Detection of minimal levels of serum anti-Müllerian hormone during follow-up of patients with ovarian granulosa cell tumor by means of a highly sensitive enzyme-linked immunosorbent assay.

Granulosa cell tumors (GCT) are ovarian neoplasms that tend to recur and spread in the pelvis and the abdomen several years after the initial treatment. Anti-Mülerian hormone (AMH) is a reliable serum marker of these tumors. To enhance the availability and the sensitivity of serum AMH determination, we developed an ultrasensitive enzyme-linked immunosorbent assay. In this work we compare the results of serum AMH levels, obtained using the ultrasensitive and the traditional assays, in 31 patients with ovarian GCT followed up for up to 7 yr. The ultrasensitive enzyme-linked immunosorbent assay has a significantly higher sensitivity than the traditional one. This resulted in the detection of low serum AMH levels, which were undetectable with the traditional assay, in several cases including one patient in whom a recurrence of a GCT had developed and two patients in whom the treatment had not been completely successful. These cases highlight the importance of the availability of a highly sensitive assay allowing evaluation with high precision of the results of treatment and to detect the recurrences of GCT at an early, preclinical stage.

[Evaluation of an immunoradiometric assay for succinylated ACTH]. / Evaluationdudosageimmunoradiométrique de l'ACTH succinylée.

A new immunoradiometric assay for succinylated ACTH using 3 monoclonal antibodies has been developed by Immunotech (I-IRMA). It was compared to a commercial immunoradiometric assay of ACTH (Nichols Institute, N-IRMA). The functional sensitivity of I-IRMA assay was estimated at 1.5 ng/L. The comparison of both methods on plasma samples withdrawn at 8 h from 47 normal subjects showed a good correlation coefficient (r = 0.83; P < 0.001). The 24-hours secretion profiles obtained by both methods were similar in 14 normal subjects. Nevertheless, the I-IRMA mean values were about 30% lower than the corresponding N-IRMA values. This difference increased to 50% when the ACTH concentrations were low, as it the case at 24 h or during the dexamethasone suppression test. During insulin hypoglycemia stimulation test, the two procedures gave similar values. Both methods applied to a pathologic population gave similar result to those obtained on normals. In 10 patients bearing corticotroph adenomas, the profiles of ACTH secretions during 24 h were similar using both methods. The I-IRMA values were lower about 30% than N-IRMA values during the base state or after the 8 mg-dexamethasone suppression test. This difference was also observed in 6 patients with corticotroph insufficiency. In conclusion, the comparison of N-IRMA and I-IRMA methods showed the validity of the new succinylated-ACTH assay which is more efficient in the lower range of ACTH concentration. This significant decrease in the sensitivity threshold may be useful in the establishment of the cure criteria in Cushing disease.

Immunoradiometric assay of succinylated corticotropin: an improved method for quantification of ACTH.

In this paper we describe the development and the evaluation of a new type of immunoassay for human corticotropin (ACTH). We succeeded, by using an original approach based upon immunization with ACTH derivatized with succinic anhydride, in raising monoclonal antibodies against this poorly immunogenic peptide. Three of the antibodies were selected to develop an immunoassay for ACTH. The assay requires the prior succinylation of the plasma samples for optimal sensitivity and specificity. This acylation treatment is fast, reproducible, and, in addition, improves the stability of the ACTH molecule in plasma, thus facilitating sample handling. The assay is performed in only 3 h with a detection limit of 0.7 ng/L. Analytical evaluation showed excellent specificity, reproducibility, and reliability. A comparison with two commonly used but time-consuming ACTH IRMAs was carried out by assaying several plasma samples in parallel and gave in both cases very good correlation.

A novel method for the production of antibodies against ACTH: their characterization and use in epitope mapping.

Our earlier attempts at immunization with human adrenocorticotropin hormone (ACTH) were unsuccessful and we therefore developed a new strategy including the chemical modification of the hormone by succinic anhydride in order to increase its immunogenicity. This process allowed us to obtain antisera with titers of up to 1/1000 and yielded 39 anti-succinylated ACTH (sACTH)-secreting hybridomas. Subsequently, the epitopes of sACTH were mapped by testing monoclonal antibodies two by two for simultaneous binding to sACTH and for their capacity to recognize its succinylated fragments 1-13, 1-17 and 1-24. The results, obtained with the use of radioactive tracers, were confirmed by and complemented with experiments conducted with biosensor technology. Seven groups of antibodies were defined on the basis of their pattern of reactivity and it was shown that four monoclonal antibodies could bind simultaneously to sACTH. Their dissociation constants (Kd) for sACTH were calculated and ranged from 10(-8) M to 10(-11) M. In order to obtain a fast and sensitive immunoassay for the hormone, we developed a protocol for the chemical modification of ACTH in serum and the most efficient monoclonal antibodies were selected on the basis of the epitope map and of their dissociation constants.

Radioimmunoassay of a new angiotensin-converting enzyme inhibitor (perindopril) in human plasma and urine: advantages of coupling anion-exchange column chromatography with radioimmunoassay.

Perindopril (P) is a prodrug whose active metabolite perindoprilat (PT) is an antihypertensive agent which acts by inhibition of angiotensin-converting enzyme (ACE). Anti-PT antiserum was produced in a rabbit immunized against PT that was covalently linked to bovine serum albumin. The radioligand is an iodinated (125I) derivative of PT-glycyltyrosinamide. Both the drug (PT) and the prodrug (P) are assayed in the same sample; PT is assayed as is and P is assayed after quantitative alkaline hydrolysis into PT. Certain data obtained from such assays suggest the occurrence in plasma and urine of a third immunoreactive component. A chromatographic fractionation of samples allowed us to isolate a new immunoreactive metabolite which was further identified as a glucuronide of PT (PT-G). Therefore, the whole assay was carried out as follows: biological samples were fractionated by stepwise chromatography on a anion-exchange resin (the first fraction contained P, the second contained PT, and the third contained PT-G); and RIA was performed on fractions 2 and 3 as is, and on fraction 1 after alkaline hydrolysis. Performances and assessments of this method are presented together with an example of a pharmacokinetic profile.

High concentrations of 2-5A, the interferon intracellular mediator, in the blood of children with acute viral infections.

We measured the concentration of 2-5A (2',5'-oligoadenylate), an intracellular mediator of the antiviral action of interferon, in the blood of children with acute viral and bacterial infectious diseases. 2-5A concentration was found to be elevated in several children with viral diseases. This elevation seemed transient and was not specific for viral infections. We provide arguments for the use of 2-5A as a marker of the evolution of diagnosed viral diseases.

Mechanisms of degradation of 2'-5' oligoadenylates.

We have studied the mechanisms of breakdown of 2'-5' oligoadenylates. We monitored the time-courses of degradation of ppp(A2'p5')nA (dimer to tetramer) and of 5'OH-(A2'p5')nA (dimer to pentamer) in unfractionated L1210 cell extract. The 5' triphosphorylated 2'-5' oligoadenylates are converted by a phosphatase activity. However, 2'-5' oligoadenylates are degraded mainly by phosphodiesterase activity which splits the 2'-5' phosphodiester bond sequentially at the 2' end to yield 5' AMP and one-unit-shorter oligomers. The nonlinear least-squares curve-fitting program CONSAM was used to fit these kinetics and to determine the degradation rate constant of each oligomer. Trimers and tetramers, whether 5' triphosphorylated or not, are degraded at the same rate, whereas 5' triphosphorylated dimer is rapidly hydrolyzed and 5'-OH dimer is the most stable oligomer. The interaction between degradation enzymes and the substrate strongly depends on the presence of a 5' phosphate group in the vicinity of the phosphodiester bond to be hydrolyzed; indeed, when this 5' phosphate group is present, as in pp/pA2'p5'A/or A2'/p5'A2'p5'A/, affinity is high and maximal velocity is low. Such a degradation pattern can control the concentration of 2'-5' oligoadenylates active on RNAse L either by limiting their synthesis (5' triphosphorylated dimer is the primer necessary for the formation of longer oligomers) and/or by converting them into inhibitory (e.g., monophosphorylated trimer) or inactive (e.g., nonphosphorylated oligomers) molecules.

Do viruses play an etiologic role in ankylosing spondylitis or psoriatic arthritis?

High venous blood levels of 2-5A, an adenylic acid polymer synthesized in the presence of double-stranded RNA and considered as a viral replication indicator, have been found in blood samples from ankylosing spondylitis and psoriatic arthritis patients, but not from patients with seropositive rheumatoid arthritis or acute chondrocalcinosis. These findings suggest the possibility that ankylosing spondylitis and psoriatic arthritis might be virus-induced diseases.

The occurrence of 2'-5' oligoadenylates in Escherichia coli.

The use of a highly specific radioimmunoassay and of HPLC permitted us to confirm the occurrence of 2'-5' oligoadenylates [p chi (A2'p5')nA] in several strains of Escherichia coli. Cellular concentrations of 2'-5' oligoadenylates ranged from 50 nM to 300 nM. The mixture of 2'-5' oligoadenylates consisted primarily of pppA2'p5'A, pA2'p5'A,A2'p5'Ap and A2'p5'A under normal conditions of growth. None of them activated RNase L. Infection of the bacteria with the single-stranded DNA phage M13 or induction of a heat-inducible, non-lytic mutant of phage lambda led to a significant increase in the total pool of 2'-5' oligoadenylates, paralleling the progressive inhibition of growth. Likewise, the inhibition of protein synthesis with chloramphenicol stimulated the accumulation of 2'-5' oligoadenylates. Furthermore, the inhibition of bacterial growth by either phage or by chloramphenicol brought about a change in the composition of the 2'-5' oligoadenylate pool; 5'-phosphorylated 2'-5' oligoadenylates accumulated and became the major components. The findings indicate a parallelism between the effects of viral infection on the synthesis of 2'-5' oligoadenylates in eukaryotes and similar effects subsequent to phage growth in the bacterium E. coli.

Epitope design for the induction of antibodies which recognize a family of molecules: example of monoclonal antibodies to 2'-5' oligoadenylates.

Monoclonal antibodies directed against 2'-5' oligoadenylates (pxA(2'pA)n 0 less than or equal to x less than or equal to 3, n greater than or equal to 1) have been obtained with A2'pA-succinyl albumin as immunogen. A competition assay using 125I iodo succinyl A2'pA tyrosine methyl ester as a tracer and thirty chemically related analogs was used to investigate the molecular basis governing their reactivity. We show that the use of a hapten as small as A2'pA elicits antibodies of high affinity for this dinucleotide (Kd = 2 x 10(-11) M). The overall immunoreactivity is essentially shared between the first moiety (5'OH A2'p) and the 2'-5' phosphodiester bond; however, the second moiety is an integral part of the epitope which extends up to the spacer. Therefore, any modification at the 5'OH end or of the 2'-5' structure dramatically decreases the binding. Modifications at the 2' and/or 3' ends are favourable if they mimic the immunogen. Modifications of the ribose backbone reveal the part of antigenicity due to the different 3'OH groups. Substitution of the bases show that the second adenine is implicated in the antigenicity. We demonstrate how, with such requirements, these antibodies recognize A2'pA alone or at the 5' end of or else included in longer oligonucleotides.

Enzyme immunoassay of 2'-5'-oligoadenylates at the femtomole level.

We have developed a competition enzyme immunoassay (EIA) for 2'-5'-oligoadenylates [p kappa(A2'p5')nA; 0 less than or equal to kappa less than or equal to 3; 1 less than or equal to n] based on an anti-A2'p5' A monoclonal antibody coated onto 96-well polystyrene plates and A2'p5' A peroxidase as a marker. It permits measurement of 5'OH(A2'p5')nA as such and p kappa(A2'p5')nA after alkaline phosphatase hydrolysis, with a detection threshold of 5 X 10(-12) M. All 2'-5'-oligomers were assayed with similar sensitivity. ATP and adenosine did not interfere at concentrations up to 10(6)-fold higher than those of 2'-5'-oligoadenylates. Reproducibility, stability of reagents and correlation with the radioimmunoassay were good. As such, this EIA is a suitable tool for studying the 2-5A system, particularly, in clinical investigations: the initial velocity of 2-5A synthetase can be determined on 10,000 cells without purification and the level of 2'-5'-oligoadenylates can be assayed on less than 1 ml of blood.

Interferon-alpha, beta and -gamma induce (2'-5') oligoadenylate synthetase in cultured mouse brain cells.

Basal and interferon (IFN)-induced levels of (2'-5') oligoadenylate synthetase activity were measured in astrocyte cultures from the mouse cerebral cortex, in neurone-enriched and mixed cerebellar cultures, and in two continuous neural cell lines by a radioimmunoassay procedure. All untreated cultures contained measureable enzyme activity. Both purified IFN-alpha, beta and recombinant IFN-gamma induced the enzyme in all cultures with the exception of the C8S cell line which did not respond to IFN-gamma. IFN-alpha, beta was more effective than IFN-gamma. The amplitude of induction by IFN-alpha, beta was highest in the cell lines, intermediate in cortical astrocytes and lowest in mixed and neurone-enriched cultures from the cerebellum.

Comparison of the effects of rabies virus infection and of combined interferon and poly(I).poly(C) treatment on the levels of 2',5'-adenyladenosine oligonucleotides in different organs of mice.

Intracellular levels of 2',5'-adenyladenosine oligonucleotides were analyzed in different organs of mice during the course of a rabies virus infection. Phosphorylated and nonphosphorylated 2',5'-adenyladenosine oligonucleotides were measured by radioimmunoassay and analyzed further by HPLC. As the infection progressed, concentrations of phosphorylated 2',5'-adenyladenosine oligonucleotides increased strongly, reaching their maxima late in the infection. In contrast, concentrations of the nonphosphorylated 2',5'-adenyladenosine oligonucleotides decreased. A similar phenomenon was observed in spleens analyzed at intervals after treatment of noninfected mice with interferon and poly(I).poly(C) and to a lesser extent after treatment of noninfected mice with interferon and poly(I).poly(C) and to a lesser extent after treatment with poly(I).poly(C) alone, but not after treatment with interferon alone. The products which accumulated during virus infection were primarily phosphorylated dimers whereas during combined interferon and poly(I).poly(C) treatment, the entire range of phosphorylated molecules from dimer to pentamer was present. These data show that infection of mice with rabies virus provokes both the induction and the activation of 2-5A synthetase, as does interferon and poly(I).poly(C) treatment. However, our data indicate that the intracellular products are different in the two situations: the species active on the nuclease were only detected in interferon- and poly(I).poly(C)-treated mice. The absence of molecules able to activate the 2-5A-dependent nuclease in virus-infected mice might well be one of the reasons why the interferon system is ineffective in rabies virus infection.

Immunological evidence for the in vivo occurrence of (2'-5')adenylyladenosine oligonucleotides in eukaryotes and prokaryotes.

A monoclonal antibody highly specific for (2'-5')adenylyladenosine oligonucleotides was used together with a 125I-labeled analog of this compound to detect and quantify phosphorylated and nonphosphorylated (2'-5')adenylyladenosine oligonucleotides in a variety of tissues and cells. These oligonucleotides were first assayed as a whole in perchloric acid extracts and then further individually characterized by HPLC analysis. Their sensitivity to alkaline phosphatase, snake venom phosphodiesterase, and T2 RNase was systematically checked. Nonphosphorylated (2'-5')adenylyladenosine oligonucleotides were found in mammalian tissues as well as in yeast and bacteria. In normal mouse brain, lung, heart, pancreas, spleen, kidney, and liver their concentrations ranged from 10 to 200 pmol/g wet weight, depending on tissue and strain. The oligonucleotides were mainly dimers, trimers, tetramers, and pentamers. In addition, phosphorylated (2'-5')adenylyladenosine oligonucleotides were shown in liver and kidney extracts.

Monoclonal antibodies to 5'-triphospho-(2'-5')adenyladenosine oligonucleotides.

Thirteen monoclonal antibodies to ppp(A2'p5')nA oligonucleotides have been produced by fusing Y3 myeloma cells with spleen cells of rat hyperimmunized with A2'p5'A succinyl albumin as immunogen. 125I-labeled A2'p5'A succinyl tyrosine methyl ester was used as a labeled probe. Antibodies were detected by their ability to bind the labeled analog and were selected for their affinity for A2'p5'A. There were no significant differences between the properties of the monoclonal antibodies and of the antiserum. They discriminated between 2'-5' and 3'-5' phosphodiester bonds: they crossreacted poorly with (A3'p5')2A (crossreactivity ratio, greater than 10(4)) and even less with ATP an adenosine (crossreactivity ratio, greater than (6)). The affinity was high (Kd = 6 x 10(-12) M) for succinyl A2'p5'A, which is the best ligand, and also high for A2'p5'A (crossreactivity ratio, 3) and (A2'p5')2A, (A2'p5')3A, and (As'p5')4A (crossreactivity ratio, 7.5). The binding to triphosphorylated isomers, ppp(A2'p5)nA, was affected by the presence of the triphosphate groups, and the affinity increased as the length of the isomer increased (crossreactivity ratio, 10,000 for n = 1 to 200 for n = 4). Thermodynamic analysis of these data demonstrated that, in dephosphorylated isomers, the binding site of highest affinity was located at the 5'-OH end of the molecule whereas in phosphorylated isomers, the favorable binding sites were in the middle and at the 2'-OH end of the chain. Use of monoclonal antibodies of such a specificity together with the 125I-labeled 2-5A analog allows quantification of (A2'p5')nA directly and of ppp(A2'p5')nA after removal of the terminal phosphates by alkaline phosphatase treatment.

2' and 3' ribonucleoside monophosphate in leukocytes of acute myeloid leukemia: markers for early diagnosis of relapse.

Levels of 2' and 3' purine and pyrimidine ribonucleoside monophosphates (2'-, 3'-NMP) in leukocytes from blood and/or bone marrow were measured in three adult patients with acute non-lymphoblastic leukemias. The measurements of 2'-, 3'-NMP were made by high-performance liquid chromatography (HPLC) at various times in the course of the disease. Complete remission (CR) was obtained for all three patients but two of these have since died after relapsing at 8 and 9 months, respectively. The third patient remains in CR at 1 1/2 year. The levels of 2'-, 3'-NMP in the leukocytes of the patient remaining in remission have not changed since the beginning of his remission. However, in the patients who relapsed 2'- and 3'-NMP levels increased first in bone marrow than in blood leukocytes. These increases occurred about 3 months before the relapse was detected by morphological criteria. These data suggest that 2'-, 3'-NMP measurements may have a prognostic value if used to monitor patients with acute myeloid leukemia in CR.