Leukemia-cell proliferation and disease progression in patients with early stage chronic lymphocytic leukemia.

The clinical course of patients with recently diagnosed early stage chronic lymphocytic leukemia (CLL) is highly variable. We examined the relationship between CLL-cell birth rate and treatment-free survival (TFS) in 97 patients with recently diagnosed, Rai stage 0-II CLL in a blinded, prospective study, using in vivo 2H2O labeling. Birth rates ranged from 0.07 to 1.31% new cells per day. With median follow-up of 4.0 years, 33 subjects (34%) required treatment by NCI criteria. High-birth rate was observed in 44% of subjects and was significantly associated with shorter TFS, unmutated IGHV status and expression of ZAP70 and of CD38. In multivariable modeling considering age, gender, Rai stage, expression of ZAP70 or CD38, IGHV mutation status and FISH cytogenetics, only CLL-cell birth rate and IGHV mutation status met criteria for inclusion. Hazard ratios were 3.51 (P=0.002) for high-birth rate and 4.93 (P<0.001) for unmutated IGHV. The association between elevated birth rate and shorter TFS was observed in subjects with either mutated or unmutated IGHVs, and the use of both markers was a better predictor of TFS than either parameter alone. Thus, an increased CLL birth rate in early stage disease is a strong predictor of disease progression and earlier treatment.

The effects of narrowbands of visible light upon some skin disorders: a review.

This review article focuses on clinical studies published in the fields of (i) photorejuvenation and anti-ageing, (ii) oily or acne-prone skin and related imperfections, (iii) skin pigmentation and lightening, (iv) dandruff and other Malassezia-related skin disorders and (v) prevention and reversal of hair loss using non-thermal, non-ablative devices (principally light-emitting diodes). It mainly focuses on clinical proof of performance and also on in vitro studies that support the clinical findings. The mode of action of narrowbands of visible light upon the skin is only briefly discussed since their biological effects have been previously reviewed.

Revisiting the Münch pressure-flow hypothesis for long-distance transport of carbohydrates: modelling the dynamics of solute transport inside a semipermeable tube.

A mathematical model of the Münch pressure-flow hypothesis for long-distance transport of carbohydrates via sieve tubes is constructed using the Navier-Stokes equation for the motion of a viscous fluid and the van't Hoff equation for osmotic pressure. Assuming spatial dimensions that are appropriate for a sieve tube and ensuring suitable initial profiles of the solute concentration and solution velocity lets the model become mathematically tractable and concise. In the steady-state case, it is shown via an analytical expression that the solute flux is diffusion-like with the apparent diffusivity coefficient being proportional to the local solute concentration and around seven orders of magnitude greater than a diffusivity coefficient for sucrose in water. It is also shown that, in the steady-state case, the hydraulic conductivity over one metre can be calculated explicitly from the tube radius and physical constants and so can be compared with experimentally determined values. In the time-dependent case, it is shown via numerical simulations that the solute (or water) can simultaneously travel in opposite directions at different locations along the tube and, similarly, change direction of travel over time at a particular location along the tube.

A chemometric approach to understanding the bioelimination of anionic, water-soluble dyes by a biomass using empirical and semi-empirical molecular descriptors.

Single correlation and multiple linear regression analyses have been applied to understand the bioelimination of 103 anionic, water-soluble dyes by a biomass at a wastewater treatment works. The chemometric approach highlighted that anionic, water-soluble dyes with larger molecular size/ionic charge ratios and containing more primary aromatic amines and unsulphonated naphthalene nuclei and fewer aliphatic alcohol groups had superior levels of bioelimination.

Co-ordinated modulation of Ca2+ and K+ currents during ascidian muscle development.

1. The development of Ca2+ and K+ currents was studied in ascidian muscle cells at twelve embryonic stages from gastrulation to the mature cell, a period of 24 h. A high degree of co-ordination occurs between the development of the inwardly rectifying K+ current (IK(IR)), which sets the resting potential, and Ca2+ and outward K+ currents, which determine action potential waveform. 2. At neurulation IK(IR), which had been present since fertilization, begins to decrease, reaching 12% of its previous density in 6 h. IK(IR) then immediately begins to increase again, reaching its previous density in another 6 h. 3. When IK(IR) begins to decrease, a high-threshold inactivating Ca2+ current and a slowly activating voltage-gated K+ current appear. 4. When IK(IR) returns to its previous density, two new currents appear: a sustained Ca2+ current with the same voltage dependence, but different conotoxin sensitivity than the inactivating Ca2+ current; and a Ca(2+)-dependent K+ current, which activates 8-10 times faster and at potentials 20-30 mV more negative than the voltage-dependent K+ current. 5. The transient downregulation of IK(IR) destabilizes the resting potential and causes spontaneous action potentials to occur. Because IK(IR) is absent when only a slowly activating high-threshold outward K+ current is present, these action potentials are long in duration. 6. The return of IK(IR) and the appearance of the rapidly activating Ca(2+)-dependent K+ current eventually terminate this activity. The action potentials of the mature cell occur only on stimulation, and are 10 times shorter in duration than those in the immature cell.

Comparison of ionic currents expressed in immature and mature muscle cells of an ascidian larva.

We have compared the voltage-gated ion channels present in larval ascidian muscle at two developmental stages: muscle precursor cells just after the terminal cell division and mature contractile muscle, 7-11 hr later. All precursor cells express a high-threshold transient Ca current and a slowly activating delayed K current, and about half the cells express a low-threshold transient Ca current. An inwardly rectifying K current, which had been present from fertilization until just before the terminal cell division, is absent. Mature muscle retains two of the tailbud currents: the low-threshold transient Ca current and the slow delayed K current, although at larger densities, and also expresses a high-threshold Ca current that is similar in most respects to the precursor cell current but that lacks inactivation. In addition, mature muscle expresses two rapidly activating outward K currents, one voltage and one Ca dependent, that generate a composite outward K current that is eight times larger and activates eight times faster than the tailbud K current. Mature muscle also reexpresses the inward rectifier. We propose that the transient absence of the inward rectifier and the slow activation of the delayed K current early in development create a window of developmental time when spontaneous electrical activity is likely.

Tumor formation by a human pre-B leukemia cell line in scid mice is enhanced by matrigel and is associated with induction of CD10 expression.

We have previously demonstrated the engraftment of human pre-B acute lymphoblastic leukemia (ALL) cells injected intravenously into irradiated scid mice. We now report on the ability of the reconstituted extracellular matrix, Matrigel, to promote the formation of subcutaneous tumors in non-irradiated scid mice by a CD10- pre-B ALL cell line termed G2. Lymphatic tumors infiltrating the dermis were seen in all eight mice sacrificed 10-13 weeks after the co-injection of G2 cells and Matrigel but in only 2/8 mice injected with leukemic cells alone. Infiltration of bone marrow, spleen, thymus, lung and liver was observed earlier and was more extensive in the Matrigel-treated group. The tumor cells derived from Matrigel-treated mice could be passaged in vitro and their colony-forming ability was higher than that of the original G2 line. When re-injected intravenously into non-irradiated scid mice, the tumor cells invaded the thymus earlier than did the G2 cells. The expression of CD10/neutral endopeptidase was induced at high levels in all tumors, in Matrigel or non Matrigel-treated animals. This up-regulation was transient as the tumor variants grown in vitro or in vivo lost expression of CD10. However, 6-8 weeks later, induction of CD10 was observed on both tumor variants and parental G2 cells growing in the thymus and at a lower level on cells in bone marrow and spleen. Culturing G2 cells in vitro at high density or in the presence of documented growth-promoting cytokines such as IL-3, IL-6, IL-7, and GM-CSF did not stimulate the expression of CD10 mRNA. The induction of this surface endopeptidase was thus associated with growth of leukemic cells in the specific microenvironments provided by the lymphoid tumors and the thymus in scid mice. The function of CD10 might be related to the hydrolysis of peptides which are critical in regulating interactions between adjacent pre-B cells, the stromal microenvironment and the transduction of growth and/or differentiation signals.

Lymphocyte function in autism and Rett syndrome.

Peripheral blood lymphocytes from 17 patients with autism were separated on a Ficoll-Hypaque density gradient. Patients had normal numbers of T and B cells and T cell subsets. Although CD4:CD8 ratios were normal for the whole group (2.09 +/- 0.97), 6 patients had elevated ratios (> 2.2) and 5 had decreased ratios (< 1.5). Mitogen-induced proliferation (concanavalin-A and phytohemagglutinin) was normal as was the autologous mixed lymphocyte reaction for the whole group. There was an abnormally increased percentage of DR+ (activated) T lymphocytes in 11 patients. With increasing age percentage of DR+ lymphocytes decreased. No patient had interleukin-2 (IL-2) receptor+ cells. Similar investigations performed on blood samples from 8 girls with Rett syndrome produced normal results. 11 of 17 autistic patients had an abnormally increased percentage of DR+ but not IL-2 receptor+ lymphocytes suggesting 'incomplete' activation, a finding which is seen in autoimmune diseases. The decrease in activated cells with increasing age suggests that there may be an autoimmune process which is more active earlier in life in a subset of autistics.

The induction of CD10 on a pre-B leukemia cell line occurs with progression of the disease in scid mice.

We have previously demonstrated the engraftment and dissemination of human pre-B acute lymphoblastic leukemia (ALL) cells into scid mice. In the current study, the temporal pattern of infiltration of a CD10- pre-B leukemia line (G2) in various murine tissues and the progression of the disease in the whole animal were monitored by quantifying human CD44 mRNA expression by the polymerase chain reaction (PCR). Irradiated scid mice were injected intravenously with 10(6) G2 cells and killed 3 days to 10 weeks later. After 2 weeks, leukemic cells were found mostly in bone marrow, but also in lung. At 6 to 7 weeks, spleen and lung contained 30% human RNA, while peripheral blood, liver, and kidney contained 2-3%. Infiltration to brain and thymus was observed at 8-9 weeks. In terms of the whole animal, spleen and liver were the major sites of tumor burden. The induction of CD10 expression was previously observed in transplanted CD10- G2 leukemic cells recovered from scid thymus at 10-12 weeks, which corresponds to the terminal stage of disease. In this study, the CD10 expression on the leukemic cells was monitored at earlier time points by flow cytometry and quantitative PCR. Induction of CD10 was first observed in bone marrow, spleen, peripheral blood, and liver at 6-7 weeks (10-fold), at the time of the onset of dissemination of the leukemia. Despite the presence of 30% human RNA in lung at 6-7 weeks, CD10 induction was not significant in that site before 10 weeks. Increased levels of CD10 were seen in all tissues between 8 and 10 weeks; the highest levels were observed in leukemic cells proliferating in thymus (113-fold) and in those found in circulation. These findings suggest that initial induction of CD10 occurs in hematopoietic tissues at the time of rapid proliferation of the leukemic cells and their infiltration of several tissues. At later time points, the increase in CD10 expression is seen on the leukemic cells found in all peripheral organs suggesting an association with disease progression.

Homotypic aggregation of pre-B leukemic cell lines by antibodies to VLA integrins correlates with their expression of CD9.

The molecules effecting adhesion of acute lymphoblastic leukemia (ALL) cells are not well defined. We investigated the expression of very late activation (VLA) integrins in five human leukemic cell lines of pre-B cell phenotype. VLA-4 was found to be the dominant integrin in all five, three possessed VLA-5, and one VLA-6. None had VLA-2, or VLA-3. Since certain anti-VLA-4 monoclonal antibodies (mAb) have been reported to induce homotypic aggregation of T and B lymphocytes we investigated the possibility that VLA-4 might be involved in aggregation of pre-B cells. mAb 44H6 (anti-VLA-alpha 4), and 4B4 (anti-VLA-beta 1) induced strong aggregation which was not blocked by the anti-FC gamma IIR mAb IV.3. However, aggregation was effected in only three of the five lines suggesting the involvement of molecules other than VLA-4. The level of expression of CD9, but not that of CD11a, CD18, CD19, CD44, or CD54, was found to correlate with the level of aggregation. Of mAb directed to CD9, CD19, CD44, endoglin, and HLA-DR only mAb to CD9 induced aggregation. Admixture of mAb ALB6 (anti-CD9) and mAb 44H6 neither potentiated nor inhibited the response indicating a common effector mechanism. We suggest that the level of CD9 may determine the level of VLA-regulated adhesion, and therefore the adhesive phenotype of leukemic pre-B cells.

A contrast-detail study of interpolated scatter and glare correction of digital fluoroscopic images.

A scheme to correct for the effects of scattered radiation and veiling glare on the contrast of digital fluoroscopic images was investigated. The correction scheme is based on using spatial interpolation of signals generated in the shadows of a lead disk array, placed in the radiation beam. Contrast-detail plots obtained using the Leeds TO.10 test object, for corrected images were compared with those for unprocessed images, for images processed using digital contrast enhancement and for images acquired using a grid. It was found that substantial improvements in image contrast were obtained using the correction scheme.

Differential kinetics of engraftment and induction of CD10 on human pre-B leukemia cell lines in immune deficient scid mice.

The sensitivity of the scid mouse model was assessed by comparing the growth of two pre-B acute lymphoblastic leukemia (ALL) cell lines, A1 and G2, established from patients at relapse. When cell numbers varying from 10(4) to 10(7) were injected intravenously into scid mice, advanced growth and dissemination of leukemia was observed at 10-12 weeks with the G2 cells. Bone marrow, spleen and thymus contained high levels of human leukemic cells and infiltration into lung, kidney, liver, and brain was observed. Two of three mice grafted with only 100 cells showed high levels of infiltration at 15 weeks, suggesting that 100 G2 cells was near the limiting cell number that could produce disseminated leukemia. With the A1 line, a minimum of 10(5) cells was needed to obtain dissemination to liver, lung, brain, and kidney; a low level of spleen infiltration occurred and thymus invasion was not observed. In vitro, both lines showed a density dependent growth in clonogenic assays but the cloning efficiency of the A1 line was 10-fold higher than for G2 cells. These results indicate that G2 and A1 lines have a dissimilar aggressiveness in vivo which does not correlate with clonogenic assay in vitro. Neither G2 nor A1 lines, growing in vitro, expressed CD10/CALLA on their surface, despite low levels of antigen on the freshly obtained relapse samples. Although A1 cells remained CD10-negative in the scid mice, G2 cells showed detectable levels of CD10, particularly on those cells found in the thymus. Several subclones of the G2 line were derived from isolated colonies in vitro; they were found to be CD10- in vitro, but to become CD10+ when proliferating into scid mouse thymus, suggesting the induction of CD10 by the murine microenvironment.

Identification of distinct epitopes of endoglin, an RGD-containing glycoprotein of endothelial cells, leukemic cells, and syncytiotrophoblasts.

Endoglin is a glycoprotein expressed predominantly on human endothelial cells. It was first identified with mAb 44G4, produced against the pre-B acute lymphoblastic HOON cell line. We now report that four mAbs independently produced against human umbilical vein endothelial cells (HUVECs), chronic myelogenous leukemia in blast crisis, or U-937 pro-monocytic cells stimulated with phorbol myristate acetate also react with endoglin. High levels of reactivity of all mAbs were observed with HUVEC, while intermediate levels were seen with HOON and U-937 cells. By sequential immunoprecipitation from HUVEC and U-937 cell extracts, it was established that RMAC8, HEC-19, 8E11, and 1G2 mAbs react with the same protein as 44G4. Three distinct epitopes recognized by 44G4, RMAC8, and 1G2 mAbs were identified by competitive radioimmunoassay and flow cytometry. The HEC-19 epitope is spatially related to the 44G4 epitope, whereas the 8E11 epitope is most closely related to the 1G2 epitope. Western blot analysis showed that all antibodies react with the endoglin dimer (Mr = 170,000) purified from placenta. Immunostaining of sections of full-term placenta revealed reactivity not only with fetal vessels but also with the syncytiotrophoblast, the fetal cell layer which interfaces with maternal blood. When HUVEC monolayers were treated with the different mAbs to endoglin, prior to incubation with U-937 cells, a 5- to 10-fold stimulation of adhesion was observed. A fibronectin hexapeptide containing RGD, but not the corresponding RGE peptide, was capable of inhibiting the increased adhesion, when tested with mAb 44G4 and RMAC8. However, the same peptides had no effect on the binding of any of the five anti-endoglin mAbs to cells. Since 44G4 and RMAC8 recognize two distinct epitopes of endoglin, and since all five mAbs stimulated adhesion, the results suggest that a signal has been triggered through endoglin on HUVECs. Endoglin might be implicated either directly, by binding to a specific integrin-like ligand, or indirectly, by regulating the level of adhesion between certain integrins and their receptors.

Bone marrow from children in relapse with pre-B acute lymphoblastic leukemia proliferates and disseminates rapidly in scid mice.

Bone marrow samples from patients with pre-B acute lymphoblastic leukemia (pre-B ALL), either at diagnosis or at relapse, were transplanted into scid mice to determine whether these freshly obtained leukemic cells could proliferate in vivo and whether there were any differences in their in vivo growth characteristics. Cells from three patients who relapsed within 13 months of diagnosis proliferated rapidly in the murine bone marrow, spleen, and thymus, invaded peripheral organs, and resulted in morbidity and mortality of the animals within 4 to 16 weeks. Cells from two patients who relapsed 3.5 years after diagnosis grew much slower than the early relapse samples, taking up to 30 weeks to infiltrate the bone marrow of recipient mice. In contrast, leukemic cells were absent or were detected at low numbers in scid mice transplanted with cells obtained at diagnosis from three patients who have not yet relapsed. These results show an increased ability of leukemic cells from patients with aggressive lymphoblastic leukemia of poor prognosis to proliferate in scid mice.

Confirmation by peptide sequence and co-expression on various cell types of the identity of CD44 and P85 glycoprotein.

The p85 glycoprotein expressed on a variety of human cell types including astrocytes and lymphocytes has not been associated with the CD44 cluster. The recent demonstration that Hermes, a glycoprotein implicated in the adhesion of lymphocytes to endothelium, belongs to the CD44 cluster raises interesting questions concerning the role of this molecule on astrocytes and on non-lymphoid cells. To obtain confirmation of the identity of p85 glycoprotein and CD44, p85 glycoprotein was purified from B-chronic lymphocytic leukemia cells by affinity to monolonal 50B4-IgG and electrophoretic elution, digested with trypsin or CNBr and fractionated by reversed-phase HPLC. The sequences of three peptides were obtained which could be aligned with the amino acid sequence deduced from the CD44 cDNA at residues 49-54, 59-66 and 309-323. These constitute the first reported peptide sequences for antigens of the CD44 cluster and confirm that p85 glycoprotein is indeed the product of the CD44 gene. Since two different cDNA clones encoding molecules with cytoplasmic tails of 72 and 5 amino acids have been isolated, the isolation of peptide 309-323 confirms the existence of a processed protein with the longer cytoplasmic domain. Using a cDNA probe, we have characterized the expression of CD44 in several normal and malignant cell types. The level of CD44 mRNA was correlated with the surface expression of CD44 antigens (50B4) in several leukemic cell lines, in astrocytoma lines and in normal granulocytes. Negative cells included the Y79 retinoblastoma line, the NALM-6 leukemic line and endothelial cells. Identical mRNA species of 5.0, 2.3 and 1.7 kb were present in all CD44-positive samples, including normal granulocytes, astrocytoma, melanoma and leukemia cell lines and leukemic cells from patients. The highest level of expression of CD44 was observed on astrocytoma lines and on acute lymphoblastic leukemia cells of immature phenotype. The presence of high levels of CD44 on malignant cells could increase the ability of these cells to adhere to matrix proteins and/or to interact with endothelium, thus potentially altering their capacity for invasiveness and metastasis.

Adult vitelliform macular degeneration: a clinical spectrum.

Adult vitelliform macular degeneration (adult Best's disease) has a spectrum of clinical appearances which may include focal macular pigment clumps as well as the more typical small, yellow lesions. We surveyed 81 patients with this diagnosis retrospectively. Ages ranged from 36 to 87 years, with an average age of 67 years. Males and females were almost equally represented. Median visual acuity at presentation was 6/12 for eyes with yellow lesions, and 6/9 for eyes with pigment clumps. Of 17 cases followed for an average of 3.6 years, there was a decrease in visual acuity of two lines or more in five cases. A significant proportion of patients also had other manifestations of age-related macular degeneration. Adult vitelliform macular degeneration probably falls within the spectrum of age-related macular degeneration.

Anti-CNS antibodies in childhood neurologic diseases.

To study the incidence of circulating anti-CNS antibodies in childhood neurologic diseases, a population study was undertaken. Serum samples were obtained from a total of 348 children and stored at -80 degrees C until being studied. The samples were collected when routine blood tests were being performed. In all cases informed consent was obtained. This study was approved by hospital ethics review committees. One hundred and ninety-nine of the samples were from children with no known neurologic illnesses and served as the control group. One hundred and twenty-one of the samples were from children with epilepsy and the remaining 28 from a number of different neurologic conditions. The serum samples were screened against normal, adult, autopsy-derived cerebellar and frontal cortex tissue sections and Western blots. Serum immunoreactivity was revealed using HRP-conjugated anti-human IgG. Significant findings included: (1) patients with epilepsy had an increased incidence of anti-CNS reactivity as revealed on frontal cortex immunoblots (p less than 0.05) but not on cerebellar immunoblots; (2) there was an increase in the incidence of immunoblot reactivity with age in the controls and the neurology cases; (3) there was an increased incidence of immunoblot reactivity in those cases with a presumed inflammatory central or peripheral neurologic disease; (4) in six additional cases with opsoclonus-myoclonus there was cerebellar-specific immunoreactivity with identified antigenic molecular weights of 27 and 35, and 62 kDaltons; (5) in 31 additional cases of systemic lupus erythematosus there was significant immunoblot reactivity (p less than 0.001) when compared to a subset of age-matched controls. There was no difference in immunoreactivity between males and females. There was no significant increase in immunoreactivity in those children with cognitive disturbances including developmental delay and mental retardation.