Prevalence and implications of cytochrome P450 substrates in Massachusetts hospital discharges.

The cytochrome P450 (CYP450) system of drug-metabolizing enzymes may contribute to individual variation in drug response. We examined prevalence of CYP450 substrates at hospital discharge for patients in two cohorts: insurance claims of Massachusetts residents and the medical records of two academic medical centers. The claims cohort included 47 473 individuals (38.2%) treated with at least one CYP450 2D6, 2C19, 3A4 or 1A2 substrate. The electronic medical records cohort included 45 905 individuals (57.4%) treated with at least one substrate. In adjusted models, substrates of CYP450 2D6 and 2C19 were associated with greater risk for 90-day readmission in both cohorts (odds ratios of 1.104 and 1.128 (P<0.001), respectively). Presence of any CYP450 substrate was associated with increased monthly medical costs (+$397, P<0.003). These analyses of more than 300 000 admissions using two different cohorts and data types indicate that CYP450 substrates are associated with greater readmission rates and greater health-care cost.

Splenocytes from tumor-bearing Corynebacterium parvum treated mice maintain interleukin-2 and -3 activity.

Systemic and local administration of the bacterium Corynebacterium parvum (more accurately known as Propionibacterium acnes) is reported to exert antitumor action via activated macrophages or short-lived cytotoxic T lymphocytes (CTL), respectively. This study examined the effect of C. parvum treatment on resulting in vitro interleukin levels, which are components in the sequence of events leading to the development of effective CTL. C. parvum administration prevented palpable fibrosarcoma development. This was concomitant with restoration and maintenance of normal interleukin-2 (IL-2) and interleukin-3 (IL-3) levels and prevention of suppressor cell development in mice injected with both tumor cells and vaccine. Our finding of C. parvum-induced maintenance of IL-2 and IL-3 levels and apparent lack of suppressor cell formation lends support to the idea of local C. parvum antitumor action possibly being mediated by CTL arising via the interleukin cascade.