[Anaphylactoid shock following Alloferin].
Reports of allergic complications related to Alloferin are very infrequent. We report a case of anaphylactoid reaction to this drug. The diagnosis was confirmed by intradermal testing.
Alcuronium↗
Biomedical subjects
D Peest
Publications and source records attributed to D Peest.
A plasma clot culture system for growing and antiproliferative drug sensitivity testing of myeloma stem cells.
An easy-to-perform clonogenic culture system for myeloma stem cells is presented which approaches the patient's in vivo situation more closely and therefore seems particularly well-suited for antiproliferative drug sensitivity assays. Bone marrow cells are propagated in clotted autologous or allogenic plasma that is enriched with 2-mercaptoethanol, insulin, and synthetic nucleotides and co-factors for nuclear synthesis, no feeder layer or conditioned medium is necessary. Clusters and colonies consisting of between 8 and 60 cells readily formed within 6-8 days after cloning yielding a plating efficiency between 0.12 and 2.16%. A linear relationship between the number of cells plated and colony formation was found from 10(5) through 2 X 10(6) cells plated. The successful growth rate for 65 tests from 53 patients amounted to 90.8%. Morphological and histochemical examination of the clusters revealed lymphoid cells at various stages of maturation ranging from lymphocytic and lymphoblastoid to lymphoplasmacytic and plasma cells. Tumor origin of the clones was demonstrated by immunofluorescence studies in which Ig-positive cells stained only for the heavy and light chain isotypes identical to those of the patient's serum paraprotein. Anti-idiotypic antisera confirmed the patient's specific malignant phenotype of the colonies formed. The technique of the assay is described in detail.
Cell Division↗
In vitro immunoglobulin production by peripheral blood mononuclear cells from multiple myeloma patients and patients with benign monoclonal gammopathy. Regulation by cell subsets.
Peripheral blood mononuclear cells (PBM) from four patients with IgG myeloma and four patients with benign monoclonal gammopathy (BMG) were stimulated with pokeweed mitogen (PWM), and the in vitro immunoglobulin production over 7 days was measured with an enzyme-linked immunosorbent assay. All myeloma patients were sufficiently treated with cytostatic drugs. Their PBM did not produce monoclonal Ig in vitro, as opposed to PBM from two patients with BMG. Unseparated PBM from myeloma patients produced smaller amounts of polyclonal Ig than unseparated cells from normal donors. However, macrophage-depleted PBM from myeloma patients produced amounts of Ig comparable to those of normal donors when autologous or allogeneic adherent cells were returned in defined numbers. T cells from three of the four myeloma patients could provide help for the Ig production by B cells from healthy donors. These results indicate that functionally normal polyclonal B cells circulate in the blood of myeloma patients. The circulating T-cell population also has no obvious defect. In contrast, blood macrophages seemed to be altered with respect to their regulating function for polyclonal Ig production. The results obtained by using cell populations from patients with BMG did not differ from those of healthy people.
Adult↗
[Terminal B-cell maturation and immunoglobulin synthesis in vitro in primary and secondary immune deficiencies].
Peripheral blood lymphocytes (PBL) from patients with various forms of primary and secondary immunodeficiencies and from 30 healthy control persons were examined for their capacity to show terminal B-cell maturation and immunoglobulin (Ig) synthesis in vitro following pokeweed mitogen (PWM) stimulation. PBL were cultured for 9 days with or without PWM and the percentages of B-cells or plasma cells with strongly positive cytoplasmic Ig (CIg+) were determined by indirect immunofluorescence on methanol fixed cytocentrifuged lymphocyte smears. In addition, newly synthesized IgA, IgG and IgM was measured in the cell free culture supernatant by means of a sensitive microplate ELISA. In 29 out of 30 control cultures the proportion of CIg+-cells increased markedly following 9-day stimulation with PWM. CIg+-cells and newly synthesized Ig were significantly correlated. In a group of 18 patients with common variable immunodeficiency (CVID) maturation to CIg+-cells was greatly impaired and the in vitro production of IgA and IgG was reduced. Two infants with severe combined immunodeficiency (SCID) failed to produce Ig prior to and following haplo-identical bone marrow transplantation despite the presence of immature B-cells. A heterogeneous group of secondary immunodeficiencies showed different forms of an impaired terminal B-cell maturation and a reduced capacity to synthesize Ig in vitro. The described PWM culture techniques in combination with the evaluation of CIg+-cells and the measurement of newly synthesized Ig in the culture supernatant proved to be a reliable in vitro correlate for terminal B-cell maturation and represent an important tool for the classification of humoral immunodeficiencies.
Adolescent↗
In vitro production of monoclonal and polyclonal immunoglobulins by peripheral blood mononuclear cells in human plasma cell myeloma.
The in vitro monoclonal and polyclonal immunoglobulin (Ig) production of peripheral blood mononuclear cells was studied in human multiple myeloma (four IgG myelomas, one IgA myeloma) and in one patient with benign monoclonal gammopathy. Using an enzyme-linked immunosorbent assay with anti-class-specific antisera and antisera against idiotypic structures on the myeloma protein, it was possible to quantitate separately monoclonal and polyclonal Ig of the same class in cell culture supernatants. After stimulation with pokeweed mitogen (PWM) patients' cells produced lower amounts of polyclonal Ig than cells from healthy adults. In contrast, production of monoclonal Ig could not be enhanced by PWM. Moreover, the kinetics of monoclonal Ig production was different from that of polyclonal Ig. Myeloma cells contained large amounts of monoclonal Ig while their content of polyclonal Ig was low. A rapid release of preformed monoclonal Ig during the first day of culture was not inhibited by puromycin. A later phase of release was partly suppressed by puromycin and was probably caused by active protein synthesis.
Adult↗
T cells in monoclonal gammopathies.
Subpopulations of human T lymphocytes were analysed by monoclonal antibodies (OKT3, OKT4, OKT8) in healthy controls and in patients with multiple myeloma (MM), Waldenström's macroglobulinemia (WM) and benign monoclonal gammopathy (BMG). Lymphocytes forming rosettes with SRBC correlated well with T cells staining in indirect immunofluorescence by OKT3 monoclonal antibodies. The relative and absolute numbers of OKT4+ T cells were significantly lower in patients than in controls. Though, the percentage of OKT8+ T cells was increased in patients, the total OKT8+ cell counts were normal in all patient groups. The ratio between OKT4+ and OKT8+ lymphocytes was low in the groups of treated MM and of WM patients compared to controls (P less than 0.001). Moreover, the ratio was lower than the normal range in 27% of BMG and 38% of untreated MM patients. The imbalance between OKT4+ and OKT8+ T cells in untreated MM was more pronounced in clinical stage III patients than in stage I and II patients. The most pronounced changes were noted in treated MM patients. The significance of the altered T cell subsets in monoclonal gammopathies with regard to polyclonal and tumor B cell regulation remains to be established.
Adult↗
[High-dose immunoglobulin therapy of chronic idiopathic thrombocytopenic purpura in adults].
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Adolescent↗
Idiotype-bearing lymphoid cells in plasma cell neoplasia.
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Aged↗
Idiotype-bearing peripheral blood lymphocytes in human multiple myeloma and Waldenström's macroglobulinaemia.
Antisera raised against idiotypic determinants (ID) of myeloma proteins and macroglobulins have been used to differentiate peripheral blood lymphocyte (PBL) populations from individual patients. ID-positive lymphocytes not resembling plasma cells have been regularly found in peripheral blood in these diseases. For further characterization ID-positive lymphocytes were enriched from the peripheral blood by affinity chromatography using heterologous anti-idiotypic sera. Two patients with IgG myeloma, one patient with Waldenström's macroglobulinaemia and two persons with benign monoclonal hyperglobulinaemia (BMH) were examined by this technique. The ID-positive PBL population was shown to be heterogeneous with respect to non-tumour-specific surface markers, such as sheep erythrocytes (SRBC), Fc and C receptors. Tumour-specific idiotypic determinants will thus allow a more correct recognition of the total tumour cell compartment in these diseases.
Adult↗
Peripheral blood lymphocyte subpopulations in multiple myeloma.
Antisera raised against idiotypic determinants of myeloma proteins and macroglobulins have been used to differentiate peripheral blood lymphocytes populations from individual patients. I.D.-positive lymphocytes not resembling plasma cells have been regularly found in peripheral blood in these diseases. This lymphocyte population is heterogeneous with respect to non-tumor-specific surface markers, such as SRBC-, Fc- and C-receptors. Tumor specific idiotypic determinants will thus allow a more correct recognition of the total tumor cell compartment in these diseases.
Animals↗
Serum antibodies against common antigens of bacterial lipopolysaccharides in healthy adults and in patients with multiple myeloma.
The incidence of infections caused by gram-negative bacteria is increased in patients with multiple myeloma due to secondary humoral immunodeficiency. In order to diagnose patients with increased susceptibility to gram-negative infections, serum antibodies against common determinants of lipopolysaccharides (lipid A and core-polysaccharide) were determined by a rapid enzyme-linked immunosorbent assay (ELISA). It was possible to define a group of patients at high risk of contracting gram-negative infections using this test. Intravenous IgG preparations used as a substitute were shown to contain antibodies against these common antigens. However, it is suggested that the clinically recognized efficacy of these preparations could be due to their containing anti-LPS antibodies.
Antibodies, Bacterial↗