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Biomedical subjects

K Bittner

Publications and source records attributed to K Bittner.

At least 19 recordsLinked to original sources

Latent inhibition of granulocyte function by cyclosporine A.

According to the literature, Cyclosporine A (CsA) is said to suppress specifically the activity of T and B cells. A significant influence on phagocyte function has been neglected. However, aggravated courses of bacterial and fungal infections have been frequently reported under the treatment with CsA, suggesting that a latent depression of phagocytic activity may possibly occur under clinical circumstances. Therefore, this study set out to assess whether CsA can also change granulocyte function under therapy conditions or not. Thirty-seven patients, 3 months-10 years after kidney transplantation being under immunosuppressive treatment with CsA + Prednisolone (n = 25), Azathioprine + Prednisolone (n = 6) and under Prednisolone alone (n = 6) underwent the study. 18 healthy persons served as a normal control group. Granulocyte function was tested ex vivo by chemiluminescence (CL) after stimulation with phorbolmyristate acetate (PMA) and with zymosan (zym) activated autologous or pool-serum. The obtained data were correlated to corresponding serum or plasma levels of CsA, human leukocyte elastase (HLE) and neopterin. Comparing the three therapy groups with the healthy control and with each other no differences could be seen in median CL values; but there was a significant (p = 0.05) negative correlation between CsA blood levels and maximum CL values of PMN. Such inhibition of CL could be calculated for zym but not for PMA stimulated PMN; suggesting that the CsA mediated inhibition of granulocyte function may be only partial and restricted to phagocytosis. In addition, a positive correlation between serum levels of human leukocyte elastase (HLE) and neopterin could be found. This indicates a simultaneous influence of CsA on both PMN and macrophages.

Adult

A rapid laser immunonephelometric assay for serum amyloid A (SAA) and its application to the diagnosis of kidney allograft rejection.

We set up a laser nephelometric assay for the quantitation of serum amyloid A (SAA) in human plasma. Therefore monospecific antibodies were raised in sheep and used in parallel to measure SAA concentrations by nephelometry and also by radial immunodiffusion, an assay usually applied for determination of SAA. The nephelometric method is precise, simple and unlike radial immunodiffusion results are obtained within an hour. The antigen concentrations determined both by laser nephelometry and radial immunodiffusion correlated highly (r = 0.98). As plasma SAA concentrations were reported to be a possible marker of kidney allograft rejection, the assay was applied to measure SAA concentrations in patients after kidney transplantation. Data were compared with clinical and other biochemical parameters. The period after kidney transplantation is reported for two cases, where SAA plasma concentrations were helpful in diagnosing allograft rejection. The rapid availability of the SAA plasma concentrations by nephelometry makes them a possible additional tool to decide quickly upon antirejection therapy.

Graft Rejection

[The dry eye in kidney transplant patients].

Fifty-three patients with severe renal disease and/or kidney transplants underwent full ophthalmological examinations, including tear breakup time, Schirmer's test, and impression cytology of the conjunctivae. Although only some 50% of the patients complained of typical dry-eye symptoms, pathologic changes of the outer eye were found in almost 70%. Tear break-up times and Schirmer's test values were greatly reduced. Morphological changes of the conjunctiva were found in almost all the patients; in 50% of these cases the changes were moderate to severe.

Adult

[Persulfate asthma in hairdressers].

At the a two-year apprenticeship, a young female hairdresser developed rhinoconjunctivitis and bronchial asthma, induced by a hair bleach containing the substance persulphate. On each occasion, her symptoms occurred in the form of an immediate reaction. The causative role of the bleach was demonstrated with the aid of an inhalation challenge test. In addition, the prick test produced a positive reaction vis-a-vis persulphate. The long latency period and the positive prick test might militate in favour of an allergic pathomechanism.

Adolescent

[Cytomegalovirus-associated superinfection of the lung following kidney transplantation].

In a kidney-transplant patient, there was superinfection of the lungs by Klebsiella pneumoniae and Legionella pneumophilia with multiple necroses in the course of a primary cytomegalovirus infection. In a later phase of the disease, there was an opportunistic colonization of the necrotic cavities and the adjacent lung tissue by Aspergillus fumigatus and Candida albicans. The cytomegalovirus infection led to a pronounced cellular immunosuppression in the patient. This favored superinfections by bacteria and fungi. A poor nutritional state and a chronic lung disease are to be considered as predisposing risk factors.

Adult