Biomedical subjects

G Pauli

Publications and source records attributed to G Pauli.

At least 109 records · Page 6Linked to original sources

PubMed1998

[Occupational asthma].

Occupational asthma is specifically induced by repeated exposure to substances in the work place. Diagnosis requires using the results of numerous tests, and a challenge test is the most appropriate to establish the diagnosis of occupational asthma due to chemical agents. Agents responsible for occupational asthma may be of animal or vegetable origin, or may be chemical agents. The pathophysiological mechanisms of occupational asthma are not well known. It is probable that immunologic mechanisms play an important role, in particular in occupational asthma due to glycoproteins. An important feature of occupational asthma is the relationship to chemical substances, for which the mechanisms are often still hypothetical. From the legal viewpoint, a recent law holds the promise of better compensation for those who are afflicted.

Asthma↗

PubMed1998

Transport of viruses through fetal membranes: an in vitro model of perinatal transmission.

A model system for perinatal transmission of viral infections was developed and transport of infectious virus particles through fetal membranes was investigated. Viruses of different families known to cause serious intrauterine infections were selected, including relevant and model viruses: the DNA-viruses HSV-1 and -2 as well as the animal herpes viruses BHV-1 and SHV-1, the RNA-virus BVDV as a model for hepatitis C virus, HIV-1 and -2, and PPV as a model for parvovirus B19. Migration of infectious virus from the maternal to the fetal side of the membrane could be detected as early as 20 min after the start of incubation. A peak of virus migration was observed after 1-2 hr. 0.02-1% of HSV-1 and 0.03-0.2% of HSV-2 were transported from the maternal side of the membrane to the fetal side. Only 0.01% of PPV migrated to the fetal side, whereas no transport of BVDV was observed. HIV-1 (1.4%) and HIV-2 (0.8%) seemed to be transported at higher rates. The concept of an active transport of infectious virus is compatible with the kinetics of penetration of the fetal membrane. The question of whether different receptors for the individual viruses on the cellular surface account for differences in virus transport will require further investigation. The fetal membrane acts as a protective barrier for the fetus, reducing greatly infectious titers or even preventing completely penetration of virus.

Extraembryonic Membranes↗

PubMed1998

Inactivation of viruses by beta-propiolactone in human cryo poor plasma and IgG concentrates.

Virus inactivation by cold treatment with beta-propiolactone (BPL) was investigated in human cryo poor plasma and purified IgG concentrates spiked with relevant human viruses or appropriate animal model viruses. The samples were treated with 0.1 or 0.25% BPL for 300 or 480 min, respectively. Residual infectivity was determined by standard microtitration assays on tissue culture cells. The inactivation of all viruses tested was more effective in IgG than in plasma. IgG: R1=4-5.5 log10 for vesicular stomatitis virus (VSV). Semliki Forest virus (SFV), bovine virus diarrhoea virus (BVDV), murine encephalomyelitis virus (MEV), feline calicivirus (FVC), suid parvovirus (PPV), simian virus 40 (SV40); R1=2-4 log10 for suid herpesvirus type 1 (SHV-1), bovine herpesvirus type 1 (BHV-1), human immunodeficiency virus type 2 (HIV-2), simian immunodeficiency virus (SIVagm3). Plasma: R1=3-5 log10 for VSV, SFV, BVDV, SHV-1, MEV:R1=0-3 log10 for HIV-1, SIVagm3 BHV-1, FCV, PPV, SV40. After addition of SIVagm3, HIV-2, and PPV to plasma or IgG, spontaneous inactivation without further addition of BPL was observed. These results demonstrate that treatment with BPL has a limited capacity to inactivate viruses. Different inactivation kinetics were observed in plasma and IgG concentrates. Therefore, virus inactivation by BPL must be tested for individual blood products independently and should not be extrapolated from other model systems.

Animals↗

PubMed1998

Recombinant birch pollen allergens (rBet v 1 and rBet v 2) contain most of the IgE epitopes present in birch, alder, hornbeam, hazel, and oak pollen: a quantitative IgE inhibition study with sera from different populations.

BACKGROUND: Pollen from trees of the order Fagales are important allergen sources in most parts of the world. Clinical, immunochemical, and molecular biology studies indicate that they contain cross-reactive allergens. The major birch pollen allergen, Bet v 1, and birch profilin, Bet v 2, a highly cross-reactive allergen, have been cloned and expressed in Escherichia coli. OBJECTIVE: The purpose of this study was to demonstrate the presence of allergens in Fagales pollens that share IgE epitopes with recombinant Bet v 1 and Bet v 2 and to determine the percentage of birch, alder, hornbeam, hazel, and oak pollen-specific IgE that can be preabsorbed with rBet v 1 and rBet v 2 from 102 sera of different populations of subjects allergic to Fagales tree pollen. METHODS: The presence of rBet v 1- and rBet v 2-homologous allergens in tree pollen extracts was investigated by IgE immunoblot inhibition experiments, and the percentage of tree (birch, alder, hornbeam, hazel, and oak) pollen-specific IgE that was bound by a mixture of rBet v 1 and rBet v 2 was determined by RAST-based quantitative IgE inhibition experiments. The clinical significance of IgE antibody cross-reactivity was studied by skin prick testing with rBet v 1, rBet v 2, and Fagales pollen extracts. RESULTS: Natural birch, alder, hornbeam, hazel, and oak pollen contain allergens that share IgE epitopes with rBet v 1 and rBet v 2. A combination of rBet v 1 and rBet v 2 accounted for 82% of tree pollen-specific IgE on average. Most of the tree pollen-specific IgE was directed against rBet v 1. CONCLUSION: rBet v 1 and rBet v 2 contain most of the Fagales pollen-specific IgE epitopes and may therefore substitute natural tree pollen extracts not only for diagnosis but also for patient-tailored immunotherapy of tree pollen allergy.

Adult↗

PubMed1998

Quality control study on the performance of GB virus C/hepatitis G virus PCR.

BACKGROUND/AIMS: A novel virus, GBV-C/HGV, with a genome RNA organization similar to that of the Flaviviridae family was identified in sera of patients with hepatitis. The presence of GBV-C/HGV RNA can only be determined by the amplification of genomic regions using the reverse transcriptase-polymerase chain reaction (RT-PCR). METHODS: To assess the quality of the RT-PCR, 14 laboratories investigated a coded serum panel that comprised three GBV-C/HGV RNA-positive sera from three different patients, dilutions of these sera, and three GBV-C/HGV RNA-negative serum samples, two of which were collected from patients with hepatitis C but without GBV-C/HGV infection. In-house RT-PCR as well as commercially available GBV-C/HGV test kits were used in this study. RESULTS: Only four laboratories (29%) reported the expected results, and four laboratories (29%) false-positive results; nine laboratories (64%) reported at least one false-negative result. Eleven laboratories (79%) detected the undiluted samples. The majority of false results were obtained with the dilutions of GBV-C/HGV RNA-positive samples. Negative results in the 10(-4) dilution were not considered to be false-negative, since during pre-screening GBV-C/HGV RNA had been detected in this dilution in only 50% of assays by the three laboratories involved in organizing the evaluation. Results obtained by commercial kits and by in-house assays were indiscriminate in quality of performance in this study. CONCLUSION: To facilitate further quality assessment studies on the performance of GBV-C/HGV RNA detection, an international GBV-C/HGV RNA standard should be made available. Further efforts are required to optimize GBV-C/HGV RT-PCR.

Austria↗

PubMed1998

Weekly systemic combination of cisplatin and interferon alpha 2a in diffuse malignant pleural mesothelioma.

The treatment of diffuse malignant pleural mesothelioma (DMPM) remains grim. Neither surgery, radiotherapy nor chemotherapy can be considered as a standard therapy. Immunotherapy with interferon (IFN) in combination with chemotherapy may be an interesting new approach. In 13 consecutive patients with DMPM, we used a weekly combination of cisplatin (CDDP) (60 mg/m2; day 2) and IFN alpha 2a (6 MU/day; days 1-4) in a protocol of two cycles of 4 weeks on/4 weeks off followed by 3 weeks on/3 weeks off. Total treatment duration was thus 25 weeks. In responders, IFN as maintenance monotherapy was continued for a further 6 months. There were nine males and four females with an average age of 65.3 years (range 51-72 years). Eleven had epithelial, one had mixed and one had a sarcomatoid form of DMPM. Five patients were classified as stage II, six as stage III and two as stage IV, as per the International Mesothelioma Interest Group. Thirty-five cycles were administered with a median of three cycles/patient (range 0.75-4). The median total cumulative dose of CDDP was 596 mg/m2 (range 114-861) and that of IFN alpha 2a was 264 MU (range 72-336). Four patients received IFN maintenance therapy, one for 3 months and three for 6 months. One patient had a complete response, four had a partial response, six had a stable disease and the disease progressed in one. One patient was non evaluable for response. All patients were assessable for toxicity. Hematological toxicity was the most frequently observed but was manageable (grade 3 anemia in five patients, grade 3 thrombocytopenia in three patients, grade 3 neutropenia in five patients). Grade 1 renal toxicity was observed in six patients, grade 2-3 asthenia in six patients and an average 5-kg weight loss was noted in nine patients. In conclusion, systemic combination of CDDP and IFN alpha 2a in large doses is effective at the expense of non-negligible toxicity.

Aged↗

PubMed1998

[Bronchopulmonary carcinosarcoma].

INTRODUCTION: Bronchopulmonary carcinosarcoma is an uncommon neoplasm consisting of mixed malignant epithelial and mesenchymal cells. EXEGESIS: We report a case of bronchopulmonary carcinosarcoma in a 62-year-old man illustrating some characteristics of this tumor of poor prognosis and unknown histogenesis. CONCLUSION: Bronchopulmonary carcinosarcoma has clinical and X rays features identical to those of bronchopulmonary epithelial malignant tumors. Most of the authors consider that a totipotential cell might be at the origin of this "mixed" tumor. Although 90% of bronchopulmonary carcinosarcomas are resectable, their prognosis is worse than that of other lung cancers, with a 6-month median survival.

Bronchial Neoplasms↗

PubMed1998

Increase in non-specific bronchial hyperresponsiveness without specific response to isocyanate in isocyanate-induced asthma: a pilot study.

Increased non-specific bronchial hyperresponsiveness (BHR) has been reported after positive reaction to isocyanates in patients with isocyanate-sensitive asthma. The increased responsiveness may, however, also precede the asthma attack. We therefore compared non-specific BHR to a cholinergic agent before and after exposure to toluene-diisocyanate (TDI) that induced no asthma symptoms in 11 workers with isocyanate-related asthma. Patients were exposed for 3 consecutive days to progressively increasing doses of TDI (5, 10, and 20 ppb min-1 for 20 min) in an exposure chamber with continuous TDI monitoring. No immediate nor late asthmatic bronchial reaction was observed in any patient after any dose of TDI during or after challenge. A significant increase in non-specific BHR was noted 24 h after the last dose of TDI challenge, however. This increase was at least one doubling dose for seven of 11 patients. In conclusion, our study shows that, in patients with isocyanate-induced asthma, exposure to TDI induces a slight but significant increase in non-specific BHR in the absence of any immediate or late bronchial response to isocyanate. This result, which requires further confirmation, may justify a proposal to measure non-specific BHR, even after a negative specific inhalation test to TDI, as an additional diagnostic element for TDI-induced occupational asthma, to help lower the percentage of the undetected occupational asthma cases.

Adult↗

PubMed1998

Consistency of the efficacy of cetirizine and ebastine on skin reactivity.

BACKGROUND: At therapeutic dosage, cetirizine and ebastine induce significant inhibition of skin reactivity to histamine. The consistency of their efficacy, that is, efficacy with the least interindividual variability among subjects, has not been carefully assessed, however. OBJECTIVE: To compare the consistency and efficacy of these antihistamines on skin reactivity. METHODS: Twenty-four healthy volunteers participated in a randomized double-blind crossover study. The areas of wheals and flares induced by increasing (0, 5, 10, 50, 100, 200, and 300 mg/mL) histamine concentrations, administered by prick tests, were measured before and four hours after intake of 10 mg of each antihistamine, allowing concentration-response curves to be established. The threshold histamine concentrations inducing wheal areas of 3 mm2 (positivity) were calculated by interpolation. The coefficient of variation (SD/mean %) was used to evaluate the consistency of the response. RESULTS: Pretreatment concentration-response curves were similar, and threshold concentrations identical (0.29 mg/mL and 0.34 mg/mL for cetirizine and ebastine, respectively). For both, curves were lower after treatment than before. After cetirizine, the threshold concentration was significantly higher (217 mg/mL) than after ebastine (0.82 mg/mL) (P < .001), and total inhibition of the wheal reaction was observed in 21 of 24 patients at the lowest histamine concentration and in 17 of 24 at the highest. Ebastine never totally inhibited reaction, even to 5 mg/mL of histamine. Over the entire concentration-response curve, the coefficient of variation for the wheal reaction was 6.3% for cetirizine and 72.6% for ebastine, and, for flares, 11.0% and 83.7%, respectively. Hence, variability was much lower after cetirizine. CONCLUSION: Our study shows clearly that the efficacy of a single therapeutic dosage of cetirizine is consistently good for suppression of cutaneous reactivity to histamine in healthy volunteers. The need for ebastine to metabolize into the active carebastine might explain its lesser consistency.

Adult↗

PubMed1998

Nasal effect of cetirizine and loratadine at 24 hours in patients with allergic rhinitis.

Numerous studies have compared the duration of the cutaneous effect of cetirizine and loratadine. We assessed their nasal effects 24 hours after administration in patients with allergic rhinitis, using a randomized, double-blind, crossover, placebo-controlled trial. Nasal challenge was performed by nebulization of increasing doubling dosages of histamine (0.04-1.28 mg/nostril) in 12 patients (seven males, five females, aged 31 +/- 7 years). Nasal airway resistance was measured by posterior rhinomanometry 24 hours after intake of cetirizine (10 mg), loratadine (10 mg), or placebo. Baseline nasal airway resistance was identical on all study days (2.86 +/- 0.10 cm H2 O/L per second). Twenty-four hours after intake, the dose-response curve of nasal obstruction to histamine was significantly lower after treatment with cetirizine compared with placebo (P < 0.05). However, although the curve was lower on loratadine than on placebo, the curves did not differ significantly. In conclusion, our study shows significant efficacy of cetirizine, but not of loratadine, in the nose at 24 hours after a single dose. This suggests that the nasal action of cetirizine is longer lasting than that of loratadine in patients with allergic rhinitis.

Adult↗

PubMed1998

Effects of various vacuum cleaners on the airborne content of major cat allergen (Fel d 1).

BACKGROUND: It has been shown that a vacuum cleaner (VC) can increase airborne cat allergen levels. This study aimed to compare the degree of leakage of airborne Fel d 1 levels among five different VCs, both under laboratory conditions and in an apartment with cats. METHODS: Three of the VCs were marketed as antiallergic: a HEPA filter VC (VC A), a water impingement and HEPA filter VC (VC B), and a foam fabric filter VC (VC C). The other two were standard VCs: VC D and VC E. VCs were tested in a 20 m3, airtight, experimental room and in a 53 m3 living room in an apartment with three cats. Air was sampled with a glass-fiber filter and an impinger at 20 l/min for 30 min before, during, and after vacuuming. Airborne Fel d 1 was measured with a two-site monoclonal ELISA assay. RESULTS: In the experimental room, no airborne Fel d 1 level was measured before using the VCs. After introducing a dust sample containing Fel d 1 in the VCs, we found that VCs A, B, and E did not provoke any increase in airborne Fel d 1. In contrast, VCs C and D significantly increased airborne Fel d 1 levels (GM: 4.9 and 5.3 ng/m3, respectively). In the apartment, all VCs induced an increase in airborne Fel d 1, which was carried by particles greater than 5 microm. However, VCs C and D provoked significantly greater increases in airborne Fel d 1 than VCs A, B, and E (P=0.0001). CONCLUSIONS: Our results suggest that: 1) The two VCs with leakage in the experimental room had greater leakages in the apartment. 2) In the apartment with cats, all VCs provoked increases in airborne Fel d 1, primarily carried by large particles. 3) Given the increased marketing of "antiallergic" VCs, further studies are needed to standardize methods for testing airborne allergen leakage by VCs.

Air Pollutants↗

PubMed1998

Epithelial uptake and transport of cell-free human immunodeficiency virus type 1 and gp120-coated microparticles.

Cell-free human immunodeficiency virus type 1 (HIV-1) can be taken up and released by a monolayer of primary human gingival cells and remain infectious for CD4+ cells. Virus-sized latex particles covalently coated with purified native HIV-1 envelope glycoprotein gp120 are also transported through the primary epithelial cells. This process is significantly stimulated by increasing the intracellular cyclic AMP (cAMP) concentration. Inhibition experiments with mannan and alpha-methyl-mannopyranoside indicated that mannosyl groups are involved in the interaction between gp120 and gingival cells. An increase of cellular oligomannosyl receptors by incubation with the mannosidase inhibitor deoxymannojirimycin augmented transcellular transport of the gp120-coated particles. The results suggest that infectious HIV can penetrate gingival epithelia by a cAMP-dependent transport mechanism involving interaction of the lectin-like domain of gp120 and mannosyl residues on glycoproteins on the mucosal surface. Penetration of HIV could be inhibited by soluble glycoconjugates present in oral mucins.

Biological Transport↗

PubMed1998

Increased immunoglobulin G production by short term cultured duodenal biopsy samples from HIV infected patients.

BACKGROUND: Secretory immunity is a major defence mechanism against infections at mucosal surfaces which are common in HIV infected patients. AIMS: To analyse intestinal immunoglobulin production in HIV infection in comparison with that in saliva and serum. PATIENTS AND METHODS: Immunoglobulin G (IgG), A (IgA), and M (IgM) concentrations were determined in supernatants of short term cultured duodenal biopsy samples, serum, and saliva from HIV infected patients (n = 28) and controls (n = 14) by radial immunodiffusion. RESULTS: IgG was increased in the supernatants of short term cultured biopsy samples and saliva from HIV infected patients compared with controls (p < 0.01), but IgA and IgM levels were normal. In contrast, both IgG and IgA concentrations in serum were higher in HIV infected patients than in controls (p < 0.002). No correlation was found between IgA produced by duodenal biopsy specimens and serum IgA. CONCLUSION: Abnormalities in mucosal immunoglobulin production in HIV infection were surprisingly small, indicating that specific secretory immunity rather than quantitative immunoglobulin production may be impaired. However, increased production of IgG could contribute to mucosal inflammation by complement activation. Our findings of normal mucosal IgA production and the lack of correlation between serum and mucosal IgA argues against an intestinal origin for the increased serum IgA levels in HIV infected patients.

Acquired Immunodeficiency Syndrome↗

PubMed1998

[Asthma and household chemical pollutants (with the exception of tobacco)].

The relationship between allergens in a domestic environment and asthma has been extensively studied and it is only recently that studies have suggested the possibility of the role of chemical pollutants in the internal environment in the genesis of asthma. The pollutants studied are oxides of nitrogen (nitrogen dioxide NO2), volatile organic components (COV), formaldehyde, ozone (O3) and sulphur dioxide (SO2). The level of nitrogen dioxide in the interior of houses may be greater than those met outside. Normal values are 400 mcg per metre3 per hour and 150 mcg per metre3 in twenty four hours. In asthmatics challenge test to nitrogen dioxide and epidemiological studies suggest that internal nitrogen dioxide is capable of provoking asthmatic crises either by a direct pollutant effect or by potentialising the allergenic crises either by a direct pollutant effect or by potentialising the allergenic response of the bronchi. COV and formaldehyde are liberated by urea formaldehyde foams and by chipboard furniture. The levels of COV and formaldehyde inside a house may be up to 10 times higher than those outside. COV and formaldehyde perhaps would have an effect on the bronchi in asthmatics at significant levels which are rarely found in the domestic environment. Ozone is an external pollutant. However, from 5-80% of the external concentrations may be found inside some locations. Thus, in certain conditions which are relatively rare, the interior concentrations of dwelling places may attain levels which are capable of inducing, in healthy subjects who are sensitive to ozone, a drop in the FEV1. As regards asthmatics, only experimental work has been able to show any bronchospastic effect of ozone, either by a direct effect on the bronchi or by the potentiation of a bronchial response to allergens. It would be convenient to perform some epidemiological studies to determine if there is a relationship between exposure to ozone internally and to bronchial changes. The concentrations of SO2 inside houses increases when coal is burnt. The levels provoking a bronchial reaction are much greater than those found inside houses. The data and the literature which is mostly recent seems to stress the role of NO2 ozone and SO2 as a factor which might favour asthmatic crises induced by allergens in atopic subjects. However, other studies will be necessary to confirm the initial data.

Adult↗

PubMed1998

Serum eosinophil cationic protein measurements in the management of perennial and periodic asthma: a prospective study.

We performed a prospective study in order: 1) to determine whether a correlation could be found between serum eosinophil cationic protein (ECP) levels and clinical and functional status in perennial asthmatics during a 5 month prospective study; and 2) to evaluate the relationship between allergic exposure and ECP levels in periodic asthmatics. Two groups of asthmatic patients were selected: a group of acutely ill perennial asthmatics and a group of periodic asthmatics. The acutely ill perennial asthmatics (n=22, mean age=39.4 yrs) were included on the basis of hospitalization for acute asthma. At the end of the hospitalization, there was a 5 month follow-up of clinical, functional and medication scores, as well as eosinophil counts and ECP levels. The periodic asthmatic group was composed of asthmatics sensitized to birch and tree pollens (n=10, mean age=33.8 yrs). The same measurement were performed on this group, before, during and after the pollen season. Under corticosteroid treatment in the acutely ill patients, there was a significant decrease in serum ECP levels between the first day of hospitalization and the day of discharge (mean: 23.2 microg x L(-1) and 9.5 microg x L(-1), respectively; p=0.006). No correlation was found between the clinical status, functional status and serum ECP levels during the 5 month follow-up. A significant increase in ECP levels was found in periodic asthmatics during the pollen season. Our results suggest that serum eosinophil cationic protein is a useful marker of allergen exposure and of acute asthma treatment. This could be of importance in the prevention and follow-up of allergic asthma; the value of serum eosinophil cationic protein measurements in the day-to-day management of adult asthmatics needs to be further clarified.

Acute Disease↗

PubMed1998

[Bronchiolitis obliterans with organizing pneumonia. Retrospective study of 19 cases].

We report a series of 19 cases of bronchiolitis obliterans with organized pneumonitis (BOOP) observed in two pneumology units at the Strasbourg University Hospital between July 1987 and June 1997. Mean patient age was 60 years. Clinical features included dry cough, exercise-induced dyspnea, and a flu-like syndrome in three-quarters of the cases. Standard chest x-ray showed a diffuse non-systemized alveolar syndrome with a air bronchogram in 18 cases and an interstitial syndrome in one-third of the cases. computed tomography of the thorax visualized bronchial dilatations by traction of the alveolar syndrome in one-third of the cases. Pulmonary function tests showed moderate restriction. Lymphocytes predominated in bronchio-alveolar lavage fluid. Pathology examination of surgical lung specimens (5 cases), transbronchial biopsies (5 cases) and scan-guided transparietal punctures (4 cases) provided the diagnosis. In 5 cases the diagnosis was based on the radiological and clinical presentation and favorable course on corticosteroid therapy. Recurrence was observed at corticosteroid withdrawal or dose reduction in 7 cases. In this series, bronchiolitis obliterans with organized pneumonitis was probably secondary to rheumatoid arthritis (1 case), breast radiotherapy (3 cases), and drugs (amiodarone: 1 case: sotalol: 2 cases: betaxolol: 1 case). An association with betaxolol has not been previously reported in the literature.

Adult↗

PubMed1998

[Experimental studies of the effects of atmospheric pollutants].

Experimental studies in man are an indispensable complement to epidemiological studies and experimental studies on animals. They aim at understanding the mechanisms of action of the main pollutants and at knowing their thresholds of triggering of the acute effects on the respiratory system. The studies made in man involve controlled exposure to different atmospheric pollutants, with measurement of the functional respiratory repercussions, studies of modification of the cells in broncho-alveolar lavage, as well as experimental protocols that combine inhalation of allergen and exposure to atmospheric pollutants by allergic subjects. The main results that are available are reported to distinguish those from normal subjects and those who are allergic. More recent protocols are based on exposure to concentrations that are close to atmospheric concentrations or those that are met in work places. The main data in the literature are reported in this journal and concern SO2 acid aerosols, dioxides of nitrogen, ozone and diesel particles. Pathogenic hypotheses concerning the undesirable effects of atmospheric pollutants on the respiratory system are considered.

Aerosols↗

PubMed1997

Abnormal predominance of IgG in HIV-specific antibodies produced by short-term cultured duodenal biopsy specimens from HIV-infected patients.

The aim of our study was to analyze HIV-specific humoral immunity in the intestinal mucosa at different stages of HIV infection in comparison with serum and saliva. Duodenal biopsy specimens from 30 AIDS patients and 9 HIV-infected patients without AIDS were cultured for 48 hours. Culture supernatants, as well as simultaneously obtained serum and saliva samples, were adjusted to the same immunoglobulin concentrations and tested for HIV-specific IgG and IgA by Western blot. The HIV antigen pattern differed clearly between IgA and IgG but was similar for each isotype independent of its origin (i.e., serum, saliva, or biopsy specimen supernatants). Short-term cultured duodenal biopsy specimens from HIV-infected patients at all stages produced predominantly IgG, which was broadly reactive with HIV antigens. Lower titers of HIV-specific IgA, which recognized few antigens, were found, mostly the glycoprotein gp160. At later stages of the disease compared with earlier stages, the reaction pattern of mucosal IgA from saliva and biopsy supernatants was even more restricted; secretory component was frequently absent. The abnormal predominance of HIV-specific IgG over IgA in mucosal secretions may result from abnormal antibody production in the mucosa rather than from serum leakage. Mucosal inflammation induced by HIV-IgG immune complexes and insufficient immune exclusion by secretory IgA may not only lead to increased mucosal HIV replication but may also contribute to gastrointestinal disease in HIV-infected patients.

Adult↗