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Adoptive transfer of bryostatin-activated tumor-sensitized lymphocytes prevents or destroys tumor metastases without expansion in vitro.

Because the requirement for long-term cell culture can make adoptive cellular immunotherapy cumbersome, experiments were designed to determine whether smaller numbers of tumor-sensitized T cells activated briefly with bryostatin 1 and ionomycin (B/I) could be returned immediately to recipient mice without in vitro expansion and still have an anti-tumor effect in vivo. Popliteal tumor-draining lymph nodes (DLNs) from mice bearing progressive MCA-105 and MCA-203 footpad sarcomas were harvested and treated for 18 h with B/I. These cells were then washed and transferred immediately to naive C57B1/6 mice. In some experiments, these mice were irradiated (500 rads) before adoptive transfer and were given interleukin-2 (IL-2, 7,500 IU i.p., b.i.d. for 3 days) after receiving the activated lymphocytes. Recipient mice were challenged with sarcoma cells (4 x 10(5) i.v.) 6 to 32 days after receiving the activated lymphocytes. Mice receiving 10(6) B/I-activated lymphocytes before tumor challenge had significantly fewer metastases than did controls. This protective effect did not require exogenous IL-2 or host irradiation. Using Thy-1 congenic donors, it was shown that B/I-activated T cells expanded in recipients when IL-2 was also given, and these cells were a prominent component (15% of total cells) in the infiltrates found in the lungs of mice 7 days after i.v. tumor challenge. Combining these B/I-"pulsed" cells with cyclophosphamide (CYP) and IL-2 to treat mice with established (3-day) metastases resulted in significant reduction in pulmonary nodules, with complete regression in many of the treated mice, which was rarely seen with CYP alone or with CYP + IL-2. Thus, adoptive transfer of tumor-sensitized, B/I-activated DLN cells confers protection against i.v. tumor challenge, without prior in vitro expansion of the effector cells. Phenotyping studies demonstrate that donor cells activated with B/I do expand in recipient mice after adoptive transfer and can move to sites of tumor. Moreover, these cells can mediate a therapeutic effect on established tumor metastases, when combined with chemotherapy.

Adjuvants, Immunologic↗

Vitamin D3 treatment to diminish the levels of immune suppressive CD34+ cells increases the effectiveness of adoptive immunotherapy.

Tumor growth can increase the number of immature bone marrow-derived CD34+ cells that exhibit natural suppressor (NS) activity toward T-cell function. Using a metastatic Lewis lung carcinoma (LLC-LN7) tumor model, these CD34+ NS cells were shown to be present within the s.c. primary tumor tissue, but their levels declined after treatment with the inducer of myeloid cell differentiation, vitamin D3. Therefore, studies determined whether vitamin D3 treatment to diminish the CD34+ NS cell levels in LLC-LN7-bearing mice would enhance (a) intratumoral immune reactivity and (b) the antitumor activity of adoptive therapy consisting of tumor-reactive lymph node cells. The results showed that vitamin D3 treatment alone increased the intratumoral CD8+ cell content and the activity of the intratumoral infiltrate, as detected by production of interferon-gamma and expression of the p55 IL-2 receptor. Although vitamin D3 treatment had no effect on the size of the primary tumor, it lessened the extent of tumor metastasis. Treating mice with the combination of vitamin D3 and adoptive immunotherapy significantly reduced metastasis in mice with established tumors, and reduced both metastasis and locoregional recurrence after surgical excision of the primary tumor. These studies demonstrate that vitamin D3 treatment increases intratumoral T-cell immune reactivity, and that coupling vitamin D3 treatment to diminish levels of CD34+ NS cells with adoptive immunotherapy enhances the effectiveness of the adoptively transferred tumor-reactive lymph node cells at limiting both metastasis and locoregional tumor recurrence.

Animals↗

Adoptive cellular therapy with tumor vaccine draining lymph node lymphocytes after vaccination with HLA-B7/beta2-microglobulin gene-modified autologous tumor cells.

Adoptive immunotherapy with anti-CD3-expanded lymphocytes from lymph nodes draining alloantigen gene-modified autologous tumor vaccines is an effective treatment of poorly immunogenic murine tumors. This phase I/II study was performed to determine the feasibility and toxicity of combining ex vivo gene transfer of autologous tumor cells and adoptive immunotherapy with anti-CD3-expanded tumor vaccine draining lymph node lymphocytes (TVDLN) in patients with metastatic melanoma and renal cell cancer (RCC). To facilitate the generation of tumor-specific lymphocytes in the TVDLN, autologous tumor cells were modified by gene transfer ex vivo to express the alloantigen HLA-B7, a modification that has the potential to enhance the immunogenicity of the tumor cells. After vaccination with gene-modified tumor cells, patients' lymph nodes were harvested; TVDLN lymphocytes were activated and expanded ex vivo with anti-CD3 and interleukin-2 (IL-2), and adoptively transferred to patients in combination with systemic IL-2. Twenty patients, nine with melanoma and 11 with RCC were treated. Tumor was harvested successfully in all 20 patients. Ex vivo gene transfer was performed using lipofection with a lipid: DNA plasmid complex containing the genes for HLA-B7 and beta2-microglobulin. The mean expression of HLA-B7 by autologous tumor cells after gene transfer was 4.53% (range 0.3%-12.1%). Lymph nodes were harvested from all 20 patients with a mean of 53 x 107 and 60 x 107 cells obtained from the gene-modified and unmodified tumor vaccine sites, respectively. Successful expansion of adequate TVDLN was accomplished in 19 of 20 harvests of unmodified vaccines and in 18 of 20 gene-modified vaccines. No major toxicities were noted after vaccination with autologous tumor cells or adoptive transfer of ex vivo activated TVDLN lymphocytes. Typical IL-2-related toxicities were observed in all patients. No objective tumor regressions were observed. MHC class I restricted, tumor-specific cytokine secretion was observed in lymphocytes from TVDLN and the peripheral blood of vaccinated patients.

Adult↗

Experiences of Dutch families who parent an adopted Romanian child.

The pilot phase of a longitudinal study of 83 children (response 86%) adopted from Romania is reported; the present status of the children is compared with the past status on the basis of parental recollection. At placement, the average age of the children was 2.9 years; at the time of the interview of the adoptive parents, the average age of the children was 6.8 years. At placement, 67% of the adoptive parents needed professional help, and 10% of the children were infected with Hepatitis B. Only 13% did not show any important psychosocial problems. The number of psychosocial problems reported by the parents at placement predicts 69% of the lag of development observed 4 years later; the age of arrival adds up to 72%. Most problems still exist 4 years after placement; however, no disruptions of the adoption have taken place yet.

Adolescent↗

Kangaroo care for adoptive parents and their critically ill preterm infant.

In this case study kangaroo care (KC) was facilitated for an adoptive mother and father who were planning to attend the birth of the infant they had arranged to adopt. Unexpectedly, the birth mother delivered at 27 weeks gestation. The infant was critically ill and required mechanical ventilation. However, in this neonatal intensive care unit where all adoptive parents and parents of mechanically ventilated infants are offered KC, these adoptive parents began KC on Day 3 while their infant daughter was still mechanically ventilated. She thrived thereafter and the entire experience was profoundly beneficial for this beginning family both at the hospital and after discharge home.

Adoption↗

Heredity, environment, and personality change: evidence from the Texas Adoption Project.

Personality changes over time can be analyzed by the same twin and adoption methods used to analyze the genetic and environmental influences on a trait at a given time. Composite parent rating measures of Extra-version, Socialization, and Stability made on two occasions approximately 10 years apart on 229 adopted and 83 nonadopted children from the Texas Adoption Project were used to illustrate this point in two ways. The first was based on correlations among family members, from which it appeared that by far the chief source of individual change was neither the genes nor shared family environment, but individual experience (and/or measurement error). The second was via a path-analytic approach to changes in the means of adopted and natural children, from which it appeared that, nonetheless, the children were tending to change on the average in the direction of their genetic parents' personalities.

Adoption↗

The Seventh Jack Tizard Memorial Lecture. Aspects of adoption.

Adoption has a long history and there has been a change in traditional assumptions and practice. It is now seen as a form of child care, one of a spectrum of resources for children in need. Adopted children generally show a good outcome but are over-represented in clinical populations. This trend is likely to continue as older children with histories of severe deprivation, neglect, abuse and institutionalization are placed. New light has been thrown on "telling" in adoption by developmental studies. Adoption disruption increases with age and other factors at placement, requiring further research into its origins and management.

Adoption↗

The adolescent outcomes of adoption: a 16-year longitudinal study.

The childhood history and adolescent adjustment of children placed in adoptive, biological two parent and single parent families were examined in a birth cohort of 1265 New Zealand children studied to the age of 16 years. This study suggested that children who entered adoptive families were advantaged throughout childhood in a number of areas including childhood experiences, standards of health care, family material conditions, family stability and mother/child interaction. However, the environmental advantages experienced by children who entered adoptive families were not directly reflected in the pattern of adolescent adjustment of this group. In particular, children placed in adoptive families had rates of externalising behaviours (including conduct disorders, juvenile offending and substance use behaviours) that were significantly higher than children reared in biological two parent families but somewhat lower than those of children who entered single parent families at birth.

Adaptation, Psychological↗

Birth parents who relinquished babies for adoption revisited.

The fact that adoption records may be opened by court decree to enable adoptees to have access to identifying information about their birth parents makes it incumbent upon those concerned with adoption practices to study the impact of this on adoptees, adoptive parents, birth parents, and professional practice. This paper reports on research addressed to the attitudes and feelings of birth parents years after they relinquished babies for adoption.

Adoption↗

I. Genotype-environment interaction in the schizophrenia spectrum: genetic liability and global family ratings in the Finnish Adoption Study.

In the Finnish Adoption Study, a national sample of adoptees with high versus low genetic liability for schizophrenia spectrum disorders was indexed by DSM-III-R diagnoses of their biological, adopting-away mothers. The rearing-family environments of the adoptees were independently evaluated from global ratings of directly observed adoptive family relationships. The interaction of high genetic liability and dysfunction of the rearing families predicted highly significantly to schizophrenia spectrum disorder of the adoptees at 21-year follow-up. Either low genetic liability or healthy rearing protected against a spectrum outcomes for the adoptees. Initial adoptive parent diagnosis, as a proxy for rearing family dysfunction, predicted to adoptee outcome only as a trend.

Adoption↗

Clinical methods in psychiatric genetics. III. Environmental stratification may simulate a genetic effect in adoption studies.

In adoption studies, the possibility of inadvertent matching between biological and adoptive parents for some environmental variable (known or unknown) correlated with illness must be considered. We examine such bias quantitatively and show how a genetic effect can be simulated. Existence of a genetic effect which is independent of environmental correlation can be accepted, when the frequency of a disease in adoptees who have a biological parent affected and no adoptive parents affected is significantly greater than the frequency of the disease in adoptees who have an adopted parent affected and no biological parents affected. The published data on schizophrenia, alcoholism, and criminality do not exclude the possibility of undetected environmental correlations simulating a genetic effect, according to this direct criterion.

Adoption↗

Adoption as a risk factor for mental disorders.

Although adoption has been viewed as a risk factor for mental disorders in children and adolescents, few studies have investigated this association in adults. To address this question, we analyzed data from a random community sample of adults where the presence of adoption in the first year of life was systematically noted and where the presence of lifetime mental disorders was determined by structured interview. In comparison to individuals raised by both biological parents, adoption was strongly associated with a history of childhood conduct disorder, antisocial personality and drug abuse or dependence. Adoption may thus be a risk factor for these mental disorders.

Adolescent↗

Ethnic identity development of internationally adopted children and adolescents: implications for family therapists.

The life story of the internationally adopted child tends to be an emotional one. How the story is told and retold in the family can have lasting consequences for the child's adjustment and well-being. In telling the story, parents are faced with a unique challenge: To what extent is it desirable to encourage their children, who already struggle with identity issues related to adoption, to identify with their cultures of origin? Therapists working on these issues with multiethnic adoptive families can find little guidance in the family systems literature. To fill this gap, the present article reviews the literature on racial/ethnic identity development and the available research on ethnic identification, self-esteem, and the psychological adjustment of cross-ethnically adopted children and adolescents. Implications for practice include developmental considerations, identifying children and families at risk, and recommendations for those in need of intervention.

Acculturation↗

Fathers of adopted children: a study of the impact of child surrender on birthfathers.

Data on their children's adoptions and their own subsequent adjustment were provided by 125 birthfathers. Paternal age at the child's birth, involvement in the adoption process, and the major reason for adoption determined the birthfathers' current views of adoption. Search for the child was correlated with hopes of retrieval. Loss of the child remained an unresolved issue independent of other areas of functioning. Legal and procedural implications are discussed.

Adaptation, Psychological↗

Use of recombinant interleukin-2 to enhance adoptive transfer of resistance to Listeria monocytogenes infection.

In vitro incubation of Listeria-immune spleen cells (LISC) with recombinant interleukin-2 (rIL-2) for at least 3 days increased their ability to transfer antilisteria resistance to recipient mice. This effect was blocked by the in vitro addition of transforming growth factor beta 1. The level of protection afforded by the transfer of rIL-2-incubated LISC was further elevated by the in vivo administration of rIL-2 at a dose that by itself did not significantly increase antilisteria resistance. The antilisteria resistance of recipient mice remained elevated for approximately 7 days and then rapidly declined to undetectable levels by 10 days. After cell transfer, recipient mice were protected against challenge with Listeria monocytogenes but not Salmonella typhimurium, Yersinia enterocolitica, or Streptococcus pyogenes. Flow cytometric analyses revealed an increase in the percentages of CD8+, NK+, and gamma delta T cell receptor+ cells but no change in the percentage of CD4+ cells as a result of LISC coculturing with rIL-2. In vitro depletion of CD4+ cells just prior to transfer had no significant effect on the adoptive transfer of resistance; depletion of CD8+ cells reduced the level of resistance by approximately 25%. Combined depletion of Thy-1.2+, CD4+, and CD8+ cells just prior to adoptive transfer diminished the level of protection in the spleens but not the livers of recipient mice. These data suggest that rIL-2 can be used to augment adoptive immunotherapy for bacterial infection in a manner similar to adoptive immunotherapy of human cancer patients. Although the protective cell population was not definitively identified, it appeared to be independent of CD4+ cells and only partly dependent on CD8+ cells.

Animals↗

Adoptive transfer of T lymphocytes to T-cell-depleted mice inhibits Escherichia coli translocation from the gastrointestinal tract.

Bacterial translocation is defined as the passage of viable bacteria from the gastrointestinal (GI) tract to extraintestinal sites, such as the mesenteric lymph node (MLN), spleen, liver, kidneys, and blood. Previously, we reported that depletion of CD4+ and/or CD8+ T cells promotes bacterial translocation from the GI tract to the MLN. In the present study, CD4+ and/or CD8+ T cells, harvested from donor mice, were adoptively transferred to mice previously depleted of T cells by thymectomy plus intraperitoneal injection of rat anti-mouse T-cell monoclonal antibodies. The adoptively transferred CD4+ and/or CD8+ T cells inhibited the translocation of Escherichia coli from the GI tract. Migration of the adoptively transferred T cells to the spleens and MLNs of the recipient mice was determined by utilizing Thy 1.1+ donor cells adoptively transferred into mice whose cells express the Thy 1.2 marker. These results provide further evidence of the importance of T cells in the host immune defense against bacterial translocation from the GI tract.

Animals↗

Foster and adoptive mothers' assessment of permanent family placements.

OBJECTIVES: To obtain the new carers' evaluation of the success of permanent placement of children within their families and any special needs in the children, and to determine the adequacy of support after placement. DESIGN: A postal questionnaire was sent to the foster or adoptive mothers of a five year cohort of 234 children placed for permanence, three to eight years previously, by one local authority. SETTING: Newcastle upon Tyne Social Services Adoption and Fostering Unit. SUBJECTS: All 234 permanent family placements recommended by the family placement panel from 1 January 1986 to 31 December 1990. MAIN OUTCOME MEASURE: The adoptive or foster mothers' evaluation of the placement. RESULTS: There was a 54% response rate, but the respondents did not differ significantly from the non-respondents in the variables tested. Only 33% of the children were placed when less than 2 years old with no special needs. Twenty per cent of the school age children had statements of special educational needs at placement. Ninety seven per cent of infant placements were rated "very successful' for the child by the new mothers, as were 90% of 1-6 year olds, but only 31% of children who were placed when older than 6 years were rated in this way. A third of the adoptive and foster mothers had experienced major difficulties in the placement and six carers said that more medical/psychiatric input would have prevented breakdown. CONCLUSION: There is a role for health care professionals to provide ongoing support, especially for older children with special needs.

Adoption↗

Visual and ocular findings in children adopted from eastern Europe.

AIMS: To evaluate ophthalmological findings in children adopted from eastern Europe. METHODS: A prospective study on 72/99 children, born 1990-5 and adopted from eastern Europe to western Sweden during 1993-7 was performed. The children (41 boys; mean age 7.5 years) were compared with an age and sex matched reference group ("ref") of Swedish children. RESULTS: 78% of the adopted children had abnormal ocular findings. 26% (ref 4%) had visual acuity (VA) of the better eye < or = 0.5 (> or = 0.3 logMAR) (p = 0.0001) and 8% (ref 0%) were visually impaired (p = 0.01). Amblyopia was found in 15% (ref 2%) (p = 0.005). 22% (ref 10%) were hyperopic (> or = 2.0 D SE) (NS) and 10% (ref 1%) were myopic (> or = 0.5 D SE) (p = 0.03). Astigmatism (> or = 0.75 D) was found in 51% (ref 23%) (p = 0.004). 32% (ref 2%) had strabismus (p<0.0001), mostly esotropia. Four cases had bilateral optic nerve hypoplasia, in three of whom a history of suspected prenatal alcohol exposure was documented. One child had congenital glaucoma. Signs of visuoperceptual problems were recorded in 37% (ref 1%) (p<0.0001). CONCLUSION: In this study, children adopted from eastern Europe had a high frequency of ophthalmological findings. Consequently, it is strongly recommended that an ophthalmological examination be performed in these children after arrival in their new home country.

Adoption↗