Envelope proteins of human T cell leukemia virus type I: characterization by antisera to synthetic peptides and identification of a natural epitope

Three peptides corresponding to selected regions of the env gene products of human T cell leukemia virus type I were synthesized by solid-phase Merrifield techniques. The sequence of peptide designated SP-65 was identical to the predicted C-terminal 12 residues of the transmembrane protein p21env, and peptide SP-74 was inferred from a region shown to be highly conserved among mammalian retroviruses. The third peptide, SP-70, was derived from a C-terminal region of the surface glycoprotein gp46. Antibodies to each peptide were raised in rabbits and were used to identify and further characterize the proteins coded by the env gene. Despite being present at very low levels in purified viral preparations, these proteins were chromatographed by reverse-phase high pressure liquid chromatography and were located by Western blot analysis of the column fractions. Anti-SP-70 recognized the surface glycoprotein (gp46) and also its C-terminal cleavage fragment (gp16). Anti-SP-65 and anti-SP-74 both reacted with the hydrophobic transmembrane protein (p21) and provided evidence that this protein does not undergo apparent C-terminal processing during viral maturation, unlike the trans-membrane protein of murine leukemia virus. As expected, anti-SP-74 also reacted with homologous proteins from other Type C and Type D viruses, confirming that peptide SP-74 corresponds to a broadly conserved region of retroviral transmembrane proteins. SP-70, which is predicted to be quite near the C terminus of the major surface glycoprotein, was also reactive with sera of HTLV-I-positive patients, indicating that this peptide corresponds to, or is part of, a native epitope recognized by the natural host.

Envelope proteins of human T cell leukemia virus type I: characterization by antisera to synthetic peptides and identification of a natural epitope

Three peptides corresponding to selected regions of the env gene products of human T cell leukemia virus type I were synthesized by solid-phase Merrifield techniques. The sequence of peptide designated SP-65 was identical to the predicted C-terminal 12 residues of the transmembrane protein p21env, and peptide SP-74 was inferred from a region shown to be highly conserved among mammalian retroviruses. The third peptide, SP-70, was derived from a C-terminal region of the surface glycoprotein gp46. Antibodies to each peptide were raised in rabbits and were used to identify and further characterize the proteins coded by the env gene. Despite being present at very low levels in purified viral preparations, these proteins were chromatographed by reverse-phase high pressure liquid chromatography and were located by Western blot analysis of the column fractions. Anti-SP-70 recognized the surface glycoprotein (gp46) and also its C-terminal cleavage fragment (gp16). Anti-SP-65 and anti-SP-74 both reacted with the hydrophobic transmembrane protein (p21) and provided evidence that this protein does not undergo apparent C-terminal processing during viral maturation, unlike the trans-membrane protein of murine leukemia virus. As expected, anti-SP-74 also reacted with homologous proteins from other Type C and Type D viruses, confirming that peptide SP-74 corresponds to a broadly conserved region of retroviral transmembrane proteins. SP-70, which is predicted to be quite near the C terminus of the major surface glycoprotein, was also reactive with sera of HTLV-I-positive patients, indicating that this peptide corresponds to, or is part of, a native epitope recognized by the natural host.

Comparison of T-antigen expression in normal, premalignant, and malignant human colonic tissue using lectin and antibody immunohistochemistry

The Thomsen-Friedenreich antigen has been implicated as a cancer-associated antigen in some human organs including the colon. Most previous studies of Thomsen-Friedenreich antigen expression in the colon used peanut agglutinin (PNA) to identify the immunodeterminant in tissues. However, evidence from other organs suggests that anti-T antibodies have specificities which differ from those of peanut lectin. To elucidate the nature of the T-immunodeterminant in colonic mucosa, we compared staining by PNA to that of a polyclonal (PAb) and monoclonal (MAb) anti-T antibody. PNA demonstrated the best sensitivity (91%) in cancer tissues but the lowest specificity (68%) in normal mucosa. Staining with MAb was only 76% sensitive but 100% specific. Sensitivity and specificity of PAb were intermediate between PNA and MAb. MAb stained fewer adenomatous polyps than either PNA or PAb, but staining appeared to correlate with premalignant features of the polyps. PNA-binding sites were more prevalent than either PAb or MAb in hyperplastic polyps. Cell cytoplasm was stained by both antibodies more often than by PNA. The majority of fetal colonic specimens stained with all three reagents suggesting that Thomsen-Friedenreich antigen may be an oncodevelopmental antigen in human colon. Differences in staining patterns in some tissues may be due to different antigenic specificities among PNA, PAb, and MAb.

Effects of halothane on the intramyocardial pressure of the canine left ventricle

In the intact canine heart a gradient of systolic intramyocardial pressure from a minimum at the epicardial region to a maximum at the endocardial region is well established. No information is, however, available regarding the effects of various anaesthetic agents on this gradient. In the present study the effects of halothane on intramyocardial pressure recorded from subendocardial and subepicardial layers of the canine left ventricular free wall were assessed. Experiments were performed on seven anaesthetised mongrel dogs ventilated with 100% oxygen. Intramyocardial pressure was recorded simultaneously from the inner and outer regions of the myocardium using two Mikro-tip pressure transducers. Halothane concentration in the inspired gas varied from 0% to 2%. In the pentobarbital anaesthetised dog halothane does not significantly change the heart rate. With increasing concentrations of halothane in inspired gas systolic intramyocardial pressure at both endocardium and epicardium decreased significantly from control values. As the halothane concentration increased, the normal differential between systolic left ventricular pressure and endocardial intramyocardial pressure was abolished. The intramyocardial pressure gradient from endocardium to epicardium, however, persisted during systole. During diastole the pressure gradient was reversed, becoming maximum in the epicardial region and minimum in the endocardial region in both control and halothane treated animals. Over the range of 0-2% halothane concentration there was no significant effect on the diastolic intramyocardial pressure gradient. These results suggest that halothane affects the myocardial tissue pressure non-uniformly across the left ventricular free wall and therefore influence sth e transmural distribution of coronary blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Halothane effects on subendocardial oxygen supply-demand balance: estimation from intramyocardial tissue pressure and left ventricular pressure

We evaluated the effect of halothane on the balance of subendocardial oxygen supply and demand in six dogs by estimating the endocardial viability ratio (EVR) based on the pressure generated within the subendocardium (ENDO-IMP). Concurrently, the conventional EVR based on left ventricular pressure (LVP) was estimated and compared with the EVR based on ENDO-IMP. The subendocardial oxygen supply-demand ratio based on ENDO-IMP (IMP-EVR) was significantly less than EVR based on LVP (LVP-EVR) (0.87 +/- 0.03 vs 1.07 +/- 0.06, P less than 0.05) during the control period. With 0.5% halothane administration, IMP-EVR improved significantly (1.04 +/- 0.07, P less than 0.05) while LVP-EVR remained unchanged (1.08 +/- 0.09). No further changes in EVR (either IMP-EVR or LVP-EVR) were observed with increasing halothane concentrations up to 2%. The relationship between the two indices was weak (r2 = 0.44, P less than 0.001) but statistically significant. Because an estimate of EVR based on direct measurement of subendocardial tissue pressure (IMP-EVR) would reflect more accurately the oxygen supply-demand balance of this region than the LVP-EVR, our results suggest that the oxygen balance of the subendocardium improves with halothane administration. The use of LVP-EVR as a hemodynamic index of subendocardial oxygen balance during halothane anesthesia, therefore, is questionable.

A qualitative agar gel immunoprecipitin (IP) test for detection of fecal occult human hemoglobin

A versatile, qualitative, agarose gel immunoprecipitation (IP) test for the detection of fecal occult hemoglobin (Hb) was developed to provide a more accurate method for the detection of occult blood in stool. This test allowed detection of 0.2 mg human hemoglobin/g of stool after a 2-h incubation. In addition, a specimen application device which can accommodate a variety of specimens was developed for this test. A study of 252 clinical stool specimens revealed a close correlation in the results obtained at three separate laboratories. The IP test identified blood in 11 out of 24 specimens collected from patients with colorectal carcinoma as compared to 4 of 24 specimens positive with a guaiac-based Hemoccult II test. The simplicity of immunoprecipitation coupled with the high sensitivity and specificity of this technique suggests that this new test would be a very useful and effective means with which to screen for occult blood in stool.

Protamine induced arterial hypoxaemia: the relationship to hypoxic pulmonary vasoconstriction

Protamine administration may induce arterial hypoxaemia in dogs and humans. However, the responsible mechanism has not been established. Protamine, as it is a pulmonary vasoactive substance, may interfere with normal hypoxic pulmonary vasoconstriction (HPV) and cause arterial hypoxaemia. This possibility was tested in dogs utilizing a one lung hypoxic model. One lung hypoxic ventilation decreased pulmonary blood flow in the hypoxic lung from 1022 +/- 96 ml X min-1 (mean +/- SEM) to 846 +/- 39 ml X min-1 (p less than 0.05) while increasing blood flow from 833 +/- 85 ml X min-1 to 1109 +/- 101 ml X min-1 (p less than 0.05) in the normoxic lung, resulting in 24 per cent effective diversion of blood flow. Protamine infusion, after heparinization, markedly elevated pulmonary vascular resistance in both lungs but preferentially in the normoxic lung (102 +/- 27 per cent increase in normoxic lung, 60 +/- 6.4 per cent increase in hypoxic lung) and significantly reversed the pulmonary blood flow shift induced by one lung hypoxic ventilation (effective diversion of blood flow was reduced to four per cent). Concurrently, arterial PO2 further decreased. Our results demonstrate that protamine interferes with effectiveness of pre-existing HPV and suggest that this mechanism, at least in part, may be responsible for arterial hypoxaemia observed after protamine infusion. The marked generalized pulmonary vasoconstriction with protamine appears to be the direct force that interferes with pre-existing auto-regulatory HPV. In addition to the well known haemodynamic effects of protamine, protamine infusion may also cause arterial hypoxaemia in those patients in whom HPV plays a significant role in maintaining arterial oxygenation.

Galactosyltransferase variant in pleural effusion

In measuring total galactosyltransferase activity in the pleural effusions from patients with benign or malignant diseases, we found no significant difference between the two groups (p greater than 0.05). However, a small amount of a galactosyltransferase variant, GT(l), could be separated from other galactosyltransferase enzymes in malignant pleural effusions by anion-exchange chromatography (DEAE-cellulose) with a buffer of low ionic strength. Other galactosyltransferases were eluted from the column with buffer of higher ionic strength. Using a mini-column method, we detected GT(l) enzyme in 19 of 26 specimens fro cancer patients, as compared with eight of 25 specimens from patients with benign disorders. The appearance of GT(l) enzyme in pleural effusion may be a tumor-associated phenomenon.

Galactosyltransferase variant in pleural effusion

In measuring total galactosyltransferase activity in the pleural effusions from patients with benign or malignant diseases, we found no significant difference between the two groups (p greater than 0.05). However, a small amount of a galactosyltransferase variant, GT(l), could be separated from other galactosyltransferase enzymes in malignant pleural effusions by anion-exchange chromatography (DEAE-cellulose) with a buffer of low ionic strength. Other galactosyltransferases were eluted from the column with buffer of higher ionic strength. Using a mini-column method, we detected GT(l) enzyme in 19 of 26 specimens fro cancer patients, as compared with eight of 25 specimens from patients with benign disorders. The appearance of GT(l) enzyme in pleural effusion may be a tumor-associated phenomenon.

Changes in peripheral vascular and cardiac sympathetic activity before and after coronary artery bypass surgery: interrelationships with hemodynamic alterations

The plasma catecholamine levels obtained simultaneously from radial artery (A), pulmonary artery (MV), brachial vein (PV), and coronary sinus (CS) were measured concurrent with hemodynamic determinations during coronary artery bypass graft (CABG) operations. Arterial catecholamine levels decreased after induction of anesthesia and increased after sternotomy; changes in veno-arterial norepinephrine (NE) differences ([PV-A]ne, [MV-A]ne, and [CS-A]ne) were of the same magnitude and direction, suggesting that NE release from various organs was of the same extent. After operation, arterial NE increased further, but the veno-arterial NE differences were in striking contrast; [PV-A]ne became markedly positive, whereas [CS-A]ne became markedly negative, indicating that NE release from extremity peripheral vasculature increased markedly while cardiac NE release decreased. These differential changes in regional sympathetic activity appear to be related to postoperative hypertension (HT) and low cardiac output (CO). There were close relationships of changes in [MV-A]ne to mean arterial pressure (r = 0.78, p less than 0.001) and systemic vascular resistance (r = 0.62, p less than 0.010, suggesting that the sympathetic nervous system plays an important role in CABG perioperative hemodynamic alterations.

Pulmonary shunting during leukoagglutinin-induced noncardiac pulmonary edema

Noncardiogenic pulmonary edema occurred in an anesthetized patient during an otherwise uneventful laparotomy. Following transfusion of an individual unit of whole blood, routine intraoperative monitoring detected sudden major pulmonary shunting (increased alveolar-arterial oxygen gradient) and an increased physiological alveolar dead space (increased arterial-alveolar carbon dioxide gradient). The noncardiac pulmonary edema probably resulted from the presence of a leukoagglutinin against the patient's granulocytes in the donor's plasma. This antibody had no apparent specificity for known HLA, neutrophil, or blood group antigens. The acute respiratory failure was transient, resolving in 72 hours with respiratory support. The presence of otherwise unexplained noncardiogenic pulmonary edema during or soon after a blood transfusion should suggest the possible diagnosis of a leukoagglutinin reaction.

Noninvasive determination of core temperature during anesthesia

A noninvasive, zero heat flux method of determining core (intracardiac blood) temperature was studied in ten anesthetized patients having whole body hyperthermia for the treatment of cancer. True intracardiac blood temperature was determined by a calibrated pulmonary artery thermistor. Accuracy, precision, and responsivity for the noninvasive system were comparable to conventional esophageal thermometry in reflecting intracardiac blood temperatures. This method of contact thermometry is convenient and independent of environmental influence, and it rapidly reflects the small changes in arterial blood temperature which evoke vasomotor responses.

Immunochemical characteristics of human anti-T antibodies

A specific and sensitive radioimmunoassay was developed to investigate the immunochemical properties of serum anti-T antibodies. Evidence was presented that the radioimmunoassay can measure non-agglutinating as well as agglutinating anti-T antibodies, while the hemagglutination method can detect only the latter type. Although the hemagglutination method failed to detect anti-T agglutinins in cord sera, the radioimmunoassay results demonstrated the presence of non-agglutinating antibodies. Presence of 1% polyethylene glycol potentiated some of the originally nonagglutinating antibodies to produce a hemagglutination reaction. Immunochemical characteristics associated with the human anti-T antibodies are discussed.

Vasodilator correction of hypotension in the postoperative period

This case is unusual in that hypotension, as opposed to hypertension, was a consequence of increased sympathetic tone in the postoperative period, but it illustrates the well known fact that patients in compensated congestive heart failure do poorly when faced with an elevated myocardial oxygen need from either increased rate or afterload. Vasodilator therapy was effective in immediately reducing afterload and systolic regurgitant fraction, thereby increasing oxygen supply and lowering myocardial oxygen consumption.

Hemodynamic and plasma catecholamine responses to hyperthermic cancer therapy in humans

Cancer patients, treated with hyperthermia (to 41.5 degrees C) under thiopental and fentanyl anesthesia, had smaller increases in heart rate and cardiac index and lesser decreases in mean arterial pressure than those reported in normal volunteers. At basal body temperature anesthesia did not alter catecholamine levels. Increasing body temperature to 39.5 degrees C and 41.5 degrees C resulted in parallel increases in heart rate and cardiac index that were directly related to the increases in plasma norepinephrine levels. At basal temperature cutaneous venous plasma norepinephrine levels exceeded those of arterial; mixed-venous plasma levels were intermediate. At 39.5 degrees C and 41.5 degrees C there were sequential increases in plasma norepinephrine. The increases in mixed-venous and arterial norepinephrine were significantly greater than in cutaneous venous blood. The differential increases in norepinephrine levels in cutaneous venous, mixed-venous, and arterial blood indicate that during hyperthermia sympathetic nerve activity in skin is decreased while that in other areas is increased, suggesting that alterations in sympathetic activity modulate the hemodynamic changes that attend hyperthermia in man.

Systemic thermotherapy (whole body hyperthermia)

This is an article reviewing the literature and our experience to date (six months) in the treatment of cancer using whole body hyperthermia in the first 60 patients. WBHT is an effective method of treating cancer. Patients were treated for a total of eight hours, 180 degrees F for two hours. WBHT was induced by means of two high-flow water filled blankets. Toxicity included fatigue, nausea, diarrhea and first degree burns. There was no evidence of visceral damage. There were no mortalities during the procedure. Objective responses were 50%, subjective responses were 65%. The literature demonstrates and our study confirms that under closely monitored conditions, WBHT is a feasible, safe and active anti-cancer therapy. WBHT may be safely used as an adjunct to other active cancer therapies including X-ray therapy and chemotherapy.

Extraction of human plasma or sera by heat treatment for a solid-phase radioimmunoassay of carcinoembryonic antigen

Heat treatment and a solid-phase radioimmunoassay are combined to give a relatively simple and rapid procedure for assay of carcinoembryonic antigen in plasma or serum. The new way we describe to extract this antigen is an alternative to the conventional method of extraction with perchloric acid. Heating plasma or serum samples in acetate buffer (0.16 mol/L, pH 5.0) at 70 degrees C for 15 min precipitates out most of the heat-labile, nonspecific plasma proteins, but leaves most of the antigen in solution, with its immunochemical properties apparently unaffected. Comparison between the heat treatment and the perchloric acid extraction yielded comparable values when tested either by solid-phase radioimmunoassay or by the zirconyl phosphate precipitation method. An added advantage of our method is that it gives the same assay values for both plasma and serum. Results for a group of pathological plasma samples, assayed by both our method and the perchloric acid-zirconyl phosphate precipitation method, gave a correlation coefficient of 0.90.

Hyperthermia potentiates doxorubicin-related cardiotoxic effects

The intercurrent administration of doxorubicin hydrochloride to a patient undergoing whole-body hyperthermia for the treatment of metastatic cancer repeatedly produced ventricular irritability and cardiac dysfunction. Individually, doxorubicin and hyperthermia were tolerated by the patient without incident. Catecholamine determinations showed that the administration of doxorubicin under hyperthermic conditions increased the liberation of both epinephrine and norepinephrine. The acute synergistic cardiotoxic effects occurred with doxorubicin dosages that were severalfold less than those associated with only mild and transient ECG disturbances under normothermic conditions.

Nature of human serum blood group T antibodies

Antibodies against blood group substance T in normal human sera consist of two types, depending upon whether or not the molecules remain immunochemically active at 37 degrees C. The two agglutinins were isolated by means of T antigen-coupled Sepharose 48 affinity chromatography. Temperature-sensitive agglutinin was eluted from the affinity column at 37 degrees C, while temperature-independent agglutinin remained bound to the antigen. Subsequently, the latter was dissociated from the column in the presence of 2.5 M MgCl2. Examination of six normal sera revealed that the levels of temperature-independent agglutinin was about twice that of temperature-sensitive agglutinin. More than 90% of anti-T agglutinins in normal sera were of the IgM class, in 8 of 11 samples studied. No direct relationship appeared to exist between anti-T titers and blood type. Thermal effects on hemagglutination, at least for anti-T agglutinin interacting with T antigen bearing red cells, is primarily due to the molecular characteristics of the agglutinin and not to the conformational change of the red cell membranes.

A simplified solid-phase radioimmunoassay for carcinoembryonic antigen

A simple and rapid solid-phase radioimmunoassay for the measurement of carcinoembryonic antigen (CEA) levels in sera or plasma is described. The procedure involves perchloric acid (PCA) extraction of the samples, followed by a rapid neutralization of excess acid with alkaline buffer solution. The PCA extracts are assayed uing antibody-coated plastic tubes and radio-labeled anti-CEA antibody as a marker. The assay may be completed in one day. The solid-phase direct-binding assay demonstrated a sensitivity of 0.5 ng CEA/ml plasmin and a marked tolerance to variations in pH and ionic strength of the system. A fair correlation between the CEA levels determined by the solid-phase radioimmunoassay and zirconium phosphate gel method was observed.

Carcinoembryonic antigen-like substances in human cavity fluids

Pleural and peritoneal fluids from humans with pathological diseases were examined for the presence of carcinoembryonic antigen-like substances (CEA-LS). Among eight samples tested by a solid phase radioimmunoassay, two pleural fluids and one peritoneal fluid showed significantly elevated CEA-activity. The substances responsible for the CEA-activity were isolated by perchloric acid-extraction followed by two successive Sephadex G-200 chromatography into two pools, Pool I (PI) and Pool II (PII). According to their sedimentation properties, PII was slightly smaller than CEA from tumor tissue-extract (CEA-TTE), while PI was larger than CEA-TTE and approximately twice the size of PII. Micro-double diffusion and antibody binding studies showed that CEA-LS possessed identical antigenic determinants as CEA-TTE, which did not cross-react with normal colon antigen (NCA).