Incubation Of Human Whole Blood Research Articles

Development and Use of Clinical Pharmacodynamic Assays to Demonstrate Target Engagement for AZD4573, a Selective and Potent CDK9 Inhibitor Currently in Phase I Clinical Trials

CDK9 (cyclin-dependent kinase 9) regulates RNA transcription through its phosphorylation of RNA polymerase II and subsequent release from a “paused” elongation state, resulting in transcriptional activity. A transient inhibition of CDK9 activity will significantly impact transcripts with a short half-life, which includes the transcript for MCL1, an anti-apoptotic protein. AZD4573 is a highly potent and selective CDK9 inhibitor. We have previously reported that AZD4573 treatment results in dose-dependent inhibition of pSer2 of RNA polymerase II, reductions in MCL1 mRNA and protein, and an increase in cleaved caspase 3, resulting in cell death of hematological tumor cell lines and regressions in AML/DLBCL in vivo models [Cidado et. al., AACR Annual Meeting, Abstract 310 (2018)].AZD4573 is currently being evaluated in a Phase I all-comers relapsed/refractory hematological malignancy trial (NCT03263637). To generate clinical evidence that the compound is inhibiting its target and having the expected downstream effects, we have developed pharmacodynamic biomarker (PD) assays for clinical use to measure the changes in pSer2/RNApol II, MCL1 protein, cleaved Caspase 3 and cleaved PARP. We have chosen a capillary electrophoresis platform which allows quantification and multiplexing while requiring lower sample quantities (<20ng/capillary) than Western blotting. Data from AZD4573-treated MV4,11 AML cells using the clinical assays were similar to what had been shown previously with Western blotting, i.e. similar dose-dependence across 0.1nM to 1uM and >80% inhibition of both pSer2 and MCL1 at 100nM (in 10% FCS). Next, we validated the use of these assays with human peripheral blood mononuclear cells (PBMCs) since we expected that some patients from the trial are likely to have significant numbers of circulating tumor cells (i.e. AML/CLL). After incubation of human whole blood with 1uM AZD4573 for different times, PBMCs were isolated and analyzed using the capillary electrophoresis assays. These results showed at least ~80% inhibition of pSer2 at 2h, consistent with preclinical efficacy modeling and predicted clinically achievable levels. In addition, we optimized the PBMC isolation protocol for the clinical sites and showed that compound washout during the procedure did not diminish AZD4573-mediated effects. In another study, we mimicked potential clinical conditions (e.g. 30 min, 1h, and 2h between blood collection and PBMC isolation, ambient vs 37°C storage conditions) and demonstrated that significant ex vivo apoptosis (i.e. activation of cleaved caspase 3) was unlikely to occur if PBMCs were isolated within 1-2h of blood collection. Finally, by showing that AZD4573 target engagement and pathway inhibition can be measured in normal PBMCs, these assays will be informative for all patients, including those without circulating tumor cells (e.g. many lymphomas).Here we describe the development and characterization of a suite of pharmacodynamic assays for clinical use with blood samples for our CDK9 program. Preliminary data from our Phase I study demonstrate successful implementation of these assays and support that AZD4573 inhibits CDK9 with the expected downstream effects, in the clinical setting. Updated results will be presented at the meeting. DisclosuresYeh:AstraZeneca: Employment, Equity Ownership. O'Connor:AstraZeneca: Employment, Equity Ownership. Cidado:AstraZeneca: Employment, Equity Ownership. Barrett:AstraZeneca: Employment, Equity Ownership.

GLS-409, a Synergistic Inhibitor of Both P2Y1 and P2Y12: Efficacy in a Canine Model of Recurrent Coronary Thrombosis and Reversibility of Human Platelet Inhibition

Introduction. Dual antiplatelet therapy with aspirin and an adenosine diphosphate (ADP) P2Y12 receptor inhibitor is a mainstay of pharmacological therapy in acute coronary syndromes. GLS-409 is a novel diadenosine tetraphosphate derivative that inhibits both P2Y1 and P2Y12platelet ADP receptors.Aims. 1) Determine the minimal dose of GLS-409 for in vivo inhibition of recurrent coronary thrombosis in a canine model. 2) Characterize the effects of the minimal antithrombotic dose of GLS-409 on the bleeding time. 3) Determine the extent and kinetics of the reversibility of platelet inhibition by GLS-409.Methods. (1) Canine Model of Recurrent Coronary Thrombosis. Recurrent platelet-mediated coronary thrombosis was initiated in anesthetized dogs by application of a stenosis at a site of vessel injury. At 1 h post-injury + stenosis, dogs were randomized to receive either GLS-409 or matched volumes of vehicle (saline). Three doses of GLS-409 were assessed: A) 0.054 mg/kg bolus + 0.00018 mg/kg/min infusion maintained for 2 hours; B) 1/10th bolus + 1/10th infusion; C) 1/100th bolus + 1/100th infusion. Coronary blood flow was monitored throughout the 2 hours post-treatment. Primary endpoints were: (i) area of the flow-time profile (index of coronary patency, expressed as % of baseline flow); and (ii) template bleeding time. (2) Reversibility of platelet inhibition following 30 minutes exposure to GLS-409. Sodium citrate 3.2% anticoagulated whole blood from healthy human volunteers (n=9) was treated with 80% inhibitory dose of GLS-409 for 30 minutes and assessed for recovery of response to ADP by flow cytometric analysis of platelet surface P-selectin and activated GPIIb-IIIa (reported by binding of the activation-dependent monoclonal antibody, PAC-1), at specified times before and after 300-fold dilution in drug-free, platelet-poor plasma.Results. (1) All dogs developed spontaneous episodes of recurrent thrombosis following coronary injury + stenosis. In the saline control group, there was no change in coronary patency during the 2 hour treatment period versus the pretreatment phase. Administration of GLS-409 at Doses A and B was associated with significant increases in % flow-time area, while Dose C had no significant effect on patency (Figure A). GLS-409 at Doses A and B which effectively inhibited recurrent coronary thrombosis, had no effect on the template bleeding time.(2) Incubation of human whole blood with GLS-409 for 30 min at room temperature, produced strong, concentration-dependent inhibition of the ADP-stimulated increases in platelet surface P-selectin and activated GPIIb-IIIa; 80% inhibition was obtained with 1.56 nM GLS-409. Blood exposed for 30 minutes to the 80% inhibitory concentration of GLS-409, then diluted 300-fold in drug-free, platelet-poor plasma (thereby reducing GLS-409 to 0.0052 nM, final concentration) showed a time-dependent recovery of reactivity to ADP as measured by both platelet surface P-selectin and activated GPIIb-IIIa (Figure B). However, while ADP-stimulated activated GPIIb-IIIa fully recovered within 60 min to levels seen in vehicle-treated samples, ADP-stimulated P-selectin response recovered to only 75% of the response seen in the vehicle-treated control (Figure B).Conclusions. (1) GLS-409 improved coronary patency in this canine model of recurrent coronary thrombosis without an accompanying increase in the bleeding time. (2) The time required after exposure of platelets to GLS-409 in whole blood for 50% recovery of ADP-stimulated PAC-1 reactivity (~26 min) is longer than published (J Thromb Haemost . 2017. 10.1111/jth.13627) recovery times after exposure to cangrelor (1.8 min), ticagrelor (4.4 min), and ticagrelor active metabolite (6.3 min), suggesting a slower off-rate for GLS-409. Incomplete reversibility of ADP-stimulated P-selectin following exposure to GLS-409 is similar to published results for cangrelor, but different from ticagrelor, both of which are selective for P2Y12. This relatively slow reversibility of GLS-409 inhibition offers another explanation, in addition to its dual specificity for P2Y1 and P2Y12, for the presently-described high potency of GLS-409 observed in the animal model. These properties suggest that GLS-409 could become a useful addition to the current drugs used in acute coronary syndromes. Further evaluation of the potential clinical utility of GLS-409 is warranted. [Display omitted] DisclosuresMichelson:Ionis: Research Funding; Sysmex: Research Funding; Baxalta: Research Funding; GLSynthesis: Research Funding; Eisai: Research Funding; Elsevier: Patents & Royalties; Ironwood: Research Funding; AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Instrumentation Laboratory: Consultancy; Pfizer: Research Funding. Yanachkov:GLSynthesis: Employment. Yanachkova:GLSynthesis: Employment. Wright:GLSynthesis: Employment. Przyklenk:GLSynthesis: Research Funding. Frelinger:Pfizer: Research Funding; Ionis: Research Funding; Sysmex: Research Funding; Baxalta: Research Funding; GLSynthesis: Research Funding; Ironwood: Research Funding.

Preclinical Evaluation of MCLA117, a CLEC12AxCD3 Bispecific Antibody Efficiently Targeting a Novel Leukemic Stem Cell Associated Antigen in AML

Although chemotherapy regimens induce initial remissions in most acute myeloid leukemia (AML) patients, their long term prognosis is very poor. Novel targeted therapies that effectively eradicate both AML blasts and their progenitors are needed.MCLA-117, a potent human CLEC12AxCD3 bispecific IgG antibody redirects patient's cytotoxic T cells to induce AML tumor lysis. CLEC12A is a myeloid differentiation antigen that is expressed on 90-95% of newly diagnosed and relapsed AML. Moreover, CLEC12A is selectively expressed on leukemic stem cells (LSCs) but not normal early hematopoietic progenitors, including hematopoietic stem cells (HSCs).MCLA-117 is a full length human bispecific IgG that incorporates CH2 region amino acid substitutions to abrogate Fcγ receptor and C1q interactions while retaining its binding to FcRn. MCLA-117 specifically binds to CLEC12A expressing myeloid cells and CD3 expressing T cells, as evaluated on healthy donor samples by flow cytometry. In line with the CLEC12A expression profile within the hematopoietic progenitor compartment, MCLA-117 did not bind the HSCs, nor the common myeloid progenitor cells. As determined by Surface Plasmon Resonance, MCLA-117 had an affinity of 3 nM for human CLEC12A and 177 nM for human CD3.The efficacy of MCLA-117 to induce T cell mediated lysis of CLEC12A+ tumor cells was evaluated in cytotoxicity assays. In co-cultures with resting healthy donor T cells and AML tumor cells MCLA-117 efficiently induced CLEC12A antigen dependent T cell activation, T cell proliferation and tumor target cell lysis. MCLA-117 induced tumor target lysis with an EC50 of 66±37 ng/mL. Upregulation of the activation CD69 marker on CD8 T cells was the most sensitive read-out for the activity of MCLA-117 (EC20 of 11±3 ng/mL). Therefore the MABEL (minimum anticipated biological effect level) concentration for MCLA-117 was defined as 10 ng/mL and is used to calculate a safe starting dose in a planned first in human study. MCLA-117 was able to activate and redirect AML patient-derived T cells to CLEC12APOS tumor cells as potently as that of healthy donor-derived T cells.The efficacy of MCLA-117 to induce lysis of AML blasts by autologous T cells in primary AML bone marrow (BM) samples with low T cell to AML blast ratios (E:T ratios of 1:7-1:80) was examined. AML patient BM samples taken at diagnosis were cultured in medium with low amounts of a cytokine cocktail to support in vitro survival of AML blasts. MCLA-117 induced up to 30-fold T cell expansion after 7-10 days. More importantly, MCLA-117 efficiently induced AML blast lysis (up to 88%) in 6/6 tested primary AML patient BM samples, even at very low effector to target ratios (see figure 1).The cytokine release potential was assessed by incubation of human whole blood and PBMC preparations with MCLA-117. Moderate to strong cytokine release in whole blood was observed (IFNγ, IL-6, IL-8, IL-10 and TNFα) after 24 hours at concentrations of 10,000 and 1,000 ng/mL MCLA-117. At concentration of 100 ng/mL and 10 ng/mL, moderate to low cytokine release and no cytokine release was observed, respectively. In PBMC preparations, moderate to strong IFNγ release was observed after 48 hours at MCLA-117 concentrations of 10,000, 1,000 and 100 ng/mL. At these concentrations, only low release of IL-2, IL-10 and TNFα and no release of IL-1β, IL-6 and IL-8 was observed.MCLA-117 may provide a novel treatment option for all subtypes of AML with highly specific targeting of myeloid blasts and progenitors and sparing the normal HSCs, as well as eradicating residual LSCs residing in the BM niche compartments. A first clinical study is planned to evaluate the safety and preliminary efficacy of MCLA-117 in adult AML patients. [Display omitted] DisclosuresVan Loo:Merus B.V.: Employment. Doornbos:Merus B.V.: Employment. Shamsili:Merus B.V.: Employment. Bakker:Merus B.V.: Employment.

Reduction of glucose and insulin concentrations during in vitro incubation of human whole blood at different temperatures

Abstract Background: Incubation of human whole blood at body temperature has been used in numerous studies without addition of glucose and insulin. The purpose of the study was to examine glucose concentration changes

Early immunomodulatory effects of linezolid in a human whole blood endotoxin model

Gram-negative sepsis resulting in endotoxin triggered septic shock is one of the leading causes of death in critically ill patients. Because treatment options are limited, recent approaches focus on immunomodulatory effects of antimicrobials. Thus, we characterized the immunomodulatory effects of linezolid at mRNA and on cytokine levels in supernatants of an ex vivo model of endotoxemia. Whole blood from 10 healthy volunteers was incubated with 50 pg/ml LPS with or without 13 microg/ml linezolid (concentrations were chosen to reflect in vivo conditions) for 2 and 4 hours (h). Quantitative real-time PCR was performed from messenger RNA (mRNA) of IL-1beta;, IL-6, IL-8 or TNF-alpha;. Cytokine levels in the supernatant were measured by ELISA for IL-6, IL-8 and TNF-alpha;. Incubation of human whole blood with LPS increased mRNA levels of cytokines several thousand fold compared with baseline. The addition of linezolid significantly reduced mRNA levels of IL-1beta, IL-6, IL-8 and TNF-alpha; (p < 0.05) after 2 and 4 h. LPS stimulation also increased levels of IL-6, IL-8 and TNF-alpha between 100 and 1000-fold. However, in contrast to mRNA - except for IL-6 - no significant reduction at protein level was observed. These results indicate that immunosuppressive effects of linezolid on mRNA transcription are only partially reflected by cytokine release.

The complement factor properdin induces formation of platelet-leukocyte aggregates via leukocyte activation

Both the complement system and platelet-leukocyte aggregates are involved in chronic and acute stages of atherosclerosis. Properdin, a positive regulator of the complement system, is secreted by leukocytes and endothelial cells. In the present study, the role of properdin in the formation of platelet-leukocyte aggregates was investigated. Incubation of human whole blood with properdin (25–200 µg/ml) resulted in a dose-dependent formation of platelet-leukocyte aggregates, with an increase of up to 2.2-fold compared to controls (p < 0.05), as analysed by flow cytometry. In addition, properdin significantly amplified ADP-induced aggregation of platelets with leukocytes by 53% (p < 0.05), while it had no effect on ADP-induced aggregation of platelets alone. Consistent with these results, properdin did not activate platelets as shown by the expression of activated GPIIb/IIIa (PAC-1 epitope) and P-selectin (CD62P) on the platelet surface. However, properdin significantly induced expression of CD11b (MAC-1) on leukocytes by 12-fold (p < 0.05) as a measure of leukocyte activation. In conclusion, the complement system component properdin induces the formation of platelet-leukocyte aggregates via leukocyte activation. The data establish a link between the complement system and platelet-leukocyte aggregates with potential significance in atherosclerotic vascular disease.

Nonfucosylated Therapeutic IgG1 Antibody Can Evade the Inhibitory Effect of Serum Immunoglobulin G on Antibody-Dependent Cellular Cytotoxicity through its High Binding to FcγRIIIa

Recent studies have revealed that fucosylated therapeutic IgG1s need high concentrations to compensate for FcgammaRIIIa-competitive inhibition of antibody-dependent cellular cytotoxicity (ADCC) by endogenous human plasma IgG. Here, we investigated whether ADCC of nonfucosylated therapeutic IgG1 is also influenced by plasma IgG in the same way as fucosylated IgG1s. Ex vivo ADCC upon CD20+ human B cells was induced by incubation of human whole blood with nonfucosylated and/or fucosylated anti-CD20 IgG1s rituximab, and quantified by measuring the remaining CD19+ human B cells using flow cytometry. Nonfucosylated anti-CD20 showed markedly higher (over 100-fold based on EC50) ex vivo B-cell depletion activity than its fucosylated counterpart in the presence of plasma IgG. The efficacy of fucosylated anti-CD20 was greatly diminished in plasma, resulting in the need for a high concentration (over 1.0 microg/mL) to achieve saturated efficacy. In contrast, nonfucosylated anti-CD20 reached saturated ADCC at lower concentrations (0.01-0.1 microg/mL) with much higher efficacy than fucosylated anti-CD20 in all nine donors through improved FcgammaRIIIa binding. Noteworthy, the high efficacy of nonfucosylated anti-CD20 was inhibited by addition of fucosylated anti-CD20. Thus, the efficacy of a 1:9 mixture (10 microg/mL) of nonfucosylated and fucosylated anti-CD20s was inferior to that of a 1,000-fold dilution (0.01 microg/mL) of nonfucosylated anti-CD20 alone. Our data showed that nonfucosylated IgG1, not including fucosylated counterparts, can evade the inhibitory effect of plasma IgG on ADCC through its high FcgammaRIIIa binding. Hence, nonfucosylated IgG1 exhibits strong therapeutic potential through dramatically enhanced ADCC at low doses in humans in vivo.

Determination of the endocannabinoid anandamide in human plasma by high‐performance liquid chromatography

Anandamide (N-arachidonylethanolamine) is an endogenous cannabinoid receptor ligand that has been implicated in various physiological and pathophysiological functions. In the present study, a liquid-liquid extraction-based reversed-phase HPLC method with fluorometric detection was validated and applied for the analysis of anandamide in human plasma. Following derivatization with the fluorogenic reagent 4-(N,N-dimethylaminosulfonyl)-7-(N-chloroformylmethyl-N-methyl-amino)-2,1,3-benzoxadiazole (DBD-COCl), the analyte was separated using an acetonitrile-water gradient at a flow rate of 0.8 mL/min, and spectrophotometric detection at 560 nm with an excitation wavelength of 450 nm. The retention times for anandamide and R+-methanandamide (internal standard) were 27.1 and 30.7 min, respectively. The validated quantification range was 1-15 ng/mL. The developed procedure was applied to determine anandamide levels in human plasma following a 24 h incubation of human whole blood at 37 degrees C in the presence or absence of phenylmethylsulfonyl fluoride, an inhibitor of the anandamide-degrading enzyme fatty acid amide hydrolase. Anandamide levels determined under both conditions were within the validated concentration range with anandamide levels being 2.3-fold higher in plasma from PMSF-treated blood.

Loss of Pentameric Symmetry in C-Reactive Protein Induces Interleukin-8 Secretion Through Peroxynitrite Signaling in Human Neutrophils

Plasma levels of C-reactive protein (CRP), nitrotyrosine, and interleukin-8 (IL-8) are known predictors of acute cardiovascular events. Peroxynitrite (ONOO-) may function as an intracellular signal for the production of IL-8; however, it is not known whether CRP regulates these events. Emerging evidence suggests that some bioactivities of CRP are expressed only when the pentameric structure of CRP is lost, resulting in formation of monomeric or modified CRP (mCRP). We studied the impact of human native CRP and bioengineered mCRP that cannot rearrange into the pentameric structure on ONOO- formation and ONOO--mediated IL-8 gene expression in human leukocytes. Incubation of human whole blood or isolated neutrophils with mCRP (0.1 to 100 microg/mL) for 4 hours increased IL-8 gene expression and secretion that was blocked approximately 70% by the NO synthase inhibitor Nomega-nitro-L-arginine methyl ester (L-NAME). In neutrophils, mCRP simultaneously increased superoxide production and endothelial nitric oxide synthase-mediated NO formation, leading to enhanced ONOO- formation, and consequently activation of nuclear factor-kappaB and activator protein-1. Native CRP had no detectable effect at 4 hours, whereas it enhanced IL-8 release after a 24-hour incubation that was blocked by L-NAME. An anti-CD16 antibody, but not an anti-CD32 antibody, produced 60% to 70% reductions in mCRP-stimulated NO formation and IL-8 release (both P<0.05). These results suggest that loss of the pentameric symmetry in CRP, resulting in formation of mCRP, leads to IL-8 release from human neutrophils via peroxynitrite-mediated activation of nuclear factor-kappaB and activator protein-1.

Effect of lead concentration on the level of glutathione, glutathione S-transferase, reductase and peroxidase in human blood

Incubation of human whole blood for 24 h at 37°C in the presence of 100–400 μg/dl lead chloride or lead acetate caused a concentration-dependent decrease in the level of reduced glutathione up to 40%. Similarly, the activities of glutathione reductase, glutathione peroxidase and glutathione S-transferase were decreased up to 25%, 50%, and 19%, respectively. Moreover, 100 μg/dl lead chloride or lead acetate slowed the process of glutathione regeneration, and delayed the time for complete regeneration from 20 to 40 min. When glutathione S-transferase was purified by affinity chromatography on Sepharose-linked glutathione, incubated with lead chloride or lead acetate, a concentration-dependent inhibition of the enzymatic activity was observed reaching 50% inhibition at a lead salt concentration of 6000 μg/dl.

PGG-glucan, a soluble beta-(1,3)-glucan, enhances the oxidative burst response, microbicidal activity, and activates an NF-kappa B-like factor in human PMN: evidence for a glycosphingolipid beta-(1,3)-glucan receptor.

PGG-Glucan, a soluble beta-(1,6)-branched beta-(1,3)-linked glucose homopolymer derived from the cell wall of the yeast Saccharomyces cerevisiae, is an immunomodulator which enhances leukocyte anti-infective activity and enhances myeloid and megakaryocyte progenitor proliferation. Incubation of human whole blood with PGG-Glucan significantly enhanced the oxidative burst response of subsequently isolated blood leukocytes to both soluble and particulate activators in a dose-dependent manner, and increased leukocyte microbicidal activity. No evidence for inflammatory cytokine production was obtained under these conditions. Electrophoretic mobility shift assays demonstrated that PGG-Glucan induced the activation of an NF-kappaB-like nuclear transcription factor in purified human neutrophils. The binding of 3H-PGG-Glucan to human leukocyte membranes was specific, concentration-dependent, saturable, and high affinity (Kd approximately 6 nM). A monoclonal antibody specific to the glycosphingolipid lactosylceramide was able to inhibit activation of the NF-kappaB-like factor by PGG-Glucan, and ligand binding data, including polysaccharide specificity, suggested that the PGG-Glucan binding moiety was lactosylceramide. These results indicate that PGG-Glucan enhances neutrophil anti-microbial functions and that interaction between this beta-glucan and human neutrophils is mediated by the glycosphingolipid lactosylceramide present at the cell surface.

Glucocorticoid receptor regulates expression of L-selectin and CD11/CD18 on human neutrophils.

Recent studies have raised the hypothesis that glucocorticoids could diminish the ability of endothelial cells to direct leukocyte traffic into inflamed tissues by inhibiting expression of the adhesion molecules endothelial-leukocyte adhesion molecule-1 and intercellular adhesion molecule-1. The aim of the present study was to investigate whether glucocorticoids also regulate the expression of L-selectin and CD11/CD18 integrins on human neutrophil granulocytes. Incubation of human whole blood with platelet-activating factor (PAF, 1 mumol/L) evoked downregulation of L-selectin and upregulation of CD11/CD18 adhesion receptors on neutrophils as measured by flow cytometry. While dexamethasone (0.1 nmol/L to 100 mumol/L) did not affect expression of adhesion molecules on resting neutrophils, it attenuated the PAF-induced changes in L-selectin and CD18 expression in a time- and concentration-dependent fashion with IC50 values of 31 and 13 nmol/L, respectively. These effects of dexamethasone were completely aborted by RU-486 (10 mumol/L), which blocks transcriptional activation of the glucocorticoid receptor, and by the protein synthesis inhibitor cycloheximide (35.5 mumol/L). Dexamethasone, up to a concentration of 1 mumol/L, neither affected significantly the release of granule enzymes nor interfered with PAF binding to its membrane receptors. Our results show that glucocorticoids at clinically relevant concentrations exert specific actions on expression of adhesion molecules on activated neutrophils, which are mediated through ligation of glucocorticoid receptors and induction of protein synthesis, and suggest a novel mechanism by which anti-inflammatory corticosteroids may inhibit leukocyte accumulation.

13C NMR investigation of cholesterol esterification rate in human whole blood

We have previously used NMR spectroscopy to measure the acyl transfer from phospholipid to cholesterol in human plasma. In the present study we investigated the processes of transfer of cholesterol and exchange of cholesteryl ester between lipoproteins during incubation of human whole blood. The rate of cholesteryl ester increase was much greater during whole blood incubation (86–118, mean = 90 μmol l −1 h −1) compared to plasma incubation (53–93, mean = 57 μmol l −1 h −1). The rate of decrease in unesterified cholesterol was identical to cholesterol ester increase during plasma incubation, but was slower during whole blood incubation, consistent with replenishment by transfer of additional unesterified cholesterol substrate from erythrocyte membranes. The analysis of lipoprotein fractions revealed an increase in cholesteryl ester content of d < 1.063 lipoproteins; the rate of increase was 47–67 with a mean of 58 μmol l −1 h −1. Although this result is comparable with that obtained by other methods, it represents the product of both CETP and β-LCAT activity. These NMR techniques provide simple and direct assessment of aspects of reverse cholesterol transport and warrant further investigation.

Interleukin-10 production during septicaemia

Interleukin-10 is produced during incubation of human whole blood with bacterial lipopolysaccharide (LPS) and down-regulates tumour necrosis factor-alpha production in this in-vitro model of endotoxaemia. 39 out of 69 (57%) patients with gram-negative (n = 25) or gram-positive septicaemia (n = 44) had increased plasma interleukin-10 (range 12-2740 pg/mL), whereas interleukin-10 was undetectable in 29 out of 33 control patients without infection and in 20 healthy volunteers. Patients with septic shock (n = 21) had higher interleukin-10 (main 58 pg/mL) than septicaemic patients without shock (11 pg/mL, p < 0.001). We conclude that interleukin-10 is produced during sepsis and might be involved in the control of the inflammatory response induced by bacterial products.

Biosynthesis, characterization and inhibition of leukotriene B 4 in human whole blood

We have evaluated the biosynthesis, characterization and inhibition of Leukotrien (LT) B 4 in unstimulated and in A23187-stimulated human whole blood. LTB 4 was assayed by radioimmunoassay (RIA) both in unextracted serum and after extraction and thin-layer chromatography (TLC). Unstimulated human whole blood allowed to clot at 37°C for 60 min produced only trace amounts of LTB 4 (0.16±0.05 ng/ml, mean±SD, n=3). LTB 4-like immunoreactivity (ir-LTB 4) detectable in unstimulated serum samples was largely overestimated by direct RIA, most likely because of interfering substance(s) unrealed to cyclooxygenasep or lipoxygenase activity. Incubation of human whole blood with A23187 (2–10 μM) resulted in a concentration-dependent stimulation of LTB 4 production. At 10 μM A23187, ir-LTB 4 was 18±2.4 ng/ml (mean±SEM, n=28). In A23187-stimulated serum samples, LTB 4 concentrations measured by direct RIA correlated in a statistically significant fashion with those measured after extraction and TLC. Nafazatrom added in vitro caused a dose-dependent inhibition of A23187-stimulated ir-LTB 4 production with an IC 50 of 17 μM.