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Biomedical subjects

J D Bos

Publications and source records attributed to J D Bos.

At least 199 records · Page 11Linked to original sources

Effect of early and late syphilis on central nervous system: cerebrospinal fluid changes and neurological deficit.

Neurological examination and investigation of the cerebrospinal fluid (CSF) was performed on 24 patients with early and 180 patients with late syphilis. In 21 (12%) patients with late syphilis positive CSF treponemal test results and neurological deficits suggestive of symptomatic neurosyphilis were found. Concomitantly all but three patients with neurosyphilis showed one or more of the following abnormal CSF variables: CSF concentration of albumin X 10(3)/serum concentration (albumin ratio) greater than or equal to 7.9; mononuclear cells greater than 5 microliters: ratio of CSF to serum IgG concentrations/ratio of CSF to serum albumin concentrations (IgG index) greater than or equal to 0.7 or of IgM/albumin (IgM index) greater than or equal to 0.1; or oligoclonal CSF immunoglobulins. In 20 (95%) patients with neurosyphilis evidence of the production of treponemal antibodies within the central nervous system (CNS) was shown. Ten (48%) patients with neurosyphilis had been treated previously for late syphilis. These observations emphasise the need to screen for neurosyphilis in patients with late syphilis. Intrathecal production of treponemal antibodies was detected in six (25%) patients with early and 44 (28%) with late syphilis who did not show any neurological deficit. Intrathecal production of treponemal antibodies indicating that the CNS was affected led us to suspect asymptomatic neurosyphilis in these patients. Seventeen (11%) patients with late syphilis but no neurosyphilis and only one (4%) with early syphilis showed additional abnormal CSF variables. Surprisingly, six out of 22 patients with treated early and 20 out of 68 patients with treated late syphilis showed evidence of treponema antibody production within the CNS. We do not know whether these findings indicate that the CNS was affected because of inadequate treatment or merely reflect persistent synthesis of treponemal antibodies associated with cured infection. In one (4%) patient with early and in 21 (13%) with late syphilis but no neurosyphilis abnormal CSF variables in the absence of positive CSF treponemal test results were observed, which excluded syphilitic inflammation of the CNS.

Antibodies, Bacterial↗

Different in situ distribution patterns of dendritic cells having Langerhans (T6+) and interdigitating (RFD1+) cell immunophenotype in psoriasis, atopic dermatitis, and other inflammatory dermatoses.

Dendritic cells bearing Langerhans cell (OKT6+) or interdigitating cell (RFD1+) immunophenotype may be regularly detected within the dermis of chronic skin diseases characterized by a lymphohistiocytic (lymphoreticular) infiltrate. These 2 subsets of antigen-presenting cells within the dermis of lesions of exacerbating chronic plaque psoriasis, exacerbating nummular dermatitis (discoid eczema), atopic dermatitis, allergic contact dermatitis, pityriasis rosea, lichen ruber planus, and cutaneous lupus erythematosus were quantified using computer-assisted morphometry. The mean dendrite length per dermal dendritic cell was significantly higher for RFD1 than for OKT6 (74.4 +/- 0.98 microns vs 70.0 +/- 1.26 microns: p = 0.0023). The mean dendrite length per dermal dendritic cell was remarkably constant for each marker in the various diagnostic categories studied. Disease-specific patterns of total dendrite length and number (expressed per 100 infiltrating mononuclear cells) of these 2 dendritic cell types within the subepidermal infiltrates were obtained. Pityriasis rosea was characterized by its unique high percentage of OKT6+ Langerhans cells. Atopic dermatitis and psoriasis had relatively high percentages of both RFD1+ interdigitating cells and OKT6+ Langerhans cells. Nummular dermatitis had an intermediate number and total dendrite length for OKT6, but was relatively low in RFD1+ cells. Allergic contact dermatitis, lichen planus, and lupus erythematosus had low numbers and dendrite lengths for both dendritic cell subsets. It is suggested that pityriasis rosea is characterized by an abnormal migration pattern of Langerhans cells. Psoriasis and atopic dermatitis may be examples of diseases in which skin-localized antigen-presenting and T-cell-inducing events are continuously taking place. The other diseases may reflect inflammatory processes in which local antigen presentation is less relevant to the tissue reaction.

Antigen-Presenting Cells↗

Contact allergy to preservatives--II.

To determine whether the prevalence of allergic reactions to certain preservatives warrants their inclusion in a routine series for patch testing, a tray of 14 preservatives was tested in 501 consecutive suspected contact dermatitis patients. More than 1% positive reactions were found with DMDM hydantoin, Kathon CG, and alkyl trimethyl ammonium chloride only. The concentration of alkyl trimethyl ammonium chloride (0.1% aqua) was considered too high. Of 6 patients reacting to the formaldehyde releaser DMDM hydantoin, 4 were positive to formaldehyde. Kathon CG may be an important allergen in the Netherlands, and it is worthwhile for dermatologists there to add it to the standard test series. The recent inclusion of quaternium-15 in the ICDRG standard series appears to be of little value to them.

Cross-Sectional Studies↗

Langerhans' cell population studies with OKT6 and HLA-DR monoclonal antibodies in vitiligo patients treated with oral phenylalanine loading and UVA irradiation.

In vitiligo patients, treated with oral phenylalanine loading combined with UVA irradiation (Phe-UVA), Langerhans' cells (LC) were counted in pigmented and depigmented skin. The LC, which were labelled with OKT6 and HLA-DR monoclonal antibodies, were expressed per linear mm epidermis. Before treatment the number of OKT6(+) cells was significantly increased in vitiliginous skin especially in the basal layer. Under treatment the number went down and was comparable to normal skin. When using HLA-DR labelling the number of LC increased in vitiliginous skin which had been treated with Phe-UVA. The influence of Phe-UVA on the shift of LC subpopulations is discussed.

Adult↗

Pityriasis rosea (Gibert): abnormal distribution pattern of antigen presenting cells in situ.

Pityriasis rosea is a skin disease which is obscure in its etiology and pathogenesis. We studied its immunopathology by immunophenotyping the inflammatory cells in situ using monoclonal antibodies that define leukocyte subsets. Findings as to T-cells and their major subsets did not reveal disease-specific data. Monocytes stained only rarely. Neither natural killer cells, B-cells nor plasma cells were ever found. An unexpected finding was the presence within the infiltrates and rarely within the epidermis of cells having the immunophenotype of interdigitating cells (RFD1+). Intense and dendritic staining with anti-T6 and anti-HLA-DR indicated Langerhans cells to be present in the dermal infiltrates, in between these infiltrates in the papillary dermis, and focally within the parakeratotic horny layer. This Langerhans' cell pattern provides evidence for dermal Langerhans cell compartmentalization and transepidermal Langerhans' cell elimination. Such a distribution indicates a change in Langerhans' cell migration processes in pityriasis rosea pathogenesis.

Adult↗

Psoriasis infiltrating cell immunophenotype: changes induced by PUVA or corticosteroid treatment in T-cell subsets, Langerhans' cells and interdigitating cells.

The effects of PUVA or corticosteroid treatment on the distribution pattern of immunocompetent cells in psoriasis symptomatic skin were investigated. A total of 29 biopsies, taken before and a regular intervals during treatment, were studied in a two-stage immunoperoxidase technique using monoclonal antibodies directed against T cells, their major subsets, interdigitating cells, and Langerhans' cells. T cell exocytosis was not affected by PUVA or corticosteroid treatment. Instead, both treatment regimens led to an initial increase in interbasally localized T8+ suppressor/cytotoxic T cells. Increased T4/T8 ratios within the subepidermal infiltrates were restored to normal except in one case, who did not respond to PUVA-treatment. Epidermal and dermal T6+ Langerhans' cells decreased to almost absent. RFD1+ interdigitating cells had the same tendency, except in the PUVA-non-responding patient. Treatment of psoriasis with PUVA or corticosteroids thus results in a normalization of an initial immune imbalance in infiltrating immunocompetent cells. A working hypothesis on psoriasis immunopathogenesis and its restoration by treatment is presented.

Adrenal Cortex Hormones↗

A new approach to contact allergenicity screening.

A new approach to contact allergenicity screening is proposed. As a first step, an immunogen-Langerhans cell (IC) binding assay (a) is suggested. LC's are isolated from trypsinized epidermis by fluorescence activated cell sorting using monoclonal antibody anti-T6. The chemical or drug under study (pre-incubated in homogenized skin as it may be allergenic only after binding to protein or upon metabolic interaction) is tested for LC binding by a radiometric assay. When binding is not established, the drug is probably inert. When binding occurs its possible effect on LC activity is studied by a LC activation/migration assay (b). When negative, this assay indicates passive binding and the drug or chemical may be expected to be inert. When migration does occur, the activated LC's may be co-cultured with autologous lymphocytes in a lymphocyte blastogenicity assay (c). A positive result in this assay will indicate the drug or chemical's allergenicity. The proposed three-step procedure for contact allergenicity screening is expected to have a high profitability.

Cell Movement↗

Immunologic and biochemical studies on a patient with pyoderma gangrenosum.

A patient with pyoderma gangrenosum without associated disease was studied. Routine investigations showed several abnormalities. High ESR, high alkaline phosphatase and glutamyl transferase (gamma-GT) levels, low iron and iron binding capacity, altered protein spectrum, presence of Staphylococcus aureus and group G hemolytic streptococci in ulcer culture, higher than normal antistreptolysin titers in the serum, and perivascular infiltration in the skin. Biochemical investigations aimed at finding any excessive hydrolytic activity did not reveal the presence of neutral proteases in circulation leaked out from PMN-leukocytes or elsewhere. Lysozyme levels were higher than normal, amylase and lipase levels were normal and 5' nucleotidase levels were below normal range. TCA-soluble polypeptides were present in the serum at levels two times higher than those in normal individuals. Immunochemical investigations showed the absence of immune complexes in the serum but presence of high amounts of C-reactive protein. Total complement activity was higher than normal and so was C3c level. Clq, C4, and C3d levels were within normal range. Biologic studies showed the presence of a factor in patient serum that made guinea pig skin hard, painful, erythematous, and eventually hairless, but not necrotic. A similar factor was either absent in normal serum or present in very low concentration. After salazopyrine treatment, all the above mentioned abnormalities corrected except that 5' nucleotidase activity remained slightly lower than normal, alkaline phosphatase levels remained slightly higher than normal, and C-reactive protein levels remained very high, though lower than those during intense disease activity.

Drug Combinations↗

Acute disseminated histiocytosis-X: in situ immunophenotyping with monoclonal antibodies.

The proliferating skin cells in a case of acute disseminated histiocytosis-X (Abt-Letterer-Siwe disease) confirmed by electron microscopy, were characterized by a panel of monoclonal antibodies using an immunoperoxidase technique. The "histiocytes" were found to stain with OKT-6 (anti-T6) and anti-HLA-DR antibodies. Unexpectedly, slight staining was also observed with Leu 3a (anti-T4) and OKM-1. A proliferative process of T4, T6, HLA-DR, OKM-1 positive Langerhans' cells has not yet been described and may be specific for histiocytosis-X.

Antibodies, Monoclonal↗