Radioimmunology: imaging and therapy

Article Abstract:

The dream of therapeutic research has always been to construct the ''magic bullet''. The term was coined to describe chemical compounds that could kill infectious organisms without affecting the host. More recently, oncologists have dreamed of magic bullets that could seek out tumor cells and specifically destroy them. Despite advances in chemotherapy, the magic bullet has remained elusive. The development of monoclonal antibody technology has rekindled the dreams of a magic bullet. Monoclonal antibody technology permits the mass production of antibodies with a single antigen specificity. If these antibodies can be developed to recognize an antigen that is present only on tumor cells, the first step towards a magic bullet may be taken. In a small number of cases, appropriate antibodies against tumor antigens have, indeed, been developed. One such antibody is 3F8 which recognizes the GD2 antigen found on neuroblastoma cells; another such antibody is T-101 which recognizes the CD-5 antigen of T-lymphocytes. These antibodies may be labelled with radioactive atoms. When used at a low level of radioactivity, these antibodies serve as markers for imaging studies. When injected into the body, they circulate in the blood and bind to tumor cells that possess the appropriate antigen. After sufficient time has elapsed, radiodetectors scan the body and create an image, indicating the locations where the greatest amount of radioactivity has concentrated. Once it has been established by the imaging procedure that the antibody has localized in the tumor, the antibody can be administered a second time. This time, however, the antibody is labelled with a high-level of radioactivity, sufficient to destroy cells in the vicinity. This procedure was used in the treatment of nine children with neuroblastoma which had proved refractory to conventional treatment. Treatment of the tumors with 3F8 antibody labelled with high levels of radioactive iodine-131 resulted in a partial response in one patient and the stabilization of disease in six. The magic bullet has not yet been achieved, but, at least in the case of a few cancers carrying unique antigens, the magic bullet is beginning to seem possible after all. (Consumer Summary produced by Reliance Medical Information, Inc.)

Radioimmunotherapy, Radiation immunology

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The future of cytokine combination therapy

Article Abstract:

The author likens the various cytokines to musical instruments; we understand the individual instruments, but do not understand how they are combined to play the symphony. The cytokines are a large and heterogeneous class of proteins which exert a variety of regulatory influences. There are four known colony-stimulating factors, a variety of loosely related proteins called interleukins, the interferons, a handful of macrophage-inflammatory proteins, and a bewildering array of growth factors. In general, each cytokine influences a variety of cells, and each cell type is influenced by a variety of cytokines. The spectrum of action of any two cytokines is different, however. In some cases, two different cytokines with a common target cell can act synergistically, while in other cases one can inhibit the effect of the other. However, until researchers can unravel the complexities of how the various cytokines work together, they will be hampered in their efforts to use these substances for the treatment of immune disorders. For example, one of the potential uses for cytokines is to hasten the recovery of the bone marrow after the marrow cells have been decimated by anti-cancer drugs. Anything which shortens the recovery period will lessen a patient's susceptibility to infection, and may permit the use of a more aggressive and effective chemotherapeutic regimen. Studies have shown that interleukin-1 beta (IL-1) hastens the recovery of neutrophils, an important type of white blood cell in the first line of the body's defense. However, the artificial introduction of IL-1 changes the regulation of cytokine receptors on the surface of many cells. Furthermore, the artificial introduction of IL-1 has many side effects including fever and chills, phlebitis, bone pain, and low blood pressure. Presumably, as more is learned about the interrelationships of the cytokines, it should become possible to increase the desired effects of interleukin-1 while decreasing the unwanted side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Usage, Physiological aspects, Hematopoiesis, Cytokines, Granulocytes, Neutrophils, Interleukin-1, Hematopoietic agents, Hematopoietic growth factors

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Unlocking clinical data from narrative reports: a study of natural language processing

Article Abstract:

A natural language processor appears to perform as well as physicians in identifying clinical conditions from narrative patient reports. Researchers compared the ability of physicians, layperson, and different automated methods to detect six medical conditions in 200 x-ray reports. Based on a majority rule, the physicians detected 101 medical conditions. Acute bacterial pneumonia was the most common condition detected while chronic obstructive pulmonary disease was identified least often. Physicians had different interpretations of an x-ray report in approximately 20% of cases. The performance of the natural language processor was indistinguishable from that of the physicians and it outperformed the layperson and the other automated methods.

Evaluation, Natural language processing, Natural language interfaces, Computer-aided transcription systems, Computer aided transcription systems

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