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Biomedical subjects

M R Shah

Publications and source records attributed to M R Shah.

31 records · Page 2Linked to original sources

Increased synovial expression of the adhesion molecules CD66a, CD66b, and CD31 in rheumatoid and osteoarthritis.

Leukocyte-endothelial interaction mediated by adhesion molecules may play a role in the ingress of inflammatory cells into the rheumatoid (RA) synovial tissue (ST). A number of these molecules have been shown to be up-regulated in the inflamed compared to normal ST. We studied the distribution of two members of the CD66 carcinoembryonic antigen adhesion molecule family, as well as that of CD31, an antigen structurally related to CD66, on various cell types in the RA compared to osteoarthritic (OA) and normal ST. Immunoperoxidase histochemistry was carried out using monoclonal antibodies to CD66a, CD66b, and CD31. This study was performed on ST from 10 patients with RA, 10 with OA, and 4 normal individuals. CD66a, and CD66b were expressed on RA and OA ST myeloid cells but not on normal ST lining cells and interstitial macrophages, suggesting that these antigens may be specific markers of diseased compared to normal ST macrophages (P < 0.05). CD31 was present on more RA and OA than on normal ST macrophages. Also, CD31 was present on most RA, OA, and normal ST endothelial cells. Our results indicate that the expression of CD66a, CD66b, and CD31, members of the immunoglobulin superfamily of adhesion receptors, is up-regulated on cells of myeloid origin in the inflamed compared to normal ST. These results suggest that the CD66 antigens and CD31 may be involved in the adhesive events in the inflamed synovium.

Antigens, CD↗

Increased synovial expression of transforming growth factor (TGF)-beta receptor endoglin and TGF-beta 1 in rheumatoid arthritis: possible interactions in the pathogenesis of the disease.

The ingress of inflammatory cells into the rheumatoid (RA) synovial tissue (ST) plays a role in the pathogenesis of this disease. Transforming growth factor beta (TGF-beta) may play a role in this process. We have investigated the distribution of endoglin, a newly described receptor for TGF-beta 1 and -beta 3, in RA compared to osteoarthritis (OA) or normal ST. Immunohistochemical analysis was carried out using an anti-TGF-beta 1 monoclonal antibody (mAb) as well as 10 mAbs raised against various epitopes of endoglin. This study was performed on ST from 10 patients with RA, 10 with OA, and 4 normal individuals. TGF-beta 1 expression was significantly up-regulated on RA compared to OA and normal ST lining cells, interstitial macrophages, and endothelial cells (P < 0.05). All anti-endoglin mAbs uniformly reacted with endothelial cells in RA, OA, and normal STs. However, 3 out of 10 anti-endoglin mAbs reacted with significantly more RA versus normal ST lining cells (P < 0.05), as well as RA compared to OA and normal macrophages (P < 0.05). There was a positive correlation between TGF-beta 1 and endoglin reactivity on the synovial lining layer and subsynovial macrophages (P < 0.05). These results indicate that TGF-beta 1 and certain epitopes of endoglin, a TGF-beta 1 and -beta 3 receptor, are up-regulated on myeloid elements in RA compared to normal ST. Endoglin is also present on ST endothelia, and its expression may also be increased on OA compared to normal ST lining cells. These findings implicate endoglin in the pathogenesis of RA.

Antibodies, Monoclonal↗

Macrophage inflammatory protein-1 beta: a C-C chemokine in osteoarthritis.

The aim of this study was to determine whether the cytokine macrophage inflammatory protein-1 beta (MIP-1 beta) is present and functionally active in the arthritic joint. We used immunoassays and bioassays to assess the presence and function of MIP-1 beta using samples obtained from 62 arthritic patients. MIP-1 beta levels were increased in synovial fluids (SFs) from patients with osteoarthritis (OA) (18.0 +/- 8.9 ng/ml) (SD) compared to patients with rheumatoid arthritis (RA) 6.1 +/- 2.9 ng/ml) or other forms of arthritis (10.4 +/- 7.0 ng/ml) (P < 0.05). Levels of OA SF MIP-1 beta were significantly greater than OA or normal serum levels of MIP-1 beta. Anti-MIP-1 beta neutralized 28% of the chemotactic activity for monocytes found in OA SFs. Isolated OA synovial tissue fibroblasts did not constitutively produce MIP-1 beta but could be induced to express this chemokine upon exposure to tumor necrosis factor-alpha, interleukin-1 beta, or lipopolysaccharide. Synovial tissue immunohistochemical staining revealed that the main immunopositive cells in OA were the lining cells as well as vascular smooth muscle and endothelial cells. A minority of macrophages were immunopositive as well. In this study, we identify MIP-1 beta as a unique cytokine increased in OA compared to RA SF. We conclude that MIP-1 beta may play a role in the ingress of monocytes into the OA joint.

Arthritis↗

The New York Teacher Rating Scale for disruptive and antisocial behavior.

OBJECTIVE: A teacher rating scale designed to reflect current diagnostic descriptors of oppositional defiant disorder and conduct disorder was developed and standardized. METHOD: Teacher ratings were obtained for 1,258 1st-through 10th-grade children from two school districts in New York and for 81 clinically referred children with conduct disorder. RESULTS: Three factors relevant to oppositional defiant disorder and conduct disorder were generated: defiance, physical aggression, and delinquent aggression. A fourth factor reflects peer problems. Internal consistency, test-retest reliability, and interrater reliability are documented using a population and a conduct disorder sample. The validity of the factors is supported by the factors' ability to discriminate between children in the general population and those with conduct disorders, by correlations with global impairment items, and by expected sex differences. CONCLUSION: The scale has utility for assessing symptoms of conduct disorder in school settings.

Adolescent↗

Thoracic BB injuries in pediatric patients.

Penetrating thoracic injury from BB shot remains an innocuous event in most patients, but factors including location, proximity, gun type, and patient weight may identify groups at risk. The following cases demonstrate morbidity and mortality in two patients, and this experience may suggest the need for reassessment of this injury.

Adolescent↗

Expression of basic fibroblast growth factor and angiogenin in arthritis.

Angiogenesis is an integral component of the vasculoproliferative phase of rheumatoid arthritis (RA). We examined the distribution of two angiogenic factors, basic fibroblast growth factor (bFGF) and angiogenin (ANG) in arthritic diseases. We used an enzyme-linked immunosorbent assay and immunohistochemical analysis to determine the levels of bFGF and ANG in synovial fluid (SF) and their distribution in synovial tissue (ST), respectively. Most SF contained little or no detectable bFGF ( < 5 pg/ml). ANG in RA SF was 248.7 +/- 17.4 ng/ml, which did not differ significantly from levels found in osteoarthritis (OA; 305.9 +/- 23.1 ng/ml). Synovial lining cells, macrophages, endothelial cells, and vascular smooth muscle cells were immunopositive for bFGF and ANG; however, their expression was not up-regulated in RA ST compared to ST from OA and normal subjects. Though bFGF and ANG are present in the joints of patients with arthritic diseases, they are not up-regulated in RA. These results suggest that not all angiogenic mediators are up-regulated in RA compared to normal subjects and subjects with other arthritic diseases. It may be that some of these mediators, like ANG, play a role in the physiology of normal synovium.

Angiogenesis Inducing Agents↗

Soluble intercellular adhesion molecule-1 in arthritis.

The objective of this study is to determine whether soluble intercellular adhesion molecule-1 (sICAM-1) is found in rheumatoid arthritis (RA) and other inflammatory disorders and to identify which cells are responsible for sICAM-1 production. Synovial fluid, blood and cells isolated from RA synovial fluids, and synovial tissues from 59 patients were studied. In addition, normal peripheral blood was obtained. sICAM-1 was assayed by an enzyme-linked immunoabsorbent assay. Synovial fluids from patients with RA and other inflammatory arthritides had significantly higher sICAM-1 levels than did osteoarthritis (OA) synovial fluids. Synovial fluid sICAM-1 levels were significantly positively correlated with synovial fluid leukocyte counts. RA synovial tissue fibroblasts released low levels of sICAM-1. Neutrophils (PMNs) isolated from synovial fluids of RA patients spontaneously released sICAM-1. However, mononuclear cells isolated from RA synovial fluid produced the largest quantities of sICAM-1. Phytohemagglutinin but not lipopolysaccharide enhanced mononuclear sICAM-1 release. sICAM-1 was increased in synovial fluids from RA compared to OA. This sICAM-1 may be important in modulating the trafficking of inflammatory leukocytes into diseased RA synovial tissue and fluid.

Adult↗

Human atherosclerotic abdominal aortic aneurysms produce interleukin (IL)-6 and interferon-gamma but not IL-2 and IL-4: the possible role for IL-6 and interferon-gamma in vascular inflammation.

Immunological mechanisms play an important role in the pathogenesis of atherosclerosis and atherosclerotic abdominal aortic aneurysms (AAA). Inflammatory leukocytes invade the vessel wall and produce cytokines which perpetuate the immune events underlying these diseases. Interleukin (IL)-1 beta, IL-8, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1, among others, may play a role in the generation by AAA. The aim of this study was to investigate the possible pathogenetic role of other proinflammatory cytokines, namely IL-2, IL-4, IL-6, and interferon (IFN)-gamma. Enzyme-linked immunosorbent assay of human explant culture supernatants revealed a significant increase in IFN-gamma production by AAA compared to occlusive (atherosclerotic) or normal (NL) aortic explants. IL-6 production was also increased in AAA compared to NL aortic explant supernatants. Neither AAA nor NL aortic tissues produced IL-2 or IL-4 in the same culture system. These results suggest that IL-6, a cytokine involved in T and B lymphocyte activation during inflammation, and IFN-gamma, which stimulates T and B lymphocytes, macrophages, endothelial cells and fibroblasts, may play a role in the pathogenesis of various vascular inflammatory diseases such as AAA.

Aorta, Abdominal↗

Intercellular adhesion molecule-1 (ICAM-1) expression and soluble ICAM-1 (sICAM-1) production by cytokine-activated human aortic endothelial cells: a possible role for ICAM-1 and sICAM-1 in atherosclerotic aortic aneurysms.

The interactions of inflammatory cells, cytokines, and cell adhesion molecules (CAM) may be important in the pathogenesis of vascular diseases such as abdominal aortic aneurysms (AAA), in which inflammation plays a role. The aim of this study was to investigate the pathogenic role of ICAM-1, a molecule involved in leucocyte-endothelial interactions, in vascular inflammation. ELISA of human explant culture supernatants revealed a four-fold increase in sICAM-1 production by AAA (n = 9) versus normal (n = 8) aortic explants. Human aortic endothelial cell (hAEC) culture was used for further studies as an in vitro model for aortic inflammatory conditions. Tumour necrosis factor-alpha (TNF-alpha) or IL-1 beta treatment of hAEC resulted in an up to 1.8-fold significant increase in sICAM-1 production compared with resting cells. In addition, the expression of ICAM-1 on cytokine-stimulated versus resting hAEC was measured by radioimmunoassay. TNF-alpha significantly induced ICAM-1 expression on these cells. These results suggest that different forms of ICAM-1, present on or released by the activated aortic endothelium, may be involved in leucocyte adhesion to and migration into the vessel wall.

Aorta, Abdominal↗

Interleukin-8 and tumor necrosis factor-alpha are involved in human aortic endothelial cell migration. The possible role of these cytokines in human aortic aneurysmal blood vessel growth.

Angiogenesis, the growth and proliferation of blood vessels, may be important in the pathogenesis of atherosclerosis and thus in human atherosclerotic abdominal aortic aneurysms (AAAs). Endothelial migration or chemotaxis is a vital component of the angiogenic response. Here, human aortic endothelial cells (hAECs) were used to investigate the effect of AAA tissue supernatants on hAEC chemotaxis. AAA tissue conditioned media were found to be chemotactic for hAECs. We have previously shown that the angiogenic cytokines interleukin (IL)-8, and tumor necrosis factor (TNF)-alpha are present in AAAs and normal aortic explant conditioned media. Currently, we have found that basic fibroblast growth factor (bFGF) and platelet-derived growth factor can also be detected in these supernatants. In order to identify whether some of these soluble mediators contributed to the chemotactic activity of these supernatants, conditioned media were preincubated with either neutralizing anti-IL-8, anti-TNF-alpha, anti-bFGF antibodies or control serum. Anti-IL-8 and anti-TNF-alpha significantly inhibited AAA tissue supernatant-induced hAEC chemotaxis (p < 0.05), while anti-bFGF did not (p not significant). These results indicate that IL-8 and TNF-alpha may be important in chemotactic activity for hAECs in vitro and possibly in AAA neovascularization. The abrogation of angiogenesis using neutralizing antibodies may be a future goal in the therapy of certain disease states such as AAA where angiogenesis plays an important role.

Antibodies, Monoclonal↗

Enhanced production of the chemotactic cytokines interleukin-8 and monocyte chemoattractant protein-1 in human abdominal aortic aneurysms.

Inflammatory leukocytes play a central role in the pathogenesis of human atherosclerotic disease, from early atherogenesis to the late stages of atherosclerosis, such as aneurysm formation. We have shown previously that human abdominal aortic aneurysms are characterized by the presence of numerous chronic inflammatory cells throughout the vessel wall (Am J Pathol 1990, 137: 1199-1213). The signals that attract lymphocytes and monocytes into the aortic wall in aneurysmal disease remain to be precisely defined. We have studied the production of the chemotactic cytokines interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) by aortic tissues obtained from 47 subjects. We compared the antigenic production of these cytokines by explants of: 1) human abdominal aneurysmal tissue, 2) occlusive (atherosclerotic) aortas, and 3) normal aortas. IL-8, which is chemotactic for neutrophils, lymphocytes, and endothelial cells was liberated in greater quantities by abdominal aortic aneurysms than by occlusive or normal aortas. Using immunohistochemistry, macrophages, and to a lesser degree endothelial cells, were found to be positive for the expression of antigenic IL-8. Similarly, MCP-1, a potent chemotactic cytokine for monocytes/macrophages, was released by explants from abdominal aortic aneurysms in greater quantities than by explants from occlusive or normal aortas. Using immunohistochemistry, the predominant MCP-1 antigen-positive cells were macrophages and to a lesser extent smooth muscle cells. Our results indicate that human abdominal aortic aneurysms produce IL-8 and MCP-1, both of which may serve to recruit additional inflammatory cells into the abdominal aortic wall, hence perpetuating the inflammatory reaction that may result in the pathology of vessel wall destruction and aortic aneurysm formation.

Aortic Aneurysm, Abdominal↗