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Structure of the VH and VL segments of monoreactive and polyreactive IgA autoantibodies to DNA in patients with systemic lupus erythematosus.

Anti-DNA IgA autoantibodies play an important immunopathologic role in SLE patients. To analyze the cellular origin and the VH and VL structure of anti-DNA IgA autoantibodies, we generated five IgA1 mAbs to DNA using B lymphocytes from three SLE patients. Two mAbs bound to ssDNA only and one to both ssDNA and dsDNA (monoreactive antibodies). The remaining two mAbs bound to DNA (one to ssDNA and the other to both ssDNA and dsDNA) and to other self and foreign Ag (polyreactive antibodies). The IgA mAb relative avidity for DNA ranged from 7.5 x 10(-8) to 8.0 x 10(-10) g/microliters. The anti-DNA IgA mAb used VH segments of the VHI(VI-3b), VHII (VH2-MC2), VHIII (WHG16G and VH26c), and VHIV (V71-2) families in conjunction with V kappa I, V kappa IIIb, or V lambda I segments. All IgA mAb VH segments were juxtaposed with JH4b segments. The heavy chain CDR3 sequences were divergent in composition and length. When compared with those of the closest reported germ line genes, the IgA mAb VH and VL gene sequences displayed a number of differences. That these differences represented somatic point mutations was formally proved in both the monoreactive IgA mAb 412.67.F1.3 and the polyreactive IgA mAb 412.66.F1 VH segments by differential PCR amplification and cloning and sequencing of genomic DNA from the mAb-producing cell lines and autologous polymorphonuclear cells. The sequences of the germ line genes that putatively gave rise to the mAb 412.67.F1.3 and mAb 412.66.F1 VH segments were identical with those of the WHG16G and VH26c genes, respectively. In not only the monoreactive mAb 412.67.F1.3 but also the polyreactive mAb 412.66.F1 and mAb 448.9G.F1 VH segments, the higher concentration of replacement (R) mutations and the higher R:S (silent) mutation ratios in the complementarity-determining region (infinity; 19:0) than in the framework region (1.0) (p = 0.00001, chi 2 test) were highly consistent with selection by Ag. In the five IgA mAb VH and VL segments, the putative and verified somatic point mutations yielded 68 amino acid replacements, of which 38 were nonconserved. Twenty of these yielded positively charged or polar residues that play a major role in DNA binding, including seven Arg, five Lys, three Tyr, two Gln, two His, and a Thr. The conserved amino acid changes included seven Asn. These findings suggest that anti-DNA IgA autoantibodies use a broad selection of VH and VL genes and enhance their fit for Ag by undergoing somatic hypermutation and Ag selection.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[A "scandal": segment IV and liver transplantation].

Partition right-left lobes keeps segment IV in continuity with the right liver, but interrupts its portal elements which arise from the left portal pedicle. A precise anatomical investigation shows that the venous inflow is totally interrupted. In 12.15% of the cases (n = 107) the biliary duct from segment IV enters close to the upper biliary confluent, into the confluent or the main duct, and can be preserved in such a bipartition; in all other cases the segment is no longer in function and doomed to atrophy. In 10.75% of the livers (n = 99), the segmental artery comes from the right hepatic stem, and the segment is correctly vascularized; but in most cases interruption of both the artery and the portal branches leads to immediate necrosis, which may be lethal. Preservation of both artery and biliary ducts is possible in only 2.15% of the cases (n = 93 casts with correct injection of arteries and ducts). Consequently the partition right-left lobes is possible in only a few cases: cholangiography and arteriography detect the favourable dispositions. In all other cases such partition is forbidden. Procurement of the left lobe from a living donor with preservation of segment IV is rarely possible, such cases being detected by a thorough pre-operative vasculo-biliary investigation: the left lobe is harvested, and segment IV left in situ (2.15% of the cases). Usually the prospective of rapid necrosis or secondary atrophy commands resection of the segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Biliary Tract Surgical Procedures↗

Different clinicopathological types of segmental sclerosing glomerular lesions in adults.

Renal biopsies and kidneys from 111 adult patients with segmental sclerosing glomerular lesions were put into different morphological groups by pathologists unaware of clinical findings. 'Overload changes' (n = 11) were large glomeruli with hilar lesions. Ten of these patients had reduced renal mass. In the 'glomerular tip lesion' (n = 10) there were changes at the tubular origin in otherwise normal glomeruli. All patients in this group had the nephrotic syndrome, completely responsive to steroids. 'Mesangial hypercellularity with diffuse segmental changes at the glomerular tip', corresponding to 'early classical focal segmental glomerulosclerosis' (n = 18), differed from the glomerular tip lesion in that glomeruli were larger and hypercellular. Most patients with this classification had the nephrotic syndrome, several were given additional immunosuppression, and less than half had complete remission. 'Diffuse multiple segmental lesions', corresponding to 'late classical focal segmental glomerulosclerosis' (n = 16), presented usually with the nephrotic syndrome, and most of these patients had no response to immunosuppression. Unlike most other groups, in 'focal segmental sclerosing lesions' (n = 56) there were genuinely focal lesions, not in every glomerulus. Most patients had asymptomatic proteinuria. Pathological study is able to classify segmental lesions that would often be grouped as 'focal segmental glomerulosclerosis' into types with different pathogenesis, clinical findings, appropriate treatment, response to treatment, and prognosis.

Adolescent↗

Analysis of Ig H chain gene segment utilization in human fetal liver. Revisiting the "proximal utilization hypothesis".

The utilization of Ig H chain gene segments during ontogeny is postulated to result from an immature recombination machinery that preferentially rearranges genes according to chromosomal position. We have tested the "proximal utilization hypothesis" using the two functional members of the VH5 family as a model. Nucleotide sequence analyses of transcripts involving these VH gene segments in 11- to 12-wk fetal liver samples revealed that they were utilized frequently, even though they are 500 kb apart. Although 50% of the H chain rearrangements in our study use the DQ52 gene segment, the most 3' end proximal human D segment, the preference for rearranging D gene segments based on 3' end proximity does not apply to other D segments because different members of the DLR family that are interspersed throughout the D locus are equally rearranged in our sample. The recurrent utilization of the DQ52 and JH4 gene segments and a propensity to preserve the two nucleotides flanking the 3' end of the VH gene segment to generate the amino acid residue at the V-D junction appear to be the major biases in the generation of an otherwise diverse fetal repertoire.

Amino Acid Sequence↗

Genetic control of segmentation in the vertebrate hindbrain.

Studies of cell commitment and gene expression suggest that the subdivision of the hindbrain into segments and the specification of their anteroposterior identity emerges from a prepattern in the early neural plate. This prepattern imposes a regional specification, but not a commitment of individual cells to specific segments, and may involve the spatial expression of the Krox-20 and Hox genes. The generation of null mutants has shown that the Krox-20 gene is required for the formation of definitive r3 and r5, and the Hoxa-1 gene is required for r4 and r5 development. A mouse mutant, kreisler, has disrupted hindbrain segmentation, with r5 and r6 failing to form. Studies of gene expression in these mutants suggest that the kreisler gene has an early role, whereas the Krox-20 and Hoxa-1 genes have later roles in the formation of definitive segments. I propose that a community effect of cell-cell signaling may underlie the commitment of cells to specific segments and discuss the implications of this for the phenotype of segmentation mutants. The receptor tyrosine kinases encoded by the Sek-1, Sek-2, Sek-3, and Sek-4 genes are segmentally expressed and could mediate cell-cell interactions that regulate cell commitment and hindbrain segmentation.

Animals↗

Orientation, density and size as cues to texture segmentation in kittens.

The ability of kittens (45-135 days of age) to segment images based on textural differences was examined using a two-alternative forced-choice procedure on the jumping stand. Tasks based on 3 textural cues--element size, element density and element orientation--were presented concurrently in a within-subject design. Texture segmentation based on element size appeared as early as 47 days of age, and segmentation based on element density as early as 57 days. In both cases, onset age varied with the specific stimulus parameters. Segmentation based on a 90 deg difference in element orientation did not appear until after 90 days and its time of appearance was independent of element size over a 2 octave range. For all segmentation cues, age was a more powerful determinant of when a task would be solved than was amount of training. The late onset of segmentation based orientation, relative to other cues, closely parallels recent findings in human infants. This evidence of differences in developmental time course provides strong support for the idea that texture segmentation based on orientation differences does not share a common neural substrate with texture segmentation based on other visual cues.

Aging↗

Inferior wall acute myocardial infarction with one-lead ST-segment elevation: electrocardiographic distinction between a benign and a malignant clinical course.

BACKGROUND: In most clinical trials, ST-segment elevation in two contiguous leads is required for diagnosis of acute myocardial infarction (AMI). This study describes the clinical course of patients with inferior wall AMI with one-lead ST-segment elevation in lead L3 in the initial ECG. METHODS: Of 394 consecutive patients with inferior wall AMI, 31 (7.8%) had an initial ECG showing ST-segment elevation (+/- 1 mm) only in lead L3 (ST < 1 mm in leads L2 and aVF) and upright T waves in inferior leads. Patients were categorized into three groups: (I) no precordial ST-segment depression (n = 6), (II) maximal precordial ST-segment depression in leads V1-V3 (n = 4), and (III) maximal precordial ST-segment depression in leads V4-V6 (n = 21). RESULTS: Patients in group III developed severe heart failure (pulmonary edema or cardiogenic shock) six times more frequently than those in groups I-II (62 versus 10%). Among patients who underwent coronary angiography, three-vessel coronary artery disease (> 50% stenosis) was more common in group III. Five of six patients in group III who underwent emergency angioplasty of the right coronary artery because of cardiogenic shock survived. CONCLUSION: Patients with inferior wall AMI and an initial ECG with ST-segment elevation only in lead L3, and maximal precordial ST-segment depression in leads V4-V6, are at risk of severe complications, especially heart failure, but their clinical course may be ameliorated by employing an aggressive interventional strategy.

Adult↗

Natural variability in the number of dendritic segments: model-based inferences about branching during neurite outgrowth.

A study was made of the possible basis for naturally occurring variations in the number of segments in individual dendritic trees. Distributions of the number of terminal segments have been studied in dendrites from rat, cat, and frog motoneurons, basal dendrites from rat visual cortex pyramidal and non-pyramidal neurons, in rat cerebellar Purkinje cell dendritic trees, and in human hippocampal dentate granule cells. By means of a mathematical model for dendritic branching, it was shown that the variation in the number of dendritic segments can be accounted for by assuming that new branches during neurite outgrowth are formed randomly at terminal segments. The observed terminal segment number distributions could be closely approximated by additionally assuming that branching probabilities decline with increasing number of terminal segments in growing dendrites. The pyramidal neuron group differed significantly from the other neuron groups in such a way as to suggest that this decline is stronger than in the dendrites of other types of neurons. By using literature data on the mean number of terminal segments in rat cerebellar Purkinje cells, measured at different times during early development, an estimate could be obtained of the time-course of the branching probabilities. The branching probability of a terminal segment was found to be in the order of 0.002 per hour in the first 4 weeks postnatal with a 5-fold transient increase in the second week.

Animals↗

Optimization of the scintigraphic segmental anatomy of the lungs.

UNLABELLED: Accurate and reproducible reporting of lung scintigraphy is predicated on a sound knowledge of the segmental anatomy of the lungs. A limited amount of hard data exists about the true segmental anatomy of the lungs. A virtual model of human lungs was created using a CT-based dataset and a Monte Carlo simulation technique to examine the optimal projections for the visualization of each segment in the lungs. METHODS: Segmental anatomy of the lungs was modeled using CT, cadaveric lungs and standard anatomical texts. The emission, scatter and attenuation of photons was modeled within these virtual lungs and the surrounding tissues. Single segmental lesions were created in eight projections and submitted for blinded reporting to four experienced nuclear medicine physicians to obtain the best views for each segment. RESULTS: The anterior and posterior oblique projections yielded the best views for 10 of 18 segments, with the laterals contributing four views, the anterior contributing two views and the posterior contributing one view. The majority of basal segments (six of nine) were best seen in the anterior and posterior oblique projections. CONCLUSION: This model overcomes the major problems associated with experimentation in the normal human and has the potential to provide answers to the major problems of scatter, attenuation and "shine-through" in lung scintigraphy.

Cadaver↗

Incidence and long-term significance of transient ST segment deviation in hemodialysis patients.

Coronary artery disease is a frequent complication of end-stage renal disease (ESRD). ST segment depression on ambulatory electrocardiography without patient awareness is a marker of what has been termed "silent ischemia". It has been suggested that in patients with coronary artery disease these transient ST segment depressions are associated with increased cardiovascular mortality. Up to 30% of patients with ESRD may display transient ST segment depression, however the significance of this finding in these group of patients who frequently have associated LV hypertrophy, and rapid electrolyte changes has not been clear. We therefore set out to determine the incidence of transient ST segment depression during ambulatory Holter monitoring in 70 consecutively studied hemodialysis patients. Sixty-seven patients wore the monitor for at least 12 hours and 16 patients (23%) demonstrated at least one minute of 1 mm ST segment depression. The presence of clinically apparent coronary artery disease, diabetes, left ventricular hypertrophy, sex or race were not significantly associated with the probability of demonstrating transient ST segment depression. The survival of patients with or without transient ST segment depression was the same at 2 years with 70% of patients remaining free of death, nonfatal myocardial infarction, or coronary bypass grafting. We conclude that patients with ESRD frequently demonstrate transient ST segment depression, however, the presence of these findings on ambulatory Holter monitoring does not appear to be associated with increased long-term mortality.

Case-Control Studies↗

Different roles of histamine receptor subtypes in ampullar & isthmic segments of human fallopian tube.

We have studied the influence of both menstrual cycle phase and subtype-selective histamine antagonists on the contractions produced by histamine isolated in human fallopian tubes. Histamine produced tonic contractions of the isolated preparations of both the ampullar and isthmic segments of the human fallopian tube were analyzed. The effects of both histamine and its antagonists were not dependent on the phase of the menstrual cycle. The isolated preparations of the ampullar segment from post menopausal patients were not responsive on histamine. When responding, the ampullar segments were slightly more sensitive to histamine than the isthmic segments. All three subtype selective histamine antagonists (pyrilamine, cimetidine and thioperamide) produced strong inhibition of histamine evoked contractions of the ampullar segment. On the other hand, only pyrilamine strongly inhibited histamine evoked contractions of the isthmic segment. The results of our study suggest that only H1 receptors were responsible for the histamine contractile effect on the isthmic segment and that all three subtypes of histamine receptors were involved in the effect of histamine on the ampullar segment of human fallopian tube.

Adult↗

Structure and genomic organization of a second cluster of immunoglobulin heavy chain gene segments in the channel catfish.

The structure, organization, and partial sequence of a 25-kb genomic region containing a second cluster of H chain gene segments in the channel catfish (Ictalurus punctatus) has been determined. Multiple VH gene segments, representing different VH families, are located upstream of a germline-joined VDJ. The VDJ segment has a split leader sequence and a single open reading consistent with that expressed in members of the VH1 family. Downstream of the germline-joined VDJ is a single JH segment and two pseudogene exons structurally similar to the Cmu1 and Cmu2 exons of the functional gene. Both pseudogene exons are multiply crippled with RNA splice sites destroyed, and open reading frames are interrupted by termination codons, insertions, and/or deletions. Sequence alignment of a 10.8-kb region within the second H chain cluster with the genomic sequence of the nine JH segments and the functional Cmu within the first H chain gene cluster indicates that the second H chain gene cluster probably arose by a massive duplication event. The JH region of the VDJ, the coding and flanking regions of the single JH segment, and the pseudogene Cmu exons were readily aligned with homologous segments in the first gene cluster. This duplication event may have extended to include the upstream VH segments. A member of the Tc1 mariner family of transposable elements is located downstream of the pseudogene Cmu2, which suggests that the transposition may have contributed to the evolution of the duplicated Cmu.

Amino Acid Sequence↗

Opsin-immunoreactive outer segments in the pineal and parapineal organs of the lamprey (Lampetra fluviatilis), the eel (Anguilla anguilla), and the rainbow trout (Salmo gairdneri).

The pineal complex of Lampetra fluviatilis, Anguilla anguilla and Salmo gairdneri was studied by means of the indirect immunohistochemical antiopsin reaction. Opsin-immunoreactive material was demonstrated in the outer segments of the photoreceptor cells in the pineal organ of all three species investigated. In the lamprey, the opsin-positive outer segments were located in the lumen of the pineal vesicle and atrium. In the two teleost species, the immunoreactive outer segments were observed in abundance in the pineal end-vesicle and stalk. These structures were found to accumulate in the prominent initial portion of the pineal stalk of the eel. In the rainbow trout, immunoreactive outer segments occurred in the wide orifice of the pineal recess at the roof of the third ventricle. In addition, outer segments of photoreceptor cells of the parapineal organ ("parapinealocytes") displayed opsin immunoreactivity. In the lamprey, opsin immunoreactivity was restricted to the central portion of the ventral parapineal retina, while the parapinealocytes in the lateral portions did not bind the antibody. In the two teleosts, immunoreactive outer segments displayed a scattered pattern. These immunocytochemical results provide direct evidence that the photosensitivity of the pineal demonstrated electrophysiologically in lampreys and teleosts (cf. Dodt 1973) is based on an opsin-containing photopigment. The presence of opsin in cells of the parapineal organ strengthens the view that also this organ may be capable of direct light perception. In the lamprey, the exclusive opsin immunoreactivity of a circumscribed group of parapineal cells suggests the existence of two types of parapinealocytes. The significance of opsin-containing photoreceptor outer segments occurring in the most proximal portion of the teleost pineal stalk is discussed, especially with regard to the interpretation of results obtained from pinealectomy experiments.

Animals↗

Regulation of bovine rod outer segment membrane guanylate cyclase by ATP, phosphodiesterase and metal ions.

In vertebrate retina, rod outer segment is the site of visual transduction. The inward cationic current in the dark-adapted outer segment is regulated by cyclic GMP. A light flash on the outer segment activates a cyclic GMP phosphodiesterase resulting in rapid hydrolysis of the cyclic nucleotide which in turn causes a decrease in the dark current. Restoration of the dark current requires inactivation of the phosphodiesterase and synthesis of cyclic GMP. The latter is accomplished by the enzyme guanylate cyclase which catalyzes the formation of cyclic GMP from GTP. Therefore, factors regulating the cyclase activity play a critical role in visual transduction. But regulation of the cyclase by some of these factors--phosphodiesterase, ATP, the soluble proteins and metal cofactors (Mg and Mn)--is controversial. The availability of different types of cyclase preparations, dark-adapted rod outer segments with fully inhibited phosphodiesterase activity, partially purified cyclase without PDE contamination, cloned rod outer segment cyclase free of other rod outer segment proteins, permitted us to address these controversial issues. The results show that ATP inhibits the basal cyclase activity but enhances the stimulation of the enzyme by soluble activator, that cyclase can be activated in the dark at low calcium concentrations under conditions where phosphodiesterase activity is fully suppressed, and that greater activity is observed with manganese as cofactor than magnesium. These results provide a better understanding of the controls on cyclase activity in rod outer segments and suggest how regulation of this cyclase by ATP differs from that of other known membrane guanylate cyclases.

3',5'-Cyclic-GMP Phosphodiesterases↗

Distribution of syndecans 1-4 within the anterior segment of the human eye: expression of a variant syndecan-3 and matrix-associated syndecan-2.

Control of the actomyosin network plays a role in regulating the movement of aqueous humor through the anterior segment of the eye. Receptors that could control its activity are unknown. In this study, we show that all four members of the syndecan family, which can regulate the actomyosin network, are present within the anterior segment. In both sections of human anterior segments and cultures of human trabecular meshwork (HTM), Schlemm's canal (HSC) and the ciliary muscle (HCM) cells from the anterior segment, syndecans-3 and -4 were the predominant family members. They were widely distributed throughout the anterior segment. Syndecan-3 within the anterior segment was a novel, recently described variant 55 kDa form. Low levels of syndecans-1 and -2 were also observed in situ and in all three cultures. Their expression was weaker and more localized than that observed for syndecans-3 and -4. Staining for syndecan-1 in HCM cultures was variable. In HTM and HSC cultures, syndecan-2 also co-distributed with fibronectin, laminin and type IV collagen suggesting that it was shed and associated with the extracellular matrix. Western blots supported this idea and showed syndecan-2 ectodomains in lysates from anterior segments.

Adolescent↗

Protein complement of rod outer segments of frog retina.

Rod outer segments (ROS) from frog retina have been purified by Percoll density gradient centrifugation, a procedure that preserves their form and intactness. One- and two-dimensional electrophoretic analysis reveals a smaller number of proteins than is observed in many cell organelles and permits quantitation of the 20 most abundant polypeptides. Rhodopsin accounts for 70% of the total protein (3 X 10(9) copies/outer segment), and approximately 70 other polypeptides are present at more than 6 X 10(4) copies/outer segment. Another 17% of the total protein is accounted for by the G-protein (3 X 10(8) copies/outer segment) that links rhodopsin bleaching and the activation of cyclic GMP phosphodiesterase (PDE). The phosphodiesterase accounts for 1.5% of the protein (1.5 X 10(7) copies/outer segment), and a 48,000-dalton component that binds to the membrane in the light accounts for a further 2.6%. The function of approximately 90% of the total protein in the outer segment is known, and two-thirds of the non-rhodopsin protein is accounted for by enzyme activities associated with cyclic GMP metabolism. The relative molar abundance of rhodopsin, G-protein, and PDE is 100:10:1. Apart from these major membrane-associated proteins, most of the other proteins are cytosolic. Thirteen other polypeptides are found at an abundance of one or more copies per 1000 rhodopsins, nine soluble and four membrane-bound, and their abundance relative to rhodopsin has been quantitated. ROS have been separated into subcellular fractions which resolve three classes of soluble, extrinsic membrane, and integral membrane proteins. A listing of the proteins that are phosphorylated and their subcellular localization is given. Approximately 25 phosphopeptides are detected, and most are in the soluble fraction. Fewer phosphorylated proteins are associated with the purified outer segments than with crude ROS. Distinct patterns of phosphorylation are associated with intact rods incubated with [32P]Pi and broken rods incubated with [gamma-32P]ATP.

Animals↗

The effect of alpha tocopherol, all-trans retinol and retinyl palmitate on the non enzymatic lipid peroxidation of rod outer segments.

The effect of a tocopherol, all-trans retinol and retinyl palmitate on the non enzymatic lipid peroxidation induced by ascorbate-Fe2+ of rod outer segment membranes isolated from bovine retina was examined. The inhibition of light emission (maximal induced chemiluminescence) by alpha tocopherol, all-trans retinol and retinyl palmitate was concentration dependent. All trans retinol showed a substantial degree of inhibition against ascorbate-Fe2+ induced lipid peroxidation in rod outer segment membranes that was 10 times higher than the observed in the presence of either at tocopherol or retinyl palmitate. Inhibition of lipid peroxidation of rod outer segment membranes by alpha tocopherol and retinyl palmitate was almost linear for up to 0,5 micromol vitamin/mg membrane protein, whereas all-trans retinol showed linearity up to 0,1 micromol vitamin/mg membrane protein. Incubation of rod outer segments with increasing amounts of low molecular weight cytosolic proteins carrying I-[14C] linoleic acid, [3H] retinyl palmitate or [3H] all-trans retinol during the lipid peroxidation process produced a net transfer of ligand from soluble protein to membranes. Linoleic acid was 4 times more effectively transferred to rod outer segment membranes than all-trans retinol or retinyl palmitate. Incubation of rod outer segments with delipidated low molecular weight cytosolic proteins produced inhibition of lipid peroxidation. The inhibitory effect was increased when the soluble retinal protein fraction containing alpha tocopherol was used. These data provide strong support for the role of all-trans retinol as the major retinal antioxidant and open the way for many fruitful studies on the interaction and precise roles of low molecular weight cytosolic retinal proteins involved in the binding of antioxidant hydrophobic compounds with rod outer segments.

Animals↗

Transgenic mice carrying the dominant rhodopsin mutation P347S: evidence for defective vectorial transport of rhodopsin to the outer segments.

To explore the pathogenic mechanism of dominant mutations affecting the carboxyl terminus of rhodopsin that cause retinitis pigmentosa, we generated five lines of transgenic mice carrying the proline-347 to serine (P347S) mutation. The severity of photoreceptor degeneration correlated with the levels of transgene expression in these lines. Visual function as measured by the electroretinogram was approximately normal at an early age when there was little histologic evidence of photoreceptor degeneration, but it deteriorated as photoreceptors degenerated. Immunocytochemical staining showed the mutant rhodopsin predominantly in the outer segments prior to histologically evident degeneration, a finding supported by quantitation of signal intensities in different regions of the photoreceptor cells by confocal microscopy. A distinct histopathologic abnormality was the accumulation of submicrometer-sized vesicles extracellularly near the junction between inner and outer segments. The extracellular vesicles were bound by a single membrane that apparently contained rhodopsin as revealed by ultrastructural immunocytochemical staining with anti-rhodopsin antibodies. The outer segments, although shortened, contained well-packed discs. Proliferation of the endoplasmic reticulum as reported in Drosophila expressing dominant rhodopsin mutations was not observed. The accumulation of rhodopsinladen vesicles likely represents aberrant transport of rhodopsin from the inner segments to the nascent disc membranes of the outer segments. It is possible that photoreceptor degeneration occurs because of a failure to renew outer segments at a normal rate, thereby leading to a progressive shortening of outer segments, or because of the loss of cellular contents to the extracellular space, or because of both.

Animals↗