CA15.3, CEA and LDH in dogs with malignant mammary tumors.

BACKGROUND: Presence of tumor markers in serum might be connected to the number of secreting cells and with the stage of the neoplasm. However, there are few studies regarding these markers in veterinary clinical oncology. OBJECTIVES: To determine the serum concentrations of cancer antigen 15.3 (CA 15.3), carcinoembryonic antigen (CEA), and lactate dehydrogenase (LDH) in female dogs with different stages of mammary cancer. ANIMALS: Ninety female dogs, including 30 that were healthy, 40 that had nonmetastatic cancer, 12 with regional metastasis, and 8 with distant lymph node metastasis. METHODS: Prospective case-controlled observational study. Serum samples were collected to measure CA15.3, CEA, and LDH from 60 female dogs with mammary cancer during mastectomy and 30 healthy female dogs during routine check-up. CA15.3 and CEA were determined by chemiluminescent immunoassay and LDH by ultraviolet kinetic method. Western blotting analysis was performed to confirm the specificity and possible cross-reactivity of human CA15.3 and CEA antibodies with canine serum. Group data were compared by ANOVA followed by Student-Newman-Keuls and Tukey's tests. Correlations were investigated by Pearson and Spearman tests. RESULTS: CEA, CA15.3, and LDH were measurable in all groups. Higher serum concentration of CA15.3 and LDH was associated with regional and distant metastases. There was a significantly higher serum CA15.3 concentration in animals with lymph node metastasis when compared with animals without metastasis. There were no significant differences in CEA among groups. Expression of CA15.3 and CEA in canine serum was confirmed by Western blotting. CONCLUSIONS AND CLINICAL IMPORTANCE: Serum CA15.3 can be used to distinguish nonmetastatic from metastatic carcinomas.

Assessment of cell proliferation and prognostic factors in canine mammary gland tumors / Avaliação da proliferação celular e fatores prognósticos em tumores mamários caninos

Three methods for the analysis of cell proliferation, mitotic index/10 high-power fields (10 HPF), mitotic index/four sets of 10 HPF (40 HPF), and MIB-1 index were evaluated in a series of canine mammary gland tumors, as well as the possible correlation between them. Fifty-six canine mammary gland tumors, including 23 benign and 33 malignant, were studied. In addition, the prognostic impact of mitotic index/10 HPF, and histological malignancy grade were evaluated in 17 malignant tumors, being seven ductal and 10 metaplastic carcinomas. The three methods used to evaluate cell proliferation were correlated with the prognostic impact of mitotic index/10 HPF and histological malignancy grade. The results showed a strong association between mitotic figure counts and MIB-1 index (P<0.0001). A correlation was observed between mitotic count per 40 HPF and MIB-1, and between mitotic index per 10 HPF and 40 HPF (P<0.05). Moreover, histological malignancy grade and mitotic figure counts were excellent prognostic factors during three-year follow-up (P<0.05). There was a correlation between the three methods used for the evaluation of cell proliferation and prognostic factors as observed in human breast cancer studies.

Avaliaram-se três métodos de proliferação celular, índice mitótico/10 campos de grande aumento (10 CGA), quatro vezes 10 CGA (40 CGA) e índice de marcação por MIB-1, em uma série de tumores mamários caninos, e as possíveis correlações entre estes métodos. Foram estudados 56 tumores mamários caninos, 23 benignos e 33 malignos. Foi também avaliado o impacto prognóstico do índice mitótico (10 CGA) e o grau histológico maligno em 17 tumores malignos, sete carcinomas ductais e 10 carcinomas metaplásicos. A correlação entre os três métodos para avaliar a proliferação celular e o impacto prognóstico do índice mitótico por 10 CGA e o grau histológico maligno foi realizada. Os resultados mostraram que existe uma forte associação entre contagem de mitose e o índice de marcação por MIB-1(P<0,0001) e correlação entre contagem de mitoses em 40 CGA e índice de marcação por MIB-1 e entre índice mitótico em 10 CGA e 40 CGA (P<0,05). Observou-se correlação entre os três métodos de avaliação da proliferação celular e os fatores prognósticos semelhante aos estudos de câncer de mama humano.

DNA flow cytometry of canine mammary tumors: comparative aspects with human breast tumors

Flow cytometric analysis of DNA content was performed on 28 samples of canine mammary tumors. Nine of them were benign and 19 were malignant. All benign tumors and 11 malignant tumors (57.9 percent) were diploid (P<0.05). Form the aneuploid tumors, five (26.3 percent) were hyperdiploid, one (5.3 percent) hypodiploid, one (5.3 percent) near triploid and one (5.3 percent) multiploid. The analysis of the expression of the markers PR and CD31 revealed a significant difference between diploid and aneuploid tumors (P<0.05). The immunoreactivity of PR was higher in diploid tumors, while the immunoreactivity of CD31 was stronger in aneuploid tumors. No difference between the markers MIB-1, c-erbB2, p53 and Cyclin D1 was observed (P>0.05). Using the flow cytometry analysis and immunohistochemistry, it was found a close relationship between aneuploidy and malignant character of neoplasias, progesterone receptor (PR) negative immunostaining and higher microvases density. No correlation between DNA content and S phase or immunoreactivity for the markers MIB-1, p53, c-erbB2 and Cyclin D1 was observed

Análise por citometria de fluxo de DNA foi realizada em 28 amostras de tumores mamários de cadela. Nove eram benignos e 19 malignos, sendo todos os benignos e 11 malignos (57,9 por cento) diplóides (P<0,05). Dos tumores aneuploides, cinco (26,3 por cento) eram hiperdiploides, um (5,3 por cento) hipodiploide, um (5,3 por cento) triploide e um (5,3 por cento) multiploide. A análise dos marcadores de expressão PR e CD31 revelaram significativa diferença entre tumores diploides e aneuploides (P<0,05). A imunorreatividade do PR foi maior em tumores diplóides e a imunoreatividade do CD 31 maior em tumores aneuploides. Para os marcadores MIB-1, c-erbB-2, p53 e Ciclina D1 não foi observada diferença significativa (P>0,05). Pela citometria de fluxo e pela imunoistoquímica verificaram-se uma relação entre aneuploidia e características malignas das neoplasias, receptor de progesterona imunoreação negativa e alta densidade de microvascular. Não foi observada correlação entre conteúdo de DNA e a fase S ou imunorreatividade para os marcadores MIB-1, c-erbB-2, p53 e Ciclina D1

Transcranial Doppler assessment of cerebral blood flow: effect of cardiac transplantation.

The authors prospectively studied transcranial Doppler changes in patients with refractory congestive heart failure before and after cardiac transplantation. They evaluated 22 patients preoperatively and 14 patients after transplantation. Mean postoperative flow velocity increased by 53.3% (p < 0.0001). Preoperative waveform changes became normal after transplantation.

c-erbB-2 expression and nuclear pleomorphism in canine mammary tumors.

The objective of the present investigation was to study the expression of c-erbB-2 and MIB-1 and try to associate them with morphological features of the cell such as nuclear pleomorphism, mitotic count and histological grade in a series of 70 canine mammary gland tumors, 22 of them benign and 48 malignant. Tumors were collected at the Veterinary Hospital of UFMG (Brazil) and the Veterinary Faculty of Porto University (Portugal). c-erbB-2 expression was determined according to the guidelines provided by the manufacturer of the HercepTest system and nuclear pleomorphism, mitotic count and histological grade according the Elston and Ellis grading system. The HercepTest is the FDA-approved in vitro diagnostic test marketed by Dako. It is a semi-quantitative immunohistochemical assay used to determine overexpression of HER2 protein (human epidermal growth factor receptor) in breast cancer tissue. MIB-1 expression was also evaluated in 28 malignant tumors. Seventeen (35.4%) of the malignant tumors were positive for c-erbB-2 expression, which was positively associated with nuclear pleomorphism (P < 0.0001), histological grade (P = 0.0017) and mitotic count (P < 0.05). Nuclear pleomorphism also showed a positive association with MIB-1 index (P < 0.0001). These results suggest that some of the biological and morphological characteristics of the tumor are associated in canine mammary gland tumors, as also reported for human breast cancer. It was also possible to show that the immunoexpression of c-erbB-2 can be a factor in mammary carcinogenesis. This fact opens the possibility of using anti-c-erbB-2 antibodies in the treatment of canine mammary tumors.

c-erbB-2 expression and nuclear pleomorphism in canine mammary tumors

The objective of the present investigation was to study the expression of c-erbB-2 and MIB-1 and try to associate them with morphological features of the cell such as nuclear pleomorphism, mitotic count and histological grade in a series of 70 canine mammary gland tumors, 22 of them benign and 48 malignant. Tumors were collected at the Veterinary Hospital of UFMG (Brazil) and the Veterinary Faculty of Porto University (Portugal). c-erbB-2 expression was determined according to the guidelines provided by the manufacturer of the HercepTest system and nuclear pleomorphism, mitotic count and histological grade according the Elston and Ellis grading system. The HercepTest is the FDA-approved in vitro diagnostic test marketed by Dako. It is a semi-quantitative immunohistochemical assay used to determine overexpression of HER2 protein (human epidermal growth factor receptor) in breast cancer tissue. MIB-1 expression was also evaluated in 28 malignant tumors. Seventeen (35.4 percent) of the malignant tumors were positive for c-erbB-2 expression, which was positively associated with nuclear pleomorphism (P < 0.0001), histological grade (P = 0.0017) and mitotic count (P < 0.05). Nuclear pleomorphism also showed a positive association with MIB-1 index (P < 0.0001). These results suggest that some of the biological and morphological characteristics of the tumor are associated in canine mammary gland tumors, as also reported for human breast cancer. It was also possible to show that the immunoexpression of c-erbB-2 can be a factor in mammary carcinogenesis. This fact opens the possibility of using anti-c-erbB-2 antibodies in the treatment of canine mammary tumors.

Infection with different Trypanosoma cruzi populations in rats: myocarditis, cardiac sympathetic denervation, and involvement of digestive organs.

We tested four isolates of Trypanosoma cruzi to assess parasite virulence and ability to cause myocarditis, cardiac sympathetic denervation, and histopathologic alterations in organs of the digestive system. The susceptibility of rats depends on the population of T. cruzi, with the ABC strain and the CL-Brener clone killing all animals, regardless of the parasitemic pattern. All tested T. cruzi populations caused acute myocarditis, but failed to induce histologic alterations in the intestine. The Cl-Brener and ABC isolates caused esophageal myositis. The myocarditis caused by the ABC, CL-Brener, and Y isolates was severe, but resolution started at the end of the acute phase. In contrast, the Col 1.7 G2 clone induced mild and sustained myocarditis. Our results also showed that T. cruzi populations able to induce severe acute myocarditis caused marked sympathetic denervation, but recovery of normal cardiac histology and innervation occurred. The sustained myocarditis induced by Col 1.7 G2 clone failed to cause sustained denervation.

The epidemiology of malaria in Rondonia (Western Amazon region, Brazil): study of a riverine population.

We report on a longitudinal study concerning the incidence of malaria in a riverine population (Portuchuelo) settled on the riverbanks of Rio Madeira, in the State of Rondonia, Brazil. We found the incidence of malaria to be seasonal, prevailing in the dry months of June and July. The Annual Parasite Index (API) was 292/1000 inhabitants, almost three times that of the state of Rondonia for the same period. In contrast with other studied Rondonian populations, malaria in Portuchuelo was more prevalent in youngsters < 16 years old, particularly in the 0-1 year age group. Adults were relatively spared, particularly those over 50 years. Besides being indicative of indoor transmission, these facts may suggest the existence of a certain degree of acquired resistance to infection and/or of lessened symptoms in older people. Riverine populations are spread over the entire Amazon region where most of its members were born. Due to the permanent presence of malaria among riverine populations, we are proposing that they may act as perennial reserves of malaria and, therefore, as sources of infection for migrants or eventual settlers at their vicinity. To date, the opposite view has been generally held. Anopheles darlingi, the main vector species in the area, is essentially sylvatic, which contributes to make the control of malaria highly problematic. The only hopes for control rest on permanent surveillance and the prompt treatment of patients, which are also problematic considering the vastness of the Amazon region and the remoteness of some of its riverine settlements.

Avaliação clínica do quinino para o tratamento de malária por Plasmodium falciparum / The clinical evaluation of quinine for the treatment of Plasmodium falciparum malaria

O quinino foi o primeiro medicamento correntemente usado para tratar malária, tendo sido abandonado seu emprego principalmente após o início do emprego da cloroquina. A partir da década de 60 com o surgimento de resistência do P. falciparum à cloroquina voltou-se a utilizar o quinino isolado ou em associação para tratar tal infecção. Com o objetivo de avaliar clinicamente a resposta ao quinino de pacientes com malária por P. falciparum, analisamos os prontuários de 484 pacientes atendidos no Laboratório de Malária da SUCEN e acompanhados por pelo menos 28 dias, e que haviam recebido diferentes esquemas terapêuticos com quinino isolado ou em associação. Do total, 81,0% dos pacientes foram curados pelos esquemas empregados, sendo que dos restantes apenas 0,6% foram R2 e nenhum R3. Tais resultados mostram ainda que esquemas contendo quinino podem ser adequados para tratar malária por P. falciparum.

Quinine was the first antimalarial drug to be employed and also the first resistance was noticed to. After 1960 quinine urged to be reintroduced in routine therapy alone or in combination. Aiming at evaluating the effectiveness of different schedules we studied 484 patients seen at the Malaria Laboratory. We used quinine alone in 126 patients, quinine plus sulfadoxine and pyrimethamine in 119 patients and quinine plus tetracycline in 239 patients. The results shown that 81% of all patients were treated with success and only 0.6% were R2. and there is no R3. We emphasize a high resistance rate to quinine either alone (23.1%) or associated to sulfadoxine and pyrimethamine (37.8%). A higher resistance rate seen with the combination might be linked to the smaller dose of quinine used in that instance. It is worth noting the high cure rate with the quinine-tetracycline association.

[The clinical evaluation of quinine for the treatment of Plasmodium falciparum malaria]. / Avaliação clínica do quinino para o tratamento de malária por Plasmodium falciparum.

Quinine was the first antimalarial drug to be employed and also the first resistance was noticed to. After 1960 quinine urged to be reintroduced in routine therapy alone or in combination. Aiming at evaluating the effectiveness of different schedules we studied 484 patients seen at the Malaria Laboratory. We used quinine alone in 126 patients, quinine plus sulfadoxine and pyrimethamine in 119 patients and quinine plus tetracycline in 239 patients. The results shown that 81% of all patients were treated with success and only 0.6% were R2. and there is no R3. We emphasize a high resistance rate to quinine either alone (23.1%) or associated to sulfadoxine and pyrimethamine (37.8%). A higher resistance rate seen with the combination might be linked to the smaller dose of quinine used in that instance. It is worth noting the high cure rate with the quinine-tetracycline association.

Longitudinal study of naturally acquired humoral immune responses against the merozoite surface protein 1 of Plasmodium vivax in patients from Rondonia, Brazil.

A longitudinal study on the naturally acquired humoral immune responses against the merozoite surface protein 1 of Plasmodium vivax (PvMSP-1) was performed in malaria patients from the Brazilian Amazon region of Rondonia. We have previously cloned and expressed a recombinant protein, ICB2-5, that encodes 508 amino acids from the N-terminal portion of the PvMSP-1 protein. This affinity-purified polypeptide was tested by an enzyme-linked immunosorbent assay in a one-year longitudinal study using sera from 34 patients who had at least one malaria infection during the study period. The results demonstrated that more than 90% of the sera from patients having experienced more than three previous malaria infections contained antibodies to ICB2-5 at the time of a new clinical episode. Unexpectedly, more than half of these multiple-infected patients had an antibody response to ICB2-5 in which the predominant isotype was IgM. In contrast, more than 83% of the sera from these same patients contained predominantly IgG antibodies against total blood-stage antigen preparations. To determine if these results were due to the lack of boosting against this portion of the PvMSP-1 molecule, the presence of IgG antibodies to ICB2-5 in the sera from 11 patients who had consecutive malarial episodes during the study year was investigated. Five of these eleven patients failed to produce IgG antibodies to ICB2-5 even after 1-3 infections. Thus, these results suggest that no boosting against this region of the PvMSP-1 molecule was achieved by natural infections among these patients.

Identification of epitopes within the circumsporozoite protein of Plasmodium vivax recognized by murine T lymphocytes.

The murine cellular immune response to the circumsporozoite (CS) protein of Plasmodium vivax was characterized using five synthetic peptides, some of which we identified as corresponding to T cell epitopes. The peptides P308-320, P344-355 and P353-364 were immunogenic, inducing a genetically restricted proliferative response, due to the activation of CD4+ T cells. The peptide P308-320 was recognized only by the lymphocytes of B10 (H-2b) mice. The other two peptides were recognized by primed lymphocytes of H-2a and H-2k mice. Of interest was the finding that one of these peptides, P353-364, induced a proliferative response of a large percentage of immune outbred Swiss mice. Our data provide evidence that, at least in mice, there is recognition of multiple T cell epitopes within the major surface antigen of P. vivax sporozoites.

Cellular immune response of humans to the circumsporozoite protein of Plasmodium vivax.

The cellular immune response to the circumsporozoite (CS) protein of Plasmodium vivax of individuals from malaria-endemic areas of Brazil was studied. We examined the in vitro proliferative response of the peripheral blood mononuclear cells (PBMC) of 22 individuals when stimulated with a CS recombinant protein (rPvCS-2) and two other synthetic peptides based on the sequence of the P. vivax CS protein. Seven of the individuals from malaria-endemic area displayed an antigen-specific in vitro proliferative response to the recombinant protein PvCS-2 and one out of 6, proliferative response to the peptide 308-320. In contrast, none of the individuals displayed a proliferative response when stimulated with the D/A peptide which represent some of the repeated units present in this CS protein. Our study, therefore, provides evidence for the presence, within the major surface antigen of P. vivax sporozoites, of epitopes capable to induce proliferation of human PBMC.

Analise da frequencia de recaidas de malaria por Plasmodium vivax em regiao nao endemica (Sao Paulo, Brazil) / Frequency of malaria relapse due to Plasmodium vivax in a non endemic region (Säo Paulo, Brazil)

Em virtude da existencia de poucas informacoes, devidamente registradas, sobre frequencia e epocas de recaidas de malaria por Plasmodium vivax, contraida no Brasil, foi analisada casuistica observada em regiao nao endemica e constituida por pacientes corretamente tratados. O indice de recaidas documentadas em Sao Paulo, foi alto (24,5 por cento), com desenvolvimento precoce na maioria das oportunidades, ou seja, em tempo inferior a tres meses.

[Frequency of malaria relapse due to Plasmodium vivax in a non-endemic region (São Paulo, Brazil)]. / Análise da freqüência de recaídas de malária por Plasmodium vivax em região não endêmica (São Paulo, Brasil).

Very few well-established information is available about the frequency and timeliness of relapses in cases of Plasmodium vivax malaria acquired in Brazil. So, we analysed a series of correctly treated patients observed out of endemic areas. The rate of relapses seen in São Paulo, which may represent that of the parasitosis in the whole country, was high, ranging from 7.5% to 24.5%, and early in most cases, i.e. appearing by three months, what anticipates a high endemicity.

Plasmodium falciparum: restricted polymorphism of T cell epitopes of the circumsporozoite protein in Brazil.

We examined the extent of variation of the 3' region of the circumsporozoite gene among Plasmodium falciparum isolates through amplification of a selected DNA fragment followed by DNA sequencing. A total of 32 isolates were analyzed, of which 24 were from Amazon endemic areas in Brazil and 8 from widely separated geographical regions in the world. Among Brazilian isolates only 2 variants were detected: 19 displayed the same sequence of strain 7G8 whereas the 4 remaining isolates differed from the 7G8 strain at five nucleotide positions which also led to amino acid changes. Variation was restricted to one of the T-helper epitopes while the sequence identified as a cytotoxic T cell epitope was conserved in all Brazilian isolates. P. falciparum samples from other geographical regions in the world showed sequences distinct from those of Brazilian isolates. However, some constancy could be observed within that variation. For instance, the most frequent nucleotide substitutions, from A and C at nucleotide positions 1015 and 1024, were the same in all isolates.