Recently, we discovered patients with inherited adenosine deaminase (ADA) deficiency are predisposed to pulmonary alveolar proteinosis (PAP). PAP is characterized by the accumulation of surfactant in the alveoli. To overcome ethical issues and limited patient samples, animal models are often utilized. Here, I investigated the lung abnormalities in ADA deficient (ADA -/-) mice, which suffer from severe hypoxia, till their death at 3 weeks. I hypothesized that, similar to ADA-deficient patients, ADA -/- mice demonstrate evidence of PAP. Indeed, electron microscopy showed thickening of type I cells, accumulation of apoptotic foamy alveolar macrophages, cholesterol and lipoproteinaceous material that is periodic-acid Schiff (PAS) positive and diagnostic of PAP. Moreover, the pulmonary abnormalities were corrected with supplementation of ADA. In conclusion, we demonstrated evidence of PAP in ADA -/- mice for the first time and their suitability to study pathogenesis of PAP in ADA deficiency.

Recently, we discovered patients with inherited adenosine deaminase (ADA) deficiency are predisposed to pulmonary alveolar proteinosis (PAP). PAP is characterized by the accumulation of surfactant in the alveoli. To overcome ethical issues and limited patient samples, animal models are often utilized. Here, I investigated the lung abnormalities in ADA deficient (ADA -/-) mice, which suffer from severe hypoxia, till their death at 3 weeks. I hypothesized that, similar to ADA-deficient patients, ADA -/- mice demonstrate evidence of PAP. Indeed, electron microscopy showed thickening of type I cells, accumulation of apoptotic foamy alveolar macrophages, cholesterol and lipoproteinaceous material that is periodic-acid Schiff (PAS) positive and diagnostic of PAP. Moreover, the pulmonary abnormalities were corrected with supplementation of ADA. In conclusion, we demonstrated evidence of PAP in ADA -/- mice for the first time and their suitability to study pathogenesis of PAP in ADA deficiency.

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This study was designed to accomplish two primary objectives: (1) to compare two test methods commonly used to evaluate toxicity of inhaled air pollutants, and (2) to observe the response as measured by each of the methods, of pulmonary alveolar macrophages exposed to 2μg hexavalent chromium. The firs t method evaluated featured use of intratracheal injections to simulate live inhalation exposures, and the second required exposure of macrophages cultured on petri plates. Pulmonary alveolar macrophages harvested from Long Evans rats were used. The two cell function parameters measured in the evaluations were chemiluminescence and oxygen consumption (which was determined for cells at rest and during phagocytosis). These two tests have been shown to be sensitive indicators of macrophage damage. Results of CL output and oxygen consumption revealed the two methods were significantly different. Evaluation of macrophages from live animals treated with CrO3 or CaCrO4showed no differences between their respective untreated controls as determined by measurement of their chemiluminescence production or of oxygen consumption rates. Alveolar macrophages that were cultured in media during treatment with the same two forms of hexavalent chromium showed statistically significant differences from untreated controls. These comparisons indicate that choices of investigative toxicological models influence interpretation of data recorded.

Masters of Science / The infants of women who smoke during pregnancy have a lower birth mass than those born of women who abstain. Animal studies reveal that reduced growth due to maternal nicotine exposure during gestation is accompanied by lung hypoplasia. Biochemical analysis suggests that these lungs contain more cells which implies that lung damage occurs. In this study we examined the in vivo effects of maternal nicotine exposure (lmg/Kg/day), the equivalent of 32 cigarettes per day, on the following parameters of fetal and neonatal Wistar rat lung:(i) the content and distribution of glycogen in fetal and neonatal lung (ii) the status of connective tissue in neonatal lung (iii) the cell composition of the alveoli in neonatal lung. Fetal rat lungs of ages 17, 18, 19 and 20 days and neonatal lungs of 1, 7, 14 and 21 day old pups were used. Light microscope techniques and special stains were used to investigate glycogen, connective tissue, macrophage numbers and morphological status of the lungs. Fetal rat lungs of ages 17, 18, 19 and 20 days and neonatal lungs of 1, 7, 14 and 21 day old pups were used. Light microscope techniques and special stains were used to investigate glycogen, connective tissue, macrophage numbers and morphological status of the lungs. Transmission electron microscope (TEM) techniques were employed to investigate the characteristics and composition of the alveolus The results show clearly that maternal nicotine exposure elevates pulmonary alveolar macrophage numbers'(PAM's) and lung glycogen levels. The quantity of elastic fibres in 1 day old neonates was significantly reduced but no changes in the quantity of reticulin and collagen fibres was observed. As a result of this change in connective tissue status, emphysema-like lesions and alveolar collapse was evident in the lungs of nicotine-exposed pups. TEM investigations revealed that changes to the composition of alveoli occurred. These included increased numbers of type II pneumocytes with high numbers of lamellar bodies with degenerative changes. Thickening of the blood-air barrier was also observed. The effect of maternal nicotine exposure has been documented in this study. However, it has not been possible to pinpoint the mechanisms involved but explanations have been proposed. Further research is required to elucidate the mechanisms by which nicotine produces these effects. Information thus obtained could help prevent the harmful effects to the fetus and neonate caused by smoking during pregnancy.

Zusammenfassung Viele Untersuchungen deuten darauf hin, dass das Surfaktantprotein A (SP-A) sowohl an der Regulation des Surfaktanthaushalts als auch als unspezifisches Opsonin an der Abwehr von Pathogenen in der Lunge beteiligt ist. Zahlreiche Polymorphismen kennzeichnen die Gene der Proteinuntereinheiten SP-A1 und 2. Die häufigste Aminosäuresubstitution Val50Leu befindet sich in der kollagenartigen Domäne, die an den Kollektinrezeptor der Phagozyten bindet. Weitere existieren in der an der Bindung an Lipopolysaccharide, Surfaktantbestandteile und Rezeptoren auf Pneumozyten beteiligten Kohlehydraterkennungsregion (CRD) der globulären Domäne. Träger des schwach exprimierten Wildtypallels 1a0 des SP-A2-Gens haben ein erhöhtes Risiko, am Atemnotsyndrom des Neugeborenen (RDS) zu erkranken. Bei der Alveolarproteinose akkumulieren die hydrophilen Surfaktantproteine A und D in den Alveolen. In der vorliegenden Arbeit wurde eine nested PCR zur isolierten Amplifikation beider SP-A-Gene etabliert. 31 Patienten mit Verdacht auf einen Surfaktantproteindefekt wurden auf neue Restriktionsfragmentlängenpolymorphismen (RFLP) im SP-A1-Gen untersucht. Der in einer Familie konstante NcoI-Polymorphismus 1162C>T in Codon 39 und der NdeI-Polymorphismus 3138T>C in Codon 184 wurden mit einer Allelfrequenz von etwa 11 % detektiert. Die Sequenzen der entsprechenden Allele wurden kloniert. Bei 14 Patienten mit idiopathischer Alveolarproteinose, therapierefraktärem Surfaktantmangel oder rezidivierender Pneumonie wurden die SP-A-Gene sequenziert. Der bisher nur SP-A1 zugeschriebene Aminosäureaustausch Val50Leu wurde als Substitution 1220G>C bei zwei Patienten im SP-A2-Gen nachgewiesen. Drei Patienten mit Alveolarproteinose waren homozygot für die Substitution Gln223Lys in der CRD des SP-A2. Bei einem Patienten handelte es sich möglicherweise um eine somatische Mutation der Leukozyten-DNA im Rahmen einer Leukämie mit sekundärer Alveolarproteinose. Ein anderer war heterozygoter Träger des seltenen Allels 6a4 mit der Aminosäuresubstitution Arg219Trp in der CRD des SP-A1 und hatte die Alveolarproteinose erst im Erwachsenenalter entwickelt. Der dritte war homozygoter Träger des sehr seltenen Allels 1a3 des SP-A2 und verstarb im Alter von 6 Wochen an konnataler Alveolarproteinose (CAP), ohne dass ein bekannter Defekt des SP-B- oder des GM-CSF-Rezeptorgens vorlag. Die SSCP-Analyse konnte allelische Varianten als Einzelstrangkonformationspolymorphismen unterscheiden, war jedoch als Suchtest in heterozygoten Proben zu unspezifisch. Der hohe Gehalt an Polymorphismusinformation (PIC) macht den SP-A-Genort sftp1 zu einem nützlichen Marker bei der Untersuchung der Surfaktantproteine und anderer auf Chromosom 10 lokalisierter Gene. / Abstract Many studies give evidence of the role of surfactant protein A (SP-A) in the regulation of surfactant homeostasis and the defence from pathogens in the lung by opsonisation. The genes for the two protein subunits SP-A1 and SP-A2 are characterised by numerous polymorphisms. The most frequently substituted amino acid Val50Leu is located within the collagen-like region, which is recognised by the collectin-receptor on phagocytes. Further amino acids are substituted in the globular region, which is involved into the binding to lipopolysaccharides, surfactant particles, and receptors on pneumocytes by its carbohydrate recognition domain (CRD). Individuals carrying the weakly expressed wild-type allele 1a0 of SP-A2 have an increased risk of developing the respiratory distress syndrome (RDS) of the new-born. Alveolar proteinosis is a disease with accumulation of the hydrophilic surfactant proteins SP-A and SP-D in the alveoli. In this study a nested PCR for separate amplification of the two SP-A genes has been established. 31 patients with suspected deficiency of a surfactant protein has been investigated for new restriction fragment length polymorphisms (RFLP) in the SP-A1 gene. The NcoI-polymorphism 1162C>T in codon 39, which was constantly inherited in one family, and the NdeI-polymorphism 3138T>C in codon 184 have been detected with an allele frequency of around 11 %. The DNA sequences of these alleles have been cloned. In 14 patients suffering from idiopathic alveolar proteinosis, therapy-refractory surfactant deficiency, or recurrent pneumonia the SP-A genes have been sequenced. The substituted amino acid Val50Leu, which was previously considered exclusively in SP-A1, has been detected in SP-A2 in two patients. Three patients with alveolar proteinosis proved to be homozygous for the substitution Gln223Lys within the CRD of SP-A2. One of these patients might have a somatic mutation in the DNA of his leucocytes, with alveolar proteinosis developing secondary to his leukaemia. Another one developed alveolar proteinosis as an adult and was heterozygous for the rare allele 6a4 which includes the substituted amino acid Arg219Trp in the CRD of SP-A1. The third one proved to be homozygous for the very rare allele 1a3 of SP-A2 and died at 6 weeks of age from congenital alveolar proteinosis (CAP) without having one of the known mutations responsible for this condition within the genes for surfactant protein B (SP-B) or the GM-CSF receptor protein. The allelic variants could be differentiated by single strand conformation polymorphism but the SSCP-analysis was not enough specific for the screening of heterozygous DNA. Due to its high polymorphism information content (PIC), the SP-A gene locus sftp1 is a useful genetic marker for the analysis of the surfactant proteins and other genes located on chromosome 10.