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Biomedical subjects

A H Rook

Publications and source records attributed to A H Rook.

113 records · Page 7Linked to original sources
PubMedDate not supplied

Red cell autoantibodies in patients with acquired immune deficiency syndrome.

Mild-to-profound anemia, thrombocytopenia, and rarely neutropenia have been observed in patients with the acquired immune deficiency syndrome (AIDS). To investigate a possible immune mechanism, blood samples from 28 hospitalized AIDS patients, four asymptomatic homosexual men, four homosexual men with the AIDS-related lymphadenopathy syndrome, 30 hospitalized patients with diseases other than AIDS, and 60 blood donors were tested for the presence of atypical red cell antibodies. Eighteen AIDS patients (64%) had anti-i, nine (32%) had autoanti-U, and 12 (43%) had a positive direct antiglobulin test. One asymptomatic homosexual man and three homosexual men with lymphadenopathy also had anti-i. In contrast, of the 30 patients with diseases other than AIDS and 60 donors, none had anti-U or a positive direct antiglobulin test. One patient with sickle cell disease had anti-i. The mean hemoglobin level of AIDS patients with anti-i or anti-U was significantly lower than the mean hemoglobin level of patients who did not have those antibodies.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Interactions of cytomegalovirus with the human immune system.

Infection of the normal host with human cytomegalovirus (HCMV) is followed by both humoral and cellular immune responses against this herpesvirus. The importance of cell-mediated immunity against HCMV is exemplified by the occurrence of severe and prolonged HCMV infections in individuals with congenital, iatrogenic, or acquired deficiencies of this arm of host immunity. In contrast, infection in most individuals with primary B cell disorders usually is not severe. The nature of different aspects of cell-mediated immunity, including cytotoxic T cell (CTL) responses and levels of natural killer cell (NKC) and antibody-dependent cellular cytotoxicity (ADCC) during infection, has been characterized in detail in susceptible populations. To a high degree, the presence or absence of CMV-specific CTL responses correlates inversely with the severity of infection, as do levels of NKC and ADCC activity. Clinical correlates of these immune responses will be discussed. In addition, recent observations implicating HCMV as an immunosuppressive virus will be presented.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

HLA-restricted cytotoxic T lymphocytes are an early immune response and important defense mechanism in cytomegalovirus infections.

Eighty-eight bone marrow transplant recipients were studied for development of cytomegalovirus (CMV) infections and associated cytotoxic lymphocyte responses. Sixty-one patients developed CMV infection that was diagnosed by virus isolation (18 patients), fourfold rises in serum antibodies (13), or both (30). Interstitial pneumonitis developed in 27 patients. Among patients tested during infection, HLA-restricted, CMV-specific cytotoxic T cell responses occurred in 25 patients, and non-restricted, non-T cell cytotoxic responses, or responses of undetermined cell type, occurred in 10 patients. Levels of CMV-specific cytotoxicity in infected and uninfected patients were compared in two ways. Eighty-nine percent of patients (32 of 36) with cytotoxicity greater than or equal to 15% lysis (50:1 effector-to-target-cell ratio) and 100% of patients (21 of 21) with sequential increases in cytotoxicity of greater than or equal to 15% lysis were infected. The median time of occurrence of CMV-specific cytotoxic responses preceded the median onset of viral shedding by 1.4 weeks, or rises in titers of serum antibody by 1.7 weeks, and of interstitial pneumonitis by 2.5 weeks. Immune competence, as demonstrated by survival from infection, was always associated with a CMV-specific cytotoxic response. The HLA-restricted cytotoxic T cell response appears to be important as an early host-defense mechanism and an early diagnostic evidence of infection.

Adolescent↗
PubMedDate not supplied

Treatment of autoimmune disease with extracorporeal photochemotherapy: pemphigus vulgaris--preliminary report.

Extracorporeal photochemotherapy is a new form of immunotherapy which involves the extracorporeal photoinactivation of peripheral blood cells by 8-methoxypsoralen in the presence of ultraviolet A irradiation, followed by readministration of the cells. To explore the efficacy of this therapy in the treatment of autoimmune disease, four patients with a lengthy history of corticosteroid and immunosuppressive drug-resistant pemphigus vulgaris were initiated on extracorporeal photochemotherapy. Three patients experienced a complete remission in cutaneous disease expression, permitting discontinuation of medications in two and a substantial decrease in the third. Significant reductions in serum antiepidermal cell antibody titers occurred in all four patients. The treatments were well tolerated without the occurrence of adverse events. These results in a small number of patients suggest that extracorporeal photochemotherapy may prove to be a useful tool in the treatment of aggressive autoimmune disease.

Aged↗