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Biomedical subjects

G Lindahl

Publications and source records attributed to G Lindahl.

At least 73 records · Page 4Linked to original sources

Signs of Sjögren's syndrome in a patient with myasthenia gravis.

A case of myasthenia gravis (MG) with recurrent submandibular salivary gland enlargement and focal lymphocytic infiltrates in lip salivary glands is described. Though the clinical and close histopathological resemblance with Sjögren's syndrome (SS), a condition characterized by impaired exocrine function of affected glands, no exocrine disturbance evolved during 3-years follow up. The clinical and histopathological overlap between MG and SS, sharing several immunological characteristics, might be of relevance in further studies on the pathogenesis of the two conditions.

Adult↗

Variation of MHC class I and II antigen expression in relation to lymphocytic infiltrates and interferon-gamma positive cells.

The occurrence of MHC antigens on epithelial cells in lip salivary glands obtained from patients with various connective tissue diseases and from bone marrow recipients was studied. The amount of infiltrating lymphocytes correlated to an increase in MHC class I and II antigen expression, but not to diagnosis or glandular function. Interferon-gamma + infiltrating cells were scanty. The role of interferon-gamma as the main inducer of MHC antigens and the notion "aberrant" HLA-DR thought to perpetuate chronic autoimmune disease are questioned.

Adolescent↗

The gene for the Lp(a)-specific glycoprotein is closely linked to the gene for plasminogen on chromosome 6.

We have studied the segregation of the Lp(a) glycoprotein phenotypes and of the plasminogen (PLG) polymorphism in three two-generation families. The inheritance of the Lp(a) gene was followed using the Lp(a) glycoprotein size polymorphism and that of the plasminogen gene, using protein and DNA polymorphisms. In the three families studied, no recombination was observed in 18 meioses. The lod score for linkage between the Lp(a) glycoprotein locus and the plasminogen locus in these families is greater than 5.0 at a recombination fraction of theta = 0. Our results show that the structural gene for the Lp(a) glycoprotein is closely linked to the gene for plasminogen on chromosome 6.

Chromosomes, Human, Pair 6↗

Cell surface proteins of a group A streptococcus type M4: the IgA receptor and a receptor related to M proteins are coded for by closely linked genes.

Two genes coding for cell surface proteins were cloned from a group A streptococcus type M4: the gene for an IgA binding protein and the gene for a fibrinogen binding protein. Both proteins were purified and partially characterized after expression in Escherichia coli. There was no immunological cross-reaction between the two proteins. The IgA binding protein, called protein Arp4, is similar to an IgA receptor previously purified from another strain of group A streptococci, but the proteins are not identical. Characterization of many independent clones showed that the two proteins described here are coded for by closely linked genes. Bacterial mutants have been found which have simultaneously lost the ability to express both genes, and a simple method to isolate such mutants is described. The existence of these variants indicates that expression of the two cell surface proteins may be coordinately regulated. Binding of fibrinogen is a characteristic property of streptococcal M proteins, and the available evidence suggests that the fibrinogen binding protein is indeed an M protein.

Antigens, Bacterial↗

Lymphocytic infiltrations of lip salivary glands in bone marrow recipients. A model for the development of the histopathological changes in Sjögren's syndrome?

By use of a PAP staining technique, the immunohistopathology in repeated biopsies from the lip salivary glands (LSGs) from patients undergoing bone marrow transplantation (BMT) was studied. In the previously normal LSGs, focally arranged lymphocytes and adjacent epithelial DR-expression appeared within 12 weeks post BMT, reaching a maximum between 26 and 52 weeks post BMT. Two years post BMT, lymphocytic infiltrates and epithelial DR-expression were still present in half of the specimens but were not seen in the remaining ones. The immunohistopathological changes seen in LSGs post BMT were indistinguishable from what has been found in Sjögren's syndrome. The appearance, and in some patients the subsequent disappearance, of the lymphocytic infiltrates and the epithelial DR-expression, without correlation to clinical symptoms of chronic graft-versus-host disease or immunosuppressive treatment, emphasizes the dynamic nature of lymphocytic infiltration of LSGs in BMT patients. Whether this also pertains to naturally occurring Sjögren's syndrome remains to be elucidated.

Bone Marrow Transplantation↗

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↗

Extensive sequence homology between IgA receptor and M proteins in Streptococcus pyogenes.

Many strains of Streptococcus pyogenes are known to express a receptor for IgA. The complete nucleotide sequence of the gene for such a receptor, protein Arp4, has been determined. The deduced amino acid sequence of 386 residues includes a signal sequence of 41 amino acids and a putative membrane anchor region, both of which are homologous to similar regions in other streptococcal surface proteins. The processed form of the IgA receptor has a length of 345 amino acids and a calculated molecular weight of 39544. The N-terminal sequence of the processed form is different from that previously found for a similar IgA receptor isolated from a S. pyogenes strain of type M60. The sequence of protein Arp4 shows extensive homology to the C-terminal half of streptococcal M proteins, but not to the streptococcal IgG receptor protein G or staphlyococcal protein A. Apart from the membrane anchor, this homology includes a sequence of 119 amino acid residues containing three repeated units and a 54-residue sequence without repeats. The protein expressed in Escherichia coli is found in the periplasmic space, in which it constitutes the major protein. Protein Arp4 is the first example of a surface protein that has both immunoglobulin-binding capacity and structural features characteristic of M proteins.

Amino Acid Sequence↗

Receptor for IgA in group A streptococci: cloning of the gene and characterization of the protein expressed in Escherichia coli.

The gene for an IgA-binding protein from a group A streptococcal strain was cloned and expressed in Escherichia coli. The IgA-binding protein, called protein Arp, was purified on IgA-Sepharose, allowing complete purification in a single step. Analysis of protein Arp by Western immunoblotting demonstrated a major IgA-binding band, with an apparent molecular weight of 42 kD. The purified protein was shown to bind serum IgA and secretory IgA, as well as monoclonal IgA of both subclasses. There was no binding to IgM, IgD or IgE, but a weak binding to IgG. Inhibition experiments with whole bacteria indicated that IgA and IgG bind at separate sites. Experiments with immunoglobulin fragments showed that protein Arp binds to the Fc region of both IgA and IgG. The equilibrium constant of the reaction between protein Arp and polyclonal human IgA was determined to be 5.6 x 10(8) M-1. Amino acid sequencing of protein Arp demonstrated a direct repeat of 7 amino acids in the NH2-terminal region, a feature previously found in several streptococcal M proteins. This suggests that protein Arp, like M proteins, may be a streptococcal virulence factor.

Amino Acid Sequence↗

Nonimmune binding of Ig to Clostridium perfringens. Preferential binding of IgM and aggregated IgG.

In an attempt to find a bacterial IgM receptor, a large number of bacterial strains of different species were screened for the ability to bind human IgM. Certain strains of the anaerobic bacterium Clostridium perfringens were found to bind a major fraction of polyclonal IgM. One bacterial strain showed a particularly high binding capacity and was studied in more detail. This strain is also able to bind a minor fraction of polyclonal IgA and IgG. Inhibition experiments indicate that the different Ig classes bind to one and the same R structure. The ability of the strain to bind polyclonal Ig is correlated to the number of subunits in the Ig. This correlation can most simply be explained by increasing avidity with increasing number of subunits. In agreement with this hypotheses, experiments with aggregated IgG show that binding ability increases with aggregate size. Experiments with Ig fragments indicate that the binding structure in Ig is located in the F(ab')2 region. The ability of this bacterial strain to bind a majority of IgM molecules as well as aggregated IgG is potentially useful in immunologic work and represents a new type of Ig binding to bacteria.

Bacteria↗

Clinical trial of sustained-release artificial tears in keratoconjunctivitis sicca and Sjögren's syndrome.

The effect of sustained-release artificial tear inserts on symptoms and signs of reduced tear production in keratoconjunctivitis sicca (KCS) was evaluated in an open clinical trial including 30 patients. A significant relief of sicca symptoms and a decrease in keratoconjunctival staining were seen in 10 patients fulfilling the study, whereas no significant effect on Schirmer test and tear break-up-time could be detected, neither in patients with pure KCS nor with KCS as a manifestation of Sjögren's syndrome. Twenty patients (67%) withdrew due to adverse effects, which were reported in total 80% of the patients. Absence of measurable tear secretion predicted treatment failure. Due to the frequent side effects, the artificial tear inserts cannot be recommended as a first line treatment in KCS patients.

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↗

Streptococcal protein G, expressed by streptococci or by Escherichia coli, has separate binding sites for human albumin and IgG.

Protein G is expressed at the cell surface of certain group C and group G streptococcal strains. The protein shows a unique and specific affinity for the Fc region of mammalian polyclonal and monoclonal immunoglobulin G (IgG). We have cloned the streptococcal gene coding for protein G into E. coli, using phage lambda as the vector. The protein G produced by E. coli infected with this phage was detected and analysed in Western blot experiments using radiolabelled IgG Fc fragments as a probe. Three major IgG Fc-binding bands were obtained corresponding to apparent mol. wts of 47,000, 57,000 and 65,000, respectively. Analysis of the expression in E. coli indicates that this heterogeneity is caused by a post-translational degradation of the molecule before lysis of the lambda infected E. coli cells occurred. The protein G produced in E. coli was purified by affinity chromatography on IgG-Sepharose followed by gel-filtration on Sephadex G-200. This highly purified E. coli-produced protein G was compared to protein G solubilized by papain from streptococci, in direct binding experiments and in a competitive binding assay. The two protein G variants were found to interact with polyclonal IgG from different species in a similar way. Streptococcal strains expressing protein G also show affinity for human albumin, and at the molecular level protein G was found to be responsible also for the binding of albumin. Thus, both E. coli-produced protein G and the proteolytic fragment of protein G obtained from streptococci, bound albumin. On the protein G molecule, two different and separate sites were found to bind IgG and albumin. Finally, when whole streptococci were incubated with human plasma, the interactions with protein G caused a coating of the bacteria with albumin and IgG, whereas other plasma proteins showed no affinity for protein G.

Bacterial Proteins↗

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↗

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↗