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Biomedical subjects

W Aulitzky

Publications and source records attributed to W Aulitzky.

At least 55 records · Page 3Linked to original sources

Effect of high energy shock waves on human spermatozoa in vitro.

We investigated the effect of high energy shock waves on human spermatozoa in vitro. Human semen samples of proven motility, kept in polyethylene tubes, were subjected to shock waves (100, 500, and 1,000) using a HM3 Dornier lithotripter. A progressive decrease in the spermatozoa vitality was observed with increasing doses of shock waves. Spermatozoa decapitation became significant with increasing doses of shock waves. A progressive decrease in sperm motility was observed following exposure to shock waves, but these changes were not significant.

Humans↗

In-vitro and in-vivo studies on the induction of neopterin biosynthesis by cytokines, alloantigens and lipopolysaccharide (LPS).

Recently we presented evidence that cellular immune responses are associated with increased in-vitro and in-vivo excretion of neopterin (Huber et al., 1983) and that, in vitro at least, macrophages and IFN-gamma play a key role in the induction of this phenomenon (Huber et al., 1984). Although this marker is increasingly applied for monitoring of human disease, there is limited knowledge about the mechanism(s) responsible for its increased biosynthesis during inflammatory states. To further elucidate this question we evaluated neopterin and IFN-levels in culture supernatants of human blood cells and in patients' sera. Cells or patients were exposed to a panel of recombinant cytokines, alloantigens or lipopolysaccharide. To investigate indirect stimulation by induction of production of endogenous IFNs, the impact of neutralization of IFNs by addition of specific antibodies was also studied. The data confirm our previous results which identified the monocyte/macrophage as the main producer cell among human blood cells. They further demonstrate that, at least in vitro, IFN-gamma, IFN-alpha and LPS can all stimulate neopterin release independently from each other. Thirdly, they indicate that stimuli such as alloantigens or TNF-alpha can indirectly enhance neopterin release by their capacity to induce production of endogenous IFN-gamma. On the basis of these data we conclude that enhanced neopterin biosynthesis does not necessarily relate to activation of T cells but can also be caused by non-immune stimuli.

B-Lymphocytes↗

[Experience using bone marrow transplantation in the treatment of hematologic neoplasms and solid tumors].

Between October 1983 and October 1985, 12 allogeneic bone marrow transplantations from HLA-identical siblings were performed for treatment of malignant disease (11 haemopoietic malignancies) or severe aplastic anaemia (1 case). All patients showed prompt and complete engraftment of donor cells on average around day 17 after transplantation. 10 patients are alive and well 50-760 days after transplantation, without any signs of recurrence and partly without immunosuppressive therapy. Two patients died, one due to relapse of the leukaemia, and one as a result of CMV interstitial pneumonia. Graft versus host disease was seen in 6 of the 12 patients. Additional immunosuppressive therapy was necessary in 4 of them. The incidence of idiopathic interstitial pneumonia in our group of patients was low (two cases). Also tested was an experimental protocol for the treatment of chemotherapy-resistant metastatic solid tumours. After removal of all clinically detectable tumour tissue by maximal surgical therapy in 5 patients, residual systemic metastases were treated by means of total body irradiation and high-dose cyclophosphamide, followed by autologous bone marrow transplantation with curative intention. Relapse occurred in 4 patients between day 100 and 720 after BMT bone marrow transplantation. Only one patient remains without sign of relapse.

Adult↗

Interferon-gamma for the treatment of metastatic renal cancer: dose-dependent stimulation and downregulation of beta-2 microglobulin and neopterin responses.

Considering rIFN-gamma as a potent biological response modifier (BRM), we started an open phase II trial with rIFN-gamma in patients with advanced renal cell carcinoma (RCC). For optimization of the dose and schedule of rIFN-gamma, two biochemical serum markers, neopterin and beta-2 microglobulin, were chosen to monitor the biological response. In order to test the magnitude and kinetics of rIFN-gamma-induced neopterin and beta-2 microglobulin release in the serum, rIFN-gamma was administered thrice at three different dose levels in a randomly assigned order (0.01; 0.1; 0.5 mg). Neopterin and beta-2 microglobulin were assessed by means of commercially available radioimmunoassays. The results revealed: 1) strong, reproducible and dose-dependent increments of both markers after the first injection 2) downregulation of the magnitude of neopterin responses with repeated injections at each of the three dose levels tested, and 3) a dose-dependent downregulation of the magnitude of beta-2 microglobulin responses and of serum baseline values at the highest dose level tested. From these data, we conclude that both the dose and schedule might be of importance for optimization of biological responses to exogenously applied rIFN-gamma.

Aged↗

Studies on the optimal dose and the mode of action of alpha-interferon in the treatment of hairy cell leukemia.

The therapeutic efficacy and side effects of alpha-2c-interferon (IFN-alpha 2c) treatment of hairy cell leukemia were compared between two different dose regimen: 10 patients received maximum tolerable doses of IFN-alpha 2c for 1 year (group A), and 11 patients received minimum doses of IFN-alpha 2c, which induced an optimal biological response (group B). Induction of neopterin excretion was chosen as the marker to define biological response and the dose of IFN-alpha 2c applied was on average only one tenth of that in group A cases. Average time of treatment in group B was 42 weeks. The data indicate that both dose levels are effective in the treatment of advanced hairy cell leukemia but that the low dose regimen is free of toxicity. Laboratory investigations on the mechanism of IFN-mediated remission in HCL further revealed that hairy cells are resistant to lysis by IFN-alpha activated large granular lymphocytes and that improved natural killer function subsequent to IFN-alpha treatment in vivo is primarily due to the disappearance of leukemic hairy cells which dilute the natural killer effector cells. These findings support the view of a direct antitumor activity of IFN-alpha as the main therapeutic principle.

Adult↗

Urinary enzyme analysis in renal allograft transplantation.

The urinary excretion of four enzymes (fructose-1,6-bisphosphatase, glutathione S-transferase, N-acetyl-beta-D-glucosaminidase and pyruvate kinase) was assayed daily in 59 patients following renal cadaveric allografting. 51 patients were given cyclosporin A (CyA group) as an immunosuppressive, 8 patients were treated conventionally with azathioprine and prednisolone (CON-group). Urinary enzyme output was evaluated by two different mathematical models. Model A follows single enzyme excretion, whereas model B also analyzes enzyme patterns. The best results were obtained by a combined analysis of all four enzymes with model B. In the CON-group the sensitivity was 1.00, the specificity 0.85, the predictive values of positive test 0.45 and all 12 graft rejections were diagnosed correctly. In the CyA group the sensitivity was 0.40, the specificity 0.99, the predictive value of positive test 0.33, and 6 out of 9 rejections were recognized. The evaluation of the single enzymes did not produce similarly good results with either model.

Acetylglucosaminidase↗

[Induction of ovulation using pulsatile GnRH administration to infertile females].

6 infertile women with primary or secondary amenorrhoea or anovulation, who failed to ovulate after clomiphene and HMG/HCG treatment, underwent 11 treatment cycles with pulsatile GnRH therapy using a portable pump. Normal ovulation occurred in 9 out of 11 treatment cycles; the luteal phase was normal in 6 cycles. One woman conceived in the second treatment cycle.

Adult↗

[Interferon-alpha in the treatment of hematologic neoplasms].

This report aims to review briefly the current status of treatment of haematological malignancies with interferon-alpha (IFN-alpha). Overall hairy cell leukemia and chronic myelogenous leukemia appear to be most sensitive to IFN-alpha. We started to investigate, how interferon exerts its antileukemic activity and in which way interferon therapy can be optimized. Our preliminary results fail to support the view of interferon mediated enhancement of host responses. They rather indicate direct effects of IFN on leukemic cells in vitro. By means of IFN-dependent biological markers (e.g. beta-2-microglobulin, neopterin) clinically effective but atoxic doses of IFN-alpha could be defined for HCL and CML. In final conclusion, the recent studies on the clinical efficacy of IFN-alpha revealed its potent antitumoral effect in hematological malignancies. However, the further proof of the potential benefit of IFN treatment versus conventional therapeutic strategies remains to be elucidated.

Cell Division↗

Effects of a potent LHRH-agonist on the pituitary gonadal axis with and without testosterone substitution.

In this study we investigated the effect of low and high dosages of a potent LHRH agonist on the pituitary-gonadal axis with special consideration to the effect on the tubular compartment of the testis. Included were 3 treatment groups: the probands in Group I were treated with 3 X 50 micrograms HOE 766/week intranasally for 5 months; in Group II with 3 X 100 micrograms HOE 766 intranasally/day for 6 months and in Group III with 3 X 200 micrograms HOE 766 intranasally plus 5 mg fluoxymesterone orally/day for 5 months. With the low dose (Group I) no changes in the seminal parameters measured could be observed whereas LH and FSH levels increased in plasma, testosterone showed no change compared to pretreatment values. When high dosages/day of a potent LHRH agonist were administered without androgen replacement (Group II) pronounced decrease of LH and FSH took place, the testosterone plasma levels approached the female range. Spermatogenesis was arrested. The agonist plus androgen replacement (Group III) counteracted the suppression of spermatogenesis.

Administration, Intranasal↗

Alpha-interferon induces remission in hairy cell leukemia without enhancement of natural killing.

The number of large granular lymphocytes (LGL) and the capacity of peripheral blood mononuclear cells (PBMC) to lyse K 562 target cells in a natural killer (NK)-like fashion was evaluated in seven hairy cell leukemia (HCL) patients undergoing treatment with recombinant interferon-alpha-2 (rIFN-alpha-2). In HCL patients, whose peripheral blood showed high numbers (greater than or equal to 15 X 10(3)/microliters) of leukemic cells the number of LGL and their capacity to lyse K 562 tumor target cells were very low prior to treatment but increased significantly (p less than 0.05) following interferon (IFN) therapy. In patients with low numbers of hairy cells (HC) in their peripheral blood, both these parameters were higher and remained largely unaffected throughout IFN treatment. In vitro, HC proved to be completely insensitive to natural killing when tested against unstimulated and IFN-activated LGL from healthy donors. These results fail to support the concept of IFN-mediated enhancement of host antitumor actions, responsible for the favourable clinical results in HCL.

Adult↗

Treatment of hairy-cell leukemia with recombinant alpha 2-interferon.

Eleven patients with hairy-cell leukemia (eight with progressive and three with non-progressive disease) were treated with low dose recombinant human alpha 2-interferon. After a 3-month treatment period, nine patients showed an improvement and one patient a partial remission. By then, transfusions were not required any more and serious infections were no longer encountered. Four patients were further treated: three for a total period of 9 months and one for 6 months; all of them reached a partial or complete remission. The treatment was equally effective in patients with both progressive and non-progressive disease. Previous absence of response to splenectomy did not preclude a positive effect of IFN therapy. In two patients, IFN dose reduction was necessary due to unremitting flu-like symptoms.

Humans↗

A biological approach to optimize interferon treatment in hairy cell leukemia.

Progress with the clinical application of interferons to neoplastic diseases has been slow and complicated by the need for attention to a new spectrum of therapeutic and toxic effects manifested by the interferons. In this report, we present a new approach to define clinically effective but atoxic doses of interferon-alpha for treatment of hairy cell leukemia. In order to find in vivo biologically active interferon doses, the biochemical marker neopterin was selected as a means to assess a cellular interferon response in vivo. Subcutaneous administration of minimal doses of recombinant interferon-alpha-2 (5-8 X 10(5) U/day), which induced maximum neopterin release in serum and urine, proved to be clinically effective: Eight of nine patients responded to this dose regimen. This response rate was comparable to that of a conventional dose schedule (3 X 10(6) U/sqm/day) which was also applied to nine patients (eight responders). Whereas no difference in the clinical efficacy between the two therapeutic strategies could be established, toxicity was clearly confined to the conventional dose regimen. These preliminary results suggest that at least in hairy cell leukemia the therapeutic dose range of interferon can be separated from the toxic.

Biopterins↗

Significance of urinary neopterin in patients with malignant tumors of the genitourinary tract.

The urinary neopterin excretion was measured by high-performance liquid chromatography in 417 healthy subjects and in 76 patients with clinically and pathohistologically verified neoplasias of the urinary tract (bladder tumor, carcinoma of the prostate, and renal cell carcinoma). The patients with early tumor stages both with bladder tumor and carcinoma of the prostate had normal urinary neopterin levels, except one patient with bladder tumor who had a value at the upper confidence limit. Of 40 patients with higher stages of bladder tumor and carcinoma of the prostate, 35 had elevated urinary neopterin levels. Two of 10 patients with bladder tumor in stage T3, 1 of 4 patients with carcinoma of the prostate Stage C, and 2 of 15 patients with prostatic cancer Stage D showed normal neopterin levels. The patients with renal cell carcinoma did not demonstrate any definite correlation between tumor stage and urinary neopterin excretion. The current study suggests that the neopterin assay may supplement laboratory measurements in tumors of the urinary tract, providing helpful information regarding case selection for the most convenient therapeutic management and postoperative follow-up.

Adolescent↗