Summary. Background: Experimental animal studies have shown that the intimal hyperplasia (IH) responsible for occlusion after successful revascularization procedures may be partially caused by a bone marrow-derived cell that migrates to the site of vascular injury. Concurrent studies have demonstrated an extensive role in wound healing for the circulating fibrocyte. Objectives: We aimed to trace the path of the circulating cell that contributes to IH and determine if it is the fibrocyte. Methods and results: We established an in vitro model whereby purified monocytes from six healthy human volunteers were cultured into fibrocytes. These cells were morphometrically similar to the vascular smooth muscle cell (VSMC) found in IH and expressed alpha-smooth muscle actin (a-SMA) as well as CD34, CD45 and Collagen I (Col I), markers indicative of the fibrocyte. In an in vivo ovine carotid artery synthetic patch graft model, carboxyfluorescein diacetate, succinimidyl ester (CFSE) labeled circulating leukocytes were observed throughout the graft as well as in the neointima in 18 sheep. These cells were shown to produce collagen and a-SMA at 1, 2 and 4 weeks. These cells then underwent immunohistochemical analysis and were found to express a set of markers unique to the fibrocyte (CD34, CD45, Vimentin and a-SMA) and also to double stain for CD34 and a-SMA. Conclusions: IH in an ovine carotid artery patch graft model is partially derived from a hematopoietic circulating progenitor cell that acquires mesenchymal features as it matures at the site of injury.

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Summary:Activation of donor T cells is required for the development of graft-versus-host disease (GVHD), a major complication of bone marrow transplantation. We investigated a murine model of GVHD across major and minor histocompatibility barriers. BALB/c recipients were lethally irradiated and transplanted with 10 7 bone marrow and 5 ؋ 10 6 spleen cells from C57BL/6 donors. There were two separate phases of clinical disease. The first phase was most severe on day 7 after transplant. Weight and condition improved until day 12 and then a second phase of clinical GVHD commenced, which persisted until euthanasia. IL-2 mRNA expression, as a measure of T cell activation, was determined by quantitative PCR. The two phases of clinical GVHD were preceded by two separate peaks of IL-2 mRNA in the spleen. Host MHC class II + cells became undetectable by flow cytometry 7 days after transplantation, whereas donor MHC class II + cells increased during the first 9 days after transplantation. Removal of donor MHC class II + cells from the graft had no effect on the first phase. Possible roles for host and donor antigenpresenting cells (APC) in the two phases of the disease are discussed. Bone Marrow Transplantation (2002) 29, 151-158. DOI: 10.1038/sj/bmt/1703328 Keywords: graft-versus-host; MHC; antigen presentation; transplantation; cytokines Acute graft-versus-host disease (GVHD) remains the most significant obstacle to successful allogeneic BMT or peripheral blood stem cell transplantation for leukemia and other conditions. In MHC-matched unrelated donor transplants, acute GVHD of grade II or above occurs in up to twothirds of cases. 1 Acute GVHD has a complex pathophysiology which can involve wasting, diarrhea, skin and gut lesions and liver damage. 2 T cell activation in response to

Uridine, uridine monophosphate (UMP) and uridine diphosphate (UDP) increased blood pressure when infused into intact anaesthetized rats and had similar effects on the perfusion pressure in the rat isolated perfused kidney. In an isolated vascular preparation, the everted rat portal vein, uridine was without effect while UMP and UDP caused log dose-related increases in contractile work. Adenosine infused at a dose of 200 nmol/kg per min blocked the response to uridine in the intact rat, converting it to a depressor response at higher doses, and reduced the response to UMP. Uridine may need to be phosphorylated to UMP to act on blood vessels. The two compounds are effective at similar dose ranges and suppress renin secretion in the isolated kidney, while UDP, which is effective at lower doses and stimulates renin secretion, may act by a different mechanism. Adenosine competes for membrane transport with uridine but its inhibition of the effects of UMP is consistent with activity at intracellular sites as well.

BALB/c mice (H-2d) given 10 Gy total body irradiation (TBI) followed by 10(7) bone marrow (BM) and 10(6) spleen cells from C57BL/6 (H-2b) donor mice received recombinant cytokines intraperitoneally (IP) twice daily. The effect on neutrophil recovery rate, graft-v-host disease (GVHD), and survival was assessed. Four reagents were used: granulocyte-colony- stimulating factor (G-CSF), granulocyte-macrophage CSF (GM-CSF), interleukin-1 (IL-1) and IL-4, both alone and in combination. The most effective combination for increasing the circulating absolute neutrophil account (ANC) above the control value at day 7 posttransplant was the combination of G-CSF and IL-1 (mean ANC 2.4 +/- 1.6 x 10(9)/L as compared with control value of 0.07 +/- 0.05, P less than .02), followed by G-CSF alone (mean ANC 1.1 +/- 0.2, P less than .0001), the combination of GM-CSF plus IL-1 (mean ANC 0.8 +/- 0.3, P less than .002), and the combination of G-CSF plus GM-CSF (mean ANC 0.8 +/- 0.3, p less than .005). At day 10 posttransplant, the most effective combination in raising the ANC was the combination of G-CSF plus GM-CSF (mean ANC 7.5 +/- 2.3 as compared with control value of 3.5 +/- 1.1, P less than .01), followed by G-CSF alone (mean ANC 6.9 +/- 2.1, P less than .02). At the doses used, neither G-CSF nor GM-CSF had a deleterious effect on the incidence or severity of GVHD; indeed, GM- CSF was associated with improved survival. In contrast, IL-1 at doses greater than or equal to 100 ng twice daily caused marked early mortality, and there was a suggestion that IL-4 at doses of 500 ng twice daily resulted in increased late mortality, possibly owing to exacerbation of GVHD. This model appears to be of value for exploring the use of hematopoietic growth factors before they are used clinically in marrow allograft recipients.

These results suggest that MM given orally is not effective in this murine model of GVHD and may not have a role in the treatment and prevention of acute GVHD arising from bone marrow transplantation in the clinical setting.

The aetiology and pathogenesis of scleroderma is incompletely understood. Recently, a cell called the fibrocyte has been shown to be derived from circulating monocytes with the ability to produce collagen. The aim of this study was to evaluate differences in the cell surface characteristics of circulating fibrocyte progenitors (monocytes) in patients with limited scleroderma compared to controls. A case-control study was performed in eight patients with limited scleroderma, which were matched with eight controls. Three-colour flow cytometry was used to assess the relative expression of cell surface markers. Statistical analysis then compared the relative expression between the two groups. In this preliminary study, there were no significant differences in the expression of circulating monocyte surface molecules involved with cell transformation, function, or migration presumed to give rise to fibrocytes, in a population of patients with limited scleroderma. Various explanations for the results are discussed.

Objective of the study is to investigate for the presence of fibrocytes, a leucocyte found at sites of injury with fibroblast-like properties, within pediatric burn wounds. Seventy 3 mm punch biopsies were taken from 53 burn wounds in 33 children between 7 months and 15 years of age at the time of planned operative debridement and grafting. After fixation and sectioning, immunohistochemistry (IHC) staining was performed for CD34, pro-collagen I, alpha smooth muscle actin, transforming growth factor beta1 and Leucocyte Specific Protein-1 (LSP-1). The presence of fibrocytes was confirmed by double immunofluorescence staining with antibodies to CD34 or LSP-1 with pro-collagen I. CD34 positive cells were present in all burn wound biopsies. Using IHC staining, in 18 patients cells positive for CD34 and pro-collagen I were identified; in 17 patients, cells positive for CD34 and alphaSMA and in 17 patients also cells positive for LSP-1 and pro-collagen I. Double immunofluorescence for CD34/pro-collagen I and LSP-1/pro-collagen I confirmed the presence of fibrocytes in specimens from 17 of 18 patients positive for these markers on IHC. Of the 17 patients whose burn wounds were complicated by hypertrophic scarring, fibrocytes were identified in 88% (n = 15) compared with 18% of those without hypertrophic scarring (P < .001). This study represents the first report of the presence of fibrocytes in acute pediatric burn wounds. These cells appear to be involved in the local response to burn wound injury and may correlate with the later development of hypertrophic burn wound scarring.