cosyntropin and Neoplasms

In order to compare the safety and the antiemetic effectiveness of tetracosactide (TCS) or beta 1,24 ACTH with those of dexamethasone (DXM) as an adjunct to high-dose metoclopramide, diphenhydramine and clorazepate, 33 patients receiving cisplatin based cancer chemotherapy were enrolled in a double-blind cross-over clinical trial. TCS and DXM were given intravenously, respectively at a dose of 2 mg and 20 mg, and concurrently to the cisplatin infusion. No statistically significant difference was noted between the two drugs with regard to efficacy or side effects. We conclude that TCS can serve as a substitute for DXM in combination antiemetic regimens for management of cisplatin-induced nausea and vomiting.

Topics: Adult; Aged; Cisplatin; Clinical Trials as Topic; Clorazepate Dipotassium; Cosyntropin; Dexamethasone; Diphenhydramine; Double-Blind Method; Drug Therapy, Combination; Humans; Metoclopramide; Middle Aged; Neoplasms; Prospective Studies; Vomiting

An immunochemical characterization of carcinoembryonic antigen (CEA) and NCA (non-specific cross-reacting antigen) was performed. Positive reactions of CEA and NCA (Mr 60 000) with some antibodies to alpha 1-acid glycoprotein (AG) were observed. Thus, both antigens may contain immune determinants in common with alpha 1-acid glycoprotein. CEA showed positive reactivity with anti-NCA. NCA showed positive reactivity with either polyclonal or monoclonal antibodies to CEA, but negative reactivity with auto-antibodies to CEA. 125I-Tetracosapeptide (synthetic peptide-24 corresponding to the amino terminal sequence of CEA) failed to react with any antisera against CEA, NCA and AG. 125I-AG also showed no immuno-reaction with any antibody against CEA, NCA and tetracosapeptide. These results suggest that some monoclonal antibodies to CEA are directed against a common antigenic determinant of both CEA and NCA in addition to AG and tetracosapeptide, and that the auto-antibody to CEA is directed against a unique immune determinant which is not common to NCA. Thus, CEA appears to contain a unique determinant not found in NCA. Similarities in the composition of both amino acids and carbohydrates of CEA and NCA suggest that CEA is 'big-big' AG and NCA is 'big' AG.

Topics: Antibodies, Monoclonal; Antigens; Antigens, Neoplasm; Autoantibodies; Carcinoembryonic Antigen; Cell Adhesion Molecules; Chromatography, Gel; Cosyntropin; Epitopes; Glycoproteins; Humans; Immunosorbent Techniques; Neoplasms; Orosomucoid

Topics: Adrenocorticotropic Hormone; Chronic Disease; Cicatrix; Cosyntropin; Fibromyalgia; Headache; Humans; Neoplasms; Neuralgia; Pain; Palliative Care

A corticotropin antiserum was obtained from rabbits immunized with synthetic 1--24 corticotropin conjugated with bovine serum albumin. The antiserum did not cross react with synthetic alpha-melanotropin or with synthetic beta-endorphin and had a cross reactivity of 0.23% with human beta-lipotropin. We developed a radioimmunoassay with the antiserum obtained, in which we used polyethylene glycol in conjunction with a second precipitating antibody for fast (15-min) separation of antibody-bound and free corticotropin. The assay had a sensitivity of 16 ng/L and was validated on patients with various pituitary and adrenal diseases. From 103 normal subjects, the median value for corticotropin in specimens collected during the morning was 34 ng/L of plasma; the upper 95% confidence limit of the normal range was 98 ng/L.

Topics: Adrenal Gland Diseases; Adrenocorticotropic Hormone; Animals; Cosyntropin; Cross Reactions; Female; Humans; Hypoglycemia; Immune Sera; Insulin; Iodine Radioisotopes; Male; Neoplasms; Rabbits; Radioimmunoassay; Reference Values