Thymuline (FTS) in rheumatoid arthritis.
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Biomedical subjects
Publications and source records attributed to B Amor.
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Anti-Epstein-Barr virus and antiinfluenza A cytotoxic T lymphocytes (CTL) have been used to study the restriction of human antiviral responses by HLA-B27 antigens. Three functional subgroups of HLA-B27 have been clearly distinguished by this "restriction-typing assay". No cross-reaction could be detected between the three subgroups either at the CTL level or at the level of antigen-presenting cells. The cells of subgroup 1 are always positive [M2(+)] when tested in immunofluorescence with a monoclonal B27-specific antibody which divides HLA-B27 into a major M2(+) and a minor M2(-) subgroup. These M2(+) group 1 cells are apparently also HLA-B27W as previously shown by Ivanyi and co-workers using anti-HLA-CTL. Subgroup 2 includes only M2(-) cells. A comparison between this group and the previously described HLA-B27K is not fully conclusive, since two typing cells which were clearly HLA-B27K apparently did not belong to group 2. Only two donors, both of Oriental origin, have been included in subgroup 3. Both of them were "M2 intermediate". These results demonstrate (1) the existence of several functional subgroups of HLA-B27 with an interesting correlation with the M2(+), M2(-), or M2 intermediate phenotypes, and (2) the possibility of using the restriction-typing assay to define such functional subgroups not detected by classical allosera.
Superoxide dismutase (SOD) is known to regulate the level of superoxide radicals inside cells. The purpose of this work was to investigate the role of SOD activity in tissue damage produced by superoxide radicals. SOD was measured in polymorphonuclear cells of patients with rheumatoid arthritis and controls. The distinct SOD activities, including manganese-containing and copper-zinc-containing enzymes, were evaluated in cytoplasma and mitochondria of human granulocytes. Except for the comparison between total SOD and cytoplasmic copper-zinc SOD, no correlation was found among the different SOD levels. Moreover, a significant decrease was observed only for cytoplasmic manganese-containing enzyme in granulocytes of adults with rheumatoid arthritis. These data confirm the necessity of evaluation of various SOD classes and suggest the interest of biochemical tests in granulocytes for early diagnosis and better comprehension of tissue damage due to inflammation.
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The exact significance of a reported androgen deficiency in women with lupus has not yet been determined. The authors decided to study plasma androgen concentrations not only in lupus, but also in other auto-immune diseases as well as non-auto -immune diseases. 43 patients (rheumatoid arthritis (RA): 10; systemic lupus erythematosus (SLE): 11; multiple sclerosis (MS): 11; patients without auto-immune disease: 11) were compared to 13 normal women. The age and the hormone concentrations of these different groups were compared by analysis of variance and by the Kruskal-Wallis test. A statistically significant reduction in androgen levels was only detected in the women with lupus. It therefore appears that the androgen deficiency is not a non-specific consequence of any disease, that it does not represent a predisposing factor for auto-immune disease in general, but that it is specific for lupus.
Peripheral blood mononuclear cells (PBMC) of 29 patients with systemic lupus erythematosus (SLE) and 14 normal individuals were investigated for the in vitro production of anti-nuclear antibodies (ANA). Twenty-eight of 29 SLE patients but only one control spontaneously produced ANA in unstimulated PBMC. Pokeweed mitogen induced ANA synthesis in six controls. No detectable ANA was observed in B cell enriched fraction except in two cases of SLE. Recombination of B + T cell enriched fractions and PBMC supernatants from SLE patients could induce B cells to synthesize ANA. These results indicate that: (1) SLE patients spontaneously produced ANA in vitro whereas controls rarely did; (2) autoreactive clones exist in normal individuals but are kept under control and (3) T cell help is required for ANA triggering.
An analysis of 80 cases of sarcoidosis admitted to the departments of respiratory medicine (36), rheumatology (19) and internal medicine (25) over a 7 year period, revealed a wide range of clinical presentations; there was a higher incidence of associated disease and a greater number of localisations of the disease in patients admitted to the department of internal medicine than in those admitted to the other two departments. On the other hand, bronchial biopsy was more commonly positive in patients admitted to the department of respiratory medicine whose respiratory function was more disturbed than the patients in the other two departments. The patients referred to the departments of rheumatology and internal medicine without radiological respiratory involvement had respiratory function tests and positive alveolar lavages. The prognosis was the same in all three departments; 50 p. 100 were treated with steroids. The recruitment of the patients in this series allows a different evaluation of the disease compared to series reported from more specialised departments.
The in vitro production of anti-double stranded DNA antibodies (anti-DNA) by peripheral blood mononuclear cells (PBMC) was investigated in 19 patients with systemic lupus erythematosus (SLE) and in 12 normal individuals, using a micro solid phase enzyme immunoassay. PBMC from SLE patients spontaneously produced anti-DNA with a higher frequency (16 of 19) than did PBMC of controls (three of 12). In addition SLE patients produced predominantly IgG antibodies. PWM and DNA enhanced anti-DNA synthesis is spontaneously low and non-producers, but acted as inhibitors in spontaneously high producers. The partial removal of T cells decreased or abolished anti-DNA synthesis in four of nine SLE patients. In contrast the B cell enriched fractions of five of nine SLE and five of seven normal patients produced the same or higher anti-DNA levels than did the corresponding unseparated PBMC. These results suggest evidence for autoreactive B cells in SLE as well as in normals, and therefore the combination of these autoreactive B cells with helper and/or suppressor T cell disorders could lead to the over production of anti-DNA seen in different patients with SLE.
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Image analysis and Fourier transformation of the various nuclear immunofluorescence patterns observed while detecting antinuclear antibodies allow an objective and quantitative definition of the fluorescence. They also point out various IF types hidden by the main pattern, without having to dilute the test serum. They make obvious the difference between speckled and reticular patterns, and reveal the existence of intermediate states. The usual nuclear IF patterns (homogeneous, ring, nucleolar, reticulated, speckled and diffuse) may be grouped, according to their photo emission, into nuclear and subnuclear patterns. The first group includes homogeneous, annular and passive nucleolar IF. The second group is composed of speckled, reticulated, mixed, and active nucleolar IF. Alternatively, these aspects may be grouped into three types: homogeneous nuclear IF (homogeneous and ring), heterogeneous nuclear IF (speckled, reticulated and mixed) and nucleolar IF (active or passive). Diffusion can affect or not these aspects and does not apply to a special type or pattern. Image analysis and the study of the image spatial spectrum lead to automated recognition of the IF types, and later on, to the discrimination of antinuclear antibodies.
The authors report 11 cases of solitary plasmocytoma of the spine. This tumour mainly affects men (9 cases) before the age of myeloma (average age 56 years). The back pain is associated with radicular irradiation (9 cases) and objective neurological signs (5 cases). The site was dorsal (5 cases), lumbar (5 cases) and rarely sacral (1 case). The vertebral lesion was either lysis (5 cases), a very characteristic polycystic appearance (5 cases) or common vertebral collapse (1 case). A lesion of the posterior arch was common (9 cases). A monoclonal immunoglobulin was demonstrated in the serum of 7 patients. Radiochemotherapy resulted in a reduction (2 cases) or complete regression (3 cases) of the monoclonal component. Radiotherapy alone did not prevent an increase of the monoclonal peak in 2 cases, nor the later occurrence of a monoclonal immunoglobulin in 2 other cases. An increase in polyclonal Ig. was an early sign of remission and their fall heralded myelomatous dissemination. The patients were followed up for an average of 6 years (range 1-16 years). The solitary course varied from 3 months to 16 years. Four patients developed metastatic plasmocytoma; 3 had medullary invasion after 1, 4, and 10 years.
The authors present 5 cases of monoarthritis which revealed adjacent bone tumours: a bony metastasis, a fibrosarcoma and three bone lymphomas. In three cases, the synovial histology showed lesions of non-specific synovitis without neoplastic invasion. A review of the literature demonstrates the rarity of these mono- or oligo- arthrites adjacent to bone tumours and two types can be distinguished: neoplastic invasion of the synovium or reactive non-specific synovitis without invasion.
The authors report a case of hypophosphoremic osteomalacia due to a soft tissue tumor. This case confirm 1,25 (OH)2 cholecalciferol deficiency. Treatment with phosphorus and 1,25 (OH)2 cholecalciferol cured osteomalacia. Accountable tumor (villonodular synovitis) had never been described previously.
The dysimmune state associated with rheumatoid arthritis was approached by the study of a T lymphocyte function, the production of helper factor: Interleukin 2 (I12). This production was measured in 11 patients in comparison with 9 controls. The I12 activity is significantly higher in the patient group. Several mechanisms may be involved in this over-production. The radiosensitive T suppressor function, which was also investigated in this study, was the same in the two groups, so can not explain this overproduction. However, the radiosensitive suppressor function is very variable in the patients, suggesting a clinical correlation which could not be confirmed in this small group of subjects.
We conducted a prospective study of the rheumatological manifestations in 20 patients with adrenal failure: 15 women and 5 men with a mean age of 56. Osteo-articular pathology was observed in 19 of the 20 cases (95%). The painful manifestations presented as arthralgia, myalgia or episodes of peri-arthritis; they were associated with active phases of the endocrine disease in 9 cases (45%). The radiological features of these patients were compared with those of age and sex matched controls who were hospitalized for other rheumatological conditions. 11 patients had radiologically visible tendinous calcifications (TC); 6 patients had 3 or more TC. The 20 patients had a total of 31 TC, which was significantly different from the controls. A related finding was calcification of the cartilages of the ears in 4 out of 10 patients (40%). Hypercalcaemia was detected in 5 cases (25%), accompanying episodes of decompensation of the adrenal failure. The pathogenesis of the tendinous calcifications is not clear. Mineralocorticoid treatment can not be considered to be a major aetiological factor for CT, calcification of the ears nor the pain, as its use was very constant. Thus, tendinous calcifications, which have rarely been reported to date, could explain a large part of the painful manifestations of adrenal failure.
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Twenty-five inpatients with chronic inflammatory rheumatic disease were entered into a double blind crossover trial. Consecutive treatment regimens consisted of a single daily dose of Bi-Profenid 150 mg at 8 pm for 3 days and a single placebo tablet at 8 pm for 3 days. Order of treatment regimens was randomly assigned. Bi-Profenid proved highly superior to placebo with a very significant (p less than 0.01) difference in effectiveness on nocturnal pain, morning stiffness and pain evaluated on the pain scale. During the short treatment period no significant clinical side-effects were recorded. The authors conclude that Bi-Profenid is effective at a daily dosage of 150 mg, thus enabling to adjust prescriptions to actual needs when pain is not continuous throughout the 24 hours.