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B Dupont

Publications and source records attributed to B Dupont.

At least 19 recordsLinked to original sources

Novel isoforms of murine intercellular adhesion molecule-1 generated by alternative RNA splicing.

Intercellular adhesion molecule-1 (ICAM-1)-deficient mice, produced by homologous recombination and previously recognized to be devoid of the common form of ICAM-1, are shown to express residual amounts of ICAM-1 Ag in thymus and lung. We demonstrate that this expression of ICAM-1 is possible because the mutated exon 5 in these animals has been skipped by alternative splicing of RNA. Three different alternative isoforms of ICAM-1 are expressed in mutant mice. Moreover, two of these isoforms are expressed in wild-type mice together with two additional alternative isoforms that cannot be produced in mutant mice. All alternatively spliced isoforms of ICAM-1 detected are missing complete extracellular Ig domains. In both mutant and wild-type mice, expression of alternatively spliced isoforms is up-regulated following stimulation of animals with LPS. Furthermore, all alternative isoforms of ICAM-1, except one, retain the ability to bind to the well-recognized ICAM-1 counter-receptor LFA-1. These findings, along with the restricted tissue distribution in mutant mice, indicate that alternative isoforms of ICAM-1 are significant physiologic adhesion structures which could play a distinct role in the functioning of the immune system of intact animals.

Alternative Splicing

[Infectious complications of implantable catheters in HIV infected patients. Retrospective study of 46 patients].

OBJECTIVES: Investigate the rate of infection in HIV positive patients with an implantable venous access device. METHODS: Forty-six totally implantable venous access devices (port-a-cath, PAC) were inserted in 46 HIV infected patients between January 1990 and May 1992. We analyzed the rate of infectious complications and tried to find predictive factors. RESULTS: There were five infectious complications in five patients. The total complication rate was 0.06 per 100 catheter days. Staphylococcus aureus was responsible in two cases, Staphylococcus epidermidis was responsible in one case and Acinetobacter in one case. No predictive factor was recognized. CONCLUSION: The rate of PAC infection was lower than in other published studies concerning HIV-infected patients. Totally implantable central venous access devices play an increasingly important role in the clinical management of HIV-related diseases. We have shown that the PAC device is safe and convenient in HIV-infected patients.

AIDS-Related Opportunistic Infections

Successful treatment of a brain abscess due to Trichoderma longibrachiatum after surgical resection.

A case of brain abscess due to Trichoderma longibrachiatum in a leukemic patient with prolonged neutropenia is reported. Definitive cure was achieved after neurosurgical resection of the abscess and prolonged antifungal therapy. Trichoderma is a filamentous fungus species, which is only exceptionally pathogenic in humans. This genus and particularly the species Trichoderma longibrachiatum should be added to the growing list of fungi causing infection in immunocompromised patients.

Adolescent

Value of liver biopsy for the rapid diagnosis of infection in human immunodeficiency virus-infected patients who have unexplained fever and elevated serum levels of alkaline phosphatase or gamma-glutamyl transferase.

We prospectively determined the value of liver biopsy for microbiological diagnosis of infection in patients infected with the human immunodeficiency virus (HIV) who had unexplained fever and whose serum levels of alkaline phosphatase or gamma-glutamyl transferase were at least 1.5 times the upper limit of normal. From December 1989 to December 1991, 108 HIV-infected patients were referred to the Liver Unit at Hôpital Laënnec (Paris) with liver abnormalities related to viral hepatitis (generally chronic), AIDS-related sclerosing cholangitis, or nonspecific lesions (detected on histologic examination). Twenty-four patients had unexplained fever and increased levels of alkaline phosphatase or gamma-glutamyl transferase, and none had evidence of hepatobiliary disease. All 24 patients had undergone routine microbiological tests to determine the cause of their chronic fever. The results of all microbiological tests were negative. We performed liver biopsies for these 24 patients and examined the specimens by means of standard direct microbiological techniques; in addition, the specimens were cultured, the specimens were analyzed by standard histopathologic methods, and specific histologic studies for fungi, mycobacteria, and viruses were performed. A microbiological diagnosis was made in 13 (54%) of the 24 cases within 12 hours to 3 days of the liver biopsy. In conclusion, liver biopsy is a powerful diagnostic tool for rapid diagnosis of infection in HIV-infected patients who have unexplained fever and abnormal liver function test results.

AIDS-Related Opportunistic Infections

Brain stem encephalitis due to varicella-zoster virus in a patient with AIDS.

We describe a patient infected with human immunodeficiency virus (HIV) who had localized brain stem encephalitis due to varicella-zoster virus (VZV) and no cutaneous eruption. Diagnosis of the infection was based on the presence of Cowdry type A intranuclear inclusions in neurons, astrocytes, and oligodendrocytes positive for VZV (as shown by immunochemical staining). Although this infection is rare, we demonstrate the need for clinicians to include VZV infection in the differential diagnosis of rapidly progressive multiple cranial nerve palsies in HIV-infected patients, particularly because specific treatment for VZV infection is effective and relatively safe.

Acquired Immunodeficiency Syndrome

Fluconazole concentrations in saliva from AIDS patients with oropharyngeal candidosis refractory to treatment with fluconazole.

Fluconazole (FCZ) has been extensively used as a primary therapy for oropharyngeal candidosis in AIDS patients. Clinical resistance to FCZ is now encountered, often related to decreased susceptibility of the isolate in vitro. We wondered if low levels in saliva play a role in the therapeutic failure, especially in patients complaining of dry mouth. Sixteen AIDS patients treated for oropharyngeal candidosis with FCZ were studied. MICs for the isolates were determined. Serum and saliva samples were collected to measure FCZ levels with a bioassay using paper disks loaded with the clinical specimens. We showed that (i) paper disks were convenient for collecting saliva in patients with dry mouth; (ii) levels in saliva depended on the FCZ dosage regimen but did not correlate with the response to therapy; (iii) correlation between concentrations in saliva and serum was poor and independent of clinical response to treatment, other therapies, or decreased salivation; and (iv) levels in saliva were always lower than MICs in patients who failed to respond to treatment. In conclusion, therapeutic failures are more likely to be related to in vitro resistance of the isolate to FCZ or insufficient dosage regimen than to decreased salivary secretion.

Acquired Immunodeficiency Syndrome

Balint's syndrome.

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Acquired Immunodeficiency Syndrome

[Uncommon fungal maxillary sinusitis of dental origin due to Scedosporium prolificans].

This is the first case report of an exceptional maxillary infection due to Scedosporium prolificans. This recently discovered fungus was identified in the sinus. In the literature, it has been observed at different locations. Identification requires careful sample taking for mycology and pathology studies emphasizing the importance in maxillary surgery. This pathogenic fungus is very invasive, particularly in immunodepressed or immunocompromised patients. Therapeutic modalities vary with the patient's immune status.

Adult

[Prevention of Pneumocystis carinii pneumonia associated with HIV infection using pentamidine aerosols. Retrospective study of 465 cases].

OBJECTIVES: At least 80% of human immunodeficiency virus (HIV)-positive patients not given prophylaxis therapy against Pneumocystis carinii develop pneumonia, a major cause of morbidity and mortality. We therefore retrospectively evaluated prophylaxis protocols given from March 1988 to July 1991 at the Pasteur Institute Hospital. METHODS: Pentamidine aerosols were prescribed for 456 HIV-positive patients as primary or secondary prophylaxis. From March 1988 to November 1989 the dose was 4 mg/kg pentamidine mesylate once a month for primary prophylaxis and 4 mg/kg twice a month for secondary prophylaxis. From November 1989 pentamidine isethionate was given at the dose of 300 mg once a month. RESULTS: Tolerance was generally good, treatment had to be discontinued in only 2 of the 456 patients due to side effects. Pneumocystis carinii pneumonia was diagnosed in 4.9% of the treated patients, but in only 2.9% of those who were compliant. Pneumocystis carinii pneumonia occurred in very immunodepressed patients and radiologically appeared as an interstitial or alveolo-interstitial syndrome, often with a macronodular element, in 65% of the patients. CONCLUSION: The results of this retrospective study confirm the prophylactic value of pentamidine aerosols given after trimethoprim-sulfamethoxasol.

AIDS-Related Opportunistic Infections

CD28 is associated with and induces the immediate tyrosine phosphorylation and activation of the Tec family kinase ITK/EMT in the human Jurkat leukemic T-cell line.

T lymphocytes require two signals to be activated. The antigen-specific T-cell receptor can deliver the first signal, while ligation of the T-cell surface molecule CD28 by antibodies or its cognate ligands B7-1 (CD80) or B7-2 has been demonstrated to be sufficient for the delivery of the second signal. Signaling via CD28 and the T-cell receptor results (i) in their costimulation of T cells to produce numerous lymphokines including interleukin 2 and (ii) in the prevention of anergy induction. Little is known about the pathway by which CD28 mediates its signals except that protein-tyrosine phosphorylation is involved. We show here in human Jurkat cells that the Tec-family protein-tyrosine kinase ITK/EMT (p72ITK/EMT) is associated with CD28 and becomes tyrosine-phosphorylated and activated within seconds of CD28 ligation. This tyrosine phosphorylation of p72ITK/EMT is rapid (within 30 sec), occurs in the absence of LCK activation, and precedes tyrosine phosphorylation of the guanine nucleotide exchange factor VAV. Secondary crosslinking of CD28 is unnecessary for the induced tyrosine phosphorylation of p72ITK/EMT. Thus, tyrosine phosphorylation of p72ITK/EMT may represent one of the earliest events in CD28 signaling. This demonstrates that a member of the Tec family of protein tyrosine kinases, similar to members of the Src and Syk families, plays a role in the activation of T cells. Furthermore, the data demonstrate that p72ITK/EMT, and by analogy other members of the Tec family, responds to extracellularly generated signals.

CD28 Antigens

Activation of src family kinase lck following CD28 crosslinking in the Jurkat leukemic cell line.

T lymphocytes require a signal via their antigen specific receptors (the T cell receptors) and an antigen independent costimulatory signal. Signals through CD28 can costimulate T cells in the presence of limiting amounts of T cell receptor signal, or in the presence of PMA, providing this second signal. CD28 signaling is known to involve the activation of protein tyrosine kinases. Using the Jurkat leukemic cell line as a model, we have tested CD28 crosslinking for its effects on the protein tyrosine kinases p56lck. We report that following crosslinking of CD28, p56lck kinase activity is increased. Crosslinking CD28 causes a shift in the relative mobility of p56lck from 56 to 60 kD similar to that seen after crosslinking of CD2 and CD4, cell surface receptors known to be associate with and activate p56lck. Finally, lck could be found in anti-CD28 immunoprecipitates in exponentially growing Jurkat and in "activated" CD28 (i.e., cross linked), but not in CD28 in resting Jurkat cells. These findings suggest an important role for p56lck in CD28 signal transduction.

Animals