Inhibition of cytokine production by cyclosporin A and transforming growth factor beta.

We investigated the ability of cyclosporin A (CsA) and transforming growth factor beta (TGF-beta) to modulate the production of TNF-alpha and TNF-beta and IFN-gamma by unseparated, nonadherent, and adherent PBMC. Treatment of unseparated PBMC with CsA resulted in a significant dose-dependent inhibition of all three cytokines ranging from greater than 90% inhibition for IFN-gamma and TNF-beta, to approximately 70% for TNF-alpha. Pretreatment of unseparated or nonadherent PBMC with TGF-beta inhibited the production of IFN-gamma by 60-70%. However, the inhibition of TNF-alpha and TNF-beta production by these cells was only minimally affected, and at 0.1-1 ng/ml TGF-beta could enhance TNF-alpha production by unseparated PBMC. In contrast, pretreatment of adherent PBMC with TGF-beta inhibited the production of TNF-alpha by approximately 60%. TGF-beta also inhibited both TNF-alpha production and tumor cell cytotoxicity mediated by murine peritoneal-derived macrophages. These observations indicate that the biological effects of CsA and TGF-beta on immune functions are of a wider range than previously reported.

Coordinated induction of autocrine tumor necrosis factor and interleukin 1 in normal human monocytes and the implications for monocyte-mediated cytotoxicity.

Cytokine production and cytotoxicity for tumor cells are two important aspects of monocyte function and the inflammatory response against tumors and infectious agents. In the present studies we provide direct evidence at the mRNA and protein levels for the existence of autocrine tumor necrosis factor (TNF) and its importance as a mediator of human monocyte cytotoxicity for WEHI-164 tumor cells. The induction of TNF and interleukin 1 beta (IL-1 beta) mRNA by exogenous TNF or IL-1 beta, as determined by Northern blot analysis, is time dependent in normal human monocytes isolated by countercurrent elutriation. With either TNF or IL-1 beta as the stimulus, TNF mRNA is induced first, peaks within 1-3 h, and declines to nearly undetectable levels by 9 h. TNF mRNA accumulation is enhanced in the presence of cycloheximide indicating that de novo protein synthesis is not required for maximal TNF mRNA induction. In contrast, IL-1 beta mRNA is induced later, peaks at 3-9 h, and remains considerably elevated at 18 h. IL-1 beta mRNA accumulation is partially suppressed in the presence of cycloheximide. TNF and IL-1 beta protein production as assayed by specific enzyme-linked immunosorbent assays correlates well with respective mRNA induction. Both TNF and IL-1 beta enhance monocyte cytotoxicity as single agents; however, their combined effect is less than additive. When both agents are combined, TNF mRNA levels, as assessed by densitometric analysis of slot blots, are approximately equal to those induced by TNF alone. In contrast, IL-1 beta mRNA levels are additive. Our studies provide evidence for highly coordinated and interrelated pathways of autocrine TNF and IL-1 induction in human monocytes and demonstrate the role of TNF and IL-1 in regulating monocyte-mediated cytotoxicity for tumor cells.

Use of tissue expander for tamponade of presacral hemorrhage. Report of a case.

A silastic tissue expander has been used to tamponade severe presacral hemorrhage in a patient undergoing abdominoperineal resection for rectal carcinoma. This technique may be applicable in similar cases when tamponade is required for uncontrolled venous hemorrhage. The presence of an expandable pelvic prosthesis may be of use postoperatively in avoiding radiation-associated small bowel injury.