Manufacturing of primary CAR-NK cells in an automated system for the treatment of acute myeloid leukemia

Acute myeloid leukemia (AML) still constitutes a dreadful disease with limited therapeutic options. Chimeric antigen receptor (CAR)-modified T cells struggle to target AML partly due to a lack of true AML-exclusive antigens and heterogeneity of the disease. Natural killer (NK) cells possess a high intrinsic killing capacity against AML and might be well suited for the treatment of this disease. However, the generation of primary CAR-NK cells can be difficult and time consuming. Therefore, robust systems for the generation of high numbers of CAR-NK cells under GMP conditions are required. Here we report on the automated generation of high numbers of primary CD33-targeting CAR-NK cells using the CliniMACS Prodigy® platform. Automated-produced CD33-CAR-NK cells showed similar phenotype and cytotoxicity compared to small-scale-produced CD33-CAR-NK cells in vitro and were able to strongly reduce leukemic burden in an OCI-AML2 NSG-SGM3 xenograft mouse model in vivo following a cross-site shipment of the cell product. This technology might be well suited for the generation of primary CAR-modified NK cells for a broad range of targets and could facilitate clinical transition.

Rapid detection and online analysis of microbial changes through flow cytometry

Short-read 16 S rRNA gene sequencing is the dominating technology to profile microbial communities in different habitats. Its uncontested taxonomic resolution paved the way for major contributions to the field. Sample measurement and analysis, that is, sequencing, is rather slow-in order of days. Alternatively, flow cytometry can be used to profile the microbiota of various sources within a few minutes per sample. To keep up with high measurement speed, we developed the open source-analyzing tool FlowSoFine. To validate the ability to distinguish microbial profiles, we examined human skin samples of three body sites (N = 3 × 54) with flow cytometry and 16 S rRNA gene amplicon sequencing. Confirmed by sequencing of the very same samples, body site was found to be significantly different by flow cytometry. For a proof-of-principle multidimensional approach, using stool samples of patients (N = 40) with/without inflammatory bowel diseases, we could discriminate the health status by their bacterial patterns. In conclusion, FlowSoFine enables the generation and comparison of cytometric fingerprints of microbial communities from different sources. The implemented interface supports the user through all analytical steps to work out the biological relevant signals from raw measurements to publication ready figures. Furthermore, we present flow cytometry as a valid method for skin microbiota analysis.

[Nephrologic analysis of 94 women with diagnosed "primary" gestosis]

Among 94 women with diagnosed "primary" gestosis during pregnancy, 67 patients demonstrated (3-6 months after delivery) chronic glomerulonephritis (25 women) or chronic pyelonephritis (28 women) or hypertension caused by others than nephrologic reasons. "Primary" gestosis was diagnosed correctly only in 29% cases. The most often reason of "secondary" gestosis was undiagnosed chronic nephropathy before and during pregnancy. Obtained results confirm other data informing that "primary" gestosis is a rare phenomenon.

[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. II. Primary hyperparathyroidism]

Among 1819 patients with renal stone disease 44 cases with primary hyperparathyroidism (p.h.p.) were diagnosed. In all cases the diagnosis of php was confirmed by histomorphological examination. In 34 patients with php solitary adenoma was found, in 5 patients an adenoma with concomitant hyperplasia of the parathyroid glands, in 2 patients hyperplasia and in 3 patients carcinoma of the parathyroid glands. Hypercalcemia was found in 86% of patients, while elevated plasma levels of PTH in 90% of patients with php. Not in all patients PTH secretion was entirely autonomous. No significant correlation was found between plasma levels of PTH and kind of pathology of the parathyroid glands as well as clinical feature of php respectively.

[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. I. Hypercalciuria]

In 1819 patients with active or non active respectively nephrolithiasis the following parameters were assessed: plasma level of calcium, phosphate, and uric acid and urinary excretion of calcium, phosphate, oxalate, uric acid and creatinine. These parameters were estimated after 5 days of diet containing 400 mg of calcium, 800 mg of phosphate, 100 mg of purines and 40 g of proteins. In 3/4 of all examined patients at least one lithogenic factor was present. More than 40% of patients showed presence of hypercalciuria. Among these patients in 68% renal in 17% absorptive and in 15% undefined hypercalciuria was diagnosed. Patients with active nephrolithiasis showed a similar frequency of hypercalciuria but more profound abnormalities of Ca P metabolism than patients with non active renal stone disease.

Pharmacokinetics of ritanserin in patients undergoing hemodialysis

The pharmacokinetics of ritanserin were studied in five patients with chronic renal insufficiency and who were undergoing periodic hemodialysis. Immediately after breakfast, a single 10-mg ritanserin tablet was administered to each patient on a day that they did not undergo dialysis. Plasma ritanserin levels were measured by a specific high-performance liquid chromatographic assay sensitive to 2 ng/mL plasma. After the oral 10-mg dose, the average time to reach the peak plasma concentration, Tmax, was 4.4 +/- 2.2 hours in these uremic patients, with a range of 2 to 8 hours. The average peak plasma concentration was 73.6 +/- 26.9 ng/mL (range: 54.6-120.0 ng/mL). Compared with a previous study in healthy volunteers, the uremic patients had a slower absorption profile, with a 39% reduction in peak plasma concentration and mean delay of 2.5 hours in Tmax. The mean area under the plasma concentration-time curve for ritanserin (2031 +/- 636 ng.hr/mL) was 47% lower compared with that in healthy volunteers (3867 +/- 1413 ng.hr/mL). The observed delayed and lower ritanserin absorption in these uremic patients may be caused by the chronic use of antacids such as aluminum hydroxide and calcium carbonate in all patients and/or by concurrent pathologic changes in the gastrointestinal mucosa of these patients. The regular hemodialysis sessions every 2-3 days did not affect the elimination rate of ritanserin, as the terminal half-life in these patients (39 +/- 23 hr) is similar to that in healthy volunteers (41 +/- 14 hr).

Cimetidine pharmacokinetics after oral administration of cimetidine retard in normal and impaired renal function

Cimetidine pharmacokinetics was investigated in four groups: Group I with three normals (serum creatinine less than 1.5 mg/dl), Group II with three kidney patients, renal function slightly impaired (serum creatinine greater than 1.8-4.3 mg/dl), Group III with three patients suffering from severe impairment (serum creatinine greater than 4.3 mg/dl) and Group IV with three patients on chronic hemodialysis. All four groups were given cimetidine retard (350 mg tablets Neutronorm retard, Ebewe Arzneimittel GmbH, A-4866 Unterach a.A., Austria). Groups I and II (normals and slightly impaired renal function) received the tablets twice a day with an interval of 12 h (7:00 a.m. and 7:00 p.m.). Groups III and IV (severely impaired renal function and hemodialysis patient were only given one dose a day (7:00 a.m.). The group of normals (I) and the group with slightly impaired renal function (II) had the highest serum cimetidine concentrations one to two h after the morning dose, followed by an exponential decrease. After the evening dose in Group I, the highest concentrations were found after 4 h. Group II had the highest concentrations four to eight h after administration. Compared to the morning dose, the exponential decrease of the serum cimetidine concentration was delayed in onset and slower in phasing out. Furthermore, concentration was higher during the night than during the day.(ABSTRACT TRUNCATED AT 250 WORDS)

[Are glomerular hyperfiltration and hyperperfusion involved in the development and progression of nephropathies?]

In the present paper the significance of non-immunological factors in the development and progression of nephropathies according to the hypothesis of Brenner et al. especially hemodynamic changes in the glomerula with glomerular hyperperfusion and/or hyperfiltration is discussed and therapeutic conclusions are made. The normalized glomerular pressure conditions (converting-enzyme inhibitors), a normalization of hyperglycemia in diabetics, a retention in the use of protein-rich diet and platelet-aggregation inhibitors, respectively, play a special part in the treatment of chronic nephropathies.

Plasma concentrations of ketanserin in chronic hemodialysed patients

Six patients on chronic hemodialysis received 20 mg ketanserin p.o. twice daily for 3 days. Plasma levels were measured daily 2 hours after application of the morning dose; however, on the third day, plasma levels were taken before, during and after dialysis. On the 4th day elimination was measured after a single dose of 20 mg ketanserin for 24 hours. Mean plasma levels ranged from 19 to 31 ng/ml. Both ketanserin and reduced ketanserin were not eliminated by dialysis. Elimination half-life was about 12 hours.

[Effects of L-arginine on glucagon and insulin secretion in patients with acute kidney failure]

In 20 patients with acute renal failure and 11 normal persons the behaviour of the glucagon and insulin secretion was examined after administration of L-arginine. Under standard conditions the glucagon level was significantly higher in the acute renal insufficiency than in the normals. Increased glucagon levels could be stated in the anuric/oliguric as well as in the polyuric phase. After administration of L-arginine in the acute renal failure a significantly higher increase of the glucagon level, but a significantly lower increase of the insulin concentration could be observed than in healthy persons. On account of these findings apart from the endocrinological changes stated also other factors seem to be involved in the pathogenesis of the carbohydrate intolerance in acute renal insufficiency.

Relation between middle molecules and parathyroid hormone in patients with chronic renal failure

In 10 moderately and 41 severely uremic patients the relation between serum parathyroid hormone (PTH) and middle molecule fraction 2 (MMS fr. 2-corresponding to MMS peak 7 of Fürst) was investigated. A significant correlation between PTH and MMS fr. 2 levels was found. This correlation was even better between PTH levels and MMS fr. 2/creatinine ratios. We would like to propose that PTH is one of several factors regulating middle molecule levels in uremic patients and that some 'toxic' effects of PTH may be mediated by middle molecules.

25-hydroxyvitamin D in patients with essential hypertension

Plasma 25-OH-D levels of normotensive and hypertensive subjects living in a highly industrial and in a nonindustrial area, were estimated. Significantly higher values were found in normotensive subjects than in hypertensive patients. Severity of arterial hypertension was not related to plasma 25-OH-D. Both groups of subjects (normotensive and hypertensive) living in the industrial area with high air pollution had lower 25-OH-D concentrations than those living in the nonindustrial region. Data presented in this paper suggest that antihypertensive treatment by pharmacologic agents exerts a depressive effect on plasma 25-OH-D level.

Serum 25-hydroxyvitamin D in patients with chronic renal failure on long-term treatment with high doses of vitamin D2

The present study was aimed at answering the following two questions: (1) What is the effect of high dose vitamin D treatment on the serum level of 25-hydroxyvitamin D (25-OH-D) in patients with chronic renal failure (CRF)? (2) Is there any effect of urinary protein loss on the serum 25-OH-D levels during treatment with pharmacological doses of vitamin D? 42 patients with CRF were studied. They were treated conservatively by a low protein diet and received 15 mg of vitamin D2 once a week. Long-term administration of vitamin D caused a significant (5- to 7-fold) increase of plasma 25-OH-D level irrespective of the degree of proteinuria. This increase was noted only during the first 5 months of vitamin D2 treatment. Surprisingly only in some patients moderate hypercalcemia (> 2.75 mmol/l) was found. From the results obtained it is concluded that (1) patients with CRF differ from normal subjects in handling of high doses of vitamin D and (2) high dosage treatment with vitamin D may prevent hypocalcemia in patients with CRF in spite of high proteinuria.

[Parathormone, calcitonin, 25-hydroxycalciferol and bone histology in patients with chronic renal insufficiency]

In 18 patients with chronic renal failure the parathormone (PTH), calcitonin (CT) and 25-OH-D blood levels were estimated before and after an intravenous calcium load. In ten patients the above mentioned biochemical parametres were confronted with histological findings obtained in bone biopsy material. Significantly elevated levels of PTH and CT were found while those of 25-OH-D were normal. Serum PTH decreased after a calcium load. In contrast to healthy persons no increase of serum CT was stated. Significant positive correlations were found between PTH and CT levels in blood serum as well as between the mineralized bone volume and 25-OH-D levels in serum. In addition a significant negative correlation was stated between the osteoid volume and 25-OH-D levels in blood serum. From the results obtained it is concluded, that from estimations of PTH, CT and 25-OH-D in blood serum histological alterations in bone biopsy material from chronic uremic patients can not be predicted. Beside secondary hyperparathyreoidism, relative deficiency of CT and active vitamin D metabolites other factors are also involved in the pathogenesis of renal osteodystrophy.

Effects of 1alpha-hydroxyvitamin D3 on serum calcium and immunoreactive parathyroid hormone in patients with chronic renal insufficiency

Six patients with chronic renal failure on regular dialysis treatment were given low doses (0.5--1.0 microgram/day) of 1alpha-hydroxyvitamin D3, monitoring the serum calcium, inorganic phosphate, immunoreactive parathyroid hormone concentration (IPTH) and alkaline phosphatase activity. The serum calcium rose in all patients after 7 days' treatment, in some subjects to hypercalcemic range; this effect persisted 6--14 days after withdrawal of 1alpha-hydroxyvitamin D3. The elevated serum IPTH rose in the first days of treatment, but later decreased to normal values. It is suggested that active vitamin D metabolites are necessary for normal response of parathyroid glands to variation in serum calcium. Low-dose 1alpha-hydroxyvitamin D3 treatment appears to be a promising method of correcting hypocalcemia and secondary hyperparathyroidism in chronic renal failure. Careful control of serum calcium is necessary, as hypercalcemia may occur even after minute doses of 1alpha-hydroxyvitamin D3.