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A captive colony of baboons has been used for three decades for various reproductive studies where application of findings to human therapeutics was desired. The characteristics of the menstrual cycle in baboons are very similar to those of women, except that of the baboon is slightly longer and there is a lower luteal phase concentration of oestradiol. The duration of pregnancy in baboons is about two-thirds that of humans but patterns of oestrogen and progesterone secretion are virtually identical. The principal oestrogen produced by the pregnant baboon is oestrone, while oestriol is the most abundant in human pregnancies. Chorionic gonadotrophin (CG) is elevated significantly only in the first trimester of a baboon pregnancy, while human pregnancy concentrations of this hormone are about one-third of the first trimester level in the second and third trimesters. Breeding success of baboons in captivity depends on care being taken to cull infertile animals from the colony prior to commencing matings. Under optimal conditions, fertility rates can reach nearly 80%. Female baboons have been successfully used to gain insights into antifertility effects of contraceptive vaccines directed against CG, spermatozoa and ovum antigens. Extensive use of the colony for developing a human chorionic gonadotrophin (HCG) antifertility vaccine has been invaluable for progress in this field. Other pharmaceuticals and devices have been successfully tested in baboons, but costs and mandated regulations for the management of these non human primates have made their current use in meaningful studies extremely difficult. [ABSTRACT FROM PUBLISHER]

Oral candidosis is a significant cause of morbidity in patients with advanced cancer. The objectives of the study were to determine the epidemiology, etiology, clinical features, and microbiological aspects of oral candidosis among community-based patients. The subjects were recruited from hospice day centers in England. The clinical component involved completion of a study questionnaire, assessment of performance status, clinical examination of the oral cavity, measurement of unstimulated whole salivary flow rate, measurement of stimulated whole salivary flow rate, and performance of an oral rinse. Oral swabs were taken from subjects with appearances indicative of oral candidosis. The laboratory component involved standard procedures to isolate, enumerate, and identify yeasts from the clinical specimens. Three hundred ninety patients participated in the study. Two hundred seventy-two (70%) patients had oral yeast carriage, and 51 (13%) patients had combined clinical and microbiological evidence of oral candidosis. On univariate analysis, the presence of oral candidosis was associated with poor Eastern Cooperative Oncology Group performance status, presence of a denture, usage of a systemic corticosteroid, the severity of xerostomia, a low unstimulated whole salivary flow rate, and a low stimulated whole salivary flow rate. Multivariate analysis identified poor Eastern Cooperative Oncology Group performance status, presence of a denture, usage of a systemic corticosteroid, and the severity of xerostomia as being independently associated with the presence of oral candidosis. Oral candidosis is relatively common in community-based patients with advanced cancer. Hence, such patients should be screened for oral candidosis and should also be screened for reversible factors that predispose to oral candidosis, such as poor dental hygiene and salivary gland dysfunction.

Advanced contraceptive peptide vaccines suffer from the unavailability of adjuvants capable of enhancing the antibody response with acceptable safety. We sought to overcome this limitation by employing two novel poly(lactic-co-glycolic acid) (PLGA) microsphere formulations to deliver a synthetic human chorionic gonadotropin (hCG) peptide antigen co-synthesized with a T-cell epitope from tetanus toxoid (TT), C-TT2-CTP35: surface-conjugated immunogen to induce phagocytosis; and encapsulated peptide to provide a depot effect, with MgCO(3) co-encapsulated in the polymer to neutralize acidity from the biodegrading PLGA polyester. A single immunization of encapsulated peptide in rabbits elicited a stronger antibody response with equivalent duration relative to a positive control--three injections of the peptide administered in a squalene-based water-in-oil emulsion. Surface-conjugated peptide was less effective but enhanced antibody levels at 1/5 the dose, relative to soluble antigen. Most remarkable and unexpected was the finding that co-encapsulation of base was essential to attain the powerful adjuvant effect of the PLGA-MgCO(3) system, as the MgCO(3)-free microspheres were completely ineffective. A promising contraceptive hCG peptide vaccine with acceptable side effects (i.e., local tissue reactions) was achieved by minimizing PLGA and MgCO(3) doses, without significantly affecting antibody response.

Synthetic peptide vaccines targeting B-cell epitopes of the extracellular domain of the HER-2 oncoprotein were evaluated for their capacity to elicit HER-2-specific antibodies with antiproliferative activity. Several HER-2 B-cell epitopes were identified by computer-aided analysis of protein antigenicity, and selected B-cell epitopes were synthesized colinearly with a promiscuous T-helper epitope (208-302) derived from the measles virus fusion protein at either the NH2 or COOH terminus linked via a four-residue turn sequence (GPSL). In addition, one epitope sequence, 628-647, was mutated to optimize disulfide pairing to mimic the native HER-2 receptor. All of the four selected epitopes elicited high-titered antibodies in outbred rabbits with exceptionally high titers for MVF-HER-2(628-647). These antibodies were cross-reactive with the native HER-2 receptor. Antibodies elicited by MVF HER-2(628-647) inhibited proliferation of human HER-2-overexpressing breast cancer cells in vitro and caused their antibody-dependent cell-mediated cytotoxicity. Furthermore, immunization with MVF-HER-2(628-647) prevented the spontaneous development of HER-2/neu-overexpressing mammary tumors in 83% of transgenic mice. The engineered, chimeric peptide B-cell immunogen MVF-HER-2(628-647) may have applications in the prevention of HER-2-overexpressing cancers.

Human chorionic gonadotropin (hCG) is expressed by common cancers and may play a role in cell transformation as well as angiogenic, metastatic, and immune escape phenomena that are central to cancer progression. Clinical trials with a vaccine targeting the carboxy-terminal peptide of -hCG have indicated that tolerance to this oncofetal antigen can be broken. Humoral responses that may modulate the biologic activity of tumor-associated hCG as well as cellular responses to hCG have been generated. Studies are in progress to further define the biologic significance of hCG in cancer and to develop a vaccine approach that will best target this expression.

The advent of immunocontraceptives represents the first truly novel approach to the development of family planning methods in over 30 years. Such products would have many advantages over existing contraceptives in that they would not elicit metabolic disturbances, would provide long-acting (i.e. 6 to 12 months) protection from pregnancy, be easy to administer, be economical to manufacture and distribute, and could, depending on their composition, be used by either men or women. Several lines of research and development currently in progress are aimed at the development of safe and effective immunocontraceptives based on reproductive hormones, components of the gametes (sperm and ova) and products of the early pre-implantation conceptus. The only prototype immunocontraceptives to have reached the stage of clinical trials in women are those based on the hormone human chorionic gonadotropin, and in men that based on follicle-stimulating hormone. However, extensive research is also underway on immunocontraceptives based on sperm and ovum components for use by women, and on immunocontraceptives based on sperm components and gonadotropin-releasing hormone for use by men. Before such preparations can be made available for wide-scale use, further research is needed on ways to overcome genetically determined variations in individual immune responses so that protective responses of a predetermined duration can be elicited in all recipients. It is anticipated that these technical problems can be solved and the clinical testing of lead products will be completed in the next decade. Almost all of the financial support for the research and development of immunocontraceptives has been provided by academic institutions and public sector agencies. In general, the pharmaceutical industry has not been willing to engage in new contraceptive development, largely because of concerns about product liability claims, anticipated low profitability and/or the risk of negative publicity. Therefore, the further development, manufacture and distribution of immunocontraceptives will probably require the collaboration of public sector agencies, governments and industry in order to overcome the current paucity of effort being put into the development and provision of new, safe, effective and acceptable methods of family planning. The purpose of this review is to provide information on the current status of research and development of potential immunocontraceptives and to attempt to stimulate pharmaceutical companies to reassess their positions with regard to the development, manufacture and distribution of these products.

The clinical and immunological effects of a vaccine consisting of CTP37, a synthetic peptide corresponding to the COOH-terminal peptide (CTP) of beta-human chorionic gonadotropin (beta-hCG) conjugated to diphtheria toxoid, combined with CRL 1005, a novel synthetic nonionic block copolymer adjuvant, were examined. Twenty-one patients with metastatic, nontrophoblastic cancers received up to four immunizations by i.m. injection of a fixed dose of CTP37 and escalating doses of CRL 1005. Doses of CRL 1005 adjuvant as high as 75 mg were administered with 1 mg of CTP37 without evidence of significant local or systemic toxicity. Immunizations resulted in the production of IgG antibody to beta-hCG. CRL 1005 doses of 3-25 mg appeared to be optimal for antibody induction. Immunizations also resulted in increases in the cellular response of peripheral blood mononuclear cells (PBMCs) to the unconjugated CTP, hCG, and diphtheria toxoid. Responding PBMCs specifically secreted the TH1-associated cytokines IFN-gamma and interleukin (IL)-2 as well as the TH2-associated IL-5 and IL-10. Increased expression of IFN gamma and IL-5 mRNAs by PBMCs 4 h after immunization was also observed. CRL 1005 administered with CTP37 in aqueous solution is well tolerated. The CTP37-CRL 1005 subunit vaccine has the capacity to stimulate potentially beneficial humoral and cellular immune responses in patients with advanced cancer.

A captive colony of baboons has been used for three decades for various reproductive studies where application of findings to human therapeutics was desired. The characteristics of the menstrual cycle in baboons are very similar to those of women, except that of the baboon is slightly longer and there is a lower luteal phase concentration of oestradiol. The duration of pregnancy in baboons is about two-thirds that of humans but patterns of oestrogen and progesterone secretion are virtually identical. The principal oestrogen produced by the pregnant baboon is oestrone, while oestriol is the most abundant in human pregnancies. Chorionic gonadotrophin (CG) is elevated significantly only in the first trimester of a baboon pregnancy, while human pregnancy concentrations of this hormone are about one-third of the first trimester level in the second and third trimesters. Breeding success of baboons in captivity depends on care being taken to cull infertile animals from the colony prior to commencing matings. Under optimal conditions, fertility rates can reach nearly 80%. Female baboons have been successfully used to gain insights into antifertility effects of contraceptive vaccines directed against CG, spermatozoa and ovum antigens. Extensive use of the colony for developing a human chorionic gonadotrophin (HCG) antifertility vaccine has been invaluable for progress in this field. Other pharmaceuticals and devices have been successfully tested in baboons, but costs and mandated regulations for the management of these nonhuman primates have made their current use in meaningful studies extremely difficult.

Human chorionic gonadotropin (hCG) and the beta subunit of this dimer glycoprotein hormone (beta hCG) have been reported by us to inhibit HIV replication. In order to identify the active site responsible for the antiviral activity, twelve overlapping peptides spanning across beta hCG were examined for their effect against HIV-caused cell death. Although the NH2-terminus of beta hCG appeared to contribute to activity, the core region was biologically inert. The most potent activity was observed with the fragment representing the carboxy-terminus of beta hCG. The dose response curve to serial dilutions of the peptide, containing amino acid residues 106-145, had a bell-shaped appearance - characteristic of hCG and beta hCG. The peak of activity corresponded to 100 ng/ml - the dose at which two thirds of virus-exposed MT-4 T lymphocytes survived. None of the tested peptides were toxic to MT-4. While the mechanism of action remains unclear, the results suggest that the COOH-terminal portion, unique to beta hCG, confers anti-HIV activity.

Prototype human chorionic gonadotropin (hCG) vaccines have demonstrated the feasibility of effectively eliciting antibodies in women and inhibiting fertility in both humans and nonhuman primates. Also, no serious side-effects due to immunization against self antigens have been revealed to date. However, the formulations so far tested in clinical trials are not suitable for widespread applications due to problems associated with complexities in production, burdensome application procedures, the need for frequent booster immunizations or cost of manufacture. Current research efforts involve the development of delivery systems to permit annual or biannual intervals between immunizations for protection from pregnancy, procedures for mucosal immunizations, methods to reduce hypersensitivity and local reactions, and procedures for reducing the cost of production. Recent progress in understanding the crystalline structure of the hCG molecule has stimulated further studies to define immunological epitope sequences that might constitute immunogens in future vaccines. The incorporation of vaccine components into biodegradable microspheres has resulted in formulations that elicit elevated antibody levels in rabbits for more than one year. Preclinical and clinical studies with such formulations are planned. Studies using totally synthetic peptide immunogens constituting hCG B-cell epitopes and "promiscuous" T-cell epitopes from bacterial or viral proteins have been shown to be equally immunogenic as conjugates of hCG peptides with macromolecular carriers. Still other peptide immunogens have been developed that can elicit antibody production without detectable proliferation of helper T cells. Some of these peptides can induce systemic immunity from oral immunization or systemic injections. Alternative vehicles for administering vaccine components with reduced local reactivity show promise for new vaccine formulations.

Nucleotide sequence analysis of selected regions of the gag, pol, env and pX genes of simian T-cell lymphotropic virus type I (STLV-I) strains indicated that African isolates were more closely related to human T-cell lymphotropic virus type I (HTLV-I) than Asian isolates. Despite these recent comparative studies on nucleotide sequence homology between HTLV-I and STLV-I isolates, only limited information is available regarding the influence of genetic differences on antigen-antibody recognition of distinct STLV-I strains. In this study, we demonstrated that sera from STLV-I-infected yellow baboons (Papio cynocephalus) reacted strongly with env gp62/68 from HTLV-I-infected cell lines MT-2 and C10/MJ. In contrast, sera from Japanese macaques (Macaca fuscata) naturally infected with Asian STLV-I had weak reactivity to env gp62/68 of these prototypic HTLV-I strains. Pst-1 restriction enzyme analysis of proviral DNA indicated that the baboon virus isolates were more closely related to HTLV-I than the Japanese isolates. These results indicate that nucleotide sequence diversity, correlates with variations in proviral restriction enzyme sites and antibody recognition of viral envelope proteins. These differences in immunoreactivity may have important implications for serologic diagnosis, as well as epidemiological and vaccine studies of STLV-I infection.

Simian T-lymphotropic virus type-I (STLV-I) seronegative females placed together with seropositive males for breeding purposes were followed from 1984-1990 to determined seroconversion rates by enzyme immunoassay and western immunoblot analysis. Two of 26 females and 1 of 4 males previously negative for antibodies to STLV-I seroconverted during the study period. Statistical analysis of sexual encounters indicated that the probability of a seronegative female testing positive for STLV-I after a sexual encounter with a seropositive male is less than 4%. These data indicate that even though sexual contact is important in the transmission of STLV-I, it may not be an efficient mode of viral infection. These data also suggest that female-to-male transmission of STLV-I occurs, as recently reported for human T-lymphotropic virus type-I (HTLV-I) infection. These results are important because HTLV-I and STLV-I share many features in common including routes of viral transmission. In addition, the difficulty of clearly quantitating the risk of sexual transmission in humans makes the primate animal model a valuable alternative to study the human infection.

The successful development of an anti-fertility vaccine necessitates overcoming obstacles in eliciting an immune response to self species body constituents. The feasibility of accomplishing this task has been demonstrated for certain antigens described in this workshop; however, additional vaccine candidate antigens may yet be revealed from the application of recent advances in molecular biology. Improvements in vaccine design are likely to occur from discovery of more appropriate epitopes on targeting antigens, new carrier molecules for terminating immunological tolerance, expression of vaccine antigens in suitable live vectors, the co-immunization with more than one antigen, the use of safer and/or more effective adjuvants and vehicles, more efficient immunization by targeting antigens to specific lymphoid cells, and the development of superior vaccine delivery systems. Research directed to restricting the immune response to the genital tract and to intentionally reverse the effects of immunization will likely be pursued in the future. All of these areas need to be addressed if vaccines are to be developed that are not only safe and effective but also highly acceptable as birth control methods.

Vaccination usually means the immunization of persons or animals against foreign infectious organisms for disease prevention. However, it has now been demonstrated that immunization against certain self substances to which tolerance normally exists can elicit beneficial effects to humans and other animals without inducing autoimmune disease. Clinical trials in women have been conducted with vaccines against reproductive antigens for the prevention of pregnancy and research is under way to develop more advanced formulations. Other self antigens have been described that might be used for developing methods of immunological therapy for such diseases as cancer, ulcers, and complications of diabetes. Emphasis is placed on the need for careful studies in appropriate animal models before any clinical application of such procedures is suggested.

A placental specific protein (Sp-1) isolated from human placentas was used to establish a radioimmunoassay for measurement of a baboon protein in the sera of pregnant baboons. No reaction was observed with any known pituitary or placental hormone in this assay system. Levels of Sp-1 were detected at 17 to 18 days of gestation and reached high levels by the end of the first trimester of pregnancy. A slow increase in serum levels continued thereafter until parturition. Disappearance of Sp-1 post partum was very slow and required 26 to 34 days to become undetectable in the serum. No function or role of Sp-1 in pregnancy has been suggested, but possible use of its measurement for detecting abnormal placental function deserves investigation.

Mean 24-hr growth hormone, luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone concentrations determined preoperatively in 16 women with benign breast masses and 17 patients with breast cancer were similar to those levels found in 25 age- and weight-matched control subjects. Mean 24-hr testosterone levels, however, were significantly elevated in women with breast cancer evaluated in the luteal phase of their cycles and were normal in postmenopausal breast cancer women. In addition, serum thyroid-stimulating hormone, thyroxine, cholesterol, and triglyceride levels were normal in these subjects. Plasma cortisols and urinary 17-hydroxysteroid excretion tended to be higher in both the benign and malignant breast disease group and probably reflected preoperative anxiety. Hence, we have found normal concentrations of a variety of endocrine and other biochemical agents that can stimulate breast tissue growth and/or have been previously reported to be disordered in women with breast cancer.

The investigation was designed to study the influence of indomethacin on gonadotropin induced ovulation in the rhesus monkey. Six mature female monkeys were treated with HMG-HCG for at least 2 control ovulatory cycles at dosage levels adjusted to induced ovulation while avoiding superovulation. Ovulation was confirmed by observation of the ovaries for fresh ovulation points at laparotomy. Following establishment of an appropriate dosage schedule, treatment was begun with indomethacin (5 mg/kg/day) starting 5 days prior to HCG and continuing to the time of laparotomy. In a second treatment cycle, indomethacin was administered at a dose of 5 mg/kg b.i.d. together with the established dose of HMG-HCG. Ovarian inspection was carried out as in the control cycles. Venous blood was obtained on treatment days 4, 7, 10 and 11 for determination of serum estrone, estradiol and progesterone. Indomethacin administration resulted in ovulation inhibition at a dose of 10 mg/kg/day when ovulation inducing doses of gonadotropins were administered. Peripheral blood steroid levels suggest that follicle maturation and estrogen production was unimparied by indomethacin. These findings indicate that the ovarian synthesis of prostaglandin may be essential in the process of ovulation.

Acute responsiveness in vivo of the baboon corpus luteum to a course of twice daily injections of human chorionic gonadotropin (hCG) has been studied with and without concomitant injections of nafarelin, a potent luteinizing hormone-releasing hormone (LH-RH) agonist. HCG injection alone caused an acute (1 hour) rise in circulating levels of progesterone (P), confirmed to be a direct effect at the luteal level, since no change in circulating levels of endogenous LH was detected. When hCG was coadministered with a low dose of nafarelin (50 micrograms per injection), circulating levels of LH rose, but the rise in serum P levels was blunted. However, when hCG was coadministered with a high dose of nafarelin (250 micrograms per injection), serum LH levels rose only in response to the first injection and serum levels of P were not elevated, suggesting a desensitization of the pituitary to the LH-RH agonist and of the corpus luteum to the hCG. The profile of luteal P during the luteal phase in response to combined treatment with hCG and nafarelin also reflected these effects, being intermediate between vehicle controls and hCG treatment alone. This first demonstration of a luteal desensitization to gonadotropin by an LH-RH agonist in primates may account for previously noted successful interception of pregnancy in baboons treated with these agents.

Fifteen adult female baboons were immunized with a conjugate of tetanus toxoid coupled with a synthetic carboxy-terminal peptide of the beta-subunit of human chorionic gonadotropin and another 15 were immunized with tetanus toxoid. Freund's complete adjuvant was used in all immunizations. All females were placed with males of proven fertility during the third menstrual cycle after the primary immunization and those not sustaining pregnancy were mated in two additional consecutive cycles. Four pregnancies occurred following 42 matings in the conjugate-immunized group and 15 pregnancies resulted from 21 matings in the tetanus toxoid-immunized animals. Low levels of antibodies reactive to baboon chorionic gonadotropin were found in the pregnant animals in the conjugate-immunized group.

Baboons were immunized using a synthetic peptide adjuvant with two purified pig zona pellucida glycoproteins. The major zona pellucida glycoprotein (ZPI) was purified by preparative isoelectric focusing, and the 80 K deglycosylated zona pellucida protein (ZPIII) was purified by preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis. The immunogenicity as well as the antigenicity of these proteins were evaluated by characterizing antibodies using the enzyme-linked immunoassay and by immunoblotting of zona pellucida proteins separated by high-resolution two-dimensional polyacrylamide gel electrophoresis. Both groups of animals developed antibodies that recognize the major zona pellucida glycoprotein, (ZPI) and immunoblotting procedures provide evidence that two of the major porcine zona pellucida glycoprotein families (ZPI and ZPIII) contain shared antigenic determinants. The animals immunized with ZPI showed decreased levels of estrogen throughout their menstrual cycles, and two of the animals ceased ovulation. All animals in the group immunized with ZPIII had a significant reduction in the numbers of antral follicles as compared with control animals. Although ovarian cyclicity was not altered significantly within a few months after immunization, two of the five animals in this group became amenorrheic by 8 months. Histologic analysis of ovarian tissue shows that follicles were absent or frequently abnormal in animals of both groups following long-term immunization. These studies demonstrate that the synthetic adjuvant is effective in inducing antibodies (to purified zona pellucida glycoproteins) that recognize antigenic determinants to either denatured or deglycosylated zona pellucida glycoproteins, and that some of these antibodies may interfere with normal ovarian function.

Investigations were done to determine whether vaccines prepared with chemically killed Staphylococcus haemolyticus RU1 and Streptococcus bovis AV46 (bacteria that have been demonstrated to express human choriogonadotropin [hCG]-like material on their surface) elicited antibodies in rabbits with specificity for hCG determinants. In addition, the anatomical locus of the hCG-like factor was determined by separation of bacterial subcellular fractions. The results demonstrated that these bacterial vaccines elicited antibodies immunologically similar to those antibodies produced in response to the whole human trophoblastic hormone, a similarity extending even to cross-reactivity with human luteinizing hormone. The bacterial hCG-like material appeared to be localized in the membranes of the cell wall, and most was present in the soluble membranous and cytoplasmic constituents. Its expression in bacteria was a strain characteristic and not a species characteristic.

The production of antibodies against human choriogonadotropin (hCG) was studied in normal and athymic (nu/nu) mice of two strains (C57/BL and Balb/c), injected with native (whole) hCG or an immunogen consisting of a synthetic hCG beta COOH-terminal peptide, residues 109-145, conjugated to diphtheria toxoid and mixed with a synthetic muramyl dipeptide analog (nor-MDP) as adjuvant. Both the short-term effect of native hCG dissolved in saline and injected IM (primary response), and the long-term effect of the native hCG and of the hCG immunogen dissolved in saline, emulsified in squalene-Arlacel A, and injected SC as a depot injection (secondary or memory response), were considered. The results obtained indicate that native hCG may be classified as a T-cell independent antigen in the sense that it can elicit low levels of IgM antibodies on a short term basis in athymic mice that have either no or very low T-cell levels. In long-term studies using hCG and the hCG immunogen no antibodies could be detected in athymic mice 14 days after a booster inoculation given 28 days after primary immunization, a regimen that produced high levels of antibodies in normal mice. Because of their inability to sustain humoral responses to native hCG as well as to other hCG immunogens, athymic mice seem well suited for in vivo studies of some of the biological effects of hCG.

We studied the effects of preimmunization with a synthetic carboxy-terminal peptide of the beta-subunit of human choriogonadotropin (hCG) conjugated to diphtheria toxoid on the growth of two tumor models, the transplantable Lewis lung carcinoma in C57BL/6J mice and the spontaneous mammary carcinoma in C3H/OuJ mice. Immunization with the conjugate prior to Lewis lung tumor implantation significantly (P less than 0.05) retarded the growth of tumors as measured by tumor weight 18 days following transplantation. The weights of Lewis lung tumors in animals preimmunized with the hCG immunogen were inversely correlated (r = 0.61) with the levels of circulating antibodies against human chorionic gonadotropin, whereas no statistical correlation was found between tumor weights and the levels of antibodies reactive to diphtheria toxoid. The number of conjugate-treated C3H/OuJ mice that developed mammary tumors was significantly (P less than 0.05) reduced compared to their vehicle-treated cohorts. Pretreatment with the synthetic muramyl dipeptide analog utilized as an adjuvant with both immunogens did not show any effect on the tumor growth in either tumor system.

Immunization of female rabbits and mice with the sperm-specific isozyme of lactate dehydrogenase, LDH-C4, significantly reduced their fertility. Similar studies have been extended to nonhuman primates. Two female baboons, immunized with human LDH-C4, produced low antibody titers. These titers were markedly enhanced by booster injections of murine LDH-C4. An additional seven female baboons responded with relatively high antibody titers after receiving murine LDH-C4 as both priming and booster dosages. All nine females received injections of murine LDH-C4 at varying times determined by serum titer levels during fertility studies. These antisera reacted with human, mouse, and baboon LDH-C4. In a series of breeding experiments, 22 of 30 matings, or 73%, were infertile as compared with 28% in control matings. This contraceptive effect of the vaccine containing LDH-C4 was related to antibody titer and was reversible. Normal pregnancies ensued in animals in which the titer declined after termination of booster injections of vaccine.

Six mature female rhesus monkeys were treated with HMG-HCG in control cycles at doses adjusted to induce ovulation while avoiding superovulation. Occurrence of ovulation was determined by observation of fresh ovulation points at laparotomy 48 to 120 hours following HCG. In subsequent cycles animals were treated with indomethacin (treatment days 4 through 10) together with the established dose of HMG-HCG. In 8 cycles indomethacin 5 mg/kg was given i.m. once daily; in 9 cycles 10 mg/kg i.m. was administered in 2 divided doses. Following this, PGF2alpha (3 mg t.i.d. s.c.) was administered for 3 days together with indomethacin 10 mg/kg and HMG-HCG, beginning on the day prior to HCG. Determinations of progesterone were performed by RIA on treatment days 4, 7, 10, and 11. Eleven of the 13 control cycles were ovulatory. With indomethacin 5 mg/kg/day, 5 of 8 cycles were ovulatory but ovulation was delayed in 2 instances. Of 9 cycles using indomethacin 10 mg/kg/day only 1 was ovulatory. When PGF2alpha was administered in susequent cycles along with indomethacin (10 mg/kg) and HMG-HCG, ovulation occurred in 13 of 19 cycles. These data suggest that local ovarian PGF2alpha may be essential in the mechanics of follicle rupture in gonadotropin-treated rhesus monkeys.

A series of overlapping peptides were synthesized representing the entire amino acid sequence of the beta-subunit of human chorionic gonadotropin (hCG) and these were reacted with a monoclonal antibody shown to be specific for hCG. One linear peptide (residues 40-52 of the sequence) reacted significantly with the monoclonal antibody but a conjugate of this peptide to diphtheria toxoid (DT) failed to elicit significant levels of antibodies reactive to hCG in rabbits. The subsequent preparation of an extended peptide (residues 38-57) in which the two cysteines were oxidized to form a loop peptide yielded a highly immunogenic antigen when conjugated to DT. Antibody levels reactive with hCG from loop peptide immunizations of rabbits exceeded those found after immunization with a 37 residue peptide representing the carboxyl terminus of the beta-hCG subunit. The antisera did not react with pituitary glycoprotein hormones with similar sequences.

Human chorionic gonadotropin (hCG) is a glycoprotein hormone produced by the placental trophoblast soon after conception and is essential for successful gestation in women. A vaccine against this hormone has been developed for the purposes of birth control and the treatment of hormone-related diseases. Synthetic peptides representing the native primary structure of the hCG beta subunit have been coupled to protein carriers to produce immunogens. Several peptides, representing varying lengths from the C-terminus of the beta subunit, were synthesized and their ability to elicit antibodies reactive to hCG and able to neutralize hCG activity in vivo was tested. A peptide representing the 37 amino acids of the C-terminal end of the beta subunit was selected as the vaccine antigen and diphtheria toxoid was selected as the carrier for the first prototype vaccine. Procedures for coupling a specified number of peptide molecules to each carrier molecule in a reproducible fashion were developed. The immunogen is mixed with an adjuvant compound and the mixture administered in an oil-in-water emulsion. Significant levels of antibodies to hCG have been elicited in several species and a marked reduction in the fertility of immunized baboons has been observed. Extensive evaluations of vaccine safety have been conducted and Phase I clinical trials have been proposed to test its utility for human birth control. Possible applications of the hCG vaccine to health problems other than birth control are being considered.

A birth control vaccine incorporating a synthetic peptide antigen representing the aminoacid sequence 109-145 of the C-terminal region of the beta subunit of human chorionic gonadotropin (hCG-beta) was submitted to a phase 1 clinical trial. Thirty surgically sterilised female volunteers, divided into five equal groups for different vaccine doses, received two intramuscular injections six weeks apart. Over a six-month follow-up there were no important adverse reactions, and potentially contraceptive levels of antibodies to hCG developed in all subjects. In the highest vaccine dose group, the results gave promise of a contraceptive effect of six months' duration.

Circular dichroic spectra have been obtained in aqueous solution and in trifluoro-ethanol for several synthetic (non-glycosylated) human choriogonadotropin carboxyl terminal peptides of the beta-subunit ranging in size from 10 residues to 40 residues. These was no evidence for formation of alpha-helicity or beta-structure, but the spectra in 90% (v/v) trifluoroethanol were consistent with the occurrence of beta-turns. The Chou-fasman predictive rules also suggest a high probability of beta-turns in these peptides which could result in the occurrence of repeating kinks. Disulfide-linked dimers were also investigated by circular dichroism, and there was evidence of stabilization of particular skewness of the disulfide dihedral angle depending upon the location of the disulfide bond. The single phenylalanyl residue at position 115 in the beta-subunit also contributed to the circular dichroic spectra above 250 nm. Antibodies raised to a peptide consisting of residues 111-145 have been shown to contain two immunological determinants, but the sum of antibodies raised to separate determinant sequences do not equal those raised to the full length peptide. These data could reflect the existence of a conformation-related determinant on the 111-145 peptide or stearic hindrance of immunoglobulin binding of two antibodies to the same peptide.

Microvillous membrane fractions from human term placentae were prepared by differential centrifugation. Extration of membranes with PBS-EDTA or KCI removed soluble cytoplasmic components and serum proteins excepting trace amounts of albumin and transferrin. PAGE-SDS revealed 11 components in the Triton solubilized crude fraction after PBS-EDTA extraction. Membrane components solubilized with Triton were not fractionated by gel filtration on Bio-Gel A-50 m but DEAE-cellulose chromatography partially resolved these components. Three fractions were obtained by stepwise elution of absorbed materials using increasing concentrations of NaCl in the equilibrating buffer. These fractions were characterized using SDS-PAGE. The material unabsorbed to the DEAE contained two components of small molecular weight and one of them showed a positive PAS stain. The first eluted protein peak showed nine components, seven of which stained with PAS. The bulk of glycoproteins with molecular weights greater than 130 000 daltons were found in this fraction. The second eluted peak from DEAE was rich in components with molecular weights less than 42 000 daltons. Four components in this fraction were not identified in the other two ion-exchange fractions. Bands representing mobilities of albumin, transferrin and alkaline phosphatase were observed in DEAE-cellulose fractions; however, 12 components of unknown structure were revealed.

Mean 24-hr prolactin concentrations were determined in 25 female control subjects, 16 women with benign breast masses, and 23 subjects with breast cancer. This evaluation performed before breast surgery revealed significantly decreased (p less than 0.02) nocturnal (12 a.m. to 7 a.m.) prolactin concentrations in 12 postmenopausal breast cancer subjects that contrasted with significantly increased (p less than 0.05) nocturnal prolactin levels in five luteal-phase premenopausal women with breast cancers. Prolactin concentrations in patients with benign breast disease were not significantly different from control subjects. Two of the premenopausal breast cancer patients had marked preoperative elevations in their mean 24-hr prolactin levels, and they were two of the three subjects who have since expired. Nocturnal prolactin secretion was significantly decreased (p less than 0.03) in four premenopausal breast cancer patients when they were studied 1 year after surgery; however, it remained the same in the eight postmenopausal breast cancer patients similarly evaluated. Although disordered prolactin regulation has been found in these women with breast cancer, its role in the etiology and progression of human cancer is still uncertain.

Immunological methods of birth control are being pursued by several routes. Leading this field are vaccines which may inhibit the function of the hormone human chorionic gonadotropin (hCG). Vaccines using at least three different immunogens and a variety of formulations have been in clinical trials during 1986. In this article Vernon Stevens describes the background of the research in this field, outlines the clinical trials planned or underway to test early hCG vaccine formulations, and gives a personal view of the research still needed to achieve a safe and effective vaccine., (Copyright © 1986. Published by Elsevier B.V.)

Radioimmunoassays utilizing antisera specific for the carboxyl-terminal portion of human chorionic gonadotrophin (hCG) beta-subunit were used to measure the concentration in human pituitary extracts of an immunoactive hCG factor (hCG') which was different from human LH (hLH). The content of hCG' from different human pituitary pools collected between 1966 and 1979 was relatively constant at 0.5-1.1 microgram per gland. The hCG' concentrations observed in acetone-dried powder of individual human pituitary glands (0.4-26 ng/mg) were close to those reported for full-term placental powder. After separation and partial purification of human pituitary glycoprotein hormones, pituitary hCG' was found mainly in the crude human FSH (hFSH) fraction. It was separated from hFSH by diethylaminoethyl-cellulose chromatography at pH 7 and by gel filtration on Sephadex G-100. On gel filtration its molecular size was larger than that of hLH or hFSH and it was strongly bound to Concanavalin A-Sepharose. The most active preparations of pituitary hCG' obtained by these procedures were approximately 5 per cent as potent by specific radioimmunoassay as hCG purified from pregnancy urine. Although the hCG' content in individual pituitary glands was more variable than the hLH content, on average pituitary hCG' was estimated to be around 25- to 50-fold less than the content of hLH, hFSH or human TSH in the human pituitary gland.

Twice daily oral thyrotropin-releasing hormone administered to female baboons throughout the menstrual cycle had no significant influence on cycle length or upon estrogen levels but produced blunted midcycle LH peaks and luteal phase progesterone levels in three fourths of the treatment cycles. Mean plasma prolactin levels were increased approximately 2.5-fold relative to untreated, ovulatory control cycles. CB-154 alone did not alter cycle length or endocrine parameters examined (mean prolactin levels were decreased but not significantly). Cycles during which CB-154 was administered concomitantly with TRH were characterized by normal ovulation as evidenced by luteal phase progesterone levels. Since the effect on LH secretion was reversed by concomitant CB-154 administration, TRH-induced anovulation in animals given long-term treatment appeared to be mediated through physiologic mechanisms sensitive to elevated circulating prolactin levels. However, this conclusion must be considered equivocal since prolactin levels were also elevated during ovulatory cycles following long-term TRH therapy. Finally, these data do no exclude the alternative possibility that anovulation in baboons given long-term TRH treatment was a reflection of thyroid disturbance and not directly attributable to elevated prolactin.

Numerous studies have demonstrated that antibodies to placental proteins in a variety of species are capable of preventing or disrupting gestation. Early work in this area was primarily directed towards the passive immunization of rodents with heterologous antisera to whole placental extracts. Toxicity and renal damage often accompanied fertility inhibition. More recent studies reported less toxicity and a higher specificity of antibodies to reproductive function when anti-placental antibodies were absorbed with serum and extracts of non-reproductive organs. Few studies have been reported in which active immunization with placental proteins was employed. The most detailed studies of active immunization have employed highly purified placental hormones. Immunizations of rats and rabbits with human placental lactogen have resulted in marked reduction in reproductive function. Immunization of human females with chemically altered (hapten-coupled/ HCG resulted in the production of antibodies reacting with unaltered HCG and pituitary LH. These antibodies were capable of reducing the level of endogenous serum LH in pre- and post-menopausal women. The also altered the events of the menstrual cycle in premenopausal women. More specific inhibition of chorionic gonadotrophin has been obtained by immunization of baboons with the beta subunit of HCG. Antifertility effects without alterations in the menstrual cycle of female baboons immunized with the beta subunit of HCG have been reported. The antibodies produced in these animals reacted significantly with human LH in vitro. The possibility of using hormonal and non-hormonal placental proteins as antigens for the specific immunological inhibition of fertility remains.

Highly purified human pituitary FSH was partially dissociated by treatment with 8M-urea, and alpha- and beta-subunits were isolated by ion-exchange chromatography and gel filtration. Tests of biological activity by in-vivo assays and in-vitro radioreceptor assays were in good agreement and showed that preparations of isolated alpha-subunit had less than 1%, and beta-subunit from 2 to 10% of the FSH activity of the intact hormone. In contrast to results reported elsewhere, most of the subunit preparations reassociated with counterpart subunit to regain biological activity equal to that of intact FSH (around 160 mg NIH-FSH-S1/mg). The intact FSH recovered as a by-product after isolation of subunits was of high biological activity, and its LH contamination was reduced by more than 90% when compared with thepurified FSH starting material. The subunits are relatively inactive in a radioimmunoassay specific for intact FSH. Sialic acid and tryptophan determinations indicated that both subunits contain sialic acid and that tryptophan is present only in the beta-subunit.

Immune reactions to a number of hormones have been induced, but information is lacking on the feasibility of inducing immune reactions to homologous gonadotropins. Female rats immunized with diazotized and tyrosylated rat pituitary extract containing gonadotropic activity and emulsified in complete Freund's adjuvant expressed various reproductive disturbances such as increased cycle length (7.0 days), increased number of sterile matings, reduced implantation in animals becoming pregnant, and reduced ability to carry fetuses to term. These effects were not exhibited by rats immunized similarly with diazotized or tyrosylated rat pituitary extract containing no detectable gonadotropic activity. Rats not becoming pregnant had a significantly higher antibody level to rat luteinizing hormone than did rats becoming pregnant. No significant elevation of rat follicle-stimulating hormone antibodies was noted. It is concluded that auto-immune reactions to gonadotropins can be induced and that very low levels of antibodies have a significant effect on reproduction.

A radioassay was used to demonstrate the high affinitiy of a crude rat uterine extract for tritiated estradiol-17B. Although no other chemical procedures were employed to further characterize the extract, it may contain the estrogen binding protein isolated by others. The isolate was antigenic in rabbits and administration of immune serum to female rats significantly lowered the in vitro retention of tritiated estradiol-17B in the rat uterus. It is thought that this immune serum could be successfully used to study the estrogen binding activity of rat uterus.