A case of bullous pemphigoid with antibodies against intercellular 130 kd antigen

Pemphigus and bullous pemphigoid are two typical autoimmune bullous diseases that involve circulating autoantibodies directed against the epidermal cell surface and the epidermal basement membrane zone, respectively. The coexistence of pemphigus and bullous pemphigoid is rare. We describe a case of a 79-year-old man who had tense bullae and erythematous, erosive lesions on his trunk and four extremities. Histopathology revealed subepidermal blister formation without any evidence of intraepidermal acantholytic changes. Direct immunofluorescence study demonstrated deposition of IgG on the epidermal intercellular spaces, as well as along the basement membrane zone; C3 was detected only on the latter. Indirect immunofluorescence study using monkey esophagus as a substrate demonstrated the presence of circulating antibodies against both junctional and intercellular antigens. In order to analyze the precise nature of this patient's antibodies, indirect immunofluorescence study using cultured human keratinocytes and immunoblot analyses were performed. Pemphigus vulgaris sera showed smooth and uniform staining on intercellular spaces. The patient's serum showed a granular and uneven staining pattern. Immunoblot analysis showed that the patient's serum reacted with the typical 230 kd (bullous pemphigoid) antigen and 130 kd antigen, which is close to the pemphigus vulgaris antigen.

Differentiation and proliferative activity in benign and malignant cartilage tumors of bone

To assess the histological grade in benign and malignant cartilage tumors of bone by more objective methods, we examined the differentiation and proliferative activity of tumor cells in six enchondromas, five chondroblastomas, and 13 chondrosarcomas immunohistochemically. A variable number of cells in all tumors showed S-100 protein and vimentin immunoreactivity. In fully differentiated cartilage of enchondromas and low grade chondrosarcomas, tenascin, which is an extracellular matrix glycoprotein, was present in small amounts or absent but was increased at the periphery of tumor lobules and even in the matrix throughout the high grade chondrosarcomas. Higher rate and intensity of proliferating cell nuclear antigen (PCNA) reactivity were found in chondrosarcomas, especially in spindle-shaped cells of high grade tumors, than in enchondromas. The distribution of PCNA-positive cells almost corresponded to the regions with tenascin reactivity. One tumor of high grade chondrosarcoma showed p53 protein immunoreactivity. Aberrant expression of cytokeratin was observed in four chondroblastomas. The expression of desmin was identified in relatively large proportions of enchondromas and chondrosarcomas, regardless of their benign or malignant nature and histological grade. Smooth muscle or muscle-specific actins also were present in a smaller number of tumors. Based on these findings, it is concluded that unusual staining characteristics were present, in addition to those of a chondroblastic nature, in the cartilage tumors of bone. Tenascin and PCNA positivity of various degrees in all chondroblastomas may suggest that they are chondrogenic tumors having a relatively high proliferative activity, albeit their benign clinical course. Proliferative activity of tumor cells in enchondromas and chondrosarcomas correlated well with their histological grade. Tenascin may play a role in promoting tumor cell proliferation of cartilagenous neoplasms and, on the other hand, the alterations of extracellular matrix involving tenascin synthesis seem to be a result of tumor development.

A nuclear factor (NF2d9) that binds to the male-specific P450 (Cyp 2d-9) gene in mouse liver

Expression of the Cyp 2d-9 (steroid 16 alpha-hydroxylase) gene in mouse liver is male specific in such Mus musculus domesticus strains as FVB/N, whereas the corresponding P450 genes in the wild mouse species Mus spretus are not sex specific in their expression. These parental differences in the gene expressions were independently inherited in F1 offspring from crosses of FVB/N and M. spretus. A 5' flanking sequence (-110CTC CTCCCTATTCCGGGCC-92) was defined as a regulatory element (named SDI-A1) for the domestic Cyp 2d-9 promoter. The nucleotide which corresponds to T at position -99 within SDI-A1 was found to be substituted with C in the wild mouse P450 genes. The placing of C at position -99 abolished the transcriptional activity of SDI-A1 in HepG2 cells as well as the binding of SDI-A1 to a nuclear factor. This factor (designated NF2d9) was purified from mouse nuclear extracts, and its cDNA cloned. The purified NF2d9 bound to SDI-A1 but not to the mutated SDI-A1 with C at position -99. The deduced amino acid sequence revealed that NF2d9 is 72 and 94% identical to mouse CP2 and human LBP-1a, respectively. NF2d9 thus belongs to the CP2 family and is the mouse homolog of human LBP-1a, which modulates human immunodeficiency virus type 1 transcription. Anti-NF2d9, which was raised against the bacterially expressed protein, supershifted the SDI-A1 complex with the liver nuclear extract. Both the bacterially expressed and in vitro-translated NF2d9 inhibited SDI-A1 complex formation, although they did not bind to SDI-A1 directly. The results, therefore, indicate that the domestic Cyp 2d-9 gene can be regulated through a specific association of NF2d9 with SDI-A1.

[Consensus and new development in epithelial ovarian cancer chemotherapy in 1995]

Recent clinical trials have confirmed that cisplatinum combination has advantages for advanced ovarian cancer interns of response rate, response duration and disease-free time, but little advantage for overall survival. Although addition of doxorubicin to cisplatin-based chemotherapy is a matter of controversy between European countries and the USA, high-dose epirubicin, which is an analog of doxorubicin, has a potent response in relapsed cases after CDDP combination chemotherapy. Clinical trails of epirubicin + CPA + CDDP for advanced ovarian cancer and underway in Japan. Under standard supportive care, escalated CDDP dose may prolong median survival time, but its advantage for long-time survival is questionable. Trials of high-dose chemotherapy as front line treatment for advanced ovarian cancer supported by PBSCT/G-CSF in combination with assessment of scheduled AUC have been collected from many world-wide institutes. GOG demonstrated that intraperitoneal administration of CDDP with intravenous CPA had obvious superiority to intravenous CDDP and CPA in overall survival and adverse effect for stage III ovarian cancer, under the conditions that 70% of cases had minimum residual tumor (< 0.5 cm). We have to make sure whether this modality has the same effect on early and stage IV ovarian cancer. Taxol plus CDDP has promising benefits for median disease free survival and median survival time, so it is becoming the standard regimen for advanced ovarian cancer in USA. The delay of the clinical introduction of taxanes should be eliminated promptly in Japan.

Combined chemoendocrine treatment with tegafur and tamoxifen for advanced renal cell carcinoma

Ten patients with advanced renal cell carcinoma were given combined chemoendocrine treatment with tegafur and tamoxifen. Patients were orally administered 800 mg/body tegafur and 20 mg/body tamoxifen daily. One patient was assessed as CR, three as PR, two as NC and four as PD. One out of two patients with estrogen receptor (ER)-positive tumors and three out of four patients with ER-negative tumors responded favorably to this treatment. Side effects observed during treatment included nausea and vomiting (Grade I in three patients and Grade II in five), leukopenia (Grade II in four patients and Grade III in two), Grade II liver dysfunction in two patients, and slight pigmentation in two patients. This treatment can be considered efficacious for renal cell carcinoma.

Immunochemical characterization of recombinant and native tropomyosins as a new allergen from the house dust mite, Dermatophagoides farinae

BACKGROUND

Two predominant mite species, Dermatophagoides farinae and Dermatophagoides pteronyssinus, are responsible for the immediate hypersensitivity reaction. Although a large number of antigens and allergens was detected in a whole mite culture extract, only the major allergens of Der I and II groups have been extensively studied. Much information on other important allergens remains to be accumulated.

METHODS

A new allergen complementary DNA (cDNA) clone was isolated from a D. farinae protein cDNA library. The expression product of the cDNA and native tropomyosin from D. farinae were purified, characterized, and evaluated.

RESULTS

An amino acid sequence deduced from the cDNA clone revealed significant homology with tropomyosins conserved in a wide range of animals. The amino acid sequences of two fragments obtained by degradation of the purified protein with cyanogen bromide coincided completely with the corresponding portions of the deduced amino acid sequence. The native tropomyosin reacted with specific IgE in the 31 sera tested at a high frequency (80.6%), comparable to that of Der f I (90.3%) and Der f II (74.2%).

CONCLUSIONS

The cloned cDNA encodes tropomyosin. The high binding response of specific IgE antibodies to recombinant and native tropomyosins demonstrates that mite tropomyosin is an additional important allergen in house dust mite.

[The relationship between genotypes of HLA-DRB1 alleles and progression of bony destruction changes of rheumatoid arthritis]

The relationship between genotypes of HLA-DRB 1 alleles and the progression of bone destruction of RA patients was assessed. The genotypes of the HLA-DRB 1 alleles were determined in 329 Japanese patients with seropositive RNA by polymerase chain reaction and allele-specific oligonucleotide probe techniques. We regarded HLA-DRB 1* 0101, 0401, 0404, 0405, 1001 and 1402 as susceptible alleles of RA and classified the patients into three groups. The s/s group consisted of those with susceptible factors in both of the HLA-DRB 1 alleles. The s/n group was made up of those having one susceptible factor and one non-susceptible factor. The n/n group consisted of those possessing two non-susceptible factors. The grading of radiographic change that was evaluated by Larsen's criteria compared with the genotyped results. In the result, the median years taken to development to grade III, IV and V were significantly shorter in the s/s groups compared with that in the s/n and n/n groups. Thus, genotyping of HLA-DRB 1 can be a useful prognostic market in the progression of bone destruction of RA.

[Efficacy and safety of percutaneous transluminal coronary angioplasty of other coronary arteries in patients with chronic total occlusion of the left anterior descending artery]

The acute and long-term outcomes of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) or left circumflex branch (LCS) in patients with chronic occlusion of the left anterior descending branch (LAD) (group A) were compared with those of sex and age matched patients undergoing PTCA of the RCA or LCX with a normal LAD (group B). Before the procedure, group A had more frequent prior myocardial infarction (96% vs 33%, p < 0.001), and a lower left ventricular ejection fraction (LVEF) (49 +/- 14% vs 71 +/- 13%, p < 0.001). The acute results were similar in the two groups with respect to primary success (group A 90%, group B 91%) and major complications (group A 6%, group B 2%). At 3 months, the rate of restenosis was 33% in group A and 27% in group B. In group A, LVEF increased significantly in patients without restenosis (53 +/- 11% vs 62 +/- 11%, p < 0.01). At long-term follow-up, group A had higher rates of persistent angina but there was no difference in outcome between the two groups. In patients with chronic total occlusion of LAD, PTCA for RCA or LCX can be performed with a low complication rate and provides a significant improvement in LVEF at 3 months in the absence of restenosis. However, at short-term follow-up, these patients have a greater incidence of persistent angina.

Effect of mild hypothermia on the coefficient of oxygen delivery in hypoxemic dogs

Hypothermia is one of therapeutic options in patients with severe acute respiratory failure. This study was designed to determine the optimum core temperature during hypoxemia by analyzing oxygen delivery (DO2) and consumption (VO2). Six dogs were ventilated using a mixed gas of N2 and air (fractional concn of O2 in inspired gas = 0.12) with total muscle relaxation under general anesthesia. Hypoxia (arterial PO2 approximately 35 Torr) was maintained during the experimental period. The core temperature was reduced progressively from 37 to 30 degrees C by surface cooling. The coefficient of oxygen delivery was defined as DO2 divided by VO2. In each animal, the DO2/VO2 was calculated by altering the core temperature by 1 degrees C, and its relative value was a third-order polynomial function of core temperature having a maximum value at a core temperature of 32.1 +/- 0.46 degrees C. At a core temperature of 32 degrees C, the blood lactate level was significantly lower than that at a core temperature of 37 degrees C (6.3 +/- 1.3 vs. 12.2 +/- 1.6 mg/dl; P < 0.05). The relative value of the DO2/VO2 was highest with limited lactate elevation at a core temperature approximately 32 degrees C. Under the condition of hypoxia, mild hypothermia approximately 32 degrees C may be optimal to improve oxygen demand-supply balance.

Reduction in risk of mortality from colorectal cancer by fecal occult blood screening with immunochemical hemagglutination test. A case-control study

Fecal occult blood testing by immunochemical hemagglutination has been shown to be superior to the Hemoccult test, both in sensitivity and in specificity. The test has been widely used as a tool for population screening in Japan, but there has been no study to evaluate the efficacy of screening using this test. A case-control study to evaluate the screening was conducted in study areas where no previous and no other concomitant colorectal cancer screening had been performed. Case series in the study were 193 cases who died of colorectal cancer. Three controls were selected randomly from the list of individuals who were alive at the time of diagnosis of the corresponding case and had been living in the same area as the case, matched by gender and by age. Odds ratios (OR) of dying of colorectal cancer for those screened within 1, 2 and 3 years of case diagnosis vs. those not screened were 0.40 [95% confidence interval (CI) 0.17-0.92], 0.41 (95% CI 0.20-0.82), and 0.48 (95% CI 0.25-0.92), respectively. OR increased towards 1.0 as the duration during which screening histories were compared was extended, and showed similar tendencies when analyzed by number of years since the most recent screening history. These results suggest that colorectal cancer screening by the immunochemical fecal occult blood test would reduce mortality from colorectal cancer.

[Residual gastritis after gastrectomy and Helicobacter pylori--its clinical significance]

Residual gastritis after gastrectomy brings the various symptoms such as abdominal pain, nausea, emesis and loss of appetite, and often hazards quality of life of the patient. Bile reflux to the stomach is believed as one of the important pathogenesis of residual gastritis, however the prevention for bile reflux cannot always heal the gastritis. Helicobacter pylori (H. pylori) is considered as one of the most important pathogenesis of gastroduodenal ulcer and gastritis, and H. pylori may possibly cause residual gastritis after gastrectomy. However, the association between infection with H. pylori and the residual gastritis has not revealed yet. In the present study, the association with H. pylori and the residual gastritis after gastrectomy was investigated in 56 patients who had undergone gastrectomy before. Twenty-four patients (42.9%) had H. pylori infection at their stomachs and the incidence of the infection in the patients with gastrectomy was significantly higher with subtotal gastrectomy. As for the histological gastritis score of Rauws (Rauws' score), Rauws' score of H. pylori positive group was significantly higher than H. pylori negative group. Furthermore, the eradication of H. pylori for the patients with serious symptoms of gastritis improved the symptoms and decreased significantly Rauws' score. These results suggest that H. pylori was associated with the pathogenesis of residual gastritis after gastrectomy.

[A case of spontaneous mesenteric fibromatosis occurred from the mesentery of the small intestine]

The fibromatosis is benign tumor which is characterized by the remarkable proliferation and the invasive growth of fibrous tissue and no distant metastasis. It usually occurs from the abdominal wall or the extremities, and rarely from the mesentery. A 54-year-old male complained of an epigastralgia and emesis. He was diagnosed through imaging as the obstructive ileus by abdominal tumor. The laparotomy was performed and a round, egg sized tumor was found wear by dilated ileum. The tumor was considered to occur from the mesentery, and the iliectomy with the tumor was completed. It was suggested that ileus occurred in the early stage because the tumor was located just by the ileum.

Characteristics of [125I]omega-conotoxin labeling using bifunctional cross linker DSP in crude membranes from chick brain

Characteristic of [125I]omega-conotoxin (omega-CgTX) labeling using bifunctional cross linker (dithio bis[succinimidyl propionate]:DSP) was systematically investigated in crude membranes from chick whole brain. [125I]omega-CgTX specifically labeled 216 kDa as a main and 236 kDa as a minor bands in the crude membranes under non-reduced condition, but not labeled under reduced condition. We investigated the effect of various Ca channel antagonists on [125I]omega-CgTX labeling with DSP in detail, and found that there is a strong correlation between the effects of Ca channel antagonists on [125I]omega-CgTX labeling of the 216 kDa band and specific [125I]omega-CgTX binding. These results suggest that labeling of the 216 kDa band under non-reduced condition with [125I]omega-CgTX using DSP involves the specific binding sites of [125I]omega-CgTX, perhaps including one of the neuronal N-type Ca channel subunits in the crude membranes.

In vitro chemosensitivity assay for human osteosarcoma using tumor xenografts

The authors have established an in vitro chemosensitivity assay for human osteosarcoma. To overcome the difficulty of maintaining primary osteosarcoma cells in culture, biopsy or surgical specimens were transplanted directly into athymic nude mice and early generation xenografts were used for in vitro scintillation assay. These xenografts enabled a large number of viable tumor cells to be obtained even from small biopsy specimens. As a result, this system afforded a workable assay in 21 (62%) of 34 osteosarcomas tested and enabled the assay of numerous drugs at 4 different concentrations. Reproducibility of the assay can be checked by using serially transplanted xenografts. Retrospectively, the in vitro results were compared with the histologic response of the resected tumor in 18 patients who had received preoperative chemotherapy. The true positive rate, true negative rate, and predictive accuracy were 40%, 100%, and 66.7%, respectively. The authors suggest that this system provides a valid tool to determine which drugs are ineffective in individual osteosarcoma patients and thus may allow more efficient therapy.

High-molecular-size mite allergens with high carbohydrate content in mite extract containing mite feces of Dermatophagoides farinae

A series of mite allergens with high carbohydrate content was fractionated from mite extract containing mite feces by ultrafiltration, and successive chromatography on Ultrogel AcA 54, Sepharose CL-6B, and DEAE Toyopearl 650S. The final fractions isolated were termed HM1-2-Eff, -0.1A, -0.1B, -0.3A, -0.3B, and -1M according to the eluted salt concentration. These six fractions were stained weakly with Coomassie Brilliant Blue but strongly with periodate-Schiff's reagent on SDS-PAGE. Their molecular weight were estimated to be 150-155 KD on Sepharose CL-6B. All of these six fractions provoked strong erythema in skin of mite-sensitive and asthmatic patients. HM1-2-Eff, -0.1A, -0.1B and -0.3B reacted with 73% of mite-sensitive patients' IgE by the nitrocellulose dot blotting. One ng/ml of 4 fractions (HM1-2-0.1A, 0.3A, 0.3B and -1M) released histamine from mite allergic patient's blood cells. HM1-2-0.3A induced proliferation of T cell from immunized mouse by mite extract containing mite feces (Dff).

[Long-term clinical study on TAP-144-SR, an LH-RH agonist depot formulation, in premenopausal patients with advanced or recurrent breast cancer. TAP-144-SR Breast Cancer Study Group]

Efficacy and safety of long-term treatment with an LH-RH agonist, TAP-144-SR were studied in premenopausal patients with advanced or recurrent breast cancer. The drug was given sc every 4 week at the dose of 3.75 or 7.5mg. The best objective response rates were 37.0% (17/46) in 3.75mg group, 30.6% (15/49) in 7.5mg group, respectively. The median duration of 12 PR patients in 3.75mg group was 280 (range: 84-830+) days. Serum estradiol level was maintained at < 30pg/ml in most patients given 3.75mg or 7.5mg as scheduled. There was no adverse reactions specific to the longterm administration subsequent to the foregoing 12-week administration study in both dose groups. In conclusion, TAP-144-SR is expected to be one of the first line therapies for patients with premenopausal breast cancer.

Flow cytometric analysis of p53 expression during the cell cycle

Mutant p53 expressed in many types of carcinoma lacks an inhibitory function on cell growth, but its role has been unclear. We performed two-parameter flow cytometry (FCM) to elucidate the relationship between the expression of p53 and the cell cycle in A431 cells. Fluorescence in situ hybridization proved that an A431 cell had two p53 genes whereas chromosome 17 was tetraploid. FCM showed that A431 cells expressed constantly high levels of p53 during the cell cycle. Under conditions of both serum deprivation and presence of hydroxyurea, p53 expression was decreased throughout the cell cycle, and the bivariate DNA/p53 distribution pattern during the cell cycle did not change. The expression of p53 was reduced to 60% for the first 4 h after the addition of cycloheximide, and showed no significant changes at least for 20 h. Treatment with Triton X-100 increased p53 immunoreactivity throughout the cell cycle. These results indicate that mutant p53 differs from proliferative markers such as PCNA, Ki-67 and DNA polymerase-alpha, and that there are no links between the expression of p53 and the cell cycle in A431 cells.

Sarcolemmal indentation in cardiomyopathy with mental retardation and vacuolar myopathy

Muscle biopsies from three patients with cardiomyopathy, mental retardation and increased serum creatine kinase levels revealed scattered fibers with tiny intracytoplasmic vacuoles containing basophilic and acid phosphatase-positive material and slightly increased amounts of PAS-positive granules. These findings are consistent with those seen in the so-called lysosomal glycogen storage disease with normal acid maltase. In addition to the vacuoles, there were occasional folds or indentations in the sarcolemma which were connected to the membrane enclosing the vacuoles. These membranes were well demonstrated histochemically by the nonspecific esterase and acetylcholinesterase stains. On electron microscopy, most of the vacuoles were bounded by membranes with basal lamina. The vacuolar membrane stained positively with antibodies raised to dystrophin, dystrophin-associated glycoproteins, laminin and type 4 collagen, and it was identical to the sarcolemma and its basal lamina. Therefore, the membrane abnormality which causes sarcolemmal folding is probably critical to understanding the pathomechanism of this disease.

Chemotherapy administered using two-route infusion of cisplatin and sodium thiosulfate and intravenous infusion of vinblastine and peplomycin in patients with oral cancer

The therapeutic effects of neo-adjuvant chemotherapy administered by two-route infusion of cisplatin and its antidote, sodium thiosulfate, and intravenous infusion of vinblastine and peplomycin were studied in 22 patients with previously untreated squamous cell carcinoma of the oral cavity or maxillary sinus. The overall response rate to chemotherapy was 90.9%, with a complete response in 12 patients (54.5%), a partial response in 8 patients (36.4%), and no change in 2 patients (9.1%). Histologic assessment showed a grade V response in 7 patients (31.8%), grade IV in 3 patients (13.6%), grade III in 5 patients (22.7%), grade II in 4 patients (18.2%), and grade I in 3 patients (13.6%). The cumulative 5-year survival rate, including 3 patients who died of another disease, was 72.2%. Leukocytopenia, an important side effect apparently induced by vinblastine, was seen, but no life-threatening complications occurred. Renal toxicity by cisplatin was minimal because of the use of sodium thiosulfate and fosfomycin. These data indicate that this mode of chemotherapy may be more effective for treating head and neck cancer than ordinary chemotherapy, from clinical and histologic standpoints. The high complete-response rate is especially noteworthy. No serious side effects or reductions in treatment period occurred. The results are preliminary and additional studies using a larger patient population are needed.

[A dose-comparative study on TAP-144-SR, an LH-RH agonist depot formulation, in premenopausal patients with advanced or recurrent breast cancer. TAP-144-SR Breast Cancer Study Group]

A comparative phase II study was performed with different doses of TAP-144-SR in ER-positive or ER-unknown premenopausal patients with advanced or recurrent breast cancer. One hundred and six patients were randomly allocated to either 3.75 mg or 7.5 mg treatment by a centralized telephone registration system. TAP-144-SR was administered sc at 4-week intervals for 12 weeks (a total of 3 injections). Ninety-five cases were evaluated with the response rate of 30.4% (14/46) in the 3.75 mg group and 24.5% (12/49) in the 7.5 mg group, respectively. Serum estradiol was decreased to postmenopausal level (< 30 pg/ml) within 3-4 weeks after the first dose in the both dose groups, and this suppression was maintained throughout the treatment period. The adverse reactions most frequently observed were climacteric disturbances like hot flashes which was likely to be due to the hypoestrogen status. In conclusion, there was no significant difference between both dose groups in terms of response rates, adverse effects, and hormonal suppression. Therefore, the lower dose is recommended for the further study.

Pharmacokinetic correlation between experimental and clinical effects on human non-small cell lung cancers of cis-diammineglycolatoplatinum (254-S) and cis-diamminedichloroplatinum

We attempted to correlate the in vitro and in vivo antitumor activities of cis-diammineglycolatoplatinum (254-S), a novel platinum complex, and cis-diamminedichloro-platinum (CDDP) against the established culture cell lines and xenografts of human non-small cell lung cancer (NSCLC) with their clinical effects, based on the previous finding that the cytotoxicity of CDDP depends on the area under the curve (AUC). The concentration of 254-S and CDDP inhibiting the in vitro growth of 4 cultured NSCLC lines by 50% (IC50) was 0.82-7.8 and 0.53-4.2 micrograms/ml, respectively, showing a similar level. Of the 4 cell lines, only the most sensitive line, RERF-LC-AI, showed an IC50 close to a specific concentration (0.50 for 254-S and 0.32 micrograms/ml for CDDP) that reproduces in vitro the clinical AUCfree (24.8 and 5.34 micrograms-hr/ml) of the respective drugs. We treated 6 lines of human NSCLC xenografts implanted in nude mice with 254-S and CDDP at a particular dose (13.2 and 3.7 mg/kg) that is equivalent to the clinical doses with respect to the plasma AUCfree. 254-S and CDDP exhibited significant antitumor effects on 2 and 1 of the 6 lines, respectively. These in vitro and in vivo findings were considered to be relatively well correlated with the reported clinical response rates of 15-19% for 254-S and 14-15% for CDDP.

[Stromelysin-1 (MMP-3) level in the sera from patients with rheumatoid arthritis and other connective tissue diseases--clinical significances in early onset rheumatoid arthritis]

Stromelysin-1 (MMP-3) is a metalloproteinase that degrades articular cartilage matrix in patients with rheumatoid arthritis (RA). We measured MMP-3 in the sera from patients with RA and other connective tissue diseases using specific sandwich EIA and studied its clinical significance in early onset RA. MMP-3 level in healthy control (n = 170) was significantly higher in male than in female. The level of MMP-3 in RA was significantly and dramatically higher than in healthy control, osteoarthritis, systemic lupus erythematosus, progressive systemic sclerosis, primary sjogren's syndrome, mixed connective tissue disease, gouty arthritis and traumatic arthritis. Serum MMP-3 significantly correlated with serum BUN or serum creatinine levels in SLE patients but not in RA patients. In early onset RA, serum MMP-3 level was significantly elevated. Furthermore, when the relationship between the serum MMP-3 level and X-ray findings of the joints in RA was studied, it was found that MMP-3 level was elevated even in stage I or II and that there was no statistical differences between stage I or II and stage III or IV, suggesting that serum MMP-3 level is elevated in the early stage of initial inflammatory process when only mild cartilage degradation is seen. These results suggest that measurements of serum MMP-3 is an important tool for establishing diagnosis of early onset RA, and that serum MMP-3 level may be a marker of cartilage destruction and of estimating therapeutic efficacy in early onset RA.