New anthracycline antibiotics 10-epi-oxaunomycin and 10-epi-11-deoxyoxaunomycin

Two new anthracycline antibiotics, 10-epi-oxaunomycin and 10-epi-11-deoxyoxaunomycin, were photochemically obtained from anthracycline metabolites D788-1 (10-carboxy-13-deoxocarminomy-cin) and D788-3 (10-carboxy-11-deoxy-13-deoxocarminomycin) and were examined for their growth inhibitory activities on cultured L1210 leukemic cells. Effects of the S configuration of C-10 and a hydroxyl group at C-11 on the bioactivity are discussed in comparison with oxaunomycin and 11-deoxyoxaunomycin.

[Autologous hematopoietic stem cell transplantation for the treatment of breast cancer]

To obtain higher anti-tumor efficacy for breast cancer (BC), high-dose chemotherapy (HDC) with autologous bone marrow transplantation (ABMT) and peripheral blood stem cell transplantation (PBSCT) is believed to be one of most effective strategies. PBSCT shows earlier hematological recovery comparing with ABMT, therefore HDC could be performed more safety to introduce PBSCT in the treatment of BC. Several investigators have reported that higher complete response (CR) rate and continuously CR rate were obtained to employ HDC in the earlier course of treatment for patient with advanced or recurrent BC responding to standard-dose chemotherapy. The efficacy of HDC has been also observed in adjuvant setting for patient with high-risk (> or = 10 axillary lymph nodes) after mastectomy. Phase III studies will clarify the efficacy of HDC with ABMT, PBSCT for the treatment of BC in near future.

Activated liver macrophages in human liver diseases

Immunohistochemical analysis using monoclonal antibodies specific for cells of monocyte/macrophage lineage reveals that resident liver macrophages have a phenotype distinct from that of monocytes or activated liver macrophages. Liver macrophages consist of heterogeneous cell populations in maturation (matured 25F9-positive and immature 25F9-negative) but the ratio of two populations is constant in normal and diseased livers. The expression of CD14 is down-regulated in resident liver macrophages as compared to that in monocytes, while the expression of 25F9 is up-regulated. On the other hand, the expressions of CD14 and Fc gamma RI are up-regulated in activated liver macrophages in viral and autoimmune hepatitis. In vitro culture of monocytes in medium without cytokines induces the phenotype similar to that of resident liver macrophages. Addition of macrophage-colony stimulating factor or interferon-gamma into the culture medium induces the expression of Fc gamma RI, the phenotype of which resembles that of activated liver macrophages. These results suggest that liver macrophages consist of heterogeneous cell populations and that both phenotype and function are affected by the local milieu of cytokines.

Nucleotide sequence analysis of the carbomycin biosynthetic genes including the 3-O-acyltransferase gene from Streptomyces thermotolerans

A 3.2-kb DNA fragment of the carbomycin biosynthetic region including the 3-O-acyltransferase gene (acyA) from Streptomyces thermotolerans was sequenced, and four ORFs were found in the fragment. The second ORF, designated ORF-A, was transcribed in the opposite direction to the other three ORFs. The first ORF was identified as carA, a gene for carbomycin resistance. The amino acid sequence of ORF-A was homologous to proteins of the cytochrome P-450 family. Streptomyces lividans transformed with pCB20, in which ORF-A was subcloned, epoxidized carbomycin B at its C-12, 13 positions, thus producing carbomycin A. The third ORF, the amino acid sequence of which showed a homology to macrolide antibiotics O-acyltransferases was identified as acyA. The last ORF (ORF-B), which starts just 3 bp downstream from the TGA termination codon of acyA, was thought to be a carbomycin 4-O-methyltransferase gene, because the amino acid sequence deduced from ORF-B showed high homology to a putative midecamycin 4-O-methyltransferase encoded on mdmC.

Case report: inhalation therapy of paromomycin is effective for respiratory infection and hypoxia by cryptosporidium with AIDS

A 24-year-old man with AIDS and hemophilia A had intractable diarrhea and fever. Upon examination of stool and of a sigmoidal biopsy specimen, cryptosporidium was revealed. Approximately 2 months after admission, respiratory infection with hypoxia due to cryptosporidium developed. Paromomycin inhalation was effective therapy. To the authors' knowledge, this is the first case of respiratory cryptosporidiosis treated successfully by paromomycin inhalation.

Low-dose granulocyte colony-stimulating factor enables the efficient collection of peripheral blood stem cells after disease-oriented, conventional-dose chemotherapy for breast cancer, malignant lymphoma and germ cell tumor

Peripheral blood stem cells (PBSCs) were collected from 29 adult patients (median age 42 years, range 14-59 years) with breast cancer, germ cell tumor and malignant lymphoma after disease-oriented, conventional-dose chemotherapy combined with daily subcutaneous injections of low-dose (50 micrograms/m2 or 2 micrograms/kg) granulocyte colony-stimulating factor (G-CSF). The median number of colony-forming units-granulocyte macrophage (CFU-GM) collected in an apheresis was 2.37 (range 0-60.6) x 10(4)/kg body weight. Taking into consideration the minimum number of CFU-GM for hematopoietic reconstitution (at least 1 x 10(5) CFU-GM/kg), it was suggested that sufficient PBSCs could be collected by a few leukaphereses, although the cell yields of PBSCs tended to differ among the chemotherapeutic regimens. Twelve patients subsequently received high-dose chemotherapy followed by peripheral blood stem cell transplantation (PBSCT), including four receiving PBSCT alone and eight both PBSCT and autologous bone marrow transplantation (BMT). When compared with the 20 patients who received high-dose chemotherapy followed by autologous BMT alone, the median day of recovery of a neutrophil count > 0.5 x 10(9)/l and a platelet count > 20 x 10(9)/l was significantly shortened in those who received PBSCT (9 vs 12 days; P < 0.01 and 14 vs 30.5 days; P < 0.001), resulting in a lower platelet transfusion requirement (4.5 vs 9; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Tumor-associated Fever in Recurrent Breast Cancer with Liver Metastases

Of 67 patients with recurrent breast cancer accompanied by liver metastases admitted to our facility between January 1990 and August 1993, 8(12%) were found to have tumor-associated fever. We examined the characteristics of these patents. These patients had fever (over 38 degrees C) for more than one week. Their leukocyte counts did not exceed 10000/mm(3), and C-reactive protein (CRP) was below 5 mg/dl in 6 patients. ALL 8 patients had extensive liver metastases. Six patients had massive metastatic lesions, while the remaining 2 had diffuse metastases. Following systemic chemotherapy, 3 patients showed a reduction in tumor size and remission of fever; they remain alive at 14, 16 and 19 months after treatment. Of the remaining 5 patients who did not respond to systemic chemotherapy, 4 died within 6 months. The results of this study suggest that unexplained fever in patients with recurrent breast cancer is closely related to liver metastases.

Red blood cell sorbitol in diabetic children

When red blood cells (RBC) were incubated with various concentrations of glucose, the RBC sorbitol level increased in a concentration-dependent manner. The elevated RBC sorbitol level was not reduced by further incubation in a glucose-free medium. In both diabetic and non-diabetic children, an increase of RBC sorbitol levels occurred in the oral glucose tolerance test and the return to baseline was delayed in diabetics compared with non-diabetics. In the majority of diabetics (87%), RBC sorbitol levels exceeded the upper limit of the normal range, which was arbitrarily determined as the mean + 2 s.d., in healthy non-diabetic children and adults. A good correlation was observed between RBC sorbitol levels and plasma glucose levels (r = 0.644). In both diabetics and non-diabetics, no correlation was observed between RBC sorbitol levels and age, and in diabetics the RBC sorbitol level was not related to the duration of disease. A good correlation was observed between RBC sorbitol levels, and hemoglobin Alc (HbAlc) or fructosamine levels in diabetic children.

Synthesis of doxorubicin-cyclodextrin conjugates

Doxorubicin-gamma-cyclodextrin conjugates have been synthesized by the coupling of 14-bromodaunomycin with mono half-ester compounds linked to a 6-hydroxyl group of gamma-cyclodextrin. Release of drug from the conjugates in saline phosphate buffer solution and in vitro antitumor activity against L1210 leukemia cells were also investigated.

Differential gene expression of fibroblast growth factor receptor isoforms in rat ovary

The gene expression of four fibroblast growth factor receptors (flg, bek, FGFR-3, and FGFR-4) in rat ovary cells was studied. Northern blot hybridization revealed that flg and bek mRNAs were detectable during all stages except a diestrus stage, whereas FGFR-3 and FGFR-4 mRNAs were almost undetectable throughout the cycles. In situ hybridization also demonstrated that only flg and bek gene expression was detectable. A modest flg mRNA signal was detected in developing antral follicles and it was more prominent in the theca-interstitial cells than in the granulosa cells. A modest to weak flg mRNA signal was seen in the hypertrophied theca-interstitial cells of atretic follicles and a very weak flg mRNA signal was observed in the corpora lutea. On the other hand, a weak bek mRNA signal was seen in granulosa and theca-interstitial cells in developing follicles and also hypertrophied theca-interstitial cells of atretic follicles, but not in the corpora lutea. Intense signals for both flg and bek mRNAs were unexpectedly found in the epithelium of paroophoron at the hilus. These results demonstrate that the bFGF receptor isoforms are expressed differentially in the rat ovary cells.

Cloning of the macrolide antibiotic biosynthesis gene acyA, which encodes 3-O-acyltransferase, from Streptomyces thermotolerans and its use for direct fermentative production of a hybrid macrolide antibiotic

A gene encoding the macrolide modification enzyme 3-O-acyltransferase (acyA) was cloned by chromosome walking onto the carbomycin biosynthetic region in Streptomyces thermotolerans TH475, with the 3' region of the gene encoding the macrolide modification enzyme 4"-O-acyltransferase (acyB1) as a probe. A shortened fragment (1.8 kb) containing acyA was subcloned with pIJ350. A high-level tylosin producer, Streptomyces fradiae MBBF, transformed with the plasmid could produce a hybrid macrolide, 3-O-acetyltylosin, most efficiently.

[Epidemiological survey of methicillin-resistant Staphylococcus aureus isolated from 34 hospitals in Japan]

Eight hundred and seventy-two isolates of clinically significant methicillin-resistant Staphylococcus aureus (MRSA) with their clinical information were obtained between 1992 and 1993 from thirty-four hospitals in Japan. The isolation frequency of MRSA was high in sputum (42.9%), pus (33.1%) and blood (14.0%). Pseudomonas aeruginosa was a major bacterial species in polymicrobial infections with MRSA. Enterobacteriaceae and Candida sp. were also frequently isolated with MRSA. Four different coagulase types were identified. Coagulase type II was found in 85.6% of all MRSA strains tested. The isolation frequencies of coagulase type III, type IV and type VII were 3.1%, 3.6% and 3.2%, respectively. The strains of MRSA contained coagulase type II were prevalent in all geographical areas of Japan, but other coagulase types were limited in western areas of the country. The strains of MRSA were tested for their susceptibility to twelve antimicrobial agents and for production of penicillinase. More than 80% of MRSA strains were highly resistant to methicillin, and were also resistant to macrolide antibiotics and tobramycin. Frequencies of resistance to gentamicin, minocycline or ofloxacin were approximately 60%, 50% or 70%, respectively. But only a small percentage of strains were resistant to arbekacin and all of the MRSA tested were susceptible to vancomycin.

[Genomic DNA fingerprinting of arbekacin-resistant MRSA by pulsed-field gel electrophoresis]

We surveyed 387 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) obtained from 26 hospitals isolated in 1993 to determine whether they became resistant to arbekacin (ABK). Twenty-five ABK-resistant MRSA (6.5%) were isolated from 9 hospitals. Analysis of genomic DNA fingerprinting by pulsed-field gel electrophoresis was used to confirm the classification by resistance patterns, phage typing and other biological characters. After digestion with endonuclease SmaI, two or three types of restriction patterns were found in ABK-resistant MRSA isolated from each hospital. We concluded that ABK-resistant MRSA may spread through nosocomial MRSA infections.

[Drug resistance and phage typing of clinical isolates of Staphylococcus aureus]

Activities of antimicrobial agents were examined against Staphylococcus aureus strains isolated in 1990. Strains resistant to benzylpenicillin were isolated at the highest frequency (93.6%), and followed by those resistant to kanamycin (51.5%), erythromycin (49.0%), gentamicin (45.1%), fluoroquinolone (33.4%) and minocycline (12.3%). Most of these drug resistant strains of S. aureus were also resistant to methicillin. It should be noted that the MRSA strains were also resistant to other multiple drugs. Annual changes of MRSA in clinical isolates have been increasing since 1981. The isolation frequencies of MRSA strains were 18.9%, 44.8% in 1981 and 1990, respectively. Among methicillin susceptible S. aureus (MSSA), however, drug resistance to other antibiotics have been decreasing year by year. Many strains among both MRSA (73%) and MSSA (86%) were sensitive to typing phages of 100 x RTD. 76% of the MRSA strains were phage typed into groups III or mixed, and 60% of the MSSA strains were typed into these two groups, also.

[Long-term observation of serum hormone fluctuations in aging model of gonadectomized rat]

Serum LH increased rapidly in both sexes after gonadectomy, showing a peak at the 8th week. Afterwards, LH decreased gradually until the 75th week. In general, LH values in males were lower than those in females. FSH, as well as LH, increased rapidly after gonadectomy. In male serum FSH reached a peak at the 8th week and then decreased showing two peaks at the 34th and 92nd weeks. Serum FSH level decreased remarkably after the 96th week in males. In females FSH increased gradually with a subsequent rapid increase from the 28th week and reached a peak at the 42nd week. Afterwards, this FSH level was maintained to the 128th week. Serum progesterone (P4) decreased after gonadectomy in females, whereas it increased to 4 fold in males. In males this high level was maintained to the 66th week. Serum estradiol (E2) decreased in both sexes until the 3rd week after gonadectomy. However, in males the serum E2 level increased at the 4th and 5th weeks and reached the level of the 1st week after gonadectomy. Afterwards, the E2 level decreased to 10pg/ml at the 40th week which was maintained to the 128th week. In females, E2 increased from the 5th to 22nd week and decreased again from the 33rd week, and then the E2 level decreased rapidly to about 10pg/ml which was maintained to the 128th week. The present experiment indicated two results in male rats. 1. Serum FSH decreased remarkably after the 96th week of gonadectomy. 2. Serum P4 increased in spite of gonadectomy.

Cold agglutinin disease following allogeneic bone marrow transplantation

We describe a case of cold agglutinin disease (CAD) following allogeneic bone marrow transplantation. This 36-year-old male developed CAD 3 weeks after allogeneic bone marrow transplantation for chronic myelogenous leukemia. Cyclosporin A and methotrexate had been administered to prevent graft-versus-host disease. Other agents administered included cytomegalovirus hyperimmune globulin and recombinant human G-CSF. Pericarditis preceded the development of CAD. The characterization of cold agglutinin (CA) was monoclonal IgM-kappa with anti-Pr antigen specificity, probably derived from the engrafted donor lymphocytes. The administration of prednisolone led to transient improvement. The CA titer decreased without further treatment 12 weeks after transplant.

Experimental induction of arthritis in rats immunized with Escherichia coli 0:14 lipopolysaccharide

OBJECTIVE

Escherichia coli 0:14 (E. coli 0:14) induces arthritis in rabbits, mice and rats. This study was designed to investigate the effects of lipopolysaccharide (LPS) on the rat arthritis model induced by systemic injections of E. coli 0:14.

METHODS

The induction of arthritis in the ankles of rats immunized by subcutaneous injections with heat-killed E. coli 0:14 and its LPS was studied. The appearance and levels of serum IgM rheumatoid factor-like substance (RFLS) was also investigated. The localization of interleukin 1 (IL-1) and LPS in the ankle joints were investigated immunohistochemically.

RESULTS

The induction rate of arthritis in rats immunized with LPS was the same as that in rats immunized with E. coli. LPS and IL-1 were detected in synovial cells, infiltrating cells and some cells on pannus in arthritic joints. Anti-LPS IgM levels in rats immunized with E. coli were as high as those in rats immunized with LPS. RFLS levels in rats immunized with LPS increased more gradually than those in rats immunized with E. coli.

CONCLUSION

Our findings suggest that LPS induces arthritis resembling rheumatoid arthritis in rats. The detection of IL-1 in synovial cells in conjunction with LPS suggests that local stimulation of IL-1 production may play an important role in the induction of this experimental arthritis.

Binding characteristics of antitype II collagen antibody to the surface of diseased human cartilage as a probe for tissue damage

OBJECTIVE

Studies have shown that collagen type II (CII) on the intact articular surface of cartilage is partially protected from binding to anti-CII antibodies by material proteinaceous in nature, not present in synovial fluid, synthesized by resident chondrocytes, and exquisitely sensitive to polymorphonuclear (PMN) attack and neutrophil elastase digestion. Thus, anti-CII antibody differential binding to articular cartilage surfaces before and after brief neutrophil elastase digestion may be used as a sensitive marker of cartilage damage.

METHODS

We measured binding of anti-CII antibodies to the pannus-free articular surfaces of 4 normal, 11 rheumatoid (RA), and 10 osteoarthritic (OA) cartilage specimens, before and after brief digestion with PMN elastase. In addition, antibody binding was quantitated with an antiserum against a 4 M guanidine extract of human cartilage surface.

RESULTS

Whereas anti-CII binding increased 59.0% +/- 2.8 after 1 h incubation of normal cartilage with elastase, both the RA and OA specimens failed to show significant increases (RA: 1.0 +/- 0.1; p < 0.001; OA: 27.2% +/- 1.6, p < 0.05). Moreover, anti-CII antibody binding to untreated cartilage specimens was highest for the RA group (Normal: 189.2.1 +/- 38.7 pg anti-lg/mg tissue; RA: 407.5 +/- 80.6, p < 0.05; OA: 243.6 +/- 50.6, NS). Concomitant binding studies with antiserum against cartilage surface material showed greater antibody binding to the articular surfaces than to the cut cartilage surfaces in normal and OA specimens. RA cartilage samples exhibited somewhat smaller antibody binding to the articular surfaces.

CONCLUSION

Our studies suggest that in human inflammatory and noninflammatory arthritides the articular cartilage surface undergoes alterations that can be detected by differential binding with anti-CII antibodies, before and after brief digestion with PMN elastase.

Cloning and nucleotide sequences of two genes involved in the 4''-O-acylation of macrolide antibiotics from Streptomyces thermotolerans

A DNA fragment responsible for the 4''-O-acylation of macrolide antibiotics was cloned from a mutant strain of the carbomycin producer Streptomyces thermotolerans. The gene encoding the macrolide 4''-O-acyltransferase was within a 2.7-kb region of the cloned fragment (15-kb). Streptomyces lividans carrying the region converted exogenously added tylosin to 4''-O-acyltylosins. Nucleotide sequencing of the region showed two open reading frames (ORFs). Expression assay using deleted plasmids showed that both ORFs were essential for optimal expression of the acyltransferase activity. One of them (acyB1) was identical with carE reported previously as a gene encoding 4''-mycarosyl isovaleryl-CoA transferase. The other (acyB2) was assumed to encode a novel regulatory protein that could active acyB1 expression. acyB1 and acyB2 were highly conserved among streptomycetes with macrolide 4''-O-acyl transferase activity.