Mitochondrial encephalomyopathies.
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Biomedical subjects
Publications and source records attributed to G Scarlato.
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We have applied a new fluorescent probe, Nile red, on normal and pathological human muscle derived cultures and compared the results with corresponding human muscle sections. In normal human muscle cultures, Nile red strain has proved useful for visualization of both intracellular lipids and membrane network. Similar patterns have been observed in muscle cultures derived from lipid storage and mitochondrial myopathies. Moreover, abnormalities in pathological muscle cultures could be revealed by establishing more advanced culture systems.
A human neuronal cell freezing technique has been developed. The results indicate that human fetal neuronal cells can be frozen with 7%-10% dimethyl sulfoxide (DMSO) as cryoprotectant. The survival of isolated thawed cells has been evaluated in culture. Cells have been frozen at -196 degrees C for 370 days without loss of viability. Average recovery rate of frozen cells was 62% of the recovery rate of cultured unfrozen controls. Thawed cells show neurite outgrowth and maintain both cellular markers such as neuron specific enolase (NSE) and neurochemical characteristics (GABA synthesis). Morphological integrity of cryopreserved neurons has been confirmed at ultrastructural level.
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Cryopreservation of human fetal adrenomedullary cells was performed, after dissociation of the gland and purification of chromaffin aggregates, using 10% dymethyl sulfoxide as cryoprotectant. More than 90% of thawed cultured clusters appear morphologically intact, showing extensive neurite outgrowth and absence of appreciable cellular loss. Immunoreactivity for tyrosine hydroxylase and response to nerve growth factor were demonstrated. These findings indicate that human medullary cells maintain their distinctive functional characteristics after cryopreservation.
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We describe a technique for the preparation of highly purified populations of Schwann cells (SC) from human fetal nerves. Cultures were prepared by chemical and mechanical dissociation of human fetal sciatic nerves by modification of the method of Kreider et al. developed for newborn rat nerve. A time course analysis of some SC-associated markers at different times in vitro was performed employing immunofluorescence (IF) and immunoperoxidase (IP) to determine the percentage of SC in culture and to evaluate the maintenance of specific SC characteristics. We compared this method with that of Askanas et al. which produces enriched SC cultures by utilizing successive re-explantation of the original nerve explant. After 48 h, approximately 90% of the cells were bipolar and S-100+ and over the next two weeks about 70-80% of cells were SC by cytologic and immunocytologic criteria. At 35 days, 35% were SC, whereas less than or equal to 2.5% of 35-day-old multi-explant cultures were SC. The SC obtained by this method displayed the typical morphological and immunological characteristics: they expressed surface laminin and nerve growth factor receptors, whereas fibronectin, which is localized on fibroblast surface, was absent.
Five patients with neuropathy and IgM M-proteins that reacted with myelin-associated glycoprotein (MAG) were treated for 10 to 20 months with cytostatic agents. In 2 patients, a decrease in serum M-protein and in anti-MAG IgM levels coincided with a progressive improvement of neuropathy. No clinical improvement and no decrease of anti-MAG IgM were observed in the other patients. The close relationship between the decrease of anti-MAG M-proteins and clinical improvement in these patients supports the pathogenetic role of the M-protein in the neuropathy.
In an open-label study, we substituted conventional levodopa plus benserazide: 100/25 (Madopar) with a controlled-release form (HBS) in 18 fluctuating parkinsonian patients for 24 months. Significantly positive results were obtained in both peak-dose and diphasic dyskinesias up to 12 months of treatment; morning akinesias were also improved up to 6 months. A general trend of deterioration, compared to the first 3-6 months of HBS treatment, was observed in "off" fluctuations after 1 year: akinesias due to a delayed response worsened after 1 year of treatment also when compared with the conventional treatment. Positive results were obtained with new HBS on standard Madopar-related psychiatric disorders.
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It is possible to grow functional primary dissociated cultures and explants from stereotactic biopsies of human parkinsonian caudate nuclei. Two major classes of cells were identified on morphological grounds. The culture cells appear to be stimulated by an unidentified soluble factor(s) obtained from human fetal neuronal cells in vitro. Culture of primary neuronal and glial cells from human adult cerebral nuclei seems to be a useful tool for several research purposes and in particular for studying both trophic factor action and target effects on afferent neurons for prospective human brain grafting.
This work was set up to investigate the possible presence of peripheral nervous system involvement as a long-term effect of the exposure to dioxin in 152 subjects with chloracne from the Seveso area; 123 age- and sex-matched subjects living in nearby towns with similar environmental pollution formed the control group. The accident in Seveso took place in July, 1976, and this study was carried out from October, 1982, to May, 1983. Although a peripheral neuropathy was not found in any of the subjects, a significant increase of the number of individuals presenting at least two bilateral clinical signs (p less than 0.05) or one abnormal electrophysiological parameter (p less than 0.02) was found in the Seveso group. Principal component analysis did not show any subdivision between these two groups. The Fisher approach to discriminant analysis reveals a clear subdivision between the group of the most exposed subjects and randomly selected subgroups of control subjects. In conclusion, clinical and electrophysiological signs of peripheral nervous system involvement occur with a statistically increased frequency in the Seveso population 6 years after the accident, although a peripheral neuropathy was not evident in any of the chloracne patients using the World Health Organization diagnostic criteria.
A multicenter, double-blind, between-patient trial comparing two doses of ketazolam (15 and 30 mg) with placebo, each given once daily, in the evening, to 92 outpatients affected by generalized anxiety disorders for at least 1 month, was carried out. After 1-week washout period 47 patients were randomized to ketazolam 15 mg, and 45 to placebo for 15 days (first period). At the end of this period, if the patient experienced a decrease on the total Hamilton Anxiety Rating Scale (HAM-A) of at least 25% of basal value, the treatment was kept unchanged for a further 15 days, otherwise 15 mg of ketazolam were added to the previous treatment (second period). Anxiety was rated after 2 and 4 weeks with the Italian HAM-A scale and with a 4-point scale (patient's assessment). Seventy-eight patients completed the first period and 75 the whole study. During the first period the percentage of responders was almost identical in both treatment groups, but during the second period a further slight improvement was observed in the early placebo responders, while the HAM-A score of patients on ketazolam continued to improve significantly (p less than 0.01) throughout the study. Likewise a significant (p less than 0.001) difference between treatments was observed, on the 4-point scale, in the population as a whole (end of first period) as well as in responder patients (end second period). Tolerability was good, except in 1 patient on placebo, who was withdrawn from the study because of severe headache.
We tested the efficacy of coenzyme Q10 (ubidecarenone, CoQ10) therapy in patients with Kearns-Sayre syndrome and other mitochondrial myopathies with chronic progressive external ophthalmoplegia (CPEO). We treated seven patients for 1 year with daily oral administration of 120 mg of CoQ10. Throughout the treatment most of our patients showed a progressive reduction of serum lactate and pyruvate levels following standard muscle exercise and generally improved neurologic functions. The ECG and echocardiogram showed no significant changes in our patients. None of our patients showed any improvement in ptosis and CPEO.
In a multicenter, double-blind trial, 63 elderly patients who had experienced a generalized anxiety disorder for at least one month were randomly assigned to receive 15 mg of ketazolam (n = 31) or placebo (n = 32) daily for 15 days. At the end of this period, if their total scores on the Hamilton Anxiety Rating Scale had decreased by at least 25%, treatment was continued unchanged for a further 15 days. Patients who did not respond to treatment were given an additional 15 mg of ketazolam daily. During the initial 15 days, 83% of the ketazolam-treated patients and 43% of the placebo patients responded to treatment (P < 0.01). During the second 15-day period, the anxiety scores of the ketazolam-treated patients continued to decline significantly, whereas the placebo patients showed no improvement. According to the investigators' assessments of severity of anxiety and patients' ratings of treatment effectiveness, ketazolam was significantly superior to placebo.
Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([99mTc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data.
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