Viral and immunologic aspects of Epstein-Barr virus infection in pediatric liver transplant recipients

Pediatric allograft recipients in particular are at increased risk for Epstein-Barr virus (EBV)-associated disorders. Early identification and diagnosis of EBV-associated disorders is critical, since disease progression can often be halted by reduction of immunosuppression. In this study we examined viral and immunologic parameters of EBV infection in the circulation of pediatric liver recipients to identify factors associated with disease. Peripheral blood DNA from pediatric liver recipients was analyzed by PCR for the EBV genes coding for the nuclear antigen 1 (EBNA-1) and the viral capsid antigen gp220. Sequences for these viral genes could be readily detected in the circulation of 36.5% of patients. Moreover, identification of the EBV genome was associated with symptomatic infection, suggesting that circulating EBV may be a useful marker of disease. Since EBV-infected B cells release the low-affinity IgE receptor (sCD23), we measured sCD23 in the circulation of pediatric liver recipients and found it to be elevated in patients with detectable virus or symptoms of infection. However, sCD23 was also elevated in cases where no EBV was detectable, suggesting that factors other than viral infection could stimulate release of sCD23. To further characterize the immune response to EBV infection, the peripheral levels of IL-4, IL-5, IL-10, and IFN-gamma were determined in pediatric liver recipients. Each of these cytokines was elevated in patients with symptoms or circulating virus compared with stable, age-matched liver recipients. IL-4, in particular, was significantly increased, indicating an important role for this cytokine in EBV infection. Together, these findings suggest that (1) monitoring circulating levels of EBV may be useful in patients at high risk and (2) cytokines that promote B cell growth and differentiation contribute to EBV-associated disorders.     

Nodular basal cell carcinoma in vivo vs in vitro. Establishment of pure cell cultures, cytomorphologic characteristics, ultrastructure, immunophenotype, biosynthetic activities, and generation of antisera

BACKGROUND AND DESIGN: In this study we developed an in vitro model of nodular basal cell carcinoma (BCC). We obtained pure cultures of BCC cells and compared the morphologic characteristics, ultrastructure, immunophenotype, and behavior of cultured tumor cells with those of their in vivo counterparts. Tumors were excised from patients undergoing Mohs micrographic surgery. We established 69 primary cell cultures from 32 patients with nodular BCC. RESULTS: Three cell types grew in primary cultures: fibroblasts, normal-appearing keratinocytes, and cells with dual (spindle and epithelioid) morphologic characteristics. Contaminating fibroblasts were removed using 0.125% trypsin-0.02% edetic acid, and normal-appearing keratinocytes were cornified and eliminated by temporarily increasing the concentration of calcium in the growth medium. The cells with dual morphologic characteristics remained intact and exhibited relentless growth in pure cultures. That these seemingly immortal cell strains represent true nodular BCC was demonstrated by (1) their biphasic morphologic characteristics and very slow cell growth rate, (2) their capability for anchorage-independent growth in soft agar, (3) their ultrastructural similarities to freshly excised nodular BCC, (4) their ability to generate antibodies selectively labeling nodular BCC tumor nests in vivo, and (5) their immunophenotypic similarities to BCC in vivo on more than 20 different cell markers. CONCLUSIONS: This study provides a simple technique for establishing pure cell cultures of nodular BCC and describes extensively the in vitro parameters of tumor cell growth. The striking differences in behavior of cultured tumor cells in the presence or absence of normal-appearing keratinocytes suggest that normal human epidermal keratinocytes can suppress the growth of BCC cells.     

Calcium induced contracture stimulates Na,K-pump rate in isolated sheep cardiac Purkinje fibers

By keeping intracellular Na+ (aiNa) low, the Na,K-pump can prevent Ca2+ overload of cardiomyocytes. We therefore examined whether Ca2+ stimulates Na,K-pump activity in sheep cardiac Purkinje fibers. By removing Ca2+, Mg2+ and K+, the fibers depolarized and aiNa rose to 70 mM. After addition of 6 mM Mg2+ and lowering extracellular Na2+ to 29 mM, 30mM Rb+ was added, and over 10-15 min aiNa recovered to 3-7 mM. Two load-recovery cycles were conducted in 10 fibers. During one of the cycles Ca2+ (0.1-1.0 mM) was added before Rb+, causing a contracture. During recovery aiNa fell faster during Ca2+ contracture than in control cycles. Between 30 and 20 mM the rates were -10.0+/-1.6 and -5.4+/-0.6 mM/min, respectively (P<0.05). In Ca2+-exposed fibers tension fell almost parallel with aiNa. Na, K-pump reactivation caused membrane potential (Vm) to hyperpolarize transiently to -70 mV. Ca2+ did not affect membrane conductance. For a given aiNa during reactivation, Vm was more negative during Ca2+ contracture and depolarized faster (P<0.05). Intracellular pH (pHi) fell from 7.11+/-0.05 to 6.92+/-0.08 (n.s.) during control load-recovery cycles and was 6.83+/-0.14 at the end of the Ca2+ cycles. ATP content of the fibers did not change significantly through two complete load-recovery cycles, but creatine phosphate (CrP) fell by about 40%. By fitting the data to a model incorporating the Hill equation we show that during Ca2+-induced contracture maximum Na,K-pump rate (Vmax) was increased by about 40% and aiNa that causes 50% pump activation (k0.5) was lowered from 21. 2+/-1.6 to 15.5+/-1.4 mM.