Half of women with lupus breastfed and most desire to breastfeed. Hydroxychloroquine, azathioprine, methotrexate, and prednisone have very limited transfer into breast milk and may be continued while breastfeeding.

Both dibutyryl cyclic AMP (DBcAMP) and cholera toxin promote the formation and elongation of processes of cultivated Greene hamster melanoma cells. The formation and maintenance of these processes, which contain many microtubules, are sensitive to colcemid and vinblastine. Tubulin was measured by [3H]colchicine binding and by acrylamide gel electrophoresis. We found that DBcAMP or cholera toxin increases the ratio of polymerized to unpolymerized tubulin but not the total amount of tubulin per cell. The sum of the lengths of microtubules per unit area was significantly greater in cells treated with DBcAMP than in control cells. Our findings support the hypothesis that cyclic AMP promotes the elongation of cell processes by stimulating the assembly of microtubules from existing tubulin.In addition to their effect on cell division (9, 39, 48), cyclic adenosine 3'5'-monophosphate and its dibutyryl derivative (DBcAMP) alter the morphology of many different cell types. Cyclic AMP induces the formation of long, narrow processes in mouse neuroblastoma (31, 43), Chinese hamster ovary cells (CHO) (25, 45), and fetal rat brain cells (46). Mouse sarcoma cells become spindly with elongated cell bodies and long, narrow processes (28). Microtubules apparently serve in both the formation and maintenance of these processes (10). Microtubules are abundant in thin sections of neuroblastoma "neurites" (44); vinblastine sulfate, a drug that forms crystalline structures with tubulin (3), inhibits the induction of long processes in neuroblastoma cells by DBcAMP (43).The correlation between microtubules and cell processes suggests three possible mechanisms whereby cyclic AMP causes a morphological change. (a) Cyclic AMP permits or promotes the reorientation of assembled tubules. (b) Cyclic AMP stimulates the de novo synthesis of tubulin, shifting the equilibrium toward the assembly of microtubules. (c) Cyclic AMP stimulates the assembly of tubules without affecting the synthesis of tubulin.We report here the effects of cholera toxin, which increases intracellular levels of cyclic AMP in melanoma cells (2, 36), and of exogenous DBcAMP on the morphology of cultivated Greene melanoma cells. We present evidence that (a) microtubules are involved in the formation

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