Structural Changes in the Liver in Post-Toxic Cirrhosis and Its Treatment with Oxidized Dextran. Immunohistochemical Research.

In adult Wistar rats, post-toxic liver cirrhosis was induced by intraperitoneal injection of 50% oil solution of CCl4 and peroral administration of 6.5% aqueous solution of ethyl alcohol over 60 days. Histological examination of the liver revealed vacuolar degeneration and necrosis of hepatocytes, formation of false lobules, expression of collagens I and III periportally and in interlobular spaces, ascites, and hydrothorax. Then, oxidized dextran with a molecular weight of 40 kDa (2 ml of a 5% aqueous solution) was intraperitoneally injected every fourth day over 30 days. Against the background of treatment with oxidized dextran, the volume density of collagens I and III decreased by more than 2 times, the "collagen-producing" activity of fibroblasts decreased by 47%, and the number of fibroblasts decreased, including by the mechanism of apoptosis. The decrease in the collagen content in the liver of rats treated with oxidized dextran was apparently associated with blockade of collagen assembly due to the aldehyde-aldehyde interaction of tropocollagens and oxidized dextran.

In Vitro Study of the Expression of CD1, CD14, CD25, CD30, CD35, CD95 Receptors by Macrophages of Mice Infected with Mycobacterium tuberculosis.

In cultures of peritoneal macrophages (MP) of male BALB/c mice infected with Mycobacterium tuberculosis from the BCG vaccine, the expression of CD1, CD14, CD25, CD30, CD35, and CD95 receptors was studied in vitro 3 months after infection. In MP cultures from intact and infected mice, mononuclear MP predominated (96 and 92%, respectively). Bi- and trinuclear MP in MP cultures from control and infected mice constituted 4 and 8.3% of all MP, respectively. In the cultures of both groups, no obvious correlations between the number of MP expressing CD-receptors and number of nuclei in these cells were found, but the expression of CD14 receptor was more often noted. In cultures from infected animals, hypertrophied MP and enhanced (by several times) expression of all CD-receptors were observed. The increase in the expression of CD-receptor can be determined by activation of plastic processes in hypertrophied MP (in epithelioid and in numerically insignificant polynuclear MP), which is due to the phenomenon of prolonged M. tuberculosis persistence in the vacuolar apparatus of these cells.

The Study of Efficiency of the Approach to Prevent the Adhesions in the Abdominal Cavity of Rats.

Adhesions in rat abdominal cavity were studied after laparotomy and subsequent single intraperitoneal injection of 2 ml of 5% aqueous solution of oxidized dextran (OD) with a molecular weight of 40 kDa (oxidation degree 10%). On days 7 and 21 after laparotomy, the number of adhesions in OD-treated rats was lower by 7.5 and 4 times than in animals not receiving OD. The number of neutrophils in adhesions on day 21 was manyfold lower in OD-treated rats. In 7 and 21 days after laparotomy, the number of fibroblasts in the adhesions of rats receiving and not receiving OD was similar, but 2-fold higher than in the peritoneum of non-operated rats. The content of collagen in adhesions on day 21 after laparotomy in OD-treated rats was 10-fold lower than in animals no receiving OD.

Destructive Processes and Fibrotic Complications in the Liver of Mice with BSG-Induced Granulomatosis Treated with Anti-Tuberculous Drugs.

Three months after infection with Mycobacterium tuberculosis (MBT) from BCG vaccine, male BALB/с mice were treated with isonicotinic acid hydrazide, dextrazide (oxidized dextran), and liposome-encapsulated dextrazide intraperitoneally or in inhalations in a dose of 14 mg/kg (calculated for isoniazid) twice a week for 6 months. All these drugs exhibit different antimycobacterial efficiency. In the liver parenchyma, an up to 5-fold decrease in the number of destructed hepatocytes was observed depending on the efficiency of treatment. No destructive processes were observed in granulomas. Type I and III collagens were revealed around the granulomas; their content in the liver parenchyma was negligible. TNFα, IL-6, MMP-1, ТIMP1 were expressed only by granuloma macrophages. As the number of damaged hepatocytes and size of inflammatory infiltrates in the liver parenchyma decreased, the content of both types of collagen decreased. No evidence of hepatotoxicity of MBT degradation products in macrophages in vivo was obtained; the assumption that fibrotic complications are only the post-destruction process was not confirmed. Fibrotic complications are supposed to be an "excessive" systemic nonspecific adaptive process aimed at the maintenance the so-called structural homeostasis initiated by activated М2-macrophages in granulomas.

Effect of Liposome-Encapsulated Dextrazide on Local Regulation of Extracellular Matrix Metabolism in Liver and Lungs of Mice with during Chronic BCG-Induced Granulomatosis.

The liposomal form of isonicotinic acid hydrazide conjugate with oxidized dextran (liposomeencapsulated dextrazide, LEDZ) injected intraperitoneally for 3 months to BALB/c mice with chronic BCG-induced granulomatosis (6 month after infection) down-regulated activities of protease (MMP) and antiprotease (TIMP-1, TIMP-2, α2-macroglobulin) components of the regulation system, which indicates a drop of destructive and inflammatory potential of BCGinduced granulomatosis. The persistent enhanced hyaluronidase activity in the liver and its reduced (normalized to control level) activity in the lungs after administration of LEDZ indicates a greater hydrolysis of hyaluronan in the liver than in the lungs. LEDZ-induced changes in MMP/TIMP system in mouse liver and lungs are characterized with relative elevation of protease activity over that of antiprotease one.

Content of the Major Extracellular Matrix Components of the Liver and Lungs in Mice with Chronic BCG-Granulomatosis Treated with Liposome-Encapsulated Dextrazide.

Administration of the liposome-encapsulated dextrazide (LEDZ) to mice 6 months after infection with mycobacterium BCG vaccine for 3 months modulated metabolism of collagens and the intensity of fibrosis of internal organs. In the liver, we observed a redistribution of glycosaminoglycans towards sulfated forms, a decrease in the content of hyaluronan, a change in the ratio of hydroxyproline fractions indicating a decrease in fibrosis via two mechanisms: suppression of synthesis and increased degradation of collagens. In the lungs, administration of LEDZ did not affect the content of sulfated glycosaminoglycans, but significantly reduced the content of hyaluronan, stimulated degradation of collagen, and reduced its synthesis, but these processes were insufficient for significant reduction of fibrotic complications in the lungs. In animals treated with LEDZ, the decrease in collagen synthesis in the liver was 2-fold more pronounced than in the lungs.

Analysis of the Efficiency of Different Antituberculous Drugs and Approaches to Treat BCG-Induced Granulomatosis in Mice and Abundance and Localization of Mycobacterium tuberculosis in the Liver.

In 3 months after infection with Mycobacterium tuberculosis (MBT) from BCG vaccine, male BALB/с mice received intraperitoneal injections of isonicotinic acid hydrazide, dextrazide, or liposome-encapsulated dextrazide, or inhalation of liposome-encapsulated dextrazide 2 times a week for 6 months. In 6 months, no MBT were detected in macrophages outside granulomas in treated mice. Macrophages containing MBT can incorporate into granulomas and leave them after suppression of MBT persistence. Liposome-encapsulated dextrazide showed the maximum therapeutic efficiency: the total MBT level in granuloma macrophages and volume density of destruction foci in the liver parenchyma decreased by 5.1 and 5.3 times, respectively, in comparison with the corresponding parameters in mice treated with isonicotinic acid hydrazide. Inhalations of liposome-encapsulated dextrazide prevented the destructive processes in liver granulomas due to macrophage migration from granulomas, which reduced granuloma sizes and destructive potential of granuloma lysosomes and therefore improved their diffusion-dependent trophics.

The In Vitro M1/M2 Polarization of Macrophages of BCG-Infected Mice.

Cultured peritoneal macrophages from intact (control) and BCG-infected (experiment) male BALB/c mice were studied 90 days after infection. Polarization of macrophages by M1 (expression of GM-CSF, IFNγ, and CD16/32) and M2 (expression of bFGF and CD36) differentiation pathways was studied with consideration for their the nuclearity class. Mononuclear cells predominated (90% and higher) in macrophage cultures of both groups and presumably, were presented by mainly epithelioid cells. The results indicated polarization of mononuclear and multinuclear macrophages in the M2 direction under conditions of BCG granulomatosis and a higher initial M2 polarization of binuclear macrophages. In control cultures, the ratio of M2 to M1 macrophages was 0.57, in experimental cultures this ratio was 1.6. It seems that long persistence of Mycobacterium tuberculosis in macrophages served as a factor stimulating the plastic processes and transformation of macrophages into epithelioid cells that form the "core" of granulomas and their enlargement upon incorporation of macrophages.

Antifibrotics Effect of Liposome-Encapsulated Composition of Oxidized Dextran and Isonicotinic Acid Hydrazide in Mice with BCG-Induced Granulomatosis Depends on Administration Route.

We studied the response of the extracellular matrix of the lungs and liver in mice with BCGinduced granulomatosis (3 months) after inhalation and intraperitoneal administration of liposome-encapsulated dextrazide (LEDZ): a conjugate of oxidized dextran (40 kDa) and isonicotinic acid hydrazide (INH). LEDZ inhalation proved to be more effective in reducing fibrosis severity, both in the lungs and liver. However, the mechanisms of the antifibrotic effect were different: increased degradation and reduced collagen synthesis in the lungs and reduced collagen synthesis and collagen degradation in the liver. This suggest that drug administration routes and delivery to the target organs are crucially important in the therapy of tuberculosis. The antifibrotic effect depended on LEDZ administration route and was more potent after LEDZ inhalation.

Peculiarities of Collagen Turnover in Aging BALB/c Mice.

Examination of collagen turnover in the liver, lungs, and spleen of BALB/c mice revealed the age-related differences in the levels of hydroxyproline and its fractions. The highest level of total hydroxyproline was observed in the lungs and spleen of young (2-month-old) mice. In the liver, this level attained maximum at the age of 6 months at the expense of elevation of protein-bound hydroxyproline relatively its level in 2-month-old mice. At the age of 12 months, the levels of total hydroxyproline in the liver and spleen were lower than in 6-month-old mice. The decrease in the collagen turnover rate in the liver of 12-month-old mice reflected lower levels of hydroxyproline fractions in comparison with the corresponding values in 6-month-old mice. The rates of collagen turnover in organs differed in mice of different ages: it was maximum in the lungs and spleen of young animals and in the liver of middle-aged mice.

Location of Pulmonary Mycobacteria Tuberculosis and Effectiveness of Various Dextrazide Compositions in Treatment of Mice with BCG-Induced Granulomatosis.

The study examined effectiveness of liposomal form of dextrazide (inhaled or intraperitoneal), free dextrazide (intraperitoneal), and isoniazid (intraperitoneal) in the treatment of BALB/c mice with BCG-induced granulomatosis. The mice were infected with mycobacteria tuberculosis 3 months prior to onset of treatment. The preparations under examinations were administered twice a week over 2 months. The decrease of the number and size of macrophagal granulomas in mice BCG-induced granulomatosis during treatment was determined by the number of living mycobacteria tuberculosis in these granulomas. The most effective treatment was achieved with liposomal form of dextrazide (a conjugate of oxidized dextran with isonicotinic acid hydrazide). Macrophages with captured mycobacteria tuberculosis, dextrazide, and dextrazide-loaded liposomes can be incorporated into granulomas. The antimycobacterial effect of dextrazide is an important factor preventing the destructive processes in granulomas and organs via a decrease in the prodestructive potential of lysosomes in macrophages realized after their migration from granulomas.

Efficacy of Inhalations of Antituberculous Compositions with Different Length of Experimental Therapy Course in Mice.

The study compared antituberculous efficacy of individual or combined administration of "free" isoniazid and liposomal form of dextrazide (a composition consisted of isoniazid and oxidized dextran) inhaled in standard (15 mg/kg) or low (3 mg/kg) dose. The therapy started 1 month after contamination of outbred ICR male mice with Mycobacterium tuberculosis strain H37Rv. Combined inhalation of liposomal form of dextrazide and isoniazid in the low dose was most effective against mycobacterium tuberculosis due to diminished prodestructive pulmonary effect and a low hepatotoxicity. A minor prodestructive effect of this combination was observed starting from 1.5 month after the onset of therapy (12 inhalations, 2 times a week), and it augmented after 24 inhalations administered during 3 months.

Structural Changes in the Lungs and Liver of Mice with Experimental Tuberculosis Treated with Liposome-Encapsulated Dextrazide.

Male BALB/с mice were intravenously infected with Mycobacterium tuberculosis H37Rv (0.5 ml of 2-week culture). One month later, treatment with liposome-encapsulated dextrazide (LEDZ, a conjugate of isonicotinic acid hydrazide (INH) and 40 kDa oxidized dextran encapsulated in phosphatidylcholine liposomes), INH, or a combination of LEDZ with INH was started. The doses of LEDZ (liposome suspension) and INH were 0.025 ml/10 g body weight and 5 mg/kg body weight, respectively. All the substances were administered 2 times a week via inhalation or intraperitoneally (a total of 40 doses). We studied the number and the size of tuberculous granulomas, the size of destruction foci and inflammatory infiltrates in the lungs and liver, the amount of fibrous connective tissue, and the dynamic of these parameters. LEDZ+INH inhalations were most effective by the therapeutic ratios in comparison with inhalation and intraperitoneal injections of INH.

Effect of Liposomal Delivery of Oxidized Dextran with Isonicotinic Acid Hydrazide on Component Profile of Pulmonary Extracellular Matrix in Mice with BCG-Induced Granulomatosis.

Intraperitoneal injections of isonicotinic acid hydrazide (INH), dextrazide (oxidized dextran+INH), or liposomes loaded with dextrazide (INH dose of 14 mg/kg) over 2 months to mice with BCG-induced granulomatosis started from postinfection day 90 induced qualitative and quantitative changes in composition of pulmonary extracellular matrix. Both dextrazide and its liposomal form decreased the levels of sulfated glycosaminoglycans and uronic acids. In contrast to INH, both preparations did not decrease the levels of total glycosaminoglycans, proteins, and galactose. This difference is explained by the fact both free and liposomal dextrazide activated MMP, but did not increase the content of TIMP-1 and TIMP-2, whereas injection of INH was followed by an increase in TIMP-2 content and a decrease in the level of free hydroxyproline, which attested to down-regulation of collagen degradation and maintenance of the conditions for pulmonary fibrosis in mice of this group.

Remodeling of the Extracellular Matrix of the Liver in Mice with BCG-Induced Granulomatosis after Administration of Liposome-Encapsulated Composition of Oxidized Dextran and Isonicotinic Acid Hydrazide.

Remodeling of the extracellular matrix of the liver in mice with BCG-induced granulomatosis after 2-month course of intraperitoneal injections of isonicotinic acid hydrazide, oxidized dextran conjugated with isonicotinic acid hydrazide, dextrazide, and its liposome-encapsulated form manifested in modification of the proteoglycan composition and hydroxyproline fractions associated with changes in hyaluronidase and MMP activities. The antifibrotic effect of dextrazide and its liposome-encapsulated form manifested in reduction of hydroxyproline fractions that reflected the process of collagen synthesis. Administration of isonicotinic acid hydrazide was followed by a decrease in hydroxyproline fractions reflecting collagen synthesis (antifibrotics effect) and degradation (profibrotic effect), which can be explained by its hepatotoxic activity.

In Vitro Analysis of the Expression of CD11, CD29, CD36, and DC-STAMP Molecules during the Formation of Multinuclear Macrophages in BCG-Infected Mice.

Expression of CD11, CD29, CD36, and DC-STAMP molecules by macrophages was analyzed in in vitro experiments. These molecules mediate cell fusion, one of the mechanisms underlying the formation of multinuclear macrophages. Macrophages were obtained from intact and BCG-infected male BALB/c mice. In intact cultures, multinuclear macrophages appeared primarily due to amitotic division of cell nuclei, while in macrophage cultures from infected mice, the process of cell fusion predominated. In intact macrophage cultures, bi- and multinuclear cells expressed primarily CD29 and CD36. In cultures from infected mice, macrophages expressing CD29 and DC-STAMP predominated, but bi- and multinuclear macrophages expressing CD11 and CD36 predominated over mononuclear ones. The study of macrophage fusion mechanism can be useful for understanding of this biological phenomenon as the mechanisms of delivery of M. tuberculosis and lysosomotropic anti-tuberculosis drugs into tuberculous granulomas to suppress M. tuberculosis persisting in macrophages and reduce the destructive potential of granulomas.

Death Mechanisms of Pulmonary Alveolocytes in Mice Infected with Influenza Viruses A/H1N1/California/04/2009 and A/H5N1/Goose/Krasnoozerskoye/627/05.

In CBA mice infected with influenza viruses A/H1N1/California/04/2009 and A/H5N1/Goose/Krasnoozerskoye/627/05 in a dose of 10 MLD50, the mechanisms of death of pulmonary alveolocytes over 10 postinfection days were studied by light microscopy, immunohistochemistry, and morphometry. In mice infected with A/H1N1, alveolocytes died predominantly via necrosis, while apoptosis mostly employed the mitochondrial pathway. In mice infected with A/H5N1, apoptosis was the dominant mechanism of alveolocyte death proceeded via membrane receptor signaling followed by switching to FAS-mediated pathway via activation of FADD, the apoptotic signal transduction protein.

Correlations between the Levels of the Main Extracellular Matrix Components in Mouse Liver in Chronic BCG-Induced Granulomatosis.

Correlations between extracellular matrix components in mouse liver revealed the pathogenetically determined dynamic structure of these interrelations (some correlations appeared while others disappeared) at various terms of BCG-induced granulomatosis. The correlations between the studied parameters were strong during the first (postinfection days 3-10) and the second (postinfection days 60-90) periods but became moderate during the third period manifested by chronic inflammation (postinjection day 180). The greatest number of correlations was observed at the beginning of the stabilization period (postinjection day 60). At this period, the content of all structural components of hepatic proteoglycans closely correlated with that of hydroxyproline. These findings attested to systemic changes in metabolism of extracellular matrix components and interrelation between some structural units of proteoglycans in the liver and the components of extracellular matrix in the lungs. The common and typical organ-specific correlations in the liver and lungs suggest the existence of correlations between different organs during progression of BCG-induced granulomatosis.

Changes in the Structure of Mouse Kidney in the Acute Period after Infection with Influenza Viruses A/H5N1 and A/H1N1.

Changes in the kidney structure in outbred and inbred male BALB/c mice were analyzed in the acute period after infection with influenza viruses A/H5N1 (10 MLD50; 10 days) and A/H1N1 (1 MLD50; 30 days). Antibodies to influenza viruses of both strains were most often expressed by endothelial cells of the glomeruli and arterioles and were rarely expressed by mesangiocytes and tubule epithelial cells. In the kidney, destructive processes induced by viruses and by ischemia due to massive blood vessel thrombosis. Mesangiocytes expressed factors, indicating that they could be qualified as M1 and M2 macrophages. Kidney destruction was more significant after infection of mice with the A/H5N1 virus, but in both experiments cell infiltrates were actually absent, probably due to blood vessel thrombosis and limited possibility of migration of mononuclear phagocytes and lymphocytes to the kidney.

Expression of Pro- and Antiapoptotic Factors in Multinuclear Macrophages of BCG-Infected Mice In Vitro.

Intraperitoneal infection of Mycobacterium tuberculosis from BCG vaccine to male BALB/c mice provoked the formation of multinuclear macrophages in the peritoneal transudate. In 2 and 3 months after infection, their number increased respectively by 34.4 and 66.7% in comparison with intact mice. At all postinfection terms, far greater amounts of caspase 3, p53, Bad, and TNFα were expressed by multinuclear macrophages than by the mononuclear ones. At these terms, the content of Bcl-2-expressing macrophages with different numbers of nuclei was pronouncedly high; of them, the number of multinuclear macrophages was maximum. In 3 months after infection, the number of macrophages expressing Bcl-2 significantly decreased irrespective of the number of their nuclei. At this term, the number of macrophages expressing caspase 3, and TNFα also decreased. In parallel, the number of macrophages expressing p53 and Bad somewhat increased. These data attest to potentiality ("readiness") of macrophages infected with Mycobacterium tuberculosis to apoptotic self-elimination.