Clinical significance of elevation in neuroendocrine factors and interleukin-6 in metastatic prostate cancer.

Serum biomarkers that reflect the complex pathways of cancer progression have contributed to the clinical understanding of many malignancies. Recent studies have suggested that certain neuroendocrine (NE) elements participate in prostate cancer (PCa) progression. Interleukin-6 (IL-6) may serve as a useful marker of and contribute to PCa morbidity. The purpose of this study was to assess the frequency of elevation of two NE factors, chromogranin A (CGA) and bombesin-like immunoreactivity (BLI), in patients with advanced PCa and to determine their relationship to serum prostate-specific antigen PSA) and IL-6 levels, as well as known prognostic indicators (hormonal state, stage). Serum CGA determined by radioimmunoassay was elevated in I (7%) of 15 androgen-dependent (AD) patients and II (52%) of 21 androgen-independent (AI) patients; and urine BLI determined by radioimmunoassay was elevated in 2 (13%) of 16 AD patients and 10 (39%) of 21 AI patients. Frequency of elevation was higher in patients with distant metastasis (bone, visceral) compared with those with local/regional extensions of the disease. Levels of the NE factors correlated well with serum and bone marrow aspirate IL-6 concentrations but not with serum PSA levels. Elevation in either NE factor predicted for shortened survival. Measurement of NE factors in PCa identifies a subset of patients with advanced disease likely to express high levels of IL-6 and have a shorter survival. If confirmed, these findings will support the existence of a clinically relevant subset of patients in whom NE factors are involved in AI PCA progression.

Ethical considerations in fetal tissue transplantation.

Recent research using fetal tissue transplants has expanded possible treatment options for several traumatic and degenerative neurologic disorders. However, the expectations of therapeutic benefit to be gained from these methods have been challenged by an equivalent degree of controversy. Fundamental viewpoints regarding abortion, physical autonomy and the principle of harm have been raised against continuing research and the use of fetal tissue transplants. In this article, we first attempt to elucidate the practice, potential and limitations of such techniques. The critical, yet unresolved issues of supply and sources of fetal tissue are also discussed. In light of these concepts, we examine certain pertinent obligations and ethical concerns that may clarify the nurses' role in dealing with cases involving the use of fetal tissue transplants.

CA 72-4 radioimmunoassay for the detection of the TAG-72 carcinoma-associated antigen in serum of patients.

Monoclonal antibody (MAb)B72.3 has been used to detect the presence of TAG-72 in the serum of carcinoma patients. We have developed new anti-TAG-72 MAbs and have selected one of these, CC49, as the "catcher" MAb with 125I-B72.3 as the detecting antibody in a double-determinant immunoradiometric assay. This combination enabled the development of a sequential assay (designated CA 72-4) that showed optimal quantitative properties as demonstrated by such parameters as linear dose-response, high re-producibility, and lack of serum-matrix and "hook-back" effects. Only 3.5% of 744 normal sera and 6.7% of 134 sera from patients with benign gastrointestinal diseases had TAG-72 levels greater than 6 U/ml. Approximately 40% of 303 patients with gastrointestinal malignancies had serum TAG-72 levels of greater than 6 U/ml (55% of the patients with advanced disease). Thirty-six percent of patients with adenocarcinomas of the lung and 24% of patients with ovarian cancer (53% stage IV patients) also had elevated serum TAG-72 levels. A poor correlation was found between the carcinoembryonic antigen (CEA) and TAG-72 values of sera obtained from gastric cancer patients. Thirty-four percent of CEA negative cases were scored positive in the CA 72-4 assay, suggesting the complementarity of the CA 72-4 assay to CEA assays in the analysis of sera from patients with certain malignancies.

Inhibitory and stimulatory effects of dianhydrogalactitol, an alkylating cytostatic agent on the humoral immune response.

The effect of an alkylating agent, dianhydrogalactitol (DAG), on the humoral immune response of C57B1 mice immunized with sheep erythrocytes was studied. Different inhibitory or stimulatory effects could be achieved by varying the time and the dose of drug administration. DAG in a dose of 1.5 mg/kg given either before or after immunization induced enhanced immune responses. Higher doses (greater than 5 mg/kg) administered in the inductive phase had a marked suppressive effect while treatments at this dosage preceding immunization resulted in a stimulation. The functionally distinct cell populations acting in the immune response to sheep red blood cells are postulated to have different sensitivity to the drug.