Reduction of soluble adhesion molecules (sICAM-1, sVCAM-1, and sE-selectin) and vascular endothelial growth factor levels in serum of rheumatoid arthritis patients following multiple intravenous infusions of infliximab

INTRODUCTION: The purpose of this study was to determine the effect of repeated infusions of infliximab, a chimeric anti-tumor necrosis factor (anti-TNF)-alpha antibody, on the levels of soluble adhesion molecules and vascular endothelial growth factor (VEGF) in patients with active rheumatoid arthritis (RA). MATERIALS AND METHODS: The treatment design consisted of 9 infusions of infliximab (3 mg/kg) at weeks 0, 2, 6, and every 8 weeks thereafter. All patients had been receiving methotrexate (MTX; 7.5-20 mg/week). Serum levels of soluble intercellular adhesion molecule (sICAM)-1, vascular cell adhesion molecule (sVCAM)-1, E-selectin (sE-selectin), and VEGF were measured by ELISA at weeks 0, 2, 6, 14, and 38 prior to infusion, and at week 62. RESULTS: A remarkable decrease in serum sICAM-1 (p<0.001), sVCAM-1 (p<0.01), sE-selectin (p<0.01) and VEGF (p<0.001) levels was observed in RA patients after the initial dose of infliximab. The second administration of the drug was followed by an even more significant suppression of serum sICAM-1, sVCAM-1, sE-selectin, and VEGF (p<0.001 in all cases). Further infliximab infusions also significantly reduced serum soluble adhesion molecules and VEGF concentrations, although these were less effective. Infliximab treatment induced a significant decrease in the number of monocytes observed until the end of the study. CONCLUSIONS: Our study, besides a rapid suppression of disease activity, showed that serum soluble adhesion molecules and VEGF concentrations are down-regulated following anti-TNF-alpha antibody therapy combined with MTX. Repeated doses of infliximab sustained the reductions in the soluble adhesion molecules and VEGF concentrations, although they were less effective than the first and second infusions of infliximab.     

The cause of infection as the main or additional cause of death in patients treated for small cell lung cancer

In 116 out of 845 patients treated for small cell lung cancer (SCLC) in the Institute of Tuberculosis and Chest Disease in Warsaw in the years 1980-1994 infection was the main or coexistent cause of death. In 4.1% infection was proved of bacterial origin and in further 6.5% of probable bacterial origin (in the later group cultures were negative or not done but fungal infection, pneumocystosis pneumonia and tuberculosis were excluded on autopsy). In 1.54% infection was of fungal origin, 1.2% patients died of Pneumocystis carinii pneumonia and 0.35% of tuberculosis. The majority of patients who died with and/or from infection had treatment-related leukopenia and 99 of them were treated with corticosteroids. Fungal infection, pneumocytosis and tuberculosis were found more frequently than bacterial infection in patients treated with cumulative dose of prednisone above 2000 mg. 33.62% patients had no symptoms or signs of infection. No connection was found between the absence of symptoms and treatment with steroids or the grade of leukopenia. In all cases infection was recognised very late, in 58 only at autopsy.     

Time course of changes in EMG activity of fast muscles after partial denervation

After partial denervation, the remaining motor units (MUs) of adult fast extensor digitorum longus muscle (EDL) expand their peripheral field. The time course of this event was studied using tension measurement and recordings of electromyographic (EMG) activity. The results show that after section of the L4 spinal nerve, when only 5.3 ± 0.63 of the 40 MUs normally supplying EDL muscle remain, the force of individual motor units starts to increase between the 1st and 2nd week after the operation and continues to do so for a further week. The drastic reduction of the number of motoneurones supplying the fast EDL leads to an increase in activity of the remaining MUs. In the 1st week after partial denervation, there was a sharp increase in the EMG activity of remaining motor units. During the next 12 days, this increase became less marked, but EMG activity remained nevertheless significantly higher than that of the unoperated EDL muscle. Many MUs became tonically active during posture. The EMG activity pattern during locomotion was also altered, so that the burst duration was positively correlated with the step cycle duration. Moreover, shortly after partial denervation, the interlimb coordination was disturbed but returned to its original symmetrical use 1–2 weeks later. Received: 17 September 1996 / Accepted: 3 November 1997     

Solitary splenic metastases from lung cancer--one-time surgical procedure

Splenic metastasis from lung cancer is a rare clinical event, most often diagnosed at the time of an autopsy. We report a case of a 68 year old man with splenic metastasis from the primary lung cancer. Staging procedures before the resection of the primary lung tumor detected the splenic lesion. Upper left lobectomy and splenectomy were done by the left postero-lateral thoracotomy with phrenotomy. The rarity of solitary spleen metastasis from lung cancer and the treatment are discussed.     

Visualisation of the extent of damage in a rat spinal cord injury model using MR microsopy of the water diffusion tensor

Magnetic Resonance Diffusion Tensor Imaging (DTI) of the control and traumatic injured spinal cord of a rat in vitro is reported. Experiments were performed on excised spinal cords from 10 Wistar rats, using a home-built 6.4 T MR microscope. MRI and histopathological results were compared. Presented results show that DTI of the spinal cord, perfused with formalin 10 minutes after the injury, can detect changes in water diffusion in white matter (WM) and in gray matter (GM), in areas extending well beyond the region of direct impact. Histology of neurons of the GM shows changes that can be attributed to ischemia. This is in agreement with the observed decrease of diffusion in the injured regions, which may be attributed to the cytotoxic edema due to ischemia. However, the diffusion changes in highly anisotropic WM seem to be caused by a direct action of mechanical force of impact, which significantly distorts the nerve fibers.     

Infestation of sand lizards (<Emphasis Type="Italic">Lacerta agilis</Emphasis>) resident in the Northeastern Poland by <Emphasis Type="Italic">Ixodes ricinus</Emphasis> (L.) ticks and their infection with <Emphasis Type="Italic">Borrelia burgdorferi</Emphasis> sensu lato

Sand lizards (Lacerta agilis) were trapped and examined for ticks from May to September in 2002 and 2003 in Northeastern Poland. A total of 233 Ixodes ricinus (L.) ticks (76 larvae and 157 nymphs) was found on 31 of 235 captured lizards (13.2%). The tick infestation is relatively low compared to that of mammals and passerine birds from the same area (Siński et al. 2006, Gryczyńska et al. 2002). Tick infestation depended on the month of capture, being the highest in spring. In autumn no ticks were recorded on any of the captured lizards. The oldest lizards carried the highest number of ticks but no differences related to sex of the host were found. All the collected ticks were analysed by PCR for the presence of Borrelia burgdorferi sensu lato, the etiological agents of Lyme disease. Spirochetes were detected in 11 out of 233 (4.7%) ticks tested. Genetic analysis confirmed that the spirochetes are members of the Borrelia afzelii, B. garinii and B. burgdorferi sensu stricto genospecies. Mixed infection were not detected. The prevalence of infection was analysed in relation to months of the capture, age and sex of the lizards, but differences were not statistically significant. The obtained results suggest that lizards are probably not B. burgdorferi reservoirs, but further studies are required to confirm this.     

Changes in glycosylation of rat liver arylsulfatase B in relation to age

The aim of this study was to determine how glycosylation of the rat liver arylsulfatase B was influenced by the age of the animal. The enzyme was purified from a liver lysosomal fraction obtained from male Wistar rats aged 18 days of gestation, 1 week, and 1, 1.5, 3 and 18 months by an affinity chromatography. Examination of the carbohydrate structures was performed after electrophoresis and blotting, followed by a very sensitive detection system with a set of six highly specific digoxygenin-labelled lectins. After densitometric measurement of the intensity of a digoxigenin-labelled lectin binding to arylsulfatase B, it could be stated that, at least, changes in sialylation are related to the growth and development of rats. Sialylation increases while fucosylation slightly decreases with age of the animal.     

Presence of Chlamydia pneumoniae in patients with and without atherosclerosis

Data published over the past decade show that Chlamydia pneumoniae is likely associated with the development of atherosclerosis. The aim of this study was to ascertain whether C. pneumoniae infections occur more frequently in patients with atherosclerosis than in healthy subjects. A total of 517 persons were studied. Serum samples, leukocytes, and tissue samples were assayed for the presence of C. pneumoniae-specific IgG and IgA antibodies and C. pneumoniae DNA. C. pneumoniae DNA was found in renal, iliac, and brachial vessels, but it was not detected in radial arteries. C. pneumoniae DNA was found most often in directional coronary atherectomy tissue specimens (11/41, 26.8%), but it was also found in the leukocytes of 14.9% (28/188) of patients with atherosclerosis and 24.6% (28/114) of patients without atheroma changes in vessels. Specific IgG and IgA antibodies were present in 63.8 and 49.9% of atheroma patients, respectively. The prevalence of C. pneumoniae antibodies differs significantly in patients with and without atherosclerosis (for IgG, p=0.002, and for IgA, p=0.006). The identification of persons with chlamydial infection of atherosclerotic arteries necessitates the examination of vascular tissues obtained during revascularization procedures. Serological investigation alone cannot identify individuals with vascular chlamydial infections. Detection of C. pneumoniae DNA in peripheral blood mononuclear cells does not seem to be the exclusive marker of persistent vascular infection. A more easily accessible parameter that allows prediction of chlamydial vascular infection is required.