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Biomedical subjects

E Penner

Publications and source records attributed to E Penner.

At least 73 records · Page 4Linked to original sources

Dissociation of immune complexes in tissue sections by excess of antigen.

Immune complexes (IC) present in the glomeruli of rabbits with chronic serum sickness (CSS) and in patients with systemic lupus erythematosus (SLE), idiopathic membranous nephropathy (IMN), and acute poststreptococcal glomerulonephritis (PSGN) were analyzed by incubation with antigenic preparations. The efficacy of these preparations to dissolve IC was assayed by comparison of results of direct immunofluorescence tests performed with the kidney tissues before and after incubation with antigenic preparations. The FITC-conjugated antisera used in these tests were specific for IgG, C3, and-in the case of CSS-for the eliciting antigen, bovine serum albumin (BSA). During the acute proteinuric phase of CSS in rabbits, incubation of tissue sections with BSA alone led to complete dissolution of IC. In many rabbits with late phase proteinuria, however, tissues had to be incubated with both BSA and aggregated fraction II of rabbit serum. In all biopsy specimens from patients with IMN, and in some specimens from patients with PSGN and SLE, aggregated fraction II of human serum resulted in complete or incomplete dissolution of IC. On the other hand, incubation of tissues with excess DNA in SLE or with streptococcal antigens PSGN did not lead to dissolution of IC. These studies suggest significant participation of antibodies to aggregated immunoglobulins (i.e., rheumatoid factors or rheumatoid-like factors) in IC found in the above-mentioned diseases. Other antigen -antibody systems, however, may also contribute to the deposits in the glomerulonephritides studied.

Animals↗

Serum and cerebrospinal fluid immune complexes containing hepatitis B surface antigen in Guillain-Barré syndrome.

A 76-yr-old male presented with Guillain-Barré syndrome after acute hepatitis B virus infection. Main immunologic features were: (a) high levels of circulating hepatitis B surface antigen-containing immune complexes in serum and cerebrospinal fluid during the acute neurologic syndrome, and (b) clearance of immune-complex material with recovery. Our data indicate that these immune complexes in cerebrospinal fluid reflect leakage from the systemic circulation via a deranged blood-brain barrier and are not generated in the cerebrospinal compartment. Possibly deposition of such immune complexes along nerve structures is important in the immunopathogenesis of some cases of Guillain-Barré syndrome.

Aged↗

[Complexed microsomal antigens in acute hepatitis B (author's transl)].

Microsomal antigens and corresponding antibodies are predominantly detected following halothane hepatitis and chronic active hepatitis with autoimmune markers. In the case of acute hepatitis B reported by us, complexed microsomal antigens were found during active disease, gradually clearing with seroconversion of microsomal markers and improvement of liver function.

Adult↗

Detection of a microsomal antigen and its antibody in human liver diseases.

Sera of 173 patients with various forms of liver disease along with serum precipitates produced by polyethylene glycol were screened for the presence of a microsomal antigen referred to as ubiquitous tissue antigen (UTA) and its antibody by double diffusion precipitation in agarose gel. UTA was detected in 7 or 26 patients with chronic active hepatitis, 1 of 5 with alcoholic hepatitis, 2 of 14 with alcoholic cirrhosis and 18 of 98 with hepatoma. Antibodies to UTA were found only in 2 patients with chronic active hepatitis, 1 with alcoholic cirrhosis and 1 with hepatoma. No UTA or its antibody were noted in sera of 5 patients with alcoholic fatty liver, 10 patients with hepatitis B, and 15 asymptomatic carriers of HBsAg. Positivity for the UTA or its antibody was restricted to severe, chronic cases irrespective of diagnosis, indicating that persistent tissue destruction might be necessary for antigen release or antibody formation.

Antibodies↗

Calcitonin load in absorptive hypercalciuria type I.

The persistence of hypercalciuria (HCU), despite long-lasting calcium restriction in the diet in patients with absorptive HCU type I gives evidence of an additional endogenous source of calcium contributing to the pathogenesis of this disorder. The role of calcium mobilization from the bone is documented by the effective suppression of enhanced calcium mobilization from the bone, by means of calcitonin load in 5 patients with absorptive HCU type I and comparison with 7 normal controls.

Adult↗

The diagnostic application of specific antiprocollagen sera. II. Analysis of liver biopsies.

Frozen, unfixed sections of human liver biopsies from patients with acute, subchronic, and chronic hepatitis or fibrotic liver disease were studied in indirect immunofluorescence with specific antisera to type I and type III procollagen. In early stages of both hepatitis and fibrotic liver disease, intralobular type III collagen synthesis is increased. Maximum values are reached years after the onset of disease. Intralobular procollagen I content is not increased in the acute stage, but rises only later. An increase of procollagen I seems to herald irreversible liver changes. This approach allows for exact localization and semiquantitative analysis of the synthesis of type I and type III collagen, and adds a new parameter to the diagnostic approaches in liver diseases.

Adolescent↗

[Effect of portocaval shunt and arterialization of the liver on antibodies to Escherichia coli in patients with cirrhosis of the liver (author's transl)].

The effect of a portocaval shunt with and without portal arterialization of the liver on serum immunoglobulin concentrations and on the incidence of antibodies to 8 different serotypes of Escherichia coli was studied in 29 patients with cirrhosis of the liver. Compared with healthy controls, the serum concentrations of IgG, IgA and IgM were significantly elevated in cirrhotic patients. No difference in immunoglobulin concentrations could be observed between shunted and arterialized cirrhotics. The incidence of E. coli antibodies was significantly higher in patients with cirrhosis of the liver, showing a further increase in patients with portocaval shunt operations. Portal arterialization of the liver after portocaval shunting did prevent this additional increase, presumably by restoring the antigen clearing capacity of the cirrhotic liver, thus avoiding an additional stimulation of the antigen response after the portocaval shunt. The quantitative contribution of E. coli antibodies to the hyperimmunoglobulinemia of patients with cirrhosis of the liver seems to be of little significance. The results of this study underline the significance of the portal hepatic blood flow for the function of the reticulo-endothelial system of the liver.

Antibodies, Bacterial↗

Detection of circulating immune complexes in alcoholic liver disease.

Sera of twenty-five patients with alcoholic liver disease and forty normal control sera were screened for circulating immune complexes by means of the anti-antibody neutralization test and by Raji-cell membrane immunofluorescence assay. IgG-containing immune complexes were detected in thirteen out of twenty-five patients with alcoholic liver diseases and in one out of forty normal individuals; in addition, IgA-containing complexes were demonstrated in seven out of thirteen sera positive for IgG complexes. The presence of immune complexes was restricted to alcoholic hepatitis and active cirrhosis, thus indicating a relationship with disease severity.

Antigen-Antibody Complex↗

[New antihypertensive agent of the imidazoline series: 5-fluoro-methyl-imidazolidinylidene-benzamine-monohydrochloride (flutonidin)].

A New Antihypertensive of the Imidazoline Series: 5-Fluoro-2-methyl-imidazolidinylidene-benzamine-monohydrochloride. 5-Fluoro-2-methyl-imidazolidinylidene-benzamine-hydrochloride (flutonidin, ST 600), a new antihypertensive imidazoline compound, was tested over 3 weeks in 20 patients with moderate to severe hypertension. Blood pressure was significantly lowered in both supine and upright position. In nearly 2/3 of the patients treated normalization of blood pressure was achieved. Side effects like sedation, dry mouth or orthostatic complaints were present in 30%. Toxic effects were not registered. It is recommended to reduce the dosage slowly especially in the aged to prevent, in part severe findings after abrupt withdrawal.

Adult↗

[Bilirubin metabolism (author's transl)].

The degradation of haemoglobin haeme of senescent red blood cells - involving NADPH-dependent haeme oxygenase and biliverdin reductase - in the reticuloendothelial cells of the spleen, bone marrow and liver accounts for 80 to 90% of the 250 to 300 mg of bilirubin formed in 24 hours. The remaining 10 to 20% derive from catabolism of other haemoproteins and from the destruction of maturing red blood cells in the marrow. In studies with isotopically-labelled metabolic precursors of haeme this fraction can be found in the early-labelled peak. In plasma virtually all the bilirubin is tightly bound to plasma proteins, largely albumin, because it is only sparingly soluble in aqueous solutions at physiological pH. In the sinusoids unconjugated bilirubin dissocates from albumin, enters the liver cells across the cell membrane through non-ionic diffusion and is bound by the two cytoplasmic proteins Y (or ligandin) and Z. Little is known about the transfer of unconjugated bilirubin from these binding proteins to the smooth endoplasmatic reticulum, where it is converted to a water-soluble ester glucuronide by bilirubin UDP-glucuronyl transferase. The physiological significance of non-glucoronide conjugates (sulphate, disaccharides) is only of minor importance. Following conjugation, bilirubin is transferred rapidly across the canalicular membrane into the bile canaliculi. This process is energy-dependent and occurs against a concentration gradient. The epithelial lining of the intestine and of the gall bladder, which can easily reabsorb lipid-soluble unconjugated bilirubin, is virtually impermeable to organic anions of the size and charge of conjugated bilirubin, thereby ensuring efficient excretion of this pigment. In the intestinal tract bilirubin is reduced to urobilinogen, which is subsequently reabsorbed to some extent into the enterohepatic circulation, removed from plasma by the liver and excreted unchanged in the bile. This rapid bacterial reduction of bilirubin makes it unlikely that unconjugated bilirubin is formed and absorbed to an appreciable degree. The residual part of urobilinogen is further reduced to urobilin, stercobilin and dipyrrolmethenes and excreted in the faeces.

Bilirubin↗

[LDH isoenzymes and gastrin in achlorhydri (author's transl)].

Several haematological findings (especially the values of serum LDH and its isoenzymes) were compared with changes in the gastrin level in pernicious anaemia. While vitamin B12 substitution therapy led to normalization of the anaemia and of the enzyme levels, gastric atrophy and, hence, the elevation in serum gastrin levels remained unchanged. Determination of serum gastrin, therefore, provides a valuable tool for the verification of the diagnosis of pernicious anaemia in treated cases.

Achlorhydria↗

[Myocardial infarct after gastroscopy. Case report and pathogenetic considerations].

Three cases are reported of myocardial infarction and severe myocardial ischemia following gastroscopy in patients with coronary heart disease. These cases demonstrate the high risk of endoscopy in such patients. It is assumed that the main pathogenetic factors are catecholamine-mediated tachycardia and the close vicinity of the lower esophagus to the right coronary artery, with its tendency to coronary spasmus.

Aged↗