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Biomedical subjects

E Berntorp

Publications and source records attributed to E Berntorp.

At least 145 records · Page 8Linked to original sources
PubMed1991

Antibody to a hepatitis C virus related protein among patients at high risk for hepatitis B.

Anti-HCV prevalence in treated hemophiliacs, their heterosexual partners, intravenous drug addicts and homosexual men was studied. In hemophiliacs and many of the intravenous drug addicts, greater than or equal to 2 sera drawn 1-18 or 1-17 years apart were available. Anti-HCV testing was performed by ELISA (Ortho). Among patients with severe and moderate hemophilia A, 87% (98/112) were positive for anti-HCV at least once and among patients with severe and moderate hemophilia B, 83% (24/29) were positive for anti-HCV. Seroconversion to anti-HCV was observed in 21% of hemophilia patients. In hemophilia A, HCV infection generally occurred during the first years of life and in hemophilia B somewhat later. Loss of anti-HCV antibody was seen in 12% (17 patients). The rest, 54% (76 patients) were seropositive in first and last samples. All 12 tested spouses to anti-HCV positive men were anti-HCV negative. 80% of the drug addicts (137/172) were seropositive for anti-HCV. In those with greater than 1 serum tested, 8% were consistently negative and 68% consistently positive. 21% seroconverted to anti-HCV while 3% lost antibody. 10% (22/211) of homosexual men were anti-HCV positive. Intravenous transmission of HCV thus seemed highly efficient whereas sexual transmission was much less efficient.

Adolescent↗
PubMed1991

Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood.

To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively. Samples from the autologous and the homologous blood were obtained before reinfusion, and were assessed as regards hematologic and biochemical parameters. The autologous blood satisfied all the intraoperative transfusion requirements of the autologous group and 75 percent of the total transfusion requirements. The operative and postoperative blood losses--hence, the total blood loss--were less in the autologous than in the control group. The autologous blood had a high hemoglobin, white blood cell, and plasma hemoglobin content and MCV compared with the homologous blood. Postoperatively, there were no differences as regards the hematologic parameters studied. There was no evidence of intravascular hemolysis in the autologous group. Postoperatively, in both groups, AT III, plasminogen, and protein C decreased. Other coagulation parameters were within normal limits in both groups. Intraoperative autotransfusion is safe and effective, and should be considered in hip arthroplasty to reduce the risks associated with homologous blood transfusion.

Aged↗
PubMed1990

Noncoagulation inhibitory factor VIII antibodies after induction of tolerance to factor VIII in hemophilia A patients.

We recently described tolerance induction with factor VIII/IX, cyclophosphamide, and high-dose intravenous IgG in hemophilia A or B patients with coagulation inhibitory antibodies. Circulating noninhibitory antibodies complexed with factor IX have been demonstrated in tolerant hemophilia B patients. Similar findings are now described in six tolerant hemophilia A patients. Complexes between factor VIII and the 'tolerant' antibody were demonstrated by subjecting plasma to gel filtration chromatography, void fractions containing factor VIII/vWF complexes being collected and adsorbed to protein A. Using 125I-labeled F(ab')2 fragments against IgG subclass and factor VIII antigen, complexes between an IgG4 antibody and factor VIII were found to adsorb to protein A. After infusion of factor VIII to tolerant patients, all factor VIII circulated in complex with IgG4 antibody. In three of the patients, the 'tolerant' antibodies inhibited an ELISA specific for factor VIII light chain but, unlike the pretolerant antibodies, did not bind radiolabeled factor VIII heavy chain. Although after induction of tolerance the patients still have circulating IgG4 antibodies against factor VIII, the antibodies differ in specificity, lack coagulation inhibitory activity, and do not enhance the rate of elimination of factor VIII.

Antigen-Antibody Complex↗
PubMed1990

Pyridoxine reduces cholesterol and low-density lipoprotein and increases antithrombin III activity in 80-year-old men with low plasma pyridoxal 5-phosphate.

We have previously observed that pyridoxine treatment reduced plasma total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol concentrations and increased antithrombin III (AT III) activity in atherosclerotic patients with subnormal plasma pyridoxal 5-phosphate (PLP) levels. In order to confirm these results, we selected 17 males with low plasma PLP levels from a group of 122 80-year-old males in whom PLP has been determined. After supplementation with 120 mg of pyridoxine per day for 8 weeks their mean plasma TC and LDL cholesterol concentrations were decreased by 10% (p less than 0.01) and 17% (p less than 0.001), respectively. There was no effect on high-density lipoprotein cholesterol and triglycerides but plasma AT III activity was increased by 6% (p less than 0.05). The mechanism by which pyridoxine acts is unclear but it is hypothesized that pyridoxine-derived PLP may enhance the catabolism of LDL and the activity of AT III by inhibiting their glycosylation.

Aged↗
PubMed1990

Lack of transmission of HIV to sexual and non-sexual contacts to HIV seropositive haemophiliacs following preventive information.

In order to evaluate the risk of HIV transmission to sexual and non-sexual contacts to seropositive haemophiliacs, HIV antibodies, p24 antigen, immunoglobulin levels and lymphocyte subsets were analyzed in a cohort of Swedish haemophiliac families to 19 patients who seroconverted in 1980-82. As controls served contacts to 26 seronegative haemophiliacs. A total of 77 contacts were investigated. Except for 3 sexual partners who had seroconverted before 1985 no signs of HIV infection were detected. It was concluded that no HIV transmission occurred to household contacts of seropositive haemophiliacs and that transmission to heterosexual partners not appeared since 1985 when the patients and their families were informed about the risk of infection.

Adolescent↗
PubMed1989

Cigarette smoke impairment of human lymphocyte function by inhibition of transglutaminase.

The in-vitro and in-vivo effects of cigarette smoke were studied in human peripheral blood lymphocytes by applying a method for the capping of beta 2-microglobulin- or phytohaemagglutinin (PHA)-stimulated lymphocyte transformation (measured as (3H)thymidine incorporation) involving the transglutaminase pseudosubstrate monodansylthiacadaverine (MDTC), whose presence resulted in significantly reduced capping and (3H)thymidine incorporation in a concentration-dependent manner. The addition of dimethyl sulphoxide-soluble particles from cigarette smoke to lymphocytes in vitro significantly reduced the capping ability and the PHA-induced (3H)thymidine incorporation. Whereas no significant change in MDTC-dependent capping inhibition was seen in lymphocytes from smokers after 10 d abstinence from smoking. there was a marked decrease in (3H)thymidine incorporation in lymphocytes from smokers after smoking three cigarettes following 10 h abstinence. The tentative conclusion is that exposure to cigarette smoke, or smoke extract, impairs MDTC-dependent capping inhibition and PHA-stimulated lymphocyte transformation by transglutaminase inhibition.

Adult↗
PubMed1989

Use of a high-purity factor VIII concentrate (Hemate P) in von Willebrand's disease.

In previous studies, we have found Hemate P (Behring) to be the only commercial virus-inactivated high-purity factor VIII concentrate that contains native von Willebrand factor. In the present study, Hemate P was given to 7 patients with the severe recessive form of von Willebrand's disease, to 2 patients with type Ia, to 1 patient with type IIB, and to 1 patient with type IIC von Willebrand's disease. A correction of the hemostatic defect was seen in all patients. Satisfactory hemostasis was also obtained in clinical situations, 1 patient undergoing major surgery and another being delivered, both without undue loss of blood. We conclude that Hemate P is an efficacious and safe product for use in cases of von Willebrand's disease when pharmacological correction of the hemostatic defect is not possible.

Bleeding Time↗
PubMed1989

Natural history of HIV infection in Swedish haemophiliacs.

The longitudinal follow-up is described of 36 anti-HIV positive haemophiliacs who had seroconverted in the period 1980-82, and of 41 seronegative controls. Laboratory variables were followed up for a mean duration of 2.5 years (1985-87). Of the 36 seropositive patients, AIDS developed in 3, and generalised persistent lymphadenopathy in 9. The HIV-seropositive patient group had lower CD4:CD8 ratios and CD4 counts but higher CD8 counts than the seronegative group. However, there was no deterioration in the values for the lymphocyte subsets during follow-up. Titration on paired sera showed an increase in anti-HIV titre with time. Testing for the presence of HIV antigen was positive in 5 patients, including 2 who later developed AIDS. We conclude that anti-HIV positive haemophiliacs, though actively immunised, often show no symptoms even as long as 7 yr after seroconversion and that, in certain patients, the immune system may even show signs of improvement.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Transglutaminase-dependent lymphocyte transformation in type 2 diabetes mellitus.

The transglutaminase involvement in phytohaemagglutinin (PHA) stimulated lymphocyte transformation (measured as (3H)thymidine incorporation) was studied in lymphocytes from 20 patients with type 2 diabetes mellitus and 20 healthy controls by including in the system the specific transglutaminase pseudosubstrate monodansylthiacadaverine (MDTC). In the presence of MDTC, (3H)thymidine incorporation was significantly and concentration-dependently reduced in both groups but more pronouncedly in the diabetes patients. The MDTC concentration needed to give a 50% reduction of the PHA-stimulated (3H)thymidine incorporation was significantly lower in lymphocytes from diabetic patients than in those from controls (p less than 0.02). The data suggest impaired lymphocyte transglutaminase function in type 2 diabetes mellitus.

Body Composition↗
PubMed1988

Incidence of symptoms and AIDS in 146 Swedish haemophiliacs and blood transfusion recipients infected with human immunodeficiency virus.

The times from infection with the human immuno-deficiency virus (HIV) to the onset of the first clinical symptom and the development of AIDS were studied prospectively in 98 haemophiliacs and 48 blood transfusion recipients infected with the virus. Patients were followed up for a median of 61 months after infection, the dates of infection being either known exactly or estimated from the interval between the last negative and first positive HIV antibody test result. The rate of progression to AIDS was significantly higher for the transfusion recipients than for the haemophiliacs. The difference in time to the occurrence of the first clinical symptom was less pronounced between the two groups, though pointing in the same direction. The results suggest that on average roughly half of all patients positive for HIV will develop some clinical sign or symptom within five to six years after infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Induction of immune tolerance in patients with hemophilia and antibodies to factor VIII by combined treatment with intravenous IgG, cyclophosphamide, and factor VIII.

The development of antibodies to factor VIII is a serious complication of the treatment of patients with hemophilia A. We successfully induced immune tolerance in patients with such antibodies with a new treatment protocol, which combined factor VIII, cyclophosphamide, and high-dose intravenous IgG, followed by regular prophylactic treatment with factor VIII. This protocol has now been used in 11 patients with hemophilia A, of whom 9 had a strong antibody response. When the initial concentration of antibodies exceeded 3 Malmö inhibitor units (corresponding to about 10 Bethesda units) per milliliter, treatment was preceded by adsorption of antibody to protein A. After two to three weeks of the combined treatment, factor VIII coagulant antibodies had disappeared in 9 of the 11 patients; in 8 of these 9 patients the half-life of infused factor VIII had normalized. The tolerant state appears to be stable after a median of 30 months. Two patients did not respond to the treatment. Because earlier treatment with factor VIII and cyclophosphamide or with factor VIII and IgG had been ineffective in these patients, our experience suggests that all three components of the protocol are required for the successful induction of tolerance to factor VIII.

Adolescent↗
PubMed1988

HIV-serology and lymphocyte subsets in relation to therapy and clinical development in haemophiliacs.

389 Swedish patients with haemophilia A, B or von Willebrand's disease were examined for HIV-1 antibodies. T-cell subsets were measured in 260 of them. HIV-1 antibodies were found in 98 of these patients. Of the 199 patients with severe or moderate haemophilia A, 44% were seropositive. They had seroconverted between 1979 and 1983. HIV-1-seropositive patients had significantly decreased numbers of CD4 cells and increased numbers of CD8 cells. The seronegative haemophilia A patients had significantly increased numbers of CD8 cells. The T-cell subsets were followed for a median of 40 months in 73 seropositive patients. All groups of patients, at different clinical stages, showed decreasing numbers of CD4 cells. The most pronounced decrease was seen in the patients who developed AIDS, followed by the group which developed HIV-related signs or symptoms. HIV antigen in serum and antibody pattern in Western blot and ELISA were followed in 89 patients. HIV-1 antigen was present and p24 antibodies were lacking in 11% and 13% of asymptomatic subjects, in 13% and 20% of patients with persistent generalized lymphadenopathy, in 33% and 38% of patients with other HIV-related signs or symptoms and in 5/6 of the AIDS patients, respectively. In conclusion, the decrease of CD4 cells and the presence of HIV antigen and/or absence of p24 antibodies were found to be prognostic markers for HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Biochemical and in vivo properties of commercial virus-inactivated factor VIII concentrates.

The following commercial virus-inactivated factor VIII concentrates were studied in vitro: AHF-Kabi and Octonativ, KabiVitrum; Hemofil T, Hyland; Factorate HP and Monoclate, Armour; Nordiocto, Nordisk Gentofte (dry heated); Kryobulin TIM3, Immuno (steam treated); Profilate, Alpha (heated as dry material slammed in heptane); Hemate P, Behring (wet heated) and Octa-V.I., Octapharma (solvent/detergent treated). The concentration of VIII:C was lowest in AHF-Kabi, whereas it ranged from 24 to 53 IU/ml in the high purity concentrates, except for Monoclate in which it ranged from 91-128 IU/ml. All concentrates but Octa-V.I. had higher values for VIII:Ag than for VIII:C. von Willebrand factor with normal distribution of multimers could only be demonstrated in AHF-Kabi and Hemate P. In vivo studies were performed in 12 severe hemophiliacs. Recovery and half-life of VIII:C did not differ between the various concentrates. Hemate P was given to 5 patients with severe von Willebrand's disease, in all of whom a correction of the hemostatic defect was seen.

Antigens↗
PubMed1988

No evidence for vertical transmission in children born to HIV seropositive male haemophiliacs.

In order to evaluate the risk of HIV transmission during conception or pregnancy from seropositive male haemophiliacs to their children, we have investigated the families of 8 HIV antibody positive haemophilia A patients. HIV antibodies could be demonstrated in 1/9 mothers after delivery of her second child, whereas all the other mothers tested were seronegative. Of the 14 children studied at least 7 must have been conceived when the father was already seropositive. HIV antibodies were tested for in 6 of these 7 children; all were negative. All 14 children are healthy and free from clinical signs of HIV infection. We conclude that the overall risk of perinatal HIV transmission in haemophilic families should be low and this knowledge may be invaluable in family counselling.

Acquired Immunodeficiency Syndrome↗
PubMed1988

An aberrant subclass pattern of HIV-specific immunoglobulin G in sera from haemophiliacs.

The immunoglobulin (lg) G subclass response against HIV was investigated in sera from 13 haemophiliacs and 21 non-haemophiliacs. Monoclonal antibodies specific for the human lgG subclasses were used in an enzyme immunoblot assay, which was evaluated densitometrically. Seven of the haemophiliacs had detectable lgG4 antibodies to p24, a pattern which was found in only one of the sera from the non-haemophiliacs (P = 0.0022). This observation could partly be explained by a longer duration of the HIV infection in the subjects with lgG4 antibodies to HIV. No connection was found between frequency of administration of blood products and presence of HIV-specific lgG4.

Antibodies, Monoclonal↗