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Biomedical subjects

A D Roberts

Publications and source records attributed to A D Roberts.

At least 19 recordsLinked to original sources

T lymphocytes mediating protection and cellular cytolysis during the course of Mycobacterium tuberculosis infection. Evidence for different kinetics and recognition of a wide spectrum of protein antigens.

Recent evidence suggests the existence of at least two pathways of acquired specific resistance to Mycobacterium tuberculosis infection; the first consisting of cytokine-mediated activation of parasitized host cells by protective T cells, and the second involving the lysis of these cells by cytolytic T cells. Evidence presented in this report shows that both of the above mechanisms are operative in experimentally infected mice, but that they differ markedly in terms of their kinetics of emergence and loss. It was found that protective T cell activity was acquired very early during the course of the infection, and was temporally associated with the onset of bacterial elimination; however, cytolytic activity did not peak until 10 to 20 days later. This report shows further that the target Ag of these effector T cell populations were apparently numerous with no evidence for preferential recognition of a few immunodominant Ag. In view of the preponderance of target proteins in the bacterial filtrate, we present the hypothesis that such proteins secreted or otherwise leaked from the dividing mycobacterium are pinocytosed from the phagosome and used by the infected macrophage as the key protective Ag leading to T cell sensitization. This hypothesis thus explains the preferential requirement for the viable bacterium in the generation of specific resistance, and further explains why protective immunity is generated even while the organism is still multiplying in an apparently unrestrained manner.

Animals

Capacity of Mycobacterium avium isolates to grow well or poorly in murine macrophages resides in their ability to induce secretion of tumor necrosis factor.

The results of this study show that clinical isolates of Mycobacterium avium fall into two categories in terms of their capacity to grow within murine bone marrow-derived macrophage cultures: those that grow progressively and those that are incapable of growing within such cells. Members of the first category were invariably of the smooth-transparent colonial type, while most of the second were of the smooth-doomed type. In addition, this paper shows that although all isolates induced tumor necrosis factor (TNF) secretion by host cells to some extent, this production was always delayed in isolates that subsequently grew well in the host cells. This observation, coupled with the demonstration that the growth of the latter isolates was inhibited by the exogenous addition of TNF, leads us to hypothesize that the ability of a given isolate to somehow avoid host macrophage TNF production early during the course of the infection is a key factor in the pathogenesis of the disease.

Animals

Dissemination of enteric Mycobacterium avium infections in mice rendered immunodeficient by thymectomy and CD4 depletion or by prior infection with murine AIDS retroviruses.

This study shows that infection of mice with the murine AIDS virus LP-BM5 or Du5H profoundly depressed the capacity of splenic T cells from these animals to respond to the T-cell mitogen phytohemagglutinin or concanavalin A or to alloantigens. Similar effects were also observed if mice were thymectomized and then infused with monoclonal anti-CD4 antibody (TxCD4- mice). When such mice were infected intravenously with Mycobacterium avium, growth of the infection was markedly exacerbated in the TxCD4- mice or in mice given murine AIDS virus 2 months earlier. In view of these data, we then investigated whether such treatments might cause dissemination of M. avium following enteric implantation of bacteria into the mouse cecum; this route was chosen in an attempt to model events in AIDS patients, in which the gut appears to be one of the major portals of M. avium infection. In this model, the entry and hematogenous dissemination of four clinical isolates of M. avium were monitored against time and found to be accelerated and enhanced in T-cell-deficient mice. In view of this finding, these novel approaches for enteric infection that use immunodeficient mice are presented as potential new models for the evaluation of immunotherapy and chemotherapy in a setting that bears some similarity to events believed to occur in AIDS patients.

Animals

Structural basis of capacity of lipoarabinomannan to induce secretion of tumor necrosis factor.

The results of this study show that lipoarabinomannans (LAM) isolated from a virulent strain and from an avirulent strain of Mycobacterium tuberculosis, which have recently been shown to differ markedly in terms of the structures of their nonreducing termini, also differ markedly in the capacity to induce the secretion of tumor necrosis factor from murine macrophages. It was found that LAM from the avirulent H37Ra strain was 100-fold more potent at inducing tumor necrosis factor secretion than LAM from the virulent Erdman strain, thus leading us to hypothesize that the structure of LAM from a given mycobacterial isolate may directly influence its ability to elicit, or avoid, cytokine-mediated mechanisms of host resistance.

Animals

A refractive and histopathologic study of excimer laser keratectomy in primates.

Using a 193-nm excimer laser, we produced wide-area, refractive keratectomies on 18 cynomolgus monkey corneas and followed them up for up to 18 months. All corneas developed some subepithelial haze by one month. Electron microscopy disclosed epithelial thickening, absence of Bowman's layer, and subepithelial activated fibroblasts surrounded by disorganized collagen. By six months, the haze faded to a variable degree, the epithelium regained normal thickness, and the collagen was more organized. Persistent corneal haze at 12 months in some corneas correlated with electronlucent spaces in the subepithelial zone. Corneas were 90 microns thinner centrally two weeks after myopic ablation, but returned to preoperative thickness by six months. Myopic flattening and hyperopic steepening of 6 diopters were targeted, and over 7 diopters of each were achieved initially. Regression of induced curvature stabilized over several months. At 18 months, 4.4 diopters of myopic flattening and 5.2 diopters of hyperopic steepening remained.

Animals

Effect of rifabutin on disseminated Mycobacterium avium infections in thymectomized, CD4 T-cell-deficient mice.

Disseminated Mycobacterium avium infection is the major cause of bacteremia in patients with acquired immunodeficiency syndrome. We present here a new animal model of this disease, thymectomized C57BL/6 mice that were intravenously infused with monoclonal antibody to selectively deplete CD4+ T cells. The increased susceptibility of such animals to M. avium infection is comparable to that of C57BL/6 beige mice and thus may provide a viable alternative to the latter model. Further, using representative strains of acquired immunodeficiency syndrome-associated M. avium (serotypes 1, 4, and 8 and a rough isolate), we show that the course of such infections in thymectomized, CD4-deficient mice can be markedly restrained and in some cases the infections can be sterilized by treatment over a 120-day period with a regimen containing 40 mg of the new antimycobacterial agent rifabutin per kg (body weight).

Acquired Immunodeficiency Syndrome

Human excimer laser lamellar keratectomy. A clinical study.

The first ten blind human eyes in the United States to receive excimer laser (ArFl 193 nm) lamellar keratectomy (reprofiling) are presented. Seven of these patients were followed 6 to 12 months after ablation. All eyes are grossly clear in the region of ablation. Results of slit-lamp examination of all flattened ablated areas show mild superficial haze at the epithelial/stromal interface. This haze might not interfere significantly with vision in patients 7 to 10. Serial pachymetry and keratometry measurements, refraction, and digital keratoscopy show a progressive filling in of the excavated area by approximately two thirds but a loss of initial diopteric correction of only one third. Histopathologic analysis was obtained for four eyes. Transmission electron microscopy of three eyes enucleated 3 to 12 days after ablation shows 40-microns ablation depths through Bowman's layer and superficial stroma with minimal adjacent tissue damage and no inflammatory cells. The epithelium is increased in thickness by 50%, and firmly attached to the underlying stroma. A 4-month postablation specimen shows keratocyte activation with increased protein synthesis (presumed collagen and ground substance).

Blindness

Experimental corneal studies with the excimer laser.

The excimer laser is potentially capable of achieving wide area central corneal reprofiling because of its extreme precision and limited penetration into adjacent tissues. A beam modifying system designed for this application is described. Initial clinical studies in monkeys and in ten human patients with blind eyes were performed. Long-term clinical data and interim histologic analyses are available from these studies. The results indicate that following ablation with an ultraviolet laser in both humans and primates, the ablated tissue shows a normal healing reaction resulting in a mild to moderate stromal interface haze. The effects of this healing on best corrected vision must be elucidated through additional research. Some loss of refractive effect was seen early in the healing process with apparent stabilization.

Animals

The variation in cervical hydroxyproline and cervical water with age.

The squamocolumnar junction is frequently not visible in the postmenopausal patient. This study attempts to identify some of the changes in the cervix that may account for this observation. Twenty-four cervical biopsy samples taken at the squamocolumnar junction were analysed for hydroxyproline (collagen) and water content. There was significantly more hydroxyproline (collagen) in the premenopausal woman than the postmenopausal woman. Similarly, there was higher percentage of water in the biopsies in the premenopausal woman than the postmenopausal woman. Further samples obtained deeper in the cervical stroma did not confirm these differences. It appears likely that differences in cervical water and cervical collagen near the surface of the cervix account, at least in part, for the lack of visibility of the squamocolumnar junction in the older woman.

Adult

Long-term hormone implant therapy--hormonal and clinical effects.

Long-term effects of hormone implants (estradiol or estradiol plus testosterone) were examined in 75 menopausal women. Both therapies relieved vasomotor symptoms with a return of significant flushing after six months, thus reimplantation was performed every six months. Estradiol levels had not returned to baseline by six months, and significant accumulation of estradiol occurred by three years. The patients given testosterone experienced a similar accumulation of testosterone. There was no significant change in mean weight, blood pressure, or liver function tests during three years. Both therapies reversed the bone biochemical changes of menopause, and in both groups there was no significant loss in bone density. Supplementation of estradiol with testosterone in implant therapy was not observed to provide additional benefit in terms of the parameters studied.

Adult

Total and alactic oxygen debts after supramaximal work.

The total and alactic oxygen debts were measured in eight subjects following supramaximal treadmill running (14.5--16.1 km/h, 20% grade) to exhaustion, on two duplicate tests separated by 48 h. Mean total oxygen debts on the two trials were 5.28 +/- 0.42 1 and 4.57 +/- 0.46 1, (r = 0.34). Mean alactic oxygen debts were 2.81 +/- 0.21 1 and 2.74 +/- 0.121 (r = 0.89). Values for maximal total and alactic oxygen debts in this study were in close agreement to those found in the literature. The inability of the subjects to adequately reproduce an exhausting supramaximal effort was the major factor preventing reliable measurement of total oxygen debt. It is concluded that the method developed for the measurement of oxygen debt is both reliable and valid for the alactic portion of the debt.

Adult

Responses to kayak ergometer performance after kayak and bicycle ergometer training.

Ten moderately active male volunteers, age 19-30 years, completed one month of training on either a kayak or a bicycle ergometer (five men in each group). The men completed sixteen 30 minute sessions of continuous work at an intensity which maintained their HR within 85-90% of its maximum, as previously determined on the kayak ergometer. After this training period the kayak group demonstrated significant decreases in VO2, VE, HR and blood lactate in submaximal kayak ergometer work and a significant increase in VO2 during maximal kayak ergometer work. These changes contributed to a significantly higher maximal kayaking work output. The bicycle-trained group did not make any of these improvements on the kayak ergometer. However in their last training session on the bicycle ergometer they were able to work at a higher submaximal load while maintaining the same heart rate as in the first training session. It was concluded that the circulatory and metabolic adjustments to kayak work are greater with kayak training than with bicycle training.

Adult

The effect of long-distance running on some biochemical variables.

Biochemical variables have been measured in a group of volunteers during and after a long-distance run. Plasma glucose levels remained relatively constant and a significant decrease in plasma bicarbonate was noted. Plasma sodium, chloride, total protein, albumin and calcium showed significant increased of an order compatible with water losses occurring during the run. Plasma potassium, urea, creatinine, uric acid, phosphate and bilirubin all show much more marked and variable increases. The plasma enzymes alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase and creatine kinase likewise increased significantly throughout the run. Whilst most constituents showed a tendency to return to normal at 20-30 hours after the run, gross increases were observed for aspartate aminotransferase and creatine kinase.

Adipose Tissue