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A definitive diagnosis of myocarditis requires right ventricular biopsy. Despite its specificity, however, right ventricular biopsy may lack sensitivity due to the focal nature of the disease. Because indium 111-monoclonal antimyosin antibody imaging can be used to detect myocardial necrosis, this procedure was performed on 28 patients clinically suspected of having myocarditis, 25 of whom had left ventricular ejection fractions of less than 45%, and the results were compared with those of right ventricular biopsy performed within 48 hr of the scan. Antimyosin scans were positive in nine patients who had evidence of myocarditis on right ventricular biopsy, and negative in 11 who had no evidence of myocarditis by biopsy. The remaining eight had positive antimyosin scans but showed no evidence of myocarditis on right ventricular biopsy. On the basis of a right ventricular biopsy standard, the sensitivity of this method was 100%, the specificity 58%. We conclude that antimyosin antibody imaging is a reliable screening method for the evaluation of patients suspected of having myocarditis, and that a positive antimyosin scan indicates the need for right ventricular biopsy to establish the histologic diagnosis.

Disubstituted (hydroxymethylphenylacetamidomethyl-; N -acetyl-α-aminobutyramidomethyl-) copoly(styrene-1% divinylbenzene) in bead form has been prepared for use in solidphase peptide synthesis. As expected, this resin retained resistance to acidolysis described by Mitchell et al. (J. Amer. Chem. Soc. 98 , 7357–7362, 1976). An additional feature of this resin is an internal reference amino acid which could be quantified following propionic acid: HCl hydrolysis for 4 h. Aminobutyric acid (Abu) was found to be stable during peptide synthesis, in particular, treatment with TFA:CH 2 Cl 2 (1:1) for 90 h at 25°C and HF:anisole (9:1) for 60 min at 0°C. The ratios of an amino acid to Abu could be used to evaluate the attachment of an amino acid to the resin, the incorporation of a subsequent amino acid, and finally, eleavage of the peptide from the resin. It is noteworthy that the weight of resin in a peptidyl resin sample could be calculated by using Abu recovery values, if the initial substitution of Abu on the resin was known. This resin which contained Abu, has been used for the extended synthesis of a heavy chain variable region from a homogeneous rabbit antibody.

Intact sheep antidigoxin antibodies and their Fab fragments have both been found to exert profound effects on digoxin pharmacokinetics in [3H] digoxin-treated dogs. Both classes of molecule remove digoxin from the extravascular space and sequester it in the circulation in protein-bound form, a form in which the digoxin is presumably inactive. These two classes of molecule differ, however, in that the intact antibody molecules interfere with digoxin excretion, thereby promoting the retention of the glycoside; this retained digoxin is eventually released in free, active form when the administered antibody is metabolically degraded. In contrast, urinary excretion of digoxin continues in Fab-treated dogs, with significant quantities of digoxin being excreted promptly in the urine in complex with Fab fragments. These differences in urinary excretion, together with the probable decreased immunogenicity of sheep antidigoxin Fab fragments, suggest that such fragments possess potential advantages over intact antibody molecules for use in the therapy of life-threatening digoxin intoxication in man.

Positively charged polymers have been shown to interact nonselectively with cells in vitro by means of an electrostatic binding to a negatively charged cell surface. We reasoned that, if a net negative charge could be introduced onto an antibody molecule, some of the nonspecific antibody interactions with cells could be avoided without affecting the function of the antibody combining site. An important result would be improved target-to-background ratios should such antibodies be used as in vivo imaging agents. To test this hypothesis, we first reacted bifunctional chelators such as diethylenetriamine pentaacetic acid with cationic polylysine polymers to permit radiolabeling with 111 In, then redered the polymer completely anionic by reacting the residual epsilon amino groups with succinic anhydride. These modified polymers were then covalently linked either to monoclonal antimyosin antibody or to its Fab fragment by means of a water soluble carbodiimide. The immunoreactivity of the antibody-polymer conjugates was not significantly diminished. 111 In-labeled antimyosin Fab modified with succinylated polylysine permitted visualization of experimental myocardial infarcts as early as 30 min after intravenous injection. An inverse exponential relationship was observed between the distribution of 201 Tl and that of polymer-modified antimyosin Fab. 111 In-labeled succinylated polymer administered by itself did not localize in the infarct. These observations suggest that anionically modified antibodies may enhance the specificity of antibody imaging.

The immune system has long been recognised as playing a central role in the organism's defence against infectious diseases and possibly the development of neoplasia. The active stimulation of the immune system by immunisation and the passive administration of antitoxins have a venerable history in medicine. Yet the concept that antibodies may be used to modify physiological or pharmacological effects or may act as diagnostic agents in the living organisms has only recently come to be recognised. Advances, both in an understanding of the structural chemistry of the antibody molecule and in the ability to culture antibody-producing cells, now permit the selection and production of homogeneous antibodies and their smaller fragments in quantity by means other than conventional immunisation. These innovations will allow the development of a new pharmacology based on the remarkable resolving power of the antibody combining site. Antibodies or their fragments are shown to inhibit the pressor action of renin, to neutralise the pharmacological actions of digitalis, to block the beta-adrenergic receptor, and to detect and image myocardial infarcts.

The antigen-combining site of antibody molecules consists of six separate loops supported by a conserved beta-sheet framework; antibody specificity arises from length and sequence variation of these 'hypervariable' loops and can be manipulated by transferring sets of loops between different frameworks. Irregular loops are the most difficult parts of protein structure to understand and to model correctly. Here, we describe two computer experiments where all the hypervariable loops were deleted from X-ray structures of mouse immunoglobulins and reconstructed using the conformational search program CONGEN. A protocol was developed for reconstruction of the hypervariable loops in McPC 603 antibody. Calculated loop conformations were generated and a model of the combining site was built from selected low-energy conformations. We then modelled hypervariable loops in another antibody molecule, HyHEL-5. Both models agreed well with the known crystal structures. Our results hold out promise for the success of future modelling studies of complete antigen-combining sites from amino acid sequences.

In an effort to extend automated Edman degradation to nanomole quantities of protein, the method of sequenator analysis described by Edman and Begg (Edman, P., and Begg, G. (1967), Eur. J. Biochem. 1, 80) was modified to permit long degradations in the absence of carrier proteins. By using an aqueous 0.1 M Quadrol program with limited, combined benezene-ethyl acetate solvent extractions, as well as a change in the delivery system for heptafluorobutyric acid, it was possible to recover and identify the first 30 amino acid residues from a sequenator run on 7 nmol of myoglobin. For 3 nmol of myoglobin, 20 steps could be identified. PTH-amino acids were identified by gas-liquid chromatography and thin-layer chromatography on polyamide sheets. Without using a carrier protein the cup to prevent mechanical losses (Niall, H. D., Jacobs, J. W., Van Rietshoten, J., and Tregear, G. W. (1974), FEBS Lett. 41, 62), the repetitive yield using this program was 93-96%. The same program has been applied successfully to peptides of 14 or more residues with or without modification by Braunitzer's reagent and to a number of larger peptides and proteins including a 216 residue segment of rabbit antibody heavy chain in which a sequence of 35 steps was accomplished on 25 nmol.

The amino acid sequence of the amino-terminal 111 residues (variable region) for the light chain of the homogeneous rabbit antipneumococcal type III polysaccharide antibody 3368 was determined. This sequence was obtained principally through automated Edmann degradations of the intact light chain and of peptides generated by tryptic digestion of the citraconylated light chain. With these methods only 2 mumol of purified light chain was required to determine the reported sequence. When compared with the light chains of four other antipneumococcal type III polysaccharide antibodies, the 3368 light chain exhibits a unique sequence in those segments of the variable region that contribute to formation of the antigen binding site (complementarity-determining regions) (10 or 11 residue differences in 12 positions). The 3368 light chain also demonstrates an insertion of three residues relative to the other four light chains in the complementarity-determining region at positions 89 to 98. These five light chains have greater than 80% sequence homology for the portion of the variable region which is not involved in antigen binding (framework).

The partial amino acid sequence of rabbit heavy (H) chains of allotype a1, a2, and a3 was determined. The H chains were derived from restricted antipolysaccharide antibodies which were shown to be precipitated quantitatively by antiallotype sera raised against pooled immunoglobulins. The N-terminal half of the H chains (C1 fragment) was isolated from a CNBr digest and subjected to automated Edman degradation. Extended homology with known sequences from rabbit pooled H chains indicated that C1 fragments were cleaved between residues 34 and 35 and/or 79 and 80. One additional cleavage site was observed at position 110 in two H chains. Section 80 to 94 of a1, a2, and a3 restricted H chains showed little sequence variation. No simple correlation between the identity of a single amino acid residue and the allotype of the H chain could be determined.

The plasminogen activator urokinase was linked covalently to a monoclonal antibody specific for the amino terminus of the beta chain of human fibrin by means of the unidirectional cross-linking reagent N-succinimidyl-3-(2-pyridyldithio)propionate. N-Succinimidyl-3-(2-pyridyldithio)propionate allowed the amino groups on urokinase to be coupled to the sulfhydryl groups on iminothiolane (which had been introduced into the antibody before the coupling reaction). The inter-heavy chain sulfhydryl of the Fab' of this antibody was also linked to N-succinimidyl-3-(2-pyridyldithio)propionate-substituted urokinase. The antibody- or Fab'-urokinase complexes were purified by two affinity chromatography steps. In the first, benzamidine was used as ligand for urokinase, in the second, a heptapeptide consisting of the 7 amino-terminal residues of the beta chain of fibrin (beta peptide) was used as ligand for the antibody. The activity of the purified conjugates was compared with that of urokinase alone in an assay measuring lysis of 125I-fibrin monomer covalently linked to Sepharose CL-4B. For any concentration of either urokinase alone or urokinase-antifibrin antibody conjugate, an equivalent amount of lysis (release of labeled peptide from fibrin monomer-Sepharose) was obtained with 1/250 the concentration (with respect to urokinase content) of antifibrin antibody-urokinase conjugate. The antifibrin Fab'-urokinase conjugate exhibited a similar enhancement of activity in comparison with urokinase. Enhanced fibrinolysis was fully inhibited by beta peptide. These results suggest that antibody targeting enhances the concentration of urokinase in the vicinity of immobilized fibrin monomer, thereby also increasing the local conversion of plasminogen to plasmin, which in turn degrades its substrate, fibrin. Univalent antigen-antibody binding is sufficient for optimal efficiency.

Although renin was identified as playing a role in cardiovascular homeostasis by the experiments of Goldblatt in the 1930's, neither its physiologic role in organs other than the kidney nor its contribution to the genesis of essential hypertension has been defined as yet. It is difficult to interpret studies with converting enzyme inhibitors because of their multiple pharmacologic effects. Specific inhibitors of renin appropriate for clinical investigation would help resolve many questions. Four classes of compounds have been demonstrated to be renin inhibitors of high potency: specific antibody, general peptide inhibitors of acid proteases, analogs of angiotensinogens, and peptides that are related to the amino-terminal sequence of prorenin. Of these, it is likely that angiotensinogen analogs will be the first applied in human studies. The minimal substrate for renin has the sequence: His-Pro-Phe-His-Leu-Leu-Val-Tyr. Variants of this sequence have yielded competitive inhibitors. Recently, remarkably active compounds have been synthesized by reducing the peptide bond that is cleaved by renin, or by incorporating the amino acid statine, found in pepstatin. These compounds have been shown now to be effective in dogs, rats, and monkeys, and most recently, preliminary studies have reported their efficacy in humans. Recent studies with one of these inhibitors, RIP, raise questions concerning both its specificity and site of action.

The use of antirenin antibody and its fragments as specific tools for the analysis of the role of renin in blood pressure regulation is assessed in this study. Specific immunoglobulin G (IgG) or its antibody fragments (Fab) raised against purified canine renal renin were employed. These agents had no effect on blood pressure in the sodium-replete unanesthetized dog but induced systemic vasodepressor response (16.4 +/- 2 mmHg mean pressure) and suppression of plasma renin activity in sodium-deplete animals. Renin-specific IgG or Fab restored mean systemic pressure of acute renovascular hypertensive dogs to normotensive levels (132 +/- 2 to 90 +/- 5 mmHg) associated with inhibition of plasma renin activity (11.2 +/- 2 to 1.4 +/- 0.7 ng angiotension I X ml-1 X h-1). A linear relationship was demonstrated between the reduction in mean systemic pressure and fall in plasma renin activity (r = 0.87, P less than 0.005). The onset of action of both agents occurred within minutes. However, the peak effect of Fab was observed within 1-2 min, while that of IgG was delayed by approximately 20 min. The duration of action of Fab was short lived (about 30 min) whereas that for IgG was prolonged (up to 24 h). The results demonstrate the usefulness of renin-specific IgG and Fab as tools in physiological studies.

In some instances, even the increased resolution that may be afforded in immunoassays by the use of monoclonal antibodies fails to effect resolution among molecules that share many epitopes. An immunoradiometric assay that simultaneously measured two different epitopes on the same molecule was devised to overcome this difficulty in the differentiation between cardiac- and skeletal-myosin light chains. Three monoclonal antibodies were examined that were 100% (1C5), 25% (2B9) and 17% (4F10) cross reactive, respectively, between the two antigens. One antibody of the pair to be studied was immobilized to cyanogen bromide-activated Sepharose 4B while the other was iodinated with 125I using the lactoperoxidase method. The antigen was mixed with the immobilized antibody, the labeled antibody was added and the precipitate then washed and counted in a gamma counter. When both antibodies of the pair to be studied (immobilized and labeled) were the same (2B9), no radioactivity above background was bound to the precipitate, indicating that the second antibody could not bind to an already occupied epitope. When two different antibodies were employed, the specificity of the assay increased over that of a single antibody. The cross reactivity of a pair approximated the product of the cross reactivities of the individual antibodies. Thus, 1C5 and 2B9 were 25% cross reactive together, 1C5 and 4F10 17% cross reactive, and 2B9 and 4F10 4.3% cross reactive.

The myocardial uptake of radioiodinated (Fab')2 fragments of antimyosin antibody [125I-(Fab')2] was compared with simultaneously administered 99mTc-pyrophosphate (Tc-PYP) in dogs undergoing coronary occlusion for 24 (N=6) or 72 hours (N=5). Relative concentrations of both agents in normal and infarcted myocardium were related to regional blood flow as determined by distribution of 55Sr-labeled microspheres in the same animals. There was an inverse exponential relationship between 125I-(Fab')2 localization and regional blood flow in 24 hr (r=-0.64) and 72 hr (r=-0.80) occluded animals. The greatest uptake of 125I-(Fab')2 was observed in subendocardial layers of the center of the infarct where regional flow was most severely impaired (1-10% of normal flow). Maximal localization of Tc-PYP was observed in subepicardial layers in samples from the periphery of the infarct where flow was only moderately reduced (31-50% of normal). Differences in distribution of these two agents in ischemic myocardium are probably related to differences in kinetics of exit from the blood pool.

The use of antirenin antibody and Fab may provide a more specific physiologic tool and potential therapeutic agent than the existing pharmacologic inhibitors. The antibody combining site, by virtue of its larger size than organic compounds, has the capacity for a larger number of intramolecular contacts with its ligands, thus allowing increased selectivity and affinity. Renin-specific Fab obtained through immunization with purified dog renal renin has been studied. Fab had no effect on blood pressure in the sodium replete conscious dog but induced systemic hypotensive responses in the sodium deplete animal or during acute renovascular hypertension. These responses were accompanied with complete suppression of plasma renin and angiotensin II levels. The vasodepressor responses of Fab were comparable to the converting enzyme inhibitor, teprotide. However, the latter induced a greater renal vasodilator effect. Since antibodies and their fragments derived from immune sera are limited in their application to physiologic study with respect to lack of homogeneity, reproducibility and limitation of quantity, we obtained monoclonal antibodies to purified human renal renin. Fusion HR3 yielded 14 renin-antibody secreting clones. Six clones have been isolated and characterized. Isotypes include IgG1 and IgM. Kd's range from 6 X 10(-9) to 7.5 X 10(-10)M renin concentration. Five clones produce antibodies with antienzymatic activity. IC50's of these antibodies range from 1 X 10(-6) to 6 X 10(-8)M. All antibodies are renin-specific and do not bind several nonrenin enzymes and proteins examined. They are also highly species specific, i.e., do not crossreact with mouse, dog, bovine or rat renins but recognize hog renin. These catalytic-site directed antibodies may be highly potent and specific tools for physiologic studies in subhuman primates and man.

We examined the direct binding of a hen egg white lysozyme peptide, HEL(46-61), to membrane I-Ak (protein encoded in the A locus of the I region) molecules in the presence of detergent. A number of synthetic peptide derivatives, which did not stimulate our T-cell reactive hybridomas, competed for the binding of HEL(46-61) to I-Ak and also inhibited the functional presentation of HEL(46-61). Inhibitors included a peptide lacking a tyrosine at position 53 and a peptide corresponding to the autologous lysozyme peptide. Presentation was examined with cells or with supported planar phospholipid membranes bearing only I-Ak and HEL(46-61). Other peptides that did not compete for the binding did not inhibit functional presentation. We concluded that the binding of an immunogenic peptide to I-A is critical for presentation, that the I-A molecule does not discriminate between autologous and foreign related determinants but does recognize structurally different peptides. Our evidence suggests that our immunogenic peptide bears noncontiguous amino acids critical for contact I-A binding interspersed with amino acids critical for interaction with T cells.

The amino terminal (positions 0 to 20) amino acid sequences of 22 rabbit antibody light chains are reported and compared with 44 amino terminal sequences previously described in the literature. Rabbit κ light chains demonstrate three different amino terminal chain lengths and considerable variability at the amino terminal end. In relating amino terminal sequence to b locus allotype, allotype-specific residues (amino acid residues unique to all light chains having a given allotype) were not identified, although certain residue alternatives were unique to some of the b5 and b9 light chains. There was no correlation of antibody specificity with amino terminal sequence. In the most striking example, identical amino terminal sequences were associated with two different carbohydrate specificities (type VIII pneumococcal polysaccharide and streptococcal group A carbohydrate) and an aminophenyltrimethylammonium specificity. An obligatory association of amino terminal sequence with complete variable region framework sequences was not observed. Thus, it is not always possible to predict the framework homology among a given pair of light chains by examination of their amino terminal sequences. The limited diversity seen among the variable regions of murine myelomas that have the same antigen-binding properties is not found in the light chains of specifically elicited rabbit antibodies.

Low renin hypertension (LRH) is characterized by suppression of plasma reninactivity (PRA) in the absence of demonstrable hypersecretion of aldosterone. We have investigated the dynamics of PRA and plasma aldosterone (PA) in 10 normal subjects and 12 LRHpatients during 6 h of upright posture on both normal and low sodium diets. Angiotensin Irecovery experiments excluded an inhibitor of either angiotensin I generation or binding to specific antibody which could account for low PRA. LRH patients could be divided into two groups on the basis of their PRA response to sodium depletion and upright posture. Those patients whose PRA never exceeded 3.0 ng/ml/h were assigned to group I. Those whose PRA achieved this level at any time were assigned togroup II. Whereas PRA and PA levels were lower in both group I and group II patients thanin the normal subjects, the ratio ofPA to PRA was consistently higher in LRH group I patients than in normal subjects; this ratio was not significantly different from normal in grou...

An investigation was made to determine whether it is possible to attract tissue plasminogen activator (tPA) to the site of a thrombus by means of an antibody with affinites for both tPA and fibrin. A bispecific antibody conjugate was constructed by cross-linking two monoclonal antibodies: one specific for tPA, the other specific for fibrin. The bispecific antibody enhanced fibrinolysis by capturing tPA at the site of a fibrin deposit. In an in vitro quantitative fibrinolysis assay, the relative fibrinolytic potency of tPA bound to the bispecific antibody was 13 times greater than that of tPA and 200 times greater than that of urokinase. When fibrin was treated with the bispecific antibody before being mixed with tPA, the relative fibrinolytic potency of tPA was enhanced 14-fold. This capture also occurred when the concentration of tPA present in the assay was less than the concentration of tPA present in normal human plasma. In a human plasma clot assay, samples containing both the bispecific antibody and tPA exhibited significantly more lysis than did samples containing tPA alone. In spite of the increased clot lysis effected by the presence of bispecific antibody, there was no significant increase in fibrinogen or alpha 2-antiplasmin degradation at equal tPA concentrations. The ability of the bispecific antibody to concentrate exogenous tPA in vivo was then examined in the rabbit jugular vein model. Systemic infusion of a small amount of tPA (10,000 units) produced no significant increment in thrombolysis over the level of spontaneous lysis (14 +/- 8%). However, the simultaneous infusion of 10,000 units of tPA and 2 mg of bispecific antibody resulted in 42 +/- 14% (p less than 0.01) lysis. These results suggest that a molecule capable of binding both fibrin and tPA with high affinity could enhance thrombolysis in the circulation by capturing endogenous tPA.

This paper describes a basically new approach to obtaining diagnostic antibodies, consisting of a one-point modification of the antibody, without loss of its activity, by a high-molecular-weight synthetic polymer with the ability of effectively chelating ions of heavy metals. As a result of this approach, preparations of active antibodies containing some tens of atoms of the metal per protein molecule can be obtained. The concentration of radioactive metal (/sup 111/In) was determined with a gamma-counter and the Mn and Cd concentrations by spectroscopy. Gel-filtration of polymer-modified antibodies after binding of /sup 111/InCl/sub 3/ is shown. Also, solid-phase radioimmunoassay of antibodies and Fab fragments, native and modified by chelating polymers, is presented.

We previously described an RIA for aldosterone based on highly specific antibodies elicited with aldosterone-3,20 dioxime bovine gamma-globulin (Poulsen, K. J. Sancho, and E. Haber, Clin Immunol Immunopathol 2: 373, 1974). We now report the development of higher affinity antibodies of similar specificity that allow the direct measurement of normal aldosterone concentrations in extracts of 100 microliters plasma. The detection limit at +/- 2 SD of mean zero value was 0.2-0.3 pg. The assay was validated by 1) zero values in adrenalectomized plasma, 2) parallel displacement plots of aldosterone standards and plasma extracts, 3) 97.7 +/- 2.5% recovery of added tracer, 4) a correlation coefficient of 0.992 and a slope of 1.08 in a plot of added vs. recovered unlabeled aldosterone, 5) 10.2% interassay variation and 5.6% intraassay variation, and 6)failure of high concentrations of a variety of steroids added to plasma to perturb the measured aldosterone concentration. The simplicity of the assay results in a high degree of productivity, in that 195 plasma samples may be processed in duplicate, in addition to standard curves, in a single working day.

We report the complete variable region sequences of three homogeneous rabbit antibody light chains and the partial sequences of five others. Wehn these are compared to other published rabbit light chain sequences, two regions of markedly increased variability are revealed, which are homologous in position to the first and third hypervariable regions of murine and human myeloma light chains. In addition, there is increased variability among the first three residues at the aminoterminal end. A hypervariable region homologous to that identified at positions 50 to 56 in myeloma light chains is not present in these rabbit antibody light chains. The available three-dimensional models of Fab fragments based on x-ray crystallography indicate that neither the amino-terminal portion of the light chain nor the region homologous to positions 50 to 56 forms a part of the combining site. Comparison of the hypervariable regions among six light chains from antibodies to Type III pneumococcal polysaccharide and among four from antibodies to Type VIII pneumococcal polysaccharide suggests that a large number of different sequences may be found in antibodies specific for these relatively simple antigens. Certain residues outside of the hypervariable regions are invariant in the rabbit light chains and correspond to residues that are required for proper chain folding in human and murine myeloma light chains, indicating that the general conformation of myeloma light chains is the same as that of light chains of elicited antibodies.

Antibodies were raised against a newly synthesized analog (CP57,609) of the alpha 1-selective antagonist prazosin, and against the alpha 2-selective antagonist, yohimbine, by immunization of rabbits with antigens prepared by covalent linkage of these ligands to albumin. Competitive inhibition of [3H]prazosin binding to anti-CP57,609 antiserum by a variety of unlabeled ligands revealed a spectrum of antibody specificity, with alpha 1-selective agents competing more potently than alpha 2-selective ligands. In contrast, alpha 2-selective ligands competed more potently with the binding of [3H]yohimbine to the anti-yohimbine antiserum than alpha 1-selective agents. These respective antisera were subjected to affinity fractionation of a CP57,609- or yohimbine-Sepharose 4B resin. Fractions from the CP57,609 resin were eluted successively with phentolamine (10(-3)M), prazosin (10(-4)M), and guanidine (5M), and from the yohimbine resin with prazosin (10(-4)M), yohimbine (10(-4)M), and guanidine (5M). The binding profiles of these fractions differed, and in certain fractions the relative order of potency of adrenergic agents was almost identical to that observed with membrane alpha-adrenergic receptors. Moreover, using these eluted fractions as immunogens, antisera have been obtained which, in the initial bleeds, already possess antiidiotypic activity. These findings therefore suggest that affinity fractionation of antibodies raised against alpha 1- and alpha 2-selective antagonists may provide useful analogs for the further study of the ligand recognition properties of alpha-adrenergic receptors. Additionally, it is probable that antiidiotypic antisera will be developed which will recognize the alpha-adrenergic binding sites.

The availability of elegant studies examining in vitro RNA translation of renin's message, the cDNA sequence of mouse-renin messenger RNA, and the complete amino acid sequence of active renin reveals the biosynthetic pathway of this enzyme. This pathway proceeds in a series of steps that correspond to the common mode of synthesis of secreted proteins. This information must now be correlated with a profusion of observations concerning inactive forms of renin that are found in kidney and other tissues in far higher concentration than the active enzyme in human plasma. At this time, in spite of great efforts on the part of many laboratories, the connection between the inactive renins of tissue or plasma and renin's biosynthetic precursors is unknown. Furthermore, the physiologic and pathophysiologic roles that inactive renins play, if any, have not been defined.

Summary A potent inhibitor of primate renin effective in vivo has been synthesized. The peptide, Pro-His-Pro-Phe-His-Phe-Phe-Val-Tyr-Lys, is an analog of the amino acid sequence found between residues 6 and 13 of renin natural substrate (angiotensinogen). The inhibitor is eight times more soluble at physiologic pH and is cleared from circulation about two-orders of magnitude more slowly than earlier substrate analog inhibitors which were not active in vivo. Infusion of the inhibitor into the monkey (M. fascicularis) blocks the rise in mean arterial pressure caused by exogenous human renin, but not by angiotensin I or II. When injected into a salt-depleted monkey, the peptide lowers blood pressure in a dose-dependent manner about as effectively as the converting enzyme inhibitor, teprotide.

There is currently great interest in acute coronary reperfusion as a therapeutic modality for severe myocardial ischemia. While some studies have demonstrated a reduction in the overall extent of necrosis by early reperfusion, other studies have identified potentially deleterious effects produced by reflow. Because membrane disruption may be an important mechanism of irreversible cell injury, we measured changes in cell membrane integrity early during reperfusion using radiolabeled anticardiac myosin (Fab')2 antibody fragments in dogs. Our method involved brief periods of exposure to the (Fab')2 so that the levels of (Fab')2 binding indicated the degree of membrane disruption at discrete times during the progression of cell injury. In the first protocol (Fab')2 fragments labeled with either 125I and 131I were injected into the left circumflex coronary artery at the onset of reflow and at 45 min of reflow after a 1-h circumflex artery occlusion. Coronary sinus flow was diverted for 5 min following each injection to prevent recirculation. The (Fab')2 binding ratio (ischemic/control) increased during the first 45 min of reflow in each of eight experiments (mean increase 170%, P less than 0.01). No significant increase in (Fab')2 binding was observed in five additional experiments in which nonspecific (Fab')2 was injected. This indicates that the increase in binding seen with antimyosin-specific (Fab')2 was due to changes in specific binding rather than to alterations in (Fab')2 delivery produced by changes in blood flow distribution. The increase in membrane damage during reflow was confirmed by a second protocol in which each animal received only a single left atrial injection of (Fab')2 followed by rapid excision of the heart. The (Fab')2 binding ratio was 1.7 +/- 0.3 (SEM) in the group that received (Fab')2 at the onset of reflow and 3.7 +/- 0.6 (SEM) (P less than 0.05) in the group that received (Fab')2 after 45 min of reflow. In a third set of experiments in which hyperosmotic mannitol was infused during reflow the mean increase in (Fab')2 binding using the first protocol was only 80 +/- 40 vs. 170 +/- 30% without mannitol (P less than 0.05). Thus, membrane damage develops early during coronary reperfusion following 1 h of circumflex coronary artery occlusion, and part of this membrane damage can be prevented by altering the conditions of reflow. A method involving brief exposure of the myocardium to antimyosin (Fab')2 is promising for detecting changes in membrane integrity during evolving ischemic injury.

Plasminogen activator therapy for acute myocardial infarction has become standard medical practice. Bleeding complications, however, limit the utility of the currently available agents. This article reviews how the tools of molecular biology and protein engineering are being used to develop safer and more effective plasminogen activators.

Thallium-201 (TI-201) distribution in acute experimental myocardial infarction (MI) (n = 18) was compared with cardiac-specific antimyosin Fab (AM-Fab) uptake, a specific marker for myocardial necrosis. When antimyosin was injected 4 hours after ligation with TI-201 administered 23 hours 55 minutes later and measurement of myocardial distribution determined 5 minutes after intravenous administration of TI-201, (1) TI-201 distribution closely correlated with microsphere regional blood flow, and (2) an inverse exponential relation to iodine-125 (I-125) AM-Fab uptake was apparent. In another group of 4 animals, TI-201 and AM-Fab were administered intravenously 4 hours after MI, and 36 hours later myocardial distribution was measured. This delayed TI-201 distribution had a close inverse linear correlation with I-125 AM-Fab uptake. This inverse linear relation also was apparent in 28-hour-old MIs in dogs (n = 4) where collateral circulation had been established. TI-201 was administered intravenously at 27 hours after MI, and TI-201 distribution was determined 1 hour later. The present study demonstrated that whereas immediate TI-201 distribution is flow-limited, delayed TI-201 distribution is a marker of cell viability which, due to prolonged circulation time and redistribution, is not flow-limited.

Specific localization of purified antibody against cardiac myosin has been demonstrated in areas of altered myocardial membrane permeability after experimental myocardial infarction. Intravenously administered radioiodine-labeled antimyosin was selectively localized in infarcted myocardium of seven dogs 24 h after coronary occlusion. The mean ratio (+/-SE) of antimyosin antibody in infarcted to normal myocardium in the center of the infarct was 4.2+/-0.4 for endocardial and 2.9+/-0.3 for epicardial layers. By utilizing (Fab')2 fragments of antimyosin obtained by pepsin digestion of purified antibody, the ratio of uptake was increased in eight dogs to 6.1+/-0.6 in the endocardial and 3.3+/-0.4 in the epicardial layers at the infarct center 24 h after occlusion. These ratios were further increased in the infarct center to 13.8+/-1.2 in the endocardial and 7.3+/-0.8 in the epicardial layers when eight dogs were sacrificed 72 h after coronary occlusion. The specificity of antimyosin (Fab')2 localization in infarcted myocardium was demonstrated in four dogs by simultaneous intravenous administration of 125I-labeled antimyosin (Fab')2 and 131I-labeled normal rabbit gamma globulin (Fab')2. Nonspecific trapping of normal rabbit IgG (Fab')2 was observed to be about 38% of total antimyosin (Fab')2 uptake in the central zone of infarction. Regional blood flow was related to antimyosin (Fab')2 uptake in infarcted myocardium by utilizing simultaneous administration of 85Sr-labeled microspheres. An inverse exponential relationship between antimyosin (Fab')2 uptake and regional blood flow was observed (r=0.85). The specific localization of antimyosin antibody or its (Fab')2 components in infarcted myocardium suggests a conceptually new approach to myocardial infarct localization and sizing.

A new approach to quantifying myocyte cell death utilizing fluorescence-activated sorting of antimyosin antibody-labeled cells was used to study the effects of oxygen-generated free radicals on cell survival. Uptake of antimyosin, reflecting sarcolemmal damage, increased under conditions which promoted elevated free radical formation and decreased in the presence of increased levels of free radical-scavenging agents. Superoxide dismutase decreased antimyosin uptake at pH 6.7 and 7.5. Mannitol decreased antimyosin uptake at pH 6.5 and 6.7 but not at pH 7.5, and dimethyl sulfoxide decreased antimyosin uptake at pH 6.4 but not at pH 7.5. These data suggest that a greater portion of hydroxyl radicals are produced at higher concentrations of hydrogen ion. Mannitol, a scavenger of hydroxyl radicals, was effective in reducing antimyosin uptake at pH 7.5 in the presence of ferrous sulfate, but had no effect on antimyosin uptake in the absence of ferrous sulfate, suggesting possible iron-mediated catalysis of hydroxyl radical formation. The data suggest that oxygen-derived free radicals can cause significant loss of membrane integrity in cultured myocytes, that the species of radical formed is dependent both on pH and the concentration of iron salts, and that this injury is, at least in part, preventable by the administration of exogenous radical scavenging agents.

To examine the role of angiotensin II in the maintenance of blood pressure and the control of aldosterone secretion in man, eight normal subjects were studied on a tilt table in sodium replete and sodium depleted states prior to and subsequent to the intravenous infusion of an angiotensin converting enzyme inhibitor (CEI). In both the sodium replete or sodium depleted state, upright tilting resulted in an increase in heart rate and a narrowing of pulse pressure. None of the sodium replete or depleted subjects fainted. Tilting was accompanied by a rise in plasma renin activity with an associated rise in plasma aldosterone concentration. When converting enzyme inhibitor was administered, which blocked the generation of angiotensin II, sodium replete subjects were able to compensate for an upright tilt, despite the absence of angiotensin II, without significant hemodynamic change when compared to control state. In sodium depleted subjects, after the administration of converting enzyme inhibitor, there was a sharp and significant decrease in systolic and diastolic blood pressure associated with a significant rise in heart rate. All but one sodium depleted subject fainted within seven minutes. Both plasma aldosterone concentration and plasma renin activity rose on tilting in both sodium replete and sodium depleted subjects. After the administration of converting enzyme inhibitor, plasma aldosterone failed to rise in association with a rise in plasma renin activity. In supine subjects, after the administration of converting enzyme inhibitor, plasma renin activity rose but plasma aldosterone concentration fell. In sodium depleted subjects, after the administration of CEI, aldosterone fell to a level significantly lower than that in supine controls and to a level no different from the supine sodium replete subject. These results indicate that angiotensin II is essential for blood pressure maintenance in sodium depleted individuals, that angiotensin II exerts a direct feedback control on renin secretion, and that angiotensin II is the primary stimulus to aldosterone secretion in response to both sodium depletion and to posture.

Sixty-three patients with life-threatening digitalis intoxication were treated with purified fragments of digoxin-specific antibodies (Fab) obtained from sheep. Twenty-eight patients developed toxicity as the result of digitalis ingestion in a suicide attempt, 5 ingested a large amount of digoxin accidentally and 30 developed toxicity in the course of treatment for underlying heart disease. The dosage of digoxin-specific Fab was calculated to be equi-molar to the amount of cardiac glycoside in the patient's body.Digitalis toxicity was completely reversed in most cases, with onset of effect usually within 30 minutes of admin- istration of Fab fragments. Unbound and, therefore, active digoxin serum concentrations decreased to undetectable levels within minutes after administration of the fragments. In all patients who had elevated serum potassium concentrations caused by massive digitalis toxicity, treatment with the Fab fragments reversed the hyperkalemia. There were no obvious adverse reactions to treatment. Potentially life-threatening digitalis intoxication can be rapidly and safely reversed by treatment with purified digoxin-specific Fab fragments.

SummaryThe potential use of a fibrin-specific monoclonal antibody-64C5 as a thrombus detecting agent was examined in a quantifiable extracorporeal circulatory model using the chicken. This species was selected because antibody-64C5 did not cross-react with chicken fibrin. Human fibrinogen was clotted with human thrombin and factor XIII on filter paper disks, which were then inserted into an ex-vivo chamber that interrupted an extracorporeal loop between a carotid artery and a jugular vein. Antibody-64C5 was injected intravenously and after an equilibration period, disks bearing human fibrin were placed in the extracorporeal chamber and exposed to circulating antibody. Uptake which was quantified by treating the disks with 125I-goat antimouse-(Fab’)2 was rapid, with 70 percent of maximal uptake occurring within 10 min. Fibrinolysis, although measurable, had no adverse effect upon uptake of the monoclonal antifibrin-64C5.

A procedure for coupling liposomes to a target specific macromolecular species, anticanine cardiac myosin antibodies, was developed. The anticanine cardiac myosin antibodies covalently coupled to liposomes were shown to retain the specific antibody activity in vitro for the homologous radioiodinated antigen. Radioisotopes can be transported inside such liposome-antibody complexes and were shown experimentally to localize in acute canine myocardial infarction. This new method of coupling of liposome to target-specific agents could provide a novel and highly specific means of transporting radioisotopes or pharmaceuticals protected within the liposomes to selected target organs.

Antibodies raised to pure canine renal renin were used to probe homology of renin from other species. Goat, rabbit, and mouse antibodies exhibited similar properties and were specific for renin as confirmed by immunodiffusion, immunoelectrophoresis, and selective inhibition of renin enzymatic activity. Goat antibody also inhibited the enzymatic activities of rat, hog, and bovine renin. Immunologic cross reactivity was further confirmed by direct binding and competition assays. Goat anti-(canine renin) antibody did not inhibit human or mouse renin activity, but readily bound to these enzymes, suggesting the presence of epitopes distant from the enzymatic site. Purified goat Fab retained only 10% to 20% of the anticatalytic activity of antibody, but this activity was largely recovered when donkey anti-goat antibody was added to the Fab-renin mixture. Thus, the major fraction (80% to 90%) of goat antibody exerted its anticatalytic activity by immune complex formation of steric hindrance and is not catalytic-site directed, whereas 10% to 20% binds an epitope at or near the catalytic site.

Four homogeneous antibodies to type VIII pneumococcal polysaccharide (S8) were isolated from the serum of a single rabbit (3322) by affinity chromatography on an S8 immunoadsorbent by utilizing gradient elution with cellobiose and NaCl. The binding properties of these antibodies were determined by a radioimmunoassay with 125I-bovine γ-globulin-S8. Cellobiose (a disaccharide unit of S8) was the immunodominant group of each of the four antibodies, but each antibody bound to this disaccharide with different relative affinities. The amino acid sequences (positions 0–40) of three of the four antibody light chains were each different both in framework and first hypervariable region sequences. The fourth antibody light chain has a blocked amino terminus. These findings indicate that antibodies elicited by a relatively simple antigen and examined at one time during the course of immunization in a single rabbit may exhibit common specificities for an oligosaccharide determinant, yet have different binding affinities for that determinant as well as different primary structures in the complementarity (hypervariable) regions and framework regions.

The binding region of immunoglobulins, which includes the portion of the molecule having the most variability in its amino acid sequence, is shown to have a surprisingly constant structure that can be characterized in terms of a simple, well-defined model. The binding region is composed of the antigen combining site plus its immediate vicinity and arises by noncovalent association of the light and heavy chain variable domains (VL and VH, respectively). The antigen combining site itself consists of six polypeptide chain segments ("hypervariable loops") which comprise some 80 amino acid residues and are attached to a framework of VL and VH beta-sheet bilayers. Having analyzed refined x-ray crystallographic coordinates for three antigen-binding fragments (Fab KOL (Marquart, M., Deisenhofer, J., and Huber, R. (1980) J. Mol. Biol. 141, 369-391), MCPC 603 (Segal, D., Padlan, E. A., Cohen, G. H., Rudikoff, S., Potter, M., and Davies, D. R. (1974) Proc. Natl. Acad. Sci. U. S. A. 71, 4298-4302), and NEW (Saul, F. A., Amzel, L. M., and Poljak, R. J. (1978) J. Biol. Chem. 253, 585-597] we use the results to introduce a general model for the VL-VH interface forming the binding region. The region consists of two closely packed beta-sheets, and its geometry corresponds to a 9-stranded, cylindrical barrel of average radius 0.84 nm with an average angle of -53 degrees between its two constituent beta-sheets. The barrel forms the bottom and sides of the antigen combining site. The model demonstrates that the structural variability of the binding region is considerably less than was thought previously. Amino acid residues which are part of the domain-domain interface and appear not to be accessible to solvent or antigen contribute to antibody specificity.

On the basis of the minimal octapeptide sequence of the renin substrate, a series of peptides was synthesized containing (3S,4S)-4-amino-3-hydroxy-6-methylheptanoic acid (statine) or (3S,4S)-4-amino-3-hydroxy-5-phenylpentanoic acid (AHPPA) at the P1P1' position. Some of these peptides also contained Nin-formyltryptophan at the P5, P3, or P3' position. Renin-inhibitory potency varied over a wide range (from inactive to IC50 = 3 nM). Potency was reduced by at least 10-fold when the peptide was shortened by two residues at either the amino or carboxy terminus. The AHPPA-containing inhibitors were several-fold less potent than the statine-containing inhibitors. Analysis of models for the three-dimensional structure of inhibitors at the active site of human renin suggests that the diminished potency of the AHPPA peptides in comparison with the statine-containing peptides was caused by a shift in the peptide backbone due to a steric conflict between the phenyl ring of the AHPPA residue and the S1 subsite. The importance of the side chain and the 3(S)-hydroxyl group of the statine residue was demonstrated by substituting 5-aminovaleric acid for a dipeptide unit at the P1P1' position, which resulted in a peptide devoid of renin-inhibitory activity. Substitutions of other basic amino acids for histidine at the P2 position caused a great loss in potency, possibly due to disruption of a hydrogen bond as suggested by molecular modeling. Studies on the plasma renins of four nonhuman species suggest that the isoleucine-histidine segment at the P2'P3' position is important to defining the human specificity of the substrate. This work suggests a number of properties important to the design of potent renin inhibitors, and demonstrates the usefulness of three-dimensional models in the interpretation of structure-activity data.

High-affinity monoclonal antibodies specific for the cardiac glycoside digoxin provide a useful system for the study of structure-function relationships between antibody combining site and specific antigenic determinants. Fifteen high-affinity monoclonal anti-digoxin antibodies were produced when spleen cells from A/J mice immunized with digoxin coupled to human serum albumin (Dig-HSA) were fused with the non-secreting murine myeloma Sp2/0 cell line. Each subcloned hybridoma antibody was analyzed for affinity and specificity for structurally related cardiac glycosides by a radioimmunoassay based on the adsorption of free [ 3 H]digoxin to dextran-coated charcoal. All of the anti-digoxin hybridoma proteins demonstrated high affinity constants ranging from 10 9 to 10 12 M −1 . Using seven different analogs of digoxin, binding specificities of the monoclonal antibodies were assessed by inhibition radio-immunoassay. The 15 hybridomas produced from fusions involving five mice could be divided into eight sets on the basis of these binding specificities. Certain antibodies exhibit a preference for the aglycone portion of digoxin, while others are more specific for the tridigitoxose sugar moiety of digoxin. Monoclonal antibody H- and L-chains were subjected to N -terminal amino acid sequence analysis. The antibodies may be divided into several sequence homology sets for both H- and L-chains. In most instances, homologous heavy chains are associated with a set of homologous light chains. Homologous partial sequences, however, do not correlate with similar antigenic specificities and affinities for digoxin. Thus the fine specificity for antigen is not dependent on V H - and V L -encoded sequences alone. These data illustrate the broad diversity of the elicited response to a single hapten, even in inbred mice.

Liposomes may act as in vivo transport vehicles for radionuclides or pharmaceutical agents. The linkage of specific antibodies to the surface of the liposome allows for site-specific targeting. Surface antibodies, however promote the sequestration of liposomes in the reticuloendothelial system, significantly reducing the effectiveness of selective localization. In this study, the binding of the sialoglycoprotein, fetuin, to the liposome surface by hydrophobic interaction significantly diminished hepatic concentration of IgG-substituted liposomes in mice. Macrophages also showed reduced phagocytosis of fetuin-coated liposomes in vitro in the presence of soluble fetuin.

We used a radioimmunoassay for fibrinopeptide A (FPA) to detect activation of blood clotting in patients with systemic lupus erythematosus (SLE). FPA levels were elevated in all patients with any degree of clinically detectable inflammation but were normal (

Intravenous injection of New Zealand White rabbits with type III pneumococcal polysaccharide vaccine conjugated with the cardiac glycoside digoxin resulted in the production of both antidigoxin and anti-type III pneumococcal polysaccharide antibodies. Among antisera of 12 rabbits examined during their peak antibody production periods, 1 to 20 mg (mean, 5.4 mg) of antidigoxin antibody could be recovered from 1 ml of serum. Antisera from five of these 12 rabbits contained antidigoxin antibodies of restricted heterogeneity as demonstrated by urea-polyacrylamide disc gel electrophoresis of fully reduced and alkylated antibodies. From the antisera of four of these five rabbits, electrophoretically homogeneous antibodies (1 to 5 mg/ml antiserum) could be isolated by affinity chromatography on ouabainamine-Sepharose columns. The structural homogeneity of two of these antidigoxin antibodies was confirmed by amino acid sequence analysis of purified light chains through the first hypervariable region. These data suggest that the conjugation of small molecules to bacterial polysaccharide vaccines may provide a general method for synthesis of immunogens that can regularly elicit antihapten antibodies of restricted heterogeneity.

Principles for the design of renin inhibitors were examined by utilizing a three-dimensional model of the enzyme with inhibitory peptides in its catalytic site. Optimal conformations were subjected to energy minimization by the computer program CHARMM. The results were then compared with the inhibitory potencies of these peptides as assessed by an in vitro renin assay. The results of the modeling study and enzymatic assay were generally congruent, showing that residues at the P5, P4 and P3 positions contributed importantly to binding, that an acetyl group can replace Pro-His at the P5, P6 position, that the lesser potency of AHPPA-containing as compared with statine-containing peptides may be related to the better fit into the S1 subsite of an isobutyl as opposed to a benzyl side chain, that histidine in the P2 position forms an essential hydrogen bond with residue 230 (which cannot be formed by another basic residue), and that there is a general correlation between inhibitory potency and calculated energy of interaction as deduced from the model. Major determinants of energy of binding are conformational strain and electrostatic interaction.

Rare spontaneous variants of the anti-digoxin antibody-producing hybridoma 40-150 (Ko = 5.4 x 10(9) M-1) were selected for altered antigen binding by two-color fluorescence-activated cell sorting. The parent antibody binds digoxin 890-fold greater than digitoxin. The variant 40-150 A2.4 has reduced affinity for digoxin (Ko = 9.2 x 10(6) M-1) and binds digoxin 33-fold greater than digitoxin. A second-order variant, derived from 40-150 A2.4 (designated 40-150 A2.4 P.10), demonstrated partial regain of digoxin binding (Ko = 4.4 x 10(8) M-1). The altered binding of the variant 40-150 A2.4 was accounted for by a point mutation resulting in substitution of arginine for serine at position 94 in the heavy chain variable region. Antibody 40-150 A2.4 P.10 also contains this arginine but owes its enhanced antigen binding to deletion of two amino acids from the heavy chain amino terminus. This unusual sequence alteration in an immunoglobulin framework region confers increased affinity for antigen.

The development of cell-membrane permeability to macromolecules is likely to be an unequivocal criterion of cell death. In order to utilize this phenomenon as an organ-specific probe in the diagnosis of myocardial infarction, the leakage of cardiac-myosin light chains from damaged myocardium as well as the entry and fixation of radioactively labeled cardiac myosin-specific antibody into cells was examined. In 25 rabbits immunized with cardiac-myosin light chains, none yielded antisera that discriminated fully between cardiac- and skeletal-muscle light chains, thus failing to yield an organ-specific reagent. While immunospecifically purified rabbit antisera raised in response to immunization with cardiac myosin resulted in useful in vivo imaging reagents for myocardial infarcts, the quantity of antibody produced by these methods was severely limiting. The application of somatic-cell fusion of mouse myeloma cells with mouse plasma cells secreting either antibody specific for cardiac myosin or cardiac-myosin light chains allowed for the cloning of hybrid cell lines that continuously secreted homogeneous antibodies. The cardiac-(light chain) antibodies, utilized either singly in a conventional radioimmunoassay or in pairs in a sandwich immunoradiometric assay, markedly enhanced the resolution between cardiac- and skeletal-muscle light chains. Either the myosin light chain or myosinspecific cell lines could be amplified by growth in vivo as plasmacytomas, permitting the harvesting of gram quantities of antibodies. Thus, the problem of supply was readily solved. These monoclonal antibodies provide a powerful tool for the localization and quantification of myocardial necrosis in vivo.