Residence of liquids in the infra-junctional portion of the proximal stomach in patients with gastroesophageal reflux disease

Patients with gastroesophageal reflux disease may have disturbances of gastric motility, which could play a role in the pathophysiology of the disease. Recent studies have suggested that the gastric region just below the gastroesophageal junction may have a distinct physiological behavior. We determined whether patients with gastroesophageal reflux disease have abnormal residence of food in the infra-junctional portion of the stomach after ingesting a liquid nutrient meal. Fasted adult patients with reflux disease (N = 11) and healthy volunteers (N = 10) ingested a liquid meal (320 ml; 437 kcal) labeled with 99m technetium-phytate and their total gastric emptying half-time and regional emptying from the stomach infra-junctional region were determined. In 8 patients, episodes of postprandial acidic reflux to the esophagus were measured for 2 h using pH monitoring. There were no differences between reflux patients and controls regarding total gastric emptying time (median: 68 min; range: 39-123 min vs 65 min and 60-99 min, respectively; P > 0.50). Food residence in the infra-junctional area was similar for patients and controls: 23 percent (range: 20-30) vs 27 percent (range: 19-30 percent; P = 0.28) and emptying from this area paralleled total gastric emptying (Rs = 0.79; P = 0.04). There was no correlation between residence of food in the infra-junctional area and episodes of gastroesophageal reflux (Rs = 0.06; P = 0.88). We conclude that it is unlikely that regional motor disturbances involving the infra-junctional region of the stomach play a relevant role in the pathogenesis of acidic gastroesophageal reflux.

Identification of a 30 kDa antigen from leishmania (L.) chagasi amastigotes implicated in protective cellular reponses in a murine model.

An antigen of apparent molecular mass of 30 kDa, termed p30, was purified from Leishmania (L.) chagasi amastigotes after separation of parasite extracts by sodium dodecyl sulfate-polyacrylamide gel eletroctrophoresis followed by electroelution. The use of the purified antigen in lymphocyte cultures from BALB/c mice previously immunised with L. (L.) chagasi amastigotes led to high levels of proliferation. Animal immunisation with p30 plus complete Freund's adjuvant either by subcutaneous or intraperitoneal route led to comparable antigenic stimulation. Similar stimulation indices induced by p30 were also obtained when animals were immunised with Corynebacterium parvum as adjuvant by the intraperitoneal route. Detection of IL-2 and IFN-gamma in the supernatants from lymphocytes stimulated by p30 and inhibition of the production of these lymphokines in the presence of anti-CD4 strongly indicated the involvement of the Th1 subset in the responses elicited by p30 antigen. Immunisation of BALB/c mice with p30 provided partial protection against challenge with L. (L.) chagasi amastigotes, indicating a protective role for p30 and that Th1 can be related to accquired resistance to visceral leishmaniasis in a murine model. Further characterisation studies were performed by the use of a monoclonal antibody directed to a cysteine proteinase of 30 kDa from L. (L.) amazonensis amastigotes. Despite the cross-reactivity presented by p30 from both Leishmania species, the p30 from L. (L.) chagasi amastigotes lacks proteolytic activity.

Inhibition of mouse and rat lymphoproliferation by gangliosides

Our previous study have demonstrated that Glycosphingolipids (GSLs) have an immunosuppressive effect on murine lymphoproliferation and IL-2 production. In the present study we examined the effect of a pool of Gangliosides (Gang) on spleen lymphocyte proliferation from either isogeneic strains of Wistar rats or BALB/c mice. Two hundred-fifty grams adult female isogeneic Wistar rats and 8-week-old BALB/c mice were used. The animals were sacrificed and the spleen harvested aseptically for cellular assays. Spleen cells suspensions were obtained by homogenization in RPMI 1640 with a loose tissue grinder. After washing, the cells were suspended in RPMI 1640 supplemented. Cell viability was measured by Trypan blue exclusion. Cells were cultured in triplicate using increasing concentrations of Gang (1; 2; 5; 10; 15; 20 mg/well) and in the presence of Concanavalin A. The cells were incubated for 48 hours and were pulsed with [3H] thymidine 18 hours prior to harvesting on glass fiber paper for counting in a beta-counter. Data were presented as rate of inhibition, as previously described. At concentrations 1 and 2 mug/well, Gang stimulated lymphoproliferation (30 percent and 50 percent, rats and mice respectively), while at concentration from 5 to 20 mg/well an increasing inhibition was observed for spleen cells from both mouse and rat (from 40 percent up to 80 percent). In preliminary studies we observed inhibition of mixed lymphocyte reaction on spleen cells from rats treated with Gang for 10 days (data not shown). Our data suggest that Gang may be investigated as a immunosuppressive drug in organ transplantation.

Gangliosideos e a resposta de hipersensibilidade retardada em camundongos / Gangliosides and the delayed hypersensitivity response in mice

Em trabalhos anteriores mostrou-se que os gangliosídeos (GSLs) têm um efeito inibitório sobre a proliferação linfocitária e a síntese de IL-2, assim como sobre a reação mista de linfócitos. Neste estudo objetivou-se avaliar o efeito dos GSLs sobre a resposta de hipersensibilidade retardada. Foram utilizados 12 camundongos BALB/c, machos, pesando em média 30 gramas, provenientes do biotério setorial da Disciplina de Parasitologia e mantidos por 5 dias para adaptação no biotério setorial da Disciplina de Técnica Operatória e Cirurgia Experimental da UNIFESP-EPM, recebendo água e ração própria para a espécie. Os animais foram distribuídos em três grupos, de acordo com as doses de GSLs, da seguinte forma: grupo 3mg. kg-1, grupo 9mg. kg-1 e grupo simulado (veículo). Os animais foram tratados, por via intramuscular, nos dias 0 e 4. O parâmetro avaliado foi o edema da pata traseira esquerda no local da inoculação do antígeno. Os animais foram anestesiados com Cetamina (60mg.kg-1) e Xilazina (10mg.kg-1), por via intramuscular, sendo em seguida submetidos à dissecção da veia jugular direita, por onde foram inoculadas 10(6) hemácias de Carneiro no dia 0, para sensibilização. No dia 4 subsequente, os animais foram novamente anestesiados e receberam, por via subcutânea, 10(8) hemácias de Carneiro, num volume de 0,02ml. Foram realizadas medidas do edema da pata traseira com paquímetro 24, 48, 72 e 96 horas após o desafio. Os dados mostraram que após 48h houve um aumento do edema em animais dos grupos simulado e 3mg (médias=2,3 and 2,1mm, respectivamente), e os camundongos do grupo 9mg não apresentaram aumento importante (média=0,1mm). Entretanto, após 72h, o grupo 9mg apresentou aumento de 1,7mm enquanto, os outros grupos não apresentaram mudança significativa no edema da pata (médias=0,2 e 0,8mm), grupos simulado e 3mg, respectivamente) comparados aos dados do dia antecedente. Após 96h, todos os grupos apresentaram desaparecimento do edema. Com base nos dados obtidos pode-se concluir que a resposta de hipersensibilidade retardada alterou-se na vigência de alta dose de GSLs.

Efeito imunossupressor dos gangliosídeos: estudo in vivo / Immunosupressive effect of gangliosides: in vivo study

Imunomodulação mais específica e eficaz é uma meta importante a ser atingida na área de órgão. Neste sentido, foi estudado previamente o papel imunomodulador dos gangliosídeos "in vitro". No presente trabalho objetivou-se avaliar este efeito agora "in vivo", mimetizando a situação do transplante alogênico. Foram utilizados 26 ratos Wistar 1 EPM, machos, com 3 meses de idade, pesando cerca de 250g, procedentes do Centro de Desenvolvimento de Pesquisa Experimental em Medicina e Biologia. Os animais fora mantidos por 5 dias, para adaptação, no biotério setorial da Disciplina de Técnica Operatória e Cirurgia Experimental da UNIFESP-EPM, recebendo água e ração própria para a espécie. Os animais foram distribuídos em grupos conforme segue: grupos experimento (que receberam 1, 3 e 6 mg/kg/dia de gangliosídeos) e um grupo controle que recebeu veículo, todos por via intramuscular durante 7 dias consecutivos. No 8º dia, com os animais anestesiados com éter etílico foi feita a remoção cirúrgica do baço de todos os animais, os quais foram sacrificados por exsanguinação, ainda sob efeito anestésico. Os baços removidos foram processados para a obtenção de linfócitos os quais foram cultivados em placa de cultura com 96 poços, distribuídos da seguinte forma: 1,5x10(5) linfócitos viáveis de cada animal dos grupos experimento e controle foram cultivados com 1,5x10(5) linfócitos viáveis de um rato não tratado, sendo assim realizada a reação mista de linfócitos. Os linfócitos provenientes dos animais dos grupos controle e 1 mg apresentaram aumento da proliferação sem nenhuma alteração. Por outro lado, foi observada uma taxa de inibição ao redor de 70 por cento sobre a proliferação linfocitária dos animais dos grupos 3 e 6 mg comparados aos animais dos grupos controle e 1 mg. O resultado desta investigação estimula a utilização dos gangliosídeos no tratamento da rejeição alogênica.

Characterization of an antigen from Leishmania amazonensis amastigotes able to elicit protective responses in a murine model.

Lymphoproliferative responses to an antigen from Leishmania amazonensis amastigotes with an apparent molecular mass of 30 kDa, termed p30, were evaluated with BALB/c mice. The p30 antigen was purified after separation of parasite extracts by sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by electroelution. Lymphoproliferative responses to p30 were obtained by subcutaneous immunization of animals with L. amazonensis amastigote extracts, and maximal stimulation indices were observed at an antigen concentration of 5 microg/ml. Induction of lymphoproliferation by p30 is stage specific, and no differences in the responses to this antigen between mice susceptible and resistant to L. amazonensis were detected. The predominant T cells characterized in the lymphocyte cultures were CD4+. Lymphokine analysis of the supernatants from these cultures indicated that Th1 is the subset involved in the lymphoproliferative responses to the antigen. BALB/c mice immunized with p30 and challenged with L. amazonensis amastigotes showed a very low level of infection, indicating a protective role for p30 and a correlation between Th1 and protection. Further biochemical characterization studies showed that this antigen presents cysteine proteinase activity.

Glycosphingolipid antigens from Leishmania (L.) amazonensis amastigotes. Binding of antiglycosphingolipid monoclonal antibodies in vitro and in vivo

Specific glycosphingolipid antigens of Leishmania (L.) amazonensis amastigotes reactive with the monoclonal antibodies (MoAbs) ST-3, ST-4 and ST-5 were isolated, and their structure was partially elucidated by negative ion fast atom bombardment mass spectrometry. The glycan moieties of five antigens presented linear sequences of hexoses and N-acetylhexosamines ranging from four to six sugar residues, and the ceramide moieties were found to be composed by a sphingosine d18:1 and fatty acids 24:1 or 16:0. Affinities of the three monoclonal antibodies to amastigote glycosphingolipid antigens were also analyzed by ELISA. MoAb ST-3 reacted equally well with all glycosphingolipid antigens tested, whereas ST-4 and ST-5 presented higher affinities to glycosphingolipids with longer carbohydrate chains, with five or more sugar units (slow migrating bands on HPTLC). Macrophages isolated from footpad lesions of BALB/c mice infected with Leishmania (L.) amazonensis were incubated with MoAb ST-3 and, by indirect immunofluorescence, labeling was only detected on the parasite, whereas no fluorescence was observed on the surface of the infected macrophages, indicating that these glycosphingolipid antigens are not acquired from the host cell but synthesized by the amastigote. Intravenous administration of 125I-labeled ST-3 antibody to infected BALB/c mice showed that MoAb ST-3 accumulated significantly in the footpad lesions in comparison to blood and other tissues.

Glycosphingolipid antigens of Leishmania (Leishmania) amazonensis amastigotes identified by use of a monoclonal antibody.

Monoclonal antibodies directed against Leishmania (Leishmania) amazonensis amastigotes were produced. One monoclonal antibody (1C3) selected by indirect immunofluorescence reacted with both amastigotes and promastigotes of L. (L.) amazonensis. Glycolipid extraction from L. (L.) amazonensis amastigotes and separation by high-performance thin-layer chromatography followed by immunoblotting demonstrated that 1C3 reacts with two glycosphingolipids which migrate chromatographically similarly to ceramide-N-acetylneuraminic acid (GM1) and ceramide-N-tetrose-di-acetylneuraminic acid (GD1a). The antibody did not react with glycosphingolipids from L. (L.) amazonensis promastigotes. Immunoprecipitation of 125I- and 35S-methionine-labeled promastigotes demonstrated that 1C3 recognizes gp63 from L. (L.) amazonensis promastigotes. Biosynthetic incorporation of labeled lipids by L. (L.) amazonensis amastigotes indicated that the glycosphingolipids reactive with 1C3 contain oleic acid in their structures. Surface labeling with galactose oxidase and sodium boro[3H]hydride indicated that galactose is present in 1C3-reactive antigens, strongly suggesting that these glycosphingolipids are localized on the surface of L. (L.) amazonensis amastigotes. Inhibition experiments of macrophage infection implicated the 1C3-reactive glycosphingolipids from L. (L.) amazonensis amastigotes in Leishmania invasion. The role of gp63 in promastigote-macrophage attachment was also demonstrated by inhibition experiments performed with 1C3, consistent with data from the literature.

Synthesis of antimony complexes of yeast mannan and mannan derivatives and their effect on Leishmania-infected macrophages.

Antimony(Sb)-yeast mannan complexes were synthesized as a strategy to introduce Sb into macrophages infected with Leishmania amastigotes. The complexes were taken up by endocytosis after specific recognition by alpha-D-mannosyl receptors on the macrophage membrane. About 90% of the intracellular parasites were destroyed by Sb-mannan in vitro, whereas the corresponding Sb concentration used as the pentavalent antimonial drug glucantime destroyed about 60% of the amastigotes. None of the Sb complexes prepared with mannan acid or basic derivatives was as effective as the simple Sb-mannan complex in clearing macrophage infection by Leishmania (L) amazonensis. The leishmanicidal effect of Sb-mannan was also demonstrated in vivo with infected hamsters. The alternative use of Sb-mannan complex in the treatment of human leishmaniasis is envisaged on the basis of parasite-killing efficiency and the use of a low antimony dose.

Lysosomal depletion in macrophages from spleen and foot lesions of Leishmania-infected hamster.

Analysis of lysosomes through acid phosphatase cytochemistry at the electron microscopy level has been performed in spleen and foot lesions from Leishmania-infected hamsters. The results showed that there is lysosomal depletion in macrophages from Leishmania donovani chagasi-infected hamster spleen and similar findings were obtained from foot lesions of Leishmania mexicana amazonensis-infected hamsters. The distribution of acid phosphatase and thiamine pyrophosphatase was also examined in the Golgi apparatus. It was possible to demonstrate that the activity of ACP is absent in infected macrophages from spleen and foot lesions of Leishmania-infected hamster while the distribution of TPP was very similar in control and infected macrophages from both systems. These results provide evidence that the lysosomal depletion can occur at the ACP synthesis and/or glycosylation level.

Depletion of secondary lysosomes in mouse macrophages infected with Leishmania mexicana amazonensis: a cytochemical study.

Leishmania amastigotes lodge and multiply within parasitophorous vacuoles, which can fuse with secondary lysosomes of the host macrophages. This study examines the effect of infection with amastigotes of L. mexicana amazonensis on the secondary lysosomes of mouse macrophage cultures. The cultures were stained for the activities of two lysosomal enzyme markers, acid phosphatase and arylsulfatase, and the light microscopic observations were supplemented by electron microscopy. Nearly all noninfected macrophages contained numerous stained secondary lysosomes. The number of such lysosomes was markedly reduced 24 h postinfection, and the reduction persisted for at least 10 days. Stained secondary lysosomes reappeared after the amastigotes were destroyed by exposure of the cultures to phenazine methosulfate or by placing them at 37.5 degrees C. The depletion of lysosomes shown by cytochemical methods may reflect a high rate of fusion of the lysosomes with the parasitophorous vacuoles, exceeding the rate of formation of new secondary lysosomes. Alternatively, the parasites may inhibit the synthesis of lysosomal hydrolases, or the assembly or formation of primary or secondary lysosomes.