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Biomedical subjects

E H Beutner

Publications and source records attributed to E H Beutner.

At least 127 records · Page 7Linked to original sources

Autoimmunity in psoriasis. Relation of disease activity and forms of psoriasis to immunofluorescence findings.

Immunofluorescence (IF) studies using the test providing information on the reactivity of stratum corneum (SC) antibodies and their in vivo binding have been performed in 193 cases of psoriasis and 89 cases with other dermatoses. It has been shown that: 1. Essentially all fully developed, active psoriatic lesions had IgG deposits in the stratum corneum at the sites of the SC antigen, presumably due to in vivo binding of SC antibodies. 2. In various forms of psoriasis SC antigen sites appeared to be completely or almost completely satured with in vivo deposits of IgG as seen in tests with SC antibodies. 3. In most but not all lesions complement components C3 and/or C4 was found in a comparable pattern in the SC, especially when multiple specimens of single cases were studied. Partial or complete saturation of the SC antigen could be observed by the performance of complement indirect IF tests for SC antibodies in such specimens. 4. In lesions with typical histology of psoriasis the above-mentioned immunologic characteristics appeared to be a constant finding. However, in specimens of recent lesions which had not yet developed typical histology a proportion (2 of 17) were negative both for IgG and complement deposits. In receding lesions weak deposits of IgG were present only in a few specimens and complement deposits were as a rule negative. 5. In a group of 89 control specimens of other dermatoses only occasional cases gave the psoriasiform IF pattern, but about 30% of the specimens gave positive reactions in the SC though these were usually of a different pattern.

Antibody Formation↗

In vitro effects of pemphigus antibodies on skin.

Acantholysis occurring in rhesus monkey skin explants cultured on sera of 9 pemphigus patients was found to be largely dependent on the titre of intercellular antibody, and not on the participation of complement. Skin explants cultured on normal human sera and pemphigoid sera failed to give rise to intercullular staining or to develop lesions. Six of eight 'negative' pemphigus sera with intercellular antibody titres of less than 20 on skin (and titres ranging from 20 to 160 on monkey esophagus) reacted with the skin explants as revealed by direct immunofluorescence with an anti-IgG conjugate. The binding of antibodies from 3 of these 6 reactive sera resulted in some pathological changes in the explants. At least two of these 3 'negative' sera came from pemphigus patients with skin lesions.

Acantholysis↗

Tissue specificity of antinuclear antibodies in scleroderma.

Studies of antinuclear antibodies (ANA) were carried out in 39 cases of systemic scleroderma and for comparison in 19 cases of systemic lupus erythematosus (SLE) using indirect immunofluorescence (IF) methods under standard conditions. The results on three different substrates--monkey esophagus, guinea pig lip and rat liver--are reported. In 48.7% of scleroderma cases ANA showed a substrate specificity. The highest percentage of positive results in scleroderma was obtained on monkey esophagus (97.4%) and the lowest on rat liver (61.5%). In SLE, in contrast, only about 13% of the sera displayed such specificity. If only sera with substrate specificity are considered, the positive results on monkey esophagus and rat liver are 94.7% and 21.1%, respectively. Titers of sera reacting positively on 2 or 3 substrates were mostly in agreement, although some sera both in systemic scleroderma and SLE showed higher titers on monkey esophagus. The IF pattern was usually the same regardless of the substrate. Tests for ANA in scleroderma should be performed on at least 2 substrates simultaneously.

Animals↗

Coexistence of bullous pemphigoid and systemic lupus erythematosus.

A vesiculobullous eruption with clinical and histological features of bullous pemphigoid developed in a 28-year-old woman with proven systemic lupus erythematosus (SLE). Serum of this patient contained elevated titers of antinuclear antibodies but basement membrane antibodies could not be detected at first, though they did appear in blister fluid. Normal monkey skin explants cultured on this patient's sera gave positive direct immunofluorescence (IF) at the basement membrane zone (BMZ) for IgG deposits. The use of tissue culture methods may be helpful because of the capacity of this test system to reveal the presence of the antibodies to the BMZ despite the presence of the antinuclear antibodies that appear to interfere with their demonstration in standard indirect IF tests.

Adult↗

Immunologic phenomena in herpes gestationis.

Immunofluorescence studies were performed in 12 cases of herpes gestations. Direct IF staining (performed in 10 of them) revealed a highly characteristic pattern, notably 1) Constantly BMZ deposits of complement component C3, 2) In most biopsy specimens also C4 and C5, 3) Deposits of C4, C5, properdin and IgG variable in different specimens of given patients. About half of the specimens examined contained properdin and about one third stained for IgG, 4) Findings of IgM, IgA, IgD and IgE were consistently negative, 5) Serum findings of BMZ antibodies in given cases were variable. In two cases circulating BMZ antibodies were detected in one of the samples examined. On the base of these findings it seems that HG is related to BP.

Autoimmune Diseases↗

Autoimmune phenomena in psoriasis.

The striatum 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. These observations afford indirect evidence for the participation of SC antibodies and the ensuing fixation of complement in the development of psoriatic lesions.

Autoantibodies↗

Studies on the Koebner phenomenon.

The examination of induced Koebner reactions in 71 patients by the IF methods and by histology at selected times after scratching, show, that immunologically specific but non-disease specific reactions of stratum corneum (SC) antibodies occur adjacent to the crusts in both control subjects and psoriasis patients. In lesions induced by scratching in patients with psoriasis there develop progressively additional foci of apparent in viveo binding of SC antibodies. IF deposits may appear before histologic or clinical changes. The widespread immune deposits in the SC with typical histologic changes of psoriasis seem to be a sign of impending clinical psoriasis while single foci of in vivo bound SC antibodies may be cleared by the body without the development of psoriasis.

Autoantibodies↗

Pemphigus antibody action on skin explants: kinetics of acantholytic changes and stability of antigens in tissue cultures of normal monkey skin explants.

The pathogenic effect of the intercellular antibodies of pemphigus was studied by using organ culture of monkey skin. Skin explants that were grown on sera with intercellular antibody titers of 320 or greater fixed these antibodies within one day as demonstrated by direct immunofluorescence for IgG. None of the control sera gave such staining patterns. Following the binding of intercellular antibodies, characteristic histologic changes appeared, notably separation of individual epidermal cells and acantholysis. These histologic changes became more marked in two to five days. During this period, the bound antibodies and the intercellular antigens decreased and disappeared. These temporal relationships of immunofluorescence and histologic findings suggest that pemphigus antibodies play a role in the induction of acantholysis.

Acantholysis↗

Substrate specificity of antinuclear antibodies in scleroderma.

Studies of antinuclear antibodies (ANA) were carried out in 39 cases of systemic scleroderma and for comparison in 19 cases of systemic lupus erythematosus (SLE) and 4 of mixed connective tissue disease (MCTD) using indirect immunofluorescence (IF) methods under standard conditions. The results on three different substrates--monkey esophagus, guineapig lip and rat liver--are reported. In 48.7% of scleroderma cases ANA showed a substrate specificity. The highest percentage of positive results in scleroderma was obtained on monkey esophagus (97.4%) and the lowest on rat liver (61.5%). In SLE and MCTD, in contrast, only about 13% of the sera displayed such specificity. If only sera with substrate specificity are considered, the positive results on monkey esophagus and rat liver are 94.7% and 21.1%, respectively. Titers of sera reacting positively on 2 or 3 substrates were mostly in agreement, although some sera both in systemic scleroderma and SLE showed higher titers on monkey esophagus. The IF pattern was usually the same regardless of the substrate, Tests for ANA in scleroderma should be performed on at least 2 substrates simultaneously.

Adult↗

Organ culture studies of pemphigus antibodies. II. Ultrastructural comparison between acantholytic changes in vitro and human pemphigus lesions.

The ultrastructural and light microscopic features of acantholysis produced in organ culture were compared with those of human pemphigus lesions. In both, an intraepidermal split was seen an typical suprabasal acantholytic cells were present. These cells contained small bundles of tonofilaments, usually located away from the cell periphery. Desmonsomal plaques with inserted tonofilaments frequently remained along the periphery of acantholytic cells and along the upper portion of the periphery of basal cells. The ultrastructural similarity between in vitro and in vivo lesions provides additional evidence to suggest that organ cultures may provide a valid model for studying the dynamics of pemphigus lesion formation.

Aged↗

Nuclear deposits of immunoglobulins in skin of patients with systemic lupus erythematosus.

Skin nuclear speckled IgG deposition was noted in seven patients. The patients' clinical courses satisfied at least four of the preliminary criteria of the American Rheumatism Association for the diagnosis of systemic lupus erthematosus (SLE). Examination of approximately 700 additional biopsies from patiets with SLE, connective tissue and various skin diseases as well as normal individuals, failed to demonstrate similar nuclear immunoglobulin deposition. Sera from these seven patients had higher titre, complement fixing anti-nuclear antibodies (ANA) of IgG class which produced a speckled nuclear fluorescent pattern. In addition, the sera of all seven patients demonstrated by gel double diffusion precipitating antibodies against nuclear ribonucleoprotein (RNP) or Sm antigens.

Adolescent↗

Studies on etiologic factors in pemphigus.

A survey of 234 cases of pemphigus yielded three observations which suggest that different forms of pemphigus may have different etiologies. 1. While the incidence of pemphigus in the age group of 21 and over was essentially the same in males and females (108 and 113) the incidence was significantly higher in females in the age group under 20. Only two of 13 patients in this group were males. Also pemphigus foliaceus and erythematosus was reported in a significantly higher proportion of the cases in the age group of 2 1/2 to 20 thus suggesting that the juvenile form of the disease differs from the adult form. 2. In four of a group of 15 cases identified as pemphigus foliaceus the disease appeared to be provoked by minor physical insults, a frequency which is significantly higher than the five cases with similar histories in the group of 198 cases identified as pemphigus vulgaris. 3. In the entire group of 234 cases two patients with pemphigus both proven by immunofluorescence had relatives with pemphigus. Also a third patient had a blood relative with bullous pemphigoid. This frequency of three per 234 is higher than would be expected by chance. Studies of one family (not included in this survey) with multiple skin antibodies suggest that such familial predispositions may be due to abnormal immune responses.

Adolescent↗