Multiple myeloma disrupts the TRANCE/ osteoprotegerin cytokine axis to trigger bone destruction and promote tumor progression.

Bone destruction, caused by aberrant production and activation of osteoclasts, is a prominent feature of multiple myeloma. We demonstrate that myeloma stimulates osteoclastogenesis by triggering a coordinated increase in the tumor necrosis factor-related activation-induced cytokine (TRANCE) and decrease in its decoy receptor, osteoprotegerin (OPG). Immunohistochemistry and in situ hybridization studies of bone marrow specimens indicate that in vivo, deregulation of the TRANCE-OPG cytokine axis occurs in myeloma, but not in the limited plasma cell disorder monoclonal gammopathy of unknown significance or in nonmyeloma hematologic malignancies. In coculture, myeloma cell lines stimulate expression of TRANCE and inhibit expression of OPG by stromal cells. Osteoclastogenesis, the functional consequence of increased TRANCE expression, is counteracted by addition of a recombinant TRANCE inhibitor, RANK-Fc, to marrow/myeloma cocultures. Myeloma-stroma interaction also has been postulated to support progression of the malignant clone. In the SCID-hu murine model of human myeloma, administration of RANK-Fc both prevents myeloma-induced bone destruction and interferes with myeloma progression. Our data identify TRANCE and OPG as key cytokines whose deregulation promotes bone destruction and supports myeloma growth.

Effects of human polymorphonuclear leukocyte elastase upon surfactant proteins in vitro.

Recent evidence has suggested that elastase is released by polymorphonuclear leukocytes (PMN) recruited from the pulmonary microcirculation into the alveoli during acute lung injury. This study was undertaken to test the hypothesis that elastase from PMN (PMN elastase) damages or degrades one or more of the surfactant proteins (SP-A, SP-B and SP-C) of the lung, and thereby alters its function. We attempted to use amounts of PMN elastase and quantities of surfactant that would be plausible in the lungs of patients with ARDS. Surfactant from normal dog lungs (2 mg phospholipid, 200 micrograms protein), and purified SP-A (20 micrograms), SP-B (10 micrograms) and SP-C (10 micrograms) from the surfactant (identified by SDS-PAGE and N-terminal amino acid sequences) were incubated for 4-8 h at 37 degrees C with various amounts (0.25-1.0 U) of human PMN elastase purified by affinity chromatography. SDS-PAGE and amino acid composition analysis of the surfactant as well as of the purified SP-A, SP-B, and SP-C showed that degradation of these proteins progressed with incubation time and with the amount of PMN elastase, and was accompanied by decreases in isopycnic density (g/cm3) and surface adsorption, and increase of surface tension of the surfactant. No effects were observed with heat inactivated PMN elastase (95 degrees C, 30 min) or with PMN elastase in the presence of human alpha-1 protease inhibitor (2 micrograms/microgram elastase). Phospholipid compositions of the surfactant after exposure to PMN elastase were not significantly different from those of the controls, suggesting that SP-A, SP-B, and SP-C play a major role in altering the surfactant properties. SP-A was also degraded by elastase and trypsin from pancreas whereas SP-B and SP-C remained intact, providing a natural surfactant without SP-A. Surface adsorption rate of the SP-A deficient surfactant was lower than that of the control, but was much higher than that of the surfactant with completely degraded SP-A, SP-B, and SP-C, suggesting that hydrophobic SP-B and SP-C are the essential components in enhancing adsorption. We conclude that proteolytic degradation of SP-A, SP-B, and SP-C causes the decrease of surfactant isopycnic density, and is responsible for retarding adsorption resulting in surfactant dysfunction.

Isolation of human polymorphonuclear leukocyte elastase by chromatography on immobilized benzamidine.

Recent evidence suggests that polymorphonuclear leukocyte (PMN) elastase causes tissue injury in a variety of diseases. Current methods of purification of elastase involve several steps which result in a low yield. We report a simple purification method. PMN (10(9) in 4 ml of 0.05 M Tris, pH 7.8, containing 0.2% Triton X-100 were disrupted and homogenized by freezing and thawing followed by sonication. After centrifugation at 100,000 g for 20 min, enzyme was extracted from the pellet with 2.5 ml of 0.05 M Tris/1M NaCl (pH 7.8). The centrifugation-extraction cycle was repeated 3 times. Elastase from 10(8) PMN was then purified using a 1 ml Protease Inhibitor Affinity-Filter prepared by binding benzamidine to silica. Enzyme activity was determined by cleavage of the synthetic substrate N-Suc-(Ala)3-pNa. SDS-PAGE demonstrated 2 polypeptides, molecular masses of 29 and 27 kD with amino acid composition and partial N-terminal sequence (Ile-Val-Gly-Gly-Arg-Arg-Ala-Arg-Pro-His-Ala-Trp-Pro-) identical with those previously reported for elastase. We obtained 50 micrograms elastase (34-fold purification) with specific activity of 52 U/mg/min from 10(8) PMN. This represents a much greater recovery (23% yield) than is achieved by other methods. This method is simple, highly reproducible, and can be performed within a 2-day period.

Purification of surfactant protein A from dog lung by reconstitution with surfactant lipids.

We have developed a simple method for purification of surfactant major apoprotein (SP-A, MW 34-38 kD) from dog lungs with high yield and purity. Lipids and proteins of partially purified surfactant were dissociated by sodium deoxycholate (DOC, 100 mM, 37 degrees C, 30 min), diluted 1:10 with borate buffer containing 3 mM CaCl2, and dialysate in the same buffer to reconstitute the lipids and proteins (4 degrees C, 48 h). The reconstituent and the partially purified surfactant were purified by ultracentrifugation on a discontinuous sucrose density gradient. Protein was isolated from the reconstituent and from the purified surfactant by delipidation, and the yields and purities were assessed by one-dimensional SDS-PAGE and 2-dimensional electrophoresis (isoelectric focusing, SDS-PAGE). We found that the surface pressure-time adsorption isotherm, minimum surface tension, and the yield and composition of lipids of the reconstituent were identical with those from the purified surfactant. Only about 0.25% of the DOC used for dissociation remained with the reconstituent and it did not affect surface properties of the reconstituent. The yield of SP-A in the reconstituent was almost the same as that in the purified surfactant, but the former contained no plasma protein whereas the latter contained significant amounts. The amino acid composition and the partial N-terminal amino acid sequence of SP-A were the same as those from the purified surfactant. Reconstituent prepared from surfactant lipids and SP-A adsorbed more rapidly and reached a higher final surface pressure than did the surfactant lipids alone. These results demonstrate that large quantities of SP-A can be purified by reconstitution with surfactant lipids, and that the purified protein is biophysically active.

Effects of activated polymorphonuclear leukocytes upon pulmonary surfactant in vitro.

Current evidence suggests that products of activated inflammatory cells cause or contribute to the acute lung injury of the adult respiratory distress syndrome (ARDS). To assess the possibility that these products may impair surfactant function during ARDS, we exposed surfactant in vitro to polymorphonuclear leukocytes (PMN) activated by phorbol myristate acetate and to the oxidant-producing pair ferric chloride/ascorbate (FeCl3/ASC). After incubation of surfactant with 8 to 32 x 10(6) activated PMN for 1 to 4 h or with FeCl3/ASC for 16 h, its isopycnic density (d), minimum surface tension (gamma min), time course of adsorption, compressibility (SC), and stability index (SI) were determined. We found progressive decreases of d, adsorption, and SI and progressive increases of gamma min and SC after exposure to activated PMN in increasing numbers or for longer time periods. Superoxide dismutase completely inhibited all of these effects except the decreased adsorption, which it did not significantly inhibit. Similar changes in all of these parameters occurred after exposure of surfactant to FeCl3/ASC. Polyacrylamide gel electrophoresis of surfactant after exposure to activated PMN showed a decrease of the major apoprotein that progressed with exposure time and was associated with the appearance of several bands with both lower and higher molecular weights than that of the apoprotein. The data show that activated PMN are capable of impairing surfactant function in vitro and of degrading the major apoprotein. They suggest that the effects upon d, gamma min, SC, and SI are mediated largely if not exclusively by oxidant radicals. While oxidants may contribute to delayed adsorption, proteolysis appears to play the principal role in this effect.

Functional abnormalities of lung surfactant in experimental acute alveolar injury in the dog.

Acute alveolar injury (AAI) was induced in dogs by injection of N-nitroso-N-methylurethane. Two to 20 days after injection, alveolar lavage phospholipids were quantified. Lavage surfactant was partially purified by centrifugation (27,000 g for 2 h), and further purified by centrifugation in NaBr density gradient (100,000 g for 4 h). Phospholipids, neutral lipids, surfactant-associated proteins, and surface properties of partially purified and purified surfactants were analyzed. Lavage disaturated phosphatidylcholine (DSPC) decreased to 37% of control at peak injury (Days 6 to 8) and increased to near normal during recovery (Days 10 to 20). Lavage phosphatidylglycerol (PG) decreased to 22% of control at peak injury and remained in that range through recovery. In both partially purified and purified surfactants, percentages of phosphatidylcholine (PC), DSPC, phosphatidylethanolamine, and cholesterol in all phases of injury and recovery were not different from those in control animals. However, percentage of PG decreased markedly during injury and remained low through recovery, whereas those of phosphatidylinositol and lysoPC increased with injury and remained elevated through recovery. The PC-to-sphingomyelin ratio (L/S ratio) and percentage of triglyceride decreased during injury and returned to control values during recovery. Surfactant apoprotein of molecular weight 38,000 from partially purified and purified surfactant decreased markedly at peak injury and recovered to normal during recovery. During early and peak injury, both preparations failed to reduce surface tension below 19 dyne/cm and their isopycnic densities were altered. These studies indicate that, in addition to decreased quantity, qualitative changes in lipids and apoproteins and reduced surface activity of the surfactant occur during nitrosourethane-induced AAI.(ABSTRACT TRUNCATED AT 250 WORDS)

Normal surface properties of phosphatidylglycerol-deficient surfactant from dog after acute lung injury.

Lung surfactant was isolated from bronchoalveolar lavage of dogs during the late phase of recovery (15 days) from acute alveolar injury induced by subcutaneous injection of N-nitroso-N-methylurethane. This surfactant was compared with surfactant from control dogs in terms of in vitro surface properties, phospholipid composition and protein content, and those of its subfractions. Phospholipid composition and protein content were similar in the two groups, except that phosphatidylglycerol (PG) was markedly reduced and phosphatidylinositol (PI) was increased in the experimental group. In both, isopycnic densities of their subfractions in continuous sucrose density gradient were identical. The time course of surfactant adsorption was similar in both groups. Minimum surface tension (gamma min) was 4.1 +/- 1.5 dynes/cm in the experimental dogs and 3.8 +/- 1.3 dynes/cm in the controls. Surface compressibility (SC), stability index (SI), and dynamic respreadability (DR) of the surfactants from the two groups were nearly identical. When compared to an artificial surfactant composed of dipalmitoyl phosphatidylcholine (DPPC) and PG in 9:1 molar ratio a mixture of DPPC-PI 9:1 prepared identically showed similar gamma min, SC, SI, and DR, and a much higher surface adsorption rate. These results suggest that PG is not essential for normal in vitro surfactant function and that its role may be assumed by PI.

Diphosphatidylglycerol in experimental acute alveolar injury in the dog.

Acute alveolar injury closely resembling that seen in humans was induced in dogs by subcutaneous injection of N-nitroso-N-methylurethane. Necrosis of alveolar epithelial cells was observed during early injury. Proliferation of immature epithelial cells which began during early injury and became massive after peak injury was followed by their differentiation to mature type II cells during recovery. Quantities of diphosphatidylglycerol (DPG) and of phosphatidylglycerol (PG) in alveolar lavage and in post-lavage lung tissue were measured. An increase in tissue DPG coincided with a sharp decrease in tissue and lavage PG during early injury. DPG was not detectable in the lavage. During late recovery, tissue DPG increased threefold over controls. This increase was accompanied by persistence of a 50% decrease in tissue PG and 83% decrease in lavage PG. Biosynthesis of DPG and PG in isolated lung mitochondria demonstrated that DPG was formed from PG in the presence of CDP-diglyceride. These findings suggest that the low level of PG in the surfactant complex during acute alveolar injury is due to increased turnover of PG to DPG in the lung.

Lysolecithin acyltransferase and alveolar phosphatidylcholine palmitate in experimental acute alveolar injury in the dog lung.

Lysolecithin acyltransferase (EC 2.3.1.23) activities in lung homogenates and in subcellular fractions, and fatty acid composition of phosphatidylcholine (PC) in lung lavage were studied in dogs with acute alveolar injury induced by N-nitroso-N-methylurethane. The specific activity in the microsomal fraction was 10 and 3 times higher than those of homogenate and mitochondrial fractions, respectively. Both the lysolecithin acyltransferase activities and the proportions of palmitate in alveolar lavage PC increased during the early phase of injury (days 2-4), and decreased during peak injury (days 6-8). Such correlation was not found during the recovery period (day 15). During recovery, specific and total activities of the enzyme were nearly 2- and 3-fold, respectively, those of controls. Nevertheless, the palmitate proportions in PC were normal, indicating that the increased enzyme activity in vitro was not reflected in increased PC palmitate during recovery. This finding indicates that the enzyme activity per cell was normal during recovery and suggests that the increase in specific and total activities is due to massive regeneration of type II cells and that the enzyme is localized mainly in these cells. The decrease in the proportion of palmitate in lavage PC during peak injury may lead to abnormality of surfactant function.

Alcohol-induced lipid change in th lung.

Quantities and qualities of lipids in lung lavage and lavaged lung tissue were studied in ethanol-fed male Sprague-Dawley rats. Experimental rats received 36% of daily energy as ethanol for 7 weeks and each control rat, receiving an isocaloric amount of sucrose, was pair-fed with an experimental rat. Body weight gain and lung protein content in these two groups were similar. The mean lung dry weight of ethanol-fed rats as compared to controls was significantly elevated. The quantity of phosphatidylcholine (PC), a key surfactant lipid, recovered from lung lavage of ethanol-fed rats was double that of controls, but the proportion of palmitate in its fatty acids was reduced. The content of cholesterol and cholesteryl ester in lung lavage of ethanol-fed rats was nearly twice that of controls but the content of triglyceride was not different. The quantity and quality of PC in lung tissue were not significantly different between these two groups. Triglyceride content of lung tissue in ethanol-fed rats was nearly three times that of controls. Ethanol increased the proportion of oleic and decreased the relative amount of palmitic, palmitoleic, and linoleic acids in triglycerides of lung tissue.

Correlation of lung compliance and quantities of surfactant phospholipids after acute alveolar injury from N-nitroso-N-methylurethane in the dog.

Acute alveolar injury was induced in dogs by subcutaneous injection of 8 mg of N-nitroso-N-methylurethane per kg of body weight. Two to seven days after the injections, the change in respiratory compliance was measured, alveolar and lung tissue disaturated phosphatidyl choline (DSPC) were quantified, and fatty acid patterns of alveolar phosphatidyl choline were determined. Progressive decreases occurred in respiratory compliance and in alveolar and tissue DSPC. Mean alveolar DSPC decreases occurred in respiratory compliance and in alveolar and tissue DSPC. Mean alveolar DSPC decreased to 22% (p less than 0.001) of that of the control study and significant linear correlation (p = 0.02) between respiratory compliance and alveolar DSPC quantity was found. Mean tissue DSPC decreased to 60% of that of the control study (p less than 0.001) and reductions in alveolar and in type II cell DSPC were estimated to be nearly equivalent. The proportion of palmitate in lavage phosphatidyl choline was increased by a mean of 9%. These studies demonstrated a decrease in surfactant lipids correlated with decreased compliances in acute alveolar injury and suggested that qualitative and quantitative changes in surfactant result from injury to alveolar type II cells.

Quantification of surfactant phospholipids in the dog lung.

We quantified total phospholipid (PL), total and disaturated phosphatidylcholine (PC and DSPC), phosphatidylglycerol (PG), and total protein in alveolar washings and lung tissue in 22 dog lungs. Quantitative recovery of alveolar material and assessment of its possible contamination by blood lipids were important determinants of methodology. To remove blood, the vessels of half the lungs were perfused with a fluorocarbon emulsion before lavage. The volume of blood removed by perfusion and the quantity and fatty acid patterns of its whole blood and plasma PL and PC were determined. Washings of unperfused lungs contained means of 21% more PL and 24% more PC than those of perfused lungs. Although this excess could be accounted for by the PL and PC in pulmonary blood, the hemoglobin and total protein content of washings and their PC fatty acid patterns indicated that blood lipids were not a major source of the excess lipid in washings of unperfused lungs. Using more recent morphometric estimates rather than the indirect ones previously used by others, the quantity of alveolar DSPC (1 mg/g lung) is calculated to be 1.8 times the amount necessary to form a packed monolayer on the internal surface of the lung at functional residual capacity.

Estimation of phosphatidylglycerol in fluids containing pulmonary surfactant.

A simple, direct and non-destructive method for quantitative separation of phosphatidylglycerol from other phospholipids in pulmonary washings is described. Total lipid extracts from dog lung washings and phosphatidylglycerol standard were spotted quantitatively on chromatoplates and separated by one-dimensional thin-layer chromatography in chloroform-methanol-water 65:25:4 (v/v/v). Quantification was performed with Rhodamine 6G and fluorometry. Washings from eleven dogs contained (mean +/- S.E.) 236 +/- 25 microgram phosphatidylglycerol per g of parenchymal wet lung tissue which accounted for 8.7% +/- 2.3 of the total phospholipids. The procedure is especially useful for quantification of phosphatidylglycerol in microgram amounts.

Structural analysis of the surface polysaccharide of Staphylococcus aureus M.

The chemical structure of the surface polysaccharide from Staphylococcus aureus M was investigated by a combination of methanolytic, hydrolytic, and chromatographic techniques. The repeating unit that was most consistent with the data was a hexasaccharide composed of N-acetyl-D-aminogalacturonic acid, N-acetyl-D-fucosamine, and taurine in molar ratios of 4:2:1. A disaccharide was isolated and characterized, by combined gas-liquid chromatography-mass spectrometry, as N-acetyl-D-aminogalacturonyl-(1 leads to 3)-N-acetyl-D-fucosamine. Taurine is linked to a carboxyl group of N-acetyl-D-aminogalacturonic acid via an amide bond.

Surface polysaccharide from Staphylococcus aureus M that contains taurine, D-aminogalacturonic acid, and D-fucosamine.

The surface polysaccharide antigen of Staphylococcus aureus M was isolated, and the component parts were identified. The antigen is composed of taurine, d-aminogalacturonic acid, and d-fucosamine. The capsule is chemically distinct from all previously reported staphylococcal capsules. Taurine and aminogalacturonic acid have not been reported previously in staphylococci.

Biological properties of the encapsulated Staphylococcus aureus M.

Strain M, classified as a Staphylococcus aureus, behaves like the other rare encapsulated staphylococcal strains. It was clumping-factor negative, grew in diffuse-type colonies in serum-soft agar, and produced rapidly fatal disease in mice. Strain M was highly resistant to phagocytosis by human or mouse leukocytes and required both specific antibody and heat-labile serum factor(s) for efficient ingestion by human polymorphonuclear leukocytes. Electron micrographs confirmed the presence of a large capsule. Agglutination studies, active or passive mouse protection experiments, and opsonic studies revealed that strain M represents a new, immunologically distinct strain of encapsulated staphylococcus. Strain M differs from other known encapsulated staphylococci in several other respects: its cellular and colonial morphology is atypical; its LD(50) in the mouse peritoneal model is 100 times less than that of other mouse lethal strains; it is poorly opsonized by normal human serum; and, finally, it possesses an unusually large capsule as seen in electron micrographs.