Tomoyasu Momose

Eosinophil active cytokines and surface analysis of eosinophils in Churg-Strauss syndrome.

There are few reports regarding the measurement of cytokines and surface analysis of eosinophils in Churg-Strauss syndrome (CSS). To examine the pathophysiology of CSS, concentrations of cytokines in serum and bronchoalveolar lavage fluid (BALF), and surface antigens on peripheral blood eosinophils were analyzed in five patients with CSS. Concentrations of cytokines (interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha), interleukin-3 (IL-3), interleukin-5 (IL-5) and granulocyte/macrophage colony stimulating factor (GM-CSF) were measured using ELISA. Surface antigens on eosinophils in peripheral blood were analyzed using flow cytometry. A concentration of interleukin-5 (IL-5) and TNF-alpha in serum was detected in five cases; however IL-1 beta, GM-CSF, and IL-3 were detected in 3 of 5, 2 of 5, and 1 of 5 patients, respectively. In BALF, TNF-alpha and IL-5 were detected in 2 of 3 and 1 of 3 patients, respectively; however, neither IL-1 beta, GM-CSF, nor IL-3 was detected in any. Newly expressed surface antigens such as CD25, CD4, and CD69 were observed on peripheral blood eosinophils in five cases. CD54 and HLA-DR were expressed in 4 of 5 and 3 of 5 patients, respectively. Eosinophils in peripheral blood are activated to various degrees, possibly depending on cytokine stimulation. This eosinophil activation may be related to the clinical stage of CSS.

Effects of intracellular cyclic AMP modulators on human eosinophil survival, degranulation and CD11b expression.

Background: Brochial asthma is characterized by infiltration of inflammatory cells such as lymphocytes and eosinophils. Theophylline is one of the most widely used drugs in the therapy of bronchial asthma, and phosphodiesterase (PDE) inhibition is thought to be an important mechanism of its anti–inflammatory actions. However, the detailed effects of PDE inhibition on eosinophils still remain unclear. Methods: Eosinophils in peripheral blood obtained from normal subjects and patients with mild off–season allergic rhinitis were purified using CD16 negative selection. The following effects of theophylline (nonselective PDE inhibitor), KF19514 (selective PDE IV inhibitor), mirlinone (selective PDE III inhibitor), procaterol (β2–adrenoceptor agonist) and N6, 2′–O–dibutyryladenosine 3′5′–cyclic monophosphate (dB–cAMP; AMP analogue) on eosinophils were examined: (1) survival in the presence of interleukin–5, (2) degranulation by granulocyte/macrophage colony–stimulating factor (GM–CSF) or platelet–activating factor (PAF), (3) CD11b expression under GM–CSF or PAF stimulation and (4) intracellular cAMP level. Results: Eosinophil survival was inhibited by theophilline, KF19514 or procaterol. GM–CSF– or PAF–induced degranulation was inhibited by theophylline, KF19514, procaterol or dB–cAMP. CD11b up–regulation by PAF was inhibited by theophylline, KF19514 or dB–cAMP, while GM–CSF–stimulated CD11b up–regulation was not significantly inhibited by any of the drugs tested. The levels of intracellular cAMP were increased by theophylline, KF19514 and procaterol. Conclusions: Intracellular cAMP is an important factor in the regulation of eosinophil biological functions. PDE IV inhibitors and β2–agonists are suggested to be useful for the treatment of bronchial asthma through inhibition of eosinophil effector function.

A Case of Pathophysiologic Study in Kimura's Disease: Measurement of Cytokines and Surface Analysis of Eosinophils

BACKGROUND Kimuras disease is a rare but distinctive eosinophilic inflammatory disorder of unknown etiology; few reported case studies have focused on the immunopathologic background of this unique disease. OBJECTIVE To define better the immunopathogenetic features of Kimuras disease, we attempted to quantitatively analyze values of cytokines and soluble interleukin-2 receptor (sIL-2R) in peripheral blood (PB), as well as perform surface immunophenotypic analysis of eosinophils from a Japanese patient with chronic relapsing Kimuras disease. RESULTS Granulocyte macrophage-colony stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-alpha) and sIL-2R were elevated, and newly expressed antigens on eosinophils CD4, CD25, and HLA-DR were found to be involved in the pathophysiology of this disorder. CONCLUSIONS Kimuras disease may be a disease in which activated lymphocytes release cytokines, and these released cytokines, such as GM-CSF and TNF-alpha cause eosinophil activation. These processes may be related to the pathogenesis of this disorder.

Intercellular adhesion molecule-1 on eosinophils is involved in eosinophil protein X release induced by cytokines.

Recent evidence suggests that adhesion molecules play important roles in eosinophil functions such as degranulation and superoxide anion production. CD11b/CD18 (Mac‐1) and CD49d/CD29 (VLA‐4) are involved in eosinophil–endothelial adhesion through their counterligands, intercellular adhesion molecule‐1 (ICAM‐1; CD54) and vascular cell adhesion molecule‐1 (VCAM‐1), respectively. CD54 is also induced on eosinophils by cytokine stimulation. We hypothesized that CD54 on human eosinophils may participate in eosinophil degranulation. CD54 was induced on eosinophils by a combination of human recombinant granulocyte–macrophage colony‐stimulating factor (rGM‐CSF) and human recombinant tumour necrosis factor‐α (rTNF‐α) within 2 hr of incubation, as determined by flow cytometric analysis. Recombinant GM‐CSF alone induced a slight but significant CD54 expression on eosinophils. Release of eosinophil protein X, an indicator of eosinophil degranulation, was induced by rGM‐CSF and this effect was synergistically enhanced by adding rTNF‐α. To determine the role of newly expressed CD54 in eosinophil degranulation, a blocking assay was performed using monoclonal antibody (mAb) against CD54 and CD18. Anti‐CD18 mAb and anti‐CD54 mAb markedly inhibited eosinophil degranulation induced by rGM‐CSF or a combination of rGM‐CSF and rTNF‐α. On the other hand, anti‐CD54 mAb had little effect on rGM‐CSF‐ or rGM‐CSF/rTNF‐α‐induced adhesion of eosinophils, whereas anti‐CD18 mAb significantly inhibited eosinophil adhesion. These results indicate that CD54 on eosinophils plays an important role in the eosinophil degranulation and that eosinophils are capable of interacting with other β2 integrin‐positive cells.

Predominant implication of IL-5 in acute eosinophilic pneumonia : Comparison with chronic eosinophilic pneumonia

Background: Acute eosinophilic pneumonia (AEP) is a rare disease with unknown etiology. To examine pathophysiology of AEP we measured the cell number of eosinophils and eosinophil active cytokines in the peripheral blood and bronchoalveolar lavage fluid (BALF) of AEP patients and compared the levels with those measured in chronic eosinophilic pneumonia (CEP) patients. Methods: Cell number of eosinophils in peripheral blood and BALF from patients with AEP (n = 3) and CEP (n = 3) were measured. Eosinophil active cytokines in serum and BALF from the patients were measured using ELISA. Results: Eosinophil cell number in peripheral blood was 274–1,377/mm3 in AEP and 526–2,500/mm3 in CEP. The percentages of BALF eosinophils were high in AEP and CEP. Eosinophilia disappeared after methylprednisolone pulse therapy (1 g for 3 days) in AEP, however the cell number of eosinophils gradually increased after methylprednisolone pulse therapy and then spontaneously decreased to within normal range without any further medication. The concentrations of IL-5 in AEP were very high in serum and in BALF, however the concentrations in CEP were low in serum and BALF. Conclusion: AEP is a disease in which eosinophil active cytokine IL-5 is predominantly involved; CEP is not. The factors involving eosinophil infiltration to inflammatory loci differ between AEP and CEP.

Interferon-γ Increases CD62L Expression on Human Eosinophils

Background: L-selectin (CD62L) and Mac-1 (CD11b/CD18) play a crucial role in the infiltration of eosinophils. However, changes in CD62L and CD11b expression on eosinophils after stimulation with cytokines were little studied. Methods: Eosinophils in peripheral blood of healthy volunteers were purified and cultured with interleukin-5 (IL-5), granulocyte/macrophage colony-stimulating factor (GM-CSF) or interferon-γ (IFN-γ). After up to 24 h incubation, CD62L and CD11b expression were examined using flow cytometry. The effects of dexamethasone (Dex), cycloheximide (CHX) or theophylline on CD62L expression on IFN-γ-stimulated eosinophils were also studied. Results: IL-5 or GM-CSF downregulated CD62L and upregulated CD11b expression on eosinophils after 30 min stimulation. Conversely, IFN-γ upregulated CD62L after 12 h stimulation in a time- and dose-dependent manner, and had no effect on CD11b expression. Dex, CHX or theophylline dose-dependently decreased CD62L expression on IFN-γ-stimulated eosinophils. Conclusions: IFN-γ is a particular cytokine which can increase CD62L expression on circulating or infiltrated human eosinophils. It is suggested that protein synthesis and intracellular cAMP participate in the increase in L-selectin expression on IFN-γ-stimulated eosinophils.

Percutaneous treatment of a free-floating thrombus in the right atrium of a patient with pulmonary embolism and acute myocarditis

Free-floating thrombi in the right atrium (RA) are extremely hazardous to patients with pulmonary thromboembolism, and optimal treatment methods remain unclear. We report a case of successful percutaneous intervention of a critical right atrial thrombus. The patient was a 50-year-old woman who had been under medication for acute myocarditis when she complained of sudden severe dyspnea. Echocardiography showed a mobile snake-like thrombus in the RA. The thrombus was pulled back to the distal inferior vena cava (IVC) using a catheter and an IVC filter was placed. Percutaneous treatment is useful for treating free-floating RA thrombi.

Spontaneous B-cell IgE production in a patient with remarkable eosinophilia and hyper IgE

BACKGROUND The pathophysiology of eosinophilia and hyper-IgE is not fully elucidated yet. OBJECTIVE To clarify the pathophysiology of a patient with remarkable eosinophilia and hyper IgE, we examined cytokine levels in serum, surface antigens of peripheral blood eosinophils and IgE production in vitro. RESULTS Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-3 (IL-3), interleukin-4 (IL-4), interleukin-5 (IL-5), and granulocyte/macrophage-colony stimulating factor (GM-CSF) in the serum were 21 pg/mL, <15 pg/mL, <15 pg/mL, 8 pg/mL, and <5 pg/mL pg/mL, respectively. Newly expressed surface antigens CD4, CD25, CD69, and HLA-DR, but not CD54, were observed on peripheral blood eosinophils. Extremely high levels of IgE secretion was found in the patients mononuclear cells without stimuli; this was not enhanced by IL-4 or IL-4 plus anti-CD40 monoclonal antibody stimulation. Furthermore, highly purified B cells spontaneously produced large amounts of IgE and the production was not enhanced in addition of his T cells. CONCLUSION The eosinophils were activated, and the B cells spontaneously produced IgE independently of T cells or cytokines, suggesting that intrinsic abnormality of B cells leading to dysregulated production of IgE in this disease.

Effect of herbal medicine (Sho-seiryu-to and Ryo-kan-kyo-mi-shin-ge-nin-to) on human eosinophil biological function

The effects were examined of Sho‐seiryu‐to and Ryo‐kan‐mi‐shin‐ge‐nin‐to on the degranulation, expression of adhesion molecules and viability of human eosinophils. Eosinophil degranulation by granulocyte/macrophage‐colony stimulating factor (GM‐CSF) and platelet activating factor (PAF) was significantly inhibited in a dose dependent fashion by Sho‐seiryu‐to and Ryo‐kan‐kyo‐mi‐shin‐ge‐nin‐to. Mean fluorescence intensity (MFI) of constitutively expressed CD11b/CD18 on eosinophils was augmented by GM‐CSF or PAF stimulation; however, the increased CD11b/CD18 expression on eosinophils was significantly down‐regulated by Sho‐seiryu‐to. Eosinophil survival in the presence of recombinant human interleukin‐5 in vitro was significantly inhibited by 1000 μg/mL of Sho‐seiryu‐to and Ryo‐kan‐kyo‐mi‐shin‐ge‐nin‐to, which possess an inhibitory effect on eosinophil function, suggesting their usefulness in the treatment of allergic diseases.