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Biomedical subjects

H Stöss

Publications and source records attributed to H Stöss.

At least 19 recordsLinked to original sources

A specific collagen type II gene (COL2A1) mutation presenting as spondyloperipheral dysplasia.

We report on a patient with a skeletal dysplasia characterized by short stature, spondylo-epiphyseal involvement, and brachydactyly E-like changes. This condition has been described as spondyloperipheral dysplasia and the few published cases suggest autosomal dominant inheritance with considerable clinical variability. We found our sporadic case to be due to a collagen type II defect resulting from a specific COL2A1 mutation. This mutation is the first to be located at the C-terminal outside the helical domain of COL2A1. A frameshift as consequence of a 5 bp duplication in exon 51 leads to a stop codon. The resulting truncated C-propeptide region seems to affect helix formation and produces changes of chondrocyte morphology, collagen type II fibril structure and cartilage matrix composition. Our case with its distinct phenotype adds another chondrodysplasia to the clinical spectrum of type II collagenopathies.

Amino Acid Sequence

The spectrum of free neuraminic acid storage disease in childhood: clinical, morphological and biochemical observations in three non-Finnish patients.

N-acetylneuraminic acid (sialic acid) storage disease is a rare autosomal recessive lysosomal disorder. Clinically two major forms exist, an infantile type with severe progression leading to early death, and a milder form (Salla disease) with a protracted course. Intermediate forms may also exist. Diagnosis rests on the determination of an excessive excretion of sialic acid in urine and concomitant storage in fibroblasts, the severe forms exhibiting the highest excretion and storage. We present clinical, morphological, and biochemical data on three non-Finnish patients with sialic acid storage disease. Patient 1 was a preterm infant with neonatal ascites, coarse face, hepatosplenomegaly, pale skin, and wispy hair. Vacuolated lymphocytes were abundant in a peripheral blood smear and he excreted large amounts of free sialic acid. High levels of free sialic acid were also found in cultured skin fibroblasts. He died at age 6 months from progressive respiratory insufficiency. Patient 2 was an 11-month-old Egyptian girl with coarse face, frequent upper respiratory tract infections, hepatosplenomegaly, and severe psycho-motor retardation. Sialic acid excretion was elevated, likewise the storage in fibroblasts. Histological investigations documented vacuolar storage in a skin biopsy and in iliac crest tissue. Patient 3 was a 16-year-old girl with slightly coarse face, severe generalized muscular hypotonia, ataxia, and kyphoscoliosis originally diagnosed as having post-partum asphyxia. She suffered progressive motor function loss and had dysarthria. Urinary sialic acid was elevated and a skin biopsy demonstrated vacuolization. The clinical variability of sialic acid storage disease is exemplified by these three cases. Simple urinary screening for free sialic acid facilitates the diagnosis. The degree of urinary excretion may indeed correlate with clinical presentation and progression.

Abnormalities, Multiple

Clinical and ultrastructural findings in three patients with geleophysic dysplasia.

Geleophysics dysplasia, a rare disorder with autosomal-recessive inheritance, is characterized by short stature with a "happy-looking" facial appearance. Nonskeletal findings, particularly in an advanced stage, include hepatosplenomegaly and valvular cardiopathy. Based on the clinical picture and the detection of lysosome-like inclusions in hepatocytes, the underlying cause of the condition is considered to be a storage defect in the metabolism of glycoproteins. The clinical course, with progressive worsening of the condition favors this hypothesis. We report on 3 further cases, in which light and electron microscopic studies of iliac crest biopsies and cultured skin fibroblasts provided additional evidence that geleophysic dysplasia represents a lysosomal storage disease. The additional discovery of storage vacuoles in chondrocytes and skin fibroblasts strongly suggests that the condition is a generalized storage defect. To date, it has not yet been possible to identify the presumed biochemical defect in the metabolic pathways of glycoproteins.

Bone and Bones

The deletion of six amino acids at the C-terminus of the alpha 1 (II) chain causes overmodification of type II and type XI collagen: further evidence for the association between small deletions in COL2A1 and Kniest dysplasia.

We have identified an 18 bp deletion in exon 49 of the type II procollagen gene (COL2A1) in a patient with Kniest dysplasia. The deletion is located at the very C-terminus of the helical domain and removes two of three Gly-Pro-Pro triplets at positions 1007-1012, which are thought to be involved in helix formation and stability. Morphological investigation of an iliac crest biopsy showed large inclusions in the endoplasmic reticulum of chondrocytes, reflecting impaired secretion of type II collagen. Electrophoretic analysis of collagens extracted from cartilage or synthesised by cultured chondrocytes showed that type II and also type XI procollagen molecules containing mutant alpha 1 (II) chains showed post-translational overmodification. These observations provide further evidence for the general association of Kniest dysplasia with small deletions in the helical domain of type II collagen.

Amino Acid Sequence

[Proliferation of T-cells, macrophages, neutrophilic granulocytes and fibroblast-like cells in the synovial membrane of patients with rheumatoid arthritis].

The aim of this study was to determine the proliferation rates within the lining layer of the rheumatoid arthritis (RA) synovial membrane (SM) as opposed to the SM of other degenerative and neoplastic joint diseases and to characterize the proliferating cells. 13 RA, 23 osteoarthritis (OA), 21 joint trauma (JT), and 9 synovial sarcoma (SS) specimens were immunostained for Ki-67 and PCNA, silver-stained for nucleolar organizer regions (AgNORs), and double stained with either T-cell- (CD3), macrophage- (CD68), or polymorphonuclear neutrophilic leucocytes (PMN)-markers (CD15). The frequency of PCNA positive synovial lining cells (SLCs) varied from 15.7 +/- 8.7% in RA (mean +/- SEM), 30.97 +/- 4.13% in JT, and 48.55 +/- 3.66% in OA to more than half of all cells in SS (67.2 +/- 3.1%). MIB-1 labeling was observed in 20.0 +/- 8.4% of SS cells., but only in 0.6 +/- 0.2% RA or < or = 1.1% in JT and OA SLCs. Mean AgNOR number per cell ranged from 2.9 +/- 0.1 in JT, 3.6 +/- 0.05 in OA and 4.3 +/- 0.3 in RA to 7.3 +/- 0.3 in SS. Significant differences were observed for Ki-67 and AgNORs, between SS and all other diseases and also between RA and OA (p < 0.01, U-test). In RA, Ki-67 was solely expressed in lymphocytes of germinal centres, but not in macrophages or PMN; in the lining layer expression of Ki-67 was only found in fibroblast-like cells. Our study confirms that T-cell or macrophage proliferation is rare in the RA SM. Also, the proliferation rates of fibroblast-like cells in the RA lining layer are rather low, in particular when compared to a sarcoma in the same anatomical location.

Arthritis, Rheumatoid

Differential expression of collagen types I, II, III, and X in human osteophytes.

BACKGROUND: Osteophytes are neoplastic cartilaginous and osseous protrusions growing at the margins of osteoarthritic joints. Their formation involves complex patterns of cellular proliferation, differentiation, as well as matrix synthesis and turnover that are poorly understood. EXPERIMENTAL DESIGN: Here we report on an experimental approach using in situ hybridization and immunohistology to elucidate pathways of chrondrocyte differentiation in human osteophytes. Ab and cDNA probes for collagen types were used as specific parameters for chondrocyte phenotypes. RESULTS: In early precartilaginous mesenchymal tissue, cytoplasmic mRNA for alpha 1(I) and alpha 1(III) collagen genes (Col1A1 and Col3A1) were found by in situ hybridization, correlating with the distribution of type I and III collagen as revealed by Ab staining. Strong expression of type II collagen both at mRNA and protein levels was the hallmark of chondrogenic differentiation in the cartilaginous zone of osteophytes. Type II collagen expression increased in all cartilaginous and fibrocartilaginous areas with growth and maturation of osteophytes. The signal intensity obtained after in situ hybridization with a COL2A1 probe was high and corresponded to that obtained in fetal cartilage, whereas normal adult articular cartilage usually did not show measurable type II collagen expression. In fibrocartilaginous areas, the most abundant, but heterogeneous tissue type seen in osteophytes, type II and III collagen mRNA expression overlapped considerably. Type III collagen was scattered, both pericellularly and interterritorially, over the whole osteophyte, excluding bone and chondrocytic cells of the deep zone. The strongest type I collagen expression was seen in bone and in the superficial fibrous layer. In areas of endochondral ossification, large chondrocytes were found expressing type X collagen, a specific marker for hypertrophic chondrocytes. CONCLUSIONS: These results show that discrete stages of cartilage differentiation can be precisely followed in osteophytes using collagen type-specific cDNA probes and Ab as markers. In addition, a fibrocartilaginous chondrocyte phenotype was identified that expresses type II and III, but not type I collagen.

Aged

Pathomorphological and biochemical alterations in Ehlers-Danlos-syndrome type IV.

We are reporting the morphological and biochemical data of a patient with the characteristic features of the Ehlers-Danlos-Syndrome Type IV (Sack-Barabas Type) who died acutely after an episode of recurrent ruptures of the bowel with subsequent septic peritonitis. Morphologically, the connective tissue of the vessel walls, the dermis and the connective tissue of internal organs, particularly that of liver and lung, showed a distinct hypoplasia of the collagenous scaffold. Collagen fibers were irregularly arranged which was also corroborated by ultrastructural examination of the collagen fibrils of the dermis and of intervertebral disc material. Immunohistochemically, a loss in the staining intensity for collagen III could be observed in all locations. In contrast, the localization of collagen I, IV, V and VI appeared normal, although with some reduced staining intensity which particularly held true for collagen I in the dermis and vessel wall. The biochemical content of collagen III in lung and liver tissue was significantly reduced when compared to control tissues. Accordingly, in the pool of newly synthesized collagen from skin fibroblasts, only minute amounts of collagen III could be found which was normally secreted and had a normal electrophoretic migration.

Cells, Cultured

Jaffe-Campanacci syndrome: case report and review of literature.

We report a 27-year-old Caucasian woman with Jaffe-Campanacci syndrome. She presented with multiple café-au-lait spots and multiple non-ossifying fibromata of the bones, noted on radiographs and proven by tissue biopsies. Only the left side was involved. She also suffered from moderate scoliosis, stenosis of the aortic isthmus, chylothorax, and a chylopericardium. The etiology is discussed.

Adult

Collagen fibrils of osteoid in osteogenesis imperfecta: morphometrical analysis of the fibril diameter.

Comprehensive electron-microscopic studies showed that the structure of the collagen fibrils in the osteoid is not uniform. In 82 cases of osteogenesis imperfecta (OI), the diameter of the collagen fibrils was determined morphometrically under standardized magnification. The morphometric investigations of collagen fibrils of the osteoid in OI show clear differences in the four subtypes and in comparison with the control group.

Bone and Bones

Osteogenesis imperfecta and hyperplastic callus formation: light- and electron-microscopic findings.

In rare cases of osteogenesis imperfecta, an "overshoot" growth of new bone may occur, which, clinically gives the impression of a tumour. This condition is known as hyperplastic callus formation. Morphology showed an excessive mixed desmal-chondral osteoneogenesis. Atypical collagen fibrils in non-callus tissue represent an indicator for this callus formation in individual patients.

Bony Callus

Cell types infected in human cytomegalovirus placentitis identified by immunohistochemical double staining.

Chronic villitis is almost always present in intrauterine infection with human cytomegalovirus (HCMV). The inflammatory response to this virus has been described in detail. However, little is known about the types of placental cells that may be infected by HCMV and six cases of HCMV placentitis were thus investigated to identify the vulnerable cell types. Immunohistochemical double staining analyses were performed using antibodies to HCMV immediate early antigens and to specific cellular marker proteins. Fixed connective tissue cells could be demonstrated to be the predominantly infected cell type in each placental tissue. Endothelial cells and macrophages were also found to be infected in all six cases, whereas evidence of trophoblast infection was obtained in four cases. It is concluded that release of infectious virus by connective tissue cells, macrophages and endothelial cells may play a critical role in transplacental transmission of HCMV. The findings further suggest that the cytopathic effect of HCMV infection on these cells might be involved in the pathogenesis of intrauterine HCMV disease.

Antigens, Viral

Defective collagen fibril formation and mineralization in osteogenesis imperfecta with congenital joint contractures (Bruck syndrome).

We describe a male patient with osteogenesis imperfecta (OI) who was born with contractures of the knee, elbow and ankle joints. During the first 4 years he suffered from recurrent fractures. He has white sclerae, mild dentinogenesis imperfecta, multiple wormian bones, severe scoliosis and short stature. Morphological analysis of cortical bone revealed typical characteristics of OI including varying width of the osteoid, swollen mitochondria and a dilated endoplasmic reticulum of the osteoblasts. Collagen fibrils of the osteoid had a varying diameter, a feature not found in typical OI patients. Analysis of compact bone showed that the size of apatite crystals and the extractability of collagen with pepsin were markedly elevated compared to controls and other OI type III and IV patients. Lysyl hydroxylation of collagen from the organic bone matrix and the electrophoretic mobility of collagen alpha 1(I)- and alpha 2(I)-chains were normal. Our results provide evidence that this patient belongs to a subtype of OI. The biochemical studies indicate that the underlying defect involves defective fibril-formation of collagen type I leading to an altered mineralization of bone.

Abnormalities, Multiple

Type X collagen expression in osteoarthritic and rheumatoid articular cartilage.

Type X collagen is a short chain, non-fibril-forming collagen synthesized primarily by hypertrophic chondrocytes in the growth plate of fetal cartilage. Previously, we have also identified type X collagen in the extracellular matrix of fibrillated, osteoarthritic but not in normal articular cartilage using biochemical and immunohistochemical techniques (von der Mark et al. 1992a). Here we compare the expression of type X with types I and II collagen in normal and degenerate human articular cartilage by in situ hybridization. Signals for cytoplasmic alpha 1(X) collagen mRNA were not detectable in sections of healthy adult articular cartilage, but few specimens of osteoarthritic articular cartilage showed moderate expression of type X collagen in deep zones, but not in the upper fibrillated zone where type X collagen was detected by immunofluorescence. This apparent discrepancy may be explained by the relatively short phases of type X collagen gene activity in osteoarthritis and the short mRNA half-life compared with the longer half-life of the type X collagen protein. At sites of newly formed osteophytic and repair cartilage, alpha 1(X) mRNA was strongly expressed in hypertrophic cells, marking the areas of endochondral bone formation. As in hypertrophic chondrocytes in the proliferative zone of fetal cartilage, type X collagen expression was also associated with strong type II collagen expression.

Arthritis, Rheumatoid

Independent expression of fibril-forming collagens I, II, and III in chondrocytes of human osteoarthritic cartilage.

Normal and osteoarthritic human articular cartilage was investigated by in situ hybridization for expression patterns of the fibrillar collagens type I, II, and III to evaluate phenotypic changes of articular chondrocytes related to the disease. In 11 out of 20 samples, a defined subset of chondrocytes in the superficial and upper middle zone of osteoarthritic cartilage showed significant levels of cytoplasmic alpha 1 (III) mRNA, whereas strong signals of alpha 1 (II) mRNA were found in the upper and lower middle zone, partially overlapping with the zone of alpha 1 (III) mRNA-expressing cells. The extent of type II and III collagen expression depended on the integrity of the extracellular matrix surrounding the chondrocytes, and the location within the articular cartilage. No alpha 1 (I) mRNA was detectable in osteoarthritic original articular cartilage. The alpha 1 (I) probe did, however, reveal signals in pannus-like tissue, osteophytes, and bone cells. In normal articular cartilage, no detectable levels of cytoplasmic mRNA for alpha 1(I), alpha 2 (I), or alpha 1 (III) were seen. Using specific mono- and polyclonal antibodies, we found deposition of type III collagen but hardly any of type I collagen in the superficial zone of osteoarthritic cartilage that is consistent with the in situ hybridization results. These results indicate a phenotypic alteration in a defined subset of chondrocytes in conditions of diseased cartilage, expressing and synthesizing collagen type III independently from type I collagen, but in part simultaneously with type II collagen.

Adult

Preferential cellular and humoral immune reactivities to native and denatured collagen types IX and XI in a patient with fatal relapsing polychondritis.

We describe a patient with histologically confirmed relapsing polychondritis, an episodic systemic disorder. Although the etiology is unknown and its pathogenesis is incompletely understood, there is evidence strongly suggesting immunologically mediated mechanisms. Enzyme linked immunosorbent assays, immunoblotting and cellular immune responses using lymphocyte proliferation assays showed strong parallel humoral and cellular immune reactivities against collagens type IX and XI. There was also a considerable response to collagen type II which, however, was less pronounced compared to collagen type IX and was directed to native epitopes. Our findings demonstrate a highly distinct immune response to minor matrix collagens in a destructive cartilage disease and thus strongly argue against nonspecific anticollagen immune reactions simply representing epiphenomena resulting from cartilage damage.

Aged