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Biomedical subjects

J C Huff

Publications and source records attributed to J C Huff.

At least 73 records · Page 4Linked to original sources

Detection of a herpes simplex viral antigen in skin lesions of erythema multiforme.

The commonest variety of erythema multiforme follows a lesion caused by a recurrent herpes simplex virus infection. In studying the immunopathogenesis of herpes-associated erythema multiforme, we examined skin lesions for the presence of a herpes simplex viral antigen by an indirect immunofluorescence test using a monoclonal antibody to a major type-common glycoprotein antigen, gB. Focal staining showed this antigen to be present in epidermal cells in 12 of 16 skin biopsy specimens. The staining was similar to, but less intense than, that seen in biopsy samples of lesions of recurrent herpes simplex virus infections. Similar findings were not seen in control skin biopsy specimens from lesions of other skin diseases; a control monoclonal stain also was negative in biopsy specimens. These findings suggest that the immune reaction and subsequent tissue damage of herpes-associated erythema multiforme are due to the presence of herpes antigens in the skin.

Antibodies, Monoclonal↗

Erythema multiforme.

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Diagnosis, Differential↗

Complement deposition in the skin of patients with herpes-associated erythema multiforme.

Granular staining for C3 by direct immunofluorescence is a frequent finding along the dermoepidermal junction and in papillary blood vessels in the early skin lesions of erythema multiforme. In order to evaluate whether the complement cascade is activated by the classical or alternative pathway, ten biopsies from patients with herpes-associated erythema multiforme, which were positive for granular C3 along the dermoepidermal junction, were stained by an immunofluorescence technic for other complement components. Staining for the components of classical pathway, C1q and C4, were found in none of the ten biopsies. However, in nine of ten biopsies, granular staining for properdin was present along the dermoepidermal junction. These findings suggest complement activation by the alternative complement pathway in herpes-associated erythema multiforme.

Biopsy↗

Neonatal lupus syndrome in successive pregnancies.

Two female siblings, born 15 months apart, developed neonatal lupus syndrome. Both had cutaneous lupus erythematosus (LE) lesions resolving with telangiectasis. Their cutaneous lesions were temporally related to transplacental passage of anti-SS-A (Ro) autoantibodies from their asymptomatic mother. Infants with this transient collagen vascular syndrome may have LE skin lesions, congenital heart block, and liver or hematologic abnormalities, and are possibly at risk for developing systemic lupus erythematosus (SLE) later in life. It is important to recognize that this syndrome may occur in successive pregnancies.

Female↗

Erythema multiforme: a critical review of characteristics, diagnostic criteria, and causes.

Erythema multiforme (EM), in its modern definition, is an acute, self-limited syndrome with distinctive skin lesions with or without mucosal lesions. Use of the terminology "EM minor" and "EM major" is a reasonable approach to separating the classical mild cutaneous syndrome, as described by Hebra (EM minor), from the usually more severe syndrome, with marked mucosal damage, as described by Stevens and Johnson (EM major). Until objective markers for EM are available, we propose preliminary diagnostic criteria for EM, based primarily on clinical features. Although hundreds of factors have been reported to cause EM, only a limited number are reasonably well documented as possible precipitating agents. Recurrent herpes simplex is an important etiologic factor in EM minor, while mycoplasmal infections and drugs may be associated with EM major. Progress in the understanding of EM will require careful attention to definition and diagnostic criteria and identification of distinct clinical and etiologic subsets within the spectrum of EM.

Erythema Multiforme↗

Class-specific antibodies to gluten in dermatitis herpetiformis.

An immune reaction to wheat protein has been previously proposed to explain the pathogenesis of dermatitis herpetiformis. In order to detect and characterize antibodies to gluten in human sera, we developed an enzyme immunoassay for class-specific antibodies. Results of this assay in 49 patients with dermatitis herpetiformis were compared with those of 38 normal control subjects, 11 patients with celiac disease, and 6 small-bowel bypass patients. IgA antibodies to gluten were significantly more frequent in dermatitis herpetiformis sera (28/49) than in normal control sera (4/38). IgG antibodies to gluten were significantly more frequent in both celiac disease (10/11) and dermatitis herpetiformis (16/49) sera than in control (5/38) sera. Dermatitis herpetiformis sera also had an increased prevalence of IgM antibodies to gluten (19/49). Small-bowel bypass patients demonstrated no antibody to gluten. Antibodies to gluten in dermatitis herpetiformis objectively mark a state of immune reactivity to wheat protein and may be involved in the genesis of the cutaneous IgA immune deposits and the skin disease.

Adult↗

Immunogenetics of the neonatal lupus syndrome.

Infants with neonatal lupus erythematosus have congenital heart block, transient cutaneous lesions, or both. Mothers of these infants have SSA/Ro autoantibodies that are passed across the placenta to the fetus and that have been temporarily associated with the syndrome. Six families with neonatal lupus were studied by HLA typing. All seven infants had transient cutaneous lesions, congenital heart block, or both. Five of six mothers were asymptomatic and one had Sjögren's syndrome. Six of seven infants and all six mothers had antibodies to SSA/Ro in their sera. The infants became seronegative by age 8 months. Five mothers were positive for HLA-DR3, five for HLA-MB2, six for HLA-MT2, and six for HLA-B8. No HLA associations were seen in infants. Gene products of the DR or similar regions may be associated with autoantibody production but not with other events in tissue injury.

Antibodies, Antinuclear↗

Detection of gluten in human sera by an enzyme immunoassay: comparison of dermatitis herpetiformis and celiac disease patients with normal controls.

We have developed a triple sandwich enzyme immunoassay to detect circulating gluten in human sera. With human sera containing known amounts of added gluten as controls, the assay was sensitive in the range of 0.75 to 75 micrograms of gluten per ml of serum. Forty-one control subjects were compared to 21 patients with dermatitis herpetiformis and 11 patients with celiac disease. The dermatitis herpetiformis and celiac disease patients had significant elevation of serum gluten values over the control subjects. Circulating gluten antigenemia is a previously unrecognized feature which may be important in understanding the pathogenesis of dermatitis herpetiformis and celiac disease.

Adult↗

Humoral immunity in stage I mycosis fungoides: an increased incidence of lymphocytotoxic antibodies.

Thirteen patients with stage I mycosis fungoides (MF) were studied for the presence of circulating autoantibodies including cold-reactive lymphocytotoxic antibodies (LCA), antinuclear antibodies and rheumatoid factor antibodies to common food antigens, bovine gamma globulin and casein; and immune complexes as measured by cryoglobulins and I125 Clq binding. A significantly increased incidence (11/13) of LCA was found in the MF patients, and this may be related to the alterations in subpopulations of T cells seen in these patients. No significant increase in any other test was noted. there was no evidence of a diffuse hyperactivity of the humoral immune system as seen in systemic lupus erythematosus, which has a similar imbalance of T cell subpopulations.

Adult↗

Fibronectin fragment(s) are chemotactic for human peripheral blood monocytes.

Both plasma-derived and cell-derived fibronectin are deposited at sites of inflammation and wound healing and are associated with migrating cell populations including monocytes/macrophages. We found that fibronectin fragments generated by endogenous protease(s) are potent chemoattractants for human peripheral blood monocytes, whereas intact fibronectin has no activity. Fibronectin preparations produced by gelatin affinity chromatography in the absence of protease inhibitors contained 90 to 220 kd fragments and had potent chemotactic and chemokinetic activity for monocytes but no activity for human neutrophils or lymphocytes. The addition of phenylmethylsulfonyl fluoride to plasma reduced but did not eliminate the recovery of fibronectin fragments and likewise reduced the chemotactic activity. When the preparations were further purified by DEAE ion exchange and Sepharose 4B molecular sieve chromatography, however, intact fibronectin was recovered that lacked both chemotactic and chemokinetic activity. When fragment-poor fibronectin was allowed to sit at 25 degrees C in NaN3 but without protease inhibitors, increased fragmentation and increased chemotactic activity were noted. In addition, chemotactically active small m.w. fragments arose from high m.w. fragments or from intact fibronectin as demonstrated by rechromatography experiments over Sephadex G-150. These findings suggest that proteolytic cleavage of fibronectin during inflammatory processes produces fragments that selectively augment the recruitment of monocytes into tissue sites of inflammation.

Cells, Cultured↗

The histopathologic evolution of recurrent herpes simplex labialis.

In a study of the natural history of recurrent herpes simplex labialis, we examined hematoxylin and eosin-stained sections of biopsies taken from lesions at various clinical stages. The earliest specific findings which could be recognized were changes within the epidermal cell nuclei, including peripheral clumping of chromatin, development of homogeneous "ground glass" appearance, and ballooning of nuclei. Eosinophilic intranuclear inclusion bodies were unusual and occurred in late lesions. Vacuolization was the earliest cytoplasmic alteration within keratinocytes. The herpes-induced changes began focally along the basal cell layer, but the entire epidermis was rapidly altered. Pilosebaceous units were commonly affected. Within the dermis, no cells with typical herpesvirus-induced changes were seen. In early lesions, mononuclear and polymorphonuclear inflammatory cells were equally prominent; in later lesions neutrophils were most numerous. Histopathologic changes of recurrent herpes simplex begin multicentrically within the epidermis and are present prior to the onset of physical findings.

Biopsy↗

Cryoglobulinemia and decreased monocyte chemotaxis is malignant melanoma.

The sera fromm 13 patients with malignant melanoma were evaluated for immune complexes by cryoprecipitation and the 125I Clq binding assay. Cryoprecipitates were identified in 12/13 patients (92%) and cryoimmunoglobulins in 7/13 patients (54%). Either cryoimmunoglobulin or elevated Clq binding was identified in 8/13 patients (62%). Incubation of normal monocytes with the resuspended cryoimmunoglobulin of 7 melanoma patients produced greater than 50% reduction in the ability of th monocytes to respond to chemotactic stimuli (p < .01). Similar inhibition was seen with cryoimmunoglobulin from erythema multiforme patients, but not with 'medium alone, albumin, heat aggregated albumin or heat aggregated-IgG in similar concentrations. No soluble factors produced in vitro could be demonstrated to produce this inhibition. Inhibition of monocyte function by immune complexes may be an important component of impaired host response to malignant melanoma, or alternatively may represent an important mechanism for the accumulation of monocytes at sites of inflammation, analogous to migration inhibition factor.

Adolescent↗

Wheat protein antibodies in dermatitis herpetiformis.

An enzyme-linked immunosorbent assay was used to detect class-specific antibodies to wheat protein antigens. Antibodies which we detected by this technique reacted indistinguishably with antigens prepared from crude gluten, crude gliadin, alpha-gliadin, Frazer fraction III, and subfraction B and B3 of Frazer fraction III. No sera reacted with a human serum albumin control antigen. The prevalence of IgG antibodies to wheat protein antigens was significantly greater in patients with gluten sensitive enteropathy, 12 of 17, (p = .00011) and in patients with dermatitis herpetiformis, 5 of 14, (p = .046) than in normal control subjects. Strongly positive reactions for IgG antibodies were present only in patients with gluten sensitive enteropathy or dermatitis herpetiformis. IgA antibodies to wheat protein antigens were found only in gluten-sensitive enteropathy patients. We have found this to be a sensitive, precise technique for measurement of antibodies to wheat protein antigens and feel that it will prove useful in evaluation of the role of immune complexes involving wheat protein antigens and their antibodies in the pathogenesis of dermatitis herpetiformis.

Adult↗