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Biomedical subjects

H G Bender

Publications and source records attributed to H G Bender.

At least 55 records · Page 3Linked to original sources

Efficient lysis of CD44v7/8-presenting target cells by genetically engineered cytotoxic T-lymphocytes--a model for immunogene therapy of cervical cancer.

Variant proteins of the CD44 surface glycoprotein family are expressed on many different human tumors and their lymph node metastases. An epitope encoded by sequences of variant exons CD44v7 and v8 and recognized by the monoclonal antibody VFF17 is frequently detected in cervical cancer, whereas the normal cervical epithelium lacks expression of this epitope. We have developed an immunotherapeutic approach for cervical cancer based on the expression of this CD44v7/8 epitope. The single chain antigen-binding fragment of VFF17 was fused to a signal transducing protein (zeta-chain) of the T-cell receptor complex (TCR) and was introduced into a retroviral gene transfer vector. Gene transfer was applied to the murine cytotoxic T-cell line cl96. All recombinant clones expressed the fusion protein on their cell surface. Functionality of the recombinant fusion protein was tested by subjection of several recombinant clones to in vitro cytotoxicity assays. CD44v7/8-expressing target cells were killed efficiently by reprogrammed cl96 in an MHC-independent fashion, whereas CD44v7/ 8-negative cells were not affected. These transfected T cell lines will now be tested in vivo using immune-deficient mice bearing CD44v7/8-expressing tumors.

Amino Acid Sequence↗

Multistep carcinogenesis of breast cancer and tumour heterogeneity.

Breast cancer emerges by a multistep process which can be broadly equated to transformation of normal cells via the steps of hyperplasia, premalignant change and in situ carcinoma. The elucidation of molecular interdependencies, which lead to development of primary breast cancer, its progression, and its formation of metastases is the main focus for new strategies targetted at prevention and treatment. Cytogenetic and molecular genetic analysis of breast cancer samples demonstrates that tumour development involves the accumulation of various genetic alterations including amplification of oncogenes and mutation or loss of tumour suppressor genes. Amplification of certain oncogenes with concomitant overexpression of the oncoprotein seems to be specific for certain histological types. Loss of normal tumour suppressor protein function can occur through sequential gene mutation events (somatic alteration) or through a single mutational event of a remaining normal copy, when a germline mutation is present. The second event is usually chromosome loss, mitotic recombination, or partial chromosome deletion. Chromosome loci 16q and 17p harbour tumour suppressor genes, which seem to be pathognomonic for the development or progression of a specific histological subtype. There are an overwhelming number of abnormalities that have been identified at the molecular level which fit the model of multistep carcinogenesis of breast cancer. When the functions of all of these genes are known and how they participate in malignant progression, we will have the tools for a more rational approach to diagnosis, prevention and treatment. This review deals only with the factors that are involved in the conversion of a normal breast cell into a malignant cell rather than those required for invasion and metastases. A key critical long-term step in the molecular analysis of breast cancer will be to link the specific molecular damage with the effects of environmental carcinogens.

Breast Neoplasms↗

The detection of micrometastases in the peripheral blood and bone marrow of patients with breast cancer using immunohistochemistry and reverse transcriptase polymerase chain reaction for keratin 19.

The aim of this study was to determine whether reverse transcriptase polymerase chain reaction (RT-PCR) for keratin 19 (K19) provides additional information when combined with immunohistochemistry when used to detect micrometastases in blood and bone marrow in patients with primary breast cancer. We studied 78 patients with breast cancer who had no evidence of distant metastases. We collected blood and bone marrow, separated the mononuclear fraction and carried out RT-PCR and immunohistochemistry for K19. RT-PCR was done by two 40-cycle rounds using nested primers. In initial experiments, RT-PCR was shown to be capable of detecting one tumour cell in one million normal bone marrow cells, which was at least 10 times more sensitive than immunohistochemistry, while retaining specificity. Five per cent of the peripheral blood and 22% of the bone marrow samples contained K19 positive cells by immunohistochemistry staining. Using RT-PCR, these proportions increased to 25% and 35%, respectively. This represents a significantly greater detection frequency (P < 0.001 and P = 0.03, respectively). RT-PCR for K19 is a more sensitive method for detecting micrometastases in patients with primary breast cancer when compared with immunohistochemistry.

Adult↗

Risk factors for recurrent VIN. Role of multifocality and grade of disease.

OBJECTIVE: To evaluate possible risk factors for recurrence of vulvar intraepithelial neoplasia (VIN): menopausal status, smoking, method of treatment (local excision with cold knife, CO2 laser vaporization, CO2 laser excision), grade and focality. STUDY DESIGN: At the dysplasia clinic of the Department of Obstetrics and Gynecology, Medical Center, Heinrich Heine University, Dusseldorf, Germany, we treated 102 patients with VIN with a mean follow-up of 3.5 years. VIN was demonstrated for all these patients by histologic examination of biopsies taken under colposcopic control. Follow-up was performed by clinical examination and colposcopy. Statistical evaluation was done by the chi 2 test. RESULTS: VIN recurrence developed in 36.6% of patients. We could not prove any correlation between recurrence of disease and menopausal status, smoking behavior or treatment method used. Recurrent VIN correlated with the grade (P < .001) and focality (P < .05) of the disease. CONCLUSION: In the prediction of possible risk of recurrence of disease, not only the grade of VIN but also the multifocality is important. Treatment should be done very carefully considering the functions of the vulva; therefore, mutilating operations ought to be avoided as much as possible.

Adult↗

[Significance of stem cell-supported high-dose chemotherapy in the treatment of gynecological malignancies: indications and current clinical trials in the Federal Republic of Germany].

The use of hematopoetic growth factors and stem cell support reduces the dose limiting hematopoetic toxicity's, resulting in a remarkable increase in dose intensity of chemotherapy. As far as data from phase I/II trials are available high dose chemotherapy (HDC) may be integrated in the systemic treatment of breast and ovarian cancers. In metastatic breast cancer HDC may induce fairly high but short response rates. Long term survival is expected in 20% of the cases. Patients with limited metastatic disease, without significant prior chemotherapy, partial or complete response to induction chemotherapy and complete remission after HDC may benefit from HDC. In phase I/II trials HDC improved recurrence free survival in high risk patients (e.g. > 9 positive LN) compared to historic controls and may therefore be a curative approach. Ovarian cancer is very chemosensitive. Conventional chemotherapies induce multidrug resistance rapidly. Just as in breast cancer-Phase I/II trials demonstrated high response rates to HDC, which again were short of duration.

Antineoplastic Combined Chemotherapy Protocols↗

Frequent allele loss on 9p21-22 defines a smallest common region in the vicinity of the CDKN2 gene in sporadic breast cancer.

Genetic studies of chromosome arm 9p have indicated the presence of one or more tumor suppressor genes involved in genetic susceptibility to various types of human cancers. To define the extent of the specific deletion of 9p21-22 in human breast cancer, we have analyzed loss of heterozygosity and homozygous deletion of 9p21-22 in 68 paired blood and tumor samples by using fluorescent multiplex polymerase chain reaction (PCR). Of these tumors, 43% (29/68), including two ductal carcinomas in situ (DCIS), showed allele loss at one or more loci analyzed. Homozygous deletion for 9p markers was detected in 7/68 (10%) of tumor samples. Eleven tumors showed allele loss at all informative loci, and 18 tumors showed selective deletion on 9p21-22. Allele deletions in six tumors did not involve microsatellite markers flanking CDKN2. The smallest common region of deletion could be defined between D9S171 and D9S126. No significant associations were observed between deletion of 9p21-22 and any of the histopathological parameters analyzed. However, the abundance of deletions of this chromosomal region still suggests that loss and inactivation of putative tumor suppressor gene(s) located on 9p21-22 may be involved in the pathogenesis of breast cancer.

Alleles↗

Metastatic choriocarcinoma in a postmenopausal woman.

Trophoblastic disease is usually related to pregnancy and occurs in about 1 in 1300 pregnancies in Western countries. Since the advent of methotrexate therapy, trophoblastic tumors have become one of the most curable malignancies. Trophoblastic disease can develop independently of gestation, but this is very rare. We report the unusual case of a 58-year-old woman who had a metastatic choriocarcinoma 6 years after menopause and 29 years after her last pregnancy. The tumor proved to be primarily resistant to monochemotherapy and developed chemoresistance to three different polychemotherapeutic regimens. Eleven months after the diagnosis of uterine choriocarcinoma the patient died from advanced metastatic disease.

Choriocarcinoma↗

Clinical impact of detection of loss of heterozygosity of BRCA1 and BRCA2 markers in sporadic breast cancer.

The development of familial and sporadic breast cancer is based on genetic alterations of tumour-suppressor genes, for which loss of heterozygosity (LOH) is one mechanism of gene inactivation. To investigate LOH of BRCA1 (17q21) and BRCA2 (13-q12-13) in sporadic breast cancer, polymerase chain reaction (PCR)-based fluorescent DNA technology for detection of microsatellite polymorphisms was applied. A total of 137 breast cancer and 15 benign breast specimens with matched normal tissue were examined. Fluorescent-labelled PCR products were analysed in an automated DNA sequencer (ALFTM Pharmacia). Losses at both loci were correlated with different histological types, age, tumour size, lymph node status, grading and steroid hormone receptor expression, [SHR: oestrogen receptor (ER), progesterone receptor (PgR)]. For BRCA1 (D17S855, THRA1, D17S579) losses could be detected in invasive ductal carcinoma (IDC; n = 108) in 32-38%, invasive lobular carcinoma (ILC; n = 19) in 21-42% depending on the marker applied, but not in benign breast tumours (n = 15). Losses of BRCA1 markers correlated with larger tumour size, higher grade, and PgR expression. For BRCA2 (D13S260, D13S267, D13S171) losses could be detected in 108 IDCs in 30-38%, in 19 ILCs in 17-39% depending on the marker applied, but not in benign breast tumours. Losses of BRCA2 markers correlated only with higher grade. Microsatellite analyses combined with detection of fluorescent-labelled PCR products by an automated laser DNA sequencer can be used for routine determination of LOH. In sporadic breast cancer, LOH of BRCA1 of BRCA2 does not add decisive prognostic value as stated for familial breast cancer.

Age Factors↗

Elevated low-density lipoprotein-cholesterol in women with polycystic ovary syndrome.

Previous studies have indicated that women with the polycystic ovary syndrome (PCOS) are affected by hypertriglyceridemia and low high-density lipoprotein-cholesterol (HDL-C) level. However, most of these studies did not control for confounding factors such as body mass index (BMI) or differences in ethnicity. Therefore, we compared the lipid data for 26 women with PCOS with those for 1428 female control participants of the Prospective Cardiovascular Münster (PRO-CAM) study who did not use hormonal contraceptives and were of similar age. Data were adjusted for age, BMI and ethnicity. Women with PCOS had higher total cholesterol (5.55 +/- 1.24 vs. 4.99 +/- 0.88 mmol/l, p < 0.05) and low-density lipoprotein-cholesterol (LDL-C) levels (3.61 +/- 1.19 vs. 3.08 +/- 0.82 mmol/l, p < 0.05) than the control subjects. Compared with the women in the control population, those with PCOS more frequently had triglyceride levels exceeding 2.3 mmol/l (11.5 vs. 1.6%, p < 0.001), LDL-C levels exceeding 4.2 mmol/l (30.8 vs. 12.1, p < 0.01), and HDL-C levels below 1.2 mmol/l (46.2 vs. 15.3%, p < 0.001). We conclude that dyslipidemia is found more frequently in women with PCOS, independently of the excess weight that is often found in this patient group.

Adult↗

Early cancer detection programmes for women at high risk for breast and ovarian cancer: a proposal of practical guidelines.

Women from families with multiple breast and/or ovarian cancers may be at increased risk to develop breast/ovarian cancer themselves. Due to personal experience with family members having these diseases they are anxious and ask for specific prophylactic measurements or treatment. The detection of two susceptibility genes, BRCA1 and BRCA2, has given insight into the genetic background of part of the familial breast/ovarian cancer syndromes. This has led to an increased demand in genetic counselling, testing, and early cancer detection programmes. Prospective data from early cancer detection programmes in this high risk population are yet not available. Based on data from epidemiological risk studies, breast and ovarian screening programmes and follow up data from breast cancer trials recommendations for an early cancer detection programme have been summarized. At the present these recommendations are tested in a prospective trial.

Adult↗

ERBB2 gene amplification detected by fluorescent differential polymerase chain reaction in paraffin-embedded breast carcinoma tissues.

For quantificative determination of ERBB2 gene amplification in archival human carcinoma specimens we have developed a rapid, non-radioactive approach, which is based on the differential polymerase chain reaction (PCR) and fluorescent DNA technique. Sequences from the ERBB2 gene and from a single-copy reference gene were amplified simultaneously by PCR, in which one of each primer pair was fluorescently labelled. PCR products were separated by polyacrylamide gel electrophoresis in an automated DNA sequencer and directly quantified after laser activation and emission scanning using appropriate software. This fluorescent differential polymerase chain reaction (fd-PCR) method was used for quantificative determination of ERBB2 gene amplification in 195 formalin-fixed, paraffin-embedded breast carcinoma tissues. ERBB2 gene amplification was found in 52 (26%) of these tumors and correlated significantly with tumor size, absence of estrogen receptor (ER) and pS2 expression, but not with absence of progesterone receptor (PR) or presence of epidermal growth factor receptor (EGF-R) expression, lymph-node metastases or grading. In univariate analysis, ERBB2 gene amplification showed no significant correlation with clinical outcome, either in the whole population or in the subgroup defined by positive axillary lymph-node metastases. However, within the node-negative subgroup, patients with ERBB2 gene amplification had significantly decreased relapse-free survival and overall survival (p < 0.05). The fd-PCR assay is a valuable tool for determination of amplification of ERBB2 gene as well as further oncogenes. In this way, more detailed information about individual tumor biology may be acquired by a routine assay.

Analysis of Variance↗

[Prenatal determination of fetal rhesus factor in amnionic cells using polymerase chain reaction].

In Rhesus incompatibility, prenatal RhD typing of the fetus requires intrauterine blood sampling by cordocentesis or by chorionic villus biopsy. Amniocentesis is easier to perform, and carries a lower risk of enhancement of maternal immunization. Therefore, we evaluated polymerase chain reaction (PCR) for fetal RhD typing in amniocytes which were isolated from amniotic fluid (18-40 gw) obtained by amniocentesis (n=26) or during delivery (n=27). In the clinically most important group of children from RhD-negative women (n=25) and in 28 newborns of RhD- positive mothers, we found a 100 percent agreement between the findings of PCR and the results of serologic typing. If these encouraging results are confirmed in a larger series, the method could be used for the clinical management of RhD-negative women with Rhesus incompatibility and a heterozygous RhD-positive partner.

Amniocentesis↗

[Animal experiment, pharmacokinetic and clinical studies of intraperitoneal therapy with interleukin-2 (n Il-2) in patients with ovarian carcinoma].

OBJECTIVE: In an orthotopic transplantation model using human ovarian cancer xenografts we evaluated antitumor effects of nIL-2 as well as its side effects in a clinical phase I/II study. METHODS: In patients with advanced ovarian cancer nIL-2 was administered i.p. in escalating doses every two days by means of a Tenckhoff-catheter. RESULTS: Considerable stimulation of intraperitoneal immune cells was observed without severe toxic side effect WHO grade III/IV. CONCLUSIONS: Due to pharmacological-pharmacokinetic advantages using the i.p. route nIL-2 was very well tolerated and showed considerable stimulation of local immune cells.

Adult↗

Concomitant measurements of interleukin-6 (IL-6) in serum and peritoneal fluid of patients with benign and malignant ovarian tumors.

The multifunctional cytokine interleukin-6 (IL-6) is produced by epithelial and mononuclear cells as well as by ovarian carcinoma cells. A prospective study was initiated to evaluate the clinical significance of systemic and local measurements of IL-6 concentrations in 67 patients with ovarian tumors. Eighteen patients who underwent laparotomy for ovarian carcinoma showed elevated levels of IL-6 in the serum as well as in the peritoneal cavity in comparison to patients with benign ovarian tumors. Furthermore, patients with advanced ovarian cancer, according to Figo-Stages III/IV, demonstrated higher IL-6 levels in the serum and ascites, respectively, than patients with Figo-Stages I/II reflecting low tumor burden. The results of the study suggest that IL-6 plays a key role in tumor-host interaction, particularly, in the possible facilitated spread of ovarian cancer cells.

Adult↗

Growth inhibition of xenotransplanted human carcinomas by a monoclonal antibody directed against the epidermal growth factor receptor.

In the athymic nude mice model with xenotransplanted human carcinomas, the effect of a monoclonal antibody (MAb 425), directed against the human epidermal growth factor (EGFR), on tumour growth was studied. Five different solid human breast carcinomas and one vulvar epidermoid cancer cell line (A431) were transplanted in nude mice, and treated with MAb 425 2.2 mg intraperitoneally (i.p.) on day 7 post-transplantation. Tumours with EGFR concentrations of > or = 16 fmol/mg soluble cytosolic protein showed growth inhibition, whereas the growth pattern of EGFR-negative tumours was unaffected. Variation of MAb 425 dosage (1.1 versus 2.2 mg) revealed no difference in the growth inhibiting effect. Different application schedules (application on day 0, 12 or 26) showed different onsets and durations of tumour growth inhibition. Repeated application (1.1 mg, day 0 and 12) was followed by a prolonged inhibitory effect. Our results suggest that growth inhibition of EGFR-positive tumours by MAb 425 may lead to an additional treatment option for patients with EGFR-positive cancer.

Animals↗

[Treatment and after-care of HIV patients with cervix dysplasia].

We have been observing an increased prevalence of cervical intraepithelial neoplasia in HIV-infected women in our department of obstetrics and gynaecology. 10 HIV-infected patients with cervical intraepithelial neoplasia were treated by CO2-laser - 6 were subjected to laser excision conisation, and 4 patients to laser vaporisation. After laser vaporisation and laser excision conisation, no postoperative complications were observed. Intraoperative bleeding was rarely seen. The preoperative examination of the CD4-cell count had no influence on the choice of the applied method of laser treatment, laser vaporisation or laser excision conisation. But all the 4 patients with a CD4-cell count < or = 200/microliters experienced recurrence of disease shortly after the first laser treatment. Only one out of five patients with CD4-cell counts between 200-499/microliters had a recurrence of disease after laser treatment. All in all, a recurrence of disease was seen in five out of ten HIV-infected patients with cervical intraepithelial neoplasia. The recurrence rate is possibly increased because HIV-infected women have multifocal cervical, vulval and vaginal dysplasia more frequently than HIV-negative patients. In our study, we observed multifocal cervical, vulval and vaginal dysplasia in four HIV-infected patients. Therefore, an accurate short-term follow-up with colposcopy and cytological smears should be carried out after the treatment of HIV-infected patients with cervical intraepithelial neoplasia.

CD4 Lymphocyte Count↗

Interactions between tumor cells and tumor infiltrating lymphocytes in human ovarian carcinoma.

The aim of our study was to investigate the lymphocytic infiltration rate of ovarian tumors and the possible use of tumor-infiltrating lymphocytes (TIL) as a therapeutic tool in gynecologic oncology. Twelve tumors were treated with digesting enzymes in order to isolate tumor-infiltrating lymphocytes as well as tumor cells, TIL were expanded by culture in the presence of human interleukin-2 (IL-2). Freshly prepared tumor cells were allowed to grow in culture medium for several days before the first investigations were performed. TIL could only be isolated from 50% of the investigated tumors. In contrast to this the isolated tumor cells could be largely expanded in 73% of the cases. The expression of the CA125 antigen in the culture supernatants served as control and could still be evaluated up to three months after isolation. In parallel the antigen expression on the cellular surface was estimated by immunocytochemistry. Evaluating the phenotypes of TIL showed predominantly CD3+, their expansion rate was only poor. Tumor cells were isolated and expanded in order to test the tumor-directed cytotoxic efficacy of TIL and for further use in transplantation to nude mice.

Adult↗