Biomedical subjects
Publications and source records attributed to J Rhodes.
Rectal-biopsy specimens were obtained from a group of patients with proctitis in different stages of activity. Large numbers of brightly fluorescent IgE-producing cells were demonstrated in rectal-biopsy specimens taken from these patients during disease activity and clinical remission. An immediate hypersensitivity reaction is suggested as one of the mechanisms involved in the pathogenesis of proctitis.
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The effect of an aldosterone antagonist on the protective action of carbenoxolone sodium on the gastric mucosal barrier has been studied in three dogs with Heidenhain pouches. The net fluxes of hydrogen ion and sodium ion were measured before, during, and after contact with a 10 mM bile acid solution at pH 2, in pouches which had not been treated with drugs, in pouches treated with carbenoxolone sodium and in pouches treated with both carbenoxolone sodium and the aldosterone antagonist, spironolactone. Hydrogen ion back diffusion from, and sodium ion gain by the untreated pouch was increased by 10 mM bile acid solution. Addition to the pouches of either carbenoxolone sodium alone or carbenoxolone sodium and spironolactone reduced the hydrogen ion back diffusion after exposure to the bile acid solution. The spironolactone did not change the protective effect of carbenoxolone on the gastric mucosal barrier. Carbenoxolone did not change the increased sodium ion diffusion caused by bile.
The effect of topical disodium cromoglycate (DSCG) has been examined in 30 patients with chronic active proctitis using a double-blind crossover trial. Each treatment period was four weeks and patients were given DSCG 200 mg by enema twice daily and 100 mg orally three times each day. Twenty-six patients completed the trial successfully, 14 responded to DSCG treatment, two improved with placebo, and 10 responded to neither. Patients who responded to DSCG had significantly more eosinophils in their rectal biopsies than those who failed to respond and in some instances the counts were very high. The findings support the hypothesis than an allergic reaction is important in the pathogenesis of proctitis.
The Fc receptor activity of single macrophages and of distinct macrophage populations was examined in terms of cellular avidity for IgG antibody by using a rosette assay which permits characterization of receptor activity at the cellular level and quantitation of any changes in such receptor activity. Marked heterogeneity was shown to exist within normal populations of macrophages. Both normal peritoneal and alveolar macrophage populations exhibit a normal or logistic distribution of cellular avidities for IgG antibody. The mean avidity of the peritoneal population, however, was found to be approximately 3 times greater than that of the alveolar population. Moreover, alveolar macrophages possess a range of cellular avidities 3 times greater than that of peritoneal macrophages. Comparison of normal unstimulated peritoneal macrophages and induced inflammatory exudate macrophages revealed a 6-fold increase in the proportion of high avidity cells in the latter population. Normal peritoneal and normal alveolar macrophages were shown to undergo a striking increase in Fc receptor activity in vitro. Under certain conditions of culture these cells acquire the antibody-binding capacity characteristic of high avidity cells in the inflammatory exudate population. Fresh guinea pig serum was shown to prevent this activation of Fc receptor function in vitro. Aged guinea pig serum was somewhat less effective. The serum factor(s) responsible appears to be consumed or exhausted in some way by macrophages. It is heat stable and has a molecular weight of less than 100,000 daltons. Serum IgF was found not to be involved in the effects of fresh serum on receptor activation in vitro. The activation of Fc receptor function described here may facilitate both the presentation of antigen to specific T lymphocytes and the antibody dependent killing of tumor cells by macrophages. Changes in receptor activity of the kind described may thus play an important regulatory role in the induction of an immune response and in the effector mechanisms of immunologic surveillance.
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Side effects from carbenoxolone are common and are due to electrolyte disturbance, such as sodium retention and hypokalaemia. They occur particularly in the elderly, who may already be being treated for other illnesses. Eight patients are described with serious side effects from carbenoxolone therapy, some of which were unrecognized for some time because of inadequate follow-up or because clinicians were unfamiliar with them.
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