Endogenous antioxidants and nasal human epithelium response to air pollutants: genotoxic and inmmuno-cytochemical evaluation.

Nasal epithelium is a source for identifying atmospheric pollution impact. Antioxidants play a relevant role in the protection of the cells from environmental injury, but scarce information is available about the interaction of endogenous antioxidants and genotoxic damage in nasal epithelium from urban populations highly exposed to traffic-generated air pollutants. An immunocytochemical and genotoxic evaluation was implemented in nasal cell epithelium in a population chronically exposed to atmospheric pollution from autumn 2004 to autumn 2005. Superoxide dismutase (SOD) and Catalase (CAT) were evaluated in nasal scrapings by morphometry and genotoxicity by comet assay. An increase in DNA damage correlates with a decrease in SOD and CAT in nasal cells during autumn and the inverse result was observed during summer (R = 0.88). Not only should exogenous antioxidant supplements be encouraged, but also a healthy diet to strengthen intracellular defenses against oxidative stress induced by exposure to air pollutants.

Time of occurrence of kidney acute antibody-mediated allograft rejection/acute cellular rejection and cell senescence: implications for function outcome.

BACKGROUND: Late versus early acute antibody-mediated rejection (AAMR) or acute cellular rejection (ACR) episodes are associated with poorer kidney function and graft survival. We explored whether cell senescence upon detection of AAMR ± ACR contributes to these results. METHODS: We reviewed the renal transplant database of 2 Institutions. Biopsies performed for acute graft dysfunction from January 2000 to March 2007 were analyzed for morphological criteria of AAMR with or without ACR (n = 17 from 17 patients). Immunoperoxidase staining for p16(INK4B) was performed on the remaining paraffin-embedded tissue in 9 of 17 cases. The average number of positive cells/high power field (HPF) was calculated in every case. Cases with rejection were grouped according to the time of presentation: early (<3 months n = 8) versus late (>3 months; n = 9). Graft function was obtained using the Modification of Diet in Renal Disease (mDRD) glomerular filtration rate estimate (eGFR) before, during rejection, and at the last visit, to calculate ΔeGFR. RESULTS: Nuclear expression of p16(INK4B) was 12.2 ± 11.3 cells/HPF in 4 of 8 biopsies performed at a median of 23 (range = 4-80) days (early AAMR ± ACR), and 59.8 ± 51.3 cells/HPF in 5 of 9 biopsies performed at a median of 1171 (range = 279-3210) days (late AAMR ± ACR). eGFR before rejection was 48.5 ± 7.6 mL/min, and 43.7 ± 4.3 mL/min for early and late rejection episodes, respectively (P = not significant [NS]). ΔeGFR of 12.5 ± 25.9 mL/min (early rejection), and -13.7 ± -12.3 mL/min (late rejection), versus last follow-up visit (P = .02) occurred at a median of 143.9 ± 94.1 and 69.6 ± 35.1 weeks after the rejection episodes, respectively. CONCLUSIONS: Even though the number of biopsies analyzed for p16(INK4a) was small, it was evident that the number of cells expressing this marker of senescence was higher among biopsy specimens obtained with late rejection episodes. This finding suggests the presence of injuries prior to the rejection episode. The significantly lower eGFR at last follow-up in the late rejection group may translate to a reduced capacity of the repair process to sustain nephron function.

Cytological damage of nasal epithelium associated with decreased glutathione peroxidase in residents from a heavily polluted city.

OBJECTIVE: To evaluate the cytological damage and glutathione peroxidase (GPX) content in the nasal epithelium of residents of Southwest Metropolitan Mexico City (SWMMC) along 1 year of ozone and PM(10) exposure. METHOD: Four nasal scrapings were obtained in 20 volunteers from a control low polluted city and SWMMC permanent residents (n = 20) during 1 year. The scrapings were obtained in September and December 2004, and February and May 2005. One part of the scraping was stained by hematoxylin-eosin technique for cytological evaluation and a second part was stained by immunocytochemistry method to evaluate GPX concentration by morphometry. RESULTS: Control subjects: in total, 30% had no cytological alterations and 70% showed only mild or moderate inflammation in four nasal scrapings. All SWMMC residents showed moderate to severe inflammatory processes in some scrapings. Additionally, dysplasia was found once (in 2 cases) or more than on scraping in five cases (25%). GPX concentration in the control group remained highest in median values throughout the study. SWMMC residents with the highest median values of GPX content were found in the May and September scrapings, and the lowest median values were found in December and February when Ozone and PM(10) levels are increased (P < or = 0.05). A lower GPX content was found as the cytological damage increased (P < or = 0.001). CONCLUSION: Cytological evaluation of nasal epithelium and GPX immunodetection are satisfactory methods to evaluate the earliest damage produced by atmospheric pollution in heavily contaminated cities.

DNA damage as an early biomarker of effect in human health.

In the last few decades the need for new approaches to assess DNA damage has been increasing due to the implications that different insults on genetic material may have on human health. In this context, the identification of how chemical agents with different mechanisms of action (i.e., antineoplastic drugs) damage DNA provides a good model to investigate some cellular and molecular mechanisms underlying the basis of genetic toxicology. The nasal epithelium is the first barrier with which environmental pollutants interact, and for this reason this epithelium can be useful as a sentinel in order to assess the interactions between the environment and the living organisms. Taking these phenomena into account and using a simple, sensitive and rapid method such as the single cell gel electrophoresis, we could obtain information and an initial approach on the DNA status. This assay in combination with other techniques that provide more information about other molecular parameters could give us a better view of the biological status of the living cell.

Pulmonary lymphoid lesions in an experimental model of collapsing glomerulopathy in rats.

UNLABELLED: The characterization of lung damage in an experimental model of collapsing glomerulopathy (CG) in rats is described. METHODS: 12 rats were divided into two groups and injected intravenously (iv) with 1 mg/saline in a final volume of 1 ml/ day in the tail vein for 5 days, with fractionated serum from control and CG subjects. Proteinuria was quantified, and the Glomerular filtration rate was calculated based on creatinine clearance (CC). Rats were sacrificed by perfusion fixation at day 5. RESULTS: Rats injected with serum from CG patients developed proteinuria (p<0.001). A decrease in CC (0.68+/-0.19) in these rats was also observed. Glomerular tuft retraction and mesangial proliferation was observed in all rats receiving serum from the CG patients. Peribronchiolar infiltrate integrated mainly by lymphocytes, was identified in all CG rats. In some areas this infiltration disrupted the basement membrane and damaged the epithelium. No histopathological abnormalities in the kidney or lungs were found in rats receiving control serum. CONCLUSION: Patchy pulmonary lymphoid infiltrates were found in the CG model. Up to now there was no information about pulmonary lymphoid infiltration in CG patients. Besides fluid overload due to renal insufficiency or a nephrotic syndrome, other causes of pulmonary involvement in CG patients should be explored.

Genotoxic differences by sex in nasal epithelium and blood leukocytes in subjects residing in a highly polluted area.

We describe differences by sex in genotoxic damage found in a population of medical students exposed to a highly oxidative atmosphere, compared with a control group, measured by the single-cell gel electrophoresis assay and histological changes in nasal epithelium smears. Cells were obtained from the nasal epithelium and blood leukocytes. Higher DNA damage in nasal cells and leukocytes was found in males compared to females and control subjects. The percentage of squamous metaplastic changes in the nasal epithelium was also higher in males compared with females and controls. The co-mutation of normal nasal epithelium by squamous cells might modify its protective function in the nose, increasing the risk of damage to the lower respiratory tract. Although, as medical students, males and females were exposed to the same environment and activity patterns, male genotoxicity damage was higher in control and exposed subjects. More research should be done in order to identify direct or indirect sexual hormone intervention.

[Collapsing glomerulopathy: a new entity associated with nephrotic syndrome and end-stage renal failure]. / Glomerulopatía colapsante: una nueva entidad asociada a síndrome nefrótico e insuficiencia renal terminal.

Collapsing glomerulopathy is an aggressive form of glomerular disease defined for its histopathological features of glomerular collapse, visceral epithelial cell damage and tubulointerstitial changes that are characteristic. Patients with collapsing glomerulopathy present with severe nephrotic syndrome, marked proteinuria, generally more than 10 g/day and rapid progression to chronic renal failure, or death due to complications of nephrotic syndrome, despite any form of treatment. Collapsing glomerulopathy presents as de novo or recurrent disease in the renal allograft. There is slight predominance in males and strong predominance in blacks as renal diseases in general. Collapsing glomerulopathy shares several clinical and histopathological features with focal and segmental glomerulosclerosis and HIV-nephropathy; nevertheless, there is enough evidence to support collapsing glomerulopathy as a different entity. It must be mentioned that collapsing glomerulopathy, focal and segmental glomerulosclerosis and HIV-nephropathy may have a similar pathophysiological mechanism of damage to the visceral epithelial cell.

[Does heart sarcoma mimick lupus erythematosus and vasculitis? Report of 2 cases]. / El sarcoma cardiaco simula lupus eritematoso y vasculitis? Informe de 2 casos.

Primary heart tumors are rare. The most common one is myxoma. It may synthetize IL-6 and frequently shown systemic clinical manifestations that confuse the diagnosis. Primary heart sarcomas are even more rare, as far as we know they have been not associated with systemic illnesses. We observed two cases with a presumptive diagnosis of systemic lupus erythematosus who were identified as primary sarcomatous heart neoplasms after surgical excision.

Kearns-Sayre syndromes an absolute indication for prophylactic implantation of definitive pacemaker?

Kearns-Sayre syndrome is a mitochondrial cytopathy characterized by chronic progressive external ophthalmoplegia, retinitis pigmentosa and heart block, the last of which determines the survival of these patients. The case of a 23 year old man with Kearns-Sayre syndrome, conduction disturbances and mitral valve prolapse is presented. The characteristics of this syndrome are described and the criteria for prophylactic installation of a pacemaker discussed.

AIDS-associated nephropathy: 5-year retrospective morphologic analysis of 87 cases.

Morphologic findings in the kidneys of 138 consecutive acquired immunodeficiency syndrome (AIDS) autopsies performed at the Mexico City General Hospital between 1986 and 1991 were studied. A total of 87 cases (63%) had renal disease, 62 cases presented glomerular alterations, and 80 cases showed tubulointerstitial damage. Glomerular collapse was seen in 30 cases (48%), mesangial expansion in 22 cases (35%), focal and segmental glomerulosclerosis in 20 cases (32%) and glomerular proliferation in only eight cases (11%). Nephrocalcinosis was seen in 25 cases (31%). Thirty-six cases (45%) presented tubulointerstitial infections: Mycobacterium tuberculosis in 19 cases (23%), Cryptococcus in 10 cases (12.5%), Cytomegalovirus CMV in eight cases (10%), Gram-negative bacteria in 3 cases (3.7%), and one case with histoplasmosis. In six cases the pathogens were multiple. Two cases showed infiltration of large-cell non-Hodgkin lymphoma. Based on the results obtained by autopsies, we conclude that in our country there is a high frequency of renal affection in AIDS patients. Clinically, this disease is infrequently diagnosed and not always related to the cause of death.