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[Immunohistochemical localization of nerve terminals in the human gingiva. Use of a new neuronal marker].

The usefulness of classical techniques for sensory nerve ending detection is compromised by intrinsic limitations. The development of immunohistochemical methods has recently produced new information on the innervation pattern in different human tissues. This study presents the results obtained by use of a new antiserum, raised against a new marker of central and peripheral neurons (PGP 9.5), which selectively labels nerve fibers and neuroendocrine (APUD) cells also in human gingiva. The possible application of this method for further researches is also briefly discussed.

APUD Cells↗

Argyrophilic cells in 202 human mucinous breast carcinomas. Relation to histopathologic and clinical factors.

Two hundred two human, mucinous breast carcinomas were investigated for the presence of argyrophilic granules, and these granules were found in 25% of the cases. The granules were located in the cytoplasm and were heterogeneously distributed within the tumors. Tumors with granules were otherwise morphologically indistinguishable from those tumors without granules. The recurrence-free survival was independent of the presence of granules, and no relation was found to other clinical or histopathologic factors. Tumors with granules were found to be estrogen-receptor positive, and they appear to have a slightly less aggressive growth pattern than tumors without granules, but the difference is far from being statistically significant. It is concluded that there is no convincing evidence that this group of primary breast carcinomas with argyrophilia originates from APUD cells.

APUD Cells↗

Gastrinoma of duodenal G-cell origin.

A 65-year-old man with hypergastrinemia associated with the Zollinger-Ellison syndrome was found to have a duodenal "carcinoid-islet cell tumor." Gastrin levels have remained normal for more than 1 year following total gastrectomy and removal of the duodenal tumor. Immunohistochemical studies for gastrin localization revealed positive staining of the tumor and of a population of nonneoplastic G-cells in the adjacent duodenal mucosa and Brunner's glands. These results support the hypothesis that gastrinomas may arise as primary tumors from duodenal G-cells rather than from ectopic pancreatic tissue. "Carcinoidislet cell tumors," like other tumors of APUD-cell origin, may express dual biochemical functions in the form of polypeptide hormone and/or amine secretion. Their content of specific hormonal products may be predicted on the basis of sensitive histochemical and immunohistochemical techniques.

Adenoma, Islet Cell↗

Prolactin, human nutrition and evolution, and the relation to cystic fibrosis.

Cystic fibrosis (CF) is a lethal, genetically transmitted disease of Caucasian populations. Its prevalence is highest (ca 1:2000 live births) among Western and Central Europeans and their descendants. Major clinical symptoms are chronic, obstructive, pulmonary disease, impaired intestinal digestion and absorption and elevated concentration of salt in sweat. The last is important, not only for diagnosis, but because it is an example of an electrolyte transport defect present in other epithelial tissues. Numerous other clinical manifestations are generally present. The history of prolactin (PRL), especially its role in osmoregulation, is outlined and related to the symptomatology and electrolyte defect of CF. Data are presented showing the relation of PRL to regulation of sweat electrolytes and its presence and probable synthesis in the coil of the human sweat gland. The basic biochemical defect of CF has not yet been elucidated, but recent research has shown that it is probably an abnormality of a regulatory factor. We propose that PRL is a likely candidate. The large variety of functions of PRL, in particular the regulation of the transport of sodium and chloride across epithelial membranes, and the regulation of mucus production, can be matched to the major disease symptomatology. Additionally, every other one of the multiple abnormalities of CF can be associated with described activities of PRL. In lower vertebrates epithelial tissues regulated by PRL are phylogenetic progenitors of affected tissues in CF. In the human, these tissues contain cells of the Diffuse Neuroendocrine System, or APUD cells, that show PRL-like immunoreactivity, or overt synthesis of the hormone. Thus, the regulatory activity of these tissues could be paracrine. The geographic distribution and the dietary habits of early Caucasians are examined. It appears that the Neolithic revolution, with the necessity of adapting to agriculturally produced foods, i.e. milk and wheat, could have brought about the genetic selection of post-translational variants of PRL. It is suggested that the combination of two or more of these mutations in the same individual may be responsible for CF. This is illustrated with proposed models of CF inheritance. We conclude by postulating that PRL acts at the level of the target cell by triggering (in conjunction with a steroid) the gene expression of unique proteins; these act as intermediaries of PRL activity; two or more abnormalities of these proteins when present in an individual produce CF; the protein abnormalities are the consequence of nutritional and ecological pressure.

Biological Evolution↗

Hormone producing pancreatic islet cell carcinoma: changing clinical presentation.

A patient with pancreatic islet cell carcinoma demonstrated spontaneous remission and recurrence of hyperinsulinism and disappearance of elevated plasma motilin levels. Despite evidence for gastrin production by the tumor initially, the Zollinger-Ellison syndrome was not diagnosed until three years after initial presentation. Diarrhea and steatorrhea could be attributed to hyperchlorhydria rather than to direct intestinal effects of elevated cirulating gastrin, gastric inhibitory peptide or motilin. Pancreatic islet cell carcinomas, considered as a type a APUD cell proliferation, frequently produce more than one hormone; the pattern of hormone secretion may differ with time and clinical manifestations may change accordingly.

Adenoma, Islet Cell↗

Argyrophil cells in normal, hyperplastic, and neoplastic endometrium.

Scanty argyrophil cells are present in a substantial proportion of normal endometria, particularly during the secretory stage of the cycle. Argyrophil cells are also present in the various types of hyperplastic endometria and are found in more than half of endometrial adenocarcinomas. In some endometrial neoplasms they are present in abundance, but tumours rich in such cells do not have any features suggestive of a carcinoid tumour and are morphologically identical to adenocarcinomas of similar grade which are devoid of argyrophil cells. Endometrial adenocarcinomas containing argyrophil cells tend to be well differentiated and tend not to invade deeply into the myometrium. It is suggested that Müllerian epithelial stem cells possess a potentiality for differentiation into APUD cells.

Adenocarcinoma↗

Regulatory peptides and neuron-specific enolase in the respiratory tract of man and other mammals.

This short review deals with the distribution and cellular localization, in the respiratory tract, of five regulatory peptides (substance P, bombesin, vasoactive intestinal polypeptide (VIP), cholecystokinin, and somatostatin) and of a newly discovered neuroendocrine enzyme marker, neuron-specific enolase. Bombesin is found in typical mucosal endocrine cells, whereas the other regulatory peptides--principally substance P and VIP--are found, in significant concentrations, in autonomic nerves of the wall of the airways. Substance P, a putative sensory neurotransmitter, is found in autonomic nerves closely associated with the mucosal epithelium and the bronchial smooth muscle. VIP nerves, on the other hand, appear predominantly to innervate blood vessels, seromucous glands of the upper respiratory tract, and bronchial smooth muscle. The presence of neuron-specific enolase in both mucosal APUD cells and autonomic nerves has established this newly discovered neuronal enzyme as a useful marker for the entire neuroendocrine system of the lung and its derivative neoplasms.

APUD Cells↗

Physiological and pathophysiological aspects of gastrointestinal peptide hormones.

The author made a review about the origin, the biochemistry the physiological and pathological roles of gastrointestinal peptide hormones. They originate from the APUD cell system, chemically from the ancient growth hormone, or placental lactogen. The theoretical prosecgastrin's first sequencies form the "secretin family", the tail sequencies form the "gastrin family". The author describes many details of their effects on the different gastrointestinal organs, they behave mainly antagonistic way to each other. Finally a discussions is given about their role in the development of peptic ulcer, in the WDHA syndrome and in malabsorption.

APUD Cells↗

Clonal analysis of insulin and somatostatin secretion and L-dopa decarboxylase expression by a rat islet cell tumor.

A cell line, RIN-m, established from a transplantable rat islet cell tumor secretes insulin (IRI) and somatostatin (SRIF) and expresses high levels of the key amine precursor uptake and decarboxylation (APUD) cell enzyme L-dopa-decarboxylase (DDC). Conditioned medium from a rat pituitary tumor line GH3, secreting GH and PRL, improved the cloning efficiency of RIN-m cells 24-fold and enabled the isolation and establishment of a large number of primary and secondary clones. These clones were used to study clonal relationships between peptide hormone secretion and APUD features of an endocrine cell. All the primary and secondary clonal derivatives, irrespective of whether they secreted peptide hormones, maintained high levels of DDC activity. In contrast, IRI and SRIF secretion patterns of the primary clones were highly variable. Selective recloning of primary clones resulted in the isolation of subclones which produced either no hormones or high levels of either IRI or SRIF, but no clone that continuously secreted high levels of both IRI and SRIF. We conclude that: 1) the rat pituitary tumor line GH3 produces a factor(s), possibly GH and/or PRL, which dramatically affects the growth and cloning efficiency of rat islet tumor cells; 2) in contrast to the variability in hormone secretion patterns, DDC activity was consistently expressed in all clones and subclones; and 3) although wide fluctuation in hormone secretion levels occurred among the primary clones, subclones were obtained which revealed that IRI and SRIF can be expressed independently. The subclones of RIN-m developed should be useful for the analyses of factors influencing the synthesis, storage, and secretion of IRI and SRIF. The persistence of high DDC activity in the primary and secondary clones suggests that the APUD property of this endocrine cell may be a primitive differentiation feature closely related to the stem cell; in contrast, peptide hormone production may be associated with more terminal differentiation events.

Adenoma, Islet Cell↗

Multiple endocrine neoplasia syndromes.

The multiple endocrine neoplasia (MEN) syndromes are characterized by autosomal dominant inheritance with a high degree of penetrance but varying expression. This review gives a classification of these syndromes and a short summary of the historical background. The pathogenesis of the disease and its possible origin in the APUD cell system are discussed together with the mechanisms underlying normal and ectopic hormone production by MEN tumors on the basis of recent findings in molecular endocrinology. The natural history and the clinical manifestations of the different syndromes are described. The sensitivity and discriminative capacity of the tests used to detect the syndromes in an early stage are compared. The choice of therapy and criteria for the timing and extensiveness of treatment are also considered. Lastly, problems associated with the ethical and legal aspects of screening, central registration, and monitoring of relatives at risk are described.

APUD Cells↗

Lymphoid tissues of the ileum in young horses: distribution, structure, and epithelium.

Lymphoid tissues in the ileum of young horses form raised plaques that are macroscopically visible from the mucosal surface. These are termed "ileal lymphoid patches". These patches are variable in size, shape and position within the ileal wall, occasionally lying along the site of mesenteric attachment. Within lymphoid patches, follicles exist in three different morphological forms: follicle/dome structures, proprial follicles, and lymphoglandular complexes (LGCs). In follicle/dome structures, the majority of the follicle lies in the submucosa and merges with a dome in the lamina propria through a gap in the muscularis mucosae. In proprial follicles, the majority, or all, of the follicle is found in the lamina propria, and in LGCs, the follicles lie in the submucosa and communicate with the intestinal lumen via a central invagination of epithelium that extends vertically through a gap in the muscularis mucosae. Follicle-associated epithelium covers the follicle/dome structures and proprial follicles. It consists of enterocytes, cells morphologically resembling M cells, intraepithelial lymphocytes, goblet cells, and amine-precursor uptake and decarboxylation (APUD) cells. The epithelium of LGCs is mainly populated by immature enterocytes, intraepithelial lymphocytes and goblet cells. Cells with coarse, long microvilli are also present. Information regarding the presence of LGCs in the small intestine is scant, but LGCs have been well described in the large intestine of many species. Further investigation will be required to determine if factors exist that are common to both the ileum of the horse and the large intestine of other species to influence the development of LGCs at these specific sites.

Animals↗

Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study.

229 stomachs resected for duodenal and gastric ulcer and carcinoma were examined with special regard to the morphological and histochemical pattern of intestinal metaplasia (IM). The results of qualitative and semiquantitative studies were analysed statistically. Whereas duodenal and gastric ulcer cases are best discriminated by the presence or absence of IM, the strongest discriminating factor between carcinoma and gastric ulcer is the content of goblet cells in metaplastic crypts. Metaplastic crypts lined exclusively with goblet cells producing sulfated acid glycoproteins could be identified in more than one third of the cancer cases. The increase in goblet cells coincides with a loss of the more differentiated cells in the metaplastic glands, such as enterocytes, APUD cells, or Paneth cells. This "enterocoli metaplasia" seems to be specific for cancer bearing mucosa and occurs more often in cancer of intestinal type; it may represent a form of a derepressive dedifferentiation. The significance of enterocoli metaplasia as a premalignant lesion remains to be elucidated.

Adult↗

I-131 metaiodobenzylguanidine uptake in a parathyroid adenoma.

We describe a patient with multicentric small bowel carcinoids, severe hypertension, primary hyperparathyroidism, and multiple parathyroid adenomas. Intense uptake of I-131 metaiodobenzylguanidine (MIBG) occurred in a parathyroid adenoma. There was no biochemical evidence of catecholamine secretion by the tumor but elevated serum levels of parathyroid hormone were demonstrated. We suspect that occasional parathyroid adenomas, like other APUDomas, may give false positive results when MIBG imaging is used to search for pheochromocytomas. This observation supports the inclusion of the parathyroid chief cells in the amine precursor uptake and decarboxylation (APUD) cell system.

3-Iodobenzylguanidine↗

[Surgical treatment of neuroendocrine tumours of the pancreas].

Gastro-entero-pancreatic (GEP) endocrine tumours can originate from various pancreatic islet cells, from endocrine cells of the gastric and duodenal mucosa, or from APUD cells of neuroectodermal origin in the gastrointestinal tract. They are benign when smaller than 2 cm, but larger tumours are generally malignant. Surgery is the only method for the curative treatment of GEP tumours. A diagnosed and localised tumour is an absolute indication for radical surgery. Conservative medical treatment may be indicated only in an inoperable condition, but in this case tumour reduction surgery is suggested. In the last 15 years 22 patients with pancreatic neuroendocrine tumours were treated without any mortality. Except for two of them, the surgical therapy was curative.

Adult↗

In vivo and in vitro binding of iodinated monoclonal antibody A2B5 to RIN insulinoma cells.

Monoclonal antibody A2B5 reacts with the cell surface of a series of amine precursor uptake decarboxylation (APUD) cells and their tumors in many vertebrate species including chicken, rat, mouse, and man. We have studied the in vivo and in vitro binding of iodinated monoclonal antibody A2B5 to rat insulinoma cells. In vitro, radiolabeled A2B5 binds specifically to RINm5F insulinoma cells and the binding of 125I-A2B5 is inhibited by unlabeled A2B5 or a ganglioside extract of RINm5F cells. In vivo, scintigrams taken Day 0 to Day 5 after injection of 131I-labeled A2B5 showed a striking localization of 131I-A2B5 in transplanted RIN tumors grown in syngeneic rats. Other control radiolabeled monoclonal antibodies did not concentrate in the tumors. 131I-labeled A2B5 did not concentrate in other transplantable tumors (colon adenocarcinoma, osteosarcoma, renal cell carcinoma, and bladder transitional cell carcinoma) grown in nude mice. The tumor/blood ratio detected 5 days after antibody injection, was approximately two to 12 times higher in the insulinoma compared to other organs and only in the insulinoma did 131I-A2B5 show a higher concentration than control antibody 125I-P3X63.

Adenoma, Islet Cell↗

Neuroendocrinelike (small granule) epithelial cells of the lung.

The presence of neuroendocrinelike epithelial cells in the lung of numerous species has been demonstrated by light and electron microscopy. Histochemical methods used to identify these cells have included staining with silver, amine-type fluorescence (APUD cell), periodic acid Schiff (PAS)-lead hematoxylin, and immunohistochemical localization of neuron-specific enolase. Cytoplasmic dense core vesicles (70-200 nm in diameter) have served as the major ultrastructural characteristic. Lung neuroendocrinelike cells have been shown to occur in fetal and adult mammals as solitary-type cells or as distinct organoids known as neuroepithelial bodies ( NEBs ). Although the frequency of both populations is considered low, solitary-type cells with dense-core granules can be found in as high as 5% of epithelial cells in the cricoid region of the guinea-pig larynx. The solitary cells can be found throughout the airways of mammals, whereas the NEBs are confined to the intrapulmonary airways. Unmyelinated fibers have been traced from the lamina propria and into the NEB, where they ramified between the component cells of the NEB. The function of lung neuroendocrinelike cells is not known, but morphological and cytochemical studies suggest that the NEBs are intrapulmonary chemoreceptors that can respond to changes in airway gas composition. Hypoxia or hypercapnia has been shown to decrease the amine cytofluorescence in these organoids and apparently to increase the exocytosis of dense core vesicles from the basal region of the cell. Immunohistochemical studies have suggested that some lung epithelial cells may contain a known neuropeptide(s), but further investigation is needed to confirm the presence of such compounds in lung neuroendocrinelike cells and their physiochemical properties. Apparent hyperplasia of lung neuroendocrinelike cells can occur readily in hamsters treated with diethylnitrosamine. It has been postulated that human lung tumors with endocrinelike properties, namely, bronchial carcinoids and lung small cell carcinomas, may originate from lung neuroendocrinelike cells. However, a more plausible explanation, based on cytokinetic studies of epithelial neuroendocrinelike cells in the lung and other organs, is that these cells originate from a nonneuroendocrine population. Interaction of such a progenitor cell population with selected carcinogens may lead to stimulation of the rate of normal differentiation or, alternately, to selection of an abnormal route of differentiation that possesses a neuroendocrine phenotype.

Animals↗

[The endocrine cells of the gastrointestinal epithelium and the metabolism of biogenic amines in the gastrointestinal tract (author's transl)].

After a review on the historical development of morphological investigations of entero-endocrine cells, dating back to 1870, a detailed synoptical review of the current stage of findings in this field is given. At the present time nine different endocrine cell types can be distinguished in the epithelium of the gastrointestinal tract. Criteria for this differentiation are properties concerning specific staining methods, aldehyde-induced fluorescence, immunohistochemistry, and ultrastructure. From present results it is obvious that distinct cell types are responsible for the synthesis of defined polypeptide hormones (e.g. gastrin, secretin, enterogastrone). The metabolism of amines, in relation to the endocrine cells of the gastrointestinal tract is of particular interest here. Points investigated include the uniqueness of endocrine cells, with regard to the metabolism of biogenic amines ("APUD-cells") and the possibility of serotonin synthesis by a definite cell type, i.e. by the EC-cell ("enterochromaffin" cell). In our experimental animal, male Wistarrats, seven different entero-endocrine cell types can be discerned by ultrastructural means: EC-, ECL-, G-, AL-, EG-, D- and D1-cells. The I-cell (found in other species) can hardly be distinguished from the AL-cell by ultrastructural means and the S-cells, as found in other species, are not to be found at all. Only some of the cited cell types can be seen by fluorescence microscopy. After formaldehyde-treatment of the tissue, the "enterochromaffin" cell shows a yellow, serotonin-specific fluorescence. This cell corresponds in shape, number and distribution to the ultrastructurally defined EC-cell. EC-cells are found predominantly in the pyloric region and the duodenum and less frequently in the middle- and hindgut and the cardiac region; seldomly EC-cells are encountered in the oxyntic gland area of the stomach. In the rat gastro-intestinal tract, number and fluorescent intensity of EC-cells does not always correspond with the serotonin content of a certain region--sometimes the level of serotonin is largely determined by the mast cells, which in the rat also contain serotonin. For example, the high serotonin content of the oxyntic gland area, which contains very few EC-cells, has to be contributed nearly exclusively to mast cell serotonin. Mast cells can be domonstrated by fluorescence microscopy, due to their histamine content, after treatment of the tissue with o-phthalaldehyde (OPD). It seems likely that the histamine content, especially that of the so-called "atypical mast cells" of the mucosa, is inversely related to their respective serotonin content. --In addition to mast cells, OPD-treatment leads to a fluorescence in some of the entero-endocrine cells of the gastrointestinal epithelium. In the gastric epithelium these fluorescing cells should be regarded as histamine-containing ECL-cells and glucagon-containing AL-cells while in the colonic epithelium they are considered to be glucagon-containing AL-cells...

5-Hydroxytryptophan↗

Age-related changes in the neuroendocrine (endocrine-paracrine) cell population and the serotonin content of the guinea pig prostate.

Neuroendocrine (endocrine-paracrine, APUD) cells of the guinea pig prostatic complex (prostate and coagulating gland) were studied at three age points (9-day-old weanlings, 11 to 12 week mature pre-breeders, and retired breeders) using serotonin immunocytochemistry for detection and subsequent morphometric analysis. Prostatic complex serotonin levels were determined for the same age groups using high performance liquid chromatography with electrochemical detection. The numbers of neuroendocrine (NE) cells in the prostatic complex of retired breeders was 1.42 +/- 0.29 NE cells/mm gland length (mean +/- SEM) and was increased nearly 24-fold when compared with mature pre-breeders with 0.06 +/- 0.03 NE cells/mm gland length and nearly 16-fold when compared with the weanlings with 0.09 +/- 0.04 NE cells/mm gland length. The increase in cell number in the retired breeders versus each of the other age groups was highly significant (p less than 0.001). The increase in NE cells appeared to take place exclusively in the prostate, whereas the number of NE cells in the coagulating gland were few and not significantly different in the three age groups. The number of urethral NE cells also appeared similar in all three age groups. The number of prostatic epithelial cells/gland length increased with age. The number of NE cells/100 prostatic epithelial cells was examined in the three age groups and the increase in retired breeders over the other two groups was still highly significant (p less than 0.001). Serotonin levels, which were measured for the whole prostatic complex, indicated a nearly 6-fold increase with age: retired breeders had 97.72 +/- 21.26 ng/g of wet tissue (mean +/- SEM) whereas mature pre-breeders had 17.1 +/- 2.88 ng/g of wet tissue (p less than 0.01). Weanling serotonin levels were not detectable. This dramatic age-related increase in prostatic NE cells and serotonin content could reflect a compensation for a decreased effectiveness of NE cell hormones, a nonfunctional primary hyperplasia, a hyperplasia secondary to endogenous hormonal or involutional changes or exogenous factors. Whatever the mechanism, this increase in prostatic NE cells with age is of great interest since human prostatic carcinoma and benign nodular hyperplasia are both strongly correlated with advanced age. Prostatic NE cells may, therefore, directly or indirectly be in the pathogenesis and/or evolution of these important pathologic processes.

Aging↗