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Biomedical subjects

R Costello

Publications and source records attributed to R Costello.

At least 73 records · Page 4Linked to original sources

Activation of primary human T-lymphocytes through CD2 plus CD28 adhesion molecules induces long-term nuclear expression of NF-kappa B.

Stimulation of highly purified human T-cells via CD2 and CD28 adhesion molecules induces and maintains proliferation for more than 3 weeks. This potent interleukin 2 (IL-2)-dependent activation does not require monocytes or accessory cells. Long-lasting IL-2 receptivity is associated with high-level expression of the inducible IL-2 receptor alpha chain (IL-2R alpha) gene that is regulated at both transcriptional and posttranscriptional levels. Increase of IL-2R alpha gene transcription involves the enhanced binding of the transcription factor NF-kappa B to its consensus sequence in the 5'-regulatory region of the IL-2R alpha gene. To dissect the molecular basis for the unusually persistent transcription of the IL-2R alpha gene, we analyzed nuclear NF-kappa B binding to a radiolabeled IL-2R alpha kappa B-specific oligonucleotide probe during the time course of CD2 + CD28 activation. Resting T-cell nuclear extracts contained KBF1/p50 homodimer. After stimulation, two new kappa B-specific complexes were identified as NF-kappa B p50-p65 heterodimer and putative c-Rel homodimer or c-Rel-p65 heterodimer. Both inducible complexes persisted for at least 3 weeks. Their relative levels were very similar for the duration of proliferation. In parallel, CD2 + CD28 activation triggered a significant intracellular thiol decrease, suggesting that oxygen radicals are involved in the signaling pathway of adhesion molecules. Finally, micromolar amounts of pyrrolidine dithiocarbamate, an oxygen radical scavenger that efficiently blocked the nuclear appearance of NF-kappa B in T-lymphocytes, also inhibited IL-2 secretion, IL-2R alpha cell surface expression, and T-cell proliferation. Together, these results suggest that NF-kappa B plays an important role in long-term activation of human primary T-lymphocytes via CD2 + CD28.

Antibodies, Monoclonal↗

Rationale for the utilization of interleukin-4, an immune-recognition induced cytokine, in cancer immunotherapy.

Interleukin-2 use for advanced cancer treatment has demonstrated that cytokines are of interest not only in the field of immunology but also in oncology. Interleukin-2 is only one member of the ever-growing family of immune recognition-induced lymphokines. Interleukin-4, a cytokine with pleiotropic effects, shares some common properties with interleukin-2. Availability of recombinant interleukin-4 has led to a better knowledge of this cytokine's functions, and also makes clinical trials possible. This brief review discusses the in vitro and in vivo data that support a potential use of interleukin-4 in cancer immunotherapy.

Animals↗

Reversible hypercapnia in acute exacerbations of chronic obstructive pulmonary disease (COPD).

We prospectively studied emergency hospitalizations due to acute exacerbations of chronic obstructive pulmonary disease (COPD) among 74 hypercapnic patients, in order to determine factors which predict reversal to normocapnia as a result of therapy. Clinical, arterial blood gas and pulmonary function data on presentation were compared to predischarge values among those 58 patients who survived the admission. Patients were divided into those who reverted to normocapnia (reversible, 40% of surviving patients), and those who remained hypercapnic (chronic, 60% of surviving patients). Reversible patients had higher admission arterial oxygen tension (PaO2) levels than those with chronic hypercapnia (6.4 +/- 1.3 kPa (mean +/- SD), as compared to 5.7 +/- 1.1 kPa) better pulmonary function (forced expiratory volume in one second (FEV1) 35 +/- 16% predicted, as compared to 26 +/- 7.9), and a lower prevalence of cor pulmonale (30% as compared to 63% of patients). No admission variable(s) distinguished individual patients as reversible or chronic hypercapnic, and, in particular, admission arterial carbon dioxide tension (PaCO2) and pH levels were similar in both groups. Furthermore, there were no differences between survivors and those 16 patients who died during the admission, apart from a higher urea level among those who died. These findings suggest that reversible patients have milder underlying disease than those with chronic hypercapnia. Our data establish the high prevalence of reversible hypercapnia among patients hospitalized with exacerbations of COPD, and, furthermore, indicate that patients who are normocapnic in the stable state can develop similar levels of hypercapnia during exacerbations as those with chronic hypercapnia.

Acute Disease↗

The pleiotropic effects of interleukin 7 and their pathologic and therapeutic implications.

Interleukin-7 (IL-7) is a cytokine initially described as a growth factor for B cell progenitors. IL-7 also induces T cell proliferation and has pleiotropic effects. IL-7 enhances T-lymphocyte cytotoxicity, stimulates anti-tumoural properties of monocytes/macrophages, and induces tumour rejection in mice. It could thus be of interest in immunotherapy and may play a role in the generation of lymphoid neoplasia because leukaemic cells of B and T lineage express functional IL-7 receptors. Finally, IL-7 is, as IL-2, a cytokine of pivotal importance in the immune system, and so could be involved in abnormal immune response such as autoimmunity.

Animals↗

IL-1 alpha is produced by T lymphocytes activated via the CD2 plus CD28 pathways.

In addition to activation via the TCR complex, resting purified T cells can be activated to proliferate by mAb directed against the two surface molecules, CD2 and CD28. We demonstrate here that only the CD2 plus CD28 combined activation induces the expression and secretion of IL-1 alpha, a cytokine classically considered as a monokine. In contrast, neither IL-1 beta nor IL-6 were produced. A second monokine, TNF-alpha was transiently expressed by T cells activated with either CD2 or CD28 mAb, but was expressed to higher levels and with a prolonged kinetics in cells activated by the CD2 plus CD28 combination. The prolonged expression of the IL-1 alpha gene could account, at least in part, for the monocyte-independent and long lasting T cell proliferation induced by the CD2 plus CD28 co-stimulation. Secretion of monokines, such as IL-1 alpha, by activated T cells, could play a regulatory role in immune responses, as well as contribute to autoimmune processes.

Antigens, CD↗

Oligoclonal immunoglobulins in serum of patients with chronic viral hepatitis.

Zone electrophoresis on agarose gel was performed in serum samples from patients with chronic viral hepatitis. On the basis of the clinical, serological, and biochemical evaluation, the patients were divided into three categories: chronic type B hepatitis; chronic type delta hepatitis; and chronic non-A-non-B (NANB) hepatitis. The results of the electrophoretic analysis showed a high incidence of oligoclonal immunoglobulin bands (OIBs) in patients with chronic B hepatitis and chronic delta hepatitis and a low incidence of OIBs in patients with NANB. Since other biochemical and serological characteristics are variable and do not correlate with clinical symptoms of disease, we suggest that oligoclonal immunoglobulins could be used as a marker to aid in studies of the natural history and pathologic course of the various types of chronic hepatitis.

Diagnosis, Differential↗

Human CD28 and CTLA-4 Ig superfamily genes are located on chromosome 2 at bands q33-q34.

CD28 is a cell surface molecule present on most peripheral T cells which has been implied in the amplification of the T-cell response in vitro. Using in situ hybridization on human prometaphase cells, we have found that the human CD28 gene maps to chromosome 2 at bands q33-q34, as shown previously for the CTLA-4 gene. CD28 and CTLA-4 are both members of the Ig superfamily, where they define a subgroup of membrane-bound single V domains. Their chromosomal proximity and their close structural relationship suggest that these two genes could be the result of the duplication of a common evolutionary precursor and may share some functional properties.

Antigens, CD↗

Prednisone effects on blood-brain barrier permeability and CNS IgG synthesis in healthy humans.

Corticosteroids reportedly decrease blood-brain barrier (BBB) permeability and/or IgG synthesis in patients with multiple sclerosis or brain tumors. However, these effects have not been studied in healthy humans. We investigated the effects of prednisone, 80 mg/day for five days, on the ratio of cerebrospinal fluid (CSF) albumin/serum albumin, a measure of blood-brain barrier (BBB) permeability, and on CSF and serum IgG levels in six healthy, normal volunteers. We found significant steroid-induced decreases in serum and CSF albumin levels and in serum IgG levels. However, we found only a nonsignificant decrease in BBB permeability and no significant change in CNS IgG synthesis. These findings, based on a small number of volunteers, suggest that it may be difficult to further decrease BBB permeability and CNS IgG synthesis in medically healthy subjects.

Adult↗

Oligoclonal immunoglobulin bands in serum in association with chronic viral hepatitis.

We studied serum immunoglobulins in 54 patients with chronic viral hepatitis. The majority had hyperglobulinemia, with immunoglobulin G (IgG) being elevated the most. High resolution protein electrophoresis revealed the presence of oligoclonal bands within the gamma-globulin region of the electrophoretic pattern (oligoclonal immunoglobulin bands) in 32 (59%) patients. Between two and seven bands were noted in each sample. In order to analyze the significance of this observation, we performed stepwise discriminant analysis of clinical, demographic, serological, and serum biochemical features in patients with and without detectable oligoclonal immunoglobulin bands. The patient's ages and serum immunoglobulin G levels were found to be important predictors of the presence of oligoclonal immunoglobulin bands. No correlation was found with the type of hepatitis, disease severity, or duration of hepatitis. On follow-up, serum samples were retested in 20 patients, over 5 to 60 months. Significant change was noted in only one patient in whom oligoclonal immunoglobulin bands (initially very prominent) became progressively weaker and finally disappeared over a 5-yr period. This was associated with an improvement in his hepatitis after loss of hepatitis following loss of hepatitis B e antigen from serum. These observations suggest that the determination of oligoclonal immunoglobulin bands in serum may be a useful marker to study the course and activity of chronic viral hepatitis in selected patients.

Adult↗

[Severe hypokalemia with few symptoms disclosing distal renal tubular acidosis].

The case is reported of a 47 year old female patient admitted with asthenia, anorexia, nausea and constipation. The poor clinical features contrasted with the severe biological disturbances: 1 mmol.l-1 serum potassium, pH 7.26, 19 mmHg PaCO2, 8 mmol.l-1 bicarbonate, myoglobinaemia and myoglobinuria. The electrocardiogram showed a flattened T wave, an U wave, and a depressed ST segment. Potassium was given intravenously at a rate of 0.38 mmol.kg-1.h-1 during the first 24 h. Renal biopsy confirmed the diagnosis of distal renal tubular acidosis, but no aetiology could be found. This patient's excellent clinical tolerance of a severe hypokalemia suggested that the potassium pool could be replaced at slower rates than those suggested in the literature for patients with severe symptoms and signs.

Acidosis, Renal Tubular↗

Exercise blood pressure response and left ventricular hypertrophy.

Although hypertension is the major cause of left ventricular hypertrophy (LVH), numerous studies failed to demonstrate a close correlation between resting blood pressure (BP) and degree of LVH. Some authors have shown better correlation between BP at work and left ventricular mass (LV mass), whereas other studies supported an association between catecholamines or angiotensin II and LV mass. In this study we investigated the relationship of resting and exercise BP and catecholamines to the degree of LVH. Nineteen patients with established mild to moderate hypertension were studied. Blood pressure was measured following a ten-minute rest and every three minutes during exercise using a Bruce protocol. Electrolytes, epinephrine (EP), and norepinephrine (NE) were measured at rest, at peak exercise, and at ten-minutes postexercise. Resting BP averaged 154 +/- 24/99 +/- 9 mm Hg and at three minutes of exercise 195 +/- 30/101 +/- 6 (P less than .001). Resting EP was 51 +/- 20 pg/mL, NE 314 +/- 187, and at peak exercise EP was 107 +/- 61 (P less than .001) and NE 1016 +/- 566 (P less than .001). The average LV mass was 277 +/- 85 g. A significant correlation was found only between systolic BP at three minutes of exercise and LV mass (r = .479, P less than .04). No other variable correlated significantly with LV mass. These data suggest that systolic BP achieved at low level of exercise (5 mets), corresponding to usual daily activities, may be the most important determinant of LVH in patients with hypertension.

Blood Pressure↗

Electrophoretic examination of proteinuria in Lowe's syndrome and other causes of renal tubular Fanconi syndrome.

Urine samples from 26 patients with five different causes of renal tubular Fanconi syndrome were examined by zone electrophoresis on agarose gel and immunofixation. The tubular disorders associated with Lowe's syndrome, cystinosis, and idiopathic Fanconi syndrome exhibited urine protein electrophoretic characteristics that differentiated them from normal and from each other. In particular, Lowe's syndrome urine exhibited four discrete bands in the gamma globulin zone. Electrophoresis of urinary proteins may be useful in distinguishing among the different metabolic disorders causing renal tubular Fanconi syndrome.

Adolescent↗