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Biomedical subjects

K Raska

Publications and source records attributed to K Raska.

At least 19 recordsLinked to original sources

Usefulness of transesophageal echocardiography in predicting mortality and morbidity in stroke patients without clinically known cardiac sources of embolus.

This study tested the hypothesis that stroke patients without a cardiac source of embolism suspected by clinical examination can be risk stratified by transesophageal echocardiography. Forty ischemic stroke patients without atrial fibrillation, prosthetic valves, ejection fraction < 20%, or recent myocardial infarction underwent multiplane transesophageal echocardiography: 24 (designated high risk) had > or = 1 of the following: left heart thrombus, vegetation, mass or spontaneous echo contrast, mobile ascending aortic or arch debris, patent foramen ovale, atrial septal defect or aneurysm, mitral annular calcification, mitral valve thickening, prolapse or mitral valve strands. End points were death, recurrent stroke, transient ischemic attack, myocardial infarction or peripheral embolism. Thirty-eight patients (95%) (23 high, 15 low risk) were followed for 14 +/- 8 months: 9 (24%) died of vascular causes including 4 who had a cardiac cause of death and 5 who had fatal strokes. Eight had recurrent strokes (4 nonfatal) and 1 nonfatal myocardial infarction occurred. Cardiovascular survival was predicted by transesophageal echocardiography: survival rates were 92% (low risk) and 63% (high risk) at 24 months (p = 0.036). Left atrial enlargement was independently associated with death from stroke (fatal stroke occurred in 25% of those with atrial enlargement compared to 8% of those with normal atrial dimension, p < or = 0.03), as was left atrial spontaneous echo contrast (50% died vs 9% without contrast, p < or = 0.03). Left ventricular hypertrophy and aortic atherosclerosis were both associated with the risk of recurrent stroke (30% of patients with ventricular hypertrophy had recurrent stroke compared to 10% with normal wall thickness (p < or = 0.05); 30% with aortic atherosclerosis had a recurrent stroke compared to none with a normal aorta (p < or = 0.05). Thus, transesophageal echocardiography clearly identifies patients at a high risk for cardiovascular mortality and morbidity after stroke despite an unsuspected source of embolism by clinical examination.

Aged↗

Interleukin-1 receptors and receptor antagonist in haemodialysis.

BACKGROUND: Biological activity of interleukin-1 (IL-1) depends on the number and type of IL-1 receptors on target cells and on the amounts of its naturally occurring inhibitor, the IL-1 receptor antagonist (IL-1ra). METHODS: Expression of IL-1 receptor was studied on the peripheral blood mononuclear cells of 20 end-stage renal-disease patients maintained by chronic haemodialysis by means of either polysulphone (10 patients) or cuprophane membranes (10 patients) and compared to that of normal controls. Plasma and cellular levels of IL-1ra and IL-1 beta were also measured. RESULTS: The proportion of monocytes expressing the IL-1 receptor was strikingly higher in haemodialysis patients than in the healthy population. This proportion further increased during haemodialysis with cuprophane but not with polysulphone. Expression of the IL-1 receptor on lymphocytes was very low in both controls and dialysed patients; in the latter there was no intradialytic variation. Plasma concentrations of IL-1 beta and IL-1ra were elevated in haemodialysis patients and undetectable in controls. Whereas plasma IL-1 beta decreased throughout haemodialysis, IL-1ra further increased, with no significant differences between the two membranes used. Total cellular IL-1 beta and IL-1ra were also higher in the patient group than in the healthy controls. A further increase of both IL-1 beta and IL-1ra was detected at the end of the haemodialysis session with any membrane. CONCLUSIONS: Monocytes of haemodialysis patients circulate in a state of activation, which makes them both producer and target of IL-1. Thus there is an autocrine upregulation of IL-1 production. Although IL-1ra levels are high, they are most likely to be expression of monocyte activation rather than represent effective inhibitors of IL-1 activity.

Adult↗

Comparison of flow and image cytometry for DNA content analysis of fresh and formalin-fixed, paraffin-embedded tissue in breast carcinoma.

DNA ploidy and S-phase fraction are considered to be prognostic variables in breast carcinoma. DNA content of 35 cases of breast carcinoma of varying histologic types and nuclear grades was analyzed by flow cytometry and image analysis in both fresh and formalin-fixed, paraffin-embedded tissue. Fresh cell and deparaffinized nuclear suspensions were used for flow cytometry. Fresh and deparaffinized tumor tissue samples were used for image analysis. The results of analysis for DNA ploidy, DNA index of DNA aneuploid Go/G1 peaks, and S-phase fraction were compared in different tissue preparations for both techniques. The two techniques produced comparable DNA ploidy results with both fresh and formalin-fixed, paraffin-embedded tissue. Sensitivity for detection of DNA aneuploidy was somewhat greater by image analysis, particularly in deparaffinized tissue. There was 89% agreement in detection of DNA aneuploidy by flow cytometry in fresh and paraffin-embedded, formalin-fixed tissue; the coefficients of variation of the DNA diploid Go/G1 peaks were much wider in the latter. In image analysis there was 91% agreement between fresh and fixed specimens. Agreement between the flow cytometry and image analysis in fresh specimens was 91%; in deparaffinized nuclear suspensions it was 94%. There is a high degree of correlation between the values of DNA index of DNA aneuploid Go/G1 peaks; the estimates of S-phase fraction are much more variable. Results also show a good correlation of the DNA ploidy with the nuclear grades.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma, Mucinous↗

Increased levels of glycoproteins containing mannose 6-phosphate in human breast carcinomas.

Newly synthesized enzymes destined for lysosomal localization contain mannose 6-phosphate (Man6-P) residues, allowing interaction with Man6-P receptors (MPRs) and subsequent intracellular targeting to the lysosome. In most cultured cells, lysosomal enzymes are rapidly dephosphorylated after targeting, but in some transformed cell lines, these proteins retain the Man6-P marker. To investigate the significance of this in human malignancy, we examined the persistence of the Man6-P marker in human breast biopsy specimens using MPR derivatives as affinity probes. In one approach, extracts of frozen tissue were standardized to protein content, fractionated by SDS-PAGE, immobilized on nitrocellulose, and probed with iodinated MPR. On average, carcinomas contained 4-fold higher levels of Man6-P glycoproteins than did benign tumors or normal breast samples. In about 15% of the carcinomas, levels of Man6-P glycoproteins were highly elevated (7-10-fold). Multiple Man6-P glycoproteins were detected, suggesting a general alteration in the synthesis or processing of many lysosomal enzymes in carcinomas. In a second approach, sections of formalin-fixed breast biopsy specimens were probed with biotinylated MPR. Malignant cells in 25 of 75 carcinomas exhibited granular cytoplasmic staining in what appears to be intracellular vesicles. Staining was specifically inhibited by Man6-P and was not observed in stromal components or lymphocytes. In addition, Man6-phosphorylated proteins were not detected in the 14 normal or benign biopsy samples examined. Staining appeared to be independent of most prognostic factors examined, including p53, cathepsin D, DNA ploidy, and hormone (estrogen and progesterone) receptor status. However, positive staining was significantly associated with high histological and nuclear grades (P < 0.05) and potentially with c-erbB-2 (P < 0.10), suggesting that elevated levels of Man6-P glycoproteins are associated with the more aggressive tumors.

Adenocarcinoma↗

Direct inhibition of human CD8+ lymphocyte activation by cyclosporine A and Rapamune-Sirolimus.

Cyclosporin A (CsA) and Rapamune-Sirolimus (RAP) have been shown to inhibit the in vitro activation of heterogeneous lymphocytes populations, but little is known about their direct actions on isolated CD8+ lymphocytes. In this study the direct effects of RAP and CsA on a highly purified population of CD8+ lymphocytes were examined. Human CD8+ lymphocytes were purified to near homogeneity and stimulated with anti-CD3 antibody, OKT3, or allogeneic cells in the presence of exogenous human recombinant interleukin 2 (IL2). The effects of CsA and RAP on cell proliferation, the entry into the S phase of the cell cycle, the surface expression of Tac antigen, and the release of soluble IL2 receptor and soluble CD8 were analyzed. When CsA and RAP were included in the stimulated CD8+ lymphocyte cultures, these responses were inhibited. OKT3-stimulated CD8+ lymphocytes were sensitive to lower concentrations of the immunosuppressants than those previously reported for peripheral blood mononuclear cells. RAP was effective at a lower dose than CsA and when the agents were applied in combination, cell proliferation was synergistically inhibited. These results demonstrate that CsA and RAP can inhibit the activation and proliferation of purified CD8+ lymphocytes in response to OKT3 or alloantigen in the presence of IL2.

CD8-Positive T-Lymphocytes↗

Identification of functional domains of adenovirus tumor-specific transplantation antigen in types 5 and 12 by viable viruses carrying chimeric E1A genes.

The adenovirus (Ad) E1A gene induces in immunized animals a strong tumor transplantation (TSTA) immunity against Ad tumors. Such immunity with group-A and group-C viruses is highly group-specific and no cross-protection is detected between serotypes 5 and 12. This fact was used to map the domains of the Ad5 and Ad12 E1A gene products, respectively, which control the TSTA. We constructed a library of 8 recombinant viruses (H5sub1101 through H5sub1108) which carry chimeric Ad5/Ad12 E1A genes in the background of Ad5. The chimeric genes are functional and these viruses are viable. Some of these constructs induce strong and highly specific tumor syngraft immunity in immunized rats. The viruses carrying the 5' terminus of the first E1A exon derived from Ad12 (viruses H5sub1101, H5sub1102 and H5sub1103) induce strong protection against Ad12 tumors irrespective of the rest of their E1A sequence. The viruses which carry the second exon of the Ad5 E1A gene (viruses H5sub1101, H5sub1102 and H5sub1106) protect against group-C tumors, regardless of the origin of the rest of their E1A gene. The 2 viruses that carry the 5' E1A terminus of the first exon of Ad12 and the second exon of Ad5 (H5sub1101 and H5sub1102) are thus effective in inducing immunity against Ad12 tumors as well as against Ad2 tumors. The viruses which carry the 5' terminus of the first exon derived from Ad5 and the second exon of Ad12 (H5sub1107 and H5sub 1108) fail to induce immunity against either tumor. Expression of only the truncated 5' terminus of the Ad12 E1A gene (viruses H5sub1104 and H5sub1105) is sufficient for induction of Ad12 TSTA. Our results provide direct and unequivocal in vivo evidence that TSTA activities of adenovirus groups A and C are controlled by different domains of their respective E1A genes. The Ad12 TSTA is a function of the 5' terminus of the first E1A exon, while the Ad5 TSTA is coded for by the 3' exon of its E1A gene.

Adenovirus E1A Proteins↗

Effects of cyclosporine and rapamycin on immunoglobulin production by preactivated human B cells.

In order to assess the direct effects of cyclosporine A (CsA) and rapamycin on B cells, we utilized a two-segment culture system of highly purified B lymphocytes consisting of induction (activation) in the presence of the formalinized Staphylococcus aureus bacteria and IL-2, and differentiation, respectively, in the presence of various combinations of cytokines. Results show that rapamycin strongly inhibited production of both IgM and IgG measured at the end of the secondary culture supported by IL-2/IL-6, whereas CsA up-regulated the immunoglobulin production. The stimulatory effect of CsA was also observed when preactivated B cells were recultured in absence of any cytokines. These results show that rapamycin and CsA have clearly distinct effects on human B lymphocyte responses in vitro. Rapamycin is a more potent in vitro immunosuppressant of B lymphocytes than CsA. It is effective at significantly lower concentrations, and it does not stimulate either the proliferation or antibody production by preactivated B cells.

B-Lymphocytes↗

IL-4 receptor expression by SAC-activated B-lymphocytes: its role in B-cell proliferation and the effect of cyclosporine (CsA), prednisolone and verapamil.

Expression of the IL-4 receptor was studied in a highly purified population of human B-lymphocytes stimulated by Staphylococcus aureus, cowan I (SAC). Flow cytometric analysis showed that incubation with SAC in the absence of detectable levels of IL-2, IL-4 and IL-6 resulted in a striking increase in cellular binding of IL-4. The SAC-stimulated B-cells responded to exogenous IL-4 by DNA synthesis. This response was unaffected by CsA or prednisolone, but was inhibited by the Ca2+ channel blocker verapamil.

B-Lymphocytes↗

Responsiveness of preactivated B cells to IL-2 and IL-6. Effect of cyclosporine and rapamycin.

In order to determine which drug may be more effective in clinical abnormalities associated with polyclonal B lymphocyte activation, we compared the in vitro effects of CsA and rapamycin on proliferation or differentiation of preactivated B cells. For that purpose, highly purified B lymphocytes were preactivated in the presence of formalinized Staphylococcus aureus bacteria and then recultured in the presence or in the absence of either rIL-2, rIL-6, or combination or rIL-2 and rIL-6. After 48 hr in culture, S. aureus bacteria upregulated significantly the binding of phycoerythrin-conjugated IL-2 and IL-6, respectively, by purified B lymphocytes, indicating generation and/or upregulation of receptors for these cytokines. Such preactivated B lymphocytes proliferated in response to optimal concentrations of rIL-2, whereas the addition of rIL-6 to preactivated cells was always accompanied by a decrease of the proliferation rate. CsA upregulated cell proliferation when it was added in the second culture period in the presence or in the absence of rIL-6, whereas rapamycin had no effect in these cases. A combination of rIL-2 plus rIL-6 upregulated significantly the proliferative responses of preactivated B cells. In such cultures both CsA and rapamycin had an inhibitory effect on the proliferative responses. IgM production was unaffected by the addition of rIL-6 to cultures of preactivated B cells, whereas addition of rIL-2 and of the IL-2/IL-6 combination enhanced considerably IgM production. Irrespective of cytokines added, CsA upregulated the production of IgM. In contrast, rapamycin inhibited IgM production in all cases. Our results indicate that, in this experimental system, rapamycin is an effective immunosuppressive agent and its use, at least in vitro, is not accompanied by an upregulation of either the proliferation or differentiation of B lymphocytes.

Antigens, CD↗

Requirement for the adenovirus type 9 E4 region in production of mammary tumors.

Oncogenic viruses demonstrating a strict tropism for the mammary gland provide special opportunities to study the susceptibility of this tissue to neoplasia. In rats, human adenovirus type 9 (Ad9) elicits mammary fibroadenomas that are similar to common breast tumors in women, as well as phyllodes-like tumors and mammary sarcomas. By constructing recombinant adenoviruses between Ad9 and Ad26 (a related nontumorigenic virus), it was shown that the Ad9 E4 region was absolutely required to produce these mammary tumors. This indicates that an adenovirus gene located outside the classic transforming region (E1) can significantly influence the in vivo oncogenicity of an adenovirus. Consistent with a direct role in mammary gland oncogenesis, the Ad9 E4 region also exhibited transforming properties in vitro. Therefore, the Ad9 E4 region is a viral oncogene specifically involved in mammary gland tumorigenesis.

Adenoviridae↗

IL-2 responsiveness of lectin-induced lymphoblasts: soluble IL-2 receptor release and differential in vitro effects of immunosuppressants.

We examined the mode of action of different immunosuppressants on the responsiveness of phytohemagglutinin (PHA)-induced lymphoblasts further stimulated by recombinant interleukin-2 (rIL-2). The stimulation of PHA blasts with rIL-2 resulted in an enhancement of tritiated thymidine ([3H]TdR) incorporation and of soluble interleukin-2 receptor (sIL-2R) release. Cyclosporin A (CsA) and prednisolone inhibited in different ways the responsiveness of PHA pre-stimulated blood mononuclear cells (PBMC) to rIL-2, as measured by [3H]TdR incorporation. The addition of CsA resulted in considerable enhancement of the release of sIL-2R, whereas the addition of prednisolone was associated with a similar enhancement only when the higher concentrations of rIL-2 were employed. EGTA, a calcium (Ca2+) chelator, and verapamil, a Ca2+ channel blocker, inhibited [3H]TdR incorporation in a concentration-dependent manner. EGTA inhibited sIL-2R release in the same manner when used alone, and reversed the CsA- and prednisolone-induced enhancement of sIL-2R release by rIL-2 induced lymphoblasts, when used in combination with CsA or prednisolone. Verapamil had a similar but less striking effect. The effects of CsA and prednisolone were also studied in PHA-induced blasts originating from purified CD4+ or CD8+ lymphocytes. Stimulation of these blasts with rIL-2 resulted in higher [3H]TdR incorporation by CD8+ blasts than by CD4+ blasts: however, no sIL-2R release was detected in supernatants of either CD4+ or of CD8+ blasts. Both CsA and prednisolone inhibited the rIL-2-induced enhancement of [3H]TdR incorporation by both T-cell subsets.(ABSTRACT TRUNCATED AT 250 WORDS)

CD4 Antigens↗

Uremic serum effects on peripheral blood mononuclear cell and purified T lymphocyte responses.

We have studied the effects of uremic serum on the activation state and function of normal lymphocytes in vitro, by examining both accessory cell-dependent and accessory cell-independent responses. Uremic serum was obtained from patients on conservative treatment and from the same patients after they have undergone six months of maintenance hemodialysis. Uremic serum inhibited the proliferative responses to mitogens and to recombinant IL-2 (rIL-2) of both peripheral blood mononuclear cells (PBMC) and purified T cell populations. However, the responsiveness to IL-2 of pre-formed lymphoblasts, obtained from both PBMC and purified T cells, in the presence of uremic serum was similar to that obtained in the presence of normal serum, or was even enhanced. Uremic serum did not affect the cellular IL-2 receptor alpha (IL-2R) generation though it inhibited significantly the release of soluble IL-2 receptor (sIL-2R) and the production of IL-2 after mitogenic stimulation. Uremic serum from patients after six months of hemodialysis enhanced, but did not completely restore, proliferative responses and IL-2 production by control PBMC. Neither IL-1 nor IL-2R, which are present at elevated concentrations in uremic serum, appeared to be responsible for serum effects on in vitro responses of control lymphocytes. In conclusion, our results indicate that uremic serum affects both accessory cell-mediated and accessory cell-independent normal T cell responses. Uremic serum inhibition of T cell proliferation is associated with down-regulation of IL-2 synthesis by lymphocytes and the induction of an abnormal state of activation of lymphoblasts which is further enhanced following chronic hemodialysis.

Cell Division↗

Binding of phycoerythrin-conjugated interleukin-6 to in vitro-activated human peripheral blood mononuclear cells--effect of immunosuppressive agents and of a calcium channel blocker.

We studied the effect of cyclosporine A, prednisolone, and the Ca2+ channel blocker verapamil on interleukin-6 binding to mitogen-activated peripheral blood mononuclear cells, using a flow cytometric technique and phycoerythrin-conjugated IL-6. All mitogenic stimuli up-regulated IL-6 binding to a variable degree. PHA alone or in combination with PMA was the most effective stimulant in up-regulating IL-6 binding in all the experiments performed. The main changes in IL-6 binding were seen in the large cell cluster, which consisted mainly of lymphoblasts. PHA and PHA/PMA, however, also up-regulated the mean fluorescence intensity on the small cell cluster, which consisted mainly of quiescent lymphocytes. The overall effect of the three pharmacological agents on mitogen-up-regulated IL-6 binding was minimal; most significant were a down-regulation by all three agents of IL-6 binding by small lymphocytes in PHA/PMA cultures, a down-regulation of IL-6 binding by CsA in PHA/PMA-induced large PBMC, and an up-regulation by verapamil of PMA-induced IL-6 binding in large PBMC. Measurements of IL-2 binding and of IL-6 production in the same cultures showed a different pattern than that seen with IL-6 binding, as well as different CsA, prednisolone, and verapamil action. In conclusion, by using a new flow cytometric technique providing information both about the quantity of bound cytokine and about the proportion of IL-6-binding cells, we have demonstrated that IL-6 receptor expression in vitro by PBMC can be up-regulated by the use of stimulants differing in the signal transduction pathways they activate. In addition, by using different pharmacological agents and stimuli to dissect different activation pathways of the in vitro immune response, we conclude that IL-6R generation is regulated differently from IL-6 production. Furthermore, since CsA and prednisolone are known inhibitors of in vitro IL-2 production, our results indicate that IL-6R generation does not rely exclusively on the presence of IL-2.

Calcium↗

Effects of hemodialysis on activation of lymphocytes: analysis by an in vitro dialysis model.

Patients undergoing maintenance hemodialysis have impaired immune responsiveness, which appears to deteriorate progressively with the duration of the replacement treatment. It has been suggested that it is caused by a chronic preactivation state of T cells caused by hemodialysis. Each treatment session has been compared with a recurring "acute-phase" inflammatory reaction. In this study, the acute effects of hemodialysis on the activation state and functional responsiveness of normal peripheral blood mononuclear cells have been evaluated by use of an in vitro dialysis model. The dialysis was carried out with either cuprophan or polysulfone membranes, with or without sodium acetate in the dialysis fluid. It was observed that a single session of in vitro dialysis did not induce production of interleukin-2 (IL-2) and did not alter the expression of IL-2 receptor (IL-2R) on the cytoplasmic membrane and the secretion of soluble IL-2R, whereas it induced transcription of mRNA for IL-2R. The proliferative response of lymphocytes to phytohemagglutinin or IL-2 in vitro also did not change after a single dialysis session. There was only a slight decrease of the release of soluble IL-2 receptor by phytohemagglutinin-stimulated cells after dialysis. Dialysis induced an active synthesis of IL-1 by peripheral blood mononuclear cells, even in the absence of sodium acetate in the dialysate bath, but there was no release of IL-1 to the circulating medium. The results show that a single dialysis encounter can acutely prime the activation of human peripheral blood mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Tumorigenicity of adenovirus-transformed cells and their sensitivity to tumor necrosis factor alpha and NK/LAK cell cytolysis.

Sensitivity of a library of cloned adenovirus-transformed rat cell lines of varying tumorigenicity to cytotoxic action of tumor necrosis factor alpha (TNF alpha) was studied and correlated with their sensitivity to NK/LAK cell cytolysis. Our data confirm earlier reports that expression of the E1A oncogene of Ad2 or Ad5 is associated with sensitivity of transformed cells to TNF alpha and also NK/LAK cytotoxicity. Ad2-transformed cell line which expresses the E3 early region in addition to the E1 gene block is resistant to TNF alpha, but remains sensitive to NK/LAK cells. All cell lines which express the E1A oncogene of highly oncogenic Ad12 are resistant to NK but not LAK cells. Their sensitivity to TNF alpha, however, varies over a broad range and does not correlate with either their susceptibility to NK/LAK cytolysis or their tumorigenic potential.

Adenovirus Early Proteins↗

Cyclosporine A and prednisolone inhibit lectin- and alloantigen-induced release of sCD8: correlation with proliferative responses.

It has been shown previously that there is a strong correlation between the in vitro release of soluble CD8 glycoprotein (sCD8) and CD8+ T lymphocyte activation. In the present study, the lectin stimulation of peripheral blood mononuclear cells (PBMC) induced a dose-dependent release of sCD8 which correlated with the magnitude of CD8 lymphocyte activation as measured by the expression of the interleukin 2 (IL-2) receptor and HLA-DR antigen and of the T cell proliferative responses. Both the proliferative responses and the release of sCD8 were inhibited by cyclosporine A (CyA) and prednisolone (PRED) in a concentration-dependent manner. When the immunosuppressants were present for only 60 min before the initiation of the cultures, an inhibitory effect was also seen, but this was maximal only when the agents were added at the initiation of the culture period; when the addition of CyA or PRED was delayed for either 24 or 48 hr after the initiation of the culture, the degree of inhibition of the proliferative response was greatly reduced. However, there was a significant inhibition of sCD8 release by CyA even when it was added 48 hr after the culture initiation. The addition of recombinant IL-2 did not affect the lectin-induced sCD8 release. The inhibition of the lectin-induced proliferative response and sCD8 release by PRED, but not that by CyA, was reversed by the recombinant IL-2. Alloantigen stimulation also induced sCD8 release and this release was inhibited both by CyA and by PRED. These data, together with the known effects of CyA on differentiation, clonal amplification, and activation of CD8 T lymphocytes, suggest that in vitro sCD8 release occurs during the early stages of activation of CD8+ cytotoxic T cells.

Antigens, Differentiation, T-Lymphocyte↗