Bright light therapy for winter depression: potential ocular effects and theoretical implications.
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Depressive Disorder↗
Biomedical subjects
B Rafferty
Publications and source records attributed to B Rafferty.
Efficacy of brief, intense light exposure for treatment of winter depression.
A high-intensity fluorescent lighting system, tilted downward toward the head, and emitting negligible levels of ultraviolet radiation, was tested under two random crossover protocols in winter-depressed patients: 30-minute sessions at (a) 3,000 lux vs. 10,000 lux in early morning, and (b) morning vs. evening sessions at 10,000 lux. Judgment of clinical remission was based jointly on relative and absolute score improvements on a Structured Interview Guide for the Hamilton Depression Scale--Seasonal Affective Disorder Version (SIGH-SAD) and a set of supplementary atypical-vegetative items. Data are presented for 24 subjects who showed relapse upon withdrawal. An overall remission rate of 75 percent was found for morning light at 10,000 lux. The rates for evening light (25%) and 3,000 lux morning light (19%) were significantly lower. The remission rate for morning light treatment of 10,000 lux for 30 minutes approximately equalled 2,500 lux treatment for 2 hours (data from our earlier studies), suggesting a reciprocity between dosing dimensions of intensity and duration. No pathological changes were revealed by ophthalmological examinations given after 2 to 6 weeks of daily treatment.
Affect↗
Development and application of radioimmunoassays for interleukin-1 alpha and interleukin-1 beta.
Specific and sensitive radioimmunoassay (RIA) systems for human IL-1 alpha and IL-1 beta, using sheep polyclonal antisera, have been developed. The assays, which do not require prior extraction of IL-1, have been used to quantify IL-1 alpha and IL-1 beta in synovial fluid and plasma and to quantify intracellular and extracellular IL-1 alpha and IL-1 beta produced by human monocytes stimulated with endotoxin.
Animals↗
Light therapy for seasonal affective disorder. A review of efficacy.
Bright artificial light has been found effective in reducing winter depressive symptoms of Seasonal Affective Disorder, although conclusions about the true magnitude of treatment effect and importance of time of day of light exposure have been limited by methodologic problems. Individual subjects' data from 14 research centers studying 332 patients over 5 years were analyzed with a pooled clustering technique. Overall, 2500-lux intensity light exposure for at least 2 hours daily for 1 week resulted in significantly more remissions--Hamilton Depression Rating Scale (HAM-D) score reduction of 50% or more to a level under 8--when administered in the early morning (53%) than in the evening (38%) or at midday (32%). All three times were significantly more effective than dim light controls (11%). Dual daily exposures (morning-plus-evening light) provided no benefit over morning light alone. In morning-evening crossovers, remission rates were 62% under morning light alone, compared with 28% under evening light alone, with a differential morning-evening response present in 59% of morning responders compared with 10% of evening responders (p less than 0.001). Remission rates with morning light were highest given low severity at baseline (HAM-D score of 10-16: 67% remission), as compared with moderate-to-severe cases (HAM-D score above 16: approximately 40% remission) where no morning-evening differences were found. Firmer conclusions await treatment studies with larger sample sizes and full assessment of atypical vegetative symptoms seen in winter depression but underrepresented in the Hamilton scale. Longer treatment course and greater light intensity may help clarify clinical response despite the impossibility of achieving a conventional blind placebo control.
Circadian Rhythm↗
The production and characterisation of monoclonal antibodies against human prolactin and the development of a two-site immunoradiometric assay.
Monoclonal antibodies against human prolactin (PRL) have been produced and characterised and used to develop a sensitive two-site immunoradiometric assay (IRMA). Nine anti-PRL monoclonal antibodies were assessed for reactivity in immunoblotting experiments with PRL, hPL, hGH and pituitary gland extract. There was no detectable crossreactivity with hPL or hGH. In liquid phase radioimmunoassay (RIA) studies using three of the antibodies there was no detectable crossreaction from hPL or hGH. Five antibodies were positive in immunocytochemical studies using sections of human pituitary gland. Using FPLC purified monoclonal antibodies, a two-site IRMA was developed that could assay PRL over the range 17.5-3500 mIU per litre and was readily adapted to assaying serum samples from patients. The two-site IRMA could be performed within one day without loss of sensitivity and has potential as a rapid and simple method for screening clinical samples.
Antibodies, Monoclonal↗
The rebound release of growth hormone (GH) following somatostatin infusion in rats involves hypothalamic GH-releasing factor release.
We have studied the rebound secretion of GH following short-term somatostatin (SS) infusions in conscious rats, using an automatic sampling system for withdrawing frequent microsamples of blood. Intravenous infusions of SS (5-50 micrograms/h per rat) inhibited spontaneous GH secretion, but when SS was withdrawn there was a large burst of rebound GH secretion. A sub-anaesthetic dose of urethane reduced such rebound bursts of GH, suggesting a hypothalamic involvement in rebound GH secretion. Passive immunization with an antibody against rat GH-releasing factor (GRF) attenuated the rebound GH secretory response to the withdrawal of an SS infusion (GH concentration during rebound secretion was 26 +/- 21 micrograms/l vs 475 +/- 127 micrograms/l (mean +/- S.E.M.), after 0.5 ml anti-GRF serum or non-immune serum respectively). The inhibition of GH rebound secretion was related to the dose of anti-GRF serum administered. Intravenous infusions of human GH (20-100 micrograms/h per rat) also reduced the size of the rebound GH secretion following SS withdrawal, in both male and female rats. We suggest that the rebound GH secretion that follows SS withdrawal in vivo is caused mainly by a hypothalamic release of GRF. Exogenous GH inhibits SS-induced rebound GH secretion in the conscious rat, possibly by inhibiting hypothalamic GRF release.
Animals↗
Preparation of monoiodinated interleukin-1 beta and its use in a radioimmunoassay.
Polyclonal anti-interleukin-1 beta (IL-1 beta) sera raised in sheep and in rabbits bound to unlabelled IL-1 beta. IL-1 beta radioiodinated using chloramine-T or Bolton-Hunter procedures was bound by the anti-IL-1 beta sera but was not displaced by unlabelled IL-1 beta suggesting that IL-1 beta was damaged during iodination procedures, resulting in alterations to the immunological properties of the tracer. Iodination using the mild oxidant N-bromosuccinimide, followed by extensive tracer purification to remove the unlabelled IL-1 beta, produced a tracer with a specific activity of 89 microCi/micrograms (0.83 atoms iodine/molecule IL-1) which was fully displaced by unlabelled IL-1 beta, allowing the development of a sensitive and specific radioimmunoassay for IL-1 beta. The radioimmunoassay has been used to quantify intracellular IL-1 beta and IL-1 beta release by peripheral blood monocytes stimulated with endotoxin.
Animals↗
Plasma immunoreactive GHRH and serum GH concentrations following pulsatile GHRH 1-40 administration in GH deficient children.
We have studied the clearance from plasma of immunoreactive growth hormone releasing hormone 1-40 (IR-GHRH) following intravenous (i.v.) and subcutaneous (s.c.) administration and the relationship between exogenous plasma IR-GHRH concentrations and GH secretion in five GH insufficient children receiving long term nocturnal pulsatile GHRH 1-40. The i.v. studies with GHRH 1-40 1 micrograms/kg demonstrated a distribution half life (t1/2) of 3.9 (SD 0.9) min and an elimination t1/2 of 53.1 (SD 3.2) min. In the s.c. studies the elimination phase was similar to the i.v. results but the transit time to the GHRH peak was slower than the i.v. distribution t1/2 9.9 (SD 3.6) min. These characteristics were maintained during successive pulses of subcutaneous GHRH. The mean IR-GHRH peaks following s.c. GHRH 1-40 administration of 1 microgram/kg and 2 micrograms/kg were 37- and 18-fold lower respectively than the mean IR-GHRH peak observed after the i.v. 1 microgram/kg bolus study. A significant correlation was shown between peak plasma IR-GHRH and serum GH concentrations during the s.c. (r = 0.75) but not the i.v. studies. Pulsatile GHRH administration has been shown to stimulate GH secretion and growth acceleration in GH insufficient children. Knowledge of the relationship between GHRH 1-40 absorption from the subcutaneous site and GH secretion is important for the development of an optimal GHRH treatment regimen in GH insufficient children.
Child↗
Radioimmunoassay for human growth hormone-releasing factor (hGRF 1-40): comparison of plasma immunoreactive GRF after intravenous and subcutaneous administration to rats.
A homologous radioimmunoassay (RIA) system was developed for human GRF 1-40 and used to measure immunoreactive (IR) concentrations of the peptide in rats to determine some of its pharmacokinetic characteristics after intravenous (i.v.) and subcutaneous (s.c.) administration. A plot of the disappearance of IR-hGRF from plasma after a single intravenous injection was fitted by a biexponential curve, analysis of which gave a half-life of 3.2 +/- 0.2 min for the initial distribution phase and 57.3 +/- 1.5 min for the elimination phase. Comparison of areas under the plasma IR-hGRF/time curves after injection of identical doses of hGRF 1-40 showed that the amount detected in the circulation after it was injected s.c. was only 14-16% of the amount detected after i.v. administration. Such results may indicate degradation of a substantial proportion of the dose of the peptide at the site of injection or during its transfer to plasma; this should be borne in mind when undertaking s.c. administration for clinical purposes or in assessing the effect of GRF analogues.
Animals↗
Growth hormone-releasing factor analogue (hGRF1-29NH2): immunoreactive-GRF plasma levels after intravenous and subcutaneous administration.
A homologous radioimmunoassay (RIA) system for human growth hormone-releasing factor 1-29NH2 (hGRF 1-29-NH2) was developed and applied to the measurement of immunoreactive (IR) concentrations of the peptide in anaesthetized rats to determine some of its pharmaco-kinetics after i.v. and s.c. administration. Analysis of the biphasic disappearance curve of IR-hGRF-1-29NH2 from plasma after i.v. injection (10 micrograms) gave values for the half-lives of the initial distribution phase (alpha) and for the elimination phase (beta) of 1.9 +/- 0.2 min and 10.4 +/- 0.2 min respectively. There was rapid uptake of the peptide from the site of s.c. injection but comparison of areas under the plasma IR-hGRF1-29NH2/time curves showed that the estimated total amount in the circulation after s.c. injection was only 4% of that obtained after i.v. administration. A large degree of degradation of the peptide is indicated either at the site of injection or during transfer to plasma; this susceptibility to rapid breakdown is reflected in the short half-life of the peptide in the circulation. Therefore the measurement of the above parameters is a prerequisite when assessing potency of GRF analogues in-vivo and when implementing suitable dosage regimens for clinical purposes.
Animals↗
Corticotropin-induced desensitization: steroidogenic and cyclic AMP responses in superfused adrenocortical cells.
The characteristics of the sensitization and desensitization of superfused, rat dissociated adrenal fasciculata cells were examined. The dynamic output of steroids and cyclic AMP was determined following pulsed treatment with various agonists. Repeated doses of identical small amounts of ACTH or ACTH gave gradually increasing responses which were maximal after 3-4 injections, but then desensitized the adrenal cells. An initial dose of 2.5 X 10(-11) moles of ACTH, itself insufficient to stimulate steroidogenesis in this system, had the effect of priming the cells, which showed an enhanced initial response and achieved maximum responsiveness on the second injection of 4 X 10(-13) moles ACTH. Thereafter, although the cells exhibited a diminishing steroid output, a dose at the end of the experiment of 8 X 10(-12) moles ACTH restored the maximum responsiveness, and demonstrated that cell loss or death could not account for the desensitization effect. Only a sensitization of the cells was observed following repeated doses of 5 X 10(-6) moles cyclic AMP. Since no desensitization effect was discernible for this agonist, it was concluded that in this system the lesion giving rise to the desensitization effect occurred prior to the adenylate cyclase catalytic unit for the generation of cyclic AMP within the cell and the receptor-nucleotide-regulatory protein complex is thus implicated in the desensitization mechanism for adrenal steroidogenesis. The studies demonstrate the exquisite sensitivity of adrenal cells to the desensitizing effects of even brief intermittent pulses of ACTH.
Adrenal Cortex↗
High-performance liquid chromatographic methods for the analysis of human parathyroid hormone in reference standards, parathyroid tissue and biological fluids.
Reversed-phase high-performance liquid chromatography (RP-HPLC) has been used to fractionate human parathyroid hormone (hPTH) from a variety of natural sources and to compare it with synthetic hPTH and hPTH fragments. Multiple radioimmunoassay systems for amino, mid and carboxyl regions of hPTH were used to monitor various preparations of hPTH previously prepared by conventional methods and ampouled in nanogram amounts for reference standard and reagent purposes. Results confirmed that they were free of detectable cleavage products, but showed that the intact hPTH comprised three or four closely associated components. A similar pattern of heterogeneity was obtained when hPTH was extracted from stored human parathyroid adenomata by a simple rapid HPLC bulk fractionation method. Comparison with synthetic 1-84 hPTH and modification of sample handling to minimize oxidative conditions, indicate that some of these components are probably intermediate oxidation products. A number of less hydrophobic components, with carboxyl region immunoreactivities, were obtained from the individual adenoma samples, human parathyroid cyst fluid, ampouled samples of human adenoma tissue culture medium, and secondary hyperparathyroid plasma ultrafiltrate when they were fractionated by RP-HPLC. The results strongly suggest that the biological degradation of hPTH is more complex than generally believed, and that RP-HPLC offers a new dimension in its analysis.
Adenoma↗
Large scale screening programme for selection of antisera for radioimmunoassay of human parathyroid hormone.
A large-scale, three-phase screening programme has been devised for the rapid selection of antisera which might be of potential use in clinical radioimmunoassays for human parathyroid hormone. A total of 122 sera from 169 guinea pigs and 6 rabbits immunized with bovine parathyroid hormone, and 12 guinea pigs immunized with human parathyroid hormone were assessed relative to reference antisera. Pre-determined criteria for the three phase programme were imposed by the requirement for antisera that could be used at dilutions greater than 10(-5) in order to ensure continuity of supplies for wide-spread distribution and by the limited availability of human parathyroid hormone for testing purposes. Of the sera tested, only 5 were selected as having high titre and sensitivity for low concentrations of human parathyroid hormone. The 5 antisera were further evaluated for amino- and carboxyl-region specificities for the human parathyroid hormone in comparison with antiserum 211/32, widely distributed for use in radioimmunoassay for clinical purposes. The selected antisera appear to be of high affinity with good recognition of the whole or carboxyl-region parts of the human parathyroid molecule.
Animals↗
Corticosteroidogenesis and adenosine 3', 5'- monophosphate production by the amino-terminal (1-34) fragment of human parathyroid hormone in rat adrenocortical cells.
Several studies have revealed a variety of interactions between PTH and ACTH. The existence of a significant area of homology in the bioactive regions of the two molecules has been proposed as a possible reason for such interactions. To clarify the relationship, corticosteroidogenic and cAMP accumulative effects of bovine PTH (bPTH 1-84), its amino-terminal fragment (bPTH 1-34), and the amino terminal fragment of human PTH (hPTH 1-34) were compared with ACTH 1-39 by determining their dose-response characteristics in collagenase-dissociated adrenocortical cells from rats. bPTH 1-84 and bPTH 1-34 (10(-8)-10(-5)M) did not alter steroid production of the cells nor did 10(-6)M bPTH 1-34 affect the steroid response curve to ACTH 1-39. However, the degree of steroidogenesis elicited by hPTH 1-34 over the dose range 3.3 X 10(-7)-3.3 X 10(-5)M was the same as that elicited by ACTH 1-39 over the range 10(-11)-10(-9) M. cAMP generation with hPTH 1-34 was maximal at 10(-4) M but the correlation between the steroid and cAMP responses with ACTH 1-39 was noticeably different from that with hPTH 1-34. In experiments with ACTH 6-24 (a competitive inhibitor of ACTH 1-39), both steroid and cAMP responses to hPTH 1-34 were greatly reduced. Oxidized hPTH 1-34 did not elicit any steroid production nor did several other peptide hormones (arginine vasopressin, angiotensin II, calcitonin, insulin, GH) at 10(-5) M. These observations indicate that hPTH 1-34 can exert a direct and specific effect on rat adrenocortical cells revealing the peptide as a full agonist for steroid production in this system. We suggest that it is a combination of sequence homology and conformational structure which permits hPTH 1-34 to interact with, and elicit its response through, the receptor for ACTH 1-39.
Adrenal Cortex↗
An homologous and sensitive radioimmunoassay for the synthetic amino-terminal (1-34) fragment of human parathyroid hormone: application to the clearance of this peptide administered in vivo.
The synthetic 1-34 amino-terminal fragment of human parathyroid hormone (hPTH 1-34) is undergoing multicentre clinical trials to assess its long term therapeutic potential in the treatment of osteoporosis. An homologous radioimmunoassay (reagents prepared from the synthetic hPTH 1-34 peptide) has been developed to monitor the pharmacokinetics of hPTH 1-34 in man and in a dog model. The assay is rugged, sensitive (detection limit 1.75 x 10(-11) moles/litre) and precise (coefficient of variation 6%). Three different ampouled preparations of the native intact hPTH 1-84, of different degrees of purity (approximately 3%-90% pure) gave complete log dose response curves parallel to that of the ampouled synthetic hPTH 1-34 peptide, and were equipotent on a molar basis. Native intact bovine PTH 1-84 showed an incomplete non-parallel displacement curve; there was no recognition of synthetic hPTH 44-68 and 53-84 peptides. Preliminary application of the assay to the determination of the plasma disappearance of hPTH 1-34 in man and dog gave half-times (t1/2) of 3-8 minutes for a first exponential component and 12-18 minutes for the second; in the dog, metabolic clearance rate was calculated to be 9ml/kg/minute and the distribution space 160ml/kg.
Amino Acids↗
Evidence that protease inhibitors reduce the degradation of parathyroid hormone and calcitonin injected subcutaneously.
1 Agents known to delay absorption from a subcutaneous site were tested in chicks for their ability to prolong the hypercalcaemic response to parathyroid hormone (PTH). 2 Polyvinylpyrrolidone was found to enhance the response but gelatine greatly reduced the 2 h hypercalcaemia. 3 The reduction by gelatine was reversed when the protease inhibitor aprotinin was added to the injection vehicle, and hypercalcaemia then persisted for more than 8 h. 4 Of other protease inhibitors studied, epsilon-aminocaproic acid was also found to enhance the hypercalcaemic response to subcutaneous PTH and its fragments but, unlike aprotinin, it was ineffective in the presence of gelatine. 5 By radioimmunoassay and bioassay respectively, it was confirmed that aprotinin raised circulating levels of PTH and also of another peptide hormone, calcitonin, injected subcutaneously. 6 Addition of calcium to the solutions injected subcutaneously abolished the hypercalcaemic response to PTH while injection of calcium and PTH simultaneously but at separate sites left the response unaltered. 7 The two protease inhibitors, epsilon-aminocaproic acid and aprotinin, each restored the response to subcutaneous PTH despite the presence of calcium at the injection site. 8 It was concluded that protease inhibitors injected subcutaneously with PTH and calcitonin in the chick reduced the rate of degradation of these hormones and that the proteases responsible for hormone degradation at the subcutaneous injection site may be released or activated by calcium ions.
Animals↗
Double isotope estimates of intestinal calcium absorption in rats: enhancement by parathyroid hormone and 1,25-dihydroxycholecalciferol.
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Animals↗
Use of protease inhibitors to protect subcutaneously injected peptide hormones against local degradation [proceedings].
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Animals↗