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Biomedical subjects

G L Wright

Publications and source records attributed to G L Wright.

At least 73 records · Page 4Linked to original sources
PubMed1996

Upregulation of prostate-specific membrane antigen after androgen-deprivation therapy.

OBJECTIVES: To determine the expression of prostate-specific membrane antigen (PSMA) before and after androgen-deprivation therapy and to compare PSMA expression with prostate-specific antigen (PSA) expression. METHODS: We studied specimens from 20 patients with prostate cancer undergoing medical or surgical castration or combination androgen-deprivation therapy in whom matched pretreatment and post-treatment tissue specimens were available and 16 patients in whom only a post-treatment specimen was available. The expression of PSMA and PSA in the tissue specimens was determined by immunoperoxidase staining. The extent of staining was calculated by multiplying the percent of antigen-positive tumor cells by the staining intensity to arrive at a stain index for each biomarker. An in vitro study assessed the concentration of PSMA and PSA in extracts of LNCaP cells cultured in the presence or absence of androgen as determined by immunoassays and Western blot analysis. RESULTS: PSMA reactivity was found to be increased in 55% (11 of 20) of post-treatment primary tissues and 100% (4 of 4) of post-treatment metastatic specimens. In contrast, PSA expression was found to be decreased in 70% (14 of 20) of post-treatment primary and 100% (4 of 4) of post-treatment metastatic specimens. Neither type of androgen-deprivation treatment nor tissue sensitivity to androgen deprivation appeared to influence degree of biomarker expression. PSMA was found to be downregulated and PSA upregulated when LNCaP cells were cultured in the presence of testosterone or dihydrotestosterone. CONCLUSIONS: The enhanced expression of PSMA in tissues and LNCaP cells after androgen deprivation suggests that PSMA is upregulated in the majority of prostate carcinomas after androgen treatment. The high expression in metastatic tissues strongly suggests that PSMA may be a clinically useful target for antibody-and genetic-directed therapy of prostate cancer that recurs after androgen deprivation. The mechanism whereby androgens suppress the expression of PSMA, and the association of PSMA with the development of hormone-independent prostate cancers, will require further study.

Androgen Antagonists↗
PubMed1996

Free and complexed prostate-specific antigen serum ratios to predict probability of primary prostate cancer and benign prostatic hyperplasia.

OBJECTIVES: Ratios of free to total prostate-specific antigen (f/t PSA ratio) improved differentiation of benign prostatic hyperplasia (BPH) from prostate cancer (CaP). Using sera obtained at least 1 month prior to biopsy-confirmed diagnosis and logistic regression adjusted for disease prevalence, probability curves are constructed to predict the presence of CaP. METHODS: The patient population included 122 (44%) BPH sera and 155 (56%) prostate carcinoma sera collected prior to any therapy. The total PSA range = 2.0-20.0 ng/mL; median age = 69 years. External reference standards for both free and total PSA assays were used to standardize the assays and correct the ratio. Probability curves and tables for cancer incidence were formulated for a subset of the total test population (total PSA range = 2.0-10.0 ng/mL; 98 BPH, 118 CaP patients) by using logistic regression and prior cancer prevalence statistics derived from a published patient screening study. RESULTS: Median f/t PSA ratios were 0.18 and 0.12 in the overall sample and 0.19 and 0.12 in the subset for BPH and CaP, respectively (P = 0.0001). The median total PSA concentrations for BPH and CaP were 5.8 and 6.7 ng/mL when total PSA range = 2.0-20.0 ng/mL and were 4.9 and 5.9 ng/mL when total PSA range = 2.0-10.0, respectively. CONCLUSIONS: Cancer probability curves were constructed to help guide decisions concerning biopsy and other aspects of prostate cancer disease management. Further validation of this approach in another series of patients is necessary and is planned.

Adult↗
PubMed1996

Effect of retinoic acid on contractile competence of vascular smooth muscle.

Rat aortic rings cultured for 24 h in protein-free medium showed a significant reduction in the contractile response to potassium (-60%) and to phorbol 12,13-dibutyrate (-65%). The addition of plasma to the medium attenuated the loss in responsiveness, and the supplementation of the plasma-containing medium with all trans-retinoic acid (RA) returned the response to potassium (85%) and phorbol ester (135%) to near normal or supramaximal compared with fresh tissue. Furthermore, the combined additions of plasma and RA resulted in significant preservation of the contractile response (75%) for at least 3 days in organ culture. Removal of the endothelium before organ culture eliminated the enhancement of contraction by plasma and RA. However, the removal of the endothelium from tissues that had been cultured with an intact endothelium or the blockade of nitric oxide synthesis in these tissues before contractile measurements had no effect on the contractile response. Finally, the incubation of tissues with phorbol ester to downregulate protein kinase C resulted in a marked attenuation (-75%) of the contractile response compared with control tissues in culture. The results suggest that circulating factors may be necessary for the maintenance of contractile function of aortic smooth muscle. Based on the opposing actions of RA and phorbol ester, the long-term regulation of contractile function may involve protein kinase C activity.

Animals↗
PubMed1995

Characterization of a prostate carcinoma mucin-like antigen (PMA).

A recently identified, high m.w. human tumor antigen, reactive with monoclonal antibody (MAb) PD41 and designated prostate mucin antigen (PMA), was found to have expression highly restricted to prostate carcinomas. Both biochemical and immunological characteristics of this antigen and its relationship to other tumor-associated mucins and various species of submaxillary mucins were evaluated. Immunohistochemical examination of submaxillary tissues revealed differential expression of this antigen and other human tumor-associated mucins, with MAb PD41 expression found only in bovine submaxillary gland serous cells. Neuraminidase treatment enhanced antibody binding by 50%, suggesting partial masking of the PD41 epitope by sialic acid. Antigenicity was reduced by treatment with alkaline-borohydride, sodium metaperiodate, beta-galactosidase, O-glycanase, and various proteolytic enzymes. MAb PD41 antibody binding also could be significantly reduced by selected lectins and sugars suggesting that the immunodominant carbohydrate involved in the epitope was an O-linked oligosaccharide containing N-acetyl galactosamine as a major component. This antigen was further distinguished from T, Tn, or Sialyl-Tn antigens and blood group carbohydrate antigens by radioimmunometric analyses. Cross-blocking and double determinant RIA experiments also showed a distinction between the PD41 epitope and several well-characterized tumor-associated mucin antigens such as MUCI, CEA, M344, OCI25, and AR3 as well as bovine submaxillary core protein. Our results indicate that the PD41-reactive epitope is a non-acidic O-linked carbohydrate or glycopeptide epitope with restricted expression in prostate carcinomas and bovine submaxillary glands. This expression is distinct from other mucin-like tumor-associated antigens identified in human prostate carcinomas.

Animals↗
PubMed1995

Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids.

The prostate-specific membrane antigen (PSMA) glycoprotein is recognized by the monoclonal antibody (MAb) 7E11-C5.3 as a predominant 100 kDa and minor 180 kDa component in LNCaP cell line extracts and its expression has been shown by immunohistochemistry to be highly restricted to prostate epithelium. The aim of the present study was to utilize Western blot analysis to determine if PSMA could be detected in human tissue extracts and body fluids and if so, which molecular forms were present. PSMA was detected as 120 and 200 kDa bands in normal, benign and malignant prostate tissues and seminal plasma. Further analysis demonstrated that the larger molecular form of PSMA may be a dimer of the lower m.w. species. The PSMA glycoprotein was not detected in the majority of non-prostate tissue extracts examined except for a low yet significant amount in normal salivary gland, brain and small intestine, suggesting that PSMA may not be as prostate-specific as originally thought. Since the prostate-specific antigen (PSA) has been shown to be maximally shed into the serum in high-grade and metastatic prostate carcinomas, it was surprising that PSMA could not be detected in serum by Western blot analysis even in patients with actively progressive metastatic disease. Second generation antibodies generated against different epitopes may be required to determine if PSMA is shed into serum. Our results support the hypothesis that PSMA is a novel prostate biomarker.

Animals↗
PubMed1995

Stability of serum prostate-specific antigen determination across laboratory, assay, and storage time.

OBJECTIVES: To understand the comparability of serum prostate-specific antigen (PSA) determinations across assays and storage time. METHODS: Serum PSA levels were determined for men aged 40 to 79 years from the clinical subset of the Olmsted County Study of Urinary Symptoms and Health Status Among Men on fresh samples and after a median of 32 months on banked samples, frozen at -70 degrees C. Baseline serum PSA levels were determined by Tandem-R PSA assay. Follow-up levels on the banked samples were determined by the IMx PSA assay and a repeat Tandem-R PSA assay in a different laboratory and by an immunofluorometric PSA assay at another site. RESULTS: The median serum PSA level determined by Tandem-R assay at baseline was 1.0 ng/mL (25th percentile, 0.6; 75th percentile, 1.7). The distributions of determination made by follow-up Tandem-R, IMx, and immunofluorometric analyses were essentially identical. Overall, the assays were highly correlated. The correlations between the baseline serum PSA determination and repeated Tandem-R, IMx, and immunofluorometric determinations were 0.96, 0.96, and 0.97, respectively (all P < 0.001). The median duration of frozen storage was 32 months (range, 26 to 39 months), and the correlations between baseline and follow-up determinations did not change when stratified by duration of storage. CONCLUSIONS: These data provide important reassurance about the use of serum PSA determinations obtained by different assays, in different laboratories, and in properly stored samples across time.

Adult↗
PubMed1995

An analytical comparison of the three most commonly used prostate-specific antigen assays: Tandem-R, Tandem-E, and IMx.

OBJECTIVES: To compare the similarity of individual prostate-specific antigen (PSA) results when using the Tandem-R PSA assay, the Tandem-E PSA assay, or the IMx PSA assay; to assess the lot-to-lot variation within (intra-assay interlot) and between (interassay interlot) the Tandem-R, Tandem-E, and IMx PSA assays; and to evaluate the individual and overall potential lot-to-lot bias of the Tandem-R, Tandem-E, and IMx PSA assays. METHODS: Forty-nine serum samples (PSA values from 0 to 85 ng/mL) were each tested by three separate lots (manufacturer's reagent materials) of Tandem-R, Tandem-E, and IMx PSA assays. Therefore, a total of nine different lots were utilized per patient sample in this investigation. Analyses primarily focused on three ranges: 0 to 10 ng/mL (low), 10 to 85 ng/mL (high), and 0 to 85 ng/mL (overall). RESULTS: In the 0 to 10 ng/mL range, 93% of the assay comparisons yielded an actual difference of less than 1 ng/mL. All three assays demonstrated excellent correlation within and between their three respective lots, within all three ranges. The 95% confidence intervals around the percent coefficient of variation (CV) demonstrated similar results for each assay (CV range, 3.2% to 6.0%). All lots demonstrated an average actual PSA bias of less than +/- 1 ng/mL. The average percent PSA bias was also similar between all three assay systems. All lots demonstrated a less than +/- 4% bias. CONCLUSIONS: Overall, the Tandem-R and IMx PSA assays yielded slightly lower results than the Tandem-E PSA assay. However, these differences were not statistically significant. In addition, the overall lot-to-lot variation (intra-assay and interassay) was not statistically significant, and the actual or percent PSA bias was minimal with these three assays. Therefore, a clinician can feel confident that a patient's serum sample should yield a similar and interchangeable result, whether it is determined by the Tandem-R, Tandem-E, or IMx PSA assay system.

Blood Chemical Analysis↗
PubMed1995

The human cytomegalovirus UL98 gene transcription unit overlaps with the pp28 true late gene (UL99) and encodes a 58-kilodalton early protein.

A murine monoclonal antibody (I2) reacts strongly with the nucleus of human cytomegalovirus (HCMV)-infected human fibroblasts. Western blot (immunoblot) analysis using I2 demonstrated that a protein with an apparent molecular mass of 58-kDa (E58) was expressed at 5 h after infection, and levels increased through 72 h. Immunoblot screening of an early cDNA expression library resulted in a positive clone which hybridized to the right end of the XbaI C fragment of the HCMV Towne strain. Further analysis demonstrated that the E58-specific clone was homologous to the putative UL98 open reading frame, which has been proposed to encode the viral alkaline exonuclease homolog. RNA analysis demonstrated a 3.0-kb RNA which is expressed at early times after infection, as well as in the absence of viral DNA replication, and which is 3' coterminal with the pp28 (UL99) gene region. Insertion of the UL98 genomic sequence into a eucaryotic expression vector and subsequent Western blot analysis using I2 demonstrated that the expressed protein comigrated with E58 from infected cells. E58 also reacts specifically with a previously described antibody, anti-P2-1, which was proposed to recognize a putative late 58-kDa protein. E58 comigrates with the putative late 58-kDa protein, indicating that these two proteins are likely the same. Analysis of the UL98 promoter revealed a TATATAA sequence located at nucleotide 142525. Insertion of the putative promoter 5' to a reporter gene demonstrated that the UL98 promoter was activated in cotransfection experiments with IE1 and IE2 proteins. These studies demonstrate that UL98 is a bona fide early gene, which is consistent with its probable role as the viral alkaline exonuclease gene.

Amino Acid Sequence↗
PubMed1994

Comparability of the Tandem-R and IMx assays for the measurement of serum prostate-specific antigen.

OBJECTIVES: To assess the comparability of the Tandem-R and IMx serum prostate-specific antigen (PSA) assays across levels of the ratio of free-to-total serum PSA found in a community-based population of healthy men. METHODS: Banked serum samples from the baseline component of the Olmsted County Study of Urinary Symptoms and Health Status Among Men were thawed and analyzed using the Tandem-R and IMx PSA assays. Serum levels also were determined for the free, noncomplexed form of PSA, PSA complexed to alpha-1 antichymotrypsin, and total PSA with a research-based immunofluorometric assay. RESULTS: The results of the Tandem-R and IMx assays were strongly correlated at all levels of the ratio of free-to-total serum PSA. The Spearman correlation coefficients ranged from 0.87 to 0.98 (all p < 0.001). The relationship between the Tandem-R and IMx assays, however, differed at low levels of free-to-total serum PSA compared with high levels. In the lowest 10th percentile of the ratio of free-to-total serum PSA (0.04 to 0.18), the IMx assay read lower than the Tandem-R (slope +/- standard error = 0.92 +/- 0.04, intercept +/- standard error = 0.21 +/- 0.14); whereas in the upper 10th percentile of free-to-total ratio (0.46 to 0.65) the IMx assay yielded values higher than the Tandem-R assay (slope = 1.21 +/- 0.07, intercept = 0.14 +/- 0.05). In the middle 90%, the slope did not statistically differ from 1.0. CONCLUSIONS: For the majority of men, results of the Tandem-R and IMx PSA assays were virtually identical. The small differences found would not be of clinical significance for most men but should be considered when comparing results of different assays in sequential determinations for a specific man.

Adult↗
PubMed1994

Changes in immunohistochemical staining of PSA, PAP, and TURP-27 following irradiation therapy for clinically localized prostate cancer.

OBJECTIVES: To determine if tissue expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and a prostate-associated monoclonal antibody (TURP-27) is retained after irradiation therapy and to compare these results with serum levels. METHODS: Immunohistochemical tests were performed on prostatic tissue obtained by needle biopsy or transurethral resection prior to and following definitive irradiation therapy for clinically localized prostatic carcinoma. PSA, PAP, and TURP-27 were studied. Results were compared with serum PSA and PAP values. RESULTS: All 20 preirradiation specimens stained positively for PSA and PAP; 19 of 20 stained for TURP-27. All 5 of the initial post-treatment biopsy specimens that showed recurrent tumor stained for all 3 markers. In 2 cases, staining for the 3 markers was greatly diminished. Only 8 of 15 post-treatment biopsy-negative specimens stained for all 3 markers. Six of 15 demonstrated loss of tissue expression for all 3 antigens. One specimen stained for PAP and TURP-27 but failed to stain for PSA. Serum PSA levels paralleled tissue expression in recurrent tumor specimens. However, 3 of the post-treatment biopsy-positive cases with PAP expressing tissue had normal serum PAP levels. CONCLUSIONS: No cases of recurrent tumor with marker-negative tissue were identified. However, benign epithelial prostate cells appear to sustain sufficient damage from irradiation to lose the capacity to produce certain proteins. Diminished contribution of benign glands to circulating PSA, in addition to decreased expression in malignant tissues, may explain the lower than anticipated serum PSA levels in patients who progress after irradiation therapy.

Acid Phosphatase↗
PubMed1993

Comparison of prostate secretory protein with prostate specific antigen and prostatic acid phosphatase as a serum biomarker for diagnosis and monitoring patients with prostate carcinoma.

Serum prostate secretory protein (PSP) levels were measured in 49 patients with benign prostatic hyperplasia (BPH), 144 patients with various stages of prostatic carcinoma (CaP), and 82 CaP patients who were followed serially. PSP values were compared with serum levels of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). In the BPH group, PSP was elevated (> 10 ng/ml) in 41% of patients, whereas PSA (> 4 ng/ml) and PAP (> 3.3 ng/ml) were elevated in 39% and 23% of the cases, respectively. PSP levels were elevated in 48% of the CaP pretreatment specimens, compared to 79% for PSA and 40% for PAP. PSP levels in cancer patients who had intracapsular disease were about two to three times higher than those observed for PAP. PSP was found to be the only marker elevated in eight (6%) pretreatment CaP patient serum specimens, while PAP was never found to be elevated when PSA was normal. PSP serum concentrations correlated with the clinical course of the disease in 79% of patients, compared with 90% for PSA and 66% for PAP. In certain patients, monitored over time, disease correlation was reflected in serum values with only a single biomarker, i.e., 1% with PAP, 8% with PSP, and 10% with PSA. This study has shown that PSP is a less sensitive serum biomarker than PSA, but more sensitive than PAP for detection and monitoring the early stages of prostate cancer. This suggests that PSP as a biomarker may be a useful adjunct for the management of a subpopulation of low-stage and -grade CaP.

Acid Phosphatase↗
PubMed1993

Prostate-specific antigen to determine progression-free survival after radiation therapy for localized carcinoma of prostate.

Prostate-specific antigen (PSA) levels after radiation therapy will more precisely and objectively identify the presence of persistent prostate carcinoma. We determined the impact of PSA marker levels on progression-free status for 123 patients treated by interstitial implantation (I-125) and 311 patients treated by external beam therapy (XRT) who have been followed for a median of 109 and 51 months, respectively. Actuarial progression-free survival curves were calculated, using standard clinical criteria, and then recalculated, using PSA marker criteria. Sera obtained twelve months or more after the initiation of XRT and twenty-four months or more after the date of I-125 were used for determination of PSA levels. Using normal PSA level (by Hybritech assay < or = 4.0 ng/mL) as the criterion for progression-free status for patients treated by XRT, 35 percent of patients with Stage A2, 20 percent of patients with Stage B1 or B2, and 10 percent of patients with Stage C tumor were progression-free at ten years. The progression-free survival by clinical criteria for Stage A2 and 65 percent, B1 was 40 percent, B2 was 35 percent, and C was 25 percent. Using undetectable PSA level (< or = 0.5 ng/mL) as the criterion, less than 10 percent of patients were progression-free at ten years, regardless of stage, grade; and treatment modality. This information should not be interpreted as indicating that radiation is ineffective therapy for prostate cancer, since clinical control of the disease among men in their eighth decade is a more practical goal than marker control. However, PSA monitoring after radiation therapy and after any local therapy for prostate cancer will provide more precise information on the success of that therapy in ablating disease.

Actuarial Analysis↗
PubMed1993

Deoxyribonucleic acid cytometric analysis of prostate core biopsy specimens: relationship to serum prostate specific antigen and prostatic acid phosphatase, clinical stage and histopathology.

We describe a sampling method of obtaining fresh prostate cells that yields adequate numbers of cells for flow cytometric deoxyribonucleic acid (DNA) analysis and produces histograms of good resolution. Exfoliated cells from 204 prostate biopsy wash specimens obtained by agitation of biopsy cores in saline were fixed and stained for DNA analysis. The mean percentage of hyperdiploid cells was statistically different between the pathologically benign and malignant specimens (p < 0.0001). Hyperdiploid cells of 22% or more exhibited a high degree of specificity for the malignant specimens with only a 1.4% (1 of 69 benign specimens) false-positive rate. However, sensitivity was only 41% (25 of 59 malignant specimens were associated with a flow cytometry analysis of 22% or greater hyperdiploid cells) because of the high false-negative rate (59%, 35 of 59). The percentage of hyperdiploid cells correlated statistically with increasing prostate specific antigen (PSA) levels and approached significance with Gleason grade but did not correlate with prostatic acid phosphatase or clinical stage. When the amount of hyperdiploid cells was 22% or more and serum PSA level was greater than 4.0 ng./ml. a 95% chance of a malignant biopsy was predicted. This result was greater than that predicted by a PSA elevation alone. Only a 5% chance of a malignant biopsy was present for patients with less than 22% hyperdiploid cells and 4.0 ng./ml. or less serum PSA, a decrease over either method separately. This method of DNA assessment permits prospective categorization of tumors by ploidy without interfering with histological assessment. The prognostic importance of ploidy analysis awaits further clinical followup.

Acid Phosphatase↗
PubMed1993

Biomolecular and clinical characteristics of PSA and other candidate prostate tumor markers.

Three new potential biomarkers--PAC, PMA, and the 7E11-C5 glycoprotein--have been identified. All three have unique features that could augment current diagnostic and therapeutic modalities. Some of the important characteristics of these potential markers are summarized in Table 1. Further studies will be required to determine if any of them will provide clinical information beyond that provided by PSA and if they will have a significant impact on the management of patients with prostate cancer. The MAb 7E11-C5 (CYT-356), now in clinical trials, promises to offer new strategies for radioimmunodetection and radioimmunotherapy of prostate cancer.

Antigens, Neoplasm↗
PubMed1992

Failure of anticytokeratin 18 antibody to improve flow cytometric detection of bladder cancer.

BACKGROUND: Bladder washing specimens containing inflammatory or squamous cells have been difficult to accurately analyze with single-parameter DNA flow cytometric (FCM) methods. METHODS: The anticytokeratin 18 antibody, CK5, was used in a multiparameter assay of 275 bladder washing and voided urine specimens to immunoselect only the bladder transitional cells for DNA analysis. RESULTS: Flow cytometric detection of transitional cell carcinoma was increased by immunoselection of CK5-positive cells in specimens from patients with disease. Unfortunately, a similar increase in hyperdiploid cells in pathologically benign specimens was observed, which resulted in a false-positive rate of 45%. In some instances, multiparameter FCM assays with CK5 could detect aneuploid cell populations not clearly evident by single-parameter analysis. CONCLUSIONS: However, the results from this study of the hyperdiploid cell fraction showed that the increased sensitivity resulting from the use of CK5 was not clinically useful because of the decrease in specificity.

Animals↗