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Abstract
Subcutaneous methylcholanthrene oncogenesis was produced in two strains of mice and statolon, an interferon inducer, was administered at different treatment regimens and at doses only just sufficient to induce an antiviral state in the host. No statistically significant extension of tumor appearance periods was observed.
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2
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Collavo D, Biasi G, Pennelli N, Chieco-Bianchi L. Effect of Polyinosinic-polycytidylic Acid on Humoral and Cellular Immunity. TUMORI JOURNAL 2018; 59:77-96. [PMID: 4146410 DOI: 10.1177/030089167305900202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Experiments have been performed to investigate the effects of polyinosinic-polycytidylic acid (Poly I:C) on humoral and cellular immunity in RFM/Un mice. Poly I:C, 0.1 mg i.p., administered 48 and 24 hours before 4 x 108 SRBC produced a marked reduction in direct PFC/106 cells and /spleen, and in the hemoagglutinin titre on the 3rd, 4th and 5th days after antigen inoculation. On the other hand, an increase in PFC and hemoagglutinin titre was observed on the 7th and 8th days. Histological examination revealed absence of germinal centers in the spleen on the 4th day. Poly I:C administered 24 and 48 hours after antigen produced an increase in direct PFC and hemoagglutinin titre on the 4th, 5th and 6th day. Histological examination disclosed evident germinal centers in the spleen on the 4th day after antigen. Poly I:C administered 5 to 1 days before antigen produced a markedly depressed direct PFC response in the groups injected 1 and 2 days before antigen. Recovery of the immune response was progressive and complete in groups injected 4 days before antigen. To study the effect of Poly I:C on secondary response to SRBC, two groups of animals injected with Poly I:C before or after antigen were reinjected with 2 x 108 SRBC. Secondary response evaluated by hemoagglutinin titre at varying intervals after the immunization disclosed in both groups a much higher antibody titre than that seen in controls receiving SRBC only. Mice injected with Poly I:C 48 or 24 hours before reimmunization with 2 x 108 SRBC were no different from controls on 3rd and 4th days in regard to number of indirect PFC as well as hemoagglutinin titre. Finally, mice immunized with two SRBC injections and then treated with Poly I:C on alternating days for 30 days had a much higher titre of hemoagglutinins than controls. In order to study the effect of Poly I:C on the cellular immune response, spleen cells from animals receiving Poly I:C 6–5 days before sacrifice were cultured in vitro with phytohemoagglutinin. DNA synthesis subsequent to PHA stimulation was evaluated by increase in 3HTdR incorporation. Cells from animals which had received Poly I:C demonstrated a remarkably higher 3HTdR uptake than cells from control animals. On the other hand, 5 x 106 spleen cells obtained from RFM/Un mice injected with Poly I:C as above were inoculated in 1–4 day old (RFM/Un x CBA/H)F1 hybrids. These were then sacrificed on day 8 and spleen indices calculated. Experimental animals disclosed GVH activity similar to that of controls (spleen index 2.3). From the results it is clear that if Poly I:C is injected before antigen the primary immune response is deppressed, whereas it is enhanced when Poly I:C is administered after antigen. On the other hand, the secondary response is generally enhanced regardless of the time of Poly I:C administration. Moreover, in Poly I:C –- treated animals there is an enhancement of PHA –- responsive cells while the GVH reactions is unchanged. As Poly I:C is capable of enhancing immune reactivity, the possibility of its use in antineoplastic chemotherapeutic protocols is suggested.
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Dey AK, Burke B, Sun Y, Hartog K, Heeney JL, Montefiori D, Srivastava IK, Barnett SW. Use of a polyanionic carbomer, Carbopol971P, in combination with MF59, improves antibody responses to HIV-1 envelope glycoprotein. Vaccine 2012; 30:2749-59. [PMID: 22366638 DOI: 10.1016/j.vaccine.2012.02.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Revised: 02/09/2012] [Accepted: 02/11/2012] [Indexed: 12/20/2022]
Abstract
Identification of optimal antigen(s) and adjuvant combination(s) to elicit potent, protective, and long-lasting immunity has been a major challenge for the development of effective vaccines against chronic viral pathogens, such as HIV-1, for which there are not yet any licensed vaccines. Here we describe the use of a novel adjuvant approach employing Carbopol 971P(®) NF (hereafter referred to as Carbopol971P), a cross-linked polyanionic carbomer, in combination with the Novartis proprietary oil-in-water adjuvant, MF59, as a potentially safe and effective adjuvant to augment humoral immune responses to the HIV-1 envelope glycoprotein (Env). Intramuscular immunization of small animals with recombinant Env glycoprotein (gp140) formulated in Carbopol971P plus MF59 gave significantly higher titers of binding and virus neutralizing antibodies as compared to immunization using gp140 with either MF59 or Carbopol971P alone. In addition, the antibodies generated were of higher avidity. Importantly, the use of Carbopol971P plus MF59 did not cause any serious adverse reactions or any obvious health problems in animals upon intramuscular administration. Hence, the Carbopol971P plus MF59 adjuvant formulation may provide a benefit for future vaccine applications.
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Affiliation(s)
- Antu K Dey
- Novartis Vaccines & Diagnostics, 45 Sidney Street, Cambridge, MA 02139, USA.
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5
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Youmans AS, Youmans GP. Failure of synthetic polynucleotides to affect the immunogenicity of mycobacterial ribonucleic Acid and ribosomal protein preparations. Infect Immun 2010; 3:149-53. [PMID: 16557931 PMCID: PMC416120 DOI: 10.1128/iai.3.1.149-153.1971] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The synthetic polyribonucleotides adenylic acid (poly A), uridylic acid (poly U), cytidylic acid (poly C), and inosinic acid (poly I), whether single- or double-stranded (poly A:U, poly I:C), cannot replace mycobacterial ribonucleic acid (RNA) in the production of a high immune response in CF-1 mice against tuberculous disease. These conclusions are based on the results of several types of experiments. (i) Poly A and poly U, used either singly or in combination, did not increase the immunogenicity of mycobacterial RNA preparations whether emulsified in Freund's incomplete adjuvant (FIA) or not emulsified. (ii) Mycobacterial ribosomal protein, extracted with 2-chloroethanol, was not immunogenic; the addition of poly A:U to the protein did not produce an immune response and FIA did not affect these results. (iii) The RNA left after the protein was extracted was partially immunogenic when emulsified in FIA even though it was partially degraded. (iv) Mycobacterial RNA prepared with ethyl alcohol and partially degraded with ribonuclease had a significantly lower immunogenic activity, and the original higher immune response was not restored by the addition of poly A:U. (v) Mycobacterial RNA totally degraded by weak alkali was not immunogenic, the original immunogenic activity was not restored by the addition of poly A:U or poly I:C, and FIA again did not influence the results. These findings suggest that (i) protein, polypeptides, or other antigenic fragments, if present, are not the specific immunogens; and (ii) mycobacterial RNA is responsible for the high immunogenic activity of mycobacterial ribosomal and RNA preparations. In addition, since the double-stranded forms of these synthetic polynucleotides markedly potentiate the formation of circulating antibodies, these results also reemphasize the lack of correlation between conventional antibody formation and immunity against tuberculosis.
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Affiliation(s)
- A S Youmans
- Department of Microbiology, Northwestern University Medical School, Chicago, Illinois 60611
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6
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Blankenhorn EP, Rodemich L, Martin-Fernandez C, Leif J, Greiner DL, Mordes JP. The rat diabetes susceptibility locus Iddm4 and at least one additional gene are required for autoimmune diabetes induced by viral infection. Diabetes 2005; 54:1233-7. [PMID: 15793267 PMCID: PMC2518668 DOI: 10.2337/diabetes.54.4.1233] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BBDR rats develop autoimmune diabetes only after challenge with environmental perturbants. These perturbants include polyinosinic:polycytidylic acid (poly I:C, a ligand of toll-like receptor 3), agents that deplete regulatory T-cell (Treg) populations, and a non-beta-cell cytopathic parvovirus (Kilham rat virus [KRV]). The dominant diabetes susceptibility locus Iddm4 is required for diabetes induced by treatment with poly I:C plus Treg depletion. Iddm4 is penetrant in congenic heterozygous rats on the resistant WF background and is 79% sensitive and 80% specific as a predictor of induced diabetes. Surprisingly, an analysis of 190 (BBDR x WF)F2 rats treated with KRV after brief exposure to poly I:C revealed that the BBDR-origin allele of Iddm4 is necessary but not entirely sufficient for diabetes expression. A genome scan identified a locus on chromosome 17, designated Iddm20, that is also required for susceptibility to diabetes after exposure to KRV and poly I:C (logarithm of odds score 3.7). These data suggest that the expression of autoimmune diabetes is a complex process that requires both major histocompatibility complex genes that confer susceptibility and additional genes such as Iddm4 and Iddm20 that operate only in the context of specific environmental perturbants, amplifying the immune response and the rate of disease progression.
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Affiliation(s)
- Elizabeth P Blankenhorn
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
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7
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Abstract
OBJECTIVE Blood cells from patients with paroxysmal nocturnal hemoglobinuria lack glycosyl phosphatidylinositol (GPI)-linked proteins, due to a somatic mutation in the X-linked PIGA gene. It is believed that clonal expansion of PIGA- blood cells is due to a survival advantage in the hostile marrow environment of aplastic anemia. Here we investigated the effects of inhibitory cytokines in mice genetically engineered to have blood cells deficient in GPI-linked proteins. MATERIALS AND METHODS The effect of inhibitory cytokines (tumor necrosis factor-alpha [TNF-alpha], interferon-gamma [IFN-gamma], macrophage inflammatory protein-1 alpha [MIP-1alpha], and transforming growth factor-beta1 [TGF-beta1]) was investigated, using clonogenic assays, competitive repopulation, and in vivo induction of proinflammatory cytokines by double-stranded RNA. The expression of Fas on progenitor cells and its up-regulation by inhibitory cytokines were analyzed by flow cytometry. RESULTS TNF-alpha, IFN-gamma, MIP-1alpha, and TGF-beta1 suppressed colony formation in a dose-dependent fashion that was similar for PIGA+ and PIGA- blood bone marrow cells. Competitive repopulation of bone marrow cells cultured in IFN-gamma and TNF-alpha resulted in a comparable ability of PIGA+ and PIGA- hematopoietic stem cells to reconstitute hematopoiesis. Fas expression was minimal on PIGA+ and PIGA- progenitor cells and was up-regulated to the same extent in response to IFN-gamma and TNF-alpha as assessed by Fas antibody-mediated apoptosis. Similarly, in vivo induction of proinflammatory cytokines by double-stranded RNA had no effect on the proportion of circulating PIGA- blood cells. CONCLUSIONS These results indicate that PIGA+ and PIGA- hematopoietic progenitor cells respond similarly to inhibitory cytokines, suggesting that other factors are responsible for the clonal expansion of paroxysmal nocturnal hemoglobinuria cells.
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Affiliation(s)
- Shashikant Kulkarni
- Department of Internal Medicine, Division of Hematology, Washington University School of Medicine, St. Louis, Mo. 63110, USA
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8
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Qu WM, Miyazaki T, Terada M, Okada K, Mori S, Kanno H, Nose M. A novel autoimmune pancreatitis model in MRL mice treated with polyinosinic:polycytidylic acid. Clin Exp Immunol 2002; 129:27-34. [PMID: 12100019 PMCID: PMC1906409 DOI: 10.1046/j.1365-2249.2002.01881.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In this study we established a new animal model for exploring the pathogenesis of autoimmune pancreatitis. We have found previously that MRL/Mp-+/+(MRL/+) mice develop pancreatitis spontaneously by an autoimmune mechanism but only when they are more than 34 weeks old. Because this disease might be a model of multi-factorial diseases controlled by genetic and environmental factors, beginning at 6 weeks old, we injected polyinosinic:polycytidylic acid (poly I:C) into MRL/+ mice and in addition, into MRL/Mp mice bearing the Fas deletion mutant gene, lpr (MRL/lpr). Poly I:C induced chronic severe pancreatitis in all the MRL/+ mice and to a lesser extent in the MRL/lpr mice by 18 weeks of age. There was no pancreatitis in control mice of both strains at the same age. Other than chronic pancreatitis, no severe autoimmune diseases were observed in MRL/+ mice. Immunohistochemical examinations revealed predominant infiltration of CD4+ T cells and Mac-2+ activated macrophages in the pancreatic lesions. Splenic expression of the mRNAs for TNF-alpha and IL-10, which is known to suppress the development of pancreatitis, were increased in both strains of mice. These findings suggest that an MRL strain of mice treated with poly I:C might be a good model for developing new approaches to the study of the pathogenesis of autoimmune pancreatitis.
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MESH Headings
- Age Factors
- Animals
- Autoimmune Diseases/chemically induced
- Autoimmune Diseases/genetics
- Autoimmune Diseases/immunology
- Autoimmune Diseases/pathology
- CD4-Positive T-Lymphocytes/immunology
- Cholangitis, Sclerosing/chemically induced
- Cholangitis, Sclerosing/genetics
- Cholangitis, Sclerosing/immunology
- Disease Models, Animal
- Female
- Genetic Predisposition to Disease
- Interleukin-10/biosynthesis
- Interleukin-10/genetics
- Liver Cirrhosis, Biliary/chemically induced
- Liver Cirrhosis, Biliary/genetics
- Liver Cirrhosis, Biliary/immunology
- Lupus Erythematosus, Systemic/genetics
- Lupus Erythematosus, Systemic/immunology
- Macrophages/immunology
- Mice
- Mice, Inbred MRL lpr
- Mice, Inbred Strains/immunology
- Pancreatitis/chemically induced
- Pancreatitis/genetics
- Pancreatitis/immunology
- Pancreatitis/pathology
- Poly I-C/immunology
- Poly I-C/toxicity
- RNA, Messenger/biosynthesis
- Spleen/immunology
- Spleen/metabolism
- Tumor Necrosis Factor-alpha/biosynthesis
- Tumor Necrosis Factor-alpha/genetics
- fas Receptor/genetics
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Affiliation(s)
- W-M Qu
- Department of Pathology, Ehime University School of Medicine, Japan
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9
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Abstract
The study of double-stranded RNA (dsRNA) encompasses a variety of fields. Basic research in this area has contributed to a greater mechanistic understanding of gene induction, tumor cell growth arrest, the establishment of antiviral states, and immunomodulation. Because of the possible clinical value of these molecules, physicians are now exploring the use of synthetic dsRNA to treat patients with cancer, HIV-1 disease, and immune dysfunction. Continued studies of the mechanisms of action of dsRNA are likely to suggest an even wider scope of clinical applications.
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Affiliation(s)
- D S Haines
- Department of Neoplastic Diseases, Hahnemann University, Philadelphia, Pennsylvania 19102
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10
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Black PL, Phillips H, Tribble HR, Pennington R, Schneider M, Talmadge JE. Correlation of immunomodulatory and therapeutic activities of interferon and interferon inducers in metastatic disease. J Cell Biochem 1988; 36:377-92. [PMID: 3132467 DOI: 10.1002/jcb.240360407] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The mechanism of therapeutic activity of recombinant murine interferon-gamma (rMu IFN-gamma) and the IFN inducer polyinosinic-polycytidylic acid solubilized with poly-L-lysine in carboxy methyl cellulose (pICLC) in treating metastatic disease was investigated by comparing effector cell augmentation with therapeutic activity in mice bearing experimental lung metastases (B16-BL6 melanoma). Effector cell functions in spleen, peripheral blood, and lung (the organ with tumor) were tested after 1 and 3 weeks of rMu IFN-gamma or pICLC administration (intravenous, three times a week). In these studies, natural killer (NK), lymphokine-activated killer (LAK), cytolytic T lymphocytes (CTL) (against specific and nonspecific targets), and macrophage tumoricidal and tumoristatic activities were measured. rM IFN-gamma and pICLC had therapeutic activity and immunomodulatory activity in most assays of immune function examined. Specific CTL activity of pulmonary parenchymal mononuclear cells (PPMC), but not in splenocytes or peripheral blood lymphocytes (PBL), during week 3 and not during week 1, correlated with the therapeutic activity of rMu IFN-gamma and of pICLC. Macrophage tumoricidal activity in PPMC, but not in alveolar macrophages, also correlated with the therapeutic activity of rMu IFN-gamma, but the opposite was true for the therapeutic activity of pICLC. NK activity of PPMC, but not of splenocytes or PBL, during week 1 correlated with the therapeutic activity of pICLC; in contrast, NK activity at any site did not correlate with the therapeutic activity of rMu IFN-gamma. LAK activity at any site did not correlate with the therapeutic activity of either agent.
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Affiliation(s)
- P L Black
- Preclinical Evaluation Laboratory, PRI, National Cancer Institute-Frederick Cancer Research Facility, Maryland 21701
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11
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Moroz C, Kupfer B, Lindner A, Many M. Treatment of patients with transitional cell carcinoma of the urinary bladder with intravesical poly I: poly C effects on natural killer function. Cancer Immunol Immunother 1985; 20:236-40. [PMID: 2415237 PMCID: PMC11038186 DOI: 10.1007/bf00205583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/1984] [Accepted: 05/28/1985] [Indexed: 12/31/2022]
Abstract
Considerable interest has been focused on the use of interferon (IFN) and IFN-inducers as antineoplastic agents in humans. The current report will focus on the effect of intravesical administration of Poly I: Poly C on NK activity in patients with TCC of the urinary bladder. NK cytotoxicity was measured in 14 patients with primary TCC, 8 patients received Poly I: Poly C and 5 other patients received intravesical thiotepa. Blood samples were obtained prior to and 48 h following each drug treatment. A variation in the initial NK level determined prior to treatment was observed in the different TCC patients: 5 patients treated with Poly I: Poly C and 5 patients treated with thiotepa exhibited low NK activity prior to treatment, whereas the other 3 patients who were treated with Poly I: Poly C had high initial NK levels. Following drug treatment it was shown that a significant elevation in the NK cytotoxicity was only observed in patients treated by intravesical Poly I: Poly C who had low NK activity prior to treatment. No such effect was observed in patients treated with thiotepa or in patients treated with Poly I: Poly C who exhibited a high NK activity prior to treatment.
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12
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Schindler TE, Sadlik JR, Hadden JW. Immunopharmacologic Regulation of the Mononuclear Phagocyte System. Pharmacology 1985. [DOI: 10.1007/978-1-4615-9406-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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KROWN S, FRIDEN G, KHANSUR T, DAVIES M, OETTGEN H, FIELD A. Phase I Trial with the Interferon Inducer Poly I:C/Poly-L-Lysine (Poly ICL). ACTA ACUST UNITED AC 1983. [DOI: 10.1089/jir.1983.3.281] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Chirigos MA, Papademetriou V, Bartocci A, Read E, Levy HB. Immune response modifying activity in mice of polyinosinic: polycytidylic acid stabilized with poly-L-lysine, in carboxymethylcellulose [poly-ICLC]. INTERNATIONAL JOURNAL OF IMMUNOPHARMACOLOGY 1981; 3:329-37. [PMID: 7333719 DOI: 10.1016/0192-0561(81)90028-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Poly-ICLC, a polyinosinic: polycytidylic acid stabilized with poly-L-lysine in carboxymethyl-cellulose was tested in mice for its immunoregulatory activity. Poly-ICLC was found to enhance T cell responsiveness but not B cells. It augmented the delayed type hypersensitivity response significantly. The results indicate Poly-ICLC to be a T cell stimulator. Macrophage tumoricidal activity was markedly enhanced both in vitro and in vivo after exposure to Poly-ICLC. Natural killer cell cytotoxicity was significantly augmented in vivo. Both macrophage and natural killer cell activity was maintained for over 3 days after only one treatment. The extended period of tumor cell cytotoxicity, exhibited by macrophages and natural killer cells, may correlate to Poly-ICLC induction of early and high levels of interferon which are maintained in the serum for a longer period of time.
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15
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Kanai Y, Sugimura T, Matsushima T. Induction of specific antibodies to poly(ADP-ribose) in rabbits by double-stranded RNA, poly(A)-poly(U). Nature 1978; 274:809-12. [PMID: 683319 DOI: 10.1038/274809a0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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16
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Dennert G, Lotan R. Effects of retinoic acid on the immune system: stimulation of T killer cell induction. Eur J Immunol 1978; 8:23-9. [PMID: 346357 DOI: 10.1002/eji.1830080106] [Citation(s) in RCA: 149] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Retinoic acid (RA), a vitamin A derivative with anti-tumor activity, was assayed for its effects on the immune system in mice. High doses of this compound (1000 microgram/mouse/day) have toxic effects and cause depletion on the peripheral lymphoid organs (spleen, thymus) while leaving the bone marrow cells unaffected. Both the in vivo and in vitro induction of cell-mediated cytotoxicity (CMC) to allogeneic tumor cells is stimulated at least tenfold by low doses (25--300 microgram/mouse/day) of RA while high doses suppress CMC induction. RA is shown to be a specific adjuvant for the induction of cytotoxic thymus-derived lymphocytes (T cells) and not a general T cell mitogen or adjuvant. It does not enhance the proliferative response in the mixed lymphocyte culture nor does it stimulate lymphocyte proliferation in response to the mitogens concanavalin A and phytohemagglutinin. The induction of cooperating T cells and the delayed-type hypersensitivity reaction are also not stimulated by RA. In contrast to the reported stimulatory effects of retinyl palmitate and retinyl acetate, RA does not stimulate the humoral response to erythrocytes. The strong adjuvant effects that RA has on the induction of CMC at low doses may be responsible for its anti-tumor activity.
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17
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Woods WA. Mechanisms of action of immunopotentiating agents in cancer therapy. ADVANCES IN PHARMACOLOGY AND CHEMOTHERAPY 1977; 14:143-62. [PMID: 329658 DOI: 10.1016/s1054-3589(08)60187-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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18
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Abstract
Injection of RNA, extracted from statolon by the SDS-phenol method, into FLV-infected mice 24 hours before SRBC immunization restored the immune response to SRBC to normal levels. Leukemosuppression was observed in 50% of the RNA-treated FLV-infected mice. These RNA-treated mice were clinically normal 25 days after infection, whereas all untreated infected mice developed erythroleukemia. Furthermore, all RNA-treated mice with suppressed erythroleukemia produced antibody which was cytotoxic for Friend leukemia cells. Our studies, and studies by others, indicate that the immunostimulatory and leukemosuppressive principle in statolon appears to be a dsRNA.
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19
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Bart RS, Lam S, Cooper JS, Kopf AW. Retention of antimelanoma effect of polyinosinic-polycytidylic acid in neonatally thymectomized, irradiated, leukopenic mice. J Invest Dermatol 1975; 65:285-9. [PMID: 1159315 DOI: 10.1111/1523-1747.ep12598349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Polyinosinic-polycytidylic acid (PIC), a synthetic polyribonucleotide, inhibits the growth of B16 malignant melanoma in C57BL/6 mice. Since PIC has been reported to augment immune responses, we tested the hypothesis that the antitumor effect of PIC against B16 melanoma is via immune stimulation. Mice were neonatally thymectomized or neonatally thymectomized and subsequently irradiated to suppress their immune reactivity. In such animals PIC retained its ability to inhibit the growth of B16 melanoma, in the face of profound leukopenia and lymphopenia, suggesting that its antimelanoma effect is probably not mediated by augmentation of the host's immune antitumor response.
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20
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Abstract
Double-stranded RNA, made as an intermediary substance in the replication of most, if not all, viruses, may play a much more important role in the pathogenesis and the recovery from virus infections than has hitherto been suspected. Apparently, dsRNA is used by both the challenge virus and the host cell in an attempt to gain "molecular control." Double-stranded RNA exerts a set of effects, which may be well balanced, not only at the level of the individual cell but also at the complex assemblage of these cells termed the organism (Fig. 1). In the cell, interferon synthesis is triggered, although interferon mRNA translation may not occur if dsRNA shuts off protein synthesis too quickly. In the whole organism, the disease severity will depend on how certain toxic reactions evoked by infection (such as cell necrosis and fever) are counterbalanced by an increase in the host defense mechanisms (for example, immune responsiveness and interferon production). Many aspects of the response, relating to either progress of, or recovery from, the disease, can be explained on the basis of a dsRNA. In addition to drawing attention to the biodynamic role of dsRNA, our hypothesis suggests specific experimental vectors designed to enhance our information on the molecular basis of the morbid process which occurs with viral infection. Finally, we suggest that, although the dsRNA molecule may be viewed as a rather simple unit structure, the opportunity for further diversity in the biological activity of a given dsRNA molecule always exists. Namely, each deviation from a perfectly double-helical arrangement introduces the possibility for emphasizing one biological reactivity at the expense of another. This latter structure-activity property may partially account for the extreme apparent diversity, commonly encountered, in the presentations of virologic illness. Appendix note added in proof. Subsequent to submission of this text, we have found that the potent mitogen effect of dsRNA for lymphocytes (murine and human) is also exquisitively sensitive to the fidelity in base pairing of the input polymer pair (59). For example, infrequent "loops" (one nucleotide per 20 base pairs) in an otherwise perfectly helical rI(n) (.) rC(n) molecule [for example, rI(n) (.) r(C(19,)U)(n)] strongly changes its mitogenic properties. This observation, which supports our thesis that a "fine structure" term can be developed for other reactions triggered by dsRNA's in biological systems, emphasizes that diverse biological effects may be encountered with an ostensibly uniform family of dsRNA's.
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21
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Harmon MW, Janis B, Levy HB. Post-exposure prophylaxis of murine rabies with polyinosinic-polycytidylic acid and chlorite-oxidized amylose. Antimicrob Agents Chemother 1974; 6:507-11. [PMID: 4157354 PMCID: PMC444680 DOI: 10.1128/aac.6.4.507] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Chlorite-oxidized amylose (COAM), polyinosinic-polycytidylic acid [poly(I:C)], and combinations of the two drugs were evaluated for their interferon-inducing properties and their ability to protect mice against rabies infection. Post-exposure administration of one or two doses (100 mug each) of poly(I:C) significantly protected mice against rabies infection. Pretreatment of mice with COAM 3 h before poly(I:C) stimulation resulted in an enhancement of the interferon response. However, the increased interferon titers were not reflected by increased protection against rabies infection over that achieved with poly(I:C) therapy alone. Therapy with COAM alone did not protect mice against rabies but, rather, was associated with enhanced mortality.
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22
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Teng CT, Chen MC, Hamilton LD. Poly(inosinic acid)-poly(cytidylic acid) inhibition of DNA synthesis in synchronized HeLa cells. Proc Natl Acad Sci U S A 1973; 70:3904-8. [PMID: 4521216 PMCID: PMC427354 DOI: 10.1073/pnas.70.12.3904] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Inhibition by double-stranded polyribonucleotides of DNA synthesis in synchronized HeLa cultures is dose- and time-dependent. Inhibition by poly(I.C) primarily affected late G(1) and early S phases of the cell cycle. Single-stranded polynucleotides, native calf-thymus DNA, and yeast RNA had no effect. Radioautography showed that after 2-hr exposure the synthetic polyribonucleotides were predominantly inside the nucleus. The results extend the spectrum of action of double-stranded RNA.
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Scher I, Strong DM, Ahmed A, Knudsen RC, Sell KW. Specific murine B-cell activation by synthetic single-and double-stranded polynucleotides. J Exp Med 1973; 138:1545-63. [PMID: 4543458 PMCID: PMC2139448 DOI: 10.1084/jem.138.6.1545] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The synthetic single- and double-stranded polynucleotides, poly I, poly C, and poly I.C, were shown to induce thymidine incorporation in six inbred strains of murine spleen cells. This stimulation was shown to be secondary to B-cell activation and not due to contamination of the polynucleotides with bacterial lipopolysaccharide (LPS). The ability of poly I.C to act as a B-cell mitogen, in addition to its behavior as a thymic-independent antigen, suggested that these two phenomena may be related. The similarity of the molecular structure of poly I.C to LPS, a material which also acts as a thymic-independent antigen and a B-cell mitogen, supports the hypothesis that the polyvalent nature of these materials accounts for their functional interaction with murine B cells.
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Gazdar AF, Sims H, Spahn GJ, Baron S. Interferon mediates enhancement of tumour growth and virus-induced sarcomas in mice. NATURE: NEW BIOLOGY 1973; 245:77-8. [PMID: 4517051 DOI: 10.1038/newbio245077a0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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25
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Rose WC. Interaction of bacterial toxins in the toxicity of chemotherapeutic agents. CRC CRITICAL REVIEWS IN TOXICOLOGY 1973; 2:159-209. [PMID: 4591818 DOI: 10.3109/10408447309025702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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26
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Diamantstein T, Vogt W, Rühl H, Bochert G. Stimulation of DNA synthesis in mouse lymphoid cells by polyanions in vitro. I. Target cells and possible mode of action. Eur J Immunol 1973; 3:488-93. [PMID: 4585312 DOI: 10.1002/eji.1830030807] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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27
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28
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Jaroslow BN, Ortiz-Ortiz L, Lenta P. The adjuvant effect of natural and artificial RNA-polynucleotides in the immune response in culture. Ann N Y Acad Sci 1973; 207:327-36. [PMID: 4517711 DOI: 10.1111/j.1749-6632.1973.tb47494.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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29
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Degré M, Dahl H. Enhanced effect of repeated administration of bacterial vaccine against viral respiratory infection. Infect Immun 1973; 7:771-6. [PMID: 4357990 PMCID: PMC422759 DOI: 10.1128/iai.7.5.771-776.1973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Administration of a standard bacterial vaccine (SBV) affords some protection against influenza infection in mice if given 4 to 5 h before inoculation of the virus. This effect was enhanced by repeated injections of SBV 7 and 14 days earlier, as measured by the length of survival, mortality rate, development of gross pneumonia, and virus multiplication in the lungs. Serum interferon levels were likewise enhanced by immunization with SBV, which may, at least in part, explain the increased preventive effect.
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31
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Bart RS, Kopf AW, Lam S. Studies on the mechanism of the anti-melanoma effect of polyinosinic-polycytidylic acid (PIC). II. Decreased growth of B-16 melanoma from prior exposure to the tumor. Abrogation of this response by PIC. J Invest Dermatol 1972; 59:442-4. [PMID: 4643883 DOI: 10.1111/1523-1747.ep12627606] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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34
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Allen LB, Cochran KW. Target-organ treatment of neurotropic virus disease with interferon inducers. Infect Immun 1972; 6:819-23. [PMID: 4404669 PMCID: PMC422616 DOI: 10.1128/iai.6.5.819-823.1972] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Interferon inducers were used against vaccinial encephalitis to study the target-organ treatment of neurotropic disease and to correlate interferon levels and the antiviral state following such treatment. A 45-mug amount of statolon, 30 mug of polyribinosinic-polyribocytidylic acid complex (poly I.poly C), or 0.0154 HA unit of Sendai virus given intracerebrally protected 100% of mice challenged the next day with 1,000 median lethal doses (LD(50)) of vaccinia virus. Significant protection against 1,000 LD(50) of vaccinia virus persisted for 1, 4, or 3 weeks after poly I.poly C, statolon, or Sendai virus (154 HA units), respectively. These doses of poly I.poly C and statolon were also used to study postinfection treatment. Mice challenged with 1, 10, 100, or 1,000 LD(50) were treated intracerebrally with poly I.poly C or statolon 24 or 48 hr later. Significant increases in survival time were seen in mice challenged with 1 to 100 LD(50) of vaccinia virus and treated 24 hr later. At challenges of 10 or 100 LD(50), statolon was more effective than poly I.poly C in increasing survival times. When treatment was delayed until 48 hr after infection, significant increases in survival time occurred only when the challenges were in the range of 1 to 10 LD(50), with poly I.poly C and statolon being equally effective. Interferon was measured by Finter's dye-uptake method, with L-929 cells and Semliki Forest virus. Poly I.poly C, statolon, or Sendai virus, given intracerebrally to mice, produced serum interferon peaks of 5,120 units/ml at 2 hr, 2,560 units/ml at 12 hr, or 320 units/ml at 18 hr, respectively. Corresponding brain interferon peaks were 640 units/g at 2 hr, 640 units/g at 4 to 24 hr, and 960 units/g at 72 hr.
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Morahan PS, Regelson W, Munson AE. Pyran and polyribonucleotides: differences in biological activities. Antimicrob Agents Chemother 1972; 2:16-22. [PMID: 4670655 PMCID: PMC444259 DOI: 10.1128/aac.2.1.16] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Maleic anhydride-divinyl ether copolymer (pyran) and the polyribonucleotides are both large polyanions with potent antiviral activity. However, they are biologically quite different. Interferon levels of 100 units or more/ml were associated with antiviral activity of polyribonucleotides. Interferon induction by pyran compounds was not primarily involved in antiviral resistance because preparations that did not induce interferon possessed antiviral activity equal to that of interferoninducing preparations. Both polyriboinosinic-cytidylic acid [poly (rI.rC)] and pyran increased the immune response to sheep erythrocytes in the Jerne hemolytic plaque-forming cell (PFC) assay, but their modes of immunoadjuvant action differed. On peak day, poly (rI.rC)-treated mice demonstrated 5.1 x 10(4) PFC/spleen (557 PFC/10(6) nucleated cells) and pyran-treated mice exhibited 4.5 x 10(4) PFC/spleen (299 PFC/10(6) nucleated cells), as compared with 2.7 x 10(4) PFC/spleen (261 PFC/10(6) nucleated cells) in controls. The compounds also differed in phagocytic alteration; polyribonucleotides did not affect phagocytosis whereas pyran produced a biphasic response. Both polyanions exhibited toxic inhibition of liver microsomal enzyme metabolism of type I and type II drugs. However, whereas pyran sensitized mice 50-fold to the lethal effects of endotoxin, the polyribonucleotides did not significantly sensitize mice to endotoxin.
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Dean JH, Wallen WC, Lucas DO. Polyinosinic-polycytidylic acid activation of mouse spleen cells in vitro. NATURE: NEW BIOLOGY 1972; 237:218-9. [PMID: 4504210 DOI: 10.1038/newbio237218a0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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Collavo D, Finco B, Chieco-Bianchi L. Immune reactivity following poly I-poly C treatment in mice. NATURE: NEW BIOLOGY 1972; 237:154-5. [PMID: 4402518 DOI: 10.1038/newbio237154a0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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38
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Herman R. The effects of interferon and its inducers on experimental protozoan parasitic infections. TRANSACTIONS OF THE NEW YORK ACADEMY OF SCIENCES 1972; 34:176-80. [PMID: 4501525 DOI: 10.1111/j.2164-0947.1972.tb02672.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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39
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Herman R, Baron S. Immunologic-mediated protection of Trypanosoma congolense-infected mice by polyribonucleotides. THE JOURNAL OF PROTOZOOLOGY 1971; 18:661-6. [PMID: 5133126 DOI: 10.1111/j.1550-7408.1971.tb03393.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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40
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Diamantstein T, Wagner B, Beyse I, Odenwald MV, Schulz G. Stimulation of humoral antibody formation by polyanions. I. The effect of polyacrylic acid on the primary immune response in mice immunized with sheep red blood cells. Eur J Immunol 1971; 1:335-40. [PMID: 4945635 DOI: 10.1002/eji.1830010506] [Citation(s) in RCA: 50] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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41
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Floersheim GL, Szeszak JJ. Poly I-poly C and endotoxins share immunosuppressive properties and increase the toxicity of alpha-amanitin and hexobarbital. AGENTS AND ACTIONS 1971; 2:150-5. [PMID: 4362164 DOI: 10.1007/bf01966754] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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42
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Diamantstein T, Wagner B, Beyse I, Odenwald MV, Schulz G. Stimulation of humoral antibody formation by polyanions. II. The influence of sulfate esters of polymers on the immune response in mice. Eur J Immunol 1971; 1:340-3. [PMID: 4945636 DOI: 10.1002/eji.1830010507] [Citation(s) in RCA: 41] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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43
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Rice JM, Turner W, Chirigos MA, Spahn G. Dose responsiveness and variation among inbred strains of mice in production of interferon after treatment with poly (I)-poly (C) (poly-D-lysine) complexes. Appl Microbiol 1971; 22:380-6. [PMID: 4330315 PMCID: PMC376318 DOI: 10.1128/am.22.3.380-386.1971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Poly-d-lysine forms a stochiometric complex with poly(I) . poly(C) which has a higher T(m) (83 C in 0.15 m NaCl) than the uncomplexed double-stranded polyribo-nucleotide (63 C). The complex was superior to poly(I) . poly(C) alone as an interferon inducer in vivo. Significant serum interferon titers were attained in Swiss mice during a 24-hr period after intraperitoneal injection of 10 to 300 mug of poly(I) . poly(C) [1.0 poly-d-lysine] complex, at concentrations of 100 to 1,000 mug/ml. The serum interferon responses (average and maximum titers) of a series of inbred strains of mice to a single intraperitoneal injection of 100 mug of complex decreased in the order: Swiss > DBA/2 > C3H > BALB/c > CF-1 > AKR, C57Bl/6, NZB > SJL > NZW and varied by a factor of approximately 100 from the most to the least responsive.
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Fraser CE, Meléndez LV, Barahona HH, Daniel MD. The effect of polyinosinic: polycytidylic acid on fluorescent and neutralizing antibodies to Herpesvirus saimiri in goats. Int J Cancer 1971; 7:397-402. [PMID: 4104422 DOI: 10.1002/ijc.2910070304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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45
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Jullien P, de Maeyer-Guignard J. Toxic effect of polyriboinosinic-polyribocytidylic acid on mouse hemopoietic stem cells. Int J Cancer 1971; 7:468-75. [PMID: 4934497 DOI: 10.1002/ijc.2910070312] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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46
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Weinstein AJ, Gazdar AF, Sims HL, Levy HB. Lack of correlation between interferon induction and antitumour effect of poly I-poly C. NATURE: NEW BIOLOGY 1971; 231:53-4. [PMID: 5283388 DOI: 10.1038/newbio231053a0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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47
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Young CW. Interferon induction in cancer: with some observations on the clinical effects of poly 1:C. Med Clin North Am 1971; 55:721-8. [PMID: 4932880 DOI: 10.1016/s0025-7125(16)32513-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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48
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Chester TJ, de Clercq E, Merigan TC. Effect of Separate and Combined Injections of Poly rI: Poly rC and Endotoxin on Reticulo-endothelial Activity, Interferon, and Antibody Production in the Mouse. Infect Immun 1971; 3:516-20. [PMID: 16558008 PMCID: PMC416187 DOI: 10.1128/iai.3.4.516-520.1971] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The effect of repeated stimulation on both the interferon and antibody systems and on reticuloendothelial activity was studied by injection of endotoxin 2 days before injection of (poly rI):(poly rC). A single injection of endotoxin or (poly rI):(poly rC) increased or decreased the response in each system depending on the time of administration. If the injection of (poly rI):(poly rC) was preceded by an injection of endotoxin 2 days before, its activity was markedly reduced in all of the three systems studied. Although different doses of endotoxin were required to induce a state of hyporeactivity or tolerance to the effects of (poly rI):(poly rC) in either system, it is possible that a common mechanism underlies the hyporeactivity in all systems.
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Affiliation(s)
- T J Chester
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, California 94305
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49
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Richmond JY. Mouse Resistance Against Foot-and-Mouth Disease Virus Induced by Injections of Pyran. Infect Immun 1971; 3:249-53. [PMID: 16557961 PMCID: PMC416139 DOI: 10.1128/iai.3.2.249-253.1971] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mouse resistance to foot-and-mouth disease virus (FMDV) was induced by intraperitoneal injections of pyran copolymer. A biphasic pattern of protection occurred with greatest resistance 4 and 48 hr after injection of this polyanion. Viremia was not detectable in pretreated mice challenge-exposed with FMDV. Incubation of virus with pyran did not alter viral infectivity in mice or tissue culture. Serum interferon was demonstrated 1 and 2 days after pyran administration.
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Affiliation(s)
- J Y Richmond
- Plum Island Animal Disease Laboratory, Veterinary Sciences Research Division, Agricultural Research Service, U.S. Department of Agriculture, Greenport, New York 11944
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50
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Bart RS, Kopf AW, Silagi S. Inhibition of the growth of murine malignant melanoma by polyinosinic-polycytidylic acid. J Invest Dermatol 1971; 56:33-8. [PMID: 5556497 DOI: 10.1111/1523-1747.ep12291892] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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