ABSTRACT
BACKGROUND: Sentinel lymph-node (LN) biopsy (SLNB) is a valuable tool to assess the regional LN status in Merkel cell carcinoma (MCC). However, its prognostic value is still debated. This study was undertaken to assess SLNB usefulness for MCC management and to determine the impact of SLNB status on disease-free survival (DFS) and overall survival (OS) by comparing SLNB-positive versus -negative patients according to demographic, clinical and treatment characteristics. PATIENTS AND METHODS: In this retrospective, multicenter observational study, SLNB was proposed to all patients referred for clinically N0 MCC. Treatment schedule consisted of wide-margin surgical resection of primary MCC followed by adjuvant radiation therapy (aRT) to the primary site and, for SLNB-positive patients, radical LN dissection followed by regional aRT. Univariate and multivariate analyses determined factors associated with DFS and OS. RESULTS: Among 87 patients with successful SLNB, 21 (24.1%) were SLNB-positive. Median follow-up for the entire series was 39 months; respective 3-year DFS and OS rates were 73% and 81.4%, respectively. Univariate analysis (all patients) identified SLNB-negativity as being associated with prolonged OS (P = 0.013) and aRT (all sites considered) was associated with longer DFS (P = 0.004) and OS (P = 0.018). Multivariate analysis (all patients) retained SLNB status and aRT (all sites considered) as being associated with improved DFS (P = 0.014 and 0.0008) and OS (P = 0.0020 and 0.0019). Moreover, for SLNB-negative patients, tumor-bed irradiation was also significantly associated with prolonged DFS (P = 0.006) and OS (P = 0.014). CONCLUSIONS: The present study demonstrates that SLNB-negativity is a strong predictor of longer DFS and OS in stage I and II MCC patients. The similar benefit for aRT on tumor bed observed in this study has to be confirmed by a prospective study. The results advocate for SLNB being considered to all MCC patients.
Subject(s)
Carcinoma, Merkel Cell/radiotherapy , Prognosis , Radiotherapy, Adjuvant , Sentinel Lymph Node Biopsy , Adult , Aged , Aged, 80 and over , Carcinoma, Merkel Cell/pathology , Carcinoma, Merkel Cell/surgery , Disease-Free Survival , Female , Humans , Lymph Node Excision , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Sentinel Lymph Node/pathology , Sentinel Lymph Node/surgery , Treatment OutcomeABSTRACT
Antibodies against porcine procolipase B were produced in rabbits. The antiserum was used to immunoinactivate various forms of native and trypsin-treated porcine colipase. Our results indicate that all forms of the porcine cofactor bind to anti-porcine procolipase B antibodies. Human colipase showed lower affinity for the antibodies than porcine colipase. No cross-reactivity was observed between pig and horse, cow, dog or chicken colipases. Immunological studies on porcine colipase, carried out in the presence of lipid, provided evidence that antibodies bind to colipase at or near the lipase binding site. The binding of antibodies to colipase is not affected by the adsorption of the cofactor at a lipid interface. Using a predictive method for identification of the antigenic determinants, it was found that, in pig colipase, regions at positions 42-48 and 70-74 might represent antigenic sites. In the horse protein, the peptide segment 42-48 was also recognized as a possible antigenic site. An immunoadsorbent gel column was prepared for a one-step isolation of porcine colipase. In contrast to purification methods described so far, immunoaffinity chromatography yielded only one form of the porcine cofactor when starting from a pancreatic extract. This protein preparation has structural, biochemical and immunochemical properties similar to that of porcine procolipase A previously isolated from pancreas in the presence of detergent.
Subject(s)
Colipases/isolation & purification , Pancreas/analysis , Protein Precursors/isolation & purification , Proteins/isolation & purification , Animals , Antibodies , Antigen-Antibody Complex , Chromatography, Affinity , Colipases/immunology , Cross Reactions , Enzyme Precursors , Epitopes , Protein Precursors/immunology , SwineABSTRACT
The secondary structure of porcine colipase (93 residues) was established according to the predictive method of Chou and Fasman (Chou, P.Y. and Fasman, G.D. (1974) Biochemistry 13, 211--222 and 222--245). The relative composition of the conformational regions was as follows: 5% alpha-helix (region 39--44), 25% beta-sheet (three regions, 7--11, 49--57 and 77--85) and eight beta-turns corresponding to 32% of the polypeptide. Colipase contains a large proportion (about 35%) of unordered structure. Estimated values for the alpha-helix and beta-sheet contents from the circular dichroism spectrum were in good accordance with the predicted model. A less satisfactory value was found for the beta-turns. A characteristic feature of the far ultraviolet dichroic spectrum is the presence of an unusual positive band at 225 nm that might be indicative of a particular spatial arrangement of the chromophores in the molecule. Two tyrosines (Tyr56 and Tyr57) and one histidine (His86) are at close vicinity in the three dimensional structure of the protein as shown by proton NMR studies. These residues are located at the end of two beta-sheet hydrophobic regions(49--57 and 77--85) which might play a role in the association of colipase with the lipid-water interface as indicated by results of the NMR studies of the taurodeoxycholate-colipase complex.
Subject(s)
Colipases , Proteins , Animals , Circular Dichroism , Histidine/analysis , Magnetic Resonance Spectroscopy , Protein Conformation , Swine , Tyrosine/analysisABSTRACT
Rabbit antiserum was raised against porcine pancreatic colipase and Fab fragments were prepared by papain digestion of purified antibodies followed by purification on protein A-Sepharose. Fab fragments showed inactivation toward porcine colipase activity similar to that of antiserum and purified antibodies. From inactivation studies carried out by incubating porcine colipase and lipase with Fab fragments in the absence of lipid or in the presence of triolein and sodium deoxycholate, it could be concluded that polyclonal antiporcine colipase antibodies contain fractions that bind specifically to epitopes at or near the functional regions of the porcine cofactor. Studies with an enzyme-linked immunosorbent assay showed that cross-reactivity of horse or chicken colipase with antiporcine colipase antiserum was lower than that of the human or porcine protein. Results of immunoactivation kinetic studies performed with the same proteins, fully confirmed these observations. Partial cross-reactivity between porcine and chicken colipases allowed us to fractionate antibodies by immunoaffinity chromatography on immobilized chicken colipase. Fraction I contains antibodies absorbed on porcine colipase not accessible when the cofactor is bound to lipid. Antibodies of fraction II, nonadsorbed on chicken colipase, inactivate porcine colipase preincubated with triolein/deoxycholate. Lipase had a protective effect against inactivation. Antibodies of fraction II bind likely to epitopes close to the specific region of colipase interacting with lipase. Our conclusions are in good agreement with analysis of the sequence of porcine, equine and human colipases by calculating local hydrophilicity indices.
Subject(s)
Colipases/antagonists & inhibitors , Proteins/antagonists & inhibitors , Animals , Binding Sites , Chickens , Colipases/immunology , Cross Reactions , Epitopes , Horses , Humans , Immunoglobulin Fab Fragments , SwineABSTRACT
Lipase and colipase have been purified to homogeneity from chicken pancreatic tissue. The enzyme has a molecular weight (48 000) and catalytic properties similar to those of pancreatic lipase from higher mammals. Hydrolysis of triolein by chicken lipase is strongly inhibited by various bile salts, including sodium taurochenodeoxycholate, which is present in large proportion in chicken bile. Inhibition is reversed by colipase. With triolein as enzyme substrate, in the presence of sodium deoxycholate, no difference was observed in the ability of pure colipase from chicken, horse or pig to fully activate bile-salt-inhibited lipase from the same species. However, kinetic studies of the hydrolysis of a lecithin-stabilized emulsion of triacylglycerol (Intralipid) by chicken lipase show that the lag period is much longer in the presence of porcine colipase than with the chicken cofactor. This might reflect the higher ability of the avian enzyme to associate with colipase from the same species than with mammalian cofactors when the triacylglycerol substrate surface is covered with amphiphilic lecithin. From our study, the chicken pancreatic lipase/colipase system appears to be functionally similar to homologous lipolytic systems from higher mammals. It is then likely that they are of comparable physiological significance in fat digestion in avian and mammalian species.
Subject(s)
Colipases/metabolism , Lipase/metabolism , Pancreas/enzymology , Proteins/metabolism , Animals , Bile Acids and Salts/pharmacology , Chickens , Colipases/isolation & purification , Colipases/pharmacology , Horses , Humans , Kinetics , Lipase/isolation & purification , Molecular Weight , Species Specificity , SwineABSTRACT
The substrate specificity of two cationic lipases with high phospholipase A1 activity purified from guinea pig pancreas has been tested towards various neutral glycerides. Triolein hydrolysis proceeded in the absence of di- and monoolein accumulation. Optimal conditions for di- and monoolein hydrolysis included an alkaline pH (9-10), a substrate concentration of 10 mM, and the presence of sodium deoxycholate (12 and 24 mM, respectively). Pancreatic colipase (bovine) had no effect on the activity of the two lipases. The comparison between the rates of hydrolysis of various substrates revealed the following order of decreasing enzyme activity: diolein greater than 1(3)-monoolein greater than tributyrin = triacetin greater than or equal to triolein = 2-monoolein. No hydrolysis of p-nitrophenylacetate and cholesteryloleate could be detected. Using 1-[3H]palmitoyl-2-[14C]linoleoyl-sn-glycerol, both enzymes displayed a strong preference for the 1-position, leading to the accumulation of 2-[14C]linoleoyl-sn-glycerol. Identical activities were found for the two lipases. It is concluded that the two cationic lipases from guinea pig pancreas represent a unique group of lipolytic enzymes different from other previously described enzymes, including classical pancreatic lipase, gastric and lingual enzymes, mold lipases and carboxylesterhydrolase.
Subject(s)
Glycerides/metabolism , Lipase/metabolism , Pancreas/enzymology , Phospholipases A/metabolism , Phospholipases/metabolism , Animals , Colipases/pharmacology , Deoxycholic Acid/pharmacology , Guinea Pigs , Horses , Hydrolysis , Phospholipases A1 , Substrate Specificity , Time Factors , Triolein/metabolismABSTRACT
We have compared the effect of several proteins, including melittin, beta-lactoglobulin A, serum albumin, ovalbumin and myoglobin, on the hydrolysis of tributyrin and triolein by lipases from various origins. All proteins tested inactivate pancreatic lipase in absence of colipase and bile salt. Inhibition is not significantly reversed by colipase in absence of bile salt except in systems containing tributyrin and melittin or triolein and beta-lactoglobulin A. In all other cases, activation of pancreatic lipase by colipase in presence of inhibitory protein requires the presence of bile salt. Lipase from Rhizopus delemar is also inhibited by the proteins that inactivate pancreatic lipase. In contrast, the activity of lipase from Rhizopus arrhizus is not affected by the proteins in the same concentration range. Inhibition of lipase activity by amphiphiles such as proteins or detergents appears to be a general phenomenon not directly related to a decrease in tension at the triacylglycerol-water interface. Inhibition could be the result of desorption of lipase from its substrate due to a change in interfacial quality.
Subject(s)
Lipase/antagonists & inhibitors , Pancreas/enzymology , Proteins/pharmacology , Rhizopus/enzymology , Animals , Bile Acids and Salts/pharmacology , Colipases/pharmacology , Horses , Kinetics , Species Specificity , Surface Tension , TrioleinABSTRACT
1. The amino acid composition of bovine pancreatic lipase is very similar to that of porcine lipase. 2. Bovine lipase possesses a residue of lysine at the N-terminal position and a half cystine or a cysteine at the C-terminal position. 3. Bovine lipase contains two free sulfhydryl groups of different reactivities to 5, 5'-dithiobis-(2-nitrobenzoic) acid. One of these groups is buried in the native conformation of the enzyme and is fully titrated in 1.5 M urea when reaction is performed in the presense of 1 mM EDTA.
Subject(s)
Lipase/analysis , Pancreas/enzymology , Amino Acids/analysis , Animals , Benzoates , Carboxypeptidases , Cattle , Disulfides , Lipase/metabolism , Nitro Compounds , Sodium Dodecyl Sulfate , Sulfhydryl Compounds/analysis , Swine , UreaABSTRACT
Porcine colipase, the protein cofactor of pancreatic lipase, was isolated from pancreas freshly collected on animals and from a side fraction from the production of insulin (Novo Nordisk A/S). Samples of purified colipase were analyzed for homogeneity by polyacrylamide gel electrophoresis, reverse-phase high-performance liquid chromatography (RPLC), quantitative N-terminal sequence determination and mass spectrometry. The activating properties of colipase preparations were assayed against tributyrin, triolein or the commercial Intralipid emulsion, in presence of bile salt. Two fractions of colipase with the same specific activity were purified from fresh pancreas. The major fraction (85%) contained one single protein corresponding to fragment 1-93 of the 95-residue form of colipase (procolipase) previously characterized in porcine pancreatic juice. The other fraction (15%) corresponded to fragment 1-91 of procolipase. Also, two fractions of colipase were purified from the side fraction supplied by Novo. These fractions consisted of the 95-residue proform of colipase and of fragment 1-93, respectively, both specifically cleaved at the Ile79-Thr80 peptide bond with partial removal of isoleucine at position 79 and serine at position 78. Procolipase split at the 79-80 bond retained full activity on tributyrin and triolein and on the Intralipid emulsion but the kinetics of hydrolysis of triacylglycerol substrates showed much longer lag periods than those observed with native procolipase. Also, all forms of procolipase split at the 79-80 bond showed one peak in RPLC but their retention time was markedly decreased as compared to that of native procolipase which indicated a weaker hydrophobic binding capacity. The value of the retention time was of the same order of magnitude as that of inactive reduced procolipase. Treatment of native procolipase by pancreatic endopeptidases showed that elastase is likely responsible for specific cleavage at the 79-80 bond of procolipase purified from the Novo extract. Limited proteolysis by trypsin of the proforms of colipase split at the 79-80 bond reduced the lag period. Results presented in this communication provide the first direct evidence showing that the finger-shaped peptide segment between half-cystine residues at positions 69 and 87 is involved in colipase-lipid interaction as previously hypothesized from the three-dimensional structure of the protein.
Subject(s)
Colipases/metabolism , Lipid Metabolism , Pancreas/enzymology , Amino Acid Sequence , Animals , Binding Sites , Colipases/chemistry , Colipases/isolation & purification , Enzyme Activation , Enzyme Precursors , Isoleucine , Molecular Sequence Data , Pancreatic Elastase , Protein Precursors/isolation & purification , Swine , Threonine , TrypsinABSTRACT
To understand the mechanism by which colipase acts as a protein cofactor for anchoring pancreatic lipase at triacylglycerol/water interface, we have used an immunochemical approach. Ten monoclonal antibodies (Mabs) against porcine pancreatic procolipase were produced. Purified immunoglobulins and Fab fragments were studied for their capacity to inhibit colipase-dependent lipase activity. These studies were carried out by using procolipase, the secretory form of the cofactor, and its trypsin-treated form obtained by removal of the amino terminal pentapeptide by trypsin. Reactivities of Mabs with both forms of the cofactor were also studied by immunoenzymatic methods. Mabs 6.1, 49.20. 75.8, 270.13 and 419.1 were found to inhibit lipolysis by preventing the binding of procolipase or trypsin-treated colipase to the lipid substrate. Mab 72.11 inhibited procolipase binding but had no effect on trypsin-treated colipase. Mab 72.11 reacted with procolipase in ELISA but showed no reactivity with trypsin-treated colipase. Finally, preincubation of Mab 72.11 with porcine procolipase prevented specific cleavage at the Arg5-Gly6 bond by trypsin. It could be concluded, that the five first residues of procolipase are structural elements of the antigenic determinant recognized by Mab 72.11. Results of ELISA additivity tests (cotitrations) further indicated that epitopes for Mabs 6.1, 72.11, 270.13 and 419.1 and for Mabs 49.20 and 75.8 are located in two distinct antigenic regions of the procolipase molecule. It appears then that the lipid binding domain of the pancreatic lipase protein cofactor comprises two regions. The first region corresponds to the amino terminal fragment of the protein. The second region is likely identical with the peptide segment at position 51-59 as previously hypothesized from NMR and spectrophotometric studies. Studies carried out on procolipase chemically modified at tyrosine residues provided evidence that epitopes for Mabs 49.20 and 75.8 are in or close to the region which contains tyrosines at positions 55 and 59, and that the two peptide regions essential for interfacial binding are spatially adjacent in the procolipase and the trypsin-treated form of the cofactor. General conclusions are in accordance with the location of antigenic regions of procolipase determined by predictive methods.
Subject(s)
Antibodies, Monoclonal/immunology , Colipases/immunology , Proteins/immunology , Animals , Antibody Specificity , Binding, Competitive , Colipases/metabolism , Colipases/ultrastructure , Enzyme Activation , Enzyme Precursors , Enzyme-Linked Immunosorbent Assay , Epitopes , Immunoglobulin Fab Fragments , Lipid Metabolism , Protein Conformation , Protein Precursors , Species Specificity , Swine , Trypsin/pharmacology , TyrosineABSTRACT
Pure colipase was prepared by immunoaffinity chromatography from porcine and human pancreatic juice. A single form of the porcine colipase was obtained, having the structural and biological properties of previously characterized porcine procolipase A. Two forms of activated colipase (N-terminal Gly) were isolated from human pancreatic juice by the same procedure. The existence of two forms of activated colipase might arise from rapid activation of a precursor form of human colipase during collection of the pancreatic juice.
Subject(s)
Colipases/isolation & purification , Pancreatic Juice/analysis , Proteins/isolation & purification , Animals , Chromatography, Affinity , Humans , SwineABSTRACT
Using soybean triacylglycerols emulsified with egg lecithin we have studied, in vitro, the influence of substrate prehydrolysis by human gastric lipase upon subsequent degradation by the pancreatic lipase-co-lipase system. Fatty acids liberated by pure human gastric lipase or juice trigger immediate activity of human pancreatic lipase. Gastric lipolysis appears to be of prime importance for dietary lipid digestion in human.
Subject(s)
Gastric Juice/enzymology , Intestinal Mucosa/metabolism , Lipase/metabolism , Lipolysis , Emulsions , Humans , Kinetics , Pancreas/enzymologyABSTRACT
We have studied the enzymatic hydrolysis of solutions and emulsions of vinyl propionate, vinyl butyrate and tripropionin by lipases of various origin and specificity. Kinetic studies of the hydrolysis of short-chain substrates by microbial triacylglycerol lipases from Rhizopus oryzae, Mucor miehei, Candida rugosa, Candida antarctica A and by (phospho)lipase from guinea-pig pancreas show that these lipolytic enzymes follow the Michaelis-Menten model. Surprisingly, the activity against solutions of tripropionin and vinyl esters ranges from 70% to 90% of that determined against emulsions. In contrast, a non-hyperbolic (sigmoidal) dependence of enzyme activity on ester concentration is found with human pancreatic lipase, triacylglycerol lipase from Humicola lanuginosa (Thermomyces lanuginosa) and partial acylglycerol lipase from Penicillium camembertii and the same substrates. In all cases, no abrupt jump in activity (interfacial activation) is observed at substrate concentration corresponding to the solubility limit of the esters. Maximal lipolytic activity is always obtained in the presence of emulsified ester. Despite progress in the understanding of structure-function of lipases, interpretation of the mode of action of lipases active against solutions of short-chain substrates remains difficult. Actually, it is not known whether these enzymes, which possess a lid structure, are in open or/and closed conformation in the bulk phase and whether the opening of the lid that gives access to the catalytic triad is triggered by interaction of the enzyme molecule with monomeric substrates or/and multimolecular aggregates (micelles) both present in the bulk phase. From the comparison of the behaviour of lipases used in this study which, in some cases, follow the Michaelis-Menten model and, in others, deviate from classical kinetics, it appears that the activity of classical lipases against soluble short-chain vinyl esters and tripropionin depends not only on specific interaction with single substrate molecules at the catalytic site of the enzyme but also on physico-chemical parameters related to the state of association of the substrate dispersed in the aqueous phase. It is assumed that the interaction of lipase with soluble multimolecular aggregates of tripropionin or short-chain vinyl esters or the formation of enzyme-substrate mixed micelles with ester bound to lipase, might represent a crucial step that triggers the structural transition to the open enzyme conformation by displacement of the lid.
Subject(s)
Lipase/pharmacology , Animals , Butyrates/metabolism , Candida , Emulsions , Guinea Pigs , Hydrolysis , Kinetics , Lipase/metabolism , Propionates/metabolism , Rhizopus , Solutions , Triglycerides/metabolism , Vinyl Compounds/metabolismABSTRACT
Porcine and equine colipases have been submitted to mild tryptic digestion. Proteolysis occurs at the Arg5-Gly6 bond with the loss of the N-terminal pentapeptide. Studies of native and trypsin-treated colipases by circular dichroism and laser chemically induced dynamic nuclear polarization indicate that proteolysis induces conformational changes in the region of the tyrosine cluster. Experiments in the presence of phospholipid provide further evidence showing that these residues are in or close to the region of the protein interacting with aggregated lipids. Kinetic studies of the reaction of bile salt-inhibited lipase with emulsified triolein in the absence and in the presence of lecithin show that tryptic hydrolysis of the protein cofactor increases its affinity for the enzyme in the presence of lipid substrate. In both cases, it was found that the apparent dissociation constant of the lipase-colipase complex is decreased by one order of magnitude. Our results confirm that the biological activity of the lipase cofactor is enhanced by specific tryptic cleavage in the amino terminal region of the polypeptide and support the suggestion by Borgström et al. (Borgström, B., Wieloch, T., Erlanson-Albertsson (1981) FEBS. Lett. 108, 407-410) that the secreted form of colipase is a precursor.
Subject(s)
Colipases/metabolism , Proteins/metabolism , Trypsin/metabolism , Animals , Chromatography, Gel , Circular Dichroism , Horses , Kinetics , Lasers , Peptide Fragments/analysis , Protein Conformation , Spectrophotometry, Ultraviolet , SwineABSTRACT
1. Two cationic lipases (Ia and Ib) were purified from homogenates of fresh guinea-pig pancreas by ion-exchange chromatography on DEAE-Sepharose and CM-Sepharose (twice for the latter) followed by gel filtration on Sephadex G-100. 2. Both enzymes were homogeneous upon polyacrylamide gel electrophoresis. Their molecular weights are 37,000 and 42,000 for lipases Ia and Ib, respectively, as determined by gel filtration on Sephadex G-100. Very close values for isoelectric points were found in the pH range 9.3-9.4. 3. The cationic lipases are characterized by a high phospholipase A activity (500 IU/mg protein using a potentiometric assay with egg yolk lecithin as substrate), resulting in an unusual phospholipase/lipase activity ratio of 1. 4. Using doubly labelled phosphatidylcholine, a specificity, A1, was described for the two enzymes, which are unaffected by N-ethylmaleimide, diisopropylfluorophosphate and p-bromophenacylbromide. The enzymes are insensitive to EDTA and slightly inhibited by CaCl2 and MgCl2, whereas sodium deoxycholate is required for maximal activity.
Subject(s)
Lipase/metabolism , Pancreas/enzymology , Phospholipases A/metabolism , Phospholipases/metabolism , Animals , Cattle , Drug Stability , Guinea Pigs , Horses , Isoelectric Point , Lipase/isolation & purification , Molecular Weight , Phosphatidylcholines/metabolism , Phospholipases A1ABSTRACT
Colipase has been isolated from acidic extracts of chicken pancreatic tissue homogenized with Triton X-100. The cofactor fully activates bile salt inhibited mammalian lipases. The amino terminal sequence of the avian protein has been determined up to position 39 and compared to the homologous region of the mammalian colipases (pig, horse, man) previously studied. From this comparison, it appears that a high degree of homology exists between the proteins.
Subject(s)
Chickens/metabolism , Colipases/isolation & purification , Pancreas/enzymology , Proteins/isolation & purification , Amino Acid Sequence , Animals , Chemical Phenomena , Chemistry , Colipases/pharmacology , Enzyme Activation , Lipase/metabolism , Octoxynol , Polyethylene Glycols , Species SpecificityABSTRACT
Four monoclonal antibodies directed against porcine colipase have been generated by hybridization of myeloma cells with spleen cells of BALB/c immunized mice. Antibodies were screened by binding to immobilized colipase in a solid-phase assay. Monoclonal antibodies were purified by affinity chromatography on colipase coupled to Sepharose. All monoclonal antibodies are of the IgG1 class with high affinity for the antigen. The dissociation constant of the complex formed in solution between porcine colipase and antibody varied from 1.1 X 10(-10) M to 1.8 X 10(-8) M. Epitope specificity was studied for each antibody and in pairs with an enzyme-linked immunosorbent assay (ELISA). Results indicate that the four monoclonal antibodies react with at least three different antigenic regions of colipase. Finally, three monoclonal antibodies were found to be potent inhibitors of colipase activity. Antiporcine monoclonal antibodies appear to be suitable probes for studying the lipid affinity site of the protein cofactor of pancreatic lipase.
Subject(s)
Antibodies, Monoclonal/biosynthesis , Colipases/immunology , Pancreas/enzymology , Proteins/immunology , Animals , Enzyme-Linked Immunosorbent Assay , Epitopes/analysis , Mice , Mice, Inbred BALB C , SwineABSTRACT
BACKGROUND: Patients with familial amyloid polyneuropathy, a rare hereditary form of amyloidosis, have progressive autonomic neuropathy. The disease usually does not induce heart failure but is associated with sudden death, conduction disturbances, and an increased risk of complications during anesthesia. Although cardiac sympathetic denervation has been clearly demonstrated, the postsynaptic status of the cardiac autonomic nervous system remains unelucidated. METHODS AND RESULTS: Twenty-one patients were studied (age, 39+/-11 years; normal coronary arteries; left ventricular ejection fraction 68+/-9%). To evaluate the density and affinity constants of myocardial muscarinic receptors, PET with (11)C-MQNB (methylquinuclidinyl benzilate), a specific hydrophilic antagonist, was used. Cardiac beta-receptor functional efficiency was studied by the heart rate (HR) response to intravenous infusion of isoproterenol (5 minutes after 2 mg of atropine, 5, 10, and 15 ng/kg per minute during 5 minutes per step). The mean muscarinic receptor density was higher in patients than in control subjects (B'(max), 35.5+/-8.9 versus 26.1+/-6.7 pmol/mL, P=0.003), without change in receptor affinity. The increase in HR after injection of atropine as well as of MQNB was lower in patients compared with control subjects despite a similar basal HR (DeltaHR after atropine, 11+/-21% versus 62+/-17%; P<0.001), consistent with parasympathetic denervation. Incremental infusion of isoproterenol induced a similar increase in HR in patients and control subjects. CONCLUSIONS: Cardiac autonomic denervation in familial amyloid polyneuropathy results in an upregulation of myocardial muscarinic receptors but without change in cardiac beta-receptor responsiveness to catecholamines.
Subject(s)
Amyloid Neuropathies, Familial/physiopathology , Isoproterenol/pharmacology , Myocardium/metabolism , Receptors, Muscarinic/drug effects , Sympathomimetics/pharmacology , 3-Iodobenzylguanidine , Adult , Aged , Amyloid Neuropathies, Familial/pathology , Atropine/pharmacology , Blood Pressure/drug effects , Dose-Response Relationship, Drug , Echocardiography , Electrocardiography , Epinephrine/blood , Female , Heart/diagnostic imaging , Heart/innervation , Heart/physiopathology , Heart Rate/drug effects , Heart Ventricles/drug effects , Heart Ventricles/metabolism , Heart Ventricles/physiopathology , Humans , Male , Middle Aged , Norepinephrine/blood , Radionuclide Imaging , Receptors, Muscarinic/physiologyABSTRACT
OBJECTIVES: The aim of this study was to assess the diagnosis of myocarditis in patients presenting with acute myocardial infarction (MI) and normal coronary angiograms. BACKGROUND: Most often in these patients, the etiologic diagnosis remains unclear once they are found to have normal coronary arteries. The diagnosis of myocarditis mimicking MI is clinically relevant, because numerous arguments suggest a relation between myocarditis and dilated cardiomyopathy. Myocardial indium-111 (111In)-antimyosin antibody (AMA)/rest thallium-201 (201Tl) imaging allows noninvasive detection of myocarditis. METHODS: Forty-five patients admitted to three intensive care units for suspicion of acute MI, with normal coronary angiograms, were investigated. Indium-111-AMA planar images and then a dual-isotope rest AMA/201Tl tomographic study were performed. Six-month echocardiographic follow-up was obtained in 80% of the patients with initial left ventricular (LV) wall motion abnormalities. RESULTS: In eight patients, AMA and 201Tl scintigraphy were negative. In two patients, a matched 201Tl defect and focal AMA uptake suggested acute MI (due to prolonged vasospasm or spontaneously reperfused coronary occlusion). In 17 patients, diffuse AMA uptake over the whole LV suggested diffuse myocarditis. In 18 patients, focal AMA uptake with a normal 201Tl scan suggested diffuse but heterogeneous, or focal myocarditis. Complete functional recovery was observed in 81% of the patients with a pattern of myocarditis. CONCLUSIONS: Among 45 patients presenting with acute MI and normal coronary angiograms, 38% had diffuse myocarditis and 40% had a scintigraphic pattern of heterogeneous or focal myocarditis. Short-term follow-up showed complete LV functional recovery in 81% of these patients.
Subject(s)
Myocardial Infarction/diagnosis , Myocarditis/diagnosis , Adult , Antibodies, Monoclonal/immunology , Coronary Angiography , Electrocardiography , Female , Humans , Indium Radioisotopes , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , Myocarditis/diagnostic imaging , Myocarditis/physiopathology , Organometallic Compounds/immunology , Prospective Studies , Radionuclide Imaging , Ultrasonography , Ventricular Function, LeftABSTRACT
The human pancreatic lipase-porcine procolipase complex has been crystallized in space group P3(2)21 (a = b = 80.3 A and c = 251 A) from a solution containing polyethylene glycol, NaCl and beta-octyl glucoside. The crystals diffract to 2.6 A on a synchrotron beam. The complex in the presence of bile salts and phospholipids crystallizes in a tetragonal space group P4(2)2(1)2 (a = b = 133.4 A, c = 92.6 A). Crystals of procolipase alone were obtained under slightly different experimental conditions (space group I432, a = b = c = 164.3 A).