Immunological aspects of Goodpasture's syndrome.
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Biomedical subjects
Publications and source records attributed to F Schwartz.
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The availability of monoclonal antibodies which bind to a specific antigen at distinct and well-defined sites has led to a better understanding of the effects of highly specific enzyme-antibody interactions on enzyme behaviour. By appropriate selection it has been possible to isolate those antibodies that are non-inhibitory to biological activity of the enzyme and bind at strategic locations on the antigen molecule, resulting in a considerable stabilization effect on the enzyme conformation. Moreover, such monoclonal antibodies proved to have a chaperone activity leading to a considerable refolding effect on the enzyme which was already partially heat denatured. Renaturation of carboxypeptidase A after heat denaturation in the presence of selected monoclonal antibodies, was followed by recovery of its enzymatic activity. The refolding effect of anti-CPA monoclonal antibodies on heat-denatured enzyme depends on the degree of denaturation of the enzyme and on the location of the antigenic site of each antibody. The additivity effect of the pairs of monoclonal antibodies on the refolding process of CPA proved to be dependent on the localization of the antigenic sites of the monoclonal antibodies studied.
From May 1977 to January 1983, 270 patients with traumatic vascular lesions were treated in our Service. Among these, 27 presented associated fractures and/or dislocations. A high index of suspicion, the early recognition of the presence of vascular injury by thorough clinical evaluation, routine use of the Doppler flowmeter and broad indication of preoperative angiography resulted in prompt repair of these lesions in the majority of cases. Early exploration, wide fasciotomies, use of temporary intraluminal shunts during the bone fixation procedures (usually by internal plates), definitive venous and arterial repair after limb stabilization was achieved and frequent use of intraoperative angiography were the predominant factors in the treatment and outcome in these complex injuries. All eight limbs with closed fractures and/or dislocations were preserved, as well as 17 of 19 (89%) of the limbs with open or exposed skeletal injuries, resulting in a limb salvage rate of 92.6%.
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