A non-oncogenic HPV 16 E6/E7 vaccine enhances treatment of HPV expressing tumors

Human papillomaviruses (HPVs) are the causative factor for >90% of cervical cancers and 25% of head and neck cancers. The incidence of HPV positive (+) head and neck squamous cell carcinomas has greatly increased in the last 30 years. E6 and E7 are the two key viral oncoproteins that induce and propagate cellular transformation. An immune response generated during cisplatin/radiation therapy improves tumor clearance of HPV(+) cancers. Augmenting this induced response during therapy with an adenoviral HPV16 E6/E7 vaccine improves long-term survival in pre-clinical models. Here, we describe the generation of an HPV16 E6/E7 construct, which contains mutations that render E6/E7 non-oncogenic, while preserving antigenicity. These mutations do not allow E6/E7 to degrade p53, pRb, PTPN13, or activate telomerase. Non-oncogenic E6/E7 (E6(Δ)/E7(Δ)) expressed as a stable integrant, or in the [E1-, E2b-] adenovirus, lacks the ability to transform human cells while retaining the ability to induce an HPV-specific immune response. Moreover, E6(Δ)/E7(Δ) plus chemotherapy/radiation statistically enhances clearance of established HPV(+) cancer in vivo.

An Ad5[E1-, E2b-]-HER2/neu vector induces immune responses and inhibits HER2/neu expressing tumor progression in Ad5 immune mice

Immunotherapy is a promising approach for the treatment of cancers. Modified adenovirus 5 (Ad5) vectors have been used as a platform to deliver genes encoding tumor associated antigens (TAA). A major obstacle to Ad5 vector immunotherapy has been the induction of vector immunity following administration or the presence of pre-existing Ad5 immunity, which results in vector mitigation. It has been reported by us that the Ad5[E1-, E2b-] platform with unique deletions in the E1, E2b and E3 regions can induce potent cell mediated immunity (CMI) against delivered transgene products in the presence of pre-existing Ad5 immunity. Here we report the use of an Ad5[E1-, E2b-] vector platform expressing the TAA HER2/neu as a breast cancer immunotherapeutic agent. Ad5[E1-, E2b-]-HER2/neu induced potent CMI against HER2/neu in Ad5 naïve and Ad5 immune mice. Humoral responses were also induced and antibodies could lyse HER2/neu expressing tumor cells in the presence of complement in vitro. Ad5[E1-, E2b-]-HER2/neu prevented establishment of HER2/neu-expressing tumors and significantly inhibited progression of established tumors in Ad5 naïve and Ad5 immune murine models. These data demonstrate that in vivo delivery of Ad5[E1-, E2b-]-HER2/neu can induce anti-TAA immunity and inhibit progression of HER2/neu expressing cancers.

Prevalence of bacterial vaginosis among young women in low-income populations of coastal Peru

The goal of this study was to determine the prevalence of bacterial vaginosis (BV) in Peruvian women from socioeconomically deprived populations and to determine the association between BV and risk factors for sexually transmitted diseases (STDs). Women were administered an epidemiologic survey to determine sexual risk behaviour and they provided biological samples to test for BV and STDs. The prevalence of BV was high (27%) and was significantly associated with having a bacterial STD or trichomoniasis. Age, marital status, and a history of sex work, but not of sexual experience, frequency of intercourse, and unprotected intercourse, were associated with BV. As BV may be a marker for STDs, screening for STDs should be performed in individuals with BV to promote early detection and treatment of co-infecting sexually transmitted pathogens.

A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders

OBJECTIVE

To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD).

METHOD

Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed.

RESULTS

Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness.

CONCLUSION

Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders.

Newly secreted adenylate cyclase toxin is responsible for intoxication of target cells by Bordetella pertussis

Adenylate cyclase (AC) toxin is present on the surface of Bordetella pertussis organisms and their addition to eukaryotic cells results in increases in intracellular cAMP. To test the hypothesis that surface-bound toxin is the source for intoxication of cells when incubated with B. pertussis, we characterized the requirements of intoxication from intact bacteria and found that this process is calcium-dependent and blocked by monoclonal antibody to AC toxin or antibody against CD11b, a surface glycoprotein receptor for the toxin. Increases in intracellular cAMP correlate with the number of adherent bacteria, not the total number present in the medium, suggesting that interaction of bacteria with target cells is important for efficient delivery of AC toxin. A filamentous haemagglutinin-deficient mutant (BP353) and a clinical isolate (GMT1), both of which have a marked reduction in AC toxin on their surface, and wild-type B. pertussis (BP338) from which surface AC toxin has been removed by trypsin, were fully competent for intoxicating target cells, demonstrating that surface-bound AC toxin is not responsible for intoxication. B. pertussis killed by gentamicin or gamma irradiation were unable to intoxicate, illustrating that toxin delivery requires viable bacteria. Furthermore, CCCP, a protonophore that disrupts the proton gradient necessary for the secretion of related RTX toxins, blocked intoxication by whole bacteria. These data establish that delivery of this toxin by intact B. pertussis is not dependent on the surface-associated AC toxin, but requires close association of live bacteria with target cells and the active secretion of AC toxin.

The effect of powder/liquid mixing ratio on the stiffness and impact strength of autopolymerising dental acrylic resins

The stiffness of representative cured autopolymerising dental acrylic resins was determined by calculation of a secant modulus from measurements in tension of load and extension, and related to the powder/liquid mixing ratio. The impact strengths of autopolymerising, heat-cure and commercial resins were compared. It was found that while the stiffness of autopolymerising resins was unaffected by variations in powder/liquid mixing ratio, extension to failure was greater with lower powder/liquid ratios. The impact strength of autopolymerising resins was found to be greater than that of heat-cure resins, and a tentative explanation is offered. These findings may help to explain the pattern of failure of acrylic resin denture bases.

Modulation of idiotypic and antiidiotypic immunoglobulin G responses in an alloimmune thrombocytopenic patient associated with extracorporeal protein A immunoadsorption

In the present case study, a patient with Non-Hodgkin. Lymphoma underwent combination chemotherapy resulting in severe pancytopenia requiring transfusion support with blood products. The patient became refractory to random donor platelet transfusions and subsequently received five immunoadsorption treatments. The patient's clinical response to immunoadsorption therapy was assessed by monitoring platelet transfusion recovery and survival. In addition, changes in antibody responses were assessed. Early during the course of immunoadsorption therapy, antiplatelet immunoglobulin G (IgG) alloantibody was detected. There was a decline in antiplatelet IgG alloantibody levels by the last immunoadsorption treatment associated with increases to platelet correct count increments after completion of immunoadsorption therapy. In addition, elevated levels of antiidiotypic IgG antibody detected early during the course of therapy were significantly reduced by the last immunoadsorption treatment. This case study suggests that specific alloimmune idiotypic IgG antibody and corresponding antiidiotypic IgG antibody responses may be modulated in association with extracorporeal immunoadsorption employing protein A/silica columns.

Modulation of idiotypic and antiidiotypic immunoglobulin G responses in an immune thrombocytopenic purpura patient as a consequence of extracorporeal protein A immunoadsorption

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by the presence of antiplatelet antibody which sensitizes platelets resulting in their clearance by the reticuloendothelial system. Extracorporeal protein A immunoadsorption has been demonstrated to be of benefit in the treatment of this autoimmune disorder. In the present study, a patient with underlying systemic lupus erythematosus (SLE) presented with ITP. The patient received 14 immunoadsorption treatments and responded to therapy. During the course of immunoadsorption treatments, there was a decline in circulating immune complex (CIC) levels, antinuclear antibody (ANA) levels, and antiplatelet IgG antibody levels. In addition, elevated levels of antiidiotypic IgG antibody detected before initiation of therapy were significantly reduced during the course of immunoadsorption treatments. This study suggests that specific autoimmune idiotypic IgG antibody and corresponding antiidiotypic IgG antibody responses may be modulated in association with extracorporeal immunoadsorption employing protein A/silica columns.

Evidence for proteolytic cleavage of covalently bound protein A from a silica based extracorporeal immunoadsorbent and lack of relationship to treatment effects

Studies were conducted to evaluate the potential cause for release of covalently bound Staphylococcal protein A (SpA) from a silica based extracorporeal immunoadsorbent matrix. In vitro tests revealed that SpA could be detected in human plasma, human serum, and chicken serum upon exposure to the immunoadsorbent matrix which had been treated to remove non-covalently bound SpA. In contrast, only minute quantities of SpA were detected after exposure of a physiologic mixture of purified albumin and immunoglobulin G (IgG) to the immunoadsorbent matrix. Additional tests, employing a cocktail of protease inhibitors and formalin as a general stabilizer and protease inhibitor, revealed significant inhibition of endogenous proteolytic activity present in plasma and serum. Prevention of this proteolytic activity also significantly inhibited the release of covalently bound SpA from the immunoadsorbent matrix upon contact with plasma or serum samples. Further analyses of serum samples from patients with immune thrombocytopenia, chemotherapy associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome, and breast cancer revealed a lack of association between the quantity of SpA proteolytically released and observed clinical responses or adverse effects experienced during immunoadsorption treatments. These studies indicate that SpA detected in plasma or serum after exposure to the immunoadsorbent is due to inherent endogenous proteolytic activity which cleaves protein fragments from the matrix and that these cleaved SpA fragments do not appear to contribute to the observed clinical responses or adverse effects in treated patients.

Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves

We collected data from a large series of patients with ocular palsies and compared them with data in previous series from the Mayo Clinic. The largest group of patients among 4,278 cases was that in which the cause was undetermined for a long period of follow-up. The abducens nerve was most commonly affected. The probability of establishing a diagnosis was higher in patients younger than 50 years and among those with associated neurologic findings or multiple ocular palsies. The prognosis for recovery was best in the vascular group but was better than 50% for all groups except those with tumors. Investigation may be tailored to each patient according to clinical findings and probabilities of finding a cause, and judicious clinical judgement should be exercised.

Experience with protein A-immunoadsorption in treatment-resistant adult immune thrombocytopenic purpura

Extracorporeal immunoadsorption of plasma to remove IgG and circulating immune complexes (CIC) was evaluated as a therapy for adults with treatment-resistant immune thrombocytopenic purpura (ITP). Seventy-two patients with initial platelet counts less than 50,000/microL who had failed at least two other therapies were studied. They received an average of six treatments of 0.25 to 2.0 L plasma per procedure over a 2- to 3-week period using columns of staphylococcal protein A-silica (PROSORBA immunoadsorption treatment columns; IMRE Corp, Seattle, WA). The treatments caused an acute increase in the platelet count to greater than 100,000/microL in 18 patients and to 50,000 to 100,000/microL in 15 patients. The median time to response was 2 weeks. Responses were transient (less than 1 month duration) in seven of those patients (10%), but no additional relapses were reported over a follow-up period of up to 26 months (mean of 8 months). Clinical responses were associated with significant decreases in specific serum platelet autoantibodies (including anti-glycoprotein IIb/IIIa), platelet-associated Ig, and CIC. Thirty percent of treatments were associated with transient mild to moderate side effects usually presenting as a hypersensitivity-type reaction. Continued administration of failed therapies for ITP, which always included low-dose corticosteroids (less than or equal to 30 mg/d), had no demonstrable influence on the effectiveness of immunoadsorption treatment but did depress the incidence and severity of side effects. The degree of effectiveness of protein A immunoadsorption therapy in patients with treatment-resistant ITP is promising and further controlled studies in this patient population are warranted.

Specificity of antibody responses affected by extracorporeal immunoadsorption of plasma over columns of protein A silica

A relationship is described between the interaction of circulating immune complexes (CIC) from plasma with staphylococcal protein A immunoadsorption treatment columns and modulation of antibody responses related to the specific CIC. Eluates from the initial immunoadsorption columns used to treat a series of patients with breast adenocarcinoma, cancer chemotherapy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (C-TTP/HUS), or immune thrombocytopenic purpura (ITP) were evaluated for disease-specific CIC containing Lex glycosphingolipid (Lex gl) adenocarcinoma-associated antigens or platelet autoantibody (anti-GPIIb/IIIa), together with the corresponding neutralizing antibody [anti-F(ab')2], and for nonspecific CIC containing cytomegalovirus (CMV) or herpes simplex virus type 1 (HSV-1) antigens. In addition, the levels of antibodies directed against CMV, HSV-1, Lex gl, and GPIIb/IIIa antigens, as well as anti-F(ab')2 antibodies, were compared in pretreatment and posttreatment serum samples. Columns used to treat breast adenocarcinoma patients contained only Lex gl CIC, and the only immunologic change observed after treatment was significant increases in anti-Lex gl antibodies in some patients. Columns used to treat C-TTP/HUS patients contained anti-GPIIb/IIIa-anti-F(ab')2 CIC, in addition to Lex gl CIC. After treatment, significant increases in anti-Lex gl and anti-F(ab')2 antibodies and significant decreases in anti-GPIIb/IIIa antibodies were observed in some patients. Columns used to treat ITP patients only exhibited anti-GPIIb/IIIa-anti-F(ab')2 CIC, and after treatment only decreases in anti-GPIIb/IIIa and increases in anti-F(ab')2 antibodies were observed in some patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Modulation of immunity in patients with autoimmune disease and cancer treated by extracorporeal immunoadsorption with PROSORBA columns

Extensive animal studies and clinical observations support an immunosuppressive role for certain antibodies and circulating immune complexes (CIC) in malignant and autoimmune diseases. Investigators have attempted to correct or modulate dysfunction by removal of antibodies or CIC from plasma. Extra-corporeal immunoadsorption of plasma over columns containing a silica matrix and covalently attached highly purified staphylococcal protein A (PROSORBA column) is a procedure that specifically removes those plasma components by the interaction of protein A with the Fc region of IgG. The interaction of CIC with the Fc receptor on protein A has three specific results. First, there is direct removal of immunosuppressive CIC from the circulation. Studies of CIC-mediated immunosuppression in experimental systems have shown dose-response relationships over wide ranges of CIC concentrations. Thus, removal of CIC relative to the IgG antibody may be expected to exert some stimulation of the immune system. Second, the complement system is activated. Elevated levels of C3a, C4a, and C5a are observed in patients' circulating plasma after PROSORBA treatment. These levels peak one to three hours post-perfusion and are near normal levels by six hours post-perfusion. These complement components are stimulators of growth and activity of immune cells. In addition, by binding to CIC they stimulate clearance of CIC by the reticuloendothelial system. Thus, treatments may induce removal of more CIC than could be anticipated by the binding capacity of treatment columns. Third, antibody is released from CIC. Interaction of CIC with bound protein A with or without the aid of activated complement components leads to liberation of free antibody. Depending upon other factors, eg, amount of circulating antigen and/or unbound IgG, either free antibody or CIC containing more antibody relative to antigen (or both) may be infused into patients with the posttreatment plasma. Such CIC function as immune stimulators rather than suppressors of immune cell activity. The consequences of the treatments are summarized as follows. Stimulation of immune cellular activity is seen one to three hours posttreatment. During the first one to three treatments, cells of the granulocyte/macrophage series show the greatest increase. During and after treatments 2 to 4, lymphocytes show the greatest increase. At this point, increased blastogenic response to mitogens is observed along with an increase in the T helper/suppressor cell ratio.(ABSTRACT TRUNCATED AT 400 WORDS)

Remission of FeLV-associated lymphosarcoma and persistent viral infection after extracorporeal immunoadsorption of plasma using staphylococcal protein A columns: details of immune response

Sixteen feline leukemia virus (FeLV)-infected cats with lymphosarcoma (LSA) were treated by extracorporeal immunoadsorption using staphylococcal protein A columns in order to remove immunoglobulin G (IgG) and circulating immune complexes (CIC) from plasma. Complete viral clearance and long-lasting tumor regression were achieved in nine of the cats and tumor regression without virus clearance was observed in two other cats. Since LSA cats rarely go into spontaneous remission, and since other forms of therapy are ineffective, these cats offered a unique system for analyzing details of the immune response to LSA and FeLV as they are cleared. Immunological parameters associated with the FeLV and LSA responses were assessed in detail in three responder cats and three nonresponders during the treatment and follow-up periods. Two serological parameters that always correlated with complete clearance of LSA were development of precipitating antibodies against FeLV-C gp70 and development of cytotoxic antibodies that kill cultured FL74 LSA cells in the presence of complement. The precipitating antibodies were detected prior to the clearance of LSA and prior to the detection of free cytotoxic antibodies. One serological parameter that always correlated with complete clearance of. FeLV was development of free antibodies to FeLV-AB gp70. Quantitative levels of FeLV-specific CIC and feline oncornavirus-associated cell membrane antigen (FOCMA)-specific CIC correlated well with fluctuating levels of the corresponding antigens and antibodies. These results suggest that the staphylococcal protein A treatment columns remove CIC "blocking factors" directly or indirectly and thereby stimulate existing antibody responses. These antibodies mediate clearance of FeLV and LSA.

Reduction in platelet-binding immunoglobulins and improvement in platelet counts in patients with HIV-associated idiopathic thrombocytopenia purpura (ITP) following extracorporeal immunoadsorption of plasma over staphylococcal protein A-silica

Platelet-directed antibodies and circulating immune complexes (CIC) were removed from plasma of patients with human immunodeficiency virus (HIV) infection and idiopathic thrombocytopenic purpura (ITP) by extracorporeal immunoadsorption using columns of Staphylococcal protein A-silica (Prosorba columns). In addition, stimulation of a broadly cross-reactive anti-F(ab')2 antibody response was observed. These antibodies also appeared to play a role in the additional removal of platelet-directed immunoglobulins (Igs) and CIC from plasma. Removal of these components from plasma was associated with diminishing levels of antibodies and CIC on patient platelets and significant increases in platelet counts. Extracorporeal immunoadsorption of IgG and CIC from plasma is a beneficial new treatment modality for HIV-associated ITP.

Tissue-integrated implants for the partially edentulous patient

Patients who have been dissatisfied with removable prostheses and have sufficient alveolar or cortical bone may be appropriate candidates for osseointegrated implants. This article demonstrates the clinical application of osseointegrated implants for the partially edentulous patient as a viable alternative treatment.

Selective removal of antigen-complexed IgG from cat plasma by adsorption onto a protein A-silica matrix

The binding of normal cat IgG, heat-aggregated cat IgG and specific immune complexes (IC) containing cat IgG to a silica matrix containing covalently bound Staphylococcus aureus protein A was evaluated. The amounts of serum relative to protein A-silica, the flow rates and the perfusion times were representative of those existing when protein A-silica columns are used for therapeutic extracorporeal immunoadsorption of IgG and IC from humans and animals. When cat IgG was present in a large excess, approximately one molecule was bound to the matrix per molecule of solid-phase protein A with a KA of 1.5 X 10(6) 1/mol. Aggregated and immune complexed IgG bound to the matrix with relatively higher affinity. IC prepared in vitro between the purified envelope glycoprotein of the feline leukemia virus (FeLV gp70) and affinity-purified cat antibodies bound to the matrix even though normal IgG was present in greater than 10,000-fold excess. Once bound, IC were not eluted from columns upon further perfusion with normal serum. However, bound IgG was eluted from columns by further perfusion of normal serum or IC. IC were at least five-fold more efficient than normal IgG in exerting this effect. The results suggest that protein A-silica columns can be used for preferential removal of IC from plasma in a clinical or experimental setting.

The use of plasmapheresis, lymphocytapheresis, and staph protein-A immunoadsorption as an immunomodulatory therapy in patients with AIDS and AIDS-related conditions

Circulating immune complexes, autoantibodies, and suppressor factors to normal lymphoproliferation may play an important role in the induction and maintenance of the cellular immunodeficiency characteristic for the acquired immunodeficiency syndrome (AIDS) and its related conditions. In order to explore the possibility that the removal of circulating humoral factors may have an immunomodulatory effect in patients with AIDS and AIDS-related conditions (ARC), we used apheresis procedures to treat patients with different clinical presentations of AIDS and ARC. Five patients with AIDS and opportunistic infections were treated with plasmapheresis. Four patients with AIDS and Kaposi's sarcoma without opportunistic infections were treated with staph protein-A immunoadsorption and two patients with ARC and peripheral neuropathy were treated with lymphoplasmapheresis. The treatments were tolerated well by all patients. Effective removal of circulating humoral immune factors was observed in all three groups. No significant clinical benefit was seen in the patients with AIDS and opportunistic infections treated with plasmapheresis. Partial tumor responses were observed in three of the four patients with AIDS related Kaposi's sarcoma treated with staph protein-A plasma perfusion, and resolution of neurologic symptoms was seen in both patients with ARC and peripheral neuropathy treated with lymphoplasmapheresis. Our preliminary results suggest that lymphoplasmapheresis may be an effective treatment modality for patients with ARC related peripheral neuropathy, that protein-A immunoadsorption is well tolerated by patients with AIDS-related Kaposi's sarcoma, and that this treatment has antitumor and immunomodulatory effects in these patients.

Quantitation of specific antibodies bound to feline leukemia virus in the plasma of pet cats

A method is described for determining levels of circulating immune complexes (CIC) composed of feline leukemia virus (FeLV) antigens and corresponding antibodies in plasma of persistently-infected pet cats. The procedure is based on the ability of high-titered heterologous anti-FeLV serum to chase cat anti-FeLV IgG from dissociated CIC by successfully competing for binding of free antigen. The eluted cat antibody is then collected and quantitated. In a study of cats in the process of clearing persistent FeLV infections, measured levels of FeLV-specific CIC correlated well with fluctuating levels of free FeLV antigen and antibody. The Raji cell assay for CIC in those cats was of comparatively little value in following the clearance of the virus, presumably because that assay does not distinguish between CIC containing viral and those containing non-viral antigens. The method described can be adapted to studies of specific immune complexes associated with a variety of syndromes, provided that the antigen eliciting the immune response is known.

Antitumor activity of protein A administered intravenously to pet cats with leukemia or lymphosarcoma

Extracorporeal immunoadsorption with protein A (SpA) containing Staphylococcus aureus Cowan I (SAC) has previously been shown to induce an antitumor and antiviral response in some feline leukemia virus (FeLV)-infected, lymphosarcoma (LSA) cats. However, the mechanism by which this response is induced is unknown. Since it is possible that SpA dissociates from the SAC column during treatment, and that intravenous infusion of SpA could be a more efficacious form of treatment than extracorporeal immunoadsorption therapy, 6 normal cats and 15 FeLV-infected pet cats with naturally occurring leukemia or LSA were infused with SpA. No toxic effects resulting from SpA infusion were observed in the normal cats. Antitumor effects were observed in one of the eight cats with LSA and in three of the six cats with leukemia, but there were no antiviral responses. The antitumor responses were objective regressions; however, all tumors recurred. These results demonstrate that infusion of SpA into FeLV-infected LSA or leukemic cats can result in an antitumor but apparently not in an antiviral response.

Acquired immunodeficiency syndrome (AIDS)--apheresis and operative risks

The removal of immune complexes, autoantibodies and suppressor factors from the circulation of patients with AIDS and AIDS related conditions by plasmapheresis and selective immunoadsorption may play a role as a therapeutic modality in these disorders. Lymphocytapheresis may also be of potential use in AIDS related conditions with presumed autoimmune basis. Perfusion of plasma over immobilized protein A columns is being evaluated as a possible immunomodulatory and antitumor therapy in patients with AIDS related Kaposi's sarcoma. Although apheresis procedures as a therapeutic modality in AIDS related conditions are still at the experimental stage, preliminary results are encouraging. The possible transmission of the disease by blood products presents a health hazard to health workers involved in the field of apheresis. Since the mode of transmission of the disease appears to be similar to hepatitis B, strict hepatitis B precautions should be enforced in every case in which AIDS suspected blood is being processed.

Clearance of feline leukemia virus from persistently infected pet cats treated by extracorporeal immunoadsorption is correlated with an enhanced antibody response to FeLV gp 70

Six persistently feline leukemia virus (FeLV)-infected pet cats were treated by extracorporeal immunoadsorption with Staphylococcus aureus Cowan I (SAC) to remove circulating immune complexes and immunoglobulin G (IgG) from plasma. In three of these cats, the FeLV infection was eliminated, whereas in the other three cats the infection persisted. The amounts of peripheral blood leukocyte (PBL)-associated FeLV, soluble FeLV envelope glycoprotein (gp70) antigens in serum, and FeLV-gp70-specific antibodies were determined in all six cats at different times during treatment. In all of the cats, there were fluctuations in the amounts of FeLV-positive PBL and of serum antigen related to FeLV gp70. The one serologic parameter that always correlated with complete clearance of FeLV in the responder cats was the development of free antibodies to gp70. These results suggest that extracorporeal immunoadsorption treatment stimulates an existing low level antibody response to FeLV in some cats, and that these antibodies mediate the clearance of FeLV. The results also suggest that determination of antibody titer to FeLV is of value in predicting the outcome of extracorporeal immunoadsorption treatments as well as when treatment may be terminated.

Clearance of feline leukemia virus from persistently infected pet cats treated by extracorporeal immunoadsorption is correlated with an enhanced antibody response to FeLV gp 70

Six persistently feline leukemia virus (FeLV)-infected pet cats were treated by extracorporeal immunoadsorption with Staphylococcus aureus Cowan I (SAC) to remove circulating immune complexes and immunoglobulin G (IgG) from plasma. In three of these cats, the FeLV infection was eliminated, whereas in the other three cats the infection persisted. The amounts of peripheral blood leukocyte (PBL)-associated FeLV, soluble FeLV envelope glycoprotein (gp70) antigens in serum, and FeLV-gp70-specific antibodies were determined in all six cats at different times during treatment. In all of the cats, there were fluctuations in the amounts of FeLV-positive PBL and of serum antigen related to FeLV gp70. The one serologic parameter that always correlated with complete clearance of FeLV in the responder cats was the development of free antibodies to gp70. These results suggest that extracorporeal immunoadsorption treatment stimulates an existing low level antibody response to FeLV in some cats, and that these antibodies mediate the clearance of FeLV. The results also suggest that determination of antibody titer to FeLV is of value in predicting the outcome of extracorporeal immunoadsorption treatments as well as when treatment may be terminated.

Feline leukemia virus envelope gp70 of subgroups B and C defined by monoclonal antibodies with cytotoxic and neutralizing functions

Nine murine monoclonal antibodies (MAb) to the envelope proteins of feline leukemia virus (FeLV) are described. Eight MAb are directed to epitopes of the same molecular species of gp70 and the other MAb is directed to the p15E moiety. Six of the gp70 epitopes are discrete; two are closely associated or overlapping. Four anti-gp70 MAb (2 of IgG2A and 2 of IgG2B subclasses) were directly cytotoxic for FeLV-producer lymphoma cells with cat or with rabbit complement (C). Another MAb (IgG2B), which was not cytotoxic alone, specifically and synergistically increased the cytotoxic effects of both IgG2A MAb. Cytotoxic anti-gp70 MAb also had virus-neutralizing capacity; one MAb recognized a determinant common to all FeLV subgroups (A, B, and C), the others recognized gp70 epitopes not present on subgroup A but common to both B and C subgroups. Competitive inhibition of MAb binding was employed to map spatial distributions of the epitopes, and the results fitted a molecule shaped as an incomplete loop. According to the model, epitopes involved with cytotoxic and virus neutralizing antibody functions were closely associated; the region involved is approximately in the center of the molecule, and it contains epitopes that are variably expressed among individual isolates of FeLV derived from different cat lymphoma cell lines.

Feline leukemia virus envelope gp70 of subgroups B and C defined by monoclonal antibodies with cytotoxic and neutralizing functions

Nine murine monoclonal antibodies (MAb) to the envelope proteins of feline leukemia virus (FeLV) are described. Eight MAb are directed to epitopes of the same molecular species of gp70 and the other MAb is directed to the p15E moiety. Six of the gp70 epitopes are discrete; two are closely associated or overlapping. Four anti-gp70 MAb (2 of IgG2A and 2 of IgG2B subclasses) were directly cytotoxic for FeLV-producer lymphoma cells with cat or with rabbit complement (C). Another MAb (IgG2B), which was not cytotoxic alone, specifically and synergistically increased the cytotoxic effects of both IgG2A MAb. Cytotoxic anti-gp70 MAb also had virus-neutralizing capacity; one MAb recognized a determinant common to all FeLV subgroups (A, B, and C), the others recognized gp70 epitopes not present on subgroup A but common to both B and C subgroups. Competitive inhibition of MAb binding was employed to map spatial distributions of the epitopes, and the results fitted a molecule shaped as an incomplete loop. According to the model, epitopes involved with cytotoxic and virus neutralizing antibody functions were closely associated; the region involved is approximately in the center of the molecule, and it contains epitopes that are variably expressed among individual isolates of FeLV derived from different cat lymphoma cell lines.

The feline oncornavirus-associated cell membrane antigen (FOCMA) is related to, but distinguishable from, FeLV-C gp70

The feline oncornavirus-associated cell membrane antigen (FOCMA) on the surface of feline lymphosarcoma (LSA) cells is defined as the target(s) recognized in immunofluorescence (IFA) tests by antibody in sera of cats relatively resistant to development of FeLV (feline leukemia virus) LSA and FeSV (feline sarcoma virus) fibrosarcoma. The specificities of antibodies in cat FOCMA-typing sera and the nature of the LSA antigens recognized were investigated in the present study. FOCMA sera obtained from viremic cats were separable into at least two classes : those which contained antibodies against the envelope glycoprotein (gp70) of subgroup C FeLV and those which did not contain antibodies against any subgroup of FeLV. The first class of sera could be further subdivided into three groups: those whose FOCMA reactivity could be completely absorbed, partially absorbed, or not absorbed by FeLV-C antigens. The second class of sera could be further subdivided into two groups: those whose FOCMA reactivity could be partially absorbed and those whose activity could not be absorbed by FeLV-C. The results indicate that the FOCMA reactivity exhibited by some viremic cat sera can be partially, if not entirely, attributed to antibodies not crossreactive with FeLV virion antigens. A consistent property of all FOCMA sera in this study is the ability to bind to 70-kDa proteins on the surface of LSA cells. Staphylococcus aureus V8 protease partial digest maps of 70-kDa proteins purified from 12 primary feline LSAs (five FeLV positive and seven FeLV negative) all showed 18-, 14-, and 10-kDa fragments. V8 maps of FeLV-C gp70 showed similarly sized fragments while the maps of the RD114, FeLV-A, and FeLV-B gp70s were distinct. However, in a subgroup-specific radioimmunoassay for FeLV-C gp70-related antigens, the LSA 70-kDa proteins were found to be serologically related to, but distinct from, FeLV-C gp70. The results on the antigenic variations among LSA 70-kDa proteins and the antibodies which bind them are entirely consistent with previous studies indicating heterogeneity among FOCMA determinants.

Perfusion of canine serum over Staphylococcus aureus Cowan 1: Evidence for release of protein A and changes in specific antibody activity

Sera from three normal dogs were assessed for levels of Clq binding IgG and complement consumption after perfusion over Staphylococcus aureus Cowan I (SAC). Increased levels of Clq binding IgG were detected after perfusion of sera over SAC and were associated with complement consumption. Canine antiserum to human erythrocytes were also perfused over SAC and assessed for Clq binding IgG and hemolytic activity. Increased levels of Clq binding IgG in post-perfusion samples were detected which were associated with a decrease in hemolytic activity. IgG was determined to be present in molecular weight fractions greater than 200,000 M.W. in post-perfusion chromatographically fractionated sera. Moreover, 5% polyethylene glycol (PEG) precipitated IgG from post-perfusion sera was functional in antibody dependent cellular cytotoxicity assays. Putative staphylococcal protein A isolated from post-perfusion sera produced a precipitin band in double diffusion agarose gel studies when reacted with normal human and canine sera. A polypeptide co-migrating with purified protein A could be detected by polyacrylamide gel electrophoresis (PAGE) analysis of the post-perfusion isolated protein A. Addition of purified protein A to canine antiserum resulted in decreased hemolytic activity of the serum which was associated with increased levels of Clq binding IgG.

Isolation and characterization of circulating feline leukemia virus-immune complexes from plasma of persistently infected pet cats removed by ex vivo immunosorption

IgG and circulating IgG immune complexes (CIC) were purified from plasma of three pet cats persistently infected with feline leukemia virus (FeLV) by adsorption to, and elution from, Staphylococcus aureus Cowan I. CIC were then separated from free IgG by sucrose gradient ultracentrifugation and were analyzed for the presence of FeLV structural proteins and corresponding specific antibodies. Radioimmunoprecipitation analysis indicated that FeLV envelope (gp70) and major core (p30) proteins, along with cat IgG heavy and light chains, were present in the CIC from all three cats. Further analysis of the CIC from one of the cats also revealed the presence of FeLV core proteins p15 and p12. IgG purified from isolated CIC was also shown to bind specifically to purified FeLV gp70, p30, and p15. These data provide direct evidence for FeLV-specific CIC in the plasma of persistently viremic pet cats, and suggest these animals are immunologically response to the virus even though free antibodies against the major structural proteins cannot be demonstrated in standard assays.

Isolation and characterization of circulating feline leukemia virus-immune complexes from plasma of persistently infected pet cats removed by ex vivo immunosorption

IgG and circulating IgG immune complexes (CIC) were purified from plasma of three pet cats persistently infected with feline leukemia virus (FeLV) by adsorption to, and elution from, Staphylococcus aureus Cowan I. CIC were then separated from free IgG by sucrose gradient ultracentrifugation and were analyzed for the presence of FeLV structural proteins and corresponding specific antibodies. Radioimmunoprecipitation analysis indicated that FeLV envelope (gp70) and major core (p30) proteins, along with cat IgG heavy and light chains, were present in the CIC from all three cats. Further analysis of the CIC from one of the cats also revealed the presence of FeLV core proteins p15 and p12. IgG purified from isolated CIC was also shown to bind specifically to purified FeLV gp70, p30, and p15. These data provide direct evidence for FeLV-specific CIC in the plasma of persistently viremic pet cats, and suggest these animals are immunologically response to the virus even though free antibodies against the major structural proteins cannot be demonstrated in standard assays.

Behavioral effects of low plus lenses

This study explored the relationship between the application of low plus reading lenses and the improvement of performance at a child's near working distance. 11 school-aged subjects were selected at random, screened for their ability to accept low plus lenses, then given a paper-and-pencil task to perform both with and without the plus lenses. Statistically significant behavioral changes were associated with wearing the low plus-power reading lenses while performing the near paper-and-pencil task.

An automated hearing screening technique for newborns

A newborn hearing screening technique (the Crib-o-gram) originally proposed by Simmons and Russ (1974) is described. The number of babies tested has now grown to over 12,000. The report presents follow-up data on the Crib-o-grain hearing screening program at Stanford University Medical Center. Improvements in test procedure and scoring have resulted in a current detection rate of 93%.

Treatment of feline leukemia and reversal of FeLV by ex vivo removal of IgG: a preliminary report

Cats that were spontaneously infected with feline leukemia virus (FeLv) were treated with a combination of low-dose irradiation and extracorporeal immunosorption using formalin and heat-fixed S. aureus as a non-specific immunosorbent to remove plasma IgG and immune complexes. The treatment resulted in reduction of circulating lymphoblasts within two weeks and clinical improvement of three of the five animals. A reversal of the FeLV status is reported in five of five cats. Two of the five cats remain FeLV negative and completely tumor free seven and eight months post-therapy at the time of writing (July 1979). A third cat returned to an FeLV positive state but remained tumor free for 24 weeks. Another cat responded to the therapy by reduction of lymphoblasts and became FeLV negative but died of a hemorrhage during an immunosorption. The last cat's status was FeLV positive, then FeLV negative, and finally FeLV positive again. He died 20 weeks after initiation of therapy. During the treatment there was a weight gain in the three cats responding by tumor regression. The results are discussed in terms of a removal of some type of immunoinhibiting factors such as antigen-antibody complexes or suppressor molecules.

Selective localization of radiolabeled immune lymphocytes into syngeneic tumors

Newly formed long-lived small lymphocytes (LLSL) generated during the immunization of mice to tumor specific transplantation antigens (TSTA) of syngeneic MCA-induced sarcomas were labeled. We then studied the localization of these labeled cells into tumor implants. "Crisis-cross" experiments were performed in which MCA sarcomas with individually distinct TSTA were studied in parallel. A selective localization of LLSL into tumors to which the lymphocytes were immune was found when small tumor pieces were implanted into immune mice whose LLSL had been labeled. Selective localization was also detected upon adoptive transfer of immune LLSL to tumor-bearing mice, but only when these mice had, before transfer, received a sublethal dose of whole body irradiation.

Selective Localization of Radiolabeled Immune Lymphocytes into Syngeneic Tumors

Newly formed long-lived small lymphocytes (LLSL) generated during the immunization of mice to tumor specific transplantation antigens (TSTA) of syngeneic MCA-induced sarcomas were labeled. We then studied the localization of these labeled cells into tumor implants. “Criss-cross” experiments were performed in which MCA sarcomas with individually distinct TSTA were studied in parallel. A selective localization of LLSL into tumors to which the lymphocytes were immune was found when small tumor pieces were implanted into immune mice whose LLSL had been labeled. Selective localization was also detected upon adoptive transfer of immune LLSL to tumor-bearing mice, but only when these mice had, before transfer, received a sublethal dose of whole body irradiation.

An automated hearing screening technique for newborns

11 182 newborn infants have had their hearing thresholds screened by automatically recording crib motion before and after a test sound. An inexpensive motion transducer translates the baby(s) movements onto a multichannel strip-chart recorder (batch testing) or a single channel recorder (individual testing). Records are read off-line and scored positive if there is a change in movement within 2.5 sec after the test sound. "Passing or failing" a baby requires about one minute's clerical scoring time, and is therefore both economical and simple. We have detected 33 neonates with serious hearing losses and perhaps missed one on long-term follow-up. This amounts to a deafness incidence of 1:329 live births. In the Intensive Care/Premature nurseries the incidence is 1:62.

Children absorb tris-BP flame retardant from sleepwear: urine contains the mutagenic metabolite, 2,3-dibromopropanol

The flame retardant, tris(2,3-dibromopropyl)phosphate (tris-BP), which is a mutagen and causes cancer and sterility in animals is absorbed from fabric by people. 2,3-Dibromopropanol, a metboloite of tris-BP and a mutagen itself, has been found in the urine samples of ten children who were wearing or who had worn tris-BP-treated sleepwear. Eight of these children were wearing well-washed sleepwear and the possibility of absorption of tris-BP from well-washed sleepwear discussed. 2,3-Dibromopropanol was not found in the urines of one child and one adult who had never worn tris-BP-treated garments.