Lymphocyte-induced angiogenesis factor is produced by L3T4+ murine T lymphocytes, and its production declines with age

Lymphocyte-induced angiogenesis factor (LIA) is a product of T lymphocytes which has been shown to stimulate new vessel formation. Because immune senescence most profoundly affects T lymphocyte functions, we suspected that LIA production would decline with age. An assay for angiogenesis stimulated by allogeneic reaction was performed by injecting spleen cells from young or old donor mice into the skin of irradiated allogeneic recipient mice. The spleen cells from young mice induced a significantly greater number of vessels than did cells from older mice. In additional experiments, spleen cells from young and old animals were treated with a monoclonal antibody GK 1.5) directed at the L3T4 antigen on murine T helper lymphocytes. Such treatment significantly reduced the new vessel formation induced by young lymphocytes but had no effect on that induced by lymphocytes from old animals. Studies employing indirect immunofluorescence demonstrated that the proportion of L3T4+ cells in the mononuclear fraction of splenocytes was nearly identical in both young and old mice. From these investigations we can conclude that (1) L3T4+ lymphocytes are responsible for LIA production, and (2) production, like that of other T lymphokines, declines with age.

Tumor vasculature in young and old hosts: scanning electron microscopy of microcorrosion casts with microangiography, light microscopy and transmission electron microscopy

Tumor growth in vivo is dependent upon new blood vessel formation. When B16-F10 melanoma cells are implanted subcutaneously in young (3 mo) and old (24 mo) C57BL/6 mice the rate of growth is dependent on the age of the mice. This study involved a wide range of histological and microscopic techniques but was limited primarily to the initial phase of tumor growth. Stereological point counting from light microscopy (LM) of standard histological sections has been used to yield data regarding blood content. Tumor-bearing mice were perfused through the aorta with a fixation solution and were infused with a low-viscosity radiopaque gel (Microfil) or resin (Mercox). Soft x-rays of the whole animal were used for identifying the feeding vessels to the tumor. Tumors with Microfil were sliced and used for microangiography and light-microscopic observation while those with resin were used to make corrosion casts for scanning electron microscopy (SEM). The different characteristics of the tumor blood vessels in different aged mice were most obvious through SEM of vascular corrosion casts. In comparison with tumors in young mice those of similar size in old hosts had more necrosis, reduced presence of angiogenic features, decreased vessel density, reduced penetration into the tumor, and enhanced tortuosity of the vessel lumen. Transmission electron microscopy (TEM) revealed incompletely developed wall structure of the vessels regardless of host. The above results are consistent with the hypothesis that retarded angiogenesis may be responsible in part for the limited growth of tumors in old hosts.

The change in aggressiveness of neoplasms with age

With aging, tumors occur more frequently. The "malignant" characteristics of tumors (ie, rapid growth and metastases), however, appear to be less prominent in the elderly. In experimental tumor models, similar observations have been recorded. The reason for this phenomenon could be that tumors (ie, malignant cells) are different in different-aged hosts. Alternatively, host features such as the fibrotic, angiogenic, or immune response may be altered by the aging process and may render the host "soil" less fertile for "malignant" tumor growth. Indeed, experimental evidence has supported the importance of each of these host features. The significance of the exploration and eventual understanding of the age-related change in tumor behavior extends beyond clinical geriatric medicine; it may, in fact, involve the very unraveling of some of the basic biology of both tumor control and the aging process itself.

Raised immunoglobulin concentrations in bronchoalveolar lavage fluid of healthy granite workers

Immunoglobulin concentrations and lymphocyte counts were determined in bronchoalveolar fluid obtained from nine symptomless, healthy, non-smoking granite workers (mean age 45.6, range 22-56 years) and nine normal, non-smoking, non industrial controls (mean age 22.8, range 21-32 years). The proteins were measured in unconcentrated lavage fluid by means of a solid phase, enzyme linked immunosorbent assay. IgG and IgA concentrations were three times greater in lavage fluid from granite workers than the samples from non-industrial controls (p less than 0.02). Eight of nine normal volunteers (89%) had no detectable IgM (less than 30 ng/ml) in the lavage fluid whereas eight of nine (89%) granite workers had detectable IgM (chi 2 = 8, p less than 0.01). Lymphocyte counts in lavage fluid from the workers were significantly greater (15.5%) than control counts (5.6%; p less than 0.05). The normal albumin concentration suggests that differences in permeability do not account for all of the increased immunoglobulin concentrations found in granite workers' lavage fluid and that some immunoglobulin is locally synthesised. It is concluded that occupational exposure to granite dust is associated with an increased proportion of lymphocytes and an increased concentration of immunoglobulin in lavage fluid that may reflect a subclinical immune inflammatory response.

The effect of disulfiram on cyclophosphamide-mediated myeloid toxicity

We have previously shown that disulfiram (DSF) blocks the urotoxicity of cyclophosphamide (CYT) in mice and increases the oncolytic effect of CYT in the L1210 murine leukemia. However, mice treated with CYT and DSF appeared to have longer-lasting neutropenia than animals treated with CYT alone. To determine whether DSF uroprotection of CYT-treated mice was associated with increased myeloid toxicity, we examined the effects of DSF plus CYT treatment on the bone marrow granulocyte/macrophage progenitor cell (GM-CFC). Marrow cellularity and GM-CFC numbers were analyzed at 1, 2 and 3 days after injection of CYT (62.5 or 125 mg/kg) or CYT plus DSF (200 mg/kg). CYT alone caused a decrease in total marrow cellularity varying from 20% to 50% of control. Animals given CYT plus DSF had a somewhat greater decrease in total marrow cellularity than those treated with CYT alone. However, in mice treated with CYT plus DSF, the GM-CFC were relatively well preserved and the recovery of the GM-CFC was not prolonged by DSF. It appears from these studies that the acute toxic effect of CYT on the granulocyte/macrophage progenitor cells is not enhanced by DSF.

A human myeloma-produced monoclonal protein directed against the active subpopulation of von Willebrand factor

The authors present a study of a human myeloma-produced monoclonal protein (IgG-k) directed against von Willebrand factor that caused an acquired von Willebrand's disease (vWD)-like syndrome. The illness was characterized by upper gastrointestinal bleeding, prolonged bleeding time, decreased platelet adhesiveness, lack of platelet aggregation in response to ristocetin, and a qualitatively abnormal Factor VIII related antigen (vWF) by two-dimensional immunoelectropheresis. Patient plasma or IgG fraction mixed with normal platelet-rich plasma completely inhibited aggregation with ristocetin, but patient platelets resuspended in normal plasma aggregated normally with ristocetin. VWF was markedly elevated and the two-dimensional immunoelectropheresis of vWF revealed a vWD type II-like pattern with an absence of the higher molecular weight forms of the vWF. Marked inhibitory activity was observed in the ristocetin cofactor assay but disappeared at the highest dilutions of patient plasma used in the assay. Infusion of cryoprecipitate following plasmapheresis led to a correction of the bleeding time, improvement in platelet adhesiveness, transient disappearance of inhibitory activity in the Factor VIII ristocetin cofactor assay, and no significant normalization of two-dimensional immunoelectropheresis of vWF. This case demonstrated a myeloma-associated monoclonal antibody that interacted specifically with that part of the Factor VIII molecule necessary for Factor VIII ristocetin cofactor activity, normal platelet adhesiveness, and bleeding time.

Slower B16 melanoma growth but greater pulmonary colonization in calorie-restricted mice

Recently, it has been demonstrated that the immune function is preserved longer and spontaneous tumors occur less frequently in calorie-restricted (but not malnourished) mice. In the present report the effect of similar dietary manipulation on tumor growth, metastases, and survival was studied. C57BL/6 mice were fed regular laboratory diets, either restricted in calories or not restricted, and later inoculated with B16 melanoma sc, iv, or ip. Local tumor growth was found to be slower; however, survival after ip injection was no different, and the number of pulmonary metastatic colonies after iv injection was greater for the underfed mice. In this weakly immunogenic tumor model, factors in addition to immunity influenced tumor growth and were altered by calorie restriction.

The age-related decline in antibody response is transferred by old to young bone marrow transplantation

The immune response declines with age. This decline correlates with thymic involution and involves primarily a loss in T-cell function, whereas humoral immunity is more variably affected. In the current experiments we have measured immunoglobulin synthesis in vitro after mitogen stimulation, and specific antibody response after vaccination. We found that the response to pokeweed mitogen by non-specific immunoglobulin production, and the response to vaccine was shown to be transferred to lethally irradiated young mice by old to young bone marrow transplantation. Both pokeweed mitogen and tetanus toxoid require T-cell help for optimal response, and, therefore, our observations are in accordance with the age-associated decline in T-cell immunity. The finding that young hosts transplanted with old bone marrow produce less antibody than young hosts transplanted with young bone marrow highlights the importance of the decline in cellular function with age.

Low-dose cytosine arabinoside in the myelodysplastic syndromes and acute myelogenous leukemia

Seven patients with a myelodysplastic syndrome or "smoldering" acute myelogenous leukemia were treated with cytosine arabinoside in low dosage. Four patients experienced transient, partial responses characterized by improved peripheral blood counts, cessation of transfusion requirements, and a decreased incidence of infection. Treatment was associated with significant, transient hematologic toxicity. The appropriate clinical role of low-dose cytosine arabinoside remains uncertain.

Interleukin-2 and aging: decreased interleukin-2 production in healthy older people does not correlate with reduced helper cell numbers or antibody response to influenza vaccine and is not corrected in vitro by thymosin alpha 1

The capacity of lymphocytes obtained from healthy young or old volunteers to produce interleukin-2 was measured and the results were compared with other measures of immune function. The in vitro effect of thymosin alpha 1 on interleukin-2 production was also measured. Interleukin-2 was lower in lymphocytes from the elderly, and individuals with low production also had lower proliferative responses in vitro to phytohemagglutinin. These individuals did not have a reduced helper T-cell number, abnormal ratio of helper to suppressor T-cells or reduced antibody production in response to vaccine. Thymosin alpha 1 did not have a consistent effect on interleukin-2 production.

Corynebacterium parvum augments antibody production in splenectomized mice and mice with sham operations

The antibody response to a variety of antigens, including pneumococcal polysaccharides, is diminished in splenectomized (splx) mice. We investigated the capacity for the biological response modifier Corynebacterium parvum to augment antibody production in splx and sham-splx mice inoculated with pneumococcal polysaccharides and tetanus toxoid. As expected, antibody response to tetanus toxoid was similar in both splx mice and sham-splx mice. C. parvum augmented anti-tetanus toxoid antibody in both sham-splx (P less than 0.05) and splx mice (P less than 0.05). Antibody against pneumococcal type 3 polysaccharides was decreased in splx mice compared with sham-splx mice (P less than 0.05). Both groups treated coincidently with C. parvum and pneumococcal type 3 polysaccharides demonstrated a biphasic antibody response which was greater than that observed in saline-treated controls (sham-splx, P less than 0.001; splx, P less than 0.05). Whereas the secondary peak response to pneumococcal type 3 polysaccharides after treatments with C. parvum appears to be due to persistent elevations of immunoglobulin G and immunoglobulin M in sham-splx mice, it is primarily due to antibody of the immunoglobulin G class alone in the splx mice.

Hormonal influences on growth of B16 murine melanoma

The influence of endocrine factors on B16 melanoma growth was investigated in young and old male mice to test the hypothesis that senescent hormonal changes account for the age-associated reduced tumor growth previously observed in our laboratory. Again it was demonstrated that tumors grow more slowly and to a lesser volume in old mice. For a test of whether senescent hormonal changes account for this tumor growth pattern, B16 was implanted into male and female C57BL/6 mice and tumor growth observed. In addition, young adult male mice were castrated and later B16 melanoma growth was determined. Tumor growth was similar in male and female mice. Contrary to our expectations, however, castrated male mice demonstrated larger tumor volumes, despite serum testosterone levels similar to those of old mice. Furthermore, after iv tumor cell injection, the occurrence of pulmonary colonies was greater in castrated mice. These observations indicate the importance of hormonal factors in this commonly explored tumor system. With regard to aging and tumor growth, however, senescent sex hormone changes probably do not account for the slower tumor growth observed in aged animals.

Specific antibody synthesis in vitro. III. Correlation of in vivo and in vitro antibody response to influenza immunization in young and old subjects

Young and elderly volunteers received a trivalent influenza vaccine and blood samples were obtained prior to, 1 week and 3 weeks after immunization. Plasma antibody levels and the capacity for in vitro lymphocyte synthesis of specific anti-influenza antibody were assessed. Additionally, prior to immunization, peripheral blood mononuclear cells were cultured in the presence of antigen, and the capacity for in vitro immunization was determined. Antibody response was therefore measured after in vivo and in vitro immunization. After in vivo immunization, plasma antibody level and in vitro synthesis capabilities were significantly greater in the young subjects, and these assays correlated significantly. The capacity for in vitro immunization was also greater in the young, but the difference did not reach statistical significance and there was no correlation with in vitro immunization potential and the response after in vivo vaccination. Assessment of in vitro antibody synthesis after vaccination however, may prove a useful tool for probing immune deficient states and testing the success, in vitro of various immune reconstitution measures.

Horner's syndrome: an unusual presentation of Hodgkin's disease

Horner's Syndrome (ptosis, anisocoria, and anhydrosis) developed in a 22-year-old woman. A mediastinal mass was noted on chest x-ray. Further evaluation led to a diagnosis of Hodgkin's disease, nodular sclerosis type. Horner's syndrome is an unusual initial manifestation of Hodgkin's disease, and, in this case, it was due to oculosympathetic damage from mediastinal compression. Because the potential for cure is high in Hodgkin's disease, this diagnosis should be considered in patients presenting with Horner's syndrome.

Effect of thymosin alpha one on specific antibody response and susceptibility to infection in young and aged mice

The antibody response to a variety of antigens has been shown to diminish with age. We investigated the capacity for Thymosin Alpha One (T alpha 1) treatment to augment antibody production in tetanus toxoid (TT) and pneumococcal capsular polysaccharide (PN) inoculated young and old mice. We also measured survival of these immunized mice after aerosol exposure to Streptococcus pneumoniae. As predicted antibody response to TT, but not PN, was significantly reduced in the old animals and T alpha 1 augmented antitetanus antibody in both young and old mice. T alpha 1 did not have an effect on anti pneumococcal antibody production. All mice that had received PN did have an antibody response, yet survival after exposure to the organism was strikingly less in the old animals. Our data support the contention that antibody response to T-dependent antigens (such as tetanus toxoid) falls with aging but can be reconstituted somewhat by thymic factors. Furthermore, for T-independent antigen (such as pneumococcal capsular antigens) the age-related changes are less evident. In the latter situation, the presence of a brisk antibody response after vaccination was not sufficient to prevent pneumonia and death in old animals.

Transfer of age-associated restrained tumor growth in mice by old-to-young bone marrow transplantation

B16 melanoma and Lewis lung carcinoma grow more slowly in aged mice. Immunesenescent changes may account for this age-related difference. To test for the effect of immune deficiency on the growth of these tumors, we treated young mice with an immunosuppressive dose of radiation and then observed tumor growth. We also radiated young mice to a higher (lethal) dose and then rescued them with either young or old bone marrow transfusion. Tumors grew more slowly in radiated mice than controls and in those reconstituted with old bone marrow. These findings support the concept of immunesenescent-related reduced tumor growth.

Pure red blood cell aplasia associated with chronic Epstein-Barr virus infection: evidence for T cell-mediated suppression of erythroid colony forming units

A prominent T cell suppressor response is known to develop and inhibit the polyclonal B cell activation induced by Epstein-Barr virus infection. Exuberant T suppressor cell activity suppressing erythropoiesis has been demonstrated in certain cases of pure red blood cell aplasia. We studied a 19-year-old man who developed pure red cell aplasia after Epstein-Barr virus infection. Over a 70-week period, lymphocyte function and serologic evidence for chronic Epstein-Barr virus infection was demonstrated. On two separate occasions, no evidence for serum inhibition of bone marrow erythroid colony formation in methylcellulose was observed. Growth of granulocyte-macrophage progenitors from the patient's bone marrow was normal. The patient's bone marrow cultures yielded 81.6 +/- 11.2 erythroid colony-forming units per 10(5) bone marrow mononuclear cells, which was approximately 50% of levels in normal control bone marrow. Culture of peripheral blood mononuclear cells for erythroid burst-forming units revealed minimal growth (less than 1% of control values). Depletion of bone marrow T cells by E-rosetting resulted in a threefold increase in erythroid colony-forming units in the patient's bone marrow but no significant increase from control bone marrow. In the patient, addition of bone marrow T cells but not peripheral blood T cells significantly suppressed autologous erythroid colony-forming unit proliferation from T cell-depleted bone marrow. These results suggest that the pure red cell aplasia associated with chronic Epstein-Barr virus infection in this case was caused by bone marrow T cell-mediated suppression of erythroid colony-forming unit proliferation.

Influenza and aging: age-related changes and the effects of thymosin on the antibody response to influenza vaccine

Despite massive immunization programs, influenza remains a major cause of morbidity and mortality for elderly people. This may occur because immune senescent recipients may respond to vaccination with inadequate antibody production. We measured antibody response to the trivalent 1983-1984 influenza vaccine in young and elderly volunteers and found a significantly reduced response in the latter. The age-associated decreased antibody production was also observed in lymphocyte cultures in which specific antiinfluenza antibody synthesis was measured. In these cultures, however, the addition of a thymic hormone preparation (either thymosin fraction 5 or thymosin alpha 1) was shown to enhance specific antibody synthesis to a greater extent in the cultures established from the elderly volunteers. If this in vitro observation of thymosin induced increased antibody production reflects what might occur in a clinical trial in which elderly subjects receive thymosin coincident with vaccine, greater protection against influenza infection may result.

Specific antibody synthesis in vitro. II. Age-associated thymosin enhancement of antitetanus antibody synthesis

A decline in T cell function accounts for many of the observed age-related deficient immune responses. Specific antibody response to many antigens requires T cell cooperation, and deficient antibody response to such antigens has been demonstrated with aging. In an effort to assess the potential reconstitutive capacity of Thymosin Fraction 5, in vitro antitetanus antibody production was measured in tetanus toxoid booster-immunized young and old volunteers. 22 young and 12 old volunteers were immunized with tetanus toxoid and plasma antitetanus antibody and in vitro lymphocyte production of antitetanus antibody was measured. Plasma antitetanus antibody response was significantly greater in the young. In vitro antitetanus antibody synthesis was negligible prior to immunization and peaked in cultures established 1 week after immunization from both young and old. When Thymosin Fraction 5 was added to the cultures, however, there was a dose-related enhancement of antibody synthesis in 7 of 10 from the group of elderly volunteers, but only 3 of 12 from the younger group. Our data indicate that specific antibody response is deficient in the elderly, but can be enhanced in vitro by thymosin. A future clinical trial of thymosin as an adjuvant to active immunization for the elderly is warranted.

Specific antibody synthesis in vitro. I. Technical considerations

Previously described methods for measuring specific antibody production in vitro are complex and frequently require the addition of a non-specific mitogen and 2 or more separate steps including a lymphocyte culture and then an antibody assay. In this report we present further details regarding a 1-step, non-mitogen requiring assay for specific antibody synthesis combining microculture and enzyme-linked immunoassay techniques. Peripheral blood mononuclear cells from recently immunized subjects are cultured in antigen-coated plastic wells and the specific antibody produced and adhered to the solid-phase antigen is measured in an enzyme-linked immunoassay. The production of specific antibody in vitro did not occur in lymphocyte preparations that were frozen, thawed and incubated, nor did it occur in cultures containing puromycin. T cell separation and remixture experiments indicated that T cells provide significant augmentation under the conditions of this assay. It is apparent that the antibody measured was synthesized in vitro and that cell-cell interactions are operant. The assay may prove useful in the assessment of immune competence and in determining in vitro the effect of certain biologic response modifiers on antibody production.

Immunoglobulin production in burned patients

To further characterize immunologic alterations found in thermally injured patients, a series of experiments dealing with lymphocyte immunoglobulin production were performed. Circulating immunoglobulin levels were measured, plasma antitetanus toxoid was quantitated, and lymphocytes were cultured and in vitro immunoglobulin production recorded. Postburn circulating immunoglobulins were initially depressed but returned to normal at a variable rate. We found a normal response to rechallenge with tetanus toxoid. However, culture of lymphocytes in vitro showed that lymphocytes from burned patients had an elevated spontaneous immunoglobulin production and no augmentation with mitogen stimulation. This alteration in immunoglobulin production was not found in a group of postoperative or trauma patients and appears to be unique to burned patients.

Vinblastine pharmacokinetics measured by a sensitive enzyme-linked immunosorbent assay

Radioimmunoassays have been developed for pharmacokinetic studies of vinblastine. Although highly sensitive, radioimmunoassays are both expensive and potentially biohazardous. This paper describes a new immunoassay procedure, enzyme-linked immunosorbent assay, which uses enzymatic activity rather than radioactivity as an index of drug concentration. Antiserum to vinblastine was attached to the plastic wells of microtiter plates and incubated in the presence of varying amounts of vinblastine which had been conjugated to alkaline phosphatase. After brisk washing of the wells, p-nitrophenylphosphate was added to each well. The amount of enzyme present in the well was quantitated by the production of the chromophore, p-nitrophenol. The concentration of free vinblastine present in a given sample was inversely proportional to the enzymatic activity. The enzyme-linked immunosorbent assay is capable of detecting as little as 5 pg of either vinblastine or vincristine and is not cross-reactive with other commonly used oncolytic agents. A pharmacokinetic study was performed in rats administered vinblastine i.v., and a triphasic elimination curve was obtained. These results indicate that the enzyme-linked immunosorbent assay provides a nonradioactive, inexpensive, and sensitive method to monitor plasma levels of vinblastine. Further, since the antibody is cross-reactive with vincristine, it would appear that similar data could be generated for vincristine.

T cells and erythroid burst forming units in chronic lymphocytic leukemia

Substantial evidence exists indicating T cell abnormalities in chronic lymphocytic leukemia (CLL). There is also evidence that the T cell is an important source of burst promoting activity (BPA) for the peripheral blood (PB) erythroid burst forming unit (BFU-e). We studied the BPA of T cells and response of BFU-e in normals and untreated early stage B cell CLL patients in a methylcellulose colony assay. Normal null cell cultures grew significantly more BFU-e than CLL null cell cultures. Addition of autologous T cells to normal or CLL null cells significantly increased BFU-e only in normals. Allogeneic coculture of T cells from CLL patients with null cells from normals yielded normal responses of BFU-e in five of six cases. In contrast, allogeneic coculture of normal T cells with CLL null cells yielded a normal response in only one of six studies. Furthermore, adding increasing quantities of autologous or normal allogeneic T cells to CLL null cells did not augment the BFU-e response. Accounting for the expanded lymphocyte pool in CLL, BFU-e are decreased in concentration but the absolute number is normal or increased. The decrease in concentration could be secondary to expansion of the null cell fraction in CLL by pre-B cells. CLL T cells appeared to augment normal allogeneic PB BFU-e in a normal fashion, whereas, in several cases, CLL BFU-e were hyporesponsive to autologous or normal allogeneic T cells. It is therefore apparent that in untreated early stage B cell CLL, erythroid progenitor cells are present in the peripheral blood but are diluted in an expanded null cell compartment and may, in some cases, be hyporesponsive to T cell BPA. T cell BPA of CLL T cells in this early stage of disease is preserved.

Hemorrhagic diathesis in multiple myeloma

Hemorrhage occurs during the clinical course in 15% of patients with multiple myeloma. We recently treated a patient with myeloma who had postoperative bleeding and hematuria despite normal coagulation parameters and platelet count. Platelet function studies revealed markedly abnormal aggregation to all stimulants. Plasma exchange successfully reversed in vitro and in vivo bleeding abnormalities.

Experimental tumors and aging: local factors that may account for the observed age advantage in the B16 murine melanoma model

In the B16 murine melanoma model tumor growth has been shown to be slower in animals of advanced age. One feature associated with this slower growth has been prominent fibrosis demonstrated in biopsies of the tumor in older animals. We have performed experiments to examine the fibrotic response in young and old mice. In non-tumor bearing animals the capacity to regain skin strength after surgical laceration and healing by primary intention was greater in old mice. Histologic preparations suggested a more prominent fibrosis at the wound site. The animals who were injected subcutaneously with B16 melanoma and treated with L 3,4-dehydroproline (an inhibitor of collagen synthesis) local tumor growth was significantly enhanced only for the old animals. Although this inhibition of collagen synthesis produced a differential growth enhancement, there remained a significant difference in tumor volume between young and old animals. We conclude that fibrogenesis is an important host defense for containing local tumor growth and that this mechanism is preserved if not enhanced in mice of advanced age. Nevertheless other factors are needed to account completely for the observed age-advantage in the B16 melanoma model.

B16 murine melanoma and aging: slower growth and longer survival in old mice

The growth characteristics and colonization potential of a transplantable melanoma administered to young (3 mo) and old (24 mo) C57BL/6 mice were investigated. After sc injection of B16-F10 melanoma cells, tumor growth was slower, and final tumor volume was less in the older mice. Furthermore, after iv injection of B16-F1 melanoma cells, the number of pulmonary colonies was also less, and the survival was greater in the older mice. These findings indicate an age advantage in this experimental tumor model that may be attributed to either physical or immunologic factors.

Bronchogenic cancer, metastases, and aging

Previously reported large autopsy series have indicated that elderly patients who die of cancer are less likely to have metastatic disease than their younger counterparts. This observation could be explained if survival were shorter in the elderly population and patients died with smaller tumor burdens. The authors analyzed Medical Center Hospital of Vermont (MCHV) Tumor Registry data on primary lung cancer with respect to age. As in the reported autopsy series, at the time of diagnosis elderly patients were less likely to have metastatic disease. Further analysis was undertaken of the patients from this series who died and were autopsied at MCHV. Although the total numbers were small, survival was not shorter in the advanced age groups. The authors suggest that elderly patients have slower tumor growth and less metastatic disease, not because of earlier diagnosis and shorter survival, but because of senescent host factors that impede aggressive tumor growth and spread.

Coexistent breast and vaginal granulocytic sarcoma

A 34-year-old woman developed a granulocytic sarcoma of the breast coincident with the development of acute myelogenous leukemia. Subsequent to the induction of leukemia remission, marrow relapse was preceded by development of breast and vaginal granulocytic sarcomas on two separate occasions. Granulocytic sarcoma is occasionally reported to involve reproductive organs, but the coexistence in two such organs is indeed rare. When granulocytic sarcoma occurs at other sites, it often precedes the development of overt leukemia. For this reason, granulocytic sarcoma should be considered in the differential diagnosis of a pelvic mass especially in a patient in whom blood smears reveal unusual or early forms.

Chronobiologic fluctuation of cyclophosphamide induced urinary bladder damage in mice

Cyclophosphamide is the most widely used alkylating agent in clinical medicine. The usefulness of this drug is often limited by its propensity to produce hemorrhagic cystitis. To be active cyclophosphamide must be metabolized by the mixed function oxidase system. It has been previously demonstrated that the oncolytic activity and host lethality of cyclophosphamide are dependent upon circadian fluctuations. When cyclophosphamide is administered i.p. to male mice there is a dose dependent increase in urinary bladder weight. Histopathologic examination of these bladders revealed hemorrhage, edema, inflammation and stretching of the epithelial lining. When administered i.p. at 4-h intervals throughout a 24-h time period, cyclophosphamide produced maximum bladder damage when administered at 0500 and 1700 and little or no damage to the bladder when administered at 0100 or 1300. These studies suggest that cyclophosphamide induced cystitis, a toxicity resulting from the metabolic production of acrolein, may also be dependent upon chronobiologic fluctuations.

Local immune response in basal cell carcinoma: characterization by transmission electron microscopy and monoclonal anti-T6 antibody

We examined lesional and perilesional skin from nine basal cell carcinomas occurring in six patients to determine the role of local immunity in the pathogenesis of these neoplasms. Marked hyperplasia of Langerhans cells and indeterminate cells as defined by monoclonal anti-T6 antibody was observed in lesional and perilesional skin of most specimens. Ultrastructurally, Langerhans cells were observed in the dermis and above the basement membrane zone where mitotic activity was documented. Apposition of Langerhans cells and indeterminate cells with degenerating and necrotic neoplastic keratinocytes and with exocytotic lymphocytes was frequently encountered. Zonal necrosis of carcinoma cells was often immediately peripheral to exocytotic lymphoid cells. These observations support the contention that an active local immunologic response is related to the biologic behavior of some basal cell carcinomas.

Pure RBC aplasia and myasthenia gravis. Coexistence of two diseases associated with thymoma

Pure RBC aplasia (PRCA) and myasthenia gravis (MG) are occasionally associated with thymoma, although the occurrence of all three in a single patient is rare. We describe a patient in whom PRCA and MG occurred in conjunction with the presence of serum autoantibodies, evidence for a serum inhibitor of erythropoiesis, and elevation of circulating thymosin alpha 1. Although a thymoma could not be detected before death, postmortem examination of the mediastinum found scattered cells within a nodule, suggestive of a lymphoepithelial thymic neoplasm.

Immunoblastic lymphadenopathy: failure of, rather than lack of immunoregulation

The lymphoid proliferation characteristic of immunoblastic lymphadenopathy is polyclonal and of B cell lineage. This proliferation of B cells could result from an inherent B cell defect, prolonged and pronounced antigenic stimulation, or inadequate immunoregulation. We recently evaluated a patient with this disorder and found excessive T cell mediated in vitro suppression of both the autologous and allogeneic blastogenic response to mitogen. This enhanced in vitro suppression suggests that the clinically observed lymphoid proliferation in this patient occurred because of autonomous or excessively stimulated B cells and not because of a lack of functional suppressor cells.

Cimetidine and the immune response. I. In vivo augmentation of nonspecific and specific immune response

Cimetidine is a commonly prescribed histamine antagonist useful in the treatment of peptic ulcer disease. Histamine receptors are found on suppressor T cells and therefore we expected to observe enhanced immune responsiveness in animals treated with this drug. Mice given daily subcutaneous injections of cimetidine (25 or 100 mg/kg) were found to produce approximately twice as much specific antibody in response to tetanus toxoid immunization. Furthermore, mitogen-stimulated splenocytes from cimetidine-treated animals proliferated to a greater extent and produced more immunoglobulin in vitro than controls. These observations offer direct in vivo evidence for immunomodulation by cimetidine.

Effect of disulfiram (tetraethylthiuram disulfide) amd diethyldithiocarbamate on the bladder toxicity and antitumor activity of cyclophosphamide in mice

Cyclophosphamide is the most commonly prescribed alkylating agent in clinical medicine. The usefulness of cyclophosphamide is often limited, however, by its propensity to cause hemorrhagic cystitis especially in children or patients receiving concomitant radiotherapy. Administration i.p. of cyclophosphamide at doses of 100 mg/kg or more to mice produced a significant increase in urinary bladder weight within 48 hr of treatment. The present studies demonstrate that disulfiram prevented cyclophosphamide-induced bladder damage when administered p.o. within 1 hr of cyclophosphamide treatment. Diethyldithiocarbamate, a sulfhydryl-containing metabolite of disulfiram, had identical uroprotective activity. Unlike disulfiram, diethyldithiocarbamate was effective only when administered 2 to 4 hr after cyclophosphamide. Disulfiram augmented slightly the antitumor activity of cyclophosphamide against L1210 murine leukemia in vivo when administered 30 min prior to cyclophosphamide. In contrast, diethyldithiocarbamate had no effect on the antitumor activity of cyclophosphamide when administered 4 hr after cyclophosphamide.

Demonstration of non-specific B-cell stimulation in patients with cirrhosis

Using a sensitive enzyme-linked immunosorbent assay technique to measure immunoglobulins produced by peripheral lymphocytes, patients with cirrhosis with, and without, hypergammaglobulinaemia were found to produce significantly more spontaneous IgG than controls (p less than 0.005). There was no difference in IgG production when pokeweed mitogen, a T-cell dependent B-cell mitogen, was added to the system. Contrary to our findings in a T-cell proliferative assay, there was no evidence of increased prostaglandin-producing suppressor cell activity in this system. To study the importance of B-cell stimulation in cirrhotic hyperglobulinaemia, normal mononuclear cells were exposed either to cirrhotic or to control sera before measuring spontaneous IgG production. Cells exposed to cirrhotic sera produced significantly more IgG than those exposed to the control sera (p less than 0.02). These findings suggest that non-specific B-cell activity occurs with patients in cirrhosis and it is argued that the severity of the hypergammaglobulinaemia in patients with cirrhosis is more likely to depend on the degree of non-specific B-cell stimulation than on the competence of the immunoregulatory system.

Specific in vivo and in vitro antibody response to tetanus toxoid immunization

Booster immunization of normal individuals with soluble tetanus toxoid (TT) produced significant levels of plasma anti-tetanus IgG and IgM detectable by an enzyme linked immunosorbent assay (ELISA). Similar changes in circulating anti-TT antibody were found in mice following primary immunization. There was. however, no correlation observed between circulating anti-TT antibody response and the proliferative response of peripheral blood mononuclear cells exposed to soluble TT in the immunized individuals. The capacity of the peripheral blood mononuclear cells to produce specific anti-TT antibody in vitro was evaluated using a new microculture antibody synthesis enzyme-linked assay (MASELA). It was observed that the production of specific antibody in vitro correlated with the circulating anti-TT antibody level and not with the proliferative response. Peripheral blood mononuclear cells from these recently secondary immunized individuals produced greater specific anti-TT antibody when cultured in TT coated plastic wells than did controls. The potential utility of this technique in assessing response to immunization and basic immune competence is discussed.

Emergence of acute non-lymphocytic leukemia in breast cancer patients

The appearance of acute non-lymphocytic leukemia (ANLL) in patients with other hematologic and non-hematologic malignancies is now a well recognized syndrome. These patients have an unusual form of leukemia with distinct clinical and morphological features. With improved therapy many cancer patients have experienced prolonged survival and cure. Some of these patients will develop ANLL as a consequence of their previous therapy, or for reasons associated with their primary tumor (host factors or common oncogenic virus). It is also possible that a fraction of these patients will develop the usual form of leukemia (de novo ANLL) that is unrelated to the underlying malignancy. Indeed, a statistical analysis assuming ANLL incidence rates to be unaffected by breast cancer or cancer therapy, predicted the occurrence of three new ANLL cases with a history of breast cancer in Wisconsin per year. Eleven patients with ANLL and a history of breast cancer were seen at the University Hospitals over a ten-year span (1969-1978). Clinical, morphological and cytogenetic features were examined and it was found that five of the eleven patients had features atypical for therapy related leukemia. Indeed, two of the patients had not received breast cancer therapy. The distinction between de novo and therapy related leukemia is important because remission and prolonged survival are more likely in the former and morbidity and mortality associated with therapy are more likely in the latter. We suggest that if features of de novo leukemia exist, despite previous therapy for underlying malignancy, intensive antileukemia therapy should be considered.

The prevention of cyclophosphamide-induced cystitis in mice by disulfiram

Cyclophosphamide administered intraperitoneally to mice at a dose of 100 mg/kg caused a dose related increase in urinary bladder weight within 48 hours of treatment. Disulfiram effectively prevented cyclophosphamide-induced increase in bladder weight when disulfiram was administered by either the oral or intraperitoneal route. Disulfiram (125 mg/kg) was most effective when given within one hour of cyclophosphamide treatment. These results suggest that disulfiram, unlike other putative protectants, is effective when administered orally.

Thymic dysfunction in chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is, in the great majority of cases, a neoplastic proliferation of B cells. The associated immunologic dysfunction accounts for many of the clinically associated phenomenon such as infection and second malignancies. Much of this dysfunction has been attributed to poor B-cell function. Functional impairment of the T-cell component is currently being elucidated. In the investigation of B cells. The associated immunologic dysfunction accounts for many of the clinically associated phenomenon such as infection and second malignancies. Much of this dysfunction has been attributed to poor B-cell function. Functional impairment of the T-cell component is currently being elucidated. In the investigation of B cells. The associated immunologic dysfunction accounts for many of the clinically associated phenomenon such as infection and second malignancies. Much of this dysfunction has been attributed to poor B-cell function. Functional impairment of the T-cell component is currently being elucidated. In the investigation of B cells. The associated immunologic dysfunction accounts for many of the clinically associated phenomenon such as infection and second malignancies. Much of this dysfunction has been attributed to poor B-cell function. Functional impairment of the T-cell component is currently being elucidated. In the investigation of B cells. The associated immunologic dysfunction accounts for many of the clinically associated phenomenon such as infection and second malignancies. Much of this dysfunction has been attributed to poor B-cell function. Functional impairment of the T-cell component is currently being elucidated. In the investigations reported herein, we further demonstrate the immune deficiency of CLL by measuring proliferation and immunoglobulin synthesis in response to mitogens. Stimulation of various cell fractions indicates that in certain cases there is deficient T-helper, while others T function appears intact. In 2 of 4 cases tested there was augmentation of ig synthesis when the CLL cells were cocultured with thymic epithelium. The implications of such in vitro modulation are discussed.

Processing of human beta-globin mRNA precursor to mRNA is defective in three patients with beta+-thalassemia

Nucleated bone marrow cells from normal individuals and from three patients with homozygous beta+-thalassemia were pulse-labeled with tritiated nucleosides. The processing of the newly synthesized globin mRNA precursors was monitored by inhibiting additional transcription with actinomycin D for 30 min. Human beta-globin mRNA is derived from its precursor via a series of reactions that generate processing intermediates. In nonthalassemic cells the precursor is processed efficiently to mature mRNA during the chase. In contrast, in beta+-thalassemic cells the processing of beta-globin RNA is defective. In one patient the beta-globin mRNA precursor turns over during the chase, but some of the intermediate RNAs accumulate and are not processed to mRNA. In two other patients a large fraction of the precursor and intermediate RNAs is not processed to mRNA. The alpha-globin mRNA precursor and intermediates are processed efficiently to mRNA-sized molecules in thalassemic and normal cells. The reduction in the rate of beta-globin but not alpha-globin RNA processing accounts for the alpha/beta globin mRNA imbalance in thalassemic erythroid cells. We discuss the possibility that the genetic lesions in beta+-thalassemia are at splicing signal sites within intervening sequences of the beta-globin gene.