Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumors burden in cancer patients

α1-Acid Glycoprotein Enhances the Immunosuppressive and Protumor Functions of Tumor-Associated Macrophages

Blood levels of acute-phase protein α₁-acid glycoprotein (AGP, orosmucoid) increase in patients with cancer. Although AGP is produced from hepatocytes following stimulation by immune cell-derived cytokines under conditions of inflammation and tumorigenesis, the functions of AGP in tumorigenesis and tumor progression remain unknown. In the present study, we revealed that AGP contributes directly to tumor development by induction of programmed death ligand 1 (PD-L1) expression and IL6 production in macrophages. Stimulation of AGP induced PD-L1 expression in both human monocyte-derived macrophages through STAT1 activation, whereas AGP had no direct effect on PD-L1 expression in tumor cells. AGP also induced IL6 production from macrophages, which stimulated proliferation in tumor cells by IL6R-mediated activation of STAT3. Furthermore, administration of AGP to AGP KO mice phenocopied effects of tumor-associated macrophages (TAM) on tumor progression. AGP decreased IFNγ secretion from T cells and enhanced STAT3 activation in subcutaneous tumor tissues. In addition, AGP regulated PD-L1 expression and IL6 production in macrophages by binding with CD14, a coreceptor for Toll-like receptor 4 (TLR4), and inducing TLR4 signaling. These results provide the first evidence that AGP is directly involved in tumorigenesis by interacting with TAMs and that AGP might be a target molecule for anticancer therapy. SIGNIFICANCE: AGP-mediated suppression of antitumor immunity contributes to tumor progression by inducing PD-L1 expression and IL6 production in TAMs.

Evaluation of serum sialic acid, fucose levels and their ratio in oral squamous cell carcinoma

Background:

Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, minimally invasive methods like serum evaluation are used for screening large populations. Thus, this study aimed to estimate serum levels of sialic acid and fucose and their ratio in oral cancer patients and in healthy control group to evaluate their role in diagnosis.

Materials and Methods:

Serum samples were collected from 52 healthy controls (group I) and 52 squamous cell carcinoma patients (group II). Estimation of serum levels of sialic acid and fucose and their ratio was performed. This was correlated histopathologically with the grades of carcinoma. Statistical analysis was done by using analysis of variance (ANOVA) test and unpaired “t” test.

Results:

Results showed that serum levels of sialic acid and fucose were significantly higher in oral cancer patients compared to normal healthy controls (P < 0.001). The sialic acid to fucose ratio was significantly lower in cancer patients than in normal controls (P < 0.01). However, comparison with histological grading, habits, gender, and age group did not show any significant result.

Conclusion:

The mean serum sialic acid and fucose levels showed an increasing trend from controls to malignant group and their corresponding ratio showed decreasing trend from controls to malignant group. The ratio of sialic acid to fucose can be a useful diagnostic aid for oral cancer patients.

Smoking and lung cancer-induced changes in N-glycosylation of blood serum proteins

Glycosylation is a key post-translational protein modification which appears important in malignant transformation and tumor metastasis. Abnormal glycosylation of different proteins can often be measured in the blood serum. In this study, we extend our serum-based structural investigations to samples provided by patients diagnosed with lung cancer, paying particular attention to the effects of smoking on the serum glycomic traces. Following a battery of glycomic tests, we find that several fucosylated tetra-antennary structures with varying degrees of sialylation are increased in their abundances in control samples provided by the former smokers, with further elevations in the lung cancer patients who were former smokers. Further detailed investigations demonstrated that the level of outer-arm fucosylation was elevated in the control samples of the former smokers and again in the lung cancer samples provided by the former smokers. This trend was particularly noticeable for the tri- and tetra-antennary structures. Different ratios of sialylation linkages were also observed that could be correlated with the different states of health and smoking status. Decreases in the abundance levels of isomers with two and three α2,3-linked sialic acids and an increased abundance of an isomer with two α2,6-linked sialic acids were noted for a fucosylated tri-sialylated tri-antennary glycan. These results demonstrate the long-term effects of smoking on glycomic profiles and that this factor needs to be considered in these and other serum-based analyses.

Microchip electrophoresis of N-glycans on serpentine separation channels with asymmetrically tapered turns

We designed and fabricated microfluidic devices with serpentine separation channels and asymmetrically tapered turns, thus allowing high efficiency separations and minimizing band broadening associated with the "racetrack" effect. We evaluated the performance of these devices by measuring the variation in separation efficiency with separation length, electric field strength, taper ratio of the turns, and number of turns. N-Glycans derived from ribonuclease B and labeled with 8-aminopyrene-1,3,6-trisulfonic acid were electrophoretically separated on serpentine channels with separation lengths of 11, 18, 22, and 36 cm at electric field strengths from 750 to 1750 V/cm. Separations on the 36-cm channel produced plate numbers up to 940,000 with an analysis time under 3.1 min, whereas separations on the 22-cm channel had a shorter analysis time (less than 1.25 min), still with respectable efficiencies (up to 600,000 plates). Turn-induced dispersion was minimized with taper ratios 2 and 3, whereas having two or four 180° turns along with the separation length did not impact the overall efficiency. The developed device was used to analyze native and desialylated N-glycans derived from the blood serum of an ovarian cancer patient and a disease-free individual. Separation efficiencies similar to that achieved with the model glycans from ribonuclease B were attained for these biological samples.

Quantification of monosaccharides through multiple-reaction monitoring liquid chromatography/mass spectrometry using an aminopropyl column

A simple, sensitive, and reproducible quantitative liquid chromatography/tandem mass spectrometry (LC/MS/MS) method was designed for the simultaneous quantification of monosaccharides derived from glycoprotein and blood serum using a multiple-reaction monitoring (MRM) approach. Sialic acids and neutral monosaccharides were efficiently separated using an amino-bonded silica phase column. Neutral monosaccharide molecules were detected as their aldol acetate anion adducts [M + CH(3)CO(2)](-) using electrospray ionization in negative ion MRM mode, while sialic acids were detected as deprotonated ions [M-H](-). The new method did not require a reduction step, and exhibited very high sensitivity to carbohydrates with limits of detection of 1 pg for the sugars studied. The linearity of the described approach spanned over three orders of magnitude (pg to ng). The method was validated for monosaccharides originating from N-linked glycans attached to glycoproteins and glycoproteins found in human blood serum. The method effectively quantified monosaccharides originating from as little as 1 microg of glycoprotein and 5 microL of blood serum. The method was robust, reproducible, and highly sensitive. It did not require reduction, derivatization or postcolumn addition of reagents.

Monitoring glycosylation pattern changes of glycoproteins using multi-lectin affinity chromatography

Previously, we reported that the distribution of glycoproteins into the lectin displacement fractions of a multi-lectin affinity column was determined by the glycosylation patterns of the proteins. This distribution was observed by the sequential use of displacers specific to the lectins in the column. In this study we have evaluated the multi-lectin column (containing Concanavalin A, Wheat germ agglutinin and Jacalin lectin) to screen glycoproteins with known glycosylation pattern changes. The presence of a glycoprotein in a given displacer fraction was determined by LC-MS/MS analysis of a tryptic digest. We have used the enzyme neuraminidase to modify the oligosaccharide chains present in human transferrin, and used the enzymes, neuraminidase and fucosidase, to modify glycoproteins present in human serum. Then, by comparison with the untreated samples, we demonstrated a distribution shift of the enzyme-treated serum glycoproteins in the displacement fractions isolated from the multi-lectin column. The fractions were analyzed by a protein assay, Sequest rank comparison and peak area measurement from the extracted ion chromatogram. The results indicated that the multi-lectin affinity column (M-LAC) is sensitive to changes in the content of sialic acid and fucosyl residues present in serum glycoproteins, and has the potential to be used to screen serum proteins for glycosylation changes due to disease. In addition, the use of a glycosidase to induce specific structural changes in glycoproteins can support the development of multi-lectin column formats specific for detecting changes in the glycoproteome of certain diagnostic fluids and types of disease.

Evaluation of serum glycoproteins in oral carcinoma

The present study was conducted on thirty untreated oral cancer patients proved by clinical and histopathological evidence and thirty healthy control subjects. The levels of glycoprotein-associated carbohydrates such as hexose, hexosamine, fucose and sialic acid were found to be elevated significantly as compared to control subjects. There was a progressive rise in these markers as the stages of oral cancer advanced.

Comparative study between the free radicals and tumor markers in patients with gastrointestinal tumors

The tumorous processes, increased level of tumor markers and the change of free radical status are associated in patents with gastrointestinal tumors. The aim of this study was to examine free radical status and tumor markers in patients with gastrointestinal tumors. Two hundered and thirteen patients with gastrointestinal tumor were examined. In the control group 44 non-tumorous patients were examined. The tumor markers (CEA, CA 19-9, CA 72-4, AFP, TPA, AGP) and free radical status (total scavenger capacity) were diagnosed using venal blood (obtained by LIA-kits and chemiluminescent methods, LIA-mAT and the Lumat Berthold instrument). It has been found that: (1) The results showed that the tumor markers, TPA and AGP are the best indicators for the tumorous process; (2) The AGP serum level was in the operable case 91.56+/-38.29 mg/dl meanwhile its value was, 128.46+/-47.62 mg/dl (P<0.001) in the inoperable case; and (3) The TPA value was 118.37+/-155.47 mg/dl in the operable case, (P<0.001) while its value was 227.32+/-244.39 mg/dl in inoperable cases. The significantly high levels of the plasma Chemiluminescent Light Intensity (CLI)=28.12+/-25.96; was obtained in patients with rectal tumors vs. in the control cases CLI= 4.27+/-5.12 RLU% (Relative Light Unit; mean+S.D.; P<0.005). In six of these cases, the free radical status examination indicated the presence of the tumor, even though the level of tumor markers was normal. It has been concluded that the testing of both regular tumor markers and free radical status has an important role in the diagnosis and monitoring of the patients with gastrointestinal tumors.

Biochemical evaluation of antitumor effect of muthu marunthu (a herbal formulation) on experimental fibrosarcoma in rats

Natural products from plants are rich sources used for treating a number of diseases. Many of the pharmacological principles of the currently used anticancer agents have been initially isolated from plants. Most of the herbal drugs are a mixture of a number of plant ingredients. Their cumulative effect increases the efficacy of the drug in curing the diseases. Muthu Marunthu is a herbal formulation comprising of eight various plant ingredients, and has been claimed to possess antitumor effect. Therefore, attention has been focused on studying the various plant ingredients in the drug as a whole for its antitumor effects. It was observed that the growth rate in rats was normal and there was no change in blood parameters such as glucose, urea, proteins, cholesterol and also in the activities of pathophysiological enzymes such as lactate dehydrogenase (LDH), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), alkaline and acid phosphatase after Muthu Marunthu administration. The tumor weight was found to be reduced in methylcholanthrene induced fibrosarcoma rats after Muthu Marunthu treatment. Elevated levels of glycocomponents of glycoproteins such as hexose, hexosamine, sialic acid and fucose in plasma of fibrosarcoma rats decreased significantly after Muthu Marunthu treatment. The DNA and RNA levels of liver and kidney, which were increased in fibrosarcoma rats, returned to near normal levels after Muthu Marunthu treatment. The vitamins such as A, C and E in plasma were decreased in fibrosarcoma rats but increased significantly after Muthu Marunthu treatment. The altered levels of copper, zinc and selenium in plasma have also been corrected after Muthu Marunthu treatment. These observations clearly suggested the antitumor potency of Muthu Marunthu in experimentally induced fibrosarcoma in rats.

Effect of radiation on serum glycoproteins and glycosidases in patients with cervical carcinoma

OBJECTIVE

The serum glycan moieties of glycoproteins and the activities of glycosidases were analyzed in order to elucidate the metabolism of glycoprotein in uterine cervical cancer.

METHODS

Serum was collected from patients at different stages of cervical cancer before and after treatment. The results were analyzed using Student's t-test.

RESULTS

The glycan moieties such as sialic acid and fucose were significantly elevated even in the early stages of carcinoma, whereas a significant elevation in hexose and hexosamine levels was observed only in the advanced stages. Among the investigated lysosomal glycohydrolases, beta-D-galactosidase, N-acetyl-beta-D-glucosaminidase and alpha-L-fucosidase activities were elevated significantly at all stages except for stage I. The altered levels of glycoproteins and glycosidases were reduced to near-normal levels after radiotherapy.

CONCLUSION

The levels of glycan moieties and the activities of glycosidases can be used as diagnostic markers to assess the stage of cancer and can be used as prognostic markers during therapy.

Inhibitory effect of calf fetuin on the cytotoxic activity of LAK cell-derived factors and tumor necrosis factor

A protein-inhibiting LAK cell-mediated cytotoxicity was isolated from a LAK cell-conditioned medium. The N-terminal amino acid sequence of this protein appeared to be identical to fetal calf fetuin. Pure isolated fetuin, as well as commercially available preparations of this protein, were shown to inhibit cytotoxic activity of both cytotoxic proteins released by LAK cells and TNF.

Serum concentrations of total sialic acid and sialoglycoproteins in relation to coronary heart disease risk markers

This study investigated the relationship between serum sialic acid concentration and cardiovascular mortality. Correlations were determined between lifestyle-related coronary heart disease risk markers (cigarette consumption, alcohol consumption, and leisure time physical activity), biological risk markers (apolipoprotein A1, apolipoprotein B, lipoprotein(a), and diastolic blood pressure) on the one hand and the concentration of sialic acid as well as sialic acid-rich acute phase proteins (orosomucoid, haptoglobin, and alpha 1-antitrypsin) on the other. A total of 145 men aged 21-46 years and with a C-reactive protein concentration below 5 mg/l were included. Total sialic acid concentration correlated significantly with apolipoprotein B (r = 0.48), number of cigarettes smoked daily (r = 0.32), and leisure time physical activity (r = -0.23) after adjustment for age and other cardiovascular risk markers. No significant partial correlations were found between serum total sialic acid concentration on the one hand and alcohol consumption, apolipoprotein A1, lipoprotein(a), and diastolic blood pressure on the other. Of the sialic acid-rich glycoproteins, orosomucoid correlated with apolipoprotein B (r = 0.38), haptoglobin with cigarette consumption (r = 0.35) and leisure time physical activity (r = -0.26) and alpha 1-antitrypsin with cigarette consumption (r = 0.18), leisure time physical activity (r = 0.17), alcohol consumption (r = -0.18), and apolipoprotein B (r = 0.21) after adjustment for age and other cardiovascular risk markers.

A comparative study of total protein, total and lipid associated serum sialic acid levels in patients with Behçet's disease and control groups

The current investigation was designed to determine the total serum sialic acid (TSA), lipid associated sialic acid (LASA), total protein (TP), and TSA/TP values for 16 patients with active form of Behçet's disease, 12 patients with other uveitis types (pathologic controls) and 22 normal individuals. Data analysis indicated significant differences in mean TSA, LASA and TSA/TP values in patients with Behçet's disease (95.6 +/- 15.3 mg/dl, 29.8 +/- 7.4 mg/dl and 12.9 +/- 2.1 mg/g, respectively) and in pathologic controls (75.8 +/- 8.1 mg/dl, 26.6 +/- 0.3 mg/dl and 10.0 +/- 0.9 mg/g, respectively) when compared to normal controls (59.5 +/- 7.5 mg/dl, 19.2 +/- 3.2 mg/dl and 8.2 +/- 0.9 mg/g, respectively) (p < 0.01). No significant difference was observed in mean LASA values in patients with Behçet's disease when compared to pathologic controls (p > 0.05). No significant difference was observed in mean TP values in patients with Behçet's disease (7.4 +/- 0.7 g/dl), normal controls (7.3 +/- 0.4 g/dl) and pathologic controls (7.5 +/- 0.6 g/dl) (p > 0.05). A statistically significant difference was observed between the patients with Behçet's disease and pathologic controls with respect to TSA, TSA/TP values (p < 0.01). The results indicated that TSA and TSA/TP is most useful for differentiating Behçet's disease from other forms of uveitis.

A re-evaluation of the lipid-bound sialic acid determination

The origin of serum sialic acid measured in the lipid-bound sialic acid determination reported by Katopodis et al. (1980) was investigated in detail. By varying the experimental conditions of sample preparation the protein, lipid and sialic acid contents of the methanol-water extract obtained from human sera were analyzed and compared in healthy controls and cancer patients. Using polyacrylamide gel electrophoretic and gel chromatographic methods it has been shown that most of the lipid-bound sialic acid was attributed to the acid alpha 1-glycoprotein (orosomucoid) fraction of human sera. Based on these observations a re-evaluation of the molecular background of the LBSA determination seems to be necessary.

Serum alpha 2-HS glycoprotein concentration in patients with hematological malignancies. A follow-up study

We observed significantly reduced serum alpha 2-HS glycoprotein concentrations in patients with acute lymphocytic, acute nonlymphocytic, chronic granulocytic and chronic myelomonocytic leukemias, Hodgkin's and non-Hodgkin's lymphomas, myelofibrosis, and multiple myeloma, but not in patients with chronic lymphocytic leukemia and polycythemia vera, as compared with healthy controls. We followed the serum level of the protein for 18 months. Patients with infectious complications, those receiving cytostatic treatment, and those in the preterminal period had further reduced serum alpha 2-HS glycoprotein levels. The reduction of serum alpha 2-HS glycoprotein concentration was primarily due to decreased production caused by infiltration of the liver, a hepatotoxic effect of cytostatic treatment, and, to a lesser degree, to increased consumption. We found statistically significant negative correlations between serum alpha 2-HS glycoprotein concentration and erythrocyte sedimentation rate, serum aspartate aminotransferase and alkaline phosphatase activities, and IgG and IgM concentrations. The determination of the alpha 2-HS glycoprotein concentration is useful for the assessment and follow-up of the clinical status and therapy of patients with hematological malignancies and also has prognostic significance.

A critical analysis of the use of sialic acid determination in the diagnosis of malignancy

The measurement of serum sialic acid in sera from individuals with leukemia, breast, gastrointestinal, lung and bladder cancers, brucellosis and manic depression is described. The serum sialic acid levels were also examined in mice bearing Landschutz ascites tumours. The presence of sialic acid-enriched glycopeptides in serum was shown. The results indicate that while sialic acid may be significantly elevated in sera of some tumour-bearing individuals, it is not solely tumour-derived. Its application as a tumour marker is limited and requires critical analysis.

Evaluation of the serum level of immunosuppressive substance in oral cancer patients

The serum level of immunosuppressive substance (IS) was studied in 40 patients with primary oral cancer and in 79 patients without cancer. Its usefulness was evaluated as a parameter for monitoring therapy as well as recurrence of the tumors. Mean values for serum IS in patients with cancer and patients without were 687 +/- 284 micrograms/mL and 464 +/- 153 micrograms/mL, respectively. Normal healthy controls had a mean value of 431 +/- 105 micrograms/mL, with the cutoff value set at 641 micrograms/mL (mean +2 SD). Patients without cancer who had a severe infectious disease showed conspicuously high serum IS levels, and these values were closely correlated with their C-reactive protein values. The positive rate of IS increased in all patients with oral cancer was 58%. The mean level of serum IS in cancer patients was significantly higher than that of the controls (P less than .01), and the level was found to be more elevated as the stage of the disease advanced (stage I to III, 48%; stage IV, 68%). Histologic analysis of the tumor cells in patients with squamous cell carcinoma (SCC) showed that the mean serum IS level of those who had poorly differentiated SCC was much higher (937 +/- 181 micrograms/mL) than that of patients with well-differentiated SCC (616 +/- 159 micrograms/mL). Patients who had recurrent or metastatic cancer, or those who died from the cancer exhibited marked elevation of the serum IS levels, whereas patients who remained free of cancer in the follow-up period showed significantly lower serum IS levels. The rise and fall of the serum IS level was closely correlated with the disease progression and/or remission. These data strongly suggest that serum IS is a useful parameter for monitoring the disease stage as well as the effect of therapy on patients with oral cancer.

Usefulness of serum glycoconjugates in precancerous and cancerous diseases of the oral cavity

Sera from 47 healthy controls, 18 normal individuals with the habit of tobacco chewing, 43 patients with oral precancerous (PC) conditions, and 40 patients with oral cancer (OC) were studied for the levels of total sialic acid (TSA), lipid-bound sialic acid (LSA), mucoid proteins, and protein-bound hexoses (PBH) (galactose and mannose). The changes in the glycoconjugate levels were insignificant between the controls and the normal tobacco chewers. All four parameters were significantly elevated in oral PC patients compared with controls. The levels of PBH and LSA showed significant increase in the oral PC patients compared with the normal tobacco chewers. A significant increase was observed in the levels of TSA, LSA, mucoid proteins, and PBH in OC patients compared with controls, normal tobacco chewers, and patients with oral PC. Increasing levels of all the biomarkers were found with progression of the malignant disease. Elevations in the levels of TSA and LSA were statistically significant in Stage IV patients compared with Stage III patients. The patients with metastases had higher levels of the biomarkers than the patients with primary OC. However, elevations only in LSA levels were statistically significant. These results suggest that evaluations of the serum glycoconjugate levels may be useful in diagnosis of the patients with oral PC or OC. In addition to their value in early detection, they can also help in staging of the disease.

Alpha 2-HS-glycoprotein: expression in chondrocytes and augmentation of alkaline phosphatase and phospholipase A2 activity

The alpha 2-HS-glycoprotein is a plasma protein synthesized in liver and enriched in bone. The concentration of alpha 2-HS-glycoprotein dynamically changes in various physiological conditions and is highest in bone during growth, suggesting that it is involved in regulation of endochondral ossification. Northern blot analysis demonstrated that mRNA transcripts from growth zone and resting zone costochondral chondrocyte cultures hybridized with alpha 2-HS-glycoprotein cDNA. However, a difference of mRNA transcript size was observed, with chondrocyte mRNA transcripts being 2.2 kb, while mRNA isolated from liver was 1.6 kb. Presence of alpha 2-HS-glycoprotein in cartilage cells was found by immunohistochemical staining of human fetal epiphyses using anti-human alpha 2-HS-glycoprotein antibody. To understand the role of alpha 2-HS-glycoprotein in cartilage growth, the effects of exogenous alpha 2-HS-glycoprotein were correlated with alkaline phosphatase (ALPase) and phospholipase A2 (PA2) activity in the chondrocyte cultures. Alkaline phosphatase specific activity was stimulated by alpha 2-HS-glycoprotein at concentrations between 0.25 and 1.25 micrograms/mL in the growth zone and resting zone cultures 2.7 and 2.0-fold, respectively. Matrix vesicle PA2 activity was increased only in the growth zone chondrocyte cultures. These results suggested that alpha 2-HS-glycoprotein may contribute to the regulation of the expression of the chondrocyte phenotype. Steady state mRNA levels of ALPase were analyzed in chondrocytes after additions of alpha 2-HS-glycoprotein. The ALPase mRNA levels remained stationary during the stimulation of enzymatic activity, indicating that the effect of alpha 2-HS-glycoprotein upon alkaline phosphatase activity is not at the transcriptional level.

Serum tumor markers of head and neck cancer: current status

The serum level of a variety of substances shows significant changes in head and neck cancer patients. Such substances are collectively called biochemical tumor markers. To date, most markers lack a high degree of specificity and sensitivity. However, serial measurement of markers showing elevated pretreatment levels may help in monitoring response to therapy. Other potential uses of tumor markers include earlier detection of recurrence and/or metastasis, and possible prediction of prognosis. Measurement of more than one marker seems to enhance the diagnostic accuracy of the test. Some markers show significant correlations with various immune parameters in head and neck cancer patients and may have a possible role in potentiating the immunodepressed status of such patients. A review of currently reported tumor markers in head and neck cancer showing their nature, sources, uses, and limitations is presented.

The position of the disulfide bonds in human plasma alpha 2 HS-glycoprotein and the repeating double disulfide bonds in the domain structure

The positions of the inter- and intra-chain disulfide bonds of human plasma alpha 2 HS-glycoprotein were determined. alpha 2 HS-glycoprotein was digested with acid proteinase and then with thermolysin. The disulfide bonds containing peptides were separated by reversed-phase HPLC and detected by SBD-F (7-fluorobenzo-2-oxa-1,3-diasole-4-sulfonic acid ammonium salt) method. One inter-disulfide bond containing peptide and five intra-disulfide bond containing peptides (A-chain) were purified and identified as Cys-18 (B-chain)--Cys-14 (A-chain), Cys-71--Cys-82, Cys-96--Cys-114, Cys-128--Cys-131, Cys-190--Cys-201 and Cys-212--Cys-229, respectively. The location of the intra-disulfide bonds revealed that the A-chain of alpha 2 HS-glycoprotein is composed of three domains. Two domains were shown to possess intramolecular homology judging from the total chain length of the domains, size of the loops formed by the S--S bonds, the location of two disulfide loops near the C-terminal end of domains A and B, the distance between two S--S bonds of each domain, the amino acid sequence homology between these two domains (22.6%), number of amino acid residues between the second S--S loops and the end of domains A and B, and the positions of the ordered structures.

Detection of malignant pleural effusions by tumor marker evaluation

Cytologic examination and determination of tumor markers (PHI, LDH, alpha-1-glycoprotein, alpha-2-HS-glycoprotein, beta 2-microglobulin, ferritin [corrected], sialic acid, IgE, fetoprotein, CEA, beta HCG and beta 1-SP-glycoprotein) were carried out in pleural fluid samples obtained from 70 patients with suspected neoplasia. Tumor markers were also determined in sera. The protein content of all pleural effusions was greater than or equal to 3 g/dl. Patients were grouped according to diagnosis as follows: (a) 42 with neoplastic diseases (7 mesotheliomas and 19 lung, 4 ovarian, 3 breast and 8 miscellaneous cancers), (b) 22 with benign inflammations and (c) 6 with congestive effusions. Of the parameters examined, only CEA and beta-HCG [corrected] gave information that the effusion was probably malignant. Using 6 ng/ml as cut-off for CEA and 10 mIU/ml for beta HCG, the sensitivity was 57.1% and 45.2%, respectively, specificity was 92.8% for both parameters and test efficiency 0.75 and 0.69, respectively. When CEA and beta HCG were considered together sensitivity increased to 73.8% and efficiency to 0.78. CEA and/or beta HCG were positive in the pleural effusions of 19 of the 20 malignant pleural effusions, all with a negative cytologic examination, which subsequently became positive in 8. Because of their high specificity, these two parameters are a useful tool and can be routinely measured to evaluate pleural effusions of dubious origin, even if CEA and beta HCG cannot, on [corrected] their own, define the primary malignancy.

Acute phase reaction, heterogeneity, and microheterogeneity of serum proteins as nonspecific tumor markers in lung cancer

The acute phase proteins, orosomucoid, ceruloplasmin, antitrypsin, and haptoglobin were measured in serum from 54 patients with lung cancer, 16 patients with benign lung inflammation, and 30 healthy individuals. A statistical correlation was found between tumor size and acute phase protein level, which, however, was ascribed to nonspecific inflammation in the tissues surrounding the tumor. The patients who subsequently could not be radically treated by surgery had higher concentrations of orosomucoid and ceruloplasmin than the radically treated patients. No difference in acute phase protein concentration was found between benign and malignant disease. The glycan-dependent microheterogeneity of orosomucoid and ceruloplasmin was analyzed by crossed affinoimmunoelectrophoresis with lectins, and the patterns of the patients with benign inflammation and malignant disease were different. The heterogeneity of ceruloplasmin was also analyzed by crossed immunoelectrophoresis without lectin. This analysis, combined with the total serum concentration of ceruloplasmin, made it possible to discriminate the 54 cases of malignancy from the 46 cases of nonmalignancy with a sensitivity of 78% and a specificity of 93%. It is suggested that the simple electrophoretic analyses of (micro-)heterogeneity is a valuable supplement to the acute phase profile in isolating high-risk patients and in monitoring radically treated cancer patients for relapse.

Three forms of BRP-2 (bone resorptive proteins) from human cancer ascites fluid and their relationship to human serum alpha-2 HS-glycoprotein

Two new forms of BRP-2, a previously described bone resorptive protein, were purified from ascites fluids obtained from patients with hypercalcemia and metastatic bone cancer. The apparent molecular weights of BRP-2 and of these two proteins were 52,000, 48,000, and 46,000, respectively, as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The three proteins have essentially the same amino acid compositions but differ with respect to their carbohydrate moieties. The amino-terminal amino acid sequences of the three glycoproteins were identical to each other as well as to human serum alpha 2HS-(human serum) glycoprotein. The relationship of the three forms of BRP-2 to alpha 2HS was also established immunochemically. The ascites proteins, as well as alpha 2HS, on a molar basis, were approximately one-tenth as potent as bovine parathyroid hormone fragment (1-34) in their abilities to stimulate calcium release from bone in vitro. This study describes for the first time a possible function for human serum alpha 2HS.

Human alpha 2-HS-glycoprotein: the A and B chains with a connecting sequence are encoded by a single mRNA transcript

The alpha 2-HS-glycoprotein (AHSG) is a plasma protein reported to play roles in bone mineralization and in the immune response. It is composed of two subunits, the A and B chains. Recombinant plasmids containing human cDNA AHSG have been isolated by screening an adult human liver library with a mixed oligonucleotide probe. The cDNA clones containing AHSG inserts span approximately 1.5 kilobase pairs and include the entire AHSG coding sequence, demonstrating that the A and B chains are encoded by a single mRNA transcript. The cDNA sequence predicts an 18-amino-acid signal peptide, followed by the A-chain sequence of AHSG. A heretofore unseen connecting sequence of 40 amino acids was deduced between the A- and B-chain sequences. The connecting sequence demonstrates the unique amino acid doublets and collagen triplets found in the A and B chains; it is not homologous with other reported amino acid sequences. The connecting sequence may be cleaved in a posttranslational step by limited proteolysis before mature AHSG is released into the circulation or may vary in its presence because of alternative processing. The AHSG cDNA was utilized for mapping the AHSG gene to the 3q21----qter region of human chromosome 3. The availability of the AHSG cDNA clone will facilitate the analysis of its genetic control and gene expression during development and bone formation.

Immunosuppressive acidic protein in patients with brain tumours: a preliminary report

The present investigation was conducted to document the serum concentrations of immunosuppressive acidic protein (IAP) in patients with intracranial tumours utilizing the single radial immunodiffusion method. Among 46 pre-operative patients, elevated serum levels of IAP were found in nine of 16 patients with gliomas, six of nine patients with metastasis, and two of 21 patients with non-glial, histologically benign intracranial tumours. The mean value of serum IAP in glial or metastatic tumours was found significantly higher than that of either non-glial or normal individuals. It was postulated that serum IAP levels could correlate with a grade of anaplasia and malignancy of the tumour. And it was also of note that serum IAP levels appeared to have a tendency to decrease in response to the treatment. In addition, serum IAP levels were found correlated with the clinical condition and course of disease as evaluated by performance status and erythrocyte sedimentation rate. Therefore, it was suggested that measurement of serum IAP could be, at least in part, useful in validating the histologic analysis of brain tumours, in following responses to treatment when used as a tumour indicator, and in monitoring the progress of the disease in patients in terms of performance status.

Relation between raised concentrations of fucose, sialic acid, and acute phase proteins in serum from patients with cancer: choosing suitable serum glycoprotein markers

Serum concentrations of fucose, sialic acid, and eight acute phase proteins were measured in single specimens from patients with cancer in order to determine whether the raised concentrations of protein bound sugars commonly found in cancer correlate with increased concentrations of the acute phase proteins. Strong positive correlations were found only with alpha 1-acid glycoprotein, alpha 1-antitrypsin, and haptoglobins. Changes in protein bound sugars and acute phase proteins were also examined in relation to patients' disease states. Serum fucose was raised more often in patients with advanced disease than in those in whom the spread of the tumour was more restricted; increased sialic acid concentrations, however, were found with a similar frequency in both these groups. Combined use of fucose and sialic acid values gave a high degree of marker positivity which could be only slightly improved on by including measurement of acute phase proteins. The combined use of serum fucose and sialic acid concentrations may have value in monitoring patients with cancer: the sialic acid provides an index of the acute phase response and the fucose a measure of the tumour spread.

Observed differences in postoperative lymphocyte transformation are explained by patient and population variations

In the present study, the kinetics of the lymphocyte response to phytohemagglutinin were examined by harvesting lymphocytes at 24 hour intervals in four nonoperated control subjects, preoperatively and postoperatively in six men who underwent herniorrhaphy, and in four people who had colectomy for adenocarcinoma. Nonorthogonal analysis after logarithmic transformation and adjustment for individual and population variations showed no differences in preoperative and postoperative transformation. No age effects were seen. The previous evidence that surgery inhibits transformation to phytohemagglutinin was explained by wide kinetic variations in both patient and control populations.

The effect of alpha 2HS glycoprotein on lymphocyte reactivity to phytohemagglutinin

The effect of alpha 2HS glycoprotein on lymphocyte reactivity to phytohemagglutinin (PHA) was investigated. The results show that alpha 2HS glycoprotein, rather than enhancing lymphocyte reactivity to PHA as suggested by earlier correlation studies, inhibits such reactivity. Experiments suggest that this inhibition is unlikely to be the result of alpha 2HS glycoprotein binding either PHA or 3H-thymidine but is more likely to act at the cellular level.

Acute-phase reactant proteins and carcinoembryonic antigen in cancer of the colon and rectum

One hundred and twenty-eight patients bearing primary malignancies of the large bowel were studied to ascertain the value of acute-phase reactant proteins (serum protein hexose, ceruloplasmin, transferrin, alpha-1-antitrypsin, seromucoid and haptoglobin) either alone or in conjunction with carcinoembryonic antigen to accurately reflect the disease status of patients both before and after resection of their large bowel malignancy. The results indicate that acute-phase reactant proteins have a higher diagnostic rate for the presence of malignancy than does CEA. Estimation of the serum protein hexose alone is of greater diagnostic value than a combination of acute-phase reactant proteins. Furthermore, serum protein hexose and CEA are complementary and when combined will reflect the presence of malignancy in a greater number of patients than either one alone. Following resection of primary large bowel cancer, acute-phase reactant proteins are as accurate as CEA in evaluating the disease-free status of patients and furthermore when combined with CEA increased the predictive value for the detection of patients with recurrent disease.

Immunoregulatory properties and LP-pattern of human ovarian carcinoma ascites and pleural effusions of nonmalignant origin

The immunoregulatory activity of ascitic fluids obtained from patients with ovarian carcinoma, and pleural effusions collected from patients with various nonmalignant diseases, was tested. The following assays were performed: in vivo, PFC-response of mouse splenocytes to SRBC; in vitro, antibody-dependent cellular cytotoxicity (ADCC), and phagocytic activity of human peripheral blood mononuclear cells (PBMoC). The migration ability of mouse splenocytes in the presence of ascitic fluids was also evaluated. Parallelly, lipid (triglyceride and cholesterol) and lipoprotein (high-density/HDL/, low-density/LDL/, and very-low-density/VLDL/) content in ascites and pleural effusions, were determined. Both types of fluids suppressed the PFC-response and inhibited phagocytosis of 51Cr-labeled sheep erythrocytes by PBMoC, but augmented ADCC of PBMoC against sheep erythrocytes. An elevation of VLDL and a decrease of HDL and LDL in ascitic fluids and pleural effusions, as compared to normal human sera, were found. There were similar changes in the cholesterol content of these lipoprotein fractions, i.e., an increase of VLDL- and a decrease of HDL- and LDL-cholesterol.

Measurement of sialyl transferase activity and serum glycoproteins in malignant and beningn (hyperparathyroid) hypercalcemia

Serum sialyl tranferase activity (STA) and protein bound carbohydrate were measured in hypercalcemic patients with surgically documented hyperparathyroidism (n = 15) or with cancer without skeletal metastases (n = 10). Precipitable protein-bound sialic acid and hexosamine, but not neutral hexoses or fucose were significantly (P less than 0.025) increased 40% and 21% respectively, in the perchlorate treated sera of cancer patients. Measurements of some specific serum glycoproteins by radial immunodiffusion assay were also different (P less than 0.05). Mean seromucoid protein was almost twice as great in the group with cancer (P less than 0.005), but four of these values overlapped those from the patients with hyperparathyroidism. The mean STA was 21.1 (range, 9.0-46.8) activity units in the patients with the cancer and 9.2 (range 1.0-17.8) in the patients with hyperparathyroidism (P less than 0.005). Six of the patients with cancer had values above the upper limit of the group with hyperparathyroidism. A discriminant function generated from these data correctly classified all the patients with hyperparathyroidism and 70% of those with cancer. Measurements of seromucoid and STA deserve further consideration as a way to discriminate some cases of hypercalcemia.

Purification and characterization of the two forms of human plasma alpha 2HS-glycoprotein

The two forms of alpha 2HS-glycoprotein were purified from Cohn fraction VI of normal human plasma and characterized in terms of their major chemical and physicochemical properties. Separation of these two proteins was achieved by chromatography on DEAE-cellulose at pH 4.4 followed by gel filtration through Sephadex G-100. The isoelectric points of the disc gel electrophoretically and immunochemically homogeneous glycoproteins were found to be at 4.1 and 4.7 and their apparent molecular weights, as determined by SDS-polyacrylamide gel electrophoresis, were shown to be 51,000 and 56,000, respectively. The amino acid compositions of both proteins were very similar, although differences, particularly in the arginine and histidine contents, were noted. The amino- and carboxyl-terminal amino acids were found to be the same for both proteins and were threonine and alanine, and valine and leucine, respectively, suggesting that both forms of this protein consist of two polypeptide chains. The total carbohydrate moiety of the relatively basic form (14%) proved to be comparable to that of the relatively acidic form (13%). More important, however, the sialic acid content of the latter was higher than that of the former. These results suggest that the difference between the two forms of alpha 2HS-glycoprotein resides both in its carbohydrate and polypeptide moieties.

Cancer serum index: a useful nonspecific test as a parameter in multimodality screening and assessment of patients with cancer of the prostate

A satisfactory, simple test for screening and monitoring of patients with prostatic cancer is still being sought. We suggest the use of a nonspecific test in combination with other tests. The ratio of two serum proteins (alpha 1 acid glycoprotein [AGP] and prealbumin [PAB]), may be useful markers for a cancer serum index (CSI). By separating serum components by gradient polyacrylamide gel electrophoresis, staining and quantitating these proteins by scanning densitometry, and dividing the area of AGP by that of PAB, indices can be obtained. In a test of sera from 450 patients with prostatic cancer, other urologic problems, and normal controls, CSIs of 360 sera presently decoded were found to be: (Formula: see text). The CSI should prove highly valuable when used in combination with selected prostatic cancer tests.

Transitional mucosa and survival in human colorectal cancer

The mucosa in 100 segments of colon and rectum resected for cancer were examined using light microscopy and histochemical techniques. The extent of abnormal or transitional mucosa was defined for each case. Transitional mucosa was present in 93 of 95 adenocarcinomas and one malignant melanoma. The average total length of transitional change was 3.4 cm the maximum length was 19.5 cm. An inverse correlation was observed between the survival and the length of transitional mucosa around locally invasive (Dukes' B) carcinomas (P = 0.005). This may be related to increased amounts of sialic acid in transitional mucosa and the ability of sialic acid to depress tumor immunogenicity. The raised levels of sialic acids in transitional mucosa may have practical value in assessment of prognosis in colorectal cancer.

Serum glycoproteins in cancer patients: first report of correlations with in vitro and in vivo parameters of cellular immunity

Serum levels of proteins previously shown to be elevated [acute-phase proteins (APP)-haptoglobin, alpha 1-acid glycoprotein, alpha 1-antitrypsin] or depressed (alpha 2 HS-glycoprotein, prealbumin, albumin) in cancer patients were correlated with tumor extent, in vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA), and quantitative delayed hypersensivity (DH) to dinitrochlorobenzene (DNCB) in 147 preoperative patients with operable solid malignancies either confined to the primary site or with regional spread only. Compared to 58 normal controls, levels of the APP were significantly elevated, alpha 2 HS-glycoprotein and prealbumin depressed, and albumin levels unchanged in patients with either local or regional tumors. In patients with normal DH to DNCB, the APP were higher and prealbumin was lower than in controls; in patients with impaired DH to DNCB, haptoglobin and alpha 1-acid glycoprotein were higher and alpha 2 HS-glycoprotein and prealbumin lower than in patients with normal DH to DNCB. Albumin levels did not differ from normals in any of the groups. Serum protein levels appeared to be more related to the immune status of the patient than to tumor extent. The levels of the three APP correlated directly with each other but inversely with alpha 2 HS-glycoprotein and prealbumin; levels of alpha 2 HS-glycoprotein and prealbumin correlated directly with each other. Levels of haptoglobin and alpha 1-acid glycoprotein correlated inversely with LR to PHA; however, levels of alpha 2 HS-glycoprotein correlated directly with LR to PHA, and uniquely the levels of alpha 2 HS-glycoprotein and LR to PHA both showed similar changes for each of the four quantitative levels of DH to DNCB measured in the cancer patients. The data show that the proteins studied, except for albumin, correlate inversely (APP) or directly (alpha 2 HS-glycoprotein and prealbumin) with in vitro and in vivo parameters of cellular immunity. The results provide a rationale for attempts to improve depressed cellular immunity by lowering circulating levels of APP, as is being attempted in ongoing trials using plasmapheresis, and assessing the effect of exogenous alpha 2 HS-glycoprotein or prealbumin in patients with low levels of these glycoproteins and depressed cellular immunity. The correlations between serum glycoprotein levels and in vitro and in vivo parameters of cellular immunity lend rationale to investigations of the interactions of serum glycoproteins and blood cells having immunologic function that determine the level of cellular immunity expressed in vivo.

Serum sialic acid and CEA concentrations in human breast cancer

The concentration of bound sialic acid in the sera of 56 normal subjects and 65 subjects with breast cancer was measured, in order to determine (1) whether serum sialic acid concentrations are raised in breast cancer and (2) whether the concentration of sialic acid in serum reflects tumour stage. The amount of sialic acid in serum was compared to serum carcinoembryonic antigen (CEA) values. Urinary hydroxyproline and serum alkaline phosphatase concentrations were used as indicators of bone and liver involvement. Erythrocyte sedimentation rate (ESR) was also measured. Significantly elevated serum sialic acid concentrations were found in breast cancer, and showed correlation with tumour stage. Serum sialic acid values did not correlate with CEA values. The results suggest that measurement of serum sialic acid concentrations may be of adjunctive value in assessing tumour stage.