Clinical experience with Repotin, a locally produced recombinant human erythropoietin, in the treatment of anaemia of chronic renal failure in South Africa.

OBJECTIVE: To evaluate the efficacy and safety of Repotin, a locally produced recombinant human erythropoietin (rHuEPO), in the treatment of the anaemia of chronic renal failure (ACRF). DESIGN: The study consisted of two multicentre non-randomised open stages. SETTING: Renal units at several teaching hospitals in South Africa. PARTICIPANTS: Haemodialysis patients with haemoglobin (Hb) levels less than 8.0 g/dl were recruited. The first stage examined 26 patients during a 12-week period in which the dose of intravenous rHuEPO was adjusted according to haematological response. In the second stage 27 patients were stabilised with intravenous rHuEPO and then maintained at a Hb level above 8.0 g/dl by subcutaneous administration for up to 1 year. OUTCOME MEASURES: In both stages, outcome was measured by clinical examination, blood pressure, full haematological parameters and blood chemistry. RESULTS: In stage 1, all patients responded to therapy with a statistically significant increase in Hb from geometric means of 6.28 g/dl to 8.50 g/dl (geometric SDs of 1.17 and 1.20 respectively). The doses used ranged from 25 IU to 125 IU/kg (average 47.1). In the second stage, Hb levels reached a mean of 8.06 g/dl (SD 0.9) and were maintained at target range with an average dose of 55.5 IU/kg three times a week. Apart from changes in serum iron, ferritin (associated with increased haematopoiesis) and potassium, there were no significant alterations in blood chemistry. The incidence of adverse events reported during the 12-month second stage was no greater than that reported for other forms of rHuEPO therapy. CONCLUSION: Repotin is a safe and effective rHuEPO preparation for the treatment of ACRF.

The Erythrina protease inhibitor: interactions with tissue plasminogen activator.

The Kunitz-type trypsin and tissue plasminogen activator (t-PA)-inhibitor from Erythrina caffra seeds was cleaved by trypsin at low pH to yield a disulphide linked two-chain molecule with reduced hydrophobicity. This change was used to separate cleaved from native inhibitor by phenyl-Sepharose chromatography. The inhibitor was not cleaved by t-PA. Trypsin, but not t-PA, catalysed resynthesis of the cleaved bond. Although the cleaved protein retained inhibitory activity for both trypsin and t-PA, 6-10 times higher concentrations were required for equivalent inhibition. Removal of the active site arginine (Arg63) from the cleaved inhibitor by digestion with carboxypeptidase B resulted in a further loss of inhibitory activity towards both proteases. The activity of the inhibitor could also be decreased by modification of one susceptible arginine residue with peptidyl arginine deiminase. These results suggest that the trypsin-reactive site of the Erythrina inhibitor is also involved in the interaction between the inhibitor and t-PA.

Bacteriophage-associated lyase activity against Klebsiella serotype K64 capsular polysaccharide.

Bacteriophage phi 64 possesses a lyase that depolymerises the capsular polysaccharide of Klebsiella K64 into a hexasaccharide having an unsaturated derivative of glucuronic acid at the non-reducing end (1). The unsaturated hex-4-enuronic acid residue generated was characterised spectroscopically (u.v. and n.m.r.) and by g.l.c.-m.s. after hydrogenation of the double bond. Partial hydrolysis, Smith degradation, methylation analysis, and n.m.r. spectroscopy have been used to establish the structures of oligosaccharides produced from the polysaccharide. Evidence from 1H-n.m.r. spectroscopy indicates that the D-Man rho residue that undergoes fission is beta. (Formula: see text).

The reactive sites of proteinase inhibitors from Erythrina seeds.

Although the Kunitz-type proteinase inhibitors from the seeds of various Erythrina species have similar molecular weights (approximately 20,000), and share many other chemical characteristics, they could nevertheless be divided into three groups on the basis of their relative abilities to inhibit chymotrypsin, trypsin and tissue plasminogen activator. Group a inhibitors were relatively specific for chymotrypsin; they were poor inhibitors of trypsin and had no apparent effect upon tissue plasminogen activator. Group b proteins inhibited trypsin strongly and chymotrypsin slightly less effectively. They had no effect upon t-PA. Group c inhibitors inhibited trypsin, chymotrypsin and t-PA. Analysis of the amino acid composition of the three groups of inhibitors revealed major differences in alanine content. Minor differences in the content of most other amino acids were also noticed. Group b and group c inhibitors had, in most cases, the same reactive sites (Arg-Ser). The sequences neighbouring the reactive sites showed a significant degree of homology. Chemical modification of arginine in proteinase inhibitors from the seeds of E. latissima and soybeans using 1-2-cyclohexanedione confirmed the presence or absence of arginine in the reactive sites.

Purification and properties of arginine esterases from Bitis arietans (puff adder) venom.

An arginine esterase (FT1) was purified from B. arietans venom by gel-filtration and ion-exchange chromatography. The purified enzyme contains 21.6% of carbohydrate, 240 amino acids including 12 half-cystine residues and has a mol. wt of approximately 43,000. The purified enzyme has a high esterolytic activity towards N-alpha-benzoyl-L-arginine ethyl ester but shows no proteolytic activity against Azocoll and no clotting activity with fibrinogen. The N-terminal sequence of the arginine esterase from B. arietans venom shares a significant degree of sequence homology with the arginine esterase of B. nasicornis, the thrombin-like enzyme of C. adamanteus and the kallikrein-like enzymes of C. atrox venoms. It would appear that the arginine esterase from B. arietans venom exists in various multiple forms of the enzyme.

Properties of the arginine esterases from Bitis nasicornis (horned adder) venom.

Five forms of arginine esterase (DE-2 to DE-6) were purified from Bitis nasicornis venom by gel filtration on Sephadex G-50, followed by ion exchange chromatography on CM-cellulose and DEAE-sepharose. They contain 17.6 to 23.1% of carbohydrate, 242 to 244 amino acids including 14 half-cystine residues and have molecular masses of about 38 kDa. The enzymes have a high esterolytic activity towards N alpha-benzoyl-L-arginine ethyl ester but show no proteolytic activity against Azocoll and no clotting activity against fibrinogen. Their sequences of the first 19 amino-terminal residues are the same, but their carbohydrate content shows some variation. Furthermore, sequence studies on the N-terminal regions of the arginine esterases from B. nasicornis venom indicate that they share a significant degree of sequence homology with the kallikrein-like enzymes of Crotalus adamanteus and C. atrox venoms and also with porcine pancreatic kallikrein. Studies on tryptic glycopeptides of the arginine esterases show that carbohydrate occurs at the N-terminal region of the molecule and also towards the center.

The capsular polysaccharide from Klebsiella serotype K54; location of the O-acyl groups, and a revised structure.

The capsular polysaccharide from Klebsiella type K54, containing both O-formyl and O-acetyl groups, has been investigated by using the techniques of methylation analysis (by gas-liquid chromatography), periodate oxidation-Smith degradation, and both 1H- and 13C-n.m.r. spectroscopy. Degradation of the native polysaccharide with a bacteriophage-induced glucosidase generated a formylated, as well as a formylated and acetylated, tetrasaccharide, whereas similar depolymerization of the deacetylated polysaccharide yielded a single tetrasaccharide; the corresponding, O-acylated octasaccharides were also isolated and characterized. These oligosaccharides, utilized in chemical and spectroscopic studies in order to determine the location of the O-acyl substituents in the repeating sequence, indicated formylation at 0-4 of each lateral D-glucosyl group and acetylation at 0-2 of alternate L-fucosyl residues. A new structure for the repeating unit in the polysaccharide is proposed.

Acylated oligosaccharides from Klebsiella K63 capsular polysaccharide: depolymerization by partial hydrolysis and by bacteriophage-borne enzymes.

The extracellular polysaccharide from Klebsiella K63 is unique in having acetic and formic ester groups attached to the D-galactopyranosyluronic residues in the trisaccharide repeating-sequence. These O-acyl substituents are shown to be somewhat resistant to mild hydrolysis by both acid and alkali. Bacteriophage-induced depolymerization of the polysaccharide generated a series of acylated oligosaccharides comprising one, or more, repeating unit(s). By mild hydrolysis with acid, the same series of oligomers was released from the polysaccharide, together with the corresponding non-acylated compounds and the expected acylated and non-acylated aldobiouronic acids. A study of these oligosaccharides, as well as of a number of their related compounds, is described, with particular emphasis on the methods used to locate the formic and acetic ester groups. The location of the O-acyl substituents on the galactosyluronic residues was further supported by the results obtained from the high-resolution, 400-MHz, p.m.r. spectra and 13C-n.m.r. spectra of a number of the oligosaccharides.

Preparation of oligosaccharides by the action of bacteriophage-borne enzymes on Klebsiella capsular polysaccharides.

Depolymerization of bacterial, capsular polysaccharides by viral enzymes provides a convenient method for preparing oligosaccharides that correspond to one or more repeating unit(s) of the polysaccharide. Previous methods used for purifying bacteriophage particles, and also the procedures employed in the isolation and purification of the oligomers generated by the bacteriophage action, have been so modified as to provide a more direct route to the degradation products. Improved techniques, both for the propagation of bacteriophage and for the isolation of the oligosaccharides formed, are reported. These simplified methods make possible the use of bacteriophages as convenient "reagents" for the preparation of oligosaccharides on a gram scale. The acid- and base-labile substituents present in certain of the polysaccharides examined were seemingly unaffected by the conditions used for depolymerization. The methods are illustrated by degradation of the capsular polysaccharides from Klebsiella serotypes K17, K36, K46, K60, K63, and K74

Structural investigation of Klebsiella K-type 4 capsular polysaccharide.

The capsular polysaccharide from Klebsiella K4 contains the tetrasaccharide repeating-sequence leads to 3)-alpha-D-Glcp-(1 leads to 2)-alpha-D-Glcp A-(1 leads to 3)-alpha-D-Manp-(1 leads to 3)-beta-D-Glcp-(1 leads to. P.m.r. spectroscopy and the measurement of optical rotation were used to establish the anomeric linkages in the polysaccharide and in the oligosaccharides derived by partial hydrolysis. The repeating unit also contains one 0-acetyl group.

The molecular structure of the capsular polysaccharide from Klebsiella type 27.

The capsular polysaccharide of Klebsiella serotype K27 had been investigated by techniques involving methylation analysis, autohydrolysis, and graded hydrolysis with acid. The anomeric configurations of the sugar constituents were determined, where possible, on the basis of p.m.r. spectroscopy and optical rotation data. The results of these studies are consistent with a primary structure in which the repeating-unit is the doubly branched hexasaccharide.

Structural studies on the capsular polysaccharide from Klebsiella serotype K64.

Partial hydrolysis with acid, methylation analysis (including uronic acid degradation), Smith degradation, and p.m.r. spectroscopy have been used to determine the primary structure of the capsular polysaccharide of Klebsiella serotype K64. The hexasaccharide repeating-unit, which also contains one O-acetyl substituent, comprises a 4)-alpha-D-GlcpA-(1 leads to 3)-alpha-D-Manp-(1 leads to 3)-beta-D-Glcp-(1 leads to 4)-alpha-D-Manp-(1 leads to chain with a 4,6-O-(1-carboxyethylidene)-beta-D-glucopyranosyl and an L-rhamnosyl group attached to the 4-linked D-mannosyl residue at 0-2 and 0-3, respectively.

The carbohydrate prosthetic groups of rat fibrinogen plasmic fragment E.

Rat fibrinogen plasmic fragment E was found to contain one oligosaccharide chain per gamma-chain attached by a glycosylamine linkage. The oligosaccharide was composed of 1 sialic acid, 1 galactose, 2 mannose and 2 glucosamine residues. The probable sequence from the nonreducing end was sialic acid leads to galactose beta leads to mannose alpha leads to mannose alpha leads to glucosamine leads to glucosamine. No difference in the rate of clearance from the rat circulation could be detected between native and desialated fragment E. A non-denaturing method for the purification of fragment E is described.