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Biomedical subjects

E Acosta

Publications and source records attributed to E Acosta.

At least 19 recordsLinked to original sources

Plasma neurotransmitters, blood pressure, and heart rate during supine-resting, orthostasis, and moderate exercise conditions in major depressed patients.

Major depressed patients showed greater heart rate, noradrenaline, and free-serotonin values than normal. Conversely, platelet-serotonin values in major depressed patients were significantly lower than normal. Patients registered the normal differential blood pressure reduction during orthostasis. They also revealed progressive and significantly higher heart rate rises during orthostasis and exercise periods, when compared to normals. Whereas noradrenaline showed maximal rises during the two last periods, adrenaline only showed small but significant increase during exercise. The analysis of correlations, together with the above data, suggests that major depressed patients register maximal neural sympathetic activity as well as adrenal glands sympathetic hypoactivity. In addition, these patients show hyperparasympathetic activity, as reflected by the free-serotonin profile. Finally, the fact that both the Hamilton Depression Rating Scale and the self-rating Beck Depression Inventory correlated positively with noradrenaline/adrenaline ratio and free-serotonin values strongly suggests that both neural sympathetic and cholinergic mechanisms are involved in major depression.

Adrenal Glands

Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients.

Dysthymic depressed patients showed platelet-serotonin (pS) + plasma-free serotonin values greater than normal as well as plasma noradrenaline values lower than normal during supine resting period (0'). Conversely, no significant differences were observed in the 0' values of any other of the measured parameters: systolic, diastolic and differential blood pressure (SBP, DBP, DP), heart rate (HR), adrenaline (Ad), dopamine (DA), cortisol, and platelet aggregability between patients and controls. Although patients showed then normal DP reduction at orthostasis (1'), this was not prevented by atropine as it does in controls. Patients but not normals showed significant rises of DBP at orthostasis and exercise (5') periods, which were positively correlated with NA rises. On the contrary, the abnormally raised resting fS values registered in patients showed progressive and significant reductions throughout the test that were negatively correlated with DBP-NA values. Adrenaline did not show the normal 5'-fS peak. The above findings suggest that dysthymics show hypoactivity of the two branches of the sympathetic system (neural + adrenal) along with hyperparasympathetic activity. Furthermore, their low NA + high pS values contrast with the high NA + low pS registered in major depressed subjects.

Adolescent

Human secretory immunoglobulin A anti-Entamoeba histolytica antibodies inhibit adherence of amebae to MDCK cells.

The presence of secretory immunoglobulin A (IgA) anti-Entamoeba histolytica antibodies in the saliva of patients with intestinal amebiasis was demonstrated by immunoblot assay, and the capacity of these antibodies to inhibit amebic adherence to a monolayer of MDCK cells was analyzed. Inhibition was due to IgA antiamebic antibodies and in part to anti-Gal-binding-lectin antibodies, as demonstrated by absorption experiments with total amebic extract and with the fraction of Gal-binding lectin. These results emphasize the relevance of secretory IgA antibodies in the phenomenon of E. histolytica adherence to epithelial cells.

Animals

Plasma neurotransmitters and cortisol in chronic illness: role of stress.

We routinely measured plasma neurotransmitters and hormone levels in order to investigate the role of stress on many types of diseases. In this study, we present results obtained from patients with severe chronic diseases. The study sample consisted of 88 patients (asthmatics, ulcerative colitis, Crohn's disease, chronic active hepatitis, chronic relapsing hepatitis, multiple sclerosis, trigeminal neuralgia, systemic lupus erithematous, and rheumatoid arthritis), and their respective controls. Noradrenaline (NA), adrenaline (Ad), dopamine (DA), platelet-serotonin (pS), free-serotonin (fS), growth hormone (GH) and cortisol (CRT) were determined during both exacerbation and improvement periods. A profile compatible with uncoping stress disorder (raised NA-Ad-DA + fS + CRT as well as low pS and NA/Ad ratio) was found during exacerbation periods when compared with improvement, as seen in controls. However, during improvement periods the neurochemical profile remained significantly different from that of normal controls. The neurochemical plus hormonal plasma profiles registered in chronic illness, both during exacerbation and improvement periods, strongly suggest that an uncoping stress mechanism underlies diseases of these patients.

Adolescent

Cytokine-induced suppression and potentiation of hapten-specific immediate hypersensitivity responses.

The ability of subcutaneously (s.c.) injected cytokines (IL-4, IL-5, IL-6, IFN alpha, IFN gamma, GMCSF) to regulate the induction of hapten-specific immediate hypersensitivity (IH) responses was studied in BPO-KLH (benzylpenicilloyl-keyhole limpet hemocyanin) sensitized BALB/c mice at the peak of a hapten-specific IgE antibody forming cell (AFC) response. To induce IH responses, mice were injected in the right pinna with either BPO-BSA (benzylpenicilloyl-bovine serum albumin), BPO-KLH (0.01-1.0 micrograms/ml) or mcAb anti-IgE (0.001 - 1.0 micrograms/ml); and in the left pinna with an equal volume of saline (0.05 ml). Pinnae were measured 5 min to 4 hr later using a micrometer caliper. Treatment of mice with IL-4 or IFN gamma dramatically suppressed the induction of IH responses in dose dependent fashion. In contrast, treatment of mice with IL-6 and IFN alpha increased these responses in dose dependent fashion, while GMCSF and IL-5 had no effect. The suppression obtained with IL-4 and IFN gamma, and the increases seen with IL-6 and IFN alpha, were transient since these cytokines, as well as GMCSF and IL-5, had no effect on IH responses elicited 21 days after the peak of BPO-specific IgE AFC responses. The data suggest that cytokine mediated effects on IH responses occur via changes in serum levels of BPO-specific IgG1 or IgE, through direct or indirect effects of cytokines on mast cells or other cell types, or by affecting the ability of BPO-specific homocytotropic antibodies to bind to mast cell surfaces.

Animals

[Esophageal achalasia: 20 years' experience with non surgical treatment].

The purpose of this paper is to report the experience acquired in pneumatic dilatation in achalasia of the esophagus up to 1990. Two hundred and six patients were studied in that period (X 50, 7 years, M/F 1:1). According to X Rays the distribution was: grade I 17.4%, grade II 54.8%, grade III 14% and grade IV 13.5%. The associated esophageal pathology was: hiatus hernia 9.7%, esophagitis 5.8%, benign stenosis 2.4%, cancer 1.4%, ulcer and diverticula 0.9% and Schatzki's ring and leiomyoma 0.4% respectively Serology for Chagas disease was positive in 23% Chagasic megacolon was more frequent than chagasic heart disease (4.3% Vs. 1.4%). Out of these, one hundred and twenty patients were treated by pneumatic dilatation. To this group we shall refer in more detail. One hundred ant two patients were dilated once and the remaining 18 twice. Esophageal manometry showed a vigorous pattern in 7.7%. The LES' pressure pre-treatment was 24.5 mm Hg and post-dilatation 13.7 mm Hg in 75.8% of the cases the result was good. The morbidity was 5% and the mortality 0.7%. Relapse was seen in 25.8% of the cases. The follow-up was X 38 months. We conclude that pneumatic dilatation is the election procedure in the treatment of achalasia since it offers good results with low morbimortality. Surgery is indicated after failure of 2 dilatations, in children, and association with esophageal neoplasms, hiatus hernia and esophageal diverticula.

Adolescent

Antibodies to the metacestode of Taenia solium in the saliva from patients with neurocysticercosis.

IgG antibodies to antigens of Taenia solium metacestodes were detected in saliva samples from patients with intracerebral cysticercosis by means of an enzyme-linked immunosorbent assay (ELISA). When compared for IgG antibody activity, saliva samples from patients with various nonparasitic neurological disorders and from clinically healthy individuals yielded significantly lower (p less than 0.001) absorbance values than saliva samples from patients with neurocysticercosis. However, no differences were observed in IgA anti-T. solium activity between patients with neurocysticercosis and controls. These results indicate that the detection of anticysticercus IgG antibodies in saliva by means of ELISA may be of value in the diagnosis of neurocysticercosis. Moreover, collection of saliva provides a noninvasive sampling method for immunoepidemiological surveys on this disease.

Animals

Diagnosis of intestinal amebiasis using salivary IgA antibody detection.

This investigation sought to determine whether detection of salivary IgA antibodies to Entamoeba histolytica could identify intestinal amebic infections among 223 school children. Four groups of children were identified through coproparasitoscopic examination: E. histolytica as other parasites only (20%); and parasite-free (25%). The diagnostic accuracy of salivary IgA antibodies to an E. histolytica membrane extract was 91.5% (sensitivity, 85%; specificity, 98%), maintaining high predictive value at different prevalences. Also, a positive correlation (r = .753, P less than .001) was observed between fecal E. histolytica membrane antigen levels and salivary IgA antibody activity. Measurement of IgA antibodies in saliva may be useful in diagnosing intestinal infections with E. histolytica within a wide range of prevalences. Moreover, sampling of saliva may be a useful non invasive test for immunoepidemiologic surveys.

Adolescent

Pimozide therapy for trigeminal neuralgia.

Pimozide was compared with carbamazepine in a double-blind crossover trial in 48 patients with trigeminal neuralgia who were refractory to medical therapy. Pimozide treatment produced greater reduction in trigeminal neuralgia symptoms than carbamazepine treatment. All of the pimozide-treated patients improved, while only 56% of carbamazepine-treated patients were relieved of their pain. Although both drugs provoked some adverse effects, it was not necessary to interrupt the trial in any case. After this 24-week trial, all patients began receiving pimozide and were followed up according to an open-label study design. In all cases, the pimozide dosage was progressively reduced until the minimal effective dose was reached. Central and peripheral mechanisms that may underlie pimozide-induced improvement are discussed.

Carbamazepine

Oral epithelial cells as the origin of pemphigus antigen in human saliva.

Absorption of pemphigus sera with normal human saliva or with scraped oral epithelial cells abolished the intercellular antibody titres, as revealed by indirect immunofluorescence. No pemphigus antigenic activity was detected on either human or macaque salivary glands, suggesting that the pemphigus antigen in saliva is a product of the epithelial lining of the oral mucosa. Indirect immunofluorescence on primary cultures of normal oral mucosa demonstrated that pemphigus antigen is synthesized by human oral epithelial cells. Salivary pemphigus antigen was isolated by affinity chromatography on Sepharose-linked IgG-fraction from pemphigus sera. Pemphigus antibody-binding material from the isolated fraction was detected in two bands with apparent molecular weights of 30,000 and 12,000 by immuno-blotting of reduced SDS-polyacrylamide gel electrophoretograms.

Adult

Relationship between the serum autoantibody titers and the clinical activity of pemphigus vulgaris.

With human tonsillar epithelium as a substrate for the indirect immunofluorescence assay, a statistically significant relationship was demonstrated between the clinical activity of the disease and the autoantibody titers in seventy-eight serum samples obtained from patients with pemphigus vulgaris. High pemphigus antibody titers were associated with severe ulceration, intermediate titers with moderate lesions, and low titers with mild pemphigus. However, the sequential studies revealed that this relationship was not always consistent throughout the course of the disease, and in three out of fourteen patients the correlation was either poor or negative. These results indicate that serial pemphigus antibody titers may not be consistent enough to be used reliably as the sole guide for monitoring disease activity.

Autoantibodies

Identification of pemphigus-like antigens expressed by SCaBER cells.

Indirect immunofluorescence revealed the presence of pemphigus-like antigenic activity on SCaBER cell monolayers after incubation with sera from patients with pemphigus vulgaris. In contrast, no fluorescence was observed after incubation of the cells with sera from patients with bullous pemphigoid, systemic lupus erythematosus or healthy individuals. In order to identify this pemphigus-like antigen, the SCaBER cell membrane proteins were solubilized in non-ionic detergent, separated according to their molecular weight by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and electrophoretically transferred to nitrocellulose sheets. After incubation with pemphigus serum followed by 125I-radiolabelled goat anti-human IgG, autoradiography revealed pemphigus antibody binding activity in the 105 Kd region in electrophoretograms of the unreduced SCaBER cell membrane extracts. This pemphigus-like antigen was isolated by affinity chromatography on the Sepharose-linked IgG fraction of sera from patients with pemphigus vulgaris.

Antigens, Neoplasm

Distal colon motility and clinical parameters in depression.

Eighty-six patients suffering from nonpsychotic unipolar major depressive disorder, according to Research Diagnostic Criteria, were rated on a modified Hamilton Rating Scale for Depression (HRS). All completed the self-rating Beck Depression Inventory (BDI). Distal colon motility (dcm) studies, performed in all the patients, differentiated two types: low intestinal tone (low-IT) = 40 subjects, and high intestinal tone (high-IT) = 46 subjects. Low-IT depressed patients showed a statistically significant preponderance in the HRS items 'retardation', 'somatization', 'fatigability', 'hypochondriasis' and 'obsessional symptoms'. The high-IT depressed patients, on the other hand, showed preponderance in the items 'guilt', 'suicide', 'insomnia', 'agitation', 'anxiety psychic', 'loss of insight', 'depersonalization' and 'paranoid symptoms'. A positive correlation (r) was found between HRS- and BDI-mean total scores. In addition, a positive correlation (r) was found between HRS scores and distal colon tone in high-IT patients, although the same was not true for low-IT patients. Our results suggest the existence of two subtypes of depressive syndromes, distinguishable on the basis of distal colon motility profiles.

Adolescent

Distal colon motility as a predictor of antidepressant response to fenfluramine, imipramine and clomipramine.

The present study gathers results obtained in the treatment of 86 depressed outpatients. The patients were grouped according to their distal colon tone, low-IT and high-IT. All the patients fulfilled the Research Diagnostic Criteria for nonpsychotic unipolar major depressive disorder and were rated on a slightly modified 18-item Hamilton Rating Scale for Depression (HRS). They also completed the 21-item self-rating Beck Depression Inventory (BDI). The 46 subjects from the high-IT group and the 40 subjects from the low-IT group were divided into three subgroups each for double-blind trials performed with clomipramine (CMI), imipramine (IMI), and fenfluramine (FENF). Normalization of HRS and BDI scores and reduction of IT were obtained with IMI and FENF but not CMI in high-IT patients; whereas normalization of both scores and increase in IT were obtained with CMI but not with IMI or FENF in low-IT patients. FENF was not tolerated in this last group. HRS and BDI scores correlated well during in-treatment periods. Our results suggest that distal colon tone is a guide to determining the pharmacotherapy in the depressive disorders. Furthermore, it was shown that FENF is a useful anti-depressant drug in one type of patient.

Adolescent

On the use of clonidine and thioproperazine in a woman with Gilles de la Tourette's disease.

A 25-year-old woman with Gilles de la Tourette's disease was successfully treated with clonidine (an inhibitor of noradrenaline release). However, the drug was stopped because of side effects. Thioproperazine, a phenothiazine derivative which blocks subcortical dopaminergic receptors, suppressed Gilles de la Tourette's symptoms totally. The patient has tolerated the drug well for over a year since its introduction. The pharmacomanometric investigation performed in this patient showed hyperactivity of her noradrenergic system.

Adult