A randomized phase 3 trial of gemcitabine with or without carboplatin in performance status 2 (PS2) patients (pts) with advanced (stage IIIB with pleural effusion or stage IV) non-small cell lung cancer (NSCLC)

7533

Background: The optimal treatment of patients with advanced NSCLC and PS2 has not been resolved. A retrospective analysis of 99 pts with PS2 in CALGB 9730 (Lilenbaum, JCO 2005) demonstrated improved survival associated with combination carboplatin- paclitaxel versus paclitaxel alone (median overall survival=4.7 vs. 2.4 mos., p=.019). Gemcitabine-carboplatin (GC) is an active doublet in advanced NSCLC and is at least as active as paclitaxel-carboplatin (PC) in PS2 pts (ECOG 1599, Tester ASCO 2004). A prospective validation of the activity of GC is needed, which is addressed by comparing GC versus gemcitabine (G) alone in this setting. Methods: 161 chemonaïve pts with advanced NSCLC and PS2 were randomly assigned to G 1250 mg/m2 alone on Days 1,8 or GC (G 1000mg/m2 Days 1,8 followed by C AUC 5 on Day 1). Cycles were repeated every 21 days for 6 cycles or until disease progression or intolerable toxicity. Primary endpoint was median survival. Conclusions: GC resulted in an improved response rate among NSCLC pts with PS2 over G alone. As expected, G3–4 toxicities were greater with GC. Overall survival data will be reported at the time of the meeting.

[Table: see text] [Table: see text]

Insulin-like growth factor signaling regulates zebrafish embryonic growth and development by promoting cell survival and cell cycle progression

Although much is known about the global effects of insulin-like growth factor 1 receptor (IGF1R)-mediated signaling on fetal growth and the clinical manifestations resulting from IGF/IGF1R deficiencies, we have an incomplete understanding of the cellular actions of this essential pathway during vertebrate embryogenesis. In this study, we inhibited IGF1R signaling during zebrafish embryogenesis using antisense morpholino oligonucleotides or a dominant-negative IGF1R fusion protein. IGF1R inhibition resulted in reduced embryonic growth, arrested development and increased lethality. IGF1R-deficient embryos had significant defects in the retina, inner ear, motoneurons and heart. No patterning abnormalities, however, were found in the brain or other embryonic tissues. At the cellular level, IGF1R inhibition increased caspase 3 activity and induced neuronal apoptosis. Coinjection of antiapoptotic bcl2-like mRNA attenuated the elevated apoptosis and rescued the retinal and motoneuron defects, but not the developmental arrest. Subsequent cell cycle analysis indicated an increased percentage of cells in G1 and a decreased percentage in S phase in IGF1R-deficient embryos independent of apoptosis. These results provide novel insight into the cellular basis of IGF1R function and show that IGF1R signaling does not function as an anteriorizing signal but regulates embryonic growth and development by promoting cell survival and cell cycle progression.

Experimental infections of pigs and mice with selected genotypes of Ascaris

Extending a previous investigation of the genotypic variability within Ascaris from humans and pigs, experimental infections of mice and pigs with selected genotypes of Ascaris were performed in the present study to explore possible host affiliation. Initial findings indicate that there is a significant difference in the ability of Ascaris eggs of genotype G1 (derived from human) and G3 (derived from pig) to infect and establish as larvae in mice and as adults in pigs, supporting the difference in the frequencies of the genotypes reported previously in natural Ascaris populations in pigs and humans in areas in China endemic for ascariasis.

Regulatory T cells and Toll-like receptors in tumor immunity

Regulatory T (Treg) cells induce immune tolerance by suppressing host immune responses against self- or non-self-antigens, thus playing critical roles in preventing autoimmune diseases. However, tumor cells may take advantage of Treg cells to protect themselves from immune attack elicited by vaccines. Recent studies demonstrate the presence of Treg cells in various types of cancers and their suppressive function. Therefore, Treg cells at tumor sites have detrimental effects on immunotherapy directed to cancer and infectious diseases. This review will discuss antigen specificity of Treg cells, the factors that contribute to Treg cell generation and suppressive function, and their regulation through Toll-like receptor signaling. It was generally though that TLR-mediated recognition of specific structures of invading pathogens initiate innate as well as adaptive immune responses through dendritic cells. New evidence suggests that TLR signaling may directly regulate the suppressive function of Treg cells. Linking TLR signaling to the functional control of Treg cells opens intriguing opportunities to shift the balance between CD4(+) T-helper and Treg cells, in ways that may improve the outcome of cancer immunotherapy.

Toll-like receptor 8-mediated reversal of CD4+ regulatory T cell function

CD4+ regulatory T (Treg) cells have a profound ability to suppress host immune responses, yet little is understood about how these cells are regulated. We describe a mechanism linking Toll-like receptor (TLR) 8 signaling to the control of Treg cell function, in which synthetic and natural ligands for human TLR8 can reverse Treg cell function. This effect was independent of dendritic cells but required functional TLR8-MyD88-IRAK4 signaling in Treg cells. Adoptive transfer of TLR8 ligand-stimulated Treg cells into tumor-bearing mice enhanced anti-tumor immunity. These results suggest that TLR8 signaling could play a critical role in controlling immune responses to cancer and other diseases.

Functional characterization of EBV-encoded nuclear antigen 1-specific CD4+ helper and regulatory T cells elicited by in vitro peptide stimulation

CD4(+) helper and regulatory T (Treg) cells play important but opposing roles in regulating host immune responses against cancer and other diseases. However, very little is known about the antigen specificity of CD4(+) Treg cells. Here we describe the generation of a panel of EBV-encoded nuclear antigen 1 (EBNA1)-specific CD4(+) T-cell lines and clones that recognize naturally processed EBNA1-P(607-619) and -P(561-573) peptides in the context of HLA-DQ2 and HLA-DR11, -DR12, and -DR13 molecules, respectively. Phenotypic and functional analyses of these CD4(+) T cells revealed that they represent EBNA1-specific CD4(+) T helper as well as Treg cells. CD4(+) Treg cells do not secrete interleukin (IL)-10 and transforming growth factor beta cytokines but express CD25, the glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR), and Forkhead Box P3 (Foxp3), and are capable of suppressing the proliferative responses of naive CD4(+) and CD8(+) T cells to stimulation with mitogenic anti-CD3 antibody. The suppressive activity of these CD4(+) Treg cells is mediated via cell-cell contact or in part by a cytokine-dependent manner. Importantly, these Treg cells suppress IL-2 secretion by CD4(+) effector T cells specific for either EBNA1 or a melanoma antigen, suggesting that these CD4(+) Treg cells induce immune suppression. These observations suggest that the success of peptide-based vaccines against EBV-associated cancer and other diseases may likely depend upon our ability to identify antigens/peptides that preferentially activate helper T cells and/or to design strategies to regulate the balance between CD4(+) helper and Treg cells.

Recognition of a New ARTC1 Peptide Ligand Uniquely Expressed in Tumor Cells by Antigen-Specific CD4+ Regulatory T Cells

CD4(+) regulatory T (Treg) cells play an important role in the maintenance of immunological self-tolerance by suppressing immune responses against autoimmune diseases and cancer. Yet very little is known about the natural antigenic ligands that preferentially activate CD4(+) Treg cells. Here we report the establishment of tumor-specific CD4(+) Treg cell clones from tumor-infiltrating lymphocytes (TILs) of cancer patients, and the identification of an Ag recognized by Treg cells (ARTC1) gene encoding a peptide ligand recognized by tumor-specific TIL164 CD4(+) Treg cells. The mutations in a gene encoding an ARTC1 in 164mel tumor cells resulted in the translation of a gene product containing the peptide ligand recognized by CD4(+) Treg cells. ARTC1 peptide-activated CD4(+) Treg cells suppress the physiological function (proliferation and IL-2 secretion) of melanoma-reactive T cells. Furthermore, 164mel tumor cells, but not tumor lysates pulsed on B cells, were capable of activating TIL164 CD4(+) Treg cells. These results suggest that tumor cells may uniquely present an array of peptide ligands that preferentially recruit and activate CD4(+) Treg cells in sites where tumor-specific self-peptide is expressed, leading to the induction of local and tumor-specific immune suppression.

Isolation of Nanjing local strains of HHV-7 and their biological and immunological characteristics

To investigate the biological and immunological characteristics of the Nanjing local strains of HHV-7, four strains of herpesvirus were isolated from saliva specimens of one healthy individual and three children suffering from a kidney disease in Nanjing. The viruses were identified by transmission electron microscopy (EM), indirect immunofluorescence assay (IFA) with a specific monoclonal antibody; nested polymerase chain reaction, restriction mapping and DNA sequencing. The virus-infected cells showed the typical cytophathic effect (CPE) under microscopy and could be detected by IFA with the human herpesvirus-7 (HHV-7) specific antibody. Under EM, herpesvirus-like and virions capsids could be found in their cytoplasm or nucleoplasm. HHV-7 DNA fragments amplified from infected cells by nested PCR were confirmed by restriction mapping and DNA sequencing. Similarly to DC strain, an known HHV-7 strain used in the present study as the positive control, the virus could be inactivated by ultraviolet irradiation for 10 min, heated at 45 centigrade degree for 30 min, pH<5 or>9 at 4 centigrade degree for 2 h and ether or chloroform for 10 h. The virus induced the production of TNF-alpha, IL-10 and IL-12 p 70 while inhibited IFN-alpha secretion, increased the percentage of CD2(+) cells while decreased that of CD4(+) or CD 45 RA(+) cells. The results indicate that the viruses isolated in Nanjing are HHV-7, which has similar biological characteristic to the known HHV-7 strain, DC. Infection with HHV-7 in vitro could affect immune function of lymphocytes by disturbing cytokine production and CD antigen expression.

Effect of Moisture and Temperature on Disease of Green Foxtail Caused by Drechslera gigantea and Pyricularia setariae

Leaf wetness duration, temperature, intermittent leaf wetness, and delayed leaf wetness were investigated for their influence on disease of green foxtail caused by Drechslera gigantea and Pyricularia setariae to determine the potential of these two fungi as bioherbicide agents in the Canadian prairies. For both fungi, disease severity increased with increasing leaf wetness duration at 15, 20, 25, 30, and 32°C. At 10°C, conidia of both fungi showed minimal germination, regardless of leaf wetness duration; however, an increase in conidial germination, appressoria formation, and disease occurred at 15°C. Conidia of both species showed 80% or greater germination at all temperatures above 15°C, whereas the optimum temperatures for appressoria formation by D. gigantea and P. setariae were 23 and 25°C, respectively. Maximum disease occurred after 48 h of leaf wetness at 32°C for D. gigantea and at 25°C for P. setariae. Disease caused by both fungi decreased when 4 h of continuous leaf wetness was followed by a 20-h dry period, and after an 8-h delay in leaf wetness following inoculation. Both fungi required immediate and prolonged periods of leaf wetness at temperatures of 15°C and above to cause severe disease on green foxtail. The moisture requirements of these fungi may limit their effectiveness as bioherbicide agents in the semi-arid Canadian prairies.

Tumor-Specific Human CD4+ Regulatory T Cells and Their Ligands

Regulatory T cells play an important role in the maintenance of immunological self-tolerance by suppressing immune responses against autoimmune diseases and cancer. Little is known, however, about the nature of the physiological target antigens for CD4(+) regulatory T (Treg) cells. Here we report the identification of the LAGE1 protein as a ligand for tumor-specific CD4(+) Treg cell clones generated from the tumor-infiltrating lymphocytes (TILs) of cancer patients. Phenotypic and functional analyses demonstrated that they were antigen-specific CD4(+) Treg cells expressing CD25 and GITR molecules and possessing suppressive activity on the proliferative response of naive CD4(+) T cells to anti-CD3 antibody stimulation. Ligand-specific activation and cell-cell contact were required for TIL102 Treg cells to exert suppressive activity on CD4(+) effector cells. These findings suggest that the presence of tumor-specific CD4(+) Treg cells at tumor sites may have a profound effect on the inhibition of T cell responses against cancer.

[Measurement of cyclosporine A in whole blood by high performance liquid chromatography(HPLC)]

Whole blood was extracted by ether under base using cyclosporine D as internal standard. The extraction was evaporated and reconstituted. The interferences were further removed by hexane. The reconstitution was injected into a C18 reversed-phase column at 70 degrees C, which was eluted with a mobile phase of acetonitrite/methanol/water(60/10/30, v/v) at flow rate 1.6 ml.min-1 and monitored at 210 nm. Three levels of BIO-RAD cyclosporine A(whole blood) calibrator were measured, all the results were within expected range. The detection limit was 25 ng.ml-1. The linearity was at least within 50-1,000 ng.ml-1. Analytical recoveries were 99.6%-108.8%. The within-run cv and between-run CV were 7.2% and 9.3%, respectively.

NMR structure reveals intramolecular regulation mechanism for pheromone binding and release

Odorants are transmitted by small hydrophobic molecules that cross the aqueous sensillar lymph surrounding the dendrites of the olfactory neurons to stimulate the olfactory receptors. In insects, the transport of pheromones, which are a special class of odorants, is mediated by pheromone-binding proteins (PBPs), which occur at high concentrations in the sensillar lymph. The PBP from the silk moth Bombyx mori (BmPBP) undergoes a pH-dependent conformational transition between the forms BmPBP(A) present at pH 4.5 and BmPBP(B) present at pH 6.5. Here, we describe the NMR structure of BmPBP(A), which consists of a tightly packed arrangement of seven alpha-helices linked by well defined peptide segments and knitted together by three disulfide bridges. A scaffold of four alpha-helices that forms the ligand binding site in the crystal structure of a BmPBP-pheromone complex is preserved in BmPBP(A). The C-terminal dodecapeptide segment, which is in an extended conformation and located on the protein surface in the pheromone complex, forms a regular helix, alpha(7), which is located in the pheromone-binding site in the core of the unliganded BmPBP(A). Because investigations by others indicate that the pH value near the membrane surface is reduced with respect to the bulk sensillar lymph, the pH-dependent conformational transition of BmPBP suggests a novel physiological mechanism of intramolecular regulation of protein function, with the formation of alpha(7) triggering the release of the pheromone from BmPBP to the membrane-standing receptor.

Analysis of the 1991-2000 influenza epidemic in Guangdong Province, China

Influenza surveillance networks in Guangdong were established to investigate the epidemiological characteristics of influenza and influenza epidemics. Influenza activity peaked annually from March to July in Guangdong in 1991-2000; influenza H3N2 predominated in the epidemic (7 years of 10); the outbreak of influenza in 1996 was the remarkable result of antigenic drift of H3N2 strain. Ten isolates of H9N2 strains were discovered from human subjects in 1998 and 1999: chicken strains isolated after the Hong Kong fowl influenza outbreak. It was found that there was just one influenza activity season per annum in Guangdong and that the influenza H3N2 subtype still predominates in Guangdong. Further research into the pathogenicity of influenza H9N2 in humans warranted.

Identification and cloning of a pheromone-binding protein from the Oriental beetle, Exomala orientalis

We have identified and cloned a pheromone-binding protein (EoriPBP) from the Japanese and American populations of the Oriental beetle, Exomala orientalis (Coleoptera: Scarabaeidae). The protein showed more than 90% amino acid identity to the previously identified pheromone-binding proteins from Popilliajaponica (PjapPBP) and Anomala osakana (AosaPBP), as well as to one of the odorant-binding proteins from Phyllopertha diversa (PdivOBP1). EoriPBP has 116 amino acids, with a calculated molecular mass of 12,981 Da. pI of 4.3, and six highly conserved cysteine residues. 5'-RACE amplifications led to the characterization of a signal peptide with 19 amino acids. The signal peptide showed high amino acid identity to the signal peptide for AosaPBP. Comparison of the amino acid sequences of the PBPs involved in the detection of similar ligands, i.e., monounsaturated lactones and ketone, suggests that the most variable residues among the PBPs from E. orientalis, P. japonica, and A. osakana are probably the most discriminating residues. As with the pheromone-binding protein from Bombyx mori, the residues at positions 61, 64, 71, and 82 in EoriPBP, PajpPBP, and AosaPBP, which are either valine, leucine, isoleucine, or methionine, are likely to be specificity determinants.

Evolution of antifungal susceptibility among Candida species isolates recovered from human immunodeficiency virus-infected women receiving fluconazole prophylaxis

The effect of fluconazole on the susceptibility of Candida isolates recovered from women infected with human immunodeficiency virus (HIV) was evaluated in a randomized, double-blind, placebo-controlled trial. Women with CD4(+) cell counts of < or =300 cells/mm(3) received either fluconazole (200 mg/week) or placebo as prophylaxis. The antifungal susceptibility of specimens was evaluated. One patient who received fluconazole and 2 patients assigned to placebo had Candida albicans isolates recovered that were resistant to fluconazole (MIC, > or =64 microg/mL). Eleven patients assigned fluconazole and 4 patients assigned placebo had non-albicans Candida strains (all Candida glabrata) recovered that were resistant to fluconazole. There was significant azole cross-resistance among the non-albicans Candida species isolates. Although the rate of azole resistance did not significantly increase after fluconazole prophylaxis, there was a trend toward more in vitro azole resistance in C. glabrata isolates from patients assigned fluconazole. Moreover, the majority of resistant vaginal isolates of Candida species were recovered after initiation of open-label fluconazole use.

[In vitro modulation of the invasive and metastatic potentials of human hepatocellular carcinoma by interlukin-2]

OBJECTIVE

To investigate the effects of interlukin-2 (IL-2) on the in vitro invasiveness and the expression of several cell surface antigens related to invasive and metastatic potentials of human hepatocellular carcinoma (HCC) QGY-7701 cell line.

METHODS

QGY-7701 cells were incubated with high concentration of IL-2 or low concentration of IL-2 in different time. The expression of ICAM-1, CD(44) and HLA-I of the tumor cells was determined by fluorescence-activated cell sorter (FACS) analysis The tumor cell binding affinity to extracellular matrix components was measured by cell attachment assay. The degree of homotypic aggregation was quantified by cell aggregation assay.

RESULTS

IL-2 treatment exhibited enhanced expression of ICAM-1 (from 8.3% to 20.5% after high concentration of IL-2 treatment and 17.3% after low concentration of IL-2 treatment) and HLA-I (from 9.8% to 25.4% and 22.1%, respectively after high and low concentration of IL-2 treatment), suppression of CD(44) (from 26.4% to 12.5% and 11.6%, respectively) on HCC cell line and decreased binding affinity to type IV collagen (from 23.5% to 12.4%, 32.3% to 13.8%, 45.7% to 19.6% at 20 min, 40 min and 60 min, respectively after high concentration of IL-2 treatment, and 9.6%, 12.5% and 17.9%, respectively after low concentration of IL-2 treatment) and fibronectin (from 18.6% to 14.1%, 31.2% to 18.4%, 44.5% to 20.5% at 20 min, 40 min and 60 min, respectively after high concentration of IL-2 treatment, and 14.6%, 17.1% and 18.9%, respectively after low concentration of IL-2 treatment) and the degree of homotypic aggregation (from 58.3% to 26.5%, 85.4% to 37.6%, 88.6% to 42.3% at 20 min, 40 min and 60 min, respectively after high concentration of IL-2 treatment, and 25.0%, 36.4% and 42.6%, respectively after low concentration of IL-2 treatment)of HCC cells.

CONCLUSIONS

IL-2 may directly alter tumor properties associated with invasive and metastatic phenotypes of HCC cells, and can inhibit the invasive and metastatic potentials of HCC cells.

Vitreous cavity-associated immune deviation induced by retinal S antigen

PURPOSE

To determine whether the vitreous cavity (VC) supports the induction of deviant immune responses to retinal soluble(S) antigen and to observe the influence of interleukin-1 (IL-1) on the immunologic properties of the VC.

METHODS

Retinal S antigen was inoculated into the anterior chamber(AC) and the VC in Wistar rats. Seven days after antigen inoculation, the recipient animals were immunized with S antigen and complete Freund's adjuvant. Delayed-type hypersensitivity (DTH) was assessed by footpad challenge. To alter systemic immune conditions, IL-1 was administrated by intraperitoneal injection.

RESULTS

Antigen-specific DTH did not develop in rats in which S antigen was injected into the AC and the VC. By contrast, when IL-1 administrated systemically, S antigen was injected into the AC and VC elicited strong DTH.

CONCLUSION

The VC supports immune deviation for soluble antigen by acitivity suppressing antigen-Specific DTH. Systemic administration of exogenous IL-1 eliminates the capacity of the VC to support immune deviation to soluble antigen locally injected.

[Effect of benzo(a)pyrene on antioxidant enzyme activities in Boleophthalmus pectinirostris liver]

The effect of different BaP concentrations on the activities of superoxide dismutase(SOD), glutathione peroxidase (GPx) and catalase(CAT) in Boleophthalmus pectinirostris liver was studied under experimental condition. The results showed that the activities of antioxidant enzymes did not change too much with BaP exposure in lower concentration, whereas the SOD and GPx activities were increased significantly with BaP exposure in higher concentration. No statistical changes were observed in the effect of BaP exposure in different concentrations on CAT activities throughout the experiment.

The rationale and design of the CPCRA (Terry Beirn Community Programs for Clinical Research on AIDS) 058 FIRST (Flexible Initial Retrovirus Suppressive Therapies) trial

The CPCRA (Terry Beirn Community Programs for Clinical Research on AIDS) 058 FIRST (Flexible Initial Retrovirus Suppressive Therapies) trial is a large, long-term, randomized, prospective comparison of three different antiretroviral strategies in highly active antiretroviral therapy-naïve, HIV-1-infected persons. The trial was designed as a flexible framework upon which other studies could be added to answer more limited, but still important, questions. This article presents the study design, discusses the challenges we have faced in implementing the trial, and describes our preliminary experiences. Control Clin Trials 2001;22:176-190