Biomedical subjects
Publications and source records attributed to E Hecker.
This report is on a 37-year-old female patient with an extraordinary large intrapleural tumor on the left, macroscopically originating from mediastinal structures. The tumor was completely removed via transpleural approach without compromising the left lung. It was identified as a thymolipoma with a weight of 2400 g.
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AIM: Lung cancer is a common disease and exact staging is of extreme importance in order to plan therapy. A frequent problem in assessing the extent of tumour spread is the question of infiltration versus compression of central airways by central tumours and a correct lymph node staging. Chest CT as the general imaging procedure of choice is often not helpful with these questions. Endobronchial ultrasound (EBUS) has been available for several years, and we were interested to find out if the addition of EBUS to regular bronchoscopy can help to differentiate between airway infiltration and external compression and improves the yield of transbronchial needle aspiration (TBNA). METHOD: Patients with central tumour growth and enlarged lymph nodes were examined with EBUS and CT, classified according to local tumour invasion, and a needle biopsy of the lymph nodes was performed after EBUS detection. RESULTS: 50 patients were examined and subsequently operated. Relative to the local T-staging EBUS resulted in a sensitivity of 89 % and a specificity of 100 %. The results were highly improved statistically compared to the CT results (sensitivity 25 %, specificity 80 %). With EBUS-guided TBNA the results of correct N-staging could be improved to 86 %. CONCLUSION: Our study suggests that EBUS, if performed by experienced endoscopists for the detection of airway wall infiltration or compression is highly accurate and superior to chest CT in assessing potential airway infiltration by a malignant tumour. Furthermore, the results of the lymph node staging could be improved through the additional use of EBUS. It is easily performed within the context of a standard bronchoscopy and may spare many patients unnecessary surgical biopsies.
The feeding of lactating goats on usual green fodder, contaminated with Euphorbia helioscopia or E. nubica, results in poisoning of the dams as well as their suckling kids. General signs of toxicity were emaciation, depression, shedding of body hair, arching of back, and possible death. Post-mortem changes of dams and dead suckling kids included congestion and hemorrhage in cardiac muscle, lung, liver, and kidneys. Blood analyses of goats exposed to these contaminants showed an increased level of serum alanine amino transferase compared to control samples, indicating cellular destruction in the liver. The latter was confirmed by histopathological changes in the organ which include severe congestion, necrosis, and degenerative changes. The goats also suffered from deterioration of renal function as indicated by increased blood urea nitrogen and creatinine levels. In histopathologic inspections of kidney, severe congestion, hemorrhage in the cortex and medulla, as well as necrosis of epithelial cells of kidney tubules were noticed. Considerable degenerative changes were also observed in heart and lung. The pathophysiological appearances indicate that by feeding on the Euphorbia species mentioned above, the goats are poisoned in a way similar to the case of E. peplus reported previously. Such intoxication most likely is due to irritant and hyperplasiogenic diterpene ester (DTE) toxins, usually present in the aerial parts of Euphorbia species and well known as tumor promoters in mouse skin. After ingestion of the toxic plant parts by the goats, the DTE toxins might be metabolized and thereby partially detoxified. Yet, at least in part, they may show up in the milk of the goats, as indicated by severe poisoning of their suckling kids. As discussed previously in lactating goats fed on fodder contaminated with E. peplus, tumor promoters of the DTE type may enter the human food chain via this source of milk. Such milk may be considered a valuable etiologic model for the investigation of economic, ecologic, and public health problems raised by human diet polluted with tumor promoters, i.e., conditional (non-genotoxic) cancerogens.
Irritant diterpene ester toxins were isolated from Euphorbia nubica and E. helioscopia, which are contaminants of the green fodder of livestock in Egypt. Fractionations of methanol extracts of aerial parts of both plants were monitored by the irritation unit on the mouse ear. Plant extracts were subjected to multiplicative distribution methods, yielding irritant hydrophilic fractions that were further purified by column chromatography. Final purification of the materials was achieved by TLC (silica gel) followed by HPLC, or by TLC alone. In this way, from E. nubica, five Euphorbia factors (Nu1-Nu5) were isolated and characterized as short-chain polyfunctional diterpene esters of tigliane-type parent alcohols. The two weak irritants Nul and Nu3 were triesters of 4-deoxy(4alpha)phorbol. Nu2 was shown to be a triester of the stereoisomeric tigliane-type parent alcohol 4-deoxyphorbol. Weak irritant Nu4 probably is a positional isomer of Nu2. Nu5 was characterized as a short-chain triester of 4,20-dideoxy-5xi-hydroxyphorbol. From E. helioscopia, six short- to medium-chain polyfunctional diterpene esters of the ingenane type, generally containing unsaturated acids were obtained, i.e., four irritant esters of ingenol (Euphorbia factors H1, H2, H5, and H6) and two esters of 20-deoxyingenol (non-irritant Euphorbia substance HS4, and irritant Euphorbia factor H8). All irritant Euphorbia factors of the tigliane and ingenane diterpene ester type described in this investigation are considered to be more or less active tumor promoters, i.e., conditional (non-genotoxic) cancerogens. The Euphorbia factors assayed exhibited moderate (H1) to low (H8) relative tumor-promoting potency in comparison to the ingenane prototype DTE tumor promoter 3-TI.
Polyarteritis nodosa (PAN) is a rare vasculitis associated with hepatitis B virus (HBV) infection in a significant proportion of cases. When used to treat HBV-related PAN, immunosuppressive agents may enhance viral replication and relaspes are frequent. In recent years the use of antiviral drugs has been proposed. We report the case of a patient with HBV-related PAN who, despite 6 weeks of interferon-alpha2b (IFN-alpha2b) monotherapy, developed life-threatening complications with bowel perforation. He was thereafter successfully treated with a combination of IFN-alpha2b, lamivudine, plasma exchanges and short-term steroids. In contrast to IFN-alpha2b, lamivudine is effective in rapidly suppressing viral replication. This may be valuable in the treatment of HBV-related PAN by contributing to a faster diminution of circulating immune complex levels. This case report highlights the importance of aggressive combined therapy in patients with HBV-related PAN.
The hypothesis was proposed that there is a risk of dietary cancer from conditional cancerogens in produce of livestock polluted with irritants of the diterpene ester type, picked up by feeding on species of Euphorbiaceae (spurge). To challenge this, several herbaceous plants of the genus Euphorbia, widespread as weeds and contaminants of livestock fodder, were identified botanically and extracts of their aerial parts were tested for irritancy on the mouse ear. As compared to a standard probe of croton oil, the extracts of E. peplus, E. nubica and E. helioscopia displayed irritancy. The most active extract (that from E. peplus) was investigated by a fractionation procedure monitored by the mouse ear assay, and five molecularly uniform irritant Euphorbia factors Pe1-Pe5 were identified as diterpene ester-type toxins. Together these factors comprise at least 11 ppm in the aerial parts. They were characterized individually to carry the diterpene parent alcohols ingenol, 20-deoxyingenol, and 20-deoxyingenol-6 alpha, 7alpha-epoxide. The irritancy of the aerial plant parts was shown to be caused mainly by the Euphorbia factors Pe1 and Pe2 together. Upon chronic administration of these irritants and hyperplasiogens as principal cancerogenic risk factors in the mouse skin initiation/promotion bioassay, Pe1 and Pe2 were established as tumor promoters. These findings together support the initial hypothesis and suggest the need for further investigations to determine whether there is a consequent risk of dietary cancer.
Lactating goats were fed on aerial parts of the herb Euphorbia peplus L. admixed with their usual green fodder. During the experimental feeding period they showed symptoms of general poisoning. In necropsy the main toxic effects were seen in the heart, lung and liver. Histopathological examinations revealed that the primary toxic effects originated from degenerative changes in parenchymal and endothelial cells. Adverse symptoms in the liver and kidney were also reflected in an alteration of the levels of certain serum enzymes and of blood urea nitrogen. The milk of the goats fed on E. peplus, consumed by their young kids, caused poisoning and even death, with signs similar to those observed in the adult dams. These observations support the hypothesis that the poisoning observed in both milk-raised kids and mother goats is caused by diterpene ester type toxins present in the aerial parts of the herb contaminating the dams fodder. Generally, such skin irritant and hyperplasiogenic toxins are known to be highly active tumour promoters of skin and other organ, e.g. in mice. Lactating goats--as an important source of milk around the world--in a setting similar to that described, may provide a valid experimental etiological model for investigation of food polluted by tumour-promoting diterpene ester toxins.
Special procedures were developed to investigate poisonous milk of lactating goats fed experimentally on aerial parts of the herb Euphorbia peplus L. In extracts of the milk, weakly irritant in the mouse-ear assay, three diterpene ester toxins were detected by techniques of high-performance liquid chromatography. They are of the ingenane structural type: Euphorbia factor Pel (ingenol 20-acetate 3-angelate), Euphorbia factor Pe2 (20-deoxyingenol 3-angelate) and Euphorbia factor Pe4 (20-deoxyingenol-6alpha,7alpha-epoxide 3-angelate). From goats milk collected 15 days after cessation of the experimental feeding period, extracts were completely free of diterpene ester toxins. The toxins polluting the milk are identical to diterpene ester entities occurring in the aerial parts of E. peplus. Of these, Euphorbia factors Pel and Pe2 are known as promoters of tumors of mouse skin. Apart from the toxic Euphorbia factors, the non-toxic parent alcohol ingenol was also detected in the milk. It is absent in the plant, and may have been generated metabolically from a certain portion of the toxic diterpene esters picked up by the goats from their fodder. The results presented here provide, for the first time, data for a novel interpretation of the locally high incidence of esophageal cancer observed in certain areas in the Caspian littoral of Iran, associated with a greater consumption of goat's (and sheep's) milk.
For protein kinase C (PKC), a family of isoenzymes with serine/threonine-kinase activity identified as the major cellular receptor for certain skin irritants and tumor promoters, a new pharmacophore model is presented. By structure/activity relationship studies of naturally occurring and synthetic diterpene esters of the tigliane type (PKC activators) it is demonstrated that in addition to the oxygen at C20 it is the O-acyl function in position C13 which is critically essential for skin-irritant and tumor-promoting bioactivities rather than other oxygen atoms. This result is confirmed and extended by computer-assisted molecular modeling of tigliane-type and ingenane-type tumor promoters. It is contrasted to certain features attributed to the pharmacophore based upon the recently determined crystallographic structure of the effector-binding domain Cys2 of PKC delta complexed with the pseudo-agonist phorbol 13-acetate.
Five Euphorbia substances, SPr1-SPr5, were isolated from the roots of Euphorbia prolifera. They were found to have similar structures but were inactive in a mouse ear inflammation assay. By nmr analysis and after single-crystal X-ray crystallography the structure of SPr5 was established as a hexaester (tetraacetate-benzoate-propionate) of a hitherto unknown polyfunctional pentacyclic diterpene parent alcohol, structurally related to myrsinol. As judged from its nmr spectra, SPr4 is an analogue of SPr5, carrying an isobutyrate substituent in place of a benzoate ester functionality. SPr1-SPr3 were partially characterized by their mass spectra as esters of diterpene parent alcohols possibly related to the myrsinol structure. SPr1-SPr5 may represent one of the product lines branching off the proposed main route of biogenesis of the oligocyclic diterpenoid skin irritants and tumor promoters occurring in many, but not all, of the species in the plant families Thymelaeaceae and Euphorbiaceae.
Electron paramagnetic resonance (EPR) spectra were measured for the spin labelled phorbol-12,13-diester [5,6]PA bound to membranes of the particulate fraction of mouse brain tissue rich in PKC receptors. [5,6]PA is a bioactive derivative of the potent tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA), carrying the spin label in a doxyl group in position 7' of the 12-O-tetradecanoyl residue. A mathematical model based on special algorithms (Griffith, O.H. and Jost, P.C. Spin labeling: theory and applications, 1976) allows a satisfactory reconstruction of the experimental spectrum. It reveals that in the experimental spectrum the signal from the [5,6]PA molecules bound non-specifically to the lipid bilayer of the membranes is superimposed by the signal of [5,6]PA molecules bound specifically, i.e. to the active site of PKC (approximately 10% of total EPR signal intensity). Moreover, interpretation of spectral parameters indicates that in [5,6]PA molecules bound specifically the tetradecanoyl chain exhibits a larger motional freedom compared to that in [5,6]PA bound non-specifically. These new findings are in accordance with views featured independently by two recent molecular models of interaction of PKC with cellular membranes (8,9).
In the extremely skin irritant and caustic latex of Excoecaria agallocha the major part of the polyfunctional diterpene esters (DTE) (group I) are aliphatic polyunsaturated 9,13,14-orthoesters of the daphnane-type parent alcohol 5 beta-hydroxyresiniferonol-6 alpha, 7 alpha-epoxide, esterified simultaneously in their 20-positions with aliphatic saturated homologous n-carboxylic acids (even numbered, C22-C30). The minor part of DTE is composed of analogous structures of 5 beta, 12 beta-dihydroxyresiniferonol-6 alpha, 7 alpha-epoxide (group II) and of aliphatic 13-polyunsaturated, 20-saturated diesters of the tigliane-type parent alcohol 12-deoxyphorbol (group III). All three groups of DTE exhibit practically no irritant activity on the mouse ear. By alkaline transesterification of groups I-III, the corresponding highly irritant multicomponent mixtures of Excoecaria factors A (OH-20 deacylated) are released. They comprise a mixture of the known Excoecaria factors A1/A2/A3 and three mixtures of hitherto unknown Excoecaria factors A4/A5, A6/A7 and A8/A9. The groups I-III are typical structures of "cryptic irritants". By an alternative, extremely mild separation procedure the highly irritant mixture A1/A2/A3 was obtained directly. It represents the "free" Excoecaria factors, the natural constituents of the latex responsible for its bioactivity.
A new and more efficient procedure was developed to obtain 5 beta-hydroxyresiniferonol-6 alpha,7 alpha-epoxide- 9,13,14-ortho(2,4,6-decatrienoate) [Excoecaria factor O1] by alkaline transesterification of corresponding 20-ester(s) genuinely present in latex of Excoecaria oppositifolia. It was obtained in a 10-fold better yield than previously, probably due to speeding up the separation procedures of the sensitive compound. O1 is an appropriate starting material for the preparation of the daphnane prototype irritant and tumor-promoting orthoester simplexin (SIM) especially of a multiple tritium-labeled form thereof. Moreover, a new Excoecaria factor O3, i.e. the 9,13,14-ortho(2,4,6,8-hexadecate-traenoate) of 5 beta,12 beta-dihydroxyresiniferonol-6 alpha,7 alpha-epoxide was isolated after alkaline transesterification of a TLC-uniform fraction, composed of corresponding 20-ester(s).
A diterpene of the ingenane-type parent alcohol with tetradecanoic acid as the acid substituent was isolated by chromatographic methods from the latex of Euphorbia matabelensis. The ingenol ester exhibited irritant activity on the mouse ear.
A number of agents including the tumor promoter 12-0-tetradecanoyl-phorbol-13-acetate (TPA) (TPA) can induce an abortive virus cycle in the EBV-non-producer Burkitt's-lymphoma line Raji. Two distant regions, DL and DR, of the EBV genome with almost complete homology carry strong promoters which are induced in an abortive or lytic cycle and additionally function as lytic origins of viral DNA replication. To set up a system in which the activity of EBV-inducing agents can be measured in a quantitative and reproducible fashion, we generated a cell line which carries multiple copies of a DR-promoter chloramphenicol-acetyltransferase (CAT) construct on an episomal vector. CAT activity is low in untreated cells, but high upon treatment of the cells with various EBV-inducing agents. Combinations of different agents can produce an over-additive effect. The Raji-DR-CAT cell line may provide a simple quantitative and reproducible test system for EBV-inducing agents, especially for tumor promoters which activate protein kinases C.
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