Clinical outcomes and predictors of success with Impella weaning in cardiogenic shock: a single-center experience.

Introduction: Cardiogenic shock (CS) is a severe syndrome with poor prognosis. Short-term mechanical circulatory support with Impella devices has emerged as an increasingly therapeutic option, unloading the failing left ventricle (LV) and improving hemodynamic status of affected patients. Impella devices should be used for the shortest time necessary to allow LV recovery because of time-dependent device-related adverse events. The weaning from Impella, however, is mostly performed in the absence of established guidelines, mainly based on the experience of the individual centres. Methods: The aim of this single center study was to retrospectively evaluate whether a multiparametrical assessment before and during Impella weaning could predict successful weaning. The primary study outcome was death occurring during Impella weaning and secondary endpoints included assessment of in-hospital outcomes. Results: Of a total of 45 patients (median age, 60 [51-66] years, 73% male) treated with an Impella device, 37 patients underwent impella weaning/removal and 9 patients (20%) died after the weaning. Non-survivors patients after impella weaning more commonly had a previous history of known heart failure (p = 0.054) and an implanted ICD-CRT (p = 0.01), and were more frequently treated with continuous renal replacement therapy (p = 0.02). In univariable logistic regression analysis, lactates variation (%) during the first 12-24 h of weaning, lactate value after 24 h of weaning, left ventricular ejection fraction (LVEF) at the beginning of weaning, and inotropic score after 24 h from weaning beginning were associated with death. Stepwise multivariable logistic regression identified LVEF at the beginning of weaning and lactates variation (%) in the first 12-24 h from weaning beginning as the most accurate predictors of death after weaning. The ROC analysis indicated 80% accuracy (95% confidence interval = 64%-96%) using the two variables in combination to predict death after weaning from Impella. Conclusions: This single-center experience on Impella weaning in CS showed that two easily accessible parameters as LVEF at the beginning of weaning and lactates variation (%) in the first 12-24 h from weaning begin were the most accurate predictors of death after weaning.

Adherence to a guided walking program with amelioration of cognitive functions in subjects with schizophrenia even during COVID-19 pandemic.

BACKGROUND: Aim of the study was to enrol a group of individuals with schizophrenia in a long-term moderate-intensity physical activity program and to evaluate its effects on their cognitive functions and cardiovascular risk factors. An additional aim of the study was the comparison of the adherence to the physical activity program before and during the COVID-19 pandemic. METHODS: Forty sedentary patients diagnosed with schizophrenia (mean age 46.4 ± 9.6) followed by the Public Mental Health Department of Ferrara were included in the study. 28 of them followed a 1-year walking program consisting of two guided walking sessions/week, while 12 maintained their sedentary lifestyle and followed the usual Cognitive Rehabilitation program. To the participants following the walking program VO2 peak and walking speed were assessed at baseline and at the end of the program. All participants were evaluated on blood pressure and anthropometric variable. Cognitive functions were assessed with the Screen for Cognitive Impairment in Psychiatry (SCIP) and with the Frontal Assessment Battery (FAB) questionnaires. RESULTS: The 20 participants completing the walking program displayed significant improvements in cognitive functions (dppc2 0.35 for SCIP and 0.26 for FAB), with a positive correlation between SCIP score and the number of sessions attended (R = 0.86, p < 0.001), evident in the patients attending to at least 75 of the 100 walking sessions. Walking speed and VO2peak increased significantly and a decrease of body weight, BMI, systolic and diastolic blood pressure was also observed. The adherence to the walking program registered during Covid-19 period did not differ from that observed before the pandemic. The 12 CG (Control Group) patients maintaining the sedentary lifestyle did not display improvements of cognitive functions. CONCLUSIONS: The main finding of this study is the improvement of cognitive functions which is significantly related to the number of walking sessions attended by participants with schizophrenia. The walking program, guided by exercise specialists, proved to be an enjoyable activity for people with mental disorder feasible even during the COVID-19 pandemic. Trial registration Retrospectively registered on ISRCTN as non-randomized trial (n. ISRCTN14763786).

Changes in selected biochemical, muscular strength, power, and endurance measures during deliberate overreaching and tapering in rugby league players.

The purpose of this study was to examine the influence of overreaching on muscle strength, power, endurance and selected biochemical responses in rugby league players. Seven semi-professional rugby league players (.VO(2max) = 56.1 +/- 1.7 mL . kg (-1) . min (-1); age = 25.7 +/- 2.6 yr; BMI = 27.6 +/- 2.0) completed 6 weeks of progressive overload training with limited recovery periods. A short 7-day stepwise reduction taper immediately followed the overload period. Measures of muscular strength, power and endurance and selected biochemical parameters were taken before and after overload training and taper. Multistage fitness test running performance was significantly reduced (12.3 %) following the overload period. Although most other performance measures tended to decrease following the overload period, only peak hamstring torque at 1.05 rad . s (-1) was significantly reduced (p < 0.05). Following the taper, a significant increase in peak hamstring torque and isokinetic work at both slow (1.05 rad . s (-1)) and fast (5.25 rad . s (-1)) movement velocities were observed. Minimum clinically important performance decreases were measured in a multistage fitness test, vertical jump, 3-RM squat and 3-RM bench press and chin-up (max) following the overload period. Following the taper, minimum clinically important increases in the multistage fitness test, vertical jump, 3-RM squat and 3-RM bench press and chin-up (max) and 10-m sprint performance were observed. Compared to resting measures, the plasma testosterone to cortisol ratio, plasma glutamate, plasma glutamine to glutamate ratio and plasma creatine kinase activity demonstrated significant changes at the end of the overload training period (p < 0.05). These results suggest that muscular strength, power and endurance were reduced following the overload training, indicating a state of overreaching. The most likely explanation for the decreased performance is increased muscle damage via a decrease in the anabolic-catabolic balance.

Non-invasive evaluation of the myocardial substrate of cardiac amyloidosis by gadolinium cardiac magnetic resonance.

OBJECTIVE: To investigate the prevalence and distribution of gadolinium (Gd) enhancement at cardiac magnetic resonance (CMR) imaging in patients with cardiac amyloidosis (CA) and to look for associations with clinical, morphological, and functional features. PATIENTS AND DESIGN: 21 patients with definitely diagnosed CA (nine with immunoglobulin light chain amyloidosis and 12 transthyretin related) underwent Gd-CMR. RESULTS: Gd enhancement was detected in 16 of 21 (76%) patients. Sixty six of 357 (18%) segments were enhanced, more often at the mid ventricular level. Transmural extension of enhancement within each patient significantly correlated with left ventricular (LV) end systolic volume (r = 0.58). The number of enhanced segments correlated with LV end diastolic volume (r = 0.76), end systolic volume (r = 0.6), and left atrial size (r = 0.56). Segments with > 50% extensive transmural enhancement more often were severely hypokinetic or akinetic (p = 0.001). Patients with > 2 enhanced segments had significantly lower 12 lead QRS voltage and Sokolow-Lyon index. No relation was apparent with any other clinical, morphological, functional, or histological characteristics. CONCLUSION: Gd enhancement is common but not universally present in CA, probably due to expansion of infiltrated interstitium. The segmental and transmural distribution of the enhancement is highly variable, and mid-ventricular regions are more often involved. Enhancement appears to be associated with impaired segmental and global contractility and a larger atrium.

Multidetector CT: a new gold standard in the diagnosis of pulmonary embolism? State of the art and diagnostic algorithms.

PURPOSE: From the early 90s, spiral CT technology has considerably changed the diagnostic capability of Pulmonary Embolism (PE), giving a direct vision of intravascular thrombi. Further technological progress has strengthened its diagnostic impact leading to an essential role in clinical practice. The advent of Multi-Detector CT (MDCT) has subsequently increased the reliability of this technique to the point of undermining the role of pulmonary angiography as the gold standard and occupying a central position in diagnostic algorithms. The aim of this paper is to appraise this evolution by means of a meta-analysis of the relevant literature from 1995 to 2004. RESULTS: The review of the literature showed the sensitivity and specificity of CT to have increased from 37-94% and 81-100% (single-detector CT) to 87-94% and 94-100% (4-channel multidetector CT), especially thanks to the possibility of depicting subsegmental clots, with an interobserver agreement of 0.63-0.94 (k). CONCLUSIONS: CT is one of the most reliable and effective methods in the diagnosis is PE, with the advantage of being extremely fast and providing alternative diagnoses. Recent improvements in MDCT technology confers the highest value of diagnostic accuracy with respect to other imaging modalities such as scintigraphy, angiography, MRI, D-dimer assay and Doppler US.

Up-regulation of p21(WAF1/CIP1) by histone deacetylase inhibitors reduces their cytotoxicity.

Histone deacetylase inhibitors show promise as chemotherapeutic agents and have been demonstrated to block proliferation in a wide range of tumor cell lines. Much of this antiproliferative effect has been ascribed to the up-regulated expression of the cyclin-dependent kinase inhibitor p21(WAF1/CIP1). In this article, we report that p21 expression was up-regulated by relatively low doses of the histone deacetylase inhibitor azelaic bishydroxamic acid (ABHA) and correlated with a proliferative arrest. Higher doses of ABHA were cytotoxic. Cells that did not up-regulate p21 expression were hypersensitive to killing by ABHA and died via apoptosis, whereas up-regulation of p21 correlated with reduced sensitivity and a block in the apoptotic mechanism, and these cells seemed to die by necrosis. Using isogenic p21(+/+) and p21(-/-) cell lines and direct inhibition of caspase activity, we demonstrate that the reduced sensitivity to killing by ABHA is a consequence of inhibition of apoptosis by up-regulated p21 expression. These data indicate the enormous potential of therapeutic strategies that bypass the cytoprotective effect of p21 and act on the same molecular targets as the histone deacetylase inhibitors.

Increased cell surface protease activity in UV-irradiated cells undergoing apoptosis.

UVB-irradiated HeLa cells undergoing apoptosis have increased cell surface protease (CSP) activity compared to viable or necrotic cells. In order to elucidate whether caspase 3 plays a role in the activation of CSP in cells undergoing apoptosis, HeLa cell cultures were pre-treated with the caspase inhibitor, DEVD, prior to being exposed to 500 Jm(-2) UVB. DEVD significantly inhibited caspase 3 activity in cells undergoing apoptosis, but did not affect the activation of CSP in these cells. The findings suggest that the activation of CSP in apoptotic cells is unrelated to caspase 3 activity.

Increased ecto-metallopeptidase activity in cells undergoing apoptosis.

Release from the cell surface of a variety of growth factors, cytokines, and proteases follows exposure to genetically stressful agents capable of inducing apoptosis and necrosis. Increased ectoprotease activity is responsible for their release. We show that increased activity of several metalloproteases on the HeLa cell surface occurs after stresses due to UVC, actinomycin D, cycloheximide, and cisplatinum, which induce the release of transforming growth factor-alpha (TGFalpha) and other bioactive molecules. The ectoprotease activities increase preferentially on apoptotic cells, while little change occurs in viable cells. Gross decreases, except for the putative TGFalphaase activity, accompany necrosis. These changes may contribute to tissue repair and the absence of an inflammatory reaction to apoptotic cell death. They appear to be due to preferential enzyme activation or to retention by cells undergoing significant categorical decreases in protein content.

Oxidation of glutamine in HeLa cells: role and control of truncated TCA cycles in tumour mitochondria.

The oxidative metabolism of glutamine in HeLa cells was investigated using intact cells and isolated mitochondria. The concentrations of the cytoplasmic amino acids were found to be aspartate, 8.0 mM; glutamate, 22.2 mM; glutamine, 11.3 mM; glycine, 9.8 mM; taurine, 2.3 mM; and alanine, < 1 mM. Incubation of the cells with [14C]glutamine gave steady-state recoveries of 14C-label (estimated as exogenous glutamine) in the glutamine, glutamate, and aspartate pools, of 103%, 80%, and 25%, respectively, indicating that glutamine synthetase activity was absent and that a significant proportion of glutamate oxidation proceeded through aspartate aminotransferase. No label was detected in the alanine pool, suggesting that alanine aminotransferase activity was low in these cells. The clearance rate of [14C]glutamine through the cellular compartment was 65 nmol/min per mg protein. There was a 28 s delay after [14C]glutamine was added to the cell before 14C-label was incorporated into the cytoplasm, while the formation of glutamate commenced 10 s later. Aspartate was the major metabolite formed when the mitochondria were incubated in a medium containing either glutamine, glutamate, or glutamate plus malate. The transaminase inhibitor AOA inhibited both aspartate efflux from the mitochondria and respiration. The addition of 2-oxoglutarate failed to relieve glutamate plus malate respiration, indicating that 2-oxoglutarate is part of a well-coupled truncated cycle, of which aspartate aminotransferase has been shown to be a component [Parlo and Coleman (1984): J Biol Chem 259:9997-10003]. This was confirmed by the observation that, although it inhibited respiration, AOA did not affect the efflux of citrate from the mitochondria. Thus citrate does not appear to be a cycle component and is directly transported to the medium. Therefore, it was concluded that the truncated TCA cycle in HeLa cells is the result of both a low rate of citrate synthesis and an active citrate transporter. DNP (10 microM) induced a state III-like respiration only in the presence of succinate, which supports the evidence that NAD-linked dehydrogenases were not coupled to respiration, and suggests that these mitochondria may have a defect in complex I of the electron transport chain. Arising from the present results with HeLa cells and results extant in the literature, it has been proposed that a major regulating mechanism for the flux of glutamate carbon in tumour cells is the competitive inhibition exerted by 2-oxoglutarate on aspartate and alanine aminotransferases. This has been discussed and applied to the data.

Effect of UV irradiation on cell surface protease activity and amino acid uptake.

The surface of most cells includes a coterie of resident proteins which act as receptors for a wide variety of ligands and other proteins which are potentially bioactive on cell-cell contact (juxtacrine effects), or else are released by enzyme activity to influence cell behaviour by autocrine or paracrine mechanisms. We previously found that UVC irradiation stimulates the release of TGFalpha from its membrane-bound preprocursor form whereby it acts as a stimulus to rapid, reparative cell multiplication; clearly this runs the risk hastening mitosis before UV-induced DNA damage is fully corrected, which in turn may increase the likelihood of residual lesions persisting and hence of new mutations being generated. We found that sublethal UVC irradiation (10 J m(-2)) of HeLa cell cultures also resulted in activation of ecto-aminopeptidase and ecto-endopeptidases which were maximal 16 and 20-24 h after irradiation, respectively. Both of these classes of protease were shown to be metalloproteases using a nonapeptide substrate (called P9) which is cognate to the N-terminal cleavage site of preproTGFalpha except for a reporter 125I-tyrosine [Piva et al., J. Cell. Biochem. 64 (1997) 353-368]. We now show that the N-terminal tyrosine cleaved from P9 by cell surface aminopeptidase activity, was found to be taken up by the cell resulting in its 10-25-fold concentration intracellularly, some two- to threefold higher than from a reservoir source, and may represent a novel salvage pathway for recovery of essential amino acids. Aminopeptidase activity was found to be both temperature- and FBS-dependent but was not reliant on ATP for its activity. Tyrosine transport across the cell membrane was also temperature and FBS-dependent but required ATP for maximal activity. UVC irradiation enhanced aminopeptidase activity but not tyrosine uptake by the cultures. The fraction of HeLa cells undergoing apoptosis increased in those cultures which were exposed to higher doses of UVC. The levels of ecto-aminopeptidase and ecto-endopeptidase activity in apoptotic cells were elevated compared to viable cells receiving the same dose of UVC. These results suggest that increased levels of cell surface protease activity in apoptotic cells would increase the amounts of free amino acids and growth factors in the extracellular medium and hence stimulate the proliferation of surrounding cells to replace those killed by UV irradiation.

Characterization and localization of mitochondrial oligopeptidase (MOP) (EC 3.4.24.16) activity in the human cervical adenocarcinoma cell line HeLa.

In this study we describe the partial purification and characterization of the HeLa cell oligopeptidase M or endopeptidase 3.4.24.16. The HeLa enzyme was isolated initially by its ability to hydrolyse a nonapeptide substrate (P9) which was cognate to the N-terminal cleavage site of preproTGF alpha. The enzyme was shown to be a metalloprotease as it was inhibited by Zn(2+)-chelating agents and DTT, and had an approximate molecular weight of 55-63 kD determined by gel filtration. Neurotensin, dynorphin A1-17 and GnRH1-9 were rapidly degraded by the enzyme while GnRH1-10 and somatostatin were not. Neurotensin was cleaved at the Pro10-Tyr11 bond, leading to the formation of neurotensin (1-10) and neurotensin (11-13). The K(m) for neurotensin cleavage was 7 microM and the Ki for the specific 24.16 dipeptide inhibitor (Pro-ile) was 140 microM which were similar to those observed from the human brain enzyme [Vincent et al. (1996): Brain Res 709:51-58]. Through the use of specific antibodies, the purified HeLa enzyme was shown to be oligopeptidase M. This enzyme and its closely related family member thimet oligopeptidase were shown to co-elute during the isolation procedure but were finally separated using a MonoQ column. Oligopeptidase M is located mainly in mitochondria though it was detected on the plasma membrane in an inactive form. The results obtained demonstrate the first recorded instance of this enzyme in human tissue cultured cells, and raise the issue of its function therein.

Cloning and expression of a cDNA encoding a nonintegrin laminin-binding protein from Echinococcus granulosus with localization of the laminin-binding domain.

We have isolated a cDNA from the hydatid tapeworm, Echinococcus granulosus, encoding a protein that binds laminin. This is the first report of a helminth parasite laminin-binding protein and the first description of a cDNA encoding a laminin-binding protein from a parasite. The cDNA clone (egmo3) was isolated from an E. granulosus protoscolex cDNA expression library, and identified on the basis of sequence homology to the nonintegrin mammalian metastasis-associated 67-kDa laminin receptor (67-LR). The amino acid sequence predicted from the cDNA sequence is 268 residues long with a calculated molecular mass of 29.9 kDa. Southern blot analysis suggested that many copies of the gene may occur in the E. granulosus genome. A Northern blot revealed that the gene is expressed as a single transcript of approximately 1 kb consistent with the size of the cDNA insert. Antibodies raised to the purified protein interacted with a 30 kDa protein in whole E. granulosus protoscoleces. A Western blot of the purified and refolded recombinant protein specifically bound 125I-labelled laminin, as did a synthetic peptide derived from the inferred amino acid sequence of egmo3 which is similar in homology to peptide G, the active ligand-binding site of 67-LR. We also isolated the 3' end of the cDNA encoding the homologous protein from the closely related species, E. multilocularis. The polypeptide encoded by egmo3 also shares substantial identity with the acidic class of ribosomal proteins which are involved in protein synthesis. As such, the egmo3 protein may be multifunctional in E. granulosus, acting as a laminin-binding molecule but also playing a role in cell division and growth.

The effects of insulin on transport and metabolism of glucose in skeletal muscle from hyperthyroid and hypothyroid rats.

The effects of insulin on the rates of glucose disposal were studied in soleus muscles isolated from hyper- or hypothyroid rats. Treatment with triiodothyronine for 5 or 10 days decreased the sensitivity of glycogen synthesis but increased the sensitivity of lactate formation to insulin. The sensitivity of 3-O methylglucose to insulin was increased only after 10 days of treatment and was accompanied by an increase in the sensitivity of 2-deoxyglucose phosphorylation; however, 2-deoxyglucose and glucose 6-phosphate in response to insulin remained unaltered. In hypothyroidism, insulin-stimulated rates of 3-O-methylglucose transport and 2-deoxyglucose phosphorylation were decreased; however, at basal levels of insulin, 3-O-methylglucose transport was increased, while 2-deoxyglucose phosphorylation was normal. In these muscles, the sensitivity of lactate formation to insulin was decreased; this defect was improved after incubation of the muscles with prostaglandin E2. The results suggest: (a) in hyperthyroidism, insulin-stimulated rates of glucose utilization in muscle to form lactate are increased mainly because of a decrease in glycogen synthesis; when hyperthyroidism progresses in severity, increases in the sensitivity of glucose transport to insulin and in the activity of hexokinase may also be involved; (b) in hypothyroidism, the decrease in insulin-stimulated rates of glucose utilization is caused by decreased rates of glycolysis; (c) prostaglandins may be involved in the changes in sensitivity of glucose utilization to insulin observed in muscle in altered thyroid states.

UVC activation of the HeLa cell membrane "TGF alpha ase," a metalloenzyme.

We have investigated the effect of UVC irradiation on "TGF alpha ase" activity using both intact HeLa cells and isolated membrane fragments with an assay based on the previously described nonapeptide substrate method [Brown et al. (1992): J Cell Biochem 48:411-423]. This method allows recognition of cleavage at the scissile bond cognate with that of the TGF alpha N-terminal cleavage site from its membrane-bound precursor. The level of ectoendopeptidase (including "TGF alpha ase") activity observed on intact cells was lower than that of ectoaminopeptidases. Addition of foetal bovine serum (FBS) enhanced aminopeptidase and dipeptidyl peptidase activity but inhibited "TGF alpha ase" activity, while phorbol 12-myristate 13-acetate (PMA) had no significant effect on the ectopeptidases monitored, expect for "TGF alpha ase," which was also inhibited, in contradistinction to their effects in other cell systems. Sublethal UVC irradiation (10 Jm-2) of the cultures resulted in activation of the ectoaminopeptidase and ectoendopeptidases which was maximal 16 and 20-24 h after irradiation, respectively. The addition of FBS to these irradiated cells appeared to reduce the increase in endopeptidase products, due in part to increased aminopeptidase activity but also to the direct inhibitory effect of FBS on the "TGF alpha ase." The activation of these proteases by UVC, even at high fluences (500 Jm-2), was not observed within the first 30 min after the cells were irradiated. Purified plasma membrane fragments were prepared from suspension cultures of HeLa cells and displayed high levels of "TGF alpha ase" activity. The rate of "TGF alpha ase" activity using 140 nM peptide substrate (P9) was 5.6 pmol/min/mg membrane protein, which was elevated to 13.7 pmol/min/mg membrane protein, 20 h after the cells had been irradiated with 10 Jm-2 UVC. Inhibition studies indicate that the plasma membrane "TGF alpha ase is a metalloenzyme as it was inhibited by EDTA, EGTA, and 1,10-phenanthroline but not by elastase or serine protease inhibitors. "TGF alpha ase" activity on intact cells was shown to be inhibited by 1,10-phenanthroline, which further supports this suggestion. Treatment of the membranes with Triton X-100 resulted in a loss of "TGF alpha ase" activity, raising the possibility that this enzyme may require a cofactor to be fully functional. We show that in purified membrane preparations of HeLa cells there is evidence for the presence of a "TGF alpha ase" which can be activated by UV irradiation, which differs from the putative "TGF alpha ase" described in various other cell lines, and which does not seem dependent on protein kinase C (PKC) activity.

Effects of glucocorticoid excess on the sensitivity of glucose transport and metabolism to insulin in rat skeletal muscle.

GENBANK/dy examines the mechanisms of glucocorticoid-induced insulin resistance in rat soleus muscle. Glucocorticoid excess was induced by administration of dexamethasone to rats for 5 days. Dexamethasone decreased the sensitivity of 3-O-methylglucose transport, 2-deoxyglucose phosphorylation, glycogen synthesis and glucose oxidation to insulin. The total content of GLUT4 glucose transporters was not decreased by dexamethasone; however, the increase in these transporters in the plasma membrane in response to insulin (100 m-units/litre) was lessened. In contrast, the sensitivity of lactate formation to insulin was normal. The content of 2-deoxyglucose in the dexamethasone-treated muscle was decreased at 100 m-units/litre insulin, while the contents of glucose 6-phosphate and fructose 2,6-bisphosphate were normal at all concentrations of insulin studied. The maximal activity of hexokinase in the soleus muscle was not affected by dexamethasone; however, inhibition of this enzyme by glucose 6-phosphate was decreased. These results suggest the following. (1) Glucocorticoid excess causes insulin resistance in skeletal muscle by directly inhibiting the translocation of the GLUT4 glucose transporters to the plasma membrane in response to insulin; since the activity of hexokinase is not affected, the changes in the sensitivity of glucose phosphorylation to insulin seen under these conditions are secondary to those in glucose transport. (2) The sensitivity of glycogen synthesis and glucose oxidation to insulin is decreased, but that of glycolysis is not affected: a redistribution of glucose away from the pathway of glycogen synthesis and glucose oxidation could maintain a normal rate of lactate formation although the rate of glucose transport is decreased.

Gliotoxin induces apoptosis in mouse L929 fibroblast cells.

The effect of the fungal toxin gliotoxin on the adherence and viability of mouse L929 cultured cells was examined. Gliotoxin at concentrations below 2 microM had no effect on cell function. The initial effect of exposure (6 h) resulted in the loss of cell adherence, with the non-adhered cells retaining viability. However, prolonged exposure (24 h) did not significantly enhance gliotoxin's effect on cell adherence, though the majority of non-adhered cells were found to have died by apoptosis, as confirmed from (i) electron microscopic examination and (ii) agarose gel electrophoresis of isolated DNA. The addition of foetal bovine serum to the culture medium had no effect on gliotoxin's activity. Ethanol (gliotoxin's solvent) had no effect on the assayed cell functions suggesting that the observed effects are due to gliotoxin alone. These results demonstrate for the first time that gliotoxin can cause apoptosis in cells of non-haematopoietic origins.

Cellular uptake and release of the immunomodulating fungal toxin gliotoxin.

Uptake of the immunomodulating agent gliotoxin into a panel of cells using biosynthetically radiolabelled 35S toxin showed rapid association of the toxin with all cell types studied with 70-85% of the total counts in the media becoming cell associated. A difference in kinetics was observed for cell lines when compared to the primary cells thymocytes, activated T-cells and macrophages. In the latter uptake was maximal after 10-15 min and radiolabel was lost from the cells as early as 100 min. In the cell lines studied, uptake was complete in less than 1 min with no loss of label after 100 min. The exception to this was a Wilms tumour line. Analysis of the fate of gliotoxin taken up into sensitive (activated T-cells) and resistant (human fibroblast) cells by HPLC showed: (a) up to 30% of the original gliotoxin taken up by sensitive cells was released as free gliotoxin over a 22 hr period. The remainder was metabolized to inorganic sulphate; (b) in T-cells gliotoxin is reduced to the dithiol form in significant amounts and this reduction may be modulated by glutathione; and (c) no reduced gliotoxin could be detected in the resistant fibroblast cell line 27Sk even though up to 50% of the original gliotoxin was still present in the free form in these cells at 22 hr. Gliotoxin became covalently associated with macromolecules in both cell types studied. Very little free gliotoxin is released into extracellular medium by the fibroblast cell line. Gliotoxin at 500 nM was found to induce apoptosis or programmed cell death in the Wilms tumour cell line but not in any other cell line studied, and this may account for the different kinetics of release of the toxin from the Wilms tumour cell line.

Studies on the effects of growth hormone administration in vivo on the rates of glucose transport and utilization in rat skeletal muscle.

The effects of growth hormone (GH) administration to rats in vivo on the sensitivity of the rate of glucose utilization to insulin were studied in soleus muscles isolated from these rats. A single injection of GH did not increase the rate of glucose transport within 1-2 h. However, 12 h after, the rate of glucose transport was increased at 10 mU insulin l-1 and was accompanied by a similar increase in the rate of lactate formation but no change in the rate of glycogen synthesis. Prolonged treatment with GH decreased the rate of glucose transport and glycogen synthesis and increased the content of glucose 6-phosphate at physiological levels of insulin but did not affect the rate of lactate formation. These results suggest that: (a) GH does not increase the rate of glucose transport acutely; however, after several hours, the sensitivity of glucose transport and glycolysis to insulin are increased; (b) prolonged elevations of the level of GH in plasma decrease the sensitivity of the rate of glucose transport and glycogen synthesis to insulin. However, redirection of glucose residues away from the pathway of glycogen synthesis towards that of glycolysis and a possible increase in the rate of glycogenolysis maintain a normal rate of lactate formation, although the rate of glucose transport is decreased.

Effects of insulin-like growth factor I on the rates of glucose transport and utilization in rat skeletal muscle in vitro.

1. The effects of insulin-like growth factor I (IGF-I) on the rates of glucose transport and utilization and its interaction with insulin were investigated in rat soleus muscle in vitro. IGF-I increased the rates of glucose transport, lactate formation, glycogen synthesis and the flux of glucose to hexose monophosphate, but it had no effect on the rate of glucose oxidation or glycogenolysis. 2. In the absence of insulin, low levels of IGF-I (0-30 ng/ml) increased the rate of glycolysis and the content of fructose 2,6-bisphosphate, but the content of glucose 6-phosphate remained unaltered; at higher levels of IGF-I (300-3000 ng/ml) the rate of glycolysis and the content of fructose 2,6-bisphosphate showed a further modest increase, but the content of glucose 6-phosphate doubled. Similar changes were seen when the level of insulin was increased from basal (0-0.4 ng/ml) to maximal (40 ng/ml). 3. Neither IGF-I nor insulin affected the contents of ATP, ADP, AMP, phosphocreatine or citrate. 4. Maximal concentrations of IGF-I increased the rate of lactate formation to a greater extent than did maximal concentrations of insulin. 5. In the presence of IGF-I, the rate of glucose utilization was less responsive to insulin. 6. The results suggest that, in rat skeletal muscle: (a) IGF-I increases the rates of glucose transport and utilization independently of insulin, and has a preferential effect on the rate of lactate formation; (b) the effects of IGF-I and insulin are not additive; (c) in addition to its effects on glucose transport, IGF-I increases the rate of glycogen synthesis and may stimulate glycolysis at the level of 6-phosphofructokinase; (d) changes in the content of fructose 2,6-bisphosphate may be part of the mechanism to regulate glycolytic flux in skeletal muscle in response to either IGF-I or insulin.

The kinetics of glutamine transport in bovine lymphocytes.

The transport of glutamine was examined in bovine peripheral lymphocytes which had been cultured in the presence or absence of Concanavalin A (Con A). Glutamine transport was mediated by a triphasic transport system in both cell populations. The calculated kinetic parameters were: Km 1.0, 4.7 and 12.7 mM and Vmax 4.5, 6.0 and 9.0 nmol/min per mg protein respectively. Con A augmented the capacity rather than the affinity of the glutamine transport systems (Vmax rates being 8.0, 12.2 and 38.0 nmol/min per mg protein respectively). Transporter I displayed Michaelis-Menton kinetics, while transporters II and III were co-operative carriers possessing Hill coefficients of 2.3 and 9.5 respectively. Preliminary studies using amino acid and ion inhibition studies suggested that transporter I was a system ASC-type carrier, transporter III a system L carrier, while the nature of transporter II was unclear.