Current treatment options in hairy cell leukemia and hairy cell leukemia variant

Hairy cell leukemia (HCL) is a chronic B-cell lymphoproliferative disorder characterized by splenomegaly, pancytopenia and circulating lymphocytes displaying prominent cytoplasmic projections. HCL has usually an indolent course and the patients with asymptomatic disease do not require therapy. Treatment of progressive symptomatic HCL includes a variety of pharmacological approaches such as interferon-alpha (IFN-alpha), pentostatin (DCF) and cladribine (2-CdA), which have significantly improved the disease prognosis. 2-CdA and DCF seem to induce a similar high response rate and a long overall survival. They are also active in relapsed patients. More recently high activity of anti-CD20 monoclonal antibody (rituximab) and anti-CD25 (LMB-2) and anti-CD22 (BL-22) immunotoxins have increased the number of therapeutic options for HCL. Splenectomy may be still indicated in patients with massive, symptomatic splenomegaly or results in severe cytopenia. IFN-alpha may have a place in patients with very severe cytopenia, in HCL in pregnancy and in patients who have failed prior therapy with purine nucleoside analogs. HCL variant (HCL-V) is a distinct clinico-pathological entity which seems to be resistant to IFN-alpha and purine nucleoside analogs - DCF and 2-CdA. However, preliminary observations suggest that monoclonal antibodies - rituximab and BL-22 immunotoxin are highly active in this disorder even refractory to 2-CdA. In this review current therapeutic strategies in HCL and HCL-V are presented.     

Purine salvage by Tritrichomonas foetus

The anaerobic protozoon Tritrichomonas foetus was found incapable of de novo purine synthesis by its failure to incorporate radiolabeled glycine or formate into the nucleotide pool. It had, on the other hand, high activities in incorporating adenine, hypoxanthine or inosine. Radiolabel pulse-chase experiments indicated that adenine, hypoxanthine and inosine all entered the pool through conversion to IMP. The parasite contained hypoxanthine phosphoribosyl transferase, adenine deaminase and inosine phosphorylase, but no adenine phosphoribosyl transferase, inosine kinase or inosine phosphotransferase activity. Adenine and inosine had to be converted to hypoxanthine before incorporation. Adenosine was also rapidly converted to hypoxanthine in T. foetus cell-free extracts, but the presence of adenosine kinase in the parasite allowed some conversion of adenosine directly to AMP. Guanine and xanthine were directly incorporated into GMP and XMP, probably due to the guanine and xanthine phosphoribosyl transferase. There were also strong enzyme activities which convert guanosine to guanine and guanine to xanthine. A guanosine phosphotransferase was found in the 10(5) X g sedimentable fraction of T. foetus, and was capable of converting some guanosine to GMP. This network of T. foetus purine salvage suggests the importance of hypoxanthine-guanine-xanthine phosphoribosyl transferase activities in the parasite.     

Adenosine and its receptors as therapeutic targets: An overview

The main goal of the authors is to present an overview of adenosine and its receptors, which are G-protein coupled receptors. The four known adenosine receptor subtypes are discussed along with the therapeutic potential indicating that these receptors can serve as targets for various dreadful diseases.     

Therapeutic management of chronic lymphocytic leukaemia: state of the art and future perspectives

Chronic lymphocytic leukaemia (CLL) is a common, often incurable low-grade-B lymphoproliferative disorder. For many years, chlorambucil alone or with steroids has been the drug of choice in treatment-naive patients. Purine nucleoside analogues (PNAs) and, more recently, monoclonal antibodies (i.e. rituximab, alemtuzumab), have increased the potential for obtaining complete or even molecular remissions. Despite these advances, recurrent and/or relapsing disease remains a major concern. In this respect, new clinical and biological agents have recently been identified, which may allow a better selection for high-risk patients, who could be offered more aggressive therapies including haematopoietic stem cell transplantation (HSCT). Although autologous transplant does not appear to provide additional benefit in advanced refractory disease, allogeneic transplant may offer a chance for cure. Non-myeloablative allogeneic transplant probably has curative potential with a better toxicity profile, and it is actively being investigated. We will review the role of the current therapeutic approach to CLL, focusing on the most recent advances in chemoimmunotherapy and haematopoietic stem cell transplantation.     

Synthesis and biological activity of novel N6-substituted and 2,N6-disubstituted adenine ribo- and 3'-C-methyl-ribonucleosides as antitumor agents

A series of N⁶-aminopurine-9-β-d-ribonucleosides and ribose-modified 3′-C-methyl analogues substituted at N⁶-position with a small group like hydroxy, methoxy or amino group or at C2(N⁶) position have been synthesized and tested against a panel of human leukemia and carcinoma cell lines. N⁶-Hydrazino-9-β-d-ribofuranosyl-purine (5) displayed the best antiproliferative activity in the low micromolar or submicromolar range against all tested tumor cell lines. The activity of this nucleoside is related in part to ribonucleotide reductase inhibition. C2-modification or 3′-C-methylation in N⁶-substituted adenosine analogues leads to a decrease or loss in activity.     

Progressive multifocal leukoencephalopathy in purine nucleoside phosphorylase deficiency

Progressive multifocal leukoencephalopathy is a demyelinating disease caused by JC virus, an opportunistic infection of the central nervous system. Although the majority of cases are infected with the human immunodeficiency virus (HIV), other immunocompromised patients are also at risk. Purine nucleoside phosphorylase is an enzyme in the purine salvage pathway that reversibly converts inosine to hypoxanthine and guanosine to guanine. Purine nucleoside phosphorylase deficiency is a combined immunodeficiency with a profound cellular defect. Neurologic abnormalities are salient features of this syndrome. We describe for the first time a patient with this rare disorder presented with progressive multifocal leukoencephalopathy.     

Adenosine Inhibition of Lipopolysaccharide-Induced Interleukin-6 Secretion by the Osteoblastic Cell Line MG-63

Adenosine is known to inhibit inflammatory responses in many cell systems via a family of purine receptors termed “P1.” The P1 family consists of the adenosine receptors (ADORA) of subtypes A₁, A_2a, A_2b, and A₃. In order to assess whether adenosine has anti-inflammatory actions in osteoblastic cells, we investigated its effects on lipopolysaccharide (LPS)-induced interleukin 6 (IL-6) release in an in vitro inflammatory functional response model. We showed that the osteoblastic cell line MG-63 expresses ADORA₁, A_2a, and A_2b but not A₃. Treatment of MG-63 cells with adenosine and pharmacological ADORA agonist 5′-N-ethylcarboxamidoadenosine or 2–[4-(2-p-carboxyethyl)phenylamino]-5′-N-ethylcarboxamidoadenosine (CGS21680) inhibits LPS-induced IL-6 release. This inhibition was protein kinase A (PKA)-dependent and mimicked by treatment with the adenylate cyclase activator forskolin. Treatment of MG-63 with the ADORA_2a-specific antagonist ZM241385 partially reversed the inhibitory effects of ADORA stimulation on LPS-induced IL-6 release. Overall, these data suggest that ADORA_2a is involved in the regulation of LPS-induced IL-6 release, thus illustrating a regulatory role for adenosine receptors in the control of inflammation and potentially osteoclastogenesis and bone resorption.     

The G22A Polymorphism of the ADA Gene and Susceptibility to Autism Spectrum Disorders

Inborn errors of purine metabolism have been implicated as a cause for some cases of autism. This hypothesis is supported by the finding of decreased adenosine deaminase (ADA) activity in the sera of some children with autism and reports of an association of the A allele of the ADA G22A (Asp8Asn) polymorphism in individuals with autism of Italian-descent. We tested the ADA G22A polymorphism in 126 North American affected sib-pair families but found no aberrant allele distributions in cases versus controls. Instead, we found an increased transmission of the G allele from fathers to affected children. Our findings suggest that the ADA G22A polymorphism plays a minimal role in susceptibility to autism in North American families.     

恶性疟原虫FCC1/HN株嘌呤核酸磷酸化酶(PNP)基因的克隆和原核表达

目的 从恶性疟原虫基因组中扩增、克隆恶性疟原虫嘌呤核酸磷酸化酶(PNP)基因,并进行原核表达产物。方法根据恶性疟原虫FCB株嘌呤核酸磷酸化酶基因编码序列,设计一对引物,引入EcoR I和Xho I。采用PCR技术从恶性疟原虫FCC/HN株基因组DNA中特异扩增PNP基因。纯化后扩增产物用EcoR I和Xho I双酶切后,定向克隆入原核质粒pET30a( )和真核质粒pcDNA3,重组质粒pET30a( )-PNP转化大肠杆菌BL21(DE3),筛选阳性重组子后,用PCR、EcoRI Xho I双酶切和DNA序列测定鉴定。用IPTG诱导重组质粒pET30a( )-PNP表达融合蛋白。结果 从恶性疟原虫FCC1/HN株基因组中特异扩增出PNP基因,将扩增的目的基因亚向插入pET30a( )和pcDNA3表达质粒的EcoR I和XhoI位点;重组子pET30a( )-PNP在大肠杆菌BL21(DE3)诱导表达中表达,表达融合蛋白分子量为31.4kDa。结论 从恶性疟原虫基因组中获取PNP基因,并成功构建pET30a( )-PNP和pcDNA3-PNP重组质粒,获得PNP原核表达产物。