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Biomedical subjects

G M Vercellotti

Publications and source records attributed to G M Vercellotti.

At least 109 records · Page 6Linked to original sources
PubMed1987

Potentiated adherence of sickle erythrocytes to endothelium infected by virus.

Systemic viral infection is a known precipitant of vasocclusive crisis in sickle patients, but the mechanism underlying this clinical observation is unknown. In the present studies, human umbilical vein endothelial cells were infected with Herpes simplex virus type 1 (HSV) to model systemic viral disease. The already abnormal adherence of sickle erythrocytes to control endothelium is enhanced 1.8 +/- 0.4-fold to HSV-infected endothelium (P less than 0.001). This component of potentiated adherence is eliminated by maneuvers that block Fc receptors, it is prevented by tunicamycin, and it is not seen using a mutant HSV that is unable to express the Fc receptor glycoprotein. Thus, the incremental adherence seen here occurs due to expression of Fc receptor activity on HSV-infected endothelium and the consequent recognition of abnormal amounts of IgG on sickle erythrocytes. We conclude that systemic viral infection potentially can induce a novel mechanism for enhancement of erythrocyte adherence to endothelium and that this may increase the likelihood of vasocclusion during viral infection.

Anemia, Sickle Cell↗
PubMed1987

Lymphokine activated killer (LAK) cell-mediated endothelial injury: a mechanism for capillary leak syndrome in patients treated with LAK cells and interleukin-2.

We have investigated the possible etiology of a severe clinical syndrome seen in cancer patients treated with a new form of cancer-specific therapy, referred to as adoptive immunotherapy. This syndrome, apparently characterized by diffuse capillary injury, results in the leakage of intravascular fluid into interstitial tissues, with consequent organ dysfunction that limits the applicability of this form of therapy. We have demonstrated, using an in vitro model of cultured human endothelial cell injury, that LAK cells--lymphocytes stimulated in vitro by IL-2--appear to be potent mediators of endothelial injury. This LAK cell-mediated endothelial cytotoxicity is both time and dose dependent and is not manifested by freshly isolated human lymphocytes or lymphocytes cultured for up to 7 days in the absence of IL-2. In contrast, significant LAK cell-mediated damage to human endothelial cells is observed in lymphocytes cultured for as little as 24 hr in media containing IL-2 and is still found in 14-day-old LAK cells. LAK cells appear to be far more potent than maximally stimulated PMNs in their cytolytic activity against endothelium. In contrast, no damage to cultured endothelial cells is provoked by very large doses of IL-2 alone. Levels of IL-2 that are 3-5 times greater than peak blood IL-2 levels, transiently present in patients following bolus IL-2 injections, fail completely to produce HEC cytotoxicity even during prolonged incubation. The mechanism by which LAK cells kill their targets appears to be analogous to that previously described for related cytolytic T lymphocytes and NK cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Capillaries↗
PubMed1987

Pluronic F-68 reduces the endothelial adherence and improves the rheology of liganded sickle erythrocytes.

A perfluorochemical blood substitute emulsified with Pluronic F-68 has been shown to improve the filterability of deoxygenated sickle red cells. We questioned whether some of the effect was independent of oxygen loading and studied the influence of Fluosol DA (Green Cross, Osaka, Japan) and Pluronic on the rheology and adhesion of sickle red cells saturated with oxygen and carbon monoxide. A 5-vol/vol% concentration of Fluosol or equivalent concentration of Pluronic was equally effective at improving the filtration of washed sickle cells through 5-micron-diameter pores at wall shear stresses approximating 1,000 dyne/cm2. The same concentration of Pluronic reduced the extensional static rigidity of irreversibly sickled cells (ISC) by 25% and also abolished the adherence of gravity-sedimented sickle cells to endothelial monolayers in the presence of saline or plasma. The inhibition of adherence was not reversible by washing and was accomplished with equal ease by isolated treatment of sickle cells or endothelium. Pluronic had no effect on the rheology or adhesion of normal adult red cells. Neither Fluosol nor Pluronic changed sickle or normal cell shape, mean cell volume, mean cell density, or cell density distribution. A lubricating effect of Pluronic on cell surfaces could explain all of the rheological observations and offers another direction of inquiry in the search for therapy for sickle cell disease.

Adult↗
PubMed1987

Granulocytes as mediators of tissue injury in shock: therapeutic implications.

In summary, over the last twenty years, we have gained a substantially improved understanding of the ways in which granulocytes can damage host tissues. Most recently, there has been a great deal of interest in the intravascular behavior of granulocytes, and the possibility that such behavior might contribute to complications of extracorporeal circulations, bacteremic infections and shock. These insights give us several ideas about possible therapeutic interventions: corticosteroids or other drugs might be used to blunt granulocyte responsiveness; iron chelation might be used to limit the production of toxic hydroxyl radical; competitive inhibition of oxidant damage might be possible using such simple compounds as methionine; protease inhibitors might blunt endothelial cell delamination. Unfortunately, most of these therapies have been tried, with mixed results. It is likely that in most cases of shock, the damage worked by granulocytes occurs very early, often before the patient is recognized as having shock or being at risk for shock. Therefore, by the time a decision is made to employ one of the above modalities, it may already be too late. Perhaps the greatest opportunities for improving our ability to treat irreversible shock and the shock lung syndrome lie with the early identification of patients at risk for development of the syndrome, so that antigranulocyte therapies can be applied before the damage is done.

Adrenal Cortex Hormones↗
PubMed1985

Protection against lethal hyperoxia by tracheal insufflation of erythrocytes: role of red cell glutathione.

Intact erythrocytes placed into the tracheobronchial tree of hyperoxic rats dramatically improved their chances for survival. Over 70 percent of the animals so treated survived more than 12 days during continuous exposure to 95 percent oxygen, whereas all of the control animals died within 96 hours. Lungs from erythrocyte-protected rats showed almost none of the morphologic damage suffered by untreated animals. Erythrocytes containing cyanomethemoglobin were as beneficial as normal erythrocytes, but cells in which glutathione was partially blocked were significantly less protective. Analogous results were obtained in vitro: 51Cr-labeled target cells released 70 to 90 percent of their label when exposed briefly to hydrogen peroxide or to toxic oxygen species generated by phorbol ester-stimulated neutrophils. Addition of intact erythrocytes decreased release by approximately 75 percent, but significantly less than this if red blood cell glutathione was partially blocked. These results suggest that insufflated erythrocytes, through their recyclable glutathione, protect rats from toxic oxygen species engendered by hyperoxia.

Animals↗
PubMed1985

Bronchiolitis obliterans after bone marrow transplantation.

Bronchiolitis obliterans occurred in the setting of chronic graft-versus-host disease 1 year after allogeneic bone marrow transplantation for chronic myelogenous leukemia. The severe obstructive pulmonary disease followed an episode of interstitial pneumonitis. The etiology and possible relationship to graft-versus-host disease of this rare pulmonary lesion following bone marrow transplantation are discussed.

Adult↗
PubMed1985

A histopathologic study of gastric and small intestinal graft-versus-host disease following allogeneic bone marrow transplantation.

Twenty-two stomach and 14 small intestinal biopsy specimens from 24 allogeneic bone marrow transplant recipients were reviewed to evaluate the histopathologic changes of graft-versus-host disease (GVHD) in these organs. Associations between these results and clinical symptoms and other biopsy results were sought. In both organs, single epithelial cell necrosis was found to correlate with GVHD. Gastric GVHD was diagnosed in eight patients and small intestinal GVHD in four. Gastric GVHD was characterized by nausea, vomiting, and upper abdominal pain without diarrhea (the latter being present in only two patients), while all four of the patients with small intestinal GVHD had upper gastrointestinal symptoms and diarrhea. These symptoms correlated with concurrent rectal biopsy findings; pathologic alterations were seen in only one of six specimens from patients with gastric GVHD but in three of four with small intestinal GVHD. These findings suggest that stomach biopsy may be necessary to diagnose GVHD in patients with upper gastrointestinal symptoms but no diarrhea and normal rectal biopsy specimens. Diagnostic problems may arise in the early posttransplantation period, when the effects of cytoreductive therapy may simulate GVHD, and in patients with gastrointestinal cytomegalovirus infection, which may also produce changes identical to those of GVHD.

Adolescent↗
PubMed1985

Oxygen radical-induced erythrocyte hemolysis by neutrophils. Critical role of iron and lactoferrin.

Human neutrophils (PMN), when stimulated with such chemotaxins as phorbol myristate acetate (PMA), destroy erythrocytes and other targets. Cytotoxicity depends on PMN-generated reactive oxygen metabolites, yet the exact toxic specie and its mode of production is a matter of some dispute. Using 51Cr-labeled erythrocytes as targets, we compared various reactive-O2 generating systems for their abilities to lyse erythrocytes as well as to oxidize hemoglobin to methemoglobin. PMA-activated PMNs or xanthine oxidase plus acetaldehyde were added to target erythrocytes in amounts that provided similar levels of superoxide. PMNs lysed 68.3 +/- 2.9% (SEM) of targets, whereas the xanthine oxidase system was virtually impotent (2.3 +/- 0.8%). In contrast, methemoglobin formation by xanthine oxidase plus acetaldehyde was significantly greater than that caused by stimulated PMNs (P less than 0.001). A similar dichotomy was noted with added reagent H2O2 or the H2O2-generating system, glucose plus glucose oxidase; neither of these caused 51Cr release, but induced 10-70% methemoglobin formation. Thus, although O2- and H2O2 can cross the erythrocyte membrane and rapidly oxidize hemoglobin, they do so evidently without damaging the cell membrane. That a granule constituent of PMNs is required to promote target cell lysis was suggested by the fact that agranular PMN cytoplasts (neutroplasts), although added to generate equal amounts of O2- as intact PMNs, were significantly less lytic to target erythrocytes (P less than 0.01). Iron was shown to be directly involved in lytic efficiency by supplementation studies with 2 microM iron citrate; such supplementation increased PMN cytotoxicity by approximately 30%, but had much less effect on erythrocyte lysis by neutroplasts (approximately 3% increase), and no effect on lysis in the enzymatic oxygen radical-generating systems. These results suggest a critical role for an iron-liganding moiety that is abundantly present in PMN, marginally so in neutroplasts, and not at all in purified enzymatic systems--a moiety that we presume catalyzes very toxic O2 specie generation in the vicinity of juxtaposed erythrocyte targets. The obvious candidate is lactoferrin (LF), and indeed, antilactoferrin IgG, but not nonspecific IgG, reduced PMN cytotoxicity by greater than 85%. Re-adding 10(-8) M pure LF to neutroplasts increased their ability to promote hemolysis by 48.4 +/- 0.9%--to a level near that of intact PMNs. We conclude that O-2 and H2O2 are not sufficient to mediate target cell lysis, but require iron bound to LF, which, in turn, probably generates and focuses toxic O2 radicals, such as OH, to target membrane sites.

Cytoplasmic Granules↗
PubMed1985

Extracellular matrix proteins (fibronectin, laminin, and type IV collagen) bind and aggregate bacteria.

The normal microbial colonization of sites in the body's tissues by certain bacteria requires that the bacteria first bind to extracellular secreted constituents, cell-surface membranes, or cell matrixes. This study examines two interactions of a variety of bacteria with the cell matrix noncollagenous proteins fibronectin and laminin and with basement membrane (Type IV) collagen. Adherence of bacteria to matrix proteins coated on tissue culture wells was examined with the use of radiolabeled bacteria. Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus sanguis bound well to fibronectin, laminin, and Type IV collagen, whereas a variety of gram-negative organisms did not bind. The interaction of soluble laminin, fibronectin, and Type IV collagen with bacteria was monitored by nephelometry with the use of a platelet aggregometer. S. aureus aggregated in response to fibronectin, laminin, or Type IV collagen. In contrast, gram-negative organisms did not aggregate with these proteins. It appears that fibronectin, laminin, and Type IV collagen can bind and aggregate certain gram-positive bacteria, and this binding is dependent on the surface characteristics of the organism. These adhesion molecules may play a role in the normal colonization of sites by microorganisms and in invasion during infections.

Adhesiveness↗
PubMed1985

Sodium morrhuate stimulates granulocytes and damages erythrocytes and endothelial cells: probable mechanism of an adverse reaction during sclerotherapy.

Stimulated by a patient with dyspnea, thrombocytopenia, and leukopenia after sodium morrhuate sclerotherapy, we studied the effect of this agent on the plasma coagulation and complement systems, the formed elements of the blood, and cultured human endothelial cells. The addition of sodium morrhuate to citrated plasma did not cause clotting or shorten the prothrombin time or partial thromboplastin time. Incubation of a 1:100 dilution of the clinical sodium morrhuate preparation in heparinized plasma led to a modest rise in [C3a]. The addition of the drug (dilutions 1:50 to 1:300) to granulocytes caused prompt aggregation (and, at the higher concentrations, granulocyte cytotoxicity [trypan blue exclusion; lactate dehydrogenase release]), but the same dilutions failed to aggregate platelets. However, 0.05% morrhuate added to washed red blood cells caused a prompt 84.0% (+/- 0.8% SEM) hemolysis, rendering the supernatant buffer a potent platelet aggregant. Not only was this sclerosing agent toxic to granulocytes and red cells, but a 1:1000 dilution of the drug also caused the destruction of 35.5% (+/- 6.6%) of cultured endothelial cells as measured by chromium 51 release. Three other agents in current use (ethanolamine oleate, sodium tetradecyl sulfate, and polidocanol) were studied and found to cause effects qualitatively similar to those of sodium morrhuate. We conclude that these drugs cause phlebosclerosis not primarily through induction of plasma coagulation, but by directly damaging endothelium and red cells, triggering platelets, and aggregating granulocytes at the venous wall endothelium. These effects likely derive from the surfactant properties of sodium morrhuate as well as its high arachidonate content.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation↗
PubMed1984

Ibuprofen inhibits granulocyte responses to inflammatory mediators. A proposed mechanism for reduction of experimental myocardial infarct size.

The use of nonsteroidal antiinflammatory agents to reduce myocardial infarct size has demonstrated a dichotomy between ibuprofen, which reduces myocardial infarct size, and aspirin, which does not. A feline model of coronary ischemia using ligation of the anterior descending artery demonstrated that intravenous ibuprofen (2.5-20 mg/kg) given immediately and 2 h after ligation significantly decreased (by about 40%) myocardial infarct size. In contrast, aspirin did not diminish infarct size at any achieved dose; in fact, at some doses it tended to increase infarct size. In vitro studies with purified granulocytes demonstrated a similar dichotomy between ibuprofen and aspirin. Ibuprofen inhibits granulocyte aggregation, superoxide production, lysosomal enzyme release, and granulocyte-mediated endothelial cytotoxicity, while aspirin is without effect on these modalities. We propose that ibuprofen's beneficial effect in experimental myocardial ischemia is related to its ability to inhibit activated granulocytes and thus to diminish myocardial cell death in experimental myocardial infarction.

Animals↗
PubMed1984

Hemodynamic profile of adverse clinical reactions to Fluosol-DA 20%.

Hemodynamic changes of 2 patients to a 0.5-ml test-dose infusion of Fluosol-DA 20% are presented. The first patient had the following symptoms and signs approximately 2 min after receiving the test dose: normotensive bradycardia of 30 beat/min, a 35% drop in cardiac output, a 50% increase in systemic vascular resistance, and a 100% increase in pulmonary artery systolic and diastolic pressures. The patient complained of shortness of breath and diffuse pressure pain of the chest. All the signs and symptoms gradually resolved without treatment over the following 3 min. The second patient complained of mild, vague chest and abdominal pressure 2 min after the test dose. The only associated hemodynamic change was a slight increase in pulmonary artery systolic pressure. A 74% drop in the neutrophil count returned to the pretest value in 10 min. In contrast to anaphylactic or anaphylactoid-type reactions, these patients did not have urticaria and had an increase in systemic vascular resistance. Their reactions were reminiscent of those occurring during systemic complement activation. The possible mechanisms and prevention of these reactions are discussed.

Adult↗
PubMed1984

Bacterial adherence to fibronectin and endothelial cells: a possible mechanism for bacterial tissue tropism.

In the pathophysiology of endocarditis, bacteria must initially adhere to the endothelial surface components of the cardiac valve before invasion and colonization. The attachment of bacteria to endothelial cell surfaces is dependent on surface characteristics of both the bacteria and the endothelial cell. Fibronectin, a glycoprotein produced by endothelial cells, binds to some bacteria but not all. This report examines bacterial adherence to human endothelial cells and to fibronectin-coated surfaces. Radiolabeled Staphylococcus aureus (Cowan I strain) and viridans streptococci avidly bound to fibronectin-coated surfaces and endothelial cell monolayers. In contrast, gram-negative organisms such as Escherichia coli bound poorly to both substrates. The adherence of S. aureus was dependent on time as well as on the concentration of fibronectin or the endothelial cell number. Bacterial adherence was specific for endothelial cells or fibronectin, since none occurred to plastic or to wells coated with collagen or albumin. The binding of S. aureus to fibronectin or endothelial cells appeared dependent on a bacterial surface protein, since treatment of the bacteria with proteases markedly decreased adherence. S. aureus was not dependent on the protein A or teichoic acid content of the cell wall, but adherence was markedly decreased in bacterial strains that had a carbohydrate capsule. S. aureus pretreated with serum or purified fibronectin manifested enhanced adherence to endothelial cells, suggesting fibronectin-fibronectin interactions. Bacteria specifically attach to endothelial cells and to fibronectin-coated surfaces, which suggests that the ability of a bacterium to attach to these substrates may reflect the propensity to invade and colonize vascular tissues such as cardiac valves.

Bacterial Physiological Phenomena↗
PubMed1984

Insufflated red cells protect lungs from hyperoxic damage: role of red cell glutathione in scavenging toxic O2 radicals.

Hyperoxia-mediated pulmonary damage may involve formation of toxic oxygen species such as superoxide, hydrogen peroxide, and hydroxyl radical. Intact red cells evidently scavenge these when insufflated in small numbers into the tracheobronchial tree of rats. Such manipulation protects hyperoxic rats for prolonged periods of time and preserves normal pulmonary histology. Of several potential oxygen metabolite scavengers, a role for red cell glutathione seems particularly likely. It has not escaped our attention that an ironic, and previously unsuspected, connotation of our results emerges: namely, that a small degree of spontaneous alveolar bleeding, which is not an uncommon feature in respiratory distress situations, may actually be beneficial to patients--particularly those ventilated with excessive inspired oxygen concentrations. If confirmatory studies from other laboratories are forthcoming, the tracheal insufflation of autologous red cells in ventilated patients might be considered in the future.

Animals↗
PubMed1984

Role of endothelial cells in human hematopoiesis: modulation of mixed colony growth in vitro.

The identification of clonal human multipotent hematopoietic progenitors has permitted an analysis of the growth factor requirements for these cells. Human endothelial cell cultures were used to examine the effects of media conditioned by the endothelial cells on human multipotent (CFU-mix) and committed erythroid (BFU-E, CFU-E) and myeloid (CFU-GM) precursors. These studies demonstrate that endothelial cells produce proteins of approximately 30,000 daltons, with isoelectric focusing points of 4.5 and 7.2, which stimulate the growth of human BFU-E and CFU-mix. A heat-labile protein(s) of 30,000 and 15,000 daltons stimulated the proliferation and differentiation of granulocyte-macrophage (CFU-GM) colonies. No erythropoietin was detected in endothelial cell supernatants. This suggests that endothelial cells, a normal component of marrow stroma, play an active role in the modulation of human hematopoietic stem cell growth.

Animals↗
PubMed1983

Inflamed fibronectin: an altered fibronectin enhances neutrophil adhesion.

Recent investigations have emphasized the role of activated granulocytes in mediating vascular endothelial injury in the pathogenesis of shock lung. In vitro studies have indicated that tight adherence of the neutrophil to the endothelium is crucial for the development of cellular injury. Fibronectin is critical to cell-to-substratum and cell-to-cell interactions. Since fibronectin resides in plasma, on endothelial cell surfaces and is secreted into cell matrices, the adhesive properties of fibronectin must be modulated, lest universal cell agglomeration occur, yet be enhanced when cell attachment is appropriate. In these studies, treatment of fibronectin-coated surfaces with neutrophil release products increased the adhesion of activated neutrophils. Similarly, endothelial cells treated with neutrophil release products become a more adherent substrate for neutrophils. This enhanced adherence generated by treatment of fibronectin with neutrophil supernatants is inhibitable by heat and the lysosomal proteinase inhibitor, pepstatin-A. Neutrophil release products cause proteolytic fragmentation of fibronectin and enhanced fibronectin immunofluorescence on endothelial cells. In addition, neutrophils are more injurious to endothelial cells that have been pretreated with neutrophil release products. Neutrophils may enhance their own adherence to endothelial cells by altering fibronectin, and this altered, or "inflamed," fibronectin may serve as an amplifier of inflammation.

Cell Adhesion↗