Lamina propria plasma cells in inflammatory bowel disease: intracellular detection of immunoglobulins using flow cytometry

This is the first application of flow cytometry for the detection of lamina propria plasma cells and their intracellular immunoglobulins in patients with inflammatory bowel disease compared to healthy controls. The study has been focused on the distribution of IgA, IgG, IgM and the four IgG subclasses. Plasma cells were detected as high CD38 positive cells. For fixation and permeabilisation a single step reagent, Ortho Permeafix®, was used.

By flow cytometry, in patients with inflammatory bowel disease compared to healthy controls, a higher percentage of IgG⁺ cells can be observed, in Crohn's disease also a higher percentage of IgM⁺ cells. Regarding the IgG subclass distribution, patients with Crohn's disease show an increase in IgG2⁺ cells, patients with ulcerative colitis an increase in IgG1⁺ and IgG3⁺ cells. These results do agree with and expand the results of earlier immunohistochemical and functional studies, which are favoured today. For the determination of lymphocyte subset proportions and the detection of intracellular antigens, flow cytometry provides a useful alternative to well-established immunohistochemical methods. By analysing a larger number of cells, this method is more reproducible and less prone to interobserver variations than immunohistochemistry, which needs the pre-selection of a mucosal area, the microscopic scoring of a limited number of cells and the circumvention of high background staining. The optimized flow cytometric protocol used in this study might be a promising tool for further investigations of various purposes.     

Diabetes insipidus renalis

Ohne Zusammenfassung     

Indolent systemic mastocytosis with elevated serum tryptase, absence of skin lesions, and recurrent severe anaphylactoid episodes

BACKGROUND: In contrast to aggressive mastocytosis, patients with indolent systemic mastocytosis (ISM) usually present with urticaria pigmentosa-like skin lesions. In those who lack skin lesions, mastocytosis is often overlooked or confused with endocrinologic, allergic, or other internal disorders. CASE REPORT AND RESULTS: We report on a 33-year-old male patient in whom severe hypotensive episodes occurred after contact with ants or yellow jackets. Since no specific IgE was detected, the serum tryptase concentration was measured and found to be clearly elevated (70 ng/ml). Consecutive staging and examination of the bone marrow revealed ISM. The patient was advised to circumvent insect contact, to take antihistamines on demand, and to carry an epinephrine self-injector for emergency events. In a retrospective analysis of 40 patients seen between 1988 and 2003, only 2 had a life-threatening mediator-related episode before ISM was diagnosed. CONCLUSIONS: Our report confirms the diagnostic value of tryptase in patients with suspected mastocytosis. In addition, the report suggests that the lack of typical skin lesions does not exclude an indolent form of mastocytosis even if the serum tryptase is clearly elevated. Finally, our case further shows that mastocytosis can be an important differential diagnosis to be considered in patients with unexplained anaphylactoid or other mediator-related symptoms.     

Basic renal physiology for molecular biologists

Journal of Molecular Medicine -     

Temperature rising elution fractionation of a random ethene/styrene copolymer

A random ethene/styrene copolymer containing 13.8 mol-% styrene was prepared with the Ziegler-Natta catalyst system Me₂Si(Me₄Cp)(N-t-butyl)TiCl₂/methylaluminoxane and characterized by means of preparative temperature rising elution fractionation (TREF) combined with size exclusion chromatography, NMR, differential scanning calorimetry and wide-angle X-ray scattering analyses of the copolymer fractions. Efforts are made to describe the distribution of the styrene content of the copolymers using the Stockmayer-Tacx distribution function. Both, comonomer distribution and molar mass distribution strongly support the presence of a single type of catalytically active center.     

The anti-apoptotic factor Bcl-2 can functionally substitute for the B cell survival but not for the marginal zone B cell differentiation activity of BAFF

The TNF family ligand B cell-activating factor (BAFF, BLyS, TALL-1) is an essential factor for B cell development. BAFF binds to three receptors, BAFF-R, transmembrane activator and CAML interactor (TACI), and B cell maturation antigen (BCMA), but only BAFF-R is required for successful survival and maturation of splenic B cells. To test whether the effect of BAFF is due to the up-regulation of anti-apoptotic factors, TACI-Ig-transgenic mice, in which BAFF function is inhibited, were crossed with transgenic mice expressing FLICE-inhibitory protein (FLIP) or Bcl-2 in the B cell compartment. FLIP expression did not rescue B cells, while enforced Bcl-2 expression restored peripheral B cells and the ability to mount T-dependent antibody responses. However, many B cells retained immaturity markers and failed to express normal amounts of CD21. Marginal zone B cells were not restored and the T-independent IgG3, but not IgM, response was impaired in the TACI-IgxBcl-2 mice. These results suggest that BAFF is required not only to inhibit apoptosis of maturating B cells, but also to promote differentiation events, in particular those leading to the generation of marginal zone B cells.     

Architectonic parcellation of the temporal operculum in rhesus monkey and its projection pattern

Summary Cyto- and myeloarchitectonic investigation of the temporal operculum and the exposed superior temporal gyrus was combined with a connection study of the projection fibers of the pertinent areas in the rhesus monkey.A belt-like organization of the auditory region with a koniocortex core (corresponding to AI) surrounded by belt areas was revealed. This organization principally resembled that of the auditory region of the cat (Rose and Woolsey, 1949; Woolsey, 1961) and that of other sensory regions (Sanides, 1972; Sanides and Krishnamurti, 1967). The belt is composed of one prokoniocortex area (proA, corresponding to AII) in parinsular location and of a caudal (paAc), lateral (paAlt) and rostral (paAr) parakoniocortex area. The latter has a particular character. It was found to be the target of thalamic projections of the caudalmost portion of GMpc. In contrast to the other parakonio areas it does not receive associations of the koniocortex.The belt areas, including the prokoniocortex, are ipsilaterally and transcallosally interconnected as in the somatic sensory (Jones and Powell, 1969a, b; Pandya and Kuypers, 1969; Pandya and Vignolo, 1969) and visual regions (Myers, 1962; Kuypers et al., 1965; Karol and Pandya, 1971).The koniocortex core is formed by two areas, Kam and Kalt, corresponding to the architectonic organization hitherto only known in man. The medial area (Kam) has a large number of homotopical callosal projections except at its medial border (to proA). The lateral area receives less callosal fibers, particularly most of its lateral portion is devoid of terminations. Since the belt areas are rich in callosal projections the supratemporal plane shows a pattern of three stripes of callosal terminations with two intermittent stripes void of terminations.While the projections of the koniocortex into the belt areas terminate prevalently in layer IV, the parakoniocortex sends fibers only into layers I and II of the koniocortex. This corresponds to results in somatic sensory (Pandya and McKenna, unpublished observations) and visual regions (Kuypers et al., 1965; Sanides and Vitzthum, 1965b; Spatz, personal communication).In contrast to other sensory regions the auditory koniocortex receives its exceptionally dense, homotopic callosal connections in the whole outer stratum with emphasis on layer III, as opposed to layer IV in the somatic sensory region.     

Cerebral dynamics of N-isopropyl-(123I)p-iodoamphetamine

Temporal changes in the distribution of N-isopropyl-(123I)p-iodoamphetamine (IMP) within the brain are measured with serial tomographic imaging. In the cerebellum there is a decrease in activity of 42% from the early [15-45 min postinjection (p.i.)] to the late (210-240 min p.i.) scan, while in the cortex the decrease is 18%, and in the basal ganglia there is no decrease within this time. In brain tumors there was no IMP uptake in the early as well as in the late scans, regardless of tumor type, perfusion rate, or blood-brain barrier dysfunction. In 11 of 43 patients with a cerebral infarction a real increase of 123I activity (mean +21%) was seen in the late images. This "filling in" phenomena might be useful in selecting patients for bypass surgery. In these patients the diaschisis cerebelli, seen in the early scans, disappeared in the late images. The regional distribution of IMP changes with time; spatial ratios might be blurred by temporal changes. High-flow areas such as visio-auditory centers can be delineated clearly after stimulation in fast early scans; in these areas the pharmacokinetics of 123I are different from other cortex regions. To get the full information from the IMP brain uptake, both spatial and temporal variation must be measured.     

Significance of preoperative prognosis

The granulocyte phagocytosis test, Karnofsky index, and ASA standard were used in the context of 287 patients for general surgery, for the purpose of retrospective elucidation of the relationship between presurgical prognostication and postsurgical complications. Sensitivity, specificity, and "predictive values" were calculated. The highest information potential in terms of prognostication was recorded from objectively measurable granulocyte phagocytosis. Presurgical prognostication was found to be of clinical relevance only to surgical problem patients.