cyclic-gmp and Malacoplakia

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Biopsy; Cyclic GMP; Escherichia coli Infections; Histiocytes; Humans; Ischemia; Kidney; Kidney Diseases; Malacoplakia; Male; Middle Aged; Periodic Acid-Schiff Reaction; Postoperative Complications; Pyelonephritis; Transplants; Urinary Tract Infections

We studied the blood mononuclear cells in a seventy-four-year old man who had urinary tract malacoplakia located to bladder, ureter and kidney. The blood mononuclear cells were isolated as described by Boyum [2] and studied by electron microscopy. They did not show bacilliform bodies or bacteria in the phagolysosomes. The microfilaments and the microtubules were not easily identifiable in the mononuclear cells of the patient. In the control, the internal skeleton of the mononuclear cells was normal. This ultrastructural finding may suggest that there is a relation between microfilaments and microtubules lesion and the low level of cyclic G.M.P. described by Abdou et al.

Topics: Actin Cytoskeleton; Aged; Cell Separation; Cyclic GMP; Humans; Kidney Diseases; Malacoplakia; Male; Microtubules; Monocytes; Urethral Diseases; Urinary Bladder Diseases

We studied monocyte function in a case of malakoplakia in an attempt to characterize the immune defect in this condition. Our patient's intracellular cyclic-GMP levels were abnormally low (mean +/- S.D. of 0.17 +/- 0.05 pmol per 10(7) malakoplakia cells, versus 0.79 +/- 0.12 in normals) p less than 0.001). After phagocytosis, his monocytes failed to release beta-glucuronidase. In the bactericidal assay, incubation of the patient's monocytes with Escherichia coli allowed growth of 542 +/- 46 colonies, normal monocytes allowed 95 +/- 22 (p less than 0.001). The percentage of monocytes with large lysosomal granules was 23 +/- 4 in the patient and 4 +/- 2 in normal controls. After in vitro incubation of the patient's cells or in vivo treatment with bethanechol chloride, the cyclic-GMP levels, bactericidal ability and lysosomal granules of the cells returned to normal levels. Low levels of cyclic-GMP could impair lysosomal function and bacterial killing in this condition. Cholinergic agonists correct the in vitro abnormalities and are beneficial in vivo.

Topics: Adult; B-Lymphocytes; Bethanechol Compounds; Blood Bactericidal Activity; Chemotaxis; Cyclic GMP; Escherichia coli; Humans; Lysosomes; Malacoplakia; Male; Microtubules; Monocytes; Parasympathomimetics; Phagocytosis; T-Lymphocytes