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Clostridium difficile toxin A-induced microvascular dysfunction. Role of histamine.

Clostridium difficile toxin A (Tx-A) mediates secretion and inflammation in experimental enterocolitis. Intravital video microscopy was used to define the mechanisms that underlie the inflammatory reactions elicited by direct exposure of the microvasculature to Tx-A. Leukocyte adherence and emigration, leukocyte-platelet aggregation, and extravasation of FITC-albumin were monitored in rat mesenteric venules exposed to Tx-A. Significant increases in leukocyte adherence and emigration (LAE) and albumin leakage were noted within 15-30 min of Tx-A exposure. These responses were accompanied by mast cell degranulation and the formation of platelet-leukocyte aggregates. The Tx-A-induced increases in LAE and albumin leakage were significantly attenuated by pretreatment with either monoclonal antibodies (mAbs) directed against the leukocyte adhesion glycoproteins, CD11/CD18, intercellular adhesion molecule-1, and P-selectin (but not E-selectin) or with sialyl Lewis x, a counter-receptor for P-selectin. The mast cell stabilizer, lodoxamide, an H1- (but not an H2-) receptor antagonist, and diamine oxidase (histaminase) were also effective in reducing the LAE and albumin leakage elicited by Tx-A. The platelet-leukocyte aggregation response was blunted by an mAb against P-selectin, sialyl Lewis x, and the H1-receptor antagonist. These observations indicate that Tx-A induces a leukocyte-dependent leakage of albumin from postcapillary venules. Mast cell-derived histamine appears to mediate at least part of the leukocyte-endothelial cell adhesion and platelet-leukocyte aggregation by engaging H1-receptors on endothelial cells and platelets to increase the expression of P-selectin. The adhesion glycoproteins CD11/CD18 and intercellular adhesion molecule-1 also contribute to the inflammatory responses elicited by toxin A.

Animals↗

Histamine metabolism in nasal polyps.

We attempted to determine the relationship of nasal polyps to histamine (HA) metabolism. Compared to that in allergy-related nasal polyps and infection-related nasal polyps, the level of HA in aspirin-induced asthma-related polyps was significantly lower. Large differences between the groups were not observed in HA-synthesizing enzyme activity, but degradative enzyme activity was much higher in aspirin-induced asthma-related polyps than in other types of nasal polyps tested. These findings suggest the possibility that the amount of HA in polyps associated with aspirin-induced asthma was less because of greatly enhanced degradation. We found, in addition, that in nasal tissues such as polyps, histamine-N-methyl transferase, rather than histaminase, was the principal degradative enzyme.

Amine Oxidase (Copper-Containing)↗

Histamine poisoning after ingestion of spoiled raw tuna in a patient taking isoniazid.

An 83-year-old woman taking isoniazid (INH) suddenly developed a headache, palpitations, and skin eruptions with itching while eating raw tuna. The symptoms were compatible with those of histamine intoxication. When given fresh raw tuna to eat, no such reactions were evoked in this patient. The episode was speculated to be due to two conditions; eating spoiled raw tuna and at the same time being on a course of INH, a potent histaminase inhibitor. We should therefore be aware of the possible adverse effects due to the interactions between drugs and foods.

Aged↗

Review: Medullary carcinoma of the thyroid: radiographic features of a unique tumor.

Medullary carcinoma of the thyroid is a unique neoplasm characterized by consistent production of a hormonal marker, calcitonin, calcification of both primary and metastatic foci, and association with other endocrine neoplasms. It accounts for 3.5%--10% of all thyroid malignancies. First described by Hazard et al. [1] in 1959, this neoplasm has become the focus of increasing clinical and experimental investigation. It occurs both sporadically and in families. When familial, it is seen as a component of the multiple endocrine neoplasia type II (MEN-II) syndromes. Interest in medullary carcinoma of the thyroid far exceeds that warranted by its infrequent occurrence. Over 200 articles dealing with this tumor have appeared in the medical literature in the last 10 years. This may be attributed to the number of distinctive properties of the tumor: the familial occurrence when associated with endocrinopathies, the propensity to produce amyloid, and the great synthetic capability for the biogenic amines calcitonin, serotonin, histaminase, and prostaglandins. Of greatest importance is the value of calcitonin radioimmunoassay for detecting patients with the tumor even though it may be evident clinically. Fifty-three patients with surgically and biochemically proven medullary carcinoma were evaluated and followed at Duke University Medical Center from 1968 to 1981. Ten patients with sporadic tumor, 37 with MEN type IIa, and six with MEN type IIb prompted this review. They will be used to illustrate the varied and sometimes characteristic radiographic manifestations of medullary carcinoma of the thyroid. This tumor has a spectrum of radiographic features in multiple organs that, when familial, facilitate its recognition and treatment.

Adolescent↗

Histamine metabolism in normal pregnancy and in toxaemia of pregnancy.

The urinary excretion of histamine and its metabolites, methylhistamine, methylimidazoleacetic acid and imidazoleacetic acid, was measured under standardized dietary conditions in 24 women with normal pregnancies and in eleven patients with toxaemia of pregnancy. In addition, histamine metabolism was studied in five healthy women at delivery and in four other healthy pregnant women during treatment with aminoguanidine, which is an inhibitor of diamino oxidase (histaminase). A slight increase in the urinary excretion of methylimidazoleacetic acid was observed in normal pregnancy as well as in toxaemia of pregnancy compared to non-pregnant women. In two toxaemic patients and in one of the healthy subjects the urinary excretion of unmetabolized histamine was moderately increased. Despite the very high diamino oxidase activity in the plasma and in the uterus during pregnancy, there were no signs of altered catabolism of endogenous histamine in the pregnant women. Smoking increased the urinary excretion of the quantitatively dominant histamine metabolite, methylimidazolacetic acid, in pregnant subjects as it also does in nonpregnant subjects. The necessity of standardized dietary conditions in the study of histamine metabolism in man was again emphasized.

Adult↗

Histamine and secondary autoimmune infertility in dark mink (Mustela vison).

Testicular histamine content was higher in December (the time of sexual quiescence) that in March (breeding time) in opaline mink. Although testicular histamine synthesis increased in March over December, the increased cellular mass and increased histaminase activity prevented the biogenic amine from rising. Dark mink, however, had higher gonadal levels of histamine in March than in December owing to an increased rate of synthesis and a decreased rate of inactivation that correlated well with the onset of autoimmune infertility in this strain. Pastel mink were intermediate to the opalines, and dark mink indicative of strain differences in the genetic control of gonadal histamine synthesis and inactivation.

Amine Oxidase (Copper-Containing)↗

Histamine-mediated hyposmotic stimulation of gastric acid secretion.

Gastric glands incubated in hyposmotic medium (200 mOsm) accumulated aminopyrine, a measure of acid secretion, to the same extent as that of paired glands in isomotic medium containing histamine (10(-4) M). These maximal responses to hyposmolality and histamine were not additive. The hyposmotic response peaked earlier than the histamine response. Hyposmotic stimulation was nearly abolished by preincubation of the glands with metiamide and cimetidine, H-2 histamine antagonists. In the presence of histaminase, no hyposmotic stimulation occurred. The response to forskolin, a stimulant of adenylate cyclase, was equivalent in hyposmotic and isosmotic media. These results indicate that hyposmolality releases histamine from a paracrine cell in the gastric gland and that histamine binds to H-2 receptors on the parietal cell to initiate a cyclic AMP-mediated stimulation of acid secretion.

Amine Oxidase (Copper-Containing)↗

Superoxide anion radical generation during the oxidation of various amines by diamine oxidase.

Diamine oxidase (DAO) or histaminase is an enzyme which deaminates histamine and several aliphatic amines to their corresponding aldehydes. Hydrogen peroxide and ammonia are side products of this reaction. The purpose of the present work was to evaluate if determination of produced hydrogen peroxide reflects DAO activity or if intermediate formation of the superoxide radical could be a reason for lack of correspondence between oxygen uptake and hydrogen peroxide production at different pH. Superoxide radical formation was determined by cytochrome c reduction in the presence and absence of superoxide dismutase (SOD). Oxygen uptake was measured with an oxygen electrode and hydrogen peroxide production by a spectrophotometric method. At pH 6.6 there was no superoxide production, but at pH 7.4 there was some, and it increased markedly at pH 9.5. Oxygen uptake also increased with increasing pH, especially with histamine as substrate. These results lead us to suggest that the mechanism of action of DAO involves the intermediate generation of superoxide radicals.

Amine Oxidase (Copper-Containing)↗

Mechanisms of lactoferrin-induced leukocyte-endothelial cell adhesion in postcapillary venules.

OBJECTIVE: The objective is to determine the contributions of electrostatic charge, endothelial cell adhesion glycoproteins (P- and E-selectins), and histamine to lactoferrin-induced leukocyte adhesion in postcapillary venules. METHODS: Rat mesentery was prepared for intravital microscopic observation. Erythrocyte velocity, vessel diameter, leukocyte rolling velocity, number of adherent and emigrated leukocytes, and velocity, flux, and number of rolling leukocytes were monitored in mesenteric venules (25-35 microns initial diameter). After control measurements were obtained for all parameters, lactoferrin, other cationic proteins (histone or alpha-chymotrypsinogen A), or transferrin (an anionic iron-binding protein) were infused into the superior mesenteric artery, with repeat measurements taken 20 min into the infusion period. In other lactoferrin experiments, animals were treated with either a monoclonal antibody (MAb) directed against P- or E-selectin, an H1- or H2-histamine receptor antagonist, or diamine oxidase (histaminase). RESULTS: Increased numbers of rolling and adherent leukocytes were observed during infusion of lactoferrin, histone, or alpha-chymotrypsinogen A but not with transferrin. The leukocyte-endothelial cell adhesion (LECA) elicited by lactoferrin was substantially greater than that induced by histone and alpha-chymotrypsinogen A. The P-selectin MAb completely prevented lactoferrin-induced LECA, whereas the E-selectin MAb had no effect. Diamine oxidase and the H1- (but not the H2-) receptor antagonist were also effective in attenuating lactoferrin-induced LECA. CONCLUSIONS: These results indicate that lactoferrin-induced LECA results from histamine-mediated expression of P-selectin on venular endothelial cells. The cationic nature of lactoferrin accounts for only a small part of its proadhesive actions.

Animals↗

Studies of pig kidney diamine oxidase.

Preparations of pig kidney histaminase were analyzed for total compositions, N-terminal residues, patterns of tryptic peptides and for subunits under dissociating conditions. The crystalline enzyme is pure by several criteria but not completely homogeneous. It is rich in acidic or amidated residues and has a low content of cysteine/halfcystine. Preparation analyzed consistently contained a few percent of carbohydrate. Subunits are concluded to be identical or highly similar with a molecular weight of about 90 000, which is consistent with other analyses.

Amine Oxidase (Copper-Containing)↗

[Study on eosinophil cationic protein (ECP) and arylsulfatase B in nasal secretions and sera from patients with nasal allergy].

Recently four tissue toxic proteins namely major basic protein (MBP), eosinophil peroxidase (EPO), eosinophil-derived neurotoxin (EDN), and eosinophil cationic protein (ECP) were found in eosinophilic leucocytes. Although the characteristics of these proteins concerning tissue damage in the local site of type I allergic reaction have been investigated mainly in lower respiratory tract, the actual clinico-pathological roles of these proteins in nasal allergy are not clarified. Contrary, eosinophils also have histaminase, arylsulfatase, phospholipase D, which are considered to act on a negative feedback mechanism in allergic reaction through inactivation of chemical mediators. Therefore, estimation of ECP and simultaneously arylsulfatase B in nasal secretion and the sera from patients with nasal allergy may clarify the dynamics of clinico-pathological state, especially in the late phase of allergic reaction in each patients. ECP concentrations in the nasal secretions from 22 patients and in the sera from 12 patients with nasal allergy were measured by RIA method. The activities of arylsulfatase B in the nasal secretions and the sera were also estimated in the same specimens as ECP by measuring its hydrolytic activity using p-nitro cathecol sulfate as a substrate. The results obtained were as follows; 1) There was a significant correlation between ECP concentrations in the nasal secretions and the severities of clinical symptoms, especially the degree of nasal obstruction. ECP concentrations also significantly correlated to the score of eosinophilic leucocytes in the nasal smears. 2) The serum ECP concentrations significantly correlated to the number of eosinophilic leucocytes in the peripheral blood, and also showed slight tendency of correlation to the severity of clinical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Proteins↗

[Reactive hypereosinophilia in parasitic diseases].

Hypereosinophilia is often linked to the presence of pluricellular parasites in host tissues. Polynuclear eosinophils are sprung from the bone marrow. After multiplying and maturing, they are thrown into the blood flow and from the blood to the tissues where they are found in immediate contact with the parasite. Eosinophils are major components of the parasitic granuloma. Parasitic diseases are a major cause of hypereosinophilia and eosinophilia is mainly due to helminths. Protozoa do not produce hypereosinophilia, except for toxoplasmosis in which a low and discontinuous eosinophilia may be seen. Subsequently, maggots producing myiasis yield to hypereosinophilia too. In helminthiasis, the action of the eosinophil granulocyte is double. In tissues, it destroys the parasite and plays a regulatory role in mastocytes degranulation. Eosinophils which participate in the inflammatory reaction secrete factors which neutralize mediators liberated by mastocytes, histamine mainly, destroyed by histaminase. In a practical point of view, blood hypereosinophilia is a very useful tool for diagnosis. Eosinophilia reach early a high value, this before the parasitic infection becomes detectable by means of resources other than immunological. The eosinophils rates decreases rapidly as an effect of the anthelmintic drug, this confirming the efficacy and specificity of the prescribed treatment.

Diagnosis, Differential↗

Histamine content of the digestive tract of a catfish Clarias batrachus (Linn.) in relation to spawning, sex and seasonal variation.

Histamine content of the digestive tract of a catfish Clarias batrachus has been estimated biologically on the atropinized guineapig ileum. A significant decrease of histamine content has been observed with the decrease of gonosomatic index (G.S.I.) during breeding season in female fishes, while no such type of change in histamine content of male fishes during breeding season has been noted. In the summer histamine content of both the sexes was signivicantly lowered in comparison with the histamine content during breeding season in both the sexes. It is concluded that higher histamine content in prespawing female fishes during breeding season may be due to the inhibition of the enzyme histaminase by gonadotrophines. It is also suggested that the route of inactivation of histamine during breeding season may be different in both the sexes, while in summer a common factor may be involved in depletion of histamine content of both the sexes.

Animals↗

[Medullary carcinoma of the thyroid gland. Report of a case].

The case of a twelve years old boy with unilateral medullary carcinoma of the thyroid gland, whose main symptoms were cough, hemoptisis, fever and weight loss is reported. The diagnosis was made by lymph node biopsy, high levels of serum calcitonin and a positive skin test for histaminase. The main clinical, anatomical and genetic features of this tumor are discussed. The familial study did not show any other affected member. Therefore, it was considered as a sporadic case. Emphasis is made on the diagnostic methodolgy.

Adolescent↗

[Current aspects of the pathology, diagnosis and therapy of C-cell carcinoma. A symposium held in Bonn, July 1991].

An essential element in the histological differentiation of medullary thyroid cancer (MTC) from other thyroid tumors is the use of immunohistochemical methods. The detection of calcitonin in the tumor cells is decisive. Factors which impair the prognosis of MTC are age (> 40 y), male sex, elevated DNA-content and mitotic activity of the tumor cells, immunoreactivity against dopa decarboxylase, histaminase and Leu-M1-antigen. Family screening is based mainly on calcitonin-stimulation tests (using pentagastrin or calcium) as a genetic marker for routine screening is not available yet. Scintigraphic methods using 99mTc-(V)-DMSA, 201Tl-chloride or 99mTc-anti-CEA antibodies become more important, especially in the detection of recurrent disease. Selective venous blood sampling is another sensitive method for localizing recurrent disease. Surgical treatment plays the dominant role in the management of MTC. Complete thyroidectomy in conjunction with systematic lymphadenectomy is now the primary treatment of choice.

Carcinoma↗

Studies on the relationship between xanthine oxidase and histamine release during intestinal ischemia-reperfusion.

Recent studies have demonstrated a connection between xanthine oxidase-generated reactive oxygen intermediates and histamine release during ischemia-reperfusion. In the present work, the effect of modulation of the endogenous histamine level on the xanthine oxidase activity was examined during the reperfusion of a canine ileal segment following a 2 hr of complete ischemia. The xanthine oxidase activity and the plasma histamine level peaked simultaneously at the beginning of reperfusion, reaching mean values of 14.9 nmol/ml/min and 12.1 nmol/l, respectively. Pretreatment with aminoguanidine, a blocker of diamine oxidase (histaminase), resulted in significantly higher levels of histamine during reperfusion, but this elevation was not accompanied by a further increase in xanthine oxidase activity. Pretreatment with the mast cell stabilizer cromolyn significantly diminished the rise in plasma histamine level, with an unchanging activity of xanthine oxidase. No significant alteration could be observed in the postocclusive activity of xanthine oxidase following the intra-arterial administration of 0.5, 1, or 5 nmol of histamine during the last 10 min of the ischemic period. These data suggest that the amount of histamine liberated during reperfusion does not result in a further increase in the xanthine oxidase activity. The release of histamine is not a cause, but rather an effect of the elevated activity of intestinal xanthine oxidase.

Animals↗

[Effects of aminoguanidine sulfate on hepatic and blood levels of histamine after partial hepatectomy in rats].

Known as a specific inhibitor of histaminase, amino-guanidin sulfate has been administered subcutaneously to Wistar rats immediately after partial hepatectomy, then once in 16 hours until 80 hours. It has thus provoked: an initial rise of the hepatic and blood rates of histamin, which is transient and reaches its apex 6 hours after the operation; then, a new rise of these rates, which lasts and even is, in percentage, maximum at 72 hours. Therefore, amino-guanidin sulfate is available to estimate the influence of the endogenous histamin upon liver regeneration.

Amine Oxidase (Copper-Containing)↗

The clinical, biochemical, and familial presentation of type V hyperlipoproteinemia in childhood.

Primary type V hyperlipoproteinemia was identified in two preadolescent children. The propositus (kindred N) was a 10-year-old girl with severely creamy plasma, lipemia retinalis, hypertriglyceridemia (triglyceridelevel, 6,800 mg/100 ml), and ypercholesterolemia (cholesterol level, 490 mg/100 ml). Her parents and an 8-year-old sister all had endogenous hypertriglyceridemia (type IV hyperlipoproteinemia). In kindred A, an 11-year-old boy had triglyceride levels as high as 1,100 mg/100 ml and recurrent abdominal pain. His father had type V hyperlipoproteinemia; his mother was normal. All three of his older teenage siblings had type IV hyperlipoproteinemia. The enzymatic activities of lipoprotein lipase (LPL), hepatic triglyceride lipase (HTL), and histaminase (H) were studied in postheparin plasma. The LPL level was low in the children and both parents in kindred N. LPL level in kindred A was normal, except for one child with type IV hyperlipoproteinemia. HTL level was normal to above normal in both kindreds. Most patients had a normal H level, but one parent (kindred N) had no preheparin H and very low levels of postheparin H. There was a strong correlation (r = 0.58, significant at less than 1% level) between release of LPL and H but not between HTL and H (r= 0.22). The mean (+/- 1 S.D.) levels of the enzymes were as follows: LPL, 2.8 +/- 0.7 micronmol/ml/hr in kindred N and 5.4 +/- 2.2 micronmol/ml/hr in kindred A; H, 13.4 +/- 6.8 units/ml in kindred N and 22.0 +/- 11.9 units/ml in kindred A; and HTL, 18.0 +/- 7.1 micronmol/ml/hr in kindred N and 14.9 +/- 6.3 micronmol/ml/hr in kindred A. The enzymatic activities of kindreds N and A were significantly different for LPL (P less than .001) and H (.025 less than P less than .05) but not for HTL. All but one child had at least one high insulin level, which was accompanied by hyperglycemia in two children. The hypertriglyceridemia in all but one child was ameliorated on therapeutic diets. These data suggest that the genetic basis of the hypertriglyceridemia in these two families is different and that hyperchylomicronemia in childhood is not confined to the rara type I hyperliporproteinemia.

Adult↗