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Biomedical subjects

A Richards

Publications and source records attributed to A Richards.

At least 37 records · Page 2Linked to original sources

A role for complement in the rejection of porcine ventral mesencephalic xenografts in a rat model of Parkinson's disease.

Vascularized whole organ discordant xenografts placed in the periphery are rejected by a rapid "hyperacute" process that involves preformed antibody binding to the xeno-antigens on the donor endothelial cells with complement activation. In the CNS, xenografts are classically thought to be rejected more slowly by a T-cell-dependent process. We now report that xenografts of embryonic porcine ventral mesencephalic tissue in the 6-hydroxydopamine-lesioned, nonimmunosuppressed rat induce both a humoral and a cell-mediated response. Over the first 10 d after implantation, the xenografts matured with identifiable TH neurons and pig-specific neurofilament fibers extending along host white matter tracts. During this period of time, IgM and complement binding were observed within the graft, as well as a CD8 cellular infiltrate, leading to rejection of the transplant over the next 25 d. These intracerebral xenografts were not associated with an early systemic antibody response. A role for complement in this rejection process was further investigated using cobra venom factor (CVF), which systemically depleted the rats of complement for 7 d. CVF treatment, when given in the period immediately before and after grafting, delayed but did not prevent the cellular immune response induced by the graft, demonstrating that xenografted neural tissue can activate the humoral arm of the rejection process, in particular the complement cascade. This suggests that interventions targeting this aspect of the immune rejection process may be of great importance for the future development of xenotransplantation for neurodegenerative conditions.

Adrenergic Agents↗

Damage to porcine islets of Langerhans after exposure to human blood in vitro, or after intraportal transplantation to cynomologus monkeys: protective effects of sCR1 and heparin.

BACKGROUND: Porcine islets offer an attractive alternative to human islets in clinical islet transplantation. The preferred method of islet transplantation is intra-portal injection into the liver. We have recently shown, both in vitro with human islets and in vivo with porcine islets, that islets exposed to allogeneic blood trigger an injurious inflammatory reaction characterized by activation of both coagulation and the complement systems. We have now tested whether a similar reaction is triggered when xenogeneic porcine islets are exposed to human blood in vitro and after intraportal transplantation into primates. Furthermore, we investigated the effect of inhibiting the complement and coagulation systems. METHOD: Islets isolated from adult and fetal porcine pancreas were perfused with fresh human blood in surface heparinized PVC tubings for 5-60 min. Blood cell counts and parameters related to coagulation and the complement system were analyzed, and islets were retrieved after the perifusion was examined by immunohistochemical method. Heparin and soluble complement receptor 1 (sCR1; TP10, 100 microg/ml) were added to the system in some experiments. Furthermore, adult porcine islets were transplanted intraportally into untreated and sCR1- (40 mg/kg BW i.v.) treated cynomolgus monkeys, and plasma insulin concentration was monitored during 60 min after transplantation. RESULTS: Porcine islets perifused with human blood triggered an immediate inflammatory reaction, characterized by a rapid consumption and activation of platelets, consumption of neutrophils and monocytes, activation of the coagulation and complement systems, and release of large amounts of insulin. Islet morphologic analysis revealed damaged islets embedded in clots and infiltrated with CD11+ leukocytes. C3a and C5b-9 was deposited on the islet surface, but human immunoglobulin was not. Complement inhibition with sCR1 reduced insulin release significantly. Intraportal islet transplantation into untreated cynomolgus monkeys resulted in a marked and rapid increase in plasma insulin concentration indicative of islet damage. Pretreatment of the monkeys with sCR1 resulted in significantly less insulin release than in untreated control monkeys. CONCLUSION: Exposure of isolated xenogeneic islets of Langerhans to blood, both in vitro and in vivo, resulted in acute islet damage. Complement and platelets seem to have a central role in the reactions described. Strategies to efficiently inhibit these reactions will be crucial for clinical intraportal islet xenotransplantation to be successful.

Animals↗

Mortality in eating disorders: a descriptive study.

OBJECTIVE: We report rates and causes of death for a cohort of 246 eating-disordered women and provide descriptive information on their eating disorder and comorbid diagnoses. METHOD: Data on mortality were collected as part of a longitudinal study of anorexia nervosa and bulimia nervosa, now in its 11th year. Other data sources included death certificates, autopsy reports, relative interviews, and a National Death Index search. RESULTS: Seven deaths have occurred during the study, all among anorexic subjects with a history of binging and purging and with comorbid Axis I disorders. The crude mortality rate was 5.1%. The standardized mortality ratios for death (9.6) and suicide (58.1) were significantly elevated (p <. 001). CONCLUSIONS: Anorexia nervosa is associated with a substantial risk of death and suicide. Features correlated with fatal outcome are longer duration of illness, binging and purging, comorbid substance abuse, and comorbid affective disorders.

Adult↗

Skill mix between nurses and doctors working in primary care-delegation or allocation: a review of the literature.

The fundamental role of primary health care teams (PHCT) is to deliver effective services to the local population. Demands on the PHCT have increased since the early 1990s and, with the advent of Primary Care Groups (PCGs), will continue to do so in a primary health care led National Health Service (NHS). Rapid changes, however, raise questions about the feasibility and delivery of new services with skill mix and the distribution of workload within the PHCT being key issues. This paper reviews the literature on workload in primary care, attitudes to delegation, inter-professional relationships and teamworking and concludes that in order to deliver the vision of a primary care led NHS, meet the health care needs of users, address the inevitable anxieties of general practitioners and bring forth the professional aspirations of nurses and other health care professionals, more equitable and less hierarchical models of multi-professional teamworking in primary care will be most successful.

Attitude of Health Personnel↗

Oral mucosal non-Hodgkin's lymphoma--a dangerous mimic.

Reports of T-cell lymphomas in the oral cavity are rare. Most have presented as a persisting ulcerated swelling. This paper reports two men, one of whom presented with a short history of increasing facial swelling and pain apparently related to a lower premolar tooth, and the other who had recurrent oral ulceration in several sites over a period of years. These types of cases are likely to present initially to general dental practitioners.

Aged↗

Mutations in a gene encoding an ABC transporter cause pseudoxanthoma elasticum.

Pseudoxanthoma elasticum (PXE) is a heritable disorder characterized by calcification of elastic fibres in skin, arteries and retina that results in dermal lesions with associated laxity and loss of elasticity, arterial insufficiency and retinal haemorrhages leading to macular degeneration. PXE is usually found as a sporadic disorder, but examples of both autosomal recessive and autosomal dominant forms of PXE have been observed. Partial manifestations of the PXE phenotype have also been described in presumed carriers in PXE families. Linkage of both dominant and recessive forms of PXE to a 5-cM domain on chromosome 16p13.1 has been reported (refs 8,9). We have refined this locus to an 820-kb region containing 6 candidate genes. Here we report the exclusion of five of these genes and the identification of the first mutations responsible for the development of PXE in a gene encoding a protein associated with multidrug resistance (ABCC6).

ATP-Binding Cassette Transporters↗

Antibody from mice immunized with DNA encoding the carboxyl-disintegrin and cysteine-rich domain (JD9) of the haemorrhagic metalloprotease, Jararhagin, inhibits the main lethal component of viper venom.

Envenoming by the Brazilian pit viper, Bothrops jararaca, induces extensive local and systemic haemorrhage in humans. The severe and occasionally lethal outcome of envenoming is prevented only by administration of antivenom which is conventionally prepared by hyperimmunization of large animals with an individual venom or a range of venoms. Since snake venoms typically consist of numerous molecules, only some of which are toxic, antivenoms are antigenically crude preparations whose therapeutic value would theoretically be enhanced by restricting antibody specificity to toxic venom molecules. We report here that high-titre IgG antibody from mice immunized by the GeneGun with DNA encoding the carboxy-terminal JD9 domain of Jararhagin, a haemorrhage-inducing metalloprotease in B. jararaca venom, extensively neutralized the main lethal component of B. jararaca venom. This is to our knowledge the first study to apply DNA-based methods to preparation of antivenom; it represents a novel approach with greater immunological specificity and fewer hazards than conventional systems of antivenom production.

ADAM Proteins↗

Anxiety-related Stroop interference in adolescents.

A group of 16- to 18-year-old students was presented with threat-related and neutral Stroop stimuli on separate cards. Participants were assigned to anxiety groups on the basis of their scores on the Beck Anxiety Inventory (BAI; A. T. Beck & R. A. Steer, 1990). It was found, as predicted, that the high-anxiety group took significantly longer to identify the color of the threat-related word than the neutral words, whereas there was no difference for the low-anxiety group. There was a significant linear relationship between interference on the task and BAI scores, showing that as anxiety increases there is a corresponding increase in interference produced by the threat-related stimuli when compared with the neutral stimuli. This study demonstrates an anxiety-related Stroop interference effect for adolescents consistent with that reported in the adult literature.

Adolescent↗

Pseudoxanthoma elasticum maps to an 820-kb region of the p13.1 region of chromosome 16.

We have performed linkage analysis on 21 families with pseudoxanthoma elasticum (PXE) using 10 polymorphic markers located on chromosome 16p13.1. The gene responsible for the PXE phenotype was localized to an 8-cM region of 16p13.1 between markers D16S500 and D16S3041 with a maximum lod score of 8.1 at a recombination fraction of 0.04 for marker D16S3017. The lack of any locus heterogeneity suggests that the major predisposing allele for the PXE phenotype is located in this region. Haplotype studies of a total of 36 PXE families identified several recombinations that further confined the PXE gene to a region (< 1 cM) between markers D16S3060 and D16S79. This PXE locus was identified within a single YAC clone and several overlapping BAC recombinants. From sequence analysis of these BAC recombinants, it is clear that the distance between markers D16S3060 and D16S79 is about 820 kb and contains a total of nine genes including three pseudogenes. We predict that mutations in one of the expressed genes in the locus will be responsible for the PXE phenotype in these families.

Alleles↗

Characterization of a nucleopolyhedrovirus from the vapourer moth, Orgyia antiqua (Lepidoptera Lymantriidae).

The first characterization of a nucleopolyhedrovirus (NPV Baculoviridae) isolated from the vapourer moth, Orgyia antiqua (Lepidoptera Lymatriidae), in the United Kingdom is presented. Transmission electron microscopy revealed that the virus nucleocapsid rods were singly enveloped in the polyhedron inclusion body (PIB) so that the virus is assigned to the SNPV subgenus of the Baculoviridae. Restriction endonuclease analyses of viral DNA indicated a genomic size of approximately 148 kb. Restriction profiles of O. antiqua SNPV closely resembled those of heterologous NPVs isolated from four different Orgyia species and was most similar to a North American SNPV isolate from the Douglas-fir tussock moth, O. pseudotsugata. In host range tests, O. antiqua SNPV was not infectious to 23 lepidopteran species representing four families. Heterologous Orgyia NPV isolates were permissive in O. antiqua larvae. Using a diet plug bioassay method, the median lethal dose response (LD(50)) for this virus in second and third instar O. antiqua larvae were estimated at 52 and 539 PIBs per larva, respectively.

Animals↗