Surgical treatment for patients with advanced pancreatic cancer.
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Humans↗
Biomedical subjects
R Andersson
Publications and source records attributed to R Andersson.
Characterization of immune responses to experimental polyvalent subunit vaccines assembled in iscoms.
Immune responses to experimental polyvalent subunit vaccines assembled in a particulate adjuvant/delivery system, iscoms, are described. The fusion protein ZZ-M5 comprises structures of staphylococcal protein A (ZZ) and the Plasmodium falciparum malaria antigen Pf155/RESA (M5). MHC congenic mice were immunized with ZZ-M5 conjugated to iscoms containing human influenza virus antigen (flu ag, M5-flu-isc) or to iscom matrix (iscom particles without flu ag, M5-isc). Comparison of antibody and T-cell responses to M5-isc and M5-flu-isc demonstrated that the flu ag in M5-flu-isc exhibits carrier-related helper functions and that the assembly of immunogens in M5-flu-isc did not result in any apparent antigenic competition. In addition, assembly of ZZ-M5 and flu ag in iscoms induced an alteration of the IgG subclass profile of the antibody response to M5. The results suggest that assembly of immunogens in iscoms may be a useful approach to the design of subunit vaccines but that both quantitative and qualitative aspects of the immunogenic properties of such constructs should be scrutinized.
Amino Acid Sequence↗
Enhanced prevalence of T cells expressing TCRBV8S2 and TCRBV8S3 in hearts of chronically Trypanosoma cruzi-infected mice.
We have analysed the relative T cell receptor (TCR) BV gene usage in T cells from hearts and spleens of CBA/HJ mice chronically infected with the Tulahuén strain of Trypanosoma cruzi. During chronic infection, CBA/HJ mice recruit T cells at the major site of inflammation (i.e. the heart), with over-representation of certain TCRBV gene subfamilies (TCRBV8S2 and TCRBV8S3). In contrast, no signal or a very weak message from a limited number of T cells was recorded from one heart of the control group. No alteration of TCRBV distribution was recorded in spleens of chronically infected CBA/HJ. Our findings indicate that there is a preferential TCRBV gene usage in the T cell response in the hearts of chronically infected mice. Furthermore, the pattern of CDR3 lengths in inflammatory T cells was altered.
Animals↗
Immunogenicity of chimeric multiple antigen peptides based on Plasmodium falciparum antigens: impact of epitope orientation.
Assembly of B and T epitopes in multiple antigen peptides (MAP) can bypass genetically predisposed unresponsiveness to B epitopes. Although the underlying mechanisms are unknown, B-cell responses to such diepitope MAP are influenced by intramolecular epitope orientation. In this study, MAP constructs were synthesized, encompassing two epitopes derived from the Plasmodium falciparum antigens circumsporozoite protein (CS) and Pf332. In addition to B epitopes, the sequences comprised T epitopes restricted to mouse H-2b (CS) or to H-2d and H-2k (Pf332) haplotypes. Congenic H-2b, H-2d and H-2k Balb mice were immunized with MAP in which the two epitopes were arranged either tandemly or in parallel. Tandemly arranged (B-T)4 MAP, in which the relevant T epitope was positioned adjacent to the lysine core [(Pf332-CS)4-core for H-2b mice and (CS-Pf332)4-core for H-2d and H-2k mice], elicited the most potent antibody responses in terms of reactivity to both epitopes. Additionally, the (B-T)4 constructs were generally most efficient in recalling proliferative T-cell responses in vitro, irrespective of the MAP used for in vivo priming. As high antibody titers were generated to both epitopes, the position of B epitopes in the constructs does not appear to be critical for an efficient B-cell response. Rather, the association of strong B- and T-cell responses to the (B-T)4 MAP constructs suggests that the intramolecular position of the relevant T epitope determines the magnitude of specific antibody production.
Animals↗
The effects of political and economic transitions on health and safety in Estonia: an Estonian-Swedish comparative study.
A general and dramatic deterioration of health in Estonia during the transition period 1990-1994 was analysed using Sweden as a comparative example. Though there were diverging trends between Estonia and Sweden in the leading cause of death, cardiovascular diseases, the gap in mortality from injury had increased most rapidly. While the injury mortality rate slightly decreased in Sweden from 1990 to 1994, it almost doubled in Estonia. In 1994, the total injury death rate for men was about 6 times higher in Estonia than in Sweden. The death rates for some types of injuries, such as alcohol intoxication and homicide, were many tenfolds higher in Estonia than in Sweden. Injury contributed the most to the widening health gap between the countries, especially in males. The mechanisms of this sudden health deterioration remain to be fully explained. It could be hypothesised that behind the traditional behavioural risk factors, the influence of socio-political factors related to economic and political reconstruction is present. A widespread risk-taking and unhealthy behaviour among Estonians can likely be partly explained as a way of coping with the distress created by the new demands of transition society. An important challenge on the way to improvement is creating the political will among policy-makers to confront the tremendous problems of controlling the factors in society that affect the population's health in Estonia.
Cardiovascular Diseases↗
Binding of immobilized fibronectin by biliary drain isolates.
Occlusion of biliary stents, as the result of bacterial adhesion and colonization onto biliary stents, still remains a major problem. Biliary proteins, such as fibronectin (Fn) and vitronectin (Vn), have been presumed to be involved in the process of bacterial adhesion to biliary biomaterial. In the present study, Fn binding by 5 strains of E. coli isolated from biliary drains or from bile was studied. All strains did not bind detectable amounts of soluble Fn but bound to immobilized plasma Fn. Adhesion of four strains of E. coli to ovalbumin was reduced by periodate treatment of ovalbumin, but adhesion to Fn was unaffected. Adhesion was inhibited by mannose-containing saccharides, trypsin treatment of the protein, and protease treatment of the bacterial cells. Autoradiography showed that components of cell extracts from three E. coli strains bind 125I-Fn but not a 150 kD Fn fragment. The findings indicate that the adhesion of these bacteria to Fn is a protein-protein interaction, inhibited by D-mannose, and possibly mediated by fimbrial components.
Animals↗
Dacarbazine-vindesine versus dacarbazine-vindesine-cisplatin in disseminated malignant melanoma. A randomised phase III trial.
In a multicentre phase III study of disseminated malignant melanoma performed in Sweden and Norway, 326 patients were randomised to receive treatment with the combination dacarbazine [DTIC] (D) and vindesine (V) with or without the addition of cisplatin (P). D was given intravenously (i.v.) at a dose of 250 mg/m2 days 1-5 every 4 weeks and V was given i.v. at a dose of 3.0 mg/m2 day 1 weekly. P was given i.v. at a dose of 100 mg/m2 day 1 every 4 weeks. There was no statistically significant difference in overall survival between the treatment arms (P = 0.22). Increased toxicity was observed in the treatment arm containing P of which leucopenia, alopecia and nausea/vomiting were the most pronounced. The median time to progression was significantly longer in patients treated with DVP (4.2 versus 2.2 months, P = 0.007). In conclusion, adding P to DV did not change overall survival but did significantly increase toxicity.
Adolescent↗
Medical help seeking behaviour of injury patients in a community in Bangladesh.
While looking for a valid source of injury information in developing countries, it is important to know the help-seeking pattern of injury patients. A population-based study of 3258 households was conducted to explore the flow of injury patients in a local area of Bangladesh. Trained field level health workers collected the information by face-to-face interviews with the head of households, using three pretested structured forms. A total of 191 injury cases and 18 injury deaths were identified with a reference period of 15 d and 5 y, respectively. The estimated annual incidence rate of injury is 311 per 1000 inhabitants per year. The majority of the injury cases were minor (70.7%) and occurred in the home area (42%) or workplace (42%). Of the total 191 injured people, 41 (21.5%) did not seek any type of treatment for their injury but almost all of these cases were simple. Only 23.3% of injury cases who sought any type of medical treatment, went to the hospital. All severe cases, 40% of the moderate cases, and only 12.5% of minor cases were attended to at a hospital for treatment of their injuries. Allopathic quack or medicine shop owners were consulted by 42% of the injury patients. Most of the educated people preferred hospital treatment for moderate injury cases. In injury deaths, 61.1% had no opportunity to receive treatment before death, and postmortem examinations were performed in 66.7% of cases.
Adolescent↗
Gammadelta+ and CD4+ alphabeta+ human T cell subset responses upon stimulation with various Mycobacterium tuberculosis soluble extracts.
By using a flow cytometric technique which allows direct identification of proliferating cells within mixed cell populations, we have previously described that soluble extracts obtained from Mycobacterium tuberculosis or M. avium represent strong stimuli for human gammadelta+ T cells. In the present study, we demonstrate that the protocol used for the preparation of M. tuberculosis soluble extracts may have an impact on their gammadelta+ T cell stimulatory capacity. In agreement with our previous data, soluble extracts prepared from bacteria killed at 85 degrees C and directly disrupted by prolonged sonication (TBe), elicited a strong proliferation of gammadelta+ T cells after 6-7 days of stimulation. In contrast, when soluble extracts were obtained from bacteria autoclaved (121 degrees C, 25 min) and then washed by centrifugation, a predominant proportion of CD4+ alphabeta+ T cells was achieved in the responding population. The stimulatory activity for gammadelta+ T cells was recovered in the supernatant of the autoclaved bacteria, indicating that autoclaving of M. tuberculosis bacilli releases an antigen(s) into the supernatant which stimulates human gammadelta+ T cells. While protease digestion of TBe only partially reduced its stimulatory capacity on gammadelta+ T cells, the stimulatory component(s) released into the supernatant after autoclavation of bacilli was found to be sensitive to protease digestion. Interestingly, in contrast to the preponderant proportion of gammadelta+ T cells induced in the responding population by unfractionated TBe, when the extract was fractionated by fast performance liquid chromatography (FPLC), most of the fractions exhibited a strong stimulatory capacity on CD4+ alphabeta+ T cells only. The gammadelta+ T cell stimulatory activity was confined to the low molecular weight range FPLC fractions. Such results may suggest a possible regulatory role of gammadelta+ T cells on CD4+ alphabeta+ T cells.
Antigen Presentation↗
The association of type II pneumocytes and endothelial permeability with the pulmonary custocyte system in experimental acute pancreatitis.
BACKGROUND: Pancreatitis-associated pulmonary injury is still associated with substantial mortality, especially when seen as a part of the multiple organ dysfunction syndrome. METHODS: The present study aimed at evaluating alterations in type II pneumocytes and the potential relationship with the development of pulmonary injury after acute haemorrhagic pancreatitis induced by an intraductal infusion of 5% sodium taurodeoxycholate in the rat. RESULTS: The results demonstrated that definite alterations in type II pneumocytes were noted 12 and 24 h after induction of pancreatitis, characterized by an increase in the number of vocalized lamellae, the exposed area of type II pneumocytes to alveolar airspace, cellular separation and apoptosis without alterations in cellular membrane integrity. Dysfunction of the pulmonary endothelial barrier was evidenced by an increase in pulmonary albumin flux and the leakage index as well as the migration of lanthanum probes from capillaries to interstitial tissues. The levels of tumour necrosis factor (TNF) in bronchoalveolar lavage fluid significantly increased during the initial phase (3 and 6 h) after pancreatitis. The phagocytic activity of the pulmonary custocyte system increased 3 and 12 h after induction of pancreatitis. CONCLUSION: Thus, pulmonary endothelial barrier dysfunction, an activated custocyte system, and initial release of TNF seems to be involved in the pathogenesis of pancreatitis-associated type II pneumocyte compromise.
Acute Disease↗
The influence of apoptosis on intestinal barrier integrity in rats.
BACKGROUND: Apoptosis is a critical step responsible for maintaining the cellular balance between proliferation and death and for controlling tumorigenesis. Although an increase in intestinal apoptotic cells has been considered to be associated with the pathogenesis of gastrointestinal injury, little is understood concerning the role of apoptosis in the development of intestinal barrier dysfunction. METHODS: Apoptosis induced by intraperitoneal injection of doxorubicin in rats was evaluated by transmission electron microscopy and the TUNEL histochemistry method. Treatment with deoxy-D-glucose (a glycolytic pathway inhibitor) or cycloheximide (a protein synthesis inhibitor) was performed after doxorubicin challenge. Passage of human serum albumin from blood to the intestinal interstitium and the intestinal lumen or from the intestine to the intestinal interstitium and blood was evaluated by means of albumin clearance. RESULTS: A significant increase in gut water content, albumin flux, and bidirectional clearance of albumin accompanied by apoptotic epithelial cell increase was noted in doxorubicin-challenged rats treated with saline. The increase in endothelial and epithelial permeability and the increase of apoptosis could partly be prevented by treatment with deoxy-D-glucose or cycloheximide. CONCLUSION: Doxorubicin-increased epithelial apoptosis within the intestine occurs simultaneously with increased bidirectional permeability of the intestinal barrier, probably associated with both glycolytic and protein synthesis pathways. Apoptosis may thus play a role in the pathogenesis of intestinal barrier dysfunction.
Animals↗
Alterations in the functions of the reticuloendothelial and protease-antiprotease systems after intraperitoneal injection of zymosan in rats.
OBJECTIVE: To evaluate alterations in the function of the reticuloendothelial system (RES) and potential protective effects of pretreatment with the antioxidants: N-acetyl-L-cysteine (NAC) or dimethyl sulphoxide (DMSO), after intraperitoneal injection of zymosan (0.50 mg/g body weight) in rats. DESIGN: Experimental study. SETTING: University hospital, Sweden. ANIMALS: 81 male Sprague-Dawley rats. INTERVENTION: Intraperitoneal injection of either 4 ml saline or zymosan suspension (0.50 mg/g body weight). One hour before the intraperitoneal injection, 1 ml of saline, or a solution of NAC (150 mg/kg) or DMSO (80 mg/kg) were given intravenously. MAIN OUTCOME MEASURES: Systemic arterial pressure, packed cell volume, concentrations of plasma proteins and plasma protease inhibitors, uptake of 125I-labelled Escherichia coli in organs, blood clearance and body uptake rate of radiolabelled E. coli, and blood flow in organs at 3, 6, and 12 hours after injection. RESULTS: The uptake of radiolabelled E. coli in the liver, spleen and lungs decreased significantly from 3 hours onwards after zymosan challenge (p <(0.05). Blood clearance and body uptake rate also decreased significantly from 3 hours onwards (p < 0.05), but this did not correlate with the reduction in organ blood flow. Significant falls in plasma concentrations of prekallikrein (p < 0.01) and protease inhibitors (p <0.05) suggested possible contact-phase activation and activation of the kallikrein-kinin and fibrinolytic system. Pretreatment with NAC, and to a less extent DMSO, significantly prevented these alterations in RES function. CONCLUSION: Zymosan induced an impairment in RES function that was not initially associated with a reduction in blood flow. Plasma proteolytic activity seems to be involved in the impaired RES function. Pretreatment with NAC or DMSO effectively improved RES function.
Acetylcysteine↗
Microsomal metabolism and activation of the environmental carcinogen 2-amino-3-methyl-9H-pyrido[23-b]indole.
2-Amino-3-methyl-9H-pyrido[2,3-b]indole (MeA alpha C) is a mutagenic and carcinogenic heterocyclic amine formed as a pyrolysis product during cooking of food and combustion of tobacco. Hepatic microsomes from PCB-induced rats metabolized MeA alpha C to four products, of which three were non-mutagenic and one was mutagenic without S9 activation. The three non-mutagenic products, which accounted for 83% of the metabolism of MeA alpha C, were characterized by mass spectrometry and NMR spectroscopy as 6-hydroxy-MeA alpha C, 7-hydroxy-MeA alpha C and 3-hydroxy-methyl-A alpha C. The mutagenic metabolite, accounting for 17% of the metabolism of MeA alpha C, was characterized as N2-hydroxy-MeA alpha C by comparison with the HPLC retention time and UV spectrum of N2-hydroxy-MeA alpha C obtained by chemical synthesis. N2-Hydroxy-MeA alpha C was very reactive and a part of it bound covalently to microsomal proteins during incubation and a part was degraded to other products during incubation or chromatography. N2-Hydroxy-MeA alpha C was mutagenic in Salmonella typhimurium TA98 without metabolic activation, resulting in 5070 revertants/microgram, which was > 20 times the specific mutagenic activity of the parent compound.
Animals↗
No additive effect of cyclosporin A compared with glucocorticoid treatment alone in giant cell arteritis: results of an open, controlled, randomized study.
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Aged↗
Effect of a platelet-activating factor antagonist on pancreatitis-associated gut barrier dysfunction in rats.
Platelet-activating factor (PAF) may play a critical and primary role in the pathogenesis of acute pancreatitis and pancreatitis-associated distant organ injury. The present study evaluated the effect of a PAF antagonist, lexipafant (an (S)-4-methyl-2[methyl-imidazo[4,5-c]pyridin-1-ylmethyl)-benzene sulphonyl]-amino]pentanoic acid ethyl ester, BB-882; British Biotech Ltd.), on the potential prevention of gut barrier dysfunction, by measuring gut origin sepsis, bidirectional permeability of the intestinal barrier, and pancreatic capillary endothelial barrier integrity, in acute pancreatitis induced by intraductal infusion of 5% sodium taurodeoxycholate. Pancreatic endothelial permeability significantly increased in animals with acute pancreatitis, whereas pretreatment with lexipafant had a preventive effect (p < 0.05 vs. pancreatitis with saline). Similarly, alterations noted in hematocrit and plasma levels of lipase and calcium were counteracted by the PAF antagonist. It also prevented the increase in albumin leakage from blood to the mucosal interstitium and from blood to the intestinal lumen in acute pancreatitis. Albumin passage from the gut lumen to blood in animals with pancreatitis pretreated with saline increased from 3 h and on, and lexipafant prevented alterations in mucosal epithelial permeability. Bacterial translocation was commonly seen in pancreatitis, whereas only a few positive cultures were observed in pancreatitis animals given lexipafant. Microthrombosis in intestinal villi seemed less frequent after lexipafant pretreatment. We conclude that (a) PAF may play a role in the pathogenesis of pancreatitis-associated intestinal dysfunction, (b) PAF may be involved in the development of distant organ dysfunction by triggering endothelial barrier dysfunction, and (c) PAF antagonists may provide potential agents for preventing pancreatitis-associated gut barrier dysfunction.
Acute Disease↗
Patterns of pancreatic cell death: apoptosis versus oncosis.
Alterations in pancreatic cell function and morphology are characteristics of pancreatic compromise in various pathophysiological conditions. The present review focuses on potential patterns of pancreatic cell death, apoptosis, and/or oncosis, after different experimental challenges, to understand their potential significance in the pathogenesis of pancreatic injury. Apoptosis is not only present during maintenance of pancreatic homeostasis but can also be initiated by extrinsic and intrinsic factors. Pancreatic cell oncosis is another pattern of cell death, occurring in pancreatic injury. The proportion of apoptosis and oncosis may depend on the severity of pancreatic cell compromise, the properties of the challenge, animal strain, and time course. The role of various inflammatory mediators and adhesion molecules, the use of transgenic animals, and the significance of apoptosis and oncosis in acute and chronic pancreatic injury are discussed. Molecular biology of pancreatic cell death provides valuable information to simplify the understanding of mechanisms in clinical pancreatic diseases and may also introduce potential modes of pharmacological management.
Animals↗
The influence of intestinal ischemia and reperfusion on bidirectional intestinal barrier permeability, cellular membrane integrity, proteinase inhibitors, and cell death in rats.
Intestinal ischemia and reperfusion injury (I/R) is probably involved in the pathogenesis of intestinal barrier dysfunction, associated with the concomitant translocation of enteric bacteria and toxins and the potential development of multiple organ failure. The intestinal endothelial and epithelial layers play a major role preventing the entry of toxic substances from the gut, but the influence of protease-antiprotease systemic balance on these barrier functions and the relationship between epithelial DNA synthesis, apoptosis, and endothelial and epithelial barrier macromolecule permeability are not fully investigated. Endothelial and epithelial barrier macromolecular permeability, epithelial DNA synthesis, the endothelial and epithelial plasma membrane system, apoptosis and oncosis, plasma levels of proteinase inhibitors, and proenzymes were measured in rats subjected to 20 and 40 min intestinal ischemia and 1, 3, 6, or 12 h reperfusion. Endothelial permeability increased after both 20 and 40 min intestinal ischemia. Epithelial permeability significantly increased during 1-6 h reperfusion after 20 min ischemia and during 1-12 h reperfusion after 40 min ischemia. Epithelial DNA synthesis increased in animals with 20 min ischemia followed by 12 h reperfusion. Plasma levels of prekallikrein, C1-esterase inhibitor, and alpha1-macroglobulin were significantly lower following both 20 and 40 min ischemia from 3 h reperfusion and on. Apoptotic epithelial cells significantly increased in animals subjected to 20 min ischemia followed by 12 h reperfusion. The severity of reperfusion injury in the intestinal endothelial and epithelial barrier seems to correlate with the period of ischemia and the pathway of cell damage and death, together with proteinase-antiproteinase imbalance.
Albumins↗
Role of intestinal permeability in monitoring mucosal barrier function. History, methodology, and significance of pathophysiology.
The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and microorganisms consists of both non-immunological and immunological defence mechanisms. The main constituents of the intestinal barrier are the endothelial and epithelial barriers. The epithelial barrier selectively restricts micromolecular permeation and almost completely restricts macromolecular permeation, while the endothelial barrier has a very limited restriction to micromolecules and only partly to macromolecules. Maintenance of the barrier depends on the integrity of cellular plasma membranes and tight junctions, as well as the elaboration of endothelial and epithelial secretory products. Focal denudation of the barrier results in permeation of potentially threatening luminal compounds including antigens, proteases, H+, bacteria and endotoxin, and also other factors chemotactic for inflammatory cells. By initiating inflammation and thus acting on subepithelial tissues, such factors can further influence endothelial and epithelial transport and barrier function. The repair of endothelial and epithelial injury is also complex, and both restitution and enhanced endothelial and epithelial cell proliferation are likely to be important. At present, however, mechanisms for intestinal epithelial and endothelial permeation, their alterations in disease and potential ways to prevent or repair injury, are still not fully elucidated.
Animals↗