Interleukin 2 receptor-targeted therapy in islet transplantation research.
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The clinical and laboratory findings in chronic granulomatous disease are illustrated by five case reports. Biochemical studies of the neutrophil bactericidal defect have revealed several molecular forms of the disease. Specific therapeutic action is nowadays possible, after early diagnosis of the condition by nitroblue-tetrazolium test and chemiluminescence. Infections are treated using antibiotics and antimycotics which penetrate well into granulocytes; additional surgical intervention or granulocyte transfusion may be necessary. Prolonged infection-free periods are achieved under prophylactic sulfamethoxazole/trimethoprim therapy, promising an improved prognostic outlook for patients with chronic granulomatous disease.
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Neovascularization is critical for the growth of tumors and is mediated by physiological substances produced by the tumors. Vascular endothelial growth factor (VEGF) is one of such potent angiogenic factors. We evaluated VEGF gene expression on urinary bladder carcinoma and renal cell carcinoma by Northern blot analysis and demonstrated that VEGF was frequently overexpressed in renal cell carcinoma, in up to 67% of patients, but not in urinary bladder carcinoma. These results suggested that VEGF was produced by renal cell carcinoma and is responsible for the hypervascularity of this tumor. TNP-470, an angiogenesis inhibitor, is a new type of anticancer drug that inhibits tumor neovascularization. We evaluated the antitumor effect of TNP-470 in mice bearing B-16 melanoma or Lewis lung carcinoma. TNP-470 at a dose of 20 mg/kg body weight inhibited growth of both tumors. The degree of antitumor effect exerted by TNP-470 was greater than that of ADM (2.5 mg/kg body weight) and as great as that of MMC (2.5 mg/kg body weight). Combination of TNP-470 with MMC enhanced the antitumor effect. Monitoring of mouse body weight did not reveal any significant changes among the treatment groups, indicating that systemic toxicity of TNP-470 was not severe. These results suggested that TNP-470 was effective for the treatment of solid tumor by inhibiting its neovascularization.
Strontium-89 is preferentially taken up at sites of increased bone mineral turnover, its uptake adjacent to malignant metastases being up to five times greater than for normal bone. Strontium-89 is also selectively retained in bone adjacent to metastatic sites. The initial therapeutic ratio is therefore good and increases with time. The pharmacokinetics of strontium-89 thus favor the objective of achieving a clinically effective beta radiation dose to tumor deposits while minimizing radiation exposure to healthy tissue. Clinical studies show that 150 MBq [corrected] strontium-89 can relieve bone pain in up to 80% of patients with prostatic metastases. Greater activities do not appear to increase this level of response. Once a response has been achieved, strontium-89 therapy can be repeated when pain recurs. Although hematologic toxicity at this dosage is low, strontium-89 should not be given to patients with evidence of significant bone marrow depression. With this precaution, no serious toxicity has been encountered when the agent is administered at the recommended doses.
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The interleukin-2 receptor (IL-2R) is expressed on proliferating T-lymphocytes following antigen stimulation. Activated IL-2R bearing lymphocytes accumulate as cellular infiltrates in autoimmune thyroiditis, insulin-dependent diabetes mellitus, rheumatoid arthritis and graft rejection. Affected cells in Hodgkin's disease, hairy cell leukaemia, non-Hodgkin's lymphoma, cutaneous T-cell lymphoma and lymphoid blast crises of chronic myeloid leukaemia also express IL-2R. Anti-IL-2R monoclonal antibodies or chimeric IL-2R toxins provide a way of selective elimination of such cells. These have been used in experimental models of autoimmunity and transplantation with beneficial results, providing a novel way of selective immunosuppression. In open uncontrolled trials, chimeric IL-2R toxin was found to be safe and effective in patients with refractory rheumatoid arthritis, insulin-dependent diabetes mellitus and IL-2R bearing leukaemias and lymphomas.
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