Clozapine as a potential treatment for refractory impulsive, compulsive, and punding behaviors in Parkinson's disease.

There have been emerging cases of medication refractory obsessions, impulsivity, compulsivity, and/or punding in Parkinson's disease. These cases have proven difficult to treat, even for the experienced clinician. We report several medication refractory cases with a positive response to treatment with clozapine.

A closed culture system for the ex vivo transduction and expansion of human T lymphocytes.

A phase I clinical trial is currently being performed at our institution, with the aim of evaluating the feasibility and toxicity related to the administration of herpes simplex thymidine kinase gene-expressing human primary T lymphocytes following allogeneic hematopoietic stem cell transplantation. The need for safe and standardized preparation conditions for gene-modified cells is crucial. We describe the closed culture system used in the current trial for ex vivo retroviral-mediated gene transfer and transduced cell selection. Cell handling is performed in closed systems using a sterile connection device that avoids opening the culture system. Cell numbers during the production process increased from 93 +/- 16 on day 0 to 440 +/- 92 x 10(6) on day 12 (7.2 +/- 1.4-fold increase) (n = 11). Transduction efficiency before and after G418 resistance-based selection was 13.5 +/- 3.8% and 90.0 +/- 1.4%, respectively. Safety and efficacy testing included a search for replication-competent retrovirus, endotoxins, Mycoplasma, and bacterial contamination (n = 0/9), PCR-DNA, % CD3+ cells (91 +/- 2%), and viability after thawing (82 +/- 3%). Effective working time from day 0 to day 12 is approximately 20 h. The closed system we developed allows for safe and reproducible ex vivo preparation of gene-modified primary T lymphocytes for clinical use.

Highly purified CD34-positive cells reconstitute hematopoiesis.

PURPOSE: The objective of this study was to characterize CD34+ cell grafts, obtained using a novel technique, from children undergoing autologous bone marrow transplantation (BMT) for cancer therapy. In particular, we wanted to determine if the CD34+ marrow cell grafts generated hematopoietic reconstitution, since a positive result would motivate further development and use of this methodology. PATIENTS AND METHODS: This pilot feasibility clinical trial involved 13 patients < or = 25 years of age with advanced solid tumors, including seven children with neuroblastoma. Harvested bone marrow underwent immunomagnetic CD34+ selection. RESULTS: In three of 13 enrolled patients, low purities of the CD34+ preparations disqualified the use of the CD34+ marrow grafts. Ten patients received myeloablative chemotherapy with etoposide, carboplatin, and cyclophosphamide, then were transplanted with CD34+ marrow grafts. In the 10 patients transplanted with CD34(+)-selected cells, the CD34+ cell purity (nucleated RBCs excluded) in the cell graft preparation was 91% total cell recovery from the starting light-density cells 2.2%, CD34+ cell recovery 38%, colony-forming unit-granulocyte-macrophage (CFU-GM) recovery 23%, and estimated tumor-cell depletion 2.6 logs (medians). The CD34+ marrow grafts administered to these patients contained a median of 2.3 x 10(6) nucleated cells, 1.4 x 10(6) CD34+ cells, and 1.3 x 10(4) CFU-GM per kilogram patient weight. Most patients experienced only the toxicities previously observed with this myeloblative chemotherapy regimen, although two unusual toxicities were observed. All 10 patients transplanted with CD34+ cell grafts engrafted. CONCLUSION: The CD34+ purified grafts were enriched in stem/progenitor cells, with five of these 10 preparations containing > or = 94% CD34+ cells. Engraftment with CD34(+)-purified cell grafts as pure as 99% confirms that autologous CD34+ cells, alone, are sufficient to provide hematopoietic rescue for myeloablated patients. The best purification results were obtained on small marrow harvests from patients with neuroblastoma. The engraftment of highly purified CD34+ cells obtained by this technology and the antitumor effect of the transplant, by which two of 10 poor prognosis patients remain clinically free of tumor, have stimulated further clinical trials.

Use of the CS-3000 Plus to prepare apheresed blood cells for immunomagnetic positive cell selection.

The Baxter CS-3000 Plus Blood Cell Separator was used to prepare progenitor cell components in a three-step process. The process was designed to remove platelets and plasma from a leukapheresis cell product before incubation with anti-CD34 monoclonal antibody (9C5) and to remove unbound monoclonal antibody after incubation. Fluorochrome-labeled cultured KG1a (CD34+) cells were added to the leukapheresis cell product (at 2% of total WBC) before CS-3000 processing to evaluate the CS-3000 process for preparing cells for immunomagnetic selection using the Isolex 300 (SA) Magnetic Separation system. Data were obtained using five leukapheresis products. Two percent of the nucleated cells were lost during the platelet reduction wash, and 67% of the platelets were removed. The amount of antibody initially added to the cells for incubation ranged from 3.9 to 7 mg (0.5 microgram/10(6) nucleated cells). The residual antibody in the cells after the antibody wash ranged from 11 to 40 micrograms. The antibody wash resulted in a 3% loss of nucleated cells and an additional 66% removal of platelets. The antibody-sensitized cells were then processed on the Isolex 300 (SA) system. The purity and yield of the Isolex KG1a cell product were 94% and 82%, respectively.

Zinc-containing innervation of the subicular region in the rat.

The subiculum is densely innervated by zinc-containing axonal terminals, but the cells of origin of those zinc-containing afferents have not previously been identified. In the present work the zinc-specific retrograde tracing method was employed to locate the zinc-containing neurons afferent to the subicular complex. Following microinfusions into the subicular region, the somata of zinc-containing neurons were found in the hippocampus, the pre- and para subiculum, retrosplenial, cingulate, and perirhinal cortices, and in the anterodorsal nucleus of the thalamus. The results show another component of the zinc-containing associational network that interconnects the cerebral cortex and amygdalohippocampal systems of the brain.

Harvesting and enrichment of hematopoietic progenitor cells mobilized into the peripheral blood of normal donors by granulocyte-macrophage colony-stimulating factor (GM-CSF) or G-CSF: potential role in allogeneic marrow transplantation.

To explore the use of stem/progenitor cells from peripheral blood (PB) for allogeneic transplantation, we have studied the mobilization of progenitor cells in normal donors by growth factors. Normal subjects were administered either granulocyte-macrophage colony-stimulating factor (GM-CSF) at 10 micrograms/kg/d, or G-CSF at 10 micrograms/kg/d, or a combination of G- and GM-CSF at 5 micrograms/kg/d each, administered subcutaneously for 4 days, followed by leukapheresis on day 5. Mononuclear cells expressing CD34 (CD34+ cells) were selectively enriched by affinity labeling using Dynal paramagnetic microspheres (Baxter Isolex; Baxter Healthcare Corp, Santa Ana, CA). The baseline CD34+ cells in peripheral blood before mobilization was 0.07% +/- 0.05% (1.6 +/- 0.7/microL; n = 18). On the fifth day after stimulation (24 hours after the fourth dose), the CD34+ cells were 0.99% +/- 0.40% (61 +/- 14/microL) for the 8 subjects treated with G-CSF, 0.25% +/- 0.25% (3 +/- 3/microL, both P < .01 v G-CSF) for the 5 subjects administered GM-CSF, and for the 5 subjects treated with G- and GM-CSF, 0.65% +/- 0.28% (41 +/- 18/microL, P < .5 v GM-CSF). Parallel to this increase in CD34+ cells, clonogenic assays showed a corresponding increase in CFU-GM and BFU-E. The total number of CD34+ cells collected from the G-CSF group during a 3-hour apheresis was 119 +/- 65 x 10(6) and was not significantly different from that collected from the group treated with G- and GM-CSF (101 +/- 35 x 10(6) cells), but both were greater than that from the group treated with GM-CSF (12.6 +/- 6.1 x 10(6); P < .01 for both comparisons). Analysis of the CD34+ subsets showed that a significantly higher percentage of cells with the CD34+/CD38- phenotype is found after mobilization with G- and GM-CSF. In the G-CSF group, immunomagnetic selection of CD34+ cells permitted the enrichment of the CD34+ cells in the apheresis product to 81% +/- 11%, with a 48% +/- 12% yield and to a purity of 77% +/- 21% with a 51% +/- 15% recovery in the G- and GM-CSF group. T cells were depleted from a mean of 4.5 +/- 2.0 x 10(9) to 4.3 +/- 5.2 x 10(6) after selection, representing 99.9% depletion. We conclude that it is feasible to collect sufficient numbers of PB progenitor cells from normal donors with one to two leukapheresis procedures for allogeneic transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Fluid velocity imaging of reservoir core samples.

Experimental definition of fluid flow in heterogeneous reservoir rock requires three dimensional imaging techniques. Fluid velocity mapping at a steady-state flow condition plus oil/water saturation mapping using MRI provides a high resolution view of the process.

Quantification of oil and water in preserved reservoir rock by NMR spectroscopy and imaging.

Reservoir rock analysis by proton NMR requires separation of the response into brine and crude oil components. Tests on preserved core from a North Sea chalk reservoir show that spin-lattice relaxation time distributions can be used to distinguish the two fluids. NMR estimates of oil and water saturations for 1.5" diameter core examined in a 10 MHz Bruker Minispec spectrometer closely match fluid contents determined by distillation. The spin-lattice relaxation contrast mechanism developed for core samples can be applied in the quantitative analysis of NMR images. The relaxation data are compared with data from chemical shift imaging on the same core sample. The results indicate that it will be possible to monitor changes in fluid distributions, in this and similar systems, under dynamic conditions such as in a waterflood.

New application of silane coupling agents for covalently binding antibodies to glass and cellulose solid supports.

Bifunctional silane reagents (3-iodopropyl)trimethoxysilane (1), (gamma-glycidoxypropyl)trimethoxysilane (2), and [1-(trimethoxysilyl)-2-(m- (or p-)chloromethyl)phenyl]ethane (3) were used to covalently link goat anti-mouse (GAM) antibodies (Ab) to glass microbeads and cuprammonium rayon hollow-fiber dialyzers. An average of 0.79 and 0.83 microgram of GAM Ab/cm2 was immobilized on the hollow-fiber dialyzers and the glass beads, respectively. The antibodies immobilized on glass microbeads or on hollow-fiber dialyzers were then used to selectively deplete CD34+ cells or CD4+ peripheral blood mononuclear cells (PBMC), respectively. Glass microbeads depleted 80% CD34+ cells with good selectivity, and the hollow-fiber dialyzers depleted an average of 81% CD4+ PBMC.

Immunomagnetic positive selection and colony culture of CD34+ cells from blood.

Immunomagnetic separation has been used to enrich CD34-positive cells in umbilical cord blood. Cell purities were increased from 0.59% preseparation to 92.7% postseparation (n = 16) with a mean yield of 75.7%. CFU were enriched 127 fold by immunomagnetic separation. Addition of combinations of recombinant growth factors resulted in cloning efficiencies of greater than 50%.

Different receptor mechanisms mediate the pyrogenic and behavioral effects of interleukin 1.

Interleukin 1 (IL-1) is a cytokine released during immune activation that mediates the host's response to infection and inflammation. Peripheral and central injections of IL-1 induce fever and sickness behavior, including decreased food motivation and reduced interest in social activities. To determine the receptor mechanisms responsible for these effects, rats were injected with IL-1 receptor antagonist (IL-1ra), an endogenous cytokine that acts as a pure antagonist of IL-1 receptors. IL-1ra blocked the increased body temperature and oxygen consumption induced by injection of recombinant human IL-1 only when both cytokines were administered i.p. In contrast, i.p. or intracerebroventricular administration of IL-1ra blocked the depressive effect of IL-1 beta on food-motivated behavior and social exploration when this cytokine was administered by the same route as the antagonist. In addition, intracerebroventricular IL-1ra blocked the reduction in social exploration produced by i.p. IL-1 beta but had only partial antagonist effects on the decrease in food-motivated behavior induced by i.p. IL-1 beta. In each case, the dose of IL-1ra was 100- to 1000-fold in excess of the biologically active dose of IL-1. These results suggest that the receptor mechanisms that mediate the behavioral and pyrogenic effects of IL-1 are heterogeneous.

Inhibition of central actions of cytokines on fever and thermogenesis by lipocortin-1 involves CRF.

In the present studies, the mechanisms underlying the inhibitory actions of lipocortin-1 on the pyrogenic and thermogenic properties of cytokines were investigated. Central (icv) injection of corticotropin-releasing factor (CRF, 4.7 micrograms) or the recombinant cytokines interleukin (IL)-1 alpha (50 ng), IL-1 beta (5 ng), IL-6 (20 ng), IL-8 (20 ng), or tumor necrosis factor-alpha (TNF-alpha, 1 microgram) in conscious rats produced significant increases in resting oxygen consumption (VO2, 13-26%) and colonic temperature (0.7-1.6 degrees C) within 2 h postinjection. Administration (icv) of a recombinant fragment (NH2-terminus, 1-188 amino acids) of human lipocortin-1 (1.2 micrograms) produced small increases in VO2 (< 5%) and body temperature (< 0.3 degrees C). Pretreatment (-5 min) with lipocortin-1 significantly attenuated the thermogenic and pyrogenic effects of centrally injected IL-1 beta (80% inhibition), IL-6 (60%), IL-8 (80%), or CRF (60%). However, pretreatment with lipocortin-1 failed to modify the actions of IL-1 alpha or TNF-alpha. We have previously demonstrated that the pyrogenic and thermogenic effects of IL-1 beta, IL-6, and IL-8 are dependent on the central actions of CRF, whereas IL-1 alpha and TNF-alpha act independently of CRF. Fever and thermogenesis induced by all of these cytokines (with the exception of IL-8) can also be prevented by administration of a cyclooxygenase inhibitor. The data presented here suggest that the potent antipyretic effects of lipocortin-1 may result from inhibition of the release or actions of CRF rather than modulation of eicosanoid synthesis.

Quantitation of tumor cell removal from bone marrow: a preclinical model.

We have developed a multiassay system consisting of fluorescence microscopy, immunocytology and tumor colony assay to monitor the removal of tumor cells from bone marrow. This system was tested in preclinical purging experiments in which neuroblastoma cells were seeded into bovine marrow and purged by treatment with monoclonal antibodies and immunomagnetic beads. Eight experiments were performed on two different neuroblastoma cell lines seeded at 2% and/or 5% contamination. We consistently demonstrated greater than a 3 log removal with one cycle of antibody/bead treatment and greater than a 1 log further reduction by addition of a second cycle. We also demonstrated removal of all detectable tumor stem cells by this purging method. We feel that this system will prove valuable for monitoring ex vivo tumor removal in future clinical studies and should be considered for use in other purging trials.