Direct effects of IL-4/IL-13 and the nematode Nippostrongylus brasiliensis on intestinal epithelial cells in vitro.

Nematode infections induce the upregulation of mucin- and glycosylation-related genes in intestinal epithelial cells in vivo. However, the factor(s) that induce these changes in epithelial cells have not been fully elucidated. In the present study, we analysed the effects of the Th2 cytokines IL-4 and IL-13 and the excretory-secretory (ES) product of the nematode Nippostrongylus brasiliensis on the gene expression of the major mucin core peptide MUC2, the sialyltransferase ST3GalIV (Siat4c) and the sulphotransferase HS3ST1 in intestinal epithelium-derived IEC-6 cells by quantitative reverse transcription (RT)-PCR. The administration of IL-4 and IL-13 resulted in a significant upregulation of ST3GalIV and HS3ST1 gene transcription, but had no effect on MUC2, in IEC-6 cells. RT-PCR studies also demonstrated the constitutive expression of IL-13Ralpha1 and IL-4R in IEC-6 cells. On the other hand, the ES product induced upregulation of ST3GalIV, but not HS3ST1 or MUC2, while coadministration of IL-13 and the ES product induced a slight but significant upregulation of MUC2. Co-incubation of live N. brasiliensis adult worms with IEC-6 cells resulted in the upregulation of ST3GalIV and MUC2. These results suggested that HS3ST1 gene expression is strictly regulated by IL-4/IL-13, while ST3GalIV and MUC2 gene expressions are regulated by redundant mechanisms.

Immunity-mediated regulation of fecundity in the nematode Heligmosomoides polygyrus--the potential role of mast cells.

Previous studies have shown that host immunity regulates the fecundity of nematodes. The present study was aimed at clarifying the reversible nature of fecundity in response to changes of immunological status and to determine which effector cells are responsible for compromising fecundity in Heligmosomoides polygyrus. Enhanced fecundity was observed in immunocompromised SCID and nu/nu mice compared to those in the corresponding wild-type mice, with significantly fewer numbers of intrauterine eggs produced in the wild-type than in the immunodeficient mice. When 14-day-old adult worms from BALB/c mice were transplanted into naïve BALB/c mice, their fecundity increased significantly as early as 24 h post-transplantation, but not when they were transferred into immune mice, suggesting the plastic and reversible nature of fecundity in response to changes in host immunological status. In mast cell-deficient W/W(v) mice, nematode fecundity was significantly higher than in mast cell-reconstituted W/W(v) or +/+ mice. The serum levels of the mast-cell protease mMCP1 were markedly increased in the wild-type as well as the mast cell-reconstituted W/W(v), but not in the W/W(v), SCID, or nu/nu mice during infection. These findings raise the interesting possibility that certain activities of mast cells, either directly or indirectly, regulate parasite fecundity during infection.

Depleted intestinal goblet cells and severe pathological changes in SCID mice infected with Heligmosomoides polygyrus.

To determine the role of T cells and mast cells in intestinal pathology and immune expulsion of intestinal nematodes, worm burdens, goblet cell responses and villus structures were analysed in T- and B-cell-deficient severe combined immunodeficiency (SCID) mice, athymic nu/nu mice and mast cell deficient W/W(v) mice after infection with the nematode Heligmosomoides polygyrus. SCID and nu/nu mice showed significantly higher worm burdens at week 9 post-infection compared with the wild-type controls. SCID and nu/nu mice showed compromised goblet cell hyperplasia and/or Muc 2 expression, indicating that both events are T-cell dependant. On the other hand, the SCID mice showed increased pathology (villus atrophy and crypt hyperplasia) and increased numbers of proliferating cell nuclear antigen positive cells compared to the wild-type controls. W/W(v) mice, conversely, were able to expel the worms normally, had normal goblet cell hyperplasia, and did not demonstrate the changes in mucosal architecture seen in SCID mice, confirming that a normal mast cell response is not necessarily required for these changes. These results suggest that a functional T-cell response, but not a mast cell response, is necessary for anti-parasite responses, goblet cell function, and maintaining normal mucosal architecture.

Substance P-induced augmentation of cutaneous vascular permeability and granulocyte infiltration in mice is mast cell dependent.

The undecapeptide substance P is thought to mediate both vasodilatation and augmented vascular permeability when released from sensory nerve endings in the skin. Substance P also induces mast cell degranulation in vitro or in vivo. However, the extent to which substance P-induced changes in vascular permeability are mast cell-dependent is unclear. We investigated this issue by injecting substance P and certain related peptides (substance P1-4, substance P4-11) into the skin of genetically mast cell-deficient WBB6F1-W/W or WCB6F1- SI/SId mice the congenic normal (+/+) mice, and W/W mice which had undergone selective local repair of their mast cell deficiency by intradermal injection of IL-3-dependent mast cells generated in vitro from the bone marrow cells of the congenic +/+ mice. Substance P induced significant augmentation of vascular permeability and significant cutaneous swelling when injected into normal mice at doses as low as 2 pmol i.d. Substance P also induced granulocyte infiltration, although the infiltrate were modest and were seen at doses of peptide from 5 to more than 20-fold higher than those required for induction of tissue swelling. The effects of substance P on tissue swelling, vascular permeability, and granulocyte infiltration were virtually entirely mast cell dependent. By contrast, substance P1-4 was inactive in our assays at 25 nmol/site, and substance P4-11 induced modest augmentation of vascular permeability, which was at least in part mast cell independent.

The protease-activated receptor-2 agonist induces gastric mucus secretion and mucosal cytoprotection.

Protease-activated receptor-2 (PAR-2), a receptor activated by trypsin/tryptase, modulates smooth muscle tone and exocrine secretion in the salivary glands and pancreas. Given that PAR-2 is expressed throughout the gastrointestinal tract, we investigated effects of PAR-2 agonists on mucus secretion and gastric mucosal injury in the rat. PAR-2-activating peptides triggered secretion of mucus in the stomach, but not in the duodenum. This mucus secretion was abolished by pretreatment with capsaicin, which stimulates and ablates specific sensory neurons, but it was resistant to cyclo-oxygenase inhibition. In contrast, capsaicin treatment failed to block PAR-2-mediated secretion from the salivary glands. Intravenous calcitonin gene-related peptide (CGRP) and neurokinin A markedly elicited gastric mucus secretion, as did substance P to a lesser extent. Specific antagonists of the CGRP1 and NK2, but not the NK1, receptors inhibited PAR-2-mediated mucus secretion. Pretreatment with the PAR-2 agonist strongly prevented gastric injury caused by HCl-ethanol or indomethacin. Thus, PAR-2 activation triggers the cytoprotective secretion of gastric mucus by stimulating the release of CGRP and tachykinins from sensory neurons. In contrast, the PAR-2-mediated salivary exocrine secretion appears to be independent of capsaicin-sensitive sensory neurons.

A role of mast cells for hepatic fibrosis in primary sclerosing cholangitis.

We encountered four patients with overt primary sclerosing cholangitis (PSC) which were histologically classified into stage 2 or 3. We examined the expression of stem cell factor (SCF), a ligand of c-kit, in injured bile ducts by immunohistochemistry, and mast cells were identified by immunohistochemistry using anti-HMCT (human mast cell tryptase) and anti-c-kit antibodies to clarify their relation with portal fibrosis coincident with destroyed bile ducts. SCF was detected in the epithelia of most bile ducts in PSC, and many HMCT- and c-kit-positive mast cells were found in portal tracts. Image analysis showed more significant numbers of c-kit-positive mast cells per area of portal tract in PSC than in chronic hepatitis C, and they might increase from stage 2 to 3. c-Kit-positive cells infiltrated into the portal tracts with SCF-positive destroyed bile ducts, and c-kit mast cells should be investigated in detail to make a role for portal fibrosis in PSC.

Kinetics and staining properties of mast cells proliferating in rat small intestine tunica muscularis and subserosa following infection with Nippostrongylus brasiliensis.

Mucosal mast-cell hyperplasia occurs in the rat small intestine mucosa after infection with Nippostrongylus brasiliensis. In the present study, the number of mast cells was found to increase in the muscularis and subserosa as well as in the mucosa of rat small intestines 2-3 weeks after infection with this nematode. Mast cells in the muscularis were stained blue by the alcian blue/safranin sequence and did not bind berberine sulfate. The staining was blocked when tissues were fixed in neutral formalin. The increase in mast cells was transient and gradually disappeared; the half-life was 40 days. After an intravenous administration of compound 48/80, mast cells in the muscularis did not discharge granules. The results indicate that these mast cells were of the mucosal type. The mast cell phenotype in the muscularis did not change even 12 weeks after infection. Mast cells in the subserosal tissue were first of the mucosal type as were those in muscularis. After 8-12 weeks, however, many subserosal mast cells became positive for berberine sulfate and safranin. These results show that mucosal-type mast cells do not undergo phenotypic changes during the period of observation when these cells appear in the muscularis but the phenotypic expression may change as the cells arise in subserosal tissue.

Increase in mucosal and connective tissue-type mast cells in the stomach with acetic acid-induced ulcer in rat.

Gastric ulcers were induced in rats by acetic acid treatment, and the mast cell kinetics in the lesions were studied. Within 24 h, mast cells had disappeared from the treated site and from the marginal zone, corresponding to the area of severe tissue injury. Regenerating epithelium appeared at day 10, and the lesion had healed by day 30. In this healing process, the number of mast cells was significantly increased, and their density in the regenerating mucosa, marginal mucosa, and marginal muscularis propria was 3.2 1.8, and 7.5-fold the control level, respectively. The increase in the number of mast cells was preceded by an increase in the percentage of S-phase mast cells. Mast cells in the mucosa were Alcian blue (AB)+/safranin (S)- and rat mast cell protease (RMCP) I-/II+, consistent with the features of mucosal mast cells throughout the observation period. On the other hand, most mast cells in the muscularis propria exhibited AB+/S+ and RMCP I+/II+ in the early period of ulcer healing. The latter feature was changed to RMCP I+/II- on day 30, indicating that immature CTMC appeared and then developed into mature CTMC during the ulcer healing. The significant change in the number of mast cells suggests that mast cells play an important role in the development and healing of gastric ulcers.

Bromodeoxyuridine labeling studies on the proliferation of intestinal mucosal mast cells in normal and athymic rats.

The proliferation of mucosal-type mast cells (MMC) in rat small intestine was studied using a bromodeoxyuridine (BrdU)-labeling method. After 24-h cumulative injections of BrdU into adult SD rats, 3.5% of MMC were labeled, while only 0.3% and 0.1% of mast cells were labeled in back skin and ear respectively. From the results, it was concluded that MMC division occurred more than 10 times as frequently as the division of skin mast cells. Similar results were obtained in athymic adult rats (F344/N Jcl-rnu) in which the number of MMC was similar to that in heterologous animals. Thus, thymic factor(s) or T cells may not have an important role in MMC division in normal states. When SD rats were infected with Nippostrongylus brasiliensis, vigorous proliferation of MMC was brought about 13 to 15 days after infection. At that period, 40% of MMC were labeled by a single injection of BrdU, and 85% of MMC were labeled by 9-h cumulative injections of BrdU, with the result that most MMC rapidly proliferated in the intestinal mucosa during this period. Mitotic figures of MMC were sometimes observed. On the contrary, hyperplasia of MMC was not observed in athymic rats infected with nematodes. Therefore, MMC hyperplasia after nematode infection is dependent on thymic factor or T cells, and its mechanism is different from that of MMC division in normal states, in which thymic factor(s) or T cells are not essential.

Mucosal mast cell proliferation following normal and heterotopic infections of the nematode Nippostrongylus brasiliensis in rats.

Infections of intestinal nematodes induce the T cell-dependent proliferation of intestinal mucosal mast cells (MMC). To examine whether nematode-induced MMC proliferation is affected by the site of infestation, adult-stage nematode Nippostrongylus brasiliensis (NB) was transplanted into the normal infection site, the duodenum, or into heterotopic sites, the peritoneal cavity (i.p.) or subcutaneous tissue (s.c.), of rats. Two weeks after duodenal inoculation, MMC numbers in the small intestine had increased 6.5-fold. In contrast, i.p. and s.c. inoculation induced only slight increases of intestinal MMC. After i.p. inoculation, worm granulomas developed in the connective tissues adhering to stomach and duodenum, and large numbers of mast cells appeared around the granulomas. The majority of the latter mast cells showed histochemical features similar to MMC: they were formalin sensitive, berberine sulfate-, alcian blue+/safranine-, and rat mast cell protease (RMCP) II+. After s.c. inoculation, worm granulomas developed at the inoculation site, but the number of mast cells around the granulomas was not significantly increased. These results suggest that intense proliferation of MMC or MMC-like cells is induced only by the infections on mucosa or in mucosa-associated tissues.

Lack of active lung anaphylaxis in congenitally mast cell-deficient Ws/Ws rats sensitized with the nematode Nippostrongylus brasiliensis.

Ws/Ws rats are deficient in both mucosal- and connective tissue-type mast cells. To study the role of mast cells in active anaphylaxis, changes in vascular permeability in the trachea upon intravenous antigen challenge with Evans blue dye were examined in Ws/Ws, heterogenic Ws/+, and normal +/ + rats sensitized with the nematode Nippostrongylus brasiliensis. Antigen challenge resulted in fatal anaphylactic shock in some +/+ and Ws/+ rats, but not in Ws/Ws rats. Marked dye leakage developed within 30 min in the trachea of +/+ and Ws/+ rats, while Ws/Ws rats showed no substantial increases in the levels of vascular permeability. Ex vivo stimulation of sensitized lung fragments from +/+ animals with specific antigen induced significant releases of histamine and leukotriene (LT) C4, while sensitized Ws/Ws rat-lung fragments did not. In Ws/Ws rats, levels of nematode-specific IgE, IgG1 and IgG2a antibodies as well as levels of lung eosinophilia were not significantly different from those in +/+ rats. These results show that mast cell-deficient Ws/Ws rats fail to develop active anaphylaxis, and this is mediated probably by the lack of mast cell-derived mediators required for initiation of the reaction.

Migration of neutrophils is dependent on mast cells in nonspecific pleurisy in rats.

To determine the role of mast cells in the recruitment of neutrophils and eosinophils, acute nonspecific pleurisy was induced by injecting isologous serum into normal +/+ and mast cell-deficient Ws/Ws rats. In +/+ rats, neutrophil infiltration peaked 4 h after serum administration, followed by influx of eosinophils after 24-48 h. The levels of neutrophil influx after 4 h as well as the activity of myeloperoxidase (MPO) in pleural lavage-cell extract were significantly lower in Ws/Ws rats than in +/+ rats. In contrast, numbers of eosinophils as well as activity of eosinophil peroxidase (EPO) did not differ significantly between Ws/Ws and +/+ rats. For local reconstitution of mast cells, +/+ rat peritoneal mast cells (PMC) or mesenteric lymph node cells (MLNC) as a control were transferred into the Ws/ Ws pleural cavity. Serum injection into animals with PMC transfer 7 days previously triggered augmented neutrophil influx by approximately 4.7-fold as compared to that in MLNC-transferred animals. Mast cells recovered from the pleural cavity of PMC-transferred rats showed histamine contents equivalent to 20% of that of freshly isolated PMC and retained the reactivity to compound 48/80. These results indicated that dependency of neutrophil recruitment on resident mast cells is greater than that of eosinophils in isologous serum-induced pleurisy.

Cytogenetic evidence of clonal evolution in a case of hemopoietic dysplasia with a 5q- chromosome.

A 70-year-old Japanese male with hemopoietic dysplasia is described. Cytogenetic investigation revealed an abnormal karyotype, 46,XY,del(5)(q13q33), in all metaphases examined at the time of diagnosis. Eight months later, a newly appearing abnormal hyperdiploid karyotype, 47,XY,5q-, +21, was observed in 74% of the cells analyzed, which was associated with evolution of the disease when a pathologic diagnosis of a myeloproliferative disorder was made.

Development of mast cells and basophils: processes and regulation mechanisms.

Mast cells and basophils are offspring of the multipotential hematopoietic stem cell. Although mast cells sometimes are misunderstood as basophils that have invaded connective or mucosal tissue, these two kinds of basophilic cells are distinguishable by morphology and surface antigenicity. Developmental processes of mast cells and basophils are different. Basophils complete their differentiation within the bone marrow, but precursors of mast cells leave the bone marrow, invade connective or mucosal tissue, proliferate, and differentiate into mast cells. The mechanisms regulating development are different between mast cells and basophils. Both T cell-dependent and fibroblast-dependent mechanisms are involved in the development of rodent mast cells, but only the fibroblast-dependent mechanism is known for development of human mast cells and only the T cell-dependent mechanism for the development of basophils of both rodents and humans. The most important cytokine for the T cell-dependent mechanism appears to be interleukin-3, whereas for the fibroblast-dependent mechanism it appears to be the ligand for the c-kit receptor (ie, stem cell factor).

Species-specific differences in heterogonic development of serially transferred free-living generations of Strongyloides planiceps and Strongyloides stercoralis.

The direction of free-living development (homogonic vs. heterogonic) in Strongyloides stercoralis and Strongyloides planiceps was examined by successive transplantation of the uterine eggs of free-living females into a test tube culture system containing fresh feces. The eggs from the first-generation free-living females of S. stercoralis did not develop into second-generation free-living adult worms, but all developed into filariform larvae. However, the majority of S. planiceps eggs from the first-generation free-living females developed into second-generation free-living adults. By successive transfer of uterine eggs of each generation, 9 generations developed, and in every cycle more adult worms developed than filariform larvae. However, the number of free-living generations was not infinite; in experiments repeated twice, the number of worms developing from the eggs of eighth or ninth generations was too small to continue further culture. These findings indicate that the pattern of free-living development is different between the 2 species.

Trichomonas tenax empyema in an immunocompromised patient with advanced cancer.

A 53-year-old male acromegalic patient with advanced rectal adenocarcinoma developed pleuritis in the course of cobalt irradiation, steroid treatment and chemotherapy. Examination of drained pleural fluid demonstrated numerous motile organisms, which were identified as Trichomonas tenax by Giemsa staining. Peptostreptococcus micros was also detected in the cultures of pleural fluid and blood. Treatment with metronidazole successfully eliminated the protozoa and cured the pyothorax.

[Imported cryptosporidiosis--report of a case in Japan and review of the literature].

A 24-year-old Japanese male who had traveled to India was referred to our institute because of severe prolonged watery diarrhea. Cryptosporidium parvum oocysts were detected in his stool specimens by the phase-contrast microscopy and modified acid-fast stain. Stool examinations were negative for other intestinal protozoa. Bacterial cultures were also negative for pathogenic agents. He was treated with sulfamethoxazole/trimethoprim (Co-trimoxazole) for 6 days and he soon recovered. To our knowledge, there have been no reported cases concerning imported cryptosporidiosis in Japan. Physicians should regard this organism as one of the causative agents of travelers' diarrhea when other pathogens are negative, since this organism is easily overlooked in routine stool examinations.

[Imported trichinellosis with severe myositis--report of a case].

A 38-year-old Japanese male who had traveled in China from September 13 to October 5, 1997, developed fever and severe conjunctivitis from October 20. After he was hospitalized in Kyoto City Hospital for persistent high fever on October 29, he developed muscular weakness and dysphagia which continued for two weeks. An electromyogram showed a myogenic pattern, and laboratory findings showed significant elevation of serum enzyme levels of muscle origin: CPK, 3,095 IU/l; aldorase, 195 IU/l; myoglobin, 7,570 ng/ml, and myoglobinuria, 94,700 ng/ml. The WBC was 10,800/microliter with 45% eosinophils. Muscular biopsy showed degeneration of muscle fibers with infiltration of macrophages and lymphocytes. On further inquiry, it was revealed that the patient had eaten smoked bear meat in China on September 30, three weeks prior to the onset of symptoms. A dot-ELISA serologic test for parasites was positive for Trichinella. Further, a coiled 1.2 mm long Trichinella larve was recovered from approximately 100 mg of frozen biopsied muscle by an enzyme digestion method. Mebendazole was given to the patient at a dosage of 200 mg/day for seven days. CPK levels were normalized within 3 days of the beginning of the treatment, and he was discharged without any symptoms. Physicians must be aware of trichinellosis and should include it in their differential diagnosis when examining patients with myositis and eosinophilia of unknown origin.