SCOPE 2 - Still Answering the Unanswered Questions in Oesophageal Radiotherapy? SCOPE 2: a Randomised Phase II/III Trial to Study Radiotherapy Dose Escalation in Patients with Oesophageal Cancer Treated with Definitive Chemoradiation with an Embedded Phase II Trial for Patients with a Poor Early Response using Positron Emission Tomography/Computed Tomography

The SCOPE 2 trial of definitive chemoradiotherapy in oesophageal cancer investigates the benefits of radiotherapy dose escalation and systemic therapy optimisation. The trial opened in 2016. The landscape of oesophageal cancer treatment over the lifetime of this trial has changed significantly and the protocol has evolved to reflect this. However, with the recent results of the Dutch phase III ART DECO study showing no improvement in local control or overall survival with radiotherapy dose escalation in a similar patient group, we sought to determine if the SCOPE 2 trial is still answering the key unanswered questions for oesophageal radiotherapy. Here we discuss the rationale behind the SCOPE 2 trial, outline the trial schema and review current data on dose escalation and outline recommendations for future areas of research.

What is the association between price and economic activity with cigarette consumption in Cuba from 1980 to 2014?

OBJECTIVES

Cuba is a tobacco-producing country that has been economically isolated as a consequence of an embargo imposed by the USA. It has also experienced a severe economic depression in the 1990s after the withdrawal of support by the former Soviet Union. These characteristics provide a unique opportunity to study the relation between large changes in economic activity, cigarette price and demand for cigarettes in a relatively isolated socialist economy.

STUDY DESIGN

This is an observational epidemiological study.

METHODS

Data were obtained on the annual price of a packet of cigarettes and the mean number of cigarettes consumed per adult living in Cuba from 1980 to 2014. Descriptive and regression analysis were used to explore the relationship between cigarette consumption and price in Cuba.

RESULTS

In 1980, the mean price of a packet of cigarettes was 1.53 Cuban peso (CUP) in 1997 prices and the mean annual per capita consumption was 2237 cigarettes. In 2014, the mean price had increased to 5.57 CUP (1997 prices) per packet of cigarettes, and consumption had fallen to 1527 cigarettes per capita. There were significant negative associations between annual cigarette consumption and both price and living through an economic depression. The elasticity was approximately -0.31 with price, and living through an economic depression was also associated with lower consumption of cigarettes (a reduction of 9%, 95% confidence intervals -0.18 to -0.001).

CONCLUSIONS

Higher cigarette pricing, along with other public health interventions, are required to protect the national population from the adverse effects of tobacco smoke exposure.

Blended learning in situated contexts: 3-year evaluation of an online peer review project

BACKGROUND

Situated and sociocultural perspectives on learning indicate that the design of complex tasks supported by educational technologies holds potential for dental education in moving novices towards closer approximation of the clinical outcomes of their expert mentors. A cross-faculty-, student-centred, web-based project in operative dentistry was established within the Universitas 21 (U21) network of higher education institutions to support university goals for internationalisation in clinical learning by enabling distributed interactions across sites and institutions. This paper aims to present evaluation of one dental faculty's project experience of curriculum redesign for deeper student learning.

METHODS

A mixed-method case study approach was utilised. Three cohorts of second-year students from a 5-year bachelor of dental surgery (BDS) programme were invited to participate in annual surveys and focus group interviews on project completion. Survey data were analysed for differences between years using multivariate logistical regression analysis. Thematic analysis of questionnaire open responses and interview transcripts was conducted.

RESULTS

Multivariate logistic regression analysis noted significant differences across items over time indicating learning improvements, attainment of university aims and the positive influence of redesign. Students perceived the enquiry-based project as stimulating and motivating, and building confidence in operative techniques. Institutional goals for greater understanding of others and lifelong learning showed improvement over time. Despite positive scores, students indicated global citizenship and intercultural understanding were conceptually challenging.

CONCLUSIONS

Establishment of online student learning communities through a blended approach to learning stimulated motivation and intellectual engagement, thereby supporting a situated approach to cognition. Sociocultural perspectives indicate that novice-expert interactions supported student development of professional identities.

Identification of a novel epigenetic code, histone H1 fucosylation, and its roles in macrophage plasticity in rheumatoid arthritis (IRM7P.491)

Macrophages (MΦ) are key players in rheumatoid arthritis (RA). High plasticity renders MΦ an attractive tool for studying epigenetic reprogramming. We have observed a highly positive correlation between TNFα and fucosylation catalyzing enzymes, fucosyltransferases (FUTs) 1, 2, 3, 4, 5, 6, 7, 9, 10, 11 (p=0.0001) in human RA synovia; these FUTs are predominantly detected in M1 inflammatory MΦ but not M2 MΦ and T cells from RA synovial fluid. A fucosylation inhibitor, 2-Deoxy-D-galactose (2-D-gal) precluded collagen II-induced arthritis in DBA/1J mice (scores 9.5±1.7 vs 0.5± 0.3, p<0.01) with reduced M1 MΦ in draining LN, decreased TNF-α and anti-CII in the serum (p<0.05).Ulex Europaeus Agglutinin I (UEA 1) affinity chromatography coupled to mass spectrometry indicated that the linker Histone H1, but not core histone H 2-4, is the major protein that modified by a fucose-α-(1-2)-gal moiety in M1 MΦ. Disrupting this moiety by 2-D-gal skewed the differentiation of M1 MΦ toward M2 anti-inflammatory phenotype with a reprogrammed gene expression, including i) robustly upregulated Il10, Arg1, and Megf8 (p<0.01) (M2 markers); ii) downregulated Ifnγ and Il6 (p<0.05) (M1 markers); iii) inhibited Actin and its associated molecules including Ahnak and Cap1, and suppressed the antigen presentation of M1 MΦ phenotype (p<0.01). We uncovered Histone 1 fucosylation as a novel epigenetic code that orchestrates MΦ transcriptome reprogramming and renders it an attractive target for RA therapy.

Intracellular signaling as measured by single cell network profiling (SCNP) is stable in longtitudinal samples of peripheral blood mononuclear cells (PBMC) from healthy donors (HD) across multiple immune cell subsets (TECH1P.839)

Biomarkers of immune function from viable cells would be of high value for many clinical applications. The immune system responds rapidly to a variety of stimuli, so identifying immune measures that are stable, robust, and relevant to clinical features/outcomes can be challenging. SCNP is a multiparametric flow cytometry assay measuring induced changes in intracellular signaling, providing a functional measure of pathway capacity in multiple cell subsets without physical separation. To assess the longitudinal stability of signaling capacity, PBMCs from 11 healthy donors (7 female, age 29 - 60) were collected at 2 time points and characterized by SCNP of 32 nodes (combinations of a modulator and an intracellular signaling readout) in 21 cell subsets. Signaling stability was assessed for each node:subset combination, calculating the ratio of the signaling variability between time points to the mean signaling level. Of 258 node:subset combinations measured: 160 (62%) had a ratio <0.1; 227 (88%) were <0.2 (i.e. the variability between time points is <20% of the average signaling). Memory B cells had the greatest, though modest, variability in signaling between sample times (median ratio 0.15, range 0.04 - 0.43); naive CD4- T cells had the least variation (median ratio 0.066, range 0.03 - 0.13). This study serves as reference for biomarker development for immune monitoring, demonstrating that signaling capacity is a stable, robust phenotype over time and within an individual.

Students' satisfaction with a dental summer programme and importance of influencing factors for choosing dentistry as their career

AIM

To study the students' satisfaction with the week-long summer programme and the importance of common influencing factors (IFs) for choosing dentistry as their career.

METHODS

Anonymous questionnaire was given to all 214 participants in July of 2011 and 2012. Demographic information including gender, age and education level was collected. The students were asked about their satisfaction with the programme with separate ratings for learning experiences, including hands-on workshops (HOW); clinic observations (CO); problem-based learning tutorials (PBL); and lectures (L). They also rated the relative importance of the ten common IFs. The Friedman test was used to study the order of their preferences of the programme's activities. The Chi-square test was used to study the influence of their demographic factors on the importance of the IFs.

RESULTS

A total of 208 students returned their questionnaires. The majority were below the age of 18 (81%), and 44% were studying in an international school. Most of the students (96%) were satisfied with the programme overall. They liked the HOWs and COs more than the PBL tutorials and Ls. 'Altruism' and 'medical/health care career' were the two most important IFs overall. 'Altruism' and 'past experience with dentist' were considered more important by those aged 18 or above. 'Past experience with dentist' and 'working with hands' were considered more important by the international school students.

CONCLUSIONS

Most participants were satisfied with the summer programme. They preferred practical, skill-based activities to knowledge-based activities. The importance of some IFs was associated with age and education system.

Journal-based learning, a new learning experience building on PBL at HKU

OBJECTIVE

To evaluate the effectiveness of a new journal-based learning (JBL) programme designed to equip students with skills necessary to understand dental research publications, thereby preparing them for continuing professional development.

MATERIALS AND METHODS

A baseline evaluation of knowledge relating to key research terms was conducted on 52 final-year BDS students. 11 weekly seminars were conducted from 8 clinical disciplines driven by a reading list of 2-5 journal articles along with a series of 'guidance' questions relating to research terms and content knowledge aspects of each paper to focus their reading and learning. Seminars were facilitated by discipline experts with supporting notes. An exit test based on research process and terminologies for the programme was conducted with 4 repeated questions from the baseline assessment. A systematic marking scheme was used and the results analysed. A focus group was run to collect feedback regarding students' views and experiences on the JBL experience.

FINDINGS

Students showed significant improvements over the baseline score. The mean score rose from 3.5 to 11.5 in the repeated questions (P < 0.001). The focus group revealed that students had learnt new information about journal classification, evidence level determination, new research terms and the structure of research papers. From the first 4 years of PBL, students recognized the importance of learning from research papers since year 1. However, JBL gave them a deeper understanding of research and the development of critical appraisal skills.

IMPLICATIONS

JBL provided final-year students the opportunity to learn significantly more about dental research, terminologies, paper structure, critical analysis and content knowledge through active-learning small group seminars.

International peer review in undergraduate dentistry: enhancing reflective practice in an online community of practice

To stimulate and enhance student learning in the areas of global citizenship, critical reflection and e-learning, an online international peer review using a purpose-built web platform, has been developed between international dental schools. Since its inception in 2007, n = 6 dental schools from six different countries have participated with n = 384 dental students engaged in online peer review. Project development was conceptually analysed utilising Lave and Wenger's notion of a community of practice (CoP). Analysis drew on the three core components within the CoP organising framework: domain, community and practice. All three components were evident in building project identity. The domain focused on both curriculum and institutional co-operation. The community was evident for both educators and students. Finally, analysis of practice was found to be significant in terms of sustained interaction and collaboration. Empirical evaluation is recommended as the next phase of project design.

Death Receptor 5 (DR5) marks the highly pathogenic interacting GM-CSF+ T helper cells and IL-23+ macrophages rendering it as an attractive therapeutic target of autoimmunity (51.4)

The highly pathogenic granulocyte-macrophage colony-stimulating factor (GM-CSF)+ IL-17+ CD4 T cells and IL-23+IRF5+M1 macrophages (MØ) exhibit a bidirectional interaction in autoimmunity. DR5 is a pro-apoptotic molecule upregulated by IRF5. DR5 deficient mice develop increased inflammation. We analyzed DR5 expression and apoptosis function of TRA-8, an anti-human DR5 antibody, in T cells and MØ in autoimmune conditions. Expression of DR5 was highly correlated with that of GM-CSF in CD4 T cells and that of IL-23 and IRF5 in MØ from synovia fluid or PBMC of rheumatoid arthritis and lupus subjects (p&lt;0.01). In vitro treatment of these samples with TRA-8 for 48 hrs resulted in 23.4% and 35.9% depletion of GM-CSF+ CD4+ T cells and IL-23+ MØ, respectively. Similar DR5 expression pattern and TRA-8 depletion effects were observed in a 3kb mouse promoter/humanized DR5 Tg mouse crossed with the SHP-1- deficient viable motheaten mice which exhibit a profound activation of inflammatory MØ and Th17 cells. Three doses of TRA-8 (0.1 mg IP, weekly) lead to a 35.7% reduction of GM-CSF+ CD4+ T cells and 45.1% reduction of IL-23+IRF5+ MØ in the draining LN, 74.4% and 94.7% decrease of Csf-2 and p19 in joints, resulting in amelioration of pneumonitis and arthritis, reduction of autoantibodies, and increase of the lifespan. Our study indicated that DR5 is highly correlated with GM-CSF in CD4+ T cells and IL-23 in MØ, and demonstrated the high therapeutic efficacy of an anti-human DR5 antibody.

Self-perceived preparedness for dental practice amongst graduates of The University of Hong Kong's integrated PBL dental curriculum

OBJECTIVES

To determine how prepared for dental practice graduates from the integrated problem-based learning (PBL) dental undergraduate curriculum at The University of Hong Kong (HKU) perceive themselves to be and to identify factors associated with self-perceived preparedness.

MATERIALS AND METHODS

A postal questionnaire was sent to five cohorts of dentists who had graduated from HKU's integrated PBL curriculum between 2004 and 2008. Using a 4-point Likert scale, the questionnaire assessed the self-perceived level of preparedness in 59 competencies grouped in nine domains. Responses were dichotomised into 'poorly prepared' and 'well prepared'.

RESULTS

The response rate was 66% (159/241). The mean proportion (±standard deviation) of respondents indicating well-preparedness was 72.0±15.1% overall, and for each domain was as follows: general patient management, 93.1±12.1%; practice management, 81.0±22.2%; periodontology and dental public health, 73.5±19.3%; conservative dentistry, 92.5±13.1%; oral rehabilitation, 62.8±24.0%; orthodontics, 23.0±32.9%; managing children and special-needs patients, 64.8±28.9%; oral and maxillofacial surgery, 52.2±25.2%; and drug and emergency management, 84.7±22.6%. The odds of self-perceived well-preparedness were increased for cohorts graduating in 2004 and 2005 and graduates working in a non-solo dental practice.

CONCLUSIONS

Dental graduates of HKU's integrated PBL curriculum felt well prepared for the most fundamental aspects of dental practice. However, apparent deficiencies of training in orthodontics and oral and maxillofacial surgery will need to be addressed by continuing education, postgraduate training and planning for the new 6-year undergraduate curriculum in 2012.

Useful field of view as a reliable screening measure of driving performance in people with Parkinson's disease: results of a pilot study

PURPOSE

To determine the correlations of the Useful Field of View (UFOV), compared to other clinical tests of Parkinson's disease (PD); vision; and cognition with measures of on-road driving assessments and to quantify the UFOV's ability to indicate passing/failing an on-road test in people with PD.

METHODS

Nineteen randomly selected people with idiopathic PD, mean age = 74.8 (6.1), 14 (73.7%) men, 18 (94.7%) Caucasians, were age-matched to 104 controls without PD. The controls had a mean age of 75.4 (6.4), 59 (56.7%) men, 96 (92.3%) Caucasians. Both groups were referred for a driving evaluation after institutional review board approval.

RESULTS

Compared to neuropsychological and clinical tests of vision and cognition, the UFOV showed the strongest correlations (r > .75, p < 0.05) with measures of failing a standardized road test and number of driving errors. Among PD patients, the UFOV Risk Index score of 3 (range 1-5) was established as the optimal cutoff value for passing the on-road test, with sensitivity 87 percent and specificity 82 percent, AUC = 92 percent (SE 0.61, p = .002). Similarly, the UFOV 2 (divided attention) optimum cutoff value is 223 ms (range 16-500 ms), sensitivity 87.5 percent, specificity 81.8 percent, AUC = 91 percent (SE 0.73, p = .003). The UFOV 3 (selected attention) optimal cutoff value is 273 ms (range 16-500 ms), sensitivity 75 percent, specificity 72.7 percent, AUC = 87 percent (SE 0.81, p = .007).

CONCLUSION

In this pilot study among PD patients, the UFOV may be a superior screening measure (compared to other measures of disease, cognition, and vision) for predicting on-road driving performance but its rigor must be verified in a larger sample of people with PD.

Modulation of dopamine uptake in rat nucleus accumbens: effect of specific dopamine receptor antagonists and sigma ligands

The ability of dopamine (DA) antagonists and sigma receptor ligands to alter [(3)H]-DA uptake was examined using synaptosomes prepared from the nucleus accumbens of female rats. Pre-incubation with compounds having a high affinity for sigma (rimcazole, haloperidol, and spiperone) receptors produced dose dependent inhibition of (3)H-DA uptake. Sulpiride, a pure DA D(2) antagonist had no effect. In contrast, DA uptake was potentiated in response to (+)-3-(3-hydroxyphenyl)-N-(1-propyl)piperidine, a mixed sigma receptor antagonist and DA D(2) receptor agonist. Similarly, SKF-10,047, a selective sigma receptor agonist, and progesterone, a putative endogenous ligand for the sigma receptor, produced significant increases in (3)[H]-DA uptake. These data suggest a potential role for sigma and DA ligands in the regulation of DA uptake in the nucleus accumbens.

Emergency treatment of neonatal hyperammonaemic coma with mild systemic hypothermia

An infant aged 3 days presented with hyperammonaemic coma and seizures, which were found to be a result of a urea-cycle defect. Haemofiltration, alternative pathway metabolites, and glucose and insulin failed to lower the plasma ammonia concentration below 2000 micromol/L. The infant was then cooled to a rectal temperature of 34 degrees C for 48 h and put on haemofiltration for 12 h. Plasma ammonia fell to around 100 micromol/L and remained at this concentration after haemofiltration. He roused from his coma, breathed spontaneously, and resumed bottle feeding. Hypothermia may be therapeutic in such instances of metabolic coma because it lowers the enzymatic rate of production of the toxin while non-enzymatic methods remove the toxin.

Burn patients' pain and anxiety experiences

The purpose of this study was to examine burn patients' pain and anxiety experiences during resting conditions and procedures. The relationship of contextual factors and interventions to pain and anxiety were also explored. Procedural pain was significantly higher than resting pain (P = .02); however, there were no significant differences in anxiety between resting conditions and procedures (P = .16). There was a significant difference between burn patients' acceptable level of pain, resting pain, and procedural pain (P = .01). Resting pain was significantly lower than patients' acceptable level of pain (P = < .01). Procedural pain was slightly lower than patients' acceptable level of pain, but these results were not statistically significant (P = .37). Percent of total body surface burned was associated with increased procedural anxiety (P = .022). Family presence correlated with decreased procedural pain (P = .011) and midazolam use (P = .047). Prior experience with the procedure was associated with increased morphine(P = .003) and midazolam use (P = .029). These findings support the multifactorial nature of burn pain and anxiety and provide guidance for practice.

Comparison of diameter and perimeter methods for tumor volume calculation

PURPOSE

Lesion volume is often used as an end point in clinical trials of oncology therapy. We sought to compare the common method of using orthogonal diameters to estimate lesion volume (the diameter method) with a computer-assisted planimetric technique (the perimeter method).

METHODS

Radiologists reviewed 825 magnetic resonance imaging studies from 219 patients with glioblastoma multiforme. Each study had lesion volume independently estimated via the diameter and perimeter methods. Cystic areas were subtracted out or excluded from the outlined lesion. Inter- and intrareader variability was measured by using multiple readings on 48 cases. Where serial studies were available in noncystic cases, a mock response analysis was used.

RESULTS

The perimeter method had a reduced interreader and intrareader variability compared with the diameter method (using SD of differences): intrareader, 1.76 mL v 7.38 mL (P < .001); interreader, 2.51 mL v 9.07 mL (P < .001) for perimeter and diameter results, respectively. Of the 121 noncystic cases, 23 had serial data. In six (26.1%) of those 23, a classification difference occurred when the perimeter method was used versus the diameter method.

CONCLUSION

Variability of measurements was reduced with the computer-assisted perimeter method compared with the diameter method, which suggests that changes in volume can be detected more accurately with the perimeter method. The differences between these techniques seem large enough to have an impact on grading the response to therapy.

Conference summary: novel HIV therapies--from discovery to clinical proof of concept

In this report we have highlighted only a few examples of the extensive efforts underway to better understand the process of HIV pathogenesis, to develop new therapeutic agents to inhibit virus replication, and to identify strategies to restore damage done to the immune system during HIV disease progression. It is expected that progress in these areas will continue to advance, and that development of more effective therapies will lead to comprehensive multifaceted, multipronged treatment regimens.

Frontiers in HIV-1 Therapy: fourth conference of the NIAID National Cooperative Drug Discovery Groups-HIV

This summary describes current studies in antiviral targeting as reported at the Frontiers in HIV Therapy conference, November 3-7, 1991, in San Diego, California. In parallel with the progressive steps in HIV-1 replication, the meeting covered potential antiviral targets starting from the time HIV-1 docks with the CD4 receptor to virus release. The summary concludes with current research trends to block HIV-1 growth.

Transferrin-like autocrine growth factor, derived from T-lymphoma cells, that inhibits normal T-cell proliferation

Transferrin, the major iron-binding protein in the plasma of vertebrate species, is an essential growth factor for cells in serum free medium. We have established a cell line, Fr, from peripheral blood mononuclear cells of a patient affected by Sézary syndrome. Fr cells show a very immature antigenic phenotype, while constitutively bearing transferrin receptor on their surface. Furthermore the Fr line does not produce or respond to interleukin 2. Finally its conditioned medium contains both a growth stimulating activity for the Fr cell line and a factor which inhibits T-lymphocyte proliferation. We have identified a protein, produced in large amounts by Fr cells, which shares the immunological properties of human transferrin. Our data suggest that this transferrin-like factor can act as an autocrine growth factor for the producer cells and as an inhibitory factor for normal lymphocytes.

In vivo treatment of neonatal mice with anti-I-A antibodies interferes with the development of the class I, class II, and Mls-reactive proliferating T cell subset

In this study we investigated the effect of monoclonal anti-I-A Ab treatment of neonatal mice on the development of alloreactive class I-specific, class II-specific, and Mls-specific T cell proliferative responses. Responses to both class I and class II alloantigens, as well as to Mls antigens, were nearly abrogated at the end of the 2- to 3-wk in vivo treatment period in both the thymus and the spleen. Development of suppressor cells could be excluded as the cause of the observed defect. Diminished responsiveness could not be restored by the addition of IL 2-containing supernatant, suggesting that the reduced T cell proliferative response in anti-I-A-treated mice is due to defective or absent MHC-specific T cell precursors. Furthermore, generation of alloreactive class I-specific proliferative responses was dependent on self-class II recognition, thus providing an explanation for the absence of class I-specific proliferating T cells. Finally, a non-Ia-restricted T cell response, i.e., Con A-induced proliferation, was not affected by anti-I-A Ab treatment. It was previously reported that neonatal anti-Ia Ab treatment results in reduced Ia-antigen expression in the thymus, and that the development of the class I-specific CTL precursors proceeds undisturbed in these mice. The present results extend these findings and suggest that in vivo development of class II-restricted T cells is dependent on interaction with Ia-encoded products on cells either in the thymus or at other sites where T cells undergo development. Moreover, these results demonstrate that in vivo development of the alloreactive class II-specific T cell repertoire is dependent on development of self-class II recognition.

In vivo treatment of neonatal mice with anti-I-A antibodies interferes with the development of the class I, class II, and Mls-reactive proliferating T cell subset

In this study we investigated the effect of monoclonal anti-I-A Ab treatment of neonatal mice on the development of alloreactive class I-specific, class II-specific, and Mls-specific T cell proliferative responses. Responses to both class I and class II alloantigens, as well as to Mls antigens, were nearly abrogated at the end of the 2- to 3-wk in vivo treatment period in both the thymus and the spleen. Development of suppressor cells could be excluded as the cause of the observed defect. Diminished responsiveness could not be restored by the addition of IL 2-containing supernatant, suggesting that the reduced T cell proliferative response in anti-I-A-treated mice is due to defective or absent MHC-specific T cell precursors. Furthermore, generation of alloreactive class I-specific proliferative responses was dependent on self-class II recognition, thus providing an explanation for the absence of class I-specific proliferating T cells. Finally, a non-Ia-restricted T cell response, i.e., Con A-induced proliferation, was not affected by anti-I-A Ab treatment. It was previously reported that neonatal anti-Ia Ab treatment results in reduced Ia-antigen expression in the thymus, and that the development of the class I-specific CTL precursors proceeds undisturbed in these mice. The present results extend these findings and suggest that in vivo development of class II-restricted T cells is dependent on interaction with Ia-encoded products on cells either in the thymus or at other sites where T cells undergo development. Moreover, these results demonstrate that in vivo development of the alloreactive class II-specific T cell repertoire is dependent on development of self-class II recognition.

Absence of the Lyt-2-,L3T4+ lineage of T cells in mice treated neonatally with anti-I-A correlates with absence of intrathymic I-A-bearing antigen-presenting cell function

In an effort to elucidate the role of intrathymic Ia-bearing antigen-presenting cells (APC) on the development of the class II-restricted T cell repertoire, we examined the effect of neonatal anti-I-A treatment on both intrathymic and splenic APC function; on the generation of Lyt-2-,L3T4+, Lyt-2+,L3T4-, and Lyt-2+,L3T4+ T cells; and on the development of class I- and class II-specific T cell functions. Both the thymus and the spleen are completely devoid of Lyt-2-,L3T4+ T cells in young mice treated from birth with anti-I-A, and also lack functions associated with this subset, i.e., alloantigen-specific interleukin 2 production (present report), allo-class II-specific and self-class II-restricted T cell proliferative responses, and helper cell function for the generation of cytotoxic T lymphocyte responses (18). Development of the Lyt-2+,L3T4- subset proceeds undisturbed in these mice, in accord with the previously reported normal levels of cytotoxic T lymphocyte precursors (18). The thymus contains normal numbers of the immature cortical Lyt-2+,L3T4+ cells, indicating that acquisition of the L3T4 marker, in and of itself, is not influenced by anti-I-A treatment. This striking absence of the lineage of T cells responsible for class II-specific T cell functions is correlated with absence of thymic APC function for class II-restricted T cell clones. When anti-I-A-treated mice are allowed to recover from the antibody treatment, splenic and thymic APC function return to normal in 2-3 wk, and thymic Lyt-2-,L3T4+ T cell numbers and functions reappear before such cells are detectable in the spleen. Collectively, these findings suggest that development of the Lyt-2-,L3T4+ lineage of class II-specific T cells is entirely dependent on functional I-A-bearing APC cells in the thymus. In addition, the presence of normal levels of Lyt-2+,L3T4-T cells argues that generation of the two major subsets of T cells (i.e., Lyt-2+,L3T4- and Lyt-2-,L3T4+) occurs through separate events, involving unique sites of interactions between precursor T cells and nonlymphoid major histocompatibility complex-bearing thymus cells.

Serum pseudouridine as a biochemical marker in the development of AKR mouse lymphoma

Pseudouridine is a modified nucleoside derived from the degradation of some species of RNA, primarily transfer RNA, the level of which is elevated in biological fluids of tumor-bearing subjects. In order to study the relationship between pseudouridine levels and the development and progression of neoplasia, we have measured pseudouridine levels in the serum of inbred mice with high (AKR) and low (BALB/c) incidence of spontaneous lymphoma and in mice carrying transplantable lymphoid tumors. Our results show that the serum level of pseudouridine: (a) in healthy mice, is higher in females than in males; (b) increases significantly in female AKR mice in the period preceding the development of lymphoma (preneoplastic period occurring at about 6 months of age); and (c) is highest in AKR mice with lymphoma, the most elevated levels being found in mice with widely disseminated disease. The latter observation was confirmed by experiments with a transplantable AKR lymphoma (T2), where a positive correlation between tumor burden and serum pseudouridine levels was found. On the contrary, in BALB/c mice carrying a transplantable myeloma tumor (MOPC-460), no increase was seen despite the presence of a considerable tumor burden. The increase of pseudouridine in the preneoplastic period, in the absence of overt disease is viewed as an early sign of the development of the disease.