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Biomedical subjects

N A Silverman

Publications and source records attributed to N A Silverman.

At least 91 records · Page 5Linked to original sources

Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumors burden in cancer patients.

Levels of glycoprotein-associated carbohydrates (neutral hexoses, hexosamine, sialic acid and fucose) were determined in the serum of patients with either local, regional or metastatic cancer, patients clinically cured of cancer, and controls (smokers and nonsmokers). Total protein-bound carbohydrates were compared with levels of 17 normal serum glycoproteins, carcinoembryonic antigen (CEA), and with lymphocyte reactivity to phytohemagglutin (PHA). Tumor burden was directly related to protein-bound carbohydrate levels in patient groups. Levels of bound carbohydrates reflect the sum of all the changes in serum glycoproteins, but primarily changes in the acute-phase proteins (alpha 1-acid glycoprotein, alpha 1-antitrypsin, haptoglobin, ceruloplasmin) found in the alpha-globulin fraction of serum. Increases in protein-bound carbohydrates in tumor-bearers were not related to increases in CEA. Increased levels of the acute-phase proteins occurred in individuals with depressed in vitro lymphocyte reactivity to PHA. A significant positive correlation was found between lymphocyte reactivity and level of alpha 2HS-glycoprotein. The results suggest that serum protein-bound carbohydrates or glycoproteins may be of adjunctive value is assessing tumor burden and immune reactivity in cancer patients.

Carbohydrates↗

Effect of age and cigarette smoking on carcinoembryonic antigen levels.

Serum carcinoembryonic antigen (CEA) levels were determined by the Hansen-Z-gel technique in 276 healthy volunteers, of whom 154 were smokers and 122 nonsmokers. The mean CEA level was significantly higher in smokers (2.7 ng/ml) than in nonsmokers (1.9 ng/ml) (P less than .001), and a significantly higher percentage of smokers had elevated CEA levels (P less than .05). In both groups, CEA levels were directly related to age. Seventy-six of the 154 smokers who entered the study ceased smoking. Their CEA levels were determined at one, three, and six months after cessation of smoking. Within three months after cessation, elevated CEA levels declined to within the range of nonsmokers and did not appear to be influenced by previous smoking habits. Both age and smoking history must be considered for accurate evaluation of CEA levels. A reappraisal of the diseases associated with elevated CEA levels that considers the influence of age and smoking may invalidate some of the correlations previously reported.

Adolescent↗

Correlation of tumor burden with in vitro lymphocyte reactivity and antibodies to herpesvirus tumor-associated antigens in head and neck squamous carcinoma.

In 94 patients with squamous carcinoma of the head and neck region, the clinical extent of tumor was correlated with in vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA) and serum complement-fixing antibodies to herpes simplex virus (HSV)-induced tumor-associated antigen (TAA). Forty-six patients were tumor-bearing and 48 were considered cured. Controls were 41 age-matched normals with histories of similar cigarette consumption. In 15 patients with Stage I carcinomas of the larynx, among whom the tumor diameter was 5 mm or less, mean LR or PHA did not differ from controls and 7 of 11 tested (63%) had antibodies to HSV-TAA. In 83 patients with more extensive tumors, LR to PHA was significantly lower than controls and 42 of 44 tested (95%) had antibodies to HSV-TAA. In both groups, LR to PHA was similar among tumor-bearing and cured patients. The study delineates a clinical tumor burden associated with impaired LR to PHA and a high incidence of antibodies to HSV-TAA in patients with squamous carcinomas of the head and neck region, and shows a correlation between the immune defects in clinically cured patients and tumor extent prior to treatment.

Adult↗

CEA levels in head and neck cancer.

Serum carcinoembryonic antigen (CEA) levels were determined for 439 patients with squamous carcinoma of the head and neck region, 154 healthy smokers, and 122 nonsmokers. Among nonsmokers 95% of the CEA levels did not exceed 5 ng/ml, but among smokers this discriminatory level was 7 ng/ml. Among tumor-bearing patients 36% of the CEA levels exceeded 5 ng/ml but only 17% exceeded 7 ng/ml. Both the incidence and magnitude of CEA elevations correlated with clinical stage of tumor; however, excluding patients with clinically apparent advanced malignancies, the incidence and magnitude of elevations were similar among tumor-bearing patients, tumor-free treated patients, and smokers. Although not predictive of ultimate survival, elevated preoperative CEA levels declined to the range of normals after resection. Similarly, during palliative irradiation for incurable tumors, CEA levels declined with regression of tumor. Irradiation did not nonspecifically elevate CEA levels. The data indicate that in patients with head and neck squamous carcinomas CEA level is not likely to contribute to a determination of prognosis after therapy; however, serial determinations may have adjunctive value in monitoring tumor response.

Carcinoembryonic Antigen↗

Humoral immunity to herpes simplex viral-induced antigens in smokers.

Antibodies to herpes simplex viral-induced antigens (HSVIA) were assayed by an indirect immunofluorescent technique in 93 regular cigarette smokers, 75 of whom also imbibed alcoholic beverages. Controls were 94 nonsmoking, nondrinking volunteers matched with the smoker for age and sex. IgA antibodies to HSVIA were detected six times more frequently in the sera of smokers than in nonsmoking controls, p less than .0005. IgG and IgM anti-HSVIA were detected with comparable frequencies in both groups, but the antibody titers were significantly higher in the smoking group than in controls, p less than .05. IgA anti-HSVIA was detected more frequently in smokers with 10 or more pack-years of cigarette exposure than in smokers with 10 or more pack-years of smoking (p less than .05) or in matched nonsmokers (p less than .02). IgA antibody titers to HSVIA were significantly higher in cigarette smokers who drank alcoholic beverages than in smokers who did not drink, p less than .025. This study demonstrates that cigarette smoking and the use of alcoholic beverages are associated with heightened humoral immunity to HSV-induced antigens in a population at high risk for development of squamous cell carcinomas of the head and neck region.

Age Factors↗

Viral-specific humoral immunity to herpes simplex-induced antigens in patients with squamous carcinoma of the head and neck.

Serum antibodies to herpes simplex virus-induced antigens (HSVIA) were quantitated in 122 patients with head and neck squamous carcinoma, 93 patients tumor-free after treatment for these malignant lesions, 27 patients with nonsquamous malignant lesions, 30 heavy smokers, and 36 nonsmokers. Serum IgA anti-HSVIA antibodies were detected in a greater percentage of sera of patients with squamous carcinoma (61 per cent), patients previously treated for these malignant lesions (56 per cent), and heavy smokers (57 per cent) than in patients with nonsquamous malignant lesions (11 per cent) or nonsmokers (8 per cent). Furthermore, titers of these antibodies were higher in patients with squamous carcinoma than in smokers. In patients tumor-free more than three years after treatment, the percentage of positive sera was significantly lower than that in untreated patients and in patients three years or less after treatment. This study demonstrates for the first time a high frequency of antibodies to HSV-induced antigens confined to subjects at high risk of developing head and neck squamous carcinoma and in patients with these malignancies as well as a correlation between the levels of these antibodies and clinical course after treatment.

Alcohol Drinking↗

In vitro lymphocyte reactivity and T cell levels in patients with melanoma: correlations with clinical and pathological stage.

In vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA) and peripheral blood thymus-dependent lymphocyte (T cell) levels were determined in 42 tumor-bearing patients with clinically operable melanoma and were compared to 41 age-matched normal controls. Patients with tumors clinically confined to the primary site (Stage I) as a group had normal immune reactivity and T cell levels, and those with regional metastases by clinical assessment (Stage II) had relatively impaired LR and T cell levels. In six of 24 patients with clinical Stage II tumors, widespread metastases (Stage III) subsequently were found. The severe immune defects in this group with occult disseminated melanoma accounted for the impaired LR and low T cell levels in the group with clinical Stage II tumors. Although overlapping levels of LR and T cells in the patients with pathological Stage II and III tumors prevent use of the data as a determinant of tumor extent in individual patients, the results show that these in vitro assays define a relation between cellular immunocompetence and tumor burden in patients with melanoma.

Adult↗

In vivo and in vitro measurements of the relationship of human squamous carcinomas to herpes simplex virus tumor-associated antigens.

An additional 244 unfiltered sera have now been studied in a series of controlled, coded tests to determine the relationship of squamous carcinomas of the head and neck and cervix to the presence of complement-fixing antibodies to herpesvirus-tumor-associated antigens (HSV-TAA) in both tumor-bearing and cured patients. Ninety % of sera from patients with squamous carcinomas had antibodies to HSV-TAA, in contrast to 11% of sera from patients with nonsquamous cancers and 4% of sera from noraml individuals. The temporal relationship of Stage 1 laryngeal carcinomas suggests that HSV-TAA appearance precedes the immune defects. An in vitro correlate of the previously demonstrated specific delayed hypersensitivity reactions in controlled skin tests of squamous carcinoma patients with HSV-TAA is reported. In leukocyte migration inhibition tests, the migration indices after incubation with HSV-TAA of peripheral blood leukocytes from patients with squamous carcinoma (x = 0.847) were in definite contrast to migration indices seen for normal leukocytes (x = 1.037) and patients with nonsquamous solid cancers (x = 1.03). Thus, these polypeptides elicit both humoral antibody response and cell-mediated reactivity.

Antibodies, Neoplasm↗

The use of prompts to enhance vicarious effects of nonverbal approval.

The effect of nonverbal teacher approval (physical contact in the form of patting approvingly) delivered to target subjects on the attentive behavior of adjacent peers was examined in a special-education classroom. In a reversal design, two pairs of moderately retarded children were exposed to nonverbal approval, with only one subject in each pair receiving approval. In different phases, nonverbal approval was delivered alone or in conjunction with a verbal prompt directed to the adjacent peer or to the class as a whole. The prompt was designed to make salient the target subject's attentive behavior and the nonverbal reinforcing consequences that followed. Providing contingent nonverbal approval alone consistently altered attentive behavior of the target subjects but did not alter the attentive behavior of adjacent peers. However, accompanying nonverbal approval with a verbal prompt did increase attentive behavior of nonreinforced peers.

Attention↗

In vitro lymphocyte reactivity and T-cell levels in chronic cigarette smokers.

Peripheral blood total leucocyte, lymphocyte and thymus-dependent lymphocyte (T cell) levels and in vitro lymphocyte reactivity (LR) to phytohaemagglutinin (PHA) were determined in 153 chronic cigarette smokers and 115 non-smokers ranging in age from 20 to 78 years. Total leucocyte, lymphocyte and T-cell levels were significantly elevated in smokers. There was no correlation with age. LR to PHA was significantly higher in smokers less than 40 years of age or in those with a 20 pack-year or less history of cigarette consumption. Older smokers or those with a history of heavier cigarette consumption did not differ from normals. The results contrast with previous demonstrations of suppression of immune reactivity after exposure to tobacco products. The possible effects of the apparent stimulation of the lymphoid system by chromic cigarette consumption is considered.

Adult↗

Reduced incidence and severity of accelerated graft atherosclerosis in cardiac transplant recipients treated with prophylactic antilymphocyte globulin.

Allograft coronary artery disease (ACAD) is the major factor limiting long-term survival of cardiac transplant recipients (CTRs). Although cyclosporine based triple drug immunosuppression has not decreased the occurrence of ACAD, some preliminary data suggests that prophylactic antilymphocyte preparations may reduce the incidence of this problem. All CTRs at Henry Ford Hospital have uniformly received prophylactic Minnesota Antilymphocyte Globulin (ALG), thereby providing a unique opportunity to investigate this hypothesis. One hundred three CTRs were followed for a median duration of 34 months with annual angiograms begun one year after transplant. Patients who died without an angiogram were considered to have ACAD based on autopsy results or if their death was clinically suspicious. Ninety-two patients underwent at least one angiogram. Fourteen patients had abnormal angiograms. Nine patients were identified as having ACAD by non-angiographic criteria. Five had autopsy proven disease, 3 died suspiciously, and 1 underwent successful re-transplantation for ACAD. By Kaplan-Meier analysis, the risk of developing ACAD was 12% in 1 year, 16% in 2 years, 22% in 3 years, 26% in 4 years, and 29% in 5 years. Risk of ACAD increased with older recipient's age, higher triglyceride levels, and diabetes, but was not affected by active CMV infection, number of acute rejection episodes, and HLA mismatching. These results suggest that prophylactic ALG reduces the occurrence of ACAD.

Adult↗