Detection of Autoantibody against 97-kD Antigen by Immunoblot,but not by Indirect Immunofluorescence,in a Patient with Linear IgA Bullous Dermatosis

A case of linear IgA bullous dermatosis in an 85-year-old man is reported. Direct immunofluorescence (IF) of the lesional skin showed linear deposition of IgA and weak deposition of IgG at the basement membrane zone. Although no circulating autoantibody was detected by indirect IF, immunoblotting analysis using NaCl-separated normal human epidermal extracts revealed a circulating IgA antibody which bound to the 97-kD antigen.     

Valsartan cardio-renal protection in patients undergoing coronary angiography complicated with chronic renal insufficiency (VAL-CARP) trial: rationale and design.

BACKGROUND: Despite an increase in the frequency of coronary angiography (CAG) in Japan, the exact incidence of contrast-induced nephropathy (CIN) remains unknown in the Japanese population, especially in patients with chronic renal insufficiency. In addition, the nature of pharmacological interventions that would benefit the patients before or after procedures such as coronary bypass graft (CABG) and percutaneous coronary intervention (PCI) has not been fully investigated. METHODS: In the trial 500 patients with renal insufficiency (defined as a glomerular filtration rate (GFR) of between 89 and 30 ml . min(-1) . (1.73 m(-2)) following CAG will be randomly assigned to receive either valsartan, an angiotensin receptor blocker or angiotensin converting enzyme (ACE) inhibitor plus valsartan.1 The primary end-point is a change in the GFR of patients, which will be followed up for 3 years, including following CABG surgery or PCI. The incidence of cardiac events as well as the adverse effects of pharmacological intervention will be evaluated. In addition, the incidence of renal artery stenosis at the time of CAG will be reported also; however, the patients with renal artery stenosis will be excluded from the present study. CONCLUSION: The present study will provide data on: 1) the exact incidence and course of renal function of CIN after CAG; and 2) the comparative therapeutic benefit of pharmacological intervention with valsartan alone or with valsartan and an ACE inhibitor in combination in patients with coexisting coronary artery diseases and chronic renal insufficiency, regardless of whether they receive CABG or PCI. In addition to these studies, an estimate of the incidence of renal artery stenosis in these patients will be demonstrated.     

Modulation of Membrane Permeability, Cell Proliferation and Cytotoxicity of Antitumor Agents by External ATP in Mouse Tumor Cells

External ATP causes a remarkable change in the passive permeability of the plasma membrane in several types of transformed cells. When mouse melanoma cells, Clone-M3, were exposed to ATP in Tris-buffered saline, a great increase in the passive permeability was induced within several minutes. Longer exposure of Clone-M3 cells to external ATP led to a decrease in cell viability. Similar results were obtained with Ehrlich ascites cells, but none of these ATP effects were noted in untransformed cells such as NIH 3T3 cells or BALB/c mouse embryonic fibroblasts. The in vitro cytotoxic effects of antitumor agents (5-fluorouracil, adriamycin, mitomicin C and nimustine hydrochloride) against Clone-M3 cells were additively potentiated by treatment with external ATP, which also synergistically enhanced the cytotoxicity of vincristine. However, the effects of these drugs on mouse embryonic fibroblasts were not modulated by ATP. These results suggest that ATP-treatment is a useful means of enhancing a selective toxicity for tumor cells.     

The Sign of Leser-Trélat Associated with Carcinoma of the Stomach

The sign of Leser-Trélat, which refers to the sudden appearance and rapid increase in size and number of seborrheic keratosis associated with a visceral malignant tumor, is very uncommon. This case concerns a 54-yr-old woman presenting with Leser-Trélat's sign associated with advanced gastric cancer. Seborrheic keratosis faded after resection of the tumor, but returned when the cancer recurred. At that time, 24-h urinary excretion of epidermal growth factor determined by radioreceptor assay was slightly elevated. Epidermal growth factor may play a part in the development of Leser-Trélat's sign.     

Human Monoclonal Antibodies against Cytokeratin 18 Generated from Patients with Gastric Cancer

By co-culturing regional lymph node B-cells and HAT-sensitive mutant cells obtained from RPMI-1788 cells, no less than 20,000 Epstein-Barr (EB)-transformed colonies were obtained from 32 patients with gastric cancer. From B-cell cultures generating antibodies reactive with gastric cancer tissues as well as cultured gastric cancer cells, two EB-transformed cell clones termed C418–59 and C1218–39 were isolated. Both of them produced human IgM-class antibodies, termed Mab418–59 and Mab 1218–39, respectively. Both antibodies reacted with an antigen with a molecular weight of 45 kd existing in gastric cancer MKN-45, MKN-1, and Kato-III cells, and also with all of 4 adenocarcinomas of the stomach in paraffin sections. The antigen recognized by both antibodies was identified as a kind of cytoskeletal protein, cytokeratin 18, In this study, it was confirmed that B-cell clones generating autoantibodies against cytokeratin 18 were present in some patients with gastric cancer.     

A New, Potent 2-Nitroimidazole Nucleoside Hypoxic Cell Radiosensitizer, RP170

The radiosensitizing activity, acute toxicity and pharmacokinetics of RP170, a new hypoxic cell radiosensitizer, were compared with those of misonidazole (MISO) and SR2S08. RP170 belongs to the group of 2-nitroimidazole nucleosides, which are designed to be selectively excluded from the neural tissue. The reduction potential of RP170 was similar to that of MISO and SR2508. The partition coefficients in octanol/water of RP170, MISO, and SR2508 were 0.094, 0,35, and 0.021, respectively. The radiosensitizing activity of RP170 was similar to that of MISO and SR2508 in vitro and in vivo. There was no significant difference in the radiosensitizing activity of RP170 in vivo between intravenous and intraperitoneal administration. The acute toxicity of RP170 was the same as that of SR2508. Pharmacokinetic evaluation showed that the concentration of RP170 in the brain was as low as that of SR2508. RP170 is expected to have the same radiosensitizing effects as MISO and SR2S08, and to be less neurotoxic than MISO.     

Effect of Nonenzymatic Glycosylation on the Titers of Circulating Autoantibodies in Pemphigus and Pemphigoid

Hyperglycemia is observed in some patients with autoimmune bullous diseases complicated by diabetes mellitus or treated with systemic corticosteroids. High concentrations of glucose can react with various proteins and change their structural and functional properties. We previously reported that nonenzymatic glycosylation of antibody can impair antigen-antibody binding. We ascertained whether glycosylation of autoantibody decreases the autoantibody titer by examining 30 sera from patients with pemphigus and pemphigoid. Nonenzymatic glycosylation in the physiological range was induced by incubation of sera with 1650 mM D-glucose at 4°C for 7 days. The titers of sera were determined by indirect immunofluorescence (IIF). In all cases, the immunofluorescence intensity of glycosylated sera was weaker than that of nonglycosylated sera. Glycosylated sera showed a lower antibody titer by 1 doubling dilution in 18 out of 30 cases, compared with nonglycosylated sera. The ten BP patients' sera were also analyzed by immunoblotting for reactivity with the BP180-GST fusion proteins, SΔ1 and 4575. All BP sera reacted with SΔ1, and 5 out of 10 BP sera reacted with both SΔ1 and 4575. In all the sera that reacted only with SΔ1, the glycosylated sera showed a 1 doubling dilution decrease in autoantibody titer. Interestingly, in 4 out of 5 sera that reacted with both SΔ1 and 4575, there were no differences in the antibody titer between glycosylated and nonglycosylated sera. These results indicate the possibility of a false decrease in autoantibody titers of sera from patients with autoimmune bullous diseases complicated with hyperglycemia. Although the false decrease in titers of autoantibodies induced by nonenzymatic glycosylation is not dramatic, it must be considered in order not to underestimate the disease activity of pemphigus in such cases.     

Distribution of mRNA for CCK-B receptor in the brain of Mastomys natalensis: abundant expression in telencephalic neurons

The distribution of chelecystokinin B (CCK-B) receptors in the Mastomys brain was studied using Northern blot analysis and in situ hybridization technique. By Northern blot analysis using³²P-labeled cDNA probe, the cortex had the highest hybridization signal of CCK-B receptor mRNA in the brain. The olfactory bulb and hippocampus showed a moderate level of signals. In situ hybridization using³⁵S-labeled cRNA probes revealed a wide and region-specific distribution of CCK-B receptor mRNA in the telencephalon. Throughout the cerebral cortex, labeled cells were found in all layers, with higher intensities in layers II, V and VI. Pyramidal cells of the layer II of the piriform cortex showed the highest level of signals in the brain. In the hippocampus, most of the pyramidal cells of the Ammon's horn were labeled, although labeled cells were not detected in other layers. Distinct signals were also detected in the various amygdaloid nuclei, caudate-putamen, reticular thalamic nucleus, hypothalamic ventromedial nucleus and inferior colliculus. This distribution pattern may further support the prominent existence of CCK-B receptors in the brain particularly in the telencephalon.