[Immunosuppression: antilymphocyte antibodies].
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Biomedical subjects
Publications and source records attributed to D Abramowicz.
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Balb/c mice made chimaeric by neonatal injection of semi-allogeneic (A/J x Balb/c)F1 hybrid spleen cells develop anti-DNA and rheumatoid factor-like antibodies in the context of hypergammaglobulinaemia with marked elevation of IgG1 and IgE serum levels. Chimaeric mice also display increased levels of antibodies to different haptens and to tobacco mosaic virus (TMV). The allotypic marker of the A/J strain is present on anti-DNA and anti-hapten antibodies. In addition, spleen cells of chimaeric mice spontaneously produce high levels of IgG1 and anti-DNA antibodies in vitro and this hyperactivity is abolished after lysis of donor lymphocytes. These findings indicate that polyclonal activation of donor B cells plays an important role in this model of autoimmunity.
Newborn Balb/c mice received a single neonatal injection of either (A/J x Balb/c) F1 hybrid spleen cells, T-cell-depleted (A/J x Balb/c) F1 hybrid spleen cells, or T-cell-depleted fully allogeneic A/J spleen cells. Chimerism was followed longitudinally during the life span by the detection of circulating donor allotype. At sacrifice, the percentage of donor cells in the spleen was measured, and cytotoxic T lymphocyte (CTL) reactivity to the tolerogen was tested. We found that T cell depletion of the semiallogeneic inoculum did not modify its capacity to generate persistent chimerism and CTL tolerance, while T-cell-depleted allogeneic cells were intrinsically deficient both in the induction and in the long-term maintenance of chimerism and CTL unresponsiveness.
Balb/c neonates injected with semi-allogeneic (A/J x Balb/c) F1 hybrid spleen cells develop an autoimmune disease associated with an immune-complex glomerulonephritis. The successful induction and maintenance of B cell chimerism is required for the occurrence of autoimmunity. The percentage of chimeric mice displaying autoimmune features increases in parallel with the number of cells injected at birth. T cell depleted inocula although readily inducing B cell chimerism were found unable to induce hypergammaglobulinaemia, circulating immune complexes and glomerulonephritis. IgG1 is the most and IgG3 the least represented IgG isotype among the immunoglobulins deposited in the glomeruli. Immunoglobulins bearing donor (A/J) allotype are detected in the glomeruli of six out of 11 chimeric mice. Rheumatoid factor activity is significantly concentrated within the immunoglobulins eluted from the kidneys, whereas anti-DNA activity is not.
Allogeneic interactions associated with experimental graft-versus-host reaction are sometimes responsible for the development of autoantibodies, immune complex lesions and malignant lymphocytic proliferation. Hypergammaglobulinaemia reflects the activation of B cells, and T cell-associated responses are deeply depressed. Some of these abnormalities are also found in chimera mice following injection of semi-allogeneic cells. The place of allogeneic interactions in human pathology has not yet been determined, but they might intervene in the pathogenesis of some autoimmune and lymphoproliferative diseases and in the acquired immune deficiency syndrome.
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Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death related to this disease. This report describes a case of aortic endocarditis due to Brucella abortus in an elderly farmer with known aortic stenosis. Urgent valve replacement was performed because of progressive heart failure despite appropriate antimicrobial treatment. The infection was cured with trimethoprim-sulfamethoxazole and rifampin given for 3 months after surgery. A review of the literature reports on the 38 other cases of cured brucella endocarditis made clear the need for combined antimicrobial treatment and surgical valve replacement.
Advances in immunosuppressive therapy over the past decade have led to dramatic improvements of patient and graft survival. The immunosuppression that is used is constantly evolving. The goal remains to find the best combination that will optimize long-term graft survival, while minimizing the adverse effects. It is likely that in the near future the results will even be improved further by the development of new medications with a better therapeutic index and the induction of transplant tolerance.
Three of the most frequent cancers occurring in transplant recipients affect the skin: Kaposi's sarcoma and spino- and baso-cellular carcinomas. The two latter neoplasms are often preceded by precancerous lesions such as keratosis, warts, porokeratosis and keratoacanthomas. We describe the clinical presentations of these lesions and detail the possible therapies in each case: local treatment, surgery, modulation of immunosuppression, and chemotherapy.