1110
difficult, if one takes account of target cell heterogeneity and poor vascular access,6 to envisage a time when it will be possible to deliver a therapeutic gene to every tumour cell. However, by choosing genes that encode locally active secreted proteins, the requirement for 100% efficient delivery is bypassed, making targeted gene therapy for cancer a technically demanding, but feasible
proposition. MRC Centre, Cambridge CB2 5ER, UK
STEPHEN J. RUSSELL
CA, Krenitsky TA. Retroviral-mediated gene therapy for the hepatocellular carcinoma: an innovative approach for cancer therapy.
1. Huber BE, Richards treatment of
Proc Natl Acad Sci USA 1991; 88: 8039-43. 2. Russell SJ, Eccles SA, Flemming C, Johnson CA, Collins MKL. Decreased tumorigenicity of a transplantable rat sarcoma following transfer and expression of an IL-2 cDNA. Int J Cancer 1991; 47: 244-51. 3. Gansbacher B, Zier K, Kaniels B, Cronin K, Bannerji R, Gilboa E. Interleukin 2 gene transfer mto tumour cells abrogates tumorigenicity and induces protective
immunity. J Exp Med 1990; 172: 1217-24. Tepper RI, Pattengale PK, Leder P. Murine interleukin 4 displays potent anti-tumor activity in vivo. Cell 1989; 57: 503-12. 5. Russell SJ. Lymphokine gene therapy for cancer. Immunol Today 1990; 11: 196-200. 6. Jam RK. Delivery of novel therapeutic agents in tumors. physiological barriers and strategies. J Natl Cancer Inst 1989; 81: 570-76. 4.
non-immune binding of more than 3 x 107 S aureus per ml in the IDEIA test is also noted in the manufacturer’s information sheets. But the clinical relevance of this false-positive reaction has not yet been recognised. It is unlikely that the required number of S aureus will be present in urethral swabs, which are usually tested by this assay; however, EIA is done for concentrated early morning urine samples, and absolute concentrations of more than 107 S aureus may therefore be achieved. Thus false-positive results due to S aureus can be obtained in contaminated urine samples, and we think that bacterial contamination should be excluded before testing for chlamydial antigens by EIAs.
J. WOLLENHAUPT Departments of Rheumatology and Microbiology, Medical School Hannover, D-3000 Hannover, Germany
EO, Paul ID, Milne JD, Crowley T. Non-invasive sampling method for detecting Chlamydia trachomatis. Lancet 1988; ii. 1246-47. 2. Paul ID, Caul EO. Evaluation of three Chlamydia trachomatis immunoassays with an unbiased, noninvasive clinical sample. Clin Microbiol 1990; 28: 220-22. 3. Chernesky M, Castriciano S, Sellors J, et al Detection of Chlamydia trachomatis antigens in urine as an alternative to swabs and cultures. J Infect Dis 1990; 161: 1. Caul
124-26. 4. Thomas
HTLV-I and uveitis SIR,-Dr Bloch-Michel and colleagues (March 21, p 750) report in uveitis associated with multiple sclerosis a local immune reaction leading to an increased production of specific antibodies to measles virus. We have reportedl evidence that a human retrovirus has an aetiological role in certain types of uveitis. Our study was done in an area endemic for HTLV-I.1 The relative risk (odds ratio) of idiopathic uveitis for HTLV-1 infection in younger patients (20-49 years) was estimated at 11-0; it was only 2-0 in older patients, indicating a role for HTLV-1 in idiopathic uveitis in younger people. Proviral DNA of HTLV-I was detected by polymerase chain reaction in all 12 samples tested from inflammatory cells in aqueous humour. Department of Ophthalmology, Kurume University School of Medicine, Kurume 830, Japan
MANABU MOCHIZUKI
Department of Internal Medicine, Kukmamoto University School of Medicine
KAZUNARI YAMAGUCHI KIYOSHI TAKATSUKI
Department of Pathology, Institute of Medical Science, Tokyo University Division of Epidemiology, Aichi Cancer Centre Research Institute
TOSHIKI WATANABE SHIGEO MORI
BJ, Gilchrist C, Hay PE, Taylor-Robinson D. Simplification of procedures test urine samples for Chlamydia trachomatis. J Clan Pathol 1991; 44:
used to 374-75.
Psoriasis of
regression in terminal AIDS
SIR,-Dr Allen (March 14, p 686) describes the disappearance psoriasis lesions in a severely immunocompromised HIV-
seropositive patient treated with cyclosporin. Allen suggests that cyclosporin had a beneficial effect in this patient. We have lately seen a patient with AID S and a very severe form of psoriasis resistant to standard topical therapy. Lesions persisted for about 2 years but finally regressed progressively when he was in the preterminal phase of his illness (CD4 count 0-01 x 109/1). During this period, the patient was treated only with multivitamins and pentamidine inhalations once every 4 weeks. The interpretation of this observation, as well as the one reported by Allen, is very difficult because spontaneous remissions of psoriasis have been noted in other patients with end-stage AIDS.! In view of the potential toxicity of cyclosporin in HIV infectionwe caution against the use of this drug in patients with psoriasis and HIV infection. Institute of
KAZUO TAJIMA
F. HARTMANN H. ZEIDLER M. FROSCH
Tropical Medicine, Antwerp, Belgium; and University Hospital, Antwerp
R. COLEBUNDERS K. BLOT V. MERTENS P. DOCKX
1. Mochizuki
M, Watanabe T, Yamaguchi K, et al. HTLV-I uveitis: a distinct clinical entity caused by HTLV-I. Jpn J Cancer Res 1992; 83: 236-39.
Staphylococcus aureus in urine and falsepositive immunoassay for chlamydia a
SIR,-Infection with Chlamydia trachomatis is now recognised as major cause of acute and chronic genitourinary diseases, and
infected patients need to be identified. Caul et all reported that examination of urine samples by enzyme immunoassay (EIA) was a non-invasive method to diagnose genitourinary chlamydial infection. Subsequent studies confirmed the value of this technique,2-4 but did not address the difficulty of false-positive results caused by bacterial contamination. We examined by IDEIA immunoassay (Novo BioLabs, Cambridge, UK; Roehm Pharma, Darmstadt, Germany) 55 urine samples from patients with bacterial urinary tract infection, but not containing chlamydia. Samples were prepared and processed by Paul and Caul’s method.2 47 urine samples containing more than 1 ()4 bacteria of various species were negative (8 Pseudomonas spp; 10 Proteus spp; 5 Escherichia coli; 3 Klebsiella spp; 1 Staphylococcus epidermidis; 20 others). By contrast, 5 of 8 urine samples with S aureus yielded positive EIA results. Further analysis by serial dilution of S aureus in otherwise sterile urine showed a dose-dependent reactivity, yielding positive results in concentrations greater than 107 S aureus per sample. A possible
Johnson T, Rapini R, Freese T, Brewton G, Rios A. Acquired immunodeficiency syndrome-associated psoriasis and Reiter’s syndrome. Arch Dermatol 1987; 123: 1622-32. 2. Walgate R. Politics of premature French claim of cure. Nature 1985; 318: 3 1. Duvic M,
Fibroblast growth factor 6 gene expression in AIDS-associated Kaposi’s sarcoma SIR,-Kaposi’s sarcoma (KS) represents an opportunistic neoplasm of unknown aetiology which is especially prevalent in individuals infected with HIV, most notably in homosexual men. The possibility of a direct role for HIV in the aetiology of KS has been raised by experiments describing the introduction of HIV-tat sequences into transgenic mice,l and has been supported by the fmding that the tat protein stimulates growth of KS-derived cells in cultureCultured KS cells proliferate in response to various autocrine and paracrine growth factors and cytokines.3,4Few studies on intact fresh KS tumour tissue have been done.s To help characterise the pathophysiology of KS cells in vivo, we used the reverse transcriptase-polymerase chain reaction (RT-PCR)6 to detect expression of fibroblast growth factors (FGFs) and their receptors in fresh KS tissue. We were surprised to find FGF6 expressed in two specimens from different individuals with AIDS. To our knowledge, this is the first report of FGF6 in KS or any other human
tumour
tissue.
difficult, if one takes account of target cell heterogeneity and poor vascular access,6 to envisage a time when it will be possible to deliver a therapeutic gene to every tumour cell. However, by choosing genes that encode locally active secreted proteins, the requirement for 100% efficient delivery is bypassed, making targeted gene therapy for cancer a technically demanding, but feasible
proposition. MRC Centre, Cambridge CB2 5ER, UK
STEPHEN J. RUSSELL
CA, Krenitsky TA. Retroviral-mediated gene therapy for the hepatocellular carcinoma: an innovative approach for cancer therapy.
1. Huber BE, Richards treatment of
Proc Natl Acad Sci USA 1991; 88: 8039-43. 2. Russell SJ, Eccles SA, Flemming C, Johnson CA, Collins MKL. Decreased tumorigenicity of a transplantable rat sarcoma following transfer and expression of an IL-2 cDNA. Int J Cancer 1991; 47: 244-51. 3. Gansbacher B, Zier K, Kaniels B, Cronin K, Bannerji R, Gilboa E. Interleukin 2 gene transfer mto tumour cells abrogates tumorigenicity and induces protective
immunity. J Exp Med 1990; 172: 1217-24. Tepper RI, Pattengale PK, Leder P. Murine interleukin 4 displays potent anti-tumor activity in vivo. Cell 1989; 57: 503-12. 5. Russell SJ. Lymphokine gene therapy for cancer. Immunol Today 1990; 11: 196-200. 6. Jam RK. Delivery of novel therapeutic agents in tumors. physiological barriers and strategies. J Natl Cancer Inst 1989; 81: 570-76. 4.
non-immune binding of more than 3 x 107 S aureus per ml in the IDEIA test is also noted in the manufacturer’s information sheets. But the clinical relevance of this false-positive reaction has not yet been recognised. It is unlikely that the required number of S aureus will be present in urethral swabs, which are usually tested by this assay; however, EIA is done for concentrated early morning urine samples, and absolute concentrations of more than 107 S aureus may therefore be achieved. Thus false-positive results due to S aureus can be obtained in contaminated urine samples, and we think that bacterial contamination should be excluded before testing for chlamydial antigens by EIAs.
J. WOLLENHAUPT Departments of Rheumatology and Microbiology, Medical School Hannover, D-3000 Hannover, Germany
EO, Paul ID, Milne JD, Crowley T. Non-invasive sampling method for detecting Chlamydia trachomatis. Lancet 1988; ii. 1246-47. 2. Paul ID, Caul EO. Evaluation of three Chlamydia trachomatis immunoassays with an unbiased, noninvasive clinical sample. Clin Microbiol 1990; 28: 220-22. 3. Chernesky M, Castriciano S, Sellors J, et al Detection of Chlamydia trachomatis antigens in urine as an alternative to swabs and cultures. J Infect Dis 1990; 161: 1. Caul
124-26. 4. Thomas
HTLV-I and uveitis SIR,-Dr Bloch-Michel and colleagues (March 21, p 750) report in uveitis associated with multiple sclerosis a local immune reaction leading to an increased production of specific antibodies to measles virus. We have reportedl evidence that a human retrovirus has an aetiological role in certain types of uveitis. Our study was done in an area endemic for HTLV-I.1 The relative risk (odds ratio) of idiopathic uveitis for HTLV-1 infection in younger patients (20-49 years) was estimated at 11-0; it was only 2-0 in older patients, indicating a role for HTLV-1 in idiopathic uveitis in younger people. Proviral DNA of HTLV-I was detected by polymerase chain reaction in all 12 samples tested from inflammatory cells in aqueous humour. Department of Ophthalmology, Kurume University School of Medicine, Kurume 830, Japan
MANABU MOCHIZUKI
Department of Internal Medicine, Kukmamoto University School of Medicine
KAZUNARI YAMAGUCHI KIYOSHI TAKATSUKI
Department of Pathology, Institute of Medical Science, Tokyo University Division of Epidemiology, Aichi Cancer Centre Research Institute
TOSHIKI WATANABE SHIGEO MORI
BJ, Gilchrist C, Hay PE, Taylor-Robinson D. Simplification of procedures test urine samples for Chlamydia trachomatis. J Clan Pathol 1991; 44:
used to 374-75.
Psoriasis of
regression in terminal AIDS
SIR,-Dr Allen (March 14, p 686) describes the disappearance psoriasis lesions in a severely immunocompromised HIV-
seropositive patient treated with cyclosporin. Allen suggests that cyclosporin had a beneficial effect in this patient. We have lately seen a patient with AID S and a very severe form of psoriasis resistant to standard topical therapy. Lesions persisted for about 2 years but finally regressed progressively when he was in the preterminal phase of his illness (CD4 count 0-01 x 109/1). During this period, the patient was treated only with multivitamins and pentamidine inhalations once every 4 weeks. The interpretation of this observation, as well as the one reported by Allen, is very difficult because spontaneous remissions of psoriasis have been noted in other patients with end-stage AIDS.! In view of the potential toxicity of cyclosporin in HIV infectionwe caution against the use of this drug in patients with psoriasis and HIV infection. Institute of
KAZUO TAJIMA
F. HARTMANN H. ZEIDLER M. FROSCH
Tropical Medicine, Antwerp, Belgium; and University Hospital, Antwerp
R. COLEBUNDERS K. BLOT V. MERTENS P. DOCKX
1. Mochizuki
M, Watanabe T, Yamaguchi K, et al. HTLV-I uveitis: a distinct clinical entity caused by HTLV-I. Jpn J Cancer Res 1992; 83: 236-39.
Staphylococcus aureus in urine and falsepositive immunoassay for chlamydia a
SIR,-Infection with Chlamydia trachomatis is now recognised as major cause of acute and chronic genitourinary diseases, and
infected patients need to be identified. Caul et all reported that examination of urine samples by enzyme immunoassay (EIA) was a non-invasive method to diagnose genitourinary chlamydial infection. Subsequent studies confirmed the value of this technique,2-4 but did not address the difficulty of false-positive results caused by bacterial contamination. We examined by IDEIA immunoassay (Novo BioLabs, Cambridge, UK; Roehm Pharma, Darmstadt, Germany) 55 urine samples from patients with bacterial urinary tract infection, but not containing chlamydia. Samples were prepared and processed by Paul and Caul’s method.2 47 urine samples containing more than 1 ()4 bacteria of various species were negative (8 Pseudomonas spp; 10 Proteus spp; 5 Escherichia coli; 3 Klebsiella spp; 1 Staphylococcus epidermidis; 20 others). By contrast, 5 of 8 urine samples with S aureus yielded positive EIA results. Further analysis by serial dilution of S aureus in otherwise sterile urine showed a dose-dependent reactivity, yielding positive results in concentrations greater than 107 S aureus per sample. A possible
Johnson T, Rapini R, Freese T, Brewton G, Rios A. Acquired immunodeficiency syndrome-associated psoriasis and Reiter’s syndrome. Arch Dermatol 1987; 123: 1622-32. 2. Walgate R. Politics of premature French claim of cure. Nature 1985; 318: 3 1. Duvic M,
Fibroblast growth factor 6 gene expression in AIDS-associated Kaposi’s sarcoma SIR,-Kaposi’s sarcoma (KS) represents an opportunistic neoplasm of unknown aetiology which is especially prevalent in individuals infected with HIV, most notably in homosexual men. The possibility of a direct role for HIV in the aetiology of KS has been raised by experiments describing the introduction of HIV-tat sequences into transgenic mice,l and has been supported by the fmding that the tat protein stimulates growth of KS-derived cells in cultureCultured KS cells proliferate in response to various autocrine and paracrine growth factors and cytokines.3,4Few studies on intact fresh KS tumour tissue have been done.s To help characterise the pathophysiology of KS cells in vivo, we used the reverse transcriptase-polymerase chain reaction (RT-PCR)6 to detect expression of fibroblast growth factors (FGFs) and their receptors in fresh KS tissue. We were surprised to find FGF6 expressed in two specimens from different individuals with AIDS. To our knowledge, this is the first report of FGF6 in KS or any other human
tumour
tissue.
