Validation of heart rate spot-check protocol to measure circadian variation and heart rate in healthy dogs and dogs with atrial fibrillation.

INTRODUCTION: Alternatives for out-of-clinic heart rate (HR) measurement are required to optimise the management of atrial fibrillation (AF) in dogs. Additionally, the presence of circadian variation (CV) in HR in pet dogs remains unknown. We aimed to identify the number and duration of spot-checks required for an accurate estimation of 24-hour HR in canine AF. Circadian variation in HR was examined in healthy dogs and dogs with AF, and spot-check-derived HR was compared with a CV-derived gold standard. MATERIALS AND METHODS: Ambulatory electrocardiogram data from healthy dogs and dogs with AF were retrospectively analysed. Heart rate was calculated from the entire recording and pre-defined periods (spot-checks) of one hour to 30 and 60 s in duration. Circadian variation in HR was determined by cosinor analysis. Bias and limits of agreement of means and median HR with mesor HR were determined by correlation and Bland-Altman analysis. RESULTS: Circadian variation in HR was identified not only in 18/22 healthy dogs and 14/21 AF dogs but only on ambulatory electrocardiogram recordings. Four-hourly spot-checks provided the most accurate estimate of mesor HR in healthy dogs (bias of the median over 30 s 7.70, limits of agreement 7.48), whereas, in dogs with AF, four, six and eight-hourly spot-checks provided reliable estimates of mesor HR (bias within -1.29 and -29.5). CONCLUSIONS: Four, six and eight-hourly HR spot-checks can estimate 24-hourly HR in dogs with AF. There was CV in HR in most healthy pet dogs and dogs with AF. Spot-check protocols cannot identify CV in HR.

Human spleen contains phenotypic subsets of macrophages and dendritic cells that occupy discrete microanatomic locations.

Macrophages (M phi s) are an important component of the immune response and mediate numerous other functions. Phenotypic and functional subsets of circulating monocytes have been described, but few similar studies have analyzed M phi s in human tissues. By use of immunohistochemical techniques and a large number of monoclonal antibodies, the presence and distribution of phenotypic subpopulations of M phi s and dendritic cells in human spleen were assessed. The results of this study show that different subsets of M phi s and dendritic cells are present in the spleen and that some of these occupy discrete microanatomic locations. In the red pulp (RP) certain groups of antigens are expressed by different proportions of uniformly distributed M phi s in the cords. On the other hand, some antigens are present on M phi s that form clusters of variable size within the red pulp. M phi s in the splenic marginal zone (MZ) share some antigens with red pulp M phi s, but in addition express CR3, Mo-2, 61D3, and 63D3. These antigens are found on only a few RP M phi s. MZ cells expressing one antigen shared with RP M phi s (Leu-3a,b) and one present largely on the MZ cells (63D3) form clusters around small vessels; these structures resemble the so-called splenic ellipsoids that may play a role in the trapping of circulating antigens. Phagocytic M phi s (tingible body M phi s) of the white pulp follicular germinal centers were also shown to differ from RP and MZ cels with respect to the expression of the antigens detected by anti-FcR, Leu-M3, Mo-2, 25F9, and anti-CR3. The unique topographical and surface antigenic features of dendritic cells were confirmed by this study. Furthermore, these cells were found to share a number of antigens with RP, MZ, and white pulp M phi s, which suggests that they may be derived from a common progenitor. The presence of phenotypic subpopulations and variation in distribution among human splenic phagocytic cells and dendritic cells may be indicative of functional specialization.

Human splenic sinusoidal lining cells express antigens associated with monocytes, macrophages, endothelial cells, and T lymphocytes.

The antigenic and functional properties of splenic sinusoidal lining cells (SLC) have not been studied extensively. Some investigators have suggested that SLC are actively phagocytic, and thus part of the mononuclear phagocyte system. Others dispute this and assign the functions of endothelial cells to the SLC. During studies in situ of phenotypic subpopulations of human splenic macrophages (M phi), we found that SLC share membrane antigens (HLA-DR and OKM5), an enzyme (lysozyme), and histochemical properties (nonspecific esterases) with monocytes and M phi. In addition, we showed that LSC, like endothelial cells, synthesize factor VIII of the clotting system and also bear the receptor for transferrin. Our previous studies found that SLC express the antigens found on helper/inducer (OKT4, Leu-3a,b) and suppressor/cytotoxic (OKT8, Leu-2a) T lymphocyte subsets. We have confirmed these observations, and have shown by means of preincubation with soluble complexes of anti-human IgG-human IgG that the detection of T cell and other antigens on SLC is not due to nonspecific binding of antibodies by Fc receptors. By using techniques designed to isolate and purify splenic M phi, we were able to obtain SLC in suspension and to demonstrate that they retain the antigens detected in situ. Thus, the human splenic SLC expresses a unique combination of antigens, histochemical properties, and cell products in common with monocytes, M phi, and T lymphocytes.

Monoclonal antibodies to T-helper/inducer and T-suppressor/cytotoxic lymphocyte subsets recognize antigens on splenic sinusoidal lining cells.

Most of the monoclonal antibodies (MoAbs) to T-lymphocyte subsets are, with few exceptions thought to recognize antigens (Ags) unique to T-cells. The authors examined the distribution of cells reacting with MoAbs to the helper/inducer (OKT4, anti-Leu-3a,b) and suppressor/cytotoxic (OKT8, anti-Leu-2a) T-lymphocyte subsets and to "pan T" Ags (anti-Leu-1, anti-Leu-4) in sections from frozen human spleen. In addition to recognizing lymphocytes in the T-zone (periarteriolar lymphoid sheaths), MoAbs to the helper/inducer and suppressor/cytotoxic T-cell subsets reacted distinctly with the red pulp sinusoidal lining cells. MoAbs to "pan T" Ags also reacted with T-zone lymphocytes but did not react with sinusoidal lining cells. MoAbs to the helper/inducer and suppressor/cytotoxic subsets of T-lymphocytes do not appear to identify Ags unique to these cells.

Isolation of human splenic macrophages and lymphocytes by countercurrent centrifugal elutriation.

Certain tissues, such as the spleen, are rich sources of mononuclear phagocytes (MP); however, separating the phagocytes from tissues and removing the contaminating cells have been difficult. We report here a method for the extraction and purification of human splenic MP that employs gentle homogenization of splenic fragments with a Tenbroeck tissue homogenizer, controlled digestion with purified collagenase to free MP from splenic stroma, incubation with DNase to dissociate cell clumps and purification by countercurrent centrifugal elutriation (CCE). With homogenization and enzymatic digestion most of the splenic nonspecific-esterase-positive cells are freed into suspension as determined by morphometric analysis of 2 micron sections from plastic embedded spleen stained for alpha-naphthyl butyrate esterase (ANB). Overall cell recovery after homogenization and enzyme treatment is 56 +/- 7%; no selective cell loss occurs as determined by differential cell counts at each purification step. CCE of up to 3 X 10(9) treated spleen cells results in recovery of 63 +/- 6% of the elutriated cells and separates nearly 50% of the recovered MP into enriched fractions. These MP are morphologically intact as determined by light and electron microscopy and are actively phagocytic. Highly purified (96%) autologous splenic lymphocytes are a useful by-product of this separation technique.