PubMed Health⌕ Search

Biomedical subjects

J T Phillips

Publications and source records attributed to J T Phillips.

12 recordsLinked to original sources

Polypharmacy in multiple sclerosis.

The goal of this article is to describe therapeutic approaches to multiple sclerosis (MS) which may be applicable to other human conditions such as epilepsy. Polypharmacy is very commonly employed in MS and it is likely to increase in the future. This paper is written with the premise that therapeutic principles and practices underlying the care of patients with MS may be useful for the treatment of people with epilepsy. We will point out some of the analogies between MS and epilepsy and we will describe the polypharmacy approach employed to treat patients with MS. We will review current information as to the etiology and pathogenesis of MS and describe potential therapeutic targets derived from this knowledge. We will identify or suggest certain therapeutic principles underlying polypharmacy in MS which may be relevant to epilepsy or other conditions. Finally, we will describe some of the obstacles to expanding rational polypharmacy and how we might overcome these problems.

Brain↗

Modification of acute experimental autoimmune encephalomyelitis in the Lewis rat by oral administration of type 1 interferons.

The effect of orally administered type 1 interferons on the severity of acute experimental autoimmune encephalomyelitis (EAE), a T cell-mediated autoimmune disease, was examined by inoculation of Lewis rats with guinea pig myelin basic protein (GPMBP) and complete Freund's adjuvant. Rats were fed either rat species-specific or human recombinant type 1 interferon (IFN) or mock IFN daily for 7 days preceding immunization and for 21 days thereafter. There was a significant decrease in the clinical score and inflammatory foci in animals fed 5000 units IFN compared with mock-treated animals. There was a significant decrease in clinical score and number of inflammatory foci in spinal cord in animals fed orally 5000 units human recombinant IFN-alpha PO compared with SC 5000 units recombinant human IFN-alpha. Oral administration of type 1 interferon, as opposed to subcutaneous administration, inhibited the secretion of IFN-gamma from ConA-activated draining popliteal lymph node cells compared with mock-fed animals. These experiments demonstrate that acute EAE is more effectively inhibited by equivalent amounts of orally in contrast to parenterally administered IFN-alpha. These results suggest that type 1 IFNs are active by the oral route and have significant clinical and histologic effects in acute autoimmune disease.

Administration, Oral↗

A clinical therapeutic trial of cyclosporine in myasthenia gravis.

We randomly assigned 39 patients with steroid-dependent generalized myasthenia gravis to treatment with cyclosporine (5 mg/kg per body weight in divided doses) or placebo. Duration of treatment was 6 months. Patients were evaluated monthly. Primary measures of efficacy were quantified strength testing, antihuman acetylcholine receptor antibody titer, and dosage of corticosteroid medication. At the end of the study, patients in the cyclosporine group had significantly greater improvement in strength (p = 0.004) and a reduction in antireceptor antibody titer (p = 0.01). Percentage reduction of steroid medication was greater in the cyclosporine group, although the difference was not statistically significant (p = 0.12). There were no treatment failures, and there was one drug failure in the cyclosporine group. In the placebo group, there were three treatment failures. No significant nephrotoxicity was noted at this dosage during the first 6 months. During the subsequent 18 months of open-label therapy, continued reduction in steroid dosage occurred. Cumulative side effects, however, caused 35% of patients to discontinue the medication; 10% did so secondary to slowly progressive nephrotoxicity.

Adult↗

Prolactin receptor expression by lymphoid tissues in normal and immunized rats.

Prolactin receptor (PRLr) expression and distribution in thymus, spleen, bone marrow, lymph nodes, and peripheral blood lymphocytes from young adult Lewis rats are analyzed using single-color flow cytometry and a well-characterized monoclonal antibody directed against the rat liver PRLr. The in vivo effects of regional immunization on PRLr expression are also examined. PRLr is found to be widely distributed among cells of the immune system and demonstrates lymphoid tissue-specific patterns of expression. Footpad immunization caused the rapid, but transient, induction of PRLr expression in the draining lymph node, with only modest effects on PRLr expression in other distant lymphoid tissues. These studies indicate that PRL may be capable of direct interaction with the immune system through differential expression of the PRL cell surface receptor on select lymphoid target cell populations.

Animals↗

Prolactin stimulates proliferation of cultured human keratinocytes.

The effect of the pituitary hormone prolactin on in vitro proliferation of human keratinocytes has been studied. Cell proliferation was determined by [3H] thymidine incorporation and cell enumeration in culture. Physiologic concentrations of prolactin markedly stimulated proliferation of newborn foreskin keratinocytes in serum-free medium. In addition, it was able to replace almost completely the growth-promoting effects of bovine pituitary extract, a commonly added supplement for keratinocyte culture. This activity was also evident in the absence of epidermal growth factor, but required the presence of insulin. Radioligand-binding studies confirmed the expression of specific prolactin binding sites (Kd 8.9 nM; 1350 sites per cell) on freshly procured keratinocyte membranes. These results extend its hormonal influences to include regulation of in vitro proliferation of human keratinocytes, and suggest the possibility of a completely defined growth medium for keratinocytes.

Binding Sites↗

Adoptive transfer of experimental allergic encephalomyelitis using serum-free, chemically defined in vitro culture conditions.

Enhanced adoptive transfer of experimental allergic encephalomyelitis (EAE) in rats requires in vitro culture of encephalitogen-sensitized donor spleen cells with either myelin basic protein or T-cell mitogen for 18-72 h prior to transfer to unimmunized recipients. The required in vitro culture period offers an opportunity to address in detail cellular and molecular immunoregulatory processes involved in the development of EAE. Conventional culture conditions using fetal bovine serum may impose analytical limitations due to the chemical complexity of the media. To permit better definition of the chemical events associated with the development of EAE, we report the successful adoptive transfer of EAE in Lewis rats using completely chemically defined, serum-free culture conditions.

Animals↗

Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis.

We randomly assigned 20 patients with progressively worsening generalized myasthenia gravis of recent onset whose illness was not controlled by anticholinesterase therapy to treatment with either cyclosporine (6 mg per kilogram of body weight per day) or placebo. Patients who had been treated with thymectomy, steroids, or other immunosuppressive agents were excluded. The duration of treatment was 12 months. Disease activity was assessed by quantified strength testing and by measurements of antihuman acetylcholine-receptor antibody. Patients were assessed at 6 months and 12 months, or at the following early end points: drug failure (doubling of creatinine), treatment failure (respiratory or swallowing difficulty), or protocol violation (stopping medication for more than five days). At six months, patients in the cyclosporine group had had significantly more objective improvement in strength; one early end point had been reached (drug failure; no treatment failures). In the placebo group, three early end points had been reached (all treatment failures). The decline in titers of acetylcholine-receptor antibody was larger in the treated group, although the difference was not statistically significant. At the end of the study (after 12 months of treatment or arrival at an earlier end point), improvement in strength and reduction in titers of anti-receptor antibody continued to be greater in the cyclosporine group. Nephrotoxicity occurred in three patients receiving cyclosporine but was nonprogressive with a reduction in dosage and reversible with discontinuation of the drug. These results are preliminary and need confirmation, but we conclude that cyclosporine is probably an effective therapy in some patients with myasthenia gravis.

Adult↗

The biochemical characterization of Syrian hamster cell-surface alloantigens. II. Immunochemical relationships between cell-surface alloantigens and class II MHC homologues.

Immunochemical comparisons between hamster cell-surface p39/p29 alloantigens and putative MHC class I and II products indicate that p39/p29 alloantigens are probable class II products. Both p39/p29 alloantigens and class II homologues have varying expression in hamster lymphoid tissues and are absent from fibroblasts. In addition, analysis by nonequilibrium pH gradient electrophoresis demonstrates similar, although nonidentical, alloantigen and class II homologous charge profiles. This observation could reflect multiple class II subregions within the hamster MHC. These data therefore suggest an immunochemical description of the hamster MHC which is compatible with MHC models proposed for other mammalian species.

Animals↗

Immunochemical characterization of Syrian hamster major histocompatibility complex homologues.

Based primarily on studies in mice and man, the organization and gene-product structures of the mammalian major histocompatibility complex (MHC) are thought to be extensively conserved. However, attempts to generalize from the specific observations of other species to Syrian hamsters have not been completely successful. Previous studies in hamsters have suggested abnormal structure, expression, and/or function of the putative hamster MHC and its products. Characterization of hamster MHC gene-products is therefore of interest. This study concerns the identification and characterization of hamster cell-surface glycoproteins homologous to MHC products of man and mouse. Utilizing radioimmunoprecipitation and serologic techniques, these molecules have been characterized with regard to molecular weight, tissue distribution and immunochemical homology to human and murine class I and II MHC products. In addition, alloantisera raised between histoincompatible hamster strains have been similarly used to identify cell-surface alloantigens of this species. The alloantisera detect cell-surface hamster molecules with immunochemical properties and tissue distribution resembling MHC class II rather than class I products. Thus, in contrast to other species, hamsters appear not to express extensively polymorphic major transplantation antigens of the class I type. Some hamster alloantigens are apparently homologous of Ia determinants since their genes are linked to Hm-1. However, other alloantigens with similar molecular weights are seemingly encoded by genes unlinked to the hamster MHC. These data support the hypothesis that the hamster MHC contains genes which encode for molecular products similar to those described in man and mouse, but that the organization and/or expression of these genes may be atypical.

Absorption↗

Biochemical characterization of Syrian hamster cell surface alloantigens. III. Hamster alloantisera immunoprecipitate class II-like, but not class I-like, molecules.

Twelve hamster alloantisera, recently produced by mutual immunizations of domestic inbred strains and recently wild, partially inbred lines, identify two cell surface molecules, 29 and 39 kilodaltons, expressed by hamster lymphohematopoietic cells. Their expression on lymph node and spleen cells suggests that hamster T cells display cell surface class II homologues. None of the alloantisera identify putative hamster homologues of class I MHC molecules. The data are consistent with the hypothesis that hamsters possess a chromosomal region, tentatively designated Hm-1, that comprises genetic loci encoding alloantigens detectable by mixed lymphocyte reactivity and by serology, a region that resembles the I region of murine H-2.

Animals↗