Kentaro Motoyama

Effect of Ca2+ agonists in the perfused liver: determination via laser scanning confocal microscopy

Ca2+ is a critical intracellular second messenger, but few studies have examined Ca2+ signaling in whole organs. The amplitude and frequency of Ca2+ oscillations encode important cellular information. Using laser scanning confocal microscopy in the indo 1 acetoxymethyl ester dye-loaded rat liver, we investigated the effect of various Ca2+ agonists that act at distinct mechanistic sites on Ca2+ signaling. Perfusion with suprathreshold doses of arginine vasopressin (AVP) (2-20 nM) caused a single Ca2+ wave that originated in the pericentral vein region and spread centrifugally to the periportal area. Lower doses of AVP (0.2-2 nM) caused multiple Ca2+ waves and Ca2+ oscillations. Perfusion with ATP (1. 4-17.5 microM) caused rapid transient elevations in intracellular free Ca2+ concentration ([Ca2+]i) occurring in isolated hepatocytes or groups of hepatocytes throughout the lobule and were of shorter duration than those due to AVP. Also in contrast to AVP, there was no specific anatomic location within the hepatic lobule that was more susceptible to ATP. Thapsigargin and cyclopiazonic acid did not cause a Ca2+ wave but rather produced a uniform and fairly simultaneous increase in [Ca2+]i in all hepatocytes in the lobule. Perfusion with 14 microM ryanodine produced a single transient spike in [Ca2+]i in a small number (<2%) of hepatocytes. Dantrolene, an inhibitor of Ca2+ release, reduced the increased [Ca2+]i occurring after AVP. Insight into the mechanism of action of these Ca2+-active compounds on Ca2+ signaling in the intact liver is provided.Ca2+is a critical intracellular second messenger, but few studies have examined Ca2+ signaling in whole organs. The amplitude and frequency of Ca2+ oscillations encode important cellular information. Using laser scanning confocal microscopy in the indo 1 acetoxymethyl ester dye-loaded rat liver, we investigated the effect of various Ca2+ agonists that act at distinct mechanistic sites on Ca2+ signaling. Perfusion with suprathreshold doses of arginine vasopressin (AVP) (2-20 nM) caused a single Ca2+ wave that originated in the pericentral vein region and spread centrifugally to the periportal area. Lower doses of AVP (0.2-2 nM) caused multiple Ca2+ waves and Ca2+ oscillations. Perfusion with ATP (1.4-17.5 μM) caused rapid transient elevations in intracellular free Ca2+concentration ([Ca2+]i) occurring in isolated hepatocytes or groups of hepatocytes throughout the lobule and were of shorter duration than those due to AVP. Also in contrast to AVP, there was no specific anatomic location within the hepatic lobule that was more susceptible to ATP. Thapsigargin and cyclopiazonic acid did not cause a Ca2+ wave but rather produced a uniform and fairly simultaneous increase in [Ca2+]iin all hepatocytes in the lobule. Perfusion with 14 μM ryanodine produced a single transient spike in [Ca2+]iin a small number (<2%) of hepatocytes. Dantrolene, an inhibitor of Ca2+ release, reduced the increased [Ca2+]ioccurring after AVP. Insight into the mechanism of action of these Ca2+-active compounds on Ca2+ signaling in the intact liver is provided.

Lovastatin decreases mortality and improves liver functions in fulminant hepatic failure from 90% partial hepatectomy in rats

BACKGROUND/AIMS Liver insufficiency occurs when the liver cannot perform critical functions such as ammonia metabolism, gluconeogenesis, or production of coagulation factors The hypothesis of this study was that decreased function of existing hepatocytes may contribute to hepatic failure, and that the function of these cells might be increased pharmacologically. Lovastatin is a 3-hydroxy-3-methylglutaryl CoA reductase inhibitor that inhibits cholesterol biosynthesis and affects the activity of some signal transduction pathways and liver transcription factors. Changes in hepatic transcription factors during liver regeneration might result in decreased liver functions, and lovastatin might prevent these changes METHODS Rats received 90% partial hepatectomy (90% PH), and either lovastatin or vehicle alone daily. Survival and liver functions were assessed. RESULTS Lovastatin increased survival to 58% (vs. 6% in controls that received 90% PH without drug), decreased the peak ammonia level to 427 microM (vs. 846 microM in controls), increased the nadir of glucose to 88 mg/dl (vs. 57 mg/dl in controls), decreased the peak prothrombin time to 23 s (vs 29 s in controls), and decreased the peak activated partial thromboplastin time to 29 s (vs. 39 s in controls). The full survival and metabolic benefits were observed when lovastatin was started at 30 min after 90% PH, but lovastatin was less efficacious when started at later times. CONCLUSIONS Lovastatin increases the function of existing hepatocytes and might be used to improve liver function after extensive hepatic resection.

The Kinetics Of Tolerance Induction By Nondepleting Anti-cd4 Monoclonal Antibody (rib 5/2) Plus Intravenous Donor Alloantigen Administration 1,2

BACKGROUND CD4+ T cells play an essential role in allograft rejection. The monoclonal anti-rat CD4 antibody, RIB 5/2, has been shown to modulate the CD4 glycoprotein without eliminating the recipient T cells. We have successfully induced tolerance to rat heart allografts by recipient pretreatment with a single dose of RIB 5/2 plus intravenous administration of donor splenocytes. In this study, we explored whether this potent regimen could induce tolerance to the more resistant kidney and skin allografts. Furthermore, we examined the kinetics and requirements for tolerance to be met by a single dose of RIB 5/2 plus i.v. alloantigen. METHODS The efficacy of a single i.p. dose of 20 mg/kg RIB 5/2 plus i.v. donor antigen (25x10(6) splenocyte) pretreatment 0, 21, or 40 days before receipt of an MHC-mismatched Lewis (RT1l) to Buffalo (RT1b) rat cardiac, renal, or skin allograft was studied. Another group of Buffalo recipients treated with RIB 5/2 plus an i.v. alloantigen +/-thymectomy received kidney transplants after 40 days. Attempts to prevent tolerance used interleukin-2 or prior sensitization. Mixed lymphocyte cultures, cytotoxic assays, and precursor frequencies of helper and cytotoxic cells, by limiting dilution analysis, serially measured in vitro cell-mediated immunity. RESULTS RIB 5/2 administration combined with i.v. alloantigen 21 days before induced tolerance to heart and kidney allografts but did not prolong skin graft survival. In contrast, kidney allografts delayed for 40 days after pretreatment were acutely rejected and survival was not affected by the thymectomy. MLC, CTL, and pTH, and pCTL precursor frequencies from recipients of long-term grafts were specifically suppressed to donor, but not third party, alloantigen. CONCLUSION A single dose of the nondepleting anti-CD4 monoclonal antibody, RIB 5/2, plus i.v. alloantigen is a potent inducer of tolerance to heart and kidney, but not skin, allografts. The RIB 5/2-induced donor unresponsiveness to a delayed kidney or cardiac allograft is time dependent but can be prolonged if specific alloantigen is present. Suppression of cell-mediated allo-immune responsiveness correlates with allograft acceptance.

Tolerance to heart and kidney grafts induced by nondepleting anti-CD4 monoclonal antibody (RIB 5/2) versus depleting anti-CD4 monoclonal antibody (OX-38) with donor antigen administration☆☆☆

BACKGROUND The monoclonal antirat CD4 antibody RIB 5/2 has been shown to modulate the CD4 glycoprotein without eliminating the affected T cells. We have shown that the administration of multiple doses of RIB 5/2 during the peritransplantation period prevents the rejection of rat kidney allografts. METHODS We compared the efficacy of a single intraperitoneal dose of 20 mg/kg RIB 5/2 plus donor antigen (25 x 10(6) spleen cells [SCs]) given by either an intrathymic or an intravenous route with the depleting anti-CD4 monoclonal antibody (mAb) OX-38 plus antigen 21 days before a major histocompatibility complex (MHC)-mismatched Lewis (RT1l) to Buffalo (RT1b) rat cardiac or renal allograft. By delaying the transplantation for 21 days, recovery from the nonspecific effects of the antibody treatment allowed the demonstration of donor antigen-specific tolerance. RESULTS OX-38 mAb given with intrathymic SCs induced tolerance to heart but not kidney grafts, whereas OX-38 given with intravenous SCs failed to prolong survival of either heart or renal allografts. In contrast, RIB 5/2 mAb administration, when combined with alloantigen given by either intravenous or intrathymic routes, induced tolerance to heart allografts, whereas only alloantigen given by the intravenous route with RIB 5/2 resulted in tolerance to renal grafts. CONCLUSIONS Concomitant administration of intravenous donor alloantigen and the modulation of CD4+ recipIent cells by nondepleting RIB 5/2, rather than elimination of these CD4+ cells with depleting mAb OX-38, is a more potent method for the induction of allograft tolerance.

A case of renal allograft loss associated with thrombotic microangiopathy during pregnancy

Abstract:  A case with graft loss during pregnancy associated with thrombotic microangiopathy (TMA) is reported. The patient was a 27‐yr‐old female who had end‐stage renal disease because of immunoglobulin A (IgA) nephropathy at age 18. She received a kidney transplant at age 20 from her mother. Immunosuppressive therapy consisted of cyclosporine A (CyA), azathioprine (AZ), and prednisolone (PSL). The amount of serum creatinine (SCr) was 0.72 mg/dL at discharge one month after transplantation. Urinary occult blood and protein appeared five and 14 months after transplantation, respectively. SCr was gradually elevated. When she was 27‐yr old, she became pregnant. The amount of SCr was 1.74 mg/dL. The dose of CyA was 150 mg/d, AZ was 50 mg/d, and PSL was 5 mg/d. At 18 wk of gestation, severe hypertension and edema occurred and she was hospitalized. SCr was elevated to 3.26 mg/dL and severe hemolytic anemia with thrombocytopenia was recognized. On the third day after hospitalization, she underwent an abortion. Renal biopsy was performed on the seventh hospitalized day. Fibromyxomatous intimal thickening including foam cells, extensive hyaline changes, and fibrin thrombi were observed in the interlobular arteries or arterioles. Recurrent IgA nephropathy with extensive crescent formation was also diagnosed. Severe chronic tubulointerstitial damage was observed and tubulitis was mild. After the biopsy, she underwent plasma exchange and methyl‐prednisolone pulse therapy. Thrombocytopenia improved one month after the abortion. However, the graft function was lost and maintenance hemodialysis was started on the 46th day after termination of the pregnancy. In this case, it is suggested that pregnancy triggered TMA resulting in graft loss. Moreover, acute exacerbation of recurrent IgA nephropathy, pre‐existing CyA arteriopathy, and severe chronic tubulointerstitial damage also caused the deterioration of graft function as well as TMA.