We used antibodies raised against individual desmosomal components to study calcium-induced desmosome formation in human keratinocytes. When keratinocytes are forced to grow as a monolayer by reducing the level of calcium ions in the culture medium, there is little contact between adjacent cells. Raising the level of calcium ions rapidly induces desmosome formation, and stratification occurs within 24 h. We found that before addition of calcium the 115,000-and 100,000-mol-wt core glycoproteins were distributed over the entire cell surface, whereas the plaque proteins (205,000 and 230,000 mol wt), the 82,000-and 86,000-mol-wt proteins, and the 150,000-mol-wt glycoprotein were located throughout the cytoplasm. 15 min after increasing the calcium ion concentration, all of these molecules appeared at the cell margins. The intensity of peripheral staining increased over the next 2 h and during this time the distribution of keratin filaments changed from predominantly perinuclear to extend throughout the cytoplasm. Keratinocytes could be dissociated with EDTA for up to 2 h after exposure to calcium. After 3 h of exposure to calcium the cells were no longer susceptible to EDTA dissociation and staining for desmosomal plaque antigens persisted in regions of intercellular contact. Desmosomal staining in stratified cultures became greatly reduced within 24 h of lowering the calcium ion concentration again. We have preliminary evidence that stratification occurs by breakdown of desmosomes at lateral surfaces and reformation at surfaces of contact between basal and suprabasal cells, rather than by rearrangement of existing desmosomes. Involucrin-positive cells in the monolayer appeared to contain more 205,000-and 230,000-mol-wt proteins free in the cytoplasm than involucrin-negative cells.Desmosomes are junctions that hold epithelial cells together; they are most abundant in tissues, such as epidermis, that are subject to mechanical stress. Despite many ultrastructural studies, there is no general agreement on the precise timing and sequence of events in desmosome formation (7,13,15,17,21,22,24,25). Electron microscopy has the limitations that it cannot provide information about changes preceeding the formation of morphologically distinct structures, and it does not give an overview of desmosome assembly in whole cell populations. The recent availability of antibodies to individual desmosomal components (3, 4, 9, 18) now makes it possible to examine desmosome formation at the molecular level.Polyclonal antisera against each of the five high molecular weight desmosomal proteins reveal the distribution of desmosomes in a range of tissues from different vertebrate species

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a multisystem disease, the pathogenesis of which remains undetermined. We set out to determine the precise abnormalities of gene expression in the blood of patients with CFS/ME. We analyzed gene expression in peripheral blood from 25 patients with CFS/ME diagnosed according to the Centers for Disease Control and Prevention diagnostic criteria and 50 healthy blood donors, using a microarray with a cutoff fold difference of expression of >or=2.5. Genes showing differential expression were further analyzed in 55 patients with CFS/ME and 75 healthy blood donors, using quantitative polymerase chain reaction. Differential expression was confirmed for 88 genes; 85 were upregulated, and 3 were downregulated. Highly represented functions were hematological disease and function, immunological disease and function, cancer, cell death, immune response, and infection. Clustering of quantitative polymerase chain reaction data from patients with CFS/ME revealed 7 subtypes with distinct differences in Medical Outcomes Survey Short Form-36 scores, clinical phenotypes, and severity.

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Objective-To evaluate oxidative injury and inflammatory status in various rheumatic diseases by measuring the levels of isoprostanes and prostaglandins in serum and synovial fluid. Methods-The concentrations of 8-iso-PGF 2 (F 2 -isoprostane indicating oxidative injury) and 15-keto-dihydro-PGF 2 (a major metabolite of prostaglandin F 2 ) were measured in both serum and synovial fluid aspirated from 26 patients with various arthritic diseases, including rheumatoid arthritis (RA), reactive arthritis (ReA), psoriatic arthritis (PsA), and osteoarthritis (OA). These prostaglandin derivatives were also measured in serum samples collected from 42 healthy control subjects. Results-Overall, serum levels of 8-iso-PGF 2 and 15-keto-dihydro-PGF 2 were much higher in patients with arthritic diseases than in the healthy control subjects. The levels of 8-iso-PGF 2 and 15-ketodihydro-PGF 2 in synovial fluid aspirated from knee joints were also high and varied among various types of arthritic patients. Although the synovial fluid level of these prostaglandin derivatives was sometimes higher than in the corresponding serum sample, this was not a consistent finding. Overall, there was no correlation between serum and synovial fluid levels of 8-iso-PGF 2 , or between serum and synovial fluid levels of 15-keto-dihydro-PGF 2 . However, a strong relation was found between the levels of 8-iso-PGF 2 and 15-keto-dihydro-PGF 2 , in both serum (r s =0.53, p<0.001) and synovial fluid (r s =0.62, p<0.001). Conclusions-These data suggest that both free radical mediated oxidative injury and cyclo-oxygenase dependent inflammatory responses are closely correlated in various types of arthritis.

Depression is common but under-recognized in RA patients starting on anti-TNF therapy. Patients with persistent depression tended to respond less well to anti-TNF, with smaller reductions in DAS28. Given that a significant reduction in DAS28 is a requirement for continuing therapy, recognition and appropriate management of depression may improve TNF effectiveness.