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The ability to integrate the elements of a multicomponent nanostructure with nanoscale precision by co-assembly provides a versatile strategy to create novel materials with tunable properties. The search for function in these materials will require new strategies to be developed that control the assembly process, especially for structurally dissimilar components, which often have a propensity to self-sort into non-integrated nanostructures. In this work, two components, a peptide (1) and an amphiphile (2), were integratively co-assembled into a multicomponent nanotube. The interaction between the two components at the supramolecular level was driven by the electrostatic complementarity of the components, which was controlled by the pH-dependent charge of 1. Characterization of the co-assembled nanotube, 1-2NT, was achieved using a combination of TEM, AFM, CLSM and SIM techniques, which showed that both components were colocalized within the nanotube. These studies, in conjunction with CD, IR and fluorescence studies, suggested that 1 and 2 were arranged in partially reorganized, self-sorted domains, which were integrated as laminated nanoribbons that coiled together into the final co-assembled nanotube.

SGN-CD228A is an investigational antibody-drug conjugate (ADC) directed to melanotransferrin (CD228, MELTF, MFI2, p97), a cell-surface protein first identified in melanoma. SGN-CD228A consists of a humanized antibody, hL49, with high specificity and affinity for CD228 that is stably conjugated to 8 molecules of the clinically validated microtubule-disrupting agent monomethyl auristatin E (MMAE) via a novel glucuronide linker. We performed comprehensive IHC studies, which corroborated published RNA sequencing data and confirmed low CD228 expression in normal tissues and high expression in several cancers, including melanoma, squamous non-small cell lung cancer (NSCLC), triple-negative breast cancer (TNBC), colorectal cancer, and pancreatic cancer. SGN-CD228A was efficiently internalized in various tumor cell types, and its cytotoxic activity was dependent on CD228 expression and internalization and intrinsic sensitivity to the MMAE payload. Compared with the valine-citrulline dipeptide linker, the novel glucuronide linker increased the cellular retention of MMAE in vitro and conferred improved antitumor activity against melanoma cell lines in vitro and in vivo. In addition, SGN-CD228A was active across melanoma, TNBC, and NSCLC cell line- and patient-derived xenograft models with heterogeneous antigen expression. In vivo, CD228 expression was important for response to SGN-CD228A but was not well correlated across all tumor types, suggesting that other factors associated with ADC activity are important. Overall, SGN-CD228A is a CD228-directed, investigational ADC that employs innovative technology and has compelling preclinical antitumor activity. SGN-CD228A is investigated in a Phase I clinical trial (NCT04042480) in patients with advanced solid tumors., (©2023 The Authors; Published by the American Association for Cancer Research.)

Strategies to create organized multicomponent nanostructures composed of discrete, self-sorted domains are important for developing materials that mimic the complexity and multifunctionality found in biological systems. These structures can be challenging to achieve due to the required balance of molecular self-recognition and supramolecular attraction needed between the components. Herein, we report a strategy to construct a two-component nanostructure via a hierarchical assembly process whereby two monomeric building blocks undergo self-sorting assembly at the molecular level followed by a supramolecular association to form a nanofiber-wrapped nanotube. The two molecules self-sorted into respective nanofiber and nanotube assemblies, yet assembly of the nanofibers in the presence of the nanotube template allowed for directed integration into a hierarchical multilayer structure via electrostatic interactions. The fiber-wrapped nanotube co-assembly was characterized using transmission electron microscopy (TEM), atomic force microscopy (AFM) and Förster resonance energy transfer (FRET) between the components. Strategies to co-assemble multicomponent nanostructures composed of discrete, spatially sorted domains with controllable higher level interactions will be critical for the development of novel, functionally competent nanomaterials.

Diabetes poses a high risk for debilitating complications in neural tissues, regulating glucose uptake through insulin-dependent and predominantly insulin-independent pathways. Supramolecular nanostructures provide a flexible strategy for combinatorial regulation of glycemia. Here, we compare the effects of free insulin to insulin bound to positively charged nanofibers comprised of self-assembling amino acid compounds (AACs) with an antioxidant-modified side chain moiety (AAC2) in both in vitro and in vivo models of type 1 diabetes. Free AAC2, free human insulin (hINS) and AAC2-bound-human insulin (AAC2-hINS) were tested in streptozotocin (STZ)-induced mouse model of type 1 diabetes. AAC2-hINS acted as a complex and exhibited different properties compared to free AAC2 or hINS. Mice treated with the AAC2-hINS complex were devoid of hypoglycemic episodes, had improved levels of insulin in circulation and in the brain, and increased expression of neurotransmitter taurine transporter, Slc6a6 . Consequently, treatment with AAC2-hINS markedly advanced both physical and cognitive performance in mice with STZ-induced and genetic type 1 diabetes compared to treatments with free AAC2 or hINS. This study demonstrates that the flexible nanofiber AAC2 can serve as a therapeutic platform for the combinatorial treatment of diabetes and its complications.

Auristatins, a class of clinically validated anti-tubulin agents utilized as payloads in antibody-drug conjugates, are generally classified by their membrane permeability and the extent of cytotoxic bystander activity on neighboring cells after targeted delivery. The drugs typically fall within two categories: membrane permeable monomethyl auristatin E-type molecules with high bystander activities and susceptibility to efflux pumps, or charged and less permeable monomethyl auristatin F (MMAF) analogs with low bystander activities and resistance to efflux pumps. Herein, we report the development of novel auristatins that combine the attributes of each class by having both bystander activity and cytotoxicity on multidrug-resistant (MDR + ) cell lines. Structure-based design focused on the hydrophobic functionalization of the N-terminal N -methylvaline of the MMAF scaffold to increase cell permeability. The resulting structure-activity relationships of the new auristatins demonstrate that optimization of hydrophobicity and structure can lead to highly active free drugs and antibody-drug conjugates with in vivo bystander activities., (©2020 American Association for Cancer Research.)

We developed a de novo protein design strategy to swiftly engineer decoys for neutralizing pathogens that exploit extracellular host proteins to infect the cell. Our pipeline allowed the design, validation, and optimization of de novo human angiotensin-converting enzyme 2 (hACE2) decoys to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The best monovalent decoy, CTC-445.2, bound with low nanomolar affinity and high specificity to the receptor-binding domain (RBD) of the spike protein. Cryo-electron microscopy (cryo-EM) showed that the design is accurate and can simultaneously bind to all three RBDs of a single spike protein. Because the decoy replicates the spike protein target interface in hACE2, it is intrinsically resilient to viral mutational escape. A bivalent decoy, CTC-445.2d, showed ~10-fold improvement in binding. CTC-445.2d potently neutralized SARS-CoV-2 infection of cells in vitro, and a single intranasal prophylactic dose of decoy protected Syrian hamsters from a subsequent lethal SARS-CoV-2 challenge., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

There is an urgent need for the ability to rapidly develop effective countermeasures for emerging biological threats, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the ongoing coronavirus disease 2019 (COVID-19) pandemic. We have developed a generalized computational design strategy to rapidly engineer de novo proteins that precisely recapitulate the protein surface targeted by biological agents, like viruses, to gain entry into cells. The designed proteins act as decoys that block cellular entry and aim to be resilient to viral mutational escape. Using our novel platform, in less than ten weeks, we engineered, validated, and optimized de novo protein decoys of human angiotensin-converting enzyme 2 (hACE2), the membrane-associated protein that SARS-CoV-2 exploits to infect cells. Our optimized designs are hyperstable de novo proteins (∼18-37 kDa), have high affinity for the SARS-CoV-2 receptor binding domain (RBD) and can potently inhibit the virus infection and replication in vitro. Future refinements to our strategy can enable the rapid development of other therapeutic de novo protein decoys, not limited to neutralizing viruses, but to combat any agent that explicitly interacts with cell surface proteins to cause disease.

Differences in glucose uptake in peripheral and neural tissues account for the reduced efficacy of insulin in nervous tissues. Herein, we report the design of short peptides, referred as amino acid compounds (AAC) with and without a modified side chain moiety. At nanomolar concentrations, a candidate therapeutic molecule, AAC2, containing a 7-(diethylamino) coumarin-3-carboxamide side-chain improved glucose control in human peripheral adipocytes and the endothelial brain barrier cells by activation of insulin-insensitive glucose transporter 1 (GLUT1). AAC2 interacted specifically with the leptin receptor (LepR) and activated atypical protein kinase C zeta (PKCς) to increase glucose uptake. The effects induced by AAC2 were absent in leptin receptor-deficient predipocytes and in Lepr db mice. In contrast, AAC2 established glycemic control altering food intake in leptin-deficient Lep ob mice. Therefore, AAC2 activated the LepR and acted in a cytokine-like manner distinct from leptin. In a monogenic Ins2 Akita mouse model for the phenotypes associated with type 1 diabetes, AAC2 rescued systemic glucose uptake in these mice without an increase in insulin levels and adiposity, as seen in insulin-treated Ins2 Akita mice. In contrast to insulin, AAC2 treatment increased brain mass and reduced anxiety-related behavior in Ins2 Akita mice. Our data suggests that the unique mechanism of action for AAC2, activating LepR/PKCς/GLUT1 axis, offers an effective strategy to broaden glycemic control for the prevention of diabetic complications of the nervous system and, possibly, other insulin insensitive or resistant tissues., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Clinical Scenario: Lower-extremity injuries in the United States costs millions of dollars each year. Athletes should be screened for neuromuscular deficits and trained to correct them. The tuck jump assessment (TJA) is a plyometric tool that can be used with athletes. Clinical Question: Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals? Summary of Key Findings: Four of the 5 articles included in this critically appraised topic showed good to excellent reliability; however, caution should be taken in interpreting these results. Although composite scores of the TJA were found to be reliable, individual flaws do not demonstrate reliability on their own, with the exception of knee valgus at landing. Aspects of the TJA itself, including rater training, scoring system, playback speed, volume, and number of views allotted, need to be standardized before the reliability of this clinical assessment can be further researched. Clinical Bottom Line: The TJA has shown varying levels of reliability, from poor to excellent, for both interrater and intrarater reliability, given current research. Strength of Recommendation: According to the Centre for Evidence Based Medicine levels of evidence, there is level 2b evidence for research into the reliability of the TJA. This evidence has been demonstrated in elite, adolescent, and college-level athletics in the United Kingdom, Spain, and the United States. The recommendation of level 2b was chosen because these studies utilized cohort design for interrater and intrarater reliability across populations. An overall grade of B was recommended because there were consistent level 2 studies.

A coumarin-tetrapeptide conjugate, EFEK(DAC)-NH 2 ( 1 ), is reported to undergo a pH-dependent interconversion between nanotubes and nanoribbons. An examination of zeta potential measurements, circular dichroism (CD) spectra, and microscopy imaging (transmission electron microscopy and atomic force microscopy) identified three different self-assembly regimes based on pH: (1) pH 2-5, positively charged, left-handed helical nanotubes; (2) pH 6-8, negatively charged, right-handed helical nanoribbons; and (3) pH ≥ 9.0, a monomeric/disassembled peptide. The nanotubes exhibited uniform diameters of 41 ± 5 nm and wall thicknesses of 4.8 ± 0.8 nm, whereas the nanoribbons existed as either flat or twisted sheets ranging in width from 11 to 60 nm with heights of 8 ± 1 nm. The UV-vis and CD spectra of the most common antiparallel, β-sheet conformation of 1 -dimer were simulated at the B3LYP/def2svpd level of theory in implicit water. These studies indicated that the transition from nanotubes to nanoribbons was coupled to an M → P helical inversion of the coumarin packing orientation, respectively, within the nanostructures. The assembly process was driven by β-sheet aggregation and π-π interactions, leading to the formation of nanoribbons, which progressively wound into helical ribbons and laterally grew into smooth nanotubes as the pH decreased.

Achieving the co-assembly of more than one component represents an important challenge in the drive to create functional self-assembled nanomaterials. Multicomponent nanomaterials comprised of several discrete, spatially sorted domains of components with high degrees of internal order are particularly important for applications such as optoelectronics. In this work, single-walled carbon nanotubes (SWNTs) were threaded through the inner channel of nanotubes formed by the bolaamphiphilic self-assembly of a naphthalenediimide-lysine (NDI-Bola) monomer. The self-assembly process was driven by electrostatic interactions, as indicated by ζ -potential measurements, and cation-π interactions between the surface of the SWNT and the positively charged, NDI-Bola nanotube interior. To increase the threading efficiency, the NDI-Bola nanotubes were fragmented into shortened segments with lengths of <100 nm via sonication-induced shear, prior to co-assembly with the SWNTs. The threading process created an initial composite nanostructure in which the SWNTs were threaded by multiple, shortened segments of the NDI-Bola nanotube that progressively re-elongated along the SWNT surface into a continuous radial coating around the SWNT. The resultant composite structure displayed NDI-Bola wall thicknesses twice that of the parent nanotube, reflecting a bilayer wall structure, as compared to the monolayer structure of the parent NDI-Bola nanotube. As a final, co-axial outer layer, poly( p -phenyleneethynylene) (PPE-SO 3 Na, M W = 5.76 × 10 4 , PDI - 1.11) was wrapped around the SWNT/NDI-Bola composite resulting in a three-component (SWNT/NDI-Bola/PPE-SO 3 Na) composite nanostructure., (This journal is © The Royal Society of Chemistry 2019.)

The purpose of our study was to examine the ability of anthropometric variables (body mass, total arm length, biacromial width) to predict bench press performance at both maximal and submaximal loads. Our methods required 36 men to visit our laboratory and submit to anthropometric measurements, followed by lifting as much weight as possible in good form one time (1 repetition maximum, 1RM) in the exercise. They made 3 more visits in which they performed 4 sets of bench presses to volitional failure at 1 of 3 (40, 55, or 75% 1RM) submaximal loads. An accelerometer (Myotest Inc., Royal Oak MI) measured peak force, velocity, and power after each submaximal load set. With stepwise multivariate regression, our 3 anthropometric variables attempted to explain significant amounts of variance for 13 bench press performance indices. For criterion measures that reached significance, separate Pearson product moment correlation coefficients further assessed if the strength of association each anthropometric variable had with the criterion was also significant. Our analyses showed that anthropometry explained significant amounts (p < 0.05) of variance for 8 criterion measures. It was concluded that body mass had strong univariate correlations with 1RM and force-related measures, total arm length was moderately associated with 1RM and criterion variables at the lightest load, whereas biacromial width had an inverse relationship with the peak number of repetitions performed per set at the 2 lighter loads. Practical applications suggest results may help coaches and practitioners identify anthropometric features that may best predict various measures of bench press prowess in athletes.

Our study purpose examined salivary hormonal responses to high-speed resistive exercise. Healthy subjects (n = 45) performed 2 elbow flexor workouts on a novel (inertial kinetic exercise; Oconomowoc, WI, USA) strength training device. Our methods included saliva sample collection at both preexercise and immediately postexercise; workouts entailed two 60-second sets separated by a 90-second rest period. The samples were analyzed in duplicate for their testosterone and cortisol concentrations ([T], [C]). Average and maximum elbow flexor torque were measured from each exercise bout; they were later analyzed with a 2(gender) × 2(workout) analysis of variance (ANOVA) with repeated measures for workout. The [T] and [C] each underwent a 2(gender) × 2(time) ANOVA with repeated measures for time. A within-subject design was used to limit error variance. Average and maximum torque each had gender (men > women; p < 0.05) effects. The [T] elicited a 2-way interaction (p < 0.05), as men incurred a significant 14% increase over time, but women's values were unchanged. Yet multivariate regression revealed that 3 predictor variables (body mass and average and maximum torques) did not account for a significant amount of variance associated with the rise in male [T]. Changes in [C] were not significant. In conclusion, changes in [T] concur with the results from other studies that showed significant elevations in male [T], despite the brevity of current workouts and the rather modest volume of muscle mass engaged. Practical applications imply that salivary assays may be a viable alternative to blood draws from athletes, yet coaches and others who may administer this treatment should know that our results may have produced greater pre-post hormonal changes if postexercise sample collection had occurred at a later time point.

Introduction: Elevated metabolism is common to spaceflight while exercise in microgravity exacerbates energy costs. Thus in-flight exercise countermeasures must be devised that minimize energy costs as they are performed on hardware operable in microgravity., Methods: Female subjects (N = 28), subdivided into athletic and sedentary groups, each performed two workouts on a resistive exercise device (Impulse Training Systems; Newnan, GA). Comprised exclusively of either tonic or phasic repetitions, each exercise bout entailed two 1 -min sets interspersed by a 90-s rest from which the work volume was determined. Oxygen consumption was measured before, during, and after workouts until gas uptake returned to pre-exercise levels. Net oxygen consumption was converted to net energy expenditures via indirect calorimetry. Mean net energy expenditure and work volume values were each compared with 2 (athletes, sedentaries) x 2 (tonic, phasic) ANOVAs, with repeated measures for workout. In addition, multivariate regression employed three predictor (body mass, body fat percentage, work volume) variables to account for the net energy expenditure variance., Results: Workouts yielded a metabolic cost of approximately 14 kcal, yet the data produced no significant intergroup or workout differences. However, work volume analysis yielded a significant (tonic > phasic) effect. The multivariate analysis explained small yet significant amounts of net energy expenditure variance., Discussion: Current results: 1) are partly attributable to higher series elastic element activity seen with Impulse repetitions; and 2) offer new information with respect to in-flight exercise protocols for female astronauts.

The purpose of our study was to assess data reproducibility from 2 consecutive front squat workouts, spaced 1 week apart, performed by American college football players (n = 18) as they prepared for their competitive season. For each workout, our methods entailed the performance of 3-6 front squat repetitions per set at 55, 65, and 75% of subject's 1 repetition maximum (1RM) load. In addition, a fourth set was done at a heavier load, with a resistance equal to 80 and 83% of their 1RM values, for the first and second workouts, respectively. A triple-axis accelerometer was affixed to a barbell to quantify exercise performance. Per load, the accelerometer measures peak values for the following indices: force, velocity, and power. To assess data reproducibility, inter-workout comparisons were made for 12 performance indices with 4 statistical test-retest measures: intraclass correlation coefficients, coefficients of variation (CVs), and the SEM expressed in both absolute and relative terms. Current results show that the majority of performance indices exceeded intraclass correlation (0.75-0.80) and CV (10-15%) values previously deemed as acceptable levels of data reproducibility. The 2 indices with the greatest variability were power and velocity values obtained at 55% of the 1RM load; thus, it was concluded that higher movement rates at the lightest load were the most difficult aspect of front squat performance to repeat successfully over time. Our practical applications imply lighter loads, with inherently higher rates of barbell movement, yield lower data reproducibility values.

The current study purpose examined the vertical height-anthropometry relationship with jump data obtained from an instrumented platform. Our methods required college-aged (n = 177) subjects to make 3 visits to our laboratory to measure the following anthropometric variables: height, body mass, upper arm length (UAL), lower arm length, upper leg length, and lower leg length. Per jump, maximum height was measured in 3 ways: from the subjects' takeoff, hang times, and as they landed on the platform. Standard multivariate regression assessed how well anthropometry predicted the criterion variance per gender (men, women, pooled) and jump height method (takeoff, hang time, landing) combination. Z-scores indicated that small amounts of the total data were outliers. The results showed that the majority of outliers were from jump heights calculated as women landed on the platform. With the genders pooled, anthropometry predicted a significant (p < 0.05) amount of variance from jump heights calculated from both takeoff and hang time. The anthropometry-vertical jump relationship was not significant from heights calculated as subjects landed on the platform, likely due to the female outliers. Yet anthropometric data of men did predict a significant amount of variance from heights calculated when they landed on the platform; univariate correlations of men's data revealed that UAL was the best predictor. It was concluded that the large sample of men's data led to greater data heterogeneity and a higher univariate correlation. Because of our sample size and data heterogeneity, practical applications suggest that coaches may find our results best predict performance for a variety of college-aged athletes and vertical jump enthusiasts.

Introduction: Numerous variables impact resultant testosterone concentrations (TC) that foretell the efficacy of workouts. Identifying variables may aid the development of in-flight exercise prescription., Methods: To identify variables that predict the variance in TC from flywheel ergometer exercise, 17 subjects did 3 workouts in a randomized order. Comprised of 10-repetition leg press sets, workouts entailed either: 1) 3 sets of both concentric and eccentric muscle actions (CE3), and concentric-only actions done for 2) three (CO3), or 3) six (CO6) sets. Venous plasma TC were collected before and at 1 and 30 min postexercise. The last two collection points served as criterion measures. Body mass, delta blood lactate levels, peak angular velocity, average power, and total work from workouts were used to predict the variance in TC., Results: Predictor variables accounted for significant levels of variance at both 1 and 30 min post-exercise for both the CE3 and the concentric-only (CO3 and CO6 bouts combined) workouts using multivariate regression. Inclusion of eccentric variables (only collected from the CE3 bout; r2 = 0.90) predicted nearly twice the variance than the concentric-only (r2 = 0.54) workouts., Conclusions: Body mass and average power indices were the best predictors of the variance in post-workout TC. Since a flywheel-based device is used to abate in-flight muscle atrophy and strength losses, exercise prescriptions may wish to monitor these indices as they impacted post-workout TC to the greatest extent. Future research should assess why eccentric variables increased the amount of explained variance from flywheel ergometer workouts.

Metal implants are in general not compatible with the tissues of the human body, and in particular, blood exhibits a severe hemostatic response. Herein we present results of a technique to mask the surface of metals with a natural biopolymer, hyaluronan (HA). HA has minimal adverse interactions with blood and other tissues, but attachment of bioactive peptides can promote specific biological interactions. In this study, stainless steel was cleaned and then surface-modified by covalent attachment of an epoxy silane. The epoxy was subsequently converted to an aldehyde functional group and reacted with hyaluronan through an adipic dihydrazide linkage, thus covalently immobilizing the HA onto the steel surface. Fluorescent labeling of the HA showed that the surface had a fairly uniform covering of HA. When human platelet rich plasma was placed on the HA-coated surface, there was no observable adhesion of platelets. HA derivatized with a peptide containing the RGD peptide sequence was also bound to the stainless steel. The RGD-containing peptide was bioactive as exemplified by the attachment and spreading of platelets on this surface. Furthermore, when the RGD peptide was replaced with the nonsense RDG sequence, minimal adhesion of platelets was observed. This type of controlled biological activity on a metal surface has potential for modulating cell growth and cellular interactions with metallic implants, such as vascular stents, orthopedic implants, heart valve cages, and more., (Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res 68A: 95-106, 2004)

This study examined the number of ambulatory care providers treating individuals with the acquired immunodeficiency syndrome who were Medicaid beneficiaries in New York State in 1988 and examined the distribution of this care across various practice settings. The study population was identified retrospectively in the New York State Medical HIV/AIDS Research Data Base and included a cohort of 5535 individuals with the acquired immunodeficiency syndrome who were enrolled in Medicaid in 1988 for at least 6 months after being diagnosed as having the disease and who had at least one ambulatory care encounter during the year. Ambulatory care for the study group was provided by more than 700 hospital or freestanding clinics and more than 3000 private physicians in 1988. Many sites had low caseloads; 47% of the clinics and 68% of the physicians treating this population saw only one or two patients with the acquired immunodeficiency syndrome who were enrolled in Medicaid. More than half the patients in the study group were seen most frequently in clinics for their ambulatory care during 1988. These data provide reassurance that a wide network of providers is involved in the care of patients with the acquired immunodeficiency syndrome who are Medicaid beneficiaries in New York.

There is a current and continuing need for health services research on the epidemiology of AIDS and its impact on health care systems. However, large data bases designed for other purposes, such as hospital discharge abstract systems and medical claims systems, are the primary source of data for AIDS research. Thus, methodologies must be developed that enable researchers to investigate AIDS using data bases designed for other purposes. In this report, we describe a methodology for utilizing Medicaid Management Information Systems (MMIS) data to conduct health services research on AIDS. We developed an ICD-9-CM diagnosis-based algorithm that accurately identified the majority of AIDS cases, both before and after AIDS-specific ICD-9-CM codes became available in October 1986. Using diagnostic categories that we had developed previously to identify AIDS cases among disabled young men in California on Medicaid, we expanded the methodology to include children, men, and women of all ages in California and New York. The algorithm worked best with young disabled males, older males, and females between 18 and 50 years of age. The algorithm worked least well with nondisabled males, females over age 50 years, and children. We also developed methodologies for defining Medicaid AIDS onset, risk group, and date of death. Our research resulted in the identification of a study population representing the majority of Medicaid AIDS cases between 1983 and 1986 in California and New York. The AIDS study population data base was used in further research on eligibility patterns, the epidemiology of the AIDS epidemic, lifetime Medicaid utilization and expenditures, and the development of a survival-based severity index for Medicaid recipients with AIDS.

The physical and chemical properties of the mammalian aorta are known to vary as a function of distance from the heart. These properties are highly dependent collagen and elastic fibers. In order to evaluate the mechanisms which regulate the accumulation of these two connective tissue proteins, gene expression was evaluated at both the biosynthetic and messenger RNA levels. Short-term (3 h) explant cultures of the medial portion of four segments of the descending aorta in newborn pigs were incubated in the presence of [3H] proline. Collagen production was quantified by collagenase digestion and elastin production was determined by immunoprecipitation. Between the conus arteriosus and the bifurcation of the iliac arteries, relative collagen synthesis increased 2-fold (from 5.8 to 12.0% of total protein synthesis), while relative elastin synthesis declined 10-fold (from 16.4 to 1.6% of total protein synthesis). Similarly, collagen production increased more than 7-fold (from 6.7 to 49.8 X 10(3) molecules/cell/h) while elastin production was reduced more than 3-fold (from 71.8 to 21.0 X 10(3) molecules/cell/h) along this developmental gradient. Elastin synthesis appeared to be controlled to a significant extent by the availability of elastin mRNA, since both cell-free translation and molecular hybridization to a cloned elastin gene probe showed gradients of elastin gene expression. Similarly, collagen synthesis was apparently regulated, at least in part, by an inverse gradient of collagen mRNA, as measured with a cloned cDNA for the pro-alpha 1(I) collagen gene. Marked changes in the amount of non-elastin protein synthesis accompanied differentiation and accounted for larger changes in relative synthesis. These results suggest that the phenotype of the cells of the porcine artery wall is distinct in different regions of this organ at this developmental stage.

Elastin mRNA levels were quantified in sheep nuchal ligament and lung during the latter half of foetal development with elastin-specific cDNA (complementary DNA) probes using both hybridization in solution (saturation analysis) and hybridization on a fixed support (Northern analysis). For the solution-hybridization studies, cDNA prepared from nuchal-ligament mRNA was enriched to 65% for elastin sequences by hybridizing it to its template at a R0t (mol X s X litre-1) value that included only the abundant class of mRNA sequences. Hybridization of this probe to RNA extracted from nuchal ligament between 70 and 138 days after conception demonstrated elastin sequences increased about 10-fold (from 0.047 to 0.438% of total RNA). In contrast, lung elastin mRNA levels increased only 3-fold (from 0.009 to 0.022% of total RNA) during the same period. Over this development period these values correspond to increases in the average number of elastin mRNA molecules from 950 to 20 000 molecules/ligament cell and from 130 to 330 molecules/lung cell. For Northern analysis, elastin mRNA was purified from near-term-sheep nuchal ligament on sucrose density gradients. Analysis of the translation products of this elastin mRNA showed that relative elastin precursor synthesis was at least 80% of total [3H]valine incorporation. The Mr of this elastin mRNA, determined by methylmercury-agarose-gel electrophoresis, was approx. 1.25 X 10(6). Northern hybridization of nuchal ligament and lung RNA to a [32P]cDNA probe, transcribed from this sucrose-gradient-purified elastin mRNA, confirmed the developmental changes in elastin mRNA levels detected by solution-hybridization techniques. The specificity of this method was confirmed by using a cloned elastin gene fragment. These studies demonstrate that elastin mRNA levels in organs such as nuchal ligament and lung increase with foetal development, but that there are significant differences in the average cellular elastin mRNA content of these two organs.

The crystal structure of a fluorescein-Fab (4-4-20) complex was determined at 2.7 A resolution by molecular replacement methods. The starting model was the refined 2.7 A structure of unliganded Fab from an autoantibody (BV04-01) with specificity for single-stranded DNA. In the 4-4-20 complex fluorescein fits tightly into a relatively deep slot formed by a network of tryptophan and tyrosine side chains. The planar xanthonyl ring of the hapten is accommodated at the bottom of the slot while the phenylcarboxyl group interfaces with solvent. Tyrosine 37 (light chain) and tryptophan 33 (heavy chain) flank the xanthonyl group and tryptophan 101 (light chain) provides the floor of the combining site. Tyrosine 103 (heavy chain) is situated near the phenyl ring of the hapten and tyrosine 102 (heavy chain) forms part of the boundary of the slot. Histidine 31 and arginine 39 of the light chain are located in positions adjacent to the two enolic groups at opposite ends of the xanthonyl ring, and thus account for neutralization of one of two negative charges in the haptenic dianion. Formation of an enol-arginine ion pair in a region of low dielectric constant may account for an incremental increase in affinity of 2-3 orders of magnitude in the 4-4-20 molecule relative to other members of an idiotypic family of monoclonal antifluorescyl antibodies. The phenyl carboxyl group of fluorescein appears to be hydrogen bonded to the phenolic hydroxyl group of tyrosine 37 of the light chain. A molecule of 2-methyl-2,4-pentanediol (MPD), trapped in the interface of the variable domains just below the fluorescein binding site, may be partly responsible for the decrease in affinity for the hapten in MPD.

An antigen-binding fragment (Fab) from a murine monoclonal antibody (4-4-20) with high affinity for fluorescein was cocrystallized with ligand in polyethylene glycol (PEG) and 2-methyl-2,4-pentanediol (MPD) in forms suitable for X-ray analyses. In MPD the affinity of the intact antibody for fluorescein was 300 times lower than the value (3.4 x 10(10) M-1) obtained in aqueous buffers. This decreased affinity was manifested by the partial release of bound fluorescein when MPD was added to solutions of liganded Fab during crystallization trials. In PEG, the ligand remained firmly bound to the protein. The liganded Fab crystallized in the monoclinic space group P2(1) in PEG, with a = 58.6, b = 97.2, c = 44.5 A and beta = 95.2 degrees. In MPD the space group was triclinic P1, with a = 58.3, b = 43.4, c = 42.3 A, alpha = 83.9 degrees, beta = 87.6 degrees, and gamma = 84.5 degrees. X-ray diffraction data were collected for both forms to 2.5-A resolution. Surprisingly, the triclinic form of the liganed antifluorescyl Fab had the same space group, closely similar cell dimensions, and practically the same orientation in the unit cell as an unliganded Fab (BV04-01) with activity against single-stranded DNA.