of tumor necrosis factor was significantly higher in the 10 patients who died (709 +/- 312 pg per milliliter) than in the 55 who survived (184 +/- 32 pg per milliliter; P less than 0.02). The mortality rate increased with the concentration of tumor necrosis factor: at a level of less than 100 pg per milliliter, 1 of 24 patients died; at 100 to 500 pg per milliliter, 6 of 34 patients; and at more than 500 pg per milliliter, 3 of 7 patients. High concentrations of tumor necrosis factor were also associated with hypoglycemia (P less than 0.02), hyperparasitemia (P less than 0.002), age under three years (P less than 0.03), and severity of illness as measured by a prognostic index (P less than 0.0005). The highest serum concentrations of tumor necrosis factor were found in patients who died shortly after admission. The concentrations in cerebrospinal fluid were within the normal range in all patients. In serum samples obtained from 38 convalescent patients, the concentration of tumor necrosis factor declined to a mean of 16 +/- 3 pg per milliliter. We conclude that the level of tumor necrosis factor is frequently increased in patients with severe falciparum malaria, particularly in those with cerebral malaria or hypoglycemia. To determine whether it is important in the pathogenesis of the signs and symptoms of the disease requires further study.     

Detection of circulating tumor necrosis factor after endotoxin administration

Cytokines, products of stimulated macrophages, are thought to mediate many host responses to bacterial infection, but increased circulating cytokine concentrations have not been detected consistently in infected patients. We measured plasma concentrations of circulating tumor necrosis factor alpha (cachectin), interleukin-1 beta, and gamma interferon, together with physiologic and hormonal responses, in 13 healthy men after intravenous administration of Escherichia coli endotoxin (4 ng per kilogram of body weight) and during a control period of saline administration. Eight additional subjects received ibuprofen before receiving endotoxin or saline. Plasma levels of tumor necrosis factor were generally less than 35 pg per milliliter throughout the control period, but increased 90 to 180 minutes after endotoxin administration to mean peak concentrations of 240 +/- 70 pg per milliliter, as compared with 35 +/- 5 pg per milliliter after saline administration. Host responses were temporally associated with the increase in circulating tumor necrosis factor at 90 minutes, and the extent of symptoms, changes in white-cell count, and production of ACTH were temporally related to the peak concentration of tumor necrosis factor. Ibuprofen pretreatment did not prevent the rise in circulating tumor necrosis factor (mean peak plasma level, 170 +/- 70 pg per milliliter) but greatly attenuated the symptoms and other responses after endotoxin administration. Concentrations of circulating interleukin-1 beta and gamma interferon did not change after endotoxin administration. We conclude that the response to endotoxin is associated with a brief pulse of circulating tumor necrosis factor and that the resultant responses are effected through the cyclooxygenase pathway.     

Neurotensin-like and somatostatin-like immunoreactivity within amacrine cells of the retina

Neurotensin-like and somatostatin-like immunoreactivity was demonstrated in the pigeon retina, using both immunohistochemical and radioimmunoassay techniques.Immunohistochemical studies utilized both the indirect immunofluorescence and immunoperoxidase procedures with two well-characterized antisera to neurotensin and three well-characterized antisera to somatostatin. Specific immunoreactivity of each antiserum was established by absorption with either 10 μM synthetic neurotensin, somatostatin or leu⁵-enkephalin. Specific immunohistochemical staining for neurotensin and for somatostatin was observed within separate populations of multistratified amacrine cells. Neurotensin-like and somatostatin-like immunoreactivity were observed within somata located in the inner nuclear layer and within varicose processes ramifying in laminae 1, 3 and 4 of the inner plexiform layer. Immunoreactive somata and processes were observed throughout the retina and their density appeared to be greatest within central retinal regions. The somata-containing neurotensin-like and somatostatin-like immunoreactivity measured about 7 μm in diameter. The cell to cell spacing of neurotensin-like immunoreactive somata was approximately 30 μm and the cell to cell spacing of somatostatin-like immunoreactive somata was approximately 27 μm in central retinal regions. Within more peripheral retinal regions, immunoreactive cells were spaced farther apart.Radioimmunoassays utilizing well-characterized antisera to neurotensin and somatostatin demonstrate specific neurotensin-like and somatostatin-like immunoreactivity in acetic acid extracts of the retina. The concentration of immunoreactive neurotensin is 59 ± 7 fmoles per whole retina (mean ± S.E.M.) or 15.4 ± 2 fmoles per mg protein. The concentration of immunoreactive somatostatin is 2209 ± 440 fmoles per whole retina or 527 ± 76 fmoles per mg protein.These results demonstrate the existence of two additional neuropeptides within selected populations of retinal amacrine cells. The localization of several different neuropeptides within the retina suggests that neuropeptides play a specific role in retinal function.     

Ultrastructural quantitation of peroxidase- and elastase-containing granules in human neutrophils.

Previous ultrastructural studies of human neutrophils showed two distinctive granule types, the azurophil (peroxidase-positive) and the specific (peroxidase-negative). By identification of granules with peroxidase activity and those immunopositive for elastase antigen, the authors defined two subpopulations of azurophil granules, one that contained peroxidase activity and no measurable elastase antigen and another that contained elastase antigen associated with a small amount of peroxidase activity. They quantitated the peroxidase-positive as well as the elastase-positive granules in human peripheral blood neutrophils and found an average of 1536 +/- 69 peroxidase-positive granules per neutrophil. Of these, 399 +/- 20 were also elastase-positive. The average elastase concentration per neutrophil was 1.59 pg, and the average concentration per granule was 4 X 10(-3) pg. It is concluded that in normal individuals approximately one-third of the azurophil granules contain elastase antigen. Because neutrophil elastase has been implicated in the pathogenesis of emphysema, quantitation of its distribution within the cell presents an approach that may help define selective azurophil granule release and its relationship to the development of emphysema.     

Immunohistochemical evidence for the presence of somatostatin,a powerful inhibitory peptide,in some primary sensory neurons

With the indirect immunofluorescence technique somatostatin or somatostatin-like immunoreactivity was found in some neuronal cell bodies in spinal ganglia, in fibers in the substantia gelatinosa of the spinal cord and in nerves in the gut. These findings suggest that a certain population of primary sensory neurons contain somatostatin (or a somatostatin-like peptide), a peptide known to exert an inhibitory action both in the central nervous system and in some endocrine systems.     

Accentuated vascular and endocrine response to SQ 20881 in hypertension.

We assessed vascular and hormonal responses to inhibition of peptidyldipeptide hydrolase, which converts angiotensin I to angiotensin II (converting enzyme) and degrades bradykinin (kininase II), in subjects given 10 meq of sodium to activate both systems. In nine normal subjects a threshold dose of 30 MICROgram per kilogram of the inhibitor, SQ 20881, modestly influenced mean blood pressure (-5 +/- 1 mm Hg, P less than 0.05), and renal blood flow (+50+/-8 ml per 100 g per minute), plasma renin activity (+ 2.3 +/- 0.6 ng per milliliter per hour), and angiotensin II (-11 +/- 3 pg per milliliter) more strikingly (P less than 0.01). In six patients with essential hypertension the threshold inhibitor dose was reduced to 10 microgram per kilogram; 30 kilogram per kilogram had an enhanced (P less than 0.01) effect on mean blood pressure (-11 +/- 2 mm Hg), renal blood flow (137 +/- 20 ml per 100 g per minute), and angiotensin II concentration (-29 +/- 12 pg per milliliter). SQ 20881 elevated plasma bradykinin concentration (7.4 +/- 2.6 ng per milliliter, P less than 0.02) only in the hypertensive patients. Because both renin-angiotensin and kallikrein-bradykinin systems are influenced, vascular responses to SQ 20881 must be interpreted cautiously, but this agent has excellent antihypertensive characteristics.     

Electron Microscopic and Immunoelectron Microscopic Demonstration of Pancreatic Polypeptide Cells in Glucagonoma: Colocalization of Pancreatic Peptide and Glucagon in Single Secretory Granules

We describe a case of pancreatic tumor in a 65-year-old woman with typical glucagonoma syndrome. Plasma glucagon (GL) and pancreatic polypeptide (PP) were markedly elevated up to 1404 and 1 200 pg/ml, respectively. Histologic examination of the metastatic tumors in liver and lymph nodes showed endocrine-type tumors composed of GL-positive cells some of which coexpressed PP immunoreactivity. Electron microscopy revealed the tumor cells with single-type secretory granules similar to normal A cell granules. Double immunogold staining demonstrated both GL and PP immuno-reactivities in the same secretory granules. Biologic and diagnostic significance of coexpression of PP and GL in a single secretory granules of pancreatic endocrine tumors is discussed briefly.     

Immunoreactive somatostatin in Warthin''s tumor.

The presence of somatostatin (SRIF) in the neoplastic epithelial cells of certain Warthin's tumors arising in the human parotid gland was found immunohistochemically, whereas the other parotid gland tumors, such as pleomorphic adenoma, oxyphilic adenoma, mucoepidermoid tumor, adenocarcinoma, and adenoid cystic carcinoma, did not show positive immunoreactivity for SRIF. The SRIF-positive Warthin's tumor had dense core granules immunoreactive with anti-SRIF serum. Moreover, a comparatively high concentration of immunoreactive SRIF was detected by radioimmunoassay in an SRIF-positive Warthin's tumor, although the other tumors also contained low levels of immunoreactive SRIF.     

Mechanism of feminization in primary liver cancer.

Primary liver cancer occasionally presents with feminization. The mechanism is unknown. We studied a young man with primary liver cancer associated with feminization that disappeared after removal of the tumor. Before operation, the serum estrone level was markedly (1113 pg per milliliter) and estradiol and estriol levels were slightly elevated. Human placental lactogen was also increased (0.52 microng per milliliter). Luteinizing hormone, follicle-stimulating hormone and prolactin levels were normal, and testosterone reduced. Beta subunits of human chorionic gonadotropin were not detected in the serum. In vitro assay of tumor tissue showed estrogenic activity and high levels of these subunits. With a reversed isotope dilution technic with crystallization to constant specific activity, we showed the tumor tissue to convert dehydroepiandrosterone sulfate and dehydroepiandrosterone to estrone and estradiol. Production of beta subunits of chorionic gonadotropin and raised serum levels of placental lactogen provided further evidence that the tumor was functioning as trophoblastic tissue.     

Immunohistochemical evidence for separate populations of somatostatin-containing and substance P-containing primary afferent neurons in the rat

The localization of two small peptides, somatostatin and substance P, has been studied with the indirect immunofluorescence technique. Both peptides were present in small neuronal cell bodies in spinal ganglia, in fibers in the dorsal horn of the spinal cord and in fibers in the intestinal wall. By comparing consecutive sections incubated with antisera to somastostatin and to substance P respectively, it was established that somatostatin, or somatostatin-like immunoreactivity and substance P, or substance P-like immunoreactivity are present in different cells. This is possibly indicated also by a somewhat differential distribution of the immunoreactive fibers in the dorsal horn: the highest concentration of somatostatin-positive fibers was observed in lamina II, whereas abundant substance P-positive fibers were present also in lamina I. Furthermore, numerous substance P-, but no somatostatin-positive fibers, were found around the central canal and in the ventral horns. In the intestinal wall more substance P-positive than somatostatin-positive fibers were seen.The present results indicate that two subpopulations of primary sensory neurons exist, one containing somatostatin, or somatostatin-like immunoreactivity, and the other containing substance P, or substance P-like immunoreactivity.     

Ultrastructural immunocytochemical studies of the localization and distribution of somatostatin, calcitonin, calcitonin gene-related peptide, and substance P in the bat thyroid follicle

Electron microscope immunocytochemistry was used to determine the intracellular localization and distribution among follicular elements of four peptides: calcitonin, somatostatin, calcitonin gene-related peptide (CGRP), and substance P in the thyroid glands of bats captured in the prehibernation phase of their annual life cycle. Previous studies have shown that this period of the hibernation-activity cycle is characterized by the accumulation and storage of secretory granules in parafollicular cells. Sites of binding of primary antisera to each of the four peptides were identified by means of affinity-purified secondary antisera directly coupled to colloidal gold particles. Calcitonin and somatostatin immunoreactivities were found in all parafollicular cells examined and in every secretory granule within these cells. CGRP was also found in all parafollicular cells examined (n = 75) but only in about half of their secretory granules. In contrast to these peptides, substance P immunoreactivity was not found in any parafollicular cells, but was localized exclusively in nerve endings within the basement membrane of the follicle.     

Pulsatile secretion of human chorionic gonadotropin in normal adults

We used very sensitive and specific monoclonal-antibody sandwich assays for human chorionic gonadotropin (hCG) and human luteinizing hormone (hLH) to measure both hormones in serum samples from normal men and women. When single serum samples from 92 men were studied, 73 percent had detectable hCG. In normal men, the amount of detectable hCG averaged 8.9 pg per milliliter, with a range of less than 3.0 to 160 pg per milliliter (biologic potency = 13,450 IU per milligram). In postmenopausal women the hCG level averaged 111 pg per milliliter and ranged from 32 to 510. In women of reproductive age the hCG level varied with the menstrual cycle. Gonadotropin-releasing hormone administered to 10 normal men increased both hCG and hLH. When daily serum samples were studied throughout a normal menstrual cycle, hCG concentrations paralleled those of hLH; follicular-phase concentrations were higher than those of the luteal phase, and there was a midcycle ovulatory peak of hCG coincident with the hLH peak. When hCG was measured every 10 minutes for six hours in eight postmenopausal women, distinct pulses were detected in parallel with those of hLH: hLH pulsed at a mean (+/- SEM) frequency of 0.56 +/- 0.08 pulses per hour; hCG pulsed at 0.54 +/- 0.07 pulses per hour. The mean pulse durations were 89 +/- 22 and 56 +/- 20 minutes for hLH and hCG, respectively. We conclude that hCG is produced in a pulsatile fashion, probably by the pituitary, in all normal adults.     

Prostatic carcinoma with endocrine features. A report of a neoplasm containing multiple immunoreactive hormonal substances

A case of prostatic carcinoma with the cellular patterns of an adenocarcinoma and carcinoid tumor is reported. The tumor contained ultrastructural dense core neuroendocrine granules, and immunoperoxidase staining revealed prostatic acid phosphatase, prostatic-specific antigen, chromogranin, neuron-specific enolase, serotonin, adrenocorticotrophic hormone (ACTH), somatostatin, parathormone, calcitonin, bombesin, and glucagon but no insulin. The patient had exhibited hypercalcemia that may have been related to hormone production by the tumor. The literature on the endocrine aspect of the prostate and its tumor is reviewed.     

Idiopathic hyperaldosteronism. A possible role for aldosterone-stimulating factor

To test the hypothesis that idiopathic hyperaldosteronism is secondary to increased adrenal stimulation by aldosterone-stimulating factor, we measured the latter in seven patients with idiopathic hyperaldosteronism and in four patients who had undergone surgical removal of an aldosterone-producing adenoma. In the patients with hyperaldosteronism, plasma aldosterone concentrations (mean +/- 1 S.E.) were 38 +/- 10 and 78 +/- 19 ng per deciliter in the supine and upright position, respectively (P less than 0.01). Supine plasma aldosterone-stimulating factor was 81 +/- 5 ng per deciliter in 15 normal subjects and 185 +/- 10 (P less than 0.01) in the patients with idiopathic hyperaldosteronism. After removal of an aldosterone-producing adenoma, plasma aldosterone-stimulating factor was normal. The supine value in each patient with idiopathic hyperaldosteronism was above the normal range (61 to 91 ng per deciliter) and increased to 290 +/- 59 ng per deciliter after four hours of upright posture. Twenty-four hour urinary excretion of aldosterone-stimulating factor was 424 +/- 35 ng (normal, 145 +/- 3; P less than 0.01) by affinity chromatography and high-pressure liquid chromatography, and it was not suppressed after two days of treatment with dexamethasone (0.5 mg orally every six hours). At the end of 48 hours, plasma concentrations were 248 +/- 40 ng per deciliter. Plasma cortisol and ACTH concentrations were under 2 micrograms per deciliter and under 40 pg per milliliter, respectively. We conclude that increased secretion of aldosterone-stimulating factor may be the cause of idiopathic hyperaldosteronism.     

Elevated plasma 1,25-dihydroxyvitamin D concentrations in infants with hypercalcemia and an elfin facies

We measured plasma concentrations of 1,25-dihydroxyvitamin D (1,25-(OH)2D) in the course of a 6-to-37-month survey of four children with hypercalcemia and an elfin facies (Williams syndrome). Levels of 1,25-(OH)2D were elevated (160 to 470 pg per milliliter) during the hypercalcemic phase of the disease, when the children were five to nine months old, and they decreased thereafter. Plasma 1,25 (OH)2D levels were higher than those found in three children (16 to 60 months old) with the elfin facies syndrome and no hypercalcemia (42 to 71 pg per milliliter) and eight children (1 to 36 months old) with hypercalcemia and no dysmorphy (12 to 140 pg per milliliter), including two children with vitamin D intoxication. Hypercalcemia in the three children with elfin facies was controlled by a low-calcium diet. Serum calcium levels fell to the normal range, and plasma 1,25-(OH)2D levels were normal for age (18 to 105 pg per milliliter) at 14 to 47 months of age, even after appropriate therapy had been discontinued. These observations suggest that hypercalcemia may be the consequence of abnormal synthesis or degradation of 1,25-(OH)2D in children with the elfin facies syndrome.     

Leydig-cell agenesis: a cause of male pseudohermaphroditism.

We studied a 35-year-old patient with female external genitalia, primary amenorrhea and XY karytotype. Plasma testosterone was 10 ng per deciliter, which did not change after administration of human chorionic gonadotropin, increased to 22 ng per deciliter after ACTH, and decreased to 0.9 ng per deciliter after dexamethasone. Plasma delta 4-androstenedione, dehydroepiandrosterone and 17-hydroxyprogesterone were in the normal range. Plasma luteinizing hormone was high, but follicle-stimulating hormone normal (7.5 mlU per milliliter). There were two testes with epididymis and vas deferens, but no Mullerian structures. Microscopical examination showed hyalinization of tubules, which were lined by normal Sertoli cells and occasional immature germ cells. No Leydig cells were seen. After castration follicle-stimulating hormone increased to 43 mlU per milliliter. We conclude that this case of male pseudohermaphroditism was probably due to a Leydig-cell agenesis, that the epididymis and vas deferens can be developed in such a condition and the follicle-stimulating hormone secretion is regulated, at least in part, by a non-androgen substance secreted by Sertoli cells.