Pharmacokinetics of anti-ganglioside GD2 mAb 14G2a in a phase I trial in pediatric cancer patients

A phase I trial of a murine anti-ganglioside (GD2) monoclonal antibody (mAb) 14G2a was conducted in 14 neuroblastoma patients and 1 osteosarcoma patient to assess its safety, toxicity and pharmacokinetics in pediatric patients. The pharmacokinetics of mAb 14G2a were biphasic with at ₁ ^2/ of 2.8±2.8 h and at ₁ ^2/ of 18.3±11.8 h. In general,t ₁ ^2/ was dose-dependent with a level of significance ofP=0.036, and it reached a plateau at doses of 250 mg/m² or more. Overall the peak serum levels were dose-dependent atP<0.001. However, they demonstrated an abrupt increase between doses of 100 mg/m² and 250 mg/m². The latter two suggest a saturable mechanism for mAb elimination. In addition, peak serum concentrations were observed earlier at higher mAb doses, which indicates the achievement of a steady state. Thet ₁ ^2/ of mAb 14G2a in children appears to be shorter than in adults. Furthermore, 2 patients demonstrated a considerable decrease int ₁ ^2/ following retreatment with 14G2a. This was paralleled by high human anti-(mouse Ig) antibody levels. This study represents the first comprehensive analysis of murine mAb pharmacokinetics in children and will be useful in the future design of mAb therapy.This work was supported by grants from FDA, FD-R-000377 and NIH U10 CA 28439 and in part by a grant from the general Clinical Research Center program, MOI RR00827, of the National Center for Research Resources, National Institutes of Health. M. M. U.-F. and C.-S. H. were supported in part by a grant from the Children's Cancer Research Foundation, and R. A. R. was supported in part by NIH grant CA 42508     

乳糖酶治疗小儿腹泻病的临床分析

目的 研究小儿腹泻病继发乳糖不耐受的年龄、病因及乳糖酶治疗继发乳糖不耐受的效果.方法 对382例腹泻继发乳糖不耐受患儿进行年龄、病因分析,同时将患儿分成治疗及对照两组,分析乳糖酶的疗效.结果 小儿腹泻继发乳糖不耐受以婴幼儿多见,轮状病毒感染是继发乳糖不耐受的主要病因,乳糖酶治疗继发乳糖不耐受疗效显著.结论 婴幼儿腹泻常规给予乳糖酶可以缩短病程,减少治疗费用,患儿及家长易于接受.     

舒芬太尼、曲马多用于小儿鼾症手术苏醒期躁动的临床研究

目的：探究舒芬太尼与曲马多对用于小儿鼾症手术苏醒期躁动的作用与影响。方法：60例ASAI或II级扁桃体肥大或腺样体肥大的鼾症手术患儿,年龄6-14岁,无呼吸系统,循环系统等疾病,一般状态良好。随机分为舒芬太尼组（s组）和曲马多（T组）,每组各30例。常规监测各项生命体征。于手术结束前20分钟（min）,S组缓慢静脉输入0．15μg／kg舒芬太尼,T组静脉输入1．2mg／kg曲马多。观察各组的：平均动脉压 （MAP）、心率（HR）、血氧饱和度（SpO2）,进行各组的镇静评分（RSS）、躁动评分（RS）、镇痛评分（VRS）、意识状态评分（OAAS）。记录拔管前（T0）、拔管时（T1）、拔管后5min（T2）、拔管后10min（T3）、拔管后20min（T4）各时间点各参数的变化。记录各组的恶心呕吐、呼吸抑制、烦躁等的发生率。结果：SpO2各组间无显著差异。MAP,HR在各时间点的变化T组大于S组,P〈0．05,有显著差异。T组在RS,RSS,VRS评分与S组有显著差异,P〈0．05。结论：0．15μg／kg的舒芬太尼在小儿鼾症手术的苏醒期可以维持稳定的血流动力学,副作用小,镇痛效果良好,可以有效减少小儿苏醒期的躁动。     

Use of oxytocin and cloprostenol to facilitate semen collection by electroejaculation or transrectal massage in bulls

Two experiments were conducted with 24 bulls in which semen collection was attempted by transrectal massage (RM) and electroejaculation (EE). In experiment 1, bulls received the following treatments on successive semen collection days: saline 10 min prior to electroejaculation (control); saline 10 min prior to 2 min of transrectal massage followed by electroejaculation; cloprostenol (CLO) 10 min prior to 2 min of transrectal massage followed by electroejaculation; oxytocin (OXY) 10 min prior to 2 min of transrectal massage followed by electroejaculation. Transrectal massage consisted of general, back and forth motion over the ampullae, prostate and urethra with a flattened hand.

In experiment 2, bulls received saline (control), oxytocin, or cloprostenol 10 min before attempting semen collection by transrectal massage. Massage was applied specifically to the ampullae for a maximum of 5 min or until a semen sample was obtained. Electroejaculation was attempted in all bulls following transrectal massage.

In experiment 1, semen was obtained in <1% of bulls by transrectal massage. However, by using an improved massage technique in experiment 2, semen was obtained in 97.2% of attempts. Semen was obtained in 96.9 and 98.9% of attempts by electroejaculation in experiments 1 and 2, respectively.

Oxytocin treatment increased the time to penile protrusion during electroejaculation in experiment 1 and during massage in experiment 2. In experiment 1, oxytocin decreased the time to semen emission and tended to decrease the number of electroejaculation stimuli to semen emission. Cloprostenol treatment, in experiment 1, resulted in an increased number of electroejaculation stimuli to penile protrusion, but did not affect the number of stimuli required for semen emission.

Massage of the ampullae prior to electroejaculation reduced both the time to semen emission and the number of electroejaculation stimuli required for semen emission. Transrectal massage of the ampullae was very effective in this experiment for producing semen emission, but quantity of semen samples was less than for electroejaculation. The usefulness of transrectal massage for semen collection in breeding soundness evaluations needs to be investigated further under field conditions.     

A sensitive and selective liquid chromatography/tandem mass spectrometry method for determination of MLN8237 in human plasma

We describe a selective and a highly sensitive high-performance liquid chromatography–electron spray ionization-collision induced dissociation-tandem mass spectrometry (HPLC–ESI-CID-MS/MS) assay for the Aurora A kinase inhibitor MLN8237 in human plasma. The intra-day precision based on the standard deviation of replicates of quality control samples ranged from 0.2 to 4% and with accuracy ranging from 96 to 102%. The inter-day precision ranged from 0.5 to 7% and the accuracy ranged from 93 to 105%. Stability studies showed that MLN8237 was stable both during the expected conditions for sample preparation and storage. The lower limit of quantification for MLN8237 was 5 ng/mL. The analytical method showed excellent sensitivity, precision, and accuracy. This method is robust and is being successfully employed in a Children's Oncology Group Phase 1 Consortium study of MLN8237 in children with cancer.     

Abnormal expression of P2X family receptors in Chinese pediatric acute leukemias

Nucleotides are new players in intercellular communication network. P2X family receptors are ATP-gated plasma membrane ion channels with diverse biological functions. Their distribution patterns and significance in pediatric leukemias have not been established. Here we investigated the expression of P2X receptors in BMMC samples from Chinese pediatric acute leukemias. Real-time PCR and Western blot results showed that P2X1, P2X4, P2X5 and P2X7 receptors were simultaneously over expressed in leukemias compared with controls, whereas P2X2, P2X3 and P2X6 were absent or marginally expressed in both groups. It was worth noting that the co-expression feature of them, especially between P2X4 and P2X7, could be observed and the highest expression of P2X7 was detected in relapsed patients. Moreover, concomitant decrease of P2X4, P2X5 and P2X7 expressions was observed at CR stage in a follow-up study. Functional P2X7 was also verified. These results suggested that P2X1, P2X4, P2X5 and P2X7 were hematopoiesis-related P2X receptors, and their signaling, especially for P2X7, might play important roles in pediatric leukemias. P2X receptors might co-operatively contribute to the malignant phenotype in human pediatric leukemias.     

Strategies for Correcting Very Long Chain Acyl-CoA Dehydrogenase Deficiency

Very long acyl-CoA dehydrogenase (VLCAD) deficiency is a genetic pediatric disorder presenting with a spectrum of phenotypes that remains for the most part untreatable. Here, we present a novel strategy for the correction of VLCAD deficiency by increasing mutant VLCAD enzymatic activity. Treatment of VLCAD-deficient fibroblasts, which express distinct mutant VLCAD protein and exhibit deficient fatty acid β-oxidation, with S-nitroso-N-acetylcysteine induced site-specific S-nitrosylation of VLCAD mutants at cysteine residue 237. Cysteine 237 S-nitrosylation was associated with an 8–17-fold increase in VLCAD-specific activity and concomitant correction of acylcarnitine profile and β-oxidation capacity, two hallmarks of the disorder. Overall, this study provides biochemical evidence for a potential therapeutic modality to correct β-oxidation deficiencies.     

骨骼肌损伤修复的生理生化机制研究

为探讨新西兰兔股四头肌损伤修复过程中,按摩对骨骼肌和运动终板(MEP)损伤修复的生理生化机制,将30只雄性新西兰大白兔随机分成正常组、自然恢复组(损伤后7d(3只)、14 d和21 d三个亚组(各6只))和按摩治疗组(按摩7d和14d两个亚组(各6只)).重物打击法制作兔股四头肌急性损伤模型,H&E染色,AchE酶组化...     

EB病毒抗体和DNA联合检测可提高儿童传染性单核细胞增多症的诊断灵敏度

目的评估EB病毒抗体VCA-IgM、VCA-IgG、EA-IgG、EBNA-1-IgG及EBV-DNA载量检测在儿童传染性单核细胞增多症(传单)中的诊断意义。方法用ELISA方法检测70例传单患儿和25例健康儿童血清中EBV四种抗体及PCR荧光定量法检测外周血单个核细胞EBV-DNA载量。结果传单患儿组EBV-DNA的阳性率为87.14%(61/70),对照组阳性率为8.00%(2/25),传单组与对照组EBV-DNA的阳性率比较差异有统计学意义(P<0.01)。EBV抗体检测中,传单组的VCA-IgM阳性率最高,达91.43%(64/70),对照组VCA-IgM全部阴性。传单组EB病毒VCA-IgM和EBV-DNA联合检测的阳性率97.1%。结论 EBV抗体和EBV-DNA载量检测对儿童传单的诊断有极高的价值,尤其是VCA-IgM抗体和EBV-DNA联合检测,可提高儿童传单的临床诊断的敏感性。     

Cardiopulmonary bypass reduces atrial Na+-K+-ATPase expression in children

Cardiopulmonary bypass (CPB) may induce serious side effects, potentially leading to myocardial failure. The Na(+)-K(+)-ATPase is a key component for myocardial function. Due to its developmental regulation, results from adult studies cannot be adopted to the situation in childhood. Right atrial myocardium from patients with left-to-right shunts at atrial level (VO, n=8) and those without (NO, n=8) was excised during heart surgery before and after CPB. Na(+)-K(+)-ATPase isoforms ATP1A1 (p=0.008) and ATP1A3 (p=0.038) decreased during CPB, which decrease was restricted to the VO group. This study highlights the importance of the underlying heart defect for susceptibility to the effects of CPB, showing a reduced Na(+)-K(+)-ATPase mRNA expression only in patients with left-to-right shunts on the atrial level. This seemed to be an early molecular event, as apart from one, none of the patients showed heart failure before or after surgery.