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Biomedical subjects

A P Peltier

Publications and source records attributed to A P Peltier.

At least 19 recordsLinked to original sources

[Antinuclear antibodies: immunological characteristics and clinical significance].

Fifty sera containing antinucleolar antibodies were o gathered in a routine laboratory during testing for antinuclear antibodies with indirect immun-fluorescence over a five-year period. The patients involved were suffering from sclerodermia (13 cases), rheumatoid arthritis (7 cases), polymyositis (3 cases), lupus (2 cases), various rhumatismal disease (59 cases) and non rhumatismal diseases in 16 cases, including 5 malignant diseases. In 80 per cent of the cases nucleolar fluorescence was combined with nuclear fluorescence of another type. The antibodies were almost always of the IgG category and belonged in 2/3 of cases to several immunoglobulin categories, most often IgG-IgA. Pretreatment of the liver cuttings with RNase always modifies the nucleolar fluorescence, most often making it negative, and pretreatment with DNase using a combination of enzymes 10 times higher also modifies it (more often decreasing it than making it negative), which indicates that the nucleolar antigen, probably an ARN with a low molecular weight, also depends upon the ADN.

Adult

Hereditary C2 deficiency associated with non-systemic glomerulonephritis.

A patient with non-systemic idiopathic glomerulonephritis was found to have a complete deficiency of C2, the second component of complement. The clinical course, histological findings and serological abnormalities are reported in detail. The renal disease was a mild glomerulonephritis with mesangial and subendothelial immune deposits comprising IgG, IgM and C3, increased mesangial matrix without significant cell proliferation. An immunogenetic analysis of the patient's family was carried out. It was demonstrated that the homozygous C2 deficiency was associated with heterozygotism for HLA-A, B and D. Only one of the C2 deficient genes was associated with the expected HLA-A10, B18 haplotype and the propositus was HLA-D2 negative. This report confirms the fact that non-systemic glomerulonephritis should be included in the variety of immunological disorders associated with a complement deficient state. However, C2 deficiency does not seem to be related specifically to a given histological variety of glomerulonephritis.

Adult

[Hypocomplementaemic leucocytoclasic vasculitis. (Mac Duffie's syndrome). One case with bacterial lymphadenitis (author's transl)].

Mac Duffie's syndrome includes a hypocomplementaemic allergic vasculitis with essentially cutaneous and articular manifestations. Its pathogenesis, still incompletely elucidated, involves the precipitation of immune complexes in the walls of the all vessels. The problem remains as to whether the alteration in the complement system is merely a reflection of this formation of immune complexes, or if it is primary, favourising the chronic infections which produce such complexes. The significance of the presence of low molecular weight precipitins reacting with C1g in the serum of a number of patients remains uncertain. The case reported, with its new clinical features, does not provide an answer to these questions but emphasises the possible role of chronic infections in the origin of this syndrome.

Adult

[The clinical significance of soluble nuclear antigen specific antibodies (author's transl)].

Anti-ENA antibodies have been found in 176 sera which nearly all contained antinuclear antibodies giving a speckled pattern of nuclear fluorescence. The charts of 134 of these 176 patients were available for a thorough clinical study. Among these 134 patients, 59 had a well defined Connective Tissue Disease including 40 SLE, 31 had a limited clinical syndrome made of Raynaud's phenomenon, inflammatory polyarthritis, swollen fingers and hyperglobulinemia and 34 had a complex clinical picture associating signs of more than one connective tissue disease. Some of the patients in this third group could be considered as-having the Mixed Connective Tissue Disease (MCTD) described by Sharp et al. Anti-RNP antibodies were more common in this series than the other anti-ENA antibodies. However, no narrow specificity could be assigned to any of these antibodies. This is true of the non anti-RNP antibodies, the anti-Sm in particular, which were found in 49 patients of whom 32 had SLE existing alone or in association with features of other connective tissue diseases and 17 had another connective tissue disease or the afore-mentioned limited clinical syndrome. In any case, the anti-ECT antibodies never reach the diagnostic value of the anti-DNA antibodies.

Adolescent

Clinical significance of antibodies to soluble extractable nuclear antigens (anti-ENA).

Clinical and biological manifestations have been studied in 134 patients whose serum had antibodies to soluble extractable nuclear antigens (ENA). 85 of the patients had anti-RNP antibodies, 18 had anti-Sm antibodies, and 31 had antibodies to one or more soluble nuclear antigen. In all groups, the predominant clinical manifestations were polyarthritis, Raynaud's phenomenon, fever, and skin involvement. Renal disease was less common in those patients with anti-RNP antibodies than in the other patients. Most patients with definite renal disease (13 out of 15) also had circulating anti-DNA antibodies. The final diagnoses in these 134 patients were well defined connective tissue disease in 59; overlap syndromes in 34; a limited clinical syndrome made up of polyarthritis Raynaud's phenomenon--often with swollen fingers--and/or hypergammaglobulin-aemia in 31, and various other clinical conditions in 10.

Adolescent

'In vitro' study of a reaction between the complement system and cellular DNA.

A direct reaction between the complement system and DNA in nuclei was demonstrated in vitro by an indirect immunofluorescence technique using cryostat-cut sections of rat liver as a substrate. This reaction occurred at physiological conditions of pH and molarity and was abolished by pre-treatment of the tissue sections by DNase. It begins by the fixation of C1q and involves the fixation and probably the activation of apparently all the components of the classical pathway of the complement system. The pattern of fluorescence given by this reaction was similar to the pattern given by anti-DNA antibodies present in sera from systemic lupus erythematosus (SLE) patients.

Animals

Lymphokine and synthesis of complement by guinea pig spleen cells.

Lymphokine preparations have been obtained from normal guinea pig spleen cells stimulated in vitro by optimal doses of insoluble Concanavalin A. The biological activity of these preparations was estimated by Macrophage Inhibition Tests performed with peritoneal cells from identical guinea pigs. Addition of these preparations to culture of normal adherent guinea pig spleen cells, gives rise to a dose related inhibition of the normal synthesis of C2, the second component of the complement system, by these latter cells. This inhibition of synthesis, appears to be due to a functional effect of lymphokine on C2-producing cells and not to a cytotoxic effect. Preliminary results indicate that the same lymphokine preparations can have a stimulatory rather than an inhibitory effect on synthesis of haemolytic C1 by the same cells.

Animals

Ribonucleoprotein (RNP) soluble nuclear antigen: demonstration of its reaction with serum antibodies by counter-immunoelectrophoresis and further partial characterization.

The soluble ribonucleoprotein nuclear antigen reactive with specific antibodies present in sera from patients with Mixed Connective Tissure disease has alpha 2-beta 1 electrophoretic mobility, thus enabling its reaction with specific serum antibodies to be studied by counter-immunoelectrophoresis. Its molecular weight determined by elution from a calibrated Sephadex G-200 gel column is about 175,000. Its purification has been attempted by successive DEAE cellulose chromatography, Sephadex G-200 gel filtration and Hydroxyapatite chromatography. Polyacrylamide gel electrophoresis of RNP antigen-containing fractions showed persistent heterogeneity which could be due either to inadequate purification or to dissociation of the RNP-antigen during electrophoresis.

Antibodies, Antinuclear

Light and electron microscopy study of capillaries in normal and inflammatory human synovial membrane.

Synovium aspirated from the knee joint by trochar was studied by light and electron microscopy in 40 cases of inflammatory arthritis and in 10 controls. The morphology of synovial capillaries, extravascular plasma diffusion, interendothelial vascular gaps, extracapillary blood cell migration, vascular congestion, endothelial hyperplasia, and obliteration of the capillary lumen by endothelial cells were compared in normal and inflammatory synovia. Inflammatory synovitis was characterised by the number and diversity of blood cells migrating through the interendothelial pathway out of the capillary lumen. Polymorphonuclear leucocytes were the blood cells most often seen at interendothelial junctions. No other capillary changes that might be related to synovial inflammation were found.

Arthritis

[Successive connective tissue diseases (scleroderma, then lupus). Clinical and biological study of 4 cases].

The authors present 4 patients who had suffered for several years from isolated systemic scleroderma and in whom, after 3, 10, 19 and 22 years, clinical, biological and histological signs of DLE appeared. There was no current further progression of the scleroderma in two cases, at the time of onset of DLE. In the oter two cases, it had disappeared. All four patients had a serum cryoglobulin. In all cases the kidneys were involved histologically : extra membranous glomerulitis in one, segmental glomerulitis in a second, and diffuse progressive glomerulitis in the last two. The authors analyse the biological changes which accompanied the clinical transformation. One of the patients had anti-ribonucleoprotein antibodies. She died from severe renal involvement which would be against the good prognosis usually associated with the presence of this type of antibody.

Adult

Ultrastructural study of human synovial membrane with immunoperoxidase.

An ultrastructural immunoperoxidase study of human synovial membrane biopsies performed in 16 patients with rheumatoid synovitis and in 14 control patients showed that: (1) plasma immunoglobulins have an intercellular distribution and seem to diffuse mainly by an intercellular rather than by a transcellular pathway; and (2) there is a difference in the distribution of plasma IgG and IgM. IgG was found in intravascular and extravascular spaces in all biopsies. IgM was found only in intravascular spaces in control biopsies, but in rheumatoid synovitis it was present in both intravascular and extravascular spaces. This difference in distribution may be due to increased vascular permeability in inflammatory synovitis.

Antibodies, Anti-Idiotypic

[Anti-deoxyribonucleic acid antibodies: comparison of results provided by 3 research methods].

Three methods of determination of anti-DNA antibodies were compared. The indirect immunofluorescence method after exposure to animal DNA (IF) and Farr's radio-immunological method with bacterial DNA labelled with C14, gave highly similar results, although there were some cases in which Farr's method gave a negative and the IF method a positive result. In part, this discordance appears to be accounted for by the variable affinity of the anti-DNA antibodies for DNA. The counter-immuno-electrophoresis method (CIEP) on the other hand, gave very different results: positive reactions in a large proportion of normal sera and a considerable proportion of false-positive and false-negative results in disseminated lupus erythematosus. It is concluded that until the CIEP method is made more reliable by technical refinement, determination of anti-DNA antibodies may be carried out by either the IF or the radio-immunological method, but a double-check, by application of the two methods at the same time, is highly advisable.

Antibodies, Antinuclear