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Biomedical subjects

R Mertelsmann

Publications and source records attributed to R Mertelsmann.

At least 145 records · Page 8Linked to original sources

BCL-2 induction is part of the strategy of Epstein-Barr virus.

Epstein Barr virus can infect B lymphocytes and epithelial cells. Epithelial cells present the natural reservoir for the virus in man. In vitro, infected cells harbor the virus predominantly in a latent state with the expression of a set of nuclear (EBNA 1-6) and latent membrane genes (LMP 1-2) and virus-transformed B cells grow as permanently immortalized lymphoblastoid cell lines, that show increased resistance to various growth inhibiting factors. Here we show that the lymphoma-associated oncogene BCL-2 is upregulated by different latent Epstein-Barr virus genes in B lymphocytes as well as keratinocyte cell lines. Thus, the induction of BCL-2 gene expression seems to be part of the survival strategy of the virus independently of the host cell infected.

B-Lymphocytes↗

Poor prognosis of prethymic phenotype acute lymphoblastic leukemia (pre-T-ALL).

Pre-T-ALL is an important subgroup of ALL with clinical features different from adult T-ALL. Expression of intracytoplasmic CD3 represents the earliest marker for the prethymic phenotype. We studied four consecutive adult patients with this phenotype. Three of the four patients did not respond to the induction chemotherapy with vincristine, daunorubicin, prednisone and asparaginase. They reached a delayed remission only after chemotherapy with cyclophosphamide and cytosine arabinoside. All four patients relapsed 3, 9, 10 and 13 months after diagnosis. One patient died 2 months after relapse, another one 2 months after allogeneic BMT performed in second relapse. We conclude that patients with early T-cell precursor leukemia do not respond adequately to conventional chemotherapy and should be considered as a high-risk subgroup within the T-lineage ALL.

Adult↗

Burkitt-like mutations in the c-myc gene locus in prolymphocytic leukemia.

The c-myc oncogene recently shown to act as a transcription factor, is involved in cellular proliferation. Deregulation of this gene can be one step in malignant transformation. In Burkitt's lymphoma (BL) the c-myc gene is consistently involved in chromosomal translocations and the first exon of the gene has been found to be a frequent target of somatic mutations. These mutations are believed to interfere with normal transcriptional regulation of the gene. We demonstrate a case of the rare prolymphocytic leukemia (PLL), a variant of chronic lymphocytic leukemia (CLL), that shows multiple Burkitt-like mutations in the first exon of c-myc and one nonconservative point mutation in the coding exon 2. Cytogenetic analysis revealed involvement of both chromosomes 8 in chromosomal translocations. Both chromosomes 8 are broken at (q23), the c-myc gene locus. Since the patient's leukemia cells exhibited high expression levels of the mutated allele of the c-myc mRNA, the point mutations alone may have accounted for transcriptional deregulation.

Amino Acid Sequence↗

Ex vivo expansion of enriched peripheral blood CD34+ progenitor cells by stem cell factor, interleukin-1 beta (IL-1 beta), IL-6, IL-3, interferon-gamma, and erythropoietin.

To provide sufficient numbers of peripheral blood progenitor cells (PBPCs) for repetitive use after high-dose chemotherapy, we investigated the ability of hematopoietic growth factor combinations to expand the number of clonogenic PBPCs ex vivo. Chemotherapy plus granulocyte colony-stimulating factor (G-CSF) mobilized CD34+ cells from 18 patients with metastatic solid tumors or refractory lymphomas were cultured for up to 28 days in a liquid culture system. The effects of interleukin-1 beta (IL-1), IL-3, IL-6, granulocyte-macrophage-CSF (GM-CSF), G-CSF, macrophage-CSF (M-CSF), stem cell factor (SCF), erythropoietin (EPO), leukemia inhibitory factor (LIF), and interferon-gamma, as well as 36 combinations of these factors were tested. A combination of five hematopoietic growth factors, including SCF, EPO, IL-1, IL-3, and IL-6, was identified as the optimal combination of growth factors for both the expansion of total nucleated cells as well as the expansion of clonogenic progenitor cells. Proliferation peaked at days 12 to 14, with a median 190-fold increase (range, 46- to 930-fold) of total clonogenic progenitor cells. Expanded progenitor cells generated myeloid (colony-forming unit-granulocyte-macrophage), erythroid (burst-forming unit-erythroid), as well as multilineage (colony-forming unit-granulocyte, erythrocyte, monocyte, megakaryocyte) colony-forming units. The number of multilineage colonies increased 250-fold (range, 33- to 589-fold) as compared with pre-expansion values. Moreover, the absolute number of early hematopoietic progenitor cells (CD34+/HLA-DR-; CD34+/CD38-), as well as the number of 4-HC-resistant progenitors within expanded cells increased significantly. Interferon-gamma was shown to synergize with the 5-factor combination, whereas the addition of GM-CSF significantly decreased the number of total clonogenic progenitor cells. Large-scale expansion of PB CD34+ cells (starting cell number, 1.5 x 10(6) CD34+ cells) in autologous plasma supplemented with the same 5-factor combination resulted in an equivalent expansion of progenitor cells as compared with the microculture system. In summary, our data indicate that chemotherapy plus G-CSF-mobilized PBPCs from cancer patients can be effectively expanded ex vivo. Moreover, our data suggest the feasibility of large-scale expansion of PBPCs, starting from small numbers of PB CD34+ cells. The number of cells expanded ex vivo might be sufficient for repetitive use after high-dose chemotherapy and might be candidate cells for therapeutic gene transfer.

Antigens, CD↗

Immunomodulatory effects of ultra-low-dose interleukin-2 in cancer patients: a phase-IB study.

High-dose interleukin-(IL-2) has been broadly studied in tumor therapy, yet it may be inhibitory to T-cell-dependent immunity. Therefore immune and tumour responses mediated by low-dose IL-2 were studied systematically with respect to the feedback organisation of immune responses. IL-2 was administered once daily at three dose levels: 0.18, 0.9, 4.5 MIU/m2 according to three different schedules requiring subcutaneous (s.c.) injection once weekly (four doses, stratum I), thrice weekly every other day (nine doses, stratum II), or five times weekly every other week (ten doses, stratum III). A total of 46 patients with advanced cancer were randomly assigned to one of the nine treatment groups. Systemic effects were induced at doses as low as 0.18 MIU/m2 IL-2 s.c. as demonstrated from measurable IL-2 serum levels, induction of circulating IL-6, a transient lymphopenia, and stimulation of delayed-type hypersensitivity (DTH) responses of the skin. Analysis of the different IL-2 schedules demonstrated (a) prolonged effects of once-weekly injections on DTH responses, lymphocyte and eosinophil counts, and (b) maximum increase of eosinophil counts and preferential expansion of activated NK cells with repeated injections every 48 h or 72 h (stratum II), while sequential treatment according to stratum III was found to be more potent in increasing the number of activated T cells. A tumour response was observed in 1/15 patients with renal cell carcinoma who experienced more than 50% tumour regression for 8 months; 12 patients had stable disease for 4 months (median). These data demonstrate prolonged immunological effects of ultra-low doses of s.c. IL-2 despite its short half-life. Furthermore, scheduling of IL-2 was found to affect immune responsiveness specifically as demonstrated by the differential effects on natural killer and T cell populations.

Adult↗

Haematopoietic growth factors and peripheral blood stem cells as supportive agents in dose intensification.

We have studied the requirements that have to be met to combine effective cancer chemotherapy with the mobilisation of peripheral blood stem cells (PBSC). We have shown that there is a differential induction of high numbers of PBSC following standard-dose chemotherapy (VIP) plus treatment with colony-stimulating factors. The combined sequential administration of interleukin 3 (IL-3) plus granulocyte-macrophage colony-stimulating factor (GM-CSF) induced maximal numbers of PBSC, including colony-forming unit-granulocyte, erythrocyte, monocyte/macrophage, megakaryocyte (CFU-GEMM) and colony-forming unit-megakaryocyte (CFU-Meg), compared with the application of GM-CSF, granulocyte colony-stimulating factor (G-CSF) or chemotherapy alone. The number of CD34+ cells was highly variable depending on the prior treatment given to the patients. Mobilised CD34+ cells--depending on the cytokines used for recruitment--had a varying cloning efficiency, and were heterogeneous as to their level of commitment. Retransfusion of G-CSF-primed progenitor cells to pilot patients following high-dose chemotherapy demonstrated that PBSC recruited by standard-dose chemotherapy plus G-CSF accelerated both neutrophil and platelet recovery.

Antineoplastic Combined Chemotherapy Protocols↗

Peripheral blood progenitor cells mobilized by chemotherapy plus granulocyte-colony stimulating factor accelerate both neutrophil and platelet recovery after high-dose VP16, ifosfamide and cisplatin.

We report on the chemotherapy plus granulocyte colony-stimulating factor (G-CSF) induced mobilization of peripheral blood progenitor cells (PBPCs) and their impact on haematopoietic recovery following high-dose chemotherapy. Twenty-four patients with advanced solid tumours or lymphomas received standard-dose chemotherapy with VP16, ifosfamide and cisplatin (VIP) followed by filgrastim (G-CSF; 5 micrograms/kg s.c. daily for 14 d) for the prevention of chemotherapy induced neutropenia and for the simultaneous mobilization of PBPCs. Maximal numbers of progenitors of different lineages were reached at day 11 (range 9-14) after VIP chemotherapy. A median of 0.415 x 10(9)/l CD34+ cells (range 0.11-1.98), 9000 CFU-GM/ml (range 2800-17,700), 3500 BFU-E/ml (range 400-10,800) and 200 CFU-GEMM/ml (range 0-4400) were recruited. One single apheresis yielded a median of 1.6 x 10(8) mononuclear cells/kg (range 0.2-5.4) or 5.4 x 10(6) CD34+ cells/kg body weight (range 0.2-24.2). Fourteen patients who showed at least a partial remission after two cycles of the standard-dose chemotherapy regimen were subjected to high-dose VIP chemotherapy (cumulative doses of 1500 mg/m2 VP16, 12 g/m2 ifosfamide and 150 mg/m2 cisplatin) with or without PBPC support. The first six patients were treated with growth factors only (IL-3/GM-CSF) and did not receive PBPCs, whereas the following eight patients were supported with PBPCs in addition to IL-3 and GM-CSF. Neutrophil recovery as well as platelet recovery were significantly faster in patients receiving PBPCs with a median of 6.5 d below 0.1 x 10(9) neutrophils/l and 3 d below 20 x 10(9) platelets/l as compared to 10.5 d and 8 d in control patients receiving growth factors only. The accelerated platelet recovery in patients supported with PBPCs might be explained--in the absence of detectable colony-forming units megakaryocyte--by the presence of glycoprotein IIb/IIIa+, non-proliferating endomitotic megakaryocytic precursor cells within G-CSF mobilized PBPCs. Our data demonstrate that chemotherapy plus G-CSF mobilized PBPCs accelerate both neutrophil and platelet recovery after high-dose VIP chemotherapy in patients with solid tumours or lymphomas.

Adult↗

Mithramycin selectively inhibits collagen-alpha 1(I) gene expression in human fibroblast.

The products of the collagen-alpha 1(I) and -alpha 2(I) genes form the triple helical molecule collagen type I, which constitutes the major ECM protein in tissue fibrosis. The collagen-alpha 1(I) gene is mainly transcriptionally regulated, and its promoter activity depends on the interaction of the transcription factors NF-I and Sp1 with a tandem repeat of evolutionary conserved NF-I/Sp1 switch elements. An increased affinity of Sp1 to these elements has been observed in experimental liver fibrosis. Here, we demonstrate that the DNA binding drug mithramycin displays a high affinity binding to the GC-rich elements in the collagen-alpha 1(I) promoter as measured by DNAse I protection and gel retardation assays. Mithramycin interferes with Sp1 but not with NF-I binding to these sites. At a concentration of 100 nM, mithramycin efficiently reduces basal and TGF-beta-stimulated alpha 1(I) gene expression in human primary fibroblasts. The transcriptional activity and mRNA steady state levels of other genes, including the collagenase gene, as well as the growth rate of fibroblasts remained unchanged on exposure to this drug. Taken together, our results indicate that the transcriptional activity of the type I collagen gene highly depends on its GC-rich regulatory elements, and further, that these elements can be differentially blocked, thereby changing the balance between ECM structural and degrading gene activities in human fibroblasts.

Blotting, Northern↗

Expression of interleukin 10 in B lymphocytes of different origin.

Interleukin 10 (IL-10) is a strong B-cell-activating factor. Since murine Ly1-positive peritoneal or lymphoma B cells strongly express IL-10, we examined malignant cells from patients with acute and chronic leukemias by reverse transcriptase polymerase chain reaction (RT-PCR) for the expression of IL-10 mRNA. High expression was found in three out of four samples from CD10+, CD5- common acute lymphoblastic leukemia (cALL) cells, whereas T-ALL samples generally did not contain IL-10 mRNA. In contrast to the murine system, only low levels of IL-10 expression were seen in 10 out of 11 samples from patients with CD5+ CLL. Myeloid derived cell lines were negative for IL-10. Epstein Barr virus (EBV) positive and negative Burkitt's lymphoma (BL) cell lines showed heterogenous IL-10 expression: BL cell lines with a nonactivated germinal center phenotype (CD10+, CD77+, CD23-, CD30-, CDw70-) expressed little or no IL-10, whereas EBV-positive and negative BL cell lines with an activated phenotype (CD77-, CD23+, CD30+, CDw70+) expressed easily detectable amounts of IL-10 mRNA. The highest expression of IL-10 was found in EBV-immortalized lymphoblastoid cell lines (LCL). Upon superinfection with non-defective EBV, the EBV-negative cell line BL 41 up-regulated IL-10 expression. Thus, in vivo IL-10 expression is not restricted to cells showing a specific (CD5+) phenotype. IL-10 may play an important role in c-ALL. The expression of IL-10 in BL cell lines is correlated to an activated phenotype in vitro and is independent of the EBV carrier status. EBV can induce IL-10 expression.

Antigens, CD↗

Serum levels of circulating ICAM-1 are increased in Hodgkin's disease.

The intercellular adhesion molecule 1 (ICAM-1) is the ligand for the lymphocyte function-associated antigen 1 (LFA-1). The ICAM-1/LFA-1 complex mediates cell-cell and cell-matrix interactions and is believed to be crucial for several immunological functions, including non-MHC-restricted cytotoxicity. Recently, a circulating form of the surface ICAM-1 molecule, the 82 kDa cICAM, has been identified. Using enzyme-linked immunosorbent assay (ELISA) we have examined 82 kDa cICAM-1 levels in the sera of 45 age- and sex-matched healthy subjects and 130 consecutive patients with Hodgkin's disease (HD). The mean +/- SD concentration of the 82 kDa cICAM-1 was significantly higher (p < 0.001) in HD patients (725.6 +/- 141 ng/ml) than in healthy controls (403.5 +/- 54.5 ng/ml). Patients with B-symptoms (n = 66) had higher cICAM-1 levels than patients without systemic symptoms (n = 64) (825.1 +/- 202.9 ng/ml versus 671.7 +/- 164.9 ng/ml; p < 0.001). Serum levels of cICAM-1 were also significantly higher (p < 0.05) in patients with disseminated disease (stage III and IV) than in those with localized disease (stage I and II). The HD patients in stage III and IV with B-symptoms had significantly higher (p < 0.001 and p < 0.02, respectively) cICAM-1 levels then stage III/IV patients lacking B-symptoms. The increase of cICAM-1 concentrations was positively correlated to increases of soluble receptors for interleukin-2 (sIL-2R) (r = 0.69; p < 0.001). Since cICAM-1 is functionally able to bind to LFA-1, increased serum levels of this molecule could be a mechanism for promoting de-adhesion and inability of Hodgkin and Reed-Sternberg cells (H-RS) to be recognized by cytotoxic effector cells, and could thus represent a way for these cells to escape immunosurveillance and for progression and spreading of disease.

Adolescent↗

N-RAS gene activation in acute myeloid leukemia: association with expression of interleukin-6.

The 21 kDa proteins encoded by RAS genes are thought to be involved in intracellular signal transduction. Expression of RAS genes activated by point mutations after transfection into mammalian cells can modulate the response of these cells to exogenously added growth factors and their expression patterns of growth factors. We analyzed leukemic cells from 50 patients with acute myeloid leukemia (AML) for the presence of activating point mutations of the N-RAS gene using polymerase chain reaction (PCR) and differential oligonucleotide hybridization. This assay allows semiquantitative determination of the relative abundance of cells carrying N-RAS mutations. Clonal activation of N-RAS, noted in the large majority of leukemic cells of the six of these patients, was correlated significantly (p = 0.0003) with the ability of these cells to express interleukin 6 (IL-6), previously shown to be expressed at high levels in approximately 30% of primary AML cells. In 16 patients, the presence of N-RAS mutations was observed only in subpopulations of leukemic cells. The 'subclonal' involvement of some but not all leukemic cells was further demonstrated by PCR analysis of individual clones grown in soft agar culture. We investigated whether additional, complementary changes in oncogene structure occurred in cells exhibiting clonal activation of N-RAS. For instance, concomitant activation of N-RAS and amplification or rearrangement of c-MYC have been observed in various tumor tissues. Southern blot analysis did not, however, reveal gross alternations of MYC gene structure or copy number in these cells.

Base Sequence↗