Biomedical subjects
Publications and source records attributed to J Korlak.
Interleukin-1 activity in cerebrospinal fluid of 30 subacute sclerosis panencephalitis and 27 multiple sclerosis patients was measured. ELISA and costimulation thymocyte test revealed no presence of interleukin-1 activity in the cerebrospinal fluid in the tested groups.
The immunological status of patients with Huntington's disease was studied and compared with that of an age-matched control group. No remarkable abnormalities in lymphocyte subpopulations were observed. The percentage of B cells, CD4+, CD8+, DR+ cells and stimulated cells bearing Tac receptors remained unchanged. The proliferative response to mitogens and the production of interleukin-1 (Il-1) were decreased, whereas the IgG level was increased. It is possible that changes in the levels of neurotransmitters affect the immunological function in basal ganglia disease.
Using the test of active E rosettes stimulated with antigen the sensitization was studied of lymphocytes from the cerebrospinal fluid and blood to basic protein of myelin, galactocerebroside and cerebral gangliosides. The investigations were conducted in groups of patients with SSPE and with other non-inflammatory neurological diseases and in a control group without evidence of organic brain damage. It was shown that in SSPE sensitization of these lymphocytes from the CSF and from the blood to the studied antigens occurred with a frequency approaching that in the group of non-inflammatory neurological diseases and less frequently than this was formerly observed in multiple sclerosis.
In 20 patients with head trauma associated with loss of consciousness without massive damage to the tissues total count of lymphocytes T in the peripheral blood was determined, and test of lymphocyte blastic transformation and leucocyte migration inhibition were done. The investigations were done one time only, usually 5 days after trauma. In the patients the total count of lymphocytes and T-cells was decreased in the peripheral blood and production of the factor inhibiting leucocyte migration was reduced. The immune disturbances observed in these patients were due probably to the action of stress triggered by trauma.
Lymphocyte subpopulations were evaluated in the cerebrospinal fluid and peripheral blood in 22 patients in the initial stage of aseptic meningitis and during convalescence. In the acute stage of the disease the proportion of lymphocytes T, including their active forms, was increased, during convalescence a further significant rise was observed in the subpopulation of lymphocytes T with a fall of the proportion of lymphocytes bearing the high "avid" Fc IgG receptor. In patients with acute meningitis and during convalescence a rise was observed in the proportion of lymphocytes T in the peripheral blood. In the acute stage of the disease the number of lymphocytes with a high binding ability of the Fc receptor was decreased. Changes in lymphocytes subpopulations in aseptic meningitis suggest mobilization of lymphocytes engaged in the cell-mediated immune response.
Humoral and cell-mediated immunity was determined in 28 epileptics, in 22 patients observed and investigated because of an only one seizure, and 26 healthy controls. Anticonvulsants had not been used in the treatment of these cases up to that time. The total lymphocyte count and the count of lymphocytes forming spontaneously rosettes with sheep erythrocytes were found to be significantly lower in the group of patients with epilepsy of unknown aetiology in relation to controls. The quantitative changes in the composition of the lymphocyte population were not significant and caused, probably, no immunological deficit, but were only a reaction to organic damage to the nervous system. Slight disturbances in the functions of the immune system cannot be, however, ruled out since this group showed also a significantly higher IgG level which suggests long-standing antigenic stimulation. No defect in IgA synthesis and disorders of the cell-mediated immunity (blastic transformation test, leucocyte migration inhibition test, skin test) were demonstrated in this study, although they had been reported by some authors in cases of epilepsy, mainly, however, in patients treated with anticonvulsants. In the patients having started anticonvulsive treatment these investigations will be repeated for establishing the effect of drugs on the immune reactions.
Immunological investigations were carried out assessing the humoral and cell-mediated immunity in 22 patients with epilepsy before starting treatment and at least one year after the onset of treatment with phenytoin or carbamazepine. Sixteen patients were treated with phenytoin and 6 with carbamazepine. In the group treated with phenytoin a statistically significant fall was observed in the serum level of IgG and a decrease in the value of blastic transformation of lymphocytes after stimulation with PHA and PPD with a rise in the number of lymphocytes forming total rosettes with sheep erythrocytes. In the group treated with carbamazepine only a statistically significant fall was observed in blastic transformation of lymphocytes stimulated with PHA, and a trend was noticed for increasing serum IgG and IgM levels. The observed changes in immunological reactivity caused by administration of phenytoin and carbamazepine show that these drugs exert an immunomodulating effect, but changes produced by them are slight and caused no immune deficit in the observed group.
The study confirming the presence of oligoclonal IgG in cerebrospinal fluid by isoelectric focusing (IEF) with PhastSystem equipment was carried out in 68 patients with clinically definite MS, in 23 with clinically probable MS and in 23 with other neurological diseases. Other indicators intrathecal synthesis of IgG were olso marked. According to the results it was confirmed that the most sensitive method of detection of intrathecal synthesis of immunoglobulins is finding of the oligoclonal IgG. Using the PhastSystem evidently shorties the diagnostic process. The sensivity of the method equals that of MRI and both have similar clinical value.
UNLABELLED: The demonstration of the presence of intrathecal synthesis of immunoglobulins as oligoclonal band (OB) in cerebrospinal fluid (CSF) is considered to be important as an aid to multiple sclerosis diagnosis. We used the Phast System equipment for OB detection in the CSF. Separation was performed on polyacrylamide gels pI 3-9.7. After separation proteins were visualised with silver staining according to manufacturer instruction or transferred electrophoretically on to nitro-cellulose membrane and developed by immunostaining technique. We also calculated indexes of intrathecal synthesis of IgG. We tested CSF of patients with clinically defined multiple sclerosis (n = 29) according to Poser criteria. In all cases IgG indexes were normal. OB were present in 83% with silver staining and in 93% when we used immunoblotting technique. CONCLUSIONS: 1. Detection of OB with Past System is easily performed in routine diagnostic process. 2. Immunoblotting technique increases sensitivity of detection of OB and needs small amounts of CSF. 3. The demonstration of OB in CSF is a method of choice in diagnostic process of inflammatory diseases of nervous system, especially in cases of MS.
During the last 12 years 4258 amniocenteses were performed between the 12th and 20th week of gestation (including 323 early amniocenteses carried out before 15th week). In every case, cytogenetical examination was performed and concentration of AFP was determined. In cases with elevated AFP level electrophoresis of AchE izoenzymes was performed. The results of the tests enabled us to calculate laboratory standard values of AFP in the amniotic fluid for 12th to 20th weeks of gestation. In 22 of 44 pregnancies with Down's syndrome the value of AFP concentration was below the 25th percentile of the laboratory normal value. In 5 of 10 pregnancies with Edward's syndrome AFP level exceeded significantly the 75th percentile of the laboratory norm. In two cases it was due to coexisting spina bifida and in one case due to omphalocele. In 28 amniotic fluid samples AFP concentration exceeded normal level and electrophoresis of AchE revealed additional band. In 26 cases increased values of AFP were due to open neural tube defect in the fetus: 13 cases of anencephaly and 13 cases of spina bifida; in the remaining two other cases omphalocele was found.
Vascular diseases of CNS are usually a result of certain risk factors. In a number of cases vascular diseases are caused by inflammatory process within arteries. Establishing the intrathecal synthesis of immunoglobulins is an important indicator of the inflammatory process in the CNS. 16 patients with multifocal vascular lesions in neuroimaging examinations (MRI or CT), were analysed for the frequency of occurrence of inflammatory process within the CNS. The presence of intrathecal synthesis of IgG was established by mathematical formulas and presence oligoclonal IgG bands. In some patients presence of oligoclonal IgG bands was found, and regarded responsible for stroke. In this group the patients were younger, and mainly without other risk factors for vascular diseases. In the majority they were patients with systemic inflammatory process (e.g. SLE). The establishing of inflammatory process within the CNS sometimes has therapeutic implications.