The hypotension and disseminated intravascular coagulation (DIC) in bacteremia is thought to be mediated by the combined actions of cytokines, prostaglandins, and complement. The contact system, via the release of bradykinin and the activation of Factor XI, has been postulated to be contributing to the observed hypotension and DIC. Using a mAb to Factor XII (C6B7), we blocked the activation of the contact system in an established experimental baboon model in which Escherichia coli was infused to produce lethal bacteremia with hypotension. The untreated group (n = 5) displayed contact activation, manifested by a significant decrease in high molecular weight kininogen (HK) and a significant increase in a2macroglobulin-kallikrein complexes (a2M-Kal). The C6B7-treated group (n = 5) showed an inactivation of Factor XII and the changes in HK and a2M-Kal complexes were prevented. Both groups developed DIC manifested by a decrease in platelet, fibrinogen, and Factor V levels. The untreated group developed irreversible hypotension. The treated group experienced an initial hypotension that was reversed and extended the life of the animals. This study suggests that irreversible hypotension correlates with prolonged activation of the contact system, and specific antibody therapy can modulate both the pathophysiological and biochemical changes. (J. Clin. Invest. 1993.91:61-68.) Key words: septic shock * bradykinin * prekallikrein * high molecular weight kininogen * a2-macroglobulin Introduction Activation of the kallikrein-kinin system concomitant with hypotension has been demonstrated to occur in humans ( 1, 2) and in a lethal baboon model (3) during gram-negative bacteremia. The consequences ofcontact activation include the generation of kallikrein, which releases bradykinin from high molecular weight kininogen (HK),' and the generation of Factor

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Glutamine-fructose-6-phosphate amidotransferase (GFAT) catalyzes the first committed step in the pathway for biosynthesis of hexosamines in mammals. A member of the N-terminal nucleophile class of amidotransferases, GFAT transfers the amino group from the L-glutamine amide to D-fructose 6-phosphate, producing glutamic acid and glucosamine 6-phosphate. The kinetic constants reported previously for mammalian GFAT implicate a relatively low affinity for the acceptor substrate, fructose 6-phosphate (Fru-6-P, K m 0.2-1 mM). Utilizing a new sensitive assay that measures the production of glucosamine 6-phosphate (GlcN-6-P), purified recombinant human GFAT1 (hGFAT1) exhibited a K m for Fru-6-P of 7 M, and was highly sensitive to product inhibition by GlcN-6-P. In a second assay method that measures the stimulation of glutaminase activity, a K d of 2 M was measured for Fru-6-P binding to hGFAT1. Further, we report that the product, GlcN-6-P, is a potent competitive inhibitor for the Fru-6-P site, with a K i measured of 6 M. Unlike other members of the amidotransferase family, where glutamate production is loosely coupled to amide transfer, we have demonstrated that hGFAT1 production of glutamate and GlcN-6-P are strictly coupled in the absence of inhibitors. Similar to other amidotransferases, competitive inhibitors that bind at the synthase site may inhibit the synthase activity without inhibiting the glutaminase activity at the hydrolase domain. GlcN-6-P, for example, inhibited the transfer reaction while fully activating the glutaminase activity at the hydrolase domain. Inhibition of hGFAT1 by the end product of the pathway, UDPGlcNAc, was competitive with a K i of 4 M. These data suggest that hGFAT1 is fully active at physiological levels of Fru-6-P and may be regulated by its product GlcN-6-P in addition to the pathway end product, UDP-GlcNAc.

Platinum compounds with the diaminocyclohexane (dach) carrier ligand are of particular interest because cell lines that have developed resistance to platinum compounds in general often retain sensitivity to dach-platinum compounds, suggesting that the dach carrier ligand affects the formation, repair, or lethality of platinum-DNA adducts. The effect of the dach ligand on platinum adduct formation was assessed by using the (HaeIII-HindIII)146 fragment of pBR322 treated to give equal amounts of dach- or ethylene-diamine-platinum adducts. The sites of adduct formation were mapped by digestion with Escherichia coli ABC excinuclease. There were no significant effects of the dach carrier ligand on the types or sites of platinum adduct formation. The effect of the dach ligand on platinum adduct repair was determined by using synthetic oligomers designed to have single, specific platinum adducts (G monoadduct; GG, AG, or GNG diadduct) with either the dach or ethylenediamine (en) carrier ligand. These adducts differed significantly in their ability to serve as substrates for ABC excinuclease with GNG greater than or equal to G greater than AG greater than GG. The dach carrier ligand had little effect on the recognition of AG and GG adducts by ABC excinuclease, but significantly improved the ability of ABC excinuclease to excise G monoadducts and GNG diadducts. These data suggest that if the carrier ligand has any effect on the repair of platinum adducts, it is more likely to exert that effect on the repair of platinum monoadducts or GNG diadducts rather than on the more abundant AG or GG diadducts. [14C]Thiourea incorporation was used to quantitate the rate of monoadduct to diadduct conversion.(ABSTRACT TRUNCATED AT 250 WORDS)

The nature of any virus-specific T cells involved in controlling human cytomegalovirus (HCMV) infection in normal subjects harboring latent virus is unknown. As an approach to this problem, peripheral blood mononuclear cells (PBM) from normal seropositive subjects were cocultured with HCMV and responding T cells expanded in interleukin 2 (IL2)-dependent culture, determining in particular whether HCMV-specific cytotoxic T cells (Tc) were generated. Coculture of PBM with free HCMV resulted in the generation of short-term T cell lines of predominantly helper phenotype (Leu 3a+), expressing no cytotoxicity. However, when PBM were cocultured on HCMV-infected fibroblasts (autologous to the donor in these experiments) predominantly Leu 2a+ lines were generated, which lysed HCMV-infected cells. The cytotoxicity of these short-term IL 2-dependent lines was HCMV-specific and human HLA-restricted; HCMV-infected target cells expressing only early viral antigens were lysed. It is concluded that HCMV-specific Tc precursors are present in peripheral blood of latently infected individuals without preceding overt infection and that effector Tc may be capable of lysing infected cells prior to viral replication.