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Biomedical subjects

H L Malech

Publications and source records attributed to H L Malech.

At least 145 records · Page 8Linked to original sources
PubMed1981

Fungal infection in chronic granulomatous disease. The importance of the phagocyte in defense against fungi.

Among 245 cases of chronic granulomatous disease which were evaluated, fungal infection occurred in 20.4 percent. Fungi encountered include Aspergillus, Torulopsis and Candida. In 18 percent of the patients with fungal infection, the disease was limited to soft tissue or bone; all did well. Most of the patients had fungal pneumonia and/or widely disseminated disease; diagnosis was usually confirmed by open lung biopsy. Patients with pneumonia or disseminated disease who received no therapy succumbed to infection, whereas more than half the patients who received antifungal therapy were cured. Modalities of treatment included antifungal chemotherapy, surgical removal of infected tissue and granulocyte transfusion. Although several patients showed dramatic improvement during granulocyte transfusions given in combination with antifungal chemotherapy, the improvement achieved was not statistically significant when compared with that achieved with chemotherapy alone. These results emphasized the importance of phagocytic cells in defense against fungi and the need for further evaluation of granulocyte transfusion therapy in compromised hosts in whom fungal infections develop.

Adolescent↗
PubMed1981

Interactions between antibiotics and human neutrophils in the killing of staphylococci.

Normal and antibiotic-pretreated staphylococci were incubated with human neutrophils to determine the interactions between cells and antimicrobials in the killing of the organisms. Staphylococcus aureus 502A pretreated during log-phase growth with subinhibitory ((1/4) minimum inhibiting concentration) (MIC) concentrations of penicillin G were more susceptible to killing by normal neutrophils than untreated bacteria (intracellular survival 0.17+/-0.04 vs. 1.5+/-0.38%, mean+/-SEM, respectively, at 35 min in 14 experiments; P < 0.01 by t test). Furthermore, this enhanced susceptibility to killing was observed even when phagosome formation was inhibited by cytochalasin B (65.6+/-4.6% pencillintreated vs. 30.5+/-4.5% untreated killed at 30 min in 14 experiments, P < 0.001). Pretreatment of S. aureus with vancomycin similarly enhanced susceptibility to killing by cytochalasin B-treated polymorphonuclear leukocytes (PMN), whereas pretreatment with gentamicin did not. The enchancement of killing by pretreatment with cell wall-active antibiotics was present in a dose-response fashion to 1/16th the MIC. It required specific antimicrobial activity; i.e., penicillin activity was inhibited by penicillinase or by incubation with bacteria at 4 degrees C. It also required active cellular metabolism and intact neutrophils. For antibiotic-pretreated bacteria to be killed by normal and cytochalasin B-treated cells, phagocytosis or binding to the cells was essential via a serum opsonindependent mechanism. In experiments with the cytochalasin B-treated cells, all bound penicillin-treated bacteria were killed vs. only a fraction (70%) of the bound untreated bacteria. Penicillin in 10 times the MIC had no direct effects on PMN phagocytic, metabolic, or microbicidal functions against a nonsusceptible organism, Candida albicans. The results indicate a cooperative effect between cell wall-active antibiotics at low concentrations and human PMN in the killing of staphylococci. The model establishes conditions for the study of the mechanisms involved in the cooperation of these bactericidal systems.

Cytochalasin B↗
PubMed1981

Indium-111-labeled human platelets: improved method, efficacy, and evaluation.

An improved method for labeling human platelets with In-111 oxine is described. The method used modified Tyrode's solution (MTS) as a labeling medium and allowed 86 +/- 7% incorporation of In-111 into platelets, which upon stimulation with ADP aggregated 66 +/- 15% of control platelets. This compared favorably with the 5% radioactivity uptake in plasma and the 36 and 55% aggregability of platelets labeled in saline and citrated saline, respectively. The influence of parameters affecting the platelet aggregability were examined. The studies revealed that excess of oxine (50 microgram oxine/1.6 x 10(9) platelets in 1 ml MTS), and centrifugation at greater than 1000 g, reduced platelet aggregability. Excess of oxine also caused a dose-dependent release of In-111 from platelets labeled either in MTS or in plasma, but 4 millimol EDTA did not. Release of In-111 upon aggregation of platelets labeled in either medium was negligible.

Blood Platelets↗
PubMed1980

Disorders of phagocyte chemotaxis.

Recent advances in understanding the physiologic and biochemical bases for recruitment of phagocytes to inflammatory sites has led to the recognition of patients who have recurrent infections because of abnormalities of phagocyte chemotaxis. In some of these patients there is abnormal chemoattractant mediator production or regulation, whereas in others there are defects in phagocytic cell function. The cellular defects in chemotaxis can be characterized as either intrinsic defects of the cellular motility apparatus or acquired defects from mediators influencing cell function or from shifts in circulating phagocyte subpopulations. Systematic study of these defects has resulted in functional, biochemical, and ultrastructural characterization of abnormal phagocyte chemotaxis in certain patients, and in some patients study has led to rational approaches for treatment. Clinical trials assessing the efficacy of such pharmacologic agents are underway.

Adolescent↗
PubMed1979

Indium-111-labeled human polymorphonuclear leukocytes: viability, random migration, chemotaxis, bacterial capacity, and ultrastructure.

Human polymorphonuclear leukocytes (PMNs) were labeled with indium-111 oxine in ethanol, and the effects of the labeling procedure, radioactivity, and concentrations of oxine and ethanol on PMN function and structure were studied in vitro. The standard labeling procedure did not alter the viability, random migration, chemotaxis, bactericidal capacity, or the ultrastructure of PMNs. Exposure to higher doses of radioactivity, or to higher concentrations of ethanol, had no appreciable effects on random migration and chemotaxis of PMNs. A dose-dependent reduction in their random migration and chemotaxis was observed when higher concentrations of oxine were used. These results indicate that In-111-labeled PMNs are structurally intact and have normal in vitro locomotion and bactericidal activity. Indium-111-labeled PMNs should be suitable for studying the kinetics and distribution of these cells in health and disease.

Blood Bactericidal Activity↗
PubMed1978

Properties of a transforming virus, KiMSV(RHHV), isolated from a co-culture of rat HTC-H1 cells with K-NRK cells.

Some morphological, biological, immunological and biochemical characterizations of a virus, rat helper virus pseudotype Kirsten sarcoma virus, KiMSV(RHHV), have been presented here. KiMSV(RHHV) has a type C virus ultrastructure. It is strictly rat tropic and is able to transform rat cells in vitro. The possibility of its being a xenotropic mouse virus has been carefully ruled out by exhaustive analyses of host range and immunological studies. Antigenically KiMSV(RHHV) demonstrates cross reactivity with an antiserum specific against rat leukaemia virus, no cross reactivity with antiserum against Moloney leukaemia virus, and only minor cross reactivity with antiserum against cat leukaemia virus. Analysis of virus proteins and glycoproteins by equilibrium acrylamide gradient gel electrophoresis showed that the virus complex possesses both a gp70 fraction and a p30 fraction. KiMSV(RHHV) sediments isopycnically in a linear sucrose gradient at 1.145 to 1.155 g/ml and possesses RNA and reverse transcriptase activity.

Animals↗
PubMed1977

Structural analysis of human neutrophil migration. Centriole, microtubule, and microfilament orientation and function during chemotaxis.

Orientation of nucleus, centriole, microtubules, and microfilaments within human neutrophils in a gradient of chemoattractant (5 percent Escherichia coli endotoxin-activated serum) was evaluated by electron microscopy. Purified neutropils (hypaque-Ficoll) were placed in the upper compartment of chemotactic chambers. Use of small pore (0.45 mum) micropore filters permitted pseudopod penetration, but impeded migration. Under conditions of chemotaxis with activated serum beneath the filter, the neutrophil population oriented at the filter surface with nuclei located away from the stimulus, centrioles and associated radial array of microtubules beneath the nuclei, and microfilament-rich pseudopods penetrating the filter pores. Reversal of the direction of the gradient of the stimulus (activated serum above cells) resulted in a reorientation of internal structure which preceded pseudopod formation toward the activated serum and migration off the filter. Coordinated orientation of the entire neutrophil population did not occur in buffer (random migration) or in a uniform concentration of activated serum (activated random migration). Conditions of activated random migration resulted in increased numbers of cells with locomotory morphology, i.e. cellular asymmetry with linear alignment of nucleus, centriole, microtubule array, and pseudopods. Thus, activated serum increased the number of neutrophils exhibiting locomotory morphology, and a gradient of activated serum induced the alignment of neutrophils such that this locomotory morphology was uniform in the observed neutrophil populayion. In related studies, cytochalasin B and colchicines were used to explore the role of microfilaments and microtubules in the neutrophil orientation and migration response to activated serum. Cytochalasin B (3.0 mug/ml) prevented migration and decreased the microfilaments seen, but allowed normal orientation of neutrophil structures. In an activated serum gradient, colchicines, but not lumicolchicine, decreased the orientation of nuclei and centrioles, and caused a decrease in centriole-associated microtubules in concentrations as low as 10(-8) to 10(-7) M. These colchicines effects were associated with the rounding of cells and impairment of pseudopod formation. The impaired pseudopod formation was characterized by an inability to form pseudopods in the absence of a solid substrate, a formation of narrow pseudopods within a substrate, and a defect in pseudopod orientation in an activated serum gradient. Functional studies of migration showed that colchicines, but not lumicolchicine, minimally decreased activated random migration and markedly inhibited directed migration, but had not effect on random migration. These studies show that, although functioning microfilaments are probably necessary for neutrophil migration, intact microtubules are essential for normal pseudopod formation and orientation, and maximal unidirectional migration during chemotaxis.

Blood↗
PubMed1976

Transfer of murine intracisternal A particle phenotype in chloramphenicol-resistant cytoplasts.

Murine intracisternal A particles have a number of properties which are common to known RNA tumor viruses, but horizontal transmission has not been previously demonstrated. The apparent absence of infectivity may be related to the failure of these particles to be released from cisternae of endo-plasmic reticulum. Previous biological studies using isolated, purified A particles have been compromised by the fact that the isolation procedure requires small amounts of nonionic detergent. Using some techniques of somatic cell hybridization, we have assessed the capacity for A particle genome transfer from positive to negative cells. Since it has been previously shown that some chloramphenicol-resistant cell lines can transfer this resistance in the cytoplasm, we have used this characteristic as a marker for cytoplasmic fragments. Mouse cells containing A particles were mutagenized, and clones resistant to chloramphenicol were selected; by enucleating these cells and fusing the resultant cytoplasts to each of two recipient mouse cell lines negative for A particles, it is possible to identify clones of cells known to be the product of a fusion event between a cytoplast and a whole cell (cybrids). Under these conditions, intracisternal A particles appear in the cybrid clones as a phenotypic trait that has not been segregated over at least 60-80 cell generations.

Cell Fractionation↗
PubMed1974

Microfilaments in epidermal cancer cells.

The occurrence and structure of microfilaments in epidermal cancers induced in mice by treatment with 3,4-benzpyrene were investigated with the electron microscope. With malignant change, pleomorphic, undifferentiated cells with a cortical zone of microfilaments became increasingly abundant. The microfilaments were 40 A in diameter and occupied the cortex of the cells beneath the plasma membrane, extended into cell processes, and were situated in the cores of microvilli. At high magnification, the filamentous areas were formed by an interconnected meshwork of filaments which in favorable planes had a polygonal arrangement. When exposed to high concentrations of cytochalasin B, the microfilaments became clumped and moderately disrupted. At the same time, the processes and microvilli of the cells were blunted. The structure of these filaments and their sensitivity to cytochalasin B place them in a class of microfilaments believed to be related to cell motility. Their presence in malignant cells may be correlated with the motile, invasive properties of these cells.

Acetone↗
PubMedDate not supplied

Anesthetic considerations in patients with chronic granulomatous disease.

Chronic granulomatous disease (CGD) is a rare, genetically transmitted disorder characterized by recurrent, life-threatening infections with catalase-positive micro-organisms and excessive inflammatory reactions that lead to granuloma formation. Long-term prophylactic antimicrobial agents and aggressive surgical management are the mainstays of therapy. The authors provided anesthetics for 17 patients with CGD undergoing 55 surgical procedures. These patients presented to surgery with multiple organ system involvement and were at significant risk for complications in the perioperative period. Granulomatous lesions of the gastrointestinal (GI) tract may predispose such patients to regurgitation and aspiration.

Adolescent↗
PubMedDate not supplied

In vitro function of granulocyte concentrates following passage through an electromechanical infusion pump.

Six units of granulocytes stored for 18 hours at 20 to 24 degrees C without agitation were passed through an electromechanical infusion device pump system (test) (Abbott) and through a 170-micron filter (control). To determine the effect of needle gauge, a 19 or 23 gauge needle was attached to the end of the pump administration set. After passage through the pump, granulocytes were evaluated for signs of cytolysis and functional loss, red cells for hemolysis, platelets for release of beta-thromboglobulin, and plasma for C3a and C5a complement activation. There was no evidence (mean +/- 1 SD) of hemolysis (less than 1.0 vs. less than 1.0 mg/dl), loss of granulocytes (123 +/- 38 X 10(3)/microliters vs. 118 +/- 29 X 10(3)/microliters), changes in any of several tests of neutrophil function, increased release of beta-thromboglobulin (15.8 +/- 5.8 vs. 17.0 +/- 6.6%), or C3a complement activation (483 +/- 221 vs. 500 +/- 200 ng/ml) after passage through the pump system (p greater than 0.05). No significant differences were seen between the use of a 19 or 23 gauge needle. Based on these in vitro data, we conclude that this pump system is acceptable for use in clinical practice when control over rate and volume of granulocyte administration is important.

Cell Survival↗
PubMedDate not supplied

In vitro characteristics and in vivo viability of platelets contained in granulocyte-platelet apheresis concentrate.

A paired prospective study was performed to compare the in vitro storage characteristics and in vivo kinetics of platelets stored in granulocyte-platelet concentrates prepared by apheresis with platelets prepared from whole blood. Platelet and granulocyte-platelet concentrates were collected from five healthy volunteer autologous donors and stored for 16 to 18 hours at 20 to 24 degrees C with and without agitation, respectively. After storage, pH, platelet count, percent release of beta-thromboglobulin, morphologic score, and percent osmotic recovery were measured. In addition, the granulocyte-platelet concentrates were assayed for total leukocyte count, release of lysozyme, and by several in vitro tests of granulocyte function. The platelets in both products were labeled with 111In oxine and infused into the donors. The pH of both products was above 6.0 at the end of storage. The units stored as platelet concentrates compared with those stored as granulocyte-platelet concentrates showed a higher percent release of beta-thromboglobulin, 18.4 +/- 4.0 percent versus 5.9 +/- 3.2 percent (mean +/- SD), but significantly better morphologic scores, 676 +/- 21 versus 525 +/- 56, and better osmotic recovery scores, 72 +/- 10 percent versus 40 +/- 7 percent, respectively (all p less than 0.05). The platelet concentrates (compared with the granulocyte-platelet product) had significantly better in vivo recovery, 49.5 +/- 15.8 percent versus 38.9 +/- 11.5 percent, and survival, 6.1 +/- 1.3 days versus 2.4 +/- 0.4 days, respectively (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Component Removal↗
PubMedDate not supplied

Alloimmunization after granulocyte transfusions.

BACKGROUND: Although granulocyte transfusions are recommended for neutropenic patients with bacterial infections that are unresponsive to antibiotic therapy, the presence of white cell (WBC) antibodies in the recipient can render these transfusions ineffective. STUDY DESIGN AND METHODS: A 25-year-old man with chronic granulomatous disease experienced a pulmonary transfusion reaction while receiving granulocyte transfusions, and he was found to be immunized to neutrophil antigen NA2. A retrospective study of alloimmunization to HLA and neutrophil antigens in 18 patients with chronic granulomatous disease who had also received repeated granulocyte transfusions was then performed. Sera were tested in lymphocytotoxicity, granulocyte agglutination, granulocyte immunofluorescence, monoclonal antibody immonobilization of granulocyte antigen, and immunoprecipitation assays. RESULTS: After the granulocyte transfusions, sera from 14 of the 18 patients contained WBC antibodies. Seven sera samples reacted in the lymphocytotoxicity, granulocyte immunofluorescence, and granulocyte agglutination assays; seven reacted in the lymphocytotoxicity and granulocyte immunofluorescence assays but not the granulocyte agglutination assay, and four did not react. When the monoclonal antibody immobilization of granulocyte antigen assay was used, three sera samples reacted with Fc gamma receptor III, three with the 58- to 64-kDa protein carrying the neutrophil antigen NB1, one with CD11a, and one with CD18. Antibodies from three patients immunoprecipitated a neutrophil protein of 60 kDa. Overall, antibodies to neutrophil antigens other than HLA could be detected in sera from eight patients. Transfusion reactions occurred in 11 of the 14 individuals with WBC antibodies and in none of the 4 without antibodies. Seven pulmonary reactions occurred in patients with WBC antibodies. The patients with WBC antibodies were given significantly more granulocyte concentrates (78 +/- 65 vs. 29 +/- 15 units, p < 0.05). CONCLUSION: Recipients of granulocyte transfusions often become alloimmunized. Screening for WBC antibodies periodically during transfusions, after adverse reactions, or before subsequent transfusions is indicated. If WBC antibodies are present, no further granulocyte transfusions should be given unless the granulocytes are collected from HLA- and/or neutrophil antigen-compatible donors.

Adolescent↗