Phase I clinical trial of a human idiotypic p53 vaccine in patients with advanced malignancy

BACKGROUND

The purpose of this study was to induce immunity to p53 by using an idiotypic vaccine, composed of a pool of eight peptides derived from the complimentarity determining regions (CDRs) of human anti-p53 antibodies.

PATIENTS AND METHODS

Subjects with advanced malignancy received up to four, monthly intradermal injections of pooled peptides (500 microg of each) admixed with granulocyte-macrophage colony-stimulating factor (GM-CSF; 100 microg). In addition, two sheep and two rabbits were also vaccinated with the pooled peptides.

RESULTS

Fourteen subjects were enrolled into the study and six of these completed the vaccination schedule. The vaccine was well tolerated by all subjects and no major adverse events were attributable to the vaccine. All subjects mounted in vivo delayed type hypersensitivity (DTH) responses to two or more of the individual vaccine peptides. Vaccine-induced antibodies specific for peptides 2, 5 or 8 were detected in four of six subjects, and two of these had vaccine-specific, cell-mediated responses. Increasing titers of p53-specific antibodies were found in one patient. No T-cell response to p53 was observed in any of the subjects. All animals developed humoral immunity to the peptides and one of the sheep developed rising serum titers of anti-p53 antibodies.

CONCLUSIONS

Vaccination with human antibody CDR regions represents a novel method for inducing human antibodies, which may in turn serve as immunological mimics of p53.

Histone H2A/H2B Dimer Exchange by ATP-Dependent Chromatin Remodeling Activities

ATP-dependent chromatin remodeling activities function to manipulate chromatin structure during gene regulation. One of the ways in which they do this is by altering the positions of nucleosomes along DNA. Here we provide support for the ability of these complexes to move nucleosomes into positions in which DNA is unraveled from one edge. This is expected to result in the loss of histone-DNA contacts that are important for retention of one H2A/H2B dimer within the nucleosome. Consistent with this we find that several chromatin remodeling complexes are capable of catalyzing the exchange of H2A/H2B dimers between chromatin fragments in an ATP-dependent reaction. This provides eukaryotes with additional means by which they may manipulate chromatin structure.

Gamma-aminobutyric acid-synthesizing cells in the retina of the chameleon Chamaeleo chameleon

Antibodies directed against gamma-aminobutyric acid (GABA) and L-glutamic acid decarboxylases 65 and 67 kDa (GAD65 and -67) were used to study the GABAergic cell populations of the chameleon retina. GABA immunoreactivity was found in the two main types of retinal interneurons, amacrine and horizontal cells. Amacrine, displaced amacrine, and intra- and interplexiform cells displayed the strongest GABA immunoreactivity of all the retinal cell types. Horizontal cells formed a continuous GABA-immunoreactive cell layer lying against the outermost portion of the inner nuclear layer. In contrast to previous studies (Quesada et al. [1996] Cell Biol. Int. 20:395-400; [1999] Eur. J. Anat. 3:13-25), the present results demonstrate that the horizontal cells of the chameleon retina are GABA immunoreactive and that a subpopulation of these is immunolabelled by an antibody against GAD65. These results indicate that GABAergic synaptic transmission plays a key role in the outer plexiform layer of the vertebrate retina.

Concentration of polar MFGM lipids from buttermilk by microfiltration and supercritical fluid extraction

Buttermilk contains the milk fat globule membrane (MFGM), a material that possesses many complex lipids that function as nutritionally valuable molecules. Milk-derived sphingolipids and phospholipids affect numerous cell functions, including regulating growth and development, molecular transport systems, stress responses, cross membrane trafficking, and absorption processes. We developed a two-step method to produce buttermilk derivative ingredients containing increased concentrations of the polar MFGM lipids by microfiltration and supercritical fluid extraction (SFE). These processes offer environmentally benign alternatives to conventional lipid fractionation methods that rely on toxic solvents. Firstly, using a ceramic tubular membrane with 0.8-micron pore size, we evaluated the cross flow microfiltration system that maximally concentrated the polar MFGM lipids using a 2n factorial design; the experimental factors were buttermilk source (fresh, or reconstituted from powder) and temperature (50 degrees C, and 4 degrees C). Secondly, a SFE process using supercritical carbon dioxide removed exclusively nonpolar lipid material from the microfiltered buttermilk product. Lipid analysis showed that after SFE, the product contained a significantly reduced concentration of nonpolar lipids, and a significantly increased concentration of polar lipids derived from the MFGM. Particle size analysis revealed an impact of SFE on the product structure. The efficiency of the SFE system using the microfiltration-processed powder was compared much more favorably to using buttermilk powder.

People with dementia and their relatives: personal experiences of Alzheimer's and of the provision of care

Little is known about the experiences of people with dementia, as there has been relatively little research carried out that includes their perspectives. In the past, user perspectives on experiences of dementia and on services have mostly been solicited from family carers, rather than from people with dementia themselves. It has been suggested that these studies may lack information and insight into the experiences of people with dementia. This study aimed at eliciting the views and feelings of people in all stages of dementia, as well as those of their relatives, on care services and on experiences of dementia. Twenty-seven people with dementia from residential and day care settings were interviewed and their daily lives videotaped. Interviews were also conducted with next of kin. This article reports on findings and issues arising from the study.

CD103+ intraepithelial lymphocytes--a unique population in microsatellite unstable sporadic colorectal cancer

Colorectal cancers with microsatellite instability (MSI) typically show increased numbers of intraepithelial lymphocytes (IEL) in comparison to microsatellite stable (MSS) cancers. The aim of this study was to determine the phenotype of this unique lymphocyte population in MSI and MSS colorectal cancers. Twenty-four individuals with sporadic colorectal cancer (17 MSI, 7 MSS) were included in this study. Intraepithelial and stromal lymphocytes were detected using immunohistochemistry with anti-CD8 and anti-CD103 antibodies, and two observers independently quantified the numbers of lymphocytes. CD103+ (alpha E beta 7+) IELs detected within tumour tissue co-expressed CD8+ while the stromal lymphocytes were phenotypically heterogeneous, with respect to CD8+ and CD103+ expression. MSI colorectal cancers harboured increased numbers of CD8+ CD103+ IELs, as well as CD8+ CD103- and CD8+ CD103+ stromal lymphocytes, when compared with MSS colorectal cancers. CD103+ IELs were found at 27-fold greater numbers in the tumour epithelium than in normal epithelium from the same patient (P = 0.001, Wilcoxon matched pairs test). From our findings, we have proposed a mechanism for the homing of these alpha E beta 7+ lymphocytes to tumour tissue in MSI and MSS colorectal cancers.

CD40L association with protection from severe malaria

CD40 ligand (CD40L), a glycoprotein involved in B cell proliferation, antigen presenting cell activation, and Ig class switching, is important in the immune response to infection. Rare coding mutations in CD40L can lead to life-threatening immunodeficiency but the potential for common variants to alter disease susceptibility remains to be explored. To identify polymorphisms in CD40L, we sequenced 2.3 kb of the 5' flanking region and the first exon of the gene in DNA samples from 36 Gambian females and one chimpanzee. Diversity was lower than the average reported for other areas of the X chromosome, and only two polymorphisms were identified. The polymorphisms were genotyped in DNA samples from 957 Gambian individuals, cases and controls from a study of severe malaria. A significant reduction in risk for severe malaria (OR = 0.52, P = 0.002) was associated with males hemizygous for the CD40L-726C. Analysis by transmission disequilibrium test of 371 cases, for whom DNA from both parents was also available, confirmed the result was not due to stratification (P = 0.04). A similar but non-significant trend was found in females. This preliminary association of a common variant in CD40L with a malaria resistance phenotype encourages further genetic characterization of the role of CD40L in infectious disease.

Double aortic arch masquerading as asthma for thirty years

A case of a 30-year-old woman with a double-barrelled aorta misdiagnosed as asthma is presented. The patient was significantly improved after surgical treatment but a degree of airway symptoms persisted. She was further investigated and diagnosed with tracheomalacia. The paediatric experience with managing tracheomalacia is briefly reviewed and recommendations for the treatment of the rare adult cases are made. Our report emphasises the importance of early diagnosis and treatment of aortic arch abnormalities.

A quantitative ultrastructural study of the optic nerve of the chameleon

The optic nerve of adult chameleons was investigated with an electron microscope. The total number of retinal ganglion cell axons, the proportion of myelinated axons, the frequency distributions of myelinated and unmyelinated axon diameters were estimated, together with the volume occupied by glial processes. These were distinguished from unmyelinated axons using an antibody directed against glial fibrillary acidic protein, in a post-embedding procedure. The total number of fibers was estimated to be 405,235 +/- 60,000 axons. The proportion of myelinated fibers varied with position between the eyeball and the chiasma; being 22-27% close to the eyeball, rising to 42-47% halfway along the optic nerve and to 56-62% close to the chiasma. Myelinated and unmyelinated fiber diameter distributions were unimodal and positively skewed, with modes of 0.7 microm and 0.2 microm, respectively. There was a significant regional variation in the size of optic nerve axons. Large myelinated axons were observed in the dorsal and ventral periphery, whereas smaller myelinated fibers and a high proportion of unmyelinated fibers were found in the center of the nerve.

Development and Application of a Pediatric Anthropometric Evaluation System

Children with developmental disabilities are at increased nutritional risk because of feeding problems, abnormal levels of physical activity, and altered weight and growth patterns. Children with physical disabilities are often more difficult to measure because of muscular contractures, spasms, scoliosis, and the presence of splints, braces, or wheelchair accessories. In addition, body weights may be difficult to obtain for heavier children with limited access to wheelchair scales. The purpose of this project was to produce a package of anthropometric measurements easier to use in children with physical disabilities but still applicable to able-bodied children, and computer software to generate growth charts. The project included the development of growth charts for each anthropometric measurement, using data from the Coquitlam Growth Study (921 children aged six to 18) and the Sunny Hill Growth Study (567 children aged one to 5.9). The custom computer software allows serial plotting of a child's measurements on growth charts, permitting comparative assessment of growth and muscle and adipose tissue development. The resultant Sunny Hill Anthropometric Pediatric Evaluation System (SHAPES) provides a tool for nutritional assessment and monitoring after intervention. The use of SHAPES is illustrated with a case study of a child who represented a challenge to traditional nutritional evaluation.

Evolutionary significance of different neurochemical organisation of the internal and external regions of auditory centres in the reptilian brain: an immunocytochemical and reduced NADPH-diaphorase histochemical study in turtles

An immunocytochemical and histochemical study was undertaken of the torus semicircularis and nucleus reuniens, the mesencephalic and diencephalic auditory centres, in two chelonian species, Testudo horsfieldi and Emys orbicularis. The nucleus centralis of the torus semicircularis receives few 5-HT-, TH-, substance P-, and menkephalin-immunoreactive fibres and terminals, in marked contrast to the external nucleus laminaris of the torus semicircularis, in which 5-HT-, TH-, substance P-, and menkephalin-immunoreactive elements and cell bodies show a laminar distribution. Dense NPY-positive terminal-like profiles and cell bodies were observed in both the nuclei centralis and laminaris, and many NADPH-d-positive cell bodies were observed in the cell layers of the latter. In the nucleus reuniens, the distribution of 5-HT-, TH-, substance P-, and menkephalin-immunolabelling resembles that seen in the torus semicircularis, but at a lower density. The dorsorostral regions of the nucleus reuniens, as in the nucleus centralis, is insignificantly labelled, in contrast to the ventrocaudal regions in which labelled elements abound. NPY-positive elements are uniformly distributed throughout the nucleus, but no labelled cell bodies were observed. NADPH-d-positive fibres and terminals were observed in both dorsal and ventral regions of the nucleus reuniens, but the few labelled cell bodies to be observed were located in the peripheral regions of the nucleus. These findings are discussed in terms of the evolution of the core-and-belt organisation of sensory nuclei observed in other vertebrate species.

Epithelial cell polarity and cell junctions in Drosophila

The polarized architecture of epithelial cells and tissues is a fundamental determinant of animal anatomy and physiology. Recent progress made in the genetic and molecular analysis of epithelial polarity and cellular junctions in Drosophila has led to the most detailed understanding of these processes in a whole animal model system to date. Asymmetry of the plasma membrane and the differentiation of membrane domains and cellular junctions are controlled by protein complexes that assemble around transmembrane proteins such as DE-cadherin, Crumbs, and Neurexin IV, or other cytoplasmic protein complexes that associate with the plasma membrane. Much remains to be learned of how these complexes assemble, establish their polarized distribution, and contribute to the asymmetric organization of epithelial cells.

Sustained elevation of calcium induces Ca(2+)/calmodulin-dependent protein kinase II clusters in hippocampal neurons

Treatment of cultured hippocampal neurons with the mitochondrial uncoupler carbonyl cyanide m-chlorophenylhydrazone (CCCP) in the absence of glucose mimics ischemic energy depletion and induces formation of Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) clusters, spherical structures with diameters of 75-175 nm [Dosemeci et al., J. Neurosci. 20 (2000) 3076-3084]. The demonstration that CaMKII clustering occurs in the intact, adult rat brain upon interruption of blood flow indicates that clustering is not confined to cell cultures. Application of N-methyl-D-aspartate (250 microM, 15 min) to hippocampal cultures also induces cluster formation, suggesting a role for Ca(2+). Indeed, intracellular Ca(2+) monitored with Fluo3-AM by confocal microscopy reaches a sustained high level within 5 min of CCCP treatment. The appearance of immunolabeled CaMKII clusters, detected by electron microscopy, follows the onset of the sustained increase in intracellular Ca(2+). Moreover, CaMKII does not cluster when the rise in intracellular Ca(2+) is prevented by the omission of extracellular Ca(2+) during CCCP treatment, confirming that clustering is Ca(2+)-dependent. A lag period of 1-2 min between the onset of high intracellular Ca(2+) levels and the formation of CaMKII clusters suggests that a sustained increase in Ca(2+) level is necessary for the clustering. CaMKII clusters disappear within 2 h of returning the cultures to normal incubation conditions, at which time no significant cell death is detected. These results indicate that pathological conditions that promote sustained episodes of Ca(2+) overload result in a transitory clustering of CaMKII into spherical structures. CaMKII clustering may represent a cellular defense mechanism to sequester a portion of the CaMKII pool, thereby preventing excessive protein phosphorylation.

The effects of unilateral pulvinar damage in humans on reflexive orienting and filtering of irrelevant information

The effects of damage to the pulvinar nucleus of the thalamus in humans on reflexive orienting and selective attention were investigated. In a spatial orienting task three patients with unilateral pulvinar damage determined the location of a visual target that followed a cue that was not informative as to the targets location. Contralesional targets were responded to more slowly than ipsilesional targets. Also, at long cue target intervals patients responses to contralesional targets that appeared at previously cued locations were slower than to non-cued locations indicating that pulvinar damage does not affect inhibition of return. In the selective attention task two of the patients identified a target that appeared at one level of a global-local hierarchical stimulus while ignoring a distractor present at the other level. The distractor indicated either the same response as the target or a different response. Response times to targets in both visual fields were similar as were interference effects from the ignored distractors. These data indicate that engaging attention contralesionally is not impaired in discrimination tasks and that filtering of irrelevant information was not impaired contralesionally.

Simple method for developing percentile growth curves for height and weight

The present paper demonstrates the ease of use of method I by Preece and Baine ([1978] Ann Hum Biol 5:1-24) in generating smoothed growth curves for both height and weight. Using the National Center for Health Statistics (NCHS) growth curve data, smoothed curves were developed and compared to those produced using the least-squares-cubic-spline method. Based on the lower sum of squares and better fit of shape as indicated by residual examination, it was concluded that the method I curve fitting procedure by Preece and Baine ([1978] Ann Hum Biol 5:1-24) fit centile growth curves for height and weight in 2-18-year-old male and female children as well as, if not better than, the least-squares-cubic-spline method used in developing the 1979 NCHS growth curves. Further, as this paper demonstrates, smoothed curves can be generated on a desktop computer using readily available software (the SOLVER function within Microsoft EXCEL).