Waived and nonwaived tests: the Clinical Laboratory Improvement Act.
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Biomedical subjects
Publications and source records attributed to I B Rosenzweig.
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Six patients with confirmed malignant disease received four consecutive weekly cycles of human recombinant interleukin-2 (IL-2) 4 days/week, continuous iv. infusion, 3 X 10(6) U/m2/day. Plasma cholesterol decreased a mean of 7% within 24 hours after IL-2 infusion and decreased by 33% within 4 days. Plasma cholesterol was significantly lower than baseline concentration by day 21 (-21%), and day 25 (-41%) was significantly lower than day 21. Decreased plasma cholesterol was the result of decreased HDL and LDL cholesterol concentrations. Plasma triglyceride demonstrated a mean increase of 46% after 4 days of therapy and remained greater than baseline concentrations at all time points analyzed. Apolipoprotein AI and AII decreased concomitantly with HDL-cholesterol concentrations, whereas apolipoprotein B after an initial mean decrease of 17% during the first cycle was not significantly different from baseline during the fourth cycle. Apolipoprotein E and Lp(a) were not significantly affected by IL-2 treatment. Plasma C-reactive protein (CRP) increased by 79% within 24 hours of therapy, increased by 254% on day 4, then decreased to baseline concentrations by day 21 after 3 days off of IL-2. Day 25 CRP was elevated compared to both baseline and day 21 concentrations. IL-2 induced plasma lipoprotein changes may be due in part to the induction of interferon gamma.
Two groups of patients were administered either 4.5 X 10(6) U or 90 X 10(6) U each of recombinant DNA-derived interferon-beta serine (IFN-beta ser) i.v. daily for 10 days. IFN-beta ser affected lipoprotein lipids of patients in a dose dependent fashion. A decrease in plasma total cholesterol concentration occurred 24 h after therapy was initiated, regardless of dose. A dose-related decrease in plasma cholesterol concentration of 9% and 23% for patients on the low dose and high dose respectively occurred after 9 days of therapy. The plasma total cholesterol concentration decrease resulted primarily from a decrease in LDL cholesterol of 28% and 50% for patients on low and high doses respectively of IFN-beta ser. HDL-cholesterol was not significantly affected by IFN-beta ser administration. A dose-related increase in plasma triglyceride concentration occurred during IFN-beta ser, increasing 74% for patients on low dose and 136% for patients on high doses. This increase was only observed after 9 days on IFN-beta ser. Cholesterol reduction and triglyceride increases followed different time courses indicating different mechanisms may be involved.
Purity of interferons has facilitated definition of pleiotropic biological effects. Alterations that might be suspect with use of impure interferons, such as those occurring in tryptophan and lipoprotein metabolism, have been defined both in vitro and in humans. Reduction in tryptophan contributes to antimicrobial effects for intracellular pathogens and may explain some clinical observations. Decreases in plasma lipoproteins occur rapidly and are of a magnitude similar to cholesterol-lowering drugs used clinically. Alteration in metabolism of amino acids and fats substantially extends the biological effects of a virus-inhibitory protein.
A comparison was made of the serum lipoprotein-cholesterol profile, obtained by cellulose acetate electrophoresis coupled with an enzymatic stain for total cholesterol, of the adult male rat, mouse, rabbit, dog, monkey and human. Four cholesterol-staining lipoprotein bands were detected in rat serum, while only three cholesterol-staining lipoprotein bands were present in the other species studied. The apparently unique lipoprotein-cholesterol band in the rat was found to electrophoretically migrate in the prealbumin region of rat serum, has been named prealbumin lipoprotein-cholesterol (PAL-C) and was shown to be a high density lipoprotein (HDL). Of the species studied those more susceptible to experimentally induced atherosclerosis had higher low density lipoprotein-cholesterol to HDL-cholesterol ratios compared to those species least susceptible to experimentally induced atherosclerosis.
We describe an assay for measuring cocaine and benzoylecgonine in meconium of infants born to mothers suspected of using cocaine during their pregnancy. The assay involves the use of fluorescence polarization immunoassay (FPIA) to screen for benzoylecgonine in a methanolic extract of the meconium. The FPIA is sensitive to 0.6 microgram benzoylecgonine per gram meconium. Confirmation of the presence (or absence) of benzoylecgonine and cocaine in meconium samples was performed by solid phase extraction of a second methanolic extract of the meconium, derivatizing using BSTFA, followed by a gas chromatographic/mass spectrometric (GC/MS) analysis, which can detect both cocaine and benzoylecgonine. The GC/MS confirmation was sensitive to less than 0.25 microgram cocaine or 0.5 microgram benzoylecgonine per gram meconium. FPIA, which is commonly used in many toxicology laboratories, is advantageous because it precludes the need to use radioimmunoassays for the initial screen. The confirmation step provides greater certainty for the presence of cocaine and/or benzoylecgonine in meconium.