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Biomedical subjects

C G Kallenberg

Publications and source records attributed to C G Kallenberg.

At least 217 records · Page 12Linked to original sources

The cellular immune response to cell-associated and cell-free cytomegalovirus (CMV) antigens after primary CMV-infection in non-immunocompromised hosts: development and maintenance of CMV-latency and its influence on immunocompetence.

Development and maintenance of cellular immunity to cell-associated CMV-antigens (CMVFF) was investigated in non-immunocompromised hosts during the first year (group I, n = 11) and 1 to 5 years (group II, n = 9) after a symptomatic primary CMV infection, as well as in healthy CMV-seropositive controls without a history of CMV disease (group III, n = 28). During the acute phase (0-2 months) of a primary CMV-infection CMVFF-induced lymphocyte proliferation was severely decreased compared to that in the post-illness phase (5-12 months), and to that in groups II and III. After the reconvalescent period (3-4 months) it gradually increased to levels seen in group III. In group II higher responses to CMVFF were found than in group III or during the post-illness phase of a primary infection. In general CMV-virion induced lymphocyte proliferation showed the same pattern of development as the CMVFF-induced lymphocyte response, but during the acute phase (0-2 months) a lack of correlation was observed between lymphocyte proliferation to CMVFF and CMV-virions. Lymphocyte proliferation to PHA, Con A, allogeneic lymphocytes and recall antigens were severely depressed in the acute phase of a primary CMV-infection and restored gradually to levels seen in groups II and III, with the exception of Con A-reactivity. The latter response remained depressed when compared to healthy seropositive controls, not only during the post-illness period, but also later on (group II).

Adult↗

[The significance of determining humoral defense factors: Ig isotypes, specific antibodies and complement].

The diagnosis of an immunodeficiency is made after detailed clinical and laboratory investigations. To guide these investigations the Dutch Working Group on Immunodeficiencies had made a protocol for evaluating the functioning of the immune system of patients. The protocol is based on the report 'Immunodeficiency' from a WHO scientific group. This paper discusses the value of laboratory investigations on the following aspects of the immune system: immunoglobulins and their subclasses, primary and secondary antibody responses in vivo, and the complement system. The evaluation of these components of the defense system can firmly establish possibly occurring severe immunodeficiency states. Some cases of chronic and/or recurrent infections, however, remain enigmas that have to be resolved by future investigations on the interactions of infectious agents with the immune system.

Antibodies↗

Thrombocytopenia and hemolytic anemia in a patient with mixed connective tissue disease due to thrombotic thrombocytopenic purpura.

A 33-year-old woman with mixed connective tissue disease (MCTD) presented with headache, fever, thrombocytopenia, hemolytic anemia, and renal involvement due to thrombotic thrombocytopenic purpura (TTP). She did not improve after treatment with prednisolone, fresh frozen plasma, antiplatelet agents, and prostacyclin, but a trial with vincristine resulted in a longlasting complete remission. TTP in autoimmune diseases probably results from immune mediated vasculopathy, which was demonstrated in our patient using nailfold capillary microscopy. Though TTP has many clinical and laboratory features in common with active MCTD, recognition of differences between the 2 conditions, i.e., microangiopathic hemolytic anemia and a negative Coombs' test in the former, is important because treatment in the 2 conditions differs.

Adult↗

B-cell proliferation and differentiation in systemic lupus erythematosus and mixed connective tissue disease.

Systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) are characterized by B-cell hyperactivity as manifested by spontaneous in vitro production of immunoglobulins (Ig), but pokeweed mitogen (PWM)-induced Ig synthesis of peripheral blood (PB) mononuclear cells, a T-cell dependent process, is markedly decreased. We analyzed the defective capacity to produce Ig in vitro in 11 patients with SLE and 11 with MCTD. PWM-activated PB T-cells, both from SLE- and MCTD-patients, did not differ from control T-cells in their capacity to produce B-cell growth factors (BCGF) and B-cell differentiation factors (BCDF). However, B-cell proliferative responsiveness to control T-cell factors was decreased compared to control B-cells (p less than 0.01). In contrast to PB B-cells splenic B-cells from a patient with MCTD who underwent splenectomy were highly responsive to T-cell factors in a dose dependent way. It is concluded that the defective PWM-induced Ig production of PB lymphocytes in SLE/MCTD is due to decreased responsiveness of PB B cells to T-cell factors. However, analysis of splenic lymphocytes may be more representative for evaluation of the immunoregulatory disturbances in these disorders.

Adult↗

Unexpected severe reversible cyclosporine A-induced nephrotoxicity in a patient with systemic lupus erythematosus and tubulointerstitial renal disease.

We describe a patient with systemic lupus erythematosus and impaired renal function probably mainly due to tubulointerstitial disease. After a six-week course of low-dose cyclosporine A, she developed a severe but reversible loss of glomerular filtration rate and effective renal plasma flow despite of low cyclosporine A plasma levels. Based upon the observed fall of the filtration fraction, the rise in the relative clearance of 99Tc-dimercaptosuccinic acid and the increase in proteinuria, we suggest that in this case the tubules and/or interstitium are the main targets for cyclosporine A nephrotoxicity. Neither our patient's clinical symptoms nor her serologic parameters improved possibly because of the low dosage and/or short duration of cyclosporine A treatment. We conclude that one should be cautious when treating patients with systemic lupus erythematosus and pre-existing renal disease with cyclosporine A especially when tubulointerstitial abnormalities are present and/or other nephrotoxic drugs are used.

Adult↗

Epidermodysplasia verruciformis: Langerhans cells, immunologic effect of retinoid treatment and cytogenetics.

A case study is presented of a 44-year-old negroid male with epidermodysplasia verruciformis (EV), cutaneous carcinomas, and impaired cell-mediated immunity (CMI), infected with human papillomavirus type 8 and 17. Analysis was made of (a) T6+ and HLA-DR+ Langerhans cells (LCs) by immunoperoxidase staining in lesional and clinically normal skin before and during retinoid treatment, (b) the effect of retinoid treatment on CMI in vivo and in vitro, and (c) cytogenetic aspects related to chromosomal instability. The results showed the virtual absence of T6+ and HLA-DR+ LCs in koilocytic areas of epidermis involved with EV. Light-exposed, clinically normal skin also demonstrated microscopic EV lesions largely devoid of T6+ and HLA-DR+ LCs. Retinoid treatment with etretinate (Ro 10-9359) appeared both to increase the CMI response in vitro to T-cell mitogens and to influence the in situ pattern of T6+ and HLA-DR+ LCs. The cytogenetic study did not show evidence of spontaneous or UV-induced chromosomal instability.

Adult↗

Lymphocyte subpopulations in peripheral blood and bone marrow in patients with idiopathic myelofibrosis.

In 8 patients with idiopathic myelofibrosis (IM) T and B cells were studied in view of the possibility that immunological dysfunctions are involved in initiating or contributing to the bone marrow fibrosis. In peripheral blood the absolute numbers of E-SRBC and OKT3+ lymphocytes were significantly reduced; in addition a significant decline was observed in the proportion and absolute numbers of OKT8+ cells, resulting in a reversed Leu-3a/OKT8 ratio. An impaired B cell function was observed in 4 of the 8 patients, characterized by a disturbed in vitro pokeweed mitogen stimulated immunoglobulin synthesis and low serum immunoglobulin levels. Immuno-histological studies of the bone marrow demonstrated a scarcity of T cells but normal numbers of B cells. However, no correlation was noted between the observed deviations of B and T cells and the degree of bone marrow fibrosis determined by means of bone marrow histology and serum procollagen-III levels. These data are not sufficient to support the hypothesis that immunological changes in IM are primarily involved in the process of bone marrow fibrosis.

Adult↗

Expression of class II major histocompatibility complex antigens on alveolar epithelium in interstitial lung disease: relevance to pathogenesis of idiopathic pulmonary fibrosis.

To determine whether expression of class II major histocompatibility complex antigens on alveolar epithelium is relevant to the pathogenesis of idiopathic pulmonary fibrosis (IPF) lung biopsy specimens were investigated from nine patients with IPF with or without connective tissue disease, four patients with sarcoidosis, eight patients with lung disease of presumably infectious origin, and five controls. The alveolar epithelium stained strongly with anti-Ia (HLA-DR) or Leu 10 (HLA-DS) monoclonal antibodies, in eight of nine biopsy specimens from patients with IPF, in three of four biopsy specimens from patients with sarcoidosis, in all six biopsy specimens from patients with presumably viral, mycobacterial, or pneumocystic lung disease, but not in control lung tissue, nor in two biopsy specimens from patients with bacterial pneumonia. Mononuclear cell infiltrates consisted of T4 positive (helper/inducer) lymphocytes, predominantly present in a nodular arrangement in the interstitium, and T8 positive (cytotoxic/suppressor) cells, distributed equally in the interstitium and subepithelially or intraepithelially. T8 cells outnumbered T4 cells in six of nine biopsy specimens from patients with IPF, but in none of the biopsy specimens from patients with sarcoidosis or interstitial lung disease of infectious origin. Although the expression of class II antigens on the alveolar epithelium which is infiltrated by T8 cells in IPF is consistent with local presentation of autoantigens and an ensuing local immune response, class II expression is also present in interstitial lung disease of sarcoidosis and microbial infections: its role in the pathogenesis of IPF must therefore remain speculative.

Adolescent↗