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Biomedical subjects

D Vergani

Publications and source records attributed to D Vergani.

At least 217 records · Page 12Linked to original sources
PubMed1983

Clinical application of a new nephelometric technique to measure complement activation.

A new nephelometric technique to measure C3d as an indicator of complement activation, is described. C3d is isolated at high concentration of polyethyleneglycol (PEG), incubated with commercially available anti-C3d antiserum at a final concentration of 2.5% PEG and then measured in a Behring Laser Nephelometer. In contrast to previously available techniques our assay detects the low concentrations of C3d present in all normal subjects, which result from the continuous C3 catabolism occurring in vivo. We have also measured C3d blood concentrations in a large number of patients with diseases associated with complement activation. Raised C3d concentrations were found in 68% of rheumatoid arthritis, 57% of primary biliary cirrhosis, 38% of chronic active hepatitis, 100% of Gram-negative bacteraemia and 100% of malaria. The nephelometric technique has proved to be sensitive, economical and fast, and could be adapted for routine determination of C3d blood concentrations to monitor disease activity and response to treatment.

Arthritis, Rheumatoid↗
PubMed1983

Yeast opsonisation and complement in children with liver disease. Analysis of 69 cases.

Opsonisation of heat-killed bakers yeast and C3 and C4 concentrations were determined in sera from 69 children with liver disease and 39 controls as simple screening procedures for abnormalities in the complement system. Where significant defects in these moieties were encountered, the activity of the following was measured: total haemolytic complement, C4, C5, total alternative pathway, factor B and D activities were measured. Complement activation was detected by the presence of C3d in EDTA plasma samples. Yeast opsonisation, C3 and C4 concentrations and activities of all complement components measured were significantly (P less than 0.001) reduced in all of 10 children with fulminant hepatic failure (FHF) and six with chronic active hepatitis (CAH). There was no consistent relationship between complement deficiency and standard tests of liver function. C3 breakdown products were identified in plasma from five patients with CAH and complement deficiency but not in three patients with complement deficiencies associated with FHF. Complement concentration and activity improved in children recovering from FHF and in CAH treated by immunosuppressants. Yeast opsonisation index was raised significantly without parallel increase in C3 or C4 concentration in eight of nine children with biliary atresia before surgery and 11 of 13 with alpha-1-antitrypsin deficiency regardless of age or the presence of active liver disease. Yeast opsonisation indices became normal after successful surgery in patients with biliary atresia.

Adolescent↗
PubMed1982

Influence of delta infection on severity of hepatitis B.

The prevalence of serum markers of primary delta infection was determined in 532 patients with acute benign hepatitis B seen in Italy, and in 111 patients with fulminant hepatitis B seen in Italy, France and England. Patients with fulminant hepatitis had significantly higher prevalence of delta markers (43/111, 39%) than did those with benign hepatitis (101/532, 19%). In 25 of the 43 patients with delta-positive fulminant hepatitis, serum markers indicated a primary hepatitis B infection while in the remaining 18, IgM antibody to hepatitis B core antigen was absent, indicating that hepatitis B preceded superinfection with the delta agent. The increased morbidity of HBsAg hepatitis with delta infection may result from the cumulative simultaneous exposure to hepatitis B virus and delta, or from superinfection of HBsAg carriers with delta.

Acute Disease↗
PubMed1982

Histological evidence of hepatitis-B-virus infection with negative serology in children with acute leukaemia who develop chronic liver disease.

A high percentage of patients with acute leukaemia in established remission develop chronic liver disease: how important hepatitis-B-virus (HBV) infection is as an aetiological factor is not clear. The presence of HBV markers in liver and serum of 23 leukaemic children with liver disease was investigated at the time of a diagnostic biopsy just before treatment withdrawal. Although, at this time, none had HBV antigens or antibodies in the serum by radioimmunoassay, HBsAg was detected by direct immunofluorescence in the cytoplasm of hepatocytes in 13 children, 7 of whom also had hepatitis-B core or e antigens in hepatocyte nuclei. This pattern of both cytoplasmic and nuclear fluorescence was present in 4 of 6 patients with the histological features of chronic active hepatitis on liver biopsy. The failure of release of viral antigens into serum and the absence of an adequate immune response were probably due to the intense chemotherapy used to induce and maintain remission, since HBV markers appeared in the serum within 15 months of stopping treatment in 8 of the children in whom viral antigens had been detected in liver tissue but in none of those whose biopsy specimens were negative by immunofluorescence. These results suggest that HBV infection may be an important cause of chronic liver disease in children with leukaemia and show that during treatment serological tests may fail to detect the presence of the virus.

Adolescent↗
PubMed1982

Lymphocyte cytotoxicity to autologous hepatocytes in HBsAg positive chronic liver disease.

Lymphocytes from 39 patients with HBsAg positive chronic liver disease were incubated with their own hepatocytes to investigate mechanisms of lymphocyte-mediated liver damage. Cytotoxicity was significantly increased in 46% overall, and in 73% of those with chronic active hepatitis. Unlike HBsAg negative chronic active hepatitis where only non-T cells were cytotoxic, HBsAg positive patients had both cytotoxic T and non-T cells. A purified liver membrane complex (LSP) and aggregated IgG both blocked non-T cytotoxicity without affecting T cell cytotoxicity; this suggests that the former is probably an antibody-dependent cell-mediated reaction against normal membrane components. This was confirmed in preliminary studies which demonstrated that preincubation of hepatocytes with the F(ab)2' fragment of an anti-human IgG reduced non-T lymphocyte cytotoxicity. T-cell cytotoxicity was restricted to HBeAg-positive patients, suggesting a relationship between T-cell cytotoxicity and viral replication. Purified HBsAg, however, blocked cytotoxicity in only three of 11 cases. Non-T lymphocytes reacting with normal membrane components may contribute to liver damage in both 'autoimmune' and virus-associated chronic liver disease, whereas cytotoxic T-cells, probably reacting with viral determinants, are exclusive to those with viral replication.

Adolescent↗
PubMed1982

Detection of potentially reversible diabetic albuminuria. A three-drop agglutination test for urinary albumin at low concentration.

Subclinical elevation of urinary albumin excretion early in the course of insulin-dependent diabetes has been shown to predict later clinical proteinuria. An agglutination test (Three-drop Albutest) to detect these lesser degrees of albuminuria has been developed. Rabbit anti-human albumin antiserum is immobilized on latex beads. In the presence of human albumin and additional antiserum in solution, a visible precipitate appears. Concentration of solid and liquid phase antiserum have been adjusted to detect urinary albumin concentrations ranging between 2.5 and 17 mg/dl, undetectable by a standard clinical method (Albustix, Ames Company, Miles Laboratories Ltd, Stoke Poges, Slough, Bucks, England). The test is specific for albumin, failing to cross-react with other plasma proteins present in urine or with bovine serum albumin. It is simple to perform and is read within 5 min. This test should find a place in the early detection of diabetics with subclinical albuminuria and in monitoring the success of attempts to reverse this risk factor for clinical diabetic nephropathy.

Albuminuria↗
PubMed1982

Correlation in rheumatoid arthritis of concentrations of plasma C3d, serum rheumatoid factor, immune complexes and C-reactive protein with each other and with clinical features of disease activity.

The concentrations of C3d in the plasma and of C-reactive protein (CRP), immune complexes and rheumatoid factor in the serum were measured in 99 patients with rheumatoid arthritis. Most patients had raised levels, the values of which correlated with disease activity assessed according to a newly described index based on multivariate analysis of subjective, semi-objective and objective features of the disease. There were also significant correlations between the values for plasma C3d and circulating immune complexes, immune complexes and rheumatoid factor, serum CRP and immune complexes, and serum CRP and plasma C3d. Measurement of plasma C3d provides a useful means of detecting in vivo complement activation, which may be involved in the pathogenesis of rheumatoid arthritis, but neither C3d levels nor any of the other variables correlated as closely with disease activity as did the serum CRP concentration.

Adult↗
PubMed1982

Specificity of T lymphocyte cytotoxicity to autologous hepatocytes in chronic hepatitis B virus infection: evidence that T cells are directed against HBV core antigen expressed on hepatocytes.

Peripheral blood T lymphocytes from 21 patients with chronic HBV infection were incubated with autologous hepatocytes in a microcytotoxicity assay. Cytotoxicity was significantly increased in 13 cases, and in 12 of these the cytotoxic effect of the T lymphocytes was inhibited by preincubating the liver cells with IgG containing antibodies to the hepatitis B core antigen (HBcAg). Normal human IgG and IgG containing antibodies to the hepatitis B surface antigen (HBsAG) were without effect. Control experiments using autologous fibroblasts as target cells showed low levels of T cell cytotoxicity and no blocking effect of anti-core antibody. All patients in whom it was possible to demonstrate HBcAg in liver tissue had significantly increased T cell cytotoxicity to autologous hepatocytes. These studies suggest that T cell cytotoxicity in patients with chronic HBV infection is directed against determinants resembling the hepatitis B core antigen on the plasma membrane of hepatocytes.

Adolescent↗
PubMed1981

Hepatic damage after exposure to halothane in medical personnel.

Two surgeons, in whom liver damage developed after occupational exposure to sub-anaesthetic doses of halothane, were found to have a circulating antibody which reacted specifically with halothane-altered hepatocyte membrane components. This antibody had been found previously only in those patients in whom severe hepatic necrosis developed after exposure to halothane and in no other form of liver injury. It may provide a specific diagnostic marker in patients in whom there are other possible causes of liver damage and could, therefore, remove the need for a challenge exposure and its attendant risks.

Adult↗
PubMed1981

Circulating immune complexes in patients with fulminant hepatic failure.

Circulating immune complexes were found in 15 of 16 patients with fulminant hepatic failure due to viral hepatitis and all of six patients who had had halothane anaesthesia; however, they were found in only five of 32 patients with paracetamol-induced hepatic necrosis. The levels of circulating immune complexes were not related to the severity of the clinical course, development of renal failure, final outcome, or severity of hypocomplementaemia. All the patients had depressed reticuloendothelial function as assessed by the clearance of 125I microaggregated albumin. These findings show that circulating immune complexes in fulminant hepatic failure are not simply a reflection of an immune response to liver antigens released as a result of the hepatic necrosis; nor are they a reflection of the failure of the reticuloendothelial system. This supports the view that circulating immune complexes are associated with immune mediated liver injury and may contribute to the process.

Acetaminophen↗
PubMed1980

Halothane hepatitis.

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Chemical and Drug Induced Liver Injury↗
PubMed1980

Antibodies to the surface of halothane-altered rabbit hepatocytes in patients with severe halothane-associated hepatitis.

Circulating antibodies reacting specifically with the cell membrane of hepatocytes isolated from halothane-anesthetized rabbits were detected in nine of 11 patients with fulminant hepatic failure after helothane-induced anesthesia. The immunoglobulin deposition, as revealed by immunofluorescence, showed a granular pattern on the hepatocyte surface membrane. Preincubation of halothane-pretreated, but not of control, hepatocytes with serum containing this antibody rendered them susceptible to cytotoxic effects of normal lymphocytes in vitro. Control studies using serum from subjects repeatedly exposed to halothane without the development of liver damage, and from patients with viral and toxic liver injury have confirmed the specificity of these findings to serve halothane-associated liver injury. These results provide further evidence of an immunologic component in this condition.

Adult↗
PubMed1980

Sarcoidosis associated with combined immunodeficiency.

The association of multiple non-caseating granulomata and a positive Kviem test is normally considered to be indicative of a diagnosis of sarcoidosis. However, although depressed cell-mediated immunity is commonly described, it is extremely rare to find a humoral immune paresis. A patient is reported who had multiple granulomata, depressed cellular and humoral immunity and a positive Kveim test.

Adult↗
PubMed1980

Identification of biliary antigens in circulating immune complexes in primary biliary cirrhosis.

The presence of biliary tract antigens in circulating immune complexes from patients with primary biliary cirrhosis (PBC) was investigated. Concentrations of immune complexes in PBC sera, measured by the Raji cell immunoassay, ranged from 58 to greater than 1,000 microgram/ml, but did not correlate with disease activity. Immunofluorescent staining of complexes bound to Raji cells was carried out with guinea-pig antiserum raised against biliary tract antigens. Positive staining reactions were observed with complexes obtained from PBC patients, but not with those obtained from patients with systemic lupus erythematosus or rheumatoid arthritis, indicating that in PBC antigenic components associated with the biliary tract are contained within the complexes.

Antigen-Antibody Complex↗
PubMed1980

Lymphocyte cytotoxicity to halothane altered hepatocytes in patients with severe hepatic necrosis following halothane anaesthesia.

Lymphocytes from three of four patients with severe unexplained hepatitis following halothane anaesthesia were cytotoxic in vitro for liver cells isolated from rabbits following halothane anaesthesia, and less so for control hepatocytes. While the latter reaction could be blocked by addition of a purified liver membrane lipoprotein (LSP), this had no effect on the cytotoxicity to "halothane" hepatocytes. These results provide evidence that patients with severe halothane-associated hepatitis are sensitised to a liver cell antigen distinct from LSP, which arises as a result of halothane anaesthesia.

Adult↗