Kunihiko Maeda

Toll-Like Receptor-2 Modulates Ventricular Remodeling After Myocardial Infarction

Background—Toll-like receptors (TLRs) are members of the interleukin-1 receptor family and transduce similar signals as interleukin-1 receptor in response to exogenous pathogens. Recent studies have demonstrated that TLRs are activated by endogenous signals, such as heat shock proteins and oxidative stress, that may contribute to ventricular remodeling after myocardial infarction. In this study, we determined whether TLR-2 was involved in cardiac remodeling after myocardial infarction. Methods and Results—Myocardial infarction was induced by surgical left anterior descending coronary artery ligation on wild-type (WT) mice and TLR-2–knockout (KO) mice. The survival rate was significantly higher in KO mice than in WT mice 4 weeks after myocardial infarction (65% versus 43%, P <0.03). Infarct size and degree of inflammatory cell infiltration in infarct area were similar between WT and KO mice. However, myocardial fibrosis in the noninfarct area of KO mice was much less than in WT mice (P <0.01) and was accompanied by reduced transforming growth factor-&bgr;1 and collagen type 1 mRNA expressions (P <0.01 and P <0.05, respectively). Left ventricular dimensions at end diastole were smaller in KO mice than in WT mice at 1 week (P <0.05) and 4 weeks (P <0.01) after surgery. Furthermore, fractional shortening was higher (27.7±2.5% versus 21.2±2.6%, P <0.05, at 1 week, and 24.3±2.0% versus 16.6±2.5%, P <0.01, at 4 weeks) in KO mice compared with WT mice. Conclusions—These data suggest that TLR-2 plays an important role in ventricular remodeling after myocardial infarction.

Regression of duodenal mucosa-associated lymphoid tissue lymphoma after eradication of Helicobacter pylori.

It is rare for low-grade lymphoma of mucosa-associated lymphoid tissue (MALT) to affect the duodenum, and no reports have mentioned any relationship between this disease and Helicobacter pylori infection. This case report describes a patient with multiple small erosions and diffuse erythema in the duodenal bulb diagnosed histopathologically as MALT lymphoma. Immunoglobulin (Ig) heavy-chain gene rearrangement was detected, and monotypic plasma cell proliferation (IgG kappa) was shown by immunohistochemistry. The lesion was localized to the duodenal bulb. Antibiotic therapy for H. pylori resulted in resolution of the morphological features of the lymphoma, as confirmed by endoscopic and pathological examination. Moreover, the gene rearrangement could not be detected after eradication of the bacterium. Although additional follow-up is needed, it is suggested that H. pylori eradication therapy may be effective for patients with MALT lymphoma in the duodenum as well as the stomach.

LAMINA PROPRIA MACROPHAGES IN THE HUMAN GASTROINTESTINAL MUCOSA : THEIR DISTRIBUTION, IMMUNOHISTOLOGICAL PHENOTYPE, AND FUNCTION

In this study we systematically investigated the cellular distribution, immunohistochemical phenotype, and mucosal disposal function of macrophages in the lamina propria of the human gastrointestinal mucosa (lamina propria macrophages; LPMs). In all tissues examined, most of these LPMs accumulated beneath the epithelial layer that covered the apex of the lamina propria of the mucosa. These cells expressed normal levels of common macrophage markers such as CD68, LN5, lysozyme, ferritin, and alpha 1-anti-chymotrypsin. In addition, they expressed high levels of 25F9 (a market for a certain subpopulation of macrophages), MHC Class II molecules, and CD74 (MHC Class II-associated invariant chain). Interestingly, LPMs possessed some epithelial cell-associated antigens such as cytokeratin, carcinoembryonic antigen (CEA), and Ber-Ep4 in their cytoplasm. Ultrastructurally, these antigens were associated with cellular debris ingested by LPMs, which were recognized as apoptotic fragments by in situ end-labeling. Furthermore, double positive-labeled granules were seen in LPMs by double staining for epithelial cell-associated antigens and in situ end-labeling. These observations suggest that one of the major functions of LPMs is the disposal of apoptotic epithelial cells and that LPMs may be involved in the regulation of mucosal epithelial renewal.

CD56-positive (nasal-type T/NK cell) lymphoma arising on the skin. Report of two cases and review of the literature.

Several authors have reported cases of patients with malignant lymphoma with unique characteristics, designated nasal‐type T/NK cell lymphoma, which expresses the natural killer (NK) cell marker and shows frequent extra‐nodal involvement and poor prognosis. We report 2 cases of this type of lymphoma which were CD56‐positive and showed a histopathologically angiocentric pattern with cutaneous and subcutaneous tumorous lesions. Patient 1 had extensive invasion of skin, underlying skeletal muscle, spleen and bone marrow, and died of sepsis 34 months after onset. Patient 2 had multiple subcutaneous nodules and invasion to mammary gland, lung, lymph node and spleen at the time of her first visit. She died of a rapid invasion of lymphoma cells to the liver 5 months after onset. Both patients showed similar immunophenotypes of tumor cells (CD2+, CD3−, CD4−, CD8−, CD20−, CD56+) and germ line configuration of the heavy chain of immunoglobulin (JH), T‐cell receptor C beta‐1 subunit DNA and T‐cell receptor J gamma subunit DNA. Epstein‐Barr virus early regions RNA was demonstrated in the nuclei of tumor cells of both patients with in situ hybridization. The histopathological examination of the skin lesions of both patients revealed the features of angiocentric lymphoma. The detection of CD56 in the tumor cells of cutaneous lymphomas should be routinely performed for the early diagnosis of this type of lymphoma with extremely poor prognosis.

Helicobacter pylori antigen in the glomeruli of patients with membranous nephropathy.

Abstract Renal biopsy specimens from patients with membranous nephropathy (MN) were studied using immunohistochemical labelling to clarify the aetiological significance of Helicobacter pylori antigen in this disease. Sixteen specimens were examined, from 7 male and 9 female MN patients. Renal specimens from patients with diabetic nephropathy and IgA nephropathy, and from autopsied patients without renal diseases were obtained as controls. Immunohistochemical labelling was performed using one polyclonal antibody and three monoclonal antibodies against H. pylori. Specimens from 11 of the MN patients revealed granular deposits along the glomerular capillary walls, which reacted positively with polyclonal antibody after trypsin pretreatment. None of the control specimens revealed positive labelling. The MN specimens showed no positive reaction with the primary antibody, which had been treated for immunoabsorption testing using sonicated H. pylori.We also determined H. pylori status in these MN patients histologically and/or serologically. Of the 11 patients whose glomeruli were positive for anti-H. pylori antibody, 7 were suitable for analysis, and all were regarded as positive for H. pylori infection. These results suggest that the presence of a specific antigen in the glomeruli of patients with MN and H. pylori infection may be involved in the pathogenesis of MN.

Immunohistochemical Recognition of Human Follicular Dendritic Cells (FDCs) in Routinely Processed Paraffin Sections

A number of monoclonal antibodies (MAbs) that recognize human follicular dendritic cells (FDCs) have been identified. Although some of them have already been applied individually in routine immunolabeling using formalin-fixed paraffin sections for diagnostic and experimental purposes, many antibodies are still employed only for immunolabeling using cryostat sections or particularly processed sections because they have been thought unsuitable for routine sections. A comprehensive examination re-evaluating their suitability in paraffin sections has not been reported. Accordingly, there is limited ability to examine the immunopathological contribution or diagnostic value of FDCs using routinely processed specimens or archived materials. In this study a broad panel of antibodies was systematically applied to the immunolabeling of paraffin sections of reactive tonsils or lymph nodes, in combination with advanced antigen retrieval (AR) techniques. Several antibodies, including Ki-M4p, X-11, 12B1, CNA.42, 1F8/BU32 (anti-CD21), BU38/1B12 (anti-CD23), Ber-MAC-DRC/To5 (anti-CD35), 1.4C3 (anti-CD106), NGFR5 (anti-nerve growth factor receptor p75), IIH6 (anti-CD55), 55K-2 (anti-fascin), and anti-S100 protein α-chain, were found to label FDCs in routine sections when combined with suitable AR techniques. Our results are easily adaptable for routine practice and provided useful suggestions concerning the immunopathological behavior and diversity of the particular cells.

Analysis of the immunoglobulin heavy chain gene of secondary diffuse large B-cell lymphoma that subsequently developed in four cases with B-cell chronic lymphocytic leukemia or lymphoplasmacytoid lymphoma (Richter syndrome)

The immunoglobulin heavy chain gene (IgH gene) was analysed in four cases of B‐cell Richter syndrome, in order to determine whether a secondary diffuse large B‐cell lymphoma (DLBCL) could arise from the same clone as the initial B‐cell chronic lymphocytic leukemia (B‐CLL) and lymphoplasmacytoid lymphoma (LPL) or be a de novo event, and whether secondary DLBCL shows an intraclonal microheterogeneity. Both the initial B‐CLL and secondary DLBCL in two cases expressed CD5 antigen. Both samples of the initial B‐CLL or LPL and the secondary DLBCL in three cases were examined for comparison. The polymerase chain reaction‐amplified IgH gene of secondary DLBCL in two cases (CD5+ case and CD5− case) were different from those of the initial B‐CLL, revealing a new malignant clone. The other case (CD5−) showed that secondary DLBCL had a sequence identical to the initial LPL, indicating the same clonal origin. The variable region of the IgH gene of secondary DLBCL (CD5+ two cases and CD5− two cases) exhibited a 0.5–9.0% somatic mutation range and no intraclonal microheterogeneity.

Characterization of dendritic cells in differentiated thyroid cancer

In this study, the types and localization pattern of dendritic cells (DCs), the expression of chemokines on carcinoma cells and of the relevant receptors on DCs, and the adhesion molecules expressed on vascular endothelial cells and DCs were examined in thyroid carcinomas. Papillary carcinoma had a higher frequency of CD1a+ immature DCs than other thyroid tumours. Macrophage inflammatory protein (MIP)‐3α was expressed strongly on the majority of papillary carcinoma cells and weakly on a minority of follicular carcinoma cells. DCs positive for chemokine receptor‐6 (CCR‐6) were densely accumulated in papillary carcinoma. DC‐SIGN+ DCs were accumulated in papillary carcinoma but rarely in follicular carcinoma. A binding assay for DC‐SIGN‐mediated adhesion of isolated DCs revealed significant inhibition of DC adhesion to papillary carcinoma tissues by neutralizing antibodies against intercellular adhesion molecule‐2 or DC‐SIGN. These results clearly indicated marked differences between papillary carcinoma and follicular carcinoma in the accumulation of immature DCs, in MIP‐3α expression on carcinoma cells, and in the frequency of CCR‐6+ DCs and DC‐SIGN+ DCs. Copyright

Biological similarities and differences between pancreatic intraepithelial neoplasias and intraductal papillary mucinous neoplasms

AbstractBackground: Ever since the classification of pancreatic intraepithelial neoplasia (PanIN) was published, studies on the precursor lesions of pancreatic cancer have been advancing along a new directions, using standardized terminology. There are few studies that have examined the biological differences between PanIN and intraductal papillary mucinous neoplasm (IPMN) in detail. Aims: PanIN and IPMN, which are similar in morphology, were compared using various indicators, with the aim of identifying the similarities and differences between the two. Methodology: A total of 46 PanINs and 37 ducts with IPMN were identified in 19 patients with invasive ductal carcinoma and 18 patients with IPMN. These PanINs and IPMNs were examined immunohistologically with respect to the expression patterns of HER2/neu, DPC4/Smad4, Akt/PKB, p53, cyclin A, Ki67, MUC1, and MUC2. Results: Significant differences in the expression of MUC1 and MUC2 were observed between IPMN-adenoma and PanIN-2 and between CIS and PanIN-3 (MUC1: p=0.001 and p=0.005, respectively; MUC2: p=0.002 and p<0.001, respectively). A significant difference in the p53 expression level was also observed between CIS and PanIN-3 (p=0.015). Conclusions: In both IPMN and PanIN, the grade of atypism increased with increasing expression of HER2/neu, DPC4/Smad4, and Akt/PKB, along with progression in the process of multistage carcinogenesis. Although the expression levels of these factors reflected the grade of atypism, they did not reflect any differences in the grade of biological malignancy between IPMN and PanIN. On the other hand, MUC1 and MUC2 may serve as indicators of the direction of differentiation, i.e., either progression to IDAC or IPMN. Positivity for MUC1 was believed to suggest differentiation into IDAC, and positivity for MUC2 appeared to be indicative of differentiation into IPMN. Such indication of the direction of differentiation seemed to appear in PanIN1-2, even before abnormalities of HER2/neu, Akt/PKB, DPC4/Smad4, p53, and cyclin A expression began to be detected.

Development, maturation and subsequent activation of follicular dendritic cells (FDC): immunohistochemical observation of human fetal and adult lymph nodes

To elucidate the processes involved in development and activation of human follicular dendritic cells (FDC), immunohistochemistry was performed on paraffin sections of fetal lymph nodes (FLN) obtained from archived autopsy material, and of adult reactive lymph nodes (ARLNs) excised for diagnostic purpose, using a panel of antibodies. Our study showed that tiny clusters of CNA.42+ KiM4p+ cells, surrounded by some B-lymphocytes, initially arose in the cortical area of underdeveloped FLN around the 20th gestational week. No co-expression of CD21 and CD35 was found. In the relatively developed FLN of the same gestational age, small eddies of immature FDC, which expressed CD21, CD35, and nerve growth factor receptor (NGFR), as well as CNA.42 and KiM4p, were observed within ill-defined aggregations of B-lymphocytes. As gestation progressed, more B-lymphocytes assembled in a compact manner and formed primary lymphoid follicles containing an extending web of mature FDC, which expressed CNA.42, KiM4p, CD21, CD35, NGFR, and sometimes CD23 and X-11. In well-developed secondary follicles of ARLNs, activated FDC expressed additional molecules such as CD55, CD106, and S100α. Our observations identified the processes of phenotypic alteration of human FDC and established practical indicators determining their developmental stage and functional phase.