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Biomedical subjects

S Sakurama

Publications and source records attributed to S Sakurama.

At least 19 recordsLinked to original sources
PubMed1997

Protection by alpha2-macroglobulin of tissue plasminogen activator against inhibition by plasminogen activator inhibitor-1.

Tissue plasminogen activator (tPA) is widely used in the treatment of acute myocardial infarction (MI). However, its thrombolytic efficacy does not correlate with the dose administered. The interactions between tPA, alpha2-macroglobulin (alpha2-M), and plasminogen activator inhibitor-1 (PAI-1) were investigated both in vitro and in patients undergoing tPA therapy for MI in an attempt to identify variables that might affect the clinical efficacy of tPA. Purified alpha2-M (5.4 mg/ml) protected 16.0% or 22.4% of tPA (12.5 IU/ml) activity from inhibition by PAI-1 at 4 or 8 IU/ml in vitro. Of nine patients treated with 5-20 mega IU of tPA for MI, the plasma activity of tPA remained increased for 15-30 min after the cessation of infusion in eight; the patient who failed to exhibit a persistent increase in tPA activity had a low plasma concentration of alpha2-M. Total tPA activity, derived from the area under the activity-versus-time curve (AUC), showed a significant inverse correlation with the ratio of the plasma PAI-1 activity to the plasma alpha2-M concentration. Total tPA activity did not correlate with plasma PAI-1 activity or plasma alpha2-M concentration alone. Results suggest that alpha2-M, by binding to tPA, protects the latter against inhibition by PAI-1.

Aged↗
PubMed1993

Proliferation and differentiation of myelodysplastic CD34+ cells in serum-free medium: response to individual colony-stimulating factors.

The presence of serum or contaminant cells may alter clonal development of haematopoietic progenitor cells in vitro. To investigate the pathogenesis of myelodysplastic syndromes (MDS), marrow progenitor cells from 13 MDS patients were highly purified using monoclonal antibodies including CD34 and immunomagnetic microspheres. The cells positive for CD34 in the purified cells were in the range from 87% to 98%. These purified cells were cultured in serum-free medium with individual colony stimulating factors (CSFs) to investigate whether CD34+ cells from MDS patients have abnormal responses to individual CSFs. Dose response experiments with the purified CD34+ cells and recombinant human macrophage-CSF (rM-CSF), granulocyte-CSF (rG-CSF), granulocyte/macrophage-CSF (rGM-CSF), interleukin-3 (rIL-3) or erythropoietin (rEP) were performed in serum-free fibrin clots in 11 patients. Five patients showed a diminished response to rG-CSF and one patient to rEP. In the remaining six patients the purified CD34+ cells did not respond to a stimulation of any individual CSFs. The results indicate that the progenitor cell growth abnormalities in these disorders involve a defect in the capacity of progenitor cells to respond to stimulation with G-CSF, and present direct evidence for the manner in which myelodysplastic CD34+ cells are impaired.

Adult↗
PubMed1992

[Human parvovirus-induced transient anemia and leukopenia after delivery].

A 30-year-old female at 27 weeks' gestation, was hospitalized on September 24 1990 because of the premature rupture of the amniotic sac. She underwent Caesarean section on the same day with 700 ml blood loss, but no blood transfusion was required. For several days after the operation, her hemoglobin level remained 7.8 g/dl and did not increase significantly in spite of parenteral iron therapy. On the 9th postoperative day, chills and pyrexia developed with leukopenia. Bone-marrow aspiration revealed severe erythroblastopenia with giant proerythroblasts, suggesting recent HPV infection, which was confirmed by the presence of anti-HPV IgM and HPV antigen by ELISA. The hemoglobin level gradually decreased to 6.0 g/dl by the 21st day, then began to increase rapidly. The serum of acute-phase containing HPV antigens inhibited BFU-E and CFU-E but not CFU-GM. The serum of convalescent-phase inhibited neither erythroid colony growth nor myeloid colony growth. These results indicate that the inhibitory effect of HPV in colony assay is highly specific for erythropoiesis and that HPV play a role in transient cessation of erythropoiesis. The reason, however, for leukopenia in HPV infection remained unclear. This case shows that HPV infection may induce severe hematological disorders even in normal person under erythropoietic stress.

Adult↗
PubMed1991

Purification of human marrow progenitor cells and demonstration of the direct action of macrophage colony-stimulating factor on colony-forming unit-macrophage.

To facilitate the investigation of the direct interaction between hematopoietic progenitors and colony-stimulating factors, we have developed a method to purify human marrow progenitor cells. Using density centrifugation, negative panning with concanavalin A coated plates, positive selection of CD34-positive cells with immunomagnetic microspheres, overnight adherence to a plastic dish, negative selection with a panel of monoclonal antibodies, and density centrifugation, human marrow progenitor cells were purified from 1.5% to 53.2%, a 42-fold purification, with a 4.8% yield. The purified cells consisted of 38% erythroid, 9% colony forming unit-granulocyte (CFU-G), 29% CFU-macrophage (CFU-M), 12% CFU-eosinophil/basophil (CFU-Eo/Ba), and 4% CFU-mix. The purified cells cultured in serum-free fibrin clots with recombinant human macrophage colony-stimulating factor (rM-CSF) for 14 days developed a pure population of CFU-M colonies. An appearance of CFU-M colonies was present after the addition of 1 U/mL of rM-CSF and the maximum stimulation was found at 100 U/mL. When the purified cells were cultured in serum-free medium with rM-CSF in a limiting dilution assay and the percentage of nonresponder wells for CFU-M colonies was plotted against cell concentration, serum-free cultures yielded a straight line through the origin, indicating that CFU-M development did not depend on accessory cells and that rM-CSF acted directly on the CFU-M.

Antigens, CD↗
PubMed1991

Fibrinogen date: congenital hypodysfibrinogenemia associated with decreased binding of tissue-plasminogen activator.

A new case of congenital hypodysfibrinogenemia associated with a thrombotic tendency (thrombosis of the peroneal artery, the pulmonary artery and the deep veins of the lower extremities), is reported. Clotting time using Reptilase was significantly prolonged. The low levels of plasma fibrinogen were demonstrated using both thrombin time (Clauss) method (45.0 mg/ml) and radial immunodiffusion technique (106.1 mg/ml). The fibrinogen is also characterized by a defective polymerization of fibrin monomers. Furthermore, the important functional property of this fibrinogen is that the patient's fibrin adsorbs approximately 31-38% of added tissue-plasminogen activator (t-PA) at the time of fibrin formation, whereas control fibrin can adsorb about 79% of added t-PA. This result could provide an explanation for the thrombotic tendency in this patient. This variant fibrinogen appears to have unique characteristics and has been designated as "Fibrinogen Date," according to the city where the proband has lived.

Afibrinogenemia↗
PubMed1991

Transitional change of colony stimulating factor requirements for erythroid progenitors.

The course of the differentiation and proliferation of the human erythroid burst-forming units (BFU-E) to colony-forming units (CFU-E) was directly investigated using a combination of highly purified BFU-E, a liquid culture system, and the following clonal assay. Highly purified human blood BFU-E with a purity of 45-79% were cultured in liquid medium with recombinant human erythropoietin (rEP) and recombinant human interleukin-3 (rIL-3) to generate more differentiated erythroid progenitors. The cultured cells were collected daily for investigating the morphology, the increment in the number of cells and the clonality. Ninety percent of purified BFU-E required not only rEP but also rIL-3 for clonal development. By 7 days of liquid culture, the total cell number increased 237 +/- 20-fold above the starting cells, while erythroid progenitors increased 156 +/- 74-fold. As the incubation time in liquid culture increased, the cells continuously differentiated in morphology. Replating experiments with rEP combined with or without rIL-3 showed the following: 1) The number of erythroblasts that were part of erythroid colonies decreased with accompanying erythroid progenitor differentiation and proliferation. 2) As the incubation time in liquid culture increased, erythroid progenitors had a graded loss of their dependency on rIL-3 and a complete loss of dependency was observed after 3 days of liquid culture. At that time 85% of the erythroid progenitors gave rise to colonies of more than 100 erythroblasts which were equivalent to mature BFU-E. These studies provide a quantitative assessment of the loss of IL-3 dependency by BFU-E and indicate that the size of the generated erythroid colonies and their IL-3 requirement correlate with the erythroid differentiated state.

Adult↗
PubMed1991

Tc-99m labeled tissue-type plasminogen activator: preparation, stability and preliminary imaging of thrombus-bearing rats.

Tissue-type plasminogen activator (t-PA) is a thrombolytic agent that directly binds to fibrin formed in clots. In terms of radiolabeling and nuclear imaging, t-PA has several advantages in Tc-99m labeling: it is stable in acidic solution at pH 3, which is suitable for labeling Tc-99m by a method of stannous reduction and blood disappearance after administration is rapid, which is desirable for imaging targets using short-lived radionuclides. Recombinant t-PA was labeled with Tc-99m by a method of stannous reduction without significant degradation of biochemical activity, over 95% of which was retained after the labeling procedure. Labeling efficiency in paper chromatography was over 98%. The moiety of hydrolyzed Tc-99m that was not eluted through the Sephadex column was estimated to be less than 10%. Tc-99m labeled t-PA, however, appeared to become unstable when diluted with normal saline. Nevertheless, in in vitro fibrin binding, Tc-99m labeled t-PA showed high affinity with fibrin: 80% of 100 ng/ml of Tc-99m t-PA bound to 10(-5) mol of the fibrinogen. Preliminary animal studies also showed a concentration of Tc-99m labeled t-PA at fresh thrombi formed in the inferior vena cava. Tc-99m labeled t-PA appears to have potential for thrombus imaging and the preparation of an instant kit.

Animals↗
PubMed1990

Effect of a factor VIII concentrate on type IIB von Willebrand's disease-associated thrombocytopenia presenting during pregnancy in identical twin mothers.

Marked thrombocytopenia developed during pregnancy in both identical twins mothers who had systemic lupus erythematosus (SLE) and also type IIB von Willebrand's disease (vWD). The proband's platelet count decreased in the third trimester of pregnancy. Large-dose gamma-globulin and prednisolone treatments were performed because of the suspicion of immune thrombocytopenic reaction associated with SLE. These treatments were not effective. Her platelet count returned to the normal range immediately after delivery. Postpartum examinations revealed the decreased ristocetin cofactor activity and the deficiency of large von Willebrand factor (vWF) multimers in preserved plasma samples from the third trimester. These abnormal findings improved after delivery. Investigation of family members revealed that the proband had inherited type IIB vWD from her mother. The other twin, who was also under treatment for SLE, became pregnant about 1 year after delivery in the proband and followed almost the same course as that observed in the proband. As bleeding tendency was observed a few days before delivery, a factor VIII concentrate (Haemate P) was administered to compete with her variant vWF. This concentrate could prevent the further decrease in her platelet count, thereby correcting the hemorrhagic tendency. It seems evident that factor VII concentrate would be effective in treating thrombocytopenia associated with type IIB vWD.

Adult↗
PubMed1990

[A latent form of essential thrombocythemia presented as portal hypertension and associated with acquired von Willebrand syndrome].

A 32 year-old male patient was admitted to our hospital because of abdominal tumor. The examination on admission showed massive splenomegaly and esophageal varices although peripheral blood cell counts were within normal limits. Exploratory laparotomy was performed with the diagnosis of portal hypertension and revealed the multiple thrombus formations in the splenic vein and the extramedullary hematopoietic findings in the spleen by the microscopic examination. In vitro colony forming assay showed the formation of spontaneous erythroid colonies in cultures of progenitor cells (from peripheral blood mononuclear cells) in erythropoietin-poor medium. Increasing thrombocytosis was observed immediately after splenectomy, and hemorrhagic diathesis of nasal bleeding and gastrointestinal bleeding were also detected. The analysis of plasma von Willebrand factor (vWF) revealed the decrease of ristocetin cofactor activity and the lack of large multimeric components of vWF. These abnormal findings observed after splenectomy led to recovery through the administration of busulfan with the improvement of thrombocytosis. Accordingly, the course of the disease clearly indicated it to be the essential thrombocythemia represented as portal vein thrombosis and in latent form with normal cell counts in peripheral blood at the time of diagnosis, and subsequently, to develop into a full-blown form associated with acquired von Willebrand syndrome following splenectomy.

Adult↗
PubMed1989

Glandular kallikrein, renin and angiotensin converting enzyme of diabetic and hypertensive rats.

To clarify the relationship between kallikrein-kinin and renin-angiotensin systems, glandular kallikrein, renin and angiotensin converting enzyme in the submandibular gland, the kidney and plasma were investigated in streptozotocin diabetic and spontaneously hypertensive rats. Kallikrein content in the submandibular gland, the kidney and plasma of diabetic rats was found to be decreased compared with nondiabetic controls. Renin activity in diabetic rats was also reduced in the submandibular gland, but the activity showed no significant changes in the kidney and plasma. The activity of angiotensin converting enzyme (ACE) in plasma significantly increased in diabetic rats. On the other hand, kallikrein content in hypertensive rats was depressed in the kidney, while the content was unchanged in the submandibular gland and plasma. Renin activity in hypertensive rats was found to be higher than that of normotensive rats in the submandibular gland, but the activity showed no remarkable changes in the kidney and plasma. ACE activity in plasma markedly decreased in hypertensive rats in contrast to diabetic rats. In hypertensive-diabetic rats, changes in the levels of these enzymes in tested materials were similar to those of diabetic rats. From these results it is reasonable to assume that (1) reduced kallikrein generation and elevated ACE activity may induce impaired kinin formation and contribute to the development of diabetes mellitus apart from the presence of hypertension and (2) low kallikrein content in the kidney could cause hypertension.

Animals↗
PubMed1985

Diamond-Blackfan syndrome: a possible role of cellular factors for erythropoietic suppression.

CFU-E growth from fractionated bone marrow cells of 5 children with Diamond-Blackfan syndrome was studied. In all patients, CFU-E growth was reduced in mononuclear cell-rich fraction. In 2 of the 5 patients, CFU-E growth was returned to normal by the depletion of E-rosette forming cells or monocytes from mononuclear cell-rich fraction. In the patient whose CFU-E growth returned to normal by the depletion of E-rosette forming cells, co-cultivation between bone marrow buffy coat cells and autologous bone marrow E-rosette forming cells resulted in a significant decrease of CFU-E growth, and there was a significant increase in CFU-E growth by treatment with monoclonal antiserum to OKT4. We concluded that immunologic causes such as cellular factors may play a role, at least in part, in the pathogenesis of Diamond-Blackfan syndrome.

Anemia, Aplastic↗
PubMed1984

Systemic amyloidosis associated with factor X deficiency.

An autopsy case of amyloidosis associated with factor X deficiency is reported. The patient showed a markedly decreased level of factor X (9% normal) and an extremely shortened half-life of intravenously infused factor X. Amyloid deposition was present in most of the visceral organs with special involvement of the liver and spleen. The amyloid in this case was thought to be AL protein, since it was potassium-permanganate-resistant and a small amount of Bence Jones protein was detected after dimethyl sulfoxide therapy. Electron microscopic study revealed a typical appearance of amyloid fibrils radiating from invaginated cell membrane of Kupffer cells, which may indicate rather rapid turnover of the amyloid. Rapidity and severity of amyloid deposition, especially in the liver and spleen, may play an important role in the development of the factor X deficiency associated with systemic amyloidosis.

Amyloid↗
PubMed1984

[The interaction of human alpha 1-antitrypsin with human plasmin].

The interaction of alpha 1-antitrypsin (alpha 1-AT) with plasmin was investigated, and the molecular weight of the inhibitor was also re-evaluated. The value of molecular weight of alpha 1-AT determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) method showed a difference depending on the presence or absence of the reducing agent, resulting in 72,000 dalton before reduction and 59,000 dalton after reduction. Conclusively, the molecular weight of alpha 1-AT was appropriate to be 59,000 dalton from considering the molecular shape of the protein. The interaction of alpha 1-AT with plasmin was analysed by SDS-PAGE method. Unreduced analysis revealed that two kinds of complexes with different molecular weight (the major of 155,000 dalton and the minor of 140,000 dalton) were formed time dependently, suggesting that the former was a native complex and the latter was a degraded product. Reduced analysis disclosed that the light chain of plasmin involved the complex formation with the inhibitor, and a peptide of 16,000 dalton appeared during the reaction. From these observations, the mechanism of action was summarized as follows. First, alpha 1-AT inhibited all of the plasmin activities by forming a 1: 1 stoichiometric complex with the enzyme, presumably with the active center of the enzyme, whose complex is undissociable in the presence of denaturing or reducing agents or both. Secondly, the native complex broke into a degraded product and a released peptide by limited proteolysis with the free plasmin which existed in the reaction mixture even with an excess of alpha 1-AT due to the reaction of complex formation being time consuming. The clinical significance of alpha 1-AT on fibrinolysis was also subject for discussion.

Electrophoresis, Polyacrylamide Gel↗