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Biomedical subjects

J R Wall

Publications and source records attributed to J R Wall.

At least 91 records · Page 5Linked to original sources
PubMed1987

Antibody-dependent cell-mediated cytotoxicity against human eye muscle cells and orbital fibroblasts in Graves' ophthalmopathy--roles of class II MHC antigen expression and gamma-interferon action of effector and target cells.

We have studied the significance of antibody dependent cell-mediated cytotoxicity (ADCC) against human orbital fibroblasts (OF) and eye muscle (EM) cells in the pathogenesis of the orbital autoimmune reactions of Graves' ophthalmopathy (GO). Possible roles of Class II MHC antigen expression on the surface of orbital target cells and of gamma-interferon (gamma-IFN) modulation of ADCC were also studied. Both OF and EM expressed HLA-DR antigen when stimulated with gamma-IFN and phytohemagglutinin, but not spontaneously, and not by thyroid stimulating hormone or alpha-IFN. Intrathyroidal T cells from a patient with GO induced greater DR expression on both OF and EM cells than equal numbers of her peripheral blood T cells. gamma-IFN treated EM and OF were more susceptible to lysis in ADCC assays than untreated targets. gamma-IFN also enhanced lysis in ADCC assays by an effect on the killer cell population. On the other hand treatment with alpha-IFN, which is a potent inducer of Class I antigen expression, did not affect the susceptibility of target cells to lysis in ADCC. When sera from patients with GO were tested in ADCC, tests were positive (% specific lysis greater than mean + 2 s.d. for normals) in 10 of 20 patients with EM cells, but in only two of 25 with OF. The degree of killing of EM cells was significantly positively correlated to that of abdominal skeletal muscle cells and, to a lesser degree, normal thyroid cells, but not OF. In sera showing killing of EM cells and OF, ADCC activity against EM cells was absorbed by preincubation with EM and orbital connective tissue membranes but not thyroglobulin and, conversely, lysis of THY cells was absorbed by preincubation of positive sera on monolayers of THY and EM cells and OF, but not vascular endothelial (VE) cells. Finally, killing of 51Cr labelled EM cells was inhibited by addition of unlabelled ('cold') thyroid cells, EM cells and OF, but not VE cells. Our findings suggest that ADCC is likely to be an important mechanism for the eye muscle cell damage of GO, but not for the associated orbital connective tissue inflammation. Since ADCC is not MHC-restricted the enhanced lysis of HLA-DR positive target cells presumably reflects other effects of gamma-IFN treatment on both the killer cell population and the target cells.

Adolescent↗
PubMed1987

Cytotoxic mechanisms in autoimmune thyroid disorders and thyroid-associated ophthalmopathy.

Cytotoxic antibodies against thyroid cells and eye muscle cells, measured as antibody-dependent complement-mediated cytotoxicity and ADCC, have been demonstrated in sera from patients with Hashimoto's thyroiditis and thyroid-associated ophthalmopathy, respectively. Such antibodies are probably never present in the absence of target cell damage. Because cell-mediated cytotoxicity plays an important role in experimental autoimmune thyroiditis, further studies are necessary to elucidate the roles of NK cells, K cells, and cytotoxic T lymphocytes in the thyroid cell damage in AITD and orbital cell damage in ophthalmopathy. The socalled aberrant expression of HLA-DR antigens on thyroid cells and orbital cells and the gamma-interferon production by activated T cells may be both intimately associated with the development of autoimmune reactions in the thyroid and the orbit. Cytotoxic antibodies and cytotoxic T lymphocytes against antigens shared between eye muscle cells and thyroid cells may be directly responsible for the eye muscle cell damage in endocrine ophthalmopathy, and they may explain the close association of ophthalmopathy with Graves' hyperthyroidism and Hashimoto's thyroiditis.

Animals↗
PubMed1986

Immunologically mediated cytotoxicity against human eye muscle cells in Graves' ophthalmopathy.

The possible roles of antibody-mediated complement-dependent cytotoxicity (AMC), antibody-dependent killer (K) cell-mediated cytotoxicity (ADCC), and spontaneous, natural killer (NK) cell-mediated cytotoxicity (NKC) against human eye muscle cells in the pathogenesis of Graves' ophthalmopathy were investigated, using as targets human eye muscle cells, by 51Cr release assays. AMC was not demonstrated in serum from any patient or normal subject. In ADCC assays, eye muscle cell lysis was significantly increased in serum from patients with Graves' ophthalmopathy compared to those with Graves' hyperthyroidism without eye disease and normal subjects. ADCC tests were positive (percent specific lysis greater than the upper limit of normal) in 5 of 13 patients with Graves' ophthalmopathy using serum diluted 1:48 and in 4 of 10 patients using serum diluted 1:6. There was no correlation between the extent of lysis of human eye muscle and that of human (abdominal) skeletal muscle and no difference between patients with Graves' ophthalmopathy and normal subjects in assays in which abdominal muscle cell targets were used. The degree of killing in ADCC tests was independent of the source of K cells, being similar in assays using effector cells from the patient, another patient, or a normal subject. ADCC activity was partially absorbed by thyroid, orbital connective tissue and eye muscle membranes, and eye muscle cells, but not by liver membranes of thyroglobulin. Four of 8 human monoclonal antibodies reactive with eye muscle membrane antigens were cytotoxic in ADCC assays. A noncytotoxic monoclonal antibody blocked the ADCC effect of serum from a patient with Graves' ophthalmopathy, while a cytotoxic monoclonal antibody enhanced killing. NKC against eye muscle cell targets was depressed in cells from hyperthyroid and euthyroid patients with Graves' ophthalmopathy compared to that in normal subjects. Demonstration of ADCC against human eye muscle cells in some patients with Graves' ophthalmopathy suggests that this may be a mechanism for the eye muscle cell damage characteristic of this disorder. Inability to demonstrate cytotoxicity in a greater proportion of patients may reflect the lack of specific criteria to identify patients with active eye muscle inflammation and the unsuitability of currently available tests for the detection of serum antibodies against eye muscle membrane antigens. The mechanism for depressed NK cell-mediated cytotoxicity against eye muscle cells in this disorder is not known.

Adult↗
PubMed1986

Evaluation of an enzyme-linked immunosorbent assay for the measurement of autoantibodies against eye muscle membrane antigens in Graves' ophthalmopathy.

We have tested for antibodies against human and pig eye muscle membrane antigens in the serum of patients with Graves' ophthalmopathy using an enzyme-linked immunosorbent assay (ELISA). Several different membrane preparations were used as source of putative antigen including a 100,000 X g pellet, a pellet depleted of the 100,000 X g (microsome) fraction, and solubilized membranes. With eye muscle membrane pellets there were no significant differences for either serum or immunoglobulins between patients with ophthalmopathy, those with autoimmune thyroid disorders without eye disease, and normal subjects for either human or pig membranes, although tests were positive determined from the upper limit of normal in a few patients with or without eye disease. This was the case regardless of the enzyme-antibody conjugate used, the membrane protein concentration or serum or immunoglobulin dilution. Pre-absorption of tissue fractions, serum, or immunoglobulins, with red blood cells or liver powder, eye muscle membranes or skeletal muscle membranes did not significantly reduce back-ground binding which was often very high, or enhance the difference between patients with ophthalmopathy and normal subjects. It was found that non-specific binding to the plastic surface of the microplates and/or tissue proteins, the presence, in human tissues, of blood-derived immunoglobulins which gave strong reactions in the ELISA, and variable fixation of membrane pellets to the plates were factors which made ELISA unsatisfactory when crude membrane pellets were used as antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Clinical significance of a new autoantibody against a human eye muscle soluble antigen, detected by immunofluorescence.

The clinical significance of a circulating autoantibody against a recently identified soluble human eye muscle-derived antigen was studied in patients with Graves' ophthalmopathy and autoimmune thyroid disorders. Tests were positive in 73% of patients with Graves' ophthalmopathy, including six of seven with no associated thyroid disease (euthyroid Graves' disease). Tests were also positive in 27% of patients with hyperthyroidism but no clinically apparent eye disease, in 13% of patients with Hashimoto's thyroiditis without eye disease, in two of 12 patients with subacute thyroiditis, in one of 20 patients with nonimmunological thyroid disorders but in none of 39 normal subjects. There were significant positive correlations between serum levels of the antibody (expressed as a titre) and the severity of the eye muscle component quantified as an index as well as the duration of the eye disease. Antibodies were detected in three of five patients with only lid lag and state who subsequently developed active ophthalmopathy, in six of nine patients who developed eye disease after treatment of their hyperthyroidism and in one of eight first degree relatives of patients with Graves' ophthalmopathy. In addition three of the 12 patients with autoimmune thyroid disease without apparent eye involvement, but positive antibody tests, have developed ophthalmopathy since the time of testing. These findings suggest that tests for antibodies against a soluble human eye muscle antigen may be useful clinically as a diagnostic test and to predict the onset of eye disease in predisposed patients and subjects.

Adolescent↗
PubMed1985

Immunologic factors in thyroid disease.

The role of immunologic reactions against orbital-specific and orbital-thyroid antigens in the pathogenesis of autoimmune thyroid disorders and Graves' ophthalmopathy is discussed. Possible mechanisms for the association of ophthalmopathy and autoimmune thyroid disorders is discussed in relation to the role of autoantibodies against eye muscle antigens.

Autoantibodies↗
PubMed1985

Antithyroglobulin monoclonal and autoantibodies cross-react with an orbital connective tissue membrane antigen: a possible mechanism for the association of ophthalmopathy with autoimmune thyroid disorders.

The possibility that Graves' ophthalmopathy and autoimmune thyroid disorders may be associated because of autoimmune reactions against antigens shared between human orbital and thyroid tissues was investigated using anti-thyroglobulin (Tg) monoclonal and autoantibodies. Eleven of 16 mouse monoclonal antibodies (MCAB) tested reacted, in an enzyme-linked immunosorbent assay (ELISA), with an antigen in human orbital connective tissue membranes (OCTmem), but not with the OCT soluble fraction, or with membrane or soluble fractions of human eye muscle, lacrimal gland or skin connective tissue. The anti-OCTmem activity was absorbed by OCTmem and Tg, but not by liver membranes or bovine serum albumin (BSA). In preliminary studies four out of 113 human MCAB against thyroid or orbital tissue antigens showed reactivity restricted to Tg and OCTmem. Sera from approximately 50% of patients with autoimmune thyroid disorders, with or without ophthalmopathy, also reacted with OCTmem. The autoantibody activity correlated closely with serum titres of antithyroglobulin but not with the presence, duration, or severity of the eye disease. The OCTmem reactivity was absorbed by Tg, thyroid membranes, and OCTmem but not liver membranes, membranes prepared from other orbital tissues, or BSA. The OCTmem-Tg shared antigen site appeared not to be native thyroglobulin since, (i) MCAB and serum autoantibodies did not react with the cytosol fraction of OCT, and (ii) because the membrane antigen was not solubilizable. Because not all patients with ophthalmopathy have detectable anti-Tg antibodies and, conversely, because not all patients with detectable anti-Tg antibodies develop ophthalmopathy it is unlikely that autoimmunity against a OCTmem-Tg shared antigen is the primary mechanism of Graves' ophthalmopathy, although this possibility has not been excluded. On the other hand the reaction of anti-Tg autoantibodies with OCT membranes may be a model for other autoimmune reactions against other thyroid-orbital tissue-shared antigens. While the pathogenesis of Graves' ophthalmopathy is likely to be multifactorial, humoral and cellular reactions against primary orbital antigens, thyroid-orbitol tissue shared antigens, or both, are likely to play important roles.

Adult↗
PubMed1984

In vitro immunoreactivity to propylthiouracil, methimazole, and carbimazole in patients with Graves' disease: a possible cause of antithyroid drug-induced agranulocytosis.

Studies of in vitro immunoreactivity to propylthiouracil (PTU), methimazole (MMI), and carbimazole (CARB), as assessed by peripheral blood lymphocyte transformation and 2 antibody tests, were carried out in 12 patients with Graves' hyperthyroidism who had developed agranulocytosis during treatment with PTU (11 patients) or CARB (1 patient) from 1 week to 10 yr earlier. Significant lymphocyte transformation responses to antithyroid drugs (stimulation indices greater than mean +/- 2 SD for normal subjects) were found in 5 of 6 patients tested, in 1 patient to PTU only, in 3 patients to MMI only, and in 1 patient to both PTU and MMI, but in none of 10 patients currently being treated with PTU who did not develop agranulocytosis. Circulating antibodies causing neutrophil agglutination in the presence of antithyroid drugs were demonstrated, using the indirect Coombs test, in 5 of 7 patients tested, in 2 patients to PTU only, in 3 patients to CARB only and in 1 patient (the only one tested with MMI) to PTU and MMI. Lymphocyte transformation and antibody tests to PTU were both carried out in 6 patients. Of these, both tests were positive in one patient, both negative in 3 patients, and 1 negative and 1 positive in 2 patients. In the 1 patient in whom both tests were carried out with CARB (patient 3), tests were negative, whereas in the 1 patient in whom both tests were carried out with MMI (patient 3), 1 test was positive, whereas the other was negative. Thus, in patients in whom both tests were carried out using the same drug, correlation between lymphocyte transformation responses and the detection of neutrophil antibodies was found in 5 of 6 cases. Antibodies reactive with neutrophils were also detected in 2 of the 5 patients tested using an enzyme-linked immunosorbent assay. In this test antibodies to PTU or MMI were not demonstrated. Possible mechanisms for the neutrophil depression in relation to these findings are discussed. It is concluded that patients with Graves' disease may be prone to develop this complication of antithyroid drug therapy because of underlying immunological abnormalities.

Adolescent↗
PubMed1984

Use of monoclonal antibodies to investigate a possible role of thyroglobulin in the pathogenesis of Graves' ophthalmopathy.

One possible mechanism for Graves' ophthalmopathy is that the progressive orbital inflammation is initiated by formation of thyroglobulin (Tg)-anti-Tg immune complexes at sites of Tg binding to extraocular muscle membranes. In this study monoclonal antibodies (MCAB) against human Tg were used as probes (1) to identify Tg in eye muscle membranes prepared from normal subjects and (2) to measure binding of human Tg and Tg-anti-Tg immune complexes to eye muscle membranes. Reactivity of anti-Tg MCAB with Tg, thyroid, and eye muscle membranes was determined by binding of [125I]anti-Tg monoclonal antibody, an enzyme-linked immunosorbent assay (ELISA), and the indirect immunofluorescence technique. Seven membrane fractions, prepared by differential sucrose gradient centrifugation, were used. Whereas [125I]anti-Tg MCAB bound to all thyroid membrane fractions tested, no [125I]anti-Tg bound to eye muscle membranes. Similarly, reactivity of anti-Tg MCAB with eye muscle membranes was not demonstrated in ELISA or immunofluorescence tests. Although Tg-anti-Tg immune complexes bound to thyroid membranes, such complexes did not bind to eye muscle membranes. Significant binding of [125I]human Tg to eye muscle or thyroid membranes was not demonstrated for any membrane preparation. On the other hand moderate, but significant, binding to skeletal muscle was shown. Similar results were found using an ELISA. Binding of [125I]anti-Tg-Tg complexes of [125I]Tg to thyroid and eye muscle membranes was not affected by the presence of normal human serum, phosphate ions, pH, or incubation temperature, conditions claimed by others to be critical for Tg and Tg-anti-Tg immune complex binding. Since Tg is not present in normal human eye muscle a major role of Tg, or Tg-anti-Tg immune complexes, in the pathogenesis of Graves' ophthalmopathy appears to have been excluded by these findings.

Animals↗
PubMed1984

Antibody-dependent cell mediated cytotoxicity against human thyroid cells in Hashimoto's thyroiditis but not Graves' disease.

Antibody-dependent cell-mediated cytotoxicity (ADCC) against human thyroid cell targets was measured in a chromium release assay, using serum from patients with autoimmune thyroid diseases. The source of effector cells was peripheral blood mononuclear cells from normal subjects. Mean (+/- SD) specific lysis produced by serum from patients with Hashimoto's thyroiditis was 27.3 +/- 6.1%, compared to 10.6 +/- 4.7% produced by serum from normal subjects and 13.3 +/- 10% using serum from patients with Graves' hyperthyroidism. Cytotoxicity using serum from hyperthyroid patients was not different after treatment. Thyroid cell targets from histologically different thyroid cell preparations (Graves' disease, multinodular goiter, normal thyroid) were equally sensitive to killing, although cells from a benign thyroid adenoma were much less sensitive. A strong positive correlation was found between percent specific lysis and titers of serum microsomal antibody. By addition of patients' immunoglobulin to normal serum, we found that microsomal antibodies were responsible for the cytotoxic effect, whereas thyroglobulin antibodies did not mediate cytotoxicity. These results demonstrate that ADCC plays an important role in the thyroid cell destruction of chronic (Hashimoto's) thyroiditis. Although cytotoxic activity was associated with the antimicrosomal-, but not antithyroglobulin-, positive immunoglobulin G fraction, it is not clear whether the microsomal antibody itself, or an unidentified antibody occurring in the same antibody fraction, is the mediator of cytotoxicity in this disorder.

Adolescent↗
PubMed1982

Demonstration of a circulating autoantibody against a soluble eye-muscle antigen in Graves' ophthalmopathy.

Mouse monoclonal antibodies against antigens in human eye muscle, orbital connective tissue, and lacrimal tissue and guineapig harderian gland have been produced by means of the hybridisation technique. From 14 fusions, over 30 antibodies have been produced, of which 24 have been maintained and characterised for the present studies. All were IgG1. Most were organ-specific, but eye-muscle antibodies tended to cross-react with skeletal muscle, one eye-muscle antibody cross-reacted with thyroidal microsomes, and both lacrimal monoclonal antibodies reacted strongly with mucus-secreting cells in human small intestine. Only one of the antibodies fixed complement. Orbital monoclonal antibodies were used as probes to identify orbital antigens. Most antigens were in the cytosol fraction, but a few were demonstrated in cytoplasmic membranes. Circulating autoantibodies against a human-eye-muscle soluble antigen were detected in 17 of 23 patients with Graves' ophthalmopathy but in only 1 of 14 patients with Hashimoto's thyroiditis, in 2 of 11 patients with subacute thyroiditis, in no patient with Graves' hyperthyroidism without eye disease, and in none with multinodular goitre.

Adolescent↗
PubMed1982

Thyroid-stimulating hormone (TSH) receptor antibodies and antibodies stimulating adenyl cyclase in relatives from two families with a high prevalence of Graves' hyperthyroidism: a ten-year follow-up study.

Thyroid-stimulating hormone (TSH) receptor antibodies and antibodies stimulating adenyl cyclase were measured in 47 relatives of patients with Graves' hyperthyroidism from two families with a high prevalence of the disease, in whom bioassays for the long-acting thyroid stimulator (LATS) had been performed 10 years earlier. Tests were also carried out in six propositi from the two families and age- and sex-matched normal subjects from six families. There had been no new cases of hyperthyroidism since the first study, although one subject was clinically and biochemically hyperthyroid at the time of study and two more were biochemically borderline hyperthyroid but clinically euthyroid. Levels of serum T4 thyrotropin, and percentage T3 resin uptake and free thyroxine indices were similar for relatives and normal subjects, although the mean serum T3 level for relatives was significantly greater than that for the normal subjects. Antibodies were not detected by either assay in any relative. Significant titers of antithyroglobulin antibodies were demonstrated in 4 of 44 relatives but in none of 46 normals tested, while thyroid cytoplasmic antibodies were detected in 8 of 44 relatives and 3 of 45 normals. The mean serum IgG for Graves' relatives was significantly greater than that for the normals, although the mean IgM and IgA levels for the two groups were not significantly different.

Adenylyl Cyclases↗
PubMed1982

The species specificity of TSH receptor binding antibodies as measured by radioreceptor study.

The species specificity of TSH binding inhibitory antibodies was compared for patients with untreated Graves' hyperthyroidism, past Graves' hyperthyroidism, active ophthalmopathy with past hyperthyroidism, and subacute thyroiditis, by measuring inhibition of TSH binding to plasma membranes prepared from human, guinea-pig, calf, pig, and dog thyroid glands in a radioreceptor assay. Results were expressed as TSH binding inhibition indices (TBII). Broad species reactivity was demonstrated. This was greatest with pig and least with guinea-pig thyroid membranes. Immunoglobulin (Ig) from patients in whom strongly positive tests with human thyroid preparations were demonstrated were usually strongly positive with all other species tested, whereas Ig from patients which were less strongly positive with human were, generally, also less positive with the other species. There was a tendency for greater species reactivity of TSH binding inhibiting antibodies from patients with treated Graves' hyperthyroidism (with or without eye disease) than of those from untreated patients with Graves' hyperthyroidism or subacute thyroiditis. Combining the data from all groups, correlation between TBII for human membranes and those of other species was best for dog and least for guinea-pig. It is concluded that the TSH binding inhibiting antibody is a polyclonal antibody against a single antigen at or near the TSH receptor, and that the degree of reactivity with its antigen in other species depends, mainly, on the amount of antibody present in the serum.

Adult↗