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Biomedical subjects

G Brubaker

Publications and source records attributed to G Brubaker.

At least 19 recordsLinked to original sources

Mutations in the coding region of c-myc occur independently of mutations in the regulatory regions and are predominantly associated with myc/Ig translocation.

Constitutive expression of c-myc resulting from a chromosomal translocation, which juxtaposes c-myc to an immunoglobulin gene, is a pivotal lesion in Burkitt's lymphomas. This deregulated expression of c-myc is associated with mutations in the regulatory regions, i.e. the first exon and the first intron of c-myc in tumors where the chromosomal breakpoint is not itself within the regulatory region. Until recently it was widely believed that the c-myc protein in these tumors is wild type. We have demonstrated that in a fraction of Burkitt's lymphomas from Africa and from the continental USA, and in mouse plasmacytomas, the c-myc gene carries mutations in the coding region. We now show that, occasionally, such mutations are also present in multiple myelomas--tumors which do not carry translocations or amplifications of c-myc. We also show that the frequency of the c-myc coding region mutations in BL is independent of the frequency of mutations in the regulatory region. These results suggest that the mechanisms that induce missense mutations involving the coding region of c-myc may be different from those that lead to mutations in the regulatory regions.

Burkitt Lymphoma

Sexual behaviour survey in a rural area of northwest Tanzania.

OBJECTIVE: Little is known about variations in patterns of sexual behaviour in different countries, cultures, and subpopulations that determine the spread of HIV-1. Quantitative studies are required to improve understanding. METHODS: To assess reported patterns of sexual behaviour, we administered a standardized questionnaire to 416 men and 498 women aged 15-49 years from a rural population in northwest Tanzania. RESULTS: Reported levels of sexual activity were highest in men and among younger age groups. The number of sexual partners and number of sex acts per unit of time were strongly correlated: men reported 10 times as many lifetime partners than women. Frequency of sexual partner exchange plateaued earlier in women (by age 25 years) than in men (by age 35 years). For the great majority, age of first intercourse was 15 years or younger; older subjects were older at first intercourse and had fewer lifetime partners than younger subjects. CONCLUSIONS: This age-related pattern suggests that more recent birth cohorts have behaviour patterns that increase the risk of sexually transmitted infectious agents such as HIV. Preventive education programmes should be targeted at young adults, who adopt higher risk profiles of frequent partner exchange linked with first intercourse at an early age.

Adolescent

Population-based study of HIV-1 infection in 4,086 subjects in northwest Tanzania.

A population-based HIV-1 seroprevalence survey of 4,086 individuals, aged 15-49 years, in the North Mara district of Tanzania from rural, periurban, and urban areas, including high-risk (prostitutes, and co-workers) individuals, was performed in 1989 and 1990. The overall seroprevalence was 7.3% (95% confidence interval, 6.5-8.1), with a gradient of seropositivity from high-risk 13.0% (9.1, 16.8), urban 8.8% (7.6, 10.0), periurban 6.5% (4.7, 8.4), to rural 2.6% (1.6, 3.7) subjects. Adjusted for population group, HIV-1 seroprevalence was significantly elevated for men over age 24 and for women 20-34 years old, while age-specific prevalence rates were similar for men and women in the rural area. Recent treponemal infection, measured by the rapid plasma reagin test, was not associated with HIV-1 seropositivity in men or women. These data suggest a growing HIV-1 epidemic paralleling rising rates in other rural areas of Africa distant from areas that have been previously recognized as having high prevalence.

Adolescent

Oral yeast flora of a population in an area of Tanzania bordering an AIDS endemic zone.

Mouth swabs from 1,288 individuals in the North Mara region of Tanzania were cultured for yeasts. Subjects were randomly selected from rural and urban areas, and a group of food handlers were also studied. Yeasts were cultured from 407 (31.6%) and Candida albicans from 141 (10.9%) subjects. A wide variety of other yeast species were also identified.

Acquired Immunodeficiency Syndrome

Effect of a malaria suppression program on the incidence of African Burkitt's lymphoma.

From 1977 to 1982, the authors attempted a malaria suppression trial in North Mara District, Tanzania, to see whether the incidence of Burkitt's lymphoma (BL) could be lowered by reducing the level of malarial infection in a child population below 10 years of age. Immediately after initiation of the suppression trial, the prevalence of malaria fell drastically in the Mara children; however, soon after, the rate of malarial infection rose again in the trial area in spite of continued chloroquine distribution, and by 1981 the prevalence of malarial infection again reached the high levels that had prevailed in the North Mara lowlands before 1977. However, during the period of chloroquine distribution in North Mara, the level of malarial infection there was constantly lower than that observed in a comparison area in South Mara, although the two areas had been similar with respect to malaria endemicity prior to the intervention. During the years of chloroquine distribution in North Mara, the incidence rate of BL there fell considerably, from about 4 per 100,000 population to about 1 per 100,000 population, and it rose again to pretrial levels in 1984, that is, about two years after the chloroquine distribution had been terminated. This apparent association between malaria suppression and decline in BL incidence at first seemed to indicate that malaria is a causal factor in BL production. A close scrutiny of the survey data revealed, however, that the decline in BL incidence might have started several years before the chloroquine distribution began; thus it appears that the malaria suppression could not have been the sole cause of the BL decline.

Adolescent

Serial studies on the evolution of drug resistance in malaria in an area of east Africa: findings from 1979 up to 1986.

Observations, previously reported for 1979-82, have been continued up to 1986 on the development of drug resistance in P. falciparum in the North Mara area of Tanzania, where a chloroquine chemosuppression campaign was attempted from 1977 to 1982. The WHO micro in-vitro test for chloroquine and other drugs was used. Because of the large number of tests done, each test was characterized by the mean minimum inhibitory concentrations (MIC) of drug needed to prevent schizont development instead of counting the numbers of schizonts. The MIC for chloroquine has risen progressively each year but changes in the findings of in-vivo tests were less dramatic possibly due to the effects of immunity. Resistance to amodiaquine has followed that to chloroquine at a lower level, and in the last years the MIC for quinine has risen. Sporadic resistance to mefloquine was found and, by in-vivo test, to sulphadoxine-pyrimethamine. Possible factors in the evolution of drug resistance are discussed together with implications for the future.

Age Factors

Comparative seroepidemiology of HTLV-I and HTLV-III in the French West Indies and some African countries.

The prevalence of antibodies detected by ELISA against human T-lymphotropic viruses, type I (HTLV-I) and type III (HTLV-III-LAV), is described in a comparative serosurvey in the French West Indies and African countries. The data confirm that the Caribbean basin is endemic for HTLV-I. In this region, HTLV-I antibody prevalence varied from 3.4% to 5.2% among blood donors and increased with age to reach a value of 33% among elderly people from the Dominica Island. In French Guyana, a South American country bordering the Caribbean sea, differences in antibody distribution across three ethnic groups (black Bonis, Indian Wayanas, and Hmongs from Asia) provide clues for investigation of the mode of HTLV-I transmission. Africa appears to be an endemic continent for HTLV-I and HTLV-III. For both viruses, the antibody prevalence exhibited an increasing gradient from northern to equatorial through Sudanic areas. These preliminary data by showing that Africa represents an endemic reservoir of HTLVs and, possibly, of other human retroviruses should stimulate further investigations on the natural history and the geographical origin of these viruses.

Adolescent

Serial studies on the evolution of chloroquine resistance in an area of East Africa receiving intermittent malaria chemosuppression.

Serial in vitro and in vivo tests for chloroquine sensitivity of Plasmodium falciparum were carried out from 1979 to 1982 in an area of E. Africa where chemosuppression with chloroquine had been attempted since 1977. Within 1(1/2) years there were signs of a decreasing drug response. Chloroquine resistance was first detected in 1981 and this increased markedly in 1982. Other contributory causes for the rise of parasite rates in children were possibly a decline in the efficiency of the drug distribution system and also immunological factors. Evidence of resistance to pyrimethamine was also found. Observations were made of the heterogeneity of the parasites' responses with emerging resistance. Implications for the future are discussed.

Child

Lymphocyte enzyme activities in East African blacks: decrease in 5'nucleotidase and possible relation to immunosuppression.

Microanalysis of subcellular organelle marker enzymes was applied to cryopreserved lymphocytes (obtained and processed in the field) from East African blacks with moderate to severe malnutrition and subject to locally endemic parasitic and infectious diseases. An initial study demonstrated that activities of these enzymes, with the partial exception of catalase, were stable to cryopreservation. Cryopreserved and thawed lymphocyte specimens (1 to 3 X 10(6) viable cells) from 26 Africans and 20 Caucasian controls were studied. There was a highly significant decrease in 5'nucleotidase activity in these African subjects. Activity of another plasma membrane enzyme, gamma-glutamyl transferase, and of marker enzymes for other intracellular organelles, was not significantly different between the two groups, indicating that the nucleotidase alteration is highly specific. 5'Nucleotidase activity in a group of 17 East African blacks of high socio-economic status lay between the values obtained in the other two groups and was not significantly different from either. Further studies on 5'nucleotidase showed no evidence that the enzyme is functionally different in Africans. The differences in activity of this enzyme in Africans may reflect the known immuno-suppressive effects of infectious disease and malnutrition or may have a genetic basis which may in turn be associated with the pathogenesis of secondary immunodeficiency.

5'-Nucleotidase

HLA antigens in East African Black patients with Burkitt's lymphoma or nasopharyngeal carcinoma and in controls: a pilot study.

A pilot study is reported of HLA-A, B, and C antigens in 141 East African Blacks comprising patients with Burkitt's lymphoma or nasopharyngeal carcinoma, either with active disease or in long-term remission, together with comparable controls. This study forms part of a wider program investigating host factors in these diseases. A protocol was selected for optimal testing of cells processed and cryopreserved between 1972 and 1976, largely under field conditions, which employed a two-color fluorochromasia typing procedure. Antigen distribution and computed haplotype frequencies in the total unrelated population are given. New findings include an approximately equal frequency of Aw23 and Aw24, a high (18%) incidence of Bw21, and the gametic associations of Aw36 with Bw44, and Aw30 with Bw45. Of the major group of B15-related antigens reported earlier. SV is the most common, and there are strong linkages of SV with Cw2 and Bu with Cw3. The possible presence of further variants at the A- and B-loci is reported. The proportion of B-locus antigen "blanks" in this study is 5.9%. Relationships have been sought between the HLA antigens and diseases studied: the antigen A29, possibly in linkage with Bw42, shows a correlation with disease susceptibility, and associations are suggested between Bw44 (in possible combination with Aw36) and resistance to both BL and NPC, and between Bw45 and long-term remission in NPC.

Adolescent

The frequency of Epstein-Barr virus infection and Burkitt's lymphoma at high and low altitudes in East Africa.

Burkitt's lymphomas (BL) is frequent in the tropical lowland of Africa but rare--even in the tropics--at altitudes higher than 5,000 feet above sea level. Serological surveys were carried out in Uganda and Tanzania to see whether the variation in BL incidence from high to low areas is paralleled by a variation in the extent of infection with the putative Epstein-Barr virus. Sera were collected from samples of the general child population living at high and low altitudes in the West Nile District in Uganda and in North Mara, Tanzania. All sera from these surveys were tested for anti-EBV antibodies to Viral Capsid Antigens (VCA) and to Early Antigens (EA) at the International Agency for Research on Cancer in Lyon, France. The results showed that both the prevalence and the strength of positive EBV (VCA and EA) titres are nearly similar in the lowlands and on the high plateux in East Africa. This lack of association between BL incidence and extent of EBV infection fails to support the notion of a causal role between the virus and the tumor, but does not totally exclude this possibility since some other environmental factor which is essential for BL development, may have a geographical distribution that parallels that of BL.

Age Factors

Space-time clustering of Burkitt's lymphoma in East Africa: analysis of recent data and a new look at old data.

Forty cases of Burkitts' lymphoma (BL) in North Mara, Tanzania, with onset between 1971 and 1977, were analysed for evidence of space-time clustering. Previous analyses in East Africa had produced conflicting results. The Knox method used in those analyses dichotomizes the space and time scales and does not take into account the degree of closeness. The Mantel method, a generalization of Knox's, does permit closeness between pairs of cases to enter into computations. To see whether this method could clarify matters, previously reported data sets from West Nile, Uganda and North Mara were reanalysed. Unexplained differences were found between West Nile and North Mara with respect to age, sex and temporal distributions of BL, and between the eastern and western parts of North Mara with respect to incidence. In West Nile between 1961 and 1965, there was clustering. All of the Mantel analyses and a few of the Knox analyses were highly significant (p less than 0.0025). Since 1966, evidence of clustering is weak. In North Mara, there was no statistical evidence of space-time clustering between 1971 and 1977, as there was none between 1964 and 1970. The conflicting results in East Africa are compatible with a model involving several factors which "move about", or with a single factor which is sporadic in some areas but constant in others. Alternatively, artifactual biases or coincidence may have created or wiped out the appearance of clustering. Results of space-time clustering analyses permit little discrimination between infectious and non-infectious etiologic hypotheses. Either one type or both may be operating.

Adolescent

Multiple cases of Burkitt's lymphoma and other neoplasms in families in the North Mara District of Tanzania.

In an area of Tanzania in which Burkitt's lymphoma (BL) is endemic, five families are described in which multiple cases of BL were found or BL occurred with other neoplasms. The patients include two brothers and one half-brother with BL, two brothers with BL, a woman with nasopharyngeal carcinoma (NPC) whose daughter had BL, a boy with BL whose sister developed chronic myelogenous leukaemia (CML), and a man with CML whose son developed BL. The two full-sib pairs with BL is significantly more than would be expected to have arisen by chance and the association of BL with NPC and CML among close relatives is remarkable in view of the rarity of the last two neoplasms in the study area. It is suggested that genetic factors may be important. It is suggested that genetic factors may be important in determining susceptibility to the three malignancies in this population, but the possibility that the clustering of cases within families may be due to local environmental factors cannot be excluded.

Adult

B15 heterogeneity in East African Blacks.

One-hundred-forty-one Blacks (135 unrelated) from Kenya and Tanzania have been tissue-typed (HLA-A, B and C loci) as part of a study of host factors involved in Burkitt's lymphoma and naso-pharyngeal carcinoma. Evidence is presented for the existence in this population of several B15-related antigens which together occur with a relatively high frequency of 30% in unrelated individuals. It is likely that these variants may include the antigens SV and perhaps Bu recently defined with population frequencies of under 1% in Caucasians. In the absence of monospecific typing sera, identification of these variants may be helped by their apparently strong association with C-locus antigens in Blacks. Recognition of these B15 variants has been largely responsible for reducing the proportion of unidentified or "blank" B-locus antigens in this population to only 6%. These findings substantiate and amplify previous reports suspecting the presence of such antigens in Blacks, and should facilitate studies of possible associations of disease with HLA in these populations.

Africa, Eastern

In vitro immunological studies on East African cancer patients. II. Increased sensitivity of blood lymphocytes from untreated Burkitt lymphoma patients to inhibition of spontaneous rosette formation.

Frozen aliquots of peripheral blood mononuclear cells from patients with Burkitt's lymphoma (BL) at various stages of the disease have been compared with samples from East African children who were healthy or who suffered from non-malinant disorders. Using the sheep-cell rosette test (which is believed to identify T-lymphocytes), we found a significant reduction in the proportion of rosette-forming cells (RFC) in the samples from untreated BL patients. After reduction of remission the difference between BL patients and controls was abolished. Rosette formation was more readily inhibited by anti-lymphocyte globulin (ALG) in samples from untreated BL patients than in controls. On induction of remission the rosette inhibition curve shifted towards the control values. The findings are compatible with the presence, in untreated BL, of a circulating factor which impairs the capacity of T-lymphocytes to form rosettes with sheep erythrocytes. It remains to be established whether the functional capacity of T-cells to protect the host against tumour proliferation is also impaired.

Africa, Eastern

In vitro immunological studies on east african cancer patients. III. Spontaneous rosette formation by cells from Burkitt lymphoma biopsies.

Spontaneous rosette formation was observed in eight out of nine Burkitt lymphoma biopsies. These were examined fresh and/or after culture in vitro for up to 48 h. The percentage of rosettes varied from 3.7% to 38%. There was a tendency for the percentage of rosettes to increase with time in tissue culture. It is suggested that the rosette-forming cells are T-lymphocytes infiltrating the tumour and functioning as a host defence mechanism against the proliferating tumour cells.

Africa, Eastern