Head and neck target delineation using a novel PET automatic segmentation algorithm.

PURPOSE: To evaluate the feasibility and impact of using a novel advanced PET auto-segmentation method in Head and Neck (H&N) radiotherapy treatment (RT) planning. METHODS: ATLAAS, Automatic decision Tree-based Learning Algorithm for Advanced Segmentation, previously developed and validated on pre-clinical data, was applied to 18F-FDG-PET/CT scans of 20 H&N patients undergoing Intensity Modulated Radiation Therapy. Primary Gross Tumour Volumes (GTVs) manually delineated on CT/MRI scans (GTVpCT/MRI), together with ATLAAS-generated contours (GTVpATLAAS) were used to derive the RT planning GTV (GTVpfinal). ATLAAS outlines were compared to CT/MRI and final GTVs qualitatively and quantitatively using a conformity metric. RESULTS: The ATLAAS contours were found to be reliable and useful. The volume of GTVpATLAAS was smaller than GTVpCT/MRI in 70% of the cases, with an average conformity index of 0.70. The information provided by ATLAAS was used to grow the GTVpCT/MRI in 10 cases (up to 10.6mL) and to shrink the GTVpCT/MRI in 7 cases (up to 12.3mL). ATLAAS provided complementary information to CT/MRI and GTVpATLAAS contributed to up to 33% of the final GTV volume across the patient cohort. CONCLUSIONS: ATLAAS can deliver operator independent PET segmentation to augment clinical outlining using CT and MRI and could have utility in future clinical studies.

A novel phantom technique for evaluating the performance of PET auto-segmentation methods in delineating heterogeneous and irregular lesions.

BACKGROUND: Positron Emission Tomography (PET)-based automatic segmentation (PET-AS) methods can improve tumour delineation for radiotherapy treatment planning, particularly for Head and Neck (H&N) cancer. Thorough validation of PET-AS on relevant data is currently needed. Printed subresolution sandwich (SS) phantoms allow modelling heterogeneous and irregular tracer uptake, while providing reference uptake data. This work aimed to demonstrate the usefulness of the printed SS phantom technique in recreating complex realistic H&N radiotracer uptake for evaluating several PET-AS methods. METHODS: Ten SS phantoms were built from printouts representing 2mm-spaced slices of modelled H&N uptake, printed using black ink mixed with 18F-fluorodeoxyglucose, and stacked between 2mm thick plastic sheets. Spherical lesions were modelled for two contrasted uptake levels, and irregular and spheroidal tumours were modelled for homogeneous, and heterogeneous uptake including necrotic patterns. The PET scans acquired were segmented with ten custom PET-AS methods: adaptive iterative thresholding (AT), region growing, clustering applied to 2 to 8 clusters, and watershed transform-based segmentation. The difference between the resulting contours and the ground truth from the image template was evaluated using the Dice Similarity Coefficient (DSC), Sensitivity and Positive Predictive value. RESULTS: Realistic H&N images were obtained within 90 min of preparation. The sensitivity of binary PET-AS and clustering using small numbers of clusters dropped for highly heterogeneous spheres. The accuracy of PET-AS methods dropped between 4% and 68% for irregular lesions compared to spheres of the same volume. For each geometry and uptake modelled with the SS phantoms, we report the number of clusters resulting in optimal segmentation. Radioisotope distributions representing necrotic uptakes proved most challenging for most methods. Two PET-AS methods did not include the necrotic region in the segmented volume. CONCLUSIONS: Printed SS phantoms allowed identifying advantages and drawbacks of the different methods, determining the most robust PET-AS for the segmentation of heterogeneities and complex geometries, and quantifying differences across methods in the delineation of necrotic lesions. The printed SS phantom technique provides key advantages in the development and evaluation of PET segmentation methods and has a future in the field of radioisotope imaging.

Effects of short-term oral corticosteroid intake on dietary intake, body weight and body composition in adults with asthma - a randomized controlled trial.

BACKGROUND: Oral corticosteroids (OCS) are an efficacious treatment for asthma exacerbations, yet risk of adverse effects may decrease patient adherence to therapy. In particular, changes in appetite and dietary intake, which lead to weight gain and changes in body composition, are considered undesirable. OBJECTIVE: To determine whether 10-day OCS therapy in adults with asthma causes changes in leptin, appetite, dietary intake, body weight and body composition. METHODS: Double-blinded, placebo-controlled randomized cross-over trial of 10 days prednisolone (50 mg) in adults with stable asthma (n = 55) (ACTRN12611000562976). Pre- and post-assessment included spirometry, body weight, body composition measured by dual-energy X-ray absorptiometry and bioelectrical impedance analysis, appetite measured using a validated visual analogue scale (VAS) and dietary intake assessed using 4-day food records. Leptin was measured as a biomarker of appetite and eosinophils as an adherence biomarker. Outcomes were analysed by generalized linear mixed models. RESULTS: Subject adherence was confirmed by a significant decrease in blood eosinophils (× 10(9) /L) following prednisolone compared to placebo [Coef. -0.29, 95% CI: (-0.39, -0.19) P < 0.001]. There was no difference in serum leptin (ng/mL) [Coef. 0.13, 95% CI: (-3.47, 3.72) P = 0.945] or appetite measured by VAS (mm) [Coef. -4.93, 95% CI: (-13.64, 3.79) P = 0.267] following prednisolone vs. placebo. There was no difference in dietary intake (kJ/day) [Coef. 255, 95% CI: (-380, 891) P = 0.431], body weight (kg) [Coef. -0.38, 95% CI: (-0.81, 0.05) P = 0.083] or body fat (%) [Coef. -0.31, 95% CI: (-0.81, 0.20) P = 0.230]. Symptoms including sleep and gastrointestinal disturbance were reported significantly more often during prednisolone vs. placebo. CONCLUSIONS AND CLINICAL RELEVANCE: Short-term OCS in stable asthma did not induce significant changes in appetite, dietary intake, body weight or composition, although other adverse effects may require medical management. This evidence may assist in increasing medication adherence of asthmatics prescribed OCS for exacerbations.

Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma.

BACKGROUND: Asthma prevalence has increased in recent years, and evidence suggests that diet may be a contributing factor. Increased use of processed foods has led to a decrease in diet quality, which may be creating a pro-inflammatory environment, thereby leading to the development and/or progression of various chronic inflammatory diseases and conditions. Recently, the dietary inflammatory index (DII) has been developed and validated to assess the inflammatory potential of individual diets. OBJECTIVE: This study aimed to examine the DII in subjects with asthma compared to healthy controls and to relate the DII to asthma risk, lung function and systemic inflammation. METHODS: Subjects with asthma (n = 99) and healthy controls (n = 61) were recruited. Blood was collected and spirometry was performed. The DII was calculated from food frequency questionnaires administered to study subjects. RESULTS: The mean DII score for the asthmatics was higher than the mean DII score for healthy controls (- 1.40 vs. - 1.86, P = 0.04), indicating that their diets were more pro-inflammatory. For every 1 unit increase in DII score, the odds of having asthma increased by 70% (OR: 1.70, 95% CI: 1.03, 2.14; P = 0.040). FEV1 was significantly associated with DII score (ß = - 3.44, 95% CI: - 6.50, - 0.39; P = 0.020), indicating that for every 1 unit increase in DII score, FEV1 decreased by 3.44 times. Furthermore, plasma IL-6 concentrations were positively associated with DII score (ß = 0.13, 95% CI: 0.05, 0.21; P = 0.002). CONCLUSION AND CLINICAL RELEVANCE: As assessed using the DII score, the usual diet consumed by asthmatics in this study was pro-inflammatory relative to the diet consumed by the healthy controls. The DII score was associated with increased systemic inflammation and lower lung function. Hence, consumption of pro-inflammatory foods may contribute to worse asthma status, and targeting an improvement in DII in asthmatics, as an indicator of suitable dietary intake, might be a useful strategy for improving clinical outcomes in the disease.

Evaluation of advanced automatic PET segmentation methods using nonspherical thin-wall inserts.

PURPOSE: The use of positron emission tomography (PET) within radiotherapy treatment planning requires the availability of reliable and accurate segmentation tools. PET automatic segmentation (PET-AS) methods have been recommended for the delineation of tumors, but there is still a lack of thorough validation and cross-comparison of such methods using clinically relevant data. In particular, studies validating PET segmentation tools mainly use phantoms with thick plastic walls inserts of simple spherical geometry and have not specifically investigated the effect of the target object geometry on the delineation accuracy. Our work therefore aimed at generating clinically realistic data using nonspherical thin-wall plastic inserts, for the evaluation and comparison of a set of eight promising PET-AS approaches. METHODS: Sixteen nonspherical inserts were manufactured with a plastic wall of 0.18 mm and scanned within a custom plastic phantom. These included ellipsoids and toroids derived with different volumes, as well as tubes, pear- and drop-shaped inserts with different aspect ratios. A set of six spheres of volumes ranging from 0.5 to 102 ml was used for a baseline study. A selection of eight PET-AS methods, written in house, was applied to the images obtained. The methods represented promising segmentation approaches such as adaptive iterative thresholding, region-growing, clustering and gradient-based schemes. The delineation accuracy was measured in terms of overlap with the computed tomography reference contour, using the dice similarity coefficient (DSC), and error in dimensions. RESULTS: The delineation accuracy was lower for nonspherical inserts than for spheres of the same volume in 88% cases. Slice-by-slice gradient-based methods, showed particularly lower DSC for tori (DSC < 0.5), caused by a failure to recover the object geometry. The region-growing method reached high levels of accuracy for most inserts (DSC > 0.76 except for tori) but showed the largest errors in the recovery of pears and drops dimensions (higher than 10% and 30% of the true length, respectively). Large errors were visible for one of the gradient-based contouring methods when delineating drop-shaped inserts. Low DSC due to systematic underestimation of the volumes was observed for our fuzzy clustering method when using nonspherical inserts. The adaptive iterative thresholding method produced the highest DSC score on our nonspherical dataset (DSC > 0.83, except for tori) and showed robustness to the insert geometry. CONCLUSIONS: This study investigated the accuracy of eight PET-AS methods for the delineation of objects with a range of nonspherical geometries. The authors' results confirmed the robustness of some segmentation approaches, but also showed the weaknesses of some of the other methods implemented, which were not observed with spherical inserts. This work therefore highlights the importance of using a variety of thin-wall inserts with complex geometries for the validation of PET-AS methods and provided useful information for further development of the methods tested.

Influence of cold walls on PET image quantification and volume segmentation: a phantom study.

PURPOSE: Commercially available fillable plastic inserts used in positron emission tomography phantoms usually have thick plastic walls, separating their content from the background activity. These "cold" walls can modify the intensity values of neighboring active regions due to the partial volume effect, resulting in errors in the estimation of standardized uptake values. Numerous papers suggest that this is an issue for phantom work simulating tumor tissue, quality control, and calibration work. This study aims to investigate the influence of the cold plastic wall thickness on the quantification of 18F-fluorodeoxyglucose on the image activity recovery and on the performance of advanced automatic segmentation algorithms for the delineation of active regions delimited by plastic walls. METHODS: A commercial set of six spheres of different diameters was replicated using a manufacturing technique which achieves a reduction in plastic walls thickness of up to 90%, while keeping the same internal volume. Both sets of thin- and thick-wall inserts were imaged simultaneously in a custom phantom for six different tumor-to-background ratios. Intensity values were compared in terms of mean and maximum standardized uptake values (SUVs) in the spheres and mean SUV of the hottest 1 ml region (SUVmax, SUVmean, and SUVpeak). The recovery coefficient (RC) was also derived for each sphere. The results were compared against the values predicted by a theoretical model of the PET-intensity profiles for the same tumor-to-background ratios (TBRs), sphere sizes, and wall thicknesses. In addition, ten automatic segmentation methods, written in house, were applied to both thin- and thick-wall inserts. The contours obtained were compared to computed tomography derived gold standard ("ground truth"), using five different accuracy metrics. RESULTS: The authors' results showed that thin-wall inserts achieved significantly higher SUVmean, SUVmax, and RC values (up to 25%, 16%, and 25% higher, respectively) compared to thick-wall inserts, which was in agreement with the theory. This effect decreased with increasing sphere size and TBR, and resulted in substantial (>5%) differences between thin- and thick-wall inserts for spheres up to 30 mm diameter and TBR up to 4. Thinner plastic walls were also shown to significantly improve the delineation accuracy for the majority of the segmentation methods tested, by increasing the proportion of lesion voxels detected, although the errors in image quantification remained non-negligible. CONCLUSIONS: This study quantified the significant effect of a 90% reduction in the thickness of insert walls on SUV quantification and PET-based boundary detection. Mean SUVs inside the inserts and recovery coefficients were particularly affected by the presence of thick cold walls, as predicted by a theoretical approach. The accuracy of some delineation algorithms was also significantly improved by the introduction of thin wall inserts instead of thick wall inserts. This study demonstrates the risk of errors deriving from the use of cold wall inserts to assess and compare the performance of PET segmentation methods.

A comparative validation of a child food frequency questionnaire using red blood cell membrane fatty acids.

BACKGROUND/OBJECTIVES: There are limited validated tools available for the assessment of dietary intake in pediatric populations. This report describes a comparative validation study of selected fatty acid intakes in children assessed by food frequency questionnaire (FFQ), compared with erythrocyte membrane fatty acids. SUBJECTS/METHODS: Overall, 46 overweight and 47 healthy-weight children aged 5-12 years (mean±SD, 9.1±1.3years, body mass index 20.5±4.0) were recruited; dietary fatty acid intakes assessed by parent report using a 135-item semi-quantitative FFQ, were compared with selected child erythrocyte membrane fatty acids assessed from fasting samples using gas chromatography. Spearman's rank correlation coefficients were calculated between fatty acid intake estimates (% of energy) and erythrocyte membrane concentrations (%mol/mol). RESULTS: Significant correlations were found between dietary and erythrocyte eicosapentanoic acid (EPA) concentration (r=0.24, P<0.05) with a statistical trend for total omega three (∑n-3) fatty acids (r=0.22, P=0.06) and linoleic acid (r=0.32, P=0.07) in the healthy-weight children only. CONCLUSION: Parental report of selected child fatty acid intakes using an FFQ can be used to provide an estimate of child intake of EPA, but further work is required to quantify this relationship for other fatty acids and in other populations.

Toxicity of alpidem, a peripheral benzodiazepine receptor ligand, but not zolpidem, in rat hepatocytes: role of mitochondrial permeability transition and metabolic activation.

Whereas alpidem is hepatotoxic, zolpidem is not. Despite closely related chemical structures, alpidem, but not zolpidem, is a peripheral benzodiazepine receptor (PBR) ligand, and is also more lipophilic than zolpidem. We compared their effects in isolated rat liver mitochondria and rat hepatocytes. Zolpidem did not affect calcium-induced mitochondrial permeability transition (MPT) in mitochondria, caused little glutathione depletion in hepatocytes, and was not toxic, even at 500 microM. At 250 to 500 microM, alpidem prevented calcium-induced MPT in isolated mitochondria, but caused severe glutathione depletion in hepatocytes that was increased by 3-methylcholanthrene, a cytochrome P4501A inducer, and decreased by cystine, a glutathione precursor. Although cell calcium increased, mitochondrial cytochrome c did not translocate to the cytosol and cells died of necrosis. Cell death was prevented by cystine, but not cyclosporin A, an MPT inhibitor. At low concentrations (25-50 microM), in contrast, alpidem accelerated calcium-induced MPT in mitochondria. It did not deplete glutathione in hepatocytes, but nevertheless caused some cell death that was prevented by cyclosporin A, but not by cystine. Alpidem (10 microM) also increased the toxicity of tumor necrosis factor-alpha (1 ng/ml) in hepatocytes. In conclusion, low concentrations of alpidem increase both calcium-induced MPT in mitochondria, and TNF-alpha toxicity in cells, like other PBR ligands. Like other lipophilic protonatable amines, however, alpidem inhibits calcium-induced MPT at high concentrations. At these high concentrations, toxicity involves cytochrome P4501A-mediated metabolic activation, glutathione depletion, and increased cell calcium, without MPT involvement. In contrast, zolpidem has no mitochondrial effects, causes little glutathione depletion, and is not toxic.

H2O2 impairs inflammatory mediator release from immunologically stimulated RBL-2H3 cells through a redox-sensitive, calcium-dependent mechanism.

OBJECTIVES: In this study we examined the effects of the inflammatory agent hydrogen peroxide (H2O2) on IgE-mediated mast cell responses. MATERIALS AND METHODS: Release of preformed granular mediators and newly synthesised TNF-alpha were measured in the RBL-2H3 mast cell line stimulated through IgE receptors (FcepsilonRI) in the presence of varying concentrations of H2O2. The sensitivity of the intracellular calcium response to H2O2 exposure was investigated. RESULTS: We found that H2O2 treatment impaired the release of preformed and newly synthesised mediators. H2O2 treatment simultaneously led to a profound inhibition of the calcium response. Calcium fluxes from both intra- and extracellular sources were impaired. H2O2 action was dependent on the intracellular redox state. Receptor activation directly stimulated intracellular H2O2 production. CONCLUSION: While in many cells H2O2 induces potent inflammatory responses we show that it can be an anti-inflammatory agent by not only inhibiting the release of preformed mediators but also by affecting the secretion of newly synthesized TNF-alpha. Inhibition is a consequence of the profound effect on intracellular calcium levels. The activation of an intracellular oxidative burst by FcepsilonRI aggregation and the sensitivity of intracellular responses to redox-altering agents point to an important regulatory mechanism of mast cell responses in inflammatory tissues.

Towards promotion, structuring and acknowledgement of patient education activities in France.

As patient education becomes more and more widespread in use among French health professionals, it is also becoming increasingly structured, but remains very heterogeneous depending on practitioners and institutions. For several years, this activity has been integrated into various professions. Training is becoming more frequent, and care providers show a certain willingness for common though on improvement and evaluation of their practices. At the same time, health institutions show an increasing interest in these activities, which they wish to promote. Significant improvements recently observed by them may finally lead to the professional and financial recognition expected by care providers.

Implementing health promotion in health care settings: conceptual coherence and policy support.

This article examines the level and conditions of development of the concept of "health promoting hospital (HPH)", in France and in Europe. Part of the literature on HPH was reviewed, looking at the kind of partnerships implemented within the HPH projects, and at the organisational strategies adopted by hospitals to be health promoting. The literature review is followed by an overview of the priorities defined by health policies in Europe. This research shows that there is still a lack of guidelines on how to put the health promotion concept into practice in health care settings. Moreover, it stresses that further research is needed in order to better define which personal skills ought to be developed through health education in health care settings, and how the development of such skills may be articulated to other priorities in health care settings.

[Intracellular calcium channels, hormone receptors and intercellular calcium waves]. / Canaux calciques intracellulaires, récepteurs hormonaux et vagues calciques intercellulaires.

The hormone-mediated intercellular Ca2+ waves were analyzed in multiplets of rat hepatocytes by video imaging of fura2 fluorescence. These multicellular systems are composed of groups of several cells (doublets to quintuplets) issued from the liver cell plate, a one cell-thick cord of about 20 hepatocytes long between portal and centrolobular veins. When the multiplets were homogeneously bathed with the glycogenolytic agonists vasopressin, noradrenaline, angiotensin II and ATP, they showed highly organized Ca2+ signals. Surprisingly, for a given agonist, the primary rises in intracellular Ca2+ concentration ([Ca2+]i) originated invariably in the same hepatocyte, then was propagated in a sequential manner to the nearest connected cells (cell 2, then 3, cell 4 in a quadruplet, for example). The sequential activation of the cells appeared to be an intrinsic property of multiplets of rat hepatocytes. The same sequence was observed at each train of oscillations occurring between cells. The order of [Ca2+]i responses was modified neither by repeated additions of hormones nor by the hormonal dose. The mechanical disruption of an intermediate cell did not prevent the activation of the next cell. These results suggest that each hepatocyte in the multiplet displays its own sensitivity to the hormone and that a gradient of sensitivity between each cell could be responsible for directing the intercellular Ca2+ wave. To test this hypothesis, we selectively isolated rat hepatocytes from periportal (PP) and perivenous (PV) areas of the liver cell plate. Periportal (PP) and perivenous (PV) rat hepatocyte suspensions were loaded with quin2/AM and hormonal responses were studied in a spectrofluorimeter. Noradrenaline, angiotensin II, and vasopressin-induced [Ca2+]i rises were greater in PV than in PP hepatocytes. In contrast, PP cells were more responsive than PV cells to ATP. The function of the InsP3 receptor (InsP3R) was also studied by measuring the InsP3-mediated 45Ca2+ release from permeabilized PP and PV hepatocytes. In permeabilized PP and PV hepatocytes, internal Ca2+ stores displayed the same loading-kinetics, the responses to InsP3 were similar, and the sizes of InsP3-sensitive compartment were not different. In a further study, we investigated by video microscopy in fura2-loaded multicellular systems of rat hepatocytes, the mechanisms controlling intercellular propagation of the Ca2+ wave and coordination of Ca2+ signals induced by the different hormones. Using focal microperfusion which allows local perfusion of any cell of the multiplet, rapid agonist removal during the Ca2+ response and microinjection, we found that second messengers and [Ca2+]i rises in one hepatocyte cannot trigger Ca2+ responses in connected adjacent cells, suggesting that diffusion across gap junctions, while required for coordination, is not sufficient by itself for the propagation of the intercellular Ca2+ wave. In addition, focal microperfusion and intermediate cell disruption experiments revealed very fine functional differences (hormonal delay, frequency of [Ca2+]i oscillations) between hormone-induced Ca2+ signals, even between two adjacent connected hepatocytes. Recent unpublished results performed in suspensions of PP and PV rat hepatocytes supported the view of a major role played by vasopressin receptors (V1a) in genesis and orientation of the Ca2+ wave. Vasopressin binding sites, V1a mRNAs detected by RNAse Protection Assay, and vasopressin-induced InsP3 production, were more abundant in PV than in PP cells. A gradient of hormone receptors could orientate the propagation of the Ca2+ wave in multicellular systems and in liver cell plate. These results suggest that the intercellular Ca2+ wave in multicellular systems of rat hepatocytes is propagated through mechanisms involving at least three factors. (ABSTRACT TRUNCATED)

Receptor-oriented intercellular calcium waves evoked by vasopressin in rat hepatocytes.

Agonist-induced intracellular calcium signals may propagate as intercellular Ca2+ waves in multicellular systems as well as in intact organs. The mechanisms initiating intercellular Ca2+ waves in one cell and determining their direction are unknown. We investigated these mechanisms directly on fura2-loaded multicellular systems of rat hepatocytes and on cell populations issued from peripheral (periportal) and central (perivenous) parts of the hepatic lobule. There was a gradient in vasopressin sensitivity along connected cells as demonstrated by low vasopressin concentration challenge. Interestingly, the intercellular sensitivity gradient was abolished either when D-myo-inositol 1,4, 5-trisphosphate (InsP3) receptor was directly stimulated after flash photolysis of caged InsP3 or when G proteins were directly stimulated with AlF4-. The gradient in vasopressin sensitivity in multiplets was correlated with a heterogeneity of vasopressin sensitivity in the hepatic lobule. There were more vasopressin-binding sites, vasopressin-induced InsP3 production and V1a vasopressin receptor mRNAs in perivenous than in periportal cells. Therefore, we propose that hormone receptor density determines the cellular sensitivity gradient from the peripheral to the central zones of the liver cell plate, thus the starting cell and the direction of intercellular Ca2+ waves, leading to directional activation of Ca2+-dependent processes.

An improved digitonin-collagenase perfusion technique for the isolation of periportal and perivenous hepatocytes from a single rat liver: physiological implications for lobular heterogeneity.

Morphological and functional heterogeneity of hepatocytes according to their position in the liver lobule has been known for many years. The digitonin-collagenase perfusion technique is widely used to study hepatocyte heterogeneity and has yielded reliable data. However, with this procedure, periportal (PP) or perivenous (PV) hepatocytes are isolated from different livers, allowing only comparison between cell populations issued from two separate animals. To overcome this drawback, we have modified this technique by perfusing the two main rat liver lobes of a single animal in succession. The procedure involved alternate clamping of the median and the left lateral lobes, restricting digitonin infusion to one lobe via the portal vein, and to the other via the caudal vena cava. Lobe exclusion during digitonin perfusion, and zonal restriction of digitonin-induced damage, were monitored using macroscopic and histological controls. We compared our results with previous data on PP and PV hepatocytes issued from two different livers using the conventional digitonin-collagenase perfusion technique. First, we found that the cellular sensitivity to angiotensin II, a calcium-mobilizing agonist, was 60% to 80% higher in PV than in PP hepatocytes, whereas, previously, no difference had been recorded. Second, we found that albumin messenger RNAs (mRNAs) were 35% more abundant in PP than in PV hepatocytes, whereas, previously, larger differences had been reported. Our results show that PP and PV hepatocytes may be isolated from a single liver using an improved digitonin-collagenase perfusion technique. Furthermore, we suggest that zonal differences can be artificially masked or amplified when comparing PP and PV cell populations from two different livers, indicating that it is preferable to use a single liver for accurate zonal comparisons between hepatocytes.

Coordinated intercellular calcium waves induced by noradrenaline in rat hepatocytes: dual control by gap junction permeability and agonist.

Calcium-mobilizing agonists induce intracellular Ca2+ concentration ([Ca2+]i) changes thought to trigger cellular responses. In connected cells, rises in [Ca2+]i can propagate from cell to cell as intercellular Ca2+ waves, the mechanisms of which are not elucidated. Using fura2-loaded rat hepatocytes, we studied the mechanisms controlling coordination and intercellular propagation of noradrenaline-induced Ca2+ signals. Gap junction blockade with 18 alpha-glycyrrhetinic acid resulted in a loss of coordination between connected cells. We found that second messengers and [Ca2+]i rises in one hepatocyte cannot trigger Ca2+ responses in connected cells, suggesting that diffusion across gap junctions, while required for coordination, is not sufficient by itself for the propagation of intercellular Ca2+ waves. In addition, our experiments revealed functional differences between noradrenaline-induced Ca2+ signals in connected hepatocytes. These results demonstrate that intercellular Ca2+ signals in multicellular systems of rat hepatocytes are propagated and highly organized through complex mechanisms involving at least three factors. First, gap junction coupling ensures coordination of [Ca2+]i oscillations between the different cells; second, the presence of hormone at each hepatocyte is required for cell-cell Ca2+ signal propagation; and third, functional differences between adjacent connected hepatocytes could allow a 'pacemaker-like' intercellular spread of Ca2+ waves.

The location of hepatocytes in the rat liver acinus determines their sensitivity to calcium-mobilizing hormones.

BACKGROUND & AIMS: In multicellular systems of rat hepatocytes and in the intact liver, inositol 1,4,5-trisphosphate (IP3)-dependent agonists induce sequentially ordered calcium ion signals. The mechanisms by which sequential waves are oriented from one hepatocyte to another are unknown. The aim of this study was to investigate the relationship between hepatocyte location in the acinus and cellular sensitivity to noradrenaline, vasopressin, adenosine triphosphate, and angiotensin II. METHODS: Periportal (PP) and pericentral (PC) rat hepatocyte suspensions, isolated by the digitonin-collagenase technique, were loaded with quin2-acetoxymethyl ester, and hormonal responses were studied in a spectrofluorimeter. The function of the IP3 receptor was studied by measuring the IP3-mediated 45Ca2+ release from permeabilized PP and PC hepatocytes. RESULTS: Increases in noradrenaline and vasopressin-induced intracellular Ca2+ concentration were greater in PC than in PP hepatocytes. In contrast, PP cells were more responsive than PC cells to adenosine triphosphate, and angiotensin II induced similar intracellular Ca2+ concentration increases in both hepatocyte populations. In permeabilized PP and PC hepatocytes, internal Ca2+ stores showed the same loading kinetics, the responses to IP3 were similar, and the sizes of the IP3 sensitive compartment were not different. CONCLUSIONS: Hepatocyte location in the acinus determines cellular sensitivity to Ca(2+)-mobilizing agonists. Intercellular Ca2+ waves in the liver could be driven by sensitivity gradients along the hepatocyte plate.

[Hormone-mediated calcium responses of rat and human hepatocytes. Study of multicellular systems by videomicroscopy]. / Réponses hormonales calciques des hépatocytes de rat et des hépatocytes humains. Etude des systèmes multicellulaires par vidéomicroscopie.

OBJECTIVES AND METHODS: Activation of hepatocyte hormonal receptors leads to the mobilization of intracellular Ca2+ which is thought to be an elaborate system for encoding hormonal messages. We studied hormone-induced calcium signals in freshly isolated multicellular systems of normal rat and human hepatocytes. Calcium signals were recorded by videomicroscopy after stimulation with noradrenaline, angiotensin II, and vasopressin. RESULTS: Calcium signals were highly organized in multiplets: the different hepatocytes responded to Ca(2+)-mobilizing hormones in a sequentially ordered manner, with a first, a second (doublets) and a third (triplets) responding cells. This pattern was an intrinsic feature of the multicellular systems, and seemed to be a result of a gradual heterogeneity of the sensitivity of the different cells, to the hormones. The stimulation of the same multiplet with two different agonists and the removal of the hormone during cell responses provides some evidence for the major role of hormonal receptors in this heterogeneity. CONCLUSIONS: Hormone responses in multicellular systems of rat and human hepatocytes are highly elaborate. The density of hormonal receptors could be the major determinant of the sequential pattern of Ca2+ responses. Hormonal receptors may be gradually distributed among the different cells of the multiplets in vitro and along the porto-centrilobular axis in situ.

Ca(2+)-mobilizing hormones induce sequentially ordered Ca2+ signals in multicellular systems of rat hepatocytes.

The development of hormone-mediated Ca2+ signals was analysed in polarized doublets, triplets and quadruplets of rat hepatocytes by video imaging of fura2 fluorescence. These multicellular models showed dilated bile canaliculi, and gap junctions were observed by using an anti-connexin-32 antibody. They also showed highly organized Ca2+ signals in response to vasopressin or noradrenaline. Surprisingly, the primary rises in intracellular Ca2+ concentration ([Ca2+]i) did not start randomly from any cell of the multiplet. It originated invariably in the same hepatocyte (first-responding cell), and then was propagated in a sequential manner to the nearest connected cells (cell 2, then 3, in triplets; cell 2, 3, then 4 in quadruplets). The sequential activation of the cells appeared to be an intrinsic property of multiplets of rat hepatocytes. (1) In the continued presence of hormones, the same sequential order was observed up to six times, i.e. at each train of oscillations occurring between the cells. (2) The order of [Ca2+]i responses was modified neither by the repeated addition of hormones nor by the hormonal dose. (3) The mechanical disruption of an intermediate cell slowed down the speed of the propagation, suggesting a role of gap junctions in the rapidity of the sequential activation of cells. (4) The same multiplet could have a different first-responding cell for vasopressin or noradrenaline, suggesting a role of the hormonal receptors in the sequentiality of cell responses. It is postulated that a functional heterogeneity of hormonal receptors, and the presence of functional gap junctions, are involved in the existence of sequentially ordered hormone-mediated [Ca2+]i rises in the multiplets of rat hepatocytes.