Osteophyte growth in early thumb carpometacarpal osteoarthritis.

OBJECTIVE: Osteophyte formation is a critical part of the degeneration of a joint with osteoarthritis (OA). While often qualitatively described, few studies have succeeded in quantifying osteophyte growth over time. Using computed tomography (CT) image data from a longitudinal, observational study of thumb carpometacarpal (CMC) OA, our aim was to quantify osteophyte growth volume and location over a three-year period in men and women. METHOD: Ninety patients with early thumb OA were recruited and assessed at baseline, 1.5 years, and 3 years with CT imaging. Osteophyte volume and location on the trapezium and first metacarpal were determined using a library of 46 healthy subjects as a nonarthritic reference database. RESULTS: There was a significant increase in osteophyte volume for women and men over the three-year follow-up in the trapezium (86.8 mm3-120.5 mm3 and 165.1 mm3-235.3 mm3, means respectively) and in the proximal metacarpal (63 mm3-80.4 mm3, and 115.8 mm3-161.7 mm3, respectively). The location of osteophyte initiation and growth was consistent across subjects and was located in non-opposing regions on the trapezium and first metacarpal. Osteophyte growth occurred about the radial and ulnar margins of the trapezial facet, while on the proximal metacarpal, growth occurred principally about the volar and dorsal margins of the facet. CONCLUSION: Osteophyte growth occurred in early thumb osteoarthritis over three years. Growth was localized in specific, non-opposing regions on the trapezium and metacarpal, raising intriguing questions about the triggers for their formation, whether the mechanisms are mechanical, biological or a combination of both.

A cancer-associated, fast, homoarginine-sensitive electrophoretic form of serum alkaline phosphatase.

Serum from patients with a variety of cancers often (p = 70%) contains a characteristic electrophoretic form of alkaline phosphatase detectable by cellulose polyacetate electrophoresis. The lower prevalence of this electrophoretic form in presumably healthy individuals (p = 7%) and noncancer hospitalized patients (p = 30%) suggests that it may be useful as a diagnostic or monitory marker.

Clinical studies of a fast homoarginine-sensitive alkaline phosphatase in patients with cancer.

The activity of an isoenzyme of alkaline phosphatase (FHAP) was measured in serum samples obtained from 1692 individual subjects. The median FHAP concentration in patients with untreated or recurrent cancer (2.73 IU/liter) was two-fold higher than in hospitalized control patients with illnesses other than cancer (1.17 IU/liter) and three-fold higher than in healthy control subjects (0.93 IU/liter). Among patients with either breast or colorectal cancer who were clinically disease free following their initial therapy, the median FHAP concentration (1.54 IU/liter) was intermediate between the median FHAP concentration in patients with untreated or recurrent cancer and that of healthy control subjects. In order to illustrate the potential clinical application of FHAP as a diagnostic cancer marker, we have selected a serum FHAP concentration of 2.22 IU/liter as a reference value above which only 3% of healthy control subjects would have a "positive" test. Utilizing this reference value, 58% of the patients in the present study with untreated or recurrent cancer would have a positive FHAP test, whereas only 11%, of hospitalized patients with illnesses other than cancer would have a positive test. These data suggest that FHAP may be equivalent to the carcinoembryonic antigen as a diagnostic cancer marker.

A comparison of fast homoarginine-sensitive alkaline phosphatase and carcinoembryonic antigen as markers in colon carcinoma.

The diagnostic value of a recently described cancer marker, fast homoarginine-sensitive alkaline phosphatase ( FHAP ), was compared with the established marker, carcinoembryonic antigen (CEA), in the diagnosis of colon cancer. Comparisons were made with respect to sensitivity, specificity, predictive value of a positive result, and efficiency. An upper limit of normal of 2.1 units/L was assumed for FHAP , based on earlier studies. Two values for the upper limit of normal for CEA were tested: 2.5 ng/mL and 5.0 ng/mL. When 2.5 ng/mL was used as the upper limit of normal for CEA, FHAP was less sensitive, more specific, and had a higher predictive value. The diagnostic efficiency was not significantly different. When the upper limit of normal for CEA was set at 5.0 ng/mL, the two tests were roughly equal in sensitivity, specificity, predictive value, and diagnostic efficiency.

Immunochemical accessibility of ribosomal protein S4 in the 30 S ribosome. The interaction of S4 with S5 and S12.

The reactivity of protein S4-specific antibody preparations with 30 S ribosomal subunits and intermediates of in vitro subunit reconstitution has been characterized using a quantitative antibody binding assay. Anti-S4 antibody preparations did not react with native 30 S ribosomal subunits; however, they did react with various subunit assembly intermediates that lacked proteins S5 and S12. The inclusion of proteins S5 and S12 in reconstituted particles resulted in a large decrease in anti-S4 reactivity, and it was concluded that proteins S5 and S12 are primarily responsible for the masking of S4 antigenic determinants in the 30 S subunit. The effect of S5 and S12 on S4 accessibility is consistent with data from a variety of other approaches, suggesting that these proteins form a structural and functional domain in the small ribosomal subunit.

Crosslinking of phenylalanyl-tRNA to the ribosomal A site via a photoaffinity probe attached to the 4-thiouridine residue is exclusively to ribosomal protein S19.

Phe-tRNA of Escherichia coli, specifically derivatized at the S4U8 position with the 9 A long p-azidophenacyl photoaffinity probe, can be crosslinked to 30 S ribosomal protein when the tRNA is placed at the ribosomal A site. This protein has now been identified by immunological methods. The protein-[3H]Phe-tRNA covalent complex, obtained by extraction with 6 M-urea, was reacted separately with each of the 21 purified antisera to 30 S ribosomal proteins. The double antibody technique was used. Anti-S19 was the only antiserum able to precipitate the radioactivity, and 66 to 81% of the added radioactivity could be precipitated. The same result was obtained with three different ribosome preparations, at low as well as high crosslinking yield, with dipeptidyl-tRNA in the A site as well as aminoacyl-tRNA, and when binding and crosslinking were performed at 20 mM-Mg2+ instead of at 5 mM. Therefore, when aminoacyl-tRNA or peptidyl-tRNA is in the ribosomal A site, position 8, which is always uridine or 4-thiouridine, must be within 9 A of protein S19.

DNA-hybridization electron microscopy tertiary structure of 16 S rRNA.

Seven regions of 16 S rRNA have been located on the surface of the 30 S ribosomal subunit by DNA-hybridization electron microscopy. This information has been incorporated into a model for the tertiary structure of 16 S rRNA, accounting for approximately 40% of the total 16 S rRNA. A structure labeled the platform ring is proposed for a region of rRNA within the central domain. This structure rings the edges of the platform and includes regions 655-751 and 769-810. Another region, the recognition complex, consists of nucleotides 500 to 545, and occupies a region on the exterior surface of the subunit near the elongation factor Tu binding site. Ribosomal proteins that have been mapped by immunoelectron microscopy are superimposed onto the model in order to examine possible regions of interaction. Good correlation between the model locations of ribosomal proteins, and regions of rRNA protected by ribosomal proteins provide independent support for this model.

Mapping the three-dimensional locations of ribosomal RNA and proteins.

Seven regions of 16S rRNA have been located on the surface of the 30S ribosomal subunit by DNA hybridization electron microscopy in our laboratory. In addition, we have recently mapped the three-dimensional locations of an additional seven small ribosomal proteins by immunoelectron microscopy. The information from the direct mapping of the sites on rRNA has been incorporated into a model for the tertiary structure of 16S rRNA, accounting for approximately 40% of the total 16S rRNA. A novel structure, the platform ring, is proposed for a region of rRNA within the central domain. This structure rings the edges of the platform and includes regions 655-751 and 769-810. Another region, the recognition complex, consists of nucleotides 500-545, and occupies a region on the exterior surface of the subunit, near the EF-Tu binding site. In addition, 19 of the 21 small subunit ribosomal proteins have been mapped by immunoelectron microscopy in our laboratory. In order to evaluate the reliability of our model for the three-dimensional distribution of 16S rRNA, we have predicted which sites of rRNA are adjacent to ribosomal proteins and compared these predictions with r-protein protection studies of others. Good correlation between the model, the locations of rRNA sites, the locations of ribosomal proteins, and regions of rRNA protected by ribosomal proteins, provides independent support for this model.

Fluorescent EIA screening of monoclonal antibodies to cell surface antigens.

We have developed a sensitive enzyme immunoassay (EIA) that is useful for detecting antibodies directed against antigenic sites on the surface of mammalian cells. Approximately 100 antigen-bearing cells were trapped in the wells of 96-well Durapore membrane filter plates (Millititer GV plates, Millipore, Bedford, MA). Antibody binding was detected with alkaline phosphatase conjugated goat anti-mouse IgG + IgM. Conjugate alkaline phosphatase activity was detected with a fluorogenic substrate in the presence of levamisole, an inhibitor of endogenous cellular alkaline phosphatase using a Fluoroskan microtiter plate reader (Flow Laboratories). The method permits accurate and reproducible screening of hybridoma supernatants using a minimal number of antigen-bearing cells.

Use of protein-stained immunoblots for unequivocal identification of antibody specificities.

The unequivocal identification of immunochemically detected proteins on nitrocellulose blots requires precise alignment of the antibody-stained antigen spot with the protein-stained pattern. We report a method for the staining of proteins on nitrocellulose membranes immediately after electroblotting with Amido Black 10B under mild conditions which do not result in loss of antigenic activity. These membranes can then be probed with immunological detection reagents and the detected antigen correlated with the stained pattern. The procedure is simple, fast and particularly useful for the identification of antibody-labelled spots on blots of high-resolution two-dimensional gels.

Epitope characterization by modifications of antigens and by mapping on resin-bound peptides. Discriminating epitopes near the C-terminus and N-terminus of Escherichia coli ribosomal protein S13.

The feasibility of using antigen modifications and synthetic resin-bound peptides to distinguish closely related epitopes has been demonstrated in this report. Epitopes recognized by five monoclonal antibodies (MAbs) specific to Escherichia coli ribosomal protein S13 have been located near the C-terminus and N-terminus of the S13 molecule; these epitopes were characterized by modifications of antigens and by utilization of peptides of increasing length synthesized on aminomethyl crosslinked polystyrene resin. Three of these MAbs react with the C-terminal peptide S13(84-117) which has five Lys residues clustered within the last 16 amino acids. Phthalylation of Lys residues almost eliminated the binding of two MAbs and reduced binding of the third by 50%. Removal of the C-terminal Lys residue(s) at the S13 C-terminus with carboxypeptidase B has no effect on the binding of these three MAbs. A 23-residue peptide corresponding to S13(95-117) was synthesized by a modified Merrifield solid phase method. Samples of resin with peptides of increasing length were obtained after each cycle of amino acid coupling. The peptides were deprotected without hydrolysis of the peptide-resin linkage and used in an enzyme immunoassay to detect the extent of MAb interaction with the lengthening peptides. The epitopes recognized by the two MAbs more sensitive to Lys modification have been localized in S13(97-117). The third MAb binds to S13(98-117) but binds more strongly when the sequence is lengthened. Two MAbs directed toward the N-terminal 22 residues of S13 were similarly characterized. Binding of one MAb, little affected by phthalylation, required the N-terminal residue of S13 to be present in the synthetic peptide. The other MAb, whose binding was inhibited by phthalylation, bound to the synthetic S13(2-22) and bound more strongly to the synthetic S13(1-22).

Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation.

BACKGROUND: Thymoglobulin, a rabbit anti-human thymocyte globulin, was compared with Atgam, a horse anti-human thymocyte globulin for the treatment of acute rejection after renal transplantation. METHODS: A multicenter, double-blind, randomized trial with enrollment stratification based on standardized histology (Banff grading) was conducted. Subjects received 7-14 days of Thymoglobulin (1.5 mg/kg/ day) or Atgam (15 mg/kg/day). The primary end point was rejection reversal (return of serum creatinine level to or below the day 0 baseline value). RESULTS: A total of 163 patients were enrolled at 25 transplant centers in the United States. No differences in demographics or transplant characteristics were noted. Intent-to-treat analysis demonstrated that Thymoglobulin had a higher rejection reversal rate than Atgam (88% versus 76%, P=0.027, primary end point). Day 30 graft survival rates (Thymoglobulin 94% and Atgam 90%, P=0.17), day 30 serum creatinine levels as a percentage of baseline (Thymoglobulin 72% and Atgam 80%; P=0.43), and improvement in posttreatment biopsy results (Thymoglobulin 65% and Atgam 50%; P=0.15) were not statistically different. T-cell depletion was maintained more effectively with Thymoglobulin than Atgam both at the end of therapy (P=0.001) and at day 30 (P=0.016). Recurrent rejection, at 90 days after therapy, occurred less frequently with Thymoglobulin (17%) versus Atgam (36%) (P=0.011). A similar incidence of adverse events, post-therapy infections, and 1-year patient and graft survival rates were observed with both treatments. CONCLUSIONS: Thymoglobulin was found to be superior to Atgam in reversing acute rejection and preventing recurrent rejection after therapy in renal transplant recipients.

Immunological reactivity of monoclonal antibodies prepared against large ganglion cells from bovine retina.

This report describes the preparation of a highly specific reagent (monoclonal antibody) that reacts selectively with large ganglion cells of bovine retina. Other cells populations of bovine retina react weakly or not at all, but neurons in brain regions of ox other than retina also bind the immunoglobulins specifically. Species specificity was indicated by a weak reaction with cat and dog retinal neurons, and organ specificity was shown by lack of reaction with bovine liver. This highly specific reagent can be used to classify the subsets of large retinal ganglion cells on the basis of their antigenic properties and to identify neurons in different brains regions that share antigenic determinants.

Production and partial characterization of monoclonal antibodies to Bothrops asper (terciopelo) myotoxin.

Seven murine monoclonal antibodies against Bothrops asper myotoxin were produced and partially characterized. They revealed the presence of at least four cross-reacting basic components in crude venom, with a common subunit mol. wt of 16,000 by sodium dodecylsulfate-polyacrylamide gel electrophoresis, but slight differences in charge. These myotoxin-related components might be isoforms of the toxin. By Western blotting and enzyme-immunoassay binding techniques, differences in the reactivities with basic venom fractions were observed among monoclonal antibodies, suggesting differences in epitope specificities. Three antibodies cross-reacted with B. nummifer crude venom. Two monoclonal antibodies were utilized to develop a two-site enzyme-immunoassay for myotoxin detection at the nanogram level. Three of the antibodies (one IgM and two IgG1) showed ability to neutralize myotoxicity of purified myotoxin in preincubation type experiments.

[A brief review of recent achievements concerning biochemistry and physiology of prostaglandins in the eye]. / A prosztaglandinokkal kapcsolatos újabb eredmények rövid áttekintése a szem biokémiájának és élettanának vonatkozásában.

Two prostaglandin molecules have important physiological and pathophysiological role in the tissues of the eye. Prostaglandin F2 alpha takes part in mediating intraocular pressure, prostaglandin E2 is the mediator of inflammation. In case of increased intraocular pressure, latanoprost a derivative of prostaglandin F2 alpha can be applied. Numerous data are available on the favourable intraocular pressure lowering effect of latanoprost. It can be applied as a single hypotensive or it can be combined with eye-drops currently used in glaucoma. It exerts its therapeutic effect by increasing uveoscleral outflow. Inflammation in the eye can be diminished by nonsteroidal anti-inflammatory drugs similarly to inflammations in other tissues of the organism. Literature on nonsteroidal anti-inflammatory drugs is enormous. Molecules of different structures inhibit the synthesis of prostaglandins. Primarily they are useful anti-inflammatory agents, reduce intraocular pressure in secundary glaucoma, inhibit intraocular miosis and prevent development of cystoid macula oedema. Nonsteroidal anti-inflammatory drugs do not exert their effects on prostaglandins themselves, but inhibit their synthesis. Hence the use of both, latanoprost and nonsteroidal anti-inflammatory drugs simultaneously, improves safety of therapy in case of patients prone to uveitis.