To study possible mechanisms responsible for the increased susceptibility to infection of patients with active systemic lupus erythematosus (SLE), a study of the serum heat-labile opsonic capacity (HLOC) in such patients was undertaken. With leukocytes from normal donors, the sera of 12 of 30 patients with active SLE demonstrated decreased HLOC for E. coli 075. The phagocytic activity was partially restored by normal serum, suggesting that decreased HLOC was responsible for the defective phagocytosis. While 8 of 10 patients with active SLE and concomitant infections showed deficient opsonic capacity to E. coli 075, only 4 of 20 such patients without infections showed the defect (P = 0.01). None of 12 patients with inactive disease had deficient opsonic capacity. Similar results were obtained with S. aureus 502A as the test bacterium. In the patients surviving infection, recovery of normal serum opsonic capacity was rapid and usually coincided with an increase of serum complement to normal levels. In three patients with active SLE and infection, the causative microorganisms were isolated and opsonic capacity for these organisms tested with the individual patients' sera. In each case, sera obtained at the onset of the infectious episode had low opsonic capacity when compared with normal sera. Serum C3 proactivator levels were low in 9 of 11 sera with deficient opsonic capacity. However, similar low values were found in other SLE sera with normal HLOC, suggesting that other factors of the opsonic system were also depleted. Addition of the classical complement components C1, C4, C2, C3, and C5 to sera with deficient HLOC failed to restore activity. Addition of pure C3 proactivator also failed to restore activity. However, addition of C3 proactivator together with 50 degrees C-heated normal serum restored activity, indicating that factors active at the early steps of opsonic activation via the alternative pathway of complement were necessary to restore opsonic activity. These findings indicate that in active SLE, a decrease of components of the alternate pathway of complement activation results in an acquired defect of serum HLOC and perhaps other related complement-mediated functions. This defect may be an important factor in the increased susceptibility to infections of patients with active systemic lupus erythematosus.
H E Jasin, J H Orozco, M Ziff
Immunoglobulin synthesis and secretion have been studied in the rabbit lower respiratory tract, both in the normal state and after infection with Diplococcus pneumoniae or Listeria monocytogenes. In vitro synthesis of immunoglobulin and specific antibody was assessed by incorporation of 14C-labeled amino acids into protein. Lower respiratory tract secretions and serum were analyzed for immunoglobulin and antibody against the infecting organism. Normal respiratory tract produced small quantities of immunoglobulin, most of which was IgG. After bacterial infection of the lower respiratory tract, there was a marked increase in local synthesis of immunoglobulin, especially IgG. Specific antibody of IgG class was produced in all lungs infected with listeria by the 11th day, and in lungs infected with pneumococcus by the 8th day. Secretions from all normal and infected lower respiratory tracts contained IgA and IgG. The IgA to IgG ratios in secretions of normal animals, and animals infected with listeria or pneumococcus, were 2.3, 2.5, and 2.6, respectively. Sera of animals infected with L. monocytogenes contained specific antibody of IgG class but lacked IgA antibody, whereas secretions had both IgA and IgG class antibody against listeria. Similarly, sera of animals infected with D. pneumoniae had IgG class antibody but no IgA antibody, whereas only IgA antibody was found in secretions. The evidence that locally synthesized immunoglobulin (especially IgA), including specific antibody, is secreted into the lower respiratory tract lumen is discussed. Further definition of the role of "local" antibacterial antibody in the respiratory tract is of considerable importance.
W L Hand, J R Cantey
There are no data available concerning total coronary blood flow to the whole heart (CBF) in man. "Effective" or "nutrient" coronary blood flow to the whole heart (MBF), supposedly a measure of flow through exchanging channels of the coronary circulation, has been measured but its validity has not been established. Accordingly, CBF and MBF were measured in 9 normal subjects, 26 patients with coronary heart disease (CHD), and 19 with noncoronary, mostly valvular heart disease (NCHD), by coincidence counting 84Rb technique. Two methods were used: single bolus (24 cases) and continuous infusion (30 cases). Various other parameters including myocardial oxygen utilization (MVO2) and lactate extraction ratio were determined. In the normal subjects CBF (386 +/- 77 ml/min) was significantly higher (P < 0.05) than in CHD (288 +/- 124 ml/min) and NCHD (292 +/- 111 ml/min). Likewise the normal MBF (380 +/- 81 ml/min) was significantly higher (P < 0.01) than in CHD (251 +/- 105 ml/min) as well as NCHD (258 +/- 104 ml/min). The myocardial Rb extraction ratio epsilon Rb) was significantly lower in normal subjects (39 +/- 9%) than in CHD (50 +/- 7%) and NCHD (52 +/- 11%) and this supports the view that epsilon Rb is flow-dependent. In both CHD and NCHD there was significant diminution of MVO2 as well as CBF. In CHD this was accompanied by a significant anaerobic trend but in NCHD it was not. It might therefore appear that in CHD, MVO2 is determined by perfusion whereas in NCHD, perfusion is determined by MVO2. In comparing CBF with MBF by paired observation testing, there was no significant difference in the normals (P > 0.3), whereas the differences were significant in CHD (P < 0.01) and NCHD (P < 0.02). This was merely a reflection of a reduced ratio of myocardial to total body epsilon Rb in CHD and NCHD, and available evidence indicates that this may be an expression of depressed transport of Rb+ rather than true shunting.
D Mymin, G P Sharma
To examine the effects of oleic acid and ricinoleic acid on jejunal absorption, steady-state jejunal perfusions were performed in healthy volunteers. Taurocholate, used to solubilize the fatty acids, did not influence absorption. Both fatty acids (concentration, 10 mM) reversed electrolyte and water net movement; that is, they induced fluid secretion; this effect was rapidly reversible. Ricinoleic acid (the active principle of castor oil) was the more potent, producing fluid secretion when perfused at concentrations at which oleic acid was without effect. However, ricinoleic acid was absorbed more slowly than was oleic acid, and hence was associated with higher intraluminal concentrations. Addition of lecithin and monoolein did not diminish the secretory effect of ricinoleic acid; addition of a secretory bile acid (taurodeoxycholate) did not enhance the effect. The response of the jejunal mucosa to a known cathartic provides observations pertinent to the pathophysiology of steatorrheal diseases in man. Dietary fatty acid also has secretory properties with respect to the human intestine; bacterial hydration, to hydroxy fatty acids, is not required to induce fluid secretion.
H V Ammon, P J Thomas, S F Phillips
Patients with lepromatous leprosy are unresponsive to lepromin skin-test material and possess defective lymphocyte function in vitro, including impaired mitogenesis in response to antigens of Mycobacterium leprae. It has been claimed that their macrophages cannot digest M. leprae in vitro; such a defect could explain both lepromin nonreactivity and impaired lymphocyte function on the basis of failure of the afferent limb of the immune response (i.e., defective macrophage "processing" of M. leprae). The present studies indicate that macrophages from patients with lepromatous and tuberculoid leprosy and from normal donors do not differ in their ability to digest heat-killed M. leprae in vitro, or in their ability to sustain the viability of M. leprae in tissue culture; that monocytes, macrophages, and polymorphonuclear leukocytes of leprosy patients and controls possess equivalent microbicidal activity against Listeria monocytogenes, Escherichia coli, Proteus vulgaris, Staphylococcus aureus, and Candida albicans; and that polymorphonuclear leukocytes from patients with lepromatous leprosy iodinate ingested bacteria normally. Whether the basic immune defect leading to the development of lepromatous leprosy resides in the lymphocyte or in the macrophage remains to be determined. However, the present study shows that phagocytic cells from patients with either principal form of leprosy function normally in a variety of sophisticated tests of antimicrobial function.
D J Drutz, M J Cline, L Levy
Studies were carried out to evaluate the changes in content of calcium and magnesium in brain during acute uremia in dogs. Ca content in gray and white matter of brain increased significantly after 3 days of acute uremia and this increment was prevented by thyroparathyroidectomy (TPTX). The administration of parathyroid extract (PTE) to normal dogs and TPTX uremic animals produced a significant rise in brain Ca. These changes were not related to alteration in the concentration of Ca in plasma or cerebrospinal fluid, to changes in calcium-phosphorus product, or to changes in blood pH. Furthermore, the infusion of large amounts of phosphate to vitamin D2-treated animals with suppressed parathyroid gland activity produced marked elevation in calcium-phosphorus product but no significant change in brain Ca. Also, uremia in vitamin D2-treated TPTX dogs failed to increase calcium content in brain despite marked elevation in calcium-phosphorus product. Hemodialysis significantly reduced Ca content of brain but the values were still significantly higher than normal. Mg content increased modestly only in the white matter of uremic dogs with intact parathyroid glands and in normal dogs and TPTX uremic dogs receiving PTE. The results indicate that (a) acute uremia of 3 days is associated with a marked rise of Ca content of brain and modest increment of Mg in certain parts of the brain, and (b) these alterations are not related to uremia, per se, but are dependent on the presence of excess parathyroid hormone. It is suggested that the neurological abnormalities noted in acute uremia may be related in part to the rise in the Ca content of brain.
A I Arieff, S G Massry
Studies were designed to examine whether the thin ascending limb of Henle (tALH) decreases its luminal solute concentration by an active or a passive transport process. In all experiments isolated segments of rabbit tALH were perfused in vitro. When tubules were perfused with solutions identical to the bath, active transport of NaCl was excluded by the following: (a) osmolality of the collected fluid remained unchanged and the same as the bath. (b) net water reabsorption could not be demonstrated, and (c) transtubular potential difference was zero. Isotopic permeability coefficients (x 10(-5) cm s-1) were calculated from the disappearance rate of the respective isotope added to the perfusate. These values indicate that tALH is moderately permeable to [14C]urea (6.97 +/- 1.95) while having a higher permeability to 22Na (25.5 +/- 1.8) and [not readable: see text]Cl (117 +/- 9.1) than any other segment similarly studied. The influx (bath-to-lumen) isotopic permeabilities were not statistically different from the above efflux permeabilities. Osmotic water permeability was immeasurably small. When tALH were perfused with a 600 mosmol/liter solution predominantly of NaCl against a 600 mosmol/liter bath in which 50% of osmolality was NaCl and 50% urea (to simulate in vivo papillary interstitium), the collected fluid osmolality was decreased significantly below that of the bath (300 mosmol/liter/mm of tubule). The decrease in osmolality was due to greater efflux of NaCl as compared to influx of urea. We conclude that active transport of salt by the tALH was not detected by the experimental protocol of the current studies, and that the unique membrane characteristics of tALH allows for generation of osmotic gradients (lumen less concentrated than adjacent surroundings) on purely passive mechanisms when perfused with isosmolal salt solutions in a bath with appropriate salt and urea concentrations. These findings are consistent with the passive counter-current model previously proposed from this laboratory.
M Imai, J P Kokko
To determine the presence of any significant structural abnormalities in the glomerular basement membrane (GBM) of diabetic individuals, GBM from normal and diabetic human kidneys were isolated and analyzed chemically and structurally. The amino acid composition of the normal GBM revealed the presence of significant amounts of hydroxyproline, hydroxylysine, glycine, and carbohydrate suggesting the presence of a collagen-like protein. There was no significant increase in the amount of hydroxylysine, hydroxyproline, or in the hydroxylysine-linked glycoside glucosyl-galactose in the diabetic kidneys. There was, however, a significant decrease in the cystine and sialic acid content of GBM from diabetic kidneys. It was further shown that the alpha-chains isolated from the collagens of normal and diabetic basement membranes had similar amino acid and carbohydrate compositions. The hydroxylysine, hydroxyproline, glycine, and hexose contents were higher by 82, 56, 74, and 94%, respectively in the alpha-chains compared with the intact basement membranes from both the normal and diabetic kidneys. The results indicate that the slight increases in hydroxylysine and hexose content observed occasionally in diabetic GBM preparations are of no statistical significance and cannot be attributed to increases in the activities of enzymes which hydroxylate lysine or glycosylate hydroxylysine, respectively.
N A Kefalides
An isolated deficiency of pituitary gonadotropins was demonstrated in six 46 XY males, 22 to 36 years of age, with and without anosmia. Undetectable or low levels of serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) clearly separated hypogonadotropic from normal adult males. Chronic (8-12 wk) administration of clomiphene citrate caused no increase in serum FSH or LH in gonadotropin-deficient subjects. However, the administration of synthetic luteinizing hormone releasing factor (LRF) resulted in the appearance of serum LH and, to a lesser degree, serum FSH in three subjects tested. While levels of plasma testosterone were significantly lower in gonadotropin-deficient subjects, plasma androstenedione and dehydroepiandrosterone were in a range similar to that of age-matched normal men. Treatment with human chorionic gonadotropin (HCG) increased levels of plasma testosterone to normal adult male values in all gonadotropin-deficient subjects. Cessation of treatment with HCG resulted in the return of plasma testosterone to low, pretreatment levels. That HCG therapy with resultant normal levels of plasma testosterone may somehow stimulate endogenous gonadotropin secretion in gonadotropin-deficient subjects was not evident. The adult male levels of serum FSH and LH after LRF, and plasma testosterone after HCG, confirm pituitary and Leydig cell responsiveness in these subjects.
R L Weinstein, R E Reitz
A radioimmunoassay has been developed for the measurement of 3,5-diiodo-L-tyrosine (DIT) in serum. DIT was coupled to porcine thyroglobulin (PTg) with a molar ratio of 205:1. Rabbits were immunized with 1 mg of immunogen emulsified in complete Freund's adjuvant. Sera were screened for their ability to bind trace amounts of [125I]DIT. A serum that bound 40% of the tracer at a final dilution of 1:1,750 was used in the assay. Assay specificity was improved by the use of thyroxine (T4)-binding globulin as a second ligand-binding protein to decrease T4 and triiodothyronine (T3) cross-reactivity with the antibody. Double antibody and polyethylene glycol radioimmunoassays were compared. DIT present in the second antiserum shifted the double antibody assay standard curve and altered estimates of assay specificity and assay sensitivity. By using the polyethylene glycol system and butanol:ethanol extracts of serum, DIT was measured in human serum. In 35 apparently healthy young adult controls DIT levels averaged 156 ng/100 ml. Random DIT levels averaged 158 ng/100 ml in 11 untreated hyperthyroid patients and 84 ng/100 ml in 15 untreated primary hypothyroid patients. No diurnal pattern in DIT levels could be demonstrated. Thyroid-stimulating hormone administration led to a variable but small rise in DIT levels, but short term T3 suppression was not associated with a measurable fall in DIT concentrations. Paired serum samples from the carotid artery and thyroid vein of 10 euthyroid goiter patients and one patient with a toxic solitary adenoma all showed a positive transthyroidal gradient indicating the thyroidal release of DIT in each patient. Measurable DIT levels of 45, 47, 68, and 80 ng/100 ml, respectively, were found in four fasting athyrotic patients indicating that the thyroid is not the only source of serum DIT.
J C Nelson, R M Weiss, J E Lewis, R B Wilcox, F J Palmer
Male hamsters were fed normal and essential fatty acid (EFA)-deficient diets for at least 12 wk before bile duct cannulation. With [32P]phosphate, hepatic synthesis of lecithin was similar, but biliary excretion of newly synthesized lecithin was significantly reduced in EFA-deficient compared to that in normal hamsters. Hepatic uptake of intravenously infused taurocholate (TC) and taurochenodeoxycholate (TCDC) were similar in both groups of animals. However, biliary excretion of intravenously infused TC was significantly reduced in EFA-deficient hamsters, whereas that of TCDC-was unchanged. The absolute rate of biliary cholesterol excretion was similar in both groups. Canalicular bile flow, as measured by [14C]erythritol clearance after functional nephrectomy, was significantly lower, with both the bile salt-dependent and independent fractions of this flow being diminished in EFA-deficient hamsters infused with TC. It is concluded that EFA deficiency leads to impaired biliary excretion of taurocholate, lecithin, and water, while cholesterol transport is unaffected, and thus results in supersaturation of bile with respect to cholesterol and production of lithogenic bile.
I J Sarfeh, D A Beeler, D H Treble, J A Balint
These studies were designed to explore the effects of nephrotoxic serum (NTS) in rats on the uptake and processing by the glomerular mesangium of intravenously administered protein macromolecules (radiolabeled aggregated human IgG, [125I]AHIgG). Measurements of [125I]AHIgG levels in preparations of isolated glomeruli correlated well with qualitative estimates of glomerular IgG deposition seen by immunofluorescent microscopy. Rats given 2 ml NTS received 25 mg/100 g body wt [125I]AHIgG 48 h later and were sacrificed at varying time intervals thereafter. NTS-treated animals demonstrated a marked increase in glomerular uptake of [125I]AHIgG as compared with concurrent controls but a normal ability to clear [125I]AHIgG from the mesangium over 72 hr. Animals given 1.0, 0.5, and 0.25 ml NTS had neither proteinuria nor significant light microscopic changes, yet had increased uptake of [125I]AHIgG of 4.4, 3.0, and 2.1 times control values, respectively at 8 h after the infusion of aggregates. Rats given 1 ml NTS and 12.5, 6.25, and 3.125 mg [125I]AHIgG/100 g body wt had increased glomerular uptake at 8 h, but there was, within both NTS and control groups, a disproportionate decrease in uptake at lower [125I]AHIgG doses. Rats given cobra venom factor (CoF) followed by a NTS shown to be complement dependent (proteinuria reduced by prior complement depletion with CoF) had less mesangial [125I]AHIgG uptake than NTS controls but greater uptake compared with normal controls. CoF itself had no effect on mesangial or reticuloendothelial system [125I]AHIgG uptake. These studies demonstrate a striking change in glomerular mesangial activity after fixation of nephrotoxic antibodies to the glomerular basement membrane, even in the absence of proteinuria and suggest that subtle alterations of the filtration surface can influence mesangial function. The effect of NTS on the mesangium is due, in large part, to the glomerular injury and proteinuria which nephrotoxic antibodies produce.
S M Mauer, A J Fish, N K Day, A F Michael
The serum lipoproteins of five patients with abetalipoproteinemia (ABL) were separated by ultracentrifugation and then analyzed either intact or after delipidation. In accord with previous findings, all of the patients lacked serum particles with the characteristics of normal low-density lipoproteins (LDL) and of the LDL apoprotein as assessed by immunochemical methods. Each patient exhibited on every examination an abnormal particle, "LDL", which had the flotational properties of LDL, the polypeptide makeup of high-density lipoproteins HDL, the spectral and morphological characteristics of neither LDL nor HDL, and a relatively low content of cholesteryl esters. The HDL were abnormal in having a marked decrease in their total plasma content, an altered proportion of the subclasses HDL2 and HDL3, and a peculiar polypeptide distribution, comprising both normal and additional components, usually not seen in normal controls. The patients also exhibited a decrease of plasma lecithin-cholesterol acyl transferase (LCAT) activity which probably accounted for the low content of cholesteryl esters in both "LDL" and HDL, and in turn for the unusual appearance of "LDL" on electron microscopy. It is concluded that ABL is a disorder affecting all serum lipoprotein classes. Whether the abetalipoproteinemia previously described and noted in the current studies is related to or independent of the abnormalities observed in the other lipoproteins was not established. How the deficiency of LCAT activity, observed in all patients studied, contributed to some of the observed structural lipoprotein abnormalities also remained undetermined.
A M Scanu, L P Aggerbeck, A W Kruski, C T Lim, H J Kayden
Previous measurements of the transepithelial potential difference (PD) of the proximal tubule have yielded widely conflicting values (range -20 to +3 mV). In a recent study, Kokko has demonstrated that the PD of the in vitro perfused isolated proximal tubule of the rabbit varies in a predictable way from -6 to +3 mV, depending on the concentration of chloride, bicarbonate, glucose, and amino acids in the perfusing solution. The present micropuncture study examines the effect of tubular fluid composition on the PD profile along the proximal tubule of the in vivo rat kidney. Low resistance measuring electrodes with large tips (3-5 microns OD) filled with 3 M KCl, were used to provide stable PD recordings. Experiments were performed to validate the use of these electrodes. Transepithelial PD measurements were made in immediate postglomerular segments identified by injection of dye into Bowman's space of accessible surface glomeruli and in randomly selected more distal segments of the proximal tubule. In the control state, the first loop was found to have a small but consistently negative PD which could be obliterated by an infusion of phloridzin. In contrast, the PD in later segments was consistently positive. Infusion of acetazolamide abolished the positive PD in the later segments. Acetazolamide and glucose infusion resulted in a negative PD which was abolished by the additional infusion of phloridzin. These data provide evidence that glucose reabsorption is electrogenic and can account for the small negative PD normally present in the early proximal tubule. The positive PD in later segments appears to be a passive chloride diffusion potential. This positive potential is discussed as an important electrochemical driving force for significant passive reabsorption of sodium in the proximal tubule.
L J Barratt, F C Rector Jr, J P Kokko, D W Seldin
Previous studies in metabolic alkalosis have demonstrated that two factors are the prime determinants of acid excretion and bicarbonate reabsorption; first, the diversion to distal exchange sites of sodium previously reabsorbed in the proximal tubule and loop of Henle; and, second, a stimulus to sodium-cation exchange greater than that produced by a low-salt diet alone. In the present study we have examined the hypothesis that these two factors are also the prime determinants of acid excretion during the administration of mineral acid loads. To test this hypothesis, we have administered to dogs ingesting a low NaCl diet a daily dose of 7 meq/kg of H+ with anions (chloride, sulfate, or nitrate) whose differing degrees of reabsorbability influence the speed and completeness with which each is delivered to the distal nephron with its accompanying Na+. After 2-3 wk of acid administration, and after an initial urinary loss of Na+ and K+, the steady-state value for plasma [HCO3-] was 8.6 meq/liter below control in the HCl group, 3.7 meq/liter below control in the H2SO4 group, and unchanged from control in the HNO3 group; all of these values were significantly different from each other. We would propose the following explanation for our findings: when HCl is administered chronically, marked acidosis occurs because distal delivery of Cl- is restricted by the ease with which the Cl- can be reabsorbed in the proximal portions of the nephron. Only when Cl- retention produces sufficient hyperchloremia to insure delivery of Na+ (previously reabsorbed in proximal tubule and loop of Henle) to the distal nephron in quantities equal to ingested Cl is this primary constraint removed. In the case of sulfuric and nitric acids, there is no constraint on distal delivery, the nonreabsorbability of the administered anion causing prompt, total delivery of Na+ to exchange sites in quantities equal to administered hydrogen. Thus, with H2SO4 and HNO3 the sole constraint on removal of the acid load is the inability of the distal exchange mechanism to conserve the Na+ increment fully by means of H+ exchange. Escape of Na+ and K+ into the urine and the resulting stimulus to Na(+)-H+ exchange remove this constraint and are responsible for establishment of a new steady-state of acid-base equilibrium at plasma [HCO3-] levels significantly higher than those seen with HCl. The feeding of HCl in the presence of a normal salt intake led to a degree of metabolic acidosis not significantly different from that seen in dogs ingesting a low-salt diet. We suggest that the presence of dietary sodium at distal exchange sites did not enhance acid excretion because it is only after a loss of body sodium stores that sodium avidity is increased sufficiently to allow full removal of the acid load. The present findings indicate that the fundamental factors controlling acid excretion and bicarbonate reabsorption in metabolic acidosis are closely similar to those operative in metabolic alkalosis.
R C De Sousa, J T Harrington, E S Ricanati, J W Shelkrot, W B Schwartz
In fetal animals, glucocorticoids accelerate development of the lung and cause precocious appearance of alveolar surfactant. To determine if the human lung also can respond to corticosteroids, we examined lungs of the human fetus and neonate for both cytoplasmic binding and nuclear uptake of glucocorticoids. In slices of fetal lung incubated with [3H]dexamethasone at 2 degrees C, specific macromolecular binding occurs primarily in the "cytoplasmic" fraction. After further incubation at 37 degrees C. nearly 75% of the radioactivity localizes in the "nuclear" fraction with a concentration of 0.3 pmol/mg DNA at apparent dexamethasone saturation (47 nM). The cytoplasmic receptor binds dexamethasone in vitro with high affinity (dissociation constant = 8.9 nM), and the affinity of various other steroids correlates with their glucocorticoid potency. Receptor was present in lungs of fetuses and neonates of gestational age 12-43 wk, with a mean concentration in hysterotomy specimens of 0.24 pmol sites/mg cytosol protein. Similar binding activity was present at lower concentration in fetal liver, gut, kidney, heart, muscle, and skin. Cytoplasmic receptor was not detected in lung and liver of premature infants with respiratory distress syndrome. This deficit appears to result from increased levels of endogenous steroids (mean cortisol 45.5 micrograms/100 ml cytosol) as well as inactivation of receptor secondary to the illness. Thus, the lung of the human fetus and neonate contains the receptor mechanism necessary for direct responsiveness to glucocorticoids. These findings support the potential usefulness of these hormones in prevention of respiratory distress syndrome in the premature infant.
P L Ballard, R A Ballard
Jejunal biopsy specimens from patients with gluten-sensitive enteropathy (GSE) (obtained during gluten challenge) as well as from normal individuals and patients with other gastrointestinal abnormalities were cultured in vitro for 48 h in the presence or absence of a peptic-tryptic digest (P-T digest) of gliadin. In the absence of gliadin the alkaline phosphatase activity in the biopsy specimens obtained from normal control individuals increased from an initial value of 384 +/- 83 U to a 48 h value of 561 +/- 151 U (mean +/- SD) (difference significant at P < 0.01). The initial alkaline phosphatase activity of specimens obtained from patients with GSE was strikingly lower than that of normals, 117 +/- 79 U, and increased to a 48 h value of 399 +/- 203 U (difference significant at P < 0.01). The biochemical change in cultured biopsy specimens of GSE patients correlated with increases in the length and regularity of brush borders of epithelial cells as seen with the electron microscope. In the presence of a P-T digest of gliadin, the alkaline phosphatase activity of biopsy specimens of control individuals increased from an initial value of 384 +/- 83 U to a 48 h value of 578 +/- 156 U. In contrast, the alkaline phosphatase activity of biopsy specimens of patients with GSE in exacerbation showed a markedly diminished increase in activity during 48 h of culture; in this case the initial activity was 117 +/- 79 U and the final activity was 203 +/- 93 U. This inhibitory effect on increase of alkaline phosphatase activity during organ culture was specific in that a P-T digest of casein (a protein not toxic in vivo to patients with GSE) had no effect on alkaline phosphatase increases in culture. Finally, these results obtained with biopsy specimens taken from patients with GSE in exacerbation were compared with results obtained from patients with GSE in remission. Alkaline phosphatase activity of specimens obtained from the latter group of patients also increased during culture but in this instance P-T digest of gliadin in the culture medium had no significant inhibitory effect. In conclusion, the inhibitory effect of gliadin on intestinal epithelial cells in organ culture represents an in vitro model of gluten-sensitive enteropathy. Inasmuch as this effect of gliadin is not seen in cultures of specimens taken from patients in remission, it appears that gliadin is not directly toxic to GSE jejunal mucosa per se, but rather toxicity requires the participation of an endogenous effector mechanism which must first be stimulated in vivo.
Z M Falchuk, R L Gebhard, C Sessoms, W Strober
Preferential expansion of the plasma volume by infusion of salt-poor hyperoncotic albumin solution decreases sodium reabsorption by the proximal tubule. The present micropuncture studies test the thesis that albumin infusion depresses proximal reabsorption by an effect unrelated to expansion of the plasma volume, perhaps due to an effect of parathyroid hormone (PTH) on proximal sodium reabsorption. Infusion of salt-poor hyperoncotic albumin significantly decreased plasma ionized calcium, increased immunoreactive PTH (iPTH) in plasma, decreased sodium reabsorption by the proximal tubule, and increased phosphate clearance. In contrast, infusions of albumin, in which the ionized calcium was restored to normal plasma levels, had no significant effect on ionized calcium, iPTH, proximal reabsorption, or phosphate clearance in intact dogs. Similarly, in parathyroidectomized animals given a constant replacement infusion of PTH, albumin infusion had no significant effect on proximal reabsorption or phosphate clearance. Plasma volume was markedly expanded following albumin infusion in all groups of dogs. These findings (a) indicate that PTH plays a significant role in the decrease in sodium reabsorption by the renal proximal tubule after salt-poor hyperoncotic albumin infusion, and (b) dissociate preferential expansion of the plasma volume from decreases in sodium reabsorption by the proximal tubule.
F G Knox, E G Schneider, L R Willis, J W Strandhoy, C E Ott, J L Cuche, R S Goldsmith, C D Arnaud
Rates of plasma acetoacetate and total ketone-body production and oxidation to CO2 were determined by an isotope tracer technique in eight obese subjects undergoing progressive starvation. After a brief fast and under conditions of mild ketonemia and minimal ketonuria, rates of acetoacetate and total ketone-body production and oxidation were directly related to the increasing plasma concentration. After a longer fast and with severer ketonemia, acetoacetate and total ketone-body production and oxidation rates were higher but became constant and unrelated to the plasma concentrations. The maximum rates of total ketone-body production and oxidation were about 150 g/24 h and 129 g/24 h, respectively. Although an increased ketone-body production was the primary factor responsible for the hyperketonemia, an imbalance between production and removal of the ketone bodies cannot be excluded. Such an imbalance could account, at least in part, for the developing hyperketonemia and for the lack of relationship between production rates and plasma concentrations.
G A Reichard Jr, O E Owen, A C Haff, P Paul, W M Bortz
Renal clearance and recollection micro-puncture experiments were conducted to evaluate the possible role of a distal tubular feedback mechanism in the phenomenon of renal autoregulation in dogs. Single nephron glomerular filtration rate (SNGFR) was measured from collection sites in both the proximal (proximal SNGFR) and distal tubules (distal SNGFR). Single nephron autoregulatory behavior was assessed by evaluating the response of SNGFR to a reduction in renal arterial pressure imposed by means of an aortic constrictor. Whole kidney function was evaluated by parallel measurements of renal blood flow and inulin clearance. Whole kidney autoregulation was observed when renal arterial pressure was decreased from 141 +/- 3 (SE) mm Hg to 101 +/- 2 mm Hg; renal blood flow and GFR were not significantly altered from control values of 3.76 +/- 0.2 ml/min.g and 0.69 +/- 0.04 ml/min.g kidney weight, respectively. In 11 autoregulating preparations, proximal transit time was likewise unchanged from the control value of 26 +/- 2 s, indirectly suggesting that the superficial nephrons also participated in the autoregulatory response. However, proximal SNGFR decreased significantly from 88 +/- 7 nl/min to 66 +/- 6 nl/min, a reduction which was proportional to the decrease in arterial pressure. In 14 dogs in which both proximal SNGFR and distal SNGFR were measured at control blood pressure (136 +/- 5 mm Hg), distal SNGFR was 47 +/- 4 nl/min, a value significantly lower than that for proximal SNGFR (79 +/- 6 nl/min). In contrast to the results based upon proximal collections, distal SNGFR was not significantly altered following aortic constriction (44 +/- 5 nl/min vs. 47 +/- 5 nl/min) therefore exhibiting autoregulation in association with that observed for the whole kidney. These experiments indicate that though superficial nephrons do possess autoregulatory capability, interruption of distal delivery due to complete collection from the proximal tubule interferes with that nephron's ability to manifest an autoregulatory response. They support the concept that a feedback mechanism, related to some function of distal delivery, is of significance in the intrinsic regulation of SNGFR. The data further suggest that quantitative estimates of SNGFR based on complete proximal collections may not be representative of those throughout the superficial cortex of the dog, at least in certain experimental circumstances.
L G Navar, T J Burke, R R Robinson, J R Clapp
Glucose is absent from human bile and present in low concentrations in bile from the rat. To study the mechanisms of this blood-bile glucose concentration difference, infusions of glucose were administered i.v. to 300-400 g male Sprague-Dawley rats with ligated renal pedicles and to two postcholecystectomy patients with indwelling t-tubes. Glucose was assayed in plasma, bile, and rat liver by a hexokinase method specific for D-glucose. In man, glucose was detected in bile when plasma glucose increased above 350 mg/100 ml. In animals studies, low concentrations of bile glucose were observed at plasma levels between 100 and 300 mg/100 ml. However, when plasma concentrations increased between 400 and 900 mg/100 ml, glucose appeared more rapidly in bile, defining by extrapolation an apparent plasma glucose threshold of 280 mg/100 ml. Intraportal phlorizin, a competitive inhibitor of glucose transport, significantly increased bile glucose concentrations. Plasma-bile concentration differences were also observed in rats after i.v. [3-14C]O-methyl glucose (3-O-MG) but not after [3H]mannitol. Hepatic glucose levels were never lower than plasma levels and liver-plasma 3-O-MG ratios were 0.92 +/- 0.22 indicating that entry of glucose and 3-O-MG into hepatocyte water was not limiting. Furthermore, when sodium dehydrocholate augmented canalicular secretion, biliary glucose excretion increased proportionally suggesting that glucose entry into bile was not impeded. When estimates of hepatic glucose secretion were compared with biliary glucose excretion, the latter increased progressively when estimated secretion rates exceeded 50 micrograms/min or when phlorizin was given. Finally, during bile stop-flow experiments, [3-14C]O-MG and [14C]glucose were selectively removed from bile compared with [3H]mannitol. The findings suggest that glucose and 3-O-MG are reabsorbed from bile after entry at the hepatocyte, accounting for their low bile-plasma ratio. The biliary glucose transport process may be described by Michaelis-Menten kinetics and is analogous to recently defined kinetics for renal tubular reabsorption of glucose. These studies provide evidence that certain products of bile secretion may undergo a "biliohepatic" circulation.
P Guzelian, J L Boyer
Liposomes were used as model targets to test the effect of immunoglobulins on biomembranes. Heat-aggregated immunoglobulins (Ig) exceeded native immunoglobulins in their capacity to release anions and glucose from model liposomes (either lecithin-dicetyl-phosphate-cholesterol or lecithin-stearylamine-cholesterol in molar ratios of 7:2:1). This interaction was not dependent upon the presence of cholesterol in the membrane. Mild heat-aggregation (10 min at 61.5 degrees C) increased the membrane-perturbing activity of certain Ig. Activity varied among classes and subclasses: IgG1 > pooled IgG > IgG4 > IgA1 > IgG3. IgG2, IgA2 and IgM were inert. Fc fragments of IgG were as active as IgG1, whereas Fab fragments were inactive. Prolonging aggregation to 60 min destroyed the activity of Ig. Membrane-activity could not be induced in non-Ig molecules (such as bovine serum albumin) by 10 or 60 min heat-aggregation. Density gradient centrifugation of IgG1 molecules indicated that membrane perturbing activity was associated with 15-20-s aggregates. Sepharose 4B chromatography demonstrated preferential interaction between cationic membranes and aggregated Ig, whereas anionic membranes interacted nonselectively with both native and aggregated Ig via salt-like interactions. One explanation for these data is that heat aggregation induces a conformational change in the Fc regions of certain Ig permitting them to interact with liposomes, presumably by enhancing their hydrophobic associations with membrane phospholipids.
G Weissmann, A Brand, E C Franklin
An 18-yr-old black woman in good general health was found to lack serum hemolytic complement activity. The sixth component of complement (C6) was undetectable by functional assay of serum or plasma and by immunoprecipitin analysis of serum. Functional titers of all other complement components were normal. The absence of C6 in the patient's serum could not be accounted for by a circulating C6 inhibitor, and addition of functionally pure C6 to the patient's serum restored hemolytic activity to normal. Both parents of the proband and five of six available siblings had approximately half the normal levels of functional C6. The other sibling had a normal C6 level. These data suggest that both parents and five siblings are heterozygous for C6 deficiency, while the proband is homozygous and one sibling is normal. Thus, C6 deficiency appears to follow classic mendelian inheritance, with all three possible genotypes recognizable within the family. Functional properties of the proband's C6-deficient serum included total absence of bactericidal activity against Salmonella typhi 0 901 and Hemophilus influenzae, type b, and inability to mediate lysis of red blood cells from patients with paroxysmal nocturnal hemoglobinuria in either the acidified serum or "sugar water" tests. The proband's serum did, however, exhibit a normal capacity (a) to generate chemotactic activity during incubation with bacterial endotoxin or aggregated IgG, (b) to mediate the immune adherence phenomenon, and (c) to coat human red blood cells, sensitized by cold agglutinins, with C4 and C3.
J P Leddy, M M Frank, T Gaither, J Baum, M R Klemperer
Prompted by previous observations of defective blood clotting in rabbits deficient in the sixth component of complement (C6), an evaluation was made of the hemostatic functions of the homozygous proband of a newly recognized human kindred with hereditary C6 deficiency. This human subject, who had no clinical evidence of a bleeding disorder, exhibited a total lack of C6 by functional and immunoprecipitin assays of serum or plasma. Standard tests of hemostatic function were normal; however, when the whole blood clotting time was measured at 25 degrees C in plastic tubes, it was at the upper range of our normal values. In confirmation of this observation, prothrombin consumption, when performed at 37 degrees C in plastic tubes, was at the lower range of normal. Inulin and endotoxin, in concentrations shown to cause activation of human complement, had little or no effect on clotting times or prothrombin consumption of normal or C6-deficient human blood. These observations indicate that absence of C6 does not have a significant effect on hemostatic function in man. In the light of other investigations, the observed differences in clotting function between C6-deficient human blood and C6-deficient rabbit blood could be due to species differences governing the susceptibility of platelets to complement activation.
R S Heusinkveld, J P Leddy, M R Klemperer, R T Breckenridge
Studies were carried out to determine whether products of activated human lymphocytes altered human monocyte function. Supernatants from sensitized human lymphocytes stimulated by specific antigen were cultured with monolayers of human monocytes. Such monocytes exhibited enhanced adherence to their culture vessels and increased glucose carbon-1 oxidation after 2-3 days of incubation. The substance responsible for these effects was found to elute from Sephadex G-100 gel columns in a fraction with 23,000 mol wt, the same fraction containing human migration inhibitory factor.
R E Rocklin, C T Winston, J R David
Normal subjects given 60 mg of prednisone orally at 8:00 a.m. developed a transient lymphopenia at 2:00 p.m. To define the populations of lymphocytes affected the number and type of lymphocytes in the peripheral blood were assayed. "Late" and "early" spontaneous sheep red blood cell rosettes were used as markers for thymus-derived (T) lymphocytes and one of its subpopulations, respectively. Receptors for aggregated gammaglobulin and complement identified bursal-equivalent or bone marrow-derived (B) lymphocytes and one of its subpopulations, respectively. 6 h after administration of 60 mg of prednisone, the blood samples showed a decrease in proportion of T cells from 69.2 +/- 2.1% to 55.9 +/- 2.8% (average +/- SE) and an increase in B-cell proportion from 21.3 +/- 2.0% to 44.8 +/- 4.1%. The changes of "early" rosettes and complement receptor lymphocytes also paralleled these. In all cases the absolute numbers of T cells and of B cells were decreased by prednisone. The density gradient distribution of the lymphocytes did not change after prednisone. These data indicate that both T and B lymphocytes are affected by the prednisone but that the T cell lymphopenia was more pronounced. The lymphopenia might reflect either sequestration in the marrow and/or transient arrest of recirculation.
D T Yu, P J Clements, H E Paulus, J B Peter, J Levy, E V Barnett
Resting O2 consumption rate (BMR) or minimal O2 consumption rate (MOC) declines with age. Data are presented that suggest that a newly described function of the pituitary may be responsible for a considerable part of the total 75% decline in the MOC with age. The new function appears to decrease the responsiveness of peripheral tissues to thyroid hormones. Response curves to injected thyroxine indicated that immature rats were three times more responsive to thyroxine than adult rats. All the major endocrine ablations were performed in this and earlier work, and only pituitary ablation (a) restored in adults part of the responsiveness to thyroxine found in immature rats and (b) arrested the normal age-associated decrease in responsiveness to thyroxine in immature rats. Bovine pituitary extracts were found that decreased the responsiveness of immature rats to thyroxine. Experiments with the new pituitary function suggested a possible endocrine mechanism to explain why partial starvation doubled the lifespan for rats only when started before puberty.
W D Denckla
Arterial concentrations and splanchnic exchange of glucose, lactate, pyruvate, glycerol, free fatty acids, and individual acidic and neutral amino acids were determined in obese and nonobese control subjects in the basal state and during a 45 min infusion of glucose. Glucose was administered to the controls at a rate (2 mg/kg/min; 144 +/- 4 mg/min) known to inhibit splanchnic glucose output without influencing peripheral glucose utilization. The obese subjects received glucose at two dose levels (75 and 150 mg/min) which simulated either the rise in insulin or the inhibition in splanchnic glucose production observed in the controls. In the basal state splanchnic glucose production did not differ significantly between obese and control subjects. However splanchnic uptake of lactate, glycerol, alanine, free fatty acids, and oxygen was 50-160% greater in obese subjects. Splanchnic uptake of glucose precursors could account for 33% of hepatic glucose output in the obese group as compared to 19% in controls. The increase in alanine and lactate uptake was due in part, to a 50% increase in splanchnic fractional extraction. Administration of glucose to the control subjects 144 +/- 4 mg/min) resulted in a 50-60% increment in arterial insulin and a 75% reduction in splanchnic glucose output. In the obese group, infusion of glucose at a rate of 75 mg/min resulted in an equivalent rise in arterial insulin, but was accompanied by a less than 40% inhibition in splanchnic glucose output. Glucose infusion at a rate of 150 mg/min in the obese resulted in a 75% reduction in splanchnic glucose output which was equivalent to that observed in controls, but was accompanied by a significantly greater rise (100-200%) in arterial insulin. It is concluded that in obesity (a) despite basal hyperinsulinemia, splanchnic uptake of glucose precursors is increased, the relative contribution to total glucose release attributable to gluconeogenesis being 70% higher than in controls; (b) infusion of glucose at rates causing equivalent increases in arterial insulin induces a smaller inhibition in splanchnic glucose output than in controls; (c) infusion of glucose at rates causing comparable inhibition in splanchnic glucose output is accompanied by a disproportionately greater increase in endogenous insulin than in controls. These data are compatible with hepatic resistance to insulin in obesity.
P Felig, J Wahren, R Hendler, T Brundin
The interaction of human neutrophils adherent to plastic petri dishes with the purified chemotactic factors C5a and kallikrein increased their rate of aerobic glycolysis 25-120% and the activity of their hexose monophosphate shunt (HMPS) 100-600%, reaching a plateau after 2 hr at 37 degrees C. The stimulation of either pathway required a chemotactically active stimulus since neither C5 nor prekallikrein or inactivated kallikrein could enhance metabolic activity. Marked suppression of the neutrophil chemotactic response by preincubation with a chemotactic factor to achieve deactivation, 5 x 10(-7) M diisopropyl fluorophosphate, or the neutrophil immobilizing factor (NIF) did not prevent the stimulation of HMPS activity or glycolysis by chemotactic factors. The metabolic inhibitors iodoacetate and 6-aminonicotinamide at concentrations which blocked enhancement of glycolysis or HMPS activity, respectively, partially suppressed the chemotactic response of neutrophils to the chemotactic factors. The capacity of a chemotactic factor to stimulate glucose metabolism of human neutrophils is associated with a maximal chemotactic response, but this stimulation is not alone sufficient for chemotaxis.
E J Goetzl, K F Austen
A new, autosomally inherited abnormal fibrinogen associated with hypofibrinogenemia has been described in several members of a family. Plasma fibrinogen measured either as thrombin-clottable protein or by immunodiffusion revealed a fibrinogen level ranging between 60 and 90 mg/100 ml. The thrombin time of plasma or purified fibrinogen was prolonged and only partially corrected by the addition of calcium. Purified fibrinogen prolonged the thrombin time of normal plasma. Fibrinopeptide release by thrombin was normal in rate and amount, but fibrin monomer aggregation was grossly disturbed, especially in a high ionic strength medium. We have designated this fibrinogen "fibrinogen Philadelphia." Acrylamide gel electrophoresis of mixtures of [121I]normal and [125I]abnormal fibrinogens revealed a slight increase in the anodal mobility of fibrinogen Philadelphia. Similarly, DEAE-cellulose chromatography showed slightly stronger binding of fibrinogen Philadelphia than normal. To elucidate the mechanism responsible for the low plasma fibrinogen concentration, simultaneous metabolic studies of autologous (patient) and homologous (normal) fibrinogen, labeled with 125I and 121I, respectively, were performed in two affected subjects. Autologous fibrinogen half-life was short and the fractional catabolic rate was markedly increased in both family members. In contrast, homologous fibrinogen half-life and fractional catabolic rate were normal. These metabolic studies demonstrate that rapid degradation of fibrinogen Philadelphia is largely responsible for the depressed levels of a plasma fibrinogen. This represents the first example of a mutant plasma protein in which the molecular defect is associated with an altered catabolism.
J Martinez, R R Holburn, S S Shapiro, A J Erslev
The formation of ursodeoxycholic acid, the 7 beta-hydroxy epimer of chenodeoxycholic acid, was investigated in three subjects with cerebrotendinous xanthomatosis and in four subjects with gallstones. Total biliary bile acid composition was analyzed by gas-liquid chromatography before and after 4 months of treatment with 0.75 g/day of chenodeoxycholic acid. Individual bile acids were identified by mass spectrometry. Before treatment, bile from cerebrotendinous xanthomatosis (CTX) subjects contained cholic acid, 85%; chenodeoxycholic acid, 7%; deoxycholic acid, 3%; allocholic acid, 3%; and unidentified steroids, 2%; while bile from gallstone subjects contained cholic acid, 45%; chenodeoxycholic acid, 43%; deoxycholic acid, 11%, and lithocholic acid, 1%. In all subjects, 4 months of chenodeoxycholic acid therapy increased the proportion of this bile acid to approximately 80% and decreased cholic acid to 3% of the total biliary bile acids, the remaining 17% of bile acids were identified as ursodeoxycholic acid. After the intravenous injection of [3H]chenodeoxycholic acid, the specific activity of biliary ursodeoxycholic acid exceeded the specific activity of chenodeoxycholic acid, and the resulting specific activity decay curves suggested precursor-product relationships. When [3H]7-ketolithocholic acid was administrated to another patient treated with chenodeoxycholic acid, radioactivity was detected in both the ursodeoxycholic acid and chenodeoxycholic acid fractions. These results indicate that substantial amounts of ursodeoxycholic acid are formed in patients treated with chenodeoxycholic acid. The ursodeoxycholic acid was synthesized from chenodeoxycholic acid presumably via 7-ketolithocholic acid.
G Salen, G S Tint, B Eliav, N Deering, E H Mosbach
Fletcher factor-deficient plasma is deficient in prekallikrein and therefore generates no bradykinin upon activation with kaolin. It also possesses a diminished rate of kaolin-activable coagulation and fibrinolysis and possesses a defect in kaolin-activable chemotactic activity. These abnormalities are also corrected by reconstitution with purified prekallikrein. Addition of intact activated Hageman factor corrected the coagulation, fibrinolytic, and chemotactic defects and addition of Hageman factor fragments corrected the fibrinolytic defect and partially corrected the chemotactic defect; neither of these corrected the kinin-generating defect. Although the Hageman factor-dependent pathways appear to be initiated by contact activation of Hageman factor, the kallikrein generated activates more Hageman factor; this feedback is necessary for the Hageman factor-dependent pathways to proceed at a normal rate. It is the absence of this feedback in Fletcher factor-deficient plasma that accounts for the diminished rate of activation of Hageman factor and therefore a diminished rate of activation of the coagulation and fibrinolytic pathways. The ability of prekallikrein to correct the coagulation, fibrinolytic, kinin-generating, and chemotactic defects of Fletcher factor-deficient plasma is consistent with the identity of the Fletcher factor and prekallikrein.
A S Weiss, J I Gallin, A P Kaplan
D-Glucose equilibrates within liver cells. We have studied its process of entry into and exit from these cells with the multiple indicator dilution technique. Labeled red cells (a vascular indicator), labeled sucrose (an extracellular reference), and labeled D-glucose were rapidly injected into the portal vein, and from serially sampled hepatic venous blood, normalized outflow-time patterns were obtained. The labeled red cell curve rises to an early high peak, and decays rapidly; and that for sucrose reaches a later and lower peak and decays less rapidly, but generates an equivalent area. The curve for labeled D-glucose begins with that for labeled sucrose, gradually rises to a peak which is later and substantially lower than that for sucrose, and then decreases slowly. At high glucose levels this curve assumes a squared-off shape, rises fairly quickly to its highest level, at the time of the sucrose peak, and then slowly decreases. Phlorizin and galactose infusion result in the emergence of a pronounced early peak, under the sucrose peak; and the curve for tracer L-glucose approaches that for sucrose. We resolve from the D-glucose curves, by model analysis, two components: throughout material, which has not entered the cells; and exchanging material, which has entered and later returned to the circulation. The analysis provides estimates of the kinetic entrance and exist coefficients; and from these, saturation of both the entrance and exit processes was evident. The characteristic transport parameters were determined. For both entrance and exit, a common Km, 2,170 mg/100 ml, and transport maximum, 5.13 mg s-1 (ml intracellular fluid)-1, were found. Both these values are exceedingly large. Several other phenomena were defined which additionally characterize the transport process: phlorizin and galacose produced competitive inhibition; the transport process was found to be relatively stereospecific; and sudden infusion of hypertonic glucose produced counter-transport of labeled D-glucose.
C A Goresky, B E Nadeau
In rat peritoneal macrophages, engaged in erythrophagocytosis in vitro, endotoxin stimulated heme oxygenase (HO) activity, which was additive to the substrate-mediated enzyme induction produced by the ingested erythrocyte hemoglobin. Endotoxin neither appeared to injure the erythrocytes, nor did it enhance the rate of erythrophagocytosis. In intact rats, HO activity in both parenchymal and sinusoidal cells of the liver was increased after treatment with endotoxin. It is likely that endotoxin directly stimulates HO activity, a process which may account for the reported rise in bilirubin formation in endotoxin-treated animals. The effect of endotoxin on HO may represent part of the general activation of phagocytic cells by endotoxin.
D Gemsa, C H Woo, H H Fudenberg, R Schmid
The effect of estrogen on prolactin (PRL) release and gonadotropin suppression was assessed in six experiments performed on four hypogonadal women. Ethinyl estradiol at a dose of 1 microgram/kg per day induced a significant elevation of serum PRL levels within the 1st wk of treatment. There was a further rise until a plateau was reached in about 3-4 wk to levels of more than 3 times the initial concentration. This was accompanied by a pattern of increased episodic fluctuation. The corresponding serum luteinizing hormone and follicle-stimulating hormone fell progressively during the study period. These data indicate that a positive feedback relationship between estrogen and PRL release exists in humans.
S S Yen, Y Ehara, T M Siler
High-affinity, limited-capacity nuclear binding activities, putative receptors for triiodothyronine, were detected after incubation of hormone with intact rat pituitary GH1 cells in culture, isolated GH1 cell nuclei, or rat liver nuclei. The total number of triiodothyronine binding sites per nucleus was similar in each case (approximately 8,000). The estimated equilibrium dissociation constants were virtually identical in isolated GH1 cell nuclei and rat liver nuclei, and both values were similar to that determined in intact GH2 cells. These results suggest that mechanisms of thyroid hormone action defined in cell culture could apply to thyroid hormone regulatory effects in vivo.
H H Samuels, J S Tsai
Recollection micropuncture study was performed in 11 thyroparathyroidectomized dogs during antidiuresis to determine the effect of continuous vasopressin infusion at 50 mU/kg/h on proximal tubule phosphate and sodium transport. The animals were divided into two groups according to changes in mean arterial blood pressure. In the first group (five dogs) with increased blood pressure and glomerular filtration rate (GFR), mean proximal tubule fluid-to-plasma inulin ratio fell significantly from 1.69 to 1.53, whereas it remained unchanged at 1.60 in the second group (six dogs) with no change in blood pressure. In contrast, mean proximal tubule fluid-to-plasma ultrafilterable phosphate ratio increased consistently in both groups, regardless of blood pressure changes. Since natriuresis as well as phosphaturia were observed in all animals, the sodium effect of vasopressin in the distal nephron must be mainly responsible for the natriuresis. It was concluded that vasopressin, when given in the doses employed, inhibits phosphate transport in the proximal tubule and sodium reabsorption in the distal nephron. An additional effect on proximal tubule sodium reabsorption appears to be related to the rise in blood pressure and GFR secondary to vasopressin administration.
S F Wen
Superoxide dismutase exerted a pronounced inhibitory effect upon xanthine oxidase-mediated reduction of iron in ferritin, ferric chloride, or ferric ADP. Maximal inhibition was observed when the superoxide dismutase concentration was only about 1% of that found in normal porcine liver. These observations indicate that superoxide anion radical is an intermediate in the reduction of iron by xanthine oxidase in vitro but not in vivo.
D M Williams, G R Lee, G E Cartwright