Effect of a variant histology on the oncological outcomes of Japanese patients with upper tract urothelial carcinomas after radical nephroureterectomy: a multicenter retrospective study

Background

An earlier systematic review and meta-analysis found that patients with a certain histological variant of upper tract urothelial carcinoma (UTUC) exhibited more advanced disease and poorer survival than those with pure UTUC. A difference in the clinicopathological UTUC characteristics of Caucasian and Japanese patients has been reported, but few studies have investigated the clinical impact of the variant histology in Japanese UTUC patients.

Methods

We retrospectively enrolled 824 Japanese patients with pTa-4N0-1M0 UTUCs who underwent radical nephroureterectomy without neoadjuvant chemotherapy. Subsequently, we explored the effects of the variant histology on disease aggressiveness and the oncological outcomes. We used Cox's proportional hazards models to identify significant predictors of oncological outcomes, specifically intravesical recurrence-free survival (IVRFS), recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS).

Results

Of the 824 UTUC patients, 32 (3.9%) exhibited a variant histology that correlated significantly with a higher pathological T stage and lymphovascular invasion (LVI). Univariate analysis revealed that the variant histology was an independent risk factor for suboptimal RFS, CSS, and OS. However, significance was lost on multivariate analyses.

Conclusions

The variant histology does not add to the prognostic information imparted by the pathological findings after radical nephroureterectomy, particularly in Japanese UTUC patients.

Prognostic significance of subclassifying pathological T3 upper tract urothelial carcinoma: Results from a multicenter cohort study

OBJECTIVE

The population with pathological T3 (pT3) upper tract urothelial carcinoma (UTUC) is heterogeneous, thereby making prognostication challenging. We assessed the clinical ramifications of subclassifying pT3 UTUC after nephroureterectomy.

METHODS

We conducted a retrospective analysis including 308 patients who underwent nephroureterectomy for pT3N0-1M0 UTUC. pT3 was subclassified into pT3a and pT3b based on invasion of the peripelvic and/or periureteral fat. Cox's proportional hazard models were utilized to determine the significant prognosticators of oncological outcomes, encompassing intravesical recurrence-free survival, recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival.

RESULTS

Multivariate analysis elucidated that pT3b status, pathological N1 status, and lymphovascular invasion status were independent risk factors for an unfavorable RFS and CSS. Although the RFS and CSS of patients with pT3b UTUC were superior to those in patients with pT4 UTUC, no significant disparities were detected between patients with pT3a and pT2.

CONCLUSION

Our findings demonstrate that pT3 UTUC with peripelvic/periureteral fat invasion is independently associated with metastasis and cancer-specific death after nephroureterectomy. These findings provide patients and physicians with invaluable insight into the risk for disease progression in pT3 UTUC patients.

Real-world outcomes of adjuvant immunotherapy candidates with upper tract urothelial carcinoma: results of a multicenter cohort study

BACKGROUND

Recent clinical trials have reported improved disease-free survival rates of patients with stage pT3-4/ypT2-4 or pN + upper tract urothelial carcinoma (UTUC) on adjuvant nivolumab therapy. However, the appropriateness of the patient selection criteria used in clinical practice remains uncertain.

METHODS

We retrospectively analyzed 895 patients who underwent nephroureterectomy to treat UTUC. The patients were divided into two groups: grade pT3-4 and/or pN + without neoadjuvant chemotherapy (NAC) or grade ypT2-4 and/or ypN + on NAC (adjuvant immunotherapy candidates) and others (not candidates for adjuvant immunotherapy). Kaplan-Meier curves were drawn to assess the oncological outcomes, including recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). Cox proportional hazards models were used to identify significant prognostic factors for oncological outcomes.

RESULTS

The Kaplan-Meier curves revealed notably inferior RFS, CSS, and OS of patients who were candidates for adjuvant immunotherapy. Multivariate analysis revealed that pathological T and N grade and lymphovascular invasion (LVI) status were independent risk factors for poor RFS, CSS, and OS.

CONCLUSION

In total, 44.8% of patients were candidates for adjuvant immunotherapy. In addition to pathological T and N status, LVI was a significant predictor of survival, and may thus play a pivotal role in the selection of patients eligible for adjuvant immunotherapy.

Comparison of neoadjuvant and adjuvant chemotherapy for upper tract urothelial carcinoma in real-world practice: a multicenter retrospective study

BACKGROUND

Multiple studies have demonstrated the effectiveness of neoadjuvant chemotherapy and adjuvant chemotherapy in patients with upper tract urothelial carcinoma compared with surgery alone. However, no clinical trial has established the superiority of neoadjuvant chemotherapy or adjuvant chemotherapy in terms of perioperative outcomes.

METHODS

We conducted a retrospective analysis encompassing 164 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy and received perioperative chemotherapy. Of these patients, 65 (39.6%) and 99 (60.4%) received neoadjuvant chemotherapy and adjuvant chemotherapy, respectively. Recurrence-free survival and cancer-specific survival were computed using the Kaplan-Meier method. Additionally, we conducted Cox regression analyses to evaluate the risk factors for recurrence-free survival and cancer-specific survival.

RESULTS

Pathological downstaging was seen in 37% of the neoadjuvant chemotherapy group. However, no pathological complete response was observed in this cohort. The Kaplan-Meier curves demonstrated significantly lower recurrence-free survival and cancer-specific survival in patients who received adjuvant chemotherapy. Multivariate Cox regression analysis revealed patients treated with adjuvant chemotherapy exhibited a marked association with inferior recurrence-free survival and cancer-specific survival.

CONCLUSION

Our study has suggested that neoadjuvant chemotherapy would be more effective in high-risk upper tract urothelial carcinoma patients compared with adjuvant chemotherapy.

A case of eosinophilic cystitis coexisting of superficial bladder cancer, mimicking muscle-invasive cancer

Introduction

Here, we present a rare case of eosinophilic cystitis coexisting with bladder cancer, which appeared to be an invasive carcinoma on imaging.

Case presentation

A 46-year-old man presented with urinary urgency. Computed tomography revealed an irregular and thickly enhanced bladder wall, which seemed to be invasive bladder cancer. Cystoscopy revealed a raspberry-like mass lesion on the entire bladder circumference. Pathological diagnosis after transurethral resection was pathological T1 urothelial carcinoma. After a thorough discussion of treatment options, the patient elected to receive intravesical Bacillus Calmette-Guérin. Three months after Bacillus Calmette-Guérin administration, no residual disease was confirmed by transurethral biopsy, and no recurrence was observed over 2 years. As peripheral eosinophilia and submucosa eosinophil infiltration were identified, the patient was diagnosed with coexisting eosinophilic cystitis and urothelial carcinoma.

Conclusion

Clinicians should consider the possibility of eosinophilic cystitis with superficial bladder cancer coexistence in patients who present with an irregular and thick bladder wall.

Efficient and versatile synthesis of novel 2alpha-substituted 1alpha,25-dihydroxyvitamin D(3) analogues and their docking to vitamin D receptors

Novel 2alpha-substituted 1alpha,25-dihydroxyvitamin D(3) analogues with 2alpha-alkyl and 2alpha-hydroxyalkyl groups were systematically synthesized from D-xylose. Their conformation on binding to the ligand binding domain (LBD) of the vitamin D receptor was analyzed. It has been found that the 2alpha-hydroxypropyl group best fits the cavity of the LBD, and the binding activity is three times higher than that for the natural hormone.

Synthesis and biological activities of novel structural analogues of 2-arachidonoylglycerol, an endogenous cannabinoid receptor ligand

Novel analogues of 2-arachidonoylglycerol (2-AG), an endogenous cannabinoid receptor ligand, were developed. Chemical synthesis of these analogues (2-AGA105 and 2-AGA109) was accomplished starting from 2-octyn-1-ol and diethyl malonate and employing Wittig coupling of triene phosphonate with an aldehyde intermediate in a convergent and stereoselective manner. These analogues should be useful lead compounds for the development of novel 2-AG mimetics.

Screening for proteinuria in Japanese schoolchildren: a new approach

By governmental mandate, Japanese school children are screened annually for proteinuria, hematuria, and glucosuria to identify children with possible renal disorders. We added urine dipstick tests for albumin and creatinine to the Japanese screening protocol, and used their dipstick results for blood, glucose and protein. The sulfosalicylic acid precipitation test was used to confirm "trace" positive protein dipsticks. The Japanese and our screening protocol have in common the same data for glucosuria and proteinuria. Their scheme has an algorithm for repeat testing of children with abnormal results, and further testing and medical evaluation for those showing persistently abnormal values. Out of the 23,121 students, we found seven with likely nephritis, one with confirmed nephritis, one with nephrotic syndrome, 170 with persistent unexplained hematuria, 19 with persistent unexplained proteinuria, 14 cases of urinary tract infection, and 20 cases of likely diabetes mellitus. We conclude that dipstick testing for albumin, protein, creatinine, glucose and occult blood has significant value in a multilevel testing scheme for identifying children with urinary tract abnormalities or diabetes. The assay of albumin increases the sensitivity of the screening, and dividing the albumin by the creatinine concentration reduces the potential errors arising from concentrated or dilute urines.

A concise and efficient route to 2alpha-(omega-hydroxyalkoxy)-1alpha,25-dihydroxyvi tam in D3: remarkably high affinity to vitamin D receptor

[reaction: see text]A convenient and potentially valuable synthetic approach to the novel 2alpha-functionalized 1alpha,25-dihydroxyvitamin D3 [1alpha,25(OH)2D3] derivatives (1a-c), which are the C2-epimer of ED-71 and its analogues, has been developed. The C2alpha-modified ring A precursors (1,7-enynes 16, n = 0, 1, and 2) were constructed stereoselectively starting from D-glucose in high yield. In the synthesized 2alpha-(omega-hydroxyalkoxy)-1alpha,25(OH)2D3 derivatives, 1a and 1b showed a greater binding affinity to vitamin D receptor (VDR), up to 1.8 times that of the native hormone.

Synthesis and biological activities of 2-arachidonoylglycerol, an endogenous cannabinoid receptor ligand, and its metabolically stable ether-linked analogues

We synthesized 2-arachidonoylglycerol (1), an endogenous cannabinoid receptor ligand, and its metabolically stable ether-linked analogues. Compound 1 was synthesized from 1,3-benzylideneglycerol (6) and arachidonic acid in the presence of N,N'-dicyclohexylcarbodiimide and 4-dimethylaminopyridine followed by treatment with boric acid and trimethyl borate. An ether-linked analogue of 2-arachidonoylglycerol (2) was synthesized from 6 and 5,8,11,14-eicosatetraenyl iodide (9). The ether-linked analogues of 2-palmitoylglycerol (4) and 2-oleoyglycerol (5) were synthesized from 6 and hexadecyl iodide (12) and 9-octadecenyl iodide (14), respectively. We confirmed that 1 stimulates NG108-15 cells to induce rapid transient elevation of the intracellular free Ca2+ concentrations through a CB1 receptor-dependent mechanism. Noticeably, 2 exhibited appreciable agonistic activity, although its activity was significantly lower than that of 1. Compound 2 would be a useful tool in exploring the physiological significance of 1, because this compound is resistant to hydrolyzing enzymes in contrast to 1. On the other hand, the ether-linked analogues of either 4 or 5 failed to act as a CB1 receptor agonist. Compounds 4 and 5 would also be valuable as control molecules in experiments where 2 is employed.

Syntheses and biological evaluation of novel 2alpha-substituted 1alpha,25-dihydroxyvitamin D3 analogues

Novel 2alpha-substituted 1alpha,25-dihydroxyvitamin D3 analogues were efficiently synthesized and their biological activities were evaluated. 2alpha-Methyl-1alpha,25-dihydroxyvitamin D3 (2), whose unique biological activities were previously reported, was modified to 2alpha-alkyl (ethyl and propyl) and 2alpha-hydroxyalkyl (hydroxymethyl, hydroxyethyl, and hydroxypropyl) analogues 3-7 by elongation of the alkyl chain and/or introduction of a terminal hydroxyl group. 2alpha-Hydroxypropyl-1alpha,25-dihydroxyvitamin D3 (7) exhibited an exceptionally potent calcium-regulating effect and a unique activity profile.

Evidence that 2-arachidonoylglycerol but not N-palmitoylethanolamine or anandamide is the physiological ligand for the cannabinoid CB2 receptor. Comparison of the agonistic activities of various cannabinoid receptor ligands in HL-60 cells

We examined the effect of 2-arachidonoylglycerol, an endogenous cannabinoid receptor ligand, on the intracellular free Ca(2+) concentrations in HL-60 cells that express the cannabinoid CB2 receptor. We found that 2-arachidonoylglycerol induces a rapid transient increase in intracellular free Ca(2+) concentrations in HL-60 cells. The response was affected by neither cyclooxygenase inhibitors nor lipoxygenase inhibitors, suggesting that arachidonic acid metabolites are not involved. Consistent with this notion, free arachidonic acid was devoid of any agonistic activity. Importantly, the Ca(2+) transient induced by 2-arachidonoylglycerol was blocked by pretreatment of the cells with SR144528, a CB2 receptor-specific antagonist, but not with SR141716A, a CB1 receptor-specific antagonist, indicating the involvement of the CB2 receptor but not the CB1 receptor in this cellular response. G(i) or G(o) is also assumed to be involved, because pertussis toxin treatment of the cells abolished the response. We further examined the structure-activity relationship. We found that 2-arachidonoylglycerol is the most potent compound among a number of naturally occurring cannabimimetic molecules. Interestingly, anandamide and N-palmitoylethanolamine, other putative endogenous ligands, were found to be a weak partial agonist and an inactive ligand, respectively. These results strongly suggest that the CB2 receptor is originally a 2-arachidonoylglycerol receptor, and 2-arachidonoylglycerol is the intrinsic natural ligand for the CB2 receptor that is abundant in the immune system.

Evidence that the cannabinoid CB1 receptor is a 2-arachidonoylglycerol receptor. Structure-activity relationship of 2-arachidonoylglycerol, ether-linked analogues, and related compounds

An endogenous cannabimimetic molecule, 2-arachidonoylglycerol, induces a rapid, transient increase in intracellular free Ca2+ concentrations in NG108-15 cells through a cannabinoid CB1 receptor-dependent mechanism. We examined the activities of 24 relevant compounds (2-arachidonoylglycerol, its structural analogues, and several synthetic cannabinoids). We found that 2-arachidonoylglycerol is the most potent compound examined so far: its activity was detectable from as low as 0.3 nM, and the maximal response induced by 2-arachidonoylglycerol exceeded the responses induced by others. Activities of HU-210 and CP55940, potent cannabinoid receptor agonists, were also detectable from as low as 0.3 nM, whereas the maximal responses induced by these compounds were low compared with 2-arachidonoylglycerol. Anandamide was also found to act as a partial agonist in this assay system. We confirmed that free arachidonic acid failed to elicit a response. Furthermore, we found that a metabolically stable ether-linked analogue of 2-arachidonoylglycerol possesses appreciable agonistic activity, although its activity was apparently lower than that of 2-arachidonoylglycerol. We also confirmed that pretreating cells with various cannabinoid receptor agonists nullified the response induced by 2-arachidonoylglycerol, whereas pretreating cells with other neurotransmitters or neuromodulators did not affect the response. These results strongly suggested that the cannabinoid CB1 receptor is originally a 2-arachidonoylglycerol receptor, and 2-arachidonoylglycerol is the intrinsic physiological ligand for the cannabinoid CB1 receptor.

Comparison of the biological activity of synthetic N-acylated asparagine or serine linked monosaccharide lipid A analogs

The mitogenicity, lethal toxicity, induction of tumor necrosis factor (TNF), production of nitric oxide (NO) and antitumor activity against Meth A fibrosarcoma by chemically synthesized N-acylated asparagine-linked (A-701, A-702 and A-703) or N-acylated serine-linked (A-607) nonphosphorylated acylglucosamine and 4-0-phosphorylated acylglucosamine (A-103) derived lipid A analogs were determined. compound A-607 (with tetradecanoyl and (R)-3-tetradecanoyloxytetradecanoyl at the C-2 and C-3 positions) induced a significant incorporation of 3H-thymidine into splenocytes of C3H/He mice at concentrations ranging from 3.13 to 50 microM, but the mitogenic activity of A-701 (2-N-acetylglucosamine), A-702 (tetradecanoyl at the C-2), and A-703 (with (R)-tetradecanoyloxytetradecanoyl and tetradecanoyl at the C-2 and C-3) was very weak. The lethality of A-703 and A-103 (with (R)-3-tetradecanoyloxytetradecanoyl at the C-2 and C-3) was weaker than that of A-607 at doses of 300 and 750 nmol/kg in C57BL/6 mice loaded with D-galactosamine. Peritoneal macrophages, stimulated with A-701-A-703, caused production of TNF which induce L929 cell lysis in vitro, and A-703 showed a high production of TNF. The compounds, except for A-607, exhibited little NO production by macrophages, but did induce the NO production in the presence of interferon gamma. Induction of TNF and NO inducible activity by A-703 was lower than that of A-607. A-703, A-607 and A-103 showed antitumor activity against Meth A fibrosarcoma in BALB/c mice. When A-703 or A-103 with muramyl dipeptide was administered, A-703 failed to show combined effects, but A-103 did. We concluded from these findings that the biological potency of asparagine compounds appears to be placed between serine- and amino-free compounds.

Disaccharides as endomannosidase inhibitors: syntheses of alpha-homomannojirimycin and beta-homomannojirimycin linked to D-glucose and D-mannose

4-O-(alpha-D-Glucopyranosyl)-alphaHMJ (Glcalpha1,4HMJ), 4-O-(alpha-mannopyranosyl)-alphaHMJ (Manalpha1,4alphaHMJ), 4-0-(alpha-glucopyranosyl)-betaHMJ (Glcalpha1,4betaHMJ), and 4-0-(alpha-mannopyranosyl)-betaHMJ (Manalpha1, 4betaHMJ) were synthesized as endomannosidase inhibitors which are potentially useful both for probing the pathways of N-linked glycoprotein processing and for the chemotherapy of some viral diseases.

Lipid A and related compounds. XXIX. Synthesis of biologically active N-acylated L-asparagine-containing D-glucosamine derivatives structurally related to lipid A

New beta-N-acylated L-asparagine-linked D-glucosamine derivatives, in which the reducing unit of lipid A has been mimicked by a lipoamino acid, have been synthesized. Compounds 1 and 2 exhibit mitogenicity and nitric oxide (NO) productivity.

Protective effect of sodium L-malate, an active constituent isolated from Angelicae radix, on cis-diamminedichloroplatinum(II)-induced toxic side effect

The effects of ingredients of Shi-Quan-Da-Bu-Tang (Juzen-taiho-to) on the nephrotoxicity and bone marrow toxicity caused by i.p. administration of 3 mg/kg cis-diamminedichloroplatinum (II) (CDDP) 9 times (on days 3, 4, 5, 6, 7, 8, 10, 11, 12) were examined in ddY mice s.c. inoculated with sarcoma 180 (S-180) cells on day 1. Angelicae Radix showed the strongest protective effect against the toxicity among the ingredients. The ED50 of a water extract of Angelicae Radix was 17.8 mg/kg for nephrotoxicity (indicated by an increase in blood urea nitrogen) and 59.4 mg/kg for bone marrow toxicity (indicated by a decrease in white blood cell count), when it was administered perorally (p.o.) on days, 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15. The water extract did not exert any significant effect on the antitumor activity of CDDP. Bioassay-directed fractionation of the water extract resulted in isolation of a constituent having protective effects against the toxicity: sodium L-malate, C4H4Na2O5, was found to exhibit protective effects against both nephrotoxicity (ED50: 0.4 mg/kg, p.o.) and bone marrow toxicity (ED50: 1.8 mg/kg, p.o.), without reducing the antitumor activity of CDDP. These findings indicate that Angelicae Radix and its constituent sodium L-malate could provide significant protection against CDDP-induced nephrotoxicity and bone marrow toxicity without reducing the antitumor activity.

[Circulating immune complexes and complement breakdown products in childhood IgA nephropathy]

Circulating immune complexes (CIC), mainly IgA-CIC have been frequently detected in IgA nephropathy and recently increased levels of C3 fragments which indicate C3 activation have been reported. However, little is known about the relationship between CIC and complement activation. We determined CIC by the solid-phase anti-C3 Facb enzyme immunoassay in 37 children with IgA nephropathy to investigate the relationship between CIC and clinical and/or histological findings, and also determined C3 fragments whether CIC correlate with complement activation. IgA-CIC were detected in 78% (27/37) with a mean level of 11.9 +/- 3.9 micrograms/ml, which was significantly higher than other glomerular diseases (P less than 0.05). IgA-CIC levels were also found significantly higher in 27 cases with proteinuria than in 10 cases without proteinuria (P less than 0.05). IgG-CIC were detected in 67% (12/18) with a mean level of 4.1 +/- 2.6 micrograms/ml, which was not significantly different from other glomerular diseases. No striking correlation was noted to exist between CIC levels at renal biopsy and the histological severity, because CIC are often present intermittently. C3d was quantitated by the rocket immunoelectrophoresis and C3 by the single radial immunodiffusion to determine the C3d/C3 ratio. The mean value of C3d/C3 was 0.63 +/- 0.19 which was significantly higher than a corresponding value for 15 healthy controls of 0.27 +/- 0.06 (P less than 0.05). Levels of IgA-CIC were found to have a significant positive correlation between C3d/C3 determined simultaneously in 33 cases (r = 0.43, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of co-administration of granulocyte colony-stimulating factor on interferon therapy

The effect of co-administration of granulocyte colony-stimulating factor (G-CSF), as an antineutropenia agent, on interferon therapy was examined in a mouse model, in anticipation of an enhancement of interferon efficacy, because neutrophils induced by G-CSF are thought to act as antitumor effectors. G-CSF was intraperitoneally co-administered with human interferon alpha A/D (IFN) on Day 6 to Day 10 after intradermal inoculation of Meth A fibrosarcoma. Although the co-administration of G-CSF could protect against neutropenia and leukopenia induced by IFN, it did not enhance the regression of tumor, and rather reduced the prolongation of survival time and the long-term survival incidence of IFN therapy. The subsequent in vitro study showed that the antiproliferative activity of peripheral blood leukocytes from Meth A-bearing mice given both IFN and G-CSF was much weaker than that of mice given IFN alone. Whether the observed nullifying effect of G-CSF on IFN therapy is also the case with tumors other than Meth A is open to further study.

[Clinico-pathological evaluation of mesangial IgA deposition of minimal change with nephrotic syndrome]

The case of IgA glomerulonephritis that shows minimal change with nephrotic syndrome is unusual. Thirteen patients of mesangial IgA deposition of minimal change with nephrotic syndrome (IgAMCNS) are discussed in comparison with twenty patients of non IgA deposition of minimal change with nephrotic syndrome (MCNS). On a common basis of hematuria, two groups are undistinguished. On a reaction pattern to steroid treatment, the former is based on IgA nephritis and the latter is based on minimal change with nephrotic syndrome. There is no difference in light microscopical findings between the two groups. Electron microscopically, the former suggests IgA nephritis and the latter suggests minimal change with nephrotic syndrome. In immunofluorescence, the former group is rare to show typical IgA glomerulonephritis. In conclusion, IgAMCNS is considered to be nephrotic syndrome with asymptomatic IgA deposit in mesangium.

Antitumor activity of T cells in lymphoid organs induced by interferon in tumor-bearing mice

Administration of human hybrid interferon-alpha A/D (IFN) for 5 consecutive days induced antitumor activity in spleen of Meth A fibrosarcoma-bearing mice 9-10 days after cessation of IFN administration. Antitumor activity assayed by the in vivo neutralization test was found in the spleen of responding mice but not in that of progressive mice. This activity was T-cell-dependent and tumor-selective. However, tumor-neutralizing activity was not found in spleen recovered as early as 3 days after cessation of IFN administration when many tumor cells are still surviving in tumor nodules and being attacked by the host. Instead, T-cell-dependent and tumor-selective tumor-neutralizing activity was found in the lymph node of tumor-bearing mice at this early stage. Furthermore, the tumor-neutralizing activity was already detected in the lymph nodes during the course of IFN administration, although there was no difference in the cell composition of the lymph nodes of IFN- and placebo-administered mice. Since IFN-alpha is apparently not a direct modifier of T cells, these results indicate that IFN probably did not directly increase the number of antitumor T cells but instead modified the host-tumor interaction in such a way that, as an early event, the enhanced T-cell response to tumor cells occurred, resulting in an increase in the antitumor T-cell population in lymph nodes. We supposed that, as the tumor regressed, these antitumor T cells would eventually leave the lymph node and migrate to the spleen.

Production of antitumor mononuclear blood cells in tumor-bearing mice by interferon-alpha A/D therapy

Administration of human interferon-alpha A/D (IFN-alpha A/D) to Meth A fibrosarcoma-bearing mice produced mononuclear blood cells with antiproliferation activity that were able to suppress Meth A growth in vitro. Their production depended on IFN doses and administration intervals. They were short-lived since antiproliferation activity was not detectable in mononuclear cells 2 days after cessation of IFN administration, although it was detectable as long as IFN administration continued. A similar production of antiproliferative mononuclear blood cells by IFN was achieved in tumor-free as well as in tumor-bearing mice, indicating no deleterious effect of the growing tumor on the production of these cells. IFN-induced antiproliferation activity was not tumor-specific since mononuclear blood cells of IFN-administered mice bearing either Meth A and Meth 1, another antigenically distinct fibrosarcoma, suppressed the in vitro growth of both Meth A and Meth 1 cells. T cells were not involved in the in vivo production of antiproliferative mononuclear blood cells by IFN therapy because the cells with this activity were produced in vivo in Meth A-bearing athymic mice and also in Meth A-bearing mice with reduced T-cell populations by the treatment with alpha mouse thymocyte globulin. T cells were not involved in their antiproliferation activity either, since the in vitro T-cell depletion of mononuclear cells did not diminish this antiproliferation activity. Because mononuclear cells surviving the in vitro T cell depletion were positive for AcM.1 (an epitope of activated macrophage) and also because the alpha Mac-1 antibody completely abolished their in vitro antiproliferation activity, this led us to conclude that it was activated monocytes in blood that were produced by IFN in a T-cell-independent fashion and that these monocytes were the cells responsible for the observed in vitro antiproliferation activity.

Antitumor activity of host T and non-T cells recovered from tumor nodules after interferon therapy

We examined the modification of host T cells of tumor nodules by interferon (IFN) therapy in mouse models. The host cells were recovered from regressing tumor nodules of mice at Day 13 after intradermal tumor inoculation at Day 0 and administration of 5 x 10(5) U/mouse/day IFN at Day 6 to Day 10. These host cells neutralized in vivo Meth A growth in a dose-dependent fashion. In vitro treatment of these cells with anti-Thy 1.2 monoclonal antibody and rabbit sera as a source of complement abrogated their tumor-neutralizing activity, but only partially, indicating that both T cells and non-T cells were involved in tumor neutralization. The finding that host cells from regressing tumor nodules of either Meth A or Meth 1, an antigenically distinct fibrosarcoma, neutralized both Meth A and Meth 1 tumors without much selectivity was consistent with possible non-T cell involvement. Most of these characteristics of host cells of regressing nodules of IFN-administered mice were also noted with host cells of progressing nodules of placebo-administered mice and there was no significant difference in neutralizing activity qualitatively or quantitatively between the two sources of host cells. There was no significant difference in host T and B cell numbers and compositions of regressing and progressing nodules either. These essentially negative findings raise the possibility, among others, that the primary target host cells to be modified by IFN were not T cells, although the therapeutic effect of IFN was dependent on the host T cells.

[Clinicopathological studies of 10 cases with focal segmental glomerulosclerosis]

The clinical picture, histopathological findings, therapy and prognosis of focal segmental glomerulosclerosis (FSGS) were investigated in a retrospective study involving 10 cases. The age of patient at the time of detection ranged from 3 to 19 years, 11 years on the average, being 9 years or above in 6 cases. There was noted a slight tendency toward predominance of males in this series. The disease was detected casually on the occasion of mass survey of urine at school in 6 cases (60%), while by clinical examination on visiting us with nephrotic syndrome in the other 4 (40%). Of the former 6 cases, 5 developed nephrotic syndrome while placed under medical surveillance. Nine of the 10 cases were treated mainly with corticosteroids, to which 5 (50%) were unresponsive and 4 (40%) responsive, with 1 (10%) of these 4 becoming unresponsive since a recurrence. Corticosteroids were not used in 1 case (10%). During follow-up period (which ranged from 1 to 10 years) 6 experienced an elevation of serum creatinine above 2.0 mg/dl, with 5 of them being unresponsive to corticosteroids and 3 begun on hemodialysis therapy. Histologically, cases in which the sum of the proportions of glomeruli affected with segmental sclerosis and with global sclerosis exceeded 30% and, in addition, there were severe tubulointerstitial lesions tended to have a poor prognosis, while those in which sclerosis involved less than 30% of glomeruli and no interstitial damage was discernible had a relatively favorable prognosis and were more frequently responsive to corticosteroids. These findings led us to conclude that FSGS has an ominous prognosis as reported previously and notably, the prognosis is much poorer for the non-steroid-responding type than for the responding type. The study also suggests that the degree of severity of histological changes is determinant of the prognosis of the disease.

Mature 98,000-dalton acid alpha-glucosidase is deficient in Japanese quails with acid maltase deficiency

We compared acid alpha-glucosidase of acid maltase-deficient Japanese quails, an animal model of human late-onset glycogenosis type II, with that of normal controls. Antibody produced in a rabbit against acid alpha-glucosidase purified from chicken pectoral muscle cross-reacted with that of Japanese quails. The presence of a 110K and 98K form of acid alpha-glucosidase was confirmed in normal controls by immunoblotting. However the 98K form was absent in the affected quails. Subcellular distribution studies demonstrated that the 98K form, but not the 110K form, was localized in the lysosomes. This suggests that the 110K form is a precursor of the mature 98K form of acid alpha-glucosidase. In the affected quails, the 110K precursor is synthesized, but maturation to the 98K form does not occur or may be extremely deficient.

Immunostaining of skeletal and cardiac muscle surface membrane with antibody against Duchenne muscular dystrophy peptide

Duchenne muscular dystrophy (DMD) is a debilitating X-linked muscle disease. We have used sequence information from complementary DNA clones, derived from the gene that is deleted in DMD patients, to generate an antiserum that stains the surface membrane of intact human and mouse skeletal muscle, but not that of DMD patients and mdx mice. Here we identify the protein reacting with this antiserum as a single component of relative molecular mass 210,000 (Mr = 210K) that fractionates with a low-ionic strength extract of intact human and mouse skeletal muscle. It is therefore distinct from the 400 K protein found in the heavy microsomal fraction of normal muscle and identified as a putative product of the DMD gene. We also analyse further the disease specificity of the antiserum. Positive staining is seen in normal controls, and in samples from patients with a wide range of muscular dystrophies other than DMD. Becker muscular dystrophy, which is allelically related to DMD, was the only other exception, and gave a sporadic staining pattern. The demonstration of a specific defect in the surface membrane of DMD muscle fibres substantiates the hypothesis that membrane lesions may initiate muscle degradation in DMD.

Molecular basis of drug resistance to new antirhinovirus agents

The modes of action of antirhinovirus agents and mechanisms of resistance to the agents are compared. Chalcone Ro 09-0410, 4',6-dichloroflavan (DCF) and RMI-15,731, which were active against rhinoviruses, inactivated the virus directly. Inactivation was associated with the binding of the agents to the virus particles, since the infectivity, reduced by exposure to the compounds, was restored to the original level by extraction of the agents with chloroform. The binding of [3H]chalcone to rhinovirus type 2 was inhibited by any of the three unlabelled agents. Furthermore, virus sublines selected for resistance to both dichloroflavan and RMI-15,731 showed cross-resistance to chalcone and vice versa. These findings indicate that the three agents exert their activities through the same mode of action (namely binding to or interaction with a specific site on the viral capsid protein) and that the binding or interaction sites for these three agents are either the same or very close to each other. Since the sublines resistant to chalcone and to RMI-15,731 have little or no capability to bind to chalcone, the resistance to these agents is conferred by changes in the viral capsid protein. On the other hand, flavone Ro 09-0179 and enviroxime, which were active widely against picornaviruses, had no ability to inactivate the virus directly, and their antiviral activity was not associated with the capsid protein.

Restoration by recombinant interferon alpha A/D of host defense systems against tumor in immunosuppressed mice

Recombinant human interferon alpha A/D (alpha A/D) restored or augmented host defense systems against tumors in immunosuppressed mice. In normal C57BL/6 mice, inoculation of B16 melanoma F1 cells caused few pulmonary metastasis, whereas in mice pretreated with cyclophosphamide (CY) it caused a high incidence of pulmonary metastasis, leading to earlier death than in the normal mice inoculated with the same dose of the tumor. alpha A/D given after the CY treatment counteracted the deleterious effects of the CY treatment. Since such restorative activity was seen even against the subline of B16 F1 which had been made resistant to its direct antiproliferative effect, alpha A/D seems to exert its effect indirectly through host defense systems. However, this activity of alpha A/D in the mice pretreated with CY was abrogated by inoculation of anti-asialo GM1 serum but not by i-carrageenan. The CY treatment reduced NK activity, while alpha A/D given after the CY treatment restored or augmented the NK cell activity in lung cells and peripheral blood mononuclear cells, but not in spleen cells. These findings suggest that the restoration or augmentation of NK activity in the lung and/or peripheral blood might be the major factor leading to the antimetastatic activity of alpha A/D in the mice treated with CY.

Antitumor and antimetastatic activities of human recombinant interferon alpha A/D

Human recombinant interferon alpha A/D (alpha A/D) was examined for its antitumor activity in several mouse tumor models using metastatic tumors, such as B16 melanoma F1, BL6 and F10, UV2237m fibrosarcoma, and K1735m melanoma. Therapeutic treatment with alpha A/D reduced the incidence of pulmonary metastasis and inhibited the tumor growth resulting in an increase of the mean survival time. Since alpha A/D also showed a prophylactic activity against the metastasis, its antitumor activity was suggested to be due to augmentation of the host defense systems. This was confirmed by the fact that alpha A/D inhibited the in vivo growth and incidence of pulmonary metastasis of B16 F1 sublines regardless of their sensitivity to the direct antiproliferative activity of the IFN in vitro.

Antivirus agent, Ro 09-0410, binds to rhinovirus specifically and stabilizes the virus conformation

The antiviral mechanisms of Ro 09-0410 (4'-ethoxy-2'-hydroxy-4,6'-dimethoxychalcone), which inactivates rhinovirus exclusively, have been investigated. It was suggested that Ro 09-0410 bound to human rhinovirus type 2 (HRV-2) and made it inactive, since the reduced infectivity was completely restored to original levels by extraction of the agent with chloroform [H. Ishitsuka, Y. Ninomiya, C. Ohsawa, M. Fujiu, and Y. Suhara (1982) Antimicrob. Agents Chemother. 22, 617-621]. This was confirmed using radioactively labeled Ro 09-0410 and HRV-2. HRV-2 was inactive while bound to the agent, whereas a subline of HRV-2 resistant to the agent had no binding site for the agent. Ro 09-0410 appeared to bind to some specific site(s) on the virion of susceptible virus strains. Treatment of rhinovirus at pH 5 or 56 degrees caused a change of the virion size and greatly reduced its infectivity. Ro 09-0410 could no longer bind to HRV-2 after such treatment. On the other hand, when the virion bound with Ro 09-0410 was treated at pH 5 or 56 degrees, the Ro 09-0410 remained bound and the conformational alteration of the virion did not take place. Furthermore, Ro 09-0410 protected HRV-2 from the reduction of infectivity caused by mild acid or heat treatment, as revealed by infectivity measurements after extraction of the agent with chloroform. These results suggest that Ro 09-0410 binds to the HRV-2 virion and prevents viral replication in the cell.

Microbial Production of Optically Pure l -Iditol by Yeast Strains

Several yeast strains belonging to genus Candida were found to selectively hydrogenate l -sorbose with enantiomeric specificity, yielding optically pure l -iditol in the culture broth. The most active strain, isolated from a commercial lemon, was identified as Candida intermedia , which produced 50 g of l -iditol per liter from 150 g of l -sorbose per liter during a 5-day fermentation period (35% yield).

New alpha-amylase inhibitor, trestatins. II. Structure determination of trestatins A, B and C

The structures of trestatins A (C56H94N2O40), B (C37H63NO28) and C (C75H125N3O52), new basic oligosaccharides with potent inhibitory activity against various alpha-amylases, have been shown by spectroscopic and chemical methods to be 1, 2 and 3, respectively.

New alpha-amylase inhibitor, trestatins. I. Isolation, characterization and biological activities of trestatins A, B and C

Trestatin complex which exhibited a potent inhibitory activity on various alpha-amylases has been isolated from the culture filtrate of Streptomyces dimorphogenes nov. sp. NR-320-OM7HB. Three major components, trestatins A, B and C, have been purified by adsorption and ion-exchange chromatography. Their spectral and chemical properties suggested that trestatins were novel basic oligosaccharide homologues each characterized by the possession of a trehalose moiety at the non-reducing end of the molecule.

Microbial Resolution of α-Hydroxy Acids by Enantiospecifically Dehydrogenating Bacteria from Soil

Thirty-three bacterial strains were isolated from soil, utilizing optically asymmetric degradation of dl -2-hydroxy-4-methylpentanoic acid ( dl -HMPA) as the screening probe. Those strains were distributed in the following group and genera: Coryneform and Bacillus, Pseudomonas, and Streptomyces. Among them, the most potent strains, Bacillus freudenreichii NRS-137KH20B and Brevibacterium albidum NRS-130KH20B, could perform the resolution of more than 30 g of dl -HMPA per liter within 4 to 5 days of fermentation. Optically pure l - and d -HMPA enantiomers were obtained in more than 80% theoretical yield, whereas the transformed enantiomer was almost quantitatively recovered as 2-oxo-4-methyl-pentanoic acid in the culture broth. The enantiospecific dehydrogenation responsible for this resolution reaction had a rather wide substrate specificity on straight or branched aliphatic C 4 to C 16 2-hydroxy acids, exhibiting the optima at chain lengths of either C 7 or C 5 , although the enantiospecificity was not changed by chain length. The process was thus successfully extended to the preparation of optically pure C 5 to C 9 2-hydroxy acids.

Direct and specific inactivation of rhinovirus by chalcone Ro 09-0410

Studies of various analogs related to the antipicornavirus agent, 4',5-dihydroxy-3,3',7-trimethoxyflavone (Ro 09-0179), led to the identification of 4'-ethoxy-2'-hydroxy-4,6'-dimethoxychalcone (Ro 09-0410), a new and different type of antiviral agent. Ro 09-0410 had a high activity against rhinoviruses but no activity against other picornaviruses. Of 53 rhinovirus serotypes so far tested, 46 were susceptible to Ro 09-0410 in HeLa cell cultures. The concentration of Ro 09-0410 inhibiting 50% of the types of rhinovirus was about 0.03 micrograms/ml, whereas the 50% cytotoxic concentration was 30 microgram/ml. Ro 09-0410 inactivated rhinoviruses in direct dose-, time-, and temperature-dependent fashion. Since infectivity, reduced by exposure to the agent, completely regained the original level by extraction of the agent with chloroform, the inactivation may be associated with the binding of the agent to some specific site of the rhinovirus capsid.

Antipicornavirus flavone Ro 09-0179

Ro 09-0179 (4',5-dihydroxy-3,3',7-trimethoxyflavone), isolated from a Chinese medicinal herb, was found to have potent antiviral activity. It selectively inhibited the replication of human picornaviruses, such as rhinoviruses and coxsackieviruses in tissue culture, but not other DNA and RNA viruses. Ro 09-0298 (4',5-diacetyloxy-3,3',7-trimethoxyflavone), an orally active derivative of Ro 09-0179, prevented coxsackievirus (B1) infection in mice. The critical time for the inhibition of rhinovirus replication by Ro 09-0179 was 2 to 4 h after virus adsorption, i.e., in the early stages of virus replication. It markedly inhibited coxsackievirus and rhinovirus RNA synthesis in infected HeLa cells, but not in a cell-free system using the RNA polymerase complex isolated from the infected cells. In the infected cells, the RNA polymerase complex was not formed in the presence of Ro 09-0179. Therefore, it is suggested that Ro 09-0179 interferes with some process of viral replication which occurs between viral uncoating and the initiation of viral RNA synthesis.

Regio-Selective 10-Hydroxylation of Patchoulol, a Sesquiterpene, by Pithomyces Species

Of some 350 microorganisms screened, four strains of Pithomyces species were found to carry out regio-selective hydroxylation of patchoulol, a sesquiterpene, to 10-hydroxypatchoulol: Pithomyces sp. NRJ201, P. chartarum NRJ210, and, to a lesser extent, P. cynodontis ATCC 26150 and P. atro-olivaceus IFO 6651 were found to catalyze this reaction. A method has been developed by which 10-hydroxypatchoulol was obtained in 25 to 45% yields in 1- to 5-liter fermentation jars at 2 to 4 g of patchoulol per liter and isolated as pure material in 30% yields.

A new antibiotic, fumaramidmycin I. Production, biological properties and characterization of producer strain

A new antibiotic, fumaramidmycin, has been isolated from a streptomycete NR-7GG1 which was characterized and named Streptomyces kurssanovii. The strain produced the antibiotic only when grown on agar plates but not in the submerged culture broth, where the contact with the vegetative mycelia appears to cause the inactivation of the antibiotic. The antibiotic shows an antimicrobial activity against both Gram-positive and Gram-negative bacteria.

A new antibiotic, fumaramidmycin. II. Isolation, structure and syntheses

A new antibiotic fumaramidmycin produced by Streptomyces kurssanovii NR-7GG1 was isolated as colorless crystals. The structure was shown to be N-(phenylacetyl) fumaramide. Starting from fumaramic acid, fumaramidmycin has been synthesized in good yield, in which the key stage involves N-acylated imino ether formation followed by mild acid hydrolysis. Five analogues of fumaramidmycin have also been prepared.

Desferrioxamine B, an inhibitor of Escherichia coli motility, reversing the stimulating effect of cyclic adenosine 3',5'-monophosphate

A substance inhibiting Escherichia coli motility was isolated by "motilometry" assay from the culture broth of Streptomyces sp. strain NR9GG8 and was found to be identical with desferrioxamine B. Its inhibitory effect was reversed by cyclic adenosine 3',5'-monophosphate (cAMP), while the motility stimulation by cAMP was diminished by this inhibitor. Its effects on various enzymes involved in cAMP metabolism of function of cAMP were examined.