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Objective-To study the eVect of a standardised training programme focusing on maintenance of fat free mass during weight reduction by energy reduction in obese children. Design-Randomised trial of physical training programme and dietary advice (group A) versus dietary advice alone (group B).Subjects-Thirty obese children and adolescents (14 group A, 16 group B) participated in the 12 week long programme; 20 children (10 group A, 10 group B) were also reassessed after one year. Measurements-Fat free mass was estimated from the resistance index, obtained by bioelectrical impedance analysis at baseline, after four, eight, and 12 weeks in all subjects, and after one year in 20 subjects. Results-The mean (SD) change in fat free mass was significantly diVerent between the two groups after 12 weeks (group A, 2.68 (3.74) kg; group B, 0.43 (1.65) kg). The change in body weight after one year was inversely correlated with the change in fat free mass after 12 weeks (r = −0.44), as assessed in the 20 subjects. Conclusions-A standardised training programme as used in this study can prevent reduction in fat free mass during weight loss in obese children. Reduction in fat free mass during weight reduction might be a risk factor for regain of weight. (Arch Dis Child 1999;81:426-428) Keywords: training programme; obesity; body composition Obesity is an ongoing problem in paediatric and adolescent health care. In previous work we identified reduction in fat free mass during rapid weight loss by energy reduction as a major factor for later regain in weight.1 Our present study aimed to: evaluate a standardised training programme for maintenance of fat free mass during weight reduction; and study the eVect of changes in fat free mass during weight reduction on the long term outcome. Resistance training has been shown to be eVective in increasing strength in children. 2There is limited information as to whether muscle growth (hypertrophy) can be induced in obese children. SubjectsThirty children consented to participate in the study and were assigned to two groups at random: group A (six boys, eight girls; mean (SD) age, 11.0 (2.5) years; mean standard deviation score for body mass index (BMI-SDS), 5.58 (2.46)) received standardised dietary advice for weight reduction by a dietitian at baseline and after four, eight, and 12 weeks of the study. In addition, subjects participated in a training programme twice weekly. Group B (seven boys, nine girls; mean age, 12.2 (2.7) years; mean BMI-SDS, 5.33 (1.79)) had the dietary intervention only. Methods BODY COMPOSITIONBody composition was estimated from bioelectrical impedance analysis. Measurements were performed at baseline and after four, eight, and 12 weeks. Total body resistance was measured by a bioelectrical impedance analyser (Akern-RJL BIA 101/S) in supine position as described previously.1 Fat free mass was estimated from the resistance index (RI), height, and age of the subject using the equations given by Shaefer et al (fat free mass (kg) = 0.15 + 0.65 × RI + 0.68 × age...

Dendritic cells (DC) are professional antigen‐presenting cells specialized in the initiation of primary immune responses. We were interested to know whether mature DC can be grown in vitro from peripheral blood mononuclear cells (PBMC) of patients with chronic myelogenous leukemia (CML), and whether they carry the Philadelphia (Ph) translocation. Using a method recently described, DC were generated from PBMC precursors of 12 patients with CML using GM‐CSF, IL‐4, and monocyte‐conditioned medium. DC exhibited the typical morphology with thin cytoplasmatic processes and expressed high levels of MHC class II, CD86, and CD83 typical for mature DC. After sorting with the monoclonal antibody CD83, a cell population of more than 95% CD83 positive cells was obtained. The presence of the Ph translocation was analyzed in these cells, in PBMC, lymphoblastoid cell lines (LCL), and in phytohemagglutinin (PHA)‐induced T blasts from the same patients by fluorescence in situ hybridization (FISH). In contrast to all other cells analyzed, the vast majority of DC (95.9 ± 0.7%) displayed the Ph translocation, irrespective of disease stage or therapy. PBMC were predominantly positive for the Ph chromosome (67.6 ± 7.3%), whereas only 11.4 ± 1% of the B cells and 4.4 ± 1.1% of the PHA blasts carried the Ph translocation. Using such leukemic DC as antigen‐presenting cells, a primary CML‐directed cytotoxic immune response in vitro was obtained, as shown by the specific recognition of Ph chromosome positive cells. We conclude that DC can be generated from blood progenitors of CML patients in vitro and exhibit, to a large extent, the Ph translocation. Such DC, which in a preliminary experiment have been able to induce a primary CML‐directed cytotoxic immune response in vitro, might be ideal candidates for adoptive immunotherapy either by direct transfer of DC for in vivo generation of a T‐cell response or by in vitro generation of CML‐specific cytotoxic autologous or HLA‐matched normal T‐cell clones for use in vivo. Genes Chromosomes Cancer 20:215–223, 1997. © 1997 Wiley‐Liss, Inc.

Graft-versus-leukemia (GvL) has been shown to be an important immune- mediated antitumor effect in hematologic malignancies. It is still unknown whether such an immunemediated antitumor effect has clinical implications in patients with solid tumors. A 32-year-old woman with inflammatory breast cancer received a bone marrow transplant (BMT) from her HLA-identical sibling. During graft-versus-host disease (GvHD) cytotoxic T lymphocytes were grown and tested in a chromium-release assay against B and T lymphocytes of the patient and donor and against a panel of breast cancer cell lines. Resolution of liver metastases was observed simultaneously with clinical GvHD in the first weeks after transplant. In addition, minor histocompatibility antigen (MiHA)- specific and major histocompatibility complex (MHC) class I antigen- restricted cytotoxic T lymphocytes recognizing breast carcinoma target cells were isolated from the blood of the patient. Pretreatment of such target cells with tumor necrosis factor (TNF)-alpha but not with interferon (IFN)-alpha or IFN-gamma increased susceptibility of these cells to lysis by cytotoxic T lymphocytes. Clinical course and in vitro results suggest that a graft-versus-tumor (GvT) effect might exist after allogeneic BMT for breast cancer. However, clinical experience on a larger scale would be required to determine the clinical efficacy of GvT effects in patients with solid tumors.

The gene of the leukocyte-specific transcript (LST1) is encoded within the TNF region of the human MHC. The LST1 gene is constitutively expressed in leukocytes and dendritic cells, and it is characterized by extensive alternative splicing. We identified 7 different LST1 splice variants in PBMC; thus, 14 LST1 splice variants (LST1/A-LST1/N) have been detected in various cell types. These isoforms code for transmembrane as well as soluble LST1 proteins characterized by two alternative open reading frames at their 3′ end. We demonstrate the presence of the transmembrane variant LST1/C on the cell surface of the monocytic cell lines U937 and THP1. Recombinant expression of LST1/C permitted its profound inhibitory effect on lymphocyte proliferation to be observed. In contrast, the alternative transmembrane variant LST1/A, the extracellular domain of which shows no amino acid sequence homology to LST1/C exerted a weaker but similar inhibitory effect on PBMC. These data demonstrate the protein expression of LST1 on the cell surface of mononuclear cells, and they show an inhibitory effect on lymphocyte proliferation of two LST1 proteins although they have only a very short amino acid homology.