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Studies on the adjuvant effect of water-in-oil-in-water (w/o/w) emulsion of sesame oil. 1. Enhanced and persistent antibody formation by antigen incorporated into the water-in-oil-in-water emulsion.

Water-in-oil-in-water (w/o/w) emulsion developed in our laboratory is as effective as water-in-oil (w/o) emulsion of Freund's incomplete adjuvant (FIA) in the stimulation of antibody formation. The emulsion is prepared by redispersion of water-in-sesame oil emulsion of an antigen solution in phosphate buffered saline with emulsifier, Tween 80. The emulsion can be stored at 4 degrees C for at least 3 months without any evidence of change in the adjuvanticity and in the w/o/w state. Even a single injection of bovine serum albumin (BSA) in the w/o/w emulsion elicited a high antibody response in mice over the period of almost whole lifespan. 10 microgram BSA in w/o/w could stimulate antibody formation up to 2(12) in hemagglutination titer, while the same dose in free solution did not elicit any detectable antibody. The tissue reactions caused by the w/o/w emulsion at the injected site and in the regional lymph nodes were much less prominent than those by FIA.

Adjuvants, Immunologic

Studies on the adjuvant effect of water-in-oil-in-water (w/o/w) emulsion of sesame oil. 2. Mode of action of the w/o/w emulsion.

The water-in-oil-in-water (w/o/w) emulsion showed potent adjuvant effect on the antibody formation to thymus-dependent antigens, but not to thymus-independent antigens. In hapten-carrier system the priming with carrier in the w/o/w emulsion enhanced more effectively the carrier specific helper function than did the priming with carrier in free solution. The cells responsible for the helper function were radioresistant. In the adoptive cell transfer system, the w/o/w emulsion was shown to enhance helper cell function. It is discussed that our w/o/w emulsion exerts the adjuvant effect by enhancing helper T cell activity.

Adjuvants, Immunologic

Basic experiments on oral administration of 5-fluorouracil emulsion as adjuvant chemotherapy to surgical treatment for gastric cancer.

Oral administration of 5-fluorouracil (5-FU) emulsion was compared experimentally with that of 5-FU aqueous solution as to the degree of absorption and tissue distribution. After oral administration of both the 5-FU emulsion and the 5-FU solution, 5-FU was detected at the highest level in both the stomach and the duodenum. This seems to suggest that 5-FU is strongly affinitive to the tissues of the gastrointestinal tract. As to the relative concentration of these two forms of the drug, the oral administration of the 5-FU emulsion resulted in a maximum value 1.5 times higher than that of the 5-FU solution. An appreciable concentration of 5-FU was maintained for a considerably long time with the administration of 5-FU emulsion. In the lymph, the maximum level of the 5-FU emulsion was three times higher than that of the 5-FU solution. The drug concentration of the 5-FU emulsion remained higher than that of the 5-FU solution through the entire duration of the experiment. Regarding the drug concentration in the regional lymph nodes, the pattern demonstrated was almost the same as in the lymph itself. It is expected that the oral administration of 5-FU emulsion may be useful as an adjuvant to the surgical treatment of gastric cancer, because of the high drug concentration resulting both in the gastrointestinal tract and in the regional lymph nodes.

Administration, Oral

Enhancement of the cancer chemotherapeutic effect by anticancer agents in the form of fat emulsion.

Utilizing the lipid-adsorbing ability of lymphatic capillaries, anticancer agents were given in the form of fat emulsion in order to deliver them to regional lymph nodes. The emulsion, in which the drug solution is contained as the innermost phase, yielded high drug concentration in the lymphatic system. Intratumoral injection of emulsified anticancer agent resulted in significantly prolonged retension of the drug within the tumor tissue. Therapeutic experiments of the emulsion also disclosed remarkable tumor reduction and cure rate as compared with aqueous solution of drugs. Oral administration of emulsified 5-Fluorouracil (5-FU) was also attempted for stomach cancer. With 5-FU, the maximum concentration of drug in thoracic lymph and stomach was greater when administered as an emulsion than as an aqueous solution, and a high concentration persisted longer. As a clinical trial of the emulsion method, eight patients with inoperable malignant growth were injected locally with emulsified anticancer agents and 121 patients were given 5-FU emulsion orally. From the clinical and histological findings, it was thought that the emulsion enhanced the chemotherapeutic effect of the anticancer agent on lymph node metastasis.

Adenocarcinoma

Effect of perfluorochemical (PFC) emulsion on acute carbon monoxide poisoning in rats.

The effect of perfluorochemical (PFC) emulsion (25 w/v per cent of PFC concentration) on carbon monoxide poisoning was studied in rats exposed to 97 per cent O2 and three per cent CO. There was no significant difference in conversion rate of hemoglobin to carboxyhemoglobin (COHb) between PFC emulsion and saline groups. However, after re-exposure to pure oxygen, PFC emulsion group circulation reconverted to oxyhemoglobin (OXYHb) at a significantly faster rate than circulation in the control group. Survival time of rats was considerably affected by infusion of PFC emulsion and prolonged in proportion to increased injection dosage. Significant elevations in plasma glucose, lactate and aldolase levels and lactate/pyruvate ratio were found in the saline group and these levels remained well within normal range in the PFC emulsion group. These results indicate that PFC emulsion can function as an oxygen carrier in the presence of carbon monoxide and can deliver sufficient oxygen to peripheral tissues.

Acute Disease

Pulmonary vascular effects of fat emulsion infusion in unanesthetized sheep. Prevention by indomethacin.

Pulmonary diffusing capacity and arterial blood Po(2) decrease in humans when 10% fat emulsion is infused. To study its effects on the pulmonary circulation and lung fluid balance, we infused 0.25 g/kg x h of a 10% fat emulsion (Intralipid, Cutter Laboratories, Inc., Berkeley, Calif.) into an awake sheep lung lymph preparation. The emulsion caused a sustained increase in pulmonary artery pressure to approximately twice base line with little change in left atrial pressure. Pa(O2) decreased an average 13 torr and lung lymph flow increased two- to threefold. Lymph/plasma total protein concentration fell as lymph flow increased; the magnitude of the lymph/plasma protein decrease was similar to that reported previously when lung vascular pressures were mechanically elevated. Heparin infusion (loading dose = 4,000 U, maintenance dose = 2,000 U/h) cleared the serum of triglycerides but did not alter the response to fat emulsion. Indomethacin infusion (loading dose = 5 mg/kg, maintenance dose = 3 mg/kg x h) blocked the rise in pulmonary artery pressure, the increase in lung lymph flow, and the fall in Pa(O2). Neither extravascular lung water nor [(14)C]urea lung vascular permeability surface area products were altered by fat emulsion infusion. We conclude that fat emulsion infusion in sheep increases lung microvascular filtration by increasing vascular pressures, but has no effect on vascular permeability. Since the effects are blocked by indomethacin, they may be prostaglandin mediated.

Animals

[Metabolic study of 3 lipid emulsions used parenteral feedings. I. Exploration in vivo in the minipig].

The metabolism of three fat emulsions (Lipiphysan, Trive 1000, Intralipid) was compared when administered by intravenous route as complete parenteral nutrition in minipigs during 14 days. With Lipiphysan, an important accumulation of glycerides appeared in liver, spleen and lung whereas the phospholipids content of those tissues was unchanged. The three fat emulsions determined an increase of linoleic acid (18:2) percentages in glycerides and phospholipids of several tissues: liver, heart, lung, spleen and kidney. Moreover, at the level of phosphatidyl-ethanolamine (PE) in liver tissue, the three fat emulsions induced a decrease of some polyunsaturated fatty acids (C20 and C22) percentages. The observed differences in the amount of liver triglycerides between the three fat emulsions seem to be related with the removal mechanisms which appear to be dependent on each fat emulsion. In fact, all tissue lipid analyses showed an increase of 18:2 percentages which agree with an uptake of the different fat emulsions used. The decrease of polyunsaturated fatty acids percentages in PE might be due to an inhibition of elongationdesaturation system or a degradation of those fatty acids.

Animals

Fat overload with a 10% soybean oil emulsion.

A 10% soybean oil emulsion (Intralipid) has been demonstrated to be an effective means of delivering an adequate caloric intake via a peripheral vein. This emulsion has generally been considered safe and free of significant complications. This is a report of a child who initially thrived on this intravenously administered fat emulsion, then suddenly developed a lifethreatening intolerance to the infusion, which appeared to be the "fat overload syndrome." This syndrome, seen frequently with earlier fat emulsions, has not been reported previously as a complication of the 10% soybean oil emulsion.

Dietary Fats

Attempt at local administration of anticancer agents in the form of fat emulsion.

A fat emulsion when injected into tissue is scarcely taken up by the blood vascular system but is retained within the tissue over a relatively extended period, and is distributed slowly into the surrounding tissues and to the regional lymph nodes. Attempts were made to use this property of the emulsion in the local administration of anticancer agents in emulsion, both in experimental animals and in man. The concentrations of bleomycin in the tumor tissue of rats were significantly higher after the intratumoral injection of the emulsion form than when the drug was administered in the aqueous solution, either systemically or intratumorally. Experimental antitumor activity against this tumor was superior after the bleomycin emulsion, as well. In the clinical trials six of eight patients with either squamous cell carcinoma of skin or local recurrence of adenocarcinoma of the breast responded favorably to this treatment.

Aged

Histological evaluation of the effect of 5-FU emulsion on lymph node metastasis of stomach cancer.

In order to evaluate the effect of anticancer drugs on the metastatic lesions of the regional lymph nodes from stomach cancers removed after oral administration of 5-FU emulsion, histological examinations of the specimens obtained from 107 surgical cases were carried out. In additional 13 cases with gastric cancer, the active 5-FU concentrations in the regional lymph nodes were determined. The effect of 5-FU emulsion in metastatic lesions as determined was histologically classified into Grades 0 to III according to the severity and extent of damaged cells and cell nests Grades II and III were judged to demonstrate the beneficial effect of the 5-FU emulsion. Such changes were identified in 62.0 per cent of the 242 metastatic lymph nodes, and the effectiveness increased as the total dose of the 5-FU emulsion administered increased (50.9 per cent for 5,000 mg or less, 70.9 per cent for 5,000 to 6,000 mg, and 72.7 per cent for 6,000 mg or more). The rate of effectiveness also varied with the histological type of the primary carcinoma, i.e. the differentiated type being more sensitive. The mean active 5-FU level in the regional lymph nodes was higher after the administration of 5-FU emulsion than of 5-FU solution supporting the earlier animal experiments.

Adenocarcinoma

Preparation of inactivated oil-emulsion vaccines with avian viral or Mycoplasma antigens.

The influence of the composition of water-in-oil emulsions on their physical characteristics was determined by preparing experimental emulsions with various water-to-oil ratios and various emulsifiers. Emulsions containing Tween 80 in the aqueous phase and Arlacel A or Arlacel 80 in the oil phase were lower in viscosity than emulsions containing only an oil-phase emulsifier. Viscosity decreased as the concentration of oil increased. Oil-emulsion vaccines prepared with aqueous- and oil-phase emulsifiers had low viscosity, were stable for more than 12 weeks at 37 C, and induced a marked primary antibody response in chickens.

Animals

Validation of a stable emulsion for the assay of lipoprotein lipase activity.

The preparation of a stable, stock, radioactive, trioleoyl glycerol emulsion in glycerol and its application to the assay of lipoprotein lipase are described. The data presented indicate that this stock emulsion combines the convenience and reproducibility of commercially available, nonradioactive emulsions with the sensitivity of sonicated, radioactive, aqueous emulsions. Furthermore, in practice, this glycerol-based emulsion appears to be specific for the protamine-sensitive extrahepatic lipase, having little or no reactivity toward the hepatic lipase measured in postheparin plasma.

Emulsions

Effect of complete parenteral nutrition using fat emulsion on liver.

Four to 8 weeks of complete parenteral nutrition including fat emulsion, 10% Intralipid, from 2 to 4 gm/kg/day, was studied in puppies. The following conclusions were reached: At the end of 4-8 weeks of complete parenteral nutrition using the infusion of fat emulsion, the lipid content of the liver was twice the value in control animals, which returned to the approximate normal value in a short period after the interruption of the fat emulsion. This increase in the lipid content was considered to be caused by a proper metabolic process of fat emulsion and would seem to indicate that the daily infusion of the fat emulsion from 2 to 4 gm could be performed safely for an extended period of time.

Alanine Transaminase

Microbiol growth in lipid emulsions used in parenteral nutrition.

Parenteral nutrition via central venous catheterization is associated with serious risks, especially that of sepsis. Lipid emulsion (Intralipid[Sweden]), which may be administered peripherally, was evaluated for its potential to support microbial growth. Washed cultures of Staphylococcus aureus, Candida albicans, and three species of Gram-negative rods were all capable of multiplying in the emulsion at room temperature. Variations in inoculum size did not affect the growth rate. Studies comparing the emulsion to amino acid-glucose solutions (total parenteral nutrition [TPN])confirmed other reports that TPN inhibits the growth of certain bacteria but merely retards fungal multiplication. When human serum was added to the lipid emulsion in an attempt to simulate in vivo conditions at the catheter tip, Escherichia coli was inhibited while the growth of S aureus and C albicians was unaltered.

Amino Acids

Gels in soap stabilized emulsions.

In some soap stabilized liquid paraffin emulsions a correlation has been found between emulsion type and the contact angle of the soap gel (the stabilizing agent) at the o/w interface. Two unrelated series of emulsions have been prepared, one series being stabilized by magnesium oleate gels and the other series by ammonium oleate gels. The soap gels were prepared by double decomposition and suppression of ionization respectively. Unlike the magnesium oleate system no inversion to w/o emulsions occurred with the ammonium oleate series. This dissimilarity is predicted from differences in the contact angles of the soap gels at the o/w interface.

Chemical Phenomena