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Biomedical subjects

M Shalit

Publications and source records attributed to M Shalit.

At least 73 records · Page 4Linked to original sources

Determinants of in vivo histamine release in cutaneous allergic reactions in humans.

To determine host factors influencing the magnitude of mediator release during ongoing cutaneous allergic reactions in humans, we compared, in 22 subjects, the first-hour, second- to fifth-hour, and total (0 to 5 hours) skin chamber histamine release to (1) the in vitro reactivity and sensitivity of basophils to antigen for histamine release and (2) skin test sensitivity and reactivity to antigen, histamine, and codeine. There was no significant correlation between the first-hour and second- to fifth-hour histamine release. With a combination of basophil, antigen, histamine, and codeine skin sensitivity and reactivity, 64% to 75% of the magnitude of the first-hour, second- to fifth-hour, and total (0 to 5 hours) skin chamber histamine release could be accounted for. We conclude that antigen-induced in vivo allergic responses are a complex phenomenon dependent, in part, on antigen sensitivity, basophil and mast cell reactivity, and end organ responsiveness to mediators.

Adolescent↗

Release of histamine and tryptase during continuous and interrupted cutaneous challenge with allergen in humans.

To help in understanding the patterns of in vivo mediator release in human allergic skin reactions, we have used a skin chamber model to challenge the denuded bases of skin blisters of 11 sensitive subjects with pollen antigens (Ags) and codeine (C), a mast cell degranulator. Challenges were performed either (1) continuously for 6 hours or (2) in an intermittent fashion that is, Ag or C for the first hour, buffer for the next 4 hours, and then Ag or C during the sixth hour. Fluids in the overlying chamber were assayed for levels of the mast cell components, histamine and tryptase. There was peak release of both histamine and tryptase during the first hour of Ag incubation (89 +/- 11 ng/ml and 1428 +/- 260 ng/ml, respectively). At continuous Ag-challenge sites, there was a plateau of histamine levels (8.0 to 9.5 ng/ml) during the next 4 hours, whereas tryptase levels decreased progressively to baseline levels. Challenge of continuous Ag-incubation sites with C, a mast cell activator, led to another peak release of both histamine and tryptase. At interrupted Ag-challenge sites, histamine levels decreased abruptly, and tryptase levels decreased progressively after the first hour. Rechallenge of such sites with Ag during the sixth hour induced a peak release of histamine but no increase in tryptase levels. Continuous challenge with C for up to 5 hours in other sites induced an initial peak histamine release without a subsequent plateau. However, such a plateau of histamine (but not tryptase) release occurred after an initial C challenge if Ag was subsequently incubated in a continuous fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neutrophil function in healthy elderly subjects.

Ten healthy elderly volunteers (mean age: 78.9) underwent a battery of neutrophil function tests. Resting adherence to endothelium, random and directed migration, phagocytosis-induced chemiluminescence, and granule secretory behavior were all indistinguishable from young healthy controls. However, in vivo delivery of neutrophils into skin abrasions was significantly reduced: 8.4 X 10(5), versus 2.7 X 10(6) in the young. In addition, their neutrophils showed a smaller increase in the surface adhesion glycoprotein CD11 and in adherence to endothelium in response to stimulation with FMLP than did cells from young controls. Inversely, baseline CD11 expression was higher in elderly subjects, suggesting that their cells may have an in vivo defect in mediator responsiveness. Serum immunoglobulin and complement concentrations were also compared. The mean IgM level of 106.3 mg/dl in the elderly was significantly below the 154.4 mg/dl in the young. In contrast, concentrations of C3, C4, and total hemolytic complement were significantly higher in the elderly.

Adult↗

Late appearance of phospholipid platelet-activating factor and leukotriene B4 in human skin after repeated antigen challenge.

Inflammatory mediators were assessed in supernatants of chamber fluids from eight ragweed- or grass-sensitive subjects during antigen-induced cutaneous inflammatory responses. Platelet activating factor (PAF) accumulated at concentrations of 1 pm to 90 mumol/L in six of eight subjects beginning at 3 hours and continuing for 9 hours after antigen challenge. Leukotriene B4 (LTB4) was detectable at cutaneous sites of antigen challenge in five of five subjects throughout the 9-hour period at levels from 1 to 36 nmol, a range of 38% to 80% of which were omega-oxidation metabolites. Histamine levels peaked in the first hour at 106 +/- 18 ng/ml and decreased to a plateau of 11 to 13 ng/ml at 3 to 9 hours after antigen challenge. No PAF and only very low levels of LTB4 (0.1 to 1.3 nmol) and of histamine (less than 2 ng/ml) were detected at buffer-control sites during the 9 hours of study. Continuous antigen exposure thus results in the persistent release of histamine and LTB4 and the late appearance of PAF, all of which may contribute to the chronicity of allergic disorders and may have a bearing on the IgE-mediated, late-phase cutaneous response.

Adult↗

Differential release of histamine and prostaglandin D2 in rat peritoneal mast cells activated with peptides.

Rat peritoneal mast cells co-cultured with mouse 3T3 fibroblasts (MC/3T3) are fully responsive to immunologic stimuli. To assess their nonimmunologic activation MC/3T3 were challenged with various peptides. Optimal concentrations of substance P (10(-4) M) and bradykinin (5 x 10(-5) M) induced histamine release of 58.2 +/- 9.3 and 66.8 +/- 6.6%, respectively, while neurotensin (10(-4) M) released only 16.6 +/- 3.7% histamine. Freshly isolated mast cells (F-MC) challenged with the same concentrations of peptides released lower percentages of histamine (substance P 45.6 +/- 5.1%, bradykinin 32.5 +/- 5.3%, neurotensin 11.3 +/- 6.0%). In both MC/3T3 and F-MC, only minute amounts of prostaglandin D2 (PGD2) were produced. In contrast, activation with anti-IgE antibodies and compound 48/80 caused both histamine release and PGD2 generation. Compound 48/80-stimulated MC/3T3 and F-MC released 80.2 +/- 3.4 and 51.8 +/- 6.2% histamine, respectively, and produced 15.4 +/- 2.8 ng/10(6) mast cells and 3.9 +/- 1.4 ng/10(6) mast cells PGD2, respectively. These findings indicate that peptides and bradykinin induce selective release of histamine with no PGD2 production in both F-MC and MC/3T3. Moreover, MC/3T3 preserve their functional characteristics of connective tissue mast cells since they are fully responsive to these peptides as F-MC.

Animals↗

Release of histamine and tryptase in vivo after prolonged cutaneous challenge with allergen in humans.

The patterns of in vivo release of histamine and tryptase were determined during prolonged Ag incubation in atopic individuals, using skin chambers placed over denuded skin blister sites. However, the patterns of histamine and tryptase release over a period of up to 9 h of Ag exposure were different. Whereas rates of release of both histamine and tryptase peaked within 1 h in an Ag dose-response fashion, that of tryptase decreased progressively thereafter and was not different from buffer challenge sites from the 5th to 9th h at all concentrations of Ag tested. The rate of histamine release reached a plateau after 2 h and remained at a constant low level throughout the 3rd to 9th h of Ag incubation. Rechallenge of the sites continuously exposed to Ag with a different second Ag at the 6th h resulted in a second peak of release of both histamine and tryptase. This persistence of in vivo histamine but not tryptase release during the later time points of the cutaneous allergic response differs from what has been demonstrated in vitro with dispersed mast cells. Whether this reflects basophil participation at these time points or an as yet undetermined mechanism for release of histamine but not tryptase by mast cells is not known. These novel patterns of mediator release after prolonged Ag exposure in vivo may have clinical relevance to allergic diseases during which atopic subjects are exposed to Ag over several hours to days.

Adult↗

Platelet activating factor increases expression of complement receptors on human neutrophils.

The phospholipid inflammatory mediator platelet activating factor (PAF) has been shown to stimulate certain functions of polymorphonuclear leukocytes (PMN). However, the effect of PAF on surface complement receptors of PMN has not been described. Using monoclonal antibodies and flow cytometry, we have assessed the effects of PAF on surface expression of membrane receptors for C3bi (CR3) and C3b (CR1) in human PMN. PAF (optimal concentration of 1 x 10(-8) M) increased CR3 190% and CR1 174% compared with unstimulated cells at 37 degrees C, while the PAF analogue lyso-PAF had no stimulatory effect. Both CR3 and CR1 responses to PAF reached maximum levels at 15-30 min. PAF effects were comparable to peak effects induced by LTB4 but less than induced by FMLP. A PAF receptor antagonist, SRI 63-441, blocked the increased complement receptor expression in a dose-dependent manner with maximal inhibition of 80-95% at 5 x 10(-6) M. Extracellular calcium had no effect on CR1 expression but slightly enhanced and EGTA partially inhibited the PAF-induced increase in CR3 expression. Simultaneous incubation with PAF and LTB4 enhanced CR3 and CR1 expression more than either agent alone. These findings indicate that PAF, alone and in combination with LTB4, can induce altered expression of complement receptors on the surface of PMN. This effect may enhance adhesion and phagocytosis by PMN at inflammatory reaction sites.

Calcium↗

Cystic changes in intracranial meningiomas. A review.

A survey on cystic meningiomas is given based upon the analysis of 85 cases in the literature and an additional three of our own. In these three cases the computerized tomography appearance led to an incorrect preoperative diagnosis of necrotic glioma or metastatic lesion. The tumours were totally removed and the definitive diagnosis of meningioma was histologically confirmed. In reviewing the literature, we found 85 cases of intracranial meningiomas with cystic changes reported. Their pathological and radiological findings are discussed.

Aged↗

Prehospital patients refusing care.

In summary, many of the complex medicolegal and ethical issues surrounding the prehospital patient who refuses all or part of the care offered by the EMS system have been reviewed. The best outcome can be achieved using a sliding scale of capacity and a conservative approach to treatment rather than releasing the patient at the scene. Finally, the roles of collateral history, inquiries as to the origin of the patient's refusal of care, direct physician interaction with the patient, a spirit of creativity and compromise in dealing with the patient, meticulous documentation, and policy issues have been discussed.

Adult↗

Arachnoid cysts: unusual aspects and management.

Several unusual aspects of primary cerebral arachnoid cysts are presented. The optimal management of these lesions is discussed. Attempts at craniotomy and excision of these cysts is not always effective in eliminating the lesion and may provoke intracranial catastrophies. Huge and bilateral cysts are best treated by cystoperitoneal shunting. In general shunting may be preferable to craniotomy and resection of the cyst. An anti-siphon device is recommended to avoid overdrainage of cerebrospinal fluid.

Adult↗

Effect of ethanol on functions required for the delivery of neutrophils to sites of inflammation.

Acute ethanol intoxication inhibits neutrophil delivery to sites of inflammation and, concomitantly, reduces the adhesion of neutrophils to surfaces. The effect of ethanol on several other neutrophil functions required for normal delivery are examined herein. Serum-free neutrophil suspensions showed normal resting adherence to endothelial monolayers in ethanol concentrations up to 1000 mg/dL, but when neutrophils were stimulated by 10(-6)M N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP) to induce hyperadherence, ethanol induced a dose-dependent inhibition that was significant at concentrations greater than or equal to 500 mg/dL. Pretreating the endothelium with ethanol had no effect. Similarly, resting surface expression of the adhesive glycoprotein Mac-1 was unaffected by ethanol, but its up-regulation induced by fMLP was inhibited by 25.5% at 250 mg of ethanol/dL and by 52.3% at 1000 mg/dL. Release of both primary and secondary granule contents after activation showed dose-dependent inhibition, whereas resting granule content and spontaneous release were unaffected. Passive neutrophil deformability was significantly enhanced in 500 mg of ethanol/dL. Thus, ethanol affects several neutrophil delivery functions normally activated by inflammatory stimuli.

Adult↗

Increased expression of CR3 (C3bi receptor) on neutrophils in human inflammatory skin reactions.

To help determine whether the neutrophils (PMN) found in skin inflammatory reactions are activated, we have compared the expression of the C3bi receptor (CR3) on such cells with that on autologous blood PMN in 10 pollen-sensitive subjects. Using skin chambers overlying denuded blister bases we collected PMN at 2 or 4 hr at sites of challenge with pollen antigen or buffer solution. These cells and PMN in autologous blood were incubated with monoclonal anti-CR3 antibody and the expression of CR3 was measured by indirect fluorescence and flow cytometry. Significantly more PMN were found at antigen than at buffer sites at 2 hr (7.02 +/- 0.45 X 10(5) vs 0.71 +/- 0.25 X 10(5] and at 4 hr (2.2 +/- 0.57 X 10(6) vs 5.47 X 10(5). The mean CR3 expressions on PMN at antigen and buffer sites were similar (117 +/- 7.4 vs 118 +/- 9.0); both were significantly greater than on blood PMN (17.6 +/- 1.5; P less than 0.005). PMN from both sites could be stimulated further in vitro with formyl-methionyl-leucyl-phenylalanine (FMLP) to express more CR3 to a level even greater than in FMLP-stimulated blood PMN (155 +/- 11 and 157 +/- 12, respectively, vs 108 +/- 7 in blood PMN). The incubation of blood PMN with the noncellular component of the chamber fluid led to a moderate (28-100%) increase in CR3 expression, but far less than the CR3 expression on the chamber fluid PMN themselves. Since surface CR3 is thought to be an activation marker important in PMN adhesion, these findings may be important in understanding the emigration of PMN in skin inflammatory reactions.

Adult↗