Biomedical subjects

J F Molina

Publications and source records attributed to J F Molina.

24 records · Page 2Linked to original sources

PubMed1995

Prolactin and systemic lupus erythematosus: prolactin secretion by SLE lymphocytes and proliferative (autocrine) activity.

Accumulated evidence suggests that prolactin (PRL) is an important immunoregulator and might have a role in the pathogenesis of systemic lupus erythematosus (SLE). Moreover, a PRL-like molecule is secreted by normal human lymphocytes and acts as an autocrine growth factor for lymphoproliferation. The objective of this study was to explore the PRL-like peptide production by peripheral blood mononuclear cells (PBMC) from patients with SLE. We investigated the PRL secretion by PBMC from six female SLE patients and nine normal subjects (5 women and 4 men). Ficoll-Hypaque isolated PBMC (1 x 10(6) cells/ml) were cultured with and without maximal stimulatory doses of PHA (1 mg/ml) or PWM (1/200). At 72 h of culture supernatants were harvested and used to determine PRL immunoreactivity by a radioimmunoassay (NIDDK-reagents). Cell extracts and concentrated supernatants were prepared to determine PRL by Western blot analysis (NIDDK-reagents). SLE non-stimulated PBMC secreted significantly higher levels of PRL than normal non-stimulated PBMC (8.09 +/- 4.15 ng/ml vs. 3.48 +/- 2.36 ng/ml, P = 0.02 by Mann-Whitney test). High levels of PRL were secreted by SLE-PHA stimulated PBMC (6.88 +/- 4.53 ng/ml) and SLE-PWM stimulated PBMC (16.57 +/- 16.39 ng/ml) compared with normal-PHA stimulated PBMC (5.83 +/- 5.27 ng/ml) and normal-PWM stimulated PBMC (8.54 +/- 5.49 ng/ml), respectively, but the differences were not significant. The maximal production of PRL was found in PWM-stimulated lymphocytes in both groups. Cells extracts prepared from SLE non-stimulated and stimulated PBMC contained a 11 KDa PRL immunoreactive material. Concentrated supernatants from SLE non-stimulated and stimulated PBMC contained both a 11 KDa and a 24-27 KDa PRL immunoreactive material. Our data indicate that PBMC from patients with SLE have an increased production of PRL-like immunoreactive material. This PRL is released in vitro as two different molecular weight forms, and appears to be derived from B rather than T lymphocytes.

Adult↗

PubMed1995

Cryoglobulinemia and other dysproteinemias, familial Mediterranean fever, and POEMS syndrome.

The introduction of newer technology in the past few years, especially the use of second-generation enzyme-linked immunosorbent assays, recombinant immunoblot assays, reverse transcriptase, and DNA amplification, have clearly defined the role of hepatitis C virus as the most important etiologic factor in the development of mixed cryoglobulinemia. This has led to a better understanding of the pathogenic mechanisms involved in disease expression, particularly vasculitis, and also has provided a rationale for the use of interferon alfa and other antiviral drugs in the therapy of these disorders. The clinical manifestations of the syndrome also have been well characterized, as well as some of the risk factors. There also has been an improvement in our understanding of the pathogenic mechanisms involved in multiple myeloma and related monoclonal gammopathies, as well as several attempts to improve early recognition of bone disease with magnetic resonance imaging. The susceptibility gene for familial Mediterranean fever has been better characterized, as have risk factors for colchicine toxicity. The role of cytokines has been better delineated for both monoclonal gammopathies and POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome.

Blood Protein Disorders↗

PubMed1995

Coexistence of human immunodeficiency virus infection and systemic lupus erythematosus.

A variety of rheumatic disorders has been reported during the course of human immunodeficiency virus (HIV) infection; however, its association with systemic lupus erythematosus (SLE) is extremely rare. The effect of HIV infection on CD4 lymphocytes may ameliorate SLE activity and spur remission. We observed 2 patients with SLE who later developed HIV infection. Both patients' lupus went into remission, and their course was complicated by aseptic necrosis of the bone. These findings suggest that HIV infection may have an important effect on the natural course of SLE and may also have a pathogenic role in avascular necrosis.

Adult↗

PubMed1995

Systemic sclerosis sine scleroderma: an unusual presentation in scleroderma renal crisis.

Renal involvement in systemic sclerosis (SSc) has a negative influence on prognosis. Cases of SSc sine scleroderma have been reported in which organ failure occurred but was not accompanied by cutaneous damage, which in some instances did develop later. We describe a patient who, after 6 months of symmetric polyarthritis, developed rapid progressive renal failure without skin changes. A diagnosis of scleroderma renal crisis, confirmed histologically, was made. Anti-RNAP III antibodies were positive. The patient developed typical scleroderma skin changes after renal failure. Despite treatment, SSc advanced to fatal endstage renal disease.

Antibodies↗

PubMed1995

Poststreptococcal reactive arthritis, clinical course, and outcome in 6 adult patients.

OBJECTIVE: To analyze the clinical course and laboratory features, as well as the outcome of 6 adult patients with articular manifestations, and evidence of streptococcal infection. METHODS: A retrospective review was performed of all patients seen in a rheumatology clinic at Louisiana State University Medical Center, with a diagnosis of poststreptococcal reactive arthritis (PSReA) to summarize the clinical features, laboratory findings, and clinical outcome between July 1991 and August 1994. RESULTS: Six patients were identified with PSReA. All had acute, severe inflammatory articular involvement that began shortly after a sore throat, with serological evidence of streptococcal infection, and accompanied by extraarticular clinical manifestations including glomerulonephritis and vasculitis, and poor response to aspirin and other nonsteroidal antiinflammatory drugs. In all cases the echocardiogram was negative, and on followup there was no evidence of cardiac involvement. In these patients antibiotic prophylaxis was not required. CONCLUSION: The clinical picture and serologic abnormalities exhibited by this group of patients suggest a diagnosis of PSReA rather than acute rheumatic fever. These cases also emphasize the resurgence of poststreptococcal infection related articular manifestations in our clinic population.

Adult↗

PubMedDate not supplied

Fibromyalgia syndrome: experience in a pediatric rheumatology clinic.

OBJECTIVE: To report our experience of fibromyalgia syndrome (FMS) in pediatric rheumatology clinic settings. METHODS: Clinical and laboratory data were reviewed in all patients with FMS between March 1992 and March 1996. Patients with FMS and an underlying rheumatic disease were excluded from the study. At presentation and follow-up visits, all patients had a tender points (TP) count that was conducted by thumb palpation. Both the children and their parents were questioned concerning the presence of widespread pain or aching. All the patients fulfilled the ACR criteria for the diagnosis of primary FMS. All children were evaluated by a protocol that included relevant information on FMS. Telephone survey questionnaires were used for patients who missed some of their follow-up visits. RESULTS: There were 59 children (47 F and 12 M) diagnosed with primary FMS. The mean age at onset was 13.7 years, and the mean age at diagnosis was 15.5 years. The mean duration of follow-up was 18.3 months. Diffuse aching was reported in 57 patients (97%), headaches in 45 (76%), and sleep disturbances in 41 (69%). Less common were stiffness in 17 (29%), subjective joint swelling in 14 (24%), fatigue in 12 (20%), abdominal pain in 10 (17%), and joint hypermobility and depression in 8 (14%) and 4 (7%) patients, respectively. The mean ESR was 15 mm/h, RF was negative in all patients, and ANA was positive (mean titer 1:160) in 17 patients. The mean initial TP count was 14.6. Nine patients were not available for follow-up. There were 50 patients available for follow-up and survey analysis, and of these 30 (60%) had improved, while 18 (36%) remained unchanged, and 2 (4%) became worse when compared with initial presentation. At the end of study follow-up, 37 patients (74%) were still taking medication (20 of them daily). Out of 25 patients whose TP counts were available at the end of follow-up, the mean TP dropped from 14.12 to 12.04 (p = 0.09) for the total group, and 14.05 to 10.84 (p < 0.01) for the patients who had improved. 22 out of 30 patients in the improved group and 7 out of 20 in the unchanged or worse group had continued active exercise programs (p < 0.001). CONCLUSION: The clinical spectrum of FMS in children is similar to that of adults but with better outcomes. The TP count correlates with clinical status only in patients who had improved. Active exercise programs seem to correlate with better outcomes. Prospective and larger patient population studies, and a longer follow-up of children with FMS are needed to clarify these findings.

Adolescent↗