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Biomedical subjects

H Link

Publications and source records attributed to H Link.

At least 397 records · Page 22Linked to original sources
PubMed1990

Results and prognosis of acute non-lymphocytic leukemia in adults. A retrospective study of 319 patients between 1977-1987.

Between 1977-87, 319 patients with AML were admitted to Hannover Medical School. At all 41 of these patients were not treated (median duration of survival 0.6 months). Among the 278 treated patients, there was a CR rate of 53.6%, the median duration of remission was 10.1 months and the median duration of survival 7.0 months. The patients with FAB-classification M4-M5 had a worse prognosis than those with M1-M3. Patients under 50 years of age had a significant higher remission rate and survival time than those over 50 years. In the last 10 years, the remission rate rose from 37.3% to 61.0% (p = 0.1776). There was a rise in median duration of survival from 5.9 months (1977-79) to 8.0 months (1984-85) (p less than 0.001). The median remission time decreased from 15.8 months (1977-79) to 12.0 months (1984-85) (p less than 0.001). After the first reinduction therapy, the remission rate (46.6%), duration of remission (5.3 months), and duration of survival (4.1 months) was lower than after primary therapy. After the second reinduction therapy the CR rate was 69.2%, and the remission time 2.9 months. The CR rate after the third reinduction therapy was 22.2%.

Adolescent↗
PubMed1990

Autoreactive T lymphocytes in multiple sclerosis determined by antigen-induced secretion of interferon-gamma.

Multiple sclerosis (MS) is a disease with unknown cause characterized by inflammation and demyelination in the central nervous system. Although an autoimmune pathogenesis has been suggested, there are no conclusive data on the number of T cells autoreactive with myelin antigens in MS compared to controls. We showed that T lymphocytes secreting interferon-gamma in response to possible target autoantigens are severalfold more common among PBL mononuclear cells in patients with MS than in patients with aseptic meningitis and tension headache. On average T cells reactive with myelin basic protein (MBP), two different MBP peptides, or with proteolipid protein amounted to 2.7-5.2/10(5) PBL from MS patients. MBP-reactive T cells were still more frequent among mononuclear cells isolated from the cerebrospinal fluid (CSF; 185/10(5) CSF cells). We concluded that T cells reactive with myelin autoantigens are strongly increased in MS. This approach to detect them could allow definition of immunodominant T cell epitopes in individual MS patients, and thereby enable further development towards specific immunotherapy.

Adult↗
PubMed1990

[Lung diseases following organ transplantation].

The immune suppression required after organ transplantation is accompanied by an elevated risk of infection by conventional and opportunistic pathogens. The lungs are the organs that are most commonly affected. Following transplantation of the kidney, pulmonary diseases have dropped from 23% to less than 5%. After bone marrow grafting, bacterial pneumonia, fungal pneumonia, bronchitis, mixed bacterial and fungal pneumonia, interstitial viral pneumonia, unclear pulmonary infiltrates, idiopathic interstitial pneumonia, pneumonia due to rare pathogens, obstructive bronchitis, and ARDS can occur. CMV pneumonia can be avoided by immunoglobulin prophylaxis, the use of CMV-negative leukocyte free blood - and platelet transfusions. The CMV pneumonia occurs as a result of a lymphocytic reaction. Obstructive bronchiolitis is probably caused by activated lymphocytes following bone marrow grafting, via the graft-versus-host reaction, and following heart-lung transplantation by the rejection reaction.

Graft vs Host Disease↗
PubMed1990

[Initial experiences with pentamidine aerosol in prevention of Pneumocystis carinii pneumonia following bone marrow transplantation].

After bone marrow transplantation there is a risk of 10% to acquire a pneumonia caused by pneumocystis carinii, if no prophylaxis is used. So far cotrimoxazol is the treatment of choice from day -14 before to day +180 after bone marrow transplantation. This substance, however, may cause allergic reactions, may augment the risk of nephrotoxicity of other drugs, and may be myelosuppressive. The prophylaxis with pentamidine-inhalation was used in 26 patients after bone marrow transplantation so far. It could be shown, that after salbutamol-inhalation 60 to 300 mg of pentamidine can be given safely in 14 to 28 days intervals. The main side effects were cough and dyspnea in some patients. Only minimal amounts of the drug could be detected in serum and urine after application. No toxic side effects and no pneumocystis carinii pneumonia were observed.

Administration, Inhalation↗
PubMed1989

Predominance of Borrelia burgdorferi specific B cells in cerebrospinal fluid in neuroborreliosis.

A nitrocellulose immunospot assay that allows the counting of cells secreting IgG, IgA, or IgM antibodies to Borrelia burgdorferi was used to compare B cell response to B burgdorferi at the cellular level in cerebrospinal fluid (CSF) and blood from patients with neuroborreliosis with that in patients with aseptic meningoencephalitis (AM) or non-inflammatory neurological diseases. 13 of the 14 patients with untreated neuroborreliosis had CSF cells secreting IgG antibodies to B burgdorferi (mean 17 cells per 10(4) CSF cells), whereas 8 of 12 patients examined had cells secreting IgA antibodies (mean 6 cells) and 10 of 12 had cells secreting IgM antibodies (mean 6 cells) per 10(4) CSF cells. IgG antibody producing cells predominated except in 2 patients with mainly or only IgM secreting cells. Cells secreting antibodies to B burgdorferi were rarely found in the blood and then at very low numbers, which reflects preferential compartmentalisation of the specific B cell response to the CSF. The cells were not detectable in CSF or blood from the two control groups. Evaluation of humoral immunity at the cellular level is a novel approach to the detection and localisation of immune events in neuroinflammatory disorders.

Adolescent↗
PubMed1989

Mononuclear cell types in cerebrospinal fluid and blood of patients with multiple sclerosis. Quantitation by immunoenzyme microassay with panel of monoclonal antibodies.

Phenotypic distribution of mononuclear cells in cerebrospinal fluid (CSF) and peripheral blood from patients with multiple sclerosis (MS) and, for reference, patients with acute aseptic meningoencephalitis (AM), and in blood only from healthy controls, was studied with an immunoenzymatic microassay enabling analysis even in the presence of a normal CSF cell count. In MS, increased CD5+ (pan-T) cell proportion in CSF compared with blood was not reflected by changes of CD4+ or CD8+ cells, while in AM, an increase of CD4+ cells was registered. Therefore, a population of CD5+, CD4-, and CD8- cells may be anticipated to exist in CSF of patients with MS. Numbers of OKB7+, OKM1+, or HLA-DR+ cells did not distinguish between MS and AM. Proliferating cells expressing transferrin receptors (OKT9+ cells) were generally few or absent in CSF and not useful as a marker of disease activity in either MS or AM.

Acute Disease↗
PubMed1989

Nerve fibre studies in skin biopsies in peripheral neuropathies. I. Immunohistochemical analysis of neuropeptides in diabetes mellitus.

Standardised skin biopsies followed by immunohistochemical examination for the presence of terminal nerve fibres reacting for neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) were evaluated. Healthy subjects regularly displayed free nerve endings of both fibre types in the papillary and reticular dermis. Both fibre types were present close to blood vessels, while CGRP immunoreactive fibres were more often encountered near sweat gland acini compared to SP fibres. Diabetes mellitus complicated by polyneuropathy was accompanied by marked reduction of SP and CGRP reactive fibres in the dermis layers. Five type I diabetes patients without clinical or neurophysiological evidence of polyneuropathy also had reduced density of both fibre types, being significant for CGRP fibres when compared with controls. Skin biopsy with immunohistochemical staining for neuropeptides may represent a sensitive tool in evaluation of patients with peripheral neuropathies.

Adult↗
PubMed1989

Immunoglobulin-secreting cells in the cerebrospinal fluid from patients with muscular tension headache.

Intrathecal B cell function in healthy subjects has been poorly elucidated. Although there are measurable quantities of immunoglobulins (Ig) in the cerebrospinal fluid (CSF) of 'normal' individuals, it is not clear whether this reflects transudation from serum or is due to some production within the central nervous system. We have therefore isolated cells from CSF to assess the frequency of Ig-secreting cells, utilizing a nitrocellulose immunospot assay for enumeration of the IgG-, IgA- and IgM-producing cells per 10(4) mononuclear cells (MNC) isolated from CSF and blood. Contrary to previous belief, the CSF obtained from 22 of 23 'normal' subjects (95%) with muscular tension headache but no evidence of organic neurological disease contained 2-50 (mean 20) IgG-secreting cells per 10(4) MNC. The corresponding peripheral blood specimens contained 0-6 (mean 3) IgG-secreting cells per 10(4) MNC. The proportion of IgG-secreting cells among MNC is thus about 7-fold higher in CSF than in blood of healthy individuals. IgA- and IgM-producing cells were also found in normal CSF, but less frequently than cells secreting IgG and at proportions similar to those in peripheral blood. We suggest that there is continuous production of Ig of different isotypes in CSF, even in subjects without any signs of neurological disease.

Adult↗
PubMed1989

B cells and antibodies in MS.

When the B-cell response was examined by enumeration of immunoglobulin (Ig)-secreting cells, normal cerebrospinal fluid (CSF)--in contrast to previous beliefs--contained IgG-secreting cells, indeed at an 8-fold higher proportion per 10(4) mononuclear cells (MNC) than blood. As expected, the proportion of IgG-producing cells was greatly increased in MS CSF. Evaluation of antibody (Ab) responses at the cellular level, thereby bypassing draw-backs inherent in determinations of circulating Ab levels, such as Ab binding to target, revealed that in one MS patient group, 57% had, in CSF, cells secreting IgG Ab against myelin basic protein (MBP) and, in another MS group, 55% had, in CSF, cells producing IgG Ab against myelin-associated glycoprotein (MAG); both MBP and MAG are possible targets for immune attack in MS. Anti-MBP and anti-MAG IgG antibody-secreting cells could occur in parallel or independently. They were rarely detected in blood, reflecting strong sequestration in CNS CSF. Their possible role in MS pathogenesis is envisaged in light of recently suggested coupling between polyclonal B-cell hyperresponsiveness and antigen-driven specific responses in autoimmune-prone individuals.

Antibody Formation↗
PubMed1989

Effect of ion channel blockers on immune response and course of experimental allergic neuritis.

The influence of the K+ channel blocker quinidine and the Ca++ channel blocker verapamil on in vivo and in vitro immune responses was tested in experimental allergic neuritis (EAN) of Lewis rats. Daily intraperitoneal injections of 4 mg quinidine produced a significant reduction of neurological deficits in EAN rats, whereas verapamil had no effect. In contrast, both drugs inhibited the in vitro proliferative response of regional lymph node cells to specific antigens of bovine peripheral myelin and purified protein derivative of tuberculin in a similar dose-dependent manner. Quinidine-treated EAN rats revealed considerably less inflammatory infiltration in target tissue than untreated EAN rats, shown immunohistochemically. Single injections of ion channel blockers into EAN rats did not improve nerve cell functions as measured by electrophysiological recordings of sciatic nerve. It is concluded that the dominant effect of quinidine in vivo is attributed to a reduction of the demyelinating autoimmune process. Hence ion channel blocking drugs can exert immunomodulatory effects, which may have implications for their clinical application.

Animals↗
PubMed1989

Recombinant human interferon (IFN) alpha-2b in chronic myelogenous leukaemia: dose dependency of response and frequency of neutralizing anti-interferon antibodies.

Twenty-seven patients with Philadelphia chromosome positive chronic myelogenous leukaemia in the chronic phase were treated with low doses of recombinant interferon (IFN) alpha-2b. Ten patients entered a complete and six a partial haematologic remission with a median duration of 5.8 and 9.1 months respectively. Five minor cytogenetic responses were observed. These results are inferior compared to other studies with higher interferon-doses. Fever was an acute side effect after injection of IFN, limb pains and fatigue occurred protractedly. Haematologic side effects, nonspecific EEG changes, weight loss, and development of pulmonary infiltrates were observed in later periods of the treatment. Eight patients developed neutralizing anti-IFN antibodies after 4.2-20.4 months (median 12.8 months). Anti-IFN antibodies were associated with relapse or refractoriness to IFN treatment: five out of nine patients with rising WBC after initial fall had antibodies, while four did not. Two out of four patients with primary non-response had IFN-antibodies. These results may indicate a serious problem in the long-term treatment of CML with recombinant interferon.

Adolescent↗
PubMed1989

Estradiol potentiates poke-weed mitogen-induced B cell stimulation in multiple sclerosis and healthy subjects.

Female preponderance in many diseases suggested with autoimmune pathogenesis, multiple sclerosis (MS) being classified as one of them, indicates a role for hormonal factors such as estrogen in disease development. To bypass monthly hormonal fluctuations in females, we evaluated in male patients with MS and male blood donors the effect of 17-beta-estradiol on numbers of IgG, IgA and IgM producing cells in cultures of peripheral blood lymphocytes. While estradiol alone had no effect, estradiol in combination with poke-weed mitogen (PWM) yielded in both groups higher numbers of IgG and IgA producing cells when compared with numbers obtained by PWM stimulation alone, indicating an additory effect of estradiol to that of PWM on B cell maturation. This effect was less pronounced in MS than in blood donors, especially for IgG producing cells, probably reflecting higher B cell activation in vivo taking place in MS. On the contrary, cells producing IgG, IgA and IgM antibodies against myelin, myelin basic protein and measles virus were not detectable after stimulation with PWM, nor with PWM and estradiol. Estradiol can in many patients with MS and in blood donors be considered a potent co-activator of B cells in presence of B cell stimulating factor in the form of PWM.

Adult↗
PubMed1989

Terminal component of complement C9 in CSF and plasma of patients with MS and aseptic meningitis.

A sensitive sandwich ELISA was applied to the measurement of the terminal component of complement C9 in CSF and plasma from 40 tension headache patients (reference group), 33 affected by clinically definite MS and 10 by aseptic meningitis. The levels of C9 in plasma were increased in aseptic meningitis. The determinations of CSF/plasma C9 ratio and C9 index, equal to (CSF C9/plasma C9): (CSF albumin/plasma albumin), thus accounting for changes of plasma C9 levels as well as damaged blood brain barrier, documented the existence of local consumption of C9 in aseptic meningitis. In contrast, only borderline alterations were evident in MS. The results indicate that local consumption of total C9 in CSF is an additional variable reflecting an acute inflammation within the CNS, but not demonstrable in MS, a chronic inflammatory CNS disorder.

Adolescent↗
PubMed1989

Intrathecal synthesis of IgG, IgA, IgM and IgD in untreated multiple sclerosis and controls.

The intrathecal production (ITP) of the immunoglobulins (Ig) G, A, M and D was examined in untreated patients with multiple sclerosis (MS) and controls. Sensitive sandwich enzyme-linked immunosorbent assay systems were applied to the determination of IgA, IgM and IgD levels in the cerebrospinal fluid and plasma from a group of 61 consecutive MS patients (41 relapsing-remitting and 20 secondary chronic progressive MS). Age-related reference limits for all Ig variables were defined in a group of 57 patients with tension headache. ITP of IgG was demonstrated in 85% of the MS patients, ITP of IgA in 41%, of IgM in 44% and of IgD in 18%. Among 9 MS patients with normal IgG index, 3 displayed ITP of IgA, 3 of IgM and 1 of IgD. Plasma IgA was elevated in 20% and plasma IgM in 24% of the MS cases. No significant variation of Ig ITP was demonstrated in a different group of 27 untreated MS patients examined during exacerbation and remission. Among control patients with other inflammatory nervous system diseases, ITP of IgA, IgM and IgD was found more frequently, and of IgG in a smaller percentage compared with MS patients.

Adult↗
PubMed1989

Intrathecal synthesis of beta-2-microglobulin in multiple sclerosis and aseptic meningo-encephalitis.

Beta-2-microglobulin (beta 2m) levels were studied in the cerebrospinal fluid (CSF) and plasma of 52 patients with clinically definite multiple sclerosis (MS) and of 14 with aseptic meningo-encephalitis (AM). Reference values for beta 2m were defined in 72 subjects of different age groups with tension headache (TH). Plasma levels of beta 2m increased with age in TH controls, particularly in the older age group, while no significant age variation could be detected for CSF beta 2m. Increased levels of beta 2m were found in the CSF and plasma of AM patients and in the CSF in MS. Calculations of CSF/plasma beta 2m ratios showed higher values in AM, reflecting intrathecal beta 2m synthesis, while only borderline alterations were evident in MS. Demonstration of intrathecal production of beta 2m is an additional CSF finding that may be useful in evaluating, among others, inflammatory nervous system disorders, but it has limited importance in the study of MS patients.

Adult↗
PubMed1989

Chronic progressive myelopathy associated with HTLV-I: oligoclonal IgG and anti-HTLV-I IgG antibodies in cerebrospinal fluid and serum.

Among 22 patients with human T-lymphotropic virus type I (HTLV-I)-associated chronic progressive myelopathy, agarose isoelectric focusing (AIF) revealed oligoclonal IgG bands in 21: in 3 in CSF only; in 11 in CSF and to some extent in serum; and in 7, identical patterns in CSF and serum. By immunoblot after AIF of CSF and serum, we observed bands of anti-HTLV-I IgG antibodies in 19 patients: in 5 in CSF only; in 9 in CSF and partly in serum; and in 5, identical in CSF and serum. Oligoclonal anti-HTLV-I IgG antibody bands could only partly be traced to oligoclonal IgG bands. If, prior to AIF, serum and CSF were absorbed with HTLV-I antigen, practically all oligoclonal HTLV-I-specific IgG antibody activity was abolished, while the oligoclonal pattern of total IgG was affected only to a minor extent. Alongside with HTLV-I-specific oligoclonal B cell response, HTLV-I myelopathy is regularly accompanied by production of oligoclonal IgG of unknown antibody specificities.

Adult↗
PubMed1989

Cells producing antibody to measles and herpes simplex virus in cerebrospinal fluid and blood of patients with multiple sclerosis and controls.

The B cell response against measles and herpes simplex virus (HSV) was evaluated in cerebrospinal fluid (CSF) and peripheral blood from patients with multiple sclerosis (MS) and controls by enumeration of cells secreting anti-measles and anti-HSV antibodies of IgG, IgA and IgM isotypes. We used a nitrocellulose immunospot assay which enables parallel enumeration of numbers of cells secreting total IgG, IgA and IgM. Anti-measles IgG antibody-secreting cells were present in CSF from 21 of 24 MS patients (mean 24 cells/10(4) mononuclear cells), and against HSV in CSF from seven of eight patients (mean 23/10(4) cells). No antibody-secreting cells were detectable in the patients' blood. Ten MS patients examined were negative for cells in CSF and blood producing anti-measles antibodies of IgA and IgM isotypes. Anti-measles IgG antibody secreting cells were also found in CSF from four of 18 controls, and anti-HSV IgG antibody-secreting cells in six of 13, especially in patients with subacute or chronic inflammatory nervous system diseases. Our results confirm that viral antibodies in MS are produced within CSF and that this B cell response is preferentially sequestered to this compartment. Whether this viral B cell response in MS reflects specific activation due to persistence of viral antigens or an epiphenomenon remains to be clarified.

Adult↗