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The multiple antigenic peptide (MAP) system for presenting epitopes to the immune system has been studied with an immunogenic foot-and-mouth disease virus (FMDV) peptide comprising amino acids 141-160 of protein VPI. Neutralizing antibody responses known to protect guinea-pigs against challenge infection were obtained with a single inoculation of 08-4 μg of peptide, presented as an octamer or a tetramer, whereas 20 μg of a dimer were required to evoke a similar level of antibody. A monomeric preparation did not elicit measurable levels of neutralizing antibody at doses up to 20 μg. The octameric MAP was also immunogenic using an aluminium hydroxide adjuvant. Antibodies elicited by the octameric, tetrameric and dimeric constructs differed qualitatively in their reaction with sequences within the 141-160 peptide. Those against the octamer reacted poorly with peptides within the 141-160 sequence, whereas those elicited by the tetramer and dimer reacted preferentially with the peptides covering the N-terminal region. The levels of neutralizing antibody obtained with the octamer and tetramer compare favourably with those obtained when the FMDV peptide is attached to carrier proteins but are lower than, those obtained when it is presented as part of a peptide-hepatitis B virus core particle. Nevertheless, the ability to elicit protective levels of neutralizing antibody without the use of a carrier protein would be a distinct advantage in the development of synthetic peptide vaccines. [ABSTRACT FROM AUTHOR]

The existence of a threshold serum metoclopramide level above which total protection from cisplatin-induced vomiting is more likely to occur has been proposed. We monitored serum metoclopramide levels prior to the third metoclopramide dose in the first cisplatin treatment cycle in patients receiving metoclopramide 2 mg/kg x 4 as part of a randomized double-blind cross-over study comparing single-agent metoclopramide with combination metoclopramide and dexamethasone. Serum samples from 35 patients (17 receiving single-agent metoclopramide and 18 receiving the combination) were analyzed using reverse-phase high-pressure liquid chromatography (HPLC). A wide variation in metoclopramide levels was observed (range 273-3380 ng/ml). Serum levels obtained from the same patient on multiple treatment cycles were well correlated, and the addition of dexamethasone did not alter serum metoclopramide levels. No threshold level could be identified for the two groups (single-agent or combination antiemetic therapy) considered individually or considered together. However, significantly more vomiting episodes and a lower incidence of total protection were noted in patients with metoclopramide levels above 1469 ng/ml receiving metoclopramide alone. This effect was nullified in the combination antiemetic group. Our data do not support a directly proportional relationship between serum metoclopramide level and antiemetic protection. However, a non-linear relationship with a possible agonist/antagonist effect is suggested. [ABSTRACT FROM AUTHOR]

Objectives: We hypothesize that prostate cancer (PC) patients who achieve and maintain an undetectable prostate-specific antigen (UD-PSA) on androgen deprivation therapy (ADT) have a predominantly androgen-dependent cancer cell population sensitive to apoptosis that allows for a prolonged time off ADT. This study summarizes patient- and treatment-related factors associated with a prolonged time off ADT in patients electing intermittent androgen deprivation (IAD)., Methods: Hormone-naïve patients with PC were treated with ADT using an antiandrogen and a luteinizing-hormone-releasing hormone-agonist. Of 255 consecutive patients, 216 (85%) achieved a UD-PSA (< 0.05 ng/ml). Ninety-three (43%) of 216 elected to stop ADT after maintaining a UD-PSA for a median of one year. Patients were followed off therapy and advised to restart ADT if the PSA level reached > or = 5.0 ng/ml. Forty-one patients received finasteride as part of IAD induction and as maintenance off therapy; these patients are excluded from the current study and are the focus of another publication. The remaining 52 patients are assessable for response being either in the off-phase of IAD > or = 1 year or having restarted IAD., Results: In the first IAD cycle, the median duration of the on-phase of IAD was 16 months (mean 19.0 months, range 3.6-71 months), and the median off-phase duration was 15.5 months (mean 24.1 months, range 3.2-87+ months). In 28 patients who maintained a UD-PSA for > or = 1 year, their median off-phase duration was 29 months (mean 35.8 months, range 7.8-87+ months), with nine (32%) still off IAD after a median follow-up of 62 months. Significant (p < 0.05) independent factors associated with prolonged off-phase duration by multivariate analysis included UD-PSA on ADT > or = 1 year (p = 0.010), PSA-only recurrence after local therapy (p = 0.039), and reaching a testosterone level > or = 150 ng/dl in > or = 4 months off ADT (p = 0.041). After a median of 66 months of follow-up, only one (2%) patient developed androgen-independent PC., Conclusions: Hormone-naïve patients who achieve and maintain a UD-PSA for at least one year during ADT may initiate IAD and anticipate a prolonged off-phase duration. Attainment of a UD-PSA on ADT may serve as an in vivo sensitivity test of a patient's tumor cell population, and allow for better selection of those best suited for IAD.

Gastrin-releasing peptide (GRP) receptor antagonists were synthesized and their ability to interact with small-cell lung cancer (SCLC) cells determined. [125I] BW1023U90, bound with high affinity (Kd = 2 nM) to a single class of sites (Bmax = 55 fmol/mg protein) using SCLC cell line NCI-H345. [125I] BW1023U90 binding was time dependent and reversible even at 37 degrees C as the ligand was minimally internalized. Specific [125I] BW1023U90 binding was inhibited with high affinity by GRP as well as bombesin (BB) but not neuromedin B (NMB). BW1023U90 inhibited the ability of BB to elevate cytosolic Ca2+ and increase the growth of SCLC cells. A BW1023U90 analogue, BW2258U89 (10 micrograms/day, SC) slowed SCLC xenograft format on in nude mice and [125I] BW 1023U90 localized to SCLC tumors 1 h after injection into nude mice. BW2258U89 (4% by weight) was placed in microspheres and slowly released over a 3-week period in nude mice bearing SCLC xenografts. The microspheres containing BW2258U89 strongly inhibited SCLC growth in vivo. A radioimmunoassay was developed for the GRP receptor antagonists and the rabbit antiserum cross-reacted totally with BW2258U89 or BW1023U90. BW2258U89 immunoreactivity (5 nM) was detected in the plasma of nude mice containing the microspheres after 1 week. These data suggest that GRP receptor antagonists bind to receptors on SCLC tumors.

The ability of reduced peptide bond analogues of gastrin releasing peptide (GRP) to antagonize small cell lung cancer (SCLC) GRP receptors was investigated. BW462U89, BW1023U90, BW2123U89 and BW2258U89 inhibited binding of (125I-Tyr4) BN to NCI-H345 cells with IC50 values of 5, 6, 140 and 10 nM respectively. The GRP analogues had no effect on basal cytosolic Ca2+ but inhibited the increase caused by 10 nM BN. BW462U89 reversibly blocked the increase in cytosolic Ca2+ caused by BN. The GRP analogues (1 microM) inhibited NCI-H345 colony formation in the absence or presence of 10 nM BN. Also, BW2258U89 (0.4 mg/kg, s.c. daily) inhibited xenograft growth in nude mice. These data indicate that BW2258U89 inhibits SCLC growth in vitro and in vivo.

To investigate the effect of a new, specific antagonist for bombesin receptors on the satiating action of exogenous bombesin, adult male rats were adapted to a nondeprivation test regimen with daily access to a palatable liquid food. In a prefeeding paradigm, rats received intraperitoneal injections of the bombesin receptor antagonist, BW2258U89 (6.25, 25, 50, or 100 micrograms kg-1) or vehicle 20 min before, and then a second injection of either bombesin (4 micrograms kg-1), gastrin-releasing peptide (GRP; 16 micrograms kg-1), the C-terminal octapeptide of cholecystokinin (CCK-8; 4 micrograms kg-1), or vehicle 5 min before a 2-h feeding test. BW2258U89 pretreatment antagonized the satiating actions of bombesin and GRP18-27 in a very potent, dose-related manner, but did not antagonize the satiating action of CCK-8. These differential results with BW2258U89 are consistent with prior results showing the potency of this antagonist for bombesin receptor-mediated effects in visceral systems; in addition, they demonstrate the selectivity of the compound for the satiating actions of peripherally administered bombesin and bombesin-like peptides.

We have previously reported that octapeptides with a -DPro psi[CH2NH]Phe- NH2 C-terminus are potent GRP antagonists and have greatly enhanced in vivo stability. Now we report the detailed syntheses of such peptides and additional attempts to further increase metabolic stability. Replacement of the -DPro psi[CH2NH]Phe-NH2 with a "-DPro-statine"-Phe-NH2 led to less potent antagonistic activity. The introduction of ThiAla and BzthAla, to replace His and Trp, respectively, did not increase activity. A series of analogs having different aromatic residues at the N-terminal, other than 3-phenylpropionic acid, are equally potent. These residues show increased activity when hydrophilic substitutions are added to the aromatic ring. Replacement of the C-terminal Phe by DPhe and D2Nal is tolerated. Even though none of these peptides have higher activity than the original lead peptide, they are potentially more metabolically stable.

Gastrin-releasing peptide (GRP) is a neuroendocrine hormone that may be involved in the pathophysiology of small cell lung carcinoma. We describe carboxylterminal peptide analogues of GRP and bombesin, a 14-residue amphibian homologue, that were modeled after the antagonist [Leu13-psi(CH2NH)-Leu14]bombesin and retained the psi bond. Three novel peptides contained a Leu insertion amino to the psi bond, i.e. ... Leu13Leu14 psi X (residues numbered after bombesin) where X = LeuNH2 or norleucine-NH2). The Leu-insertion analogues behaved as pure partial agonists/antagonists when examined for the ability to stimulate [3H]thymidine incorporation into quiescent Swiss 3T3 cells (agonist activity) and to diminish the agonist response of GRP (antagonist activity). A time course of [3H]thymidine incorporation into quiescent cells indicated maximal incorporation at 20-h post-peptide addition for bombesin and GRP and a Leu-insertion peptide, but the extent of the incorporation for the Leu-insertion peptide was half that of GRP and bombesin. The agonist dose responses of the Leu-insertion peptides (EC50 values of 1-10 nM) paralleled GRP and bombesin, but the maximal response of the Leu-insertion peptides, even at concentrations as high as 10(-4) M, was half the maximal value of GRP or bombesin. High concentrations of the Leu-insertion peptides antagonized 10 nM GRP (a concentration that produced a near-maximal GRP response) yielding a response that was half the maximal value of GRP and equivalent to the maximal response of the Leu-insertion peptides alone. Analogues of the form ... Leu13 psi X behaved as complete antagonists. The KD values of the Leu-insertion peptides for competitive binding versus 125I-GRP (2-50 nM) were as potent as parent ... Leu14 agonists. Stability studies indicated that peptide potencies for both agonist and antagonist activities diminished upon peptide incubation in medium or on cells. The results suggested that, for the Leu-insertion peptides, degradation into distinct products with different activities was not responsible for their partial agonist/antagonist behavior. Computer-generated molecular modeling studies indicated that the novel structures could adopt energy minimized conformations for either an agonist or an antagonist as proposed earlier (Coy, D.H., Heinz-Erian, P., Jiang, N.-Y., Sasaki, Y., Taylor, J., Moreau, J.-P., Wolfrey, W.T., Gardner, J.D., and Jensen, R. T. (1988) J. Biol. Chem. 263, 5056-5060).

Effects of dopamine (DA) and the N,N-di-n-propyl derivative of 2-amino-5,6-dihydroxytetralin (dipropyl-A-5,6-DTN) were compared on renal blood flow in phenoxybenzamine pretreated dogs. Equivalent increments in renal blood flow were observed in the dose range of 12-190 nmol (ED50 of DA, 1.4 x 10(-8) mol; ED50 of dipropyl-A-5,6-DTN, 1.2 x 10(-8) mol, n = 7). Effects of 47 nmol of DA and dipropyl-A-5,6-DTN were reduced equally by simultaneous injections of 0.5 mg sulpiride (76 +/- 4 and 59 +/- 6%, respectively, n = 5). Intravenous injections of dipropyl-A-5,6-DTN in doses of 4-16 micrograms/kg elevated arterial blood pressure and decreased heart rate and cardiac contractility in open chest, vagotomized dogs, confirming its neuronal inhibitory effect mediated by DA2-presynaptic receptors. Dipropyl-A-5,6-DTN also caused dose-related femoral artery vasoconstriction in the hexamethonium pretreated dog. The hypertensive effect of intravenous dipropyl-A-5,6-DTN and its femoral vasoconstrictor effect were abolished by phenoxybenzamine. These results show that dipropyl-A-5,6-DTN possesses DA1-, DA2- and alpha-adrenergic activities. It is significant that by introducing di-n-propyl substitution on the nitrogen of 5,6-dihydroxy-2-aminotetralin, potent DA1-agonist activity can be conferred upon a molecule which is inactive in that respect. Further, beta-adrenergic activity of the primary amine is replaced by potent alpha-adrenergic activity by this substitution.

Late nausea and vomiting lasting 2-7 days occurs in 20%-68% of patients receiving cisplatin. We therefore studied the effects of oral metoclopramide given at doses of 20, 50, or 100 mg four times a day for 25 doses (7 days) beginning after cisplatin to determine the maximum tolerated dose (MTD) for prophylactic oral antiemetic regimens. Patients were stratified into younger (less than or equal to 30 yr old) and older (greater than 30 yr old) groups. Dose escalation was performed without or with concomitant oral diphenhydramine. For the younger group, the MTD for metoclopramide without diphenhydramine was less than 20 mg, and the MTD with diphenhydramine was 20 mg. For the older group, the MTD without diphenhydramine was 20 mg, and the MTD with diphenhydramine was 50 mg. Extrapyramidal reactions in the younger group and agitated depression in the older group were the major dose-terminating toxic effects. Patient acceptance of these regimens was excellent.

An open-label clinical trial was conducted to test the safety and efficacy of intravenous metoclopramide monohydrochloride in preventing chemotherapy-induced nausea and vomiting. Thirty-eight patients received a total of 83 assessable courses of chemotherapy with cisplatin alone or in combination with other cytotoxic agents. In 19 of 38 patients (50%) or 40 of 83 courses (48%), nausea or vomiting did not occur ("total protection") and in six of 38 patients (16%) or 19 of 83 courses (23%), emesis occurred one of two times ("major protection"). Thus, 25 of 38 patients (66%) receiving 59 of 83 courses (71%) of cisplatin-containing chemotherapy attained either total or major antiemetic protection with metoclopramide. In those patients who received multiple courses of chemotherapy, antiemetic protection afforded by metoclopramide remained unabated. At this dosage, the drug was well tolerated with minimal side effects. Intravenous metoclopramide is consistently effective in preventing emesis associated with cisplatin when used either alone or in combination with other cancer chemotherapy agents that are in themselves emetogenic.

A series of 2-amino-1,2,3,4-tetrahydronaphthalene compounds bearing substituents on the nitrogen and in the aromatic ring was synthesized from beta-tetralone intermediates. Compounds were screened in vivo for dopaminergic activity using tests in which apomorphine was especially active. It was found that apparent dopaminergic activity is inherent in 2-dialkylaminotetralins, the dipropylamine substitution being the most consistently productive amine group studies. Activity was greatly enhanced by proper substitution in the aromatic ring. The 5,6-dihydroxy group was the best potentiating group found. These data support the idea that the extended conformation for the phenylethylamine moiety of ampmorphine and dopamine is favorable for dopaminergic agonist activity. They also suggest that an unetherified catechol group may not be essential for such activity.

In an effort to identify further the structural requirements for central dopamine receptor agonists, some monohydroxyl analogs of the known agonist 5,6-dihydroxy-2-dipropylamino-1,2,3,4-tetrahydronaphthalene were synthesized. They were examined for production of emesis in dogs and stereotyped behavior in rats. The most potent was 5-hydroxy-2-dipropylamino-1,2,3,4-tetrahydronaphthalene, which was more potent than apomorphine but less so than the dihydroxyl analog. The two enantiomers of the monohydroxyl analog were synthesized by conventional methods from an optically active intermediate, 2-benzylamino-5-methoxy-1,2,3,4-tetrahydronaphthalene. The resolution of this amine was performed with the aid of mandelic acid. Dopaminergic activity was found to be confined to the levo enantiomer. Requirements for both substitution and chirality in the tetralines were found to correspond closely to those known for the dopaminergic aporphines.