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Scope: The eosinophil cationic protein (ECP) is one of the mediators released during eosinophil activation. These cells are effector cells taking part into the Th2-lymphocyte dependent allergic inflammation. Assaying ECP concentrations in blood and sputum may be useful in evaluating allergic inflammation (asthma and rhinitis). This summary considers the value of measuring ECP levels for the diagnosis of various diseases where an eosinophil-mediated tissue inflammation plays a role., Current Situation and Salient Points: Levels of eosinophil cationic protein have been determined in nasal secretions, sputum, gastric secretions, feces and serum. They are increased during seasonal allergic rhinitis and perennial rhinitis, allergic asthma and atopic dermatitis. They are also increased in various gastro-intestinal disorders, some of which are associated with IgE: eosinophil intestinal diseases (esophagitis, gastro-enteritis and colitis), gastro-intestinal food allergy and intestinal parasitoses. Finally, they are increased in non IgE-dependent disorders: non allergic asthma with aspirin intolerance, respiratory infections, sinonasal polyposis, Churg-Strauss disease and idiopathic hyper-eosinophilia (HES) syndrome., Perspectives: Assaying serum ECP could help in the diagnosis of several diseases. With parasitic disease the pathogenic progression may be accurately assessed, when serological tests are less indicative. ECP assay may point to non allergic asthma, either Fernand-Widal syndrome or Churg-Strauss disease. As for gastro-intestinal disorders, it indicates an eosinophilic tissue reaction. In the event of isolated hypereosinophilia, ECP assay may clarify whether it is benign or tending towards idiopathic HES. The assay of peroxidase and eosinophil-derived neurotoxin (EDN) should be also considered.

Study Aim: The aim of this retrospective study was to assess the role of thyroid peroxidase immunodetection in the cytological diagnosis of follicular variants of thyroid papillary cancer (FVTPC) which are difficult to identify by standard cytology., Patients and Methods: Between 1991 and 1998, 3,505 thyroid fine needle aspiration biopsies were performed by thyroid peroxidase immunocytochemistry and 1,576 patients were operated on. Out of a total of 227 thyroid papillary cancers (TPC), 42 (18.5%) were diagnosed as FVTPC. The results of standard cytology and thyroid peroxidase immunodetection were compared with the histological findings., Results: The rate of false negatives for TPC in standard cytology was 11% (25/227 cases), with 40% of these false negatives being FVTPC; ten out of 42 (23.8%) cases of FVTPC were not identified by standard cytology. However, cytology with thyroid peroxidase immunodetection diagnosed 224 out of the 227 TPC (99%), and all the FVTPC were correctly identified (100%)., Conclusion: FVTCP are the most frequent source of false negatives in standard cytology. Thyroid peroxidase immunodetection allows most of these errors to be avoided, and correctly identifies 99% of TPC including FVTPC.

Two peroxidases A and B were purified from a borate buffer extract (pH = 10,4) of durum wheat semolina (Triticum durum), var. Bidi 17, by chromatography on DEAE-cellulose, salting out by 3M ammonium sulphate and two chromatographies on CM-cellulose; specific activities of peroxidase A or B were increased 114 or 66 fold. Molecular weight, amino acid composition, absorption spectrum, pH optimum, thermal stability and KM values differentiate the two enzymes. Ion Ca++ was shown as an activator of both peroxidase activities; the presence of an inhibitor in the crude extract was demonstrated.

Since their first description by P. Langerhans in 1868, the identification of these "clear dendritic cells of the epidermis" has been facilitated by the discovery of specific markers: enzymes ATP ase, endogenous peroxidase; Birbek granules, an ultrastructural organelle described in 1961; immunological membrane markers shared with the Macrophage-Monocyte-Histiocyte system (1977): receptors for the Fc fragment of the immunoglobulins and for complement, HLA-DR (la) antigen. In the skin, the Langerhans cell represents the epidermal equivalent of the macrophage, forming in conjunction with keratinocytes, a reticulo-epithelial system: the fact that the Langerhans cell is marked by the glial S-100 protein suggests that the Langerhans cell represents a monocyte sub-population, morphologically and functionally different from tissue-histiocytes; recently the discovery of membrane antigens defined by monoclonal antibodies: OKT 6, OKT 11 and BL 6, suggests that Langerhan 's cells may be considered as "distinct" macrophages, that have acquired antigenic differenciation in thymic and epidermic epithelia. The nosologic connection between Langerhans cells and "indeterminate cells of the epidermis" remains unclear.

Cytoenzymatic analysis of cells infiltrating heart transplants in the rat confirms the high participation of monocytes and macrophages. However, when comparing iso and allografts, only slight differences are observed in the lysosomal enzyme specific colorations, whereas a striking difference in these colorations is found between heart infiltrates and peritoneal exsudates from these recipients. This could favour the hypothesis of a local macrophage activating process within the graft but seems more probably due to differences in cell maturation stages.

In a retrospective study of 112 adult patients with acute leukaemia (AL), the percentage of undifferentiated leukaemia was reduced to almost 1% by an analysis of routine cytochemical reactions (PAS, peroxidase, esterases and esterase inhibition), B and T lymphocyte markers (IgS, E-rosettes, HuTLA) cAll antigen and ultrastructural detection of peroxidase activity (PO-ME). A simultaneous study of cALL antigen and PO-ME showed reciprocal exclusion of these markers, except in one case of mixed leukaemia. Therapeutically, the value of these tests lies in that patients with typical PAS reaction and cALL antigen consistently respond to vincristine- corticosteroid treatment, whereas patients without cALL and with PO-ME are frequently resistant to that combination of drugs.

Peroxydase activity in various benign thyroid diseases has been investigated. In hyperthyroid patients treated with antithyroid drugs, the observed increase in iodide-peroxydase activity (7 times that of normal tissue) is double than that of the DNA content. In goiter, the activity is 3 times that of normal tissue while the DNA content is unchanged. These results are in agreement with those obtained in rats maintained on a low iodine diet suggesting that high cellular enzymatic activity is due to specific enzyme induction in excess of cell proliferation and protein synthesis.

A case associating a systemic mastocytosis and an acquired myeloperoxidase deficiency is reported. The myeloperoxydase deficiency is studied by cytochemical techniques in optical and electron microscopy and confirmed by biochemical measures. An important defect in bactericidal and candidacidal activity is demonstrated in vitro in P.N.M. The authors discuss the links between the two anomalies which might bring one more argument for the common origin of both granulocytes and mastocytes.

Radioiodine uptake and metabolism study show variations in the functional state of thyroid glands of Xenopus through larval development. During metamorphic climax, the level of hormone synthesis is the highest ; after metamorphosis, labeled thyroid hormones proportion decreases significantly. Normal metamorphosis sequences depend on the gland functional state changes.

This paper describes a morphologic, quantitative, cytochemical study of mononuclear non lymphoid cells in knee synovial fluid in osteoarthritis and various arthritides. Morphologic criteria allow to identify among these cells various synoviocytic and monocytic subtypes with in both types, phagocytic subtypes. Quantitative study shows in arthritides an important afflux of monocytes and a hyperexfoliation of synoviocytes. In fluids with intermediate cellularity, Monocytes/Synoviocytes ratio allows the differential cytodiagnosis between osteoarthrosis and arthritis. All monocytic subtypes and especially the phagocytic one are highly significantly increased in arthritides. Synoviocytic subtypes show a lower increase, except the phagocytic one, which is not changed. Giant multinuclear synoviocytes are found in every type of disease and cannot constitute a cytodiagnosis marker. Alcian Blue and hyaluronidase treatment show hyaluronate in a few percentage of Synoviocytes. Cytoenzymologic study shows that synoviocytes and monocytes are positive in all tested hydrolases: beta Glucuronidase, Acid Phosphatase, alpha Naphthyl Acetate Esterase, these activities being always higher in synoviocytes. With peroxidase, synoviocytes are always negative, so this reaction although it marks only a minority of monocytic population can be used as an extra cytologic criterion for discrimination of mononuclear cells in synovial fluid. In these four enzymes there is no significant quantitative difference at cellular level between osteoarthrosis and arthritides. Lysosomal enzymatic activity in both monocytic and synoviocytic cells confirms their heterophagic properties. However synoviocytic heterophagy seems to be a physiological process not or few affected by inflammatory events. On the opposite, monocytic heterophagy and then macrophagic transformation of monocytes appears as a major aspect of intrasynovial inflammatory reaction. If a large majority of exfoliated synoviocytes comes from A type synovial lining cells and if they belong to Mononuclear Phagocyte System, why do they so weakly, or not, participate as phagocytes to inflammatory reaction.