Background: Interleukin 1 (IL-1) is a pluripotent cytokine that promotes angiogenesis, tumor growth, and metastasis in experimental models; its presence in some human cancers is associated with aggressive tumor biology. The purpose of these studies was to characterize the role of IL-1in human cancers and determine if inhibition of IL-1via its receptor antagonist, IL-1Ra, alters tumor growth and metastatic potential. Methods: IL-1mRNA or protein levels were determined in clinical tumor samples, cancer cell lines, and xenografts using quantitative reverse transcription-PCR or ELISA. Biological activity of tumor-derived IL-1 protein was shown via induction of permeability across endothelial cell monolayers. The effects of recombinant IL-1Ra on tumor lines in culture (cell proliferation and IL-8 secretion) and in xenograft models (tumor growth, metastatic potential, and intratumoral levels of IL-8 and VEGF) were characterized. The effects of IL-1Ra-mediated regression of xenograft growth on angiogenic proteins (IL-8 and VEGF) were evaluated in an IL-1-producing melanoma (SMEL) xenograft model. Results: IL-1mRNA was highly expressed in more than half of all tested metastatic human tumor specimens including non^small-cell lung carcinoma, colorectal adenocarcinoma, and melanoma tumor samples. Constitutive IL-1 mRNA expression was identified in several cancer cell lines; tumor supernatant from these cell lines produced a significant increase in endothelial cell monolayer permeability, a hallmark event in early angiogenesis, in an IL-1-dependent manner. Moreover, systemic recombinant IL-1Ra resulted in significant inhibition of xenograft growth and neovessel density of IL-1-producing, but not non-IL-1-producing, tumor cell lines. Subsequent analysis of SMEL, a melanoma cell line with constitutive IL-1 production, showed that neither exogenous IL-1 nor IL-1Ra altered tumor cell proliferation rates in vitro. Gene expression analyses of IL-1Ra-treated SMEL xenografts showed a >3-fold down-regulation of 100 genes compared with control including a marked down-regulation of IL-8 and VEGF. Conclusions: These data show that the IL-1 gene is frequently expressed in metastases from patients with several types of human cancers. IL-1Ra inhibits xenograft growth in IL-1-producing tumors but has no direct antiproliferative effects in vitro ; decreased tumor levels of IL-8 and VEGF may be an early surrogate of IL-1Ra-mediated antitumor activity. IL-1Ra may have a role alone or with other agents in the treatment of human cancers.Many proteins or other factors present in the tumor microenvironment directly promote tumor cell proliferation and survival or induce processes, such as angiogenesis, that indirectly promote tumor growth and metastasis. Experimental models have shown that local production of interleukin 1 (IL-1) influences tumor growth and metastases either through direct proliferative effects or by promoting inflammatory and angiogenic pathways in host cells (1 -4). IL-1 induces an angiogenic phenotype in endothelial t...

TWO retrospectively matched groups of loM*-risk women were studied, one that chose to give birth in an out-ofhospital birth center stafled and run by nursemidhives, and another that labored and delivered in a tertiar?, care teaching hospital. The groups were mafched.for IOW risk status at 37 weeks. Although outcomes for both groups uere similar, the use of almost all interventions during labor and delivery H'QS signijicantly more frequent in the hospital group. These findings are consistent with studies of other settings in which the place of birth was s h m v to have an impact onchildbirth experience, thus demonstrating that birth centers can oversee childbirth as safely and rrvith less intervention than do hospitals. Larger comparative studies are needed to explore the impact and safety of hospital and orit-of-hospital birth settings. (BIRTH 14:1, March

Therapeutic, IV.