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Biomedical subjects

H F Starnes

Publications and source records attributed to H F Starnes.

At least 19 recordsLinked to original sources
PubMed1993

Interleukin-1 beta induces interleukin-1 receptor antagonist and tumor necrosis factor binding protein in humans.

Sustained release or high levels of interleukin-1 (IL-1) and/or tumor necrosis factor (TNF), as observed after endotoxin challenge, can produce a variety of toxicities. Naturally occurring inhibitors to IL-1 and TNF, IL-1 receptor antagonist (IL-1ra) and soluble TNF receptor forms, have been detected. These proteins may function to buffer or limit the effects of these cytokines as part of a regulatory network. As part of a clinical trial of recombinant human interleukin-1 beta (rhIL-1 beta), serial plasma samples were obtained from 6 patients with metastatic melanoma treated with 30-min infusions of rhIL-1 beta for 5 consecutive days. The presence of circulating IL-1 receptor antagonist and soluble TNF binding proteins (TNF-R55-BP and TNF-R75-BP) were assessed. A maximum 86-fold increase for IL-1ra, a 7-8-fold increase for TNF-R55-BP, and a 2-3-fold increase for TNF-R75-BP were seen 2-4 h, 1 h, and 4 h, respectively, after rhIL-1 beta infusion. On each day of the treatment, the secretion of IL-1ra and release of TNF-R55-BP was observed, but there was no accumulation above baseline value for IL-1ra before each of the 5 daily infusions. Although there was a steady decrease of the 6-h postinfusion plasma levels for IL-1ra and TNF-R55-BP over the 5 treatment days, no increase of clinical side effects was noted. Two patients had measurable levels of TNF-alpha, but no correlation to TNF-binding proteins was observed. Our data show that early after rhIL-1 beta infusion the induction of IL-1ra secretion, as well as TNF-binding protein release, is observed.

Adult↗
PubMed1993

Evidence for activation of the sympathetic nervous system by recombinant human interleukin-1 beta in humans.

Administration of interleukin-1 beta (IL-1 beta) to humans initiates a cascade of metabolic, hematologic, and cardiovascular events. To investigate the role of the sympathetic nervous system in the early cardiovascular response to IL-1 beta in humans, we recorded the heart rate, blood pressure, and changes in hand vein compliance in five patients with malignant melanoma treated with a 30-min infusion of 10,000-20,000 U/kg of human recombinant IL-1 beta. All patients developed fever, chills, and marked hemodynamic changes. During or shortly after the infusion, a dramatic decrease in hand vein compliance occurred (vasoconstriction). At the time of maximum venoconstriction (35 min after the start of the IL-1 beta infusion), the mean heart rate and systolic blood pressure were significantly increased by 30 mm Hg and 31 beats/min, respectively. Venoconstriction always preceded the onset of chills by several minutes (mean of 7 min), was closely correlated with the heart rate, and could be reversed by local administration of the alpha-antagonist phentolamine, indicating involvement of catecholamines. Our study shows that cardiovascular responses that occur early after IL-1 beta administration in humans are most likely the result of adrenergic stimulation possibly through its effect on the central nervous system.

Adult↗
PubMed1992

Differential metabolic responses to tumor necrosis factor with increase in age.

Previous studies have shown varied responses to the effects of tumor necrosis factor (TNF) on glucose and lipid metabolism. To elucidate possible causes for this variation, the present study compared sequential changes in plasma glucose, lactic acid, triglyceride (TG), free fatty acids (FFA), and plasma insulin levels in 1.5- and 16-month-old, normal, fed, male rats, 1 to 6 hours after different doses of intravenous (IV) TNF. In addition, assessment was made of TNF injected intraperitoneally (IP) in precannulated and intact young (1.5 months) rats and of the dose-response (0.25 to 50 micrograms/100 g rat) and the sensitivity to insulin in intact rats. Finally, the metabolic responses and changes in serum insulin and corticosterone concentration after IP TNF were compared in 1.5-, 5-, and 16-month-old rats. Data show that metabolic responses vary with increase in age and experimental conditions. Dose-dependent decreases in plasma glucose (1.4 to 3.9 mumol/mL) and elevations in lactic acid (0.8 to 3.0 mumol/mL) were greater in 1.5- versus 16-month-old rats, were delayed in cannulated rats, and were preceded by hyperglycemia following larger IV doses. Plasma TG levels were elevated after TNF in all groups except precannulated rats, and also showed differences with age. In young rats, the elevation in TG peaked 2 hours after IP injection with return to baseline and was preceded by an elevation in FFA levels. In older rats, which were hypertriglyceridemic at base line, the elevation in TG by TNF occurred by suppressing the decrease in TG of controls, was not accompanied by an increase in FFA levels, was sustained for 5 hours, and was of greater magnitude than in young rats. Significant changes in plasma insulin did not occur in young and older rats after IV TNF. However, young rats had a significant decrease (P less than .02) in plasma insulin and an elevation in corticosterone levels after IP TNF, whereas older rats exhibited an increase in plasma insulin (P less than .02) and a comparable elevation in plasma corticosterone. Young rats also showed an increase in plasma insulin following IP TNF when hypoglycemia was prevented by the infusion of glucose. However, when insulin levels were held comparable (2.4 ng/mL), glucose uptake was enhanced (P less than .05) compared with controls. These findings indicate that mobilization of energy substrates occurs during the initial exposure to TNF, which is altered by the nutritional state of the rats and the dose and route of administration.(ABSTRACT TRUNCATED AT 400 WORDS)

Aging↗
PubMed1992

Sepsis-induced cascade of cytokine mRNA expression: correlation with metabolic changes.

The relationships between metabolic alterations and tissue-specific gene expression of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), gamma-interferon (gamma-IFN), and interleukin 1 and serum levels of TNF-alpha and IL-6 before and after a live Escherichia coli septic challenge to rats were examined. From 0 to 2 h, serum glucose significantly decreased while plasma glucagon increased. By 8 h, plasma glucagon, serum insulin, and glucose appearance were significantly elevated. Gene expression of phosphoenolpyruvate carboxykinase increased 1 h after E. coli but by 4 h was significantly decreased. TNF-alpha mRNA (liver and spleen) and serum peptide levels peaked 1-2 h after the septic challenge and then decreased substantially by 6-8 h. Spleen IL-6 and gamma-IFN mRNA expression reached a maximum 4 h after E. coli challenge, whereas serum IL-6 levels were elevated by 2 h after injection of the bacteria. The increase in TNF-alpha mRNA and serum peptide levels correlated with the early fall in serum glucose and rise in plasma glucagon. Alterations in the rate of glucose appearance and plasma glucagon were observed later and coincided with the increased mRNA expression of IL-6 and gamma-IFN. Thus the metabolic alterations observed in the septic rat are associated with a complex cascade of several cytokines.

Aminoisobutyric Acids↗
PubMed1991

Effectiveness of a purified human hemoglobin as a blood substitute in the perfused rat liver.

The efficacy of purified cross-linked human hemoglobin solution in maintaining the metabolic integrity of perfused livers from fed rats was determined and compared with that of livers recirculated with red blood cells, perfluorocarbon, and Krebs' Ringer bicarbonate buffer media at normal and accelerated flow rates. The data indicate that oxygen utilization was comparable in livers perfused with red blood cell medium (53.5 +/- 4.0 microL.g liver-1.min-1), hemoglobin (45.7 +/- 1.9), and perfluorocarbon (57.2 +/- 6.1) and less in livers perfused with Krebs' Ringer bicarbonate buffer solution at normal (17.4 +/- 1.4) and high (27.7 +/- 1.4) flow rates. Bile flow, the outflow of glucose and lactic acid, and residual glycogen levels were similar when livers were perfused with red blood cells (hematocrit, 19) and hemoglobin solutions containing 7 g hemoglobin/dL at flow rates of 1.1-1.2 mL.g liver-1.min-1. However, livers perfused with perfluorocarbon at 1.1 mL.g-1.min-1 showed a significantly greater (P less than 0.01) decline in bile flow and outflow of glucose and lactic acid. Livers perfused with Krebs' Ringer bicarbonate buffer at normal (1.3 mL.g-1.min-1) and accelerated flow rates (3.0 mL.g-1.min-1) also showed a progressive decrease in bile flow and marked glycogenolysis as well as depletion of adenosine triphosphate content. In addition, morphological studies (light and electron microscopy) showed more vacuoles, membrane alterations, and increased mitochondrial swelling in livers perfused with Krebs' Ringer bicarbonate buffer and perfluorocarbon. These findings suggest that hepatocyte function in livers from fed rats is maintained equally well with hemoglobin solutions and with red blood cell medium, suggesting that cross-linked hemoglobin solution may serve as an effective blood substitute for maintaining adequate oxygenation and metabolic integrity of the isolated perfused rat liver.

Analysis of Variance↗
PubMed1990

Anti-IL-6 monoclonal antibodies protect against lethal Escherichia coli infection and lethal tumor necrosis factor-alpha challenge in mice.

Potentially fatal physiologic and metabolic derangements can occur in response to bacterial infection in animals and man. Recently it has been shown that alterations in the levels of circulating cytokines such as IL-6 and TNF-alpha occur shortly after bacterial challenge. To understand better the role of IL-6 in inflammation, we investigated the effects of in vivo anti-mouse IL-6 antibody treatment in a mouse model of septic shock. Rat anti-mouse IL-6 neutralizing mAb was produced from splenocytes of an animal immunized with mouse rIL-6. This mAb, MP5-20F3, was a very potent and specific antagonist of mouse IL-6 in vitro bioactivity, demonstrated using the NFS60 myelomonocytic and KD83 plasmacytoma target cell lines, and also immunoprecipitated radiolabeled IL-6. Anti-IL-6 mAb pretreatment of mice subsequently challenged with lethal doses of i.p. Escherichia coli or i.v. TNF-alpha protected mice from death caused by these treatments. Pretreatment of E. coli-challenged mice with anti-IL-6 led to an increase in serum TNF bioactivity, in comparison to isotype control antibody, implicating IL-6 as a negative modulator of TNF in vivo. Anti-TNF-alpha treatment of mice challenged i.p. with live E. coli resulted in a 70% decrease in serum IL-6 levels, determined by immunoenzymetric assay, compared to control antibody, thereby supporting a role for TNF-alpha as a positive regulator of IL-6 levels. We conclude that IL-6 is a mediator in lethal E. coli infection, and suggest that antagonists of IL-6 may be beneficial therapeutically in life-threatening bacterial infection.

Acute-Phase Reaction↗
PubMed1990

Preliminary report: effects of interleukin-1 on platelet counts.

Recombinant human interleukin-1 beta was given in 5 daily intravenous infusions to ten patients with metastatic malignant disorders as part of an antineoplastic trial. All ten patients experienced transient increases in heart rate, low-grade fevers, and rigors. A neutrophil-dominated 100% rise in leucocyte counts occurred 4-8 h after treatment. Leucocyte counts returned to baseline levels within 24 h of interleukin-1 beta infusion. A 50% rise in platelets occurred in response to interleukin-1 beta; the increase in platelet counts was first noted 6 days after treatment began and was sustained for 24 days after treatment. Interleukin-1 beta may therefore be beneficial in the treatment of conditions of thrombocytopenia associated with haematological disorders and chemotherapy for malignant disorders.

Adult↗
PubMed1990

The transforming growth factor-betas. A new family of immunoregulatory molecules.

Within the past three years there has been a rapid expansion in our knowledge of the role TGF-beta mediates in regulating immune responses in vitro. Whether the TGF-beta will be clinically useful to suppress immune responses to transplanted organs or autoimmune responses is unknown. However, now that highly purified quantities of TGF-beta are available through recombinant DNA technologies, questions concerning the in vivo immunosuppressive activities of TGF-beta can be answered.

Animals↗
PubMed1989

Results of surgery for obstructing carcinomatosis of gastrointestinal, pancreatic, or biliary origin.

Results of operation for obstructing carcinomatosis of gastrointestinal (GI), pancreatic, or biliary origin were reviewed to assess relief of symptoms, management of re-obstruction, and duration of hospitalization. A retrospective review (1977 to 1986) identified 89 patients, 59 (66%) of whom had tumors originating in the colon, and 19 (21%) in the stomach. Normal bowel function was restored for a median of 102 days in 66 patients (74%) and all but four (94%) were discharged. Forty-one (46%) patients remained unobstructed until death. Twenty-three (26%) were not relieved by operation and died a median of 33 days later (P less than .005). Forty-eight (81.4%) of the 59 colon cancer patients and ten (52.6%) of 19 with gastric cancer (P less than .05) were benefited by the operation, although comparison of duration of function was less striking (P less than .1). In-hospital mortality was 13% and complications occurred in 44%. Obstruction recurred in 38% of those relieved by the initial operation. Normal bowel function was restored in six (46%) of 13 patients undergoing a second laparotomy (median, 158 days) and in six of 13 (46%) treated with nasogastric suction. Obstruction recurred again in four of the latter six patients (median, 39 days). Hospitalization averaged 31 days (median, 25 days) for the first procedure and 41 days (median, 39 days) for patients operated for recurrent obstruction. These results justify laparotomy for intestinal obstruction in known or suspected carcinomatosis, particularly of colonic origin, if performance status is compatible with a reasonable quality of life.

Adenocarcinoma↗
PubMed1989

The in vivo distribution of human peripheral blood lymphocytes and lymphokine-activated killer cells adoptively transferred in human pancreatic cancer-bearing nude mice.

In this study we evaluated human pancreatic cancer xenotransplanted into nude mice as a model suitable for adoptive immunotherapy studies. A pancreatic cancer cell line (MIA PaCa-2) was chosen and its growth in nude mice and sensitivity to lysis by human lymphokine-activated killer (LAK) cells were characterized. This line grew in 96% of the cases when young (4- to 6-week-old) Swiss/NIH nude mice were used. The line was highly sensitive to lysis by LAK cells in a standard chromium-51 release assay (67.8%), similarly to other cell lines known to be highly sensitive, such as K562 (75.6%) and the melanoma cell line SU.102 (53.1%). To assess their in vivo distribution, human peripheral blood lymphocytes (PBLs) and LAK cells were adoptively transferred into nude mice after labeling with indium-111 oxine. The results of this study show that adoptively transferred PBLs and LAK cells localize in this heterologous system as they do in autologous systems. PBLs are taken up mostly by the liver and spleen. The percentage of the administered dose of radioactivity taken up corrected by weight (percent dose per gram tissue) is 64.3 +/- 15.6%d/gm (liver) and 43.5 +/- 9.5%d/gm (spleen). LAK cells are taken up by liver (43.2 +/- 5.3%d/gm) and spleen (28.0 +/- 4.9%d/gm) but also localize significantly more than PBLs in other organs such as lungs (12.9 +/- 3.5%d/gm vs 1.4 +/- 0.3%d/gm, p less than 0.01), kidneys (19.1 +/- 2.1%d/gm vs 6.3 +/- 1.5%d/gm, p less than 0.001), and pancreatic tumors growing in orthotopic position (1.93 +/- 0.36%d/gm vs 0.56 +/- 0.06%d/gm, p less than 0.05). When the nude mice are pretreated with human recombinant tumor necrosis factor, localization of LAK cells compared with PBLs is even further enhanced both in tumors implanted in the pancreas (3.1 +/- 0.5%d/gm vs 0.56 +/- 0.06%d/gm, p less than 0.01) and in the subcutis (12.5 +/- 8.3%d/gm vs 0.95 +/- 0.29%d/gm, p less than 0.001).

Animals↗
PubMed1988

Hormonal and metabolic response to recombinant human tumor necrosis factor in rat: in vitro and in vivo.

Tumor necrosis factor (TNF; cachectin) has been implicated as a mediator of the toxic manifestations of overwhelming bacterial infection as well as the chronic catabolic state of cancer cachexia. We have examined the acute metabolic and hormonal response after administration of recombinant human TNF in the rat. TNF given by intraperitoneal injection produced dose- and time-related increases in hepatic amino acid uptake, decreases in serum trace metal concentrations, and a pattern of endocrine hormone alterations characteristic of the acute phase response to tissue injury. In vitro zinc transport studies by rat hepatocytes cultured in the presence of TNF alone, or in combination with recombinant human interleukin 1, another mediator of the acute phase response, demonstrated that neither monokine was capable of directly stimulating zinc transport into cells. These findings suggest that TNF may function as an endogenous mediator of the early metabolic response to sepsis and that the trace metal changes induced by TNF in vivo may occur through a secondary mechanism.

Amino Acids↗
PubMed1988

Tumor necrosis factor and the acute metabolic response to tissue injury in man.

Tumor necrosis factor (cachectin), a protein produced by monocytes and macrophages, has been implicated as an important mediator of the lethal effects of endotoxic shock and the cachexia of chronic infection. Recombinant human tumor necrosis factor alpha (rTNF) was given intravenously to patients as part of an antineoplastic trial. Fever, tachycardia, and at higher doses, hypotension occurred after a single injection of rTNF. Metabolic effects after rTNF administration were dose related and included enhanced energy expenditure with elevated CO2 production, increased whole body protein metabolism and peripheral amino acid efflux from the forearm, and decreased total arterial amino acid levels associated with a significant increase in plasma cortisol. Elevated serum triglycerides, as well as increased glycerol and free fatty acid turnover were seen, suggesting increased whole body lipolysis and fat utilization after rTNF. These findings indicate that administration of TNF in man reproduces many of the acute physiologic and metabolic responses to tissue injury, including energy substrate mobilization.

Acute-Phase Reaction↗
PubMed1988

Surgical therapy for thyroid carcinoma: a review of 1249 solitary thyroid nodules.

A total of 1249 "cold" solitary thyroid nodules were excised at the Brigham and Women's Hospital from 1948 through 1987. Of these nodules, 241 showed malignant conditions: 123 were papillary, 42 were mixed papillary-follicular, and 43 were pure follicular carcinomas. There were also 23 anaplastic, 8 medullary, and 3 Hürthle cell carcinomas. These patients were followed up from 3 to 31 years, with a mean range of 10 years. Fifty-three patients with well-differentiated tumors underwent total thyroidectomies, and 179 underwent subtotal thyroidectomies (excluding anaplastic, medullary, and Hürthle cell tumors). Regional lymph node involvement was commonly found but appeared not to affect survival; tumor size and local spread and extent of thyroid gland involvement did affect survival. A small percentage of well-differentiated thyroid tumors do, in time, undergo anaplastic change that leads to metastasis and death. There was no 30-day mortality rate. The late mortality rate was 2% for papillary and 14% for follicular carcinomas. Papillary tumors are becoming more common. Older aged patients and male patients appear to carry poorer prognoses for survival. The total thyroidectomy procedure has not improved survival over subtotal thyroidectomy and carries a higher complication rate.

Adenocarcinoma↗
PubMed1987

The acute metabolic effects of tumor necrosis factor administration in humans.

It has been suggested that the monokine tumor necrosis factor (TNF) (cachectin) is responsible for metabolic abnormalities frequently accompanying malignant neoplasms. The acute metabolic effects of TNF in patients with cancer were studied. Subcutaneous administration of recombinant human TNF led to a rise in the C-reactive protein level (4.4 +/- 1.2 mg/dL vs 11.6 +/- 1.8 mg/dL) and a reduction in the serum zinc level (12.9 +/- 0.8 mumol/L vs 7.3 +/- 0.8 mumol/L [79 +/- 5 mg/dL vs 48 +/- 5 mg/dL]) (values are the mean +/- SEM). Forearm efflux of total amino acids more than doubled after intravenous TNF injection, principally because of increases in release of the gluconeogenic amino acids alanine and glutamine. Concomitantly, the arterial levels of alanine, glutamine, and total amino acids fell, indicating that TNF also stimulated the uptake of amino acids by other tissues. The observed amino acid pattern cannot be explained solely on the basis of measured changes in cortisol, glucagon, or insulin levels. These findings are discussed in relation to known alterations of amino acid metabolism in cancer-associated cachexia.

Adult↗
PubMed1987

Altered peripheral amino acid uptake in obstructive jaundice.

To characterize amino acid metabolism in obstructive jaundice, the amino acid uptake in tissues of bile duct-ligated (BDL) rats was determined. Fischer 344 rats underwent either bile duct ligation or sham laparotomy and were pair fed for 72 hr. Amino acid uptake was determined in peripheral skeletal muscle (quadriceps femoris, soleus, and rectus abdominis), liver, blood, and other tissues by accumulation of alpha-[14C]-aminoisobutyric acid following intracardiac injection. Although total hepatic amino acid uptake was unaltered in the BDL animals compared with the sham-operated controls, amino acid uptake in peripheral skeletal muscle was significantly decreased in all muscle groups studied in the BDL rats. The relative concentration (percentage dose per gram normalized to the animal mass) for quadriceps femoris was 0.16 +/- 0.02 for BDL and 0.32 +/- 0.04 for sham-operated rats, P less than 0.005. Muscle protein was lower in BDL animals when compared with sham-operated rats (P less than 0.05). Total trunk blood amino acid levels were not significantly different in the two groups; however, there was a decreased serum level of branched-chain amino acids in the BDL group, P less than 0.05. No differences in plasma glucose or serum insulin were found in the two groups; lactate levels were lower in the BDL group, and plasma triglyceride levels were three times higher in the BDL animals. These data suggest that obstructive jaundice in the rat is associated with organ-specific metabolic abnormalities consistent with impaired peripheral amino acid uptake.

Amino Acids↗