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Biomedical subjects

C L Hall

Publications and source records attributed to C L Hall.

At least 37 records · Page 2Linked to original sources

Identification of a novel heparin binding domain in RHAMM and evidence that it modifies HA mediated locomotion of ras-transformed cells.

We have previously reported that the hyaluronan (HA) receptor RHAMM (Receptor for HA Mediated Motility) [Turley et al., 1991] contains two HA binding motifs located within a 35 amino acid region of its C-terminus end [Yang et al., 1993] and that HA stimulation of the motility of ras-transformed fibroblasts is mediated via its interaction with RHAMM. Here we show that RHAMM also contains binding sites for heparin (HP) and that interaction of HP with these sites can regulate the locomotion of ras-transformed fibroblasts. At low concentrations (0.01 mg/ml), HP inhibited HA-induced locomotion of ras-transformed cells in a manner independent of RHAMM. At higher, but still physiological concentrations (0.1 mg/ml), HP alone stimulated cell locomotion and this stimulation appeared to be RHAMM-dependent as it was blocked by anti-RHAMM antibodies. Other related glycosaminoglycans such as chondroitin sulfate and dermatin sulfate had no effect on cell motility. In ligand blotting assays, GST-RHAMM fusion protein was shown to bind biotin-labelled HP and this binding was displaceable with unlabelled HP. In similar ligand binding analyses conducted with truncations of RHAMM fusion protein, the HP binding region was found to be localized in the same 35 amino acid segment of RHAMM that contains the two HA binding domains. Synthetic peptides corresponding to these HA binding domains were retained on and bound effectively to an HP-Sepharose affinity column. Fusion proteins generated by linkage of these peptides to the non-HP binding amino terminus of RHAMM conferred HP binding capacity to the genetically engineered proteins. Conversely, deletion of the HA binding domains of RHAMM resulted in fusion proteins devoid of HP binding activity. The relative affinities of RHAMM for HA and HP, as determined by competition and transblot assays as well as quantification of binding at various salt concentrations, indicated that RHAMM had lower affinity for HP than that for HA. These results demonstrate the existence of a new HP binding motif that has biological relevance to cell locomotion.

Amino Acid Sequence↗

Hyaluronan and the hyaluronan receptor RHAMM promote focal adhesion turnover and transient tyrosine kinase activity.

The molecular mechanisms whereby hyaluronan (HA) stimulates cell motility was investigated in a C-H-ras transformed 10T 1/2 fibroblast cell line (C3). A significant (p < 0.001) stimulation of C3 cell motility with HA (10 ng/ml) was accompanied by an increase in protein tyrosine phosphorylation as detected by anti-phosphotyrosine antibodies using immunoblot analysis and immunofluorescence staining of cells. Tyrosine phosphorylation of several proteins was found to be both rapid and transient with phosphorylation occurring within 1 min of HA addition and dissipating below control levels 10-15 min later. These responses were also elicited by an antibody generated against a peptide sequence within the HA receptor RHAMM. Treatment of cells with tyrosine kinase inhibitors (genistein, 10 micrograms/ml or herbimycin A, 0.5 micrograms/ml) or microinjection of anti-phosphotyrosine antibodies inhibited the transient protein tyrosine phosphorylation in response to HA as well as prevented HA stimulation of cell motility. To determine a link between HA-stimulated tyrosine phosphorylation and the resulting cell locomotion, cytoskeletal reorganization was examined in C3 cells plated on fibronectin and treated with HA or anti-RHAMM antibody. These agents caused a rapid assembly and disassembly of focal adhesions as revealed by immunofluorescent localization of vinculin. The time course with which HA and antibody induced focal adhesion turnover exactly paralleled the induction of transient protein tyrosine phosphorylation. In addition, phosphotyrosine staining colocalized with vinculin within structures in the lamellapodia of these cells. Notably, the focal adhesion kinase, pp125FAK, was rapidly phosphorylated and dephosphorylated after HA stimulation. These results suggest that HA stimulates locomotion via a rapid and transient protein tyrosine kinase signaling event mediated by RHAMM. They also provide a possible molecular basis for focal adhesion turnover, a process that is critical for cell locomotion.

Antibodies↗

Do mesangial immune complex deposits affect the renal prognosis in membranous glomerulonephritis?

Patients with rheumatoid arthritis who develop membranous glomerulonephritis associated with gold or penicillamine therapy have been shown to get better when the drugs are discontinued, whereas up to 50% of patients with idiopathic membranous glomerulonephritis develop renal failure. A feature of the lesion in rheumatoid disease is the presence of mesangial immune complex deposits in addition to the basement membrane deposits of classical idiopathic membranous glomerulonephritis. To determine whether the presence of mesangial immune complexes indicates a different renal outcome in membranous glomerulonephritis we studied 3 groups: group A 10 patients with rheumatoid arthritis and drug induced membranous glomerulonephritis with mesangial immune complex deposits, group B 14 patients with idiopathic membranous glomerulonephritis with additional mesangial immune complex deposits and group C 25 patients having classic idiopathic membranous glomerulonephritis with deposits solely in the glomerular basement membrane. After median follow up of 72 months, nephrotic range proteinuria resolved in all cases in group A after drug withdrawal, 93% of group B, but only 60% of group C (groups A + B vs C, X2 = 7.8, p < 0.01). Serum creatinine remains less than 500 mumol/l in all patients in group A, 93% of group B, but only 64% of group C (groups A + B vs C, X2 = 7.6, p < 0.01). Mesangial immune complex deposits were predominantly of the IgM isotype in both the rheumatoid and idiopathic membranous group. The presence of mesangial immune complex deposits suggests either a different pathogenesis or host responsiveness to that found in classic idiopathic membranous glomerulonephritis, and predicts a more favourable renal outcome.

Adult↗

Idiopathic polymyositis complicated by arthritis and mesangial proliferative glomerulonephritis: case report and review of the literature.

A 56-yr-old male developed a systemic illness while receiving cyclical oral etidronate therapy for idiopathic osteoporosis. The illness, characterized by fever, proximal myopathy and inflammatory synovitis, was associated with interstitial lung disease and mesangial proliferative glomerulonephritis. Elevated plasma creatine phosphokinase level and inflammatory muscle biopsy findings confirmed a diagnosis of polymyositis (PM). Antibodies to Jo-1 were also detected. A review of the literature reveals that mesangial proliferation is the commonest glomerular lesion and suggests a possible association between arthritis and glomerulonephritis in PM. The prognosis of this renal lesion appears to be good, although only limited data is available.

Arthritis↗

A nuclear magnetic resonance study of the glucose metabolism of Hymenolepis diminuta exposed to histamine and serotonin in vitro.

The direct effects of the inflammatory mediators, histamine (HI) and serotonin (SE), on the glucose metabolism of Hymenolepis diminuta in vitro were studied by analyzing the excretory products from culture media, containing D-1-13C-glucose and various concentrations of HI and/or SE, by 1H-nuclear magnetic resonance (n.m.r.) spectroscopy. The results revealed that HI markedly accelerated the glycolysis process by increasing the amount of lactate production. The increased glycolytic activity was reflected in a concentration-dependent increase in glucose uptake. Excretion of acetate was also stimulated by HI. A low concentration of SE significantly increased succinate, acetate and lactate excretions, whereas a high concentration had little effect on lactate production and significantly decreased succinate and acetate excretions. A combination of HI and SE treatment at a low concentration had no significant effect, but at a high concentration showed an additive effect, with an increase in lactate production, a decrease in succinate production and an increase in glucose uptake. Thus this work confirms that HI and SE directly influence, albeit differently, energy metabolism of the tapeworm H. diminuta.

Animals↗

Atypical antiglomerular basement membrane disease associated with thin membrane nephropathy.

Antiglomerular basement membrane (anti-GBM) disease is characteristically described with linear deposition of IgG along the GBM. We report two unusual cases of IgA and IgM anti-GBM disease associated with diffuse thinning of the GMB, and review the literature on atypical immunoglobulin species in this disorder. Both patients were male, aged 55 and 49 years, and presented with isolated microscopic haematuria, neither having shown evidence of impaired renal or pulmonary function on follow-up for 4 and 6 years respectively. Renal histology revealed minor focal mesangial changes only, but immunoperoxidase preparations demonstrated intense linear staining of the GBM with IgA in one case, and IgM with C3 in the other. On electron-microscopy there was diffuse thinning of the GBM in both cases, mean thickness 220 and 295 nm respectively (normal range 350-450 nm). Antinuclear antibodies were not detected and their glucose tolerance tests were normal. Assays for circulating IgG anti-GBM antibodies using indirect immunofluorescence (IF) and radioimmunoassay (RIA) were negative in both patients, although IgA anti-GBM antibodies with specificity confirmed by inhibition studies were identified in the first case. Thin GBMs in these patients may expose the Goodpasture antigen to toxic or infectious insults, thus altering its antigenic profile and promoting this unusual immune response.

Autoimmune Diseases↗

Home blood pressure recording in mild hypertension: value of distinguishing sustained from clinic hypertension and effect on diagnosis and treatment. Bath Health District Hypertension Study Group.

To identify the prevalence and magnitude of clinic changes in blood pressure and determine their effects on the diagnosis and treatment of hypertension, 268 patients with a BP greater than or equal to 160/95 mmHg on three consecutive occasions (twice in the general practitioner's surgery and once in the hospital clinic) recorded a home BP series with an electronic sphygmomanometer. Of these patients, 114 had never received antihypertensive treatment and 154 were receiving treatment. On return to the hospital clinic (second clinic visit) the BP was measured independently by the patient and doctor using electronic and mercury sphygmomanometers respectively and compared with the mean BP of the home series. In some 80% of both untreated and treated patients the second clinic BP was higher than the mean BP of the home series and in some 40% of patients a clinic rise of greater than 20/10 mmHg was recorded. Clinic falls in BP occurred in some 20% of both untreated and treated patients, but averaged only 4/4 mmHg. Treatment decisions based on a mean diastolic blood pressure of greater than or equal to 95 mmHg in the home series resulted in antihypertensive treatment not being started in 38% of untreated patients and not increased in 31% or reduced in 16% of treated patients when treatment would have been started, increased or continued unchanged on the basis of the second clinic (fourth recorded) diastolic blood pressure of greater than or equal to 95 mmHg. A patient recorded home series provides a representative sample of BP which distinguishes patients with sustained hypertension from those with clinic hypertension and may help reduce the overdiagnosis and overtreatment of mild hypertension.

Antihypertensive Agents↗

Value of patient-recorded home blood pressure series in distinguishing sustained from office hypertension: effects on diagnosis and treatment of mild hypertension. Bath District Hypertension Study Group.

To identify the incidence and magnitude of office hypertension and determine its effect on diagnosis and treatment, 104 patients with a systolic blood pressure greater than or equal to 160 mmHg and a diastolic blood pressure greater than or equal to 95 mmHg on three consecutive office visits recorded a home BP series with an electronic sphygmomanometer. At the fourth office visit the blood pressure was measured independently by the patient and doctor using electronic and mercury sphygmomanometers, respectively, and compared with the mean blood pressure of the home series. In 80% of patients, the fourth office blood pressure was higher than the mean blood pressure of the home series. An office rise greater than or equal to 10/5 mmHg occurred in some 60% of patients, greater than or equal to 20/10 mmHg in 36% and 30/15 mmHg in 19% of patients. Office falls in blood pressure occurred in 20% of patients but averaged 3/2 mmHg. Treatment decisions based on the mean blood pressure of the home series resulted in treatment not being started in 25 patients (24%) who would have received treatment on their fourth office blood pressures. A patient-recorded home series provides a representative sample of blood pressure distinguishing patients with sustained hypertension from those with office hypertension and reducing the over diagnosis and over treatment of mild hypertension.

Adult↗

Purification of acyloxyacyl hydrolase, a leukocyte enzyme that removes secondary acyl chains from bacterial lipopolysaccharides.

Leukocytes contain an enzyme that detoxifies bacterial lipopolysaccharides (also called endotoxins) by removing fatty acyl chains that are attached in acyloxy acyl linkage to the glucosamine backbone of lipid A. We describe the purification of an enzyme that carries out this activity, termed acyloxyacyl hydrolysis, from the HL-60 human promyelocyte cell line. The enzyme is a glycoprotein of apparent Mr = 52,000-60,000 that is found in low abundance (less than 0.001% of the cell lysate protein), principally in the granule fraction of the cells. The protein has two disulfide-linked subunits of apparent Mr = 50,000 and 14,000-20,000, each of which contains N-linked oligosaccharides. This is the first lipopolysaccharide-degrading enzyme that has been purified from animal cells.

Carboxylic Ester Hydrolases↗

The natural course of gold and penicillamine nephropathy: a longterm study of 54 patients.

To elucidate the natural course of gold and penicillamine nephropathy and to facilitate appropriate clinical management 54 patients with rheumatoid arthritis who developed proteinuria during treatment with intramuscular gold thiomalate (21) or oral D penicillamine (33) were studied in detail throughout the whole of their renal illnesses. Renal biopsy was performed and creatinine clearance and proteinuria were measured serially for a median period of 60 months (range 16-130 months) in the gold treated and 74 months (range 13-158 months) in the penicillamine treated patients. During gold (penicillamine) treatment 48% (43%), 71% (82%) and 86% (91%) of patients had presented with proteinuria by 6, 12 and 24 months of treatment. After stopping gold (penicillamine) treatment proteinuria reached a median maximum of 2.1 g/day (4.2 g/day) at 2 months (1 month) before resolving spontaneously so that by 6, 12 and 18 months 38% (36%), 62% (64%) and 76% (88%) of patients were free of proteinuria. The median initial and most recent creatinine clearances of the gold (penicillamine) treated patients were 77 ml/min (80 ml/min) and 59 ml/min (78 ml/min) respectively and no patients died from or needed treatment for chronic renal failure. HLA B8 and/or DR3 alloantigens were identified in 64% of the gold treated and 56% of the penicillamine treated patients. In the gold (penicillamine) treated patients renal biopsy revealed membranous glomerulonephritis (GN) in 72% (88%), an immune complex mesangial glomerulonephritis in 10% (6%), minimal change nephropathy in 10% (6%) and no significant glomerular abnormalities in 8% (0%). The study has demonstrated the close similarity between gold and penicillamine nephropathy. It has also demonstrated that some 75% of cases develop during the first year of treatment, the proteinuria resolves completely when treatment is withdrawn, progressive deterioration of renal function is most uncommon, corticosteroid therapy is unnecessary and several different types of glomerulonephritis are associated with gold and penicillamine treatment.

Adult↗

The effect of continuing penicillamine and gold treatment on the course of penicillamine and gold nephropathy.

The effect of continuing penicillamine or gold treatment was examined in 53 patients with biopsy proven penicillamine (32) or gold (21) nephropathy. Thirty-two patients stopped penicillamine or gold treatment as soon as proteinuria was detected whilst 21 patients continued treatment for periods of 2-11 months. The 24-hour creatinine clearance and urinary protein excretion were measured serially for a median period of 6 years. No significant differences were observed in the initial or maximum proteinuria, the duration of the proteinuria or in the initial or latest creatinine clearances between the groups of patients. These results indicate that penicillamine or gold treatment may be continued for short periods under close supervision despite moderate proteinuria without causing permanent renal damage. As several alternative non-nephrotoxic agents are available for the treatment of rheumatoid arthritis, continued treatment with penicillamine or gold despite proteinuria is seldom indicated.

Aged↗

Localisation of haematuria by red cell analysers and phase contrast microscopy.

The urinary erythrocyte morphology of 120 patients with haematuria of diagnosed cause (41 glomerular, 79 non-glomerular) was examined by red cell analyser (RCA) and by phase contrast microscopy (PCM). By RCA three distinct ranges of modal erythrocyte cell volume (ECV) were observed. The modal ECVs in glomerular haematuria (35-50 fl) were significantly lower than in non-glomerular haematuria (65-148 fl) and both were clearly distinct from 'debris patterns' (12-33 fl). In duplicate specimens very similar ECVs were observed before and after centrifugation and after storage for up to 15 h. There was no correlation between the modal urinary ECV and the urinary specific gravity or the peripheral venous ECV. The source of the haematuria (glomerular or non-glomerular) was identified correctly by RCA (PCM) in 100% (60%), 68% (71%) and 22% (39%), respectively, of patients with macroscopic, 3+ microscopic and 1-2+ microscopic haematuria. In no patient was the haematuria localised incorrectly by RCA as compared with 10% incorrect localisation by PCM. RCA and PCM are complementary non-invase tests and both should be performed whenever possible in the investigation of haematuria.

Adolescent↗

Natural course of penicillamine nephropathy: a long term study of 33 patients.

To elucidate the natural course of the nephropathy associated with penicillamine and thereby facilitate its clinical management 33 patients with rheumatoid arthritis who developed proteinuria during treatment with oral penicillamine were studied in detail throughout their renal illness. Renal biopsies were performed, and creatinine clearance and proteinuria were measured serially for 74 months (range 16-148 months). Fourteen patients developed proteinuria within six months after the start of treatment and 27 within 12 months. When treatment was stopped the proteinuria reached a median peak of 4.2 g/24 h (range 0.3-15.0 g/24 h) at one month (range 0-7 months) before resolving spontaneously by six months (12 patients), 12 months (21), or 18 months (29). In all patients but one, who developed carcinoma of the renal pelvis, proteinuria resolved by 21 months and its median duration was eight months. The median first and last measurements of creatinine clearance showed no appreciable change (80 ml/min and 78 ml/min), and no patient died from or needed treatment for renal failure. The HLA-B8 or HLA-DR3 alloantigen, or both, were identified in 10 patients. Renal biopsy specimens showed membranous glomerulonephritis in 29 patients, minimal change nephropathy in two, and electron dense deposits in the mesangial regions in two. In all the patients whose nephropathy was due solely to treatment with penicillamine the proteinuria resolved completely when the drug was withdrawn; renal function did not deteriorate, and corticosteroids were unnecessary.

Adolescent↗