Search PubMed⌕ Search

Biomedical subjects

K Ayed

Publications and source records attributed to K Ayed.

At least 73 records · Page 4Linked to original sources

[The first thirty months of kidney transplantation in Tunisia].

Kidney transplantation is actually the best replacement therapy for the end stage renal failure. It sets free the hemodialysed patient from the hemodialysis restraint and contributes to solve the socio-economic problems risen by chronic hemodialysis. The authors report the results of this technic during the first 30 months of kidney transplantation in the "Hôpital Charles Nicolle" of Tunis. They describe the first steps which led to kidney transplantation, the therapeutic regimens, the medico-legal problems and the specific complications observed during this start period.

Costs and Cost Analysis↗

Treatment of alpha chain disease. Results of a prospective study in 21 Tunisian patients by the Tunisian-French intestinal Lymphoma Study Group.

Between 1981 and 1985, the authors studied 21 Tunisian patients with alpha chain disease. Twenty of 21 underwent laparotomy. According to Galian et al. six patients were classified Stage A, two Stage B, and 13 Stage C. The therapeutic regimen included the following: (1) Antibiotics: In the case of intestinal bacterial overgrowth (IBO), antibiotics selected by their antibiograms were delivered; in absence of IBO, metronidazole plus ampicillin were first given. The antibiotic treatment was changed in case of therapeutic failure. (2) Chemotherapy: From 1981 to 1983 a cyclophosphamide, Adriamycin (doxorubicin), teniposide (VM-26), prednisone (CHVP) protocol (Adriamycin 35 mg/m2, teniposide 50 mg/m2 day 2, cyclophosphamide 300 mg/m2 days 2 through 4, prednisone 40 mg/m2 days 1 through 10) was used. After 1983 bleomycin 15 mg, Adriamycin 30 mg, vinblastine 10 mg were given on day 15. Serum immunoelectrophoresis and immunohistochemical study of duodenojejunal specimens were made on a 3-month and 6-month basis, respectively. Survival curve analysis was made according to Kaplan and Meier. Results were as follows: (1) Stage A: Six patients were first treated by antibiotics alone; two complete responses (CR) persisting 42 and 55 months later were observed, respectively. The four antibiotic failures were submitted to further chemotherapy with four subsequent failures and two deaths. (2) Stage B-C: Chemotherapy led to nine CR with one precocious relapse, a salvage chemotherapy allowing to one more CR. (3) All stages mixed, percentage of survival reached 90 +/- 12% at 2 years and 67 +/- 25% at 3 years, all patients alive beyond 3.5 years being disease-free.

Actuarial Analysis↗

Study of circulating immune complexes during the evolution of visceral Mediterranean leishmaniasis.

In the present study, sera of 56 children suffering from visceral Mediterranean leishmaniasis were analysed. The incidence of circulating immune complexes (CIC) by ELISA technique using the conglutinin binding assay was 39% before treatment, 28% after the first treatment, and nil at the end of the second one. The C4 levels remain low even after treatment. The anti-leishmania antibodies (AAL) account for 95% of the cases before treatment and 84% after treatment. The rheumatoid factor (FR) also remains with more or less the same frequency (74%) before and after treatment. The search for a correlation between the presence of CIC and the other immunological factors show that the average titre of AAL is higher in the group of patients that have CIC than in the group that does not. The C4 levels are significantly reduced in the CIC positive group of patients, whereas the rate of IgG is significantly increased in the same group. The study of the evolution of CIC under treatment in nine patients shows that they disappear at the end of the treatment, and that the FR reduces but does not disappear.

Animals↗

[Antibodies against extractable nuclear antigens. Clinico-biological correlations in 100 cases].

The clinical significance of antibodies directed against extractable nuclear antigens with currently well-known antigenic targets, is studied in 100 patients affected with various connective tissue inflammations. The anti-Sm is the most frequently encountered antibody in lupus disease and overlapping connective tissue inflammations with a lupus component while the anti-RNP is related to mixed inflammation of the connective tissue and the dry syndrome. These antibodies, without being specific markers for a given disease, represent an additional biological argument for a better nosological classification of connective tissue inflammations. The use of immuno-impression, a more sensitive technique than immunodiffusion, could provide a better understanding of the immune response during these diseases and specify the diagnostic and prognostic value of various auto-antibodies. Analysis by immuno-impression of 36 sera among the 100 with antibodies directed against extractable nuclear antigens has enabled us to compare the two techniques and study the different specificities of these antibodies.

Adult↗

[The value of using HEP/2 cells as compared to sections of rat liver in the detection of autoantibodies using indirect immunofluorescence in human pathology].

1,400 sera taken from patients suspected of having autoimmune diseases and sent to the laboratory for determination of antinuclear antibodies, are tested by comparative indirect immunofluorescence on 2 subtrata; rat liver section and HEP/2 cells. The 143 positive sera on rat liver sections are also positive on HEP-2. In the 1,010 sera which are negative on rat liver sections, 165 are positive on HEP-2, 113 give a nuclear fluorescence, 26 give a cytoplasmic fluorescence and 26 give a nuclear and cytoplasmic fluorescence. Three positive sera were also used in immunofluorescence on another cells: VERO and MRC 5, as well as dual immunodiffusion versus thymic and splenic cell extracts and 76 p. cent of these sera were found positive with these techniques. This confirms the advantage of the use of HEP/2 cells in demonstrating autoantibodies, especially when they are not detected on rat liver sections, like the anticentromer antibodies. This substratum offers the advantage of detecting not only antibodies directed against nuclear antigens, but also those directed against cytoplasmic antigens.

Antibodies, Antinuclear↗

[HLA, A, B, C, DR, C4, Bf in insulin-dependent diabetics in the Tunisian population].

There is no doubt that the autoimmune process in human disease depends on genetic factors. Varying associations were noticed between HLA DR and autoimmune disorders. The frequency of HLA-A-B and DR antigens as well as the Bf and C4 allotypes have been investigated in insulinodependant diabetes mellitus (IDDM) and compared to that of healthy controls in Tunisian population. An increase of A30, DR3, DR4, BfF1, C4AQ0 and C4BQ0 and decrease of B40, DR2, DR5 and DR6 were found in diabetes when compared to the value observation controls. The strongest association was noticed with HLA, DR3 and DR4. The prospective role of DR2 and DR5 antigens were also confirmed. Examination of HLA, Bf and C4 alleles. Two supratypes associated with IDDM have been observed among the Tunisian patients.

Adolescent↗

[Immunologic aspects of leprosy].

Lepromatous leprosy is accompanied by a complex deficit in cell mediated immunity concerning Mycobacterium leprae. The physiological mechanism of this deficit remains unknown. According to some studies there may be, in those suffering from leprosy, a trouble in the macrophage and presentation of antigens. Other studies suggest an increase in the suppressive activity of lymphocytes. Recently some authors emphasized the deficit in the production of interleukin 2. It is difficult, for the time being, to find out whether such immunological abnormalities are primitive or secondary to the accumulation of the bacillus into the organism.

Humans↗

Enzyme immunoassay analysis of antibody specificities present in the circulating immune complexes of selected pathological sera.

Using immobilized anti-C3 antibody and an enzyme immunoassay, sera from 26 patients (eight with systemic lupus erythematosus (SLE), four with Hashimoto's thyroiditis, eight haemophiliacs and six with post-hepatitis cirrhosis) containing high levels of circulating immune complexes (IC) were selected. The IC were precipitated with 2.5% polyethylene glycol, washed, treated with acid buffer, neutralized and tested using an enzyme immunoassay in parallel with the original sera for antibody activity against a panel of antigens: human myosin and thyroglobulin, mouse actin and tubulin, calf thymus DNA and trinitrophenyl coupled to bovine serum albumin (TNP/BSA). It was found that all the isolated IC may contain IgG, IgA and IgM antibodies reacting with actin tubulin and TNP/BSA and also, depending upon the disease, antibodies reacting with some of the other antigens of the panel. By comparison to the antibodies present in the original sera, higher titers of antibodies were found in the isolated IC while some antibody specificities not detected in a given serum were occasionally noted in the isolated IC. The antibodies present in the IC seem to possess characteristics similar to those of polyreactive human natural autoantibodies. It is concluded that natural autoantibodies participate actively in the formation of IC found in pathological sera.

Actins↗

[Complete deficiency in the C2 fraction of complement associated with a glomerular nephropathy: apropos of 2 cases].

Two patients with non-systemic idiopathic glomerulonephritis were found to have a complete deficiency of C2, the second component of complement; the clinical course and serological abnormalities are reported in detail. An immunogenetic analysis of the patients of two families was carried out. It was demonstrated that the homozygous C2 deficiency was associated with homozygosity for HLA-A25-B18-DR2-BfS-C4A4-C4B2 haplotype.

Adult↗

[Chronic proximal spinal amyotrophies in Tunisia. Clinical, genetic, epidemiologic and histopathologic study].

The results of a clinical, pathological, genetic and epidemiological study of 101 cases of chronic proximal spinal muscular atrophy are reported. Ages at onset allow to distinguish clearly an infantile, a juvenile and an adult groups. The infantile and juvenile groups comprising 93 p. 100 of the patients, were characterized by onset before the age of 20 (54 p. 100 before age 5) and by a large intra- and interfamilial clinical variability. The severity of the disease was unrelated either to sex or the sporadic or familial nature of the disease. On the other hand it was closely related to age at onset and to the pathology of the muscles. There seems to be no genetic heterogeneity in this group. Inheritance is of the autosomal recessive type in the great majority of cases. Certain sporadic cases may be due to a dominant mutation or to a phenocopy, as suggested by segregation analysis. The adult group, comprising 6 patients, included 4 cases of autosomal dominant inheritance without consanguinity of the parents, and one case of dominant inheritance.

Adolescent↗

Natural killer cells in Behçet's disease.

We studied natural killer (NK) cell activity and numbers in the peripheral blood obtained from patients with Behçet's disease (BD) in inactive and convalescent stage, and from healthy controls. Ratios of helper/suppressor cells (OKT4/OKT8) were below 1.0 in patients with active stage and were normal in the convalescent stage of BD. A relative increase of OKT8+ cells and at the same time of Leu 7+ cells was obtained in the active and convalescent BD stages. Double marker analysis revealed that the sub-population of cells expressing both the T8+ and the Leu 7+ antigen (T8+/Leu 7+) was increased in patients with active stage, and normal in the convalescent stage. The frequency of cells reactive with Leu 11 monoclonal antibody (active NK cells) was evaluated in patients with BD. Data from peripheral blood showed an increased sub-population of T8+/Leu 7+ double marker cells, and a decreased Leu 11+ cell sub-population in patients with active BD, but the majority of Leu 7+ cells in patients with convalescent stage lacked OKT8 antigen when investigated in a double marker system. A parallel increase of Leu 11+ cells was observed in the convalescent stage. This phenotypic analysis was carried out with the NK in vitro functional evaluation of cell populations from peripheral blood. NK cell activity in the clinically active stage of BD was significantly lower than that of healthy controls and patients in the convalescent stage. The decrease of peripheral blood NK function in patients with active BD may be related to the presence of immature forms of NK cells and/or to the increased percentage of T8+/Leu 7+ cells.

Adult↗