Persistently positive culture results in a patient with community-acquired pneumonia due to Legionella pneumophila.

We describe a patient with community-acquired pneumonia due to Legionella pneumophila serogroup 6. This patient was found to have bronchoalveolar carcinoma of the lung by means of cytologic testing in 1 of 2 bronchoalveolar lavage samples, but no lesions were visible on bronchoscopy. Despite intravenous administration of azithromycin to the patient, repeat culture and polymerase chain reaction showed persistence of Legionella; the isolates remained susceptible to azithromycin. The patient did not respond to 14 doses of daily intravenously administered azithromycin. The poor outcome may have been partially due to the suspected underlying lung malignancy, as shown by cytologic examination, and by a delay in seeking medical attention.

Exon 11 of the rat cholesterol esterase gene encodes domains important for intracellular processing and bile salt-modulated activity of the protein.

The rat pancreatic cholesterol esterase is a 74,000 molecular weight protein encoded by a gene with 10 introns and 11 exons. The last exon of the cholesterol esterase gene is the largest and is also the least conserved exon among the cholesterol esterase genes of various species. The current study investigates the functional role of the exon 11 domain in rat cholesterol esterase. The transfection of native cholesterol esterase cDNA into COS cells resulted in an enzymatically active cholesterol esterase that was secreted by the cells. In contrast, transfection of cholesterol esterase cDNA with 88% of the exon 11 residues deleted from the sequence resulted in a protein that was not secreted by the cells. The cholesterol esterase with deletions in the exon 11 domain retained the ability to bind bile salt but was found to be enzymatically inactive. The inefficient secretion and the loss of enzyme activity for the truncated protein were not due to deletion of the proline-rich repeating units located in the exon 11 domain at the carboxyl terminus of the cholesterol esterase. The expression of rat cholesterol esterase with zero or one proline-rich units resulted in a truncated protein that was secreted by the transfected COS cells. The cholesterol esterases with reducing numbers of the proline-rich repeating units were also active in hydrolyzing p-nitrophenyl butyrate and cholesteryl oleate. The cholesterol esterase with fewer proline-rich repeating units were more active than the native enzyme in substrate hydrolysis at low bile salt concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Aspartic acid 320 is required for optimal activity of rat pancreatic cholesterol esterase.

The acidic amino acid residue required for the catalytic activity of rat pancreatic cholesterol esterase has been identified in this study by sequence comparison with other serine esterases and by site-directed mutagenesis experiments. The sequence comparison studies identified 3 acidic residues in homologous domains between cholesterol esterase, acetylcholinesterase, cholinesterase, and Geotrichum candida lipase that may potentially be the catalytic acidic residue in these proteins. The role of Glu78, Asp79, and Asp320 in the catalytic activity of rat cholesterol esterase was then addressed by mutagenesis and expression of the cDNA. Results showed that replacement of Glu78 or Asp79 with alanine has no effect on the ability of the cholesterol esterase to hydrolyze the artificial water-soluble substrate p-nitrophenyl butyrate. In contrast, the Asp320-->Ala320 substitution abolished the enzyme activity of the cholesterol esterase. The specific requirement of Asp320 for optimal enzyme activity was demonstrated by substitution of the aspartic acid with glutamic acid, thus retaining the charge unit at this position. The Asp320-->Glu320 substitution resulted in an enzyme that displayed normal interaction with bile salt. However, catalytic activity of this mutagenized protein was reduced by approximately 50%. These results strongly suggested that aspartic acid 320 is an important component of the catalytic triad of pancreatic cholesterol esterase. The specific requirement of aspartic acid, instead of glutamic acid, for optimal activity is different from that of other members of the serine esterase gene family.

Purification of pancreatic cholesterol esterase expressed in recombinant baculovirus-infected Sf9 cells.

A cDNA clone encoding the entire coding sequence of rat pancreatic cholesterol esterase (bile salt-stimulated lipase) was subcloned into the Baculovirus transfer vector pVL1392 and used to co-transfect Spodoptera frugiperda (Sf9) insect cells with wild-type Autographa californica nuclear polyhedrosis virus (AcNPV) DNA. Two recombinant proteins (M(r) 74 kDa and 64 kDa) reactive with anti-cholesterol esterase IgG were produced and secreted by the infected Sf9 cells in large quantities in a time-dependent manner. The 74-kDa protein was detectable in the cultured medium at the second day post-infection and increased progressively, reaching a level of 50 micrograms/ml of culture medium after 8 days. Amino-terminal sequencing of this recombinant protein showed that the signal peptide of cholesterol esterase was correctly cleaved, resulting in the production of mature protein. The 64-kDa recombinant protein was not detected in the medium until Day 5 post-infection and accumulated to a level of 25 micrograms/ml at Day 8. Both the 74- and the 64-kDa cholesterol esterases were biologically active and hydrolyzed the artificial substrate p-nitrophenyl butyrate. Results of this study demonstrated that Baculovirus-infected Sf9 cells can be used for high-level expression of pancreatic cholesterol esterase. The recombinant enzyme will be useful for further characterization of this protein.

Site-specific mutagenesis of an essential histidine residue in pancreatic cholesterol esterase.

The histidine residue essential for the catalytic activity of pancreatic cholesterol esterase (carboxylester lipase) has been identified in this study using sequence comparison and site-specific mutagenesis techniques. In the first approach, comparison of the primary structure of rat pancreatic cholesterol esterase with that of acetylcholinesterase and cholinesterase revealed two conserved histidine residues located at positions 420 and 435. The sequence in the region around histidine 420 is quite different between the three enzymes. However, histidine 435 is located in a 22-amino acid domain that is 47% homologous with other serine esterases. Based on this sequence homology, it was hypothesized that histidine 435 is the histidine residue essential for catalytic activity of cholesterol esterase. The role of His435 in the catalytic activity of pancreatic cholesterol esterase was then studied by the site-specific mutagenesis technique. Substitution of the histidine in position 435 with glutamine, arginine, alanine, serine, or aspartic acid abolished the ability of cholesterol esterase to hydrolyze p-nitrophenyl butyrate and cholesterol [14C]oleate. In contrast, mutagenesis of the histidine residue at position 420 to glutamine had no effect on cholesterol esterase enzyme activity. The results of this study strongly suggested that histidine 435 may be a component of the catalytic triad of pancreatic cholesterol esterase.

Identification of the active site serine in pancreatic cholesterol esterase by chemical modification and site-specific mutagenesis.

Chemical modification and site-specific mutagenesis approaches were used in this study to identify the active site serine residue of pancreatic cholesterol esterase. In the first approach, purified porcine pancreatic cholesterol esterase was covalently modified by incubation with [3H]diisopropylfluorophosphate (DFP). The radiolabeled cholesterol esterase was digested with CNBr, and the peptides were separated by high performance liquid chromatography. A single 3H-containing peptide was obtained for sequence determination. The results revealed the binding of DFP to a serine residue within the serine esterase homologous domain of the protein. Furthermore, the DFP-labeled serine was shown to correspond to serine residue 194 of rat cholesterol esterase (Kissel, J. A., Fontaine, R. N., Turck, C. W., Brockman, H. L., and Hui, D. Y. (1989) Biochim. Biophys. Acta 1006, 227-236). The codon for serine 194 in rat cholesterol esterase cDNA was then mutagenized to ACT or GCT to yield mutagenized cholesterol esterase with either threonine or alanine, instead of serine, at position 194. Expression of the mutagenized cDNA in COS-1 cells demonstrated that substitution of serine 194 with threonine or alanine abolished enzyme activity in hydrolyzing the water-soluble substrate, p-nitrophenyl butyrate, and the lipid substrates cholesteryl [14C]oleate and [14C] lysophosphatidylcholine. These studies definitively identified serine 194 in the catalytic site of pancreatic cholesterol esterase.

Enzyme-linked immunoabsorbant assay of apolipoprotein AII in plasma, with use of a monoclonal antibody.

We produced a monoclonal antibody (C2-22) to human apolipoprotein (Apo) AII and describe its use in an enzyme-linked immunoabsorbant assay (ELISA) for Apo AII in human plasma and lipoprotein subfractions. No cross reactivity of the antibody with Apo CI, CII, CIII, E, or ablumin was detected. Apo AI and low- and very-low-density lipoprotein cross reacted by 0.25%, less than 0.2%, and less than 0.3%, respectively. Whole plasma high-density lipoprotein (HDL) and HDL subfractions (HDL2 and HDL3) produced parallel displacement curves. This quantitative ELISA is based on competition between solid-phase-bound Apo AII and free Apo AII. Bound C2-22 is detected by alkaline-phosphatase-labeled second antibody. The standard curve for the assay is linear for plasma diluted 500-fold originally containing 140 to 1140 mg of Apo AII per liter. Delipidation of plasma samples exposed no additional antigenic sites. Within- and between-run CVs were respectively 8.4% and 8.7% at 327 mg/L of Apo AII, and 6.8% and 7.4% at 587 mg/L. Results correlated well with those by a polyvalent-antisera-based RIA procedure: r = 0.916, p less than 0.01, RIA = 0.896 ELISA -19.1 mg/L.

Expression of normal and tumor-associated antigens in human breast carcinoma.

The expression of six cytoplasmic/membrane antigens (beta 2-microglobulin, HLA, HLA-DR, carcinoembryonic antigen, and two breast tumor-associated antigens (TAAs), B6.2 and B72.3) was investigated in serial sections of 28 human breast carcinomas using monoclonal antibodies and the avidin-biotin complex immunoperoxidase technique. The frequency of expression and linkage between these antigens was determined, and antigenic expression was related to patient age, morphologic differentiation, cytologic grade, and estrogen receptor/progesterone receptor content of the tumor. The expression of beta 2-microglobulin and HLA correlated with morphologic differentiation, well-differentiated and moderately well-differentiated tumors expressing these antigens more often than poorly differentiated tumors. Expression of the TAAs, however, was not related to differentiation. There was no linkage between beta 2-microglobulin/HLA and the TAAs. Carcinoembryonic antigen was found to be linked to the TAA, B6.2. Expression of the TAA, B72.3, correlated with patient age. Eighty percent (23 of 28) of the tumors were positive for carcinoembryonic antigen or at least one of the TAAs. The estrogen receptor/progesterone receptor status of the tumor was not statistically related to the expression of any of the antigens studied. Analysis of tumor antigen profiles may provide important information relevant to prognosis, therapy, and early detection of cancer, as well as insights into the nature of the neoplastic process.

Evaluation of the peroxidase-antiperoxidase method for demonstrating cell membrane B2-microglobulin.

The peroxidase-antiperoxidase (PAP) immunohistochemical technic was evaluated for its usefulness in studying B2-microglobulin (B2m) expression in the cell membrane of human tumor lines grown in athymic mice. Eleven human tumor xenograft lines expressing various amounts of B2m were used. B2m was assessed by three methods: PAP technic on formalin-fixed, paraffin-embedded tissue; indirect immunofluorescence on frozen sections; and radioimmunoassay on soluble tumor extracts. The three technics gave comparable results, and the PAP technic proved to be useful in evaluating B2m.

Heterogeneity of beta 2-microglobulin in human breast carcinoma.

beta 2-microglobulin (beta 2m) content and distribution in human benign and malignant breast tissues have been investigated by immunohistologic means, and wide differences in the expression of this protein have been observed. The distribution of beta 2m as determined by indirect immunofluorescence was uniform throughout normal human and benign breast tumor tissues, as well as in human tumor xenografts grown in athymic mice, but marked difference in beta 2m content was demonstrated between individual tumors. In breast carcinomas, heterogeneity in beta 2m expression was found to exist within individual tumors. This heterogeneity was evident mainly in moderately well-differentiated tumors; the majority of poorly differentiated tumors did not express beta 2m at all. It is suggested that the expression of surface beta 2m is an indicator of tumor cell differentiation or maturation.

Regional growth differences of human tumour xenografts in nude mice.

Human tumour cells of the HEP-2 and SW480 cell lines were inoculated subcutaneously into 4 locations on the athymic (nude) mouse lateral trunk. There was no difference in size between tumours grown on the right side of the body and those grown on the left. However, 4 weeks after inoculation, anterior tumours were 3 times as large as posterior tumours. The results indicate a predilection for tumour xenograft growth in the anterior region of the lateral nude mouse trunk.

beta 2-microglobulin in human tumors heterografted into athymic mice.

Beta 2-microglobulin (beta 2m) content of several human tumor lines implanted into athymic mice was investigated. The concentration of this protein was found to vary greatly from tumor to tumor. The growth rate of the tumors was inversely related to the amount of the extractable beta 2m. The fastest growing, undifferentiated tumors contained the least amount of beta 2m.

Release of beta 2-microglobulin by human tumors grown in nude mice.

Human tumors implanted subcutaneously into athymic mice produced human beta 2-microglobulin which was readily identified and quantified in mouse plasma. Implanted solid tumors of the lines Clouser, SW480, Hep-2, Capan-1, and HT-29 released amounts of beta 2-microglobulin directly related to tumor mass. The extractable beta 2-microglobulin per gram of tumor was constant for each cell line, but there was a 100-fold variation between the lines. In general, the plasma level of beta 2-microglobulin correlated with the amount of free beta 2-microglobulin extracted from each tumor. From these observations it can be concluded that the variablility observed in the circulating levels of beta 2-microglobulin among cancer patients is related to the beta 2-microglobulin content of the tumor and the total tumor mass.

Influence of the mouse hepatitis virus (MHV) infection on the growth of human tumors in the athymic mouse.

The growth characteristics and histological appearance of tumors resulting from transplantation of the tumor lines HEp-2 and SW480 into pathogen-free and mouse hepatitis virus infected athymic mice were studied. Subcutaneous or intraperitoneal implantation 1 x 10(6) neoplastic cells into pathogen-free animals resulted in tumor growth. Subcutaneous transplants grew locally, surrounded by a capsule of connective tissue. The fibrovascular stroma supporting the neoplastic tissue was minimal and infiltration of tumor capsule was observed. Intraperitoneal tumors grew in a multifocal pattern, were not encapsulated, showed marked invasiveness and metastasized. The same number of neoplastic cells (1 x 10(6)) transplanted into hepatitis-positive animals failed to develop into grossly visible tumors. When the number of transplanted cells was increased to 2 x 10(7), tumors appeared in a few animals. All tumors, regardless of the site of transplantation, were characterized by the presence of severe fibrohistiocytic reaction at the site of implantation that possibily influenced the tumor growth. No evidence supporting T-cell-mediated tumor rejection was observed. It is concluded that the state of health of the athymic mice is critical for the growth of human tumors and may account for the variations in reporting successful transplantation of such tumors in nude mice.

Monitoring the therapy of human tumor xenografts in nude mice by the use of lactate dehydrogenase.

With the use of circulating human lactate dehydrogenase (LDH) as a tumor marker, growth and remission of human tumor lines SW480, HEp-2, and Clouser, implanted into female BALB/c athymic nude mice, were followed during therapy. Three types of therapy were used: X-radiation, cyclophosphamide, and diphtheria toxin. After therapy tumor sizes were measured with calipers and compared to changes in the levels of circulating human LDH. Changes in LDH levels paralleled changes in tumor size, but the enzyme fluctuations were more pronounced. Mice bearing intraperitoneally growing SW480 and HEp-2 tumors were effectively treated with diphtheria toxin, and the measurement of circulating LDH was examined as a parameter for gauging the effectiveness of chemotherapy on tumors that could not be visualized. Circulating human LDH can be used to detect intraperitoneal tumor growth and/or remission and to predict death of the animal due to the tumor.

Growth patterns and metastatic behavior of human tumors growing in athymic mice.

The growth characteristics and metastatic behavior of human tumors growing in athymic nude mice were studied. Human tumor cell lines HEp-2 (carcinoma or larynx) and SW480 (colon carcinoma) were transplanted into athymic nude mice of BALB/c origin. Tumor cells (1 x 10(6) and 2 x 10(7)) were given either s.c. or i.p. Following s.c. injection tumors developed rapidly to become easily palpable with 2 weeks forming a s.c. tumor focus surrounded by a thick fibrous capsule. Animals with s.c. transplants were little affected by the growing tumor. At the time they were sacrificed at Day 34 (HEp-2) and 62 (SW480), a large part of the tumor was necrotic. Capsular infiltration and invasion of lymphatic vessels and perineural and perivascular lymphatic spaces were observed. Metastases to regional lymph nodes were seen in animals kept alive for up to 6 months. Following i.p. transplantation, tumors spread widely in the peritoneal cavity, invaded intraabdominal organs, and metastasized to mediastinal lymph nodes and lungs. Fifteen of 26 animals (60%) developed metastases. Necrosis of the i.p. growing tumors was minimal. All animals in this group died as a result of tumor growth.

Human lactic dehydrogenase as a marker for human tumor cells grown in athymic mice.

Human tumors implanted s.c. into athymic mice released lactic dehydrogenase (LDH) isoenzymes unique to human tissue. These isoenzymes were readily identified and quantitated in mouse plasma. When injected into mice i.p. or i.v., human LDH isoenzymes were rapidly cleared from the blood circulation, decreasing to within 10% of the initial value in 12 hr. When human tumor cell lines (HEp-2 and T-24) were injected i.v. into heterozygote or athymic mice, they released LDH isoenzymes over a 24-hr period. When these cells were injected by the i.p. route, they released the isoenzymes over the 4-day period studied. Solid tumors of HEp-2, T-24, and SW-733 cells s.c. implanted continuously released amounts of LDH that were directly related to tumor mass. Therefore, the measurement of plasma levels of human LDH isoenzymes in athymic mice is a useful parameter for detecting the presence and growth of human tumors in these animals. Since the bulk of the released LDH is assumed to derive from injured or destroyed human tumor cells, the assay for these isoenzymes should provide a useful marker for determining the effectiveness of experimental antitumor therapy in athymic mice.