acyclovir and Carcinoma--Renal-Cell

Topics: Acyclovir; Carcinoma, Renal Cell; Delusions; Female; Humans; Middle Aged; Schizophrenia, Paranoid; Valacyclovir; Valine

To describe a case of limbic encephalitis which initially presented as viral limbic encephalitis and during the clinical evaluation a renal carcinoma was diagnosed.. Patient with history of peripheral paresis of right facial nerve, 1 month after symptoms appearance and treatment, developed fever, vomiting, grand mal seizure, decreased level of consciousness, confusion, hallucinations and agitation. The patient initially presented a clinical picture of viral LE. which confirmed by CSF. MRI brain showed areas with pathological intensity signal in the region of limbic system unilateral. During the clinical evaluation a renal carcinoma was discovered and a nephrectomy has been performed.. Although PLE typically presents as a chronic or subacute disease, it may be fulminant and clinically indistinguishable from an acute HSVE. This association pose the problem of a possible relation between this two syndromes and the correct diagnosis is very important, because there are effective treatments.

Topics: Acute Disease; Acyclovir; Anti-Bacterial Agents; Anticonvulsants; Carcinoma, Renal Cell; Cerebrospinal Fluid; Diagnosis, Differential; Drug Therapy, Combination; Electroencephalography; Encephalitis, Viral; Enoxaparin; Ethambutol; Follow-Up Studies; Herpesvirus 1, Human; Humans; Isoniazid; Limbic Encephalitis; Limbic System; Magnetic Resonance Imaging; Male; Meningoencephalitis; Methylprednisolone; Middle Aged; Nephrectomy; Neuropsychological Tests; Paraneoplastic Syndromes, Nervous System; Phenytoin; Rifampin; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vancomycin

An estimated 11,600 Americans will die of renal cell carcinoma in 1998. The lack of effective chemotherapy or radiotherapy requires the investigation of novel treatment modalities. We compared two forms of toxic gene therapy, cytosine deaminase (CD) plus 5-fluorocytosine (5-FC) and thymidine kinase (TK) plus acyclovir (ACV), in pre-clinical models of human renal cell carcinoma.. Replication-deficient recombinant adenoviral vectors containing the Rous sarcoma virus promoter driving CD (Ad-RSV-CD) or TK (Ad-RSV-TK) gene expression were constructed and tested for in vitro cell-killing assays at various viral multiplicity of infection (MOI) and in vivo for growth inhibition of a human renal cell carcinoma, SK-RC-29 models. Subcutaneous tumors of SK-RC-29 were examined by electron microscopy for presence of intercellular gap junctions. Levels of expression of the gap junctional associated connexin 43 protein in SK-RC-29, 31, 38, 42, 52 human RCC cell lines were examined by western immunoblotting.. In vitro cell-killing assay comparing Ad-RSV-CD/5F-C and Ad-RSV-TK/ACV at a wide range of MOI (2.5 to 20) revealed superior cell-kill by Ad-RSV-CD/5-FC over Ad-RSV-TK/ACV. Consistent with these results, we observed that Ad-RSV-CD/5-FC but not Ad-RSV-TK/ACV demonstrated a significant in vivo tumor growth inhibition. These results are corroborated by the lack of gap junctions in SK-RC-29 subcutaneous tumors by the electron microscopy and the absence of connexin-43 in all five human RCC cell lines by western immunoblotting.. We have demonstrated in this study that Ad-RSV-CD/5-FC is superior to Ad-RSV-TK/ACV for the treatment of human RCC in cell culture and animal models. The results are supported by the lack of gap junctional communication between RCC cells assessed by connexin-43 expression.

Topics: Acyclovir; Adenoviridae; Antimetabolites; Carcinoma, Renal Cell; Cytosine Deaminase; Flucytosine; Genetic Therapy; Genetic Vectors; Humans; Kidney Neoplasms; Nucleoside Deaminases; Thymidine Kinase; Tumor Cells, Cultured