Exposure and inhalation risk assessment in an aluminium cast-house

To date the exposure, absorption and respiratory health effects of cast-house workers have not been described since most studies performed in the aluminium industry are focused on exposure and health effects of potroom personnel. In the present study, we assessed the external exposure and the absorbed dose of metals in personnel from the aluminium cast house. This was combined with an evaluation of respiratory complaints and the lung function of the personnel. 30 workers from an aluminium casting plant participated and 17 individuals of the packaging and distribution departments were selected as controls. The exposure was assessed by the quantification of total inhalable fume with metal fraction and by the determination of urinary aluminium, chromium, beryllium, manganese and lead concentration. Carbon monoxide (CO), carbon dioxide (CO2), aldehydes and polyaromatic hydrocarbons and man-made mineral fibres concentration were assessed as well. In order to evaluate their respiratory status each participant filled out a questionnaire and their lung function was tested by forced spirometry. Total inhalable fume exposure was maximum 4.37 mg m(-3). Exposure to the combustion gases, man-made mineral fibres and metal fume was well below the exposure limits. Beryllium could not be detected in the urine. The values of aluminium, manganese and lead in the urine were all under the respective reference value. One individual had a urinary chromium excretion above the ACGIH defined biological exposure index (BEI) of 30 microg g(-1) creatinine. There was no significant difference in any of the categories of the respiratory questionnaire and in the results of the spirometry between cast house personnel and referents (Chi-square, all p > 0.05). Exposure in cast houses seem to be acceptable under these conditions. However, peak exposure to fumes cannot be excluded and the potential risk of chromium and beryllium exposure due to the recycling of aluminium requires further attention.

Analysing and interpreting routinely collected data on sharps injuries in assessing preventative actions

BACKGROUND

Sharps injuries (SI) occur frequently in hospitals and are a risk for exposure to bloodborne pathogens. During the 1990s, the safety service of a university general hospital introduced, in collaboration with the occupational health service, specific measures to reduce the number of SI.

AIM

The aim of this study was to assess the occurrence and evolution of SI during this period and to evaluate the effectiveness of the preventative measures taken, making use of routinely collected data.

METHOD

In a retrospective study, we analysed the number of SI recorded from 1990 to 1997. The study population was all employees at risk of SI. Because the introduction of intensive preventative measures dates from 1996, an effect on the incidence of SI can be expected from 1996. To assess this effect, mean incidence rates for 1990-1995 and for 1996-1997 were compared.

RESULTS

In the study period, a total of 4230 SI were recorded. The global SI incidence rate decreased from 33.4 SI per 100 occupied beds per year in 1990-1995 to 30.1 in 1996-1997 (P < 0.01). In the same period, among nurses a decrease in incidence rate from 17.2 to 12.7 SI per 100 person-years was noted (P < 0.0001) and for the hotel service from 4.8 to 3.7 (not significant).

CONCLUSION

Although this study has various restraints, these results suggest that intensive preventative actions, in combination with technological advances, may have contributed to a drop of 67 SI cases per year.

Hepatitis B Vaccination Coverage in Belgian Health Care Workers

BACKGROUND

The hepatitis B virus (HBV) vaccination policy for health care workers (HCW) started in Belgium in 1983. An update of vaccination coverage and rates of seroconversion and seroprotection among HCW can give an insight into the actual status and encourage further development of vaccination programs.

PATIENTS AND METHODS

5,064 HCW were tested for anti-HBs. We considered those who had a positive anti-HBs test as seroconverted (SC) and those who had an anti-HBs titer > 10 IU/l as seroprotected (SP).

RESULTS

4,771 HCW were eligible for vaccination; 84.9% of them were effectively vaccinated. Among high-risk professions (nurses, care and laboratory workers), 94.79% were vaccinated; for other professions the vaccination coverage was 69.26%. Of the 1,015 non-vaccinated persons, 293 were anti-HBs positive. Among these 54.95% declared they had had a previous hepatitis infection that was serologicaLly proven to be HBV (anti-HBc positive). Of the remaining 132 positives, 70.45% had previously undergone surgery and/or transfusion. Among these 1,015 non-vaccinated HCW, 59.03% were anti-HBs positive. Of these, 373 were nurses, care or laboratory workers. This contrasts with the results for HCW in other sectors, where 11.49% were anti-HBs positive.

CONCLUSION

In our sample, high vaccination, seroconversion and seroprotection rates were achieved, at least for higher risk HCW. The same conclusion can be drawn if we consider hospital departments which carry a higher risk of blood-borne infections.

The immunogenicity and reactogenicity profile of a candidate hepatitis B vaccine in an adult vaccine non-responder population

Approximately 5% of vaccinees display an inadequate response after the administration of the standard three dose hepatitis B vaccine. A new hepatitis B vaccine (HBsAg/AS04) formulated with the adjuvant AS04 which contains 3'-deacylated monophosphoryl lipid A (3D-MPL) and alum has been developed. AS04 enhances the immune response which may be beneficial to non-responders. In a single-blind, randomised study, we tested the immunogenicity and reactogenicity of the new vaccine with that of commercially established hepatitis B vaccine, both on a 0, 1, 6 months schedule in 20-60 years old non-responders (titre <10 m IU/ml after four doses of hepatitis B vaccine). One month after the first dose the seroprotection rate was 44% for group 1 (58 subjects) receiving the established vaccine versus 66% for group 2 receiving HBsAg/AS04 (57 subjects) (P=0.03). One month after the second dose this was 58 and 81%, respectively (P<0.005) and 1 month after the third dose this was 68 and 98%, respectively (P<0.001). One month after each dose, GMTs were 34, 56 and 111 mIU/ml for group 1 versus 123222 and 1937 mIU/ml for the HBsAg/AS04 group (P<0.05, <0.01 and 0.0001, respectively). Pain at the injection site was the most commonly reported local symptom and very few symptoms were scored as severe. In this group of adult non-responders to previous hepatitis vaccination, the HBsAg/AS04 vaccine was well tolerated and induced, at all time-points, a superior immune response compared to the licensed hepatitis B vaccine.

Asthma prevalence in children living in villages, cities and refugee camps in Palestine

Previous studies have suggested that asthma prevalence is generally lower in the Middle East than in more developed countries. The aim of this study was to investigate the prevalence and severity of asthma and asthma symptoms in schoolchildren in the Ramallah District in Palestine. In the autumn of 2000, 3,382 schoolchildren aged 6-12 yrs were surveyed in 12 schools, using the International Study for Asthma and Allergies in Childhood (ISAAC)-phase III, parents-administered translated questionnaire. The crude prevalence rates for "wheezing-ever", "wheezing in the previous 12 months", and "physician-diagnosed asthma" were 17.1, 8.8 and 9.4% respectively, with urban areas having higher prevalence rates than rural areas. Within urban areas, refugee camps had higher prevalence rates than cities. Yet, within the rural areas, the 12-month prevalence was lower in the deprived villages than other residences. Place of residence remained significant for asthma and asthma symptoms, after adjusting for sex, age, and place of birth. To conclude, children from refugee camps appear to be at higher risk of asthma than children from neighbouring villages or cities. The prevalence of asthma and asthma symptoms in Palestine appears to be close to that of Jordan, but it is much lower than Israel, and lower than some other countries in the region, such as Kuwait and Saudi Arabia, and more developed countries. This initial study is a baseline for a study on lifestyle and environmental determinants for asthma among Palestinian children.

Psychometric properties of the "Modified Transplant Symptom Occurrence and Symptom Distress Scale"

The aim of this study was to assess key aspects of the reliability and validity of the "Modified Transplant Symptom Occurrence and Distress Scale," an instrument measuring symptom experience associated with side effects of triple drug therapy in transplant patients. This cross-sectional, comparative study included 108 renal transplant recipients (61% men; 39% women) with a median age of 47 years and a median posttransplant status of 5.5 years. Renal transplant patients were matched by age and gender with 108 healthy control persons not taking immunosuppressive drugs. Content validity, construct validity and discriminant validity of the instrument were substantiated. Internal consistency reliability was not useful to assess in this instrument, as the conditions for calculating Cronbach's alpha were not satisfied. These findings document the validity of the "Modified Transplant Symptom Occurrence and Symptom Distress Scale" as an instrument to measure symptom experience with immunosuppressive drugs.

Observer variation in computed tomography of pleural lesions in subjects exposed to indoor asbestos

To assess the reliability of computed tomography (CT) in detecting discrete pleural lesions, the interobserver and intra-observer variability in reading the conventional and high-resolution CT (HRCT) scans of 100 volunteers, who had worked for > or = 10 yrs in a building with known asbestos contamination, was evaluated. In the first session, pleural abnormalities were detected by a single radiologist (A1) in 13 subjects. In the second session, the scans were read again independently by the same radiologist (A2) and two other experienced radiologists (B, C). The final decision for the presence of pleural lesions was made in a final consensus reading. This gave a diagnosis of pleural abnormalities in 18 subjects, of whom eight (44%) had been detected by all three readers, five (28%) by two readers and four (22%) by only one reader; one scan, rated normal by all readers during the second session, was reconsidered because pleural abnormalities had been noted at the first reading (A1). The intra-observer agreement for reader A was good (kappa (kappa) 0.68) but the interobserver agreement between the readers was only fair to moderate (weighted kappa: A2-B=0.43, A2-C = 0.45, B-C = 0.26) in the second reading session. In conclusion, when looking for the prevalence of pleural lesions in indoor asbestos exposed subjects, the potential lack of consistency in reporting the presence of small pleural abnormalities must be borne in mind and strict precautions must be taken.

Occupational risk of infection by varicella zoster virus in Belgian healthcare workers: a seroprevalence study

OBJECTIVES

To assess the prevalence of varicella zoster virus (VZV) antibodies in Flemish (Belgian) healthcare workers, to investigate the association between seronegativity and selected variables, and to assess the reliability of recall about disease as a predictor of immunity.

METHODS

A seroprevalence study of VZV antibodies (IgG) was conducted among a systematic sample of 4923 employees in various professional groups, employed in 22 hospitals in Flanders and Brussels (Belgium). Information about sex, age, department, job, and years of employment, the country of origin, and history of varicella was obtained. The presence of VZV antibodies was investigated with the enzyme linked immunosorbent assay (ELISA), Enzygnost anti VZV / IgG (Dade Behring, Marburg, Germany). Statistical analysis was performed by calculating prevalences and prevalence ratios (PRs) and their 95% confidence intervals (95% CIs). Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the recalled history were determined.

RESULTS

The prevalence of VZV seropositivity in Flemish healthcare workers was 98.5% (95% CI 98.1 to 98.8). Seronegativity was significantly associated with age and job, increasing with both older and younger age. The prevalence of seronegative workers was significantly less in nursing staff than non-nursing staff. There was no significant difference for sex and years of employment. The PPV and NPV of recalled history were 98.9% and 3.4%. Sensitivity and specificity were 83% and 38.9%.

CONCLUSION

The prevalence of VZV seropositivity was very high in this sample of Flemish healthcare workers. Because of this low overall susceptibility, VZV infection seems not to be an important occupational risk among healthcare workers in Flanders. The increasing seronegativity above the age of 45 is possibly due to a loss of detectable antibodies. A positive history of varicella was a good predictor of immunity, but a negative history had no value as a predictor of susceptibility in adults.

Prevalence of hepatitis A antibodies in a large sample of Belgian health care workers

Health care workers (HCW), especially women (for example, pediatric nurses and day nursery workers), have been shown to be at risk for viral hepatitis A infections. In order to obtain a more precise estimate of the risk in Belgian HCW, a seroprevalence study was undertaken. The data from this study have been compared with the age-specific seroprevalence of anti-HAV in the general population (GP) as recently estimated. During 1996-1997, a sample of 5,068 employees in 22 general hospitals, geographically distributed over the Flemish and Brussels regions of Belgium, was tested for the presence of anti-HAV. Comparison of the anti-HAV prevalences in HCW and GP shows a significantly lower prevalence in HCW for the age groups 25-34, 35-44 and 45-54 years. Within these age-groups, employees performing catering tasks have the highest prevalence. This difference could be explained by socioeconomic parameters: overrepresentation of higher social classes in better educated HCW. The number of unprotected individuals in young and older age groups (25-54 years) is greater than in the general population. In view of the changing HAV epidemiology in western Europe, the number of unprotected persons will rise in the coming years. Considering the more severe course of the disease as age increases, vaccination may become important in the occupational health strategy for HCW.

Prevalence of hepatitis C antibodies in a large sample of Belgian healthcare workers

OBJECTIVE

To assess the risk of hepatitis C virus (HCV) infection among Belgian (Flemish) healthcare workers.

DESIGN

A seroprevalence survey of HCV IgG antibodies.

SETTING AND PARTICIPANTS

A systematic sample of 5,064 employees from 22 general hospitals in Flanders and Brussels, Belgium, was tested at the annual occupational medical examination. Together with demographic and occupational data, information was collected on the frequency of blood contact, needlestick injuries, and medical and surgical history. The blood samples were tested using the third-generation Abbott Screen Kit test, with confirmation by Matrix, LIA, and an in-house polymerase chain reaction and the Quantiplex-HCV b-DNA test.

RESULTS

21 persons were found to be positive for HCV markers. The overall prevalence was 0.41% (95% confidence interval [CI95], 0.24-0.59). A statistically significant association was found with a history of blood transfusion (odds ratio [OR], 4.14; CI95, 1.67-10.31) and with history of a clinically apparent hepatitis (OR, 3.98; CI95, 1.60-9.90). Although the ORs for the frequency of blood contact were slightly elevated (between 1.17 and 2.73), this association was not significant. Moreover, a history of needlestick injuries showed a nonsignificant OR of 1.28 (CI95, 0.53-3.09), and no statistically significant difference was found with a variety of duties and tasks. The ORs for potential occupational risk factors were adjusted according to age, gender, antecedents, and other confounders using a logistic regression analysis. Based on this procedure, the ORs decreased slightly.

CONCLUSIONS

Flemish healthcare workers showed a lower HCV seropositivity than is seen in the general population; a history of blood transfusion and of clinically apparent hepatitis was most strongly associated with the presence of HCV markers. We concluded that employees in Flemish regional general hospitals are not at an overall increased risk for HCV infection, although occasional transmission through percutaneous injuries is possible, and prevention therefore remains imperative.

Nuclear 24 kD fibroblast growth factor (FGF)-2 confers metastatic properties on rat bladder carcinoma cells

The tumorigenic and metastatic properties of rat bladder carcinoma NBT-II cells transfected with a cDNA encoding the 24 kD nuclear isoform of human fibroblast growth factor-2 (FGF-2) were analysed and compared with those cells producing the 18 kD cytoplasmic isoform FGF-2. In transfected clones, 24 kD FGF-2 was found in the nucleus, and no FGF-2 was secreted. RT-PCR analysis showed no upregulation of FGF-2-specific receptor FGFR2c expression in these proliferating transfected cells. A shorter latency period for in vivo tumor formation and abundant spontaneous lung metastases were only seen if nuclear FGF-2-producing cells were injected subcutaneously into nude mice. Intravenous injection of 24 kD FGF-2-producing cells led to extensive experimental lung metastases whereas injection of control NBT-II cells or 18 kD FGF-2-producing cells did not. As FGF-2-producing cells have no specific FGF-2 receptors, our results suggest that the 24 kD FGF-2 has nuclear targets, and activates metastatic property of carcinoma cells via a mechanism other than the conventional FGF receptor-mediated signaling pathway.

The SFL activity secreted by metastatic carcinoma cells is related to laminin 5 and mediates cell scattering in an integrin-independent manner

We have previously reported that an in vivo-selected metastatic variant of NBT-II rat carcinoma cells, M-NBT-II, produces and secretes a factor with cell-scattering activity, SFL, that is potentially involved in tumor progression. This biological activity was purified and characterized as a laminin 5 (LN5) -related protein. This SFL/LN5 protein consists of the (alpha)3, (beta)3 and (gamma)2 chains of expected sizes. Laminin 5 is a multifunctional secreted glycoprotein thought to be involved in cell adhesion and migration, mainly via its interaction with (alpha)3(beta)1 and (alpha)6(beta)4 integrins. SFL/LN5, and purified human laminin 5, induced the scattering and motility of MDCK cells and the formation of actin stress fibers and focal contacts in A549 cells. These events were dependent on activation of the small GTP-binding protein Rho. (Alpha)v colocalized with vinculin in the focal contacts of activated cells whereas (alpha)3 and (alpha)6 integrins did not. Blocking antibodies directed against (alpha)3 and (alpha)6 integrins or the laminin 5 integrin-binding site did not abolish SFL/LN5 biological activity, which, in contrast, was completely inhibited by heparin. Thus, SFL/LN5 activity in epithelial cell scattering and cytoskeletal reorganization is probably independent of integrin receptors.

The community effect in FGF-1 mediated tumor progression of a rat bladder carcinoma does not involve a direct paracrine signaling

A community effect was found to occur between heterogeneous tumor cell populations leading to an overall increased tumorigenicity without a clonal dominance of the more tumorigenic clone. In the rat bladder carcinoma cell line NBT-II, this effect appears mediated by the Fibroblast Growth Factor-1 (FGF-1) through either a direct or an indirect signaling pathway. Neovascularization induced by FGF-1 was found not to be responsible for the community effect. The present study shows that the community effect does not involve a direct FGF-1 signaling since tumor cells expressing a dominant-negative FGF receptor mutant were still responding to the highly tumorigenic FGF-1 expressing cells. Tumors arising from inoculates of the FGF-1 producing NBT-II cells mixed with non tumorigenic epithelial MDCK cells contain only the tumorigenic cells indicating that MDCK cells may exerce a helper effect for the growth of the tumor not dependant on their own growth. Therefore the helper function of MDCK cells must be distinguished from a community effect where the contribution of low tumorigenic cells not only provides an in vivo growth advantage to few highly tumorigenic cells but become themselves highly tumorigenic indicating that the community effect may require cell-cell specific cooperativity independent from an helper effect.

The prevalence of infections in psychiatric institutes in Belgium

To assess the prevalence of infections in psychiatric institutes in Belgium, a cross-sectional study was performed within a cluster sample of psychiatric patients from 29 psychiatric institutes (about 40% of all Belgian psychiatric institutes). During May 1992, 8679 patients were analysed. Of the study population 59% were men. The mean age +/- SD was 54.5 +/- 18.3 years, with a median of 55 years. The mean hospitalization period was 9.6 +/- 14.5 years with a median of 2 years. A total of 1334 infections were reported, and 13.1% of the patients had a least one infection (95% CI: 12.4-13.8%) at the time of the study. The most common infections were dermatological infections (31.6%), lower respiratory tract infections (25.8%), urinary tract infections (12.4%) and conjunctivitis (11.6%). Statistically significant associations with infection prevalence were found with age, psychiatric diagnosis, activity of daily living score, the duration of hospitalization, and the qualification of the person answering the survey form. The relevance and the limitations of this study are discussed.

FGF-2 and FGF-1 expressed in rat bladder carcinoma cells have similar angiogenic potential but different tumorigenic properties in vivo

The comparative biological properties of NBT-II cells, a rat bladder carcinoma cell line constitutively expressing FGF-1 and FGF-2 were analysed in nude mice. FGF-1 is not secreted by the transfected cells unless the cDNA contains a signal sequence; conversely, NBT-II cells transfected with FGF-2 coding sequence produce and secrete the factor in a biologically active form. Bovine brain capillary endothelial cells are stimulated to proliferate upon addition of medium conditioned by the FGF-2-producing cells and this activity can be abrogated by the addition of anti-FGF-2 blocking antibodies. In addition, the FGF-2-containing medium, which cannot stimulate NBT-II cells due to absence of appropriate receptors, is able to induce scattering of NBT-II cells expressing the FGFR1. It has been reported previously that FGF-1-producing cells are highly tumorigenic in nude mice and induce carcinoma with a period of latency reduced from 6 to 5 weeks when compared to parental NBT-II cells. In contrast, NBT-II cells producing FGF-2 are no more tumorigenic than parental cells, indicating that FGF-1 and FGF-2 have different oncogenic properties in carcinoma. FGF-1 and FGF-2 are potent antiogenic factors that trigger the host endothelial cells. VEGF, another potent angiogen was found to be expressed in small amounts by NBT-II cells and to be expressed in reduced amount in the FGF-producing cells. In the NBT-II system in vivo FGF-1 and FGF-2 are highly and comparatively angiogenic in the resultant carcinoma and this occurs in the absence of production of significant amounts of VEGF by the carcinoma cells. Taken together, our results indicate that activated angiogenesis is not sufficient for rapid tumor expansion. FGF-1 behaves as a tumorigenic factor in the NBT-II bladder carcinoma cell model, whereas expression and secretion of large amounts of FGF-2 are not sufficient for increasing tumor growth.

[Molecular aspects of invasiveness and metastasis]

Tumor progression involves the emergence of cell variants with increased proliferative and invasive potentialities. The acquisition of the invasive and metastatic behavior is associated with modulation of cell-cell and cell-substrate interactions. Tumor cells have to dissociate from the primary tumor and migrate through the basal lamina and the surrounding stroma before reaching the vessels. An aberrant expression of some growth factors and their cognate receptors, may contribute to an increase malignancy of tumor cells. We have postulated than such growth factors could be involved in the early events of metastatic spreading by altering cell interactions within a tumor, including proliferation, scattering and migration of tumor cells. In the rat bladder carcinoma NBT-II cell experimental model, we have shown that FGF-1 is a multifunctional factor during tumor progression; FGF-1 acts as a mitogenic factor, a scatter factor, an angiogenic factor, an inducer of matrix degradating enzymes and a tumorigenic factor. NBT-II cells producing constitutively FGF-1 are more invasive, tumorigenic and metastatic than non-producing cells. However, we have shown that within a tumor, FGF-1 producing cells are not dominant in vivo but rather confer by a community effect an "en bloc" behavior to the whole cell collective. This effect could be established either directly by a paracrine mechanism or indirectly by other induced factors. We provide evidence for a novel concept in tumor biology: tumor progression may result from a community effect mediated by a growth/scatter factor produced by a minority of the carcinoma cells.(ABSTRACT TRUNCATED AT 250 WORDS)

FGF-1 but not FGF-4 secreted by carcinoma cells promotes in vitro and in vivo angiogenesis and rapid tumor proliferation

The progressive growth of solid tumors is dependent on the tumor ability to recruit new blood vessels from the surrounding host tissues. We show here that acidic Fibroblast Growth Factor (FGF-1) produced by a rat bladder carcinoma transfected cell line (NBT-II cells) is a potent inducer of angiogenesis. After injection in nude mice, NBT-II cells transfected with FGF-1 form rapidly growing carcinomas which are highly vascularized, whereas carcinoma cells producing a biologically active form of FGF-4 behave like non-producer cells. The vasculature of the tumors obtained with NBT-II cells producing a secreted form of FGF-1 is dramatically expanded but lacking in some places a complete endothelial lining. Conditioned medium from these cells induce formation of capillary-like structures in vitro, whereas those of FGF-4 and non-secreting FGF-1 producing cells failed to induce such structures. Our results indicate that the expression of FGF-1 may promote tumor growth, at least in part, by inducing angiogenesis, and that the acquired ability of tumor cells to secrete FGF-1 but not FGF-4, may result in aberrant neovascularization of the tumor.

Increased risk for hepatitis A among female day nursery workers in Belgium

To assess the risk for hepatitis A virus (HAV) infection in an occupational group potentially at risk for faeco-oral contact with very young children, a prevalence study of total anti-HAV antibodies (IgG/IgM) was conducted among 591 female employees in day nurseries in Flanders, Belgium, and in a reference group of 560 healthy female blood donors, matched for age. Analysis was also performed on formally exposed persons (n = 413) versus blood donors (n = 560). The overall prevalence of HAV markers was 48.4% (95% CI: 44.2-52.5) in exposed day nursery personnel, compared with 42.9% (95% CI: 38.7-47.0) in blood donors. The age-specific prevalence rates showed a steeper rise from the age of 30 years among the exposed employees than among the blood donors, with significantly higher prevalences between 35 and 44 years of age. The discrepancies levelled off above 60 years of age. Standardization for parenthood using logistic regression did not affect the odds ratio. These results are in line with recent findings of a higher prevalence of HAV markers among groups of workers professionally exposed to small children. Appropriate measures for the protection of these groups should be taken.

A scatter factor-like factor is produced by a metastatic variant of a rat bladder carcinoma cell line

The rat bladder carcinoma epithelial NBT-II cell line undergoes, in vitro, a morphological transition to a fibroblast-like state in the presence of different growth factors. We have selected, in vivo, a metastatic clone, designated M-NBT-II, which has a mesenchymal phenotype and secretes into the culture medium a factor able to dissociate epithelial clusters of NBT-II or MDCK cells. This factor was designated scatter factor-like (SFL) by analogy to the HGF/SF, which has the same dissociating effect in these two cell lines. Here, we show that SFL factor and HGF/SF are different factors: (i) no HGF/SF transcripts could be detected using either specific rat HGF/SF cDNA probes or PCR; (ii) blocking antibodies against rat HGF/SF do not inhibit the SFL activity; and (iii) crude culture medium or partially purified SFL factor-containing fractions do not induce MDCK tubulogenesis, a biological assay that is specific for HGF/SF activity in vitro. We report the partial purification of the SFL factor, based on ion exchange and reverse-phase chromatography. The results indicate that the M-NBT-II metastatic variant secretes a dissociating factor sharing some common biological properties with the HGF/SF, which suggests that the SFL factor is a member of the HGF/SF family and may be involved in tumor progression.

Creation of an hepatocyte growth factor/scatter factor autocrine loop in carcinoma cells induces invasive properties associated with increased tumorigenicity

Exogenous HGF/SF converts subconfluent cultures of NBT-II epithelial carcinoma cells into mobile fibroblast-like cells while being only mitogenic for cells maintained at high density. To investigate the potential role of such factor in tumor progression, we generated HGF/SF-producing NBT-II cells by transfection with an expression plasmid containing human HGF/SF cDNA. HGF/SF-producing cells also exhibit a fibroblastic phenotype. Media conditioned by these cells are potent inducers of in vitro tubulogenesis which can be inhibited with specific anti-HGF/SF antibodies; these antibodies are also able to reverse the scattered phenotype of the HGF/SF-producing cells. In addition spheroids of HGF/SF-producing cells are dispersed into 3D collagen gels suggesting an increase of invasive properties of these cells. When injected in nude mice, these HGF/SF-producing cells induce tumors appearing more rapidly than did those obtained with untransfected cells. These results show that HGF/SF can promote motility and invasive properties of NBT-II bladder carcinoma cells and also confers a tumorigenic advantage when acting as an autocrine factor.

A minority of carcinoma cells producing acidic fibroblast growth factor induces a community effect for tumor progression

It is generally accepted that primary tumors become heterogeneous as a consequence of tumor-cell genetic instability. Clonal dominance has been shown to occur in some experimental models allowing a subpopulation of cells to overgrow the primary heterogeneous tumor and to metastasize. Alternatively, interactions among coexisting tumor subpopulations may contribute to the emergence of a malignant invasive primary solid tumor. We asked the question whether emergence of carcinoma cells producing a growth/dissociating factor within a tumor cell population may be a determinant for tumor progression and for clonal dominance. To mimic such a situation, we have investigated the impact of tumor subpopulation heterogeneity in an in vivo model in which mixtures of carcinoma cells that differ in their ability to produce acidic fibroblast growth factor are injected into nude mice. Our data indicate that a growth-factor-producing cell subpopulation can confer increased tumorigenicity to an entire cell population and subsequently elicit a shorter delay for appearance of metastasis. A community effect via cell interactions may account for a heterogeneous tumor cell population rather than clonal dominance during progression of certain tumor types.

Secreted or nonsecreted forms of acidic fibroblast growth factor produced by transfected epithelial cells influence cell morphology, motility, and invasive potential

Addition of exogenous acidic fibroblast growth factor (aFGF) to NBT-II epithelial carcinoma cells results in fibroblastic transformation and cell motility. We have generated aFGF-producing NBT-II cells by transfection with recombinant expression vectors containing human aFGF cDNA, or the human aFGF cDNA coupled to a signal peptide (SP) sequence. The effects of the nonsecreted and the secreted 16-kDa growth factor on the morphology, motility, and cell invasive potential (gelatinase activity) were compared. aFGF coupled to a SP was actively secreted out of the producing cells. The secretion of aFGF was not necessary for induction of gelatinase activity, as this was observed in NBT-II cells producing aFGF with or without SP. Production of aFGF, whether secreted or not secreted, resulted in increased in vitro motility of most isolated clones; however, there was no correlation between aFGF level and motility rate. The data suggest that expression of aFGF in NBT-II cells induces metastatic potential through an autocrine or intracrine mechanism.

Expression of transfected transforming growth factor alpha induces a motile fibroblast-like phenotype with extracellular matrix-degrading potential in a rat bladder carcinoma cell line

Acquisition of cell motility is often correlated with the malignant progression of a transformed cell. To investigate some of the mechanisms involved in the development of a migratory state, we transfected the NBTII rat carcinoma cell line, which forms stationary epithelial clusters in culture, with the gene encoding human transforming growth factor alpha (TGF alpha). Expression of TGF alpha in NBTII cells resulted in cells of motile and vimentin-positive phenotype with internalized desmosomal components, analogous to the treatment of cells with exogenous TGF alpha. The clones expressed a 5.2-kb TGF alpha message and synthesized an 18-kDa form of TGF alpha. Supernatants of TGF alpha-producing clones induced the internalization of desmosomal components, the production of vimentin, and increased motility in untransfected epithelial NBTII cells, indicating that the factor produced by the clones was in a biologically active form. TGF alpha-producing clones secreted significant levels of a 95-kDa gelatinolytic metal-loproteinase, virtually absent in untransfected cell supernatants. In contrast, levels of inhibitors of metalloproteinases and of a plasminogen activator were similar in untransfected and TGF alpha-transfected NBTII cells. These results suggest that expression of TGF alpha in an epithelial tumor cell results in the development of a motile, fibroblast-like phenotype with matrix-degrading potential, which could result in a more aggressive tumor in vivo.

[Modulation of epithelial differentiation of cultured rat bladder carcinoma]

Epithelium-to-mesenchyme transformation plays a key role in tissue remodelling in embryos since it allows cells from the primitive epithelia to migrate to other sites where they participate in the formation of new structures. A similar phenomenon may be involved in the detachment of malignant cells from neighboring primary tumor cells, which is a prerequisite to the invasion of neighboring tissues or the development of metastases. To test this hypothesis, an in vitro model using a rat bladder carcinoma cell line was developed. Cells exhibited epithelial features under standard culture conditions. After exposure to a soluble inducer (acidic FGF) or the specific extracellular matrix components (collagens), the cells acquired a fibroblastic phenotype, separated from one another, and started to move freely on the substrate. Inducers were found to act synergistically on the fibroblastic transformation of carcinoma cells and to promote the penetration of these cells into collagen gels.

In vivo and in vitro biological effects of the flame retardants tris(2,3-dibromopropyl) phosphate and tris(2-chlorethyl)orthophosphate

Tris(2,3-dibromopropyl)phosphate (Tris-BP) and Tris(2-chloroethyl) orthophosphate (Genomoll P) were analyzed for mutagenic and carcinogenic activity in several in vitro and in vivo mammalian systems. In the in vitro tests both Tris-BP and Genomoll P increased sister chromatid exchanges in V79 cells with a dose-response relationship for Tris-BP. The mutation assays using the same cells (HGPRT locus) were negative. Both compounds showed positive results in the transformation of Syrian hamster embryo cells. A very low frequency of transformation in the C3H10T1/2 cells was obtained; we consider this result essentially negative. In the in vivo assays Tris-BP gave positive and Genomoll P questionable results in the micronucleus test performed on Chinese hamsters. Both gave negative results in short-term skin tests. In the long-term skin tests, Tris-BP showed an initiating activity which was not observed with Genomoll P. When they were used as promoters both chemicals increased the incidence of lung adenomas in mice. Comparatively, Genomoll P is far less hazardous than Tris-BP.