An assessment of sequential measurements of immune complex levels in ovarian cancer patients with respect to clinical progress

Ovarian cancer-associated antibodies recovered from ascites: their use for the isolation of ovarian cancer-associated antigen to produce monoclonal antibodies

Immune complexes (ICs) were recovered from the ascites of a patient with stage IV endometrioid ovarian cancer by sequential precipitation with 33% saturated ammonium sulfate and 2.5% polyethylene glycol 6000 (PEG 6000), followed by affinity chromatography on protein A-Sepharose CL-4B. The IgG-containing ICs were dissociated using 8 M urea, separated by ion-exchange chromatography on Sephadex QAE-50, and subsequently analyzed for purity by immunoelectrophoresis (IEP) and radial immunodiffusion (RID). Recovered antibody was tested for reactivity by immunohistologic techniques against paraffin-embedded tumor tissue and acetone-fixed cell suspensions of epithelial tumors. The antibody which demonstrated ovarian cancer-associated activity was absorbed with antigen extracts of breast, colon, and lung cancers as well as keratin to reduce cross-reactivity. The absorbed endometrioid ovarian cancer-associated antibody (OCAAb) was used to produce an immunoadsorbent column for the recovery of tumor-associated antigens. A mouse monoclonal antibody designated FEN-1 was produced using this antigen-containing fraction, and preliminary screening has demonstrated ovarian tumor-associated reactivity. The use of autologous ICs as reagents for preparing tumor antigen-rich immunogens may provide a valuable tool in the search for tumor-associated antigens.

Immune complexes in ovarian carcinoma

Immunodiagnostic screening may improve the survival of ovarian carcinoma by earlier detection and follow-up during treatment. Presently, several ovarian cancer-associated antigens are being utilized to monitor treatment response; a specific and precise test for screening is not currently available. The present study was designed to investigate the presence and clinical significance of circulating immune complexes (IC) in patients with ovarian carcinoma using a polyethylene glycol (PEG) assay. If this assay were to prove clinically useful in patients with ovarian carcinoma, its potential as a screening test would then be evaluated. Serum was obtained from 38 patients with advanced ovarian carcinoma preoperatively, postoperatively, and prior to the administration of a combination chemotherapy regimen containing cisplatin. Five patients had values greater than or equal to 0.10. This test identified only 12.5% of the patients with active disease. Serial sampling failed to reveal any correlation with disease status. Our experience does not support the usefulness of IC levels in studying or treating patients with ovarian carcinoma.

The value of the monoclonal antibody (cancer antigen 125) in serial monitoring of ovarian cancer: a comparison with circulating immune complexes

The use of circulating immune complexes and a commercial monoclonal antibody to ovarian cancer (CA 125 kit) in monitoring progress in patients with ovarian cancer has been assessed. While changes in immune complexes were apparent in some patients with active progression of disease, the marked change in values and linear trend make the use of CA 125 a useful clinical marker.

The study of antibodies and antigens dissociated from the immune complexes extracted from ovarian carcinoma ascitic fluid

In previous studies in our laboratory, heteroantisera were produced in rabbits by immunization with extracts of ascitic fluids from ovarian epithelial carcinomas. Reverse passive hemagglutination (RPHA) assay of these sera was used for the immunodiagnosis of ovarian cancer. Antibodies attached to lysed sheep red blood cells were able to detect tumor antigens in 63% of ovarian carcinoma sera. In the present study we have shown that the antigens detected in these assays are in fact contained in circulating immune complexes and are recoverable by disassociation with 8 M urea and separation of antibody and antigen by ion exchange chromatography. The antibodies thus obtained from immune complexes (IC) were assayed by indirect immunofluorescence against a variety of paraffin-embedded tissue sections. Poorly differentiated ovarian epithelial carcinomas and papillary serous adenocarcinomas, as well as the tumors grown by implantation of the latter in nude mice, were all positively stained, while the Krukenberg tumor metastatic to the ovary, the benign ovarian cyst, the normal ovary, and the normal fallopian tube were all negative. Complete blocking of immunofluorescence staining by prior absorption of antibody with the dissociated antigen was achieved. The present study demonstrates that the antibodies and antigens dissociated from the immune complexes isolated from the ascitic fluids provide useful reagents for immunodiagnosis.