Early controlled clinical trials.
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Common Cold↗
Biomedical subjects
P D Hart
Publications and source records attributed to P D Hart.
Calixarenes with host-mediated potency in experimental tuberculosis: further evidence that macrophage lipids are involved in their mechanism of action.
Some time ago, it was found that attachment of hydrophilic polyoxyethylene chains to various hydrophobic phenols and alcohols gave water-soluble products which, although inactive in vitro, influenced and experimental tuberculous infection. With short chains the infection was suppressed, and with long chains it was promoted. Later work concentrated on Macrocyclon (short chain) and HOC-60 (long chain), both derived from a hydrophobic, polyphenolic calixarene. Growth of Mycobacterium tuberculosis inside macrophages (M phi) was inhibited by Macrocyclon and stimulated by HOC-60. Also, triglyceride lipase from M phi extracts and an extracellular phospholipase were inhibited by Macrocyclon and stimulated by HOC-60. This suggestion of a mechanism has been strengthened by the finding that M phi cultivated in monolayers and treated with Macrocyclon showed accumulation of lipid and little formation of fatty acid after incubation of killed cells. With HOC-60, lipid was depleted and much fatty acid was found.
Animals↗
Stimulation or inhibition of the respiratory burst in cultured macrophages in a mycobacterium model: initial stimulation is followed by inhibition after phagocytosis.
Microorganisms cause varying degrees of stimulation of superoxide (O2-) production (respiratory burst [RB]) in macrophages but in some cases apparently inhibit the RB induced in the same monolayers by a conventional stimulator. We have explored these differences. A mycobacterium model, the slowly multiplying mouse pathogen Mycobacterium microti, induced a modest RB in resident macrophage monolayers, compared with the substantial RB induced by opsonized zymosan (Zy). However, if the 1-h M. microti pulse immediately preceded the Zy assay (instead of being concurrent), the RB was consistently less than that elicited by the Zy alone. Cytochalasin (an inhibitor of phagocytosis) enhanced Zy-induced RB, supporting the view that the burst is cell surface mediated, but this agent apparently eliminated the inhibition of the Zy-induced RB caused by prior M. microti exposure, suggesting that this inhibition may have an intracellular origin. The inhibition described extended not only to another mycobacterium (Mycobacterium bovis BCG) but also to a previous application of Zy itself. The general implications for macrophage functions of these observations on timing and sites of initiation are briefly discussed.
Animals↗
Dual energy X-ray absorptiometry versus skinfold measurements in the assessment of total body fat in renal transplant recipients.
Traditional methods for estimating total body fat rely on the assumption that body fat distribution and bone mineral content are constant. However, in patients undergoing renal transplantation rapid changes in body composition occur, with variations in fat distribution and bone mineral content. In order to determine the reliability of skinfold measurement (SFM) in these patients, we compared it with dual energy X-ray absorptiometry (DEXA), which estimates body composition without reliance on assumptions of constant fat distribution and bone mineral content. Thirty-four adult renal transplant recipients were studied at the time of transplantation and again after 3 and 6 months. The correlation coefficients of DEXA vs SFM at the three time points were 0.84, 0.78, 0.85, respectively (P = 0.0001). In 34 healthy adults serving as controls, the correlation coefficient was 0.95 (P = 0.0001). Total body fat increased progressively following renal transplantation (P < 0.03 by 6 months) with SFM showing considerable disagreement with DEXA measurements of percentage total body fat. Thus skinfold measurements underestimated changes in total body fat following renal transplantation, especially in those gaining substantial amounts of body fat, and DEXA appeared to be a more appropriate technique.
Absorptiometry, Photon↗
Low protein diets in chronic renal insufficiency.
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Adult↗
Amalgamation of two endocytic probe techniques: fluoresceinated cationized ferritin can show up, sequentially, selected structures, first in living cells and then by electron microscopy.
Fluorescein isothiocyanate-cationized ferritin (FITC-CF) has hitherto been used mainly to identify structures in living cells by light microscopy, by virtue of its fluorescent properties. We show here that this conjugate can be used, after immediate fixation of the same cell sample and preparation of thin sections, to recognise the same structures, by virtue of the ferritin's electron opacity. The conjugate should thus have a new use as a single-application, dual-purpose probe, e.g. in endocytic studies. The procedure may have advantages over similar dual-purpose probes in not requiring staining or special treatment.
Animals↗
Ammonium chloride, an inhibitor of phagosome-lysosome fusion in macrophages, concurrently induces phagosome-endosome fusion, and opens a novel pathway: studies of a pathogenic mycobacterium and a nonpathogenic yeast.
The weak base ammonium chloride has been previously reported to inhibit lysosomal movements and phagosome-lysosome (Ph-L) fusion in cultured mouse macrophages (M phi), thus reducing delivery, to an intraphagosomal infection, of endocytosed solutes that have concentrated in secondary lysosomes. We have now addressed the question, whether NH4Cl might affect any direct interaction (if it exists) between such infection phagosomes and earlier, nonlysosomal compartments of the endocytic pathway, i.e., solute-containing endosomes. The phagosomes studied were formed after ingestion of the mouse pathogen Mycobacterium microti and the nonpathogenic yeast Saccharomyces cerevisiae; and the endosomes were formed after nonreceptor-mediated endocytosis of electronopaque and fluorescent soluble markers. By electron microscopy, survey of the cell profiles of M phi that had been treated with 10 mM NH4Cl so that Ph-L fusion was prevented, and that displayed many ferritin-labeled endosomes, revealed numerous examples of the fusion of electronlucent endosomes, revealed numerous examples of the fusion of electronlucent vesicles with phagosomes, whether containing M. microti bacilli or S. cerevisiae yeasts. Fusion was recognized by transfer of label and by morphological evidence of fusion in progress. The fusing vesicles were classed as endosomes, not NH4Cl-lysosomes, by their appearance and provenance, and because lysosome participation was excluded by the concurrent, NH4Cl-caused block of Ph-L fusion and associated lysosomal stasis. No evidence of such phagosome-endosome (Ph-E) fusion was observed in profiles from M phi treated with chloroquine, nor in those from normal, untreated M phi. NH4Cl-treated living M phi that had ingested yeasts at 37 degrees C, followed by endocytosis of lucifer yellow at 17 degrees C (to accumulate labeled endosomes and postpone label passing to lysosomes), were then restored to 37 degrees C. Fluorescence microscopy showed that as many as half of the yeast phagosomes (previously unlabeled) rapidly became colored. We inferred that this transfer was from endosomes (by Ph-E fusion) because Ph-L passage was blocked (by the NH4Cl). We conclude that NH4Cl induces Ph-E fusion at the same time as it suppressed Ph-L fusion. We discuss the mechanisms of these concurrent effects and suggest that they are independent; and we consider the implications of NH4Cl opening a direct route for endocytosed molecules to reach an intraphagosomal infection without involving lysosomes.
Ammonium Chloride↗
Randomised controlled clinical trials.
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History, 20th Century↗
Mycobacterial infection is an important infective complication in British Asian dialysis patients.
To define the extent and nature of mycobacterial infection in patients on an adult dialysis unit whose catchment population contains a large proportion of non-Caucasian subjects, a retrospective survey of all new patients accepted onto our maintenance dialysis programme between January 1987 and December 1989 was carried out. Twenty-six Asian, 13 Afro-Caribbean, two Oriental and 170 Caucasian patients were accepted onto the dialysis programme in the three-year recruitment period. Eight of the 26 Asian patients, but none of the others, had developed mycobacterial infection by the end of December 1990. One patient had a cerebral tuberculoma with miliary mottling on chest X-ray, one pulmonary tuberculosis, one tuberculous adenitis and 5 tuberculous peritonitis (four due to Mycobacterium tuberculosis and one Mycobacterium kansasii). All the patients had been living in the UK for an average of 15 (range 6-24) years, with no known recent exposure to tuberculosis. Five patients are now alive and well, one developed malabsorption following M. kansasii peritonitis, but two with tuberculous peritonitis died before treatment could be instituted. Mycobacterial infections were associated with a high level of mortality and morbidity. No Asian patient developed mycobacterial infection during post-transplant immunosuppressive therapy in the study period, probably because of the routine anti-tuberculous chemoprophylaxis employed in this group of patients. The diagnosis of mycobacterial infection should be suspected when an Asian dialysis patient develops a pyrexia of unknown origin. It is likely, though not proven, that anti-tuberculous chemoprophylaxis might reduce this high incidence of tuberculous infection in Asian dialysis patients.
Adult↗
Disease pattern in the elderly.
Analysis of the disease pattern in elderly patients was carried out over a seven-year period (1980-1986) on the medical wards of the University College Hospital, Ibadan, Nigeria. A total of 2,676 patients were reviewed. Cardiac, neoplastic and infective diseases accounted for the most common diseases. Early diagnosis and treatment as well as improvement in preventive medicine are suggested ways to a vigorous healthy old age with concomitant reduction of morbidity and mortality in this age group.
Aged↗
Diseases of the middle-aged population: a study of 4,184 patients.
Within a seven-year period (1980-1986), 4,184 Nigerians aged 31-60 years were admitted into the medical wards of the University College Hospital, Ibadan, Nigeria. The clinical notes of these patients were analysed and the principal diagnoses for each case was coded in accordance with the International Classification of Diseases. Cardiovascular, infective, neoplastic and neuro-muscular diseases constituted the commonest disorders being 70pc of all diseases at admission in this age group. The relevance of these findings in the light of the pattern of diseases elsewhere is discussed.
Age Factors↗
Tubular lysosomes and their drug reactivity in cultured resident macrophages and in cell-free medium.
Lysosomes were assessed in normal living resident mouse peritoneal macrophages, using mainly phase-contrast microscopy (PCM), darkfield microscopy (DFM), and fluorescence microscopy (FM) after terminal acridine orange (AO) staining; these procedures avoided dyes during experimentation. After a few hours of culture a variable proportion of the normal spherical lysosomes began to assemble in a linear fashion. Fully formed tubular structures, with appearances generally recognized as characteristic of tubular lysosomes (TL), could be seen by PCM or, after labeling, by FM, at 2-5 days (best usually at 4-5 days). This peak was followed by a reduction, and at 8-10 days most of the TL had disappeared, leaving only spherical lysosomes. Renewal of the medium at this stage was followed by a temporary reappearance of TL, suggesting that the medium was a major factor in their initial development also. Formation of TL was enhanced by chloroquine (Cq), though to a lesser degree than by phorbol ester (PMA); in contrast NH4Cl (like Cq a weakly basic amine) caused their disassembly into spherical lysosomes. Manual disruption of the monolayer macrophages enabled TL to be transferred to a cell-free medium, in which they remained apparently stable for several hours. Two known microtubule depolymerizers caused disassembly of TL in the intact cells, reinforcing the idea that the TL are associated with the cytoplasmic microtubule (MT) system; but these agents were inactive in vitro, suggesting that disorganization of the system was responsible for this change.(ABSTRACT TRUNCATED AT 250 WORDS)
Ammonium Chloride↗
Outbreak of Paederus dermatitis in southern Nigeria. Epidemiology and dermatology.
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Animals↗
Abnormal mucociliary action in asthma and bronchiectasis.
Nasal mucociliary clearance (NMCC) time was measured in four groups of patients: asthmatics with allergic rhinitis, asthmatics without rhinitis, bronchiectasis and normal subjects. The saccharin method was used for the study. The NMCC time was prolonged significantly in the asthmatic groups and group with bronchiectasis when compared with control subjects (P less than 0.001). It is likely that the impaired mucociliary clearance is due to a combination of mucus abnormality and ciliary malfunction.
Adult↗
Polyanionic agents inhibit phagosome-lysosome fusion in cultured macrophages: a reply to the suggestion of Goren, Vatter, and Fiscus to the contrary.
The paper and review by Goren et al. (J. Leukocyte Biol. 41, 111, 1987) contain serious objections to the reports from several laboratories on the pattern of fusion of secondary lysosomes with phagosomes (yeasts being predominantly the target) in polyanion-treated macrophages; these reports had concluded that the polyanions were inhibitors of this fusion. The main objection by Goren et al. is to the alleged misuse of electron microscopic (EM) lysosome markers; many instances of phagosome-lysosome (P-L) fusion in the treated cells have therefore been missed. The central argument is that 1) the "hydrocolloid" properties of certain of these polyanions hinder the passage of the enmeshed marker from lysosome to phagosome after their fusion and 2) this hindrance is mistakenly interpreted as indicating that fusion has not taken place, thus giving rise to the belief that the polyanions can inhibit fusion. In reply, we explain that we score as P-L fusion any instance of marker (ferritin) being seen anywhere in a fused phagosome (phagolysosome). For this crucial reason, immobilisation of marker by a hydrocolloid polyanion, e.g., in lysosomal residue of phagolysosomes or just within phagosome membranes (as in Goren's Figs. 5 and 6 [8]), would not seriously threaten the marker distinction between fusion and nonfusion (with consequent underestimation of the former) and therefore would not invalidate the reports of a high incidence of nonfusion in polyanion-treated macrophages. Such inhibition of P-L fusion is supported by using as lysosomal label the nonpermeant fluorescent probe lucifer yellow (accepted by Goren et al. as a reliable indicator of fusion). Further support comes from the correlated inhibition of the saltatory movements of secondary lysosomes previously described; static lysosomes will have their contact with the phagosomes severely restricted. Another criticism is based on the failure of certain salient properties and functions of phagosomes to change significantly after polyanion treatment of the macrophages; these include intraphagosomal digestion, presence of lysosomal enzymes, and acidification. However, this indirect evidence can be accounted for alternatively by the operation of factors (primary lysosomes, endogenous acidification, etc.) not affected by the polyanionic block. We conclude that fusion inhibition by the polyanions is a real phenomenon, as previously reported, notwithstanding the hydrocolloid properties of some of them. Furthermore, an explanation based on hydrocolloid properties is questionable, since one or possibly two of the five main polyanionic agents appear not to be hydrocolloids.
Cells, Cultured↗
Inhibition of phagosome-lysosome fusion in macrophages by certain mycobacteria can be explained by inhibition of lysosomal movements observed after phagocytosis.
We have investigated the mechanism of the inhibition of phagosome-lysosome (P-L) fusion in macrophages known to occur after infection by Mycobacterium tuberculosis and by the mouse pathogen Mycobacterium microti. We have used an M. microti infection and have studied, first, the saltatory movements of periphagosomal secondary lysosomes by means of visual phase-contrast microscopy (a similar use of the method having been previously supported by computer analyses). The movements became slow or static after ingestion of live but not of heat-killed M. microti. They were unaffected by a fusiogenic mycobacterium M. lepraemurium. Second, we studied the behavior of a normally fusiogenic unrelated organism, Saccharomyces cerevisiae, after its phagocytosis by cells already containing live M. microti ingested 18 h previously. We observed, using a fluorescent assay of fusion, that many of these yeast phagosomes now also failed to fuse with the lysosomes; in contrast, when the host M. microti had been heat killed the yeast phagosomes fused normally. These observations were extended by ultrastructural quantitative analyses of P-L fusion, which confirmed the nonfusion of phagosomes of live M. microti and, more particularly, the change to nonfusion from the normal fusion behavior of the separate phagosomes of accompanying yeasts. Third, we have assembled evidence against the likelihood that these M. microti-induced phenomena are nonspecific, i.e., secondary to a general depression of activity of heavily infected host cells. The evidence includes the feasibility of adjusting the degree of infection so as to facilitate visual assessment of organelle movements without the presence of detectable damage to the cells studied; the absence of lysosomal stasis after comparable infection with another mycobacterium of comparable virulence (M. lepraemurium); and the reversibility of the stasis. We conclude that inhibition of lysosome saltatory movements (and consequently its secondary effect on the associated yeasts) is a significant, specifically induced phenomenon. From these observations and considerations, therefore, in conjunction with the analogous inhibition of lysosomal movements in normal macrophages by some chemical inhibitors of P-L fusion, and our suggestion that this association is causally related, we now suggest that M. microti-induced focal lysosomal stasis is also the main means by which the inhibition of P-L fusion is brought about by this organism. This concept is strengthened by the observations on S. cerevisiae, which provide strong evidence that stasis can cause suppression of fusion.
Animals↗
Computer graphics and numerical techniques in the measurement of movements within cells.
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Animals↗
Chemical inhibitors of phagosome-lysosome fusion in cultured macrophages also inhibit saltatory lysosomal movements. A combined microscopic and computer study.
The effects on lysosomal movements produced by the weak base ammonium chloride and by a representative polyanion poly-D-glutamic acid (PGA), previously reported to inhibit phagosome-lysosome (P-L) fusion, have been studied in cultured mouse macrophages using direct visual phase-contrast microscopy, a previously described (1, 3, 7) fluorescence assay of fusion, and computer analysis techniques. Treatment of the macrophages with 5-10 mM NH4Cl for 0.5-2 h or with 100 micrograms PGA/ml for 5 d caused a striking inhibition of saltatory lysosomal movements, as well as the expected inhibition of P-L fusion. Two other anionic fusion inhibitors tested, dextran sulphate and suramin, inhibited movements similarly. Removal of the NH4Cl from the cell medium reversed the lysosomal stasis and restored P-L fusion. Computer analyses of changes in lysosomal positions in treated and untreated macrophages during 2, 10, and 30-s intervals, using data from photomicrographs, computer graphics, and quantitative nearest-neighbour techniques developed for this purpose, supported the qualitative visual observation of the inhibition of lysosomal movements by the fusion inhibitors NH4Cl and PGA. Over the chosen intervals, from 80 to 96% of the lysosomes could be paired within 1 micron of each other in the NH4Cl- and PGA-treated cells in comparison with 50-70% in normal cells. The differences between the drug-treated and normal cells were highly significant. In an analogous system, the lysosomal stasis induced by hypertonic sucrose was examined and it was observed that P-L fusion too was inhibited. Both effects were reversible. We conclude that inhibition of P-L fusion and of lysosomal movement are associated. We suggest a causal relationship between these changes, namely, that the lysosomotropic inhibitors of fusion under study produce their effects largely, though perhaps not exclusively, by reducing saltatory lysosomal motion and consequently periphagosomal assembly, rather than directly and independently on P-L contact or on the fusion process itself. The possibility is raised that microtubules may be involved in the effector mechanism of these modulations.
Acridine Orange↗