Pharmacokinetics of pirprofen in children with juvenile chronic arthritis

Pirprofen (100 or 200 mg; Rengasil) was administered to experimental groups of children (children with juvenile chronic arthritis, JCA) and to a control group of children (children without JCA) as a single dose or as repeated doses. The pharmacokinetics of pirprofen in these children were compared to the pharmacokinetic parameter values obtained in healthy volunteers and in elderly arthritic adults receiving 400 mg of pirprofen. The children were examined regularly and laboratory values were determined in order to detect possible side effects. The results demonstrated that the pharmacokinetics of pirprofen were similar for children and adults when taking into account the dose and the body weight. There was no drug accumulation after repeated administration of pirprofen. As already observed in rheumatic adults, pirprofen remains in synovial fluid longer than in plasma.

Cystic fibrosis patients' B-lymphocyte response is resistant to the in vitro enhancing effect of corticosteroids

Cystic fibrosis is associated with an cAMP-regulated channel defect, which has been evidenced in many cell types including B lymphocytes. To document a B-cell dysfunction potentially related to this defect, we studied the in vitro IgG production by lymphocytes from 11 cystic fibrosis patients. B lymphocytes were co-cultured with autologous monocytes and stimulated with Staphylococcus aureus Cowan or with Nocardia-delipidated cell mitogen in the presence of low concentrations of IL2. Cystic fibrosis patients' cells produced amounts of IgG comparable with that of normal and control patients' cells. However, dexamethasone (10(-7) mol l-1) had no effect on the response of cystic fibrosis patients' cells, whereas it enhanced that of the latter two groups. This resistance of cystic fibrosis cells was true with concentrations of dexamethasone up to 10(-6) mol l-1, whereas this agent induced a dose-related enhancement from 10(-8) to 10(-6) mol l-1 in cultures of normal cells. Co-culture experiments showed that cystic fibrosis B lymphocytes themselves are resistant to the effect of dexamethasone. In contrast dexamethasone normally suppressed the anti-CD3 antibody-induced response of cystic fibrosis T cells in the presence of IL2 and the IL1 alpha- or beta-induced collagenase production of cystic fibrosis fibroblast cell lines. Thus cystic fibrosis B lymphocytes exhibit a selective defect which may interfere with the normal interactions between the hormonal and immune systems and may participate in the sensitivity of cystic fibrosis patients to bacterial bronchopulmonary infections.

Inhibition of HSV-1 multiplication in rat embryo fibroblasts constitutively expressing the EJ-ras oncogene

In order to examine cellular gene involvement in HSV-1 expression, we constructed different rat embryo fibroblast cell lines immortalized by adenovirus E1A or c-myc, with or without the human EJ bladder carcinoma transforming oncogene EJ-ras. HSV-1 multiplication was strongly inhibited in cells expressing EJ-ras genes compared to immortalized control cells. Virus adsorption and penetration were not quantitatively modified, but HSV-1 DNA replication was inhibited. The expression of viral thymidine kinase (TK) activity after infection by recombinant virus with the TK coding sequence under immediate-early (IE) promoter control showed that IE gene expression is inhibited in cells expressing EJ-ras. Analysis of IE gene transcription by Northern-blot hybridization and by nuclear run-off transcription assay indicates that this inhibition takes place at the transcriptional level.

[Colonization by pyocyanic bacillus and its treatment in cystic fibrosis]

In cystic fibrosis infection is localized to the bronchi and self-perpetuated by a disorder of mucociliary clearance. At a certain stage of the disease infection is caused by Pseudomonas aeruginosa (PA), and the patient cannot get rid of it as cystic fibrosis reduces his defence mechanisms against this organism, a naturally weak pathogen. The presence and significance of persistent bronchial PA infection result from complex phenomena which have been summarized as "an opportunistic organism in a host whose defences have been very peculiarly compromised". The toxicity of PA and the inappropriate inflammatory response of the host concur to create permanent alveolar lesions which are gradually spreading out. The effectiveness of antibiotics depends on the organism and its resistance, on pharmacokinetic factors bringing the drug in situ and on local conditions of redox, physico-chemical environment and nutrition. Other factors intervene more roughly, including patient's age, liver impairment, lung anatomy (excluded areas), general malnutrition and vitamin deficiencies. Thus, the part played by other treatments in the antibiotic therapy of cystic fibrosis can no longer be ignored, just as it is no longer sensible to limit the use of antibiotics to obvious infections. To evaluate the effectiveness of antibiotics is not easy, but it can be demonstrated beyond any doubt when the above mentioned factors are taken into account. The use of antibiotics creates practical problems relating to their cost, their dosage, their side-effects, the adequacy of therapeutic infrastructures and, above all, it raises the question of short- and long-term changes in microbial ecology.

Assignment of the gene for neuroendocrine protein 7B2 (SGNE1 locus) to mouse chromosome region 2[E3-F3] and to human chromosome region 15q11-q15

The gene for 7B2, a protein found in the secretory granules of neural and endocrine cells (gene symbol SGNE1) was localized to the E3-F3 region of mouse chromosome 2 and to the q11-q15 region of human chromosome 15. This was determined by in situ hybridization, using a mouse 7B2 cDNA and an intronic fragment of the corresponding human gene as probes. The respective locations of SGNE1 in the two species correlate with the conservation of loci between these subregions of mouse chromosome 2 and human chromosome 15. Clinically, the human SGNE1 DNA fragment may serve as a molecular probe of this locus in both the Prader-Willi and the Angelman syndromes, which are often accompanied by submicroscopic chromosomal deletions in the 15q11-15q13 region.

Stable expression and function of EBV/C3d receptor following genomic transfection into murine fibroblast L cells

The Epstein-Barr virus (EBV) and the C3d component of complement bind to the same cell surface receptor (EBVR/CR2) which is part of the B lymphocyte differentiation antigen recognized by the monoclonal antibodies (mAb) of the cluster of differentiation 21 (CD21). To analyze EBV and C3d binding to this receptor, mouse fibroblasts were transfected with human genomic DNA and rare CD21-positive cells were selected and cloned by cell sorting. The presence of the human gene in host cell DNA as well as its transcription product were assayed with a cloned EBVR/CR2 cDNA by Southern and Northern blotting analysis, respectively. A glycoprotein of apparent molecular mass of 140 kDa, similar to that found in human B lymphocytes, was immunoprecipitated with anti-CD21 mAb and proved to be functional since both C3d and EBV bound efficiently and specifically to mouse cells expressing EBVR/CR2. However, no expression of EBV nuclear antigens, early antigens and viral capsid antigens was detected in cells exposed to EBV. This indicates that the presence of EBVR/CR2 is not sufficient to allow full infection of mouse fibroblasts.

Structure and regulation of the blast-2/CD23 antigen in epithelial cells from nasopharyngeal carcinoma

Undifferentiated nasopharyngeal carcinoma (NPC) is tightly associated with the Epstein-Barr virus (EBV) and very heavily infiltrated with T lymphocytes. We demonstrated recently that NPC epithelial cells produce immuno-regulatory molecules, including the Blast-2/CD23 antigen, which is induced in B lymphocytes upon infection by EBV. We demonstrate here that CD23 expression is a non-constant but highly specific feature of epithelial cells from NPC. The C15 and C17 NPC tumor cells express mainly the b form of CD23, which is known to be non-lineage-specific and IL-4-inducible. C17 cells were found also to weakly express the a form of CD23, which has been described as B cell-specific. In addition, several factors potentially released in vivo by tumor infiltrating lymphocytes (TILs) are able to regulate CD23 expression in NPC cells. In particular, we found that IL-4 was a potent inducer of CD23 expression in C15 cells, as shown at both the protein and the mRNA levels. These results, together with the already reported expression of class II MHC antigens and the release of IL-1 by NPC cells, suggest that the interactions between TILs and malignant cells are a key factor in NPC pathogenesis and development.

Herpes simplex type 1 activation by Epstein-Barr virus nuclear antigen 1

We have investigated the effect of Epstein-Barr virus nuclear antigen 1 (EBNA-1), a nuclear protein encoded by EBV, on herpes simplex virus type 1 (HSV-1) infection either in cells constitutively expressing EBNA-1 or in transient expression assays. Rat-1 cells and rat embryo fibroblasts (REF) immortalized by c-myc or E1A were transfected with a specific EBV DNA fragment coding for EBNA-1. Cloned cell lines which constitutively expressed this antigen were infected with HSV-1. Our results indicate that in EBNA-1-expressing cells, virus growth was higher than in control cells for different virus strains or rodent cell lines. This increase was maximal when cells were infected at low multiplicity, as determined by virus growth, and correlated with the stimulation of viral DNA synthesis. REF + c-myc and Vero cells were cotransfected by an EBNA-1 expression vector driven by Moloney murine leukaemia virus LTR and HSV-1 immediate-early (alpha 0) or early thymidine kinase upstream promoter regulatory regions linked to chloramphenicol acetyltransferase (CAT) coding sequences as effectors. In both cell lines, stimulation of CAT expression by EBNA-1 was observed only with the immediate-early promoter. These results suggest that EBNA-1 can transactivate immediate-early HSV-1 expression.

[Joint tolerance of pefloxacin and ofloxacin in children and adolescents with cystic fibrosis]

Retrospective analysis of 63 patients with mucoviscidosis (age: 11 to 21 years), treated with pefloxacine, shows the occurrence of arthropathies ascribed to pefloxacine in 9 patients (age: 9 to 20 years), or 14% of the patients under treatment. The dose of pefloxacine was normal (9 to 16 mg/kg/day) in all cases, except one case of overdose (29 mg/kg/day). Mechanical arthralgias, affect the knees, elbows and wrists, resulting in functional discomfort, and frequently accompanied by mechanical synovial extravasation. They always subside after pefloxacine is discontinued. The role of age is essential as the incidence of arthropathies reaches 45% when pefloxacine is first administered between the ages of 15 and 20 years. Retrospective analysis of 37 patients with mucoviscidosis (age: 2 to 20 years), treated with ofloxacine, failed to show any joint complication. In this study, the best joint tolerance of ofloxacine, compared with pefloxacine is statistically significant. Arthropathies induced by pefloxacine represent an original entity which seems related to the cartilage toxicity of quinolones, observed in animal experiments, during growth.

Inhibition of platelet-activating factor biosynthesis via the acetyltransferase by arachidonic and oleic acids in ionophore A23187-stimulated bovine neutrophils

Platelet-activating factor (PAF) is a phospholipid mediator of inflammation and allergy that is synthesized by several inflammatory cells including neutrophils. Addition of exogenous arachidonic acid to ionophore A23187-stimulated bovine neutrophils led to the inhibition of PAF biosynthesis assayed by incorporation of [3H]acetate into PAF and by bioassay; under the same conditions, leukotriene B4 (LTB4) formation was not decreased. The activities of the PAF metabolism enzymes indicated that the PAF synthesis inhibition by arachidonic acid is mediated via the acetyltransferase inhibition which is the last enzyme of the PAF formation. Another unsaturated fatty acid, oleic acid, exhibited the same inhibitory effect on [3H]acetate-PAF formation; however, the saturated stearic acid did not lead to any inhibition. These findings suggest that liberation of unsaturated fatty acids from membrane phospholipids, as a consequence of phospholipase A2 activation, would modulate PAF formation via inhibition of the acetyltransferase. In addition, the utilization of arachidonic acid oleic acids in activated neutrophils furnishes an easy means of blocking PAF synthesis in order to understand the role of this mediator in cellular processes.

t(2;8) variant translocation in Burkitt's lymphoma: mapping of chromosomal breakpoints by in situ hybridization

In 6 different Burkitt lymphoma cell lines with t(2;8) variant translocations (J1, LY66, LY91, BL21, BL64, JBL2) the breakpoints on chromosome 8q+ were mapped in relation to each other and to c-myc by in situ hybridization. The probes used were derived from chromosome 8q24 and comprised a c-myc probe, a probe located 48 kb downstream of c-myc, 3 probes adjacent to the chromosomal breakpoints of BL64, LY91 and JBL2, respectively, and 2 probes located in the 5' and 3' part of the thyroglobulin gene. The breakpoints of LY91 and JBL2 lie less than 200 kb and greater than 200 kb downstream of c-myc, whereas the distance to c-myc of the BL64 breakpoint and of the thyroglobulin probes is unknown. By recording the hybridization signals specific for these probes on chromosomes 2p- and 8q+ of each cell line it was possible to establish the order of breakpoints on band 8q24 relative to the c-myc and thyroglobulin genes as follows: centromere--c-myc--J1--BL64--BL21--LY91--JBL2--+ ++LY66--thyroglobulin--telomere. This information is essential for further mapping of this important chromosomal region.

[Iron deficiency and Pseudomonas aeruginosa colonization in cystic fibrosis]

The incidence of iron deficiency and its relationship with the concentration or iron in sputum and the number of Pseudomonas aeruginosa (PA) colonies was studied in an unselected group of 53 cystic fibrosis (CF) patients with an age range of 3 months to 21 years. Parameters used to assess the iron status included serum iron, the % saturation of transferrin (n = 53). The number of subjects with depletion of iron stores was estimated by levels of ferritin (n = 50). The concentration of iron and of PA was measured in a subgroup (n = 24) and compared to a control group (n = 8) with pulmonary infections of varying etiology. A close correlation was found between serum iron and the % saturation of transferrin (r = 0.952; p less than 0.001). Between 22.6 to 28.3% of patients were found to be iron deficient. An abnormally low ferritin (less than 12 ng/ml) was noted in 28% of cases but no correlation could be established between changes of serum iron and ferritin levels as a function of the degree of infection and/or of inflammation. In 62% of cases (n = 15) the concentration of iron in sputum was found to be within the range of control values (12-27 mumols/l). In 38% of cases (n = 9), ferritin values were above 27 mumols/l. No correlation was found between the concentration of iron and the number of PA colonies in sputum. We can therefore conclude the following: 1) iron deficiency is more common in CF than previously reported; 2) ferritin levels constitute a poor index of iron deficiency; 3) colonisation with PA is not associated with iron content of bronchial secretions.

Tumor-specific loss of 11p15.5 alleles in del11p13 Wilms tumor and in familial adrenocortical carcinoma

We have compared constitutional and tumor genotypes in nine cases of hereditary Wilms tumor (WT) and in three unrelated cases of familial adrenocortical carcinoma (ADCC). Since susceptibility to these tumors can be observed in malformation syndromes associated with a constitutional deletion of band 11p13 (WT) and with a constitutional duplication of band 11p15.5 (WT, ADCC), we investigated these two candidate regions by using 11p polymorphic markers. As expected, somatic chromosomal events, resulting in a loss of heterozygosity limited to region 11p15.5, were observed in the tumor of two familial cases of adrenocortical carcinoma. Surprisingly, however, analysis of the WT of two patients with a constitutional deletion of band 11p13, associated with aniridia, genitourinary abnormalities, and mental retardation (WAGR syndrome), revealed a loss of heterozygosity limited to region 11p15.5. These data therefore suggest that observation of a specific loss of heterozygosity may not necessarily point to the site of the initial germinal mutation. Together with previous similar observations of a loss of heterozygosity limited to 11p15.5 in breast cancer and in rhabdomyosarcoma, our data suggest that region 11p15.5 may carry a non-tissue-specific gene that could be involved in genetic predisposition, in tumor progression, or in both.

Limiting dilution cloning of B cells from patients with multiple myeloma: emergence of non-malignant B-cell lines

Multiple myeloma (MM) is a B-cell malignancy characterized by the accumulation of slowly proliferating malignant plasma cells in the bone marrow (BM). Several reports have shown the existence of an abnormal B-cell compartment including proliferative idiotypic B cells (i.e., B cells bearing the same idiotypic determinants as the myeloma protein) in the BM and peripheral blood (PB) of patients with MM. In order to study whether this abnormal compartment can be grown in vitro, we cultured the PB and BM of 23 patients with MM using limiting dilution methods. Our purpose was to restrict the effect of suppressor cells and the possible overgrowth of the cultures by the more rapidly growing B cells, which occurs in bulk cultures. Spontaneously growing cells were obtained only from patients seropositive for the Epstein-Barr virus (EBV) and all the cultures were composed of B cells carrying the EBV genome. Thus, positive cultures were generated only in the presence of B cells latently infected with EBV in vivo. The mean frequency of these B cells (1 in 25,000 B cells) was as low in MM patients as in healthy donors. This low frequency indicated that malignant cells do not bear the EBV genome in vivo and that the in vivo regulation of the EBV infection is unaffected in patients with MM. No Ig-gene rearrangements, specific of the autologous myeloma cells, were found in the cell lines obtained from BM or PB. Thus, the putative malignant B cells or myeloma cells were not able to generate cell lines in vitro, either spontaneously or after endogenous infection with EBV.

Studies of variations of subcutaneously infused desferrioxamine and iron movements in thalassaemia children

Desferrioxamine (DFO) plus ferrioxamine (FO) variations and alterations in plasma and urinary iron (Fe) levels were investigated in eight children with thalassaemia major during a 12-h s.c. DFO infusion at a dose of 40 mg/kg body weight. During the infusion, blood samples were regularly taken and total urine was also regularly collected in all patients. In the plasma, a mean DFO plus FO plateau level of 9 mg/l was reached after 4 h and remained steady in the subsequent 8 h. At 30 h the mean DFO plus FO concentration in plasma was still 4.5 mg/l. At 30 h, the urinary excretion ranged from 15% to 70% of the infused dose (mean: 42%). In plasma, the Fe concentration increased on average by 20% (range 10%-30%), remained steady during the DFO infusion, then returned to the basal level after 16-24 h. Urinary Fe excretion started early and still persisted 18 h after the infusion. The amount excreted at 30 h ranged from 5 to 27 mg (mean: 13.6 mg). This study emphasizes the delay in obtaining a DFO plus FO plateau in plasma, the important interindividual variations and the slow decrease of the drug after the end of the infusion. It points out the delay and the values of the urinary Fe excretion compared to the plasmatic and urinary drug variations.

Phenotypic analysis of human myeloma cell lines

Multiple myeloma (MM) is a B-cell malignancy characterized by the accumulation, primarily in bone marrow, of a clone of plasma cells. The nature of the stem cells feeding the tumoral compartment is still unknown. To investigate this special point, we have studied the phenotypes of nine well-known human myeloma cell lines (HMCLs) and compared them with those of normal lymphoblastoid cell lines (LCLs). Twenty-four clusters of differentiation involved in B lymphopoiesis were investigated using a panel of 65 monoclonal antibodies (MoAbs). For each cluster, the percentage of positive cells and the antigen density were determined, giving rise to a "quantitative phenotype". We thus classified the HMCLs into two different groups: those with cytoplasmic mu chains (c mu+) and those without (c mu-). In the first (c mu+) group, comprising seven cell lines, the HMCLs had a phenotype of pre-B/B cells close to that of Burkitt's lymphoma cell lines. They expressed low densities of surface mu chains, without detectable cytoplasmic or surface light chains. Three of them were infected with the Epstein Barr virus (EBV). These c mu+ HMCLs bore most of the B-cell antigens except CD23. They expressed the CALLA antigen (CD10) and lacked the plasma-cell antigen PCA1. In contrast, LCLs expressed surface light chains, high densities of CD23, low densities of PCA1 antigen, and no CD10 antigen. The c mu- HMCLs had a plasma-cell phenotype, lacking most of the B-cell antigens and expressing high densities of PCA1 antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pharmacokinetics of ceftazidime in cystic fibrosis]

Ceftazidime has been recognized as an invaluable antibiotic for the treatment of lower respiratory infections in patients with cystic fibrosis. In these patients the apparent volume of distribution of ceftazidime is increased. Its clearance is besides increased, with a significant reduction in the area under concentrations curve. The distribution of ceftazidime in the bronchi seems to be very satisfactory. It results from these data that dosage in children with cystic fibrosis may reach 200 to 300 mg/kg/day divided into 3 or 4 injections. The intrabronchial administration of ceftazidime has not proved effective.

6q1 monosomy: a distinctive syndrome

A female infant with a de novo del 6q14q16.2 and five other patients with del 6q1 reported in the literature allow the delineation of a characteristic syndrome, the main features of which are: severe mental retardation, a round face with full cheeks, upslanting palpebral fissures, a short neck, umbilical hernia, malpositioned feet with syndactyly II-III, and typical dermatoglyphics with an excess of whorls and clinodactyly of the Vth finger.

Treatment of severe Epstein-Barr virus-induced polyclonal B-lymphocyte proliferation by anti-B-cell monoclonal antibodies. Two cases after HLA-mismatched bone marrow transplantation

We treated two children who developed Epstein-Barr virus-induced polyclonal B-cell proliferation after HLA-mismatched bone marrow transplantation for congenital immunodeficiency with two monoclonal anti-B-cell antibodies. Lymphoproliferative syndrome occurred between 50 and 60 days after bone marrow infusion, and was diagnosed by the presence of spontaneously growing B cells containing Epstein-Barr-nuclear antigen in the blood and bone marrow. The mouse monoclonal anti-B-cell antibodies used were a CD21-specific antibody recognizing the CR2 receptor on B cells (BL13, IgG1) and a CD24-specific antibody binding B cells at all steps of differentiation (ALB9 IgG1). Both antibodies were given intravenously (0.2 mg/kg/body weight.d for 10 days). All clinical and biological manifestations resolved within 3 weeks of treatment. Recurrence was not seen at 18- and 15-month follow-ups. T-cell function developed normally; B-cell function remained partially deficient in one patient 21 months after bone marrow transplantation. These results suggest that monoclonal anti-B-cell antibodies could be useful in controlling severe polyclonal lymphoproliferative syndrome in profoundly immunodeficient patients after bone marrow transplantation.

Cytogenetic evaluation of bone marrow involvement in Burkitt's lymphoma

Twenty-six bone marrow samples from 21 patients with Burkitt's lymphoma were examined cytogenetically after short-term culture. Clonal chromosomal changes were detected in one of 18 samples from morphologically normal marrows, and in three out of six samples with verified tumor invasion. Three patients had the translocation (8;14)(q24;q32) and one had t(2;8)(p12;q24). Two samples with suspect tumor involvement (less than 5% putative tumor cells) showed no clonal abnormalities. In two samples without morphologic bone marrow infiltration and with only normal metaphases in short-term cultures, clones with t(8;14)(q24;q32) were revealed after a longer time (3-12 weeks) spent in vitro.