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Biomedical subjects

F R Smith

Publications and source records attributed to F R Smith.

At least 37 records · Page 2Linked to original sources

Selective immunomodulation by the antineoplastic agent mitoxantrone. II. Nonspecific adherent suppressor cells derived from mitoxantrone-treated mice.

Mitoxantrone exerts a potent suppressive influence upon humoral immune responses. The B cell is a likely target for this inhibitory effect, and we have reported evidence supporting this possibility. The impact of mitoxantrone upon T lymphocyte reactivity was assessed as a second mode of action of this novel antineoplastic drug. TH and TS lymphocyte induction were tested in the in vitro anti-sheep erythrocyte response, and a surprising differential effect of mitoxantrone was observed. Helper activity was abrogated and suppressor function was enhanced. In apparent disagreement with this result, mitoxantrone inhibited the in vivo induction of TS cells using trinitrophenylated spleen cells. Macrophages were investigated as potential mediators of these effects upon immunoregulatory function. Replacement of macrophages in mitoxantrone-treated spleen cell preparations by normal adherent cells allowed the induction and complete expression of TH lymphocyte function. Conversely, replacement of mitoxantrone-treated macrophages with normal adherent cells before induction of TS cells failed to generate TS cell function. Thus, TH cells were resistant and TS cells were completely susceptible to mitoxantrone. Furthermore, supplementation of normal TH cell cultures with splenic macrophages from mitoxantrone-treated mice inhibited the induction of helper function. Production of the lymphokines IL 2 and TRF in mitoxantrone-treated mice was normal. This is consistent with the retention of functional TH cells in drug-treated spleens. Macrophages in the spleens of mitoxantrone-treated mice were responsible for the abrogated helper function and the enhanced suppressor activity. Although TS cell induction was directly inhibited by the drug, the effect upon TH cell function was secondary to the action of mitoxantrone-induced suppressor macrophages. Mitogen-stimulated lymphokine production was normal. Thus, mitoxantrone is a selective immunomodulator. The macrophage-mediated suppression of TH cell induction and humoral immunity investigated in spleens from mitoxantrone-treated mice is an intriguing finding that may have significant implications for immunotherapy.

Animals↗

Resolving pathways of functional coupling within protein assemblies by site-specific structural perturbation.

Site-specific structural modification is a powerful tool for studying functional mechanisms in proteins where the structures may be manipulated by direct chemical modification, by selection of naturally-occurring mutants, or by site-directed mutagenesis. Here, we present a general strategy for such studies, which we term "mapping by structure-function perturbation." A series of functional perturbations (i.e., deviations of functional behavior from that of the native protein) are mapped against the structural locations of the modified sites, obtained over a range of locations. The modifications are treated as arbitrary perturbations of structure at specific locations, in contrast to the conventional approach of trying to interpret their local stereochemistry. The map yields information on structural locations of functional events and pathways of coupling within protein assemblies. We have applied this approach to the ligand-linked subunit assembly of human hemoglobin, using both chemically-modified heme sites (CN-met), and amino acid residues altered by mutation and chemical modification.

Hemoglobins↗

Bacterial and viral pathogens causing fever in infants less than 3 months old.

We studied 182 sick, febrile (temperature greater than 38 degrees C) infants less than 3 months of age, who presented at our Tripler Army Medical Center, Honolulu, during a one-year period, to determine the relative causes of fever in this age group. Blood, cerebrospinal fluid, urine, nasopharyngeal secretions, and stool specimens were cultured for bacterial and viral pathogens. Paired acute and convalescent sera were collected to serologically confirm infection in infants from whom viral isolations were obtained only from the nasopharynx or stool. A viral pathogen was isolated in 75 infants (41%) and a bacterial pathogen was isolated in 27 infants (15%). Nonpolio enteroviruses were the most common pathogens demonstrated. They were isolated from 64 infants (35%), and 40 (62%) of these infants had aseptic meningitis, the most frequently made diagnosis. Urinary tract infection was the most common bacterial infection observed. It occurred in 20 infants (11%) and was most often seen without associated pyuria in uncircumcised male infants. Salmonellosis, the second most common bacterial infection, was observed in six infants (3%), and two of these did not have diarrhea or other gastrointestinal tract symptoms. No infant had septicemia and only one infant had bacterial (group B streptococcal) meningitis.

Bacterial Infections↗

Experimental resolution of cooperative free energies for the ten ligation states of human hemoglobin.

Tetrameric human hemoglobin can assume ten molecular forms that differ in the number and configuration of ligands bound at the four heme sites. For each of these species we have determined the cooperative free energy--i.e., the deviation in free energy of ligation from that which would obtain for the same sites binding as independent alpha and beta subunits. These cooperative free energies were resolved from measurements on the dissociation into dimers of tetramers in which each subunit is either unligated (Fe2+ deoxy) or "ligated" by conversion into the cyanomet form (Fe3+ CN). The results indicate that each hemoglobin tetramer acts as a three-level molecular switch. During the course of ligation, the total cooperative free energy (6 kcal/mol over all four binding steps) is expended in two transitions that are synchronized with particular ligation steps. Whether a cooperative energy transition occurs or not depends upon how the ligation step changes both the number and configuration of ligated subunits. The hemoglobin tetramer is thus a "combinatorial switch." The finding of three distinct free energy levels for the ten ligation states suggests the existence of three major structural forms of the hemoglobin tetramer.

Hemoglobins↗

A monoclonal antibody that recognizes an Ly-6-linked antigen inhibits the generation of functionally active T cell subsets.

A monoclonal antibody (mAb) generated against the chemically-induced BALB/c Meth A sarcoma, designated HD42, reacts in cytotoxic tests with Meth A as well as with BALB/c peripheral lymph node cells and mitogen-activated spleen cells. The antigen was detected by FACS analysis on BALB/c spleen and lymph node cells, and by absorption assays on all normal lymphoid cells of BALB/c but not B6 mice. The expression of the antigen was not found on normal adult lung fibroblasts, on brain, nor on an extensive panel of tumors of BALB/c and B6 origin. Because the strain distribution of the antigen is reciprocal to that of Ly-6.2 and is not expressed in congenic C3H.Ly-6b mice, we have tentatively defined it as Ly-6.1 and referred to the mAb as alpha-Ly-6.1. The presence of alpha-Ly-6.1 abrogates both the Con A-induced and the IL 2-dependent proliferative response of normal T cells, whereas the response of normal B cells to LPS remains unaffected. alpha-Ly-6.1 is a potent suppressor of the primary in vitro plaque-forming cell (PFC) response to SRBC. Pretreatment of normal splenic T cells with alpha-Ly-6.1 and complement had no effect on the ability of these cells to generate in vitro either T helper cells (TH) or T suppressor cells (TS) to SRBC. However, addition of antibody in the absence of complement during the generation of TH or TS, or posttreatment of these T cell subsets with antibody and complement after in vitro education, completely removed the functional activity of these cell types. Addition of alpha-Ly-6.1 to MLC suppressed the MLR as well as the generation of cytotoxic lymphocytes (CTL), whereas the presence of the antibody during a cell-mediated lympholysis (CML) had no effect. Therefore, it appears that alpha-Ly-6.1 recognizes an antigen that is important for the generation of TH and TS cell subsets.

Animals↗

Effect of furosemide on the clinical course of transient tachypnea of the newborn.

The effect of furosemide on the course of transient tachypnea of the newborn was evaluated in a controlled, prospective study. Fifty infants with transient tachypnea of the newborn were randomly assigned to control or treatment groups. Those in the treatment group were given furosemide, 2 mg/kg orally, at the time of diagnosis followed by 1 mg/kg 12 hours later if the symptoms persisted. Infants in the control group received a placebo. Compared with infants in the control group, the furosemide-treated group demonstrated no significant difference in the duration of tachypnea nor in the length of hospitalization. It is concluded that oral furosemide, at the doses used in this study, does not significantly affect the clinical course of transient tachypnea of the newborn.

Female↗

Transient tachypnea of the newborn. An analysis of neonatal and obstetric risk factors.

Clinical data from 100 neonates with transient tachypnea of the newborn (TTN) and 100 well neonates were compared for the relative incidence of various neonatal and obstetric factors. The incidences of male sex and macrosomia were substantially higher in infants with TTN. Obstetric histories of mothers of neonates with TTN were characterized by longer labor intervals and a higher incidence of failure to progress in labor leading to cesarean delivery. Excessive maternal sedation, perinatal asphyxia, and elective cesarean delivery without preceding labor were not seen more frequently when TTN developed.

Asphyxia Neonatorum↗

Urinary D-lactate excretion in infants with necrotizing enterocolitis.

Urinary D-lactate excretion, expressed as the molar D-lactate/creatinine ratio, was measured serially in nine term and premature infants with necrotizing enterocolitis, 15 healthy term infants, and eight term and premature infants sick but without NEC. The mean (+/- SD) uDL/CR of the infants with NEC was 1.63 +/- 1.09, significantly greater than the mean uDL/CR of the healthy infants (0.16 +/- 0.04) or the sick infants without NEC (0.43 +/- 0.32). The uDL/CR of infants with NEC rose coincident with the onset of disease, reached peak values at an average of 5.8 days, and subsided to baseline levels on recovery. Seven of the nine infants with NEC reached or exceeded a peak uDL/CR of 1.47; no infant without NEC reached this ratio. We conclude that uDL/CR is increased in infants with NEC and demonstrates the increased enteric bacterial activity in this disease.

Creatinine↗

Free energy coupling within macromolecules. The chemical work of ligand binding at the individual sites in co-operative systems.

Individual-site binding curves such as those obtainable from techniques of DNase footprinting or nuclear magnetic resonance spectroscopy can be used to monitor structurally localized events within biopolymers. This paper discusses thermodynamic aspects of individual-site ligand binding for co-operative systems where the binding of ligand at a local site is coupled to binding of the same ligand species at other sites within the macromolecule. Individual-site binding isotherms have the following properties. (1) They provide a direct indication of the role played by the particular site in the overall binding reaction. (2) They can be used to determine the energetic contribution of loading the site regardless of the complexity of the system. (3) They can be used to resolve microscopic equilibrium constants and co-operativity constants in cases where the classical isotherm is incapable of such resolution. The microscopic constants bear a complex relation to the chemical work of loading each individual site. For a system with two interacting sites we derive analytical relationships between the individual-site loading energies and the microscopic constants. These relationships prescribe, for any values of the microscopic constants, how the co-operative energy is partitioned between events at the two sites. At fixed ligand activity the binding free energy can be estimated directly from an individual-site isotherm. This quantity, which is also a composite of the microscopic constants, provides a useful measure of site--site interaction. Several examples and applications are discussed for these properties of individual-site binding reactions.

Binding Sites↗

Brain cancer: issues and dilemmas.

A cohort study covering the eight year period, 1970-1977, identified eight deaths attributed to brain cancer among employees at a refinery/chemical plant. Five of the cases were primary brain cancers and three were either metastatic from another site or the site was undetermined. A ninth case of brain tumor unspecified was identified. Five primary brain cancers would have been expected, based on national statistics. Some issues and dilemmas related to such a cohort study were discussed.

Adult↗

Posture and lumbar puncture headache: a controlled trial in 50 patients.

A prospective single blind trial in 50 patients was performed to investigate the effect of posture on post lumbar puncture headache (LPH). A difference between the frequency of headache at five hours between the two groups (prone for four hours, versus 30 degrees head down tilt for 30 minutes followed by supine posture for 3 1/2 hours) did not reach significance. These findings do not support the suggestion that a prone posture, by possibly reducing cerebrospinal fluid (CSF) leakage, significantly reduces the frequency of this common clinical problem. The value of bed rest after lumbar puncture remains equivocal. Other methods used for reducing LPH are reviewed.

Clinical Trials as Topic↗

Cholesterol turnover in lipid phases of human atherosclerotic plaque.

The turnover of free cholesterol in atheromatous plaque lipid phases was studied in a patient undergoing peripheral vascular surgery. [14C]Cholesterol was injected intravenously 139 days prior to surgery, and [3H]cholesterol was injected 12 days pre-op. The plasma cholesterol specific radioactivity decay curves were determined from the times of isotope injection until surgery. At surgery, atheroma, skin, muscle, and tendon were obtained. Lipid phases of plaque homogenate were isolated by density gradient centrifugation. The top layer of the gradient, layer 1, contained the cholesteryl ester oil droplet phase, layer 2 was enriched in phospholipid bilayer phase, layer 3 contained cholesterol monohydrate crystals and the pellet, layer 4 had more dense plaque components such as collagen and elastin. The tissue:plasma specific radioactivity ratios on days 12 and 139 respectively were muscle, 0.86, 2.47; skin, 0.74, 1.20; tendon, 0.18, 1.45; total plaque, 0.22, 1.39; plaque layer 1, 0.31, 1.50; layer 2, 0.22, 1.53; layer 3, 0.08, 0.61; and layer 4, 0.20, 0.88. Thus, plaque atheroma, which contains physically distinct forms of cholesterol, had correspondingly different rates of cholesterol turnover. Cholesterol solubilized in liquid oil droplets (layer 1) and liquid crystalline phospholipid bilayers (layer 2) had specific radioactivity values similar to those of tendon cholesterol, and represented tissue cholesterol that was undergoing slow equilibration with the plasma cholesterol pool. Pellet cholesterol (layer 4), which is probably connective tissue-associated, had lower specific radioactivity values, well below those of plasma cholesterol even after 5 months. Crystalline cholesterol (layer 3) had the lowest specific radioactivity values of all tissues and plaque fractions. Therefore, cholesterol in the crystalline state is relatively inert. Since crystalline cholesterol can account for over 40% of plaque free cholesterol, resistance to mobilization of this lipid may be an important obstacle to plaque regression.

Aged↗

Therapeutic percutaneous aspiration of pancreatic pseudocysts.

The therapeutic efficacy and safety of percutaneous aspiration of chronic pancreatic pseudocysts was evaluated. Eight patients underwent aspiration a total of ten times. Permanent resolution was obtained in two patients and a third nonsurgical candidate was offered an alternative therapeutic modality. This procedure is simple, rapid, and safe and could become the initial approach to selected patients with a chronic pancreatic pseudocyst.

Adult↗

Comparison of the effects of colestipol hydrochloride and clofibrate on plasma lipids and lipoproteins in the treatment of hypercholesterolemia.

The effects of colestipol HCl resin and clofibrate on plasma lipid and lipoprotein levels were compared in 65 patients with primary hypercholesterolemia. Patients were randomly assigned to treatment with colestipol (in progressive doses of 15, 20, and 30 g/day), clofibrate (2 g/day), or placebo resin; lipoprotein levels were determined at months 0, 2, 4, 6, and 9. The colestipol group received both colestipol and clofibrate during months 7 through 9 of the study. After 6 months of treatment, mean plasma total cholesterol fell from 333 to 266 (P less than 0.01) on colestipol, and from 329 to 270 (P less than 0.05) on clofibrate. More patients responded, however, to colestipol than to clofibrate. Both drugs also produced significant reductions in LDL cholesterol levels, and clofibrate lowered plasma triglycerides as well. HDL cholesterol level did not change significantly on either medication. The placebo group showed no change in any of the parameters studied. A significant difference was not observed between the effects of 15 g/day of colestipol and those of the higher doses studies. Addition of clofibrate to colestipol did not enhance the latter's hypocholesterolemic action.

Cholesterol↗