[Incompatibility of radiographic contrast media. In vitro and in vivo studies on the possible mechanisms].
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Complement System Proteins↗
Biomedical subjects
J Ring
Publications and source records attributed to J Ring.
Histamine release, complement consumption, and microvascular changes after radiographic contrast media infusion in rabbits.
The intravenous injection of RCM into rabbits produced dose-dependent changes in SAP, MVP, and RBCV, as well as plasma histamine and complement concentrations. After infusion of 8 ml/kg Hypaque-50, SAP dropped from 86 +/- 3 mm Hg to 50 +/- 3, MVP from 42 +/- 2 cm H2O to 26 +/- 3, and RBCV from 0.98 +/- 0.11 mm/sec to 0.37 +/- 0.13. The microvascular changes appeared 10 sec after injection and persisted for 10 to 40 min. During the course of the reaction it was observed that leukocytes adhered to the endothelial walls and red blood cells shrank and finally aggregated in the microvessels. The microvascular changes were accompanied by an increase in plasma histamine concentration, with an average of 44 ng/ml after 2 min, and a drop in total plasma CH50 by an average of 46%. Infusion of 8 ml/kg hyperosmolar saline solution (4.1 gm/dl or 1324 mOsm/L) produced initial changes in microvascular parameters which returned to normal within a few seconds. At the same time plasma histamine concentration increases slightly without changes in complement. It is concluded that the hyperosmolar properties of RCM may contribute to the initial hemodynamic changes observed after RCM infusion. However, the prolonged microcirculatory disturbances produced by RCM in rabbits appear to be a direct effect of the chemotoxicity of these compounds. Part of this chemotoxicity might result form initial release of vasoactive mediators such as histamine and activation of the complement system.
Animals↗
[Cyclic adenosine 3-5 monophosphate (c-AMP) and allergy].
Cyclic adenosin-3-5-monophosphate (c-AMP) plays a central role in regulating immune responses. Increased intracellular c-AMP has an inhibitory effect on release of histamine and other mediators from basophile leukocytes or mast cells as well as lysosomal enzymes from polymorphs. It depresses cell-mediated immune reactions and antibody formation. The hormonal factors which increase intracellular c-AMP are either of neuroendocrine origin (e.g. epinephrin) or inflammatory products (e.g. prostaglandins and histamine). This seems to be an endogenous mechanism of regulation which is able to stop immune or allergic reactions. Patients suffering from atopic diseases (asthma and/or atopic dermatitis) show a decreased reactivity to betaadrenergic stimuli. The defect is demonstrable in vitro in peripheral leukocytes which show a significantly smaller increase in intracellular c-AMP after betaadrenergic stimulation than normal leukocytes.
Antigen-Antibody Reactions↗
Increased in vitro histamine release by radiographic contrast media in patients with history of incompatibility.
This study was designed to compare in vitro leucocyte histamine release in patients with a history of previous radiographic contrast media (RCM) reactions and normal controls. Peripheral leucocytes of ten patients with a positive history of RCM imcompatibility and nineteen normal volunteers were stimulated in vitro with different RCM in different concentrations and the amount of histamine released was measured in the supernatant. There was a significant increase in histamine release induced by RCM in low doses (0.02-0.1 M) in the patients as compared to the normals. At the high doses (0.2-0.3 M), no significant differences were found. Leucocytes from four of the patients were stimulated preferentially by the dye responsible for the incompatibility. Six patients showed no such preference. The increased "releasability" of the patients' leucocytes could not be transferred by serum. Normal leucocytes, when incubated with serum from "high releasing" patients did not show increased histamine release after stimulation with the respective dye. It is suggested that an excessive non-immunological response of basophil leucocytes to RCM stimulation might, in part, account for the adverse clinical reactions observed. Furthermore, leucocyte histamine release might be a useful diagnostic tool for detecting patients with a high risk of developing contrast media reactions.
Adult↗
[Concentration of intravenously administered gammaglobulin preparations in dog skin (author's transl)].
Chemical modification of standard gammaglobulin with enzyme treatment (pepsin) or stabilization (beta-propiolactone) is able to influence elimination, fragmentation and organ distribution of intravenously administered gammaglobulins as shown in 36 dogs after i.v. application of allogenic and xenogenic gammaglobulin preparations. Pepsin-gammaglobulin was eliminated and fragmented most rapidly. Gammaglobulin concentrations of all preparations in the skin showed as slower decrease than comparable blood concentrations. The highest skin concentrations 10 days after i.v. application were found for beta-propiolactone gammaglobulin with 6.2 +/- 1.6 microgram/g compared to a blood level of 7.9 +/- 0.9 microgram/ml.
Animals↗
[Immunological changes during hydrotherapy].
Immunological tests were performed in 34 patients undergoing hydrotherapy according to Kneipp. IgM, alpha2-macroglobulin and complement factor C3 concentrations were increased after this treatment, but not in ten healthy volunteers. Specific antibody activities (staphylococci, E. coli, streptococci) remained unchanged. After intracutaneous testing with different protein and bacterial antigens reactions were significantly more intense (diameter of reaction) after hydrotherapy, while total number of reacting patients remained the same. Pokeweed stimulation ratio was increased in the lymphocyte transformation test, while PHA and PPD stimulation rates remained unaltered.
Adult↗
[The anaphylactoid reaction after colloid infusion].
All colloidal volume substitutes carry the risk of anaphylactoid reactions. The general incidence of 0.03% is low; however severe complications can occur. There are differnet pathomechanisms involved in the induction of anaphylactoid reactions after infusion of different colloids. Protein aggregates are of pathogenic importance in human serum albumin incompatibility. The addition of stabilizers to the plasma protein solutions can alter the immunogenicity of the protein molecule. Antibodies of the classes IgG and IgM seem to play a role in severe dextran incompatibility. There was a direct correlation of the intensity of the clinical symptoms with the anti-dextran-antibody titer.
Anaphylaxis↗
[Immunological findings in infusions of colloidal solutions].
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Anaphylaxis↗
Incidence and severity of anaphylactoid reactions to colloid volume substitutes.
All available colloid volume substitutes carry the risk of anaphylactoid reactions. In a multicentre prospective trial, 69 cases of anaphylactoid reactions have been observed among 200 906 infusions of colloid volume substitutes. The frequency of severe reactions (shock, cardiac and/or respiratory arrest) was 0-003% for plasma-protein solutions, 0-006% for hydroxyethyl starch, 0-008% for dextran, and 0-038% for gelatin solutions.
Aged↗
[Long-term therapy using horse anti-dog lymphocyte globulin without sensitization against horse protein].
Eight mongrel dogs received a standard daily i.v. infusion of 20 mg/kg b.w. deaggregated horse-anti-dog-lymphocyte-globulin (ALG) and additional prednisolone (1 mg/kg b.w. daily i.v.) over a maximum period of 82 days following pretreatment with deaggregated normal horse IgG. No sensitization against horse protein was observed during therapy of afterwards as proved by lack of humoral antibodies against horse antigens, maintained lymphopenia, good compatibility, longterm prolongation of xenogeneic skin graft survival (85.6+/-20.6 days, n=8' untreated controls 12.5+/-1.3 days, n=4) and longterm suppression of cytotoxic antibodies against donor lymphocytes. The level of preformed agglutinating antibodies against horse erythrocytes was significantly reduced, while preformed antibodies against other species remained normal. The immune response to a challenge injection of anti-lymphocyte-serum (ALS) 6-11 weeks after termination of treatment was significantly lower in the ALG treated animals as compared to the control group. These results suggest the involvement of a specific mechanism of unresponsiveness against ALG other than immunosuppression only. It is concluded, that by the described method sensitization against ALG can be prevented during longterm treatment.
Animals↗
High incidence of horse serum protein allergy in various autoimmune disorders.
In 186 persons (68 patients suffering from different so-called autoimmune diseases, 30 kidney recipients, 38 control patients from a surgical ward, and 50 healthy volunteers) the immune response to horse IgG was examined. The lowest rate of sensitization was found in kidney transplant recipients (3%) and the highest in autoimmune patients (33%). After excluding 39 patient who had received horse serum treatment prior to the examination, it was found that without previous injection of horse serum, 27% of the patients with autoimmune disease were sensitized to horse IgG. Compared to the other groups (kidney transplant recipients, 4%: surgical controls, 0%; healthy volunteers, 3%), this difference was statistically significant (p is less than 0.01).
Allergens↗
Immunological properties of a high molecular weight component from yeast cell autolysate in dogs and evaluation of its potential role in human dextran reactions.
A high molecular weight component (HMC) of autolysate from Saccharomyces cerevisiae yeast cells was prepared. HMC was found to be immunogenic in dogs, inducing hemagglutinating antibody formation. Upon HMC challenge of immunized dogs, systemic anaphylactoid reactions were observed in 4/5 animals. The most prominent symptom was decreased cardiac output. Decrease in mean arterial pressure and increase in pulmonary arterial pressure were also observed. Consumption of total serum complement activity amounted to 22% of initial values. HMC also exhibited mitogenic activity in lymphocyte cultures from nonimmunized and immunized dogs. Since yeast autolysate is used as nitrogen source for Leuconostoc mesenteroides in the production of clinical B 512 dextran it is a theoretically possible trace contaminant of such solutions. Therefore, dogs hyperimmunized with HMC were also challenged with clinical dextran. No anaphylactoid signs were observed. These data suggest a negligible causal role of macromolecular contaminants derived from yeast cell autolysate in rare human anaphylactoid reactions following infusion of clinical dextran.
Anaphylaxis↗
Influence of the immune response on the absorption of protein from the gut.
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Administration, Oral↗
Anaphylactoid reactions due to non-immune complex serum protein aggregates.
The infusion of aggregate-containing i.v. human gamma-globulin as well as human serum albumin can lead to severe anaphylactoid reactions with decrease in mean arterial pressure, increase in pulmonary artery pressure and decrease in cardiac output in unsensitized dogs, while the deaggregated solutions are well tolerated. During these anaphylactoid reactions, no significant changes in the serum complement activity of the dogs were observed. In clinical human serum albumin incompatibility, stimulation with albumin aggregates led to a high response in the lymphocyte culture, whereas deaggregated albumin had no stimulatory effect. By deaggregation of horse anti-human lymphocyte globulin prior to clinical administration, the compatibility of ALG therapy was improved.
Anaphylaxis↗
[Incidence of anaphylactoid reactions following infusion with colloid volume substitutes].
All available colloid volume substitutes carry the risk of anaphylactoid reactions with a total incidence of 0.033%. The frequency of life threatening reactions was 0.003% for plasma protein solutions, 0.006% for hydroxyethyl starch, 0.008% for dextran and 0.038% for gelatin solutions.
Anaphylaxis↗
[Infusiontherapy with colloidal volumesubstitutes (author's transl)].
All colloidal plasma substitutes carry the risk of anaphylactoid complications with a general incidence of 0.03%. This incidence seems low; however severe complications may occur after infusion of colloids, including also human albumin solutions. In spite of the risk of anaphylactoid reactions, however, colloids should not be ommited from volume replacement therapy. When choosing a colloid for volume replacement the solution-specific risk of anaphylactoid complications has to be taken into consideration. From an increasing number of recent case reports the impression of a rising rate of complications has emerged; this impression was not substantiated by a prospective controlled trial performed in 1975. Since dextran in addition to its safe volume effect possesses well documented antithrombotic properties, it cannot be replaced by any other colloid without the addition of another thromboprophylactic agent.
Anaphylaxis↗
[Scoring system for evaluation of severity and progress of chronic posttraumatic osteomyelitis (author's transl)].
From the anamnestic data of 50 patients suffering from chronic posttraumatic osteomyelitis a severity scoring system was developed, based on the duration of the disease, the time of hospitalization and the number of surgical interventions. The clinical course of 18 patients, undergoing an autovaccination treatment, was registered by another scoring system ("Munich-Murnau-Scale") regarding wound morphology, bone radiology and erythrocyte sedimentation rate.
Adolescent↗
Cumulation and elimination of horse-anti-dog lymphocyte and normal horse gammaglobulin in dogs.
Two groups of dogs received daily intravenous doses of 20 mg/kg 131-I-labelled horse-anti-dog lymphocyte globulin or normal horse gammaglobulin respectively over a period of 11 days. Horse-anti-dog lymphocyte globulin showed a significantly higher eleimination rate than normal horse gammaglobulin. In contrary to the continuous increase in serum radioactivity during normal horse gammaglobulin treatment, there was a plateau after the 5th day in the horse-anti-dog lymphocyte globulin group. The xenogeneic protein concentration, measured with the single radial immunodiffusion technique, at the end of treatment was 165 +/- 8 mg/1 in the horse-anti-dog lymphocyte globulin, compared to 498 +/- 15 mg/1 in the normal horse gammaglobulin group. After treatment horse-anti-dog-lymphocyte globulin treated animals showed a significantly higher increase in active hemagglutination titer against horse erythrocytes with an average of 2(-8).
Animals↗