[Determination of the activity of key enzymes in the human adipose tissue].
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Adipose Tissue↗
Biomedical subjects
H W Doerr
Publications and source records attributed to H W Doerr.
Prevalence of antibodies to human herpesviruses and hepatitis B virus in patients at different stages of human immunodeficiency virus (HIV) infection.
The results of antibody assays for viruses of the herpes group (HSV, EBV, VZV and CMV) and for hepatitis B virus (HBV) were retrospectively evaluated in 439 HIV-seropositive patients classified into different stages of HIV infection. The prevalence of specific IgG, IgM and IgA antibodies in these groups was compared with that of a control group of HIV-negative unselected hospital patients. Antibodies to herpes viruses and HBV were more prevalent amongst HIV-seropositives, especially LAS and AIDS patients than in controls. However, marked differences were found only with CMV-IgG and anti-HBc-IgG, both with a comparatively low prevalence in HIV-negative persons (64.5% and 23.2%). Significantly more seropositives were found among asymptomatic HIV carriers (83.3% and 50%) and still more in patients with full-blown AIDS (95.4% and 82.5%). The increased frequency of CMV and HBV antibodies, already seen in asymptomatic HIV patients reflects their higher risk for sexually transmitted infections. Moreover, IgA antibodies to CMV were detected in 25.4% of LAS and 37.3% of AIDS patients, respectively, but only in 7.6% of the controls. Elevated CMV-IgA titres were found exclusively in HIV-infected persons. The differences in the antibody patterns found in this cross-sectional study may reflect the progression of the HIV disease. However, prospective follow-up studies are required to assess the value of these markers as indicators of prognosis in HIV-infected subjects.
Acquired Immunodeficiency Syndrome↗
Detection of cytomegalovirus in bronchial lavage and urine using a monoclonal antibody to an HCMV early nuclear protein.
Laboratory diagnosis of 24 cases of human cytomegalovirus (HCMV) infection in patients with the acquired immunodeficiency syndrome, renal transplant recipients and premature infants was achieved. These results were obtained by a rapid, sensitive and versatile HCMV-antigen detection method, which combined cell culture and immunoperoxidase staining with a monoclonal antibody to an HCMV "early" nuclear protein. The results were compared with HCMV isolation by the conventional cell culture method. While some of these immunocompromised patients lacked a significant antibody response, infective HCMV could be detected in the patients' urine and bronchial lavage fluid. The diagnostic procedure took no longer than 24 h. The usefulness of this antigen test for an effective diagnosis in immunocompromised individuals was demonstrated. We recommend routine analysis of various specimens, since recent developments in chemotherapy of HCMV infection and the risks of long-term damage demand immediate management of the patients concerned.
Adult↗
Six enteropathogens isolated from a case of acute gastroenteritis.
Isolation of six different gastrointestinal pathogens (Entamoeba histolytica, Plesiomonas shigelloides, Campylobacter jejuni and three different Salmonella species [Salmonella typhimurium, Salmonella blockley and Salmonella hadar]) in the feces of a German female tourist suffering from acute diarrhoea after a trip to Bali.
Acute Disease↗
Serologic detection of active infections with human herpes viruses (CMV, EBV, HSV, VZV): diagnostic potential of IgA class and IgG subclass-specific antibodies.
In 175 sera from healthy persons as well as those suffering from primary or secondary herpes virus infections/reactivations, serum antibodies were assessed by an indirect ELISA in the immunoglobulin classes A, G and M and the subclasses G1-4, using carrier-fixed antigens (CMV, VZV, HSV) and monoclonal tracer antibodies. In a similar way EBV-specific antibodies were tested by an indirect IFT. Only IgG1 antibodies were detectable in nearly all persons. Virus-specific IgA and IgG3 may support conventional serological methods (IgM, IgG) indicating recent infection/reactivation with VZV, EBV and possibly CMV. Furthermore, differentiation of primary and secondary CMV and VZV infection was possible in some cases, when IgG3 was detectable before IgG1 in subsequent blood specimens. Recurrent herpes lesions could not be diagnosed serologically.
Antibodies, Monoclonal↗
Laboratory diagnosis of congenital human cytomegalovirus infection using polymerase chain reaction and shell vial culture.
Congenital HCMV infection was diagnosed at the 22th week of gestation. The infection was suspected because HCMV IgM was detected in a serum sample obtained from the woman's husband. HCMV infection was detected in the amniotic fluid by polymerase chain reaction, shell vial culture (immunoperoxidase assay) and conventional virus isolation. Serologic testing in paired sera of the woman and in umbilical cord blood for specific IgM and IgA remained negative. As serological data (preconceptional HCMV serostatus) were incomplete, a clear differentiation between primary and secondary infection could not be achieved; consequently, risk quantification could not be determined. Viruria was detected in the offspring during the 1st week post partum. No clinical signs of cytomegalic inclusion disease were diagnosed up to six weeks post partum. Our case report indicates that for pregnancy surveillance, serologic testing for HCMV antibody should also be performed in the spouse.
Adult↗
Improvement of serological diagnosis of human cytomegalovirus infection in renal transplant recipients by testing for specific immunoglobulin E by ELISA.
The kinetics of human cytomegalovirus (HCMV)-specific immunoglobulin E (IgE), M (IgM), A (IgA) and G (IgG) were studied in 421 sera obtained from 19 renal allograft recipients by enzyme-linked immunosorbent assay (ELISA). Cytomegalic inclusion disease (CID) occurred in 11 (57.9%) patients. HCMV infection was diagnosed in all (100%) of these patients by testing for specific IgE. In contrast, increased levels of IgM and IgA class antibody against HCMV were detected in only 45.5% and 18.2% patients suffering from primary or recurrent HCMV infection, respectively. Concerning the time interval between the onset of clinical symptoms and the first positive test, no significant differences in the kinetics of HCMV-specific immunoglobulins E, M, A and G were observed. Elevated specific IgE levels persisted for longer time intervals than the other immunoglobulin classes. As shown by the present study, specific IgE proved to be a more reliable serologic marker than IgM and IgA for the serologic detection of HCMV infection in renal allograft recipients.
Adult↗
Congenital rubella syndrome after maternal reinfection.
This report concerns a case of congenital rubella syndrome (CRS) with atypical immune response affecting an infant whose mother had repeated evidence of immunity before pregnancy. Laboratory diagnosis of CRS could only clearly be achieved by virus isolation after the second month of life despite typical clinical features of CRS and multiple organ involvement. After the first month of age, low concentrations of specific IgM antibodies were revealed by ELISA and confirmed by a reference test system (IgM-specific haemagglutination inhibition assay). Persistent and increasing high levels of IgM antibodies were detected only after the 6th month of life. Later on IgG antibody levels decreased. Immunological investigations showed an IgG1-hypoglobulinaemia. The unusual feature of the present case report is not only the failure of the maternal rubella immunity to prevent CRS, but the defect of the child's immune system, probably attributable to congenital infection. As a consequence, laboratory diagnosis of CRS could not be achieved initially by the proved serological methods.
Adult↗
Unusual course of herpes simplex virus encephalitis after acyclovir therapy.
This is a report on a case of herpes simplex encephalitis (HSE) taking an unusual course after initially successful acyclovir therapy. The etiology of HSE was proven serologically, by repeated detection of herpes simplex virus (HSV)-specific DNA sequences in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) and was supported by cerebral imaging. After both the neurological symptoms and laboratory findings had improved initially under acyclovir therapy, the patient's clinical condition deteriorated accompanied by a renewed increase in CSF pleocytosis and protein content. Nuclear magnetic resonance (NMR) imaging confirmed the finding of bilateral, mainly temporal lesions compatible with a diagnosis of relapsing HSE. The patient responded well to a second cycle of antiviral therapy but required a third treatment cycle due to renewed deterioration later on. HSV-specific DNA sequences could not be demonstrated in several consecutive CSF samples taken after the first week of illness but increased inflammatory changes typical of HSE were seen on NMR during phases of deterioration. IgM-class antibodies against HSV were detected in CSF 4 weeks after onset of symptoms and stayed positive for at least 7 weeks. Reasons for the repeated deterioration and possible explanations for the absence of HSV DNA in spite of what could be seen as relapses are discussed.
Acyclovir↗
Prophylaxis of cytomegalovirus disease in high-risk patients.
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Adoptive Transfer↗
A prognostic score for postherpetic neuralgia in ambulatory patients.
The main objective was to develop a scoring system for easy use by the physician in daily clinical practice in deciding the appropriate treatment for his herpes zoster patient. Data from 635 patients who did not receive antiviral therapy were included in this analysis. Of these, 131 developed postherpetic neuralgia (PHN). Of the 29 variables tested univariately in this study, 15 showed a significant correlation with the incidence of PHN, but only six proved to contribute to the overall predictive power in the multivariate approach. Using two independent approaches, the model showed a very satisfactory performance in the validation sample. Patients without acute pain rarely developed PHN. In those with acute pain, being female, being over 50 years of age, having more than 50 lesions, having lesions of a hemorrhagic nature, having cranial or sacral localisation of the rash or having pain in the prodromal phase proved to be significant, multivariate factors. An easy-to-use scoring system used in a risk graph is proposed. These data should be useful in the individual treatment decision as well as in the design and analysis of therapeutic trials in herpes zoster.
Adult↗
Enterovirus infections in Germany: comparative evaluation of different laboratory diagnostic methods.
BACKGROUND: The diagnosis of an enterovirus infection may be achieved through direct virus detection from fecal or cerebrospinal fluid (CSF) samples by virus isolation or PCR. Serologically, a significant rise in antibody titer may be detected and different enteroviral types can be differentiated using the neutralization assay. PATIENTS AND METHODS: We investigated the contribution of these different laboratory parameters to the diagnosis of enterovirus infections occurring in the Frankfurt am Main area during the years 1997 to 1999, including an echovirus 30 outbreak in a group of children with aseptic meningitis in 1997. Samples were referred from 1,013 patients; virus isolation was attempted from 579 CSF specimens and from 400 stool samples. 208 CSF samples were tested by PCR. RESULTS: During the echovirus 30 outbreak we identified 22.3% of samples as positive, almost exclusively echovirus 30. In 1998 only 7.1% of samples were positive and a rather broad range of agents was isolated. In 1999 10.4% were positive, predominantly coxsackie B5 and echovirus 11. We could show that in acute enterovirus infections, virus detection by cell cuLture and PCR is superior to serological methods (neutralization assay and IgM assay). For virus isolation, there was a higher rate of positives from stool compared to CSF (1997: 27.8% versus 25%; 1998: 14.4% versus 3%; 1999: 17.9% versus 8.5%). When comparing PCR and virus isolation from the CSF, the former yielded a higher rate of positive results but was not clearly superior to virus isolation from CSF. CONCLUSION: The recommended method for the diagnosis of acute enterovirus infections is virus isolation from feces. In cases of suspected aseptic meningitis virus isolation and PCR are valuable for the direct detection of virus in CSF.
Acute Disease↗
Rapid diagnosis of primary dengue fever by the immunochromatographic test and by electron microscopy--a case report.
A 21-year-old woman presented with an acute febrile illness after a two-week holiday in Jamaica. Her symptoms started two days after return, with sudden onset of continuous high fever (> 39 degrees C), dizziness and nausea. Three days later she developed a generalized macular rash, which led to the tentative diagnosis "acute dengue fever." Laboratory confirmation was achieved by demonstrating anti-dengue IgM and IgG antibodies in paired sera; in addition, flavivirus particles were directly visualized by electron microscopy.
Adult↗
Low correlation of serology with detection of Chlamydia trachomatis by ligase chain reaction and antigen EIA.
The aim of the present study was to evaluate the diagnostic accuracy of serology by using new assays for the detection of genus and species-specific IgG, IgM, IgA and secretory IgA antibody in female sex workers. Cervical swabs and first void urine (FVU) from 314 female sex workers were submitted to nucleic acid amplification by ligase chain reaction (LCx, Abbott). Concomittantly, blood samples were tested for the presence of IgG, IgM and IgA antibodies using a genus-specific assay (rELISA, Medac) and species-specific test (SeroCT, Orgenics). Chlamydia trachomatis infection was detected in a total of 30 (9.6%) female sex workers by LCR. With rELISA, seroprevalences for IgG, IgM, and IgA antibody to Chlamydia were 88.9%, 19.1% and 62.7%, respectively. IgG and IgA antibody prevalences against C. trachomatis (SeroCT) were 65.0% and 23.9%, respectively. In comparison to the positive LCR results obtained from cervical swab and/or FVU, the sensitivity of rELISA for Chlamydia IgG, IgA and IgM detection was 93.3%, 83.3% and 16.7%, respectively. With SeroCT, the sensitivity for C. trachomatis-specific IgG and IgA detection was 86.7% and 33.3%, respectively. The specificities of both serologic tests in comparison to LCR were very low. In conclusion, the correlation of serology with active C. trachomatis infection of the lower genital tract is very low. According to our results, serologic testing for Chlamydia can exclude active infection of the lower genital tract with a high reliability (> or = 95%). However, detection of C. trachomatis can only be reliably achieved by nucleic acid amplification assays.
Antibodies, Bacterial↗
Activity of cellular thymidine kinase 1 in PBMC of HIV-1-infected patients: novel therapy marker.
Cellular cytoplasmatic thymidine kinase 1 (TK1) catalyzes the intracellular phosphorylation of anti-HIV-1 nucleoside analogs zidovudine (AZT) and stavudine (d4T) to the corresponding monophosphate form. In HIV-1-infected patients, treated with combination therapy including one of these compounds for more than 1 year, enzymatic activity of TK1 in peripheral blood mononuclear cells (PBMC) was determined by radioactive assay. TK1 activity in PBMC of HIV-1-infected patients correlated with CD4 cell count (r = 0.4, p<0.05) and HIV-1 RNA copy number (r = 0.4, p<0.05), being lower in patients with decreased CD4 cell count and high viral load. Furthermore,TK1 activity differs between HIV-1-infected individuals treated for more than 6 months (13.5 pmol/mg/h) compared to patients treated for less than 6 months (28.1 pmol/mg/h; p<0.05) with chemotherapeutic agents including thymidine analogs. The results demonstrate that TK1 deficiency in PBMC of HIV-1 infected patients may develop due to continuous treatment with thymidine analogs and correlates with a more progressed stage of disease expressed as diminished CD4 cell count and increased viral load.
Adult↗
Antibodies against human CMV-induced "early" antigens detected by immunoblotting are not exclusively associated with active infection.
We investigated the correlation between the prevalence of antibodies against human cytomegalovirus (HCMV) "early" proteins and the state of infection. Two hundred and twenty-eight HCMV-IgG-positive (HCMV late-antigen ELISA) sera, drawn from subjects with active and non-active HCMV infections, were tested for specific IgG antibodies against HCMV "early" antigens by a Western blotting micromethod. Applying virus strain AD-169, we found antibodies to HCMV "early" antigens in 59% of all cases, irrespective of origin. Subjects with an elevated risk of cytomegalic inclusion disease (renal transplantation patients, AIDS patients) revealed significantly broader immune reactions when compared with healthy HCMV-antibody carriers. However, in follow-up studies we detected one patient who lacked an immune response to HCMV "early" antigens during active infection and subsequent convalescence. Our results indicate that active HCMV infection is not necessarily associated with the formation of antibodies against "early" antigens. Moreover, these antibodies may persist during non-active infection.
Acquired Immunodeficiency Syndrome↗
Replication of human herpesvirus type 6 (strain AJ) in JJHan cells grown in protein-free medium.
The human T-cell line JJHan, commonly used as a substrate for human herpesvirus type 6 (HHV-6) replication, was established in a protein-free 1:1 mixture of Ham's F12 and Iscove's modified Dulbecco's medium. After 250 passages (4 years) in protein-free medium, the cells, designated JJHan-PF, were cocultured with JJHan cells chronically infected with strain AJ of HHV-6 conventionally grown in serum-supplemented medium. The production of viral antigen was monitored by indirect immunofluorescent antibody staining. The infectivity of the virus in JJHan-PF cells was similar to that in JJHan cultures as shown by HHV-6 antigen detection using a convalescent phase serum. The results show that JJHan-PF cells provide a sensitive substrate for HHV-6 replication without the interference of serum or other proteins usually added to the culture medium.
Cell Line↗
Prolonged Th2 cell activation and increased viral replication in HIV-Leishmania co-infected patients despite treatment.
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AIDS-Related Opportunistic Infections↗