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Biomedical subjects

G Quattrocchio

Publications and source records attributed to G Quattrocchio.

28 records · Page 2Linked to original sources

Effects of a gluten-free diet in primary IgA nephropathy.

In an uncontrolled study a gluten-free diet was given to 29 patients affected by primary IgA nephropathy (IgAGN). All of them followed the diet for 6 months, 23 patients for 1 year and 9 for 2 to 4 years. Mean levels of IgA containing circulating immune complexes (IgAIC), detected by a specific conglutinin assay and by measuring IgA content in 2.5% polyethylene glycol precipitates, on an unrestricted diet, significantly decreased after 6 months of gluten-free diet (p less than 0.01) and remained reduced during the follow-up. A decrease in IgAIC levels was evident in 85.7% of the cases with basal positive data, with complete normalization in 64.3% of them. IgA to gluten antigens (ethanol- or saline-soluble gliadin, glutenin and the lectin fraction termed glyc-gli) as well as to heterologous bovine and egg albumins were found to be significantly increased on an unrestricted diet in the group of 14 IgAGN patients with basal positive IgAIC. The mean levels of IgA to most dietary antigens significantly decreased after 6 months to 1 year of a gluten-free diet. A decrease in IgA to ethanol-soluble gliadin was evident in 81.8% of the cases with basal positive data, with complete normalization in 63.6%. A subgroup of 27.5% of IgAGN patients showed positive IgAIC values associated with increased IgA values to a variety of dietary antigens. A gluten-free diet induced in 75% of the cases a parallel improvement in these abnormal immunological data. Mean proteinuria values were found to be significantly decreased after 6 months of the diet and a reduction was also observed in microscopic hematuria. However, mean blood creatinine levels showed a significant increase after the gluten-free diet. The data of this study indicate that a gluten-free diet can modify some immunological abnormalities in a group of IgAGN patients, reducing levels of IgAIC and IgA to dietary antigens. The clinical course does not seem to be favorably influenced, since a relentless progression towards renal failure was observed.

Adult↗

Clearance of polymeric IgA aggregates in humans.

Clearance of aggregated human secretory immunoglobulin A (AHS-IgA) was studied in nine patients affected by primary IgA nephropathy (IgAGN) and six normal volunteers from the medical staff. Samples of whole blood, erythrocytes, and serum were taken from 3 to 120 minutes after injection of 0.5 mg of 131iodine-labeled AHS-IgA. No significant radioactivity was recorded on erythrocytes. The clearance curve of AHS-IgA from the circulation, calculated by measuring trichloroacetic acid precipitable radioactivity in serum, was found to be biexponential with an initial fast component significantly prolonged in patients (mean half-time, 19.4 minutes, range, 14 to 26 minutes) compared with controls (mean, 12.2 minutes, range, 7.6 to 16.8 minutes; P less than 0.01). These data indicate that clearance of aggregated polymeric IgA does not involve the erythrocyte transport system and seems to be defective in IgAGN patients.

Adult↗

Complement receptor (CR1) and IgG or IgA on erythrocytes and in circulating immune complexes in patients with glomerulonephritis.

This study reports the quantitative analysis of complement receptor (CR1) molecules on erythrocyte surface, the amount of immunoglobulin-containing material (IgG-IC and IgA1-IM) on the erythrocyte surface, and the concentrations of circulating immune complexes (IgG-CIC and IgA-CIC); also reported are the HLA phenotypes of 44 patients affected by various forms of glomerulonephritis (including 20 primary IgA nephropathy, 11 membranous glomerulonephritis, 9 lupus nephritis and 4 renal vasculitis). Erythrocyte CR1 molecules were found to be decreased (P less than 0.02) and erythrocyte IgG-IC were less than in controls (P less than 0.025) in lupus nephritis patients, whereas IgG-CIC were significantly greater (P less than 0.02). In patients affected by primary IgA nephropathy, mean erythrocyte CR1 concentrations were significantly decreased (P less than 0.02). Patients with impaired renal function had mean erythrocyte CR1 values significantly greater than those with normal renal function (P less than 0.002). Immunoglobulin-containing material on the erythrocyte surface was not significantly increased, whereas the serum concentrations of both IgA-CIC and IgG-CIC were significantly increased (P less than 0.02). In membranous nephropathy erythrocyte CR1 molecules were quantitatively similar to control data and no increase in CIC was observed. Conversely, erythrocyte IgG-IC were significantly increased (P less than 0.01). No significant relationship among erythrocyte CR1 molecules, erythrocyte surface-associated immunoglobulins, CIC, and HLA phenotype was observed in any patient group.

Adult↗

Lymphocyte subsets assayed by numerical tests in CAPD.

Peripheral and peritoneal lymphocytes were assayed by numerical tests in adults on peritoneal dialysis. T lymphocytes were classified by monoclonal antibodies (OKT3, OKT4, OKT8) and B lymphocytes by the presence of surface immunoglobulins, using the immunofluorescence technique. Peripheral T cells showed no significant change from the normal, except for T suppressor cells which increased in patients with 2 or more peritonitis episodes. Examination of peritoneal lymphocytes showed a significant reduction in S-IgA lymphocytes (B cells bearing IgA receptors) and an increase in T-suppressor cells (OKT8+) in patients who developed peritonitis in the follow-up study. The implications of these results are discussed with particular reference to susceptibility to peritonitis.

Adult↗

Influence of gluten-derived fractions on chemiluminescence production by human neutrophils.

The effects of gliadin and glyc-gli on leukocyte chemiluminescence response were assessed in vitro. A dose-dependent increase in chemiluminescence response of neutrophils stimulated by zymosan was observed by using gliadin at concentrations ranging between 1 and 20 micrograms. By increasing glyc-gli concentration, a bimodal response was observed with an enhancement up to 50 micrograms/ml, followed by suppressive effects, which were again dose-dependent. The possible implications of these findings in human pathology are discussed.

Celiac Disease↗

[Thrombotic microangiopathy during urinary tract infection].

An 84 year-old woman was admitted because of sepsis, thrombocytopenia, anaemia and acute renal failure that required hemodialysis. The diagnostic tests performed during hospitalization showed a severe urinary tract infection due to Enterococcus faecalis, resulting in mild sepsis. This infection was responsible for acute tubular necrosis and thrombotic microangiopathy, in a clinical context of difficult differential diagnosis and hemolytic-uremic syndrome.

Aged, 80 and over↗