Idiotypic intramolecular help. Induction of tumor-specific antibodies by monoclonal anti-idiotypic antibody with the help of Fc-specific T helper clones

In this study, the mechanism of anti-Id vaccination was investigated by using cloned Th cells and an anti-idiotypic mAb. 2F10, an anti-idiotypic mAb derived from an Igh1-e allotype mouse strain, which induces protection against the L1210/GZL DBA/2 tumor, was used to prime DBA/2 mice. An Fc (Igh1-e)-specific syngeneic Th clone was cocultured in the presence of 2F10 anti-Id with 2F10-Fab-primed B cells. The Th clone responded with proliferation and also provided help for 2F10-Fab-primed B cells to produce antibodies that bind to L1210/GZL and not to P815 tumor cells. Intact 2F10 anti-Id was presented to Fc-specific Th cells by Fab (or Id) primed B cells more efficiently than the fragment mixture (Fab plus Fc) of 2F10 anti-Id, indicating that 2F10-Fab (or Id)-primed B cells capture 2F10 anti-Id through surface Ig receptors. Presenting B cells are sensitive to treatment with chloroquine and must come from H-2 matched mice, indicating that the Ag presentation by Fab-primed B cells to Fc-specific Th cells requires processing and is MHC restricted. Collectively these results outline a mechanism that may operate in anti-Id therapy of tumor-bearing animals by using tumor Ag mimicking anti-idiotypic antibodies. A similar mechanism could be effective in tumor patients immunized with xenogeneic anti-idiotypic antibodies operating under the "intra(Ag) molecular help."

A note on the role of background tumor incidence in risk assessment for carcinogens

The extrapolation of animal bioassay data to humans for the purpose of estimating risk from food additives, drugs, pesticides, etc. is still the primary approach to carcinogenic risk assessment. When the extrapolation is based on tumor data with high background incidence (e.g., hepatocellular tumors in rodents), its direct relevance to the human situation is sometimes questioned. This paper suggests a method for adjusting the acceptable excess risk level for humans according to the background incidence of the tumor type used for extrapolating from animals to humans. Application of the suggested "fixed relative risk" extrapolation method in setting acceptable low-risk exposure levels for humans is illustrated for methylene chloride.

Retrospective evaluation of general anesthesia for oral and maxillofacial surgery during a 10-year period (1976-1985)

Anesthetic cases of oral and maxillofacial surgery during the period 1976-1985 were reviewed. There was a total of 653 cases, and the most frequently performed operation in this series was open reduction of maxillofacial bone fracture (22.8%). Special clinical problems were encountered in the 72 cases (11.02%) who underwent surgery for osteoradionecrosis, because most of them suffered from trismus and stiff neck. Nasotracheal intubation was more commonly used (84.69%). Sixty six cases received tracheostomy since they suffered from serious trismus and/or severe maxillofacial fracture. The recently introduced method of induction using etomidate and fentanyl seemed effective in maintaining hemodynamic stability. In 147 cases (22.51%), the anesthesia lasted more than 4 hours. In 366 cases (56.04%), a local infiltration of the operation field was performed with 1:100,000 epinephrine. Of these, 76 cases developed cardiac arrhythmia, mainly VPC (ventricular premature contraction) 12 of whom had a history of preoperative cardiac arrhythmias. The incidence of preoperative medical disease was 10.27%, the most common being cardiovascular (32.84%) and respiratory (26.87%) disease. Complications occurred during anesthesia in 122 cases (18.69%) with a high incidence of cardiac arrhythmia (67.21%).

Automaticity of the SN and A-V junctional tissue before and after chemical denervation in the dog

Automaticity of SN and A-V junctional tissue was studied in 40 dogs in which a stable junctional rhythm was obtained following thermal ablation of the SN and sulcus terminalis. Atrial overdrive pacing studies were performed both before and after chemical denervation of the heart. Control sinus cycle and junctional CL were 438 +/- 13 ms and 751 +/- 23 ms, respectively. Chemical denervation resulted in significant prolongation of both junctional CL and maximal corrected junctional recovery time; junctional rate was down to 46 percent of the sinus rate observed before suppression of SN activity. Neither sinus CL nor maximal corrected SN recovery time changed significantly after administration of drugs. The basal autonomic nervous system has a relatively greater influence on the junctional pacemaker than on the normal SN in the dog and, when SN was suppressed, chemical denervation prolonged the junctional CL by 23 percent and junctional recovery time by 63 percent.

Characterization of "regulatory" idiotope-specific T cell clones to a monoclonal anti-idiotypic antibody mimicking a tumor-associated antigen (TAA)

As reported previously, 3A4 is a paratope-specific anti-idiotypic mAb and induces cellular and humoral anti-tumor-associated Ag (TAA) responses. In this study, the specificity, MHC restriction and Ag processing requirement of Th cell lines and clones were determined that recognize an idiotypic determinant (Id) on 3A4. The anti-Id-3A4 is part of a tumor-associated idiotypic network which is involved in the regulation of the immunity against the DBA/2 L1210/GZL tumor. These 3A4-Id-specific T cell clones are phenotypically Th cells and recognize Id in the context of MHC class II molecules under MHC restriction. Moreover, the recognition of Id by these T cell clones is chloroquine sensitive, suggesting that they recognize processed Id. However, the 3A4-Id-specific T cell clones respond only to 3A4 and not to TAA. Because these clones do not recognize TAA, their biologic role in antitumor immunity could be as regulatory T cells involved in the idiotypic network regulation.

Characterization of "regulatory" idiotope-specific T cell clones to a monoclonal anti-idiotypic antibody mimicking a tumor-associated antigen (TAA)

As reported previously, 3A4 is a paratope-specific anti-idiotypic mAb and induces cellular and humoral anti-tumor-associated Ag (TAA) responses. In this study, the specificity, MHC restriction and Ag processing requirement of Th cell lines and clones were determined that recognize an idiotypic determinant (Id) on 3A4. The anti-Id-3A4 is part of a tumor-associated idiotypic network which is involved in the regulation of the immunity against the DBA/2 L1210/GZL tumor. These 3A4-Id-specific T cell clones are phenotypically Th cells and recognize Id in the context of MHC class II molecules under MHC restriction. Moreover, the recognition of Id by these T cell clones is chloroquine sensitive, suggesting that they recognize processed Id. However, the 3A4-Id-specific T cell clones respond only to 3A4 and not to TAA. Because these clones do not recognize TAA, their biologic role in antitumor immunity could be as regulatory T cells involved in the idiotypic network regulation.

Potential role of anti-idiotype antibodies in active tumor immunotherapy

The tumor-specified cellular and humoral immunity induced by anti-idiotype antibodies (Ab2s) 2F10 and 3A4 has been studied. Ab2s were made against a monoclonal anti-L1210/GZL lymphoma, 11C1. They were screened for their ability to block 11C1 binding to tumor, induce tumor-specific DTH and CTL responses, and induce an anti-tumor humoral response. Two Ab2s, 2F10 and 3A4, which were found to have similar fine specificity and to induce similar cellular and humoral responses, were compared for their ability to elicit tumor-protective immunity. Interestingly, only preimmunization with the 2F10 Ab2 protected animals from live tumor challenge. The possible causes for this discriminatory biological effect induced by otherwise similar Ab2s are discussed.

Uterine abnormalities in rats exposed neonatally to diethylstilbestrol, ethynylestradiol, or clomiphene citrate

The toxicity of the synthetic estrogens diethylstilbestrol (DES), and ethynylestradiol (EE), and the antiestrogen clomiphene citrate (CC) was evaluated by assessing postnatal uterine growth and development prior to the onset of puberty in the rat. Both DES and EE, administered during the neonatal period (postnatal days 1-5), initially increased uterine weight and luminal epithelium hypertrophy. However, uterine weight declined in both DES- and EE-treated animals and fell below controls beyond day 11. Luminal epithelium stimulation generally paralleled uterine weight changes. Precocious development of uterine glands occurred after estrogenization (compared to untreated controls), but subsequently gland numbers were approximately 60% of control levels. Neonatal CC exposure induced only slight uterine weight gain but caused prolonged luminal epithelium hypertrophy and inhibited uterine gland genesis. Luminal epithelium hypertrophy appears to be a useful measure of antiestrogen activity. These data demonstrate the toxicity of DES and EE as assessed by altered prepubertal uterine gland development. Additionally, the inhibition of uterine gland genesis after neonatal CC exposure occurs in conjunction with prolonged luminal epithelium hypertrophy.

Alterations in developing rat uterine cell populations after neonatal exposure to estrogens and antiestrogens

Exposure of rats to either estrogens or antiestrogens during early postnatal development reduces subsequent uterine growth as measured by uterine weight. However, individual uterine cell types respond differently to these agents and uterine weight alone cannot discern subtle or even large alterations in individual cell populations. Using a computerized planimetric technique, we estimated the prepubertal growth of the uterine luminal epithelium, endometrial stroma, glands, and circular and longitudinal muscle after exposure of neonatal rats (postnatal days 1-5) to the estrogens 17 beta-estradiol (E2), diethylstilbestrol (DES), or ethynylestradiol (EE), and the antiestrogens tamoxifen or clomiphene citrate. On postnatal day 26, the cross-sectional areas of the luminal epithelium, endometrial stroma, and circular muscle were reduced after estrogen exposure, compared to untreated controls, while longitudinal muscle cross-sectional area was not affected. Since cell densities (cell number/unit area) were increased, these estrogen-induced area reductions demonstrate a decrease in cell size. Total cell numbers, estimated as the product of cell type areas and their respective cell densities, were also reduced by neonatal estrogen exposure. The synthetic estrogens DES and EE were more potent than E2 with respect to reduction of uterine growth. Neonatal antiestrogen exposure caused large area reductions only in the uterine glands and luminal epithelium. Little change in cell density occurred in any cell population exposed to antiestrogen. These data demonstrate that the decreased uterine growth resulting from estrogen exposure during early postnatal development is a consequence of combined hypotrophy and hypoplasia in all cell types except longitudinal muscle while antiestrogen-induced morphological alterations were limited to hypoplasia having epithelial cell specificity.

Postnatal uterine development in the rat: estrogen and antiestrogen effects on luminal epithelium

We examined the effects of the synthetic estrogens, diethylstilbestrol (DES) and ethynylestradiol (EE), and the triphenylethylene antiestrogen, clomiphene citrate (CC), on uterine growth and development in the rat. These compounds, unlike estradiol, do not bind significantly to rat serum alphafetoprotein (AFP). Administration of DES or EE during the period of normal uterine gland genesis (postnatal days 10-14) induced luminal epithelium hypertrophy and increased uterine wet weight. The durations of these responses were dose-related. By day 26, luminal epithelium cell numbers were significantly depressed, compared to controls. Uterine gland development was delayed 6 to 9 days, depending upon estrogen dose, and the numbers of uterine glands ultimately achieved were generally less than in untreated control animals. While a daily dose of 0.1 micrograms CC/rat did not alter uterine development, 10 micrograms CC/rat caused prolonged luminal epithelium hypertrophy and inhibited uterine gland genesis without inducing the large increases in uterine weight or the decreases in luminal epithelium cell number seen after estrogen exposure. The number of stromal cells was significantly increased on day 26 after CC exposure. Together with previous studies, these data demonstrate the greater potency and developmental stage specificity of non-AFP-bound estrogens with respect to altering uterine gland development. In addition, these data suggest that the disruptive influence of antiestrogens on gland genesis may be mediated through an indirect influence on the uterine stroma.

Reappraisal of atrioventricular junctional pacemaker automaticity in the sick sinus syndrome. Clinical significance and the role of autonomic chronotropic influences

Postpacing impulse recovery times of the junctional tissue (junctional automaticity) were determined by atrial or ventricular overdrive pacing in 27 patients with dysfunction of the sinus node. The maximum junctional recovery time (MJRT) could be measured in 22 patients and ranged from 1,630 to 9,730 ms (mean 3,860 +/- 2,077); the maximum corrected junctional recovery time (MJRTc) could be measured in 18 patients and ranged from 140 to 5,986 ms (mean 2,089 +/- 1,529). Autonomic influence on the JRTs was evaluated by intravenous administration of atropine (1.5 mg) alone or in combination with propranolol (5 to 6 mg). Of the seven patients in whom MJRTc and/or MJRT could be measured before and after drug intervention, the JRTs shortened in four and prolonged in three after combination of atropine and propranolol. Atropine alone shortened MJRT in all eight patients studied. Our data reveal that both vagal and catecholamine-dependent factors (especially vagal over-activity) are operative in the escape mechanism of the junctional tissue.

Single photon emission computed tomography of the thyroid

Single photon emission computed tomography (SPECT) entails imaging at multiple positions along an arc and computed-assisted reconstruction of transaxial, coronal, and sagittal images. To determine if SPECT imaging of the thyroid augments information provided by planar imaging, both SPECT and pinhole planar scans were performed in 52 patients with thyroid disease. After 123I (n = 45), Tc99m (n = 5), or thallium-201 (n = 2) administration, images were acquired at 30 intervals along a 180 degree arc. Nodules that were hypofunctioning on planar scans (n = 4) were equally well shown on SPECT images. SPECT analysis of 123I uptake by 5 palpable nodules with completely normal 123I planar scans demonstrated the nodular tracer uptake was increased (n = 1), equivalent (n = 3), or decreased (n = 1) in comparison with that of extranodular tissue. In 6 of 12 multinodular goiters, transaxial SPECT images showed tracheal compression, which was confirmed by neck x-ray, flow volume loops, or surgery. A neck phantom study was performed to assess the accuracy of SPECT-determined functional thyroid volume. SPECT-estimated volumes (30-173 mL; n = 11) correlated well with true volumes (r = 0.996; P less than 0.001). Our observations suggest that SPECT is a useful adjunct to planar imaging in 1) estimating functional volume for 131I dosimetry; 2) evaluating the size, extension, and tracheal compression of multinodular goiter; and 3) determining the functional properties of palpable nodules with normal 123I planar pinhole images.

Detection of activated double-stranded RNA-dependent protein kinase in 3T3-F442A cells

We have previously reported that cultured mouse 3T3-F442A cells exhibit a transient, double-stranded RNA (dsRNA)-dependent phosphorylation of the dsRNA-dependent eIF-2 alpha kinase (eIF-2 alpha, alpha-subunit of the eukaryotic initiation factor 2) (dsI). When dsI is activated by low levels of dsRNA, it is a potent inhibitor of protein synthesis. The transient expression of dsI is due to an autocrine effect of interferon at specific stages of growth and differentiation, and it may represent a mechanism for regulating cell growth and differentiation in 3T3-F442A cells. In this report, the purification of dsI from 3T3-F442A cell cultures by a two-step procedure is described. A specific immune serum to dsI was prepared by immunizing a rabbit with highly pure preparations. Immune precipitation studies demonstrate that the serum reacts with phosphorylated dsI both in vitro and in vivo and with de novo synthesized dsI after induction with interferon. We find that dsI of 3T3 cells can undergo phosphorylation in vitro without the addition of dsRNA and in vivo in the absence of viral infection. These results are consistent with a physiologic role for dsI in the growth and differentiation of these cells.

Iodine-123 SPECT of the thyroid in multinodular goiter

Iodine-123 single photon emission computed tomography (SPECT) imaging of the thyroid was performed in two patients with multinodular goiter and swallowing difficulty to provide the functional and anatomic orientation of the goiter in relation to the airway. Transaxial slices showed the retrolaryngeal extension of the enlarged thyroid and the tracheal compression by the goiter in both patients. Sagittal and coronal sections confirmed the posterior extension of the goiter. Tracheal displacement was confirmed by roentgenography of the neck in both patients. Vocal cord paralysis demonstrated by fiberoptic laryngoscope and esophageal compression shown by esophagography were found in a patient with toxic multinodular goiter with coexisting papillary carcinoma of the thyroid. In this patient, both the tracheal compression noted in SPECT imaging and the tracheomalacia suggested by the flow volume loop pattern in pulmonary function test were confirmed at the time of thyroidectomy. Our observation suggests that SPECT imaging of large multinodular goiter may be useful in preoperative delineation of the functional anatomy and the extension of goiter in relation to the airway.

Analysis of the idiotypic network in tumor immunity

Herein we have analyzed the expression of idiotopes associated with a monoclonal anti-tumor-associated antigen (TAA) antibody in DBA/2 mice which have progressively growing tumors or resist tumor growth. A panel of eight monoclonal antiidiotypic antibodies raised against a monoclonal antibody which reacts with a mouse mammary tumor virus cross-reactive qp52 envelope protein (TAA) of the L1210/GZL lymphoma was used to measure the expression of idiotopes in sera from different treatment groups. Significant correlations between the expression of certain idiotopes and the growth of the tumor or the establishment of anti-tumor immunity are seen. 1) Idiotypes detected by anti-idiotype D11 are high in anti-idiotype immunized progressor or tumor-susceptible mice and low or absent in regressor mice, i.e., the mice immunized with the protective 2F10 anti-idiotype; 2) the 3A4-detected idiotypes are less frequent or absent in irradiated tumor-immunized regressor mice than in untreated mice challenged with live tumor or progressor mice; 3) no difference in the anti-TAA titers is seen in mice in which the tumor growth is inhibited and in mice in which the tumor grows; 4) no difference in 11C1 idiotype + anti-TAA titer was observed between regressor and progressor mice; and 5) mice with normal or accelerated tumor growth have higher titers of idiotypes detected by a polyclonal anti-idiotype. These findings provide evidence for a regulatory idiotype network induced by the growing L1210/GZL tumor or by anti-idiotypic immunization. The titer of anti-TAA antibody does not correlate with the biology of tumor growth, but certain idiotopes correlate with either progressive or regressive tumor behavior. Therefore, the target of the idiotype regulation is likely to be anti-tumor T effector cells. Effective idiotype therapy of tumors must deal with the complexity of idiotype regulation induced by the tumor itself and is unlikely to be successful if anti-idiotypes are used only as internal mimicry of a TAA.

Analysis of the idiotypic network in tumor immunity

Herein we have analyzed the expression of idiotopes associated with a monoclonal anti-tumor-associated antigen (TAA) antibody in DBA/2 mice which have progressively growing tumors or resist tumor growth. A panel of eight monoclonal antiidiotypic antibodies raised against a monoclonal antibody which reacts with a mouse mammary tumor virus cross-reactive qp52 envelope protein (TAA) of the L1210/GZL lymphoma was used to measure the expression of idiotopes in sera from different treatment groups. Significant correlations between the expression of certain idiotopes and the growth of the tumor or the establishment of anti-tumor immunity are seen. 1) Idiotypes detected by anti-idiotype D11 are high in anti-idiotype immunized progressor or tumor-susceptible mice and low or absent in regressor mice, i.e., the mice immunized with the protective 2F10 anti-idiotype; 2) the 3A4-detected idiotypes are less frequent or absent in irradiated tumor-immunized regressor mice than in untreated mice challenged with live tumor or progressor mice; 3) no difference in the anti-TAA titers is seen in mice in which the tumor growth is inhibited and in mice in which the tumor grows; 4) no difference in 11C1 idiotype + anti-TAA titer was observed between regressor and progressor mice; and 5) mice with normal or accelerated tumor growth have higher titers of idiotypes detected by a polyclonal anti-idiotype. These findings provide evidence for a regulatory idiotype network induced by the growing L1210/GZL tumor or by anti-idiotypic immunization. The titer of anti-TAA antibody does not correlate with the biology of tumor growth, but certain idiotopes correlate with either progressive or regressive tumor behavior. Therefore, the target of the idiotype regulation is likely to be anti-tumor T effector cells. Effective idiotype therapy of tumors must deal with the complexity of idiotype regulation induced by the tumor itself and is unlikely to be successful if anti-idiotypes are used only as internal mimicry of a TAA.

Tumor-specific idiotype vaccines. III. Induction of T helper cells by anti-idiotype and tumor cells

In a previous report, we have demonstrated the induction of tumor-specific immunity by monoclonal anti-idiotype antibodies generated against a monoclonal anti-tumor antibody, 11C1, that also cross-reacts with mouse mammary tumor virus envelope glycoprotein gp52. Also, we showed that whereas one anti-idiotype antibody, 2F10, could induce protective immunity, another anti-idiotype antibody, 3A4, induced nonprotective immunity. Here we demonstrated the existence of T helper cells which recognize anti-idiotypes that exert differential controls on tumor growth. The qualitative nature of idiotype recognizing T cells generated in response to 2F10, 3A4, irradiated tumor, and progressively growing tumor was compared. The reactivity pattern of idiotype recognizing T cells obtained from 2F10 and irradiated tumor immunized mice were similar in nature in the sense that Lyt-2- T cells obtained from these immunized mice responded to both 2F10 and 3A4 as antigen, although T cells from tumor immunized mice responded better to 3A4 antigen. On the other hand, the idiotype-recognizing T cells obtained from 3A4-immunized mice showed a similar reactivity pattern to T cells isolated from mice during the early phase of tumor growth (within day 4 to 5 after the inoculation of 10(4) live tumor cells). Lyt-2- T cells isolated from mice immunized with 3A4 or during the early phase of tumor growth responded only to 3A4 antigen. The inability of Lyt-2- T cells, isolated from 4- to 5-day-old tumor in mice, to cooperate with 2F10-TNP is not due to the absence of 2F10 idiotype recognizing T cells as 2F10 id recognizing T cells are present when examined at the precursor level. These data on the idiotype specificity of T helper cells show a correlation with the presence of anti-tumor immunity. This information will help in the design and application of idiotype vaccine in tumor immunotherapy.

Tumor-specific idiotype vaccines. III. Induction of T helper cells by anti-idiotype and tumor cells

In a previous report, we have demonstrated the induction of tumor-specific immunity by monoclonal anti-idiotype antibodies generated against a monoclonal anti-tumor antibody, 11C1, that also cross-reacts with mouse mammary tumor virus envelope glycoprotein gp52. Also, we showed that whereas one anti-idiotype antibody, 2F10, could induce protective immunity, another anti-idiotype antibody, 3A4, induced nonprotective immunity. Here we demonstrated the existence of T helper cells which recognize anti-idiotypes that exert differential controls on tumor growth. The qualitative nature of idiotype recognizing T cells generated in response to 2F10, 3A4, irradiated tumor, and progressively growing tumor was compared. The reactivity pattern of idiotype recognizing T cells obtained from 2F10 and irradiated tumor immunized mice were similar in nature in the sense that Lyt-2- T cells obtained from these immunized mice responded to both 2F10 and 3A4 as antigen, although T cells from tumor immunized mice responded better to 3A4 antigen. On the other hand, the idiotype-recognizing T cells obtained from 3A4-immunized mice showed a similar reactivity pattern to T cells isolated from mice during the early phase of tumor growth (within day 4 to 5 after the inoculation of 10(4) live tumor cells). Lyt-2- T cells isolated from mice immunized with 3A4 or during the early phase of tumor growth responded only to 3A4 antigen. The inability of Lyt-2- T cells, isolated from 4- to 5-day-old tumor in mice, to cooperate with 2F10-TNP is not due to the absence of 2F10 idiotype recognizing T cells as 2F10 id recognizing T cells are present when examined at the precursor level. These data on the idiotype specificity of T helper cells show a correlation with the presence of anti-tumor immunity. This information will help in the design and application of idiotype vaccine in tumor immunotherapy.