RESUMO
Adeno-associated viral vector 9 (AAV9) has recently been shown to penetrate the blood-brain barrier via intravascular administration, making it a good candidate for diffuse gene delivery. However, the potential side effects of systemic delivery are unknown. Intrathecal viral vector administration may be more invasive than intravenous injections, but it requires far less vector and it can be performed on an outpatient basis, making it an ideal route of delivery for clinical translation. A total of 12 domestic farm pigs (<20 kg) underwent a single-level lumbar laminectomy with intrathecal catheter placement for AAV9 delivery. Animals were perfused and the tissue was harvested 30 days after treatment. Gene expression was assessed by anti-green fluorescent protein immunohistochemistry. Although a single lumbar injection resulted in gene expression limited to the lumbar segment of the spinal cord, three consecutive boluses via a temporary catheter resulted in diffuse transduction of motor neurons (MNs) throughout the cervical, thoracic and lumbar spinal cords. We now present the first successful robust transduction of MNs in the spinal cord of a large animal via intrathecal gene delivery using a self-complementary AAV9. These promising results can be translated to many MN diseases requiring diffuse gene delivery.
Assuntos
Dependovirus/genética , Técnicas de Transferência de Genes , Neurônios Motores/metabolismo , Medula Espinal/citologia , Suínos , Transdução Genética , Animais , Vetores GenéticosRESUMO
Hemgn (a gene symbol for hemogen in mouse, EDAG in human and RP59 in rat) encodes a nuclear protein that is highly expressed in hematopoietic tissues and acute leukemia. To characterize its regulatory mechanisms, we examined the activities of a Hemgn promoter containing 2975 bp of 5' flanking sequence and 196 bp of 5' untranslated region (5' UTR) sequence both in vitro and in vivo: this promoter is preferentially activated in a hematopoietic cell line, not in nonhematopoietic cell lines, and is sufficient to drive the transcription of a lacZ transgene in hematopoietic tissues in transgenic mice. Mutagenesis analyses showed that the 5' UTR including two highly conserved GATA boxes is critical for the promoter activity. GATA1, not GATA2, binds to the GATA binding sites and transactivates the Hemgn promoter in a dose-dependent manner. Furthermore, the expression of human hemogen (EDAG) transcripts were closely correlated with levels of GATA1 transcripts in primary acute myeloid leukemia specimens. This study suggests that the Hemgn promoter contains critical regulatory elements for its transcription in hematopoietic tissues and Hemgn is a direct target of GATA1 in leukemia cells.
Assuntos
Células da Medula Óssea/metabolismo , Fator de Transcrição GATA1/fisiologia , Regulação Leucêmica da Expressão Gênica , Leucemia Mieloide Aguda/genética , Proteínas Nucleares/genética , Regiões Promotoras Genéticas , Transcrição Gênica , Regiões 5' não Traduzidas , Animais , Sequência de Bases , Linhagem Celular Tumoral , Criança , DNA , Humanos , Leucemia Mieloide Aguda/patologia , Camundongos , Camundongos Transgênicos , Dados de Sequência Molecular , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Neoplastic transformation of rat liver cells in vitro by DNA-mediated gene transfer with an oncogene, hhcM, derived from human (Mahlavu) hepatocellular carcinoma, is described and compared with that of NIH3T3 cells. hhcM was cloned in a neomycin-resistant simian virus 40 promoter vector (pNeor/S) and was designated pNrpM-1. BRL-1 or NIH3T3 cells, transfected with pNrpM-1 DNA, showed significant morphological changes, loss of contact inhibition, and anchorage-independent growth. They became highly tumorigenic in nude rats and nu/nu mice. Control BRL-1 and NIH3T3 cells, whether transfected with pNeor/S DNA or not, remained contact inhibited and nontumorigenic. Both the transformants and the tumor cells contained integrated hhcM DNA as shown by Southern blot hybridization. The complete nucleotide sequence of the hhcM 3.0-kilobase DNA was also determined, and it consisted of a possible open reading frame for a protein of 52 kilodaltons (467 amino acids). The high-level production of a slightly modified form of this 52-kilodalton protein in a bacterial expression system has been successfully achieved. The bacteria-produced protein was similar in electrophoretic behavior to the 52- to 53-kilodalton protein synthesized in a cell-free translation system using rabbit reticulocyte lysate programmed with hybrid-selected hhcM-specific mRNA from Mahlavu hepatocellular carcinoma cells.
Assuntos
Carcinoma Hepatocelular/genética , Transformação Celular Neoplásica , DNA de Neoplasias/análise , Neoplasias Hepáticas/genética , Fígado/patologia , Proteínas de Neoplasias/biossíntese , Transfecção , Animais , Sequência de Bases , Resistência Microbiana a Medicamentos , Fibroblastos/patologia , Humanos , Dados de Sequência Molecular , Neomicina/farmacologia , RatosRESUMO
The significantly higher event-free survival rates of Down syndrome (DS) children with acute myeloid leukemia compared with non-DS children is linked to increased sensitivity of DS myeloblasts to 1-beta-D-arabinofuranosylcytosine (ara-C) and the enhanced metabolism of ara-C to ara-C triphosphate (J. W. Taub et al., Blood, 87: 3395-3403, 1996). The cystathionine-beta-synthase (CBS) gene (localized to chromosome 21q22.3) may have downstream effects on reduced folate and S-adenosylmethionine pathways; ara-C metabolism and folate pools are linked by the known synergistic effect of sequential methotrexate and ara-C therapy. We have shown that relative CBS transcripts were significantly higher in DS compared with non-DS myeloblasts, and CBS transcript levels correlated with in vitro ara-C sensitivity (J. W. Taub et al., Blood, 94: 1393-1400, 1999). A leukemia cell line model to study the relationship of the CBS gene and ara-C metabolism/sensitivity was developed by transfecting CBS-null CCRF-CEM cells with the CBS cDNA. CBS-transfected cells were a median 15-fold more sensitive in vitro to ara-C compared with wild-type cells and generated 8.5-fold higher [3H]ara-C triphosphate levels after in vitro incubation with [3H]ara-C. Severe combined immunodeficient mice implanted with CBS-transfected CEM cells demonstrated greater responsiveness to therapy, reflected in significantly prolonged survivals after ara-C administration compared with mice implanted with wild-type cells and treated with the same dosage schedule. The transfected cells also demonstrated increased in vitro and in vivo sensitivity to gemcitabine. Deoxycytidine kinase (dCK) activity was approximately 22-fold higher in transfected CEM cells compared with wild-type cells. However, levels of dCK transcripts on Northern blots and protein levels on Western blots were nearly identical between CBS-transfected and wild-type cells. Collectively, these results suggest a posttranscriptional regulation of dCK in CBS-overexpressing cells that contributes to increased ara-C phosphorylation and drug activity. Further elucidating the mechanisms of increased sensitivity of DS cells to ara-C related to the CBS gene may lead to the application of these novel approaches to acute myeloid leukemia therapy for non-DS patients.
Assuntos
Antimetabólitos Antineoplásicos/farmacologia , Cistationina beta-Sintase/genética , Citarabina/farmacologia , DNA Complementar/genética , Síndrome de Down/complicações , Leucemia Experimental/enzimologia , Animais , Antimetabólitos Antineoplásicos/metabolismo , Cromossomos Humanos Par 21/genética , Cistationina beta-Sintase/biossíntese , Cistationina beta-Sintase/metabolismo , Citarabina/metabolismo , Desoxicitidina Quinase/metabolismo , Síndrome de Down/enzimologia , Síndrome de Down/genética , Feminino , Expressão Gênica , Humanos , Leucemia Experimental/tratamento farmacológico , Leucemia Experimental/genética , Masculino , Camundongos , Camundongos Endogâmicos ICR , Camundongos SCID , Transfecção , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
Several related human transforming DNA sequences, hhc, and a putative normal liver homologue, c-hhc, have been molecularly cloned from the genomic DNAs of individual African and Asian hepatomas and from normal liver respectively. hhcM (Mahlavu) and hhcK3 (Korean), but not c-hhc, transformed NIH3T3 cells in DNA-mediated gene transfer assays. Transformed cells were found tumorigenic in athymic NIH Swiss nu/nu mice. In view of recent epidemiological studies implicating hepatitis B virus (HBV) infection early in life as causative for the eventual development of primary hepatocellular carcinoma in humans in Southeast Asia, the Far-East, and certain areas of Africa, we hereby analyzed the relationship between these hhcs and HBV in a survey of 20 hepatomas for DNA sequences homologous to hhcM and HBV by sequential hybridizations against [32p]hhcM and [32p]HBV probes. hhcM related DNA sequence were found highly amplified in 80% of the 20 hepatomas but HBV DNA sequence was rare or low. hhcM lends itself as a marker for human hepatomas. However, overall results indicated that patients with integrated HBV DNA sequences showed high copy number of hhcM sequence. Furthermore, EcoR1-restricted hepatoma DNAs showed that HBV and hhcM DNA sequences resided at different fragments in hepatomas. Our results suggest that HBV contributes to hepatocarcinogenesis probably via an activation mechanism involving possibly an integration or transient interaction of HBV DNA with hepatocyte DNA sequences, leading to recombination and eventual amplifications of the hhcM sequence in Mahlavu.
Assuntos
Carcinoma Hepatocelular/genética , DNA de Neoplasias/análise , DNA Viral/análise , Vírus da Hepatite B/genética , Neoplasias Hepáticas/genética , Oncogenes , Animais , Carcinoma Hepatocelular/etiologia , Transformação Celular Neoplásica/etiologia , Transformação Celular Viral , Sondas de DNA , Amplificação de Genes , Regulação da Expressão Gênica , Hepatite B/complicações , Humanos , Fígado/análise , Neoplasias Hepáticas/etiologia , Camundongos , Recombinação GenéticaRESUMO
Resistance to the antifolate methotrexate (MTX) can cause treatment failure in childhood acute lymphoblastic leukemia (ALL). This may result from defective MTX accumulation due to alterations in the human reduced folate carrier (hRFC) gene. We have identified an hRFC gene point mutation in a transport-defective CCRF-CEM human T-ALL cell line resulting in a lysine to glutamic acid substitution at codon 45 (E45K), which has been identified in other antifolate-resistant sublines (JBC 273:30 189, 1998; JBC 275:30 855, 2000). To characterize the role of this mutation in MTX resistance, transfection experiments were performed using hRFC-null CCRF-CEM cells. E45K transfectants demonstrated an initial rate of MTX influx that was approximately 0.5-fold that of CCRF-CEM cells, despite marked protein overexpression. Cytotoxicity studies revealed partial reversal of MTX and raltitrexed resistance in E45K transfectants, while trimetrexate resistance was significantly increased. Kinetic analysis indicated only minor differences in MTX kinetics between wild-type and E45K hRFCs, however, K(i)s for folic acid and 5-formyltetrahydrofolate were markedly reduced for E45K hRFC. This was paralleled by increased folic acid transport and reduced synthesis of MTX polyglutamates. Collectively, the results demonstrate that expression of E45K hRFC leads to increased MTX resistance due to decreased membrane transport and, secondarily, from alterations in binding affinities and transport of folate substrates. However, despite these findings, we could find no evidence of this mutation in 121 childhood ALL samples, suggesting that it does not contribute to clinical MTX resistance in this disease.
Assuntos
Antimetabólitos Antineoplásicos/farmacocinética , Proteínas de Transporte/genética , Resistencia a Medicamentos Antineoplásicos/genética , Leucemia/tratamento farmacológico , Proteínas de Membrana Transportadoras , Metotrexato/farmacocinética , Mutação Puntual , Substituição de Aminoácidos , Células da Medula Óssea/patologia , Proteínas de Transporte/fisiologia , Criança , Ácido Fólico/farmacocinética , Humanos , Cinética , Leucemia/genética , Leucemia/patologia , Estrutura Terciária de Proteína , Proteína Carregadora de Folato Reduzido , Transfecção , Células Tumorais CultivadasRESUMO
The presence of sequence variants in the human reduced folate carrier (hRFC) was assessed in leukemia blasts from children with acute lymphoblastic leukemia (ALL) and in normal peripheral blood specimens. A CATG frame shift insertion at position 191 was detected in 10-60% of hRFC transcripts from 10 of 16 ALL specimens, by RFLP analysis and direct sequencing of hRFC cDNAs. In genomic DNAs prepared from 105 leukemia (n = 54) and non-leukemia (n = 51) specimens, PCR amplifications and direct sequencing of exon 3 identified a high-frequency G to A single nucleotide polymorphism at position 80 that resulted in a change of arginine-27 to histidine-27. The allelic frequencies of G/A80 were nearly identical for the non-leukemia (42.2% CGC and 57.8% CAC) and leukemia (40.7% CGC and 59.3% CAC) genomic DNAs. In cDNAs prepared from 10 of these ALL patients, identical allelic frequencies (40 and 60%, respectively) were recorded. In up to 62 genomic DNAs, hRFC-coding exons 4-7 were PCR-amplified and sequenced. A high-abundance C/T696 polymorphism was detected with nearly identical frequencies for both alleles, and a heterozygous C/A1242 sequence variant was identified in two ALL specimens. Both C/T696 and C/A1242 were phenotypically silent. In transport assays with [(3)H]methotrexate and [(3)H]5-formyl tetrahydrofolate, nearly identical uptake rates were measured for the arginine-27- and histidine-27-hRFC proteins expressed in transport-impaired K562 cells. Although there were no significant differences between the kinetic parameters for methotrexate transport for the hRFC forms, minor (approximately 2-fold) differences were measured in the K(i)s for other substrates including Tomudex, 5,10-dideazatetrahydrofolate, GW1843U89, and 10-ethyl-10-deazaaminopterin and for 5-formyl tetrahydrofolate.
Assuntos
Proteínas de Transporte/genética , Proteínas de Membrana Transportadoras , Polimorfismo de Nucleotídeo Único , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Substituição de Aminoácidos , Linfócitos B/metabolismo , Sequência de Bases , Transporte Biológico/genética , Criança , Análise Mutacional de DNA , DNA Complementar/química , DNA Complementar/genética , DNA de Neoplasias/química , DNA de Neoplasias/genética , Frequência do Gene , Humanos , Células K562 , Metotrexato/farmacocinética , Mutagênese Insercional , Plasmídeos/genética , Mutação Puntual , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , RNA Neoplásico/genética , RNA Neoplásico/metabolismo , Proteína Carregadora de Folato Reduzido , Células-Tronco/metabolismo , TransfecçãoRESUMO
Reduced folate carrier (RFC) transcripts in human leukemias were measured by a competitive PCR assay. Total RNAs were reverse transcribed and amplified in the presence of competitive templates for RFC and beta-actin. RFC transcripts were normalized to transcripts for beta-actin. In a series of K562 sublines, a approximately 30-fold range of RFC transcripts measured by PCR assay closely agreed with results of Northern analysis and varied in proportion to RFC protein on Western blots and [3H]methotrexate transport. RFC transcripts varied over a 88-fold range in 49 specimens from 48 children with acute lymphoblastic leukemia (ALL). Median RFC transcripts were similar for 15 T-cell and 33 B-precursor ALL samples (RFC/beta-actin = 6.13 x 10(-3) and 7.92 x 10(-3), respectively) and for 41 diagnostic (7.20 x 10(-3)) and 8 relapse (5.58 x 10(-3)) samples. Whereas PCR measurements of RFC transcripts approximated changes in methotrexate transport in B-precursor ALL blasts (n = 10), for T-ALL blasts (n = 12) there was no apparent relationship between these parameters. For hyperdiploid B-precursor blasts (n = 11) with greater than 52 chromosomes and three to five copies of chromosome 21, the median RFC transcript level was approximately 3-fold higher than that for diploid B-precursor blasts. RFC transcripts were also elevated for two of three B-precursor specimens with acquired trisomy 21. Our results suggest that RFC gene expression is far more predictive of methotrexate uptake capacity in B-precursor than T-ALL and that increased copies of chromosome 21 in B-precursor ALL blasts are generally associated with increased RFC transcripts. Hence, the good prognosis for children with hyperdiploid B-precursor ALL treated with antimetabolite-based chemotherapy and the high levels of methotrexate and methotrexate polyglutamates accumulated may, in part, reflect elevated RFC gene expression and capacities for methotrexate transport.
Assuntos
Proteínas de Transporte/biossíntese , Proteínas de Membrana , Proteínas de Membrana Transportadoras , Ploidias , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Adolescente , Sequência de Aminoácidos , Antimetabólitos Antineoplásicos/farmacocinética , Proteínas de Transporte/genética , Criança , Pré-Escolar , Feminino , Expressão Gênica , Humanos , Imunofenotipagem , Lactente , Células K562/metabolismo , Células K562/patologia , Leucemia de Células T/genética , Leucemia de Células T/metabolismo , Leucemia de Células T/patologia , Masculino , Metotrexato/farmacocinética , Dados de Sequência Molecular , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras B/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras B/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Proteína Carregadora de Folato Reduzido , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Trítio , Células Tumorais CultivadasRESUMO
To test the hypothesis that young depressed patients have prolonged rather than shortened sleep, 14 depressed patients aged 17-25 and age-matched normal control subjects were allowed to sleep as long as they wanted. All subjects increased their sleep over baseline values, but the extended sleep period of the depressed patients was almost twice as long as that of the control subjects. The distribution of sleep stages in the extended period did not differ. The depressed patients had changes in the length of REM periods similar to those of older subjects. The findings suggest an interaction between age, sleep, and depression.
Assuntos
Transtorno Depressivo/complicações , Distúrbios do Sono por Sonolência Excessiva/complicações , Transtornos do Sono-Vigília/complicações , Adolescente , Adulto , Fatores Etários , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Distúrbios do Sono por Sonolência Excessiva/fisiopatologia , Distúrbios do Sono por Sonolência Excessiva/psicologia , Eletroencefalografia , Humanos , Inventário de Personalidade , Sono/fisiologia , Sono REM/fisiologiaRESUMO
In 1998, over two-thirds of children diagnosed with cancer will be cured of their disease. This has been accomplished by improvements in understanding the biology of the various forms of cancer and stratifying protocol-based therapies (surgery, radiotherapy and chemotherapy) based on predicted treatment outcome and risk of treatment failure. The excellent prognosis of subgroups of malignancies, including acute lymphoblastic leukaemia, Hodgkin's disease, non-Hodgkin's lymphoma and Wilms' tumour, has led to the modification of therapies to decrease or minimise long term adverse effects which may have a significant impact on the quality of life of survivors. The lessons learned from the treatment of paediatric cancer may lead to improvements in the treatment of adult cancers.
Assuntos
Neoplasias/mortalidade , Neoplasias/terapia , Neoplasias Encefálicas/terapia , Criança , Pré-Escolar , Doença de Hodgkin/terapia , Humanos , Leucemia/terapia , Neoplasias/diagnóstico , Neuroblastoma/terapia , Prognóstico , Retinoblastoma/terapia , Rabdomiossarcoma/terapia , Sarcoma de Ewing/terapia , Tumor de Wilms/terapiaRESUMO
The binding of aflatoxin B1, AFB1, a potent hepatocarcinogen, to various high molecular weight (HMW) DNAs from human normal liver and two liver cancer cell lines, Alexander primary liver carcinoma (PLC) and Mahlavu hepatocellular carcinoma (hHC) and from NIH/3T3 cell have been investigated. The kinetics of AFB1 binding to these DNAs showed similar initial rates but the extents of binding to the PLC and hHC DNAs seemed to be slightly higher. Preferential AFB1 bindings were identified in both PLC and hHC DNAs compared to normal liver DNA when analyzed by restriction endonuclease digestions and agarose gel electrophoresis. A critical AFB1 binding dosage, ranging 100 to 460 fmole/microgram DNA, was found to activate the carcinogenic effect of the Mahlavu hHC HMW DNA, but not normal liver HMW DNA, rendering it capable of inducing focal transformation in NIH/3T3 cell. Excessive AFB1 binding on the hHC and PLC HMW DNAs resulted in an "over-kill" of both cell transformation capability and templating activity of the DNA.
Assuntos
Aflatoxinas/metabolismo , Carcinógenos/metabolismo , Transformação Celular Neoplásica , DNA/metabolismo , Proto-Oncogenes , Aflatoxina B1 , Aflatoxinas/toxicidade , Animais , DNA/genética , Enzimas de Restrição do DNA , DNA Polimerase Dirigida por DNA/metabolismo , Relação Dose-Resposta a Droga , Humanos , Cinética , Fígado/metabolismo , Camundongos , Camundongos Endogâmicos , Peso Molecular , Hibridização de Ácido Nucleico , Biossíntese de Proteínas , Proto-Oncogene MasRESUMO
Prevention of ventricular fibrillation after aortic unclamping using lidocaine hydrochloride as an additive to cold potassium blood cardioplegia was studied prospectively in 46 patients undergoing elective myocardial revascularization. Patients were similar with respect to age, ventricular function, severity of coronary artery disease, cross-clamp time, completeness of revascularization, frequency of internal thoracic artery grafting, systemic temperature at the time of cross-clamp removal, and mean infusate volume and temperature. Patients receiving lidocaine blood cardioplegia (group 1, 23 patients) had a significant reduction in the incidence of ventricular fibrillation (22% versus 74%; p less than 0.0005) and in the mean number of cardioversion attempts required to defibrillate the heart (0.5 +/- 1.3 versus 1.9 +/- 0.97; p less than 0.0005) after cross-clamp removal compared with controls (group 2, 23 patients). There were no differences between the two groups postoperatively with regard to cardiac enzyme release, hemodynamic measurements, or clinical outcome. Patients receiving lidocaine blood cardioplegia tended to have a lower incidence of new postoperative atrial fibrillation (9% versus 26%). Ventricular function was preserved equally in both groups. We conclude that lidocaine is a safe additive to potassium blood cardioplegia and significantly reduces the incidence of ventricular fibrillation after aortic unclamping.
Assuntos
Soluções Cardioplégicas , Lidocaína , Revascularização Miocárdica/métodos , Fibrilação Ventricular/prevenção & controle , Idoso , Temperatura Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Revascularização Miocárdica/efeitos adversos , Potássio/sangue , Estudos Prospectivos , Infecção da Ferida Cirúrgica/etiologiaRESUMO
Impressive gains have been made in the therapy of childhood acute lymphoblastic leukemia (ALL) in recent years such that remissions today are commonly achieved in up to 95% of patients and long term disease-free survival rates approach 70%. Methotrexate is a key component in ALL consolidation and maintenance therapies and is administered intrathecally in the prophylaxis and treatment of central nervous system leukemia. Critical determinants of methotrexate sensitivity and resistance (dihydrofolate reductase levels, methotrexate membrane transport, methotrexate polyglutamylation) previously described in cultured cells have recently been identified in lymphoblasts from children with ALL. Heterogenous expressions of increased dihydrofolate reductase or impaired methotrexate transport can be detected in both diagnostic and relapsed ALL specimens by flow cytometry with fluorescent methotrexate analogues. Lymphoblasts from children with ALL synthesize long chain polyglutamates and correlations have been established between the accumulation of methotrexate polyglutamates in ALL blasts and characteristic patient prognostic features. Variations in methotrexate polyglutamate accumulation may reflect changes in polyglutamate synthetic or degradative enzymes, or may be secondary to changes in methotrexate influx or dihydrofolate reductase levels. Other critical elements in treatment response to methotrexate include the dose and route of methotrexate administration, its catabolism to 7-hydroxymethotrexate, and the rate of methotrexate plasma clearance. A unique relationship exists between chromosome 21 and ALL leukemogenesis, and response to treatment including methotrexate. A better understanding of the molecular bases of methotrexate response and the development of methotrexate resistance in childhood ALL should facilitate further improvements in the effectiveness of methotrexate-based chemotherapy for this disease.
Assuntos
Antimetabólitos Antineoplásicos/farmacocinética , Proteínas de Membrana , Proteínas de Membrana Transportadoras , Metotrexato/farmacocinética , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Adulto , Antimetabólitos Antineoplásicos/uso terapêutico , Transporte Biológico , Biotransformação , Proteínas de Transporte/metabolismo , Criança , Cromossomos Humanos Par 21/genética , Suscetibilidade a Doenças , Intervalo Livre de Doença , Síndrome de Down/complicações , Resistencia a Medicamentos Antineoplásicos , Antagonistas do Ácido Fólico/farmacocinética , Antagonistas do Ácido Fólico/uso terapêutico , Meia-Vida , Humanos , Metotrexato/uso terapêutico , Proteínas de Neoplasias/metabolismo , Células-Tronco Neoplásicas/metabolismo , Ácido Poliglutâmico/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Prognóstico , Proteína Carregadora de Folato Reduzido , Indução de Remissão , Tetra-Hidrofolato Desidrogenase/metabolismoRESUMO
The improved outlook for children diagnosed today with acute lymphoblastic leukemia (ALL) over that 40 years ago is remarkable. With modern therapies and supportive care, complete remissions are achieved in up to 95% of patients and long-term disease-free survival rates approach 80%. Methotrexate is a key component in ALL consolidation and maintenance therapies and is administered intrathecally in the prophylaxis and treatment of central nervous system leukemia. Recent reports have significantly extended the results of preclinical studies of methotrexate response and resistance to patients with ALL. The application of new and sensitive molecular biology techniques makes it possible to study specific chromosomal and genetic alterations [t(12;21), hyperdiploidy, deletions or methylation of p15INK4B and p16INK4A] which potentially contribute to methotrexate response and resistance in childhood ALL. Studies of the relationships between genetic alterations and ALL progression, methotrexate pharmacology, and long term event-free-survivals may lead to the better identification of subgroups of patients who exhibit unique levels of sensitivity or resistance to chemotherapy including methotrexate. Further, by characterizing the roles of translocation-generated fusion genes (TEL-AML 1) and tumor suppressor genes (p15INK4B and p16INK4A) in treatment response, it may be possible to identify new and selective targets and/or treatment strategies for both children and adults with ALL who are refractory to current therapies.
Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Metotrexato/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Antimetabólitos Antineoplásicos/metabolismo , Criança , Progressão da Doença , Ácido Fólico/metabolismo , Humanos , Metotrexato/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Prognóstico , Recidiva , Fatores de RiscoRESUMO
The relative effects of extended sleep, reduced sleep, and shifts of habitual sleep time on subsequent performance and mood were studied. Ten healthy male university students who regularly sleep 9.5-10.5 hr were the subjects. Measurements were obtained from a 45-min auditory vigilance task, a 5-min experimenter-paced addition task and a mood adjective check list 30 min after awakening, at midday, and in the evening following five electroencephalographically recorded nights of sleep. The experimental treatments compromised at 9.5-10.5 hr habitual sleep condition and four conditions in which the regular sleep period was lengthened, reduced, delayed, and advanced by 3hr. Following each 3-hr altered condition of sleep there was an equivalent decline in vigilance performance and in subjective arousal as measured by the mood scales. Together with other recent evidence, the present results support the hypothesis that acute disruption of the 24-hr sleep-wakefulness cycle produces degradations in human performance largely independent of total sleep time.
Assuntos
Percepção Auditiva/fisiologia , Cognição/fisiologia , Emoções/fisiologia , Sono/fisiologia , Nível de Alerta/fisiologia , Ritmo Circadiano , Discriminação Psicológica , Eficiência/fisiologia , Humanos , Masculino , Tempo de Reação/fisiologia , Autoavaliação (Psicologia) , Privação do Sono , Fases do Sono/fisiologia , Sono REM/fisiologia , Fatores de Tempo , Vigília/fisiologiaRESUMO
EEG was recorded over left and right hemispheres at temporal leads (T3, T4) referred to the vertex (Cz) in 16 right-handed male subjects. Musical chords were presented randomly in monaural sequence, during a task which required a selective motor response to stimuli presented to one ear. The integrated amplitude of the 8-13 Hz alpha rhythm was measured when subjects listened passively. Under all conditions, a lower mean alpha amplitude was recorded over the right hemisphere than the left, regardless of which ear was stimulated. Alpha suppression over the right temporal area was accentuated when the performance task directed attention to the stimulus. Reaction time to left ear stimulation was shorter than that for the right ear. With monaural stimulus presentation behavioral asymmetry, and various EEG asymmetries can be observed. There is hemispheric asymmetry associated with attention to task relevant stimuli indicated by reduction in the alpha rhythm over the right temporal area and asymmetry in reaction time with greater efficiency of the left ear to muscial chords.
Assuntos
Percepção Auditiva/fisiologia , Eletroencefalografia , Lateralidade Funcional/fisiologia , Música , Tempo de Reação/fisiologia , Adulto , Atenção , Humanos , MasculinoRESUMO
Behavioral and psychophysiological correlates of irregularity in chronic sleep routines were studied. Two groups each of 18 healthy male university students were classified as either irregular sleepers or control subjects according to retrospective questionnaires, and sleep chart criteria. The control group was composed of persons who slept naturally from 12-8:00 a.m. for 7-8 hr. Irregular sleepers were defined as those whose retiring and awakening times varied by about 2-4 hr. Measurements were obtained from an auditory reaction time task, a mood adjective check list, of sublingual temperature and pulse rate 30 min. after awakening in the (a) morning, at (b) noon, in the (c) afternoon and (d) early evening following an electroencephalographically recorded 12-8:00 a.m. sleep night. At various points in the diurnal cycle irregular sleepers compared with the control group had significantly lower levels of pulse rate and body temperature, but significantly longer reaction times. During the four time periods negative affects (deactivation-sleep, depression, general deactivation, inert-fatigued) were significantly greater and positive mood states (cheerful, energetic, general activation--significantly less in the irregular sleepers. The irregular sleepers averaged significantly less stage 4, and REM, but more stage 2 and transitions between sleep stages. The present results indicate that relatively lowered levels of physiological arousal indexes, psychomotor performance and subjective mood are associated with irregularity in chronic sleep routines of young adult males. These psychobehavioral correlates of chronically maintained sleep pattern variations complement and extend previous findings on degradations in waking functions following acute 2-4 hr temporal shifts of habitual sleep periods. It is postulated that there were psychobehavioral deficits in the irregular sleepers attributable either to selective sleep stage (REM and/or stage 4) deprivation or to the more general consequence of disturbed sleeping patterns per se or to both of these factors.
Assuntos
Nível de Alerta/fisiologia , Percepção Auditiva/fisiologia , Emoções/fisiologia , Sono/fisiologia , Temperatura Corporal , Ritmo Circadiano , Humanos , Masculino , Psicofisiologia , Pulso Arterial , Tempo de Reação/fisiologia , Fases do Sono/fisiologia , Sono REM/fisiologia , Fatores de TempoRESUMO
The relationship between chronic differences in sleep duration and waking behaviors was explored by comparing two groups of 10 healthy male university students who regularly slept nocturnally for 7-8 h or for 9.5-10.5 h. Measurements were obtained of sublingual temperature, from a 45 min Wilkinson auditory vigilance task and a mood adjective check list 30 min after awakening in the morning, at midday ind in the early evening following an electroencephalographically recorded night of sleep. In both subject groups body temperature increased from morning to early evening, while misses on the vigilance task correspondingly declined during the day. The average daily level of oral temperature and performance were significantly lower in the 7-8 h (control) group than in the long sleepers. Positive mood states (Cheerful, Energetic, General Activation, High Activation) were significantly greater and negative affects (Anger-Hostility, Depression) significantly less in the long sleepers. As a result of the mean difference in total sleep time existing between groups control subjects averaged significantly less stage 2, and stage REM sleep. It was postulated that there were behavioral deficits in the control group attirbutable either to selective sleep stage deprivation or to the general consequence of reduced sleep per se or to both of these factors.
Assuntos
Temperatura Corporal , Emoções , Sono , Percepção Visual , Adolescente , Adulto , Ritmo Circadiano , Humanos , MMPI , Masculino , Tempo de Reação , Fases do Sono , Sono REM , Fatores de Tempo , VigíliaRESUMO
Electrographic (EEG) patterns of nocturnal sleep were investigated in young psychiatric patients during unipolar depressive episodes. EEG-sleep data was recorded in 20 non-psychotic depressed patients all under 26 years old individually matched with a normal control group. All 20 subjects slept in the laboratory for 1-3 consecutive baseline nights from 12-8:00 a.m. During a subsequent extended condition 14 in each group were allowed to sleep ad-lib. Although the mean total time asleep on baseline nights was about the same between groups (greater than 7.1 hr), the depressives had a statistically significant reduction in REM time, increased transitions into stage 1, but most especially averaged: (a) less stage 4; and (b) more stage 1. Compared with the prior eight-hour night 27/28 subjects among both groups exhibited elevated time asleep during the extended condition, but the patients' mean total 10.3 hr sleep was significantly greater by 1.5 hr than the controls (X = 8.8 hr). Sleep exceeding 9 hr on the ad-lib night was a consistent phenomenon which occurred in significantly more (11/14) young depressed patients contrasted to 4/14 control subjects. These findings indicate that young persons with primary affective disorders do not exhibit nocturnal EEG disturbances of comparable severity to most older depressed patients such as reduced time asleep, increased wakefulness or lowered slow-wave (stages 3 and 4) sleep. Although no direct evidence of symptomatic 'hypersomnia' in these patients was provided, the present results demonstrated that some young persons with clinical depression have the capacity to sleep for sustained periods.
Assuntos
Depressão/fisiopatologia , Sono/fisiologia , Adolescente , Adulto , Eletroencefalografia , Feminino , Humanos , Masculino , Fases do Sono/fisiologia , Sono REM/fisiologiaRESUMO
Fluctuations in physiological variables resulting from naps and the relationship of these to previously studies changes in performance and subjective activation associated with napping were examined. The subjects were eighteen healthy male university students who habitually slept 1/2-2 hr in the afternoon. Measurements were obtained of our physiological variables, from a continuous 10-min auditory reaction time task and two factors of an Activation. Deactivation Adjective Checklist 20 min before and after a control condition and two electroencephalographically recorded afternoons of sleep. The experimental conditions comprised a 2-hr period of wakefulness, a 1/2 hr nap from 4.35-5.05 p.m., and a 2-hr nap from 3.05-5.05 p.m. Following each sleep treatment, when compared with the control condition, there were statistically significant shifts of improved reaction time performance, and elevated activation as reflected by the two self-report scales, inceased EEG frequency, heart rate, and electrodermal responses. The shifts of increased behavioral efficiency, subjective and physiological activation were approximately equivalent in extent between 2-hr and 1/2-hr naps. These findings indicate that besides the previously reported facilitation by naps of performance and mood, physiological activation is increased following accustomed episodes of afternoon sleep.