Further observations on the inhibition of tumor growth by Corynebacterium parvum with cyclophosphamide. IX. Macrophage content of tumors in mice.
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Biomedical subjects
Publications and source records attributed to B Fisher.
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Since it has been demonstrated that the administration of Corynebacterium parvum is associated with increased hepatocyte proliferation in both normal and regenerating livers, it seemed appropriate to determine whether the use of this agent would affect the hepatic atrophy which occurs following end-to-side portacaval shunts. When administered at shunting, liver weight and liver deoxyribonucleic acid failed to decrease to the same extent as that occurring in untreated, shunted rats. An increase in liver deoxyribonucleic acid synthesis was observed following portacaval shunt only in treated rats. Corynebacterium parvum administration to portacaval shunt rats with livers demonstrating marked atrophy 15 to 18 days following shunting resulted in the reversal of such atrophy. There was an increase in liver weight and deoxyribonuclei acid to the extent that those values were equal to, or greater than, those of livers from nonshunted rats. By increasing the number of cells within liver, Corynebacterium parvum administration prevents or reverses the decrease in liver size, that is, atrophy, which occurs after portacaval shunts were performed.
Findings from this study using a transplantable C3H mammary tumor failed to indicate interaction relative to growth parameters between two foci present in the same host. Whether they were growing alone or in the presence of a second focus, tumor growth rates were similar until the combined mass of multiple tumors approached that which was incompatible with survival. Only then was a difference in growth observed. Cytokinetic parameters, i.e., labeling index, primer-dependent DNA polymerase index or growth fraction, DNA synthesis time, tumor doubling time, and cell cycle time, were also similar whether tumors grew alone or in the presence of a second focus. Following removal of a tumor, changes were observed within 24 hr in the kinetics of the residual focus. There was an increase in labeling index (duration approximately equal to 10 days) and primer-dependent DNA polymerase index with a decrease in the tumor doubling time. Minimal change was noted in DNA synthesis time and cell cycle time. The kinetic changes observed were reflected in a measureable increase in tumor size approximately equal to a week following tumor removal. Absence of an alteration in DNA synthesis time and cell cycle time indicates that the increase in tumor growth was probably due to a conversion of noncycling cells in G0 phase into proliferation. Relationship of the findings to the use of adjuvant chemotherapy is considered.
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Blocks of axillary lymph nodes from 78 patients with invasive breast cancer, which after "routine" pathological examination were regarded as negative for metastases, were step-sectioned at 20 u intervals. Occult metastases were detected in 24% of the cases. A significant association between such metastases and a lack of or slight degree of an intraductal carcinomatous component of the dominant cancer was noted. There was no relationship between occult metastases and 15 other histopathological and 3 clinical features investigated, including an average 5 year survival rate. Similarly there was no correlation between any of the possible discriminants investigated in the 24% of patients who have died of their diseases or are living with recurrence regardless of the presence of occult metastases. Factors accounting for the lack of universal survival in patients with Stage I (and those with occult metastases that might be designated as stage 11/2) remain enigmatic. It is concluded that attempts to detect occult metastases by extending histopathological methods may be more academic than practical or therapeutically significant.
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Using a standard heterologous assay in which lymphokines alter guinea pig peritoneal macrophage migration, it was found that regional lymph node cells (RLNCs) from patients with primary breast cancer elaborate soluble factors which variably affect such migration. Variation of migration resulted when soluble factors employed were obtained from different nodes in the same patient as well as from nodes from different patients. Some nodes from a patient elaborated migration inhibition factors (MIF) and other migration enhancing factors (MEF). The findings are in keeping with others obtained by us relative to the variation in lymphocyte transformation and thymidine uptake by RLNCs and further emphasize that all RLNs in patients with breast cancer are not biologically similar. They lend support to our previous hypothesis that the reason why some RLNs contain metastases and others do not is more likely due to biological differences than because of anatomical happenstance, i.e., transport of tumor cells to some nodes and not to others.
It has been observed that patients with metastatic brain lesions developed neurologic symptoms when given Corynebacterium parvum. To obtain more information in patients with intracranial mass lesions, intracranial pressures (ICP) were measured or observed in six patients undergoing C. parvum therapy. All patients except two (one previously shunted, one recently operated) demonstrated a profound increase in ICP. It is presumed that either edema is formed within brain and tumor tissue (inasmuch as neurologic deterioration has not been observed in patients without an intracranial lesion) or transient increases in cerebral blood flow adversely alter an already compromised intracranial volume. Surgical decompression of tumor volume or use of Lasix may abort this response to C. parvum infusion.
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The authors used a questionnaire sent to the directors of the 256 approved American psychiatric residency programs to examine the availability, content, and orientations of group therapy training. They found that 78% of the responding programs offered group therapy training, a substantial increase from earlier estimates; that an approach incorporating didactic courses, observation and leadership of groups, supervision, and participation in an experiential group was gaining increased acceptance; that most of the programs provided a variety of arrangements for supervision of group training; that the theoretical orientations mirrored the field of group therapy itself; and, finally, that associated disciplines were gaining increasing acceptance.
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The administration of cyclophosphamide and Corynebacterium parvum in combination results in tumor growth inhibition greater than that resulting from the use of either agent alone. The precise mechanism(s) by which this chemoimmunotherapy combination results in a synergistic inhibiting effect is not known. The possibility was entertained that the tumor effect might be related to a greater decrease in serum-mediated interference with cellular cytotoxicity, i.e., "blocking" activity, by both agents in combination rather than by either alone. The present findings fail to support such an explanation. C. parvum by itself failed to decrease serum inhibition and in conjunction with cyclophosphamide resulted in an effect that was no greater than that produced by cyclophosphamide alone.