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Biomedical subjects

H Hintner

Publications and source records attributed to H Hintner.

At least 73 records · Page 4Linked to original sources

Tissue amyloid P component in normal human dermis is non-covalently associated with elastic fiber microfibrils.

Tissue amyloid P component (TAP), a protein that crossreacts immunohistochemically with the normal plasma glycoprotein serum amyloid P component (SAP), is invariably associated with elastic fiber microfibrils in adult humans. We have investigated the nature of this association. Aliquots of minced, homogenized dermis, obtained following ethylenediamine tetraacetic acid (EDTA) separation of whole adult human skin, were extracted with different reagents, and the presence or absence of TAP in the pellet and in the supernatant following centrifugation was determined by SDS-PAGE and immunoblotting using anti-SAP antibodies. TAP was extractable from dermis using reagents which disrupt non-covalent bonds, including sodium dodecyl sulfate (SDS) and guanidine hydrochloride. TAP was not extracted by high molarity salt solutions, non-ionic detergents, or the reducing agents dithiothreitol and 2-mercaptoethanol. EDTA solution was similarly unsuccessful at eluting TAP from the dermal preparation, indicating that the association of TAP with elastic fiber microfibrils is not simply the result of Ca++-dependent binding. Collagenase solubilized some TAP, but this does not prove covalent linkage to elastic tissue of part of the TAP, because the apparent Mr of TAP extracted was identical to that of normal SAP subunits. We cannot completely exclude the possibility that a few subunits in each multimeric TAP molecule are covalently attached to the microfibrils. However, our findings that denaturing agents alone extracted most of the TAP from normal human dermis strongly suggest that the great majority of the dermal TAP is non-covalently bound to elastic fiber microfibrils. Thus TAP is not an integral constitutent of elastic fiber microfibrils.

Adult↗

[Benign prostatic hyperplasia: a stromal disease].

Morphometric studies show that benign human prostatic hyperplasia is a stromal disease caused by the activation of smooth muscle cells. This activation manifests itself in increased amounts of cytoplasmic organelles, which are preferably localized in the perinuclear region. Moreover, marked vesicular activity is present. Besides considerable overproduction of type I and III collagens, the architecture of the extracellular matrix is altered distinctly. In spite of strong evidence that androgens and estrogens regulate the growth of epithelial and stromal cells in the prostate and the induction of fibromuscular overgrowth in various animal models, the exact role of steroids in the pathogenesis of benign prostatic hyperplasia still remains to be elucidated.

Androgens↗

[Oral manifestations of HIV infection].

Skin and mucous membranes including the oral mucosa are among the preferential locations of opportunistic infections and secondary neoplasms in patients infected with the human immunodeficiency virus (HIV). Infections of the oral mucosa such as thrush occur in a high percentage of AIDS patients, patients with AIDS-related complex or HIV-seropositive individuals. The clinical appearance of the infections (herpes virus infection, periodontitis) is often marked by aggressive expansion, frequent recurrences or resistance to therapy. Oral "hairy" leukoplakia is considered to be a characteristic lesion in HIV-infected individuals. Tumors like Kaposi's sarcoma, squamous cell carcinoma and non-Hodgkin lymphoma of the oral mucosa may cause marked morbidity in AIDS patients. Such oral lesions are frequently the first indication of an HIV-infection. Dentists should be aware of the oral manifestations of HIV-infection and initiate diagnostic and therapeutic measures in the interest of the patients and for epidemiologic reasons.

Candidiasis, Oral↗

[Acquired, surface giant nevus cell nevi in generalized, atrophic, benign epidermolysis bullosa].

A 10-year old girl with generalized benign atrophic epidermolysis bullosa (EB) developed large nevomelanocytic nevi over a period of 1 year. Since such nevoid lesions have been repeatedly observed in other patients with generalized benign atrophic EB they should be regarded as a characteristic clinical feature of this type of mechanobullous disease. Regular observation of such patients will demonstrate the significance of these pigmented lesions as precursors of malignant melanoma.

Biopsy↗

Amyloid P component binds to keratin bodies in human skin and to isolated keratin filament aggregates in vitro.

Dermal keratin bodies, consisting mainly of keratin intermediate filament aggregates (KIFA) coated with IgM anti-KIF autoantibodies, are present in normal human skin and occur in increased quantities in certain skin diseases. Keratin bodies are normally rapidly removed, but in primary localized cutaneous amyloidosis (PLCA) they are converted by an unknown mechanism to amyloid. Amyloid P component (AP), a glycoprotein identical to, and derived from, the normal plasma protein serum amyloid P component (SAP), is present in all forms of amyloid including PLCA. We investigated the interaction between SAP, keratin bodies, and KIFA. Immunofluorescence staining of normal skin using fluoresceinated anti-SAP and rhodamine-conjugated anti-IgM, or AE-1/AE-3 anti-keratin antibodies followed by Texas Red-conjugated anti-mouse immunoglobulin, showed that 52% +/- 4 (mean +/- sem, n = 6) of keratin bodies bound anti-SAP. Similar findings were present in a biopsy from a patient with lichen planus. Isolated KIFA, prepared by 8M urea extraction of normal human epidermis or cultured keratinocytes, were preincubated with normal human serum as a source of SAP and then stained with fluoresceinated anti-SAP. Bright fluorescence seen when the incubation medium contained Ca++ was absent in the presence of ethylenediamine tetraacetic acid. Specific Ca++-dependent binding of SAP to KIFA was confirmed using immunoblotting. Binding of SAP to KIFA did not prevent their degradation following exposure to trypsin or alpha-chymotrypsin. Similarly, partial enzymatic digestion of KIFA did not abrogate their ability to bind SAP. Our findings, that SAP is associated with keratin bodies in skin and exhibits Ca++-dependent binding to KIFA in vitro, identify keratin filaments as a newly recognized ligand for SAP.

Benzothiazoles↗

[Amyloid K].

Electron-microscopic, histochemical and immunological studies have shown that the deposits of primary and secondary localized cutaneous amyloid (amyloid K) consist mainly of keratin filament material. The amyloid P component is the second most significant constituent. Pathogenetically, defective keratinocyte apoptosis is the most likely mechanism of generation for amyloid K. Apoptosis is a distinct mode of cell death according to which individual basal keratinocytes disintegrate in physiological and pathological conditions to form membrane-bound "apoptotic" bodies consisting mainly of keratin filament aggregates. These lose their protective membrane and drop into the upper dermis, where they present as keratin (Civatte, cytoid) bodies, which are regularly coated with immunoglobulins. Overproduction of keratin bodies and/or a defect in their degradation by enzymatic digestion or phagocytosis by macrophages and fibroblasts, followed by conversion into amyloid fibrils, may be responsible for the generation of deposits of amyloid K.

Amyloid↗

[Amyloid P components in normal human skin and skin with lesions].

Amyloid P component (AP) is a glycoprotein which is found in tissue deposits of all types of amyloid and is identical to and derived from serum amyloid P component (SAP). SAP binds in a calcium-dependent fashion to various ligands, such as agarose, desoxyribonucleic acid, fibronectin, C4-binding protein, glycosaminoglycans and isolated amyloid fibrils. Tissue AP (TAP) is also a constituent of the normal human renal glomerular basement membrane and is, in adult humans, invariably associated with elastic fiber microfibrils in connective tissue throughout the body, including that of blood vessels. In normal human skin anti-AP antibody binding was localized to the microfibrils of oxytalan fibers in the papillary dermis and to the peripheral microfibrillar mantle of elaunin and mature elastic fibers in the reticular dermis. Since SAP binds to fibronectin and glycosaminoglycans, which in turn bind to collagen fibers, TAP on elastic fiber microfibrils may play an important role in the maintenance of the normal dermal architecture and in dermo-epidermal adhesion. Under pathological conditions, AP is found in all forms of cutaneous amyloidosis, including primary localized cutaneous amyloid (PLCA); it is also detectable on keratin bodies, which represent precursor structures for PLCA. The association of AP with elastic fiber microfibrils and amyloid fibrils and their close anatomical relationship in vivo may reflect the significance of AP in the deposition of cutaneous amyloid.

Amyloidosis↗

Nidogen and heparan sulfate proteoglycan: detection of newly isolated basement membrane components in normal and epidermolysis bullosa skin.

The epidermal basement membrane zone comprises various biochemical constituents, some of which may be affected or involved in certain forms of mechanobullous diseases. Recently, nidogen and a low density form of heparan sulfate proteoglycan--two ubiquitous, noncollagenous components of basement membranes--were isolated and characterized, and affinity-purified antibodies to each component were prepared. These antibodies were used to study the distribution of both antigens in normal and diseased human skin. By immunofluorescence, both nidogen and heparan sulfate proteoglycan were linearly distributed along the basement membrane of the dermal-epidermal junction, adnexal structures, and blood vessels of normal human skin. On suction-induced blisters of normal skin, both antigens were found at the base of the blister, indicating that each was within or below the lamina lucida. By indirect immunoelectron microscopy, both antigens were ultrastructurally located within the lamina densa. The staining patterns for nidogen and heparan sulfate proteoglycan were examined in 11 patients with either junctional, dominant dystrophic, or recessive dystrophic epidermolysis bullosa, and were found to be not different from the patterns observed in normal skin.

Antibodies, Monoclonal↗

Phagocytosis of keratin filament aggregates following opsonization with IgG-anti-keratin filament autoantibodies.

IgG-anti-keratin intermediate filament autoantibodies occur in low titers in all normal human sera. These same antibodies are present in high titers in the sera of patients who have diseases in which cells containing keratin intermediate filaments (KIF) have been damaged, such as systemic lupus erythematosus, graft-versus-host disease, and cutaneous tumors. Since some human autoantibodies are thought to function in part as opsonins promoting the removal of insoluble cellular proteins after tissue injury, we investigated the influence of IgG-anti-KIF autoantibodies on the phagocytosis of insoluble KIF aggregates by human monocytes and polymorphonuclear neutrophils (PMN). Keratin intermediate filaments assembled in vitro were reconstituted into dense spherical KIF aggregates 0.3-2.5 microns in diameter by dialysis against phosphate-buffered saline. Immunoelectron microscopy revealed that, as expected, human IgG-anti-KIF autoantibodies bound to the KIF aggregates. Human monocytes or PMN were incubated either with nonopsonized KIF aggregates or with KIF aggregates that had been reacted with IgG-anti-KIF autoantibodies. The uptake of KIF aggregates was visualized by indirect immunofluorescence, immunoperoxidase staining, and immunoelectron microscopy. Monocytes rapidly and efficiently bound and phagocytosed KIF aggregates that had been coated with IgG-anti-KIF autoantibodies. Nonopsonized KIF aggregates, in contrast, were taken up much less efficiently. Differences were most marked at 4 degrees C for 60 min with phagocytosis of opsonized KIF aggregates by 23 +/- 8% of monocytes in contrast to phagocytosis by only 0.2 +/- 3% monocytes when nonopsonized KIF aggregates were used. Similar results occurred at 37 degrees C for 5 min with phagocytosis by 38 +/- 28% vs 1.8 +/- 0.4% of monocytes of opsonized and nonopsonized KIF aggregates, respectively. A high percentage of PMN also phagocytosed opsonized KIF aggregates, whereas nonopsonized KIF aggregates were ingested less avidly. These data indicate that the opsonization of extracellular KIF aggregates by IgG-anti-KIF autoantibodies plays an important role in promoting the phagocytosis of KIF aggregates. The subsequent phagocytosis represents a rapid and very effective mechanism for the removal of insoluble KIF following keratinocyte cell death.

Autoantibodies↗

[Anti-keratin filament autoantibodies].

IgG anti-keratin-filament autoantibodies occur in all human sera and reach high titres in the sera of patients with various cutaneous and non-cutaneous diseases. At indirect immunofluorescence, these autoantibodies may, depending on their titre, appear as 'upper-cytoplasmic' antibodies or 'stratum-corneum' antibodies. In vitro, IgG anti-keratin-filament autoantibodies significantly enhance (as opsonins) the phagocytosis of keratin-filament aggregates by human monocytes and polymorphonuclear leucocytes. They may therefore, also in vivo, play a role in the removal of insoluble extracellular keratin-filament aggregates generated by necrotic or apoptotic cell death. Keratin (Civatte) bodies and deposits of localized cutaneous amyloid are examples of such keratin-filament aggregates that are found in various skin diseases but are also regularly present in large amounts in normal human skin. IgM anti-keratin-filament autoantibodies, which may, at indirect immunofluorescence, appear as 'general cytoplasmic' antibodies, also occur in all human sera and reach high titres in the sera of patients with various diseases. The regular presence of IgM in keratin bodies or deposits of localized cutaneous amyloid therefore probably represents the binding of IgM anti-keratin-filament autoantibodies to their respective antigens. To what extent these in vivo-bound autoantibodies prevent any further damaging reaction by the immune system in response to the liberation of keratin-filament autoantigen is as yet unclear.

Amyloid↗

Apoptotic keratin bodies as autoantigen causing the production of IgM-anti-keratin intermediate filament autoantibodies.

The presence of numerous keratin bodies in the upper dermis is a characteristic finding in skin lesions of patients with various dermatoses such as cutaneous graft-versus-host disease, lichen planus, or chronic discoid lupus erythematosus. These keratin bodies are generated by apoptotic keratinocyte death, consist largely of keratin intermediate filaments (KIF), and are constantly covered with immunoglobulins, mainly IgM. Apoptosis is also thought to occur under physiologic conditions in the skin as it does in other organs, but keratin bodies are not frequently reported as being found in nonlesional skin. In order to assess the frequency of keratin bodies in normal skin, we examined serial sections of 10 normal human skin specimens and 5 dermal sheets prepared from normal human skin for the presence of keratin bodies. They were visualized by direct immunofluorescence using a fluorescein isothiocyanate (FITC) rabbit antihuman IgM conjugate. In addition the KIF origin of keratin bodies was demonstrated by a double-staining immunofluorescence procedure using a FITC-conjugated rabbit antihuman IgM followed by a mouse monoclonal antibody against keratin and a sheep antimouse immunoglobulin conjugated with Texas Red. One specimen was also examined for keratin bodies at the ultrastructural level. In serial sections, all 10 normal human skin specimens had numerous keratin bodies as assessed by visualization of globular IgM deposits. Evaluated on dermal sheets, the number of keratin bodies ranged from 39-262 per mm2. Nearly all keratin bodies also stained with the antikeratin antibodies. Ultrastructurally the remarkable number of keratin bodies, which consist of filaments measuring approximately 10 nm in diameter or of more granular material, in normal human skin was confirmed. In order to investigate the capacity of KIF material in keratin bodies to function as autoantigen, we examined the sera of the 10 skin donors and, in addition, of 30 normal healthy individuals and 10 patients with rheumatoid arthritis for the occurrence and specificity of IgM-anti-KIF autoantibodies by an enzyme-linked immunosorbent assay and by immunoblot. IgM-anti-KIF autoantibodies were found in all 50 test sera. In the majority of the sera the specificity of these autoantibodies included the 51 kD and the 58 kD KIF protein, which are constituents of KIF in keratin bodies and basal keratinocytes. Quantitatively, the antibody activity of the IgM-anti-KIF autoantibodies varied from serum to serum, being highest in the sera of patients with rheumatoid arthritis.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗

Immunologic properties of enzymatically degraded human keratin intermediate filaments.

In order to gain insight into the metabolism of keratin intermediate filaments (KIF) as well as the ability of KIF degradation products to interact with the immune system, we performed enzymatic degradation of purified KIF and examined their interaction with anti-KIF autoantibodies and their ability to act as immunogens. Aliquots of KIF aggregates were exposed to 3 different enzymes, that is, alpha-chymotrypsin, plasmin, and trypsin, in dose- and time-dependent experiments. The effect of the digestion was monitored sequentially by polyacrylamide gel electrophoresis and simultaneously by transmission electron microscopy. Furthermore, the KIF degradation proteins were then examined for their ability to bind anti-KIF autoantibodies by immunoblot and for their immunogenicity. In addition, preincubation of KIF with anti-KIF autoantibodies prior to the digestion procedure was performed to investigate a possible protective effect of this treatment against proteolytic degradation. The experiments demonstrated that: (1) KIF are degraded by serine proteinases, (2) with prolonged incubation time intact KIF are progressively replaced by more granular-amorphous material in transmission electron microscopy, (3) anti-KIF autoantibodies bind to KIF degradation proteins, (4) preincubation of KIF with anti-KIF autoantibodies does not exert any major protective effect for KIF against proteolytic degradation, and (5) the enzymatic degradation products of KIF can function as effective immunogens causing the formation of high-titer anti-KIF antibodies.

Autoantibodies↗

[Filaggrins].

It has been shown in recent studies that a group of histidine-rich proteins play a significant role--as interfilamentous matrix proteins--in keratin formation in the epidermis of man and other species. These proteins have been termed filaggrins in reference to their ability to aggregate in vitro reconstituted keratin filaments to macrofibrils with a striking similarity to the ultrastructural keratin pattern. Filaggrins derive from high molecular weight precursor proteins--profilaggrins--which are synthesized in the keratohyaline granules and break down rapidly into filaggrins when the granular cells undergo transition into corneocytes. Further metabolic breakdown of filaggrins leads to the formation of other compounds which subserve physiological functions: e.g. urocanic acid, which is possibly a natural sunscreen, and free amino acids, which are thought to contribute to the hygroscopic character of the horny layer and to its barrier function. Alterations of filaggrin metabolism have been recognized in a number of pathological states of the skin and may be responsible for disturbed epidermal differentiation.

Amino Acids↗

[Autoimmune hemolysis caused by anti-Pr].

Following an infection with mycoplasma pneumoniae, an anti-Pr-antibody developed in a hitherto healthy man, aged 41. Within a period of 5 days the antibody caused a severe autoimmune hemolytic reaction. The patient died on the fifth day after admission due to hemolysis and uremia. The autoantibody showed a reactivity with a broad thermal range from 4 degrees C to 37 degrees C. As an initial warning sign, the patient presented an expressed livedo reticularis. Massive wholeblood exchanges could not stop the fatal process.

Adult↗