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Biomedical subjects

N Dainiak

Publications and source records attributed to N Dainiak.

At least 73 records · Page 4Linked to original sources

Primary human marrow cultures for erythroid bursts in a serum-substituted system.

To determine environmental requirements for erythroid burst formation in primary culture, we added human bone marrow cells to serum-depleted methylcellulose, agar, or fibrin clot cultures. Optimal BFU-E proliferation was present in cultures prepared with Iscove's modified Dulbecco medium, 248 micrograms/ml transferrin, 1.63 micrograms/ml ferric chloride, 117 micrograms/ml bovine serum albumin, and each of seven preparations of erythropoietin. Burst number was comparable to that in serum containing culture. Reducing sodium dodecyl sulfate electrophoresis of commercial albumin preparations showed them to contain abundant lipoproteins. Results of experiments with human plasma albumin found to be greater than 98% pure by one- and two-dimensional gel electrophoresis and delipidated albumin indicate that an albumin source is needed for burst formation to occur. Together with albumin, exogenous phosphatidylcholine but not phosphatidylserine augmented burst number. Bursts routinely appeared in serum-depleted culture without added burst-promoting activity (BPA). However, leukocyte-conditioned medium (LCM) and its high-speed supernatant and pellet fractions enhanced burst formation. Antimembrane IgG capable of neutralizing BPA reduced burst number to a level below that achieved in LCM-depleted culture, suggesting that endogenous BPA was inactivated. We conclude that human marrow BFU-E proliferation requires iron-saturated transferrin, albumin, and erythropoietin. Exogenous BPA and phospholipids enhance but are not essential for burst formation to proceed in primary culture.

Blood↗

Correction of clotting factor "deficiencies" in plasma from patients with lupus-like anticoagulants.

Identification of spurious coagulation factor deficiencies that are known to occur in association with lupus-like anticoagulants (LLACs) requires the use of cumbersome laboratory procedures. To determine whether single-stage assays employing the APTT system may be used to identify such artifacts, we measured multiple clotting factor levels by several techniques in plasma of six patients with typical LLACs. While normal activities of factors VIII, IX, XI and XII were measured in only 4/24 APTT assays (17%) employing human plasma substrate, normal factor activities were present in all 24 APTT assays employing bovine, canine or rabbit plasma substrate. Normal factor II, V and X activities were recorded in all but one case in assays that utilized a modified Stypven time, while normal factor VIII levels were determined in 5/6 plasmas when the thromboplastin generation test was employed. These results indicate that the use of heterologous plasma substrates in the APTT system may provide a simple method to identify such coagulation factor "deficiencies".

Animals↗

Chromosome analysis of isolated colony erythroblasts in chronic myelogenous leukaemia.

To isolate and karyotype the progeny of erythroid progenitors, we applied colony erythroblasts derived from plasma clot marrow cultures from two healthy adults and two patients with newly diagnosed Ph1+ chronic myelogenous leukaemia (CML) to discontinuous Stractan density gradients. Erythroid colony proliferation by patient cells was increased relative to that of normal donor cells (P less than 0.01). 'Endogenous' colonies appeared in patient but not in normal donor marrow cultures. Greater than 95% of nucleated cells equilibrating at rho greater than or equal to 1.071 were basophilic proerythroblasts. While analysis of chromosome spreads of normal donor cells in this fraction showed normal karyotypes, cells from patient marrow cultures were Ph1+, whether cultured in the presence or absence of added erythropoietin. These findings suggest that chromosome abnormalities of erythroid progenitors may be expressed by their progeny in tissue culture, and that Stractan may be a useful supporting medium for separating colony erythroblasts for chromosome analysis.

Adult↗

Mechanisms of abnormal erythropoiesis in malignancy.

In order the investigate mechanisms of diminished red cell production in malignancy, we assayed erythroid progenitor cell proliferative responses to erythropoietin in plasma clot cultures of bone marrow cells from 34 cancer patients. Erythroid colony growth by marrow cells of 11 healthy donors (means of 58 CFU-E and 19 BFU-E derived colonies/6 X 10(4) cells) was similar to that in cultures of cells from patients either with (means of 44 CFU-E and 22 BFU-E derived colonies/6 X 10(4) cells) or without (means of 50 CFU-E and 19 BFU-E derived colonies/6 X 10(4) cells) myelophthisis. Colony formation was normal at all erythropoietin concentrations tested, indicating that both the CFU-E and BFU-E retain normal erythropoietin sensitivity in vitro. CFU-E proliferation correlated negatively (r = -0.56; P less than 0.001) with the level of hemoglobin. In contrast to marrow cell proliferative responses to erythropoietin, serum erythropoietin levels were inappropriately reduced in all 19 patients in whom they were measured, a finding which may be important in the pathogenesis of anemia in patients with cancer.

Carcinoma, Squamous Cell↗

Platelet-derived growth factor promotes proliferation of erythropoietic progenitor cells in vitro.

To investigate serum requirements for optimal erythropoiesis in vitro, we studied the response of erythroid progenitor cell proliferation in culture to platelet-derived growth factor (PDGF). Human bone marrow cells cultured with platelet-poor plasma-derived serum (PDS) form fewer erythroid colonies than do cells cultured with human whole blood serum or fetal calf serum (P less than 0.05). Treatment of washed platelets with thrombin releases a low molecular weight (less than 100,000) factor that enhances colony growth. This secreted factor appears to be PDGF, based upon the ability of partially purified and electrophoretically pure PDGF to restore colony-forming capacity of PDS-containing cultures to 70-96% of the level found in control cultures with whole blood serum or fetal calf serum. Enhancement of colony growth by PDGF was noted only in marrow cultures supplemented with erythropoietin and PDS. Presence of bioactive erythropoietin in PDGF preparations was excluded by assay in hypertransfused, polycythemic mice, and in fasted rats. Although PDGF stimulates erythroid burst formation in marrow cultures containing optimal concentrations of burst-promoting activity (BPA), it does not influence proliferation of circulating erythroid bursts, regardless of BPA concentration added to culture. We conclude that PDGF is a serum determinant of optimal erythroid progenitor cell proliferation in marrow culture. The activity of PDGF is distinct from that of the apparent erythroid specific growth factors erythropoietin and BPA.

Animals↗

Correlation of clinical and in vitro erythropoietic responses to androgens in renal failure.

To assess in vitro erythropoietic cultures as a tool to discriminate between patients whose anemia improves with and those whose anemia fails to improve with androgens, bone marrows of 24 anemic patients receiving maintenance hemodialysis in hormone-depleted plasma clots were cultured. While erythroid colony proliferation in the presence and absence of androgens by cells of seven patients with good clinical outcomes who were initially studied was similar to that of normal donors, it was reduced (P less than 0.001) in cultures of cells from seven patients whose clinical responses were ultimately poor. Fewer than 25 colonies/6 X 10(4) cells at optimal erythropoietin concentrations, and less than a 25% enhancement in colony growth by androgens were observed in only those cultures derived from clinical nonresponder marrows. Using these criteria, nine of ten prospectively classified patients (five clinical responders and four nonresponders) were identified correctly.

Adult↗

Surface membrane vesicles from mononuclear cells stimulate erythroid stem cells to proliferate in culture.

In order to examine the contribution of cell surface materials to erythroid burst-promoting activity (BPA), we separated media conditioned by a variety of human cell types into pellets and supernatants by centrifugation. When added to serum-restricted cultures of nonadherent human marrow cells, pellets contained about half of the total stimulatory activity. Freeze-fracture electron microscopy of the pellets revealed the presence of unilamellar membrane vesicles ranging from 0.10 to 0.40 microM in diameter. The amount of BPA in culture increased with added vesicle concentration in a saturable fashion. Preparation of leukocyte conditioned medium (LCM) from 125I-wheat germ agglutinin labeled cells and studies comparing the glycoprotein composition of vesicles with that of leukocyte plasma membranes suggest that LCM-derived vesicles are of plasma membrane origin. Moreover, partially purified leukocyte plasma membrane preparations also contained BPA. While disruption of vesicles by freezing/thawing and hypotonic lysis did not alter BPA, heat, trypsin, or pronase treatment removed greater than 65% of BPA, implying that vesicle surface rather than intravesicular molecules express BPA. Results of BPA assays performed in two-layer clots indicated that proximity to target cells is required for vesicle BPA expression. We conclude that membrane vesicles spontaneously shed from cell surfaces may be important regulators of erythroid burst proliferation in vitro.

Animals↗

Erythropoiesis during an erythroblastic transformation of chronic myelocytic leukemia.

The requirement of erythropoiesis for erythropoietin were studied in a patient with Ph chronic myelocytic leukemia who had undergone an erythroblastic transformation. Transfusions resulted in a suppression of erythropoiesis. Plasma clot culture studies indicated that both the CFU-E and BFU-E in the peripheral blood of this patient were dependent upon erythropoietin for their differentiation and proliferation. Neither of these committed erythroid stem cells was cloned in the absence of erythropoietin. These studies suggest that the proliferation and differentiation of erythroid stem cells during the erythroblastic crisis of this disorder remain dependent upon physiologic regulators.

Adult↗

Hemoglobin F production in testicular malignancy.

The peripheral blood of 3 patients with testicular malignancy and elevated hCG levels was examined for Hb F production. Increases of percent chemically determined Hb F and/or F cell number were observed in each case when or soon after the hCG level was elevated. In these cases, Hb F production correlated with the degree of clinically evident malignancy. These observations suggest that the reactivation of Hb F synthesis may be applied to the evaluation of disease activity in patients with testicular malignancy.

Adult↗

In vitro steroid sensitivity testing: a possible means to predict response to therapy in primary hypoproliferative anemia.

We investigated the effects of various steroids on erythroid colony formation by normal human bone marrow and peripheral blood, and by marrow and peripheral blood from 18 patients with primary hypoproliferative anemia. These agents were variously found to enhance both CFU-E and BFU-E derived colony growth by normal human cells. Fluoxymesterone and dexamethasone were the most active inducers of CFU-E proliferation, and etiocholanolone and dexamethasone were the most potent burst augmenters. Androsterone did not significantly influence BFU-E proliferation in 66% of the marrow cultures from hematologically normal donors. Colony formation by erythroid progenitor cells of the patients with hypoproliferative anemia was reduce (20 +/- 10 CFU-E derived colonies/6 X 10(4) marrow cells; 12 +/- 5 BFU-E derived colonies/1 X 10(5) blood cells) when compared to growth by normal cells (65 +/- 14 CFU-E derived colonies/6 X 10(4) marrow cells; 21 +/- 9 BFU-E derived colonies/1 X 10(5) blood cells). Colony formation by marrow or peripheral blood cells of eight patients with steroid-responsive anemia was only moderately reduced (26 +/- 11 CFU-E derived colonies/6 +/- 10(4) marrow cells; 17 +/- 3 BFU-E derived colonies/1 X 10(5) blood cells) when compared to growth by marrow cells of three steroid-unresponsive patients (3 +/- 1.5 CFU-E derived colonies/6 X 10(4) cells). Whereas the addition of steroids of the same class to marrow and peripheral blood cultures of the steroid-responsive patients enhanced colony growth by 60-300%, their addition to marrow cultures of the steroid-unresponsive patients increased colony growth by less than 60%. It appears that further investigations using in vitro culture techniques as predictors of response to steroid therapy in patients with hypoproliferative anemia may be warranted.

Androstanes↗

Humoral suppression of erythropoiesis in systemic lupus erythematosus (SLE) and rheumatoid arthritis.

Anemia due to inadequate red cell production often accompanies systemic lupus erythematosus and rheumatoid arthritis. We investigated its pathogenesis in 17 patients with these disorders, using a plasma clot culture system. In serum from normal donors and nonanemic patients CFU-E derived colony formation was not significantly altered by normal marrow cells (mean 74 +/- 12 colonies/6 x 10(4) cells), whereas colony formation was inhibited (mean 36 +/-6 colonies/6 x 10(4) cells) in serum from 10 anemic patients. In serum from anemic patients proliferation of the more primitive BFU-E was also reduced in three cases. In two patients with a humoral inhibitor, colony growth was suppressed by autologous marrow cells. In another patient without an inhibitor, colony formation was not suppressed by autologous bone marrow. The physical properties of this inhibitor are compatible with those of an immunoglobulin. Moreover, its presence is related to disease activity and it can be removed by successful therapy with either corticosteroids or plasma exchange. Circulating inhibitors of erythropoiesis may play an important role in causing severe anemia in patients with these rheumatic diseases.

Adolescent↗

Serial assessment of doxorubicin cardiotoxicity with quantitative radionuclide angiocardiography.

We measured cardiac performance sequentially, using quantitative radionuclide angiocardiography to estimate left ventricular ejection fraction in 55 patients receiving doxorubicin for treatment of cancer. With final doxorubicin dosages greater than 350 mg per square meter, the lowest ejection fraction measured was significantly less than the initial determination. Five patients had severe cardiotoxicity (congestive heart failure). All had an ejection fraction of less than 30 per cent at the time of heart failure, and demonstrated moderate cardiotoxicity (a decline in ejection fraction by at least 15 per cent to a final value of less than 45 per cent) before clinical manifestations. Six patients with moderate toxicity in whom doxorubicin was discontinued did not have heart failure or a further decline in ejection fraction during the follow-up period. Moderate toxicity was continued, but mild toxicity (decline of ejection fraction by greater than 10 per cent, noted in 11 patients) was not well predicted. The assessment of radionuclide left ventricular ejection fraction during doxorubicin therapy may make it possible to avoid congestive heart failure.

Adult↗

Induction of erythropoietic colonies in a human chronic myelogenous leukemia cell line.

The ability of cells derived from the K562 cell line to generate erythropoietic colonies was studied. The K562 cell line was derived from a patient with chronic myelogenous leukemia 8 yr ago by Lozzio and Lozzio. Rare benzidine-positive colonies formed when these cells were cloned in plasma clots (3 +/- 1/10(4) cells), and their number was not substantially increased by the addition of erythropoietin (9.5 +/- 1/10(4) cells). Sodium butyrate was capable of markedly enhancing the number of benzidine-positive colonies (19.5 +/- 1/10(4) cells) formed, while the combination of sodium butyrate plus erythropoietin exerted a synergistic effect on erythropoietic colony formation (57 +/- 4/10(4) cells). The K562 cell line is a long-term culture system that contains human erythropoietic stem cells. This cell line should be useful in future studies on the cellular and molecular events associated with human erythroid cell differentiation.

Benzidines↗

Erythropoietin-dependent primary pure erythrocytosis.

We investigated the pathogenesis of isolated erythrocytosis of 14 yr duration in a 28-yr-old man. The increase in red cell mass was attributed to increased erythropoietin production. An extensive search for recognized causes of secondary erythrocytosis was unrevealing. Family members were found to be hematologically normal. After reduction of the circulating red cell mass by 20%, erythropoietin activity nearly quadrupled, thus suggesting a normal erythropoietin response to phlebotomy. When bone marrow cells of the patient were cultured in plasma clots in the absence of added erythropoietin, endogenous erythroid colony formation was observed, a pattern previously believed to be specific for polycythemia vera bone marrow cells. Our observations suggest that the erythrocytosis in this individual is best explained by an abnormal "servoregulatory" mechanism of erythropoietin production. In addition, this is the first instance in which the rule that endogenous erythroid colony formation is correlated with the diagnosis of polycythemia vera has not held.

Adult↗

Antibody-mediated acquired sideroblastic anemia: response to cytotoxic therapy.

A 5 1/2-yr-old child developed severe anemia with erythroid hypoplasia and 50% ringed sideroblasts in his bone marrow. A serum inhibitor of erythropoiesis was demonstrated, utilizing syngeneic and autologous bone marrow in a plasma-clot culture system. The IgG fraction of the patient's serum effected similar suppression of erythroid colony formation. Prednisone therapy was ineffective, but following treatment with cyclophosphamide, normal erythropoiesis was established, ringed sideroblasts disappeared, and his serum no longer inhibited erythropoiesis in vitro. Cyclophosphamide was discontinued, and the patient has remained hematologically normal. This patient is an example of antibody-mediated sideroblastic anemia successfully treated with a cytotoxic drug.

Anemia, Sideroblastic↗