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Biomedical subjects

E H Beutner

Publications and source records attributed to E H Beutner.

At least 109 records · Page 6Linked to original sources
PubMed1981

Earliest clinical and histological changes in psoriasis.

Studies were performed in 89 patients with active psoriasis and in 10 normal volunteers. Areas of uninvolved skin of 10 x 10 cm in size were demarcated and closely observed for 14 days. In 54 patients with psoriasis, there developed very fine, erythematous papules almost skin level (with no scaling of the surface), which changed in the course of observation into typical pinpoint papules. Histological and histochemical studies of these finest changes, referred to as prepinpoint papules, revealed fairly abundant infiltrates composed in a large part of polymorphonuclears. The cells penetrated into the epidermis forming focally small accumulations in the stratum corneum. The granular layer became atrophied or blurred, the stratum corneum was orthokeratotic and there was no epidermal proliferation, i.e. no psoriatic features. Immunofluorescence studies showed in about 50% of prepinpoint papules in vivo fixed immunoglobulins, and in 20% of them also complement. The studies point to the role of polymorphonuclears in the earliest stages of the development of psoriatic lesions.

Complement C3↗
PubMed1981

Plasmapheresis in the treatment of systemic lupus erythematosus.

Plasmapheresis has been used as a supplementary method for the treatment of 11 cases of SLE (7 with lupus nephritis and 4 without renal changes). In 7 cases there was a marked improvement during the plasma exchanges which lasted from 2 months to 3 years of follow up. In one case the direct result was satisfactory but after 3 months there was a severe relapse and the patient died. In 3 cases (two without lupus nephritis) plasmapheresis was without any effect. We believe that plasmapheresis is chiefly indicated in severe cases with high levels of ds-DNA antibody titers.

Adolescent↗
PubMed1981

Plasmapheresis as a supplementary treatment in pemphigus.

Four cases with pemphigus 3 p. vulgaris and one p. foliaceus were treated with plasmapheresis. The volume of plasma exchange was 500-800 ml once a week for 6 weeks. In one patient the procedure was repeated four times, within 8 months. All patients were treated with prednisone and azathioprine or cyclophosphamide at the same time, but in lower dosages. The results were satisfactory and the remission after the treatment lasted for 11 months to 2 years.

Adult↗
PubMed1980

A case of cicatricial pemphigoid or cicatricial linear IgA bullous dermatosis.

A case has been described with clinical features of cicatricial pemphigoid, but immunofluorescent (IF) biopsy findings are suggestive of linear IgA bullous dermatosis (LABD), i.e., the presence of IgA deposits with a linear pattern at the basement membrane zone. The patient failed to respond to sulfones and gave a limited response to corticosteroid. These findings suggest that therapy of the type found to be effective in cutaneous forms of LABD, i.e., combinations of low doses of sulfones and corticosteroids, may be indicated in such cases.

Adrenal Cortex Hormones↗
PubMed1980

Epidermolysis bullosa acquisita: a clinical disorder of varied etiologies. Two cases and a review of immunologic and other reported findings.

Epidermolysis bullosa acquisita (EBA) is an acquired mechanobullous disorder characterized by traumatically induced bullae in skin subjected to frictional injury, i.e., acral extensor surfaces or any point of sufficient mechanical distress. Two new patients with EBA are reported. Histopathologic findings were subepidermal ballae with sparse superficial perivascular mononuclear cell inflammatory infiltrates. The periodic acid-Schiff (PAS)-positive basement membrane zone (BMZ) was split between the floor and roof of the blisters with most attached to the blister roof. Electron microscopy of normal skin from one patient revealed a bandlike zone of granular material within the dermis immediately beneath the basal lamina. Nonbranching filaments were embedded in the granular material. Electron microscopy of normal skin from the second patient revealed a markedly diminished density of anchoring fibrils but no granular material. Immunologic findings in skin biopsies were C'3, IgG, and other immunoglobulins in varying combinations in both cases and in all reported cases. Comparisons of direct immunofluorescent (IF) findings in nine reported cases with 223 cases of bullous pemphigoid (BP) suggest that BMZ deposits of IgG plus IgA and/or IgM occur more frequently in EBA than in BP. Indirect IF studies of patients' sera revealed antibodies to the BMZ in two samples of one of our two cases and in one of seven cases reported by others. While both EBA and BP characteristically yield positive IF findings in the BMZ, clinical, electron microscopic, and some immunopathologic findings indicate that the two diseases are distinct.

Adult↗
PubMed1980

Studies in immunodermatology. VIII. Immunofluorescence studies of stratum corneum antibodies.

Stratum corneum antibodies (SCAb) as detected by indirect immunofluorescence (IIF) can be absorbed from human sera with homogenates of normal human callus which contain stratum corneum antigen. Titers of concomitantly present antibodies remain unchanged in sera absorbed with callus, thus showing that this absorption is specific. SCAb reacting in a passive hemagglutination assay with an antigen derived from human callus by means of a trypsin-phenol-water extraction can be specifically absorbed with the homologous antigen. However, absorption with callus fails to remove the hemagglutinating antibodies and absorption with the trypsin-phenol-water antigen preparation fails to remove SCAb detected by IIF. These data indicate a nonidentity relationship between these antigen systems despite their similar histological and anatomical tissue distribution. Reactivity of immunoglobulins and complement only with areas of traumatized stratum corneum in skin explants cultured on sera containing SCAb provide some insight as to a possible normal physiologic role for these ubiquitous complement-fixing autoantibodies.

Animals↗
PubMed1980

Quantitative studies on immunofluorescent staining. VII. Fractionation of conjugates by acid dialysis to reduce nonspecific staining.

Dialysis of fluorescein-conjugated antibodies at pH 5.8-6.0 can reduce unwanted nonspecific staining. Selective precipitation of highly fluoresceinated proteins in mildly acidic buffer is a simple technique which can produce a reagent with greatly improved nonspecific staining characteristics with little or no loss of antibody activity. This technique may be especially useful when fluorescent antibody tests are to be performed on tissues which have a high propensity for nonspecific staining such as skin.

Dialysis↗
PubMed1980

Complement-fixing intercellular antibodies in a case of cicatricial pemphigoid.

A patient with ocular and oral lesions, as well as cicatricial pemphigoid, had intercellular antibodies to a titer of 80 by indirect immunofluorescence (IF) microscopy staining tests with her serum. These were identified as pemphigus-like antibodies, since direct IF microscopy indicated no intercellular IgG deposits. Complement IF microscopy tests of the serum gave a closely comparable titer (40) of intercellular antibodies. Since serum samples of patients with true pemphigus either fail to fix complement or have much lower complement fixation titers, the complement IF microscopy tests of patients' serum samples may be of value in differentiating pemphigus-like antibodies from pemphigus antibodies.

Autoantibodies↗
PubMed1979

Immunopathology of psoriasis.

Immunofluorescence (IF) studies by the direct and indirect methods demonstrate immunoglobulins and complement bound in vivo in psoriatic scales. The IF pattern is comparable to that of stratum corneum antibodies (SCAb) bound in vitro on specific substrate, as visualized by the indirect IF method. Formation of immune complexes can be responsible for the "squirting papilla" phenomenon, and conversion of the stratum corneum - which is normally an inaccessible antigen - into its reactive form seems to be brought about by proteases of polymorphonuclear leukocytes. Stimulation of protease production by polymorphonuclears appears to be an important factor in the pathogenesis of psoriasis. The stratum corneum of the epidermis is probably the target, and becomes an antigen for SCAb present in the circulation.

Antibodies↗
PubMed1979

Mitochondrial antibodies--heterogeneity and effects on mitochondrial respiration.

Sera containing antimitochondrial antibodies (MTA) were tested for binding to intact mitochondria, sonic fragments (SMP), Complex I + III and to oligomycin sensitive ATPase (OS-ATPase) from bovine heart by indirect immunofluorescence. Antigens capable of binding to MTA were present in mitochondria and its fragments tested. Maximum binding was observed with SMP. It appears that one or more antigen binding sites are present on the matrix side of the inner mitochondrial membrane or some location exterior to the inner membrane. Normal human serum or sera containing MTA did not effect the respiration of intact mitochondria or sonic particles. However, NADH-cytochrome c reductase activity of complex I + III was enhanced by 10-60% by sera containing MTA antibodies.

Absorption↗
PubMed1979

[Is psoriasis an autoimmunologic disease?].

DThe defective function of T-lymphocytes, which is a finding in active psoriasis, is transitional and reversible, whereas the immunological mechanism is mainly related to the formation of immune complexes consisting of stratum corneum antibodies and stratum corneum antigen, which through binding of complement and activation of chemotactic complement components is responsible for the phenomenon of "squirting papillae". The earliest lesions preceding pin point papules, called pre-pin-point papules, were induced by stripping or developed spontaneously in a marked field closely observed for several days. In the changes preceding earliest psoriatic lesions. Abundant polymorphonuclear infiltrates are present, and polymorphs seem to play an important role in a selfperpetuating of disease process. The therapeutic implications of the immunologic studies in psoriasis are: either depletion of activated polymorphs (eg. continuous peritoneal dialysis) and/or removal of the factors responsible for their activation (eg. treatment of focal infections) or external use of the drugs affecting the antigenicity of stratum corneum (tars), or inhibition of exocytosis (a probable mechanism of puva).

Autoimmune Diseases↗
PubMed1978

Autoimmunity in psoriasis. A complement immunofluorescence study.

The stratum corneum (SC) antibodies are present in all human sera as seen by indirect immunofluorescent (IF) staining. They appear to bind in vivo to the stratum corneum of psoriatic lesions. They fix complement in vitro in a two step complement IF test system using either anti C4 or anti C3 conjugates as indicators. IF tests with proper controls showed that the SC antigen in psoriatic scales is coated not only with IgG but in a majority of the lesions also with complement. In the present studies in fully developed lesions complement was detectable in 88% of the specimens studies and in about 50% of very fresh linear lesions of unintentional Köbner type. These as well as some previously published observations afford indirect evidence for the participation of SC antibodies and the ensuing fixation of complement in the development of psoriatic lesions.

Antibody Formation↗