Morphological aspects of cell death associated with a cytolethal concentration of methylprednisolone sodium succinate (500 micrograms/ml) on the BLA1 lymphoblastoid cell line were studied over a 48-hr incubation period by light, transmission and scanning electron microscopy. Studies revealed two distinctive morphological changes induced by the steroid from 1 hr onwards after treatment. One showed contortion and "blebbing" of the cytoplasm and nucleus accompanied or followed by nuclear pyknosis, resulting in the formation of membrane-bounded bodies containing apparently normal cytoplasmic organelles with or without nuclear fragments. The other showed "rounding up" of the cell with loss of cytoplasmic protrusions and long slender surface processes, aggregation of well-preserved cytoplasmic organelles, accompanied by nuclear pyknosis and fragmentation. In both cases many of the features are typical of apoptosis. The subsequent degeneration of cells and fragments not unexpectedly resembled in vitro autolysis. This in-vitro system is suitable for studying the early biochemical events and intracellular control mechanisms of apoptosis.
Summary.-The cytolethal response to treatment with prednisolone was investigated in vitro in eight human lymphoblastoid cell lines containing varying concentrations of specific cytoplasmic glucocorticoid receptors. A similar response was observed in seven of the lines irrespective of their concentration of cytoplasmic receptors, and pharmacological doses of steroid, well above those required to saturate receptors in cell-free extracts, were required for a massive lethal response. One cell line derived from Burkitt's lymphoma was refractory to lethal effects even with pharmacological doses of steroid.A similar unresponsiveness to the cytolethal effect of prednisolone in vitro was observed in fresh lymphoblasts derived from patients with acute lymphoblastic leukaemia despite evidence of a satisfactory clinical response to therapy which included steroid. The resistance of human lymphoblastoid cells to treatment with glucocorticoids in vitro may result from a defect in activation subsequent to the binding of steroid to cytoplasmic receptors.
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