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Biomedical subjects

J Reuben

Publications and source records attributed to J Reuben.

At least 37 records · Page 2Linked to original sources

Protracted severe immune dysregulation induced by cardiopulmonary bypass: a predisposing etiologic factor in blood transfusion-related AIDS?

A large percentage of patients with blood transfusion related AIDS received their transfusion during cardiac surgery requiring cardiopulmonary bypass. We hypothesized that the procedure of cardiopulmonary bypass (CPB) in patients undergoing cardiac surgery might be associated with severe immune dysregulation and hence predispose this group in particular to the acquisition of blood transfusion transmitted AIDS. T-cell subset enumeration and their ratio (T4/T8) and T-cell function (local GVH reaction) were serially studied before, during, and 1 and 6 days after surgery in 15 patients undergoing cardiac surgery requiring CPB, in 10 patients undergoing cancer resections (CA), and 11 patients without cancer undergoing elective, non-cardiac general surgical procedures (GEN). Compared to the preoperative values, a significant decline (p less than 0.002) in T4/T8 ratios occurred during CPB (1.63 +/- 0.80 vs 2.55 +/- 0.95), during CA (1.26 +/- 0.71 vs 1.81 +/- 0.72), and during GEN procedures (1.18 +/- 0.59 vs 1.64 +/- 0.68). T4, T8, and T4/T8 ratios returned to preoperative values in both the CA and GEN groups by the first postoperative day; in contrast, T4/T8 ratios remained significantly depressed (p less than 0.05) in CPB patients on the first and also on the sixth postoperative days when compared to preoperative values. This sustained depression in T4/T8 ratios is attributable to a significant increase in the proportion of T8 (suppressor cell) subset in the CPB patients which persisted through the sixth postoperative day. In contrast, in CA and GEN, the proportion of T8 subset returned to the preoperative level by the sixth postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Alpha interferon production in patients with hairy cell leukemia: correlations with disease activity and remission status.

Nineteen patients with hairy cell leukemia (HCL) were studied for in vitro production of alpha interferon (IFN alpha). The patients were divided into three groups. The first group consisted of 8 patients with active disease, all of whom showed a severe deficiency in IFN alpha production (no detectable titers in 6 and less than 40 units/ml in the other 2) compared to normal controls (range: 320-10,500 units/ml; median: 2,560 units/ml). The second group consisted of 6 patients who achieved a partial remission (PR) after IFN alpha treatment. These 6 patients had normal numbers of mononuclear cells in the peripheral blood, but still had deficient IFN alpha production (titers of IFN alpha were below 10 units/ml in 5 of the 6 patients). The third group consisted of 5 patients in complete remission (3 after IFN alpha treatment and 1 each after splenectomy and infection). This group had IFN alpha production that was not significantly different from that of controls 35 years or older (median: 640 units/ml; range 60-2,560 units/ml for patients vs. 1,513 units/ml; range 320-5,120 units/ml for controls; p greater than 0.05). These data show a direct relationship between the activity of HCL and the capacity to produce IFN alpha in vitro. The data also suggest that deficiency of endogenous production of IFN alpha may be relevant to the induction and sustenance of remissions in this disease and that relapses may be partly associated with failure to fully restore endogenous IFN alpha production.

Adult↗

Serologic studies in hairy cell leukemia: high prevalence of Epstein-Barr and cytomegalovirus antibodies and absence of human T-cell lymphotrophic viruses antibodies.

Serum from 60 patients with hairy cell leukemia (HCL) were studied for the presence and the titers of antibodies to Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human T-cell lymphotrophic viruses (HTLV). Eighty-three percent of the patients were seropositive for EBV, with a (reciprocal) geometric mean titer (GMT) of 960. Seventy-eight percent of the patients had antibodies to CMV with a GMT of 435. All 21 patients tested for HTLV I and HTLV III were seronegative; only one patient showed detectable antibodies to HTLV II. The potential role of these infections in the physiopathology of HCL is discussed.

Antibodies, Viral↗

A phase I study of intravenous azimexon therapy in human cancer.

Azimexon, a synthetic derivative of the 2-cyanaziridines, was given intravenously daily for 5 days to 19 cancer patients in a Phase I trial designed to determine the drug's tolerable dose, toxicity, and effects on immune and nonimmune host defense parameters. No myelosuppression, neurologic, renal, hepatic, or gastrointestinal toxicities could be detected. The only toxic side effect observed after 5 days of intravenous azimexon was a self-limiting dose-dependent hemolysis. Absolute lymphocyte count (ALC) increased from a pretreatment value of 0.96 X 10(3)/microliter to 1.56 X 10(3)/microliter on day 21 (p less than 0.05). This increase was induced primarily by the less hemolytic 200-250 mg/m2 doses of azimexon. Among 12 patients given this lower dosage. ALC increased from an average initial value of 0.90 X 10(3)/microliter to 1.86 X 10(3)/microliter on day 21 (p less than 0.01). Absolute number of OKT3+ cells increased from 0.524 to 0.914 X 10(3)/microliter (p less than 0.05) with lower drug doses. The mean absolute number of OKT4+ cells increased from 0.294 on day 0 to 0.574 X 10(3)/microliter on day 21 (p less than 0.05), and the number of OKT8+ cells increased from 0.202 to 0.388 X 10(3)/microliter, with no significant changes in helper/suppressor ratio. Significant increases in mitogenic responses to phytohemagglutinin (PHA) [from 13.4 to 35.7 X 10(3) net cpm (p less than 0.05)] and to concanavalin A (con A) [from 6.4 to 25.6 X 10(3) net cpm (p less than 0.05)] were also observed with higher drug doses. Azimexon may have a role in managing cancer-associated dysregulation of the immune response.

Adjuvants, Immunologic↗

Modulation in vitro of immune parameters in homosexual males with the preclinical complex of symptoms related to acquired immune deficiency syndrome by azimexon.

In search of potential therapeutic agents for the acquired immunodeficiency syndrome (AIDS) among homosexual males, we studied in vitro the immunorestorative effect of azimexon in patients with this syndrome. Since a reduction in the ratio between helper inductor and suppressor/cytotoxic T-cell subsets (OKT-4/OKT-8) seems to be the hallmark of the syndrome, we measured azimexon-induced numerical changes in T-cell subsets and correlated them with changes in a simultaneously tested T-cell function as measured by the xenogeneic local graft-versus-host reaction (GVHR). Following incubation of peripheral blood mononuclear cells from 10 homosexual subjects with 10 micrograms/ml of azimexon at 37 degrees C for 1 h, the median number of T cells defined by the OKT-8 phenotype declined from 0.6 X 10(3) to 0.33 X 10(3)/mm3 (p less than 0.02), resulting in an increase in the OKT-4/OKT-8 ratio from 0.65 to 1.37 (p less than 0.01). There were no numerical changes in T cells defined by OKT-3 and OKT-4 phenotypes. Similar decreases in OKT-8-defined T cell occurred among eight heterosexual controls. The restoration of the OKT-4/OKT-8 ratio among the homosexual subjects was associated with a significant improvement in their T-cell function. Thus, the median volume of the local GVHR increased from 38.2 to 63.5 mm3 (p less than 0.02). Parallel changes in OKT-4/OKT-8 ratio and changes in local GVHR following incubation with azimexon were observed. These results suggest that azimexon may be an important immunorestorative agent. Clinical trials with this agent in patients with AIDS or its preclinical complex of symptoms seem warranted.

Acquired Immunodeficiency Syndrome↗

Treatment of hairy cell leukemia with recombinant alpha-interferon.

Thirty patients with hairy cell leukemia were treated with recombinant interferon alpha-A (rIFN alpha A; Roferon-A); seven were previously untreated. Nine complete and 17 partial remissions were documented by bone marrow core biopsies. All patients' peripheral blood hematologic indexes either improved or normalized. Twelve of 13 patients with retroperitoneal or mediastinal adenopathy obtained remissions of tumor masses. All seven patients with splenomegaly showed prompt reduction in the size of the spleen to normal size. The incidence of complete remissions was significantly higher (P = .02) in previously untreated patients (5 of 7) than in those in whom splenectomy had been performed (4 of 23), a result presumed to be related to the pretreatment tumor burden. rIFN alpha A was well tolerated; mild fatigue was the most frequent complaint. In most patients, tumor remissions resulted in an improved quality of life: they eliminated the need for transfusing blood products and reduced the incidence of infections, and immune deficits were apparently restored in some of the patients. We conclude that rIFN alpha A is an effective therapy for all stages of hairy cell leukemia including previously untreated or newly diagnosed patients.

Adult↗

Heterogeneity of non-Hodgkin's lymphoma probed by nucleic acid cytometry.

Flow cytometric analyses of cellular DNA, RNA, and double-stranded RNA content were performed on lymph nodes and extranodal tissue from 177 patients with non-Hodgkin's lymphoma. With increasing histologic grade, a higher incidence of aneuploidy, higher proliferative activity, and higher total and double-stranded RNA content were found. Despite considerable cytometric heterogeneity within histologic grades and morphologic subdivisions, conformity between cytometric and morphologic classifications was observed in 85% of cases. Among intermediate-grade and high-grade lymphomas, increased proliferative activity and diploidy were associated with more frequent responses to treatment. Thus, nucleic acid-derived parameters relate to morphologic subtypes and permit an objective approach to lymphoma classification based on ploidy, proliferation, and RNA characteristics that also had prognostic implications.

Aneuploidy↗

Alpha interferon for induction of remission in hairy-cell leukemia.

We treated seven patients who had progressive hairy-cell leukemia with daily doses of 3 million units of partially pure alpha (leukocyte) interferon by the intramuscular route. Three patients had a complete remission, and four had a partial remission, according to strict criteria for a response. After treatment, bone-marrow aspirates showed an absence of leukemia cells in three patients and 5 per cent or fewer in three others. Normalization of subnormal peripheral-blood values occurred in six of six patients with anemia, in seven of seven with granulocytopenia, and in four of four with thrombocytopenia. Remissions have been maintained for over 6 to over 10 months. Alpha interferon appears to be highly effective in patients with hairy-cell leukemia.

Adult↗

Nonbacterial thrombotic endocarditis in a male homosexual with Kaposi's sarcoma.

Nonbacterial thrombotic endocarditis (NBTE), or marantic endocarditis, was found at autopsy in a young male homosexual with Kaposi's sarcoma. Vegetations were seen in the mitral and aortic valves. Embolic phenomena and cytomegalovirus infection were noted in the brain, spleen, liver, lung, gastrointestinal tract, and bone marrow. To our knowledge, this is the first reported case of NBTE in a young immunosuppressed homosexual man with Kaposi's sarcoma.

Adult↗

Lymphadenopathy in homosexual men. Morbid anatomy with clinical and immunologic correlations.

This is a study of the histopathologic features of lymph nodes removed from eleven young, homosexual men, all of whom presented with lymph node enlargement of more than 3 months' duration, accompanied, in the majority of cases, by fever and weight loss. Reactive follicular and sinusoidal hyperplasia were the main findings in 10 patients. The medullary sinuses were packed with monomorphic round sinusoidal cells associated with neutrophils. In one of the 10 patients, granulomas packed the subcapsular sinuses, especially. Another patient presented with lymphoid-depleted nodes with absent germinal centers and a prominent vascular skeleton; this latter feature made it difficult to distinguish this picture from the nodal form of Kaposi's sarcoma. All patients had a history of sexual promiscuity and used "recreational" drugs. Nine of 10 patients had deficient cellular immunity and inverted T-cell helper/suppressor ratios. The only patient with normal cellular immunity had nodal granulomas. Humoral immunity was normal in all patients.

Adult↗

Nucleotide-amino acid interactions and their relation to the genetic code.

The apparent dissociation constants of the complexes of AMP with the methyl esters of amino acids in aqueous solution exhibit good correlations with features of the genetic code and with the frequencies of occurrence of amino acid residues in proteins. Thus it is likely that chemically selective nucleotide-amino acid interactions were involved in the processes of chemical evolution that have led to the emergence of the genetic code. Based on these correlations a storage device for the information regarding nucleotide-amino acid interactions is proposed. It involves processes of simultaneous polymerization to polynucleotides and polypeptides.

Adenosine Monophosphate↗

Structure of mutagen nucleic acid complexes in solution. Proton chemical shifts in 9-aminoacridine complexes with dG-dC, dC-dG, and dA-dT-dG-dC-dA-dT.

The influence of self-complementary oligodeoxynucleotides on the chemical shifts of protons of the mutagenic acridine dye 9-aminoacridine has been measured. Upfield shifts indicative of intercalative binding are found in the cases of dG-dC, dC-dG, and dA-dT-dG-dC-dA-dT but not in dA-dT. Geometries for the complexes that are compatibile with the chemical-shift data and the X-ray structure of the complex between ri5C-rG and 9-aminoacridine determined by Sakore et al. [Sakore, T.D., Jain, S.C., Tsai, C., and Sobell, H.M. (1977), Proc. Natl. Acad. Sci. U.S.A. 74, 188--192] can be identified using recent theoretical estimates of shifts induced by nucleotide bases.

Acridines↗

On the relative location of the inhibitor-and calcium-binding sites in bovine trypsin as determined by nuclear magnetic resonance. Possible ambiguities in paramagnetic probe mapping studies.

Possible pitfalls in mapping studies utilizing the nuclear relaxation rates induced by paramagnetic probes are pointed out. In cases in which a distance is sought between a paramagnetic ion and a small molecule (e.g. substrate, inhibitor, etc.), both bound non-covalently to a macromolecule, heterogeneity in the system with respect to the binding of either of them may result in ambiguous conclusions. It is shown that the trypsin-gadolinium (III)-inhibitor system is heterogeneous, as revealed in the dependence of the water and inhibitor proton line-widths upon both the Gd3+ and the enzyme concentrations and in the effects of added Ca2+ on the line-widths. The results imply that in published work (Abbott et al. (1975) Biochemistry 14, 4935) the distance from a weak rather than from the strong metal ion binding site of trypsin (EC 3.4.21.4) may have been determined.

Amidines↗

Hormonal induction of glutamate dehydrogenase in rat liver.

Glutamate dehydrogenase rapidly increases in microsomes and appears in the cytoplasm after administration of cortisone, cAMP, hydrocortisone-acetate. Prolonged administration of ACTH maintains high level of enzyme in the mitochondria and microsomes. Hydrocortisone-acetate, insulin and cortisone decrease drastically enzyme in mitochondria.

Adrenocorticotropic Hormone↗

Structure of a DNA intercalation complex as determined by NMR using a paramagnetic probe.

Longitudinal relaxation rates of the protons of the 3,8-dimethyl-N-methyl-phenanthrolinium (DMP) cation in solutions containing DNA are strongly affected by the addition of the paramagnetic manganese (II) ions due to the electron-nuclear dipolar interaction in the ternary Mn-DNA-DMP Complex. Two possible models for the DMP-DNA intercalation complex are examined and one of them is unequivocally discriminated on the basis of the proton relaxation data. It is concluded that in the intercalation complex the long axis of the DMP molecule is almost perpendicular to the hydrogen bonds of the DNA base-pairs.

Chemical Phenomena↗