The clinical utility of comprehensive measurement of autoimmune disease-related antibodies in patients with advanced solid tumors receiving immune checkpoint inhibitors: a retrospective study.

BACKGROUND: The comprehensive measurement of autoimmune disease-related antibodies (Abs) before immune checkpoint inhibitor (ICI) treatment may be useful for predicting the development of immune-related adverse events (irAEs); however, the clinical utility is not well known. MATERIALS AND METHODS: We retrospectively analyzed patients with advanced solid tumors treated with ICI monotherapy or doublet combination therapy between July 2014 and December 2020 at single institute. Anti-nuclear antibody (ANA), anti-thyroglobulin (Tg) Ab, anti-thyroid peroxidase (TPO) Ab, anti-glutamic acid decarboxylase (GAD) Ab, anti-acetylcholine esterase receptor (AchR) Ab, and platelet-associated immunoglobulin G (PA-IgG) Ab were comprehensively measured for the screening before ICI therapy. RESULTS: Of 275 registered patients (median age, 70 years; male, 64.4%; Eastern Cooperative Oncology Group performance status of 0 or 1, 88.7%; and prior regimen of 0-1/≥2, 88.7%/11.3%), 128 non-small-cell lung cancer, 35 gastric cancer, 33 head and neck cancer, 24 melanoma, 19 renal cell carcinoma, 13 urothelial carcinoma, 12 esophageal cancer, 5 malignant mesothelioma of pleura, 2 endometrial cancer, and 4 other cancer were included. The number of patients with positive ANA, Tg, TPO, PA-IgG, GAD, and AchR Abs was 52 (24.9%), 38 (14.5%), 11 (10.1%), 6 (3.5%), 5 (2.0%), and 1 (0.5%), respectively. There was no association between the development of any irAEs and Abs positivity, while thyroid dysfunction developed more frequently among patients with than without Tg Ab or TPO Ab (39.5% versus 12.5%, P < 0.01; 45.5% versus 14.3%, P = 0.02). CONCLUSIONS: The clinical utility of comprehensive measurement of autoimmune disease-related Abs before introduction of ICI therapy was limited for predicting irAE. However, Tg and TPO Abs were risk factors as regards the development of ICI-induced thyroid dysfunction.

Incidence of and risk factors for incisional hernia after closure of temporary ileostomy for colorectal malignancy.

PURPOSE: Incisional hernia is a major complication after stoma closure and can cause uncomfortable symptoms. In this study, we evaluated the risk factors for hernia formation with the aim of reducing the incidence of incisional hernia. METHODS: A total of 134 oncology patients underwent closure of a temporary loop ileostomy between May 2004 and December 2013. The incidence of incisional hernia was determined by routine follow-up computed tomography scanning every 6 months. The relationships between patients' characteristics, including age, sex, obesity, diabetes mellitus, surgical site infection, chronic obstructive pulmonary disease, hypertension, hypoalbuminemia, smoking, and presence of a midline hernia and the occurrence of incisional hernia were retrospectively evaluated. RESULTS: The median follow-up time was 47 months (range 8-130). Hernias occurred in 23.9% of patients (32/134). The median time to detection of hernias was 8 months (range 2-39). The Chi-squared test revealed significant differences in obesity (P = 0.0003), hypertension (P = 0.0057), and incisional hernia history (P = 0.0000) between patients with and without incisional hernia. Multivariable analysis and univariate analysis revealed that hypertension and the presence of midline incisional hernia were risk factors for incisional hernia. CONCLUSIONS: Hypertension and the presence of a midline incisional hernia were the major risk factors for incisional hernia after loop ileostomy closure. These risk factors can be addressed before planning surgery.

Chemical modification of arginine residues of porcine muscle acylphosphatase.

Acylphosphatase (acylphosphate phosphohydrolase, EC 3.6.1.7) from porcine skeletal muscle is inactivated by phenylglyoxal following pseudo-first-order kinetics. The dependence of the apparent first-order rate constant for inactivation on the phenylglyoxal concentration shows that the inactivation is also first order with respect to the reagent concentration. Among the competitive inhibitors for the enzyme examined, inorganic phosphate and ATP almost completely, and Cl- partially, protect the enzyme against the inactivation. The dissociation constants for inorganic phosphate and ATP determined from protection experiments by these inhibitors agree well with those from inhibition experiments by them. These results support the idea that the modification occurs at the phosphate-binding site. The amino-acid analysis reveals the lack of reaction at residues other than arginine. Circular dichroism spectra of the modified enzymes show that the inactivation seems not to be due to denaturation of the enzyme resulting from the modification of the non-essential arginine residues. The relationship between the loss of the enzyme activity and the number of arginine residues modified in the presence and absence of ATP shows that one arginine residue is possibly responsible for the inactivation of acylphosphatase.

Antigenic structure of adenylate kinase from porcine skeletal muscle--II. Immunochemical cross-reactivity of fragments from adenylate kinase.

Specific antibody to a fragment [CBb(2-56)] of porcine muscle adenylate kinase was purified from goat antiserum against adenylate kinase on an immunoadsorbent column. This anti-CBb antibody cross-reacted in solid phase radioimmunoassay with two other CNBr-fragments of adenylate kinase, CBfN(81-125) and CBfC(126-194). This cross-reactivity explained their high inhibition activities in quantitative precipitin reaction between adenylate kinase and goat antiserum shown in the previous work. Cysteinyl residues of the enzyme (positions 25 and 187) were S-cyanylated with 2-nitro-5-thiocyanobenzoic acid and the enzyme was cleaved at these residues. Fragment 1-24 thus obtained was purified. The fragment 1-24, composing the N-terminal half of CBb(2-56), accounted for full activity of CBb to anti-CBb in radioimmunoassay. Hence antigenic region(s) of CBb(2-56) exist in its N-terminal half, 2-24, and this determinant(s) may be closely related to the cross-reactivity among CB-fragments. CBfN also bound to the antibody fraction which had not been adsorbed to CBb-Sepharose (non-anti-CBb). CBfN carried additional antigenic regions. In conclusion, we propose that the antigenic reactive region(s) of adenylate kinase responsible for the cross-reactivity of the CB-fragments are as follows: -Glu-Glu-Lys-Leu-Lys-Lys- (2-7), -Glu-Glu-Phe-Lys-Arg-Lys- (103-108), -Glu-Glu-Thr-Ile-Lys-Lys- (143-148).

Chronic treatment with captopril, SQ29,852, hydralazine and a 33% fish meal diet in malignant stroke-prone spontaneously hypertensive rats.

Malignant stroke-prone spontaneously hypertensive rats (M-SHRSP) are a useful animal model for studying juvenile malignant hypertension. Using M-SHRSP males, the effects of SQ 29,852 [(S)-1-[6-amino-2-[[hydroxy (4-phenylbutyl) phosphinyl]oxy]-1-oxohexyl]-L-proline; 30-40 mg/kg per day], captopril (30-40 mg/kg per day), hydralazine hydrochloride (10-15 mg/kg per day) and a 33% fish meal diet on the prevention and therapy of malignant hypertension were examined. Drugs and diet were given separately, beginning at weaning, maturity or adulthood. Observed effects included antihypertension, prolonged life span and prevention and/or reversal of angionecrosis. Each treatment resulted in an antihypertensive effect, but some adult rats seemed treatment-resistant. SQ 29,852 was the most effective treatment for reducing blood pressure. The life span of animals in the treated groups was extended significantly beyond that of the controls. In particular, those rats treated with either captopril or SQ 29,852 lived in excess of 500 days. This included not only those in which treatment resulted in a lowering of blood pressure, but also those whose severe hypertension was not so reduced. Angionecrosis was observed in the organs of many of the non-treated animals, including the brain, heart, kidneys and testes. Both hydralazine and the fish meal diet had a limited effect, if any, on the prevention or reversal of angionecrosis. In contrast, almost none of the rats given either captopril or SQ 29,852 showed cerebrovascular lesions or angionecrosis of the brain, heart and kidneys; angionecrosis in adult M-SHRSP kidneys disappeared within 10 or 18 days after the initiation of SQ 29,852 or captopril, respectively. This data seems to support a possible role for these two drugs not only in prevention, but also in repair, of angionecrosis independent of markedly high blood pressure in M-SHRSP. Based on our overall observations, SQ 29,852 was seen as the most effective of the treatments studied.

Complex formed from 3-hydroxy-4-formylpyridine, glutamic acid, and technetium--a possible cholescintigraphic agent.

In order to obtain a technetium-99m-labeled cholescintigraphic agent suitable for kit preparation, reactions of a variety of aromatic aldehydes, amino acids, and [99mTc] pertechnetate were examined under mild conditions. Aqueous solutions of the three reactants were heated in a boiling-water bath and the products analyzed by means of thin-layer chromatography for the formation of organic technetium complexes. 3-Hydroxy-4-formylpyridine (HFP) and 1-methyl-3-hydroxy-4-formylpyridinium chloride (N-Me-HFP) formed the complex with excellent yields, whereas 3-hydroxy-2-formylpyridine, 4-nitrosalicylaldehyde, salicylaldehyde, and isonicotinaldehyde did not. The complex is concluded to be the Tc-99m chelate of the Schiff base formed from the aldehyde and amino acbbits administered with the complex of HFP, glutamic acid and Tc-99m. The results indicate that it is promising as a cholescintigraphic agent.

Isolation and properties of creatine kinase from porcine skeletal muscle.

Creatine kinase has been isolated in a good yield from porcine skeletal muscle. The enzyme was purified about 8-fold from crude extract of porcine skeletal muscle in a yield of about 44%. The purified enzyme was homogeneous, as judged by sedimentation velocity (S020,W=5.31S), sedimentation equilibrium, and polyacrylamide gel electrophoresis. The molecular weight of the enzyme was determined to be 83,200 by high-speed meniscus-depletion sedimentation equilibrium analysis. The molecular weight of its subunit was estimated to be 43,000-44,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The amino acid composition of the enzyme was determined.

Isolation of three creatine kinases MM from porcine skeletal muscle.

The purified creatine kinase MM of porcine skeletal muscle [Takasawa, T. & Shiokawa, H. (1981) J. Biochem. 90, 195-204] was separated into three distinct fractions by isoelectric focusing (IEF) in a sucrose gradient column, and the three active fractions were isolated by repeated IEF. There were one major fraction with isoelectric point (pI) 6.57 and two minor fractions with pI 6.74 and pI 6.34, respectively. No differences were observed in the IEF pattern of the enzyme in the presence and absence of dithiothreitol throughout the column. There was no interconversion from one form to another during IEF. The distribution of the three forms on IEF was not affected by adding protease inhibitor to the extraction medium. Of the three fractions, the major fraction had the highest specific activity. The three fractions differed from one another in their amino acid compositions. Not only porcine muscle but also rabbit muscle creatine kinase displayed this type of heterogeneity. Such microheterogeneities may occur widely in muscle creatine kinases.

Dimer structure of three creatine kinases MM from porcine skeletal muscle.

Three active fractions, FI, FII, and FIII, of porcine muscle creatine kinase MM isozyme, which had been isolated as single peaks by repeated isoelectric focusing (IEF), were subjected to reconstitution experiments to study their dimer structure. The specific activities of the three fractions were almost uninfluenced by a dissociation-reassociation procedure. Only one component was observed on IEF after reassociation of the subunits of FII. Three components were observed on IEF after reassociation of subunits of FI and FIII. These results show that FII, with isoelectric point (pI) 6.57, has a homodimeric structure (M2M2), consisting of two identical subunits. FI and FIII, with pI 6.74 and pI 6.34, respectively, have heterodimeric structures (M1M2 and M2M3, respectively), consisting of two nonidentical subunits.

Fluorescent probes for antibody active sites. II. Further studies on two groups of anti-MANS antibodies with significantly different effects on MANSamide fluorescence produced by a single rabbit.

As described previously, a single rabbit (No. 13) produced two groups of anti-MANS antibodies with significantly different effects on MANSamide fluorescence. These groups, anti-MANS antibody (415 nm) and anti-MANS antibody (465 nm), had emission maxima at 415 nm and 465 nm, respectively. This paper deals with the immunochemical properties of the two groups of antibodies (1) The results of fluorometric titration of these groups with MANSamide indicated that anti-MANS antibody (465 nm) had a higher affinity for MANSamide than did anti-MANS antibody (415 nm). (2) More than 70% of anti-MANS antibody (415 nm) was adsorbed on Sepharose covalently coupled with bovine serum albumin, which was used as a carrier during immunization, while a hlaf of anti-MANS antibody (465 nm) was adsorbed. (3) Only one of the groups, anti-MANS antibody (465 nm), had precipitating activity toward MANS-rabbit serum albumin used as a test antigen.

Antigenic structure of adenylate kinase from porcine skeletal muscle. IV. Two antigenic determinants on carboxyl-terminal peptide 126-194.

Delineation of the location(s) of antigenic activity in CNBr peptide 126-194 from porcine skeletal muscle adenylate kinase (AK) was attempted. Peptide 126-194 was digested with chymotrypsin, Staphylococcus aureus V8 protease and trypsin, and several short peptides were purified from the digests by reverse-phase high-performance liquid chromatography (HPLC). Inhibition of the binding of radioiodinated peptide 126-194 to goat antibody to porcine skeletal muscle AK (anti-AK antibody) by the peptides obtained by the enzymatic cleavages was examined by solid phase radioimmunoassay (RIA). At least two antigenic determinants have been identified from the results. One is in the amino (N)-terminal half region 126-154, especially in the vicinity of 131-144, and the other is in the carboxyl (C)-terminal half region 165-183, especially in the vicinity of 165-171. Both of them seem to correspond to exposed and accessible regions in the three-dimensional structure of AK. The correlation between antigenicity and high mobility of the loop in the estimated antigenic region 131-144 is also discussed.

Fluorescent probes for antibody active sites. I. Production of antibodies specific to the N-methyl-2-anilinonaphthalene-6-sulfonyl group in rabbits and some fluorescent properties of the hapten bound to the antibodies.

1. Rabbits were immunized with N-methyl-2-anilinonaphthalene-6-sulfonyl (MANS) bovine serum albumin (MANS-BSA) prepared by the reaction of bovine serum albumin with N-methyl-2-anilinonaphthalene-6-sulfonyl chloride to obtain IgG fraction containing anti-MANS antibodies. 2. Both N-methyl-2-anilinonaphthalene-6-sulfonate (MANSate) and N-methyl-2-anilinonaphthalene-6-sulfonamide (MANSamide), which are virtually non-fluorescent in aqueous solution, became strongly fluorescent, with a blue shift of about 100 nm, when they were specifically bound to the antibodies against the hapten group contained in the IgG fractions. 3. IgG fractions were obtained from five immunized rabbits at intervals after the primary immunization. The fluorescence characteristics of the hepten were carefully examined with preparations of IgG fraction differing in source and time of bleeding. One of the rabbits showed a very interesting immune response. The rabbit produced two groups of anti-MANS antibodies which were significantly different in their effect on the fluorescence properties of the hapten group. One of the groups was exclusively produced at the early stage in the immune response. The other group appeared at the late stage. It is suggested that the two groups differ as regards the structure of the hepten combining sites. 4. The above findings indicate that the MANS group can be successfully used as a hapten with useful properties as a fluorescent probe.

Purification and properties of porcine testis acylphosphatase.

Acylphosphatase has been purified from porcine testis and its properties were compared with those of porcine skeletal muscle acylphosphatase. The molecular weight of the testis enzyme was found to be 10,600, similar to that of porcine skeletal muscle acylphosphatase, on sedimentation equilibrium analysis. The specific activity of the testis enzyme was 10,800 mumol/min/mg at 25 degrees C with benzoyl phosphate as substrate, i.e., higher than that of the muscle enzyme, 7,200 mumol/min/mg, under the same conditions. The pI of the testis enzyme was 8.3, i.e., lower than that of the muscle enzyme, 10.6. There were marked differences in the amino acid compositions of the two enzymes. In particular two histidine residues were present in the testis enzyme but none were present in the muscle enzyme, and no cysteine residue was present in the testis enzyme but one was present in the muscle enzyme. The carboxyl terminal amino acid of the testis enzyme seemed to be lysine, while that of the muscle enzyme is tyrosine. The peptide maps of the testis and muscle enzymes indicated considerable differences in the amino acid sequences of the two enzymes. Differences in the antigenic structures of the two enzymes were demonstrated on enzyme linked immunoassaying and double immunodiffusion. These results indicate that the porcine testis acylphosphatase is an isozyme different from the porcine skeletal muscle acylphosphatase.

Properties of three creatine kinases MM from porcine skeletal muscle.

The properties of three fractions (FI, FII, and FIII) of porcine creatine kinase MM, which have been isolated by isoelectric focusing, were compared. Sugars were not detected in them. Their carboxyl-terminal sequences were identical and were determined to be -Thr-Lys by digestion with carboxypeptidases A and B. Immunodiffusion and competitive radioimmunoassay could not differentiate the three fractions from one another. Their amino-terminal sequences revealed that they had different primary structures. At residue 1, although all the three fractions had Pro, FI and FIII had an additional amino acid, Ser. At residue 23, only FI had Leu in addition to Ser, the amino acid common to the three fractions. These results indicate that differences among the three fractions of porcine creatine kinase MM are based on differences in the primary structures of the subunits in their dimer structures, and confirm the conclusion that FII is a homodimer and FI and FIII are heterodimers, which was reported in the preceding paper [Takasawa, T. & Shiokawa, H. (1983) J. Biochem. 93, 383-388].

Ontogenic expression of the two isozymes, Ch1 and Ch2, of chicken muscle acylphosphatase.

Activities of the two isozymes, Ch1 and Ch2, of chicken muscle acylphosphatase were measured in breast muscles, leg muscles, and livers of developing chicks from day 11 in ovo to day 15 of free life. Measurement was performed using rabbit antibodies which could selectively precipitate Ch1 or Ch2. The activity contents of both Ch1 and Ch2 in muscles were low before hatching but rapidly increased after hatching. Ch1 showed a more marked increase than Ch2. In liver, on the other hand, the activity contents of Ch1 and Ch2 remained low throughout the period of pre- and post-hatching.

Crystallization and properties of acylphosphatase from porcine skeletal muscle.

A crystalline acylphosphatase has been obtained from porcine skeletal muscle. The purification procedure consists of extraction with water, phosphocellulose column chromatography, CM-cellulose column chromatography, and crystallization. The enzyme was homogeneous by polyacrylamide gel electrophoresis. A high yield (39%) of the pure enzyme was attained by the use of buffers containing 10 mM 2-mercaptoethanol to prevent dimerization of the enzyme in the purification process. Activity assay in the presence of bovine serum albumin showed a high specific activity of the enzyme (about 7,000 mumol/min/mg at 25 degrees C with benzoyl phosphate as substrate). The molecular weight was determined to be 11,100 by sedimentation equilibrium. The amino acid composition of the enzyme was determined. The amino-terminus of the enzyme was blocked and the carboxyl-terminal residue was tyrosine.

Carbohydrate-binding activity of concanavalin A containing various numbers of calcium and manganese ions.

After treatment with EDTA, fragment-free concanavalin A (Con A), F3, was fractionated into three major fractions, f1, f2, and f3, by CM-cellulose chromatography. Fully metallized fragment-free Con A, F3M, was prepared by incubation of F3 with excess metal ions and also fractionated into f1M, f2M, and f3M by the same method as for F3. The Con A preparations obtained were analyzed for metal content by atomic absorption spectrophotometry and for number of carbohydrate-binding sites by ultraviolet absorbance change on binding of p-nitrophenyl alpha-D-mannopyranoside (PNP . Man) to Con A. Both f1 (Ca: 0.2, Mn: 0.1) and f1M (Ca: 0.4, Mn: 0.2) had less than 0.6 carbohydrate-binding sites per tetramer of Con A. f2 (Ca: 2.1, Mn: 0.9) and f2M (Ca: 2.1, Mn: 1.9) had 1.9 and 1.8 carbohydrate-binding sites, respectively. f3 (Ca: 4.1, Mn: 2.1) and f3M (Ca: 3.8, Mn: 4.0) had 4.1 and 4.2 carbohydrate-binding sites, respectively. Carbohydrate-binding sites of Con A were in a stoichiometric relation to bound Ca2+. The molar absorptivity change at 317 nm was 2 X 10(3) M-1 . cm-1. Precipitation activity of the above Con A preparations towards glycogen was also estimated using glycogen labeled covalently with Remazolbrilliant Blue R. The precipitation activity of Con A as well as PNP . Man-binding was strongly affected by the number of bound Ca2+. A slight contribution by Mn2+ was also detected in the precipitation activity.

Crystallization and properties of creatine kinase from equine skeletal muscle.

A crystalline creatine kinase was obtained from equine skeletal muscle. The enzyme was homogeneous, as judged by ultracentrifugation and disc electrophoresis on polyacrylamide gel. The crystalline enzyme had a specific activity of 110 units per mg of protein, that is, 14-fold purification over the crude extract of equine skeletal muscle. The molecular weight of the enzyme was determined to be 84,600 by the conventional low-speed sedimentation equilibrium method, and s020,w was 5.32S. Eight cysteine residues were found on amino acid analysis, two of which were essential for the enzymatic activity.

Antigenic structure of adenylate kinase from porcine skeletal muscle. I. Three immunochemically active peptides obtained by cleavage with cyanogen bromide.

Analysis of the quantitative precipitin reaction of adenylate kinase from porcine skeletal muscle with goat anti-adenylate kinase antiserum indicated that there are at least four antigenic determinants on the enzyme molecule. Porcine adenylate kinase was cleaved with cyanogen bromide, and four peptides were fractionated by ion-exchange chromatographies. Three fragments, CBb (2-56), CBfN (81-125), and CBfC (126-194), inhibited the quantitative precipitin reaction of intact adenylate kinase with goat antiserum. CBb, CBfN, and CBfC also inhibited the binding of 125I-labeled adenylate kinase to the specific antibody purified from goat antiserum. In both inhibition studies, the inhibitory activity of each fragment was extremely high, and reached 70% or more in the latter case. From these results and in view of the presence of the sequence -Glu-Glu-X-X'-Lys (or Arg)-Lys- in each immunochemically active fragment, we suggest that these fragments have similar antigenic determinants which are cross-reactive.

The primary structure of chicken muscle acylphosphatase isozyme Ch1.

The amino acid sequence of chicken muscle acylphosphatase isozyme Ch1 was determined. The protein consists of 102 amino acid residues, does not contain histidine, and the NH2-terminus is acetylated: Ac-Ser-Ala-Leu-Thr-Lys-Ala-Ser-Gly-Ser- Leu-Lys-Ser-Val-Asp-Tyr-Glu-Val-Phe-Gly-Arg-Val-Gln-Gly-Val-Cys-Phe-Arg- Met- Tyr-Thr-Glu-Glu-Glu-Ala-Arg-Lys-Leu-Gly-Val-Val-Gly-Trp-Val-Lys-Asn- Thr- Ser-Gln-Gly-Thr-Val-Thr-Gly-Gln-Val-Gln-Gly-Pro-Glu-Asp-Lys-Val-Asn-Ala- Met- Lys-Ser-Trp-Leu-Ser-Lys-Val-Gly-Ser-Pro-Ser-Ser-Arg-Ile-Asp-Arg-Thr-Lys- Phe-Ser- Asn-Glu-Lys-Glu-Ile-Ser-Lys-Leu-Asp-Phe-Ser-Gly-Phe-Ser-Thr-Arg-Tyr-OH. This sequence differs in 44% of the total positions from the other isozyme (Ch2) of chicken muscle acylphosphatase (Ohba et al., the accompanying paper). The sequence of Ch1 has three substitutions from that of turkey muscle acylphosphatase; these are Ser from Ala at position 9, Ser from Arg at 47, and Lys from Asn at 83. The sequence has about 80% homology with those mammalian muscle acylphosphatases.