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The role of platelet-activating factor (PAF) in stimulating neutrophils during interaction with HUVEC has been investigated using the specific PAF receptor antagonists WEB 2086 and YM 264. PAF antagonists at concentrations up to 40 microM had little effect on the adhesion of neutrophils to control or IL-1 beta-stimulated HUVEC monolayers. However, polarization of neutrophils on adhesion to IL-1-treated HUVEC was markedly diminished in the presence of PAF antagonists. In addition, the PAF antagonists WEB 2086 and YM 264 strongly inhibited the migration of neutrophils across IL-1-treated endothelial monolayers. Priming of neutrophil respiratory burst and arachidonic acid release caused by contact with IL-1-treated endothelial cells was also inhibited by PAF antagonists. However, priming as a consequence of transmigration was not inhibited by either WEB 2086 or YM 264. These results suggest that HUVEC-associated PAF plays a central role in the polarization and subsequent transmigration of neutrophils during interaction with HUVEC monolayers. Moreover, the results further suggest that PAF is responsible for priming neutrophils during contact with HUVECs. However, after transmigration, factors other than PAF are responsible for the priming of neutrophil function.

Using a sensitive flow cytometric assay, which measures the intracellular oxidation of 2'7' dichlorofluorescein (DCFH) by H2O2, we have assessed, at a single-cell level, the effects of a variety of physiological priming agonists and cytochalasin B (CB) on purified populations of neutrophils stimulated at different points along the signal response transduction pathway. Pretreatment of purified neutrophils with the physiological priming agonists monocyte interleukin-8 (IL-8), granulocyte-monocyte colony-stimulating factor (GM-CSF), platelet-activating factor (PAF), IL-1 beta, tumour necrosis factor-alpha (TNF-alpha), IL-6, and non-stimulatory doses of formyl-methionyl-leucyl-phenylalanine (FMLP), resulted in an increased percentage of cells generating an oxidative burst in response to subsequent receptor stimulation with FMLP. CB had a similar but much more pronounced effect on cellular recruitment to a receptor-mediated responsive state. Activation of protein kinase C (PKC) using the phorbol ester phorbol myristate acetate (PMA) resulted in a heterogeneous response, with all cells generating H2O2, but with two populations differing in their magnitude of response. Physiological priming agonists had no effect on the heterogeneity of the PMA response. However, pretreatment with CB dramatically altered the PMA response, producing a homogeneous population highly responsive to stimulation with PKC. In contrast, direct stimulation of G proteins with fluoride (A1F-4) was primed both by physiological priming agonists and by CB. These results demonstrate that priming of neutrophils by physiological agonists involves changes at the level of signal transduction which enable a previously non-responsive cell to respond to a secondary stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

We describe the case of a 46-year-old woman with rheumatoid arthritis who developed a severe reaction to sulfasalazine, characterized by dysphasia, seizures, rash and the development of strongly positive pANCA (perinuclear antineutrophil cytoplasmic antibodies). Her condition improved spontaneously upon withdrawal of sulfasalazine. Dysphasia has not been reported as a side effect of sulfasalazine.

When human peripheral blood neutrophils were stimulated with various agonists which activate and/or prime neutrophils, we found that Cl- efflux was enhanced with a dramatic (50%) loss of intracellular Cl-. Interestingly, the Cl- efflux was enhanced by both agonists which induce a rapid transient increase in intracellular Ca2+ concentration ([Ca2+]i) [class I, e.g. N-formyl-methionyl-leucyl-phenylalanine (fMLP), interleukin-8 (IL8), platelet-activating factor, leukotriene B4 and C5a] and those which do not induce such an [Ca2+]i elevation [class II, e.g. tumor necrosis factor alpha (TNF) and granulocyte-macrophage colony-stimulating factor (GM-CSF)]. The time course of agonist-stimulated Cl- efflux differed depending on the agonist. Class I agonists such as IL8 and fMLP exhibited a 1 min lag phase before the onset of Cl- efflux; class II agonists such as GM-CSF and TNF displayed a 2 and 5 min lag phase, respectively. Both IL8 (class I)- and TNF (class II)-stimulated Cl- efflux exhibited similar sensitivity to inhibition by different types of ion transport inhibitors [ethacrynic acid (EA), amiloride, 4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid, anthracene-9-carboxylic acid, and 4-4'-diisothiocyanatostilbene-2,2'-disulfonic acid]. On the other hand, natural Cl- efflux, which is thought to be mainly mediated by Cl-/Cl- self exchange, was not inhibited by EA (0.5 mM) or amiloride (0.3 mM). These results imply that both class I and class II agonist-stimulated Cl- efflux occurs via a common Cl- transporter which is different from that reported previously in resting human neutrophils. Although all agonists which induced a Cl- efflux also induced shape change of neutrophils, there did not appear to be a causal relationship between shape change and agonist-stimulated Cl- efflux. However, a temporal correlation was found to exist between agonist-stimulated Cl- efflux and intracellular alkalinization following agonist stimulation. Agonist-stimulated Cl- efflux therefore seems to be a common phenomenon activated by several agonists which act through different signal transduction pathways.

The elevation of intracellular levels of cyclic AMP by forskolin stimulation of adenylate cyclase regulates early and late phase neutrophil responses differentially. Early phase neutrophil responses as measured by shape change in response to chemotactic factors, transmigration across a polycarbonate membrane and priming were unaffected by forskolin-induced elevation of intracellular cAMP. Late phase neutrophil responses such as release of superoxide anions, activation of phospholipase A2 and platelet activating factor (PAF) synthesis were inhibited by increasing intracellular cAMP through the addition of 10 microM forskolin for 10 min prior to stimulation. N-Formyl-methionyl-leucyl-phenylalanine-stimulated arachidonic acid release fell from 9.3% (untreated cells) to 4.6% in forskolin-treated cells. PAF generation was also inhibited from 430 pg/10(6) cells in untreated cells to background levels in forskolin-treated cells (110 pg/10(6) cells). Also, the reduction of cytochrome c by superoxide anions fell from 4.2 nmol/10(6) cells in the absence of forskolin to 2.0 nmol/10(6) cells following forskolin treatment. These results indicate that in neutrophils the elevation of cAMP acts differentially on cellular responses, not affecting early activation events, but markedly inhibiting late events such as the release of inflammatory mediators.

We demonstrate for the first time that recombinant human monocyte interleukin-8 (rhMIL-8) primes human neutrophil responses to fMLP. Human neutrophils preincubated for 10 min with 10(-8) M rhMIL-8 and then stimulated with micromolar fMLP show enhanced release of superoxide anions, platelet-activating factor (PAF) and arachidonic acid compared with cells which are not initially exposed to rhMIL-8. We also demonstrate that this enhancement of the neutrophil response is dependent on the dose of rhMIL-8 with the greatest enhancement corresponding with IL-8 levels which cause maximum shape change of neutrophils. Priming of neutrophils occurred after only 30 seconds preincubation with rhMIL-8 indicating that the mechanism of IL-8 priming is extremely rapid as was stimulation of neutrophil shape change by rhMIL-8. Priming of neutrophils with rhMIL-8 did not increase sensitivity to fMLP but enhanced responsiveness to activating concentrations. rhMIL-8 alone at levels used for priming caused no release of superoxide anions, arachidonic acid or PAF. These results suggest that IL-8 primes neutrophil phospholipase A2 and NADPH-oxidase activation in response to fMLP.

The mechanism of the inhibitory action of glucocorticoids on glucose uptake is incompletely understood. Treatment with corticosteroids of cells in which glucose uptake is stimulated at insulin postbinding and postreceptor sites may clarify the site of the steroid inhibitory action. Hydrogen peroxide, which has been shown to stimulate the insulin receptor tyrosine kinase, and phorbol myristate acetate (PMA) which stimulates protein kinase C were, therefore, used as stimulators of glucose transport in this study. These studies demonstrate that dexamethasone and the sphingoid bases, sphinganine and sphingosine, inhibit glucose uptake that has been stimulated at either the receptor kinase or protein kinase C level in both 3T3-L1 and 3T3-C2 cells. These data confirm glucocorticoid inhibitory action at a post binding level and support the suggestion that some corticosteroid inhibitory effects may be mediated by an action on sphingolipid metabolism.

A recombinant DNA sequence, lambda RB6, was isolated from a human X chromosome library and shown to be X-specific by hybridisation to DNA from a human-mouse somatic cell hybrid containing X as the only human chromosome. The cloned sequence was located on the long arm distal to Xq13 using a human-mouse somatic cell hybrid containing a partial human X chromosome. DNA samples isolated from control human females were digested with the restriction enzyme MspI, and analysed by "blotting" and hybridisation to the radioactive cloned DNA. Eight of 14 individuals from a random population showed a single hybridising band 7.5 kilobase pairs (kb) in length, but six showed an additional band 10.1 kb in length. DNA from 12 members of a family with X-linked thyroxine-binding globulin deficiency was analysed for the segregation of this polymorphism. The results show that the polymorphism is inherited in a Mendelian fashion, and that the disease locus is not closely linked to the polymorphic site. Such polymorphisms will be useful as markers for chromosome mapping and for the antenatal diagnosis of genetic diseases.

A library of 50,000 recombinants representative of the human X chromosome has been constructed. Human X chromosomes were physically separated using a fluorescence-activated cell sorter. The DNA was purified from the chromosomes, digested to completion with the restriction enzyme EcoRI and cloned into the phage lambda gtWES.lambda B. The X-derived nature of the recombinants was confirmed by hybridization to rodent/human cell line DNA containing only the human X chromosome. Such libraries will be particularly useful for the investigation of genetic diseases such as Duchenne muscular dystrophy, where the basic defect has not been elucidated, and of neoplasia, where several specific chromosomal anomalies, particularly for the leukaemias, have been identified.

Our patient, a 23-year-old white woman with congenital rubella syndrome, presented with claudication and upper extremity hypertension. To our knowledge this is the first patient with congenital rubella syndrome to present with an abdominal coarctation. Since 75% of the patients with abdominal coarctation are young women, this may be only a chance association.

From a group of 251 high-risk patients less than 65 years of age, 84 with angiographic or vascular laboratory proven peripheral arterial occlusive disease were evaluated in detail. The following risk factors were identified: smoking in 91% with an average of 35 +/- 18 pack/years; treated or untreated hypertension in 40%; hyperlipidemia in 49%; obesity with a body weight greater than 120% of ideal in 18%; diabetes in 9%; family history of premature vascular disease in 70%; and hyperuricemia in 13%. Based on these results, we have introduced a practical approach for investigating and managing risk factors that can be administered by paramedical personnel, utilizing a questionnaire given to patients and standard blood tests to identify important risk factors. The results of the completed questionnaires and blood test are entered on a microcomputer. A program written using d-Base III stores the data, identifies the risk factors and grades their severity. We have designed an information booklet that highlights the individual patient's risk factors and suggests alternatives for management based on the sources of medical and community help available in our area.