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Biomedical subjects

E Hedfors

Publications and source records attributed to E Hedfors.

At least 37 records · Page 2Linked to original sources

Lymphocytic infiltrates and epithelial HLA-DR expression in lip salivary glands in connective tissue disease patients lacking sicca: a prospective study.

Focal lymphocytic infiltrations indistinguishable from what has been described in Sjögren's syndrome (SS) were found in lip salivary gland (LSG) biopsies in 15 of 80 patients with various connective tissue diseases (CTDs) lacking sicca. During a 4-year follow-up period, none of the patients developed symptoms or signs of decreased lacrimal or salivary gland function. Focal lymphocytic infiltrates of LSGs seemingly unrelated to glandular function are to be found in patients' various CTDs and therefore the diagnostic value of a positive LSG biopsy in this context has to be questioned.

Adult↗

Lymphocytic infiltration and HLA-DR expression of salivary glands in bone marrow transplant recipients: a prospective study.

Lymphocytic infiltration and epithelial HLA-DR expression of lip salivary glands were studied by means of an immunohistoenzymatic staining technique in patients undergoing repeated lip salivary gland biopsies before, and 12, 26, 52 and 104 weeks after bone marrow transplantation (BMT). Within 12 weeks of transplantation, lymphocytes, mainly of the anti-Leu3a+ T 'helper' phenotype, were seen infiltrating the salivary glands of all the patients, reaching a maximum between 26 and 52 weeks. Epithelial HLA-DR expression, present at the 12th week after BMT, was seen close to the lymphocytic infiltrates in all the specimens. Two years after BMT, lymphocytic infiltrates and epithelial HLA-DR expression were still noted in about half of the specimens but not seen in the remaining ones. No correlations were found between immunohistopathology and earlier or persistent chronic graft-versus-host disease or immunosuppressive treatment. The significance of the findings as well as their resemblance to idiopathic connective tissue diseases, notably Sjögren's syndrome, are discussed.

Adolescent↗

Arthroscopic and immunohistologic characterization of knee joint synovitis in osteoarthritis.

We studied 10 patients who had arthritis of the knee joint, but no other signs of rheumatic disease. The clinical diagnosis of osteoarthritis was corroborated by arthroscopic evidence of characteristic cartilage degeneration. Signs of inflammation were confined to areas of the synovial membrane that lay near the cartilage; thus, the major part of the joint cavity was not affected. The intensity of the synovial inflammation varied within the areas involved, but was always most pronounced in regions rimming the cartilage. Biopsy samples selected from regions of intensely inflamed synovium contained foci of T lymphocytes, which were bordered by immunoglobulin-carrying B lymphocytes and plasma cells, as well as strongly HLA-DR positive dendritic-like cells adjoined to alpha Leu-3a+ T helper lymphocytes. In tissue samples taken from macroscopically noninflamed areas, only a few infiltrating lymphocytes were seen. Thus, the inflammatory synovial changes found in osteoarthritis appear to be anatomically restricted and of varied intensity but, when present, are microscopically indistinguishable from the changes that have been previously described as indicative of rheumatoid arthritis.

Arthroscopy↗

The synovial membrane of healthy individuals--immunohistochemical overlap with synovitis.

The synovial membrane of healthy volunteers was analysed by immunohistochemical staining of biopsies sampled under direct vision at arthroscopy or obtained blindly by needle. Infiltrating Leu-4+ T lymphocytes were found scattered in all biopsies but frequently also perivascularly accumulated. A majority of the synovial lining cells expressed either the OKM1 monocyte/macrophage marker or HLA-DR antigens. Some OKM1- HLA-DR+ lining cells also expressed the Leu-3a T 'helper' cell marker. In the sublining tissue non-lymphoid cells with varying morphology including macrophage- and fibrocyte-like cells were found expressing either HLA-DR, or Leu-3a, or both antigens simultaneously, whereas OKM1+ macrophage-like sublining cells were rare. The perivascular T lymphocyte accumulation as well as the phenotypic heterogeneity of infiltrating and residing cells, previously thought indicative of synovitis, were thus also found in the synovial membrane of healthy individuals.

Adult↗

Anticardiolipin antibodies during pregnancy.

A case of antinuclear antibody negative systemic lupus erythematosus, characterized by repeated vessel occlusion and spontaneous abortions, in which anticardiolipin antibodies seemed to be transiently present during early pregnancy is reported. The possible role of the antibodies inducing abortion is discussed.

Abortion, Habitual↗

The use of immunoblotting and immunoprecipitation of (U) small nuclear ribonucleoproteins in the analysis of sera of patients with mixed connective tissue disease and systemic lupus erythematosus. A cross-sectional, longitudinal study.

Antibodies to ribonucleoproteins (RNP) and to the Sm antigen in sera from patients with mixed connective tissue disease (MCTD) and systemic lupus erythematosus were studied using the techniques of immunoblotting and immunoprecipitation of U small nuclear RNPs. A cross-sectional study indicated that antibodies reacting with a 68K protein were associated with anti-RNP specificity in MCTD, but rarely occurred in systemic lupus erythematosus patients' sera. A longitudinal study demonstrated the persistence of MCTD blotting patterns over many years, and the subsequent disappearance of those specificities in sera from patients who were in prolonged remission.

Antibodies↗

Periductal lymphocytic infiltrates in salivary glands in myasthenia gravis patients lacking Sjögren's syndrome.

In eight of eleven patients with clinical and serological evidence of myasthenia gravis (MG), immunohistological analysis of biopsies from labial salivary glands (LSG) showed focal periductal lymphocytic infiltrates, mainly composed of anti-Leu 3a+ T helper lymphocytes, a finding usually regarded as indicative for Sjögren's syndrome (SS). None of the patients could however, according to functional criteria, be considered as having SS. This study thus indicates that lymphocytic infiltrates in LSG can be seen in MG, which has been thought of as an organspecific autoimmune disease with symptoms and signs confined to striated muscles.

Adolescent↗

Intraarticular variation in synovitis. Local macroscopic and microscopic signs of inflammatory activity are significantly correlated.

Multiple biopsy specimens from various parts of the synovial membrane were sampled under direct vision during arthroscopic surveying of the inflamed knee joints of 12 patients with various arthritides. Considerable variation in the macroscopic signs of inflammatory activity was found within the single joint. However, there was a highly significant correlation (P less than 0.001) between local macroscopic signs of inflammatory activity and microscopic signs (by immunohistochemical analysis of the corresponding tissue sample). The profound intraarticular variation in inflammatory activity was seen irrespective of clinical diagnosis. An immunohistologic pattern comprising foci of T helper cells, associated immunoglobulin-bearing cells, and HLA-DR-expressing dendritic cells was not specific for rheumatoid arthritis or any other diagnosis, but was found in the biopsy samples from sites that macroscopically demonstrated maximal inflammatory activity.

Adult↗

Epithelial HLA-DR expression and T lymphocyte subsets in salivary glands in Sjögren's syndrome.

Salivary glands obtained at biopsy from patients with Sjögren's syndrome and controls were studied with regard to phenotype of infiltrating and residing cells, by means of a double immunoenzymatic staining technique. The infiltrating lymphocytes, which were sparse or absent in the control group in contrast to their abundant presence in the Sjögren patients, consisted in both groups mainly of T lymphocytes, the majority of which were T helper cells. In the controls, the glandular epithelial cells were HLA-DR- whereas in the Sjögren patients HLA-DR+ epithelial cells were found, mainly confined to areas, where the epithelial cells were seen in close proximity to the periphery of dense lymphocytic infiltrates. The data are in accordance with recent findings of HLA-DR expressing residing cells in the target organs of various chronic inflammatory diseases and might indicate the induction of HLA-DR expression in nonlymphocytic cells of target organs in which a cellular infiltration dominated by cells of the T helper phenotype is found.

Adult↗

Rifamycin SV in local treatment of synovitis--a clinical, arthroscopic and pharmacologic evaluation.

Intraarticular injections of rifamycin SV were repeated weekly in patients with rheumatic disease with a chronic knee joint effusion. The clinical signs of synovitis were reduced in all, but disappeared in only one. A post injection reaction with transient local pain and effusion appeared at the third or a later injection in all the patients prompting withdrawal of 3. At these later injections local drug retention was shown by parallel determinations of rifamycin SV in synovial fluid and serum. The post treatment synovial fibrosis seen at arthroscopy could possibly explain the drug retention and the post injection inflammatory reaction. Thus, local treatment with rifamycin SV alleviated but rarely abolished synovitis.

Adolescent↗

Phenotypic characterization of synovial tissue cells in situ in different types of synovitis.

Immunohistochemical double-staining was performed on frozen sections from synovial biopsies obtained at arthroscopy from 22 patients with different kinds of synovitis. Not only in specimens from patients with rheumatoid arthritis and seronegative chronic polyarthritis, but also in those from patients with synovitis due to psoriasis, trauma, or crystals, were seen many alpha Leu-1-positive T lymphocytes--in most cases predominantly of the alpha Leu-3a-positive T "helper" cell type--in close contact with HLA-DR-positive macrophages/dendritic cells. Presence of many HLA-DR-positive, often OKM1-negative, and irregular sublining cells characterized all forms of chronic arthritis.

Adult↗