Study of childhood renal tumours using antisera to fibronectin, laminin, and epithelial membrane antigen

Using a peroxidase-antiperoxidase staining procedure, formalin fixed paraffin embedded sections of fetal and normal kidney; benign (mesoblastic nephroma); and malignant tumours (Wilms' tumour, clear cell renal carcinoma, rhabdoid renal tumour, and bone metastasising renal tumour of childhood (BMRTC] were examined for their reactivity with antisera to fibronectin, laminin, and epithelial membrane antigen. Mesoblastic nephroma contained fibronectin but no laminin. Most Wilms' tumours lacked both fibronectin and laminin; 50% of rhabdoid renal tumours were positive for fibronectin and laminin--rhabdoid tumours as recognised morphologically may, in fact, be two separate entities. BMRTC and clear cell renal carcinoma lacked both fibronectin and laminin. Epithelial membrane antigen was present in most of the tubular Wilms' tumour but absent in blastemal Wilms' tumours. The presence of epithelial membrane antigen in rhabdoid tumours was surprising, as histologically, this type of tumour shows no sign of epithelial differentiation. Epithelial membrane antigen antiserum stained clear cell renal carcinomas: epithelial membrane antigen is found in the distal and not the proximal tubules of fetal and normal kidneys. Thus an obvious interpretation is that clear cell renal carcinomas originate from distal rather than from proximal tubules, as has always been thought. On the basis of these results and data from other published findings some possible histogenetic origins of childhood renal tumours were proposed.

Experience with the live Oka-strain varicella vaccine in children with solid tumours

A comparative evaluation of radioimmunoassay (RIA), indirect immunofluorescence, fluorescent antibody to membrane antigen, competitive inhibition RIA, and complement fixation methods for determining the immune status to varicella-zoster virus (VZV) showed that RIA was the most sensitive test. However, this test is still not regarded as being entirely satisfactory and possible reasons are discussed. To date, 28 children, mainly with solid tumours, have been inoculated with the Oka-strain live varicella vaccine. Two of these vaccinees developed minor reactions, but only 62% developed a RIA-detectable humoral response. Approximately 46% of the responders had lost induced antibody within 12 months of vaccination. None of the 6 vaccinees that have subsequently been in contact with varicella developed any illness suggesting that they had been protected.

The E7-associated cell-surface antigen: a marker for the 11p13 chromosomal deletion associated with aniridia-Wilms tumor

Unbalanced interstitial deletions of the p13 region of human chromosome 11 have been associated with congenital hypoplasia or aplasia of the iris, mental retardation, ambiguous genitalia, and predisposition to Wilms tumor of the kidney. Utilizing somatic cell hybrids containing either the normal or abnormal chromosome 11 from a child with Wilms tumor and aniridia, we previously mapped the E7 cell-surface antigen to the 11p1300-to-11p15.1 region. To localize even further the site of this antigen on chromosome arm 11p, we have produced somatic cell hybrids from the fibroblasts of a second child with Wilms tumor and aniridia and a different deletion of 11p [46,XY, del (11)(pter----p14.1::p11.2----qter)]. Furthermore, the normal and deleted chromosome 11 could also be distinguished on the basis of a restriction fragment length polymorphism for the beta-globin gene. Hybrid cells containing the deleted chromosome were not killed in the presence of complement and the E7 monoclonal antibody (which recognizes E7 cell surface antigen), while hybrid cells containing the patient's normal chromosome 11 were killed. Thus, expression of the E7-associated cell-surface antigen can be mapped to the 11p13 region, and it appears to be a potential marker of the chromosome abnormality associated with aniridia-Wilms tumor.

Endogenous tumor lectins: a new class of tumor markers and targets for therapy?

Endogenous lectins of normal tissues can play a functional role in recognition processes and cell adhesion. These functions are areas of particular relevance to tumor growth and metastasis. Our initial results on endogenous lectins of different tumors lead to the working hypothesis that the pattern of endogenous lectins is qualitatively and quantitatively different between different types of tumors and between tumors and normal, nonmalignant tissues. The endogenous lectins may thus prove to be potentially important in establishing a new concept for a rational lectin-based type of diagnosis and therapy of various tumors.

The distribution of epithelial membrane antigen in the kidney and its tumours

The distribution of epithelial membrane antigen (EMA) in the kidney and its tumours has been studied using a polyclonal anti-EMA antiserum and the immunoperoxidase-antiperoxidase technique (PAP). Twelve fetal and 10 adult kidneys examined showed EMA to be confined to the distal tubular or collecting duct epithelium or their embryological precursors. The examination of 55 primary renal tumours showed EMA to be present on the epithelial tumours, on tubular epithelium in nephroblastoma, but not on mesenchymal tumour cells nor on undifferentiated areas of nephroblastoma.

Blood group antigen expression in nephroblastoma

The histological distribution of A, B, H, Lewis, Pr, i and I blood group antigens (BGA) was studied in 19 nephroblastomas and one mesoblastic nephroma by means of the indirect immunofluorescence technique. In addition to general conclusions about the relatively limited BGA expression in the tumour cells, their histological distribution was found to be related to the differentiation level of these renal embryonic tumours. By comparison with normal embryonic, fetal and adult kidney it was shown that the nephroblastoma differentiation level is not higher than that of a 3-month fetal kidney. Furthermore, i antigen appears to be a non-specific marker of the histiocytic macrophage cells of the nephroblastoma stroma.

Skeletal muscle differentiation in Wilms' tumor. Antibody identification and explant culture

We studied a case of Wilms' tumor with focal areas of well-differentiated skeletal muscle by immunoperoxidase staining using anti-skeletal muscle myosin and by tissue culture explant of the tumor. Strong immunostaining occurred in areas of well-differentiated muscle but also occurred in focal areas where the cells were undifferentiated. The primary explant of this tumor was attempted using standard serum-containing culture media and a serum-free hormonally defined culture medium. While serum-containing culture media gave rise to a fibroblastlike cell population, the serum-free hormonally defined medium produced cells of myoid origin. Ultrastructurally, all stages of early myogenesis from myoblasts to myotubules were observed in this primary explant grown in serum-free medium.

Analysis of human tumor cells for Ia-like antigens with monoclonal antibodies

Cultured and noncultured human solid tumors were analyzed for expression of Ia-like antigens with the use of two monoclonal antibodies and a rabbit antiserum against human Ia-like antigens. Of 27 tumor cells tested, 3 melanomas bound antibodies [e.g., 21,563 cpm 131I-labeled staphylococcal protein A ([131I]SpA) with monoclonal antibody Q5/6], but 24 others (1 melanoma, 9 neuroblastomas, 1 medulloblastoma, 3 gliomas, 4 sarcomas, 2 colon carcinomas, 2 transitional cell carcinomas of the bladder, 1 teratoma, and 1 squamous cell carcinoma of the lung) did so minimally or not at all (0-427 cpm [131I]SpA with antibody Q5/6. Monoclonal antibody Q5/6 was quantitatively absorbed with homogenates of 32 noncultured tumors to determine if Ia-like antigens were expressed by neoplastic cells in vivo. Ten milligrams (wet wt) each of 5 of 7 noncultured melanomas removed more than 83% (median, 85%) of the antibody. In contrast, 10 mg each of 10 neuroblastomas, 7 carcinomas, 4 sarcomas, and 4 Wilms' tumors removed less than 47% (median, 19%) of the antibody; even 100 mg of these tumors removed less than 68% (median, 44%) of the antibody.

Basement membrane antigen in Wilms' tumor

A basement membrane antigen was prepared from renal cortical basement membranes by partial reduction and alkylation. The antigen was partially purified by gel filtration chromatography. By indirect immunofluorescence, the antigen was found within five Wilms' tumors adjacent to tumor cells. The location and configuration of antigen was similar to that of flocculent electron-dense material observed ultrastructurally. The localization of this antigen provides immunohistochemical evidence for the production of basement membrane components by Wilms' tumors.

Lack of association between HLA specificities and Wilms' tumour

HLA antigen distribution was determined in thirty patients with Wilms' tumour, and their frequencies compared with those of an ethnically matched control population. No statistically significant association was found between any single HLA antigen and Wilms' tumour disease. The value of prospective HLA typing studies, with special respect to genetic aspects, histopathological subgrouping and survival rate of Wilm's tumour patients is discussed.

A study of childhood renal tumours using xenogeneic antiserum

Fifty-six primary childhood renal tumours, 14 normal and 12 fetal kidneys were examined for their staining reaction with xenogeneic anti-Wilms' antiserum. The antiserum was raised by injecting Wilms' tumour extracts into 6-month-old rabbits which had been rendered tolerant in utero with pooled normal kidney extracts. Renal carcinomas, mesoblastic nephroma and a large proportion of tubular wilms' tumours were stained by the antiserum. In contrast, 6 of 7 bone-metastasising renal tumours of childhood (BMRTC) failed to fluoresce when treated with the antiserum, suggesting that the BMRTC has a different origin from the other childhood renal tumours studied.

Studies of tumor implants in immunologically privileged sites

Wilms' tumor, renal cell carcinoma, and neuroblastoma in animals were transplanted from donors to recipients with strong histocompatibility differences. No strong evidence of the privileged site theory was found in this study and no obvious evidence of an immunosuppressive effect of testosterone was found. The most important factor noted in these studies was that the take of tumor transplant seems to be related more to the type of tumor itself. Further studies of transplant results of such different types of tumors are warranted and are being conducted. An interaction between the hormonal supportive concept and the privileged site seems tenable.

[Immunochemical study of the alpha-globulins in human kidney tumor tissue]

Four individual tissue proteins were studied both in normal and tumoral tissue of kidney (hypernephroma, Wilms tumor) using immunochemical analysis. Occurrence of an antigen, which was absent in definitive tissue of homologous origin, as well as a decrease in biosynthesis of some homologous antigens were found in malignant tissue.

[IgA-immunoglobulins and HLA-A1 antigen in Wilms' tumor. Significance for the prognosis of the disease]

In 45 patients with Wilms' tumor of the kidney the IgG, IgA, and IgM serum immunoglobulin levels were quantitated and 23 antigens of HLA-A and HLA-B locues were typed on the same patients' lymphocytes. In 22 individuals with increased IgA immunoglobulin level a more frequent incidence of HLA-A 1 antigen was found. This antigen was established in 62.5% of patients with IgA levels higher than 200 IU/ml. Considering the fact that 86.35% of the patients survive two years, and 16 of 22 patients (= 72.72%) are practically cured, it is suggested that the simultaneous occurrence of increased levels of IgA immunoglobulin and of HLA antigen A 1, is a favourable prognostic sign.

[Determination of pregnancy-associated glycoprotein for diagnosis and control of tumours in childhood]

Of 31 patients with solid, malignant tumours, 15 were shown to have over 0.5 mg/100 ml Serum concentration of alpha-2 pregnancy-associated glycoprotein (alpha2-PAG). These increased values were found for patients with neuroblastomas, Wilms tumours and rhabdomyosarcomas. However, for several different lymphomas and haemoblastoses, alpha2-PAG could not be demonstrated with the electroimmunodiffusion technique used (Laurell). From 230 children with non-neoplastic diseases, 62 had demonstrable concentrations of alpha2-PAG, of 38 healthy children, 2 were positive, while from 50 newborn infants, with different illnesses no increased values were found. Post-operative controls using repeated determination of d2-PAG are complicated by the slow change in concentration, and by the influence of chemotherapy. The determination of alpha2-PAG for the initial diagnosis of malignant diseases in childhood and for post-operative monitoring of the disease, is therefore of only limited value at least until further investigations have been carried out.

Tumour-specific antibodies reactive with cell-surface antigens in children with Wilms' tumour

Tumour-specific antibodies directed against membrane antigens were demonstrated by immunofluorescence in three of 45 patients with Wilms' tomour. Antibody capable of collaborating with K cells to kill Wilms' tumour was present in two additional patients. No patient exhibited both membrane immunofluorescence and K-cell collaborating antibody. Of 27 patients with non-renal solid tumours and 52 age-matched controls, none possessed tumour-specific antibody.

Neuroblastoma, Wilms' tumor, and cytomegalovirus

The possibility that neuroblastomas and Wilms' tumors are induced by cytomegalovirus (CMV) was raised and discussed. A large percentage of patients with these tumors have complement-fixing antibodies against CMV. A hypothesis was presented.

Non-organ-specific and tumour-specific antibodies in children with Wilms' tumour

Sera from groups of children with Wilms' tumour, with non-renal solid tumours, and from control children were studied by immunofluorescence and by absorption techniques. A high proportion of sera from both tumour groups contained non-organ-specific auto-antibodies. Three of the 45 sera in the Wilms' group and one of the 27 sera in the "other" solid tumour group contained antibody reacting with normal kidney cells. Only one of 45 sera in the Wilms' tumour group contained tumour-specific antibody.

A fetuin-like antigen from human nephroblastoma

An antigen was detected in pooled human nephroblastomas using antiserum prepared in rabbits against an ethylemediaminetetra acetic acid (EDTA) extract of the tumors. This antigen was not found in normal human plasma or kidney extracts, and was not related to the ABO or Forssman blood groups. The antigen was detected in extracts of cultured nephroblastoma cells, but was not present in extracts of normal human fetal kidney cell cultures. The antigen is believed to be present at the cell surface, as cell viability was not significantly lowered during the extraction procedure. A reaction of complete identity was demonstrated by Ouchterlony double diffusion experiments with this antigen and purified bovine fetuin. The antigen was not found in extracts of human fetal spleen, thymus or kidney, nor in human fetal serum. Furthermore, the antigen does not possess determinants in common with the human alpha-fetoprotein of hepatomas, nor was it detected in human renal clear cell carcinoma. Initial characterization of the antigen showed it to be nondialysable, not sedimentable at 100,000 times g for 2 h, stable to repeated freeze-thawing and to incubation at 56 degrees C for 1 h, and water soluble over a wide pH range. The antigen was susceptible to digestion with pronase and trypsin and possibly hyaluronidase, but not to ribonuclease or neuraminidase. The protein portion is therefore of major importance to the structural integrity of this antigen. The relationship between this antigen and other abnormal materials reported previously in nephroblastoma patients is being studied.

Isolation of Wilms' tumor antigens by chelation

A procedure for ethylenediaminetetraacetate extraction of minced Wilm's tumor was assessed as a method for isolating Wilm's tumor antigens. An antigen was detected by immunodiffusion using an adsorbed antiserum to this extract. This antigen was also found in ethylenediaminetetraacetate extracts of in vitro cultures of nephroblastoma cells.

A tumor-associated antigen in human nephroblastomas

Antisera prepared against extracts of human nephroblastomas (Wilms' tumors) allowed the characterization in these extracts, and in a few extracts of tumors of other organs, of a tumor-associated antigen. This antigen is different from all previously described antigens, and was named W antigen (W for Wilms). It does not seem to be a carcinoembryonic antigen, and hence it could be of viral origin.