Assessing the Current State of Cognitive Frailty: Measurement Properties

BACKGROUND

Currently, an estimated 25-30% of people ages 85 or older have dementia, with a projected 115 million people worldwide living with dementia by 2050. With this worldwide phenomenon fast approaching, early detection of at-risk older adults and development of interventions focused on preventing loss in quality of life are increasingly important. A new construct defined by the International Consensus Group (I.A.N.A/I.A.G.G) as «cognitive frailty» combines domains of physical frailty with cognitive impairment and provides a framework for research that may provide a means to identify individuals with cognitive impairment caused by nonneurodegenerative conditions. Using the integrative review method of Whittemore and Knafl., 2005 this study examines and appraises the optimal measures for detecting cognitive frailty in clinical populations of older adults.

METHODS

The integrative review was conducted using PubMed, CINAHL, Web of Science, PsycInfo, and ProQuest Dissertations and Theses. From the total 185 articles retrieved, review of titles and key words were conducted. Following the initial review, 168 articles did not meet the inclusion criteria for association of frailty and cognition. Of the 18 fulltext articles reviewed, 11 articles met the inclusion criteria; these articles were reviewed in-depth to determine validity and reliability of the cognitive frailty measures.

RESULTS

Predictive validity was established by the studies reviewed in four main areas: frailty and type of dementia MCI (OR 7.4, 95% CI 4.2-13.2), vascular dementia (OR 6.7, 95% CI 1.6-27.4) and Alzheimer's dementia (OR 3.2, 95% CI 1.7-6.2), frailty and vascular dementia (VaAD) is further supported by the rate of change in frailty x macroinfarcts (r = 0.032, p < 0.001); frailty and the individual domains of cognitive function established with the relationship of neurocognitive speed and change in cognition using regression coefficients; individual components of frailty and individual domains of cognitive function associations inculded slow gait and executive function (β -0.20, p < 0.008 ), attention (β -0.25 p < 0.008), processing speed (β -0.16, p < 0.008), word recall (β - 0.18, p = 0.02), and logical memory (β = 0.04, p =0.04). Weak grip was predictive for changes in executive function (β - 0.16, p =0.008). Physical activity was associated with changes in executive function (β = -0.18, p= 0.02) and word recall (β = 0.17, p= 0.02), individual components of frailty and global cognitive function were found in several studies which included grip strength (r = - 0.51, p < 0.001), gait speed (r = - 0.067, p < 0.001), and exhaustion (β - 0.18, p < 0.008).

CONCLUSIONS

This paper presents the first-known review of the measurement properties for the cognitive frailty construct since the published results from the International Consensus Group (I.A.N.A/I.A.G.G). Evidence presented in this review continues to support the link between physical frailty and cognition with developing validity to support distinct relationships between components of physical frailty and cognitive decline. Results call attention to inconsistencies in reporting of reliability, validity, and heterogeneity in the measurements and operational definition for cognitive frailty. Further research is needed to establish an operational definition and develop psychometrically appropriate clinical measures to construct an understanding of the relationship between physical frailty and cognitive decline.

Genotoxicity of carbon nanofibers: are they potentially more or less dangerous than carbon nanotubes or asbestos?

The production of carbon nanofibers and nanotubes (CNF/CNT) and their composite products is increasing globally. CNF are generating great interest in industrial sectors such as energy production and electronics, where alternative materials may have limited performance or are produced at a much higher cost. However, despite the increasing industrial use of carbon nanofibers, information on their potential adverse health effects is limited. In the current study, we examine the cytotoxic and genotoxic potential of carbon-based nanofibers (Pyrograf®-III) and compare this material with the effects of asbestos fibers (crocidolite) or single-walled carbon nanotubes (SWCNT). The genotoxic effects in the lung fibroblast (V79) cell line were examined using two complementary assays: the comet assay and micronucleus (MN) test. In addition, we utilized fluorescence in situ hybridization to detect the chromatin pan-centromeric signals within the MN indicating their origin by aneugenic (chromosomal malsegregation) or clastogenic (chromosome breakage) mechanisms. Cytotoxicity tests revealed a concentration- and time-dependent loss of V79 cell viability after exposure to all tested materials in the following sequence: asbestos>CNF>SWCNT. Additionally, cellular uptake and generation of oxygen radicals was seen in the murine RAW264.7 macrophages following exposure to CNF or asbestos but not after administration of SWCNT. DNA damage and MN induction were found after exposure to all tested materials with the strongest effect seen for CNF. Finally, we demonstrated that CNF induced predominantly centromere-positive MN in primary human small airway epithelial cells (SAEC) indicating aneugenic events. Further investigations are warranted to elucidate the possible mechanisms involved in CNF-induced genotoxicity.

A randomized trial on sodium reduction in two developing countries

Hypertension remains the most common cardiovascular risk factor in developing countries, yet the majority of patients have no access to pharmacological therapy. Population-wide preventive strategies, such as salt restriction, are an attractive alternative, but experience in resource-poor settings is limited. To address this question, we conducted a randomized crossover study of salt restriction in adults living in Nigeria and Jamaica in order to estimate the mean blood pressure (BP) response. After a 4-week run-in period to determine willingness to adhere to a low-salt diet, 56 Jamaicans and 58 Nigerians completed an 8-week crossover study of low-salt and high-salt intake. Baseline BPs were in the normotensive range (systolic=125 mmHg in Jamaica, 114 mmHg in Nigeria). Baseline urinary sodium excretion was 86.8 and 125.6 mEq/day in Nigeria and Jamaica, respectively. The mean difference between urinary sodium excretion at baseline and at the end of the 3-week low-sodium phase was 33.6 mEq/day in Nigeria and 57.5 mEq/day in Jamaica. During the high-sodium phase, mean change in urinary sodium excretion from baseline to week 3 was 35.0 and 5.5 mEq/day in Nigeria and Jamaica, respectively. The mean change in systolic BP ('high' vs 'low' sodium phase) was approximately 5 mmHg in both groups. This study suggests that the efficacy of sodium reduction in developing countries equals those noted in more affluent cultures. If promoted on a wide scale, sodium reduction could be used to treat persons with established hypertension, and more importantly, to prevent age-related increases in BP in poor communities.

Review article: the stages of gastrointestinal carcinogenesis--application of rodent models to human disease

The development of gastrointestinal cancer in humans and animals occurs through a consecutive series of stages termed initiation, promotion and progression. The characterization of each of these stages has been elucidated in several model systems as well as in human neoplasms. Both single, putatively initiated cells and preneoplastic foci have been identified by marker protein differences as well as by mutational changes. The promotion stage involves the clonal expansion of single initiated cells. Such expansion can be rapidly reversed by a variety of means, of which acute fasting (as exemplified in rat hepatocarcinogenesis) is among the most rapid and efficient. This reversal involves a selective apoptosis of preneoplastic cells and preneoplastic lesions, associated with a marked increase in expression of the proto-oncogene c-myc. Transition of cells from the stage of promotion to that of progression initially involves specific karyotypic alterations, as noted in both the rat liver model and human colon carcinogenesis. In the former, the transition appears to be associated with enhanced expression of the H119 imprinted putative tumour suppressor gene. Thus, the use of model systems may be applied directly to the human circumstance, increasing the potential both for rational prevention of gastrointestinal neoplasia and for new approaches to the therapy of neoplastic disease in the progression stage.

Cytogenetic analysis of three rat liver epithelial cell lines (WBneo, WBHa-ras, and WBrasIIa) and correlation of an early chromosomal alteration with insulin-like growth factor II expression

Cytogenetic changes that occur during the progression of rat hepatocarcinogenesis were assessed with three rat liver epithelial cell lines derived from WB cells. Previously characterized WBneo, WBras, and WBrasIIa cells were grown in culture and analyzed for structural and numerical chromosomal integrity by banded karyotype analysis. The WBneo cells had a low level of aneuploidy with a consistent loss of the Y chromosome by passage 7. The ras-transfected cell line selected for growth in soft agar, WBras, had acquired a loss of chromosome 3 (12%) or 3p (34%), a trisomy of chromosome 1, as well as the chromosome Y loss. The cell line produced from tumors generated by injection of the WBras cells into a syngeneic F344 rat, WBrasIIa, contained additional chromosomal changes. The WBrasIIa line comprised cells retaining a trisomy of chromosome 1 (55%) and cells with two copies of chromosome 1, with a minimal duplication of 1q3.7 to 1q4.3 (45%). This tumor-derived cell line contained, in addition, a higher percentage of cells with a loss of all or part of chromosomes 3 and 6, indicating the possible presence of tumor suppressor genes in this region. The smallest region of duplication of chromosome 1 was bands 1q3.7-4.3. The insulin-like growth factor II (IGF-II) gene is located within the region of duplication on chromosome 1. Because IGF-II is both a rat liver mitogen and an inhibitor of apoptosis, its expression was examined in these three rat liver epithelial cell lines. Northern blot analysis demonstrated an increase in IGF-II mRNA expression in the WBras and WBrasIIa cell lines relative to the WBneo control cell line. Several IGF-II transcripts analogous to those detected in fetal rat liver were observed. An additional IGF-II transcript that migrates above the 28S ribosomal marker was also observed. These results were confirmed at the protein level by immunohistochemical and Western blot analysis. This increased expression of IGF-II may confer a selective growth advantage to rat liver epithelial cells with a duplication of 1q3.7-4.3. This growth advantage may be enhanced by the further sequential loss of putative tumor suppressor genes on chromosomes 3 and 6.

Karyotypic changes in a multistage model of chemical hepatocarcinogenesis in the rat

Karyotypic analysis of the stages of rat hepatocarcinogenesis has been facilitated by the development of an initiation-promotion-progression (IPP) protocol that permits separation and characterization of morphologically normal and altered hepatocytes in each of these three stages. The expression of the membrane antigen gamma-glutamyl transpeptidase (GGT) during the promotion and progression stages of rat hepatocarcinogenesis permits the isolation, culture, analysis, and comparison of hepatocytes in the two stages, which express this marker of carcinogenesis. Female rats were administered 10 mg diethylnitrosamine/kg at 5 days of age. One group of initiated rats was maintained on dietary phenobarbital admixed into a laboratory chow diet at 0.05% for 9 months after weaning (promotion protocol). This initiation-promotion (IP) group was compared with one subjected to the complete IPP protocol. The IPP group was initiated with diethylnitrosamine, maintained on phenobarbital for 6 months after weaning, and then subjected to a 70% partial hepatectomy and administered 100 mg ethylnitrosourea/kg 24 h later. These rats on the IPP protocol were then maintained on phenobarbital for an additional 3 months prior to sacrifice. At sacrifice, single hepatocyte suspensions were obtained and separated into populations of cells expressing or not expressing GGT. These hepatocyte populations were cultured separately and subjected to standard cytogenetic analysis. At least five animals per treatment and 100 metaphase spreads of good morphology per animal were examined. Although GGT- cells from the IP protocol were 80% tetraploid and 20% diploid, the GGT+ hepatocytes were greater than 90% diploid. The GGT+ cells from this protocol had a low rate of random aneuploidy (4.0 +/- 1.3%) compared with corresponding cells from the IPP protocol, but a higher level of background aneuploidy compared with GGT- cells from the IP protocol. The GGT+ hepatocytes from animals on the IPP protocol had a 35% incidence of aneuploidy. In addition, the GGT+ population had a 28 +/- 5% incidence of chromosomal breakage and a 17 +/- 5% incidence of chromosomal rearrangements. The primary nonrandom chromosomal changes observed in cells from the IPP protocol included duplication of all or part (1q37-43) of chromosome 1 and the loss of chromosomes 3p and/or 6q. These studies indicate that rat hepatocytes in the stage of promotion are euploid, whereas those in the stage of progression exhibit considerable genetic instability. The presence of multiple copies of chromosome 1 or a duplication of a region of this chromosome indicates that alteration of gene dosage for one or more of the genes present in this region is critical to the neoplastic conversion of rat hepatocytes, whereas the loss of all of 3p and the last light band of 6q may indicate the presence of tumor suppressor genes. Thus, the IP and IPP protocols coupled with the ability to isolate GGT+ and GGT- hepatocytes permit the differential cytogenetic characterization of the stages of promotion and progression in rat hepatocarcinogenesis.

The initiation-promotion-progression model of rat hepatocarcinogenesis

Carcinogenesis is a multistage process consisting of the three distinct stages: initiation, promotion, and progression. The initiation-promotion-progression (IPP) protocol models these stages and establishes a method whereby agents that possess a carcinogenic risk can be classified as acting primarily at any one or combination of these stages. In one hepatocarcinogenesis IPP protocol, rats were initiated with 10 mg of diethylnitrosamine/kg body wt at 5 days of age, started on the promoting agent phenobarbital at weaning, subjected to a 70% partial hepatectomy at 6 months, and, at the peak of proliferation, given a putative progressor agent, ethylnitrosourea ([ENU] 100 mg/kg, ip) or hydroxy-urea ([HU] 3 x 150 mg/kg, ip). Administration of the promoting agent was discontinued after the progressor agent was given, and the rats were sacrificed 6 months later. The number and volume fraction of promoter-independent (growth in the absence of the promoting agent) altered hepatic foci (AHF) were then determined by quantitative stereology. The number of such AHF increased with either ENU or HU treatment compared with animals not given a progressor agent. In addition, hepatocytes isolated from animals subjected to an IPP regimen with ENU as the progressor agent exhibited a greater degree of chromosomal breakage and aneuploidy than animals not given a second initiator. A variation of this model, in which the promoting agent was maintained after administration of the progressor agent, was examined. In this IPP model, the number of heterogeneous AHF (foci-in-foci) increased after application of the progressor agent (ENU or HU). An increased incidence of hepatocellular carcinoma was also observed in animals subjected to the IPP protocol when promotion was maintained until sacrifice. Thus, the characteristics of progression--increased chromosomal damage, aneuploidy, growth of AHF in the absence of continued tumor promotion, the presence of foci-in-foci, and an increased incidence of malignant neoplasia--have been used as end points for the demonstration of progressor activity by ENU. In addition, the potential progressor activity of HU and benzene has been demonstrated with the IPP model of rat hepatocarcinogenesis.

Interactive cytogenetic effects on rat bone-marrow due to chronic ingestion of 2,5,2',5' and 3,4,3',4' PCBs

Rats who were fed low doses of single PCBs, either 2,5,2',5' or 3,4,3',4', did not demonstrate any chromosome breakage or mitotic changes in their bone marrow cells. However, there was a significant increase in chromosome damage observed in bone marrow cells of rats ingesting 10 ppm 2,5,2',5' plus 0.1 ppm 3,3,3',4' in combination. It is suggested that this PCB combination, previously found to cause superadditive chromosome damage in vitro, is also capable of causing chromosome damage in vivo, but these effects do not compromise cell proliferation because the mitotic index is not depressed.

Biochemical markers associated with the stages of promotion and progression during hepatocarcinogenesis in the rat

Specific biochemical changes occurring during hepatocarcinogenesis have been sought by many investigators. The development of multistage models for hepatocarcinogenesis in the rodent has renewed interest in such marker alterations in preneoplastic as well as neoplastic hepatocytes. Preneoplastic altered hepatic foci (AHF) exhibit specific histomorphologic changes as viewed with tinctorial stains and show a variety of biochemical changes as evidenced by enzyme and immunohistochemistry and by other histochemical markers. During the reversible stage of promotion when AHF are scored by multiple markers, the distribution of markers within these lesions differs with the use of different promoting agents. One interpretation of this finding is that each promoting agent stimulates the replication of a set of initiated cells exhibiting the phenotypic characteristics of a specific programmed phenotype. The same markers score AHF during the stage of progression, but many AHF in this stage are phenotypically heterogeneous, exhibiting in tissue sections a "focus-in-focus" pattern of marker alteration. These latter changes can be correlated with the appearance of karyotypic alterations in preneoplastic hepatocytes. On the other hand, it has been difficult to demonstrate the activation, either mutational or transcriptional, of proto-oncogenes until this stage of progression in rat hepatocarcinogenesis. Thus, a study of biochemical and molecular markers during the stages of hepatocarcinogenesis may lead to a better understanding of potential mechanisms involved in the development of neoplasia through the stages of initiation, promotion, and progression.

Study of the separate and combined effects of the non-planar 2,5,2',5'- and the planar 3,4,3',4'-tetrachlorobiphenyl in liver and lymphocytes in vivo

Polychlorinated biphenyls (PCBs) are a group of industrial chemicals that are widely distributed in the environment. Because these compounds occur as mixtures, studies of their possible interactive effects are essential for an understanding of the mechanism of the toxicity of these mixtures. For the determination of a possible interaction of the effects in vivo of 2,5,2',5'-tetrachlorobiphenyl (TCB) and 3,4,3',4'-TCB, rats were exposed to a single dose of diethylnitrosamine (DEN) and subsequently to 0.1 p.p.m. 3,4,3',4'-TCB and/or 10 p.p.m. 2,5,2',5'-TCB in the feed for 1 year. The two major targets of PCB toxicity, the liver and the peripheral blood, were examined after these treatments. TCB treatment after DEN exposure caused a predominance of increased placental glutathione S-transferase (PGST) and deficiencies of ATPase as preneoplastic markers in focal hepatic lesions. When 0.05% phenobarbital (PB) was administered after DEN exposure, the distribution of markers in altered hepatic foci (AHF) was essentially equal for increased PGST and gamma-glutamyltranspeptidase (GGT) and for ATPase deficiency. Many of these AHF also exhibited increased P450 b/e expression. Our results demonstrated that the two PCB congeners interacted in vivo to produce an increase in AHF that were PGST positive and ATPase negative. PGST-positive and ATPase-negative AHF correlated best with focal areas of P450 b/e expression. The combination of the two PCBs caused a greater than additive decrease in the total number of lymphocytes and antibody-producing B-cells. Also the thymocyte-dependent T-helper cells isolated from the animals receiving the combination of TCBs demonstrated a morphologically abnormal subpopulation. The results indicate that the interaction of 2,5,2',5'-TCB and 3,4,3',4'-TCB in vivo induced much greater toxicity and mutagenicity in peripheral lymphocytes and hepatocytes than treatment with either congener alone.

Management of the medial canthal tendon in nasoethmoid orbital fractures: the importance of the central fragment in classification and treatment

The medial canthal tendon and the fragment of bone on which it inserts ("central" fragment) are the critical factors in the diagnosis and treatment of nasoethmoid orbital fractures. The status of the tendon, the tendon-bearing bone segment, and the fracture pattern define a clinically useful classification system. Three patterns of fracture are appreciated: type I--single-segment central fragment; type II--comminuted central fragment with fractures remaining external to the medial canthal tendon insertion; and type III--comminuted central fragment with fractures extending into bone bearing the canthal insertion. Injuries are further classified as unilateral and bilateral and by their extension into other anatomic areas. The fracture pattern determines exposure and fixation. Inferior approaches alone are advised for unilateral single-segment injuries that are nondisplaced superiorly. Superior and inferior approaches are required for displaced unilateral single-segment injuries, for bilateral single-segment injuries, and for all comminuted fractures. Complete interfragment wiring of all segments is stabilized by junctional rigid fixation. All comminuted fractures require transnasal wiring of the bones of the medial orbital rim (medial canthal tendon-bearing or "central" bone fragment). If the fracture does not extend through the canthal insertion, the canthus should not be detached to accomplish the reduction.

In vitro chromosome damage due to PCB interactions

In order to study the possible mutagenic properties of polychlorinated biphenyls (PCBs), human lymphocyte cultures were examined for chromosome breakage, rearrangements, sister-chromatid exchange, and mitotic delay. The present study, which used cyclophosphamide as a positive control, shows that one planar PCB congener, 3,4,3',4'-tetrachlorobiphenyl, caused dose-related chromosome breakage in human lymphocytes exposed in vitro to 0.1-10(-4) micrograms/ml. In contrast, the non-planar PCB, 2,5,2',5', did not cause chromosome damage in comparable tests even at concentrations as high as 1 microgram/ml. However, when 3,4,3',4' at a concentration lower than that which causes chromosome breakage (10(-5) micrograms/ml) was combined with a non-clastogenic concentration of 2,5,2',5', the chromosomal damage observed was far in excess of what one would expect from higher doses of 3,4,3',4' alone. These results suggest that some PCB congeners may interact to cause synergistic genotoxic effects.

Critical parameters in the quantitation of the stages of initiation, promotion, and progression in one model of hepatocarcinogenesis in the rat

Critical parameters in the quantitation of altered hepatic foci (AHF) developing during multistage hepatocarcinogenesis in the rat include: 1) the enumeration of AHF induced by test agents as well as those AHF occurring spontaneously in livers of untreated animals; 2) the volume percentage or fraction of the liver occupied by all AHF as a reflection of the total number of altered cells within the liver and the degree of tumor promotion which has occurred; and 3) the phenotype of individual AHF as determined by multiple markers with serial sections. These parameters, especially the number of AHF, should be corrected by the presence of spontaneous AHF which increase with the age of the animal, more so in males than females. While accurate estimation of the background level of spontaneous AHF can be important in demonstrating that a carcinogenic agent does not possess the ability to increase the numbers of AHF above the background level, a better method to distinguish the effectiveness and relative potencies of agents as initiators or promoters is reviewed. The relative effectiveness of four different markers--gamma-glutamyltranspeptidase (GGT), a placental form of glutathione S-transferase (GST), canalicular ATPase, and glucose 6-phosphatase (G6Pase)--was described for the chemicals C.I. Solvent Yellow 14 and chlorendic acid as promoting agents in males and females. C.I. Solvent Yellow 14 is a more effective promoting agent in females than males, and AHF exhibit extremely low numbers scored by GGT. On the other hand, the numbers of AHF present in livers of male rats promoted by this agent are more than twice those seen in livers of female animals, possibly owing to the effectiveness of this agent as an initiator in the male but not the female. Very few AHF, especially in the male, are scored by GGT during chlorendic acid promotion. The distribution of phenotypes with these markers also differs in the spontaneous AHF appearing in the livers of animals fed 0.05% phenobarbital on either a crude NIH-07 or AIN-76 purified diet. Such studies emphasize the extreme dependence of the promoting stage of hepatocarcinogenesis on environmental factors of sex, diet, and the molecular nature of the promoting agent itself. The hallmark of the final stage of progression in the development of hepatocellular carcinomas is aneuploidy, which may be reflected by phenotypic heterogeneity within individual AHF, termed foci-in-foci. The implications of such quantitative analyses during hepatocarcinogenesis induced by specific agents in relation to the specific action of the agent at one or more of the stages of hepatocarcinogenesis are discussed.

Ploidy and karyotype of hepatocytes isolated from enzyme-altered foci in two different protocols of multistage hepatocarcinogenesis in the rat

The ploidy and karyotypes of hepatocytes isolated from the livers of rats subjected to the protocols of Peraino et al. and of Solt and Farber were determined by the examination of such cells in primary culture. A study of 100 or more metaphases from each of five rats on each protocol revealed that 75-80% of gamma-glutamyltranspeptidase-positive (GGT+) hepatocytes isolated from livers of rats in either protocol were diploid, whereas only 23-33% of GGT- cells were diploid. Fifty percent or more of the karyotypes of hepatocytes from livers of rats receiving the Solt-Farber protocol exhibited one or more chromosomal breaks, whereas hepatocytes from livers of rats subjected to the Peraino protocol showed no increase in chromosomal breakage over that in normal controls. These studies demonstrate that the majority of GGT+ cells from altered hepatic foci are diploid and that the greater toxicity of the Solt-Farber protocol over that of Peraino is correlated with marked chromosomal breakage of GGT+ hepatocytes.

Split-Root Assays Using Trifolium subterraneum Show that Rhizobium Infection Induces a Systemic Response That Can Inhibit Nodulation of Another Invasive Rhizobium Strain

Subterranean clover plants possessing two equally infectible and robust lateral root systems (“split roots”) were used in conjunction with several specific mutant strains (derived from Rhizobium trifolii ANU843) to investigate a systemic plant response induced by infective Rhizobium strains. This plant response controls and inhibits subsequent nodulation on the plant. When strain ANU843 was inoculated onto both root systems simultaneously or 24, 48, 72, or 96 h apart, an inhibitory response occurred which retarded nodulation on the root exposed to the delayed inoculum but only when the delay period between inocula was greater than 24 h. Equal numbers of nodules were generated on both roots when ANU843 was inoculated simultaneously or 24 h apart. The ability to infect subterranean clover plants was required to initiate the plant inhibitory response since preexposure of one root system to non-nodulating strains did not retard the ability of the wild-type strain to nodulate the opposing root system (even when the delay period was 96 h). Moreover, the use of specific Tn 5 -induced mutants subtly impaired in their ability to nodulate demonstrated that the plant could effectively and rapidly discriminate between infections initiated by either the parent or the mutant strains. When inoculated alone onto clover plants, these mutant strains were able to infect the most susceptible plant cells at the time of inoculation and induce nitrogen-fixing nodules. However, the separate but simultaneous inoculation on opposing root systems of the parent and the mutant strains resulted in the almost complete inhibition of the nodulation ability of the mutant strains. We concluded that the mutants were affected in their competitive ability, and this finding was reflected by poor nodule occupancy when the mutants were coinoculated with the parent strain onto a single root system. Thus the split-root system may form the basis of a simple screening method for the ranking of competitiveness of various rhizobia on small seeded legumes.

Biological behavior of human breast carcinoma-associated antigens expressed during cellular proliferation

The cell surface-binding properties of two murine monoclonal antibodies reactive with human mammary tumor cells are described. Fluorescence-activated cell sorter analyses demonstrate that both monoclonal antibodies, B6.2 and B38.1, are reactive with the surface of the majority of human breast tumor cell lines tested but are unreactive with a variety of normal human cell lines, melanomas, sarcomas, and lymphoid tumors. Antibody B6.2 was also reactive with selective carcinomas, while antibody B38.1 showed even broader reactivity. The two monoclonal antibodies were unreactive with the surface of a variety of normal human tissues obtained at biopsy, including lymph nodes, bone marrow, and spleen, but were reactive with mammary tumor cells obtained from four of six pleural effusions. Surface binding to mammary tumor cells by both monoclonal antibodies was shown to decrease during density-dependent arrest; further cell cycle analysis demonstrated differential antibody surface binding during S phase. Prolonged exposure of mammary tumor cells to antibody showed no evidence of antigen capping or internalization. Both monoclonal antibodies were shown to lyse mammary tumor cells in antibody-dependent cell-mediated cytotoxicity.

Modulation of 5-FU metabolism in human MCF-7 breast carcinoma cells

We have previously demonstrated a highly significant relationship (P less than 0.0001) between the incorporation of 5-fluorouracil (5-FU) into total cellular RNA and loss of clonogenic survival of the human MCF-7 breast carcinoma cell line. The present studies explore the applicability of this relationship to MCF-7 cells exposed to 5-FU and modulating agents such as PALA, MTX, and MMPR. PALA treatment produces a minimal increase in the absolute amount of 5-FU incorporated into total cellular RNA, but it results in a three-fold enhancement of the [3H]FU/32P ratio, which measures 5-FU misincorporation into newly synthesized RNA. MTX and MMPR increase intracellular PRPP levels up to four-fold; nevertheless these agents result in only minimal increases in absolute (5-FU)RNA formation. In contrast, the relative incorporation of 5-FU into newly synthesized RNA of MTX- or MMPR-treated cells is increased 2.5-fold. The combination of PALA/MMPR results in a two-fold absolute increase in (5-FU)RNA formation and a nine-fold enhancement of the [3H]FU/32P ratio. Combinations of modulating agents with 5-FU result in more than additive decreases in MCF-7 clonogenic survival. The relationship between 5-FU incorporation into RNA and loss of clonogenic survival was highly significant (P less than 0.0002) when corrected for newly synthesized RNA, while the correlation with absolute amounts of (5-FU)RNA formation was less significant (P less than 0.05). These studies demonstrate that the relationship previously established between (5-FU)RNA formation and loss of clonogenic survival should be corrected for the amount of newly synthesized RNA when 5-FU is combined with modulating agents that alter rates of RNA synthesis.

Rescue of thymidine cytotoxicity in L1210 ascites by elevated endogenous levels of deoxycytidine

Although the biochemical and cytokinetic effects of thymidine (TdR) have been extensively studied in vitro, other parameters may be encountered in vivo that could alter its therapeutic efficacy. L1210 cells in culture are sensitive to the growth inhibitory effects of TdR, while TdR infusions in mice bearing L1210 ascites fail to prolong survival. Our results demonstrate that the TdR levels achieved in the serum and ascites fluid during sc and iv infusions range between 10(-4) and 10(-3) M. These levels are sufficient to inhibit the growth of bone marrow and intestinal mucosa cells, as evidenced by 32P incorporation studies. However, these TdR levels fail to exhibit the growth of L1210 ascites, despite the fact that these cells are sensitive to similar concentrations in vitro. The absence of growth inhibition in the L1210 ascites is shown to be due to increased endogenous CdR levels (approximately 2 X 10(-5) M) in the ascites fluid. The concomitant serum CdR levels were at least ten times lower than those achieved in the ascites. This factor probably accounts for the differential effect of TdR on normal cells as compared in vivo with agents such as TdR or even antimetabolites, such as cytarabine, may be modulated by increased CdR levels in the local tumor milieu. These studies are relevant in that TdR is currently being used in a variety of clinical protocols using the nucleoside alone at high doses or in combination with methotrexate, 5-FU, or cytarabine.