Importância clínica da resistência a múltiplas drogas nas leucemias agudas / The clinical importance of the resistance to multiple drugs in acute leukemias

Um número significativo de pacientes com leucemia aguda falha em conseguir cura devido ao desenvolvimento de resistência aos quimioterápicos. Uma série de evidências indica que a expressao do gen mdr 1, que codifica para a glicoproteína P (GpP), contribui para a resistência das células leucêmicas aos agentes antineoplásicos. A GpP funciona como uma bomba de efluxo, dependente de ATP, transportando diversas drogas, aparentemente nao-relacionadas, para o exterior da célula. Essa açao pode ser modulada por uma série de drogas denominadas reversoras ou moduladoras da resistência a múltiplas drogas (MDR). No presente trabalho, sao citados alguns métodos para a detecçao do fenótipo MDR, salientando-se que, possivelmente, os resultados mais seguros sao aqueles que utilizam a associaçao de vários métodos. Apesar das divergências quanto ao método mais sensível e específico, a maioria dos autores concorda com o fenótipo MDR, isoladamente, influencia no prognóstico. A coexpressao da GpP com a molécula CD34 confere um pior prognóstico nas leucemias agudas. Os autores demonstram, usando testes de cultura celular com quimioterápicos isoladamente ou associadas a agentes reverssores, que essa linha de pesquisa pode sugerir, no futuro, um tratamento clínico individualizado. Eles enfatizam a necessidade de um estudo integrado dos hematologistas com a pesquisa básica, visando proporcionar uma nova opçao terapêutica aos pacientes refratários ao tratamento convencional.

Sensitivity of vincristine-sensitive K562 and vincristine-resistant K562-Lucena 1 cells to anthracyclines and reversal of multidrug resistance

The phenomenon of multidrug resistance (MDR), that involves the efflux pump P-glycoprotein, can be reversed by a number of substances known as MDR modulators or reversing agents. In the present study we investigated the action of three anthracyclines, mitoxantrone and vincristine on short-term (72 h) cultures using 2 methods ([3H] incorporation and MTT (3-[4,5-dimethylthiasol-2-yl]-2,5-diphenyltetrazolium bromide)), on 2 cell lines: K562, a human erythroleukemia, and a vincristine-resistant subline K562-Lucena 1. Using the same culture methods plus flow cytometry analysis, the reversing potentials of cyclospotin A and verapamil were studied in both cell lines. There were differences in the sensitivity and resistance profiles of the two lines to the various drugs but daunorubicin (5 mug/ml) and idarubicin (0.035 mug/ml) were the most effective when each was used in high concentration. Cyclosporine at 200 mug/ml and verapamil at 5 mug/ml reversed MDR in the resistant line, and had a synergistic action with chemotherapeutic agents on the sensitive line. Again differences were demonstrable between combinations of the various drugs and reversal was only clearly shown with the method measuring cell proliferation ([3H] incorporation) but not by the method measuring metabolic activity (MIT). The efflux of rhodamine-123 mimics the functional activity of the pump and cyclosporine was a better reversing agent by this criteria. These data show that the results obtained in in vitro studies attempting to identify treatments for different types of leukemias depend to a large extent on the methods used to measure cell response.

Trifluoperazine reduces the expression of CD69 in phytohemagglutinin-activated lymphocytes

Trifluoperazine (TFP) is a phenothiazine capable of inhibiting lymphocyte proliferation as well as natural killer cells (NK) and lymphokine-activated killer cells (LAK) cytotoxic activity. CD69 is a surface molecule induced by various mechanisms of cellular activation. In the present work the modulation of CD69 expression by TFP was investigated on PHA-stimulated peripheral blood mononuclear cells and compared to that of CD25 (IL-2 receptor) expression. Determination of surface molecules was performed in an indirect immunofluorescence assay using anti-CD69 or anti-CD25 monoclonal antibodies, and analyzed by flow cytometry. The time course of the expression of these two molecules differed: CD69 expression was already declining at 48 h, whereas CD25 was still increasing at 72 h after stimulation. TFP (10 muM) reduced CD69 expression by 71.8 per cent at 24 h, 68.4 per cent at 48 h and 24 per cent at 72 h following activation. In contrast, the same dose of TFP did not significantly affect CD25 expression at 24 h but showed an inhibitory effect at later times. These results suggest that different activation pathways are involved in the expression of CD25 and CD69.

Some biological properties of the human amniotic membrane interferon

Human amniotic interferon was investigated to define the species specificity of its antiviral action and compare its anti-cellular and NK cell stimulating activities with those of other human interferons. The antiviral effect was titrated in bovine (RV-IAL) and monkey (VERO) cells. Amniotic interferon exhibited, in bovine cells, 5% of the activity seen in monkey cells, while alpha interferon displayed 200%. No effect was detected with either beta or gamma interferon in bovine cells. Daudi cells were exposed to different concentrations of various interferons and the cell numbers were determined. The anticellular effect of the amniotic interferon reached its peak on the third day of incubation. Results suggested a higher activity for alpha and gamma interferons and a lower activity for beta when compared to amniotic interferon. Using total mononuclear cells as effector cells and K 562 as target cell in a 51Cr release assay, it was demonstrated that low concentrations of amniotic interferon consistently stimulated NK cell activity in cells derived from several donors, the results indicating a higher level of activity with this interferon than with alpha and beta interferons