[Eprex and daily autologous transfusion].
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Biomedical subjects
Publications and source records attributed to M Chassaigne.
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In an attempt to improve in vitro pharmacological purging of autologous grafts, the ability of doxorubicin (DOX), alone and in combination with mafosfamide (AZ), to eliminate tumor cells from human bone marrow was assessed. HL60 and Raji cells were mixed with a 20-fold excess of normal marrow cells and were incubated either with DOX (0.4-3.2 micrograms/ml) for 1 h or AZ (20-140 micrograms/ml) for 30 min or both drugs sequentially. Cytotoxicity was evaluated on tumor cells and GM-CFU by clonogenic assays and on earlier hemopoietic progenitors by liquid long-term marrow cultures (LTMC) for 5 weeks. DOX at 3.2 micrograms/ml and AZ at 140 micrograms/ml spared 1.08 and 1.23% of GM-CFU respectively, and yielded similar tumor cell log-kills for HL60 cells (3.04 and 2.95) and Raji cells (3.24 and 3.40). With the combination of AZ and DOX, the best therapeutic index was observed when the cells were incubated with AZ prior to DOX. Under these conditions, AZ at 80 micrograms/ml together with DOX at 1.6 micrograms/ml significantly increased log-kill values for HL60 cells to 3.96 by a synergistic effect and for Raji cells to 3.85 by an additive effect. In LTMC, GM-CFU recovery after treatment with AZ alone and with the combination of AZ and DOX was 59.9 and 20.0%, respectively, while it was 7.9 and 2.9% at culture initiation. These results suggest that the purging efficiency of DOX is comparable to that of AZ and may be enhanced by combination with AZ.
Results of typing for HLA B27 antigens of 106 patients in whole blood with a FITC monoclonal anti HLA B27 antibody and analysis by flow cytometry are compared to the results obtained by the classical microlymphocytoxicity test. By flow cytometry analysis, there are not false negative result, but, because of cross reactions of the used monoclonal antibody with other specificities of the CREG B7 group, false positive result may be encountered. The flow cytometry analysis for typing HLA B27 antigens using a monoclonal antibody can be a good screening technique: so it's rapid and moreover the negative results can be accepted. The positive results must be confirmed.
Serum platelet bindable immunoglobulin G (SPbIgG) and anticardiolipin antibodies (ACA) have been assayed in SLE patients with (group A, n = 8) and without thrombocytopenia (group B, n = 8). Moreover, we studied the binding of serum IgG on platelet proteins using a Western blotting procedure. Increased levels of SPbIgG were found in all thrombocytopenic patients and in five cases of group B. A binding of serum IgG on platelet proteins (80 and 53 kDa) was seen in seven of eight thrombocytopenic patients and in only one case of group B. ACA were present in the serum of four patients in each group and a significant inhibition of ACA IgG by entire washed platelets was achieved in only two severe thrombocytopenic cases. These data suggest that participation of ACA to the platelet destruction can be evoked for a few SLE patients, whereas recognition of platelet protein determinants by lupus autoantibodies is necessary to the thrombocytopenia.
L-Asparaginase has been encapsulated in Swiss mouse or human erythrocytes by hypotonic haemolysis followed by isotonic resealing and reannealing. The details of incorporation and properties of carrier erythrocytes are presented. When L-asparaginase loaded into 51Cr-labelled erythrocytes, was infused intravenously, the same half-life was found for asparaginase and 51Cr. In addition, L-asparaginase loaded into erythrocytes was much more effective in eliminating plasma asparagine compared with the same dose of free L-asparaginase injected in solution, during a sustained period (14 days).
Erythrocytes can be used to entrap drugs, enzymes or other molecules with active properties, with various encapsulation procedures. The method of internalization we are using includes an hypotonic dialysis step. Carrier erythrocytes survival depends on the dialysis process and the carried molecule. Research has led us to perform preclinical trials on animals for several drugs and enzyme therapies and for the improvement of oxyphoric capacity of erythrocytes. There exist many potential clinical applications for each kind of internalized molecules.
An in vitro study of platelet concentrates storage for 5 days was performed in PVC bags. Modification of the original three-day containers were introduced by thickness reduction. The results at fifth day were comparable to those at third day in standard plastic bags. During storage, variations of platelet counts were very slight with a low LDH release. PH was stable with a good maintenance of phase microscope platelet morphology. PCO2 and PO2 measurements showed a satisfactory gas permeability which could explain a limited lactate production. If in vivo studies of transfusion recovery confirm these data, platelet concentrates storage could be extended up to 5 days by such modifications of standard three-day PVC bags.
Internalization of inositol hexaphosphate (IHP) in mammalian red blood cells (RBC) produces a modification of the hemoglobin-oxygen affinity, leading to a rightward shift of the dissociation curve. The process of incorporation, based on an osmotic shock, has been tested on RBC of different species. Two dialysis protocols have been defined to transform RBC, the first one for small volumes in a cellulose bag and the other for larger volumes using a commercially available dialysis device. Different optimal conditions must be used for each species. Most of the cellular characteristics of the transformed RBC having encapsulated IHP are similar to those of native cells. For several species, such modified RBC could be reinfused and used for physiological studies.
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Oxygen affinity of haemoglobin is modulated by several parameters such as the allosteric effector 2-3 DPG for most mammalians. Inositol hexaphosphate (I.H.P.) exerts the same effect on haemoglobin. A previously developed new methodology for the entrapment of drugs into erythrocytes has been adapted to I.H.P.; it is based on a reversible osmotic shock. I.H.P. loaded red blood cells have characteristics very similar to those of native cells. The decrease in oxygen affinity is related to the dose of encapsulated I.H.P. In piglets, transfusion of such cells has led to an increase of oxygen extraction from haemoglobin. Normal anesthetized animals regulate their oxygen consumption by reduction of cardiac output.
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