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Purpose: Androgen deprivation therapy (ADT) has been used as an adjuvant treatment to radiation therapy (RT) for the management of locally advanced prostate carcinoma. Long-term ADT decreases bone mineral density (BMD) and increases the risk of osteoporosis. The objective of this clinical trial was to evaluate the efficacy of risedronate for the prevention of BMD loss in nonmetastatic prostate cancer patients undergoing RT plus 2 to 3 years of ADT., Methods and Materials: A double-blinded, placebo-controlled, randomized trial was conducted for nonmetastatic prostate cancer patients receiving RT plus 2 to 3 years of ADT. All had T scores > -2.5 on dual energy x-ray absorptiometry at baseline. Patients were randomized 1:1 between risedronate and placebo for 2 years. The primary endpoints were the percent changes in the BMD of the lumbar spine at 1 and 2 years from baseline, measured by dual energy x-ray absorptiometry. Analyses of the changes in BMD and bone turnover biomarkers were carried out by comparing mean values of the intrapatient changes between the 2 arms, using standard t tests., Results: One hundred four patients were accrued between 2004 and 2007, with 52 in each arm. Mean age was 66.8 and 67.5 years for the placebo and risedronate, respectively. At 1 and 2 years, mean (±SE) BMD of the lumbar spine decreased by 5.77% ± 4.66% and 13.55% ± 6.33%, respectively, in the placebo, compared with 0.12% ± 1.29% at 1 year (P=.2485) and 0.85% ± 1.56% (P=.0583) at 2 years in the risedronate. The placebo had a significant increase in serum bone turnover biomarkers compared with the risedronate., Conclusions: Weekly oral risedronate prevented BMD loss at 2 years and resulted in significant suppression of bone turnover biomarkers for 24 months for patients receiving RT plus 2 to 3 years of ADT., (Copyright © 2013 Elsevier Inc. All rights reserved.)

We describe a recent clinical case experience of antithyroid arthritis syndrome and literature search from 1965 to 1996 on antithyroid medication and associated arthritis using MEDLINE and EMBASE. The antithyroid arthritis syndrome is a transient migratory polyarthritis that occurs within 2 months of starting thionamide treatment, and resolves within 4 weeks of stopping therapy. Discontinuation of medication is necessary. Alternative forms of treatment for hyperthyroidism should be sought. Nonsteroidal antiinflammatory drug or treatment of the rheumatic complaints is recommended or if unsuccessful, corticosteroid treatment.

We present a comprehensive comparison of the anatomical distributions of the cloned mu, delta and kappa opioid receptor mRNA in rat brain. Northern blot analysis revealed that mRNA species encoding the three receptors differed in size and were differentially localized in brain regions. In peripheral tissues analyzed, the 3 mRNA species were detected only in the spinal cord. The distributions of mu, delta and kappa receptor mRNA in rat brain were examined by in situ hybridization histochemistry using gene-specific probes. Mu receptor mRNA was predominately localized to thalamic, brainstem and reticular core nuclei and was highest in the habenular and thalamic nuclei. In contrast, kappa receptor mRNA was expressed in hippocampus including dentate gyrus, hypothalamic and some thalamic nuclei and also present in cortex, caudate putamen, olfactory tubercle and nucleus accumbens. Delta receptor mRNA was prominent in cerebral cortex, olfactory tubercle, hippocampus, caudate putamen and nucleus accumbens. These results show that the mRNA distribution for each opioid receptor subtype in brain is unique and correlate well with the known distribution of the corresponding opioid receptor binding sites.

We report the isolation and characterization of a rat cDNA clone encoding a mu-opioid receptor. This receptor, a 398 amino acid protein, shares 59% overall identity with the mouse delta- and kappa-opioid receptors. Transient expression of the receptor in COS cells revealed high-affinity binding of mu-selective opioid antagonists and agonists, with a KD for naloxone approximately 1.5 nM, and for [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO) and morphine at the high-affinity site of 2-4 nM, confirming a mu-opioid pharmacological profile. Northern blotting and in situ hybridization histochemistry revealed that the mu-opioid receptor mRNA was expressed in many brain regions, including cerebral cortex, caudate putamen, nucleus accumbens, olfactory tubercle, septal nuclei, thalamus, hippocampus, and medial habenular nucleus, in keeping with the known distribution of the mu-opioid receptor.

Rabbit anti-rat anti-human thyrotropin anti-idiotypic antibodies have been raised. These antibodies were active at the thyrotropin (TSH) receptor, in that they inhibited 125I-labeled bovine TSH binding to thyroid plasma membranes, stimulated adenylate cyclase activity through a guanyl nucleotide-dependent mechanism, augmented radioiodide transport into isolated porcine thyroid follicular cells and induced such cultured cells to organize into follicles. Aside from substantiating the expectation that anti-hormone anti-idiotypic antibodies may possess properties of the original hormone, this work raised the possibility that thyroid-stimulating antibodies which cause the hyperthyroidism of Graves' disease may be anti-TSH anti-idiotypic antibodies.

We have extended our study of an incomplete variant of multiple endocrine neoplasia Type I (MEN IBurin). In this syndrome, primary hyperparathyroidism and prolactin-secreting adenoma are common, with hormone-secreting pancreatic tumors being rarely seen. The recent localization of the prolactin structural gene to chromosome 6 made further investigation of linkage to HLA of particular interest. Results in 2 multigeneration families exclude close linkage to HLA. We cannot at this time draw any inference regarding linkage of MEN IBurin to the prolactin structural gene.

Human and porcine thyroid plasma membranes were submitted to sodium-dodecyl sulphate polyacrylamide gel electrophoresis in the absence and presence of reductant and electrotransferred onto nitrocellulose paper. Native bovine TSH, IgG from all 10 patients with active Graves's disease tested, as well as rabbit anti-bTSH anti-idiotypic antibody were found to bind to a single Mr approximately 197,000 band present only in non-reduced gels. We conclude that TSH and Graves' IgG bind to the TSH holoreceptor.

On the premise that an antibody combining site is a mirror image of its antigen epitope, it is expected that an anti-idiotypic antibody (i.e., an antibody specific for the combining site of the first antibody) will be homologous to the epitope. Anti-idiotypic antibodies raised against hormones or drugs would, therefore, be anticipated to interact with their respective receptors. According to this schema, anti-idiotypic antibodies could either be antagonists or agonists. Most of the anti-idiotypic antibodies raised against hormones and neurotransmitters to date have proved, however, to be agonists. We have raised antithyrotropin (anti-TSH) anti-idiotypic antibodies and found these to interact with the high affinity binding site for TSH on thyroid plasma membranes and to induce cGMP-dependent adenylate cyclase activation and iodide transport into dispersed thyroid cells, as well as to promote their organization into follicular structures. The anti-TSH anti-idiotypic antibody interacted with a holoreceptor band of relative mass (Mr) approximately 200 000, resolved on sodium dodecyl sulfate-polyacrylamide gel electrophoresis from thyroid membranes and transferred to nitrocellulose paper. In another set of experiments we raised anti-idiotypic antibodies against monoclonal antibodies specific, respectively, for the alpha and beta subunits of TSH. Neither the alpha nor beta monoclonal antibody specific anti-idiotypic antibodies interacted with the TSH holoreceptor. The combinations of the two anti-idiotypic antibodies, however, did so and increased basal cyclase activity significantly compared with normal immunoglobulin G. As a result of the second set of experiments, we propose that the interaction of TSH with its receptor involves two signals delivered by the two subunits rather than a single signal requiring their combination. Anti-idiotypic antibodies raised against highly purified hormones can be obtained in large amounts. They facilitate simple isolation of hormone receptors and are useful as probes for hormone-receptor interactions.

TSH is a heterodimeric glycoprotein hormone, whose dissociated subunits are without biological activity. This has precluded the assessment of the relative contribution of each subunit to hormone action. We have raised anti-idiotypes to monoclonal antibodies specific, respectively, for the alpha and beta hTSH subunits. The anti-beta anti-idiotype inhibited 125I-hTSH binding to the beta subunit-specific monoclonal quantitatively, whereas 125I-hTSH binding to the alpha subunit-specific monoclonal was not inhibited by anti-alpha anti-idiotypes, suggesting that only the former is an "internal image" anti-idiotype. Neither of the two anti-idiotypes nor equimolar mixtures thereof inhibited 125I-bTSH binding to thyroid membranes, even though radiolabelled anti-idiotypes showed saturable binding to thyroid plasma membrane which was inhibited 41-65% by bTSH. Each anti-idiotype alone caused 9% inhibition (compared to 50% by NRIgG) of thyroid plasma membrane adenylate cyclase. Equimolar mixtures (125 micrograms/ml IgG of each anti-idiotype) induced enzyme activity equivalent to 85% of that of 250 mU/ml of TSH. The TSH-like action of the two anti-idiotypes was also reflected in their capacity to increase (450% by 250 micrograms/ml IgG compared to normal rabbit IgG) the uptake of 131I into isolated thyrocytes and to promote the organization of such cells into follicular structures. At 250 micrograms/ml, anti-beta anti-idiotype promoted the organization of small follicles and only at a concentration of 500 micrograms/ml did it enhance 131I uptake.

Serum levels of immunoglobulins (Ig) IgA, IgG and IgM were measured in 96 HLA-typed patients with Graves' disease and an equal number of sex and age matched controls. Patients showed significantly increased serum immunoglobulin levels compared to controls. HLA DR3-positive patients had larger elevations of IgG concentration than their HLA-DR3-negative counterparts. Variation in serum immunoglobulin levels was not associated with sex, treatment or ophthalmopathy. It is suggested that the hypergammaglobulinemia of Graves' disease is related to defective suppressor cells triggered by Ig or Ig-linked genes. HLA-related gene(s) must, in addition, be involved to account for hypergammaglobulinemia G in the HLA DR3-positive subset of patients.

Antimicrosomal antibodies are present in the sera of most patients with autoimmune thyroiditis, and Graves' disease. It has, in general, been difficult to separate antimicrosomal activity from that directed against the thyrotropin (TSH) receptor in Graves' IgG preparations. The "microsomal" antigen has been localized to the endoplasmic reticulum and microfollicular aspect of thyrocytes; its structure is however unknown. In an attempt to identify the thyroid microsomal antigen, we studied the interaction of Hashimoto's IgG with high microsomal antibody titre and negative for thyroglobulin with purified thyroid plasma and light microsomal membranes. We allowed Hashimoto's, Graves', and control IgGs to bind to protein blots of thyroid plasma membranes resolved on SDS-PAGE under non-reducing conditions. All seven Hashimoto's IgG at a concentration of 2 mg/ml interacted with an M approximately 197,000 polypeptide corresponding to the TSH holoreceptor. By contrast to Graves' IgG (which were positive at 1 mg/ml), however, this binding was not blocked by pretreatment of the protein blots with TSH. Normal IgGs showed no binding at concentrations of up to 2 mg/ml. Both Hashimoto's and Graves' IgG interacted with TSH-affinity column-purified receptor preparations. Two of the Hashimoto's IgGs induced adenylate cyclase activation in thyroid plasma membranes, three inhibited TSH-stimulated enzyme activation, and two were without effect. Two classes of autoantibodies, other than TSH receptor directed, were encountered; one class raised to antigens common to all seven patients and another class unique to individual patients, eg, Mr 210,000 and Mr 20,000 polypeptides. We propose that the TSH receptor has multiple epitopes (functional domains), and the one to which antimicrosomal antibody bind is likely to be spatially separated from that with which Graves' IgG and TSH interact. Differences in affinity or number of sites allows for the demonstration of Graves' IgG against a background of antimicrosomal antibody.