Selective estrogen receptor modulator idoxifene inhibits smooth muscle cell proliferation, enhances reendothelialization, and inhibits neointimal formation in vivo after vascular injury.

BACKGROUND: Idoxifene (ID) is a tissue-selective estrogen receptor modulator (SERM). The pharmacological profile of ID in animal studies suggests that it behaves like an estrogen receptor (ER) agonist in bone and lipid metabolism while having negligible ER activity on the reproductive system. It is unknown whether ID retains the vascular protective effects of estrogen. METHODS AND RESULTS: In cultured vascular smooth muscle cells (VSMCs), ID inhibited platelet-derived growth factor-induced DNA synthesis and mitogenesis with IC(50) values of 20.4 and 27.5 nmol/L, respectively. Treatment with ID resulted in S-phase cell cycle arrest in serum-stimulated VSMCs. ID 1 to 100 nmol/L significantly protected endothelial cells from tumor necrosis factor-alpha (TNF-alpha)-induced apoptosis in vitro. Virgin Sprague-Dawley rats ovariectomized 1 week before the study were treated with ID (1 mg x kg(-1) x d(-1)) or vehicle by gavage for 3 days before balloon denudation in carotid artery. The SMC proliferation in injured vessels was determined by immunostaining for proliferating cell nuclear antigen (PCNA). The number of PCNA-positive SMCs was reduced by 69%, 82%, and 86% in the media at days 1, 3 and 7, respectively, and by 78% in the neointima at day 7 after injury in ID- versus vehicle-treated group (P:<0.01). ID significantly enhanced reendothelialization in the injured carotid arteries as determined by Evans blue stain and immunohistochemical analysis for von Willebrand factor. In the former assay, the reendothelialized area in injured vessels was 43% in ID-treated group versus 24% in the vehicle group (P:<0.05); in the latter assay, the numbers of von Willebrand factor-positive cells per cross section increased from 24. 8 (vehicle) to 60.5 (ID) (P:<0.01) at day 14 after injury. In addition, the production of nitric oxide from excised carotid arteries was significantly higher in ID-treated than the vehicle group (8.5 versus 2.7 nmol/g, P:<0.01). Finally, ID treatment reduced neointimal area and the ratio of intima to media by 45% and 40%, respectively (P:<0.01), at day 14 after balloon angioplasty. CONCLUSIONS: The results indicate that ID beneficially modulates the balloon denudation-induced vascular injury response. Inhibition of VSMC proliferation and acceleration of endothelial recovery likely mediate this protective effect of ID.

A novel method for chronic measurement of pleural pressure in conscious rats.

Pleural pressures are used to evaluate lung function and are generally measured acutely in anesthetized animals. Previous attempts to measure pleural pressure chronically in conscious animals have involved surgical implantation of pressure-sensitive catheters directly into the pleural cavity. The success of these techniques has been limited by lung damage and/or tissue growth and encapsulation of the pressure-sensitive catheter with damping or loss of the signal. These problems have been eliminated by developing a novel surgical procedure for placement of a pressure-sensitive catheter beneath the pleural surface. The catheter (attached to a radiotelemetry transmitter) is surgically implanted beneath the serosal layer of the esophagus within the thoracic cavity. This is accomplished by making a small incision in the serosal layer of the esophagus caudal to the diaphragm and advancing the catheter cranially into the thoracic cavity until pressure changes are maximal. The accuracy of these measurements was verified by comparison with direct pleural pressure measurements over the range of -3 to -34 cm H2O. The pleural pressure changes remained constant for at least 14 weeks following surgery, and there was no evidence of tissue damage or growth around the catheter. This novel method for measuring pleural pressure chronically in conscious rats will facilitate evaluation of the effects of drugs, environmental agents, or disease on respiratory function by allowing repeated and simultaneous measurements of both ventilatory (breathing) patterns and lung function in conscious animals.

Phagocytosis, killing, and oxidant production by bovine monocyte-derived macrophages upon exposure to Brucella abortus strain 2308.

Phagocytosis and intracellular survival of Brucella abortus, and oxidant production by monocyte-derived macrophages from ten B. abortus-naive cows were studied. Phagocytosis of bacteria opsonized with naive-autologous sera or reactor serum was significantly less than phagocytosis of bacteria opsonized with fetal bovine serum. After phagocytosis, intracellular survival of bacteria opsonized with naive-autologous or reactor sera was significantly less than survival of bacteria opsonized with fetal bovine serum. Production of oxidant by macrophages stimulated with B. abortus opsonized with naive-autologous, reactor, or fetal bovine sera was not significantly different. Although macrophages from one animal showed significantly less phagocytic activity, intracellular killing and oxidant production by macrophages from the ten individual cows toward B. abortus opsonized with naive-autologous, reactor, and fetal calf sera were homogeneous. The abilities of the macrophages to phagocytize and to kill B. abortus were not associated with each other or with oxidant production. Innate resistance or sensitivity to B. abortus was not identified in the cows based on macrophage function.

Clinical pathologic alterations associated with subcutaneous administration of recombinant human interleukin-4 to cynomolgus monkeys.

Recombinant human interleukin 4 (rhuIL-4) is a candidate for the treatment of refractory cancer based on its potential to enhance immune function. Recombinant human IL-4 was administered subcutaneously at 0, 1, 5, or 25 micrograms/kg/day for 28 days with a 14-day recovery to male and female cynomolgus monkeys as part of the preclinical safety evaluation. Clinical pathologic changes related to treatment with rhuIL-4 were evidence of consumptive coagulopathy, erythrocyte fragmentation, lymphocytosis, and lymphocyte morphologic changes indicative of marked antigenic or mitogenic stimulation, mild eosinophilia and neutrophilia, hypoalbuminemia, hypocholesterolemia, and hypertriglyceridemia. Based on data obtained after the 14-day recovery period, the clinical pathologic changes associated with rhuIL-4 administration were considered to be reversible.

Preclinical evaluation of recombinant human interleukin-4.

Recombinant human IL-4 (rhuIL-4) is primate-specific and produces multiple biologic effects on lymphoid cells involved in protection against cancer. RhuIL-4 was evaluated in the cynomolgus monkey to support clinical studies for the immunotherapy of cancer. Administration of rhuIL-4 to monkeys by SC injection of 0, 0.5, 2.5 or 12.5 micrograms/kg BID for one-month (with two-week recovery) resulted in alterations in clinical chemistry and hematology (CCH) parameters consistent with a consumptive coagulopathy. Histomorphologic evaluation revealed increased granulopoiesis, testicular atrophy, and proliferative and inflammatory vascular lesions (VL). IVL principally affected the arterial tree with some proliferation of medial smooth muscle. During the latter part of the treatment and recovery period. CCH parameters approached or returned to pretreatment values, the former finding attributed to the production of antibody to rhuIL-4. At final necropsy, bone marrow appeared normal, and IVL decreased in incidence and severity. ELISA studies of serum indicated 50-90% of the monkeys developed antibody titers > 1000 by Day 22 (not observed in man). The frequency and severity of adverse effects due to rhuIL-4 in the clinic appear to be does-related and reversible with few objective responses to therapy observed. Common toxicities included milk to moderated fever and fatigue and an occasional change in hematopoietic, hepatic and renal function. The monkey predicted hematologic findings, but not all target organ effects.

Comparison of oxidant production by bovine neutrophils and monocyte-derived macrophages stimulated with Brucella abortus strain 2308.

Oxidant production by bovine monocyte-derived macrophages and neutrophils was compared after stimulation with phorbol myristate acetate (PMA), opsonized zymosan (OZ), and B. abortus opsonized with naive-autologous, reactor, or fetal bovine sera. Neutrophils responded more rapidly to all stimuli and produced up to 100-fold greater oxidant than did equal numbers of bovine monocyte-derived macrophages. Macrophages and neutrophils stimulated with PMA, OZ, and reactor-opsonized B. abortus had higher mean oxidant production than phagocytes exposed to B. abortus opsonized with autologous sera, fetal bovine serum, or nonopsonized bacteria. Stimulation of macrophages by opsonized zymosan, buffer, and B. abortus opsonized with autologous sera, reactor serum, or fetal bovine serum resulted in low levels of oxidant production that were not significantly different. Only PMA caused a significantly higher level of oxidant production by macrophages.

Arthrotomy versus arthroscopy and partial synovectomy for treatment of experimentally induced infectious arthritis in horses.

To evaluate the clinical, laboratory, and histologic effects of 2 methods of treatment for infectious arthritis in horses, Staphylococcus aureus (3.4 to 3.9 x 10(3) colony-forming units) was inoculated into the tarsocrural joints of 8 horses on day 0. Each horse was treated with phenylbutazone (2 g, PO, q 24 h) and gentamicin sulfate (2.2 mg/kg of body weight, IV, q 8 h) for 14 days. On day 2, general anesthesia was induced, and each horse had 1 tarsocrural joint treated by arthrotomy, with removal of accessible fibrin and lavage with 3 L of sterile balanced electrolyte solution. An indwelling plastic drain was placed in the standing horse to provide a means for lavage with 3 L of balanced electrolyte solution twice daily for 72 hours. The contralateral tarsocrural joint was treated via arthroscopic debridement, synovectomy, and lavage with 3 L of balanced electrolyte solution. Arthrotomy and arthroscopic portals were allowed to heal by second intention. Lameness and thermographic examinations, analysis and bacteriologic culture of synovia, CBC, and WBC differential count were performed prior to inoculation and on days 1, 3, 6, 8, and 13. On day 14, each horse was euthanatized, and the joints were measured, opened, and photographed. Synovium and articular cartilage were obtained for semiquantitative histologic (H&E stain) and histochemical (safranin O fast green stain) evaluation. Lameness and joint circumference were significantly (P less than 0.05) greater in limbs treated by arthroscopy, synovectomy, and lavage. Arthrotomy with lavage eliminated the S aureus infection significantly (P less than 0.05) earlier than arthroscopy, synovectomy, and lavage, however, both treatments eliminated the infection in all but a single joint.(ABSTRACT TRUNCATED AT 250 WORDS)

Pre-clinical toxicity of IL-4: a model for studying protein therapeutics.

The purpose of this presentation was to review issues and findings in the pre-clinical development and evaluation of recombinant human protein therapeutics. Since human cytokines and lymphokines are endogenous proteins, their pre-clinical development and evaluation would seem straightforward and their toxicities minimal. Unfortunately, the pre-clinical development of this class of agents has been problematic and confounding. Some of the clinical toxicities and pharmacodynamics have been predicted by the pre-clinical evaluation and others have not. Some molecules are species specific which limits species selection for pre-clinical evaluation. Other confounding issues include: route of exposure, synergy of toxicity with other lymphokines, length of study design, immunogenicity, predictiveness of pre-clinical evaluation and iatrogenic toxicities. An approach used by SWPRD in the evaluation of this class of molecules was discussed. Insight gained during the pre-clinical and clinical development of these molecules should simplify the further development of protein therapeutics that follow. Specific studies with recombinant human interleukin-4 (rhuIL-4) were reviewed in detail as part of a pre-clinical safety evaluation. Native IL-4 has properties that exemplify many of the immune recognition-induced lymphokines and is produced principally by activated T-lymphocytes CD4+. It is a co-factor in B-cell proliferation and enhances ex vivo B-cell expansion and is believed to be a candidate for the treatment of refractory cancer based on this immune enhancement ability. rhuIL-4 is a 15,400 molecular weight cytokine produced in a yeast expression system.(ABSTRACT TRUNCATED AT 250 WORDS)

Histomorphologic observations for cynomolgus monkeys after subchronic subcutaneous injection of recombinant human interleukin-4.

Recombinant human interleukin-4 (rhuIL-4) is a candidate for the treatment of refractory cancer based on its potential to enhance the function of the immune system. Total daily dosages of 0 (placebo control), 1, 5, or 25 micrograms/kg of rhuIL-4 were given as divided (b.i.d.) subcutaneous dosages to male and female cynomolgus monkeys (5/sex/group) for 1 month followed by a 2-week recovery. Histomorphologic evaluation of 3/sex/group at 1 month revealed vascular lesions, granulocytic hyperplasia, and seminiferous tubular atrophy attributed to treatment with rhuIL-4. Dosage-dependent proliferative and inflammatory vascular lesions with eosinophil infiltration affected principally the arterial tree. After 2 weeks of recovery, these lesions, including chronic endarteritis and chronic and/or obliterative arteritis, occurred with an overall lower incidence, and were not observed for monkeys from the 1.0 micrograms/kg/day group. Granulocytic hyperplasia in bone marrow observed for monkeys from all groups given rhuIL-4 at 1 month was not present after 2 weeks of recovery. Seminiferous tubular atrophy was observed for monkeys from the 5 and 25 micrograms/kg/day groups at 1 month and after 2 weeks of recovery.

Comparison of single-dose and conventional trimethoprim-sulfadiazine therapy in experimental Staphylococcus intermedius cystitis in the female dog.

Cystitis was produced in 4 groups of 6 female dogs each, using salicylic acid, ethanol, and Staphylococcus intermedius. Group-I dogs served as nontreated controls. Starting 2 days after infection was induced, group-II dogs were treated with trimethoprim-sulfadiazine at a dosage of 15 mg/kg given orally 2 times a day for 21 days; groups-III and -IV dogs were treated with single oral dosages of the antibiotic at 60 mg/kg and 90 mg/kg, respectively. Group-I dogs (controls) remained infected for the 26-day duration of the study. The response to therapy seen in group-II dogs was better than the therapeutic responses in groups-III and -IV dogs (P less than 0.05). Results of the present study do not support the efficacy of single-dose therapy for this model of cystitis.

Sequential morphological and quantitative changes in blood and bone marrow neutrophils in dogs with acute inflammation.

Blood and bone marrow morphology were studied sequentially in dogs during experimental inflammation induced by intramuscular injection of turpentine. Depletion of the bone marrow storage pool of mature neutrophils and an increase in mitotic activity and number of early granulocyte precursors were evident within 24 hours. During the next three days, intense granulocytic hyperplasia resulted in replenishment of the bone marrow storage pool. Neutrophils with foamy vacuolation and increased basophilia of the cytoplasm (toxic neutrophils) were present in the blood by eight hours postinjection. The number of toxic neutrophils paralleled the intensity of clinical signs and changes in rectal temperature but not the number of band neutrophils. This indicates that changes in number of toxic neutrophils in sequential leukograms can be a prognostic indicator in dogs with severe inflammation.

Ultrastructure of canine toxic neutrophils.

Turpentine-induced inflammation was used as a model to study the ultrastructure of canine toxic neutrophils. Circulating toxic neutrophils contained large amounts of rough endoplasmic reticulum, but lamellar aggregates (Döhle bodies) were not observed. Cytoplasmic basophilia in Wright's stained neutrophils related to the persistence of rough endoplasmic reticulum and polyribosomes. Foamy vacuolation of the cytoplasm at the light microscopic level corresponded with irregular, electron-lucent areas which were not membrane bound. However, the presence of membrane remnants and myelin figures within lucent areas, as well as dilation and rupture of membranous structures in bone marrow precursors, indicated that these areas may have been membrane bound. In severely affected cells, there were few lysosomal granules. Early and intermediate neutrophils in the bone marrow of turpentine-injected dogs contained dilated and fragmented rough endoplasmic reticulum associated with irregular, electron-lucent areas in the cytoplasm and perinuclear space. Myelin figures were often in association with these electron-lucent areas. These findings indicated that cytoplasmic immaturity and cellular degeneration were involved in the morphogenesis of toxic neutrophils in the dog.