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OBJECTIVE: Autoantibodies against goblet cells in the gastrointestinal mucosa have been described in patients with inflammatory bowel disease (IBD) but a corresponding autoantigen has not yet been identified. The aim of this study was to identify such an antigen. METHODS: First, 10 candidate autoantigens were discarded based on double stainings of appendiceal sections and a mucin-producing cell line (HT29-mtx). Second, an appendiceal cDNA library was immunoscreened with IBD sera. RESULTS: Three out of 48 positive clones were identified as complement C3. Using immunoprecipitation of in vitro transcribed and translated C3, seven of 17 primary sclerosing cholangitis patient sera, 15 of 65 IBD sera, and none out of 54 sera from healthy blood donors showed C3 immunoreactivity. The results were confirmed using western blot and an enzyme-linked immunosorbent assay with alternative sources of C3 protein. CONCLUSION: In conclusion, we have identified complement C3 as a potential autoantigen in IBD and primary sclerosing cholangitis.

BACKGROUND: Primary sclerosing cholangitis (PSC) is an inflammatory disease of the bile ducts with an unknown etiology. A number of autoantigens have been proposed, but an early diagnostic marker is still lacking. Our aim was to identify such an autoantigen. METHODS: Immunostaining was performed on normal human bile duct with sera from patients with PSC and controls. To identify an autoantigen a cDNA library from normal human choledochus was constructed and immunoscreened with patient sera. Using in vitro transcription and translation and immunoprecipitation we examined the immunoreactivity against PDZ domain containing 1 (PDZK1) in 35 patients with PSC, 198 control patients, and 94 healthy controls. RESULTS: We observed a previously unpublished staining pattern in which cytoplasmatic granules and apical cell membranes of biliary epithelial cells were stained by PSC sera. Strong immunoreactivity to these structures was obtained with 12 out of 35 PSC sera (34%) but not with sera from healthy controls. By screening the cDNA library we identified PDZK1 as a candidate antigen. Immunoreactivity against PDZK1 was detected in 9% of PSC patients, 2% of inflammatory bowel disease (IBD) patients, 8% of autoimmune pancreatitis patients, 18% of Grave's disease patients, and 1% of healthy controls. CONCLUSIONS: Previously unpublished, specific, and strong autoantibodies against epithelial cells of the bile duct in PSC sera were identified. Furthermore, PDZK1 is suggested as a potential new autoantigen.

Parathyroid glands from inbred rats were transplanted to rats of the same strain. The transplantation resulted in hyperparathyroidism and persistent hypercalcaemia. These hypercalcaemic animals were compared with the hypocalcaemic donors and with untreated controls. No significant differences in serum gastrin values were found between the different groups. In all three groups, one series of animals was killed 6 weeks after the transplantation (6w series) and another after 14 weeks (14w series). Quantitative studies of the antral gastrin cells showed an increase in the number of these cells per unit volume in the 6w series in the hyperparathyroid recipient animals. The number of gastrin cells per unit segment was also higher in the recipient animals than in the parathyroidectomized and untreated groups in both the 6w and 14w series. The amount of gastrin extracted from antral mucosa did not differ between the different groups. The findings show that an experimentally induced hyperparathyroidism in the rat gives a transient increase in the number of antral gastrin cells but no changes in the antral gastrin or serum gastrin levels.

Argentaffin cells from different parts of the gastro-intestinal tract were examined electron microscopically by the semi-thin/ultra-thin sectioning technique. All these cells contained round or pleomorphic secretory granules, which were mainly concentrated in the infranuclear zone, except in the antrum, where they occurred with a similar frequency in all the peri-nuclear areas. The highest frequency of granules was found in the colon. The largest granules were seen in the duodenum and the smallest in the large intestine. Argentaffin cells with processes oriented towards the glandular and villous surface were most frequent in the small intestine. No secretory granules were seen in the most apical part of these processes, where in an earlier study serotonin immunoreactivity was observed. This may indicate that serotonin can be stores in a non-granular form. No close topographic relationship was found between the argentaffin cells and other endocrine cell types or the nervous system.

BACKGROUND: Chromogranin (Cg) A is expressed in neuroendocrine and neuronal tissues. It is involved in the generation of secretory granules and is cleaved to form biologically active peptides. Targeted ablation of the Chga gene resulted in increased plasma catecholamines, high blood pressure, and decreased size and number of adrenal medullary chromaffin granules. The aim of this study was to determine whether Chga null mice display changes in the morphology and function of the endocrine pancreas. MATERIALS AND METHODS: Sections of pancreata from Chga-/-, Chga+/- and Chga+/+ mice, were immunostained with antibodies against synaptophysin, CgA, CgB, secretogranin II and the four major pancreatic islet hormones. Plasma was analysed for glucose, insulin, glucagon, somatostatin and pancreatic polypeptide (PP). RESULTS: CgA epitopes were undetectable in the islets of Chga-/- animals. CgB and secretogranin II epitopes were expressed in the islets of all animal groups albeit with decreased expression in Chga-/- islets. The islet number and size were decreased in the Chga-/- animals compared with Chga+/+. The proportion of insulin cells was decreased but somatostatin and PP cells were increased in Chga-/- mice compared to Chga+/+ mice. The nuclear size was decreased in insulin cells and increased in somatostatin cells in Chga-/- mice. Plasma insulin level was markedly decreased in the Chga-/- mice although fasting plasma glucose and glucagon were normal. CONCLUSION: Ablation of the Chga gene affected the islet volume, the composition, distribution and nuclear size of islet cell types and plasma insulin concentration. Our data indicate decreased insulin cell function and increased glucagon cell function. Our study shows that CgA exerts a significant influence on the endocrine pancreas with importance in maintaining islet volume, cellular composition and function.

Inflammatory bowel disease (IBD) comprises diseases that are characterized by chronic or relapsing inflammation of the gastrointestinal tract. Primary sclerosing cholangitis (PSC) is an extraintestinal manifestation in IBD. Immunoreactivity against an autoantigen that is expressed both in the gastrointestinal tract and the biliary tract could be the link between these diseases. A possible source of such an antigen is goblet cells. Immunostainings of normal human tissues using IBD patient sera showed goblet cell immunoreactivity against goblet cells in all parts of the gastrointestinal tract. The most frequent immunostaining was found against goblet cells in the appendix against which 84% (42/50) of IBD patients compared to 8% (4/50) of healthy blood donors showed immunoreactivity. To identify the corresponding antigen we used three different approaches, investigation of immunoreactivity to different candidate proteins compared to IBD sera, immunoscreening of an appendiceal cDNA library, and immunoprecipitation of protein lysates from mucin producing cells followed by SDS-PAGE and 2D gel electrophoresis. These approaches led to the identification of several candidate autoantigens of which complement C3 is the most promising. A novel staining pattern with strong immunoreactivity to granules and the apical membrane of biliary epithelial cells was identified with 35% (12/34) of PSC sera compared to none of healthy controls (n=28). Screening of a cDNA library from normal human choledochus identified PDZ domain containing 1 (Pdzk1) and Glutathion S transferase theta 1 (GSTT1) as potential candidates. Pdzk1 is an interesting candidate which is expressed in the intestinal tract and bile ducts. GSTT1 antibodies were not specific for PSC and are thought to develop as an alloimmune response in patients with the GSTT1-null genotype. In conclusion, we have identified specific immunoreactivity to goblet cells and biliary epithelial cells using sera from patients with IBD and PSC respectively. We have also identified several potential autoantigens.

Our aim was to elucidate the incidence and distribution pattern of ghrelin-immunoreactive (IR) cells in various types of human gastric endocrine tumors, and their surrounding mucosa, and relate the findings to total ghrelin concentrations in plasma.It has been demonstrated previously, that ghrelin-IR cells are present not only in normal human gastric oxyntic mucosa, but also in all types of enterochromaffinlike (ECL) cell carcinoids (ECL-CCs), and in mucosal regions affected by ECL cell hyperplasia.Forty-eight gastric endocrine tumors were included in the study: 32 type I ECL-CCs, 3 type II, 9 type III, 1 non-ECL-CC, and 3 poorly differentiated endocrine carcinomas. The tumors were analyzed immunohistochemically with antibodies raised versus chromogranin A, synaptophysin, serotonin, somatostatin, vesicular monoamine transporter 2 and ghrelin. Total ghrelin in plasma was measured in 20 patients, using a commercial radioimmunoassay kit.Ghrelin-IR cells were found in all types I and II ECL-CCs but in only a few cases of the other tumors. Ghrelin-IR cells were also found among the hyperplastic endocrine cells in the mucosa surrounding types I and II, where they showed diffuse, linear, nodular and adenomatoid hyperplasia patterns. In type III ECL-CCs and poorly differentiated endocrine carcinomas, only diffuse and linear ghrelin-IR cell hyperplasia was present in the oxyntic mucosa in about half of the cases, whereas the mucosa of the non-ECL-CC did not show this feature.Despite the frequent occurrence of ghrelin-IR cells in both the neoplastic parenchyma and the oxyntic mucosa, plasma total ghrelin concentrations remained within the reference range and can therefore not be used as a clinical marker to identify ghrelin expressing ECL-CCs or ghrelin cell hyperplasia.

Chromogranins and secretogranins belong to the granin family of proteins, which are expressed in neuroendocrine and nervous tissue. In earlier publications we have described the development of region-specific antibodies against CgA and CgB. In this study we describe antibodies to SgII and SgIII and their usefulness for immunohistochemical staining. Peptides homologous to defined parts of secretogranins II and III were selected and synthesized. Antibodies were raised and immunostainings were performed on normal human pancreas. The SgII 154–165 (N-terminal secretoneurin), SgII 172–186 (C-terminal secretoneurin) and SgIII antibodies immunostained all insulin-immunoreactive cells, most of the glucagon cells and some of the pancreatic polypeptide cells. The SgII 225–242 antibody immunostained only the insulin-containing cells. None of the antibodies immunostained the somatostatin cells. This study is the first observation of the expression of SgIII in human tissues, where we show expression of SgIII in three of the four major islet cell types in human pancreas.

Prohormone convertases (PCs) are proteinases that cleave inactive prohormones to biologically active peptides. Seven PCs have been identified; two of them, PC1/3 and PC2, have only been localized in neuroendocrine (NE) tissues; a third, furin, in both endocrine and exocrine tissues. We have studied the immunoreactivity of PC1/3, PC2 and furin in the four major NE cell types of the human pancreas by using double immunofluorescence techniques. The study also included the expression of NE secretory protein 7B2 (secretogranin V), a member of the granin family, which influences the function of PC2. The results showed that the three PCs and 7B2 were expressed only in endocrine pancreas, furin also in exocrine cells. Insulin (B) cells harboured PC1/3 and PC2, but not furin. Glucagon (A) cells were immunoreactive to all three PCs; all glucagon cells expressed PC2, but one subpopulation showed PC1/3 immunoreactivity and another furin. Only a few somatostatin (D) cells contained PC2, but no other proconvertase. Pancreatic polypeptide (PP) cells were non-reactive to all three PCs. 7B2 occurred only in insulin and glucagon cells. A varying co-localization pattern was observed between PCs and between PCs and 7B2, with the exception of PC1/3 and furin which were not co-localized. In conclusion, our study shows that PCs are localized in insulin and glucagon cells and do seem to be important in these cell types for processing of hormone and other protein precursors, especially chromogranins, but for the two other major cell types probably other enzymes are of importance.

Objective. Colectomized patients often have diarrhoea and increased gastric acid secretion. Although serotonin influences gastrointestinal (GI) motility and secretion, GI serotonin-producing enterochromaffin (EC) cells have not been investigated after colectomy, nor have the antral gastrin cells. The aim of this experimental study was to investigate the GI tract in rats 8 weeks after subtotal colectomy, with particular emphasis on the frequency and distribution of EC and gastrin cells. Material and methods. Immunohistochemical techniques were used to identify the two endocrine cell types. Results. The colectomized animals had diarrhoea. Body-weight was lower and the small intestine shorter in the colectomized animals compared with sham-operated and untreated controls. In the two surgically treated groups, the antral mucosa was thinner and the small intestinal mucosa was thicker compared with that of the untreated rats, whereas the thickness of the rectum of the colectomized rats was increased compared with that of the control groups. In the colectomized animals, the number of EC cells was increased in the small intestine and rectum, whereas the numbers of both EC and gastrin cells were decreased in the antrum. Conclusions. The results indicate that colectomy exerts a significant influence on the GI mucosa and on the endocrine cell systems studied. An increased number of EC cells can result in alterations in motility and secretion, which may be important in the pathogenesis of the diarrhoea that often occurs after colectomy.

Chromogranin A (CgA) and its valuable complement synaptic vesicle protein 2 (SV2) are neuroendocrine (NE) markers. Post-translational processing of CgA has been reported to vary in different NE cell types and tumors, but little is known regarding the expression of various CgA epitopes and SV2 in NE pulmonary tumors. We studied the immunoreactivity to six CgA epitopes and SV2 in ten typical (TC) and ten atypical (ACT) carcinoids, five large-cell NE carcinomas (LCNEC) and five small-cell carcinomas (SCLC), also comparing the results with clinicopathological characteristics of tumors. The sequences CgA 17--38 (vasostatin), 176--195 (chromacin), 375--384 (parastatin) and 411--424 (C-terminal parastatin) and SV2 were relevant markers for the CT/ATC group, whereas the antibody to CgA 176--195 was a better marker for the LCNEC/SCLC group. An inverse correlation was found between proliferative activity and granule-related markers in the CT/ACT group, and a direct correlation in poorly differentiated tumors. The expression of granule-related markers did not correlate with hormone content or clinical characteristics of NE tumors. The expression of CgA epitopes and SV2 occurs in all NE tumors, differing between better differentiated and poorly differentiated tumors but not within the respective groups.

Cellular localisation of chromogranins and processed products in the diffuse neuroendocrine system and related tumours

Region-specific antibodies against chromogranin B display differentimmunoreactivity in the human pancreatic islet cell types.

Chromogranin (Cg) B is an acidic glycoprotein present in neuroendocrine tissue. The sequence shows several dibasic amino acid positions susceptible to proteolytic cleavage. The purpose of this study was to elucidate the expression of CgB epitopes in the human endocrine pancreas. Tissue sections of six human pancreata were immunostained with 16 different region-specific antibodies to the CgB molecule, using double immunofluorescence techniques. The CgB epitope pattern varied in the four major islet cell types. B (insulin)-cells expressed immunoreactivity to all region-specific antibodies. The antibodies to the N-terminal and mid-portions of CgB showed moderate immunoreactivity, the C-terminal antibodies weak. A (glucagon)-cells were reactive only to the N-terminal and mid-portion antibodies but, after microwave pretreatment, to all antibodies, whereas D (somatostatin)-cells expressed only the sequence CgB 244–255 and a subpopulation CgB 580–595. PP (pancreatic polypeptide) cells were immunostained with antibodies between CgB 1–417 and a few with CgB 580–593. The fragment CgB 244–255 was expressed in all four cell types. The cause of these differences may be cell-specific cleavage or masking of the molecule, but varying translation of CgB mRNA is also possible. The extent to which these epitopes reflect fragments having biological functions remains to be evaluated.

Antibodies to six specific regions of the chromogranin A (CgA) molecule were used to study their immunoreactivity in human neuroendocrine (NE) tumors. Tissue specimens from endocrine pancreatic tumors (n = 14), duodenal carcinoids (n = 2), bronchial carcinoids (n = 5), ileal carcinoids (n = 5) appendix carcinoids (n = 2), medullary thyroid carcinomas (n = 6), parathyroid adenomas (n = 2), and pheochromocytomas (n = 8) were analyzed. The results showed that the NE tumor types expressed varying numbers of CgA fragments. A variation in frequency of the expression of immunoreactive cells was sometimes seen also within the same tumor type. The midportion fragment CgA 176-195 (chromacin) was the only fragment expressed in all tumors. Benign and malignant tumors expressed different patterns, being especially true of insulinomas and pheochromocytomas. These findings suggest that region-specific antibodies to CgA fragments can be used as a diagnostic tool for the characterization of NE tumors.

Knowledge concerning tissue-specific expression of the five somatostatin receptor subtypes is of great importance in understanding their physiological function. We developed rabbit polyclonal antibodies specific for each human somatostatin receptor subtype and report our results concerning the expression in normal endocrine pancreatic cells. The antibodies were produced by immunizing rabbits with fragments specific for the five cloned somatostatin receptor subtypes. Colocalization of these somatostatin receptors with the four major islet hormones--insulin, glucagon, somatostatin, and pancreatic polypeptide--was studied in normal human endocrine pancreatic cells, using double-immunofluorescence staining. High expression of somatostatin receptor subtypes 1, 3, and 4 was found in all endocrine pancreatic cells. Somatostatin receptor subtype 2 was frequently expressed in alpha and beta cells, whereas expression was low in pancreatic polypeptide cells and intermediate in delta cells. Somatostatin receptor subtype 5 was expressed in most beta and delta cells but almost absent in alpha and pancreatic polypeptide cells. There is a variability in the normal expression of somatostatin receptor subtypes among the different human endocrine pancreatic cells. Knowledge of this expression and the physiological function mediated by these receptors will be valuable in the future when considering treatment of endocrine disorders.

Thyroidectomy appears to reduce the serotonin content in the rat brain, whereas hyperthyroidism has the opposite effect. As it is not known whether the serotonin-producing cells of the gastrointestinal tract are influenced by these conditions, the effects of thyroparathyroidectomy and induced hyperthyroidism were studied experimentally, particularly as regards the serotonin- and gastrin-immunoreactive cells of the gastrointestinal tract. Immunocytochemical and quantification techniques were used to localize and determine the numbers of serotonin and gastrin cells. In thyroparathyroidectomized rats the intestine was significantly shorter and the mucosa thinner than in sham-operated and untreated controls, whereas the converse was found in the hyperthyroid rats. Following thyroparathyroidectomy, there were fewer gastrin-immunoreactive cells in antrum and the serotonin-immunoreactive cells were significantly less dense throughout the gastrointestinal tract. In hyperthyroid rats, gastrin-immunoreactive cells were more numerous, as were the serotonin-immunoreactive cells in the small intestine, whereas these cells were fewer in antrum and caecum. In conclusion, the thyroid gland exerts a significant influence on the gastrointestinal tract and on the serotonin- and gastrin-immunoreactive cells. The observed alterations may reflect a direct effect of the thyroid hormones, although indirect factors must also be considered.

The effect of hypophysectomy on the gastrointestinal tract was studied in the rat 8 wk after operation, particularly regarding the frequency and distribution of serotonin, somatostatin and gastrin-immunoreactive cells. Body weight, the length of the intestine and the thickness of the mucosa of the antrum and small intestine were all reduced in the hypophysectomised rats compared with sham-operated and untreated controls. In the hypophysectomised animals the serotonin-immunoreactive cells were fewer in the antrum and caecum, whereas they were more numerous in the proximal large intestine. There were fewer gastrin-immunoreactive cells in the antrum, while the somatostatin-immunoreactive cells were more numerous in the antrum and caecum. The significant influence of hypophysectomy on the gastrointestinal tract could be direct, but could also be associated with the marked effect of pituitary deficiency on endocrine cells, known to exert both trophic and antitrophic actions. However, it could also be an indirect effect on metabolism, resulting in lower food intake, other endocrine cell systems, and growth factors.

The effects of bilateral adrenalectomy on the serotonin-, somatostatin-, and gastrin-immunoreactive cells in the rat gastrointestinal tract were studied four weeks after surgery. Body weight was reduced and the small intestine shorter in adrenalectomized animals compared with controls, while no changes were found in the histology of the mucosa. In the adrenalectomized animals the number of serotonin-immunoreactive cells was increased in the cecum and large intestine, while the somatostatin-immunoreactive cells were decreased in number in the antrum and increased in the corpus, cecum, and large intestine. The gastrin-immunoreactive cells in the antrum were not affected in number, but their nuclear size was enlarged, possibly indicating increased cellular activity.

Background/Aims: Genetically diabetic (db/db) mice are a model for non-insulin-dependent diabetes in humans. The gastrointestinal tracts in 12-week-old db/db and nondiabetic control (db/+) mice were studied with particular emphasis on the endocrine cells. Methods: Immunocytochemical and quantification techniques were used to localize and determine the number of cells containing serotonin and various regulatory peptides. Results: In the antrum, the gastrin- and serotonin-immunoreactive cells were increased in number. In the large intestine, the enteroglucagon and the peptide tyrosine-immunoreactive cells were increased in number, whereas there were fewer serotonin-immunoreactive cells. There were also fewer somatostatin-immunoreactive cells in most gastrointestinal regions. In diabetic mice, the intestine was longer and its mucosa thicker than in control mice. Conclusions: The results indicate that the genetic diabetic (db/db) condition exerts a significant influence on the gastrointestinal tract and on the endocrine cell systems studied. The observed alterations may reflect the effect of indirect factors rather than the diabetes per se.

Objectives: Somatostatin inhibits hormone release through 5 G proteinYcoupled somatostatin receptors (sst1-sst5). However, the role of somatostatin in islet physiology is not fully known. The immunoreactivity to sst1 to sst5 in normal human endocrine pancreas has been described. The present study reports the expression of sst1 to sst5 in human pancreatic islets with type 2 diabetes mellitus. Methods: Pancreatic autopsy specimens from individuals with type 2 diabetes mellitus and matched controls were double immunostained to demonstrate sst1 to sst5 in the major islet cell types. Results: Most apparent differences in type 2 diabetic islets were the lack of sst1 and sst4 in glucagon cells and sst1-3 and 4 in somatostatin cells, whereas minor changes were demonstrated in insulin cells. The pancreatic polypeptide cells showed a reversed staining pattern in diabetic islets compared with the controls. Conclusions: In type 2 diabetes mellitus, the sst pattern differed from that of the controls in somatostatin, pancreatic polypeptide, and glucagon cells, to a minor extent in insulin cells. It is unclear whether the changes in sst patterns are primarily due to the diabetes or secondary to metabolic disturbances. However, this study may be the basis for further functional studies to evaluate the role of sst1 to sst5 in the diabetic state.

The aim of the present study was to investigate ECLomas and enterochromaffin-like (ECL) cell hyperplasia in gastric human mucosa regarding the immunohistochemical expression of chromogranin A (CgA) epitopes and to measure the same CgA epitopes in plasma samples. Eight gastric biopsies from ECLomas, seven of type I and one of type III, and biopsies from one patient showing only ECL cell hyperplasia were included in the study. Our results revealed a varying expression of region-specific CgA epitopes in the ECLomas regarding both the frequency of immunoreactive cells and intensity of immunoreactivity. CgA284-301 (pancreastatin) was not revealed in any neoplasm, whereas CgA361-372 (catestatin) was expressed in all ECLomas. However, the number of immunoreactive cells to vesicular monoamino transporter 2 (VMAT 2) or the commercial monoclonal CgA (CgA250-284) antibodies were generally higher. The plasma concentrations of the region-specific CgA radioimmunoassays differed considerably, with highest concentrations of CgA1-17 and CgA116-130 epitopes and the lowest with the CgA17-37, CgA63-76, CgA238-247 and CgA441-424 epitopes. No relationship was found between tissue expression and plasma concentration of CgA epitopes. In conclusion, this study shows that VMAT 2 and the commercial CgA antibodies seem more useful for histopathological diagnosis of ECLomas than the antibodies to the other CgA regions.

A characteristic feature of neuroendocrine tumors is production and release of peptide hormone. Ghrelin is a 28-amino acid hormone that stimulates GH release. In this paper, we describe a patient with a metastasizing gastric neuroendocrine tumor displaying intense immunoreactivity for ghrelin and extremely high circulating levels of ghrelin. Tumor tissue biopsies from the primary tumor and one liver metastasis were examined by immunohistochemistry. Ghrelin and several other hormones and tumor markers were measured in blood. The clinical course of the patient was followed. Tumor tissue biopsies showed immunoreactivity for cytokeratin, chromogranin A, human synaptic vesicle protein 2, synaptophysin, and ghrelin. Grossly elevated circulating levels of total ghrelin, 2100 microg/liter (reference interval < 5 microg/liter) and active ghrelin, 28 microg/liter (reference interval < 0.1 microg/liter) were found at presentation. Chromogranin A, chromogranin B, and calcitonin levels were also increased. Both total and active ghrelin increased, despite treatment, during follow-up of the patient. We have identified and characterized a patient with a malignant gastric neuroendocrine tumor secreting ghrelin as the main hormone. This might be a new tumor entity of the stomach, and it is suggested that patients with malignant gastric neuroendocrine tumors should be investigated for ghrelin production.

Patients with autoimmune polyendocrine syndrome type 1 often have autoantibodies against neurotransmitter synthesizing enzymes, including the pyridoxal phosphate-dependent enzymes glutamic acid decarboxylase and aromatic L-amino acid decarboxylase. Using a candidate approach, we have identified the histamine-synthesizing enzyme histidine decarboxylase, also pyridoxal phosphate dependent, as an autoantigen in this disorder. Anti-histidine decarboxylase antibodies reacting with in vitro translated antigen were found in 36/97 (37%) of autoimmune polyendocrine syndrome type 1 patients studied. The antibodies also reacted with the native enzyme in HMC-1 cell lysates and did not cross-react with the highly homologous aromatic L-amino acid decarboxylase. Anti-histidine decarboxylase antibodies were associated with a history of intestinal dysfunction (P = 0.017). Gastric and duodenal biopsies from a patient with anti-histidine decarboxylase antibodies were studied by immunohistochemistry. The oxyntic mucosa was found to lack the histamine producing enterochromaffin-like cells, suggestive of an autoimmune destruction. To our knowledge, this is the first report of autoantibodies against histidine decarboxylase and absence of gastric enterochromaffin-like cells.

The spontaneously diabetic Goto-Kakizaki rat harbors the same defects expressed in human type 2 diabetes. It is not clear, however, whether stress factors emanating from the adrenal glands are involved in causing the diabetic state. For that reason, the authors studied gland size and expression of adenylyl cyclase isoforms in adrenal glands from Goto-Kakizaki and normal rats. Goto-Kakizaki rat adrenals were found to weigh only about half as much as those of control rats. This decrease was the result of a reduction of the cortex, especially of the zona fasciculata, whereas the medulla was unaffected. Cell density measurements showed that the total number of medullary cells in Goto-Kakizaki rats was lower than that in controls. In the cortex, the cell density did not differ between the two groups; thus, our results point to a marked hypotrophy. In the medulla of Goto-Kakizaki rats, the nuclear size was significantly increased, and there was also an overexpression of adenylyl cyclase 1, 2, 4, 6, and 8 isoforms in the adrenalin-producing cells, indicating an increased functional capacity. In the cortex, despite the cortical hypotrophy, adenylyl cyclase 5 immunoreactivity was markedly increased in Goto-Kakizaki rats, especially in the zona reticularis. It is unclear whether this morphologic change in the diabetic adrenal glands together with the overexpression of different adenylyl cyclase isoforms plays a role in the pathogenesis of this diabetic state or is a genetic defect or compensatory mechanism of diabetes in this spontaneous rodent model of type 2 diabetes.

Introduction Knowledge about the relation between G proteins and adenylyl cyclases (ACs) is important for the construction of signaling paradigms to increase our understanding of signal transduction in the normal state and its alterations in pathologic states, such as type-2 diabetes. Aims and methodology The immunocytochemical expression patterns of the stimulatory Gs proteins (G alpha-s and G alpha-olf) and the in vitro Ca2+-stimulated ACs (AC1, 3, and 8) were studied in normal and spontaneously diabetic Goto-Kakizaki (GK) rat pancreatic islets with use of well-characterized antibodies. The expressions of G alpha-11 and AC2, abundant in pancreatic islets, were also studied. Results G alpha-s and G alpha-olf were mainly expressed in insulin cells, and G alpha-11 in glucagon cells. The immunoreactivity to G alpha-s and G alpha-olf and to AC1 and AC3 was higher in the GK islets than in the controls, whereas AC8 was found only in the diabetic islets. Strong G alpha-11 and AC2 immunoreactivity was seen equally in both animal groups. G alpha-s was colocalized with all ACs, whereas G alpha-olf was mainly colocalized with AC3, and G alpha-11 with AC1. Conclusion The current findings may help in drawing a more specific signaling paradigm coupling Gs proteins to ACs.

Insulin-like growth factor II (IGF-II) appears to play an important role during fetal life in cell growth and differentiation in several organs, including the pancreas. In the present study we investigated the cellular localization of IGF-II in human fetal pancreas at 16, 18 and 22 embryonic weeks and compared it with adult pancreas. Single and double immunofluorescence methods were used to study co-localization of IGF-II with the four major islet hormones - insulin, glucagon, somatostatin, pancreatic polypeptide - and with islet amyloid polypeptide (IAPP). Distinct IGF-II immunoreactive (IR) cells were found in the endocrine, but not in the exocrine, pancreas. The intensity of IGF-II immunoreactivity was more pronounced in the fetal than in the adult pancreas. In fetal pancreas IGF-II immunoreactivity was observed in virtually all insulin-IR cells and in subsets of the glucagon, somatostatin and IAPP cells. In the adult pancreas, IGF-II immunoreactivity was found in insulin/IAPP cells only. Our results suggest a broader effect of IGF-II in fetal endocrine pancreatic cells than in the adult.

Thyroidectomy appears to reduce the serotonin content in the rat brain, whereas hyperthyroidism has the opposite effect. As it is not known whether the serotonin-producing cells of the gastrointestinal tract are influenced by these conditions, the effects of thyroparathyroidectomy and induced hyperthyroidism were studied experimentally, particularly as regards the serotonin- and gastrin-immunoreactive cells of the gastrointestinal tract. Immunocytochemical and quantification techniques were used to localize and determine the numbers of serotonin and gastrin cells. In thyroparathyroidectomized rats the intestine was significantly shorter and the mucosa thinner than in sham-operated and untreated controls, whereas the converse was found in the hyperthyroid rats. Following thyroparathyroidectomy, there were fewer gastrin-immunoreactive cells in antrum and the serotonin-immunoreactive cells were significantly less dense throughout the gastrointestinal tract. In hyperthyroid rats, gastrin-immunoreactive cells were more numerous, as were the serotonin-immunoreactive cells in the small intestine, whereas these cells were fewer in antrum and caecum. In conclusion, the thyroid gland exerts a significant influence on the gastrointestinal tract and on the serotonin-and gastrin-immunoreactive cells. The observed alterations may reflect a direct effect of the thyroid hormones, although indirect factors must also be considered.

Pinto HC, Ferra MA, Baptista A, de Moura MC & Portela-Gomes GM. Serum gastrin and gastrinimmunoreactive cells in the antral mucosa of patients with alcoholic liver disease. APMIS 2000;108:51‐6. Background/Aims. Hypergastrinaemia has been reported in liver cirrhosis; meanwhile, it is unclear whether it is associated with an increase in gastrin cell function. The serum gastrin concentration and the number of gastrin cells in antral biopsies were studied in patients with alcoholic liver disease. Methods. Immunocytochemical and quantification techniques were used to localize and determine the number of gastrin cells. Results. Slight non-significantly higher serum gastrin values were observed in the alcoholic liver disease patients compared with controls, but the individual variation within the groups was considerable. The frequency of gastrin cells did not differ between groups. However, the size of the gastrin cell nuclei was larger in patients with liver disease than in controls, indicating increased cellular activity. Conclusions. Alcoholic liver disease, with a disturbed liver function, influences the gastrin cells. The observed alterations may reflect the effect of alcohol and/or malnutrition, or may be secondary to the influence of liver disease on other regulatory peptides.

The effects of bilateral adrenalectomy on the serotonin-, somatostatin-, and gastrin-immunoreactive cells in the rat gastrointestinal tract were studied four weeks after surgery. Body weight was reduced and the small intestine shorter in adrenalectomized animals compared with controls, while no changes were found in the histology of the mucosa. In the adrenalectomized animals the number of serotonin-immunoreactive cells was increased in the cecum and large intestine, while the somatostatin-immunoreactive cells were decreased in number in the antrum and increased in the corpus, cecum, and large intestine. The gastrin-immunoreactive cells in the antrum were not affected in number, but their nuclear size was enlarged, possibly indicating increased cellular activity.

Co-localization of chromogranin (Cg) A, B, and C has been studied in different neuroendocrine cell types in histologically normal mucosa from human gastrointestinal tract (corpus, antrum, duodenum, ileum, and colon) using single-, double-, and triple-immunofluorescence stainings. Virtually all enterochromaffin (EC) cells contained CgA, and those in the luminal two thirds of the antral mucosa and villi of small intestine often also contained CgB. A few EC cells in the duodenal crypts contained CgC. Most gastrin cells harbored both CgB and CgA, although rather more CgB than CgA, but some gastrin cells contained all three types, i.e., also CgC. Some CCK cells also contained all three chromogranins. Enteroglucagon cells in the duodenal villi contained CgA and some CgB. CgA (but not B or C) was found in some secretin, GIP, enteroglucagon/peptide YY, and neurotensin cells. A few somatostatin cells contained CgA but neither CgB nor CgC. CgA and C were found mainly in the basal cell region, whereas CgB occurred more diffusely throughout the cytoplasm. This varying distribution suggests that not all secretory granules contain CgA, or that CgB may occur in a nongranular form. The varying composition of the different chromogranins may reflect their complex functional roles in the widespread neuroendocrine system.

Co-localization of chromogranin (Cg) A, B and C has been studied in different neuroendocrine cell types in histologically normal mucosa from human gastrointestinal (GI) tract (corpus, antrum, duodenum, ileum and colon). Single, double and triple immunofluorescence stains were used, including appropriate controls. The results showed that whereas CgA cells predominated in all GI-regions, CgB cells were numerous in antrum, few in duodenum (only villi), and almost non-existent in corpus, ileum and colon. CgC cells were sparse in antrum and duodenum (only crypts). Concerning co-localization, gastrin cells harboured CgA and B, some also CgC. All EC cells displayed CgA-immunoreactivity. The EC cells localized in the luminal 23 of the antral mucosa and those in the duodenal villi also contained CgB. Occasionally the EC cells in the duodenal crypts displayed CgC. Almost all cells showing immunoreaction to enteroglucagon/PYY, secretin, neurotensin, or GIP were positive for CgA. Somatostatin cells were with few exceptions CgA-negative, and displayed neither CgB nor C immunoreactivity. CCK cells, indirectly identified, were negative for CgB and C, probably also for CgA.Regarding intracellular localization, CgA and C were seen closer to the basal cell regions, whereas CgB was found more diffusely spread throughout the cytoplasm. This difference in localization between chromogranins suggests that not all secretory granules contain CgA or that CgB may appear in a non-granular form. The results confirm previous findings that CgA occurs in most neuroendocrine cell types of the GI-tract. In most gastrin cells there were two sets of chromogranins, CgA and B, a minority all three chromogranins. All EC cells were CgA immunoreactive, a minority also contained CgB (antrum + duodenal villi) or CgC (duodenal crypts), but not both. All CCK cells seem to be devoid of chromogranins. With few exceptions the same was true of the somatostatin cells. An interesting question posed by the present study is why the chromogranins occur in varying extent and composition in the different cell types.

Forty-five carcinoids from the gastrointestinal tract, classified on morphological grounds, were stained with an argentaffin technique (Masson-Hamperl, Virchows Arch [Pathol Anat] 266:509-548, 1927) and three argyrophil techniques (Grimelius, Acta Soc Med Upsal 73:243-276, 1968; Sevier-Munger, J Neuropathol Exp Neurol 24: 130-135, 1965; and Hellerstrom-Hellman, Acta Endocrinol (Kbh) 35:518-532, 1960). Most but not all carcinoids from the embryonal midgut were argentaffin, whereas most fore- and hindgut carcinoids were nonargentaffin. The argyrophil stain of Sevier-Munger stained all argentaffin tumors and in addition a few nonargentaffin foregut carcinoids. The Grimelius stain stained all and the Hellerstrom-Hellman stained none of the tumors, irrespective of their location. In the argentaffin carcinoids the frequency of argyrophil cells exceeded that of argentaffin cells.

A quantitative study was made of the enterochromaffin (EC) cells, visualized with the Masson (slightly modified) and Falck-Hillarp techniques, in the rat gastrointestinal tract. Different factors influencing the quantification were analysed and the magnitude of methodological errors was estimated. The two histochemical techniques visualized the EC cells in different ways, influencing the quantification results. This means that a comparison of the quantitative results obtained by these techniques can only be made after correction by some factors. The frequency of EC cells is given as the number of cells both per mm3 mucosa (cellular density) and per segment of mucosa with a base of 1 mm2. The latter information takes into account both cellular density and mucosal thickness. The highest frequency of EC cells was found in the pyloric gland area of the stomach. On the border with the duodenum there was a marked decrease in this frequency and in the whole intestine the frequency was low, with only minor fluctuations of the mean values. The frequency was increased in the caecum, followed by a gradual decrease in the large intestine. The quantitative variation of the EC cells at the same gastrointestinal level was considerable, and was greater between animals than between serial sections within the same animal. The difference in EC cell frequency that was required to give significance was calculated. For quantitative studies the Masson method has some minor advantages over the Falck-Hillarp technique, as routine formalin-fixed deparaffinized sections can be used and no counterstaining is needed for the areal estimation.

Summary The staining characteristics of the ent.eroohromaffin cell system in the hU111an and rat gastrointestinal tract were studied with 3 histochemical procedures - the Masson method, formaldehydeinduced fluorescence (FIF), and immunocytochemical techniques using both monoclonal and polyclonal serotonin antisera. A simple modification of the Masson technique is described and COInpared with several other modifications of the same technique. The specificities of the 2 antisera were examined with regard to serotonin and other monoamines and their albumin conjugates, monoamine precursors and metabolites, and also to serotonin-related substances. In the intestine, with very few exceptions the same cells reacted positively with the 3 staining methods, but often serotonin immunoreactivity was observed in larger cytoplasmic areas than the other 2 staining reactions. In the antral mucosa, a cell population with the same staining characteristics as mentioned above was seen, but 2 further cell populations were identified - one displaying FIF-argentaffin reactions but no serotonin immunoreactivity, and the other showing the opposite characteristics. At immunostaining, a discrepancy in the staining results between the 2 antisera was noted a larger number of antral serotonin immunoreactive cells being demonstrated with the polyclonal than with the monoclonal antiserum ; this discrepancy disappeared when the polyclonal antiserum was pretreated with C-terminal tetragastrin. A mi nor discrepancy in the number of stained cells was still observed between the use of immunostaining with monoclonal or with tetragastrinpretreated polyclonal antiserurn, and the use of the FIF-argentaffin reactions. The reason for this discrepancy is unclear.

On the basis of staining results in closely related semi-thin sections from rat antral mucosa immunostained with polyclonal serotonin antibodies and silver-stained for the argentaffin reaction, respectively, three different cell populations could be distinguished. One of these cell populations showed both serotonin immunoreactivity and an argentaffin reaction, a second one serotonin immunoreactivity alone, and a third one only an argentaffin reaction. These cell populations were studied electron microscopically in ultra-thin sections located between the stained semi-thin sections. The cell population displaying an agentaffin reaction and serotonin immunoreactivity showed secretory granules of the enterochromaffin cell type. A similar granular appearance was observed in cells which only exhibited an argentaffin reaction. Serotonin immunoreactivity in the absence of an argentaffin reaction was evident in some G (gastrin) cells, and in some D1 and possibly also some D (somatostatin) cells; but not all the endocrine cells of the non-enterochromaffin type displayed serotonin immunoreactivity. The significance of the different reactions in the three cell populations is discussed.

The effects of endogenous hypergastrinemia and hypogastrinemia on the exocrine and endocrine pancreas were studied in the rat. Hypergastrinemia was induced by antral exclusion, and hypogastrinemia by antral resection. The studies were made 14 weeks after surgery. The total weight of the pancreas was increased both in hypergastrinemic and hypogastrinemic animals, due to hypertrophy of the exocrine cells. In contrast, the volume and total weight of the pancreatic islets were decreased. There was no numerical difference in the A-, D-, PP-cells between the hyper- and hypogastrinemic animals, respectively, and the controls. The number of insulin-producing (B-) cells was certainly reduced after the induction of hypogastrinemia. There was, however, signs of increased B-cell activity, which might contribute to an underestimation of the number of B-cells with the technique used. These findings do not support the hypothesis that antral gastrin has trophic influence on either exocrine or endocrine pancreas.

Argentaffin cells from different parts of the gastro-intestinal tract were examined electron microscopically by the semi-thin/ultra-thin sectioning technique. All these cells contained round or pleomorphic secretory granules, which were mainly concentrated in the infranuclear zone, except in the antrum, where they occurred with a similar frequency in all the peri-nuclear areas. The highest frequency of granules was found in the colon. The largest granules were seen in the duodenum and the smallest in the large intestine. Argentaffin cells with processes oriented towards the glandular and villous surface were most frequent in the small intestine. No secretory granules were seen in the most apical part of these processes, where in an earlier study serotonin immunoreactivity was observed. This may indicate that serotonin can be stores in a non-granular form. No close topographic relationship was found between the argentaffin cells and other endocrine cell types or the nervous system.

The effects of gastroenteroanastomosis, antral exclusion and antral resection on the enterochromaffin (argentaffin) cell system in the rat alimentary tract were studied 6 weeks after the operation. When measured as cell density per mm3 mucosa, the number of enterochromaffin cells was decreased in most gastrointestinal regions following the three surgical procedures. In the antral exclusion group this decrease was most apparent in the caecum and large intestine, and in the animals with antral resection it was most pronounced in the proximal and middle regions of the small intestine. When expressed per segment mucosa, the enterochromaffin cells were even more reduced in number in all three experimental groups, as a result of mucosal atrophy in the entire gastrointestinal tract. The atrophy was most pronounced in animals with gastroenteroanastomosis, and least pronounced in those with antral exclusion. The underlying mechanisms of the effects on the enterochromaffin cell system under these experimental conditions are discussed.

The effect of vagotomy on the enterochromaffin (argentaffin) cells in the rat gastrointestinal tract was studied 6 weeks after the operation. No effect was found, as indicated by the following parameters--the frequency of the silver-positive cells in different parts of the digestive tract, the intensity of the argentaffin reaction in the individual cells, and the nuclear size of the enterochromaffin cells.

The 5-HT levels in biopsies from the rat gastrointestinal tract were measured by a sensitive liquid chromatography method with electrochemical detection. The highest levels were found in the gastroduodenal and cecal regions. Sham-operated controls were compared with rats subjected to combined truncal vagotomy and pyloroplasty or pyloroplasty alone 5 weeks after surgery. Significantly decreased 5-HT levels were demonstrated in animals subjected to vagotomy + pyloroplasty or to pyloroplasty alone, compared with sham-operated controls. In the upper gastrointestinal tract of vagotomized animals significantly decreased 5-HT levels were found when compared with animals subjected to pyloroplasty alone. However, anesthesia and surgery (sham operation) per se markedly increased 5-HT levels of the gut even 5 weeks postoperatively, when compared with acutely killed rats. The underlying mechanism is still obscure. However, vagotomy largely prevented this increase. Therefore, the importance of correct controls is emphasized, since previous investigations claim to have demonstrated increased 5-HT levels in vagotomized animals, when compared with nonoperated controls.