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Biomedical subjects

J Levin

Publications and source records attributed to J Levin.

At least 109 records · Page 6Linked to original sources

A single amino-acid substitution in the Ets domain alters core DNA binding specificity of Ets1 to that of the related transcription factors Elf1 and E74.

Ets proteins form a family of sequence specific DNA binding proteins which bind DNA through a 85 aminoacids conserved domain, the Ets domain, whose sequence is unrelated to any other characterized DNA binding domain. Unlike all other known Ets proteins, which bind specific DNA sequences centered over either GGAA or GGAT core motifs, E74 and Elf1 selectively bind to GGAA corecontaining sites. Elf1 and E74 differ from other Ets proteins in three residues located in an otherwise highly conserved region of the Ets domain, referred to as conserved region III (CRIII). We show that a restricted selectivity for GGAA core-containing sites could be conferred to Ets1 upon changing a single lysine residue within CRIII to the threonine found in Elf1 and E74 at this position. Conversely, the reciprocal mutation in Elf1 confers to this protein the ability to bind to GGAT core containing EBS. This, together with the fact that mutation of two invariant arginine residues in CRIII abolishes DNA binding, indicates that CRIII plays a key role in Ets domain recognition of the GGAA/T core motif and lead us to discuss a model of Ets proteins--core motif interaction.

Amino Acid Sequence↗

Induction of apoptosis in blood cells from a patient with acute myelogenous leukemia by SC41661A, a selective inhibitor of 5-lipoxygenase.

Participation of leukotriene products in normal ex vivo hematopoiesis is well established. With increasingly specific inhibitors of lipoxygenases, it becomes possible to more closely define any participation of their biosynthetic products in these events. We cultured chronic myelogenous leukemia cells from the peripheral blood of several patients in blast crisis with three inhibitors of lipoxygenases: ETYA, and the more selective A63162 (Abbott) or SC41661A (Searle). All three agents reduced labelling of DNA with H3 thymidine measured at 4 h and reduced cell numbers by 72 h. An antisense deoxyoligonucleotide to the 5-lipoxygenase mRNA 'start' codon inhibited DNA synthesis at 24 h, as did two control oligonucleotides. Marked nuclear ultrastructural changes characteristic of apoptosis were induced by SC41661A in a subset of cells with the ultrastructure of promyelocytes. Whether this response characterizes a common pattern of this subset of leukemic cells to SC41661A, if damage to mitochondria with reduced function of bcl-2 protooncogene product located at that site might have contributed or some other mechanism was responsible, and if inhibition of 5-lipoxygenase activity was involved, are questions to be decided in the future.

5,8,11,14-Eicosatetraynoic Acid↗

Failure of the International Normalized Ratio to generate consistent results within a local medical community.

Use of the International Normalized Ratio (INR) has been recommended as a means of standardizing prothrombin time (PT) results for management of oral anticoagulant therapy. During the evaluation of a new lot of thromboplastin reagent, however, INR values were obtained that were inconsistent with results obtained with the prior lot of reagent from the same manufacturer. A local normalized ratio (LNR) was substituted for the INR for the new reagent, based on a calculated local sensitivity index (LSI). Validation of the LSI was performed at the three hospitals in the medical community by testing an identical panel of aliquots from 64 plasmas obtained from patients who were chronically receiving oral anticoagulants. Each test result was classified according to the INR value as low, low therapeutic, high therapeutic, or high. Local normalized ratio values obtained at one hospital in the community were in reasonable agreement with INR determinations in the other two hospital laboratories. Classification mismatches occurred using the INR, however, in 84 of 280 (30%) of the paired samples. Thus, the inability to generate consistent INR values within a local medical community raises serious concern about the reliability of the INR concept in its current form.

Anticoagulants↗

A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section.

BACKGROUND: Hypotension after spinal anesthesia for cesarean section remains a common and serious complication despite the use of uterine displacement and volume preloading. The current study revaluated the role of crystalloid volume preloading in this context. METHODS: In a two-stage open sequential design, patients presenting for elective repeat cesarean section were allocated to receive either no preload or 20 ml/kg crystalloid administered over 15-20 min before spinal anesthesia. Hypotension was defined as a decrease in systolic pressure to less than 100 mmHg and to less than 80% of baseline value, and the study was designed to detect a 20% difference in the incidence of hypotension between the groups, with statistical significance at the 10% (alpha = 0.1) level, one-tailed. RESULTS: One hundred forty patients were studied. Hypotension occurred in 43 (55%, 95% CI 43.4-66.4) preloaded and 44 (71%, 95% CI 58-81.8) unpreloaded subjects, a difference in incidence of 16% (95% CI 0.04-31.6), which was statistically significant. There were no significant differences in the severity, timing, or duration of hypotension; the dose requirement for ephedrine; or the clinical and biochemical status of neonates between the groups. The only difference seen was a lower mean base excess (-3.4, SD 2.81 mM-1) in the neonates of hypotensive mothers compared to neonates of nonhypotensive mothers (-2.4, SD 1.99 mM-1). CONCLUSIONS: The study confirms that hypotension associated with spinal anesthesia for cesarean section cannot be eliminated by volume preloading in the supine wedged patient. The relatively small reduction in incidence of hypotension challenges our perception of the value of crystalloid preload. Though volume preload in the elective cesarean section is advocated, the requirement for a mandatory administration of a fixed volume before spinal anesthesia for urgent cases has been abandoned.

Adult↗

Distribution of bacterial endotoxin in human and rabbit blood and effects of stroma-free hemoglobin.

Bacterial endotoxin (lipopolysaccharide [LPS]) is known to interact with numerous components of blood, including erythrocytes, mononuclear cells, platelets, neutrophils, lipoproteins, and plasma proteins. The relative affinities of LPS for these elements, and the distribution of LPS between them, are unknown. Cross-linked stroma-free hemoglobin (SFH), a potential substitute for erythrocyte transfusion, produces in vivo toxicity in animals consistent with significant LPS contamination. Therefore, we studied the distribution of LPS in human and rabbit blood and examined whether the presence of SFH altered LPS distribution. In either the presence or absence of SFH, LPS was associated predominantly with high-density lipoproteins and apoproteins. There was lesser binding to low- and very-low-density lipoproteins. Examination of the apoprotein pool by column chromatography and density centrifugation demonstrated that LPS in this fraction was predominantly protein bound. Binding of LPS to SFH resulted in dissociation of a portion of the LPS into low-molecular-weight complexes. Cell-bound LPS was only 2 to 16% of the total and was unaffected by SFH. The distribution among blood cells demonstrated predominant binding to platelets in human blood but predominant binding to erythrocytes in rabbit blood. Cellular distribution was not significantly altered by SFH.

Acute-Phase Proteins↗

Biological and biochemical characteristics of murine megakaryoblastic cell line L8057.

Biological and biochemical characteristics of a murine megakaryoblastic cell line (L8057), derived from an irradiated C3H/He mouse, were studied. The L8057 cells grew in liquid cultures with a doubling time of 24 to 27 hours. By light and electron microscopy, the L8057 cells were small and basophilic with a high nuclear/cytoplasmic ratio, but large cells (approximately 25 to 60 microns) were sometimes seen. Western blot analysis of cell extracts demonstrated that murine megakaryocyte and platelet antigens, glycoprotein (GP) IIb/IIIa, fibronectin, and factor VIII:RAg were expressed in L8057 cells. Acetylcholinesterase (AChE)-positive cells were rare (< 2.0%). Flow cytometric analysis demonstrated that 8.7% of the cells were spontaneously polyploid (> 4N DNA levels). In response to phorbol diester (TPA, 50 nm), L8057 cells showed a decrease in proliferation and a marked increase in cell size and amount of cytoplasm. The morphology of the cells became similar to that of megakaryocytes, with larger and lobulated nuclei and expansion of the demarcation membrane system compartment. The proportion of cells with ploidy levels greater than 4N increased to 40.8% (8N, 21.3 +/- 3.2%; 16N, 13.1 +/- 2.6%; > or = 32N, 6.4 +/- 4.9% [n = 4]). More than 90% of the cells became AChE-positive. TPA also increased the expression of GP IIb/IIIa, fibronectin and factor VIII:RAg. Thus, the L8057 cell line provides a potentially superior model with which to study the characteristics of megakaryocytic biology, differentiation and biochemistry.

Acetylcholinesterase↗

Purification of Limulus polyphemus proclotting enzyme.

Horseshoe crabs (Limulus polyphemus and Tachypleus tridentatus) possess a proteolytic blood coagulation system within their amebocytes that, after release and endotoxin activation, generates a polymerized insoluble coagulin clot. Clotting enzyme from horseshoe crab amebocyte lysate is the protease that activates the clottable protein (coagulogen) which then forms the coagulin clot. Comparison of the previously published descriptions of this enzyme has revealed significantly discordant biochemical characteristics. We purified a 60-kDa proclotting enzyme from L. polyphemus amebocyte lysate to a single band on polyacrylamide gel electrophoresis. After electrophoresis, evaluation of enzymatic activity of this protein within gels demonstrated that the band of purified protein corresponded to enzymatic activity, as detected by amidolytic activity for chromogenic substrates and by gelation of coagulogen applied to the gel. The enzymatic activity was inhibited by serine protease inhibitors. The purified proclotting enzyme had a molecular weight and amino acid composition different from the previously published characterizations of proclotting enzymes from both L. polyphemus and T. tridentatus.

Amino Acids↗

Evidence that interleukin-6 does not play a role in the stimulation of platelet production after induction of acute thrombocytopenia.

The induction of thrombocytopenia results in elevated levels of thrombopoietin (TPO), which can be detected in the plasma of experimental animals. Acute, severe thrombocytopenia (platelet count less than 5% of control) was produced in mice by the administration of either guinea pig or rabbit antimouse platelet antiserum. Control mice received equal volumes of normal serum. At various times after the induction of thrombocytopenia (0.5, 1, 2, 3, 4, 6, 12, and 24 hours) citrated plasma was collected, and circulating interleukin-6 (IL-6) levels were measured using the IL-6-dependent murine hybridoma cell line B9. At no time points after induction of thrombocytopenia were plasma IL-6 levels significantly different from control animals that received normal serum. However, injection of heterologous serum did result in slightly elevated plasma IL-6 levels (at 2 and 3 hours) compared with basal levels measured in uninjected animals. This brief increase was not related to the production of thrombocytopenia. Protein fractions from the plasma of thrombocytopenic rabbits were also tested for the presence of IL-6. Preparations that contained TPO, as shown by stimulation of megakaryocyte maturation in vitro, did not contain detectable levels of IL-6. The ability of the B9 assay to detect the elevation of IL-6 levels in murine or rabbit plasma was verified after the administration of bacterial endotoxin, which is known to increase circulating IL-6 concentrations. IL-6 levels were highly elevated in rabbit or mouse serum after the administration of 5 mg/kg or 1 mg/kg of endotoxin, respectively. Anti-IL-6 antiserum did not neutralize the in vitro megakaryocyte maturation activity of partially purified TPO from the plasma of thrombocytopenic rabbits. In addition, IgG purified from the same antiserum did not neutralize partially purified TPO, as shown after incubation with TPO and subsequent precipitation with agarose-bound protein A. These results show that, unlike TPO, levels of IL-6 do not increase after the induction of acute, severe thrombocytopenia, and strongly suggest that IL-6 does not mediate the thrombopoietic response to acute thrombocytopenia. Although prolonged administration of IL-6 has been shown to induce thrombocytosis, IL-6 and TPO are apparently different and immunologically distinct molecules.

Animals↗

Composition of lipid A in the S and R forms of Shigella dysenteriae serovar 1.

A chemical analysis was performed of lipid A, isolated by acid hydrolysis of the lipopolysaccharide from the S and R forms of Shigella dysenteriae serovar 1. Differences in the moiety of both lipids and sugars were compared. The lipid portion consisted of a homologous series of fatty acids ranging from C12:0 to C18:0 (predominant homologues, C12:0, C14:0 and C16:0) and the homologous series of 3-hydroxy acids ranging from C12:0 to C16:0 (predominant homologue, 3-OH-C14:0). The major sugar portion consisted of D-glucosamine. The toxicity of lipid A in mice (LD50) ranged between 300-400 micrograms/mouse, and values from the Limulus amebocyte lysate assay were recorded as titres of 10(-5) to 10(-6) mg/ml.

Animals↗

The safety and efficacy of ten percent pentastarch as a cardiopulmonary bypass priming solution. A randomized clinical trial.

Ten percent pentastarch is a low-molecular-weight hydroxyethyl starch with greater oncotic pressure and shorter intravascular persistence than 6% hetastarch. To evaluate its safety and efficacy as a component of cardiopulmonary bypass priming solution, we prospectively studied 90 patients undergoing coronary artery bypass grafting or valve replacement necessitating cardiopulmonary bypass (bubble oxygenator and moderate systemic hypothermia). Sixty patients were randomized to receive 75 gm of either 10% pentastarch (group P) or 25% albumin (group A), and 30 patients received lactated Ringer's solution alone (group C). Intravascular colloid osmotic pressure during cardiopulmonary bypass was highest with either of the colloid primes (15-minute measurement: group P, 15.7 +/- 2.2 mm Hg (mean +/- standard deviation); group A, 15.2 +/- 2.0 mm Hg; group C, 11.3 +/- 1.7 mm Hg; p less than 0.05, groups P and A compared with group C). This was associated with a lower volume requirement during cardiopulmonary bypass to maintain the venous reservoir (group P, 333 +/- 318 ml; group A, 483 +/- 472 ml; group C, 1332 +/- 1013 ml; p less than 0.05, groups P and A compared with group C). Urine output during cardiopulmonary bypass was similar in each group. Net intraoperative fluid balance was lowest in the colloid groups (groups P and A, 5.7 +/- 1.4 L; group C, 6.9 +/- 1.3 L; p less than 0.05, groups P and A compared with group C). Cardiac index shortly after weaning from cardiopulmonary bypass was greatest in group P (group P, 3.2 +/- 0.9; group A, 2.8 +/- 0.8; group C, 2.7 +/- 0.6 dyne.sec.cm-5; p less than 0.05, group P compared with group C). Changes in alveolar-arterial oxygen gradients, shunt fraction, and effective compliance were similar in all groups. During cardiopulmonary bypass, pentastarch appeared to cause the greatest degree of hemodilution, as suggested by the lowest hemoglobin, factor VII and IX levels and platelet count. The activated partial thromboplastin time was significantly prolonged during and immediately after cardiopulmonary bypass in group P relative to groups A and C (p less than 0.05), although there were no significant differences in the activated clotting time before cardiopulmonary bypass, during cardiopulmonary bypass, or after heparin neutralization. As well, clinical indices of hemostasis, including mediastinal drainage, red cell, platelet, and fresh frozen plasma requirements, and reoperation for excessive postoperative bleeding, were similar. We conclude that pentastarch, when used in cardiopulmonary bypass prime, is as safe as either albumin or Ringer's solution alone.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Coagulation↗

Histologic studies of splenic megakaryocytes after bone marrow ablation with strontium 90.

We previously showed that purified strontium 90 produced sustained bone marrow ablation in mice, lowering platelet levels to less than 10% of normal 11 days after administration. Platelet levels later rose exclusively from splenic production and were maintained at a stable level (58% of normal) from 20 to 115 days after injection. However, there was no change in the total number or ploidy distribution of splenic megakaryocytes, as immunologically detected by flow cytometry. To further study the characteristics of splenic thrombopoiesis after bone marrow ablation by 90Sr, we measured the frequency, cross-sectional area, and endomitotic figures of histologically recognizable megakaryocytes (as well as bare megakaryocyte nuclei) in mouse spleen sections. During the hematopoietic nadir 9 days after injection of yttrium 90-free 90Sr, the size (area) of megakaryocyte cross-sections (mean +/- SD, 1079.3 +/- 661.6 microns 2; normal, 398.7 +/- 192.8 microns 2) was greater than for any other time studied, but megakaryocyte frequency (corrected for size) did not increase until day 16. Overall, splenic megakaryocytes in marrow-ablated mice 16 or more days after 90Sr injection showed substantial increases (p = 0.001 for both comparisons) in mean area (707.5 +/- 386.2 microns 2) and sectional frequency (mean +/- SEM, 4.52 +/- 0.20 per 1.83 mm2; normal, 0.78 +/- 0.06 per 1.83 mm2). Megakaryocyte bare nuclei and endomitotic figures were also more numerous after 90Sr, injection, suggesting acceleration of megakaryocyte maturation and platelet production. The induction of splenic platelet production after bone marrow ablation is associated with increased size of recognizable megakaryocytes, despite lack of change in overall splenic megakaryocyte ploidy.

Animals↗

Bone marrow cell differential counts obtained by multidimensional flow cytometry.

Five-dimensional flow cytometric analysis of normal bone marrow aspirates was utilized to determine the frequency of neutrophils, eosinophils, monocytes, lymphocytes, nucleated erythrocytes, reticulocytes, platelets, and a cell population that included blasts of each of the cell lineages, megakaryocytes, plasma cells, and basophils. Each of these bone marrow cell populations had unique features with respect to forward light scatter, orthogonal light scatter, and staining with Thiazole-Orange, LDS-751, and CD45 labeled with Phycoerythrin (PE). The identity of the cell populations was verified by sorting each of the cell populations and subsequent light microscopic examination of the cells. The frequencies of the nucleated bone marrow cell subpopulations of 50 normal donors were for neutrophils, mean 72.3%; SD +/- 5.1; 95% limits, 70.9-73.8%; eosinophils, mean 1.8%; SD +/- 1.3; 95% limits, 1.4-2.1%; monocytes, mean, 2.8%; SD +/- 1.2; 95% limits, 2.5-3.1%; lymphocytes, mean 12.1%; SD +/- 3.6; 95% limits 11.1-13.2%; nucleated erythrocytes, mean 8.9%; SD +/- 3.9; 95% limits, 7.8-10.1%; and the cell population that included blasts of each of the cell lineages, megakaryocytes, plasma cells, and basophils, mean 1.6%; SD +/- 1.2; 95% limits, 1.3-1.9%. The percentage of reticulocytes in bone marrow aspirates from 50 normal donors correlated with the reticulocyte frequency in the peripheral blood of these donors. However, the mean frequency of reticulocytes was significantly greater (p < 0.0001) in bone marrow (mean 2.19%; SD +/- 0.88) than in peripheral blood (mean 1.71%; SD +/- 0.88). The technique could discriminate between immature and mature reticulocytes based on the brighter staining with both Thiazole-Orange and LDS-751 of the immature reticulocytes. This was confirmed by cell sorting of both reticulocyte populations, which revealed larger clumps of New Methylene Blue staining material in the brighter Thiazole-Orange and LDS-751 stained reticulocytes. The immature reticulocytes were present in normal bone marrow, but not in normal peripheral blood. As expected, a significantly greater frequency of nucleated cells was found in bone marrow aspirates (mean 0.85%; SD +/- 0.59) than in peripheral blood (mean 0.20%; SD +/- 0.11). The frequency of platelets was significantly lower in bone marrow (mean 1.24%; SD +/- 0.69) than in peripheral blood (mean 2.94%, SD +/- 1.14). Flow cytometric bone marrow analysis can provide clinical laboratories with a technique that generates quantitative bone marrow cell differentials and potentially can reduce the need for light microscopic examination of bone marrow smears.

Benzothiazoles↗

Cell cycle status of murine megakaryocyte and granulocyte-macrophage colony-forming cells in bone marrow and spleen.

The cell cycle status of megakaryocyte colony-forming cells (Meg-CFC) and granulocyte-macrophage colony-forming cells (GM-CFC) from the spleen and bone marrow of C57BL mice was evaluated by determining the effects of hydroxyurea (OHU) or cytosine arabinoside (Ara-C), both in vivo and in vitro, upon colony-forming cells (CFC). The concentrations of cells in culture (2 x 10(6) to 4 x 10(6)/ml for spleen and 0.25 x 10(5) to 1.0 x 10(5)/ml for bone marrow) did not alter cell cycle status of either Meg-CFC or GM-CFC. Determination of cell cycle status following in vivo administration of OHU indicated that 25.2% of Meg-CFC and 28.1% of GM-CFC in the spleen, and 26.0% of Meg-CFC and 29.5% of GM-CFC in the bone marrow, were in cycle. In vitro incubation of CFC with OHU showed that in the spleen 25.1% of Meg-CFC and 24.2% of GM-CFC were engaged in DNA synthesis, whereas in bone marrow 28.5% of Meg-CFC and 29.2% of GM-CFC were synthesizing DNA. Incubation with Ara-C, in vitro, gave similar results, with 26.0% of Meg-CFC and 26.2% of GM-CFC in the spleen, and 27.1% of Meg-CFC and 31.4% of GM-CFC in the bone marrow, in cycle. In summary, significant differences were not observed between the cell cycle status of Meg-CFC and GM-CFC, whether derived from spleen or bone marrow. In vitro and in vivo measurements (with OHU) and in vitro measurements with two cytotoxic drugs (OHU versus Ara-C) also provided similar results. The data suggest that the regulation of DNA synthesis in both Meg-CFC and GM-CFC in the murine spleen and bone marrow is similar.

Animals↗

Correlation of in vitro and in vivo biological activities during the partial purification of thrombopoietin.

We have evaluated three in vitro assays for megakaryocyte maturation as monitors of biological activities of thrombopoietin (TPO). The in vitro measurements, that is, potentiation of murine megakaryocyte colonies in soft agar cultures, growth of single murine megakaryocytes in soft agar, and acetylcholinesterase production in liquid cultures of murine bone marrow cells, were correlated with measurements of thrombopoiesis stimulatory activity in vivo, based on labeling of newly formed platelets with [75Se]selenomethionine. Protein fractions produced during the purification of TPO from the plasma of thrombocytopenic rabbits were used to evaluate the in vitro assays. Potentiation of murine megakaryocyte colony growth in soft agar was least valuable as a TPO assay, due to variability. Growth of single megakaryocytes in vitro, in a serum-free, agar culture system, correlated well with measurement of thrombopoiesis-stimulating activity in vivo, in regard to increases in specific activity during the purification, and was the most sensitive of the three assays. The serum-free, liquid culture assay also correlated well with the in vivo assay, and it had the additional advantage of being feasible for evaluation of the large numbers of protein fractions produced by high-resolution chromatographic procedures. Using the liquid culture system to assay fractions from gel permeation high performance liquid chromatography, a biologically active fraction with a molecular weight range of 40-47 kd was identified.

Acetylcholinesterase↗

Effects of interleukin 3 and interleukin 6 on platelet recovery in mice treated with 5-fluorouracil.

We have studied the effects of murine recombinant interleukin 3 (IL-3) and human recombinant interleukin 6 (IL-6) on platelet recovery after administration of 5-fluorouracil (5-FU) to mice. 5-FU at 250 mg/kg body weight was administered as a single i.p. injection, and treatment with IL-3 alone, IL-6 alone, or a combination of IL-3 plus IL-6 was initiated immediately following the 5-FU or after a delay of 2 days. In addition, the effects of the combination of IL-3 plus IL-6 were evaluated following delays in initiation of their administration until 4 or 6 days after 5-FU treatment. In all schedules, the IL-3 and IL-6 treatments were discontinued 8 days following 5-FU. IL-3 and IL-6 were given s.c. three times daily; each injection of IL-3 was 80,000 U, each injection of IL-6 was 5000 U, and the combination comprised separate injections of IL-3 and IL-6 at the same respective doses. The combination of IL-3 and IL-6, initiated immediately or 2 days following 5-FU, diminished the platelet nadir and increased platelet counts on individual days during the recovery phase, thus apparently decreasing the time required for recovery to a normal platelet level. However, using self-modeling nonlinear regression, in order to analyze variability in the duration of thrombocytopenia, statistically significant shortening of the period of thrombocytopenia could not be consistently demonstrated. Neither IL-3 alone nor IL-6 alone had any effect on the above parameters. Recovery of hematocrit values and white blood cell levels was unaffected by administration of either IL-3 or IL-6 alone or the combination of both cytokines. We propose that IL-3 and IL-6 can act synergistically to enhance platelet recovery following 5-FU-mediated thrombocytopenia, but their modification of the response to 5-FU is modest.

Animals↗