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H Wachter

Publications and source records attributed to H Wachter.

At least 379 records · Page 21Linked to original sources
PubMed1986

Who will get AIDS?

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Activation of the macrophage/lymphocyte system in AIDS, ARC and AIDS risk groups].

Elevated neopterin levels are indicative of activation of the cellular immune system. Studies on excretion of neopterin in patients with AIDS and ARC, as well as in members of risk groups have demonstrated repeated or permanent stimulation of the immune system. This stimulation can be observed in all risk groups independent of LAV/HTLV-III infection. Additionally, in vitro replication of LAV/HTLV-III has been observed to be quantitatively greatest in activated CD4+-lymphocytes. Hence, we conclude that activation of the cellular immune system represents the central cofactor for progressive LAV/HTLV-III infection. These findings seem to contrast with most reports in the literature to date, but observations of other authors corroborate them. As consequence of these studies, therapeutic regimens using immunostimulatory strategies should be prevented in AIDS and ARC patients. Immunosuppressive treatment should be considered.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Urinary neopterin, a marker of clinical activity in patients with Crohn's disease.

Urinary neopterin excretion was measured in 34 patients with Crohn's disease. Neopterin excretion showed a significant correlation with disease activity using a clinical activity score. An interacting effect of previous medical or surgical therapy on neopterin excretion could be ruled out. Disease localization and extent did not exert any influence on neopterin excretion. Neopterin values were significantly correlated with disease duration, body weight and the presence of a palpable abdominal mass. Multiple stepwise regression analyses identified the combination of neopterin, hematocrit, weekly stool frequency, palpable abdominal mass and related symptoms as predicting clinical activity better than Crohn's Disease Activity Index (CDAI). Thus, neopterin determination may be introduced as an additional biochemical parameter in the assessment of disease activity.

Adolescent↗
PubMed1986

Urinary neopterin reflects clinical activity in patients with rheumatoid arthritis.

Neopterin is a marker for activation of cellular immunity. Urinary neopterin levels were measured in 106 patients with rheumatoid arthritis (RA) and in 45 patients with osteoarthritis. Levels were significantly higher in RA patients than in osteoarthritis patients and were strongly dependent on stage and activity of RA. Correlations with other laboratory parameters were weak. Multivariate analysis demonstrated that urinary neopterin levels reflected clinical activity better than did other laboratory findings. Thus, urinary neopterin determination might be useful in monitoring RA patients.

Aged↗
PubMed1986

A simple index relating clinical activity in Crohn's disease with T cell activation: hematocrit, frequency of liquid stools and urinary neopterin as parameters.

Crohn's disease is characterized by alternating acute and quiescent periods. Several indices for activity of the inflammatory process have been proposed to have criteria for prognosis of the clinical course and therapeutic efficacy. Neopterin is specifically released from human monocytes-macrophages after induction by interferon-gamma secreted from activated human T lymphocytes. Thus, urinary neopterin excretion is elevated in diseases involving activation of cellular immunity. Fifteen clinical and laboratory parameters, including urinary neopterin levels, collected from 35 visits of patients with Crohn's disease, were compared using multiple linear regression analysis with a simple clinical activity index as reference. Prediction of clinical activity was best with the combination of hematocrit, weekly number of liquid stools and neopterin. A simple triple-parametric Crohn's disease activity index was established on the basis of this result. Its quality was tested on independent data obtained from 25 repeat visits of 13 of these patients. A comparison with the well-known Crohn's Disease Activity Index (CDAI) was performed. The results obtained with the proposed activity index were slightly better than those with the eight-parametric CDAI for the data from the first as well as from the repeat visits. We conclude that our simple index is a reliable and easily accessible measure for clinical activity in patients with Crohn's disease.

Adolescent↗
PubMed1986

Neopterin as a prognostic indicator in patients with carcinoma of the uterine cervix.

In vitro, neopterin, a pyrazinopyrimidine compound, is excreted by human monocytes-macrophages after induction by supernatants from activated T-lymphocytes or by recombinant gamma-interferon. In vivo, it represents a noninvasive test for activation of cellular immune reactions. To evaluate the prognostic value of pretherapeutic urinary neopterin levels and of serial neopterin measurements during follow-up in women with cervical cancer, 1088 urine specimens from 186 consecutive patients were analyzed. Clinical assessments were made without knowledge of the results of neopterin assays (a "blinded" assessment). During the observation period (June 1980 to March 1984), 27 relapses, 18 metastases, and 26 deaths were seen. The prognostic significance of pretherapeutic neopterin and other possible prognostic clinical and laboratory parameters was tested by the univariate and multivariate Cox proportional hazards model using a stratification according to stage and surgical treatment. The combination of age at diagnosis, pretherapeutical hemoglobin, leukocyte count, and neopterin was found to predict survival best. On the basis of this result, risk groups were identified exhibiting markedly different survival behavior. A highly significant association was found between serial neopterin measurements and the risk for a relapse, metastasis, or death. The data suggest that urinary neopterin levels might be a useful adjuvant parameter in monitoring women with cervical cancer.

Adenocarcinoma↗
PubMed1985

Significance of urinary neopterin in patients with malignant tumors of the genitourinary tract.

The urinary neopterin excretion was measured by high-performance liquid chromatography in 417 healthy subjects and in 76 patients with clinically and pathohistologically verified neoplasias of the urinary tract (bladder tumor, carcinoma of the prostate, and renal cell carcinoma). The patients with early tumor stages both with bladder tumor and carcinoma of the prostate had normal urinary neopterin levels, except one patient with bladder tumor who had a value at the upper confidence limit. Of 40 patients with higher stages of bladder tumor and carcinoma of the prostate, 35 had elevated urinary neopterin levels. Two of 10 patients with bladder tumor in stage T3, 1 of 4 patients with carcinoma of the prostate Stage C, and 2 of 15 patients with prostatic cancer Stage D showed normal neopterin levels. The patients with renal cell carcinoma did not demonstrate any definite correlation between tumor stage and urinary neopterin excretion. The current study suggests that the neopterin assay may supplement laboratory measurements in tumors of the urinary tract, providing helpful information regarding case selection for the most convenient therapeutic management and postoperative follow-up.

Adolescent↗
PubMed1985

[1st case of AIDS in Salzburg. Important diagnostic hint by determination of neopterin].

This case report describes the first case of AIDS in Salzburg. The patient belonged to the male homosexual risk group. He presented with opportunistic infections: oral candidiasis, bilateral Pneumocystis carinii pneumonia and cerebral toxoplasmosis. The diagnosis of AIDS was corroborated by highly elevated urinary neopterin levels. Despite treatment with antibiotics the patient died within 5 weeks due to cardiorespiratory insufficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Neopterin release in human mixed lymphocyte culture: requirement of HLA-DR disparity.

Recent evidence suggests that immune responses in vivo as well as in vitro are accompanied by release of neopterin [C. H. Huber, et al. (1983) J. Immunol. 130, 1047]. This investigation aimed to elucidate the genetic control of in vitro neopterin release in family mixed lymphocyte culture (MLC) studies. Neopterin levels and responder cell proliferation were assessed in a total of 92 MLCs established from different intrafamilial combinations. Results indicated a strong association between the magnitude of responder cell proliferation and the neopterin levels induced by stimulation with allogeneic cells. This conclusion was based on three findings: first, almost no neopterin release and proliferation was seen in MLCs established between HLA genotypically identical siblings; secondly, very low proliferation and neopterin levels were observed in MLCs between HLA-DR phenotypically identical family members; and thirdly, high neopterin release and strong cellular proliferation were a feature of MLCs established between individuals differing for at least one HLA-DR antigen. We thus conclude that T cell activation subsequent to recognition of HLA-DR disparity represents an essential prerequisite for induction of neopterin release in human MLC.

Biopterins↗
PubMed1985

Neopterin levels in long-term renal allograft recipients.

In this paper we present results dealing with neopterin levels in the urine of 21 kidney grafted patients during long-term allograft survival. Data dealing with results of urinary neopterin excretion to predict acute cellular allograft rejection during the immediate post-transplant period have been reported previously. The evaluation of patients included a physical investigation and numerous biochemical parameters as described below. We found that neopterin excretion is normal or elevated, but if elevated levels remain stable the prognosis for the allograft seems to be good.

Biopterins↗
PubMed1985

Neopterin as a new biochemical marker in the clinical assessment of ulcerative colitis.

In previous publications we showed that neopterin, a pyrazino-pyrimidin compound, represents a biochemical marker for the assessment of cellular immune responses. We thought that the evaluation of this marker molecule might enable insight into the activity of cellular immune responses underlying ulcerative colitis (UC). Evaluation of urinary neopterin excretion in 25 consecutive untreated UC patients revealed striking correlations between neopterin levels and the severity of disease: elevated levels were observed in 9 out of 9 patients with moderately severe to severe, in 3 of 4 with mild and in none of 12 patients with quiescent disease. Further evidence for a correlation between disease activity and neopterin excretion was obtained on the basis of long-term follow-up studies performed in 4 cases. These studies indicated normalization of neopterin levels when clinical remission was achieved. Thereafter, the relative significance of neopterin excretion for determination of clinical stage was assessed by linear correlation analyses and was compared with conventional clinical parameters such as anemia, number of motions per day, raised temperature, ESR and extent of bowel involvement. The logarithm of neopterin excretion and the extent of bowel involvement were the two single parameters most closely related to the clinical stage of ulcerative colitis. We, therefore, conclude that evaluation of neopterin excretion in ulcerative colitis patients represents a new and useful tool for the clinical monitoring of disease activity.

Adolescent↗