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Biomedical subjects

R E Phillips

Publications and source records attributed to R E Phillips.

At least 19 recordsLinked to original sources

Antigenic oscillations and shifting immunodominance in HIV-1 infections.

A typical protein antigen contains several epitopes that can be recognized by cytotoxic T lymphocytes (CTL), but in a characteristic antiviral immune response in vivo, CTL recognize only a small number of these potential epitopes, sometimes only one, this phenomenon is known as immunodominance. Antigenic variation within CTL epitopes has been demonstrated for the human immunodeficiency virus HIV-1 (ref. 11) and other viruses and such 'antigenic escape' may be responsible for viral persistence. Here we develop a new mathematical model that deals with the interaction between CTL and multiple epitopes of a genetically variable pathogen, and show that the nonlinear competition among CTL responses against different epitopes can explain immunodominance. This model suggests that an antigenically homogeneous pathogen population tends to induce a dominant response against a single epitope, whereas a heterogeneous pathogen population can stimulate complicated fluctuating responses against multiple epitopes. Antigenic variation in the immunodominant epitope can shift responses to weaker epitopes and thereby reduce immunological control of the pathogen population. These ideas are consistent with detailed longitudinal studies of CTL responses in HIV-1 infected patients. For vaccine design, the model suggests that the major response should be directed against conserved epitopes even if they are subdominant.

Amino Acid Sequence

The effects of natural altered peptide ligands on the whole blood cytotoxic T lymphocyte response to human immunodeficiency virus.

Cytotoxic T lymphocytes (CTL) directed against human immunodeficiency virus (HIV)-1 are detectable in the majority of infected individuals, and their early appearance as the initial viremia is suppressed is thought to represent a potent antiviral response. Variation which arises in CTL epitopes can affect recognition by CTL, and we have observed previously that variant epitopes in HIV-1 gag which arise in HIV-1-seropositive donors may act as T cell receptor (TCR) antagonists of their own CTL (Klenerman et al., Nature 1994, 369: 403). The most important question arising from these observations is the extent of these immune escape mechanisms in vivo. Here we show that fresh, uncultured lymphocytes taken directly from HIV-1-infected patients are susceptible to TCR antagonism by variants present within their own virus. In contrast to HLA Class II-restricted T cell responses, where anergy may be induced, we find that in vitro, natural variants may stimulate and sustain growth of CTL. These CTL lines retain lytic specificity exclusively for the original peptide. If this represents events in vivo, natural HIV altered peptide ligands (APL) have the capacity to inhibit the range of CTL directed against an epitope, not simply those clones selected in vitro. Partial activation of CTL by APL could also act to drive an ineffectual CTL response incapable of lysing infected cells bearing these natural antigenic variants. Distortion of lymphocyte populations and function by APL might represent a further mechanism of immune evasion by HIV.

Amino Acid Sequence

The stimulatory and inhibitory effects of dopamine on prolactin secretion in the turkey.

Dopamine (DA) was infused into the third ventricle of anesthetized laying turkey hens at various concentrations to determine its effect on both basal prolactin (PRL) levels and ongoing electrically induced PRL secretion. The infusion of DA at rates of 1.0 or 10.0 nmol/min resulted in dose dependent increases in plasma PRL. These infusions had no inhibitory effect on electrically stimulated PRL release. The infusion of DA at 100.0 or 500.0 nmol/min caused no stimulation of PRL secretion and totally inhibited the PRL response elicited by electrical stimulation of the medial preoptic nucleus. These results show that dopaminergic influences are involved in both stimulating and inhibiting avian PRL secretion and suggest possible biphasic actions of DA within the brain.

Animals

Serotonergic stimulation of prolactin secretion is inhibited by vasoactive intestinal peptide immunoneutralization in the turkey.

The neuronal mechanisms that govern prolactin (PRL) secretion in the turkey appear to involve monoaminergic systems. Considerable evidence indicates that serotonin (5-HT), acting centrally, is a potent stimulator of PRL secretion. This study, using birds actively immunized against VIP, tests the hypothesis that 5-HT stimulates PRL secretion by releasing vasoactive intestinal peptide (VIP). Nonimmunized turkeys were injected ip with saline, quipazine (5-HT agonist; 5 mg/kg), methysergide (5-HT antagonist; 8 mg/kg), or methysergide plus quipazine, and VIP-immunized birds were injected with saline or quipazine. Quipazine increased plasma PRL levels from 26.8 +/- 7.1 ng/ml at Time 0 to a peak value of 148.1 +/- 31.4 ng/ml 2 hr after infection. Pretreatment with methysergide or VIP-immunoneutralization abolished the PRL response to quipazine. Intraventricular infusion of 5-HT (1 nmol/min) caused plasma PRL to rise from a baseline of 16.3 +/- 2.6 ng/ml to 85.2 +/- 14.3 ng/ml after 30 min in nonimmunized control birds. Serotonin infusion did not induce PRL secretion in the VIP-immunized birds. These findings suggest that serotonergic stimulation of PRL secretion in the female turkey requires a functional VIPergic system.

Animals

The role of material surface chemistry in implant device calcification: a hypothesis.

We proposed that a similar mechanism for calcification exists for poly(ether)urethanes and glutaraldehyde stabilized tissue. The mechanism is based on the propensity of the polyether component of the materials to complex calcium and provide initiating sites for ultimate formation of calcific deposits. Data evaluating the role ether containing materials have on calcification demonstrate that the rate of mineralization of either tissue valves or polymer valves can be controlled by paying attention to the basic chemical mechanism of complexation occurring at the surface and within the bulk of the implant devices. The molecular models described above, point out that the driving force for complexation with either the polyethers of the polyurethane or the polyether of glutaraldehyde is very strong, therefore, controlling the driving force may lead to medical devices with longer term durability.

Animals

Hypoglycaemia in paediatric admissions in Mozambique.

We studied the incidence and clinical associations of hypoglycaemia in an acute medical paediatric service in Maputo, Mozambique. Of 603 children, 43 (7.1%) were hypoglycaemic. 16 of these with Plasmodium falciparum malaria had a shorter illness, and a higher incidence of convulsions and focal neurological signs than those with other diagnoses, but were less likely to die. Hypoglycaemia also complicated protein energy malnutrition, pneumonia, encephalitis, intestinal parasite infection, and nephrotic syndrome. 25 of the 603 children died: 7 (16.3%) of 43 with hypoglycaemia and 18 (3.2%) of 560 who were normoglycaemic, (relative risk of death 5.8 [95% confidence interval 2.25 to 14.93]). Hypoglycaemia is common in children in hospital in Mozambique, and should be suspected in any acutely-ill child regardless of the primary disease.

Child

Active immunization with vasoactive intestinal peptide prevents the secretion of prolactin induced by electrical stimulation of the turkey hypothalamus.

Immunoneutralization of endogenous vasoactive intestinal peptide (VIP) by active immunization with chicken VIP (cVIP) reduced both basal circulating prolactin (PRL) and steady-state levels of pituitary PRL mRNA in the turkey. This immunoneutralization severely curtailed the plasma PRL response induced by infusion of cVIP into the median eminence, and totally blocked the plasma PRL release effected by electrical stimulation of the medial preoptic nucleus. This is the first demonstration that a stimulated PRL secretion can be blocked by neutralizing VIP availability. These findings imply that among the neurochemicals released by electrical stimulation, only VIP directly stimulates PRL secretion. In addition to serving as a PRL releasing factor, VIP also appears to be involved in the regulation of pituitary PRL mRNA expression.

Animals

Heterosexual transmission of human immunodeficiency virus type 1 variants associated with zidovudine resistance.

During zidovudine therapy, human immunodeficiency virus type 1 (HIV-1) acquires a distinctive set of mutations that diminish the sensitivity of the virus to this drug in vitro. An AIDS patient is described who, while being treated with zidovudine, transmitted HIV-1 bearing a drug resistance mutation to a young woman who had never received zidovudine treatment. DNA sequencing of HIV-1 proviruses confirmed that these 2 persons shared HIV genetic variants, including a mutation at codon 70 in the reverse transcriptase gene associated with reduced in vitro sensitivity to zidovudine. This mutation persisted in the woman > 1 year in the absence of antiretroviral therapy. HIV-1 with genetic markers of zidovudine resistance can be transmitted heterosexually, but it is uncertain whether dissemination of drug-resistant virus will substantially reduce the usefulness of this drug.

Adult

Role of vasoactive intestinal peptide in the control of prolactin-induced turkey incubation behavior. I. Acute infusion of vasoactive intestinal peptide.

Vasoactive intestinal peptide (VIP) stimulates prolactin (PRL) secretion. Ovine PRL induces incubation behavior in avian species. This study was designed to determine whether VIP can elevate plasma PRL for up to 3 h. Saline or porcine VIP (pVIP; 30, 60, or 150 ng/min) was infused into the median eminence of laying turkeys for 1 h. The 60- and 150-ng doses of pVIP increased plasma PRL (p < 0.01), whereas the 30-ng dose was insignificant. Pituitary PRL content decreased in pVIP-treated turkeys. Two-hour infusion of 60 or 150 ng chicken VIP (cVIP)/min produced similar elevations of plasma PRL (p < 0.001), which declined within 80 min. Both treatments induced insignificant increases in pituitary PRL mRNA. Saline or cVIP (30, 60, or 60 [pulsed] ng/min) was infused into the median eminence for 3 h. Sixty ng cVIP/min induced the largest PRL release (p < 0.05). The pulsatile and low-cVIP treatments resulted in release of a significant amount of PRL in comparison to the saline treatment (p < 0.01). All cVIP treatments resulted in decreased pituitary PRL content (p < 0.05). The 60-ng dose increased PRL mRNA (p < 0.1). This study shows that 60 ng VIP/min causes the maximum PRL release in laying turkeys. However, pituitary PRL content is depleted and PRL synthesis cannot maintain PRL secretion at high levels.

Animals

Role of vasoactive intestinal peptide in the control of prolactin-induced turkey incubation behavior. II. Chronic infusion of vasoactive intestinal peptide.

Hyperprolactinemia is associated with incubation behavior in avian species. Increased nesting activity is a major indication of incubation behavior. Vasoactive intestinal peptide (VIP) stimulates prolactin (PRL) secretion from the anterior pituitary. The goal of this study was to induce incubation behavior by stimulating PRL through chronically infusing VIP into the third ventricle of turkey brains. In experiment 1, porcine VIP (pVIP) was infused into the median eminence at a rate of 60 ng/min for 7 days by means of osmotic pumps implanted s.c.. Plasma PRL increased significantly in the pVIP-treated turkeys (p < 0.001). Although egg laying was not affected by the pVIP infusion, the mean oviduct weight decreased (p < 0.057). In experiment 2, saline or pVIP (30 or 60 ng/min) was infused into the third ventricle of laying turkeys for 12 days. Both pVIP treatments increased plasma PRL for 9 days (p < 0.05). The 30-ng pVIP/min infusion decreased nesting activity, plasma LH, ovary and oviduct weight, hypothalamic GnRH I, and anterior pituitary VIP receptors (p < 0.1). However, ovine PRL infusion (20.8 ng/min) into the same turkey flock increased nesting activity (p < 0.01). In conclusion, pVIP does not induce incubation behavior in laying turkeys.

Animals

Dynorphin modulates prolactin secretion in the turkey.

Big dynorphin (prodynorphin 209-240), dynorphin A (prodynorphin 209-225), dynorphin B (prodynorphin 228-240), beta-endorphin (beta-lipotrophin 61-90), or Met-enkephalin, each infused into the third ventricle, were tested for their effect on PRL release in the anesthetized turkey hen. Laying hens that received big dynorphin at the rate of 0.35 nmol/min showed a 5.1-fold increase in serum PRL at the end of a 30-min infusion period. In a second experiment, the big dynorphin-induced PRL increase was 2.6-fold. Nest-deprived, previously incubating hens that received big dynorphin displayed an 8.2-fold increase in serum PRL. Laying and nest-deprived incubating control birds infused with saline displayed no PRL increases. Laying hens that received dynorphin A (0.35 nmol/min) showed a 1.5-fold increase in serum PRL after 30 min of infusion; after 40 min of infusion, this increase rose to 2.7-fold. Infusions of beta-endorphin (0.35 nmol/min), or Met-enkephalin (0.35 nmol/min) failed to evoke PRL increases in either laying or nest-deprived incubating turkeys. Infusion of big dynorphin or dynorphin A for 120 min maintained an elevated PRL level across the period, a level equal to that evoked by electrical stimulation of the medial preoptic nucleus (ES/POM). Infusion of dynorphin B (0.48 nmol/min) or a reduced dose of dynorphin A (0.09 nmol/min) augmented the PRL response evoked by ES/POM. No augmentation was noted for beta-endorphin or Met-enkephalin, nor for saline-infused controls. The dynorphin-induced PRL response appeared to be dose-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: treatment with Sandostatin.

The mechanism and response to treatment of severe life-threatening hypoglycaemia (plasma glucose 1.15 +/- 0.73 mM/l [+/- SD]) was studied in eight Thai patients with falciparum malaria. Plasma insulin concentrations were inappropriately high (range 1.0-21.8 mU/l), lactic acidosis was common (arterial blood lactic acid concentration 1.44-17.8 mM/l), but the glucose counterregulatory response, indicated by plasma cortisol, growth hormone, catecholamines and glucagon concentrations, was intact. Hyperinsulinaemia was successfully treated in five patients by a continuous intravenous infusion of the long-acting somatostatin analogue Sandostatin (SMS 201-995), 50 micrograms/h. In volunteer studies a single intramuscular injection of Sandostatin (100 micrograms) suppressed quinine-induced hyperinsulinaemia within 15 min; this effect was maintained for 6 h. These results suggest that Sandostatin may be a safe and effective way of correcting the hyperinsulinaemic hypoglycaemia complicating quinine treatment of falciparum malaria. This treatment could be particularly useful in fluid-overloaded patients with recurrent hypoglycaemia despite dextrose infusions.

Adolescent

Effects of reproductive status, ovariectomy, and photoperiod on vasoactive intestinal peptide in the female turkey hypothalamus.

Vasoactive intestinal peptide (VIP) appears to be a physiologically relevant prolactin (PRL)-releasing factor during the avian reproductive cycle, yet little is known of the factors involved in modulating the hypothalamic concentrations of this neuropeptide. A heterologous chicken VIP radioimmunoassay was developed to examine the effects of reproductive status, ovariectomy, and photoperiod on hypothalamic VIP immunoreactivity in the female turkey. VIP concentrations were highest in the median eminence/infundibular nuclear complex (ME/INF) relative to other subregions of the hypothalamus and changed only in this region during the reproductive cycle. Quiescent, nonphotostimulated hens subjected to stimulatory photoperiod exhibited a 1.6-fold increase in VIP in the ME/INF (quiescent 59.9 +/- 6.0 vs photostimulated 95.8 +/- 7.1 pg/microgram protein). An additional 2-fold increase in ME/INF VIP concentrations was observed in laying hens (183.0 +/- 28.5 pg/microgram protein). Coincident increases in plasma PRL were also observed. In contrast, during incubation and the photorefractory stage, a dissociation between hypothalamic VIP and plasma PRL occurred. No changes were observed in VIP in incubating hens, yet a 6-fold increase in PRL was noted, compared to layers. In addition, ME/INF VIP concentrations exhibited no change during the photorefractory stage, whereas a 28-fold decrease in plasma PRL occurred. VIP concentrations in the ME/INF of laying hens were unaffected by ovariectomy, whereas exposure to short photoperiod reduced VIP by 44%. The inhibitory effects of short photoperiod could not be reversed by administration of exogenous steroids, while steroid treatment reduced VIP concentrations by 45% in the ovariectomized hens. These results provide additional correlative evidence for a modulatory role of VIP in PRL secretion and suggest that the expression of this neuropeptide in the INF may serve as a neural link between photoperiodic mechanisms and PRL release during the avian reproductive cycle.

Animals

Anaemia of Plasmodium falciparum malaria.

The pathophysiology of the anaemia of falciparum malaria is both complex and multifactorial, and results in a condition which is a major cause of mortality and morbidity in patients, especially children and pregnant women, living in malarial endemic areas. The importance of anaemia as a cause of death in malaria may well be underestimated because of difficulty in diagnosis, especially where parasitaemia may be low and the clinical picture may be confused with other causes of anaemia. Two clinical presentations predominate: severe acute malaria in which anaemia supervenes, and severe anaemia in patients in whom there have been repeated attacks of malaria. The major mechanisms are those of red cell destruction and decreased red cell production. Potential causes of haemolysis include loss of infected cells by rupture or phagocytosis, removal of uninfected cells due to antibody sensitization or other physicochemical membrane changes, and increased reticuloendothelial activity, particularly in organs such as the spleen. Decreased production results from marrow hypoplasia seen in acute infections, and dyserythropoiesis, a morphological appearance, which in functional terms results in ineffective erythropoiesis. The role of parvovirus B19 as a possible cause of bone marrow aplasia in a few cases is postulated. Finally, there is now evidence which points to genetic factors, HLA associated, which may protect against the development of malarial anaemia and which has become common in areas endemic for malaria.

Anemia

Human immunodeficiency virus genetic variation that can escape cytotoxic T cell recognition.

In a longitudinal study of HIV seropositive patients, there were fluctuations in the specificity of cytotoxic T cells for the virus. This was matched by variability in proviral gag DNA epitope sequences in the lymphocytes of these patients. Some of these viral variants are not recognized by autologous T cells. Accumulation of such mutations in T-cell antigenic targets would provide a mechanism for immune escape.

Amino Acid Sequence

Involvement of dopamine in prolactin release induced by electrical stimulation of the hypothalamus of the female turkey (Meleagris gallopavo).

Controversy exists regarding the role of dopamine (DA) in the regulation of avian prolactin (PRL) secretion. Consequently, we injected apomorphine, a DA agonist, and pimozide, a DA receptor blocker, into laying and nest-deprived incubating turkeys and studied their effect on PRL secretion before (-20, -10, 0 min), during (5, 10, 20, 30 min), and after (5, 15, 30 min) electrical stimulation in the ventromedial nucleus of the hypothalamus. Apomorphine (10 mg/kg, ip) completely abolished the electrical stimulation-induced PRL increase in both laying and nest-deprived incubating hens. Pimozide (2 mg/kg, ip) potentiated electrical stimulation-induced PRL secretion in laying hens. In the two pimozide experiments, peak responses were 10.9-fold for the pimozide-treated group vs 2.9-fold for the control group, and 5.4-fold for the pimozide-treated group vs 2.6-fold for the control group. In nest-deprived incubating hens, PRL response to electrical stimulation was unaffected by pimozide treatment. These data support the concept that DA is inhibitory to the neuroendocrine system which stimulates PRL secretion in laying hens. In incubating hens, the dopaminergic inhibition is diminished, allowing for the increased PRL level observed during incubation.

Analysis of Variance