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C Nilsson

Publications and source records attributed to C Nilsson.

At least 19 recordsLinked to original sources

Tracking the neurodegeneration of parkinsonian disorders--a pilot study.

The purpose of the study was to explore the possibilities of using diffusion tensor imaging (DTI) and tractography (DTT) for the differential diagnosis and monitoring of disease progression in idiopathic Parkinson's disease (IPD), compared with the atypical parkinsonian disorders multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). A 3.0-T MR scanner was used. DTI was acquired using a single-shot EPI sequence with diffusion encoding in 32 directions and a voxel size of 2 x 2 x 2 mm3. DTI data were analysed and DTT was performed using the PRIDE fibre tracking tool supplied by the manufacturer. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) within each tract were determined. DTI and DTT images in patients with moderate to advanced MSA demonstrated degeneration of the middle cerebellar peduncles and pontine crossing tracts, with decreased FA and increased ADC. This accounted for most of the pontine and cerebellar atrophy characteristic of this disease. In contrast, patients with PSP showed a selective degeneration of the superior cerebellar peduncle. Three-dimensional images of whole-brain white matter tracts demonstrated a reduction of cortical projection fibres in all patients with PSP. Visualization of the selective degeneration of individual fibre tracts, using DTI and DTT, adds qualitative data facilitating the differential diagnosis of parkinsonian disorders. Repeated measurements of FA and ADC values in a whole fibre tract might be used for monitoring disease progression and studying the effect of treatment in neuroprotective trials. The results are preliminary considering the small number of subjects in the study.

Adult↗

Development of a disease-specific quality of life questionnaire for children & adolescents with idiopathic thrombocytopenic purpura (ITP-QoL).

Quality of life (QoL) assessment in children with coagulation disorders is a relatively unstudied area. While hemophilia-specific questionnaires (such as Haemo-QoL) are available, no instrument for children with idiopathic thrombocytopenic purpura (ITP) has been validated yet. A disease-specific questionnaire for children with ITP was therefore developed (ITP-QoL) in three phases: (a) a preparatory phase; (b) a developmental phase; (c) a pilot testing phase. Since dimensions of Haemo-QoL were considered important for children with ITP, items were adapted, reformulated and additional dimensions were included. Two age-group versions were designed for children (aged 3-7, 8-18 years) and parents in Italian, German, and Swedish languages and were pilot tested.

Adolescent↗

Impact on the cytomegalovirus (CMV) viral load by CMV-specific T-cell immunity in recipients of allogeneic stem cell transplantation.

Patients experience cytomegalovirus (CMV) reactivation after stem cell transplantation (SCT) and need repeated courses of pre-emptive therapy. Analysis of CMV-specific immunity might help to assess the need for antiviral therapy. Forty-eight patients were studied during the first 3 months after SCT. Peripheral blood lymphocytes were stimulated by CMV antigen, and interferon (INF)-gamma production by CD3+ and CD4+ T cells was analysed. Results were correlated to transplant factors and CMV disease. Patients with INF-gamma production by CD3+ cells at 4 weeks after SCT had lower peak viral loads than patients with no such production (P=0.03). There was a similar tendency as regards CD4+ cells (P=0.09). Patients who underwent reduced-intensity conditioning (RIC) more frequently had CD3+ (48%) and CD4+ immunity (56%) 4 weeks after SCT compared with patients who received myeloablative conditioning (CD3+ 25%; CD4+ 35%). There was no effect of stem cell source, donor type or acute graft-versus-host disease. Three of 48 patients developed CMV disease and none of them had detectable INF-gamma production. CMV-specific T-cell response is associated with a lower rate of CMV replication. RIC results in improved T-cell reconstitution. Recovery of CMV-specific immunity might be delayed in patients with CMV disease. These observations suggest that detection of CMV-specific T-cells is useful in assessing the immunity against CMV.

Adolescent↗

Identification of markers for PCB exposure in plasma from Swedish construction workers removing old elastic sealants.

The objective of the present study was to identify PCB-indicators of occupational exposure related to the removal of old elastic sealants. Blood samples were collected from workers involved in removing elastic sealants. Samples were also taken from age- and sex-matched controls. A majority of the exposed workers were re-sampled after 10 months. All samples were analysed for 19 PCBs. The levels in the exposed workers were twice as high as those in the controls, 575 and 267 ng g(-1) lipid, respectively, but were essentially unchanged at the second sampling. The PCB patterns also differed. Levels of many less chlorinated PCBs were much higher in the exposed workers, compared to the controls, and principal component analysis (PCA) revealed that easily metabolized PCBs decreased in the exposed workers during the study. This finding indicates that elimination exceeded uptake during the study period, and that the safety information given to the workers had been effective. PCA was also used to identify exposure markers. The relatively persistent PCBs 56/60 and 66, the easily metabolized PCBs 44, 70 and 110 (with vicinal hydrogens in meta/para-positions) and the very persistent PCBs 153 and 180 were found to be good markers for occupational, recent occupational and background (dietary) exposure, respectively. A PCA model based on these markers was equally effective in differentiating between exposed individuals and controls, and between recent and less recent exposure, as a model based on all PCBs.

Air Pollutants↗

Relationship between maternal and child cytokine responses to allergen and phytohaemagglutinin 2 years after delivery.

Little is known at present about the relation between parental and child cytokine profiles. In this study we aimed to investigate the cytokine profile of 2-year-old children and their corresponding mothers, 2 years after delivery. Peripheral blood mononuclear cells (PBMC) were isolated from IgE-sensitized (n=15) and non-esitized (n=58) 2-year-old children and their mothers. The responses to ovalbumin, cat and phytohaemagglutinin (PHA) were investigated using the enzyme-linked immunospot (ELISpot) technique. Interferon (IFN)-gamma-, interleukin (IL)-4-, IL-10- and IL-12-producing cells were enumerated. At 2 years of age, IgE-sensitized children exhibited increased numbers of IL-4-producing cells in response to PHA and also showed an increase in IL-10- and IL-12-producing cells to allergen that was more pronounced in response to ovalbumin than to cat. A statistically significant increase in the numbers of IFN-gamma-, IL-10- and IL-12-producing cells to the allergens, but not to PHA, was found in the mothers of IgE-sensitized children irrespective of their own atopic status. IgE levels and cytokine responses were correlated between the mothers and their children, indicating that cytokine responses to both allergen and PHA might be governed by genetic factors. We speculate that the increased cytokine response to allergen, as opposed to the allergic status of the mother, might be a better predictor and/or a risk factor for the child to develop IgE-sensitization in early life.

Allergens↗

ImmunoCAP Phadiatop Infant--a new blood test for detecting IgE sensitisation in children at 2 years of age.

BACKGROUND: Correct diagnosis of immunoglobulin E (IgE)-mediated disease is the prerequisite for secondary allergy prevention during early childhood. OBJECTIVE: To evaluate the diagnostic efficacy of a new blood test, Phadiatop Infant, in detecting IgE sensitisation to food and inhalant allergens among children at 2 years of age. METHODS: Children (n = 239) were followed prospectively from birth to 2 years of age for the presence of IgE sensitisation and the development of atopic manifestations. Immunoglobulin E sensitisation was evaluated by skin prick test (SPT) and analysis of allergen-specific IgE antibodies in plasma to food and inhalant allergens. The children were classified into three groups: IgE-sensitised, non-IgE sensitised and inconclusive, depending on SPT and allergen-specific IgE results. RESULTS: Twenty-six (11%) of the children were classified as IgE-sensitised, 182 (76%) as non-IgE sensitised and 31 (13%) as inconclusive. Phadiatop Infant was positive in 50 (21%) of the children. Ten children (4%) with identified IgE antibodies against the selected food and inhalant allergens showed negative Phadiatop Infant. Three children showed positive Phadiatop Infant but were negative in the other tests performed. These results correspond to positive and negative predictive values for Phadiatop Infant of 89 and 99%, respectively. Children with clinical symptoms of atopic diseases had significantly increased levels for Phadiatop Infant (P < 0.01). CONCLUSION: Phadiatop Infant appears to be a reliable alternative to SPT and the measurement of allergen-specific IgE antibodies in plasma for detecting clinically important IgE sensitisation among children at 2 years of age.

Age Factors↗

Diagnosis of early preterm labour.

While preterm contractions occur almost as often extremely preterm as they do closer to term, birth due to spontaneous preterm labour before 27 weeks of gestation is rare, accounting for 0.05-0.7% of all births in different populations. Although the likelihood that uterine contractions before 27 weeks of gestation represent true preterm labour is low, the risk of adverse outcome in such cases is high. A correct diagnosis is important, and a useful diagnostic test should have a high sensitivity. In most reports, only 30-40% of women hospitalised for spontaneous preterm labour experience a preterm birth, suggesting a low positive predictive value of clinical diagnosis based on uterine contractions and vaginal examination. Transvaginal ultrasonographic scanning (TVUSS) of cervical length has shown a high sensitivity for preterm birth, 90-100% for preterm birth before 33-35 weeks, using a liberal cutoff at 30 mm. Assessment of cervicovaginal fetal fibronectin (FFN) levels has shown a sensitivity of about 80%. Adding FFN assessment to TVUSS might contribute insignificantly to the prediction of preterm birth. In a retrospective study of 147 women with spontaneous preterm labour and intact membranes before 27 weeks in our department, 61% of hospitalised women and 77% of women receiving tocolytic infusion therapy delivered before 32 weeks. Among 66 singleton pregnancies delivered before 32 weeks, at admission, 94% either had an effaced cervix or cervix with >/=2 cm dilation (74%), vaginal bleeding (61%) or serum C-reactive protein level >20 mg/l (40%), whereas one of these findings only was present in 18% of women who delivered at later gestations. Among 132 women with symptoms of spontaneous preterm contractions before 27 weeks not admitted for hospital care, only 2 (1.5%) delivered before 32 weeks, not significantly higher than for all other women (0.6%). Although TVUSS may be useful when the diagnosis of spontaneous preterm labour is in doubt, the main predicament in early spontaneous preterm labour may not be to predict preterm birth but to prevent it, since many women appear in advanced labour or with manifest chorioamnionitis.

Biomarkers↗

The fragile X tremor ataxia syndrome in the differential diagnosis of multiple system atrophy: data from the EMSA Study Group.

The recent identification of fragile X-associated tremor ataxia syndrome (FXTAS) associated with premutations in the FMR1 gene and the possibility of clinical overlap with multiple system atrophy (MSA) has raised important questions, such as whether genetic testing for FXTAS should be performed routinely in MSA and whether positive cases might affect the specificity of current MSA diagnostic criteria. We genotyped 507 patients with clinically diagnosed or pathologically proven MSA for FMR1 repeat length. Among the 426 clinically diagnosed cases, we identified four patients carrying FMR1 premutations (0.94%). Within the subgroup of patients with probable MSA-C, three of 76 patients (3.95%) carried premutations. We identified no premutation carriers among 81 patients with pathologically proven MSA and only one carrier among 622 controls (0.16%). Our results suggest that, with proper application of current diagnostic criteria, FXTAS is very unlikely to be confused with MSA. However, slowly progressive disease or predominant tremor are useful red flags and should prompt the consideration of FXTAS. On the basis of our data, the EMSA Study Group does not recommend routine FMR1 genotyping in typical MSA patients.

Aged↗

Bacterial lipopolysaccharide both renders resistant mice susceptible to mercury-induced autoimmunity and exacerbates such autoimmunity in susceptible mice.

The initiation and severity of systemic autoimmune diseases are influenced by a variety of genetic and environmental factors, in particular bacterial infections and products. Here, we have employed bacterial lipopolysaccharide (LPS), which non-specifically activates the immune system, to explore the involvement of innate immunity in mercury-induced autoimmunity in mice. Following treatment of mouse strains resistant [DBA/2 (H-2(d))] or susceptible [SJL(H-2(s))] to such autoimmunity with mercuric chloride and/or LPS or with physiological saline alone (control), their immune/autoimmune responses were monitored. Resistant DBA/2 mice were rendered susceptible to mercury-induced autoimmunity by co-administration of LPS, exhibiting pronounced increases in the synthesis of IgG1 and IgE, high titres of IgG1 deposits in the kidneys and elevated circulating levels of IgG1 antibodies of different specificities. Furthermore, the percentages of the T cells isolated from the spleens of DBA/2 mice exposed to both mercury and LPS that produced pro-inflammatory cytokines were markedly increased by in vitro stimulation with phorbol myristate acetate (PMA) and ionomycin, which was not the case for splenic T cells isolated from mice receiving mercuric chloride, LPS or saline alone. In addition, exposure of susceptible SJL mice to mercury in combination with LPS aggravated the characteristic features of mercury-induced autoimmunity, including increased synthesis of IgG1 and IgE, the production of IgG1 anti-nucleolar antibodies (ANolA) and the formation of renal deposits of IgG1. In summary, our findings indicate that activation of the innate immune system plays a key role in both the induction and severity of chemically induced autoimmunity.

Animals↗

Enhanced cellular immunity and systemic control of SHIV infection by combined parenteral and mucosal administration of a DNA prime MVA boost vaccine regimen.

The immunogenicity and protective efficacy of a DNA and recombinant modified vaccinia Ankara (MVA) vaccine administered by two different routes were investigated. DNA expressing HIV-1 IIIB env, gag, RT, rev, tat and nef, and MVA expressing HIV-1 IIIB nef, tat and rev and simian immunodeficiency virus (SIV) macJ5 gag/pol and vaccinia HIV-1 env, were used as immunogens. Four cynomolgus macaques received DNA intramuscularly (i.m.) at month 0 and intrarectally (i.r.) and intra-orally (i.o.) at 2 months, followed by MVA i.m. at 4 months and i.r. and i.o. at 8 months. Another group of four monkeys received the same immunogens but only i.m. Overall, stronger cellular immune responses measured by ELISPOT and T-cell proliferation assay were detected in the group primed i.m. and boosted mucosally. Following homologous intravenous simian-human immunodeficiency virus (SHIV) challenge, one of eight vaccinated animals was completely protected. This monkey, immunized i.m. and i.r.+i.o., exhibited the highest levels of HIV Env, Nef and Tat antibodies, high HIV Tat cytotoxic T-lymphocyte activity and T-lymphocyte proliferative responses to HIV Env. Four weeks post-challenge none of the monkeys immunized i.m. and i.r.+i.o., and only two out of four animals immunized i.m., demonstrated detectable plasma viral RNA levels. In contrast, all eight control animals had demonstrable plasma viral RNA levels 4 weeks post-challenge. Thus, stronger cellular immune responses and reduction of challenge virus burden were demonstrated in animals immunized i.m. as well as mucosally, compared with animals immunized i.m. only. The breadth and magnitude of the induced immune responses correlated with protective efficacy.

Animals↗

Low numbers of interleukin-12-producing cord blood mononuclear cells and immunoglobulin E sensitization in early childhood.

BACKGROUND: Successful pregnancies are associated with skewing towards a Th2 cytokine profile. Cytokine responses to allergens can be detected in cord blood mononuclear cells (CBMC), suggesting allergen priming already in utero. OBJECTIVE: To investigate the cytokine profile in CBMC after in vitro stimulation with allergens and to relate the responses to the outcome in terms of allergic disease at 2 years of age. METHODS: CBMC were isolated from 82 children. The responses to ovalbumin (OVA), birch, cat and phytohaemagglutinin (PHA) were investigated by the ELISpot technique. The numbers of IFN-gamma-, IL-4- and IL-12-producing CBMC were counted for each stimulation. The children were followed prospectively; skin prick test (SPT) and RAST towards food and inhalant allergens were assessed at 24 months of age. RESULTS: Sixteen (19.5%) children were classified as IgE sensitized (positive SPT; > or =3 mm and/or RAST; > or =0.35 kUA/L). The numbers of IL-12-producing CBMC after stimulation with birch, OVA and cat were lower among IgE-sensitized children, statistically significant for cat. IFN-gamma-producing cells, did not differ in numbers between the sensitized and non-sensitized children. Children who had atopic eczema/dermatitis syndrome (AEDS) during the observation (n=53) had significantly lower numbers of IFN-gamma-producing CBMC after stimulation with OVA and cat than their non-AEDS counterparts. CONCLUSIONS: Although the numbers of infants in our study are limited our data suggest that a low number of IL-12-producing CBMC is associated with IgE sensitization during early childhood and that a reduced number of IFN-gamma-producing CBMC promotes the development of AEDS during the first 2 years of life.

Allergens↗

Class separation of buildings with high and low prevalence of SBS by principal component analysis.

In this study, we were able to separate buildings with high and low prevalence of sick building syndrome (SBS) using principal component analysis. The prevalence of SBS was defined by the presence of at least one typical skin, mucosal and general (headache and fatigue) symptom. Data from the Swedish Office Illness Study describing the presence and level of chemical compounds in outdoor, supply, and room air, respectively, were evaluated together with information about the buildings in six models. When all data were included the most complex model was able to separate 71% of the high prevalence buildings from the low prevalence buildings. The most important variable that separates the high prevalence buildings from the low prevalence buildings was a more frequent occurrence or a higher concentration of compounds with shorter retention time in the high prevalence buildings. Elevated relative humidity in supply and room air and higher levels of total volatile organic compounds in outdoor and supply air were more common in high prevalence buildings. Ten building variables also contributed to the separation of the two classes of low and high prevalence buildings.

Air Pollutants↗

Vaccination of autologous stem cell transplant recipients with live varicella vaccine: a pilot study.

A pilot study of vaccination with live, attenuated varicella vaccine for prevention of zoster was performed in autologous stem cell transplant (SCT) recipients. Nine patients were vaccinated between 3-4 months after transplantation. The antigen-specific immune response was studied by lymphocyte proliferation. No systemic side effects were seen. One of nine patients developed herpes zoster HZ during follow-up. There was a tendency for a strengthened specific immune response after SCT ( p=0.12). This pilot study shows that vaccination with live, attenuated varicella vaccine can be performed safely 3-4 months after autologous stem cell transplantation. Additional studies are needed to assess efficacy of this approach in the prevention of HZ.

Adult↗

Drying of linseed oil paints: the effects of substrate on the emission of aldehydes.

The effect of substrate on the emission of aldehydes from linseed oil paint was investigated. Plates of glass, fiberboard, gypsum board, lime mortar and wood lath were painted, and then placed into emission chambers. Samples were collected every eighth hour over 10 days with 2,4-dinitrophenylhydrazin samplers. Analysis was performed with liquid chromatography/UV-detection and mass spectrometry. Paint applied on gypsum board gave the highest total amount of emitted carbonyls, and that on wood lath gave the least. Painted glass had the highest contribution of unsaturated species, and lime mortar, the lowest. Lime mortar also had the highest momentary levels of a single species, 443 nmol/h/m2 of propanal, while fiberboard peaked at only 123 nmol/h/m2 of propanal. In turn, the emission from the painted fiberboard had the slowest decline, and thus at the end of the experiment the highest levels. All substrates gave an emission that peaked within 16 h.

Air Pollution, Indoor↗

The effect of metronidazole on busulfan pharmacokinetics in patients undergoing hematopoietic stem cell transplantation.

Busulfan (Bu) is an important component of some myeloablative regimens prior to stem cell transplantation (SCT). Over the last few years it has been shown that other drugs administered concomitantly can influence Bu pharmacokinetics. In the present study, we compared Bu concentrations (trough levels) in three groups of patients. Group A (n=5) received metronidazole as graft-versus-host disease prophylaxis during Bu treatment. Group B (n=9) received Bu only for 2 days followed by 2 days of Bu and metronidazole. Group C (n=10) was a control group that received Bu without metronidazole. The mean Bu levels for Group A receiving metronidazole during conditioning was significantly (P<0.001) higher (948+/-280 ng/ml), compared to those observed in the control group (507+/-75 ng/ml). In Group B, the administration of metronidazole resulted in a significant (P<0.001) increase in Bu levels (807+/-90 ng/ml) during the last 2 days, compared to 452+/-68 ng/ml during the first 2 days. In Group A, one patient died with multiorgan failure, three experienced veno-occlusive disease (VOD) and one developed hemorrhagic cystitis. Elevated liver transaminases (AST, ALT) and bilirubin were detected in all Group A patients. In Group B, six patients had elevated liver function tests but no VOD was observed. We conclude that metronidazole should not be administered simultaneously with Bu to avoid the high plasma levels of Bu, which may lead to severe toxicity and/or treatment related mortality.

Adolescent↗

CD14 and development of atopic disease at 2 years of age in children with atopic or non-atopic mothers.

BACKGROUND: CD14, a myeloid cell marker and LPS receptor has been acclaimed to play a role in development and manifestation of atopic allergy, as the gene encoding CD14 is located in a chromosomal region linked to total IgE levels and atopic disease. OBJECTIVE: To investigate the levels of soluble (s) and membrane bound (m) CD14 in cord blood and at 2 years of age from children with atopic or non-atopic mothers and relate these parameters to atopy development at 2 years of age. METHODS: Blood samples were collected at delivery (cord blood) and at 2 years of age among infants with atopic (n = 41) and non-atopic (n = 32) mothers. Blood samples were also obtained from mothers at the same occasions. Levels of sCD14 and total IgE were measured in plasma, and percentages of CD14+ cells were measured in cord and peripheral blood mononuclear cells. RESULTS: We observed significant differences in sCD14 levels in cord blood, where children with atopic mothers had the highest levels. The same pattern could be observed in the mothers at delivery. At 2 years of age no significant differences in sCD14 levels were observed between children with atopic mothers and children with non-atopic mothers and no association between sCD14 and atopic disease was found. Further, we observed large differences in sCD14 and mCD14 with respect to age, where newborns displayed a higher frequency of CD14+ cells compared with the 2-year-olds and the mothers. The reverse was observed for sCD14, with significantly lower values in cord blood than those seen in the 2-year-olds and mothers. CONCLUSION: Based on our findings, we suggest that CD14 could be involved in the regulation of IgE production, but that it might also be important for the maturation and development of the neonatal immune system.

Adult↗

Levels of soluble CD30 in cord blood and peripheral blood during childhood are not correlated with the development of atopic disease or a family history of atopy.

BACKGROUND: The CD30 molecule has been linked to Th2 responses. Furthermore, elevated levels of the soluble form of CD30 (sCD30) in blood as well as of the expression of CD30 on the plasma membrane of T cells are associated with atopic disease. OBJECTIVE: To assess the potential usefulness of sCD30 levels as a prognostic indicator of and/or diagnostic marker for the development of atopic disease in children. METHODS: sCD30 levels in cord blood and peripheral blood from 36 2-year-old (10 atopic and 26 non-atopic) and 74 7-year-old (35 atopic and 39 non-atopic) children were determined employing an ELISA procedure. Atopy was diagnosed on the basis of clinical evaluation in combination with a positive skin prick test. RESULTS: No significant correlation between sCD30 levels in cord blood and the development of atopic disease at 2 or 7 years of age was observed. At 7 years of age, the circulating sCD30 levels in children with atopic disease (median 41 U/mL, range 6-503 U/mL) did not differ from the corresponding values for non-atopic subjects (median 41 U/mL, range 8-402 U/mL). The same was true for children at 2 years of age. Furthermore, the sCD30 levels of children who had developed atopic eczema/dermatitis syndrome by the age of 7 years (median 49 U/mL, range 14-503 U/mL) were not significantly elevated in comparison with those of the non-atopic children. Finally, neither sCD30 levels in cord blood nor peripheral blood at 2 or 7 years of age could be linked to a family history of atopy. CONCLUSION: These findings indicate that the sCD30 concentration in cord blood is not a reliable prognostic indicator of, nor a useful diagnostic marker for, atopic disease in children up to 7 years of age. If such correlations do exist, they might be masked by age-dependent variations in the circulating levels of sCD30, which may reflect individual differences in the maturation of children's immunological responses.

Aging↗