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Biomedical subjects

A J Pesce

Publications and source records attributed to A J Pesce.

At least 37 records · Page 2Linked to original sources
PubMed1990

Cationization of protein antigens. V. Effect of the degree of cationization on patterns of immune responsiveness.

Preparations of bovine serum albumin (BSA) were cationized by substituting anionic side chain carboxyl groups with polycationic aminoethylamide groups. Different degrees of substitution were obtained by varying the reaction time. Mice immunized with partially cationized proteins produced early increased levels of antibody over those made by mice immunized with nBSA, followed by a period of decreased response before returning to a second period of enhanced and prolonged antibody synthesis. In contrast, fully substituted BSA gave rise to a significantly enhanced response which was delayed in its onset. Differences in isotype or in antibody specificity during the early and late periods of enhanced responsiveness could not be demonstrated. Cell transfer experiments showed that T cells harvested from mice immunized with the less cationized cBSA preparations could, in contrast to T cells from mice immunized with the fully cationized preparations, suppress antibody responses to both nBSA and cBSA in normal mice. These data are consistent with the possibility that the partially cationized proteins, in contrast to the fully cationized antigen, yield a unique pattern of responsiveness due to retention of determinants necessary for the induction of Ts while exhibiting the enhanced immunogenicity characteristic of cationized molecules.

Animals↗
PubMed1990

In vitro measurement of phosphorylated zidovudine in peripheral blood leucocytes.

A method has been developed to measure the concentration of total phosphorylated zidovudine (ZDV) inside peripheral blood leucocytes (PBLs) using a modified commercial radioimmunoassay (RIA) specific for ZDV. ZDV 5'-monophosphate was readily synthesized and used as a procedural control for RIA modification. PBLs were isolated from healthy volunteers and incubated with ZDV for 24 h to allow metabolic phosphorylation. Viable cells were counted, washed, and extracted overnight with 60% methanol. After evaporation, the extract was reconstituted in Tris buffer, pH 9.5. Because of minimal RIA antibody cross reactivity with phosphorylated ZDV, samples were split into two fractions, one of which was treated with alkaline phosphatase (AP) to liberate phosphate groups. Each fraction was then assayed for ZDV. Concentrations of phosphorylated ZDV were determined by subtracting the concentration of the non-AP-treated fraction from that of the treated fraction. Recovery of phosphorylated ZDV from cell extracts was approximately 90%, and reproducibility was acceptable (coefficients of variation less than 15% for concentrations greater than or equal to 0.25 ng/ml). Intracellular concentrations (0.1-1.4 pmoles/10(6) cells) followed a nonlinear dose-response relationship over the range 0-50 microM extracellular ZDV, with concentration-dependent saturation. These results demonstrate the feasibility of determining concentrations of phosphorylated ZDV in HIV-infected patients, a potentially key step in establishing a therapeutic range and optimal dosing regimen for these patients.

Alkaline Phosphatase↗
PubMed1990

Modulation of the immune response to allergens: phospholipase A degradation products suppress IgG and IgE response in mice.

Degradation products of phospholipase A2 (PLA2), the major allergen of honeybee venom, were prepared by peptic digestion of the enzyme and fractionated by molecular exclusion chromatography. The largest of the isolated products, P-1, was found to be a centrally nicked PLA2 molecule with a loss of several amino acids. It was examined for its antigenic, immunogenic and immunosuppressive properties. This peptic product was unable to block antigen-antibody reactions between PLA2 and anti-PLA2 antibodies and was incapable of inducing passive cutaneous anaphylaxis in rat skin sensitized with mouse anti-PLA2 IgE antibodies. BDF1 female mice injected intravenously with P-1 exhibited suppressed IgG and IgE anti-PLA2 responses to a subsequent PLA2 immunization. Intravenous administration of P-1 to mice with ongoing immune response to PLA2 resulted in decline of antigen-specific IgE titers. Transfer of splenic T cells from mice injected with P-1 into naive recipients caused profound suppression of the response to subsequent immunization with PLA2 indicating presence of PLA2-specific T suppressor cells. These results indicate that a degradation product of PLA2 prepared by peptic digestion lost antigenic and immunogenic properties of the intact enzyme but retained immunosuppressive properties, thus offering a novel approach to allergen immunotherapy.

Allergens↗
PubMed1989

Concomitant administration of cyclosporin and ketoconazole in renal transplant recipients.

18 renal transplant recipients receiving cyclosporin, prednisone, and azathioprine were given ketoconazole, a potent inhibitor of the cytochrome P-450 enzyme system. Within a month ketoconazole-induced blockade of cyclosporin metabolism allowed a significant reduction (451 vs 106 mg/day; 77%) of the mean dose of cyclosporin without altering cyclosporin whole blood trough levels, although maximum blood levels were almost halved. This dose reduction was maintained in patients followed up for up to 13 months. Renal and hepatic function were unchanged after the addition of ketoconazole. This drug interaction has the potential to reduce dramatically expenditure on cyclosporin in transplant recipients.

Administration, Oral↗
PubMed1989

Hemoglobin determination in plasma or serum by first-derivative recording spectrophotometry. Evaluation of the procedure of Soloni, Cunningham, and Amazon.

The authors tested the plasma hemoglobin measurement procedure of Soloni, Cunningham, and Amazon (Am J Clin Pathol 1986;85:342-347), which uses recording derivative spectrophotometry. By this technique, the authors were able to measure plasma or serum hemoglobin down to a level of 10 mg/L (1 mg/dL). The method was found to be quantitative and not affected by bilirubin or lipemia. Methemoglobin did not interfere with the assay. The observed first derivative maxima and minima were reproducible but instrument dependent. The authors applied this technique to the measurement of serum hemoglobin in 100 healthy human subjects. They observed a geometric mean value of 68 mg/L (6.8 mg/dL) with the actual range 21-189 mg/L (2.1-18.9 mg/dL). The authors confirm that this technique is a simple, rapid, and reproducible method for determining plasma or serum hemoglobin.

Bilirubin↗
PubMed1989

A comparison of the clinical utility of the radioimmunoassay, high-performance liquid chromatography, and TDx cyclosporine assays in outpatient renal transplant recipients.

Rapid and precise cyclosporine measurements are necessary to maximize immunosuppression and minimize toxicity. The new cyclosporine and metabolites TDx fluorescent polarization immunoassay was studied to determine its precision, sensitivity, and stability. Further, it was compared with the existing radioimmunoassay and high-performance liquid chromatography assays for clinical utility. The TDx procedure utilizes 50 microliter of serum or blood. The range of the assay is 0-1000 ng/ml for serum and 0-2000 ng/ml for whole blood. Precision studies of three control levels provided coefficients of variation of 2.1-5.8% for both assays. The sensitivities of the assays were less than 25 ng/ml for serum and less than 50 ng/ml for whole blood. In order to compare the TDx with the currently used RIA and HPLC methods, 362 simultaneous whole blood and serum samples were obtained from 122 renal transplant recipients over a 4-month period. The serum and whole blood TDx assays excluded fewer patients than either the RIA or HPLC assays with regard to sensitivity. The mean serum cyclosporine concentration for samples above the sensitivity was as follows: TDx 120 +/- 5 ng/ml, RIA 116 +/- 4 ng/ml, and HPLC 100 +/- 5 ng/ml. The mean whole-blood cyclosporine concentration for samples above the sensitivity was as follows: TDx 585 +/- 19 ng/ml, RIA 543 +/- 14 ng/ml, and HPLC 178 +/- 5 ng/ml. Serum and blood TDx levels correlated well with RIA levels, with regression coefficients of r = 0.813 and r = 0.897, respectively. Serum and blood TDx levels did not correlate strongly with HPLC levels, with regression coefficients of 0.332 and 0.781, respectively. Seventeen patients were diagnosed as having acute cyclosporine nephrotoxicity. The serum and whole-blood cyclosporine concentrations in these patients were at the upper end of the therapeutic range for all analytical methods. Five patients had acute cellular rejection; serum and whole-blood cyclosporine levels in these patients did not differ significantly from the stable patients when measured by each of the analytical methods. In conclusion, the TDx cyclosporine and metabolites assay provides reliable blood and serum concentrations that correlate well with RIA measurements in renal transplant recipients. This assay offers rapid sample turn-around times making possible same-day results for all patients without putting great demands upon the laboratory.

Ambulatory Care↗
PubMed1989

Co-trimoxazole (sulphamethoxazole plus trimethoprim) peritoneal barrier transfer pharmacokinetics.

The pharmacokinetics of co-trimoxazole (sulphamethoxazole plus trimethoprim) were studied in end-stage renal disease in patients undergoing treatment with continuous ambulatory peritoneal dialysis (CAPD) and free of peritonitis. Plasma and dialysate concentrations were monitored for 1 exchange after administration of a single oral or intraperitoneal dose of co-trimoxazole, and were fitted by a pharmacokinetic model that took into account the equilibrium nature of CAPD by including return from the peritoneum in oral studies and from the plasma in intraperitoneal studies. Clearances were calculated and compared by analysis of variance. There was a significant effect of direction of flow (p less than 0.01), plasma-peritoneal clearances being larger than peritoneal-plasma clearances for both drugs. In addition, there was a significant difference (p less than 0.0001) between sulphamethoxazole clearances and trimethoprim clearances, with the latter being greater in both directions.

Administration, Oral↗
PubMed1989

An evaluation of the cyclosporine and metabolites whole blood TDx assay.

The new Abbott TDx cyclosporine and metabolites fluorescent polarization immunoassay procedure provides a 20-min sample turn-around time, using 50 microliters of sample for the analysis of cyclosporine in whole blood. A precipitation agent and a lysing agent are utilized as a pretreatment step. The range of the whole blood assay is from 0 to 2,000 ng/ml, with a sensitivity of 50 ng/ml. Precision studies at 3 control levels provided coefficients of variation of 2.1-4.8% for both assays. In order to compare this assay with the currently used Sandoz polyclonal radioimmunoassay (RIA) method. 200 whole blood samples were obtained from 20 renal, cardiac, and hepatic transplant recipients. The mean whole blood cyclosporine concentrations for samples above the sensitivity level were as follows: TDx 754 ng/ml (+/- 31) and RIA 619 ng/ml (+/- 22). Blood TDx levels correlated strongly with RIA levels, with a regression coefficient of r = 0.915. This new assay provides reliable blood cyclosporine concentrations that correlate well with RIA measurements. This assay offers rapid sample turn-around times, making same-day results for outpatient drug monitoring possible.

Cyclosporins↗
PubMed1989

Liquid-chromatographic monitoring of cytosine arabinoside and its metabolite, uracil arabinoside, in serum.

This is a "high-performance" liquid-chromatographic method for quantifying the antileukemic drug cytosine arabinoside (cytarabine; 1-beta-D-arabinofuranosylcytosine; Ara-C), with a structural analog, 5-methylcytidine, as the internal standard. We used a C18 reversed-phase column and ammonium acetate (0.5 mol/L, pH 6.5) as the mobile phase, monitoring the column effluent at 280 nm. Tetrahydrouridine was present in the sample-collection tubes to inhibit conversion of cytosine arabinoside to uracil arabinoside. The standard curve is linear to 100 mg/L. Analytical recovery is 98%. Coefficients of variation for within-run and between-run imprecision were 2.0% and 4.3% at 20 mg/L and 2.7% and 2.7% at 80 mg/L, respectively. Assay sensitivity was limited by the amount of endogenous material in each patient's serum, making assay of a pre-infusion sample necessary for accurate calculations. In a trial patient population, the assay was shown to have potential for the detection of toxic concentrations in patients receiving high doses of Ara-C.

Aged↗
PubMed1989

Microplate measurement of urinary albumin and creatinine.

We describe microplate methods for measurement of human urinary albumin (HUA) by competitive enzyme-linked immunosorbant assay (ELISA) and creatinine with a modified commercial enzymatic kit. Incorporation of substrate mixing into the competitive ELISA changes the dynamic absorbance-concentration response, greatly simplifying calculations and improving sensitivity and accuracy. Measurement of creatinine in urine and plasma samples with a commercially available enzymatic kit modified for analysis by use of an inexpensive microplate reader produced values comparable in precision and accuracy to those obtained by an automated kinetic Jaffé method.

Adult↗
PubMed1988

Hyperthermia, hypertension, hypertonia, and coma in a massive thioridazine overdose.

This report characterizes an atypical presentation of a thioridazine overdose. Clinical manifestations included wide Q.R.S. complex, hyperthermia, hypertension, hypertonia, and coma. Plasma catecholamine levels were markedly elevated. The patient was treated with dantrolene sodium and supportive care. The patient's condition improved over time, with questionable response to dantrolene sodium. Supportive care was the mainstay of treatment.

Acute Disease↗
PubMed1988

Regulation of the immune response to allergens by immunosuppressive allergenic fragments. 1. Peptic fragments of honey bee venom phospholipase A2.

Nine patients with anaphylactic sensitivity to honey bee venom (HBV) were treated with P-1, a pepsin derived fragment of HBV phospholipase A2 (PLA2). P-1 caused only rare reactions with doses of 100 micrograms/injection. Treatment resulted in a substantial decrease in specific anti-PLA2 IgE and IgG antibodies as well as a decline in skin test sensitivity to PLA2. Another group of HBV-sensitive patients was treated with unaltered PLA2. Doses greater than 20 micrograms/injection were not tolerated. PLA2 injections caused an increase in anti-PLA2 IgG and IgE antibodies as well as increase in skin test sensitivity. This study demonstrates that a nonimmunogenic fragment derived from an allergen can downregulate immune responses and thus offer a new modality for therapy of allergic diseases.

Adult↗
PubMed1988

C3 dependent, C5 independent immune complex glomerulopathy in the mouse.

This study examines the role of complement in a murine model of accelerated nonproliferative immune complex glomerulopathy. Two C5 deficient strains (DBA/2J and B10.D2oSnJ) as well as normocomplementemic mice consistently develop heavy proteinuria and glomeruli show loss of normal visceral epithelial cell architecture within 4 days of intravenous antigen administration. In contrast, animals depleted of C3 with cobra venom factor fail to develop proteinuria and retain discrete foot processes. Semiquantitative evaluation of antigen and antibody in glomeruli shows equivalent deposition in mice from all groups. The localization of these deposits, however, is different in C3-depleted mice. There is extensive accumulation of deposits along the subepithelial aspect of the glomerular basement membrane of normocomplementemic and C5 deficient mice while deposits in glomeruli of C3-depleted animals accumulate in the subendothelial region and do not cross the glomerular basement membrane. These data demonstrate that in this model, glomerular injury is dependent on complement components generated up thru C3 but not C5 or latter components. In addition, our data suggest that C3 is important in the movement of immune complexes across the glomerular basement membrane. Although the mechanism by which complement is mediating injury in this model is not known, it does not appear to involve an inflammatory cell infiltrate or the terminal complement components.

Animals↗
PubMed1988

Clinical variability of cyclosporine pharmacokinetics in adult and pediatric patients after renal, cardiac, hepatic, and bone-marrow transplants.

The most important limitation associated with the clinical use of cyclosporine is the narrow therapeutic range between its efficacy and toxicity. Effective treatment is further complicated by significant variation in intrapatient and interpatient pharmacokinetics of the drug. We describe a practical approach to pharmacokinetic analysis that does not interfere with the cyclosporine dosage regimen or with clinical management of the patient. To optimize therapy, we individualized patient management by using noncompartmental pharmacokinetic analysis. Mean residence time (MRT) and volume of distribution at steady-state were calculated from data on concentration vs time after dose. We applied this approach to 24 kidney, 12 heart, 8 bone-marrow, 7 liver, and 5 pancreas transplants. Individualized requirements for cyclosporine dose and dosage interval can be predicted from these parameters. MRT is the most useful pharmacokinetic parameter, because it allows prediction of the optimal dosage interval.

Adult↗