Changes of plasma lipids and lipoprotein levels during danazol treatment for endometriosis

Previous data of lipid and lipoprotein level changes with the application of danazol, an isoxazol derivative of 17-alpha-ethinyl testosterone, have been conflicting. We measured cholesterol, triglycerides, low density lipoproteins and high density lipoproteins, estradiol and progesterone in 62 patients treated for endometriosis with danazol 600 mg daily. The fasting blood samples were taken before, every month during danazol medication, and 4, 12 and 24 weeks after cessation of therapy. Inconsistent changes in total cholesterol and triglyceride levels were observed. The data showed a constant, though not significant increase of the mean LDL levels. Plasma HDL decreased approximately 45% during the first two months of danazol influence and remained constantly low for the rest of the treatment. The atherogenic ratio (LDL:HDL) was doubled by-danazol. Five patients developed a reversible type IIa hyperlipoproteinemia. The plasma levels of estradiol decreased, but showed normal midfollicular values during the treatment period. In contrast, the plasma levels of progesterone fell significantly and were sometimes undetectable. These findings demonstrate an atherogenic potential of danazol, especially when long term treatment is taken into consideration.     

Long-term suppression of pituitary-gonadal function with three-month depot of leuprorelin acetate in a girl with central precocious puberty

OBJECTIVE: The efficacy of a 3-month depot preparation of the GnRH agonist leuprorelin acetate in central precocious puberty was studied. METHODS: Treatment with a 3-month depot of leuprorelin acetate was performed subcutaneously in a 7.3-year-old girl with central precocious puberty. RESULTS: During treatment the hormonal suppression was constant and complete as demonstrated by suppressed GnRH stimulation tests and prepubertal estradiol plasma levels. The size and volume of the uterus and ovaries returned to the normal range. The rate of bone maturation was significantly reduced with a ratio deltaBA/deltaCA of 0.58 for 3 treatment years. Thus, the effects of treatment were comparable to those reported for treatment with 1-month depot of GnRH agonists. CONCLUSION: Three-month depots have the advantage of a prolonged injection interval which is more convenient for the patients and reduces costs by necessitating fewer visits to the physician and being approximately 10% cheaper than the 1-month depot. We suggest that comparative and randomized studies be performed to make 3-month depots of GnRH agonists available for routine use in children with central precocious puberty.     

Measles virus-induced changes in leukocyte function antigen 1 expression and leukocyte aggregation: possible role in measles virus pathogenesis.

Measles virus (MV) infection of U937 cell or peripheral blood leukocyte cultures was shown to induce changes in the expression of leukocyte function antigen 1 (LFA-1) and cause marked aggregation of these cells. Addition of selected monoclonal antibodies specific for LFA-1 epitopes that did not neutralize MV in standard neutralization assays were found to block both virus-induced leukocyte aggregation and virus dissemination. These data suggest that MV modulation of LFA-1 expression on leukocytes may be an important step in MV pathogenesis.     

Improvement in circulating superoxide dismutase levels: role of nonsteroidal anti-inflammatory drugs in rheumatoid arthritis

Superoxide anion radical plays a significant role in inflammation, like rheumatoid arthritis. Superoxide dismutase enzyme known to dismutate superoxide anion radical does not play any significant role in this multisystem disease. This paper reports that very low levels of circulating superoxide dismutase levels are observed in patients with rheumatoid arthritis and these levels significantly improve with NSAID therapy. The possible mechanism of the action is discussed.     

Direct effect of danazol on endometrial hyperplasia in adenomyotic women: treatment with danazol containing intrauterine device

It is well known that danazol has a direct effect on endometriosis tissue and cell. We have been treating adenomyotic women with danazol containing intrauterine device (D-IUD) from June 1993 to August 2000 and significant decrease of dysmenorrhea and serum CA-125 levels were observed. Of fifty-nine adenomyotic women, eight women were also diagnosed by endometrial biopsy as endometrial hyperplasia and one woman was diagnosed as atypical endometrial hyperplasia. In these endometrial hyperplastic patients, endometrial tissues were obtained before insertion and at the time of removal or exchange of D-IUD and examined pathologically. In all of the 9 women, histopathological findings of endometrial hyperplasia disappeared after D-IUD treatment. In particular, in one patient, findings of atypical endometrial hyperplasia also disappeared after D-IUD treatment. She is now closely observed at our clinic using D-IUD. By these evidences, we postulate that D-IUD is one of the treatment choices of endometrial hyperplasia given exposure of the endometrium to such an extraordinary high concentration of danazol released by D-IUD and avoidance of adverse effects of oral danazol or general administration of GnRH and progesterone. In particular, in atypical endometrial hyperplasia case, its mechanisms might give great benefit to patient. However, mechanisms of direct effect of danazol on endometrial hyperplasia remain to be elucidated in the future study.     

Association of human leukocyte antigen E polymorphism with human cytomegalovirus reactivation in Chinese burn patients

The seroprevalence of human cytomegalovirus （HCMV） in adults increased steadily from 55% in developed countries to over 90% in developing countries like China [1]. As all her- pesviruses, HCMV establishes lifelong latency after primary infection. In immunocompetent individuals, host immune responses prevent the development of overt HCMV diseases. However, in immunoeompromised people who suffer from burn injuries, HCMV reactivation has been shown to lead to significant diseases with considerable morbidity and mortal- ity [2-4]. Recently, increasing evidence has suggested that HCMV reactivation might have been considerably underesti- mated in burn patients [5,6]. Review of the available litera- ture identifies 〉50% of HCMV antibody-positive burn patients may reactivate this virus [5,6]. Although the exact mechanisms of HCMV reactivation are still not clearly under- stood, the immune system and host genetics are thought to be the non-behavioral factors determining the acquisition of a reactivation.     

Cadmium and mercury levels in saudi women and its possible relationship with hypertension

The association between elevated blood pressure and blood cadmium and mercury levels was examined (2001–2002) in 185 Saudi women previously selected for a case-control study of lead and hypertension risk. Blood pressure was measured twice according to the World Health Organization recommendations. Cadmium and mercury were determined with graphite furnace and hydride system-atomic absorption spectrometry, respectively. Mean blood cadmium concentrations were 0.874±0.995 μg/L in hypertensive and 0.785±0.665 μg/L in controls. While blood mercury concentrations for hypertensives and controls were 3.506±3.617 μg/L and 3.687±3.186 μg/L, respectively. Participants were classified according to the median of blood cadmium and mercury levels. After adjustment for potentially confounding variables, the final logistic regression analyses revealed that women with blood cadmium ≥0.627 μg/L were 3.934 times were more likely to be hypertensive than those with blood cadmium levels <0.627 μg/L, although this was marginally significant (p=0.098). This was likely the result of the small number of subjects, resulting in the weak power to detect a strong significant difference between hypertensives and control cases. On the other hand, the final regression model showed no association between hypertension and mercury. However, this finding should not be conclusive because of the inappropriate choice of the biomarker indicator. Nevertheless, our study supports the hypothesis that exposure to cadmium might increase the risk of hypertension.     

Expression of human leukocyte antigen G is associated with prognosis in nasopharyngeal carcinoma

Human leukocyte antigen G (HLA-G) has multiple immune regulatory functions including the induction of immune tolerance in malignancies. The roles of HLA-G have not been investigated in nasopharyngeal carcinoma (NPC). This study is aimed to evaluate the role of HLA-G as prognostic factor for NPC patients as well as its role in the immune regulation. Western assays showed high HLA-G expression in NPC cell lines, but low in the immortalized nasopharyngeal epithelial cell line NP69. HLA-G protein was further detected in 79.2% of 552 NPC specimens with immunohistochemistry (IHC), but not in normal nasopharyngeal epithelium tissue. Moreover, high expression of HLA-G predicted poor survival of NPC patients and positively correlated with tumor N classification and recurrence or metastasis. Multivariate analysis indicated that HLA-G was an independent and unfavorable prognostic factor. Furthermore, the presence of CD68+ macrophages and IL-10 were also examined, which are two prognostic markers of NPC and important factors for regulating immune surveillance. The correlations of HLA-G with these two immune factors were revealed in NPC tissues. Taken together, our results suggest that HLA-G is an independent biomarker for NPC prognosis, and HLA-G might contribute to NPC progression, which might jointly regulate immune surveillance in NPC together with macrophages and IL-10.     

The role of circulating antigen in the formation of immune deposits in experimental membranous nephropathy

To investigate the role of circulating antigen in the formation of subepithelial immune deposits in the Heymann rat model of membranous nephropathy, the renal uptake and site of renal deposition of intravenously injected renal tubular antigen (F X 1A) was studied. F X 1A, (15, 30, 60, and 600 micrograms) radiolabeled with 125I, and bovine serum albumin (BSA; 15 micrograms) labeled with 131I were intravenously injected into naive rats. Plasma clearance and organ uptake of brush border antigens were determined. Of the injected F X 1A, 75% was cleared from the circulation by 1 hr as compared to 10% of the BSA. Uptake of F X 1A by heart, lung, and spleen was less than 1% at all doses studied. Renal uptake of F X 1A (29.8 micrograms/g tissue) was greater than that for liver (4.75 micrograms/g), spleen, heart, and lung (each less than 1 microgram/g tissue). Evaluation of washed renal homogenate and isolated glomeruli confirmed specific tissue-associated F X 1A antigen. Direct immunofluorescence demonstrated deposits of F X 1A antigen along the glomerular capillary wall in animals injected with F X 1A. Small scattered electron dense deposits were demonstrated in the subepithelial space. Similar binding could be reproduced in vitro by incubating cryostat sections of normal rat kidney or isolated glomeruli with solubilized F X 1A antigens. Direct binding of a tubular antigen to a constituent of the glomerulus could initiate in situ immune complex formation, and may explain the variably demonstrable "cross-reactivity" of the Heymann antibody with the glomerular capillary wall.     

Enhanced antibody response to a detergent-soluble antigen in human filariasis after treatment with diethylcarbamazine

An antigen fraction has been isolated from the water insoluble component of cattle filarial parasiteSetaria digitata by detergent NP-40 solubilization, precipitation with ammonium sulphate and fractionation on sephadex G-100. Immunoglobulin G response to the isolated antigenic fraction was selectively suppressed in asymptomatic microfilaraemic people in comparison to the amicrofilaraemic groups of endemic normals and chronic patients. However, treating microfilaraemic people with diethylcarbamazine enhanced the antibody levels by 10-fold. These results suggest that active infection suppresses the response induced by the isolated antigenic fraction which is elevated after clearance of microfilariae.     

Characterisation of a secretory antigen from Toxoplasma gondii and its role in circulating antigen production

Hughes H. P. A. and van Knapen F. 1982. Characteristics of a secretory antigen from Toxoplasma gondii and its role in circulating antigen production. International Journal for Parasitology12: 433–437. In vitro culture of RH Toxoplasma gondii in HEp2 cells was found to yield an antigen, of mol. wt. 324,000 dallons, which is one of the components of circulating antigen (CAg). Hydrophobic interaction electrophoresis of ¹²⁵I labelled solubilised parasites has shown that this antigen, in common with the other CAg component, is of intracellular origin. Cyclophosphamide had no effect on either parasite proliferation or on secretion of antigen in vitro. Although immune lysis appears to be the major pathway of CAg release in vivo, secretion by the parasite may be important in the expression of CAg in serum and body fluids immediately following infection.     

The role of inflammatory and anti-inflammatory cytokines in the pathogenesis of human tegumentary leishmaniasis

In tegumentary leishmaniasis caused by Leishmania braziliensis, there is evidence that increased production of IFN-γ, TNF-α and absence of IL-10 is associated with strong inflammatory reaction and with tissue destruction and development of the lesions observed in cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML). We evaluate the role of regulatory cytokines and cytokine antagonists in the downregulation of immune response in L. braziliensis infection. Peripheral blood mononuclear cells from CL and ML were stimulated with soluble Leishmania antigen in the presence or absence of regulatory cytokines (IL-10, IL-27 and TGF-β) or antagonists of cytokines (α-TNF-α and α-IFN-γ). Cytokines production (IL-10, IL-17, TNF-α and IFN-γ) was measured by ELISA. IL-10 and TGF-β downmodulate TNF-α and IL-17 production, whereas IL-27 had no effect in the production of TNF-α, IFN-γ and IL-17 in these patients. Neutralization of TNF-α decreased IFN-γ level and the neutralization of IFN-γ decreased TNF-α level and increased IL-10 production. This study demonstrate that IL-10 and TGF-β are cytokines that appear to be more involved in modulation of immune response in CL and ML patients. IL-10 might have a protective role, since the neutralization of IFN-γ decreases the production of TNF-α in an IL-10-dependent manner.     

Interleukin-1 receptor antagonist gene polymorphism and circulating levels of human immunodeficiency virus type 1 RNA in Brazilian women

Interleukin-1 receptor antagonist (IL-1ra) gene polymorphisms in 83 human immunodeficiency virus (HIV)-seropositive women were evaluated. Fourteen of the subjects (16.9%) were homozygous for IL-1ra allele 2 (IL-1RN*2). These women had a lower median level of HIV RNA than did women homozygous for allele 1 (IL-1RN*1) (P = 0.01) or heterozygous for both alleles (P = 0.04). Among 46 subjects not receiving antiretroviral treatment, HIV levels were also reduced in IL-1RN*2 homozygous individuals (P < 0.05). There was no relation between IL-1ra alleles and CD4 levels.     

Inhibitory effects of danazol and medroxyprogesterone acetate on [3H]thymidine incorporation in human endometrial cancer cells

Effects of medroxyprogesterone acetate (MPA) and danazol (1 nM-10 microM) on cultured cancer cells from human endometrial adenocarcinomas obtained by hysterectomy were simultaneously investigated. Of twenty-four endometrial adenocarcinomas examined, five tumors were successfully maintained in primary cell culture. The addition of MPA as well as danazol in culture of cells from the five tumors resulted in a significant inhibition of [3H]thymidine incorporation in cancer cells from three tumors having progesterone receptors (PR). The minimum effective concentrations of MPA and danazol for the inhibition of [3H]thymidine incorporation were found to be 10 and 100 nM, respectively. The difference in effective concentration could be explained by a higher affinity of MPA to PR than that of danazol in cancer cells. On the other hand, neither danazol nor MPA affected [3H]thymidine incorporation in cultured cells from the remaining two tumors, in which PR was absent in one but present in the other. These findings, together with our previous findings that danazol inhibited the growth of a human endometrial cancer cell line with PR, suggest that a growth-inhibitory effect of danazol on human endometrial cancer cells is mediated through PR in the cells.     

Impaired NK-cell-mediated cytotoxic activity and cytokine production in patients with endometriosis: a possible role for PCBs and DDE

Endometriosis is a gynaecological disorder characterized by the presence and growth of endometrial tissue in ectopic sites. In this study we examined the immunological functions of patients with endometriosis and serum level of PCBs and p,p'-DDE to verify the impact of these environmental contaminants on the dysregulation of immune functions. We found that proliferative responses and immunoglobulin production were not dysregulated in patients with endometriosis while NK cell activity was significantly down-regulated in these patients. Moreover, a significant down-regulation of IL-1beta and IL-12 production was found in patients with respect to controls. Serum levels of PCBs and p,p'-DDE were found to be significantly higher in women with endometriosis than in the control group, with respect to the sum of the congeners most prominent in human tissues. In particular, total PCBs concentration in patients with endometriosis and controls was respectively 330 and 160 ng/g fat with respect to the most abundant congeners, while p,p'-DDE concentration was of 770 and 310 ng/g fat. Moreover, we found that normal human PBMC pulsed with PCBs, p,p'-DDE and their combination showed a significant down-regulation of NK cell cytotoxic activity and IL-1beta and IL-12 production. These findings suggest that changes in specific immune parameters correlate with elevated serum PCBs and DDE levels and endometriosis.     

Induction of chromosomal aberrations and sister chromatid exchanges by chlormadinone acetate in human lymphocytes: a possible role of reactive oxygen species

Genotoxicity study of a synthetic progestin chlormadinone acetate (CMA) was carried out in human lymphocytes using chromosomal aberrations (CAs) and sister chromatid exchanges (SCEs) as parameter. Effect of CMA was studied at 10, 20, 30 and 40 microM. CMA was genotoxic at 30 and 40 microM. With a view to study the possible mechanism of genotoxicity of CMA, superoxide dismutase (SOD) and catalase (CAT) were used separately and in combination along with the CMA (40 microM) at different doses. SOD treatment increased CAs and SCEs at both the doses. CAT treatment decreased the frequencies of CAs and SCEs in both, separately and in combination with SOD, suggesting a possible role of reactive oxygen species for the genotoxic damage.