CYP2C8*3 increases risk of neuropathy in breast cancer patients treated with paclitaxel.

BACKGROUND: Paclitaxel-induced neuropathy is an adverse event that often leads to therapeutic disruption and patient discomfort. We attempted to replicate a previously reported association between increased neuropathy risk and CYP2C8*3 genotype. PATIENTS AND METHODS: Demographic, treatment, and toxicity data were collected for paclitaxel-treated breast cancer patients who were genotyped for the CYP2C8*3 K399R (rs10509681) variant. A log-rank test was used in the primary analysis of European-American patients. An additional independent replication was then attempted in a cohort of African-American patients, followed by modeling of the entire patient cohort with relevant covariates. RESULTS: In the primary analysis of 209 European patients, there was an increased risk of paclitaxel-induced neuropathy related to CYP2C8*3 status [HR (per allele) = 1.93 (95% CI: 1.05-3.55), overall log-rank P = 0.006]. The association was replicated in direction and magnitude of effect in 107 African-American patients (P = 0.043). In the Cox model using the entire mixed-race cohort (n = 411), each CYP2C8*3 allele approximately doubled the patient's risk of grade 2+ neuropathy (P = 0.004), and non-Europeans were at higher neuropathy risk than Europeans of similar genotype (P = 0.030). CONCLUSIONS: The increased risk of paclitaxel-induced neuropathy in patients who carry the CYP2C8*3 variant was replicated in two racially distinct patient cohorts.

A morphological and histological examination of the pan-tropical spotted dolphin (Stenella attenuata) and the spinner dolphin (Stenella longirostris) adrenal gland.

The morphology and histology of the cetacean adrenal gland are poorly understood. Therefore, this study examined 32 pairs of adrenal glands from 18 pan-tropical spotted dolphins (Stenella attenuata) and 14 spinner dolphins (Stenella longirostris). In both species, the cortex was pseudolobulated and contained a typical mammalian zonation. Medullary protrusions (0-3 per section) and a medullary band were identified in both species. For S. attenuata, no statistical differences were found in the cortex to medulla (CM) ratio or the percent cross-sectional area (PCA) of the adrenal glands compared with sex or sexual maturity. The mean CM ratio for S. attenuata was 2.34 and the PCA was 64.4% cortex, 29.4% medulla and 6.2%'other'. 'Other' indicates blood vessels, connective tissue and the gland capsule itself. For S. longirostris, there was no statistical difference in the CM ratio compared with sexual maturity. However, a statistical difference was found between the CM ratio and sex, suggesting sexual dimorphism (female CM ratio = 2.46 and males = 3.21). No statistical differences were found in the PCA of S. longirostris adrenal glands by sexual maturity. However, a statistical difference was found between the PCA by sex. Female S. longirostris adrenal glands consisted of 65.0% cortex, 27.3% medulla and 7.7% 'other', whereas male adrenal glands consisted of 71.7% cortex, 22.7% medulla and 5.6% 'other'.

Morphological changes in the Atlantic bottlenose dolphin (Tursiops truncatus) adrenal gland associated with chronic stress.

Beach-stranded Atlantic bottlenose dolphins (n=68) were categorized as either "acutely stressed" (if they died from net entanglement, boat strike, or acute infection; 31 animals) or "chronically stressed" (if they suffered from or died as a result of long-term disease or debilitating injury; 37 animals). No significant differences in mass between the right and left adrenal glands were found within each category. However, the average gland mass (AGM), based on the right and left glands together, was 5.2g for acutely stressed animals and 11.01 g for chronically stressed animals (P<0.001). Significant differences were also found, in terms of the ratio of cross-sectional areas of the cortex to medulla, between acutely stressed (ratio 1.22) and chronically stressed (ratio 1.63) animals (P=0.027). Adrenal glands of acutely stressed animals consisted of 48% cortex, 41% medulla, and 11% other tissue elements (connective tissue, blood vessels and gland capsule), whereas the corresponding figures for chronically stressed animals were 53%, 36%, and 11%. The mean estimated mass values for cortex, medulla and other tissue were, for acutely stressed animals, 2.36, 1.9, and 0.54, respectively, whereas for chronically stressed animals the corresponding figures were 6.06, 4.04, and 1.29 (P<0.001 for each of the three comparisons). Overstaining with haematoxylin (HEM) and immunohistochemical labelling (IHC) of the enzyme phenylethanolamine N-methyl transferase (which converts norepinephrine to epinephrine) were used to determine the percentage of epinephrine-producing cells in relation to the overall cross-sectional area of the adrenal gland. The percentage values in acutely as compared with chronically stressed dolphins were 6.7% and 15.93%, respectively (P=0.021). The results therefore suggest that in bottlenose dolphins chronic stress results in increases in (1) adrenal mass, (2) cortex to medulla ratio, and (3) epinephrine-producing cells within the medulla, giving rise to an increase in the thickness of the medullary band.

Morphology and histology of the atlantic bottlenose dolphin (Tursiops truncatus) adrenal gland with emphasis on the medulla.

This study provides the first detailed description of the Atlantic bottlenose dolphin (Tursiops truncatus) adrenal gland with emphasis on the medulla. Thirty-one dolphins of varying age and sex were used in this study. No statistical differences were found between the right and left gland mass, however, the left was typically greater. Mean mass for the right and left adrenal glands were 4.99 +/- 0.513 and 5.36 +/- 0.558 g, respectively. No statistical differences were found between average gland mass and sexual maturity or sex. The average cortex/medulla ratio was 1.22 +/- 0.060 meaning approximately 48% is cortex, 41% is medulla, and 11% was categorized as other (i.e. blood vessels, connective tissue, etc.). The cortex contained pseudolobules and the typical zonation. A medullary band, consisting of highly basophilic staining cells was found at the periphery of the medulla. Projections of the medulla to the gland capsule were noted. Immunolabelling with polyclonal antibodies against the enzymes dopamine beta hydroxylase and phenylethanolamine N-methyl transferase indicated that noradrenaline producing cells are found throughout the medulla including the medullary band while adrenaline producing cells are only found within the medullary band. Transmission electron microscopy confirmed the presence of two distinct cell populations within the medullary band and a single cell population throughout the medulla.

Prospective CYP2D6 genotyping as an exclusion criterion for enrollment of a phase III clinical trial.

A phase III study was performed to compare the efficacy and safety of lamotrigine (Lamictal), desipramine (Norpramin), and placebo in the treatment of unipolar depression. Desipramine is extensively metabolized by cytochrome P450 2D6 (CYP2D6), and kinetics of this compound are altered in poor metabolizers. Genotyping was utilized to exclude poor metabolizers in order to increase subject safety and to eliminate the need to continuously monitor plasma desipramine levels. As part of screening, subjects were genotyped for the *3(A), *4(B), and *5(D) alleles, which identify approximately 95% of poor metabolizers. Extensive metabolizers were eligible for randomization to the lamotrigine, desipramine, or placebo arm. Follow-up genotyping for the *6(T) and *7(E) alleles was performed after study enrollment and was used to identify poor metabolizers who may have been incorrectly identified as extensive metabolizers upon initial three-allele screening. Of 628 subjects screened for *3(A), *4(B), *5(D) alleles, 590 (93.9%) were classified as extensive metabolizers. The remaining 38 (6.1%) subjects were poor metabolizers and excluded. Subsequent *6(T) and *7(E) testing revealed that two poor metabolizers had been enrolled, and the follow-up genotyping provided an explanation for the high desipramine plasma concentrations in one subject. No differences in phenotypic or allelic frequencies were found between the study population and literature populations. However, the frequency of poor metabolizers varied among clinical sites (0-15%). For a compound that is extensively metabolized by CYP2D6, prescreening subjects for *3(A), *4(B), *5(D), *6(T) and *7(E) alleles can increase subject safety and eliminate the need to continuously monitor drug plasma concentrations.

Identification and chromosomal assignment of two heterozygous mutations in the Trp53 gene in L5178Y/Tk(+/-)-3.7.2C mouse lymphoma cells.

The thymidine kinase locus (Tk1) in Tk(+/-)-3.7.2C mouse lymphoma cells is widely used to identify mutagenic agents. Because Trp53 (the mouse homolog of human TP53) is located with Tk1 on chromosome 11 and is critical in regulating cellular responses following exposure to DNA damaging agents, we wanted to determine if these mouse lymphoma cells harbor mutations in Trp53. Single-stranded conformation polymorphism (SSCP) analysis of PCR-amplified exons 4-9 of Trp53 indicated mutations in both exons 4 and 5. We sequenced exons 4-9 from isolated clones of Tk(+/-)-3.7.2C cells and a Tk-/- mutant (G4). Mutant G4 has two copies of the chromosome carrying the Tk1- allele and no copy of the chromosome carrying the Tk1+ allele and thus could establish linkage of the individual Trp53 and Tk1 alleles. DNA sequence analysis revealed no mutations in exons 6-9 in any Tk(+/-)-3.7.2C or G4 clones. As suggested by SSCP, there was a nonsense mutation in exon 4 at bp 301 (codon 101) in one Trp53 allele. Tk(+/-)-3.7.2C clones have both mutant and wild-type sequences at bp 301; G4 clones have wild-type exon 4 sequence. These data allow assignment of the Trp53 exon 4 mutated allele to chromosome 11 carrying the Tk1+ allele. The exon 4 mutation leads to a stop codon early in translation, thus functionally deleting the Trp53 allele on the Tk1(+)-bearing chromosome. As previously reported, we find a missense mutation in exon 5 at bp 517 (codon 173) in one Trp53 allele. Using the G4 clones we determined that the exon 5 mutation is linked to the Tk1- allele. Thus the Tk +/-(-)3.7.2C mouse lymphoma cells have two mutant Trp53 alleles, likely accounting for their rapid cell growth and contributing to their ability to detect the major types of mutational damage associated with the etiology of tumor development. This ability to integrate across the mutational events seen in the multiple stages of tumor development further supports the use of the assay in chemical and drug safety studies and its recommendation as part of the required screening battery for regulatory agency submissions.

Radiation quality affects the efficiency of induction and the molecular spectrum of HPRT mutations in human T cells.

Human T lymphocytes can be used to determine the frequency and molecular spectrum of somatic cell gene mutations induced by ionizing radiations both in vivo and in vitro. In vitro exposure of these G0 cells to low-LET 137Cs gamma rays results in the induction of HPRT mutations and a predominant molecular spectrum of DNA deletions and rearrangements, particularly total gene deletions (11-12%). Similar results are found in samples from humans exposed to low-LET radiation from 131I. The doubling dose for mutation induction is calculated to be 0.8 and 1.0 Gy from these exposures performed in vitro and in vivo, respectively. In vitro studies of the effects of high-LET radiation from exposure to 222Rn also showed an induction of HPRT mutations, with a doubling dose of approximately 0.2 Gy. With this radiation, the predominant mutations were small partial deletions, with less than 2% total gene deletions. Studies of humans exposed to high-LET radiation from 239Pu showed an increased HPRT mutant frequency for the group, although no significant dosimetry could be defined. In contrast to the humans exposed to 131I, no increase in the frequency of total gene deletions was found. This is consistent with the results for 222Rn in vitro. The available data show that radiation quality affects both the efficiency of induction and the molecular spectrum of HPRT mutations in human T lymphocytes both in vitro and in vivo. The mutational spectrum may be relatively specific for radiations of different quality and thus allow a more precise measurement of the induction of somatic gene mutations resulting from individual exposures to radiation, and thereby provide more sensitive assessments of health risks.

The aminothiol WR-1065 protects T lymphocytes from ionizing radiation-induced deletions of the HPRT gene.

Aminothiols, such as WR-2721 and its active free thiol, WR-1065, reduce mutations from ionizing radiation in exponentially growing cells. In this study, human noncycling G0 T lymphocytes were exposed in vitro to gamma-irradiation in the presence or absence of WR-1065. The five treatment groups were: (a) control; (b) treatment with 4 mM WR-1065; (c) treatment with 3 Gy of gamma-radiation, from a 137Cs source; and (d) and (e) treatment with WR-1065 30 min prior to or 3 h after 3 Gy of gamma-irradiaiton, respectively. A total of 224 cloned HPRT mutants representing 179 independent mutations were analyzed for genetic alterations using multiplex PCR. Ionizing radiation alone significantly increased the percentage of mutations with gross structural alterations compared to controls (P = 0.02). Although the frequency of such large structural mutations was not different from control cells treated with WR-1065 alone, this aminothiol significantly reduced their frequency among irradiated mutants (P = 0.01) when the radioprotector was present during the irradiation. Addition of WR-1065 3 h postirradiation also greatly reduced the percentage of gross structural alterations; however, due to small numbers, this was not statistically significant. This is the first demonstration that the antimutagenicity of WR-1065 in human cells specifically protects against these kinds of large-scale DNA alterations induced by ionizing radiation. WR-1065 and similar aminothiol compounds may afford protection against radiation-induced mutations through polyamine-like processes, e.g., stabilization of chromatin structure, inhibition of cell proliferation, and influences on DNA repair systems.

Hprt mutations in human T-lymphocytes reflect radioprotective effects of the aminothiol, WR-1065.

Aminothiols such as WR-2721 and its active free thiol WR-1065 have previously been shown to reduce mutations resulting from ionizing radiation in exponentially growing cells. In this study, non-dividing human G0 T-lymphocytes were exposed to the aminothiol radioprotective agent, WR-1065, 30 min before or 3 h after external beam gamma-irradiation and subsequently assessed for survival and mutation induction at the hprt locus. Cytotoxicity due to gamma-irradiation was reduced only when the WR-1065 was present during irradiation. The frequency of hprt mutations, however, was reduced regardless of time of administration, although the reduction was statistically significant only when WR-1065 was added 30 min before irradiation (P < 0.01). This is the first study to demonstrate the protective effects of WR-1065 against radiation-induced mutation in a reporter gene using a human non-cycling cell. Hprt mutations arising in vivo in these cells may be useful for monitoring the radioprotective effect of aminothiols in human populations.

TCR beta PCR from crude preparations for restriction digest or sequencing.

T cell specificity is determined by the combinatorial association of specific variable (V), diversity (D), and junctional (J) regions. Clones of T cells (clonality) can occur, in the blood or in tissue, after proliferation of activated T cells. Determining clonality in mutation assays is necessary to distinguish between mutants and mutational events. We have developed a novel approach to determine clonality among T cell isolates, using restriction digests of PCR-amplified cDNA of the T cell receptor beta gene. The T cell receptor beta gene was PCR-amplified by use of a consensus primer, beginning from a cell pellet of 2,000-5,000 cells or from extracted RNA. This TCR (T cell receptor) beta chain PCR product can also be directly sequenced, allowing simple and easy identification of Vbeta and CDR3 sequence from a small number of cells. The utility of this method is demonstrated by PCR, restriction digest, and sequencing of the TCR beta cDNA from eight T cell clones isolated from 2 individuals. A clone of three identical isolates (one 3-mer) and a clone of two identical isolates (one 2-mer) were determined from restriction digests using two different enzymes. This new method is an easier and more rapid way of determining clonality than traditional methods, e.g., Southern blotting.

Further studies on the activation of glucocerebrosidase by a heat-stable factor from Gaucher spleen.

Using Sephadex G-75 and DEAE-cellulose column chromatography, an 8270-Da glycopeptide (designated Fragment II) has been isolated from a cyanogen bromide-formic acid digest of a heat-stable factor from Gaucher spleen which activates a lipid-depleted preparation of lysosomal glucocerebrosidase from human liver. Fragment II contains all of the activity present in the native heat-stable factor. Compared with the parent factor, Fragment II contains four fewer cysteine and methionine residues and one less of each of the following: aspartic acid, threonine, serine, valine, isoleucine, and leucine. Nearly all of the monosaccharides present in the parent heat-stable factor can be accounted for in Fragment II, including three glucosamine, three mannose, one sialic acid, and one fucose. By itself, Fragment II has little or no stimulatory activity; its major effect is to markedly increase the sensitivity of glucocerebrosidase to activation by phosphatidylserine. A mixture of 1 microgram phosphatidylserine and 2 micrograms of the cyanogen bromide fragment activates the lipid-depleted preparation of glucocerebrosidase 50% more than 30 micrograms phosphatidylserine alone. Analysis of the Km and Vmax of glucocerebrosidase at various hydrogen ion concentrations revealed that the heat-stable factor and phosphatidylserine together dramatically increase the catalytic efficiency (Vmax/Km) of glucocerebrosidase while making apparent three ionizable groups that participate in the catalysis. Phosphatidylserine alone recruits two ionizable groups, but catalytic efficiency is lower than when heat-stable factor is also present. Heat-stable factor alone has no discernable effect on the ionization of functional groups on the enzyme or on catalytic efficiency. By sucrose density gradient ultracentrifugation, it was shown that preincubation of rat liver glucocerebrosidase with phosphatidylserine and heat-stable factor shifted the enzyme completely from a 56,600-Da form to a 188,100-Da form. The activity of the slower sedimenting form of glucocerebrosidase was totally dependent upon exogenous bile salt activator, whereas the faster sedimenting form exhibited the same activity in the presence or absence of sodium taurocholate. It appears that the heat-stable factor promotes the transfer of phosphatidylserine to glucocerebrosidase, which, in turn, results in an increase in both the catalytic efficiency and size of the enzyme.

The survival of anaerobes during sewage treatment employing biological filter beds.

During the passage of sewage through a typical treatment plant employing biological filter beds and operating under dry weather flow conditions, about 7% of the input of anaerobic organisms survive to be released in the effluent. The greatest fall in numbers occurs in the first of two primary settling tanks operating in series and during passage through the filter beds. The predominant organisms were Bacteroides species, gram-positive cocci and clostridial species. There is no significant difference in the rate of survival of any of the genera through the different stages of treatment.

Kainic acid stimulation of the lateral septum elicits tachycardia.

Electrical stimulation of the lateral septum results in a transient cardiodeceleration which may represent parasympathetic rebound to a brief sympathetic activation. Kainic acid (KA) is a potent neuronal excitant. Stimulation of the lateral septum by KA produced a short-latency tachycardia. Vehicle injections, as well as KA administration to adjacent structures, did not effect significant changes in heart rate. Intraventricular KA, however, did result in a significant tachycardia. Knife cuts of the fornix, interrupting the glutamatergic innervation of the septum, completely blocked the cardiovascular response to KA. Pharmacological treatments reducing sympathetic activity prevented or reversed KA-elicited tachycardia. Thus, it appears that septal administration of KA produces sympathetic activation. KA may serve as a useful tool in studies assessing central regulation of the autonomic nervous system, and the interrelationship between autonomic activity and seizure-induced neuronal loss.

Activators of spleen glucocerebrosidase from controls and patients with various forms of Gaucher's disease.

Glucocerebrosidase from normal human spleen, and spleen from cases of neurologic (types 2 and 3) and nonneurologic (type 1) Gaucher's disease, was delipidated and inactivated by extraction from membranes with sodium cholate and ice-cold 1-butanol. Control glucocerebrosidase was stimulated markedly by large quantities (20-30 micrograms/assay) of phosphatidylserine (PS), or by a combination of smaller amounts (1-2 micrograms) of PS and 3 micrograms of a heat-stable factor (HSF) derived from the spleen of a patient with Gaucher's disease. The residual glucocerebrosidase from a nonneurologic case, but not a neurologic case, was also responsive to PS and HSF. The combination of HSF and PS decreased the Km of the normal enzyme for 4-methylumbelliferyl-beta-D-glucopyranoside from 8.0 to 1.6 mM. These effectors also increased the reactivity of glucocerebrosidase to the inhibitor conduritol B epoxide; HSF alone had no effect (t1/2 = 19 +/- 0.5 min) whereas the maximum rate of inactivation (t1/2 = 4.0 min) by conduritol B epoxide was achieved in the presence of a mixture of PS (1 microgram) and HSF (3 micrograms). Phosphatidylglycerol (PG) and phosphatidic acid, also acidic phospholipids, were effective activators of glucocerebrosidase. Varying the fatty acid composition of PG had little effect on its ability to stimulate glucocerebrosidase activity. However, in the case of phosphatidylcholine (PC), a weaker activator than PG or PS, fatty acid composition had a significant impact on the ability of this neutral lipid to activate glucocerebrosidase; dilinoleoyl-PC and dicaproyl-PC were moderately effective activators, but distearoyl-PC and dioleoyl-PC were almost totally inactive. The mono-, and di-, and trisialogangliosides (GM1, GD1, and GT1 were less than half as effective as PS as activators of glucocerebrosidase. These results indicate that acidic phospholipids and the heat-stable factor may both play a role in explaining the genetic heterogeneity of Gaucher's disease.

Enzymic differentiation of neurologic and nonneurologic forms of Gaucher's disease.

This study explores the biochemical basis that may distinguish neurologic and nonneurologic forms of Gaucher's disease. Crude membrane preparations from spleens of controls and patients representing the three clinical categories of Gaucher's disease were delipidated by extraction with sodium cholate and n-butanol. Total beta-glucosidase activity was estimated using 4-methylumbelliferyl-beta-D-glucopyranoside (MUG) as substrate, and glucocerebrosidase activity was determined using (3H)-glucocerebroside. beta-Glucosidase and glucocerebrosidase activities were reconstituted by inclusion of sodium taurocholate or phosphatidylserine in the assay medium. When assays contained phosphatidylserine, residual beta-glucosidase activity in delipidated spleen preparations from type 1, nonneurologic cases were five times greater than cases of neurologic Gaucher's disease (82.3 vs. 11.3 units per mg protein). However, beta-glucosidase assays using sodium taurocholate did not discriminate Gaucher's disease subtypes. Similar results were obtained when spleen preparations were analyzed for glucocerebrosidase using glucocerebroside as the substrate. Brain beta-glucosidase from patients representing the three classes of Gaucher's disease showed a similar pattern of sensitivity toward phosphatidylserine. The specific activity of beta-glucosidase in an extract of brain from the one case of type 1 Gaucher's disease analyzed was five times greater than the mean residual specific activity of brain beta-glucosidase measured in five cases of type 2 and type 3 Gaucher's disease. These findings suggest that, in patients with type 1 Gaucher's disease, glucocerebrosidase may show greater activity in the presence of acidic phospholipids than glucocerebrosidase does in patients with neurologic forms of the disease. The ability of the brain enzyme from a type 1 case to be profoundly stimulated by an acidic phospholipid may explain why such individuals are spared central nervous system involvement.

The genetics of Artemia salina. VII. Reproductive isolation.

Fifteen of 20 gonochoristic Artemia populations are crossfertile with diploid San Francisco shrimps, producing fertile F1 and viable F2 progeny. Partial sex linkage of white eye was observed and frequency of crossing over between the white and sex loci did not exceed the range of values observed in San Francisco shrimps. Possible mechanisms for wide dispersal of this diploid genotype are discussed. Five populations are reproductively isolated from San Francisco shrimps: Mono Lake, Hidalgo, Lake Urmia, San Bartolomeo, and Tunisia. The last two are inter-fertile.