Intracoronary photodynamic therapy reduces neointimal growth without suppressing re-endothelialisation in a porcine model

OBJECTIVE

To examine the effects of intracoronary PhotoPoint photodynamic therapy (PDT) with a new photosensitiser, MV0611, in the overstretch balloon and stent porcine models of restenosis.

METHODS

28 pigs were injected with 3 mg/kg of MV0611 systemically 4 h before the procedure. Animals were divided into either the balloon overstretch injury (BI) group (n = 19) or the stented group (n = 9). After BI, a centred delivery catheter was positioned in the artery to cover the injured area, and light (532 nm, 125 J/cm(2)) was applied to activate the drug (n = 10). Control arteries (n = 9) were not activated by light. In the stented group, the drug was light activated before stent deployment. Serial sections of vessels were processed 14 days after treatment in the BI group and 30 days after treatment in the stented group for histomorphometric or immunohistochemical analysis.

RESULTS

Intracoronary PDT significantly reduced intimal thickness in both BI and stented arteries (about 65%: 0.22 (SEM 0.05) mm v 0.62 (0.05) mm, p < 0.01; and about 26%: 0.40 (0.04) mm v 0.54 (0.04) mm, p < 0.01, respectively). PDT increased luminal area by

CONCLUSION

Intracoronary PhotoPoint PDT with MV0611 reduces intimal proliferation without suppressing re-endothelialisation in a porcine model of restenosis.

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MESH Headings

• Angioplasty, Balloon
• Animals
• Cell Proliferation
• Coronary Restenosis/prevention & control
• Coronary Vessels/injuries
• Feasibility Studies
• Female
• Immunohistochemistry
• Male
• Mesoporphyrins/pharmacokinetics
• Mesoporphyrins/therapeutic use
• Photochemotherapy/methods
• Photosensitizing Agents/pharmacokinetics
• Photosensitizing Agents/therapeutic use
• Random Allocation
• Stents
• Swine
• Tunica Intima

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PhotoPoint photodynamic therapy with local drug delivery eliminates vessel wall cells in arteriovenous graft models

PURPOSE

To demonstrate the feasibility of PhotoPoint photodynamic therapy (PDT) with local drug delivery, optimize dosimetry in a rabbit jugular vein model, and investigate its ability to deplete potential neointimal precursor cells in the vessel wall in a canine arteriovenous graft (AVG) model.

METHODS AND MATERIALS

Photosensitizer MV2101 was administered locally in rabbit veins, incubated for 0-40 min and activated with external laser light. In canine veins, MV2101 was incubated for 30 min and activated by light. Tissues were excised at acute and chronic timepoints.

RESULTS

PhotoPoint PDT reduced cell populations in both models with maximum depletions occurring at 20 min (> or = 100 J/cm2) in rabbit veins (> 90% depletion) and 30 min (200 J/cm2) in canine veins (> 85% depletion). Chronic veins revealed no evidence of PhotoPoint PDT-related abnormalities.

CONCLUSIONS

PhotoPoint PDT with local MV2101 dramatically depleted potential neointimal precursor cells in the vessel wall. This suggests local drug delivery is feasible and that PhotoPoint PDT may be an efficacious treatment that could prolong AVG patency in the clinic.

Proton radiation therapy for medium and large choroidal melanoma: preservation of the eye and its functionality

PURPOSE

Evaluation of efficacy and safety of proton radiation therapy (PRT) for medium- and large-size choroidal melanoma with focus on preservation of the eye and its function.

METHODS

Retrospective review of 78 patients with 60 medium and 18 large-size choroidal melanomas at a median follow-up of 34 months.

RESULTS

The 5-year data for local control, metastases-free survival, and disease-specific survival were estimated to be 90.5 +/- 3.7%, 76.2 +/- 6.7%, and 75.6 +/- 7.6%, respectively. Eye preservation was achieved in 75.3% of patients, with useful (better than 20/200) visual acuity (VA) in 49.1% of surviving patients. Both local failure and complications led to enucleation. Prognosticators were tumor close to the optic disc (p = 0.003), large tumors involving the ciliary body (p = 0.041), and local failure (p < 0.001). Prognostic factors for VA following PRT were initial VA (p = 0.001), doses to optic disc (p = 0.001) and fovea (p = 0.022) higher than 35 CGE (Cobalt Gray equivalent), tumor close to the optic disc (p = 0.034), and retinal detachment (p < 0.001). Tumor basis diameter was significantly related to metastases free survival (p = 0.02), overall survival (p = 0.033), and disease specific survival (p = 0.017), but did not impair local tumor control, rate of enucleation, and VA.

CONCLUSION

The present data suggest that PRT is an effective and safe treatment for medium and large size choroidal melanoma. PRT can preserve the eye and its function in a reasonable percentage of patients. Further evaluation in controlled clinical trials comparing PRT to plaque radiotherapy and enucleation is required.

Nasopharyngeal carcinoma: repeat treatment with conformal proton therapy--dose-volume histogram analysis

PURPOSE

To analyze control, survival, and complication rates of conformal proton radiation for recurrent nasopharyngeal carcinoma.

MATERIALS AND METHODS

Sixteen patients with nasopharyngeal carcinoma initially treated with 50.0-88.2 Gy photons were re-treated with protons to additional doses of 59.4-70.2 CGE. Local-regional control and survival were correlated with extent of relapse, recurrence versus persistence, and prescribed dose and were subjected to dose-volume histogram analysis. Mean follow-up was 23.7 months (range, 4-47 months).

RESULTS

Twenty-four-month actuarial overall and local-regional progression-free survival rates were both 50%. The 24-month actuarial overall survival rates for patients with "optimal" dose-volume histogram coverage versus "suboptimal" coverage were 83% and 17%, respectively (P = .006). Doses to critical structures were low (0-22.0 Gy); no central nervous system side effects supervened.

CONCLUSION

Adequate tumor coverage, as evaluated by using dose-volume histogram analysis, was found to be the most important variable influencing local-regional control and survival. No central nervous system complications were observed; increases in the dose to adjacent critical structures are being evaluated.

Proton radiation therapy for chordomas and chondrosarcomas of the skull base

OBJECT

Local tumor control, patient survival, and treatment failure outcomes were analyzed to assess treatment efficacy in 58 patients in whom fractionated proton radiation therapy (RT) was administered for skull base chordomas and chondrosarcomas.

METHODS

Between March 1992 and January 1998, a total of 58 patients who could be evaluated were treated for skull base tumors, 33 for chordoma and 25 for chondrosarcoma. Following various surgical procedures, residual tumor was detected in 91% of patients; 59% demonstrated brainstem involvement. Target dosages ranged from 64.8 and 79.2 (mean 70.7) Co Gy equivalent. The range of follow up was 7 to 75 months (mean 33 months). In 10 patients (17%) the treatment failed locally, resulting in local control rates of 92% (23 of 25 patients) for chondrosarcomas and 76% (25 of 33 patients) for chordomas. Tumor volume and brainstem involvement influenced control rates. All tumors with volumes of 25 ml or less remained locally controlled, compared with 56% of tumors larger than 25 ml (p = 0.02); 94% of patients without brainstem involvement did not experience recurrence; in patients with brainstem involvement (and dose reduction because of brainstem tolerance constraints) the authors achieved a tumor control rate of 53% (p = 0.04). Three patients died of their disease, and one died of intercurrent disease. Actuarial 5-year survival rates were 100% for patients with chondrosarcoma and 79% for patients with chordoma. Grade 3 and 4 late toxicities were observed in four patients (7%) and were symptomatic in three (5%).

CONCLUSIONS

High-dose proton RT offers excellent chances of lasting tumor control and survival, with acceptable risks. In this series all small- and medium-sized tumors with no demonstrable brainstem involvement have been controlled; all such patients are alive. Surgical debulking enhanced delivery of full tumoricidal doses, but even patients with large tumors and disease abutting crucial normal structures benefited.

Pre-clinical trials using hepatic gene delivery

The development of gene therapy as a potential technique for treating serious metabolic or infectious disorders has generated much interest. The general applicability of gene therapy depends on the efficient transfer of the desired gene to specific tissues and cells. One of the most attractive sites for gene transfer is the liver because it plays a major role in many metabolic processes and is involved in a large variety of diseases. Nonviral strategies have been conceived for delivering genes to the liver but this approach is still at the preclinical stage. This review outlines the more commonly used approaches and discusses the progress that has been made toward developing a widely applicable, clinically relevant gene transfer procedure for the liver.

Immune complexes of LDL induce atherogenic responses in human monocytic cells

The ability of immune complexes of LDL or acetylated LDL (acLDL), together with antibodies to LDL, to induce a proatherogenic phenotype in human monocytic cells has been explored. Treatment of THP-1 monocytic cells or peripheral human monocytes with LDL immune complexes containing intact anti-LDL markedly enhanced the ability of these cells to subsequently bind and take up LDL, whereas aggregated LDL or LDL immune complexes prepared with F(ab')2 fragments of anti-LDL had no significant effect. Activation of THP-1 cells with intact LDL immune complexes also stimulated mRNA expression for the scavenger receptor. Additionally, activation of THP-1 cells with insoluble immune complexes of LDL or LDL stimulated generation of reactive oxygen intermediates that, in turn, could oxidize exogenous LDL. These results indicate that the binding of lipoprotein immune complexes to Fc receptors on monocytic cells activates a series of responses that could accelerate the initiation or progression of atherosclerosis.

Oncostatin M activates low density lipoprotein receptor gene transcription in sterol-repressed liver cells

Oncostatin M (OM), a cytokine produced by macrophages and activated T cells, has been shown to be a potent inducer of liver low density lipoprotein receptor (LDLR) activity by increasing LDL uptake and cell surface LDLR number in HepG2 cells. To investigate whether OM regulates the transcription of the LDLR gene and if the effect is independent of the sterol pathway, we examined the effects of OM on the promoter activity of the LDLR gene and the expression of LDLR mRNA. HepG2 cells were transfected with hybrid genes containing three different lengths of DNA fragments from the 5' flanking region of the LDLR gene that were fused to the coding region of the chloramphenicol acetyltransferase (CAT) gene. OM induced an approximately 3-fold increase in CAT activities in pLDLR-CAT vector-transfected cells that were incubated in lipoprotein-depleted medium and a 6-fold increase in CAT activities when the transfected cells were treated with sterols. OM stimulated similar increases in CAT activities in HepG2 cells transfected with pLDLR-CAT 234, pLDLR-CAT 1563, and pLDLR-CAT 6500, suggesting that the essential cis-acting element that mediates the OM effect is located within the 177 base pairs upstream of the transcription start site of the LDLR gene. Examination of the regulation of the endogenous LDLR mRNA expression by OM gave results similar to those in transfected cells. OM increased the levels of mRNA of LDLR, regardless of the presence or absence of lipoprotein and sterols. These data suggest that the up-regulation of the LDLR by OM is at the transcriptional level through a nonsterol mediated mechanism.

Inhibitors of angiotensin converting enzyme decrease early atherosclerosis in hyperlipidemic hamsters. Fosinopril reduces plasma cholesterol and captopril inhibits macrophage-foam cell accumulation independently of blood pressure and plasma lipids

The effect of two angiotensin converting enzyme (ACE) inhibitors on the development of atherosclerosis was determined in hyperlipidemic hamsters. Preliminary studies indicated that only fosinopril (50 mg/kg) temporarily decreased mean arterial pressure, while after chronic dosing fosinopril and captopril (50 mg/kg) were ineffective. The same dose of fosinopril and captopril inhibited the angiotensin I pressor response, indicating these agents suppressed ACE activity in vivo. In the 3 week atherosclerosis experiment, all hamsters were fed chow supplemented with 0.05% cholesterol and 10% coconut oil. Control hamsters were compared with those receiving either 50 mg/kg per day of fosinopril or 50 mg/kg per day of captopril. After 3 weeks, fosinopril reduced plasma total cholesterol, low density lipoprotein (LDL) plus very low density lipoprotein cholesterol and total triglycerides by 17%, 27% and 45%, respectively. Captopril only reduced high density lipoprotein cholesterol by 20%. Neither fosinopril or captopril altered blood pressure at 3 weeks. Atherosclerosis was quantified from en face preparations of the lesion-prone aortic arch that were stained with oil red O (for cholesteryl ester and triglycerides). In control hamsters, oil red O labeled numerous subendothelial macrophage-foam cells located along the inner curvature of the aortic arch. Compared with controls, fosinopril reduced the number of intimal macrophage-foam cells/mm2, foam cell size and the fatty streak area by 85%, 38% and 90%, respectively. Captopril decreased these parameters by 44%, 16% and 53%. Thus captopril decreased early atherosclerosis without affecting plasma LDL cholesterol or blood pressure, which suggested that inhibiting ACE (or kininase II) directly impeded the accumulation and formation of macrophage-foam cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of Egr-1 by oncostatin M precedes up-regulation of low density lipoprotein receptors in HepG2 cells

Oncostatin M (OM), a 28 kilodalton glycoprotein cytokine, is structurally and functionally related to interleukin 6 and leukemia-inhibitory factor. We reported previously that OM strongly up-regulated low density lipoprotein (LDL) receptors in human liver cells by a tyrosine kinase-mediated mechanism. Now, we demonstrate that the transcription factor Egr-1 is induced by OM. The induction of Egr-1 was time and concentration dependent; maximal inductions of 10-fold occurred by 30 min at concentrations of 10-25 ng/ml and higher. This concentration dependency was identical to those for OM-mediated tyrosine phosphorylation and LDL receptor up-regulation. The Egr-1, tyrosine kinase, and LDL receptor responses were inhibited at similar concentrations of genistein, suggesting that induction of Egr-1 and up-regulation of LDL receptors depended on activation of tyrosine kinase by OM. In contrast, depletion of protein kinase C by preincubation with 4 beta-phorbol 12-myristate 13 alpha-acetate did not affect OM-mediated induction of Egr-1 or up-regulation of LDL receptors, indicating that protein kinase C is not required for the OM action. Other similar cytokines were investigated, and, of these, only interleukin 1 could increase both Egr-1 and LDL receptor activity. The correlation among tyrosine kinase phosphorylation, Egr-1 induction, and LDL receptor regulation suggests that Egr-1 may be a nuclear signal transducer utilized by OM to induce transcription of the LDL receptor gene. In support of this possibility is the discovery of an Egr-1 consensus sequence (GAGGGGGCG) at approximately 330 base pairs upstream from the transcription initiation site of the LDL receptor promoter region.

Prostacyclin agonists reduce early atherosclerosis in hyperlipidemic hamsters. Octimibate and BMY 42393 suppress monocyte chemotaxis, macrophage cholesteryl ester accumulation, scavenger receptor activity, and tumor necrosis factor production

We determined the effects of two prostacyclin agonists (octimibate and BMY 42393) on the progression of the fatty streak in vivo and on macrophage function in vitro. Hamsters were fed chow plus 0.05% cholesterol and 10% coconut oil. Control hamsters were compared with animals receiving either octimibate (10 or 30 mg/kg per day) or BMY 42393 (30 mg/kg per day). After 10 weeks of treatment, octimibate decreased plasma total cholesterol and triglycerides by 43% and 32%, respectively. Neither agonist affected blood pressure or heart rate. Lesion-prone aortic arches were stained with hematoxylin and oil red O and examined en face. Compared with controls, octimibate and BMY 42393 on average decreased mononuclear cells attached to the luminal surface by 44% and reduced subendothelial macrophage-foam cell number by 56%, foam cell size by 38%, and fatty streak area by 63%. Since octimibate is a putative inhibitor of acyl coenzyme A cholesterol acyltransferase, we studied the effect of both agents on cholesteryl ester metabolism in murine macrophages. At 10 microM, octimibate and BMY 42393 decreased cholesteryl ester accumulation in macrophages by 90% and 41%, respectively. Octimibate inhibited cholesteryl ester synthesis by 96% and increased the rate of cholesteryl ester degradation by 52%. Both prostacyclin agonists reduced macrophage scavenger receptor-mediated uptake of acetylated low density lipoprotein by 24-66% and increased cyclic adenosine monophosphate levels. Octimibate and BMY 42393 inhibited the secretion of tumor necrosis factor by 80-88% when macrophages were activated with lipopolysaccharide. At 10 microM, both agents decreased human monocyte chemotaxis to N-formyl-methionyl-leucyl-phenylalanine by 64-79%. The in vitro results with octimibate and BMY 42393 are consistent with the low number of small foam cells quantified in vivo. We suggest that octimibate and BMY 42393 suppress monocyte-macrophage atherogenic activity and cytokine production and thus inhibit the development of early atherosclerosis.

Oncostatin M is a mitogen for rabbit vascular smooth muscle cells

The growth regulatory protein oncostatin M was initially discovered in macrophage-conditioned medium. We investigated the effects of oncostatin M on cultured rabbit aorta smooth muscle cells (SMCs) and found that the peptide stimulated an increase in the incorporation of [3H]thymidine into DNA. The magnitude of the stimulation was dependent on oncostatin M concentration and SMC confluency. In subconfluent cultures, 1-2 nM stimulated 4- to 5-fold increases in DNA synthesis after 20 hr. Other structurally related cytokines (granulocyte colony-stimulating factor, leukemia inhibitory factor, interleukin 6, ciliary neurotrophic factor) did not affect SMC DNA synthesis. After 5 or 8 days, oncostatin M caused a doubling in SMC number and also induced a transformed phenotype. The combination of oncostatin M and platelet-derived growth factor for 8 days resulted in a 4-fold increase in cell number, approximately the same increase in cell number as induced by the addition of 10% fetal calf serum. Further investigation suggested that the mitogenic effect of oncostatin M was in part due to tyrosine kinase activation. Within 1-2 min, the factor increased phosphotyrosine levels of several SMC proteins. In addition, detectable increases in diacylglycerol levels occurred within 2-5 min, reached 50% above control by 30 min, and remained elevated through 45 min of incubation with oncostatin M. SMC inositol phosphate levels were also elevated within 2 min and then returned to near control values by 20 min. Within 30 min, oncostatin M induced expression of the immediate-early gene EGR-1. These data indicate that oncostatin M may be an important, naturally occurring mitogen for vascular SMCs.

Macrophage-derived factors increase low density lipoprotein uptake and receptor number in cultured human liver cells

Recent evidence suggests the possibility that macrophages can influence lipoprotein metabolism. Therefore we investigated the ability of cultured macrophages to alter low density lipoprotein (LDL) uptake in a human liver cell line (HepG2). Conditioned media from phlogogenic-induced mouse peritoneal macrophages or from a human macrophage cell line stimulated with endotoxin increased HepG2 LDL uptake by as much as 60-70%. The increase was due, in part, to a significant macrophage-induced 40% increase in the number of LDL receptors per cell. Although macrophage conditioned media inhibited HepG2 cholesterol synthesis, the LDL receptor up-regulation did not appear to be due to the effects on cholesterol synthesis. The LDL receptor stimulatory activity was sensitive to proteolysis and heat. Its molecular mass was approximately 20 kDa based on gel filtration. Several macrophage secretory proteins were tested in HepG2 cultures for LDL uptake stimulation. Of these, oncostatin M (approximately 18 kDa by gel filtration) gave the strongest response. The rank order for LDL uptake stimulation was oncostatin M much greater than interleukin 6 = interleukin 1 = transforming growth factor-beta 1. A neutralizing antibody directed against oncostatin M inhibited the ability of conditioned media to up-regulate LDL receptors by 85%. Thus, our results indicate that macrophages can secrete several proteins that up-regulate LDL receptors in HepG2 cells and that most of the up-regulatory activity in macrophage conditioned media appears to be due to oncostatin M.

Effect of in vivo inhibition of neutrophil adherence on skeletal muscle function during ischemia in ferrets

Neutrophils are reported to play an important role in the genesis of tissue damage during reperfusion after periods of ischemia in a variety of organs and may also be involved in loss of tissue function during ischemia. To test this hypothesis, the monoclonal antibody, MoAb 60.3, which prevents the adhesion of ferret neutrophils to cultured human endothelial cells at a concentration of 30 micrograms/ml, was tested in a model of peripheral vascular disease to determine whether it would preserve skeletal muscle function during ischemia. In an anesthetized ferret the muscles of the hindlimb were stimulated electrically to contract isometrically and the force of contraction was measured. Under normal perfusion conditions the contractile force peaked within 1 or 2 min of initiation of stimulation and gradually declined to approximately 80% of peak force after 20 min. When femoral arterial pressure was reduced to 45 mmHg by partial occlusion of the abdominal aorta, peak force was reduced by 25 +/- 7%, and within 5 min the force decayed to approximately 20% of the original peak, resulting in an area under the force-time curve (AUC) of 32 +/- 5% of that seen during the normal flow period. During ischemia after treatment with MoAb 60.3 (2 mg/kg iv), peak force was 94 +/- 3% and AUC was 49 +/- 5% of that observed during the normal flow period, a significant protective effect compared with the untreated control group (P = 0.0294). When the nonneutrophil-directed monoclonal antibody, L6, was tested in this model, no protective effects were evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Oncostatin M up-regulates low density lipoprotein receptors in HepG2 cells by a novel mechanism

Oncostatin M is a growth regulatory protein secreted by macrophages and activated T lymphocytes. In a hepatoma cell line (HepG2) the polypeptide very potently increased low density lipoprotein (LDL) uptake with an EC50 of 0.1-0.2 nM. The stimulation of LDL uptake was detectable by 2 h, was maximal by 8 h, and remained elevated through 20 h of oncostatin M incubation. In a similar fashion, oncostatin M also increased the number of cell surface LDL receptors by a mechanism that was inhibited by cycloheximide or the protein kinase C inhibitor H-7. Oncostatin M stimulation of LDL uptake and receptor protein occurred regardless of the state of cholesterol-dependent regulation of HepG2 LDL receptor (i.e. cells incubated in medium containing lipoproteins responded to the same extent as did cells incubated in the absence of lipoproteins). No significant effects were observed on sterol synthesis over 8 h or on DNA synthesis over 24 h. Oncostatin M induced rapid alterations in HepG2 phospholipid metabolism. Within 5-15 min there was a 20-50% increase in incorporation of 32P into several classes of phospholipids, including the phosphoinositides. Radiolabeled diacylglycerol levels were elevated 20% by 2 min and nearly 50% by 15 min. In addition, the polypeptide induced rapid increased (within 1 min) in phosphorylation of HepG proteins on tyrosine residues. Stimulation of both phosphotyrosine and LDL receptor up-regulation by oncostatin M was decreased by the tyrosine kinase inhibitor genistein. We propose that oncostatin M up-regulates HepG2 LDL receptor expression by a mechanism that includes stimulation of a tyrosine kinase followed by generation of phospholipid-related second messengers.

Efficacy of a monoclonal antibody (MoAb 60.3) in reducing myocardial injury resulting from ischemia/reperfusion in the ferret

The myocardial salvage efficacy of a monoclonal antibody (MoAb 60.3) directed at the CDw 18 membrane antigen complex essential for normal neutrophil function was evaluated in a ferret occlusion/reperfusion model. When infused i.v. over a 10-min interval beginning at the 45th minute of a 90-min occlusion at a fixed dose of 2 mg/kg, the antibody afforded 33 and 45% reductions in infarct size following reperfusion intervals of 6 and 24 h, respectively. Administration of that same dose via the left atrium over 1 h beginning at the 75th minute of occlusion and continuing until the 45th minute of reflow resulted in only a 14% reduction in infarct size. If MoAb 60.3 administration was withheld until the 5th-15th minute of reperfusion, the mean levels of salvage were 19 and 8%, respectively, following 6- and 24-h periods of reflow. Time-course hemodynamic data indicated that the monoclonal antibody caused no alterations in oxygen utilization that might be responsible for the levels of salvage observed.

Lipopolysaccharide (LPS) alters phosphatidylcholine metabolism in elicited peritoneal macrophages

We investigated the effects of LPS on mouse peritoneal macrophage phospholipids using radiolabeled precursors. LPS (200 ng/ml) stimulated incorporation of [32P] into all classes of phospholipids within 0.5 hr, and after 2 hr the increase was 60% greater than controls. Separation of the phospholipid classes by thin-layer chromatography revealed a selective increase in incorporation of label into phosphatidylcholine (PC) (90% increase compared to approximately 50% in the other phospholipids). In macrophages labeled with [3H]-choline, LPS stimulated both the incorporation of label into PC and the release of incorporated label into the medium. The time dependencies of stimulated [3H] release and [32P] incorporation were similar. These data are consistent with the hypothesis that LPS activates macrophages via a PC-specific phospholipase-dependent mechanism.

Effects of anagrelide on platelet cAMP levels, cAMP-dependent protein kinase and thrombin-induced Ca++ fluxes

Anagrelide (BL-4162A, 6,7-dichloro-1,5-dihydroimidazo[2, 1-6] quinazolin-2[3H]one monohydrochloride hydrate) is a potent and broad spectrum inhibitor of platelet aggregation. Prior studies showed that anagrelide inhibited platelet cyclic AMP (cAMP) phosphodiesterase activity but did not appreciably elevate platelet cAMP levels. We examined the effects of anagrelide on washed human platelets and found that anagrelide caused significant elevation of cAMP levels. Anagrelide treatment also resulted in activation of the platelet cAMP-dependent protein kinase at anagrelide concentrations of 0.1 to 1 microgram/ml, which inhibited platelet aggregation but caused only small increases in platelet cAMP content. When whole platelets were incubated with radiolabeled phosphate, anagrelide increased phosphorylation of platelet proteins with relative molecular weights of 22, 26, 50 and 80 kilodaltons. The pattern of protein phosphorylation stimulated by anagrelide treatment was similar to that observed when the platelets were treated with forskolin. Anagrelide also inhibited the rise in intracellular Ca++ caused by thrombin, as measured using Fura-2-loaded platelets. The inhibition of increased intracellular Ca++ resulted from block of thrombin-induced mobilization of intracellular Ca++, as well as prevention of Ca++ influx through the plasma membrane. Anagrelide itself had no influence on inositol 1,4,5-trisphosphate-induced Caz5++ release from isolated platelet membrane vesicles. These studies suggest that anagrelide inhibits platelet phosphodiesterase activity in intact platelets resulting in an elevation in cAMP levels sufficient to activate the cAMP-dependent protein kinase and inhibit agonist-activated Ca++ fluxes.

Estrogen stimulation of phosphatidylinositol metabolism in mouse uterine tissue

The effect of estrogens on incorporation of labeled precursor into inositol-containing phospholipids (PI) from ovariectomized mouse uterus was investigated. The results indicate that diethylstilbestrol (DES) a potent mitogen, stimulated incorporation of myo-[3H]inositol into uterine PI in 1-3 h, with maximal incorporation occurring at 6 h. This activity followed a dose-dependent increase, with a maximal effect at 5 micrograms/kg. Incorporation of radiolabeled phosphorous into the polyphosphoinositides was also increased in estrogen-stimulated uterine tissue. Studies using a weak uterotropic DES derivative, Z,Z-dienestrol, produced an early stimulation of the PI response comparable to DES. This activity was increased by Z,Z-dienestrol, with minimal estrogen receptor occupancy, and did not result in stimulation of DNA synthesis. These findings would suggest that uterine PI stimulation may not occur via an estrogen receptor-mediated mechanism related to tissue proliferation induced by estrogens.

Beta-epidermal growth factor is the des-asparaginyl form of the polypeptide

Reversed-phase high performance liquid chromatography of mouse epidermal growth factor (EGF) yielded two major forms, alpha- and beta-EGF, and a minor component, gamma-EGF. All three forms exhibited receptor-binding activity. Analysis of native alpha- and beta-EGF by mass spectrometry and partial Edman degradation led us to propose that alpha-EGF has a primary structure equivalent to that originally reported for EGF and that beta-EGF is the des-asparaginyl form of the polypeptide. When the purified alpha- and beta-polypeptides were cultured with human embryonic palatal mesenchymal cells stimulation of cell proliferation was observed at concentrations as low as 0.01 ng/ml with maximal stimulation occurring at about 1 ng/ml. Essentially no difference was noted in the mitogenic potency of the two forms. This suggests that the NH2-terminal region of EGF is not critical for mitogenic activity.

Inhibition of arachidonic acid metabolism is not involved in dexamethasone-induced growth inhibition in embryonic palatal development

Previous studies have shown that glucocorticoids induce cleft palate in susceptible strains of mice and inhibit proliferation of palatal mesenchyme cells in vivo and in culture. The present study shows that the synthetic glucocorticoid, dexamethasone (DEX), inhibits serum-stimulated arachidonic acid release in cultured mouse palatal mesenchyme cells. Arachidonic acid could neither prevent the DEX effect on cell proliferation when added in culture nor prevent glucocorticoid-induced cleft palate when administered in vivo. Furthermore, the time course for DEX-induced inhibition of arachidonic acid release (maximal by 5h) is markedly different from the time courses for both inhibition of cell proliferation in culture and cleft palate induction in vivo (3 to 4 days). These results suggest that both DEX-induced cleft palate formation and inhibition of palatal cell proliferation arise from some mechanism other than a DEX-induced inhibition of arachidonic acid metabolism.

Influence of epidermal growth factor and cyclic AMP on growth and differentiation of palatal epithelial cells in culture

A serum-free, hormonally defined medium was developed which supports growth and differentiation in primary culture of epithelial cells from prefusion embryonic mouse palatal shelves. Using this culture system, medial epithelial programmed cell death was investigated. In the absence of EGF, medial epithelial cells undergo cell death and detach from the substratum by 24 hr of culture. The addition of EGF alone or in combination with various agents which increase intracellular cyclic AMP levels prevented medial epithelial cell death in both cell and organ culture. EGF appeared to exert its most dramatic effect in cell culture on growth and differentiation of the squamous oral epithelial cells. In addition, EGF and agents such as 8-bromo-cyclic AMP, dibutyryl cyclic AMP, or cholera toxin synergistically stimulated the appearance of a long-lived, rapidly proliferating cell type by Day 4 of culture. Our results suggest that both EGF and cyclic AMP together may be important in regulating proliferation of embryonic palatal epithelial cells.

Role of glucocorticoids and epidermal growth factor in normal and abnormal palatal development

The purpose of this chapter has been to discuss glucocorticoid and EGF involvement in normal and abnormal palatal development. It is to be hoped that we have made clear the important point that these hormone/growth factors and their receptors are present during normal embryonic palatal development to provide for regulation of growth and cellular differentiation. When these hormone/growth factors are administered in pharmacological or large doses that result in teratogenesis, these potent chemicals and their receptors then become inducers of cleft palate. The primary reason for this is that the hormone/growth factor receptors have unique and special areas of localizations in target (embryonic and fetal) tissues, e.g., glucocorticoids in the palate. Therefore, large amounts of these chemicals are specifically bound to receptors in these target tissues and these high levels of hormone/growth factor-receptor complexes result in aberrant development, e.g., glucocorticoids cause inhibition of palatal mesenchymal cell growth. These effects are distinct from the interactions of physiological levels of these hormone/growth factors with their receptors in these target tissues during development, e.g., glucocorticoids cause induction of key enzymes and modulation of EGF receptor levels. The exact molecular mechanism(s) by which high levels of hormone/growth factors--receptor complexes exert harmful effects on embryos or fetuses is (are) unknown and remain(s) a challenge for the future. Interaction of hormone/growth factors and their receptors certainly cannot provide an explanation for the mechanism of all types of craniofacial teratogenesis, but this concept certainly appears capable of providing important information relating to the mechanisms of many animal and human teratogens. The fact that these chemicals and their receptors are involved in normal development makes them all the more important since subtle alterations in their levels or activities could result in teratogenesis without an exposure to pharmacological levels of these hormone/growth factors. It seems that progress in this area will develop quickly since the techniques of recombinant DNA research are available in conjunction with responsive in vitro cell systems such as the established line of human embryonic palatal mesenchymal cells. Clearly, the future looks very exciting for understanding the role that these hormone/growth factors and their receptors play in normal and abnormal palate development.

Growth and differentiation of embryonic mouse palatal epithelial cells in primary culture

The study of both normal and abnormal mammalian palatal development would be greatly enhanced by the advent of a cell culture system for the palatal epithelium in the absence of its mesenchyme. We have developed such a method for the primary culture of the secondary palatal epithelium from the embryonic mouse which allows for both epithelial cell proliferation and differentiation into the three cell types normally found in vivo. These include the terminally differentiated medial epithelial cells and the appearance of the nasal epithelial cell phenotype (ciliated pseudostratified), as well as the oral epithelial cell phenotype (stratified squamous). The most successful culture medium tested consisted of a 1:1 mixture of DMEM/F-12 basal medium supplemented with fetal bovine serum and epidermal growth factor (EGF). Epithelial cell attachment, DNA synthesis and differentiation are greatly stimulated by the presence of EGF and by an extracellular matrix (ECM) substratum. Our results have demonstrated for the first time the feasibility of culturing embryonic palatal epithelial cells in primary culture in the absence of any mesenchymal tissue.

Dexamethasone affects phosphatidylinositol synthesis and degradation in cultured human embryonic cells

Dexamethasone (DEX), a glucocorticoid which induces cleft palate, causes marked alterations in the synthesis and degradation of phosphatidylinositol (PI) but not phosphatidylcholine in an established fibroblastic cell line derived from a human embryonic palate. Incorporation of radiolabeled inositol into phosphatidylinositol as well as degradation of prelabeled phosphatidylinositol is stimulated by DEX. The dose-response curves for the DEX-induced effect on PI synthesis and DEX-induced inhibition of cell proliferation are nearly identical, with the maximal responses occurring at 10(-8)M DEX. Our results suggest that DEX-induced inhibition of human embryonic palatal mesenchyme cell proliferation and alterations in synthesis and degradation of phosphatidylinositol are related.

Effects of 12-O-tetradecanoylphorbol 13-acetate on glycerolipid metabolism in cultured myoblasts

We recently reported that treatment of differentiated chick embryo myoblasts in culture with the potent tumor promoter 12-O-tetradecanoylphorbol 13-acetate (TPA) caused a 2-fold increase in the level of 1,2-diacylglycerol in the plasma membrane fraction within 15-30 min (Grove, R.I. and Schimmel, S.D. (1981) Biochem. Biophys. Res. Commun. 102, 158-164). This system has been characterized further and the metabolic origin and fate of the stimulated diacylglycerol have been investigated. The stimulation of 1,2-diacylglycerol was insensitive to alterations of Ca2+ concentration in the medium and to the presence of inhibitors of Ca2+ flux, protein synthesis and prostaglandin synthesis. The fatty acid composition of the newly formed diacylglycerol was similar to that of phosphatidylcholine. In addition, the glycerol moiety of the diacylglycerol was shown to be derived from a lipid with metabolic turnover similar to that of phosphatidylcholine. The tumor promoter was also found to stimulate rapidly synthesis of phosphatidic acid, phosphatidylinositol and phosphatidylcholine. A possible model is proposed, therefore, in which the tumor promoter stimulates a membrane-associated phospholipase C which generates 1,2-diacylglycerol via the hydrolysis of phosphatidylcholine. The newly formed diacylglycerol is then metabolized back to phosphatidylcholine or to phosphatidic acid and phosphatidylinositol.

Prescreening for environmental teratogens using cultured mesenchymal cells from the human embryonic palate

Mesenchymal cells from the prefusion human embryonic palate have been established in culture and can be grown in either a serum-free hormone-supplemented medium or a serum-containing medium. The growth of these cells is quite rapid in culture and inhibited in a dose-dependent manner by most teratogens thus far tested, such as dexamethasone. These cells are highly sensitive to a variety of DNA synthetic and mitotic inhibitors. The responses of these cells are complementary to the ovarian tumor cell attachment assay of Braun et al [1, and in this volume]. When used in conjunction with the tumor cells, the overall reliability is greater than 90% with only one false-negative, allopurinol.

Effect of Ca++ on triphosphoinositide extraction in fusing myoblasts

Ca++-dependent degradation of triphosphoinositide has been postulated to regulate levels of membrane-bound Ca++ and to generate a 1,2-diacylglycerol fusogen in cell fusion. Triphosphoinositide metabolism was therefore studied during Ca++-induced fusion of cultured chick embryo myoblasts. Using a frequently cited extraction procedure, it was found that apparent Ca++-dependent triphosphoinositide degradation was actually due to inhibition of extraction. A new procedure using the ion-pairing reagent tetrabutylammonium sulfate was developed which was unaffected by Ca++ and gave 2- to 20-fold greater extraction of triphosphoinositide than existing procedures. With this procedure, no changes in triphosphoinositide metabolism were found during myoblast fusion.

Binding of phorbol-12-myristate-13-acetate to cultured myoblasts

The tumor promoter phorbol 12-myristate 13-acetate (PMA) binds in a rapid (maximal at 30 min), reversible, and non-saturable manner to cultured embryonic chick myoblasts. Serum was not required for binding although it promoted the release of PMA from the cells. This appears to be due to PMA binding to serum proteins. At any concentration tested, approx. 10% of the total PMA was bound at 5 min and 30% was bound at 30 min. It is estimated that a PMA concentration in the cell membrane of only 1 molecule of PMA/5000 molecules of membrane lipid elicits maximal biological responses in these cells.