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A Rifai

Publications and source records attributed to A Rifai.

At least 73 records · Page 4Linked to original sources

Preparation of phosphorylcholine-conjugated antigens.

In response to the need for a phosphorylcholine (PC) hapten that could be attached easily to carrier molecules, synthesis of PC-carrier conjugates was undertaken. An isothiocyanate-PC derivative was prepared by mixing p-aminophenyl-PC with thiophosgene. The isothiocyanate-PC derivative was coupled directly to aminoethylated Ficoll at room temperature in a bicarbonate buffer. Maximum coupling, 31 PC groups per Ficoll molecule, occurred within 16 h. The number of PC per Ficoll was determined spectrophotometrically at 245 nm. This approach was also successively used for conjugating PC to bovine serum albumin and aminoethylated Sepharose.

Choline↗

Persistence of primitive cerebral vasculature in a newborn. A case report of whole brain AVM.

A case of a two-day-old infant with a massive arteriovenous malformation involving the entire brain vasculature is reported. The appearance of the cerebral vasculature on computed tomography scans and angiographic studies in this newborn is similar to the primitive vasculature in an embryo. The findings in this case give strong support to ontogenesis maldevelopment as the etiology of cerebral arteriovenous malformations. The role of embryogenesis in the development of an arteriovenous malformation is discussed as it contrasts with other pathogenetic hypotheses.

Brain↗

Microsurgical removal of suprasellar meningiomas.

The authors report 17 cases of large suprasellar meningiomas operated on during the 2-year period from February 1982 through March 1984. The tumors ranged from 4 to 9 cm in diameter. These patients presented with severe visual loss (4 were blind) and optic atrophy or papilledema. These tumors were noteworthy in their encroachment against and around the carotid arteries and optic nerves laterally, as well as against the hypothalamus with extension into the interpeduncular cistern and frontal fossa. Advanced microsurgical technique assisted in total removal of all tumor tissue with preservation of vital structures. There were three deaths: two from pulmonary embolism and one from gastrointestinal hemorrhage. The surgical technique for the total removal of these very large tumors is described.

Adult↗

Glomerular deposition of immune complexes prepared with monomeric or polymeric IgA.

Clearance kinetics and renal deposition of soluble IgA immune complexes (IgA IC) were examined to determine the nephritogenic potential of IgA molecular form in mediating experimental IgA nephropathy. The immune complexes were prepared by mixing purified radiolabelled monomeric (mIgA) or polymeric (pIgA) IgA anti-dinitrophenyl (DNP), derived from MOPC-315 myeloma, with DNP conjugated Ficoll (DNP8-Ficoll). Clearance of IgAIC from the circulation was curve fitted by two exponential components. The first component was similar for both mIgA IC and pIgA IC. The second component was slightly more rapid for mIgA IC than for pIgA IC. Immunofluorescence studies, however, showed that only pIgA IC deposited in the kidneys. Analysis of IgA IC by gradient polyacrylamide gel electrophoresis indicated that mIgA formed only small latticed complexes. The critical role of IgA IC lattice size in renal deposition was confirmed by demonstrating that large latticed mIgA IC, prepared by covalent cross-linking mIgA with a specific affinity labelling antigen, deposited in the kidneys in a pattern similar to pIgA IC. Our results suggest that the monovalency of mIgA is responsible for its inability to form a large latticed nephritogenic complexes.

Animals↗

Clearance of circulating IgA immune complexes is mediated by a specific receptor on Kupffer cells in mice.

To characterize the physiology of circulating IgA immune complexes (IgA-IC), the dynamics of IgA-IC removal by the liver were examined. After intravenous injection, covalently cross-linked IgA antibodies to the dinitrophenyl determinant were rapidly removed from the circulation by the liver. Immunofluorescence microscopy and light and electron microscope autoradiography showed that the IgA-IC were associated with Kupffer cells. With increasing doses of injected IgA-IC the clearance velocity approached a maximum, thus prolonging the circulation of IgA-IC. All these observations indicated a receptor-mediated process. Saturating doses of various potential receptor-blocking agents, heat-aggregated mouse IgG, microaggregated human serum albumin, and purified dimeric IgA did not influence the clearance pattern and hepatic uptake of radiolabeled IgA-IC. Mouse livers were also perfused via the portal vein with 1 microgram of IgA-IC. In the presence or absence of serum proteins, 43% of the perfused IgA-IC were removed in a single passage. This liver uptake was not reduced with simultaneous perfusion of large doses of aggregated mouse IgG, aggregated human serum albumin, or purified free dimeric mouse IgA. In contrast, the liver uptake of radiolabeled IgA-IC was decreased by 88% with the addition of 1 mg unlabeled IgA-IC. These observations support the conclusion that removal of IgA-IC from circulation is mediated by a specific IgA receptor on Kupffer cells.

Animals↗

Clearance kinetics and fate of mouse IgA immune complexes prepared with monomeric or dimeric IgA.

To determine the pathophysiologic mechanism(s) involved in experimental IgA nephropathy, the clearance kinetics and tissue distribution of soluble IgA immune complexes in mice were investigated. Purified radiolabeled dimeric (dIgA) and monomeric (mIgA) IgA antidinitrophenyl, obtained from MOPC-315, were covalently cross-linked with a bivalent affinity-labeling antigen, bis-2,4-dinitrophenyl pimelic ester. After i.v. injection, heavy polymers (greater than 1.2 X 10(6) m.w.) were rapidly removed from circulation. Analysis of circulating intermediate-latticed complexes by gradient polyacrylamide gel electrophoresis indicated that polymers with a minimal composition of four dIgA or eight mIgA were required for rapid elimination. The dIgA and mIgA complexes with lattices smaller than this critical size were removed at slower rates (yielding a t1/2 of 35 min for complexes with dIgA and a t1/2 of 60 min for complexes with mIgA). Tissue distribution of both dIgA and mIgA immune complexes was similar. The liver was the major organ involved in uptake of IgA immune complexes with an insignificant amount in the bile. Heavy polymers of dIgA or mIgA were predominantly localized in the hepatic nonparenchymal cells.

Animals↗

Stable, soluble, model immune complexes made with a versatile multivalent affinity-labeling antigen.

We describe here the synthesis of a family of multivalent affinity-labeling antigens based on the soluble carbohydrate polymer Ficoll. Ficoll was derivatized successively with chloroacetate, ethylenediamine, and glutaric anhydride and finally esterified with 2,4-dinitrophenol. Prior to esterification, the polymer could also be derivatized with tyramine to allow trace iodination and with the monosaccharides galactose or mannose. The numbers of substituent groups could be controlled at several points in the synthesis. The resulting multiple dinitrophenyl esters on a Ficoll or glycosylated Ficoll polymer specifically cross-linked anti-dinitrophenyl antibodies to form covalently cross-linked antigen-antibody complexes. The glycosylated Ficolls were particularly made for studies of the influence of antigen structure on the behavior of immune complexes. The intermediates in the synthesis are suitable for other derivatizations as well. These model immune complexes are stable and soluble, they can be separated by size, and they overcome some of the limitations on the study of complexes imposed by previous techniques of preparing them.

Affinity Labels↗

Influence of antigen on immune complex behavior in mice.

To explore the possibility that the behavior of immune complexes can, under some circumstances, be directed by the antigen, we have studied the behavior of complexes of identical size made with the glycoproteins, orosomucoid (OR), and ceruloplasmin: or with their desialylated derivatives, asialo-orosomucoid (ASOR) and asialo-ceruloplasmin. Such desialylated proteins are rapidly removed from the circulation by a hepatic cell receptor for galactose, the sugar exposed upon removal of sialic acid. Mixtures of 125I-goat anti-ASOR with either ASOR or OR and mixtures of 125I-rabbit anti-OR with either ASOR or OR form complexes identically. The complexes were separated by density gradient centrifugation and injected intravenously into C3H mice. Blood clearance and hepatic uptake of the OR complexes and ASOR complexes were markedly different. T 1/2 for the goat OR complexes exceeded 300 min, whereas that for the ASOR complexes was 15 min. More detailed studies using rabbit complexes of various sizes revealed that light rabbit complexes behaved similarly to the goat complexes. The light rabbit OR complexes were cleared slowly, with only 18% found in the liver at 60 min, whereas the light rabbit ASOR complexes were cleared much more rapidly, with 62% found within the liver by 30 min. This rapid clearance was completely suppressed by a prior injection of a blocking dose of ASOR, which implies uptake by a galactose-mediated mechanism on hepatocytes. As the size of the rabbit complexes increased, so did the rate of Fc receptor-mediated clearance. Heavy rabbit OR complexes were cleared more rapidly than light OR complexes but not so rapidly as heavy ASOR complexes. The clearance and hepatic uptake of the heavy OR complexes were markedly suppressed by a prior injection of heat-aggregated gamma globulin, a known Fc receptor-blocking agent (45% hepatic uptake without and 6% with aggregated gamma globulin). The heavy rabbit ASOR complexes exhibited inhibition of blood clearance and hepatic uptake by both galactose receptor-blocking and Fc receptor-blocking agents. A blocking dose of ASOR reduced the hepatic uptake at 30 min from 75 to 49%, and heat-aggregated gamma globulin reduced it from 75 to 39%, which suggests that these heavy complexes were removed from the circulation by receptors both for the immunoglobulin and for the antigen. Cell separation studies and autoradiographs confirmed that those complexes cleared primarily by galactose-mediated mechanism were within hepatocytes, and those cleared by Fc receptors were within the nonparenchymal cells of the liver. It seems probable, therefore, the some antigen-antibody complexes may be removed from the circulation via receptors not only for immunoglobulin but also for antigen.

Animals↗

An abnormality of immune complex kinetics in murine lupus.

In order to understand better the role of immune complex metabolism in the pathogenesis of autoimmune diseases, we have investigated the early stages of immune complex uptake by the liver, the major organ responsible for clearance of soluble complexes in the mouse. Livers were perfused in situ via the portal vein over 3 to 5 min with trace amounts of radiolabeled soluble model immune complexes. In 4 nonautoimmune strains (BALB/c, DBA/2, CAF1, NZW) 60 to 72% of the model complexes perfused were taken up and remained in the liver after 20 min of continuous perfusion with oxygenated Krebs-Henseleit buffer. In NZB and NZB/W F1 female mice at ages 0.5 to 11 mo, 66 to 78% of the model complexes remined in the liver. However, when a dose of heat-aggregated human gamma-globulin sufficient to saturate the reticuloendothelial system was perfused 7 min after radiolabeled complexes, 15.2 +/- 7.2% (mean +/- SD) of the complexes were displaced in the nonautoimmune strains. In contrast, 32.6 +/- 10.5% of the complexes were displaced from the liver in NZB and NZB/W F1 female mice (p < 0.001). Thus, although hepatic uptake of immune complexes in autoimmune mice appears to be normal or even enhanced, there may be impaired phagocytosis by the hepatic RES or weaker binding of complexes to the surface of the Kupffer cells. Such surface-bound immune complexes remaining accessible to the circulation may contribute to the autoimmune process.

Aging↗

The specificity of uptake of model immune complexes and other protein aggregates by the murine reticuloendothelial system.

We have studied the selectivity of the murine reticuloendothelial system in recognizing and removing from the blood model immune complexes and several aggregated proteins. Although both IgG anti-DNP model immune complexes and micro-aggregated albumin exhibited rapid hepatic uptake, which is saturable, they did not cross-inhibit each other. Aggregates of ovalbumin, a glycoprotein rich in mannose (a sugar recognized by Kupffer cells), had no effect on the uptake by the liver of either IgG immune complexes or micro-aggregated albumin. The finding that transferrin aggregates were not taken up by the liver at all suggests that aggregation alone is not sufficient to overcome the lack of a specific hepatic receptor for that protein. Thus, several mechanisms exist whereby aggregated proteins can be cleared from the blood by the reticuloendothelial system, an observation consistent with the selective failure of reticuloendothelial function found in several human diseases.

Animals↗

Experimental IgA nephropathy.

An animal model for IgA immune complex nephritis was developed. IgA immune complexes formed in vitro with an IgA anti-dinitrophenyl (DNP) derived from MOPC-315 plasmacytoma, and dinitrophenylated bovine serum albumin (DNP-BSA) produced mild focal glomerulonephritis in mice. Similar, but more severe pathological changes were produced with complexes formed in vivo either in normal mice or MOPC-315 tumor-bearing mice. In contrast to the focal nature of the PAS-positive glomerular lesions observed by light microscopy, immunofluorescent examination revealed IgA deposits in all glomeruli. This discrepancy between immunofluorescent and histopathologic findings as well as the distribution of the immune complexes within the affected glomeruli, are some of the features which bear resemblance between this experimental model and human IgA nephropathy. Fixation of complements by DNP-BSA-IgA immune complexes, formed in vitro or in vivo, was shown to occur in the glomeruli of mice with IgA immune complex nephropathy. The pattern of C3 glomerular deposits was similar to that of IgA. However, complement proved to be nonessential for complex deposition. This conclusion is based on the observation that decomplemented mice, although showing no deposition of C3 in their glomerulus, developed glomerular immunohistological changes similar to those observed in experimental mice that were not decomplemented. Polymeric IgA was observed to be critical for renal deposition of complexes and induction of nephritic histological changes. In contrast, monomeric IgA immune complexes failed to produce glomerular deposits. This finding raises the possibility that secretory IgA, which is predominantly polymeric, may play a role in human IgA-associated glomerulonephritis.

Animals↗

Adrenal scintigraphy in low renin essential hypertension.

Adrenal scintigraphy was performed on 23 patients with low renin essential hypertension (LREH). After baseline scintigraphy was shown not to be helpful, 13 of these 23 patients underwent dexamethasone suppression adrenal scintigraphy. Four adrenal imaging patterns were observed: unilateral imaging with adenoma; bilateral early or late imaging with hyperplasia; no uptake with normal adrenals. These imaging patterns were shown to be predictive of the individual patient's response to spironolactone administration of functional adrenal cortical abnormalities in LREH supplies direct evidence for the hypothesis that LREH has an adrenal mineralocorticoid etiology.

Adenoma↗

Normal adrenal asymmetry: explanation and interpretation.

Although adrenal imaging with 19-iodocholesterol provided much useful diagnostic information, spatial resolution was less than ideal. With the greater target-to-background ratios afforded by NP-59, differences between the right and left adrenal glands--in terms of position, configuration, and depth-related activity--can now be defined. Analysis of the scintigrams of 21 individuals with no evidence of adrenal disease has allowed us to characterize the normal degree of adrenal asymmetry. Appreciation of this asymmetry is necessary if the potential for greater diagnostic accuracy afforded by NP-59 is to be realized.

Adrenal Glands↗