Capacity of B-lymphocytic lines of diverse tumor origin to produce and respond to B-cell growth factors: a progression model for B-cell lymphomagenesis

Human cell lines established from cases of acute lymphoblastic leukemia, lymphosarcoma, Burkitt's lymphoma and multiple myeloma and representing stages of B-lymphocyte development ranging from pre-B through to plasma cells, were assessed for their ability to produce and respond to B-cell growth factors (BCGF). All B-cell lines studied were found to be constitutive producers of a growth activity which assisted the S-phase entry of normal activated B-cells and provided growth support for lymphoblastoid cells transformed by Epstein-Barr virus. Furthermore, all lines responded by enhanced proliferation to supernatants from a BCGF-producing T-cell hybridoma. Not all lines, however, displayed autostimulation to their own supernatants and no tumor B-cell line appeared totally dependent on soluble factors for its growth. Non-tumorigenic B-cell lines, by contrast, revealed a strict dependency on homologous growth factor for their continued proliferation in suspension culture. The findings support a progression model of lymphomagenesis based upon the utilization, production and, ultimately, emancipation from growth-promoting soluble factors.

Acute effects of antiarrhythmic drugs on stable ventricular premature beats. Controlled comparison of lorcainide and lidocaine

Nineteen patients with refractory but stable ventricular premature beats (VPB) received 3 medications intravenously at 24-h intervals. Lorcainide (2 mg/kg) and placebo were given double-blind in randomized sequence and the third treatment was 100 mg lidocaine, the standard reference drug. Continuous ECG recordings were made for the first 2 hours after administration to study the antiarrhythmic effect; the stability of the arrhythmia, the absence of residual and of period effects, and the interdrug differences in efficacy were statistically evaluated. Lorcainide significantly reduced the frequency of VPB during the 2-hour period, whereas the effect of lidocaine was more short-lived. The median individual peak reduction in VPB was 96% for lorcainide and 47% for lidocaine. No significant reduction in VPB was observed with placebo. Adverse effects were acceptable with either active treatment.

Prenalterol: a partial beta 1-adrenoceptor agonist or a beta-blocker with intrinsic activity?

Hemodynamic studies have demonstrated a significantly reduced beta 1-adrenoceptor stimulating effect of prenalterol compared to dobutamine suggesting a partial agonism on the receptor. In order to prove this hypothesis we administered 80 micrograms/kg of prenalterol within 5 minutes in 8 healthy volunteers during a continuous infusion of dobutamine (15 micrograms/kg/min). In addition to heart rate, blood pressure and the double product, the systolic time intervals QS2I, PEP and LVET and the echocardiographically determined parameters FS and Vcf were measured for evaluation of ventrical function. The injection of prenalterol caused a distinct attenuation of the cardiostimulating effects of dobutamine: there was a prompt fall in heart rate and systolic blood pressure and a typical negative inotropic effect on the parameters of left ventricular function. In the experimental conditions selected, the effects of prenalterol were those of a beta-sympatholoytic agent. Prenalterol should therefore be classified as a partial beta 1-adrenoceptor agonist or as a beta-blocking agent with pronounced intrinsic sympathomimetic activity. The beta 1-stimulating potency of prenalterol amounts to about 60% of a full agonist.

Selective inhibitory effect of Hu-IFN-gamma on the agarose clonability of tumor-derived lymphoid cell lines

Recombinant human interferon alpha (IFN-alpha) and interferon gamma (IFN-gamma) were compared for their ability to influence the proliferative capacity of tumor-derived cell lines and of normal B lymphocytes infected in vitro by Epstein-Barr virus (EBV). EBV-induced B-cell proliferation was suppressed almost completely when 10(2) U/ml IFN-alpha were added to the culture medium while the same dose of IFN-gamma had significantly lower inhibitory activity. The pure IFNs differed in their ability to influence the growth of three Burkitt lymphoma-derived cell lines, Raji, Daudi, and Namalwa, depending on whether the cells were propagated in suspension or in semisolid cultures. IFN-alpha inhibited cell proliferation under both culture conditions with thresholds of sensitivity characteristics for each cell line. In contrast, IFN-gamma had no effect on the growth in suspension but it abolished the clonogenic potential of tumor cell lines in semisolid agarose. The results suggest that the two IFN types may exert their growth inhibitory activity through different mechanisms of action.

Leukocyte migration inhibitory factor production by activated lymphocytes representing immunological memory or virus-receptor interaction: response of T cell subsets to Epstein-Barr virus nuclear antigen, response of B cells to UV inactivated Epstein-Barr virus

Both T and B lymphocytes are known to produce leukocyte migration inhibitory factor (LIF) after appropriate activation. We showed that EBV nuclear antigen (EBNA) triggered T cells for LIF production in an immunologically specific way: only T cells of seropositive individuals responded. Both Fc receptor positive and negative T cells produced LIF, and the presence of macrophages was necessary. The virus itself activated B cells independently of the serological status of the donors, thus the function was not based on immunological memory. This phenomenon was independent of the transforming capacity of the virus, because UV-inactivated virus also elicited LIF production by B lymphocytes. This triggering seems to be the consequence of the virus-receptor interaction on the cell surface.

Subgroup analysis of BL-cell lines with polyclonal BL-specific antibodies

A Burkitt's lymphoma (BL)-specific antibody (anti-GP70), previously described, was used to analyse 22 different BL-cell lines. The results indicated specificity of antibodies to lines that contain both surface membrane Ig (SmIg) and cytoplasmic Ig (CyIg). BL-cell lines derived from more immature B cells that do not have SmIg but rather have only CyIg were negative. A comparative study with antibody to common ALL antigen (CALLA) and to another BL-specific antigen (BLA) revealed coexpression of GP70 with those two antigens, but no identity between them.

Correlation between tumorigenicity and banding pattern of chromosome 15 in murine T-cell leukemia cells and hybrids of normal and malignant cells

The most common chromosomal aberration in murine T-cell lymphomas is trisomy of chromosome 15. It has now been shown that the chromosomal region 15E exhibits a variant early replication banding pattern after 5-bromo-deoxyuridine labeling during part of the preceding S-phase. This variation is restricted to T-cell tumors. Plasmacytomas bearing the specific translocation t(12;15) show a normal early replication banding pattern of chromosome 15. In T-cell tumors all three chromosomes 15 of one cell are of the same variant banding type. In hybrids between tumor and nontumor cells, the number of cells expressing the variant early replication banding pattern is related to the degree of malignancy. Chromosomes 15 in one cell never expressed the variant and the normal banding pattern simultaneously. All five to six chromosomes 15 from one hybrid cell are of the same banding type irrespective of their parental origin. With respect to the type of early replication banding pattern, there is complete reversibility; tumor-parent-derived chromosomes 15 change to normal, and normal-parent-derived chromosomes 15 change to tumor.

Interaction between Epstein-Barr virus-determined nuclear antigen (EBNA) and the viral DNA

Epstein-Barr virus (EBV) nuclear antigen (EBNA) was purified from the Burkitt lymphoma line Raji and its EBV DNA-binding properties were characterized. EBNA binding protected fragments of about 30 bp of B95-8 cell-derived EBV DNA from an excess of DNase I. Human anti-EBNA antibodies prevented DNA binding. Purified extracts from EBNA-negative cells did not protect EBV DNA against DNase I digestion. Mapping of the EBV DNA fragments protected from endonuclease (EcoRI, HindIII, SalI) digestion revealed many binding sites. Similar results were obtained following mixing of crude cell extracts and HindIII-digested fragments of EBV DNA and subsequent immunoprecipitation of the EBNA-DNA complex. In experiments involving the analysis of EBV DNA, fragments were protected from DNase I digestion by purified EBNA.

Immunoglobulin gene organization of ultraviolet-illuminated human lymphoblastoid cell lines producing both IgM and IgG

We have studied the immunoglobulin gene organization of ultraviolet light (u.v.)-induced variant cells derived from an Epstein-Barr virus-transformed cell line. One variant produced IgG1 and two variants produced both IgM and IgG1 whereas the parental cell line produced IgM. Southern blot analyses of DNAs of these cells revealed a newly rearranged JH fragment in all the variants. The newly rearranged JH fragment also hybridized with the C gamma 1 sequence. The mu and gamma 1 chains produced in the double isotype-producing variants share the same VH sequence. u.v. illumination also induced rearrangement of the C lambda gene in the IgG1-producing variant. The double isotype producers contained the immunoglobulin gene organization and mutation best explained by fusion of the IgG1 producer and the parental IgM producer.

[Lipoprotein Lp(a) as a risk factor for heart infarct--a family study]

Lp(a) concentrations, apolipoprotein A-I and B, and various lipid parameters were measured from members of 3 families in which myocardial infarction frequently occurred. No correlation could be found between Lp(a) concentration and other lipoprotein parameters. It has been demonstrated that myocardial infarction and atherosclerotic diseases occur only in patients with Lp(a) concentrations higher than 70 mg/dl. An unfavourable Apo B/Apo A-I relation or LDL/HDL relation, associated with high Lp(a) concentration seems to play a decisive role in the development of atherosclerosis or myocardial infarction. The study suggests that subjects with Lp(a) values higher than 100 mg/dl could suffer from a special form of hyperlipoproteinemia ("Hyper-Lp(a)").

Studies on the polyoma-virus-induced tumor-specific transplantation antigen (TSTA)--does middle or large T-antigen play a role?

Mice and rats could be immunized against the polyoma-virus-induced tumor-specific transplantation antigen (TSTA) by repeated inoculation of frozen or irradiated cells of an MT-cDNA-transformed rat cell line (2.8) that contains only the polyoma middle T-antigen, or by cells that carried a host range mutant and expressed a full-length large T-antigen, but only non-functional N-terminal fragments of small and middle T. This shows that neither large T nor an intact middle T is necessary to elicit a polyoma tumor-specific graft rejection response. Either one of them is sufficient by itself.

Further studies on the asymmetry of chromosome 15 duplication in trisomic leukemias of heterozygous origin: preferential status of the AKR chromosome

Four combinations of translocation heterozygotes with cytogenetically distinct chromosomes 15 were used to investigate whether the T-cell leukemia-associated preferential duplication of the AKR-derived chromosome 15 (AKR-15) is determined by factors within this chromosome, or is due to genes within the AKR genotype, but outside chromosome 15. Two of the four combinations were also used to determine whether the AKR-15 duplication preference could be cancelled by MCF-viremia in permissive F1 hybrids. Chemically and virally induced 15-trisomic leukemias showed the same AKR-15 duplication preference, which was due to some autonomous property of AKR-15 itself. It was maintained in (C57BL 6;15 X C57BL) F1 leukemias, where 6;15 is the only AKR-derived chromosome propagated on the C57BL/background. In the (C57BL 6;15 X AKR) F1 hybrid cross where both chromosomes 15 are of AKR origin, duplication occurred at random. To approach the second question, MCF viremia was induced by neonatal virus inoculation into permissive (AKR 6;15 X B6Fv-In) F1 hosts. The preferential duplication status of the AKR-derived 6;15 remained unchanged.

Antibodies against a synthetic peptide identify the Epstein-Barr virus-determined nuclear antigen

Five peptides corresponding to amino acid sequences predicted from all three reading frames of the nucleotide sequence of the third internal repeat array (IR3) of the Epstein-Barr virus (EBV) genome were synthesized chemically. All five peptides elicited antipeptide antibodies in rabbits. The antiserum raised against a 14-residue copolymer of glycine and alanine gave brilliant EBV-specific nuclear staining in the anticomplement immunofluorescence (ACIF) assay, in line with the original definition of the EBV-determined nuclear antigen (EBNA) [Reedman, B. M. & Klein, G. (1973) Int. J. Cancer 11, 499-520]. Eight EBNA and EBV DNA-carrying lines showed nuclear staining with the antipeptide antibody, whereas five EBV DNA negative lines failed to stain. The staining pattern was more discretely punctate than the finely dispersed diffuse EBNA staining obtained with human antisera. Human EBV antibody-positive but not EBV-negative sera reacted with the synthetic peptide in an ELISA test. The peptide-specific antibodies were purified from the sera of healthy EBV-seropositive persons by affinity chromatography with the peptide. They gave an EBV-specific, brilliant punctate nuclear ACIF staining similar to that of the rabbit antipeptide antibodies. It was concluded that the glycine-alanine structure encoded by the IR3 region contains a native determinant of EBNA, detected by the ACIF test. Immunoblotting with the rabbit and human peptide-specific antibodies identified poly-peptides that varied between 70 and 92 kilodaltons in size in different EBV-positive cell lines, corresponding closely to a previously identified variation pattern in the size of EBNA. In addition, rabbit antipeptide antibodies identified two cellular polypeptides, 44 and 49 kilodaltons in size.

T lymphocyte culture established by repeated stimulation with the autologous lymphoblastoid line. MHC class II restricted interactions with B blasts

An OKT3+T4+T8-DR+ lymphocyte line was developed from an Epstein-Barr virus (EBV) seropositive individual by repeated stimulation in vitro with autologous EBV-infected B cells. The T cell population designated E-44 was carried for eight months in the presence of Interleukin-2 and was repeatedly tested for cytotoxicity, proliferation and lymphokine production in response to the autologous and a panel of allogenic B cells. The E-44 cells lysed the autologous lymphoblastoid cell lines (LCL) and allogenic B cell lines sharing the DR6.1 major histocompatibility complex antigen with the lymphocyte donors. The EBV genome-negative lymphoma line BJAB and its two, infected in vitro, EBV-positive sublines were lysed with similar efficiencies. Autologous Staphylococcus aureus protein A (Prot-A) induced B, but not Phytohaemagglutinin (PHA)-induced T blasts were also lysed. It is likely that E-44 recognized an antigenic component derived from the fetal calf serum in association with class II determinants expressed on the B cells. Preincubation of E-44 cells with saturating amounts of OKT3 and Leu3a monoclonal antibodies abrogated the lytic effect on the autologous LCL. Cold target competition experiments demonstrated that, within, the population, the same cells reacted with the autologous Prot-A-induced blasts, the EBV-transformed LCL, and also with Daudi (an EBV genome-positive BL line). Although Daudi was the target which was lysed with the greatest efficiency, the avidity of interaction was highest with the autologous LCL because these cells competed best. Among the cells that were sensitive for the lytic effect, only the autologous LCL and Prot-A-induced B blasts triggered release of detectable amounts of Interleukin-2 and induced proliferation of the culture. The results suggest that the affinity of interaction with the target may be decisive for the triggering of the various T cell functions.

Detection of an Epstein-Barr virus-associated membrane antigen in Epstein-Barr virus-transformed nonproducer cells by leukocyte migration inhibition and blocking antibody

Soluble membrane fractions derived from Raji cells trigger lymphocytes of Epstein-Barr virus (EBV)-seropositive, but not EBV-seronegative, individuals to release a lymphokine that inhibits leukocyte migration. The reaction can be blocked by the sera of patients with EBV-DNA-carrying tumors, Burkitt lymphoma, or nasopharyngeal carcinoma. Absorption of these sera with EBV-positive, but not EBV-negative, cells abrogates their blocking activity. These findings suggest that the antigen responsible for the leukocyte migration inhibition reaction is an EBV-encoded or an EBV-induced membrane component. The antigen is not identical with EBV-associated nuclear antigen or any other known antibody-detected EBV antigen.

Immune resistance of semisyngeneic F1 hybrid mice to lymphoma grafts differs from natural hybrid resistance in its genetic pattern

Resistance of semisygeneic F1 hybrid mice immunized three times with irradiated tumor cells was compared to the genetic pattern of natural hybrid resistance to challenge with live tumor cells. Syngeneic mice responded equally well to immunization with all five hemopoietic tumor lines tested as the naturally much more highly resistant F1 hybrids. Natural hybrid resistance was found to be severely reduced by sublethal irradiation with 4 Gy, in contrast to hybrid resistance to parental bone marrow.

Natural killer cell sensitivity of human lymphoid lines of B-cell origin does not correlate with tumorigenicity or with the expression of certain differentiation markers

Human B-cell lines derived from normal donors (LCL) or from Burkitt lymphomas (BL) were compared for their sensitivity to natural (NK) and interferon (IFN)-activated (IAK) cytotoxicity, mediated by effector cells from normal human blood. In four cases, a BL and an LCL line were derived from the same donor and had been kept in culture for the same period of time. The BL series included both Epstein-Barr virus (EBV)-carrying and EBV-negative lymphoma lines. The latter were compared with their own EBV-converted, Epstein-Barr nuclear antigen (EBNA)- and EBV-DNA-positive sublines, established by in vitro infection with two different viral substrains. LCL and BL lines from the same donor were lysed with equal efficiency by both NK and IAK effectors. There was no relationship between the NK sensitivity and the nude mouse tumorigenicity of different EBV-converted Ramos sublines, or the expression of differentiation markers such as insulin receptor, surface IgD, and the B2 surface antigen. Moreover, EBV-converted sublines of BJAB differed in their NK sensitivity, in spite of closely similar expression of these markers. NK-sensitive Ramos and BJAB sublines induced a stronger proliferative response upon confrontation with allogeneic lymphocytes than their NK-resistant counterparts. This suggests that the target cell may play an active role in triggering the lytic interaction. There was no correlation between this property and any of the other parameters studied.

Floating pulmonary embolus: unusual cause of recurrent syncope

A 69-year old woman was admitted because of recurrent syncopal episodes. In hospital, she had repeated attacks of near fainting or syncope when she was turned into the left decubitus position. Continuous arterial pressure monitoring revealed that severe hypotension initiated these events. Secondarily, the heart rate dropped markedly. The symptoms quickly reversed when the patient was turned back into the supine or right decubitus position. Angiography revealed a large, riding and partly floating pulmonary embolus that obstructed the pulmonary circulation to a variable degree, apparently influenced by the patient's body position. During subsequent emergency surgery the angiographic findings were confirmed. It appears that the severe hypotensive episodes were caused by intermittent high degree obstruction of the pulmonary circulation by the floating pulmonary embolus, a mechanism that, to our knowledge, has not previously been described as a cause of recurrent syncope.

[Echocardiographic study for optimizing therapy with physiologic heart pacemakers--the relevance of mitral valve motion]

The hemodynamic effects of the AV-intervals 50, 150 and 250 ms were studied in 19 patients with VDD pacemakers and compared to VVI stimulation and 12 normal individuals. LV dimensions and systolic and diastolic time intervals were measured with echo-phonoapexcardiography. The amplitude of LV-contraction, LV enddiastolic diameter, PEP, LVET and PEP/LVET significantly improved with physiological pacing when compared to VVI-stimulation. The optimal AV-interval was 50 ms in 8 patients, 150 ms in 7 and 250 ms in 4. Mitral valve closure (128 +/- 13 ms) and PEP (193 +/- 19) were grossly delayed in comparison to normal individuals. With increasing AV-intervals PEP and the onset of rise in the apexcardiogram were not changed but mitral valve closure occurred earlier, being 128 +/- 13 ms at AV = 50, 82 +/- 36 ms at AV = 150 and 20 +/- 73 ms at AV = 250. Simultaneously LV-filling time normalized for cycle length decreased from 50 +/- 5% to 45 +/- 8% and 38 +/- 10% respectively. In the presence of early mitral valve closure there was a late mitral notch, which occurred 10 +/- 20 ms after the onset of rise of the apexcardiogram. Thus the onset of the isovolumic contraction period was defined. In patients with VDD pacemakers therefore, echocardiography allows measurements of LV function, of the late onset of systole, and of mitral valve closure, which depends on the previous PR-interval. These values need to be considered in programming the optimal AV-interval and cannot be derived from normal individuals.

Chromosomal translocations activating myc sequences and transduction of v-abl are critical events in the rapid induction of plasmacytomas by pristane and abelson virus

Plasmacytomas with short latent periods can be induced in BALB/c mice by a single intraperitoneal (i.p.) injection of 0.5 ml pristane followed 20-40 d later by an injection of Abelson virus. The karyotypes of 18 such tumors were determined; 10 of these had rcpt 12;15, 5 had rcpt 6;15 and 3 had no translocations, but two of these have been shown to have interstitial deletions of chromosome 15. The specific breakpoints were the same as described in pristane-induced plasmacytomas, i.e., at 15D2 /3, 6C2 , and 12F2 . Near diploid karyotypes and trisomy of chromosome 11 were frequently seen. All of the Abelson-plus-pristane-induced plasmacytomas (ABPC) were studied as transplanted tumors, contained integrated v- abl sequences, and actively transcribed v- abl mRNA. All but one of these tumors contained abundant myc RNA transcripts. The shortness of the latent periods of the ABPC suggests that the rcpt 12;15 and rcpt 6;15 occur soon after pristane administration and are present at the time Abelson virus is introduced. In this form of plasmacytomagenesis , activated v- abl genes appear to bypass other genetic changes that require a much longer period of time in pristane plasmacytomagenesis . Nonetheless, the consistent finding of chromosome-15 alterations and abundant myc expression in these plasmacytomas emphasize the apparent need for multiple events even in the genesis of some tumors induced by rapid transforming viruses.

[The effect of amiodarone on thyroid gland function]

Plasma concentrations of T4, FT4, T3, rT3 and TBG, as well as of TSH before and after stimulation with TRH were studied in 25 patients, who had been treated with amiodarone for up to nine years. At the beginning of therapy, all the parameters mentioned above were found to be in the normal range in all patients. After two months of therapy, T4 had increased from 100 nmol/l +/- 24 nmol/l to 155 nmol/l +/- 32 nmol/l (p less than 0.01), and FT4 from 22 pmol/l +/- 10.5 pmol/l to 32 pmol/l +/- 8 pmol/l (p less than 0.01). T3 had decreased to the lower normal range (n.s.). TBG showed no significant changes. The TRH-tests had been normal in the beginning, but they remained positive in only 20% of the cases. At the end of the study, rT3 exceeded the normal range in all 25 patients. Two patients developed definite hyperthyroidism with elevations of T3 up to 4.7 nmol/l and 7.5 nmol/l, respectively. In one of them, we decided to discontinue amiodarone. Testing of thyroid function under antithyroid drug therapy revealed a hyperfunctioning autonomous adenoma, which was successfully eliminated by radioactive iodine therapy. In the other patient, it was not possible to withdraw amiodarone, so we initiated long-term treatment with antithyroid drugs. Our data support the assumption that amiodarone causes an impairment of the peripheral conversion of T4 to T3. As a result, one finds elevated serum concentrations of T4, which, in combination with the mainly negative TRH-test, must not be interpreted as proof of a hyperthyroid metabolic state being present. Hyperthyroidism is confirmed only if serum concentrations of T3 are also elevated.