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Biomedical subjects

S M Davies

Publications and source records attributed to S M Davies.

At least 19 recordsLinked to original sources
PubMed1995

Unrelated donor bone marrow transplantation: influence of HLA A and B incompatibility on outcome.

We have studied the outcome of 211 consecutive unrelated donor (URD) bone marrow transplants (BMT) performed at the University of Minnesota (Minneapolis, MN) between May 1985 and December 1992. Ninety patients (43%) received marrow matched serologically at HLA A, B, and DR loci; 86 (41%) received marrow with a major and 32 (15%) marrow with a minor serologic mismatch at the HLA A or B locus. Multivariate analysis revealed that older age had an adverse effect on survival. In younger (age less than 18 years) recipients, survival after fully matched (A, B, and DR sub-type) or major mismatched (A or B locus), DR subtype-matched donor BMT was not significantly different (P = .4; survival: 53% v 41%, respectively, at 3 years). For adults, survival after matched donor BMT was significantly better than that with mismatched donors (P < .01; survival: 30% v 10%, respectively, at 3 years). Formal quality of life assessment by telephone interview demonstrated similar functional status in survivors of URD and related donor (RD) BMT at least 2 years post-BMT. URD BMT provides effective therapy for a variety of lethal hematopoietic diseases that rivals outcome of RD transplant in some cases. Use of URD marrow with a major mismatch at one HLA A or B locus is well tolerated in young, but not in older, recipients. These observations should be used to improve donor selection and counseling for URD BMT candidates.

Adolescent↗
PubMed1995

Hematopoietic growth factors for graft failure after bone marrow transplantation: a randomized trial of granulocyte-macrophage colony-stimulating factor (GM-CSF) versus sequential GM-CSF plus granulocyte-CSF.

Delay in hematologic recovery after bone marrow transplantation (BMT) can extend and amplify the risks of infection and hemorrhage, compromise patients' survival, and increase the duration and cost of hospitalization. Because current studies suggest that granulocyte-macrophage (GM) colony-stimulating factor (CSF) may potentiate the sensitivity of hematopoietic progenitor cells to G-CSF, we performed a prospective, randomized trial comparing GM-CSF (250 micrograms/m2/d x 14 days) versus sequential GM-CSF x 7 days followed by G-CSF (5 micrograms/kg/d x 7 days) as treatment for primary or secondary graft failure after BMT. Eligibility criteria included failure to achieve a white blood cell (WBC) count > or = 100/microL by day +21 or > or = 300/microL by day +28, no absolute neutrophil count (ANC) > or = 200/microL by day +28, or secondary sustained neutropenia after initial engraftment. Forty-seven patients were enrolled: 23 received GM-CSF (10 unrelated, 8 related allogeneic, and 5 autologous), and 24 received GM-CSF followed by G-CSF (12 unrelated, 7 related allogeneic, and 5 autologous). For patients receiving GM-CSF alone, neutrophil recovery (ANC > or = 500/microL) occurred between 2 and 61 days (median, 8 days) after therapy, while those receiving GM-CSF+G-CSF recovered at a similar rate of 1 to 36 days (median, 6 days; P = .39). Recovery to red blood cell (RBC) transfusion independence was slow, occurring 6 to 250 days (median, 35 days) after enrollment with no significant difference between the two treatment groups (GM-CSF: median, 30 days; GM-CSF+G-CSF; median, 42 days; P = .24). Similarly, platelet transfusion independence was delayed until 4 to 249 days (median, 32 days) after enrollment, with no difference between the two treatment groups (GM-CSF: median, 28 days; GM-CSF+G-CSF: median, 42 days; P = .38). Recovery times were not different between patients with unrelated donors and those with related donors or autologous transplant recipients. Survival at 100 days after enrollment was superior after treatment with GM-CSF alone. Only 1 of 23 patients treated with GM-CSF died versus 7 of 24 treated with GM-CSF+G-CSF who died 16 to 84 days (median, 38 days) after enrollment, yielding Kaplan-Meier 100-day survival estimates of 96% +/- 8% for GM-CSF versus 71% +/- 18% for GM-CSF+G-CSF (P = .026). These data suggest that sequential growth factor therapy with GM-CSF followed by G-CSF offers no advantage over GM-CSF alone in accelerating trilineage hematopoiesis or preventing lethal complications in patients with poor graft function after BMT.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1994

Developmental regulation of genomic imprinting of the IGF2 gene in human liver.

Control of the expression of the human insulin-like growth factor II gene is known to be complex, displaying both tissue-specific and developmental regulation. Insulin-like growth factor II is expressed at high levels in most tissues in the human fetus and appears to be important in fetal growth. In adult life, high levels of expression are found chiefly in liver, kidney, skin, nerve, and muscle tissue. Recent studies in the human fetus have demonstrated that in all tissues examined, including liver, the human insulin-like growth factor II gene is imprinted, with the paternally inherited allele expressed and the maternally inherited allele silent. The present study demonstrates that while the insulin-like growth factor gene is imprinted in human fetal liver, imprinting is relaxed in the second half of the first year of postnatal life, and thereafter the insulin-like growth factor gene is biallelically expressed.

Adult↗
PubMed1994

Frequent polymorphism in exon 15 of the adenomatous polyposis coli gene.

In the course of a study of tumor suppressor gene mutation in hepatoblastoma, a frequent neutral polymorphism was identified at codon 1493 in exon 15 of the gene causing adenomatous polyposis coli (APC). As the polymorphism introduces a new BsaJ1 site, DNA amplified by the polymerase chain reaction (PCR) can be rapidly screened for this polymorphism. This polymorphism can be used in cosegregation studies for presymptomatic diagnosis of APC and family studies.

Adenomatous Polyposis Coli↗
PubMed1994

Second infusion of bone marrow for treatment of graft failure after allogeneic bone marrow transplantation.

The availability of hematopoietic growth factors has introduced a new therapeutic modality to the treatment of graft failure after bone marrow transplantation (BMT). However, the clinical value of other therapeutic approaches to graft failure has not been reported in detail. We have studied the outcome of second infusions of BM for treatment of primary and secondary graft failure in 33 patients who received an allogeneic BMT at our institution between 1974 and 1992. Patients had received BM from a related (n = 28) or unrelated (n = 5) donor for hematological malignancy or BM failure. After primary graft failure, 57% (12 of 21) of reinfused patients engrafted and the Kaplan-Meier estimate of survival at 1 year is 24% (CI 6-42%). After secondary graft failure, 33% (4 of 12) of reinfused patients engrafted and survival is 25% (CI 0-50%) at 1 year. Infection, predominantly fungal, was the most frequent cause of death. Acute or chronic graft-versus-host disease (GVHD) developed in 52% of evaluable reinfused patients. We conclude that reinfusion of donor marrow can be an effective intervention in the treatment of primary and secondary graft failure. These data can serve as a comparative historical experience for the assessment of hemopoietic growth factors in the treatment of graft failure.

Acute Disease↗
PubMed1994

Comparison of engraftment in recipients of matched sibling of unrelated donor marrow allografts.

Bone marrow transplantation (BMT) from unrelated donors (URD) is being increasingly used as a treatment modality for patients with hematological malignancy and graft failure. We hypothesized that use of unrelated donors with increased degrees of histoincompatibility, as determined by standard serological techniques, would be associated with increased difficulty in achieving engraftment and more frequent graft failure. Engraftment was analyzed in 108 patients with hematologic disease who underwent BMT from a fully serologically HLA-matched unrelated donor (n = 40) or a partially serologically HLA-matched unrelated donor (n = 68). These patients were compared with 236 patients who received BMT from matched sibling donors (MSD group) over the same time period. Primary graft failure occurred in 5% of the MSD group, 6% of the serologically matched URD group and 15% of the partially serologically matched URD group (p = 0.06). Univariate and multivariate analysis of factors relating to primary graft failure showed the only significant variable to be full or partial serological HLA-matching in the URD group. Secondary graft failure occurred in 0.7% of the MSD group, 15% of the serologically matched URD group and 25% of the partially serologically matched URD group (p < 0.0001). Univariate and multivariate analysis of secondary graft failure showed the only significant variable to be a related or unrelated donor. We conclude that primary graft failure is a significantly more frequent event in recipients of bone marrow from partially serologically matched URD than in recipients of MSD or fully serologically matched URD marrow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Reduced topoisomerase II and elevated alpha class glutathione S-transferase expression in a multidrug resistant CHO cell line highly cross-resistant to mitomycin C.

We have isolated a multidrug-resistant derivative of Chinese hamster ovary CHO-K1 cells by exposure to progressively increasing concentrations of Adriamycin. This cell line, designated CHO-Adrr, was 27-fold more resistant than the parental line to Adriamycin and showed similar degrees of cross-resistance to several other topoisomerase II (topo II) inhibitors, including mitoxantrone, daunomycin and etoposide. CHO-Adrr cells showed a lower (4-fold) level of cross-resistance to vincristine and colchicine, drugs associated with the multidrug-resistant phenotype. While CHO-Adrr cells showed no enhanced resistance to several mono- and bi-functional alkylating agents or to UV and ionizing radiation, they were greater than 80-fold resistant to mitomycin C (MMC). There was a 5-fold decreased level of daunomycin accumulation in CHO-Adrr cells compared to CHO-K1 cells and this was associated with increased drug efflux. The resistant cells had amplified multidrug resistance gene (mdr) sequences and overexpressed (mdr) mRNA. Verapamil was able to completely reverse Adriamycin resistance but reversal of MMC resistance was only partial, with residual 23-fold resistance. CHO-Adrr cells expressed a 4-fold reduced level of topo II protein but overexpressed an alpha class (basic) glutathione S-transferase (GST). Analysis of cell hybrids showed that while the level of resistance to Adriamycin dropped by a factor of 3 in CHO-K1/CHO-Adrr hybrids compared to CHO-Adrr/CHO-Adrr hybrids, resistance to MMC dropped 10-fold. Thus, CHO-Adrr cells appear to exhibit simultaneously several different drug resistance mechanisms including MDR and GST overexpression, and topo II reduction.

Amsacrine↗
PubMed1992

Consequences of the division of nursing labour for elderly patients in a continuing care setting.

Detailed analysis of nursing activity has suggested that unqualified nursing auxiliaries provide most of the direct patient care and one-to-one contact for elderly patients requiring continuing care. In order to investigate the effects of this division of labour on the quality of care received, a comparison of the content of nurses' verbal interaction with patients was made between qualified and unqualified staff. Content analysis of tape-recorded nurse-patient interaction revealed recurring types of nurse verbal behaviour and a framework for examining similarities/differences between qualified and unqualified staff was developed. Frequency counts for individual verbal behaviour types suggest some differences between staff grades, particularly in relation to verbal behaviours which attempt to increase the patients' control over their activities and environment. The difficulty of assessing the implications of the differential use of particular verbal strategies is discussed in relation to the absence of evidence to confirm patient outcomes in relation to different verbal techniques. Further research in this area is required.

Choice Behavior↗
PubMed1991

Relationship between topoisomerase II level and chemosensitivity in human tumor cell lines.

Patients with metastatic testis tumors are generally curable using chemotherapy, whereas those with disseminated bladder carcinomas are not. We have compared levels of the nuclear enzyme topoisomerase II in three testis (SuSa, 833K, and GH) and three bladder (RT4, RT112, and HT1376) cancer cell lines which differ in their sensitivity to chemotherapeutic agents. The testis cell lines were more sensitive than the bladder lines to three drugs whose cytotoxicity is mediated in part by inhibiting topoisomerase II: amsacrine; Adriamycin; and etoposide (VP16). The frequency of DNA strand breaks induced by amsacrine was higher (1.5- to 13-fold) in the testis cells than in the bladder cells. The level of topoisomerase II-mediated DNA strand breakage in vitro, measured by filter trapping of amsacrine-induced protein:DNA cross-links, was similarly higher in nuclear extracts from the testis than the bladder cells. Western blot analysis showed a generally higher level of topoisomerase II protein in testis than in bladder cell nuclear extracts. Topoisomerase II protein expression broadly correlated with drug-induced strand breakage in both protein extracts and whole cells, but not with population doubling time. However, despite a 2- to 20-fold increased sensitivity to the different topoisomerase II inhibitors, the testis line 833K had a less than 2-fold higher level of topoisomerase II protein than that of the bladder line RT4. These results indicate that the level of expression of topoisomerase II is an important determinant of the relative chemosensitivity of testis and bladder tumor cell lines, but that additional factors must contribute to the extreme chemosensitivity of testis cells.

Amsacrine↗
PubMed1990

Isolation and partial characterisation of a mammalian cell mutant hypersensitive to topoisomerase II inhibitors and X-rays.

We have isolated, following one-step mutagenesis, a Chinese hamster ovary cell mutant hypersensitive to the intercalating agent, adriamycin (4-fold compared to parental CHO-K1 cells). This agent exerts at least part of its cytotoxic action via inhibition of the nuclear enzyme, topoisomerase II. The mutant, designated ADR-3, showed hypersensitivity to all classes of topoisomerase II inhibitors, including actinomycin D, amsacrine (m-AMSA), etoposide (VP16) and mitoxantrone. ADR-3 cells also showed cross-sensitivity to ionizing radiation, but not to UV light. Cellular accumulation of radiolabeled actinomycin D was similar in parental and mutant cells. At equimolar doses, adriamycin induced more protein-associated DNA single- and double-strand breaks in ADR-3 cells than in CHO-K1 cells. Topoisomerase II activity was elevated to a small but significant degree in ADR-3 cells, and this was reflected in a 1.5-fold higher level of topoisomerase II protein in ADR-3 than in CHO-K1 cells, as judged by Western blotting. ADR-3 cells were hypersensitive to cumene hydroperoxide but cross-resistant to hydrogen peroxide, suggesting possible abnormality in the detoxification of peroxides by glutathione peroxidase or catalase. Glutathione peroxidase activity against hydrogen peroxide was similar in CHO-K1 and ADR-3 cell extracts, but activity against cumene hydroperoxide was evaluated to a small but significant extent in mutant cells. Catalase levels were not significantly different in ADR-3 and CHO-K1 cells. ADR-3 cells were recessive in hybrids with parental CHO-K1 cells with respect to sensitivity to topoisomerase II inhibitors and X-rays, and represent a different genetic complementation group from the previously reported adriamycin-sensitive mutant, ADR-1 [Davies et al., J. Biol. Chem., 263 (1988) 17724-17729].

Animals↗
PubMed1990

DNA repair in radiation sensitive mutants of mammalian cells: possible involvement of DNA topoisomerases.

Mutants are invaluable in the study of DNA repair processes. The past 10 years have seen a rapid proliferation of papers describing the isolation of mammalian cell mutants exhibiting DNA repair abnormalities. A variety of DNA-damaging agents, including radiation, alkylating agents and bleomycin, have been used to select mutants. This mini-review will concentrate on radiation (particularly ionizing radiation)-sensitive mutants, whether selected directly on the basis of radiation sensitivity or subsequently found to be cross-sensitive to radiation. Commonly observed DNA repair defects are associated with sensitivity to radiation. For UV-sensitive mutants a defect in the incision step of excision repair is frequently seen. For ionizing radiation-sensitive mutants, the common feature is a defect in the repair of DNA strand breaks. This may take the form of a reduced rate of strand-break rejoining or of a lowering in the fidelity of rejoining. Recent work suggests that the DNA topoisomerases may participate in the repair of DNA strand breaks and that strand breaks induced by both topoisomerase inhibitory drugs and radiation may be repaired by common pathways.

Animals↗
PubMed1989

Isolation of two Chinese hamster ovary cell mutants hypersensitive to topoisomerase II inhibitors and cross-resistant to peroxides.

We have isolated two Chinese hamster ovary cell lines, designated ADR-4 and ADR-5, which exhibit hypersensitivity to intercalating agents and epipodophyllotoxins. These drugs are thought to exert their cytotoxicity via an interaction with the enzyme topoisomerase II. However, there is no apparent change in the level or catalytic activity of topoisomerase II in the mutant cells. Drug sensitivity does not appear to be due to increased drug transport because accumulation of radiolabeled actinomycin D is similar in mutant and wild-type cells. Both mutant cell lines show enhanced resistance to hydrogen peroxide and to organic peroxides. ADR-4 cells show a degree of temperature sensitivity. ADR-5 cells show mild sensitivity to UV irradiation. Neither cell line shows significant sensitivity to mono- or bifunctional alkylating agents, ionizing radiation, or bleomycin. Cell fusion studies indicate that the phenotype of each mutant cell line is recessive and that the mutants represent two different genetic complementation groups. These studies also indicate that ADR-4 and ADR-5 Adriamycin-sensitive mutant, ADR-1. These results indicate that sensitivity to topoisomerase II inhibitors can result from abnormalities in several genes. These drug-sensitive mutants may be useful for studying the mechanisms of cell killing by topoisomerase II inhibitors, free radicals, and heat.

Amsacrine↗
PubMed1989

Overproduction of topoisomerase II in an ataxia telangiectasia fibroblast cell line: comparison with a topoisomerase II-overproducing hamster cell mutant.

Ataxia telangiectasia (AT) cell lines are characterised by their hypersensitivity to ionizing radiation and bleomycin, and their failure to inhibit DNA synthesis after DNA damage. A recent report [Singh et al. (1988) Nucl. Acids Res. 16, 3919-3929] indicated that a reduction in topoisomerase II (topo II) activity was a feature of AT lymphoblast cell lines. We have studied the possible role of DNA topoisomerases in determining the phenotype of an AT fibroblast cell line. AT5BIVA cells are sensitive to the topo II inhibitors etoposide (VP16) and amsacrine (m-AMSA), compared to normal human fibroblasts (MRC5-V1 and VA13). AT5BIVA cells express a 3-fold higher level of topo II protein than MRC5-V1 cells, and 6-fold higher than VA13. This is reflected in elevated topo II activity in AT5BIVA cells. Untransformed AT5BI cells also show elevated topo II activity compared to untransformed normal cells. The extent of overproduction of topo II in AT5BIVA cells is comparable with that seen in a mutant Chinese hamster cell line, ADR-1, which is similarly hypersensitive to both bleomycin and topo II inhibitors. However, ADR-1 cells show neither hypersensitivity to ionizing radiation nor abnormal inhibition of DNA synthesis following DNA damage. Topo II overproduction per se does not appear sufficient to generate an "AT-like" phenotype. AT5BIVA cells express a reduced level of topoisomerase I (topo I) and are hypersensitive to the topo I inhibitor, camptothecin. ADR-1 cells express a normal level of topo I, indicating that a reduction in the level of topo I is not the inevitable consequence of an elevation in topo II.

Amsacrine↗