The neuropeptide substance P(SP) has been implicated in the mediation of inflammation and immune-mediated disease such as arthritis. Recently, it was reported that SP was markedly increased around the blood vessels in inflamed gingiva as well as in close association with the inflammatory cell infiltrate. These results support that SP may contribute to the pathophysiology of neuronal inflammation in human periodontal tissues. SP may regulate inflammatory/immune responses by stimulating the proliferation of human T cells, differentiation and antibody-secreting potential of B cells, macrophage respiratory burst, connective tissue proliferation, and the secretion of cytokines from monocytes and T cells. Here, I studied potential role of SP as a costimulatory chemical signal in inflammatory/immune responses, by determining the released proinflammatory cytokines such as MIP-1alpha, IL-1beta, and IL-6 from culture supernatants of homogeneous immune cell lines. Serum free cell supernatants were concentrated with TCA precipitation, fractionated with SDS-PAGE, and subjected into western blot analysis. Among 15 cell lines tested, macrophage/monocyte cell line RAW264.7 and WR19m.1 showed the highest level of induction of MIP-1alphawhen stimulated with LPS. Discrete IL-6 bands with multiple forms of molecular mass were detected from supernatants of B cell lines A20(32kDa), Daudi(32, 35kDa), and SKW6.4(29kDa), which were expressed constitutively. IL-1beta could not be detected by the method of western blot analysis from supernatants of all cell lines tested except RAW264.7, WR19m.1, and erythroid cell line K562 which showed the least amount of IL-1betasecretion. SP 10(-9)M with suboptimal dose of LPS treatment showed synergistic induction of MIP-1alpharelease from RAW264.7 or WR19m.1, and also IL-6 release from A20, but this synergism is not the case in costimulation of RAW264.7 or WR19m.1 with SP 10(-9)M and TPA. Although treatment of T cell line CTLL-R8 with SP 10(-7)M or PHA+TPA induced modest level of MIP-1alpha secretion, synergism was not observed when they are applied together. These findings all together suggest the possibility of a regulatory role of SP in inflammatory/immune reaction through differential modulation of bioactivities of other chemical cosignals.
Arthritis ; B-Lymphocytes ; Blood Vessels ; Blotting, Western ; Cell Line* ; Chemokine CCL3 ; Connective Tissue ; Cytokines* ; Electrophoresis, Polyacrylamide Gel ; Erythroid Cells ; Gingiva ; Humans ; Inflammation ; Interleukin-6 ; Macrophages ; Monocytes ; Negotiating ; Neurons ; Neuropeptides ; Respiratory Burst ; Substance P* ; T-Lymphocytes

A quadriparetic 62-year-old male patient completely cured from small cell lung cancer was admitted to the hospital. The patient complained of dizziness and spontaneous horizontal nystagmus was present in both eyes. He was tolerable during the cancer treatment, but 4 months later he became bed ridden status and totally dependent on all of the daily living activities. Brain metastasis of primary cancer and paraneoplastic syndrome were suspected first, however the brain MRI and paraneoplastic antibody study revealed negative result. With reviewing his medical history, he took chemotherapy including carboplatin. We suspected the ototoxicity induced by carboplatin, as carboplatin has a unique side effect including ototoxicity affecting the balance function while preserving the hearing function. Clinicians should keep in mind this adverse effect in any patient with chemotherapy including carboplatin and who subsequently develops nystagmus and functional level impairment. In such, we present this case with the related literatures.
Activities of Daily Living ; Brain ; Carboplatin ; Dizziness ; Eye ; Hearing ; Humans ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Nystagmus, Pathologic ; Paraneoplastic Syndromes ; Small Cell Lung Carcinoma

OBJECTIVE: To explore the relationship between a number of clinically relevant variables and sonographic imaging data in respect to the level of impairment experienced in the affected and unaffected shoulders of hemiplegic stroke patients. METHOD: Fifty-one hemiplegic stroke patients (32 males, 19 females; 29 right-sided hemiplegics, 22 left-sided hemiplegics) participated in this study. A musculoskeletal radiologist conducted a sonographic exam on both the affected and unaffected shoulders of all patients and two physicians classified the severity of the injury on a six-point rating scale. Clinical variables including age, sex, duration of injury, spasticity and muscle power of the hemiplegic side, and level of functional activity of the shoulder were assessed. RESULTS: The sonographic rating scores of hemiplegic shoulders were positively correlated with age (p<0.01) and negatively correlated with level of muscle spasticity (p<0.05). The sonographic rating scores of unaffected shoulders were positively correlated with duration of injury (p<0.01). Affected shoulders received sonographic rating scores that reflected significantly more impairment than those of unaffected shoulders (p<0.001), and pre-morbid handedness did not affect the relationship between impairment rating and shoulder injury status. CONCLUSION: Hemiplegic stroke influences not only affected shoulders, but also unaffected sides. Proper management of spasticity, enhancement of motor recovery, and avoidance of unaffected shoulder overuse should be considered to prevent shoulder problems following strokes which result in hemiplegia.
Functional Laterality ; Hemiplegia ; Humans ; Male ; Muscle Spasticity ; Muscles ; Shoulder ; Stroke

Angioimmunoblastic lymphadenopathy with dysproteinemia(AILD), first described at early seventies, is a clinico-pathologic syndrome which has common features of lymphadenopathy, hepatosplenomegaly, fever, rash and dysproteinemia. It is a lymphoproliferative disease, differs from malignant lymphoma by the high frequency of constitutional symptoms and by the presence of generalized lymph node enlargement, hepatosplenomegaly, cutaneous menifestations and polyclonal hypergammaglobulinemia at the time of clinical onset. Peripheral T cell lymphomas(PTCL) are morphologically and immunologically heterogeneous group of lymphoproliferative disorders that are composed of postthymic lymphocytes. There are group of cases showing features similar to AILD, and these cases are classified as AILD like PTCL. We report a rare case of AILD like PTCL in an 8 year old boy, who visited Seoul National University Hospital with fever, hepatosplenomegaly and cervical lymphadenopathy, and diagnosed as AILD like PTCL by lymph node biopsy. He did not respond to conventional chemotherapy and died 1 year after clinical onset during chemotherapy, showing feature of multiple brain infarction of unknown etiology.
Biopsy ; Brain Infarction ; Child ; Drug Therapy ; Exanthema ; Fever ; Humans ; Hypergammaglobulinemia ; Immunoblastic Lymphadenopathy* ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma ; Lymphoma, T-Cell, Peripheral* ; Lymphoproliferative Disorders ; Male ; Paraproteinemias ; Seoul