Infection of Glia by Human Pegivirus Suppresses Peroxisomal and Antiviral Signaling Pathways.

Human pegivirus (HPgV) infects peripheral leukocytes but was recently shown to be a neurotropic virus associated with leukoencephalitis in humans. In the present study, we investigated the neural cell tropism of HPgV as well as its effects on host immune responses. HPgV wild type (WT) and a mutant virus with a deletion in the HPgV NS2 gene (ΔNS2) were able to productively infect human astrocytes and microglia but not neurons or an oligodendrocyte-derived cell line. Of note, the ΔNS2 virus replicated better than WT pegivirus in astrocytes, with both viruses being able to subsequently infect and spread in fresh human astrocyte cultures. Infection of human glia by HPgV WT and ΔNS2 viruses resulted in suppression of peroxisome-associated genes, including PEX11B, ABCD1, PEX7, ABCD3, PEX3, and PEX5L, during peak viral production, which was accompanied by reduced expression of IFNB, IRF3, IRF1, and MAVS, particularly in ΔNS2-infected cells. These data were consistent with analyses of brain tissue from patients infected with HPgV in which we observed suppression of peroxisome and type I interferon gene transcripts, including PEX11B, ABCD3, IRF1, and IRF3, with concurrent loss of PMP70 immunoreactivity in glia. Our data indicate that human astrocytes and microglia are permissive to HPgV infection, resulting in peroxisome injury and suppressed antiviral signaling that is influenced by viral diversity. IMPORTANCE Human pegiviruses are detected in 1 to 5% of the general population, principally infecting leukocytes, although their effects on human health remain uncertain. Here, we show that human pegivirus infects specific neural cell types in culture and human brain and, like other neurotropic flaviviruses, causes suppression of peroxisome and antiviral signaling pathways, which could favor ongoing viral infection and perhaps confer susceptibility to the development of neurological disease.

Differential disease phenotypes and progression in relapsing-remitting multiple sclerosis: comparative analyses of single Canadian and Saudi Arabian clinics.

OBJECTIVE: Relapsing-remitting multiple sclerosis (RR-MS) phenotypes differ widely although the variables contributing to this heterogeneity remain uncertain. To assess geographic and ethnic effects on RR-MS phenotypes, we investigated RR-MS patients in Canada and Saudi Arabia. METHODS: A retrospective analysis of patients followed in two MS Clinics was performed in Medina, Saudi Arabia and Edmonton, Canada. Demographic and clinical data were collected for each patient and analyzed using univariable and multivariable statistics. Univariable and multivariable linear regression were used to distinguish the significant clinical and demographic features and neurological systems associated with the change in expanded disability status scale (EDSS) between clinical assessments. RESULTS: Patients with treated RR-MS were recruited (n = 51, Saudi; n = 47, Canada) although the disease duration was longer in the Canadian cohort (5.6 ± 2.2 yr.) compared to the Saudi cohort (4.4 ± 1.4 yr.) (P < 0.05), annual relapse rate and EDSS change were higher in the Saudi cohort (P < 0.05). Infratentorial lesion-associated presentation differed (Canada, n = 23; Saudi, n = 13) among groups (P < 0.05). Spinal cord lesions on MRI were more frequently detected in Canadian (n = 23) compared to Saudi (n = 1) patients (P < 0.05). Patients within the Saudi cohort displayed a significantly greater change in Expanded Disability Status Scale (EDSS) between first and second assessments. CONCLUSIONS: Despite differences in geographic location, ethnicity, and predominance of infratentorial lesions in the Canadian group, the RR-MS phenotypes were similar although the Saudi cohort displayed a more severe disease course.

Disability progression in multiple sclerosis is associated with plasma neuroactive steroid profile.

BACKGROUND: Neuroactive steroids (NASs) exert multiple biological effects on development and inflammation. The effects of NASs on disease progression in multiple sclerosis (MS) are uncertain, prompting analyses of NAS profiles during the transition from clinically isolated syndrome (CIS) to relapsing-remitting (RR) MS. METHODS: Subjects with CIS or RRMS and healthy controls (HCs) were recruited; demographic and clinical data as well as disability scores measured by the Expanded Disability Status Scale (EDSS) were recorded. Matched plasma NAS and amino acid (AA) concentrations were measured. RESULTS: HC (n = 17), CIS (n = 31), and RRMS (n = 33) groups showed similar ages and sex distribution although disability scores were higher in the RRMS group. The conversion rate of CIS to RRMS group was 51.6% (n = 16) during a mean follow-up period of 1.85 years. The RRMS group showed significantly higher mean allopregnanolone, aspartate, and taurine concentrations with lower epiallopregnanolone concentrations than CIS patients, and higher L-serine-O-phosphate and lower alanine, arginine, and glutamine concentrations than the HC group. Among CIS and RRMS groups, multivariate hierarchical regressions revealed that higher concentrations of plasma tetrahydrodeoxycorticosterone (THDOC) may predict disability worsening. CONCLUSIONS: RRMS and CIS patients exhibited differing concentrations of both NASs and AAs in plasma while both THDOC and pregnanolone might serve as biomarkers of disability worsening.

Cognitive Implications of Deep Gray Matter Iron in Multiple Sclerosis.

BACKGROUND AND PURPOSE: Deep gray matter iron accumulation is increasingly recognized in association with multiple sclerosis and can be measured in vivo with MR imaging. The cognitive implications of this pathology are not well-understood, especially vis-à-vis deep gray matter atrophy. Our aim was to investigate the relationships between cognition and deep gray matter iron in MS by using 2 MR imaging-based iron-susceptibility measures. MATERIALS AND METHODS: Forty patients with multiple sclerosis (relapsing-remitting, n = 16; progressive, n = 24) and 27 healthy controls were imaged at 4.7T by using the transverse relaxation rate and quantitative susceptibility mapping. The transverse relaxation rate and quantitative susceptibility mapping values and volumes (atrophy) of the caudate, putamen, globus pallidus, and thalamus were determined by multiatlas segmentation. Cognition was assessed with the Brief Repeatable Battery of Neuropsychological Tests. Relationships between cognition and deep gray matter iron were examined by hierarchic regressions. RESULTS: Compared with controls, patients showed reduced memory (P < .001) and processing speed (P = .02) and smaller putamen (P < .001), globus pallidus (P = .002), and thalamic volumes (P < .001). Quantitative susceptibility mapping values were increased in patients compared with controls in the putamen (P = .003) and globus pallidus (P = .003). In patients only, thalamus (P < .001) and putamen (P = .04) volumes were related to cognitive performance. After we controlled for volume effects, quantitative susceptibility mapping values in the globus pallidus (P = .03; trend for transverse relaxation rate, P = .10) were still related to cognition. CONCLUSIONS: Quantitative susceptibility mapping was more sensitive compared with the transverse relaxation rate in detecting deep gray matter iron accumulation in the current multiple sclerosis cohort. Atrophy and iron accumulation in deep gray matter both have negative but separable relationships to cognition in multiple sclerosis.

Association of Factor V Secretion with Protein Kinase B Signaling in Platelets from Horses with Atypical Equine Thrombasthenia.

BACKGROUND: Two congenital bleeding diatheses have been identified in Thoroughbred horses: Glanzmann thrombasthenia (GT) and a second, novel diathesis associated with abnormal platelet function in response to collagen and thrombin stimulation. HYPOTHESIS/OBJECTIVES: Platelet dysfunction in horses with this second thrombasthenia results from a secretory defect. ANIMALS: Two affected and 6 clinically normal horses. METHODS: Ex vivo study. Washed platelets were examined for (1) expression of the αIIb-ß3 integrin; (2) fibrinogen binding capacity in response to ADP and thrombin; (3) secretion of dense and α-granules; (4) activation of the mammalian target of rapamycin (mTOR)-protein kinase B (AKT) signaling pathway; and (5) cellular distribution of phosphatidylinositol-4-phosphate-3-kinase, class 2B (PIK3C2B) and SH2 containing inositol-5'-phosphatase 1 (SHIP1). RESULTS: Platelets from affected horses expressed normal amounts of αIIb-ß3 integrin and bound fibrinogen normally in response to ADP, but bound 80% less fibrinogen in response to thrombin. α-granules only released 50% as much Factor V as control platelets, but dense granules released their contents normally. Protein kinase B (AKT) phosphorylation was reduced after thrombin activation, but mTOR Complex 2 (mTORC2) and phosphoinositide-dependent kinase 1 (PDK1) signaling were normal. SH2-containing inositol-5'-phosphatase 1 (SHIP1) did not localize to the cytoskeleton of affected platelets and was decreased overall consistent with reduced AKT phosphorylation. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Defects in fibrinogen binding, granule secretion, and signal transduction are unique to this thrombasthenia, which we designate as atypical equine thrombasthenia.

Intrathecal effects of daclizumab treatment of multiple sclerosis.

OBJECTIVES: We previously reported that daclizumab, a humanized monoclonal antibody against CD25, reduced contrast-enhancing lesions (CEL) in patients with multiple sclerosis (MS) who were suboptimal responders to interferon-ß and that this response correlated with expansion of CD56(bright) NK cells. These data have been reproduced in a placebo-controlled multicenter trial (CHOICE study). The current study investigates whether daclizumab monotherapy reduces CEL in untreated patients with relapsing-remitting MS (RRMS) and the effects of daclizumab on the intrathecal immune system. METHODS: Sixteen patients with RRMS with high inflammatory activity were enrolled in an open-label, baseline-vs-treatment, phase II trial of daclizumab monotherapy for 54 weeks and followed by serial clinical and MRI examinations and immunologic biomarkers measured in the whole blood and CSF. RESULTS: The trial achieved predefined outcomes. There was an 87.7% reduction in brain CEL (primary) and improvements in Multiple Sclerosis Functional Composite (secondary), Scripps Neurologic Rating Scale, and Expanded Disability Status Scale (tertiary) outcomes. There was significant expansion of CD56(bright) NK cells in peripheral blood and CSF, with resultant decrease in T cells/NK cells and B cells/NK cells ratios and IL-12p40 in the CSF. Surprisingly, CD25 Tac epitope was equally blocked on the immune cells in the CSF and in peripheral blood. CONCLUSIONS: Daclizumab monotherapy inhibits formation of MS plaques in patients with RRMS and immunoregulatory NK cells may suppress activation of pathogenic immune responses directly in the CNS compartment. CLASSIFICATION OF EVIDENCE: The study provides Class III evidence that daclizumab reduces the number of contrast-enhancing lesions in treatment-naive patients with RRMS over a 54-week period.

Oculoleptomeningeal amyloidosis in a large kindred with a new transthyretin variant Tyr69His.

OBJECTIVE: To describe the clinical, radiologic, and pathologic findings of a kindred with oculoleptomeningeal amyloidosis and a newly associated transthyretin mutation. BACKGROUND: Transthyretin (TTR) amyloidosis can present in the form of oculoleptomeningeal amyloidosis. Clinical features include dementia, seizures, stroke-like episodes, subarachnoid hemorrhage, ataxia, myelopathy, deafness, radiculopathy, and ocular amyloidosis. Eight TTR mutations associated with oculoleptomeningeal amyloidosis have been described. METHODS: Fourteen individuals from a kindred with oculoleptomeningeal amyloidosis were examined clinically and radiologically. Analysis of the TTR gene was performed. Neuropathologic examination was obtained on the index patient. RESULTS: Affected individuals had vitreous amyloid, radiculopathy, seizures, stroke-like episodes, encephalopathy, and dementia. Severely affected individuals died by the end of the fifth decade. Leptomeningeal enhancement on contrast MRI and elevated CSF protein were the defining features on investigations. Sequencing of exon 3 in the TTR gene found a base pair substitution at codon 69. This resulted in heterozygosity for normal tyrosine and variant histidine (ATTR Tyr69His) in affected family members. Domino liver transplantation was attempted as treatment for one family member. CONCLUSIONS: The ATTR Tyr69His mutation is associated with oculoleptomeningeal amyloidosis. Expression of the genotype is variable. This has implications for treatment of affected individuals and counseling of family members. Efficacy of liver transplantation in patients with oculoleptomeningeal amyloidosis remains unknown. The authors advocate the investigation of liver transplantation in patients with severe symptoms due to oculoleptomeningeal amyloidosis.

Chronic dietary Cu(2+)-deficiency alters cholecystokinin signal transduction in isolated rat pancreatic acini.

This study tested the hypothesis that diminished exocrine pancreatic function observed in Cu(2+)-deficient rats is associated with alterations in the cholecystokinin (CCK) signal transduction pathway. Male Sprague-Dawley rats were maintained on either a control diet (11 ppm Cu2+) or a Cu(2+)-deficient diet containing 6000 ppm triethylenetetramine tetrahydrochloride. For the duration of the study rats had free access to water and food. After 4 weeks, rats were sacrificed and pancreatic acini isolated for measurement of amylase content, cholecystokinin-stimulated amylase release and total inositol phosphate formation. Plasma Cu2+ levels were significantly (P < 0.05) decreased in rats on a Cu(2+)-deficient diet (19.2 +/- 3.4 micrograms Cu2+/dL), compared with the control diet (77.0 +/- 3.5 micrograms Cu2+/dL). Both amylase content of pancreatic acini and total CCK-8-stimulated amylase release were significantly decreased in Cu(2+)-deficient rats. In addition, Cu(2+)-deficient rats exhibited a decrease (153.5 +/- 30.9%) in the magnitude of CCK-8-stimulated total inositol phosphate formation compared with control rats (220.8 +/- 11.9%). Moreover, CCKA receptor affinity on pancreatic membranes was not significantly altered by Cu(2+)-deficiency, while CCKA receptor density was significantly (P < 0.05) decreased in Cu(2+)-deficient rats. The addition of Cu2+ to the binding assay of Cu(2+)-deficient rats did not restore receptor density to control values. The data demonstrates that adequate dietary intake of Cu2+ is important to maintain the functional integrity of the exocrine pancreas.

Response of rat exocrine pancreas to high-fat and high-carbohydrate diets.

Intake of diets with high fat content is a risk factor for acute pancreatitis and pancreatic cancer. The underlying mechanisms leading to the development of these diseases due to high fat intake are currently unknown. The current study was designed in rats to determine the physiologic and pathological consequences of a highfat diet that contained excess amounts of cottonseed oil or a high-carbohydrate diet that contained high amounts of sucrose on the exocrine pancreas. Rats were maintained on the diets for 4 weeks, and a cannula was inserted into the right jugular vein and one into the pancreatic duct for collection of pancreatic juice. Volume of the pancreatic juice and concentrations of amylase, lipase, and trypsinogen in the pancreatic juice were measured before and after infusions of CCK-8. Results showed that basal and CCK-stimulated pancreatic outputs of volume, amylase and lipase but not trypsinogen, were significantly elevated in intact rats given a high-fat diet when compared with rats given a high-carbohydrate diet. Forty-eight hours later, rats were sacrificed, and parts of the pancreas were removed for isolation of pancreatic acinar cells and for histopathologic studies. Pancreatic acini isolated from rats on a high-fat diet showed significantly lower basal and CCK-stimulated amylase release when compared with those on a high-carbohydrate diet. Histology of the pancreas of rats on a high-carbohydrate diet appeared normal; however, the pancreas of rats on high-fat diet showed significant alterations in exocrine pancreas. These results showed abnormalities in the exocrine pancreas of rats on a high-fat diet, that were not found in rats on a high-carbohydrate diet; further, they support the contention that a high-fat diet has a deleterious effect on the pancreas.

Estradiol alters cholecystokinin stimulus-response coupling in rat pancreatic acini.

We have previously demonstrated that altered exocrine pancreatic stimulus-secretion coupling is associated with ovariectomy and chronic estradiol administration. To elucidate possible mechanisms underlying those effects we examined the ability of chronic administration of different doses of estradiol to regulate the CCK signal transduction pathway in isolated rat pancreatic acini. Doses of estradiol ranging from 0.5 to 119 micrograms/day were administered to ovariectomized rats for 18 days. Ovariectomy was associated with enhanced CCK-stimulated pancreatic amylase release, whereas estradiol dose dependently decreased the magnitude of CCK-stimulated amylase release. Ovariectomy was also associated with enhanced CCK receptor numbers on acinar cell membranes. Estradiol administration was associated with dose-dependent decreases in CCK receptor numbers. Neither ovariectomy nor estradiol administration affected CCK receptor affinity. Moreover, estradiol administration was associated with increased expression of the alpha-subunit of the heterotrimeric G protein Gq/11 (Galphaq/11). Recent findings (H. Ohnishi, S. A. Ernst, D. I. Yule, C. W. Baker, and J. A. Williams. J. Biol. Chem. 272: 16056-16061, 1997) demonstrate that Galphaq/11 may exert a tonic inhibitory effect on pancreatic enzyme release. In view of these findings, the increased expression of Galphaq/11 induced by estradiol likely contributes to the inhibition of pancreatic enzyme release. We conclude that the effect of estradiol to decrease pancreatic secretion is mediated through regulation of CCK receptor density and Galphaq/11 expression.

Effects of diversion and reperfusion of pancreaticobiliary juice on amylase release from isolated rat pancreas.

Diversion of pancreaticobiliary juice from the small intestine results in resetting of the normal negative-feedback regulation of exocrine pancreatic secretion. The mechanism by which this process occurs is not well understood. To examine this regulatory process, we investigated the effects of pancreaticobiliary juice diversion and reperfusion on exocrine pancreas using isolated rat pancreatic acini. Two groups of rats were surgically prepared for pancreaticobiliary juice diversion and reperfusion. Both groups received a liquid diet via a duodenal cannula and saline by intravenous infusion for 24 hours following surgery. Forty-eight hours after the surgery and infusions, the rats were sacrificed, and acinar cells were quickly isolated from each pancreas. Amylase release from isolated acini was measured in response to doses of cholecystokinin octapeptide (CCK-8) and carbachol. Acinar cell receptor binding was measured by using CCK-8 labeled with iodine 125 and N-tritium-methscopolamine bromide as radioligands. Amylase release in response to both CCK-8 and carbachol was significantly decreased in the diversion group when compared with that of the reperfusion group. Receptor binding sites of CCK-8 and methscopolamine bromide were similar in the diversion and reperfusion groups. The results suggest that cholecystokinin- and carbachol-mediated amylase response is affected by pancreaticobiliary juice diversion through a process that most likely involves alteration of post-receptor-mediated intracellular signaling pathways.

Nucleotides regulate the binding affinity of the recombinant type A cholecystokinin receptor in CHO K1 cells.

Cholecystokinin (CCK) receptors on rat pancreatic acinar cells display two binding affinity states in the presence of adeninine and guanine triphosphates with the effect of ATP mediated by the enzyme nucleoside diphosphate kinase. To determine whether this behavior was intrinsic to a single receptor protein we studied the binding affinity of CHO cells stably transfected with a cloned rat CCKA receptor. 125I-CCK binding to intact cells at 37 degrees C revealed two affinity states for CCK of Kd values 20 pM and 2.4 nM. Membranes prepared from these cells displayed a single affinity state for CCK but two affinity states could be restored in the presence of GTP[gamma S], ATP and ATP[gamma S] but not AMP-PCP. ATP and ATP[gamma S] but not AMP-PCP were substrates for nucleoside diphosphate kinase present in CHO cell membranes and transferred their terminal phosphate to GDP. These findings indicate that the interconvertible affinity states of the CCK receptor are inherent in a single receptor protein and that nucleoside diphosphate kinase mediates the effect of ATP to regulate these two affinity states.

Effects of diet on cholecystokinin-stimulated amylase secretion by pancreatic Acini and amylase mRNA levels in rat pancreas.

To investigate the mechanisms by which dietary compositions regulate the exocrine pancreas, we examined the effects of no-fat diet (NFD) and high-fat diet (HFD) on cholecystokinin (CCK)-stimulated amylase secretion from rat pancreatic acini. Rats were maintained for 4 weeks on NFD or HFD, which contained 0 or 45% fat and 58 or 29% carbohydrates, respectively. Pancreatic acini were isolated and stimulated by graded doses of CCK for 30 min. Maximal CCK-stimulated amylase secretion by pancreatic acini from rats on NFD (23.1 +/- 4.3 U/mg protein at 10(-10) M) was significantly higher than that of HFD (5.5 +/- 1.6 U/mg protein at 10(-10) M). In contrast, expressed as a percentage of the initial content, maximal CCK-stimulated amylase secretion by pancreatic acini from rats on NFD (15.0 +/- 0.8%) tended to be lower than that from rats on HFD (28.1 +/- 3.5%). To study further the effects of the diets on amylase mRNA levels, another group of rats was maintained on the respective diets for 4 weeks, sacrificed, and total pancreatic RNA isolated. Amylase mRNA levels in rats on NFD were 2.5 times higher than in rats on HFD. The results suggest that alterations in CCK-stimulated amylase secretion by pancreatic acini, as well as modifications in pancreatic amylase expression, may be involved in the mechanisms by which the exocrine pancreas adapts to diet.

Microglia in colony-stimulating factor 1-deficient op/op mice.

Mice that are homozygous for the autosomal recessive mutation osteopetrosis (op) suffer from a general skeletal sclerosis, and the numbers of macrophages in various tissues are significantly decreased. We report that microglia in op/op mice are not affected by the mutation. They have normal morphology and are present in the CNS in normal frequency. In cultures, disaggregated cells of neopallia can form microglia, but such cells from neopallia of op/op mice form microglia only when colony-stimulating factor 1 (CSF-1) is added to the culture medium. The addition of granulocyte/macrophage (GM)-CSF or interleukin (IL)-3 to the culture medium does not stimulate production of microglia. Microglia that form in op/op neopallial cell cultures, in the presence of CSF-1, are capable of Fc-receptor-mediated phagocytosis. Based on our experiments, it seems that microglia are CSF-1 dependent but in op/op mice (in which CSF-1 is absent) microglia may use other locally produced factors.

Nucleoside diphosphate kinase associated with rat pancreatic membranes regulates CCK receptor affinity.

We have previously demonstrated in permeabilized rat pancreatic acini that the existence of two affinity states of the pancreatic cholecystokinin (CCK) receptor seen in intact cells depends on the presence of ATP. In the present study, we demonstrate that this effect of ATP is mediated by the enzyme nucleoside diphosphate kinase (NDPK). Northern blot hybridization analysis demonstrated NDPK mRNA in pancreas. Furthermore, pancreatic membranes possessed NDPK activity, which transferred high-energy phosphate groups to [8-3H]GDP. This enzyme also utilized UTP and ITP as a source of gamma-phosphate for GTP formation while guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) was formed in the presence of adenosine 5'-O-(3-thiotriphosphate) (ATP gamma S). However, adenylyl (beta, gamma-methylene)-diphosphate (AMP-PCP) did not serve as a substrate for NDPK. Analysis of 125I-Bolton-Hunter-labeled CCK octapeptide ([125I]BH-CCK-8) binding data in the absence of nucleotides was consistent with a single affinity state with dissociation constant (Kd) equal to 80 pM and maximal binding equal to 50.8 fmol/mg. ATP, UTP, ITP, ATP gamma S, and GTP gamma S all induced two CCK binding affinity states, which in the presence of 1 mM ATP were Kd = 74 pM for high-affinity sites and Kd = 4.3 nM for low-affinity sites: AMP-PCP did not induce two affinity states. GDP at 10 microM had no effect on CCK binding but potentiated the effect of ATP. GTP gamma S, in addition to inducing high- and low-affinity states, also elicited a significant concentration-dependent reduction in the total number of measurable CCK receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of cholecystokininA receptor agonist activity by a family of cholecystokininB receptor antagonists.

The dipeptoid cholecystokinin (CCK)B antagonists PD136450, Cam-1279 and CI988 stimulated amylase release from isolated rat pancreatic acini with an efficacy similar to CCK8, but with a much weaker potency (ED50, 0.6, 0.9 and 1.3 microM, respectively). In contrast to CCK8, however, none of these compounds elicited inhibition of amylase release at supramaximal concentrations. In addition, 10(-4) M PD136450 blocked the inhibition induced by high concentrations of CCK8. Competitive inhibition of [125I]BH-CCK8 binding by PD136450 indicated that this compound bound with a single affinity state to all CCK receptors on acini. Maximal stimulation of amylase release by PD136450 was dependent upon occupation of virtually the entire complement of CCK receptors. PD136450 at all concentrations examined had only a limited ability to stimulate total phosphoinositide hydrolysis and at maximum induced only 20% of maximal CCK stimulation. Measurement of intracellular calcium ([Ca++]i) by digital imaging of Fura-2 indicated that 1 microM PD136450 induced repetitive [Ca++]i oscillations with a magnitude of 346.0 +/- 4.5 nM and frequency of 1.3 cycles per min. These oscillations were still present in Ca(++)-free medium and were blocked by the phospholipase C inhibitor, U73122. Because the dipeptoid compounds can occupy all available pancreatic CCKA receptors, these compounds must induce a configuration of the receptor different from either CCK8 or the previously characterized partial agonist CCK-JMV-180, thereby inducing a distinct signaling pattern. Because the dipeptoid compounds do not fully mimic CCK actions, it is likely that they interact with only some of the critical binding sites within the CCKA receptor normally occupied by CCK8.