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Biomedical subjects

A M Teppo

Publications and source records attributed to A M Teppo.

At least 127 records · Page 7Linked to original sources
PubMed1984

Measurement of serum amyloid A protein concentrations as test of renal allograft rejection in patients with initially non-functioning grafts.

Serum amyloid A protein concentrations were monitored in 10 renal transplant recipients who required dialysis after transplantation because of an initially non-functioning graft. Fifteen rejection episodes were identified by repeated fine needle aspiration biopsies of the grafts. All rejections were characterised by pronounced increases in serum amyloid A concentrations, the mean peak value being 363 (SE 57) mg/1 as compared with a mean preoperative concentration of 14 (5) mg/1. The rise in concentrations preceded the start of anti-rejection treatment by an average of 2.5 days in eight of the rejection episodes, in five episodes it occurred the same day, and in two episodes it occurred the next day. With exclusion of the predictable surgery induced rise in values, which peaked on the second postoperative day, there were 17 increases in amyloid A concentrations peaking at greater than or equal to 100 mg/1; in two cases they were not related to documented rejection. These findings show that measurements of serum amyloid A concentration provide a valuable non-invasive aid in identifying acute renal allograft rejection, including that in patients whose graft does not function initially.

Adult↗
PubMed1984

Enzyme-linked immunosorbent assays for antibodies to poly(A), poly dAT and histones: possibly useful tools for the evaluation of prognosis and disease activity in systemic lupus erythematosus.

In a prospective study 222 sera from 56 patients with systemic lupus erythematosus (SLE) were tested for antibodies to poly(A), poly dAT and histones using enzyme-linked immunosorbent assay (ELISA). Patients with active disease had significantly more often antibodies to poly(A), poly dAT and histones than patients with inactive disease. There was a positive correlation between the activity score of the disease and the levels of poly(A)-antibodies of IgG and IgM class, poly dAT-antibodies and antibodies to histones. Patients with SLE-nephritis had a higher level of poly dAT and IgG class poly(A) antibodies than patients without nephritis. Interestingly, patients with an SLE-nephritis had lower levels of IgM-poly(A)-antibodies than those without nephritis. Attempts to use the ELISAs in predicting the SLE exacerbations were unsuccessful. However, the assays can be used as parameters in the estimation of the disease activity.

Adolescent↗
PubMed1984

DNA antibodies with and without complement-binding ability.

The relationship between immunoglobulin class and complement-binding ability of DNA antibodies was studied by indirect immunofluorescence and Crithidia luciliae (CL) as substrate in the sera of 28 patients with SLE and antibodies to CL-DNA. In 15 of 28 cases the antibodies bound complement and were IgG either alone or in combination with IgA and IgM. In the remaining 13 sera the antibodies were either IgA or IgM and did not bind complement. Only one of nine patients with nephritis had CL-DNA antibodies of IgM alone, whereas that was true for 10 of 19 patients without nephritis. The factors influencing the complement binding were further studied by using purified IgM rheumatoid factors. Their ability to 'mask' the IgG-type CL-DNA antibodies and to inhibit the binding of complement was confirmed. These findings suggest that complement activation in SLE does not occur in patients with IgM-type anti-ds-antibodies or in patients with rheumatoid factor activity.

Antibodies↗
PubMed1984

Massive cutaneous hyalinosis. Identification of the hyalin material as monoclonal kappa light chains, adhesive 90 kD glycoprotein, and type I collagen.

The hyalin material in massive cutaneous hyalinosis, a disease characterized by extensive tumorous periodic acid-Schiff-(PAS) positive extracellular cutaneous deposits, has been elucidated by biochemical and immunologic methods. Three major components were found: kappa light chains, a mannose-rich glycoprotein, and type I collagen. Trace amounts of fibrinogen, fibronectin, laminin, IgG, pregnancy-specific glycoprotein, albumin, and keratan sulfate, but not keratin, were also present. The kappa light chains were monoclonal, cryoprecipiting, and more basic than the kappa chains from two myeloma patients. The glycoprotein, which could not be identified as any known glycoprotein, had an apparent molecular weight of 90,000 D. Amino acid analysis showed that glutamic acid, aspartic acid, leucine, and threonine were abundant, whereas hydroxyproline, hydroxylysine, and sulfhydryl amino acids were absent. The carbohydrate content of the protein was approximately 20%. The major monosaccharides were mannose and N-acetylglucosamine. Galactose, N-acetylneuraminic acid and fucose also were present. The third major component of the hyalin material was identified as type I collagen. A humoral immune response to the storage material was found: the patient's serum contained IgM and IgG class antibodies against the mannosylglycoprotein (90 kD glycoprotein) and against type I collagen.

Aged↗
PubMed1984

Control of the acute-phase serum amyloid A and C-reactive protein response: comparison of total replacement of the hip and knee.

The acute-phase serum protein response induced by arthroplasty of the knee was compared with that induced by arthroplasty of the hip in patients with rheumatoid arthritis (RA). Total replacement of the knee (n = 13) caused a markedly greater serum amyloid A protein (SAA) (P less than 0.001) and C-reactive protein (CRP) (P less than 0.001) elevation that did total replacement of the hip (n = 13). This effect was not merely due to the use of tourniquet in the knee arthroplasties, since synovectomy of the knee, matched for the duration of the use of tourniquet, induced an SAA response that was significantly lower (P less than 0.001) than that caused by replacement of the knee; the SAA response after knee synovectomy was similar to that after hip arthroplasty. The kinetics and magnitude of the SAA response in patients with reactive amyloidosis were similar to those found in RA patients without amyloidosis. The results show that replacement of the knee is a stronger stimulator of SAA and CRP elevation than replacement of the hip. Thus, total replacement of the knee, possibly due to the performance of the arthroplasty under ischaemic conditions, appears to be more traumatic to the organism than total replacement of the hip.

Adolescent↗
PubMed1984

Profiles of antinuclear antibodies in chronic active hepatitis, primary biliary cirrhosis and alcoholic liver disease.

The profiles of specific antinuclear antibodies were determined in sera from 23 patients with the idiopathic type of chronic active hepatitis (CAH), 15 patients with primary biliary cirrhosis (PBC) and 25 patients with alcoholic liver disease (ALD). The indirect immunofluorescence test for antinuclear antibodies using cultured human embryonic fibroblasts as substrate was positive in 78% in CAH, in 73% in PBC and in 24% in ALD. Seventeen percent of CAH sera and 33% of PBC sera stained small speckles in interphase nuclei. This staining pattern probably represents a new subset of ANA as the centromeres (kinetochores) were not stained. Antibodies to native DNA by the Crithidia luciliae test were found in only one serum from a patient with CAH. In addition, 17 percent of the CAH sera reacted with the saline extract of rabbit thymus by double immunodiffusion. Antibodies to the Sm- or RNP-antigens were not found. SS-B antibodies could be demonstrated in 39% of the CAH sera by a sensitive immunoenzymatic technique. Patients with CAH also had significantly higher levels of antibodies against denatured, single-stranded DNA (ss-DNA) and a synthetic RNA molecule, poly(A) as compared to other groups. Patients with an atypical cholestatic CAH had an antinuclear-antibody profile resembling that of the other CAH patients, but different from that of PBC patients. Patients with alcoholic cirrhosis had significantly higher levels of ss-DNA- and poly(A)-antibodies than other patients with ALD. It is concluded that the determination of an antinuclear-antibody profile using the ELISA seems to be clinically useful in the classification of chronic liver diseases.

Adult↗
PubMed1984

Antibody profiles of sera giving different nuclear staining patterns.

Antibodies to three major antigens of the non-histone or saline-extractable nuclear antigen (ENA) complex were sought by counterimmunoelectrophoresis (CEP) in three groups of sera which gave different patterns in the immunofluorescence test for antinuclear antibodies (ANA). Precipitins, mainly anti RNP and anti SS-B, were found most commonly (61%) in 70 sera with a speckled ANA pattern but were less frequent (8%) in 61 sera with a homogeneous ANA pattern and exceptional (1%) in 72 sera which showed fibrillar ANA staining. Rim staining was an insensitive indicator of nDNA antibody. An enzyme immunoassay (EIA), specific for anti-SS-B was more sensitive than CEP and identified this antibody in 28 sera, compared with 18 for CEP.

Adult↗
PubMed1984

Serum esterase activity in reactive systemic amyloidosis and its relation to amyloid A degrading activity.

Patients with reactive systemic amyloidosis have a reduced ability to degrade amyloid A protein fibrils in vitro. The amyloid A degrading activity in serum has been attributed to a neutral serine protease or proteases. Our results show that patients with reactive systemic (amyloid A) amyloidosis have low activities of two serum esterases, namely, arylesterase and paraoxonase, whereas the activity of a third esterase, cholinesterase, is normal. The combination of reduced arylesterase (less than 55 kU/L) plus reduced paraoxonase activity (less than 35 U/L) was found in 32% of patients with rheumatoid arthritis complicated by amyloidosis, but in only 5% of a control nonamyloid patient group, including patients with rheumatoid arthritis, liver disease, and hypoalbuminemia (p less than 0.001). A significant correlation between serum arylesterase and amyloid A degrading activity was found (patients with rheumatoid arthritis plus amyloidosis, n = 31, r = 0.51, p less than 0.01; all patients, n = 95, r = 0.34, p less than 0.001). Our results suggest that the amyloid A degrading activity may be closely related to the esterase activity in serum.

Adolescent↗
PubMed1984

Antibodies to gliadin, gluten and reticulin glycoprotein in rheumatic diseases: elevated levels in Sjögren's syndrome.

An enzyme immunoassay was used to measure circulating antibodies to gluten, gliadin and to 'reticulin glycoprotein' in 25 patients with Sjögren's syndrome (SS), in 20 patients with rheumatoid arthritis without SS and in 19 patients with systemic lupus erythematosus without SS. Antibody levels to these three antigens were significantly higher in SS than in the other groups. In SS the level of antibodies to 'reticulin glycoprotein' correlated positively with the levels of antibodies to both gliadin and to gluten but not with the level of antibodies to SS-B antigen. Patients with primary SS had higher antibody levels to 'reticulin glycoprotein' than had patients with secondary SS, whereas no significant difference between primary and secondary SS was found in the levels of the antibodies to gliadin or to gluten. Circulating antibodies to gliadin, gluten and 'reticulin glycoprotein' have not been previously recognized in SS. Their occurrence suggests that small bowel injury may be a common finding in SS.

Adult↗
PubMed1984

Comparative study of serum amyloid-related protein SAA, C-reactive protein, and beta 2-microglobulin as markers of renal allograft rejection.

The effect of renal allograft rejection on the concentrations of the amyloid-related protein SAA, C-reactive protein (CRP), and beta 2-microglobulin (beta 2m) were compared, and the usefulness of post-transplant monitoring of these proteins in rejection diagnosis was evaluated. On the basis of the data from 30 reversible allograft rejections, the SAA test in rejection diagnosis was found to be more useful than either the beta 2m or CRP tests. The dramatic rejection-induced SAA elevation made it possible to choose a limit value for the SAA test that combined high sensitivity with reasonably high specificity. In contrast, limit values for beta 2m or CRP giving high sensitivity were combined with relatively low specificity. It is concluded that while post-transplant monitoring of SAA, CRP and beta 2m can all provide useful information aiding the early recognition and verification of acute allograft rejection, the properties of SAA are best suited for the purpose of a rejection marker.

Adult↗
PubMed1983

Amyloid A fibril degrading activity in serum in liver disease--relation to serum acute phase and other protein levels.

Human serum contains amyloid A degrading activity. This activity is decreased in patients with reactive systemic amyloidosis. To study the specificity of this finding, we evaluated the effect of liver disease per se on the amyloid degrading activity in serum as well as its relation to serum amyloid A (SAA), the putative precursor of amyloid A fibrils, and other serum protein levels in alcoholic and non-alcoholic non-malignant liver diseases without signs of amyloidosis. The amyloid A-degrading activity was significantly decreased in liver cirrhosis. The lowest activity was seen in patients with advanced cirrhosis. There was a positive correlation between the degradative activity and indices of hepato-cellular synthetic function (serum albumin, r = 0.77; serum prealbumin, r = 0.65). Most of the patients with liver disease had a detectable SAA level; 77% had a level higher than 5 mg/l (compared to 12% among blood donors). However, the SAA increase was generally only slight, e.g. in alcoholic liver cirrhosis the median SAA level was 15 mg/l. The results show that liver dysfunction per se decreases amyloid A-degrading activity in serum. A reduced activity cannot therefore be regarded as specific for reactive amyloidosis. Since reactive amyloidosis is extremely rare in liver cirrhosis, it seems obvious that a reduced amyloid degrading activity alone, in the absence of a markedly elevated SAA level, does not predispose, at least in patients with liver disease, to amyloidosis.

Amyloid↗
PubMed1983

Correlation of persistently high serum amyloid A protein and C-reactive protein concentrations with rapid progression of secondary amyloidosis.

The importance of serum amyloid A protein in the progression of renal failure was studied over three years in 28 patients with secondary (amyloid A type) amyloidosis predominantly due to rheumatoid arthritis. Creatinine clearance, the amount of protein in the urine, and serum amyloid A and C-reactive protein concentrations were determined regularly. Linear regression analysis showed a close correlation between the change in creatinine clearance each year and both serum amyloid A concentrations (20 patients: r= -0.83, p less than 0.001) and C-reactive protein concentrations (28 patients: r= -0.80, p less than 0.001). The correlation between serum amyloid A and C-reactive protein concentrations was also significant (317 parallel measurements: r=0.81, p less than 0.001). These findings suggest that monitoring serum amyloid A or C-reactive protein concentrations is valuable in assessing the prognosis in secondary amyloidosis and that therapeutic measures that lower serum amyloid A concentrations may reduce the formation of amyloid.

Amyloid↗
PubMed1983

Serum prealbumin, transferrin and immunoglobulins in fatty liver, alcoholic cirrhosis and primary biliary cirrhosis.

The serum concentrations of prealbumin, transferrin and immunoglobulins, as well as their concentration ratios, were determined in patients with fatty liver, alcoholic cirrhosis and primary biliary cirrhosis to evaluate the usefulness of these measurements in the differentiation between these diseases, and in the evaluation of the severity of the liver injury. Alcoholic cirrhosis was characterized by high IgA/prealbumin and IgG/prealbumin ratios, whereas in fatty liver these ratios remained normal or close to normal. The IgG concentration and the ratio of IgG/prealbumin were markedly higher in advanced than in early alcoholic cirrhosis, IgG/prealbumin being the most sensitive indicator. None of the assays reflected the degree of fatty degeneration. In primary biliary cirrhosis the mean IgG concentration was 93% higher than in alcoholic cirrhosis. One of ten patients with primary biliary cirrhosis had a normal IgM level, whereas 2 of 10 patients with alcoholic cirrhosis had a value above normal (greater than 2.9 g/l). IgM alone did not differentiate between alcoholic and primary biliary cirrhosis, while the ratio of IgA/IgM seems useful: a value over 2.0 was found in all patients with alcoholic cirrhosis but in none of those with primary biliary cirrhosis.

Adult↗
PubMed1983

DNA antibodies and complement in SLE patients. A follow-up study.

Sixty-seven patients with systemic lupus erythematosus (SLE) were followed up for 3-19 months (mean 12) in a prospective study. The activity of SLE was estimated on clinical grounds and correlated with DNA antibody and complement levels. The disease reactivations consisted mostly of articular and cutaneous symptoms. There were 17 relapses and 22 complicating infections during the follow-up period. The levels of antibodies to native, double-stranded (ds) DNA (P less than 0.001) and antibodies to denatured, single-stranded (ss) DNA of IgG class (P less than 0.001) and C3 (P less than 0.001) correlated best with disease activity, which was estimated on the clinical symptoms and signs. These assays were not reliable, however, in predicting minor exacerbations. The levels of IgM class ss-DNA antibodies were significantly higher in SLE patients without nephritis than in SLE nephritis patients. In most cases, the combination of IgG class ss-DNA antibody and complement (C3 and CH50) determinations differentiated SLE relapse from infection.

Autoantibodies↗
PubMed1983

alpha 1-Antitrypsin and reactive systemic amyloidosis.

1. Serum contains amyloid A-degrading activity. This activity is markedly reduced in patients with rheumatoid arthritis (RA) complicated by amyloidosis. alpha 1-Antitrypsin inhibits the degradative activity. To test the hypothesis that the activity of this enzyme is regulated by alpha 1-antitrypsin, we determined the concentrations, elastase-inhibitory activity and phenotypes of alpha 1-antitrypsin in 24 RA patients with and in 26 RA patients without amyloidosis. 2. alpha 1-Antitrypsin concentrations and biological activity were significantly increased in both patient groups compared with control subjects, but there was no difference between the two patient groups. 3. All patients who had developed amyloidosis were of the normal protease inhibitor (Pi) MM-phenotype. 4. We conclude that the difference in the amyloid A-degrading activity between RA patients with or without amyloidosis cannot be accounted for by differences in concentration, activity or Pi type of alpha 1-antitrypsin.

Adult↗
PubMed1983

Serum amyloid A levels in human renal allograft rejection.

Serum amyloid A (SAA) levels were studied in 35 recipients of cadaveric renal transplants. Marked SAA elevations were seen during all acute allograft rejection episodes. The mean peak SAA level in well-documented rejections was 446 mg/l (median 415 mg/l, range 132-1040 mg/l; controls less than 1 mg/l). Rejections in patients receiving cyclosporin-A alone as post-transplantation immunosuppressive medication were characterized by a significantly higher peak SAA level than rejections in patients receiving cyclosporin-A in combination with methylprednisolone (539 +/- 53 mg/l, mean +/- SEM, vs 226 +/- 9 mg/l, P less than 0.01). Excluding surgery-induced SAA elevations in the immediate postoperative period, seven significant SAA peaks not related to allograft rejection were observed. These were associated with surgical complications and infections, and in one case probably with the underlying rheumatic disease, which was complicated by amyloidosis. The results show that acute renal allograft rejection induces a dramatic acute phase SAA response. Since SAA is an easily measured serum component and the rejection-induced elevation is an early event, monitoring of SAA in kidney transplant patients may have considerable clinical significance.

Adult↗