Divergent and synergistic regulation of matrix metalloprotease production by cytokines in combination with C-C chemokines.

The chemotactic effects of chemokines on cells has long been known, but it is now clear that chemokines also have much broader activities and are also involved in a number of disease pathologies, such as rheumatoid arthritis, cancer metastasis and other inflammatory processes. This study investigates the effects of four C-C chemokines, CCL2, CCL3, CCL4 and CCL5 either alone or in the presence of two regulatory cytokines TNF-alpha and TGF-beta and their effect on secretion of two matrix metalloproteases MMP, MMP-2 and MMP-9, and the expression of one membrane bound MMP, MMP-14, by a monocytic human cell line, MonoMac6. All four C-C chemokines were shown to be chemotactic, but only CCL2 and CCL4 had any significant stimulatory effect on MMP-9 and MMP-2, respectively. Both TNF-alpha and TGF-beta were found to divergently enhance MMP-9 and MMP-2 secretion respectively, with stimulation indexes of two and five respectively. Simultaneous treatment with TNF-alpha and chemokine resulted in up to a fifteen-fold stimulation of MMP-9 secretion and treatment with TGF-beta and chemokine resulted in up to a fifteen-fold stimulation of MMP-2 secretion, while TNF-alpha in combination with CCL4 stimulated MMP-14 expression five-fold. Chemokine receptor expression was also investigated using a calcium-sensitive dye and FACS analysis. CCL2, CCL3, and CCL5 all resulted in a detectable enhancement of cytoplasmic Ca2+concentration. CCL4 was unable to activate Ca2+ mobilization, despite the presence of CCR5, the receptor for CCL4. There appeared to be no correlation between MMP production and chemotaxis. The strong synergy between chemokines and cytokines and the enhanced production of MMP may signify the differential regulatory mechanisms of the two cytokines and chemokines in disease pathology.

Divergent effects of infliximab and anakinra therapies on macrophage phenotype from patients with refractory rheumatoid arthritis.

Previously, we documented the co-expression of the inducible nitric oxide synthase (NOS2) and protein kinase C-eta (PKC-eta) in peripheral blood-derived macrophages (PBDM) from moderate to severe rheumatoid arthritis (RA) patients with elevated plasma nitric oxide levels but not from those with non-inflammatory osteoarthritis (OA) or normal plasma NO levels. The presence of PKC-eta was found to be required before macrophages could acquire the NOS2-positive phenotype and make copious levels of NO. In the current study, we report the divergent effects of two biological-based RA therapies which target TNFalpha function (infliximab) or IL1 response (anakinra) on the development of the NOS2-positive phenotype by PBDM in patients with refractory RA. Both infliximab and anakinra were effective in improving disease symptoms. However, treatment with anakinra, but not infliximab led to a complete suppression of NOS2 expression in PBDM and consequently, a more pronounced reduction in plasma NO levels. Data also revealed a requirement of both TNF-alpha and IL-1 in the development of the NOS2-positive macrophage phenotype. Finally, the data have shed light on the molecular mechanisms by which NO production may be regulated during disease progression to severe RA, and thus, offer a novel insight into the identification of future therapeutic targets for the treatment of inflammatory diseases.

Outcome of Medicare patients with emphysema selected for, but denied, a lung volume reduction operation.

BACKGROUND: Lung volume reduction operation shows promise in relieving symptoms and improving function in highly selected patients with emphysema. Withdrawal of Medicare funding for patients selected for operation by standard criteria created a matched control group with which to compare lung volume reduction recipients. METHODS: A retrospective study was done comparing 22 volume reduction candidates denied operation with 65 contemporaneous and comparable volume reduction recipients. Baseline physiologic characteristics were compared and longitudinal measures of pulmonary function were followed up for 24 months. RESULTS: Patients denied operation were similar to volume reduction recipients in all baseline measurements. Patients denied operation experienced a progressive worsening of their function, whereas volume reduction patients experienced sustained improvements. Absolute survival to date is 82% for the surgical group and 64% for the medical group. CONCLUSIONS: The improvement seen in volume reduction patients cannot be attributed to the effects of patient selection or preoperative and postoperative rehabilitation.

Humoral response to HSV-1 subunit vaccines--a statistical analysis.

Following primary infection with HSV, the virus becomes latent in the local sensory ganglia for the lifetime of the host. In some cases, periodic reactivation may occur due to various stimuli and cause a recrudescent lesion at or near the initial site of infection. As yet there is no suitable vaccine to prevent its spread within the human population. We investigated the potential of a large number of commercial and experimental adjuvant preparations to enhance the immunogenicity of an HSV-1 glycoprotein subunit vaccine. Evaluation was based on toxicity, total antibody titre, neutralizing antibody production and protection against lethal challenge. All adjuvants tested increased the titre of antigen specific total and neutralizing lg when compared to subunit vaccine alone, although functional neutralising antibody was only detected in some cases. Following challenge, a broad range of protective responses was noted but no correlation between antibody levels and protection was observed. The results emphasize the requirement of adjuvants when using subunit preparations as vaccine formulations and demonstrate that the magnitude and effectiveness of the induced immune response varies greatly with the choice of adjuvant.

Atypical receptor-mediated signal transduction events in the EGF-dependent growth-inhibited cell line, MDA-468.

It is now generally considered that early signalling from tyrosine kinases that induce mitogenesis is initiated through the formation of heteromeric complexes consisting of the autophosphorylated tyrosine kinase and a number of tyrosylphosphorylated proteins, including phospholipase C-gamma (PLC-gamma) and GTPase activating protein (GAP). However, since much of this work has been performed on proliferative, chimeric cell lines expressing heterologous receptor molecules, we examined the nature of the epidermal growth factor receptor (EGFR) signalling complex formation in the human breast cancer cell line, MDA-468. This cell line has an amplified, native EGFR gene, correspondingly overexpresses the EGFR, and its growth in culture is inversely related to the EGF concentration. Our results indicate that in MDA-468 cells, both the EGFR and PLC-gamma are phosphorylated on tyrosine residues and can be co-immunoprecipitated. This occurs at both high and low EGF concentrations regardless of the proliferative endpoint. The molecular association is correlated with a significant increase in total inositol phosphates formed in response to the growth factor treatment. In contrast, however, there is no evidence that GAP is either phosphorylated on tyrosine residues or forms a complex with the activated EGFR in EGF-treated MDA-468 cells. These observations suggest that as a model for growth factor action, the formation of heteromeric protein signalling complexes may demonstrate considerable diversity depending upon both cell type and physiology.

Toxicity of 3'-deamino-3'-(3-cyano-4-morpholinyl) doxorubicin and doxorubicin in nude mice bearing human tumour xenografts.

The toxicity of the intensely potent anthracycline 3'deamino-3'-(3-cyano-4-morpholinyl)doxorubicin (MRA-CN) has been evaluated in nude mice bearing human colonic cancer xenografts. In addition to dose related toxicity manifested as weight loss and effects on the haematology profile, we obtained evidence of cardiotoxicity with MRA-CN, which has not been reported previously. Even a single dose of 0.012 mg kg-1 could induce significant myocardial changes as seen by electron microscopy. Our results suggest that nude mice bearing human tumour xenografts may offer a very sensitive model for the evaluation of anthracycline induced cardiomyopathy. In view of the potential of MRA-CN in cancer treatment, these results need to be confirmed and extended.

Antibody mediated targeting of radioisotopes, drugs and toxins in diagnosis and treatment.

The recent resurgence of interest in site specific delivery of radioisotopes, chemotherapeutic drugs and toxins for the diagnosis and treatment of cancer, and for the selective manipulation of the immune system, can be directly related to the need for improved diagnosis and the fact that for many cancers, for example lung, colon and gastric, the conventional treatments of surgery, radiotherapy and chemotherapy have reached a plateau in terms of the number of patients cured. To date, because of their specificity, the major emphasis has been on the use of antibodies as carriers and extensive in vitro, in vivo preclinical and clinical evaluation is underway. The aim of this article is to review recent progress, highlight avenues being explored to overcome limitations and to indicate new approaches that are evolving in antibody mediated targeting.

Doxorubicin-anti-carcinoembryonic antigen immunoconjugate activity in vitro.

An in vitro model consisting of a series of 11 human cancer cell lines with varying density of expression of membrane carcinoembryonic antigen (CEA) has been used to evaluate conjugates of doxorubicin (Adriamycin) covalently linked by a carbodiimide method to goat polyclonal antibodies and mouse monoclonal antibodies to CEA. Conjugates were produced which retained both antigen binding and drug cytotoxicity. IC50 values were determined for free drug, free drug mixed with unconjugated antibodies and for the immunoconjugates. Cell lines that were very sensitive to free drug (IC50 less than 100 ng/ml) were also found to be highly sensitive to conjugated drug and similarly cell lines resistant to drug (IC50 greater than 1,000 ng/ml) were also resistant to conjugated drug. Although there was no correlation between CEA expression and conjugates efficacy, competitive inhibition studies using autologous antibody to block conjugate binding to cells indicated immunoconjugates specificity for the CEA target.

Comparison of tetrazolium colorimetric and [3H]-uridine assays for in vitro chemosensitivity testing.

We have routinely used a [3H]-uridine microplate assay for assessing chemosensitivity. A colorimetric assay with the advantages of safety, cost and simplicity has previously been described and relies on the ability of living cells to reduce a soluble tetrazolium salt, 3-4,5-dimethylthiazol-2,5-diphenyl-tetrazolium bromide (MMT), into an insoluble formazan precipitate. We compared the chemosensitivity of 14 human tumour cell lines of colonic, lung and cervical carcinoma origin to doxorubicin, vindesine or vindesine immunoconjugates in both the [3H]-uridine assay and a modified MTT assay to evaluate whether we could change to the non-radiolabelled method. Correlation between the concentration of drug causing 50% inhibition of cell growth (IC50) for these agents between the two assays was very poor. However, taking account of recent reports in the literature, we modified the MTT assay by removing serum-containing medium and using dimethyl sulphoxide to solubilise the formazan precipitate. This considerably improved the correlation between the assays for doxorubicin (r = 0.871; P = 0.001) and vindesine (r = 0.981; P less than 0.001). Our data indicates that the MTT assay can be used to replace the [3H]-uridine assay for chemosensitivity screening, but further modifications are necessary to improve the sensitivity and decrease the problem of cell loss after washing, which was noted with some adherent cell lines.

Reinfection of guinea pigs with herpes simplex virus type 2: failure to establish a second latent ganglionic infection.

Guinea pigs were infected with herpes simplex virus type 2 (HSV 2) and at various times thereafter reinfected at a different site with the same or a different strain of HSV 2. Viruses were isolated from infected tissues either from the site of primary or secondary infection or from regional ganglia. Viral isolates were characterised by DNA fingerprinting using restriction endonucleases capable of differentiating between the virus strains used. The second infection resulted in a second site of peripheral persistence of the virus, but did not establish a second site of ganglionic infection.

Effect of liposomally trapped antitumour drugs on a drug-resistant mouse lymphoma in vivo.

A TLX-5 mouse lymphoma which was resistant to 1-ß-D-arabinofuranosyl cytosine (AraC) was used in vivo to study the possibility of using liposomes as drug-delivery vehicles in order to overcome drug resistance.The effects of free drugs (AraC, AraCTP and methotrexate) and the liposomally associated drugs on the survival time of tumour-bearing mice were determined.As a more sensitive measure of cell survival, (125)IUdR was incorporated into the DNA of the ascites TLX-5 cells before i.p. injection. Cell survival and the cytotoxic effects of the drugs on the tumour cells were determined by using a double-headed gamma counter to measure the retention of the (125)I label.Both AraC and AraCTP, either as the free drugs or liposomally associated, had no effects on the tumour. Due to the lack of response of tumour cells to these drugs, further studies were initiated with free and liposomally associated methotrexate (MTX), a drug to which the cells were known to be sensitive. It was found that the liposomally associated MTX, at a 5-10-fold lower dose than the free drug, was (a) more effective in prolonging the survival of tumour-bearing mice and (b) as effective as the free drug in killing tumour cells (as measured by the (125)I retention).In vivo MTX was more effective in the liposomally associated form, whereas liposomally entrapped AraC and AraCTP were ineffective. It is proposed that in vivo liposomally associated drugs may be acting not by actively localizing in the tumour cells, but by the liposomes providing a slow-release drug depot, improving the pharmacokinetic properties of MTX.

Liposomally trapped AraCTP to overcome AraC resistance in a murine lymphoma in vitro.

Two cell lines, one sensitive and one resistant to the cytotoxic effects of cytosine arabinoside (AraC) were studied in vitro as a drug-resistance model. The sensitivity of these cell lines, to the effects of free and liposomally trapped AraC and AraCTP as well as empty liposomes alone and mixed with free drug, was studied. This was done by following the inhibition of [3H]-dT incorporation into cellular DNA during exposure to the various drugs and liposomes. Some of the liposomal-lipid compositions inhibited [3H]-dT incorporation at very low concentrations, which made them unsuitable for further study. Liposomes composed of a 7:2:1 molar ratio of phosphatidylcholine:cholesterol:phosphatidic acid were selected as a suitable non-inhibitory carrier. Sensitivity of the two cell lines to free AraC differed by 3 logs, when compared in the [3H]-dT-incorporation assay. The resistant cell line was studied further, and was found to be up to 2 logs more sensitive to AraCTP when given in liposomes than to either the free drug alone or mixed with empty liposomes. It appears from these studies that liposomes are able to help overcome drug resistance in this cell line in vitro.

Tissue distribution and tumour localization of 99m-technetium-labelled liposomes in cancer patients.

The possible use of liposomes (phospholipid vesicles) to direct cytotoxic drugs to tumours has led us to investigate the tissue localization of i.v. injected 99m-Tc-labelled liposomes in cancer patients. Twenty mg or 300 mg doses of liposomal lipid (7:2:1 molar ratio of phosphatidylcholine : cholesterol : phosphatidic acid) were used in a study of 13 patients with advanced cancer and one with polycythaemia rubra vera (PRV). In all cases except the patient with PRV the major site of uptake of the label was the liver and spleen. In the patient with PRV the liver uptake was greatly reduced and the major site of uptake was found in regions corresponding to marrow. With the exception of one patient with a primary hepatoma, there was no significant tumour uptake of the label.

Potential of liposomes as drug-carriers in cancer chemotherapy: a review.

Liposomes are bilayered phospholipid vesicles that have been proposed as vehicles for the selective delivery of cytotoxic drugs into malignant cells. In vitro and in vivo experiments have indicated that the activity of a range of drugs or their active metabolites may be enhanced by encapsulation in liposomes, particularly when used against drug-resistant tumours. Moreover, liposomal entrapment certainly has a marked effect on the tissue distribution and rates of clearance of cytotoxic drugs, and also appears to reduce their toxicity in most cases. However, in both animal and patient studies, the major sites of uptake following IV administration consistently appear as the liver and spleen. Preferential tumour uptake has therefore not yet been achieved, althrough a degree of localization of liposomal labels can be demonstrated in the vicinity of experimental animal tumours in certain circumstances. Liposomes may have a future role in cancer chemotherapy, but much laboratory work remains to be done before clinical application can be considered.

Possible tumor localization of Tc-99m-labeled liposomes: effects of lipid composition, charge, and liposome size.

The possible in vivo distribution of liposomes after they have been directly labeled with Tc-99m has been studied in rats bearing the Walker 256 carcinoma. The importance of lipid composition, charge, and size of liposome were studied with respect to possible tumor-localizing properties. Tumor uptake was best with small, fluid-membrane, negatively charged liposomes, as indicated by the distribution of the Tc-99m label. The uptake was visualized on scintigrams.