Airways microbial flora in COPD patients in stable clinical conditions and during exacerbations: a bronchoscopic investigation.

Patients affected with chronic obstructive pulmonary disease (COPD) undergo frequent exacerbations of their illness characterized by increased cough and expectoration. The precise aetiology of these episodes often remains unknown. In the absence of clinical or radiographic signs of pneumonia, bacterial or viral cultures of sputum usually provide little useful information. Thus, we performed fibreoptic bronchoscopy using a protected specimen brush (PSB) to obtain uncontaminated secretions for culture from 56 patients with COPD, 16 with stable clinical conditions and 40 affected with exacerbations of the disease. The aim of our study was to evaluate bronchial microbial flora by quantitative aerobic and anaerobic culture of each specimen. Twenty five subjects (45%), 4 (16%) in stable state and 21 (84%) with COPD exacerbations, had specimens which gave rise to significant bacterial growth (> 10(3) colony forming units.mL-1). The predominant bacteria were Streptococcus pneumoniae (in 10 cases) and alpha-haemolytic streptococci (in 6 cases); other bacteria found were coagulase-negative staphylococci and Branhamella catarralis in (2 cases each), and Proteus mirabilis, Haemophilus influenzae, Pseudomonas aeruginosa, Aerococcus viridans and Chromobacterium violaceum (each in a single case only). Although significant bacterial growth was more frequently found in patients with chronic obstructive pulmonary disease exacerbations and in those with a higher degree of bronchial inflammation, the differences between the two groups of patients were not statistically significant. Nevertheless, the results obtained in our study confirm the validity of and the need for reliable sampling methods (like the protected specimen brush) to demonstrate significant bacterial colonization of the airways in chronic obstructive pulmonary disease patients.

Regulation of endocytic-transcytotic pathways and bile secretion by phosphatidylinositol 3-kinase in rats.

BACKGROUND & AIMS: Phosphatidylinositol 3-kinases (PI3-K) are a family of enzymes that play key roles in control of cell growth, membrane recycling, and vesicular endoexocytotic processes. The aim of this study was to investigate the effect of a specific PI3-K inhibitor, wortmannin, on bile secretion, cytoskeleton organization, and endotranscytotic pathways in rats. METHODS: Isolated perfused rat liver (IPRL) and isolated rat hepatocyte couplets (IRHCs) were used. RESULTS: Wortmannin induced a 25% inhibition of basal bile flow in IPRL (P < 0.01). Horseradish peroxidase biliary excretion in the IPRL was markedly decreased by wortmanin. In IRHC incubated with 25 nmol/L wortmannin for 10 minutes at 37 degrees C, morphological studies showed early significant dilatation of bite canalicular lumen (P < 0.001). At short intervals (3 minutes), uptake of the fluid-phase marker, Lucifer yellow, was markedly decreased by exposure to wortmannin (P < 0.001). At longer times (20 minutes), Lucifer yellow was retained in basolateral area of IRHC as compared with control cells, where the marker was rapidly transported to the pericanalicular area. In IRHC, wortmannin induced a marked disorganization of microfilaments. CONCLUSIONS: Wortmannin inhibits basal bile flow, endocytosis, and transcytotic transport of fluid-phase markers in the liver, and causes an early dilatation of the canalicular lumen and disorganization of microfilaments. These findings suggest that PI3-K is involved in the regulation of vesicle trafficking, cytoskeleton organization, and the process of bile formation.

Role and mechanisms of action of acetylcholine in the regulation of rat cholangiocyte secretory functions.

UNLABELLED: We investigated, in isolated bile duct units (IBDU) and cholangiocytes isolated from normal rat liver, the occurrence of acetylcholine (ACh) receptors, and the role and mechanisms of ACh in the regulation of the Cl-/HCO3- exchanger activity. The Cl-/HCO3- exchanger activity was evaluated measuring changes in intracellular pH induced by acute Cl- removal/readmission. M3 subtype ACh receptors were detected in IBDU and isolated cholangiocytes by immunofluorescence, immunoelectron microscopy, and reverse transcriptase PCR. M1 subtype ACh receptor mRNA was not detected by reverse transcriptase PCR and M2 subtype was negative by immunofluorescence. ACh (10 microM) showed no effect on the basal activity of the Cl-/HCO3- exchanger. When IBDU were exposed to ACh plus secretin, ACh significantly (P < 0.03) increased the maximal rate of alkalinization after Cl- removal and the maximal rate of recovery after Cl- readmission compared with secretin alone (50 nM), indicating that ACh potentiates the stimulatory effect of secretin on the Cl-/HCO3- exchanger activity. This effect of ACh was blocked by the M3 ACh receptor antagonist, 4-diphenyl-acetoxy-N-(2-chloroethyl)-piperidine (40 nM), by the intracellular Ca2+ chelator, 1,2-bis (2-Aminophenoxy)- ethane-N,N,N', N'-tetraacetic acid acetoxymethylester (50 microM), but not by the protein kinase C antagonist, staurosporine (0.1 microM). Intracellular cAMP levels, in isolated rat cholangiocytes, were unaffected by ACh alone, but were markedly higher after exposure to secretin plus ACh compared with secretin alone (P < 0.01). The ACh-induced potentiation of the secretin effect on both intracellular cAMP levels and the Cl-/HCO3- exchanger activity was individually abolished by two calcineurin inhibitors, FK-506 and cyclosporin A (100 nM). CONCLUSIONS: M3 ACh receptors are markedly and diffusively represented in rat cholangiocytes. ACh did not influence the basal activity of the Cl-/HCO3- exchanger, but enhanced the stimulation by secretin of this anion exchanger by a Ca2+-dependent, protein kinase C-insensitive pathway that potentiates the secretin stimulation of adenylyl cyclase. Calcineurin most likely mediates the cross-talk between the calcium and adenylyl cyclase pathways. Since secretin targets cholangiocytes during parasympathetic predominance, coordinated regulation of Cl-/HCO3- exchanger by secretin (cAMP) and ACh (Ca2+) could play a major role in the regulation of ductal bicarbonate excretion in bile just when the bicarbonate requirement in the intestine is maximal.

Cytotoxicity of bile salts against biliary epithelium: a study in isolated bile ductule fragments and isolated perfused rat liver.

We evaluated cytotoxic effects of different unconjugated and glycine- and taurine-conjugated bile salts (BS) against bile duct epithelial cells in isolated bile ductule fragments and isolated perfused rat liver. Ultrastructural morphometric studies were performed in polarized rat bile ductule fragments exposed in vitro to increasing concentrations (10-100 micromol/L) of lithocholate (LCA), deoxycholate (DCA), chenodeoxycholate (CDCA), cholate (CA), ursodeoxycholate (UDCA), their taurine-conjugates, and glycoconjugates of cholic (GCA) or chenodeoxycholic acid (GCDCA) for 20, 30, or 75 minutes. To evaluate the cytotoxicity of unconjugated hydrophobic bile salts against biliary epithelium (BDE) in the whole liver, livers were isolated from rats with impaired taurine-conjugation capacity (beta-alanine treatment) and perfused for 70 minutes with 2 micromol/min LCA (n = 6), CDCA (n = 6), CA (n = 6), or 0.5 micromol/min tauro-LCA (n = 4). In isolated bile ductule fragments, hydrophobic unconjugated bile salts (LCA, CDCA, DCA) induced a marked damage of intracellular organelles, mainly mitochondria. The damage started at a concentration of 10 micromol/L and became prominent at concentrations higher than 50 micromol/L. No damage of the apical and basolateral membrane was seen and tight junctions appeared intact. UDCA, taurine and glycoconjugated bile salts failed to induce any evident ultrastructural alteration. In taurine-depleted isolated livers, perfused with LCA, CDCA, or CA, bile duct epithelial cells showed no evidence of intracellular damage, despite the increased biliary excretion of unconjugated BS. Marked alterations of the apical cell membrane were seen only in livers perfused with LCA and in isolated segments of the biliary epithelium. In contrast with biliary epithelium, hepatocytes showed prominent subcellular damage with CA and CDCA, and profound alterations of the canalicular membrane with LCA and tauro-LCA. We have shown that, in vitro, BDE cells are not damaged by taurine- or glycine-conjugated BS, but they are very sensitive to cytotoxicity of hydrophobic unconjugated BS. Such sensitivity is not present in the whole liver, probably because of the specificity of BS transport processes, the microvascular architecture of the bile ductal system, and the presence in bile of a physiological surfactant, such as phospholipids.

A morphometric study of the epithelium lining the rat intrahepatic biliary tree.

BACKGROUND/AIMS: Morphological and functional heterogeneity of intrahepatic bile duct epithelial cells has been suggested in situ and in isolated cholangiocytes. The aim of this study was to evaluate if: (a) bile ducts, when isolated, maintain morphometric parameters similar to ducts in situ, (b) cellular organelles show heterogeneity in ducts of different size, and (c) some features permit different classes of bile ducts to be distinguished. METHODS: Studies in situ were conducted on normal liver processed for light or electron microscopy. Data were also obtained from preparations of intrahepatic biliary tree isolated from rat liver. The whole biliary tree was cut at different levels to obtain bile ducts of different diameter. The diameter of ducts, the number of lining cells, the size and the area of individual cells, the nucleo/cytoplasmic ratio, the volume density of mitochondria, endoplasmic reticulum, Golgi complex and lysosomes have been evaluated. RESULTS: The diameter of intrahepatic bile ducts ranged from 5 to 100 micrograms and the area of lining cells ranged from 8 to 100 micrograms2. A highly significant linear relationship existed between duct diameter and bile duct epithelial cell area (r = 0.97, p < 0.001) or number of lining cells (r = 0.96, p < 0.001). The volume density of mitochondria ranged from 7.58 +/- 2.0% of cytoplasmic volume in the smallest isolated bile ducts to 8.50 +/- 2.7% in the largest (p = NS). The volume density of lysosomes was low and was not significantly different in ducts of different size. Rough endoplasmic reticulum was inconspicuous in the smallest ducts and increased only slightly in the largest. The inverse relationship between the nucleo/cytoplasmic ratio and duct diameter was striking (r = -0.78, p < 0.001). All morphometric data were equivalent if bile ducts were evaluated in situ or in isolated fragments. Taken together, the data allowed bile ducts to be classified into 3 classes: < 10, 10-50, and > 50 micrograms in diameter. DISCUSSION: Our data show that (a) isolated bile ducts maintain morphometric characteristics similar to the tissue in situ, (b) a low grade of morphological heterogeneity is evident for intracellular organelles in ducts of different diameter and (c) the diameter of ducts, the number of lining cells and especially the nucleo/cytoplasmic ratio may indicate the origin of fragments examined where functional studies are being considered.

Brefeldin A inhibits the transcytotic vesicular transport of horseradish peroxidase in intrahepatic bile ductules isolated from rat liver.

The fungal metabolite Brefeldin A (BFA) has become a valuable tool to address mechanisms of membrane transport in eukaryotic cells. The aim of the study was to investigate the action of BFA on the endocytic and transcytotic pathways in the biliary epithelium. Intrahepatic bile ductules were isolated from rat liver by collagenase digestion and mechanical separation of biliary tree from parenchymal tissue. Tissue remnants were first incubated in L-15 culture medium in absence or presence of BFA (10 or 20 mumol/L) or a BFA-inactive analog (B-36, 10 or 20 mumol/L) for 20 minutes at 37 degrees C. They were then exposed to horseradish peroxidase (HRP) (10 mg/mL) for 3 minutes at 37 degrees C and finally prepared for electron microscopy immediately (time 0) or after further 5, 10, 15, 20, 60, or 120 minutes' incubation in HRP-free medium with or without BFA. In control cells, HRP was predominantly found in regularly shaped, spherical vesicles. In the presence of BFA but not of its analog, HRP was retained in a prominent tubular juxtanuclear network. Part of this network was labeled for thiamine pyrophosphatase (TPP), a Golgi enzyme marker. A morphometric analysis of HRP-containing structures was performed to quantify the intracellular distribution of HRP. In presence of BFA, the volume density (VD = % area) of HRP-containing structures in the basolateral region was not significantly different with respect to control cells at 0 (1.08 +/- 0.11 vs. 1.32 +/- 0.11) or 5 minutes, respectively (1.33 +/- 0.19 vs. 1.40 +/- 0.13). On the contrary, VD or HRP-containing structures in the apical region at 15 minutes decreased from 1.95 +/- 0.19 in control cells to 1.12 +/- 0.20 (P < .02) in BFA-treated cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Regulation of intracellular pH in periportal and perivenular hepatocytes isolated from ethanol-treated rats.

The aim of this study was to gain information on intracellular pH (pHi) regulation in periportal (PP) and perivenular (PV) hepatocytes isolated from rats pair-fed liquid diets with either ethanol (T rats) or isocaloric carbohydrates (C rats). pHi was analyzed by the pH-sensitive dye BCECF in perfused subconfluent hepatocyte monolayers. Cells were acid-loaded by pulse exposure to NH4Cl and were alkali-loaded by suddenly reducing external CO2 and HCO3- (from 10% and 50 mM, respectively, to 5% and 25 mM) at constant pHout. In cells from C rats: (a) steady-state pHi was higher in PP than in PV hepatocytes in the presence, but not in the absence, of bicarbonate; (b) pHi recovery from an acid load was 35% higher in PP than in PV cells in the presence of HCO3-, whereas it was similar in HCO3(-)-free experiments; and, on the contrary, (c) pHi recovery from an alkaline load was 30% higher in PV than in PP cells. In cells from T rats: (a) steady-state pHi was always lower than in cells isolated from pair-fed animals; (b) steady-state pHi was similar in PP and PV hepatocytes either in the presence or absence of bicarbonate in the perfusate; (c) pHi recovery from an acid load was not significantly different in PP and PV cells either in the presence of HCO3- or in HCO3(-)-free experiments; and (d) pHi recovery from an alkaline load was similar in PP and PV cells. Our data suggest that chronic ethanol treatment selectively modifies pHi by affecting the activity of ion transport mechanisms regulating pHi in PP and PV hepatocytes isolated from rat liver.

Effect of Brefeldin A on transcytotic vesicular pathway and bile secretion: a study on the isolated perfused rat liver and isolated rat hepatocyte couplets.

This study investigated the effect of Brefeldin A (BFA) on the transcytotic vesicular pathway labeled with horseradish peroxidase (HRP) in both isolated rat hepatocyte couplets (IRHC) and the isolated perfused rat liver (IPRL). To evaluate the role of the transcytotic vesicular pathway on bile secretion, the effect of BFA on bile secretion in the IPRL was then investigated. In the basolateral area of IRHC, BFA showed no effect on the density and percentage of area of HRP-labeled vesicles. However, HRP-labeled vesicles tended to accumulate in the juxtanuclear area of BFA-treated hepatocytes (P < .001 vs. controls). In the pericanalicular area, on the other hand, HRP-labeled vesicles were depleted compared with controls (P < .001). In keeping with these findings, although the early peak remained unchanged, BFA inhibited as much as 50% of the late peak of HRP excretion in bile, after a pulse load of HRP in the IPRL. Bile flow and the biliary secretion of bile salts (BS) and phospholipids were not modified by BFA in isolated livers perfused without BS in the perfusate or with 1 mumol/min taurocholate (TCA). In BFA-treated livers, peak bile flow and BS output decreased by 20% (P < .05 vs. controls) only when a 5 mumol TCA bolus was administered. In conclusion, this study demonstrates that BFA inhibits the transcytotic vesicular pathway in the liver. However, BFA has no significant effect on bile secretion either in basal conditions or during perfusion with physiological amounts of BS. BFA slightly decreases bile flow and BS output only after an overload of BS, providing evidence against the physiological relevance of the transcytotic vesicular pathway in the process of bile formation.

Tubulovesicular transcytotic pathway in rat biliary epithelium: a study in perfused liver and in isolated intrahepatic bile duct.

Morphometric ultrastructural analysis of horseradish peroxidase-containing structures has been performed in vivo, in rat liver and, in vitro, in isolated bile ducts to determine whether a transcytotic vesicle pathway exists in biliary epithelial cells. In vivo, horseradish peroxidase (100 mg/kg body wt) was given by intraportal injection in normal rats (n = 15) or 1 hr after administration of 600 mg/kg valproic acid (n = 15). Ultrastructural morphometric analysis was conducted on livers between 1 and 40 min after horseradish peroxidase injection. In vitro, bile ducts were isolated on collagenase digestion, incubated in horseradish peroxidase for 3 min and prepared for electron microscopy immediately or after incubation for another 5, 10, 15 or 20 min in horseradish peroxidase-free medium at 37 degrees C. In four experiments, colchicine (10(-5) mol/L) or beta-lumicolchicine (10(-5) mol/L) was added to the culture medium 2 hr before horseradish peroxidase. In a separate series of experiments, 50 mumol/L taurocholic acid or 500 mumol/L ursodeoxycholic acid was added to the culture medium 12 min before horseradish peroxidase. The volume density (percent area) of horseradish peroxidase-containing structures was analyzed in the 1-microns-wide area of basolateral or apical cytoplasm. In vivo, horseradish peroxidase-containing structures maximally increased from the basolateral to the periluminal region over a 20-min interval (percent area increased from 0.09 +/- 0.12 to 2.02 +/- 0.33; p < 0.001) and over a 10-min interval in valproic acid-treated animals (from 0.17 +/- 0.11 to 2.05 +/- 0.36; p < 0.001). In vitro, horseradish peroxidase immediately labeled vesicles in the basolateral cytoplasm. Within 15 min, the vesicles were labeled in the periluminal region (percent area increased from 0.36 +/- 0.08 to 1.90 +/- 0.17; p < 0.001). Colchicine but not beta-lumicolchicine decreased the volume density of labeled structures in the apical cytoplasm (percent area at 15 min, 1.94 +/- 0.24 after beta-lumicolchicine and 1.04 +/- 0.29 after colchicine; p < 0.01). Taurocholic or ursodeoxycholic acid did not change the migration pattern of labeled vesicles, but peroxidase tended to appear earlier in the apical cytoplasm, especially after taurocholic acid. In addition, taurocholic acid increased the percentage of labeled tubules in the apical cytoplasm. These studies show that a polarized tubulovesicular transcytotic pathway exists in rat biliary epithelium and is microtubule dependent. These tubulovesicular structures are labeled with horseradish peroxidase, which is rapidly transported from the cell periphery to the luminal area.(ABSTRACT TRUNCATED AT 400 WORDS)