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Biomedical subjects

L Kater

Publications and source records attributed to L Kater.

At least 55 records · Page 3Linked to original sources
PubMed1990

Binding of antibodies to nonhistone nucleoproteins on keratinocytes in suspensions.

Antibody binding on the cell surface of epidermal cells, recently established on cultured neonatal foreskin cells, is supposed to play a role in the pathogenesis of in vivo antinuclear antibodies (ANA) of the skin. To study this phenomenon in suspensions of adult human keratinocytes, a cell system more closely related to the in vivo situation, we investigated the binding capacity of nine sera with various antibody profiles against nuclear components, as well as a murine monoclonal Sm-antibody. It was found that sera containing antibodies against nonhistone nucleoproteins bound to the cell surface of keratinocytes, whereas monospecific anti-dsDNA sera and the murine anti-Sm serum did not. This binding was found in both basal and suprabasal keratinocytes. The percentage of cells showing antibody binding was not significantly enhanced by preirradiation with ultraviolet light, as was found in a previously study. The cell surface binding is probably an antigen-antibody binding and not the result of cross-reactivity. Such cell surface binding may be important for the formation of in vivo ANA in the skin.

Antibodies↗
PubMed1990

In vivo antinuclear antibody of the skin: diagnostic significance and association with selective antinuclear antibodies.

Immunofluorescence microscopy of the skin has disclosed antibodies bound to epidermal cell nuclei in several connective tissue disorders. To establish the diagnostic potential of this phenomenon the results of immunofluorescence microscopy of biopsy specimens from 1651 subjects with various diseases and from 315 patients with systemic connective tissue disorders and related diseases were reviewed. It was found that the predictive value of the phenomenon for the presence of a systemic connective tissue disorder was, in general, 88%. Except for the homogeneous and thready patterns, which seldom appear, but are specific for SLE, in vivo antinuclear antibody (ANA) does not discriminate better between the various disorders than do serum antibodies. The presence of in vivo ANA in the skin was related to serum antibodies against non-histone nucleoproteins, but not to anti-dsDNA antibodies. Combined with the finding that antibodies against non-histone nucleoproteins can bind on the surface of human keratinocytes, this suggests that ANA of the skin occurs in vivo.

Antibodies, Antinuclear↗
PubMed1989

A new and highly sensitive immunohistologic diagnostic criterion for Sjögren's syndrome.

Immunohistologic investigation of the sublabial salivary glands of 65 surgical patients who were free of systemic disease (control) and 19 patients with Sjögren's syndrome resulted in a new diagnostic criterion for SS that was more disease-specific than the widely used lymphocytic focus score criterion. Our bivariate classification criterion, which is based on the percentages of IgA- and IgG-containing plasma cells, has a specificity of 95.4% and a sensitivity of 100%, while its overall percentage of misclassification is 3.6%. This immunohistologic diagnostic criterion results in a reduction of the percentage of false-positive diagnoses from 9% to 4.6%.

Age Factors↗
PubMed1989

Quantitative immunohistologic and histomorphometric diagnostic criteria for Sjögren's syndrome.

Sjögren's syndrome (SS) is a chronic auto-immune exocrinopathy, especially affecting the lacrimal and salivary glands. The aim of this study is to improve the diagnostic possibilities of the sublabial salivary gland (SSG) biopsy. The SSG biopsies of 19 patients with SS and 65 healthy control subjects were used in a quantitative immunohistologic and histomorphometric study. Statistical analysis of the immunohistochemical data resulted in a diagnostic criterion, which is based on the percentages of IgA- and IgG-containing plasma cells. Statistical analysis of 3 immunohistologic and 6 histomorphometric features resulted in a combined immunohistologic and histomorphometric criterion, which is based on 2 immunohistologic parameters (the percentages IgA- and IgG-containing plasma cells) and 3 histomorphometric parameters (the volume percentages of acini, intralobular ducts and diffuse lymphoplasmacytic infiltrate). The immunohistologic diagnostic criterion has a specificity of 95.4%, a sensitivity of 100% and an overall percentage of misclassification of 3.6%. The combined diagnostic criterion has a specificity of 98.5%, a sensitivity of 100% and an overall percentages of misclassification of 1.2%. Furthermore it reduces the number of false positive diagnoses with a factor 6 from 9% to 1.5%.

Biopsy↗
PubMed1989

A prospective immunofluorescence study of immune deposits in the skin of primary Sjögren's syndrome.

There are conflicting opinions concerning the epidermal immunofluorescence pattern in primary Sjögren's syndrome. In a prospective study of 12 patients we found a characteristic pattern of epidermal nuclear/cytoplasmic IgG deposits in 8 (67%). This pattern was associated with the presence of antibodies against SSA/Ro and SSB/La in the serum and was also found in 2 out of 5 LE patients with monospecific antibodies against SSA/Ro. There is a resemblance to the pattern of dust-like particles described in the diseased skin of patients with subacute cutaneous LE. In one patient with primary Sjögren's syndrome, IgG deposits were confined to epidermal cell nuclei (in vivo ANA). Instead of antibodies against SSA/Ro or SSB/La, this particular patient had nRNP-antibodies. From this study, we conclude that the epidermal IgG deposits in primary Sjögren's syndrome may represent antibody binding to the sites within epidermal cells where the respective antigens are located.

Antibodies, Antinuclear↗
PubMed1988

Circulating IgA immune complexes and skin IgA deposits in liver disease. Relation to liver histopathology.

Alcoholic liver disease (ALD) is characterized by elevated serum IgA concentrations, the presence of circulating immune complexes containing IgA, and IgA deposits along sinusoids in the liver. When combined with the presupposed IgA-clearance function of the liver, a causal association between IgA abnormalities and the liver disease in ALD can be suggested. This prompted us to study the presence and concentration of circulating IgA-containing immune complexes (IgA-CIC) in 41 patients with ALD and 41 patients with other nonalcoholic liver diseases having comparable serum IgA levels. We searched for relationships among IgA-CIC and history of alcohol abuse, liver histopathology, and IgA deposits in the liver. Using an anti-IgA inhibition binding assay, 56% of the patients exhibited IgA-CIC in polyethylene glycol precipitate of serum and 38% showed IgA-CIC in whole serum. The prevalence and concentration of IgA-CIC was lowest in cases with nonspecific changes or steatosis in the liver biopsy and highest in cases with hepatitis or cirrhosis (P less than 0.01). The occurrence of IgA-CIC was not related to a history of alcohol abuse or to the presence of IgA deposits along hepatic sinusoids (which occurred in 78% of ALD and 20% of non-ALD cases). A skin biopsy was available from 34 patients (19 with ALD and 15 with non-ALD). In 68% of these biopsies, IgA deposits were observed in superficial blood capillaries.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigen-Antibody Complex↗
PubMed1988

Immunoglobulin A in the diagnosis of alcoholic liver disease.

The diagnostic relevance of the serum immunoglobulin A (IgA) concentration and liver deposition of IgA for chronic excessive alcohol consumption was evaluated in 164 patients with biochemical liver abnormalities. A relationship was demonstrated between the amount of daily alcohol consumption and the two IgA parameters and serum gamma-glutamyl transpeptidase. A continuous pattern of IgA deposition along hepatic sinusoids proved to be the best diagnostic feature, combining a specificity of 0.91 with a sensitivity of 0.75. Although serum IgA has a specificity of 0.78, its diagnostic value is restricted by a sensitivity of 0.50, making it not superior to serum gamma-glutamyl transpeptidase. Furthermore, serum IgA proved to be related to liver histopathology. High levels of serum IgA are found in hepatitis and cirrhosis, without significant differences between alcoholic and nonalcoholic patients. However, in the case of mild histopathologic changes in the liver, such as steatosis and fibrosis, significantly higher serum IgA concentrations are found in alcoholic than in nonalcoholic liver disease.

Alcohol Drinking↗
PubMed1988

Immunoglobulin A subclass-containing plasma cells in the jejunum in primary IgA nephropathy and in Henoch-Schönlein purpura.

We studied the distribution of IgA1- and IgA2-containing plasma cells in the jejunum of 5 patients with primary IgA nephropathy and of 2 patients with Henoch-Schönlein purpura. The percentage of IgA-containing cells (62.3 +/- 4.6) was below the level found in normal (79.4 +/- 5.1) (p less than 0.001). The percentage of IgA1-containing plasma cells relative to the total IgA-containing cells was too low in 2, normal in 3 and too high in 2 subjects (mean percentage 68.1 +/- 9.6; normal 69.0 +/- 3.8). Our data do not support an increased production of IgA1 in the jejunal mucosa of patients with primary IgA nephropathy or with Henoch-Schönlein purpura.

Adolescent↗
PubMed1987

Chorea in systemic lupus erythematosus and "lupus-like" disease: association with antiphospholipid antibodies.

Twelve patients with chorea from a population of 500 patients with SLE and "lupus-like" disease were reviewed. Clinical histories, including time relationships of chorea to the systemic illness and other neurologic manifestations, are reported. Chorea appeared early in the course of disease in most patients, but the development of cerebral infarctions or TIAs occurred subsequently in seven of nine patients demonstrating antiphospholipid antibodies. The relationship of chorea to the presence of these antibodies in nine of 12 patients and the therapeutic outcome are briefly discussed.

Adult↗
PubMed1987

Spontaneous IgA synthesis by blood mononuclear cells in alcoholic liver disease.

Changes in the concentration and composition of serum immunoglobulin A (IgA) and deposits of IgA in tissues are well-known characteristics of alcoholic liver disease. We investigated whether these changes also accompany IgA synthesis by peripheral blood mononuclear cells (MNC), by counting immunoglobulin-producing cells using a solid-phase enzymatic 'spot' test, and by analysis of immunoglobulin content in lysed cells with culture supernatant using conventional enzymatic methods. Patients with alcoholic liver disease exhibited a significantly higher number of spontaneously IgA-producing cells than did normal healthy controls (1.7 X 10(6) cells/blood and 0.5 X 10(6) cells/blood, respectively, P less than 0.01). The IgA content of MNC directly after isolation was also higher (38 and 13 ng/10(6) MNC, respectively, P less than 0.01), as was the IgA production during an unstimulated 6-day culture period (520 and 95 ng/10(6) MNC put into culture, respectively, P less than 0.001). The spontaneously IgA-producing cells assessed directly after isolation of mononuclear cells correlated with the IgA production during an unstimulated culture (P less than 0.01). We conclude that in alcoholic liver disease, B lymphocytes circulate which may have been activated in vivo.

Antibody-Producing Cells↗
PubMed1987

The prevalence and clinical associations of the lupus anticoagulant in systemic lupus erythematosus.

To determine the prevalence and clinical associations of the lupus anticoagulant (LAC) in patients with systemic lupus erythematosus (SLE), we studied 74 patients with SLE, 6 with lupus-like disease and a heterogeneous group of 45 patients with various autoimmune diseases. LAC was demonstrated in 19 SLE patients (26%), 5 patients with lupus-like disease (83%) and in none of the other patients. Statistically significant associations were found between LAC and a history of thromboembolic events (p less than 0.001), fetal loss (p less than 0.001), thrombocytopenia (p less than 0.01), biologically false-positive VDRL test (p less than 0.02) and convulsions (p less than 0.05). A negative correlation was found between LAC and a history of butterfly rash (p less than 0.01) and the presence of antibodies against extractable nuclear antigen (p less than 0.01). No significant difference was found between LAC-negative SLE patients and patients with other autoimmune diseases with respect to the prevalence of thromboembolic events or fetal loss. We conclude that LAC is a useful marker to identify a subset of patients with SLE or lupus-like disease at risk of thromboembolic events, fetal wastage, and thrombocytopenia.

Abortion, Spontaneous↗
PubMed1986

Five-year survival in Hodgkin's disease. The prospective value of immune status at diagnosis.

Immune status was measured in 47 previously untreated patients with Hodgkin's disease. For all patients, a 5-year follow-up was established. Immunologic capacity was measured by delayed-type hypersensitivity tests to common recall-antigens; enumeration of T- and B-lymphocytes in the peripheral blood; in vitro lymphocyte responsiveness to mitogens, antigens, and allogeneic lymphocytes; and serum levels of immunoglobulins. Compared with healthy controls, skin reactivity was decreased in the patients (P less than 0.05), but was not a prognostic marker with regard to survival. Total lymphocyte counts and the numbers of T- and B-cells did not differ between surviving and deceased patients. Decreased in vitro lymphocyte responsiveness to phytohemagglutinin and impaired responding capacity of patients lymphocytes in the mixed lymphocyte culture (MLC), used as markers, were a poor prognostic sign (P less than 0.001). The relevant clinical parameters with regard to 5-year survival were age, stage, and B symptomatology (P less than 0.005). The prognostic information supplied by age plus responding capacity in the MLC exceeded the predictive value of any combination of clinical parameters. Lymphocyte stimulation to pokeweed mitogen and antigens, stimulatory capacity of patients' lymphocytes in mixed lymphocyte cultures, the spontaneous DNA-synthesis, and immunoglobulin levels, did not provide prognostic information. The use of mixed lymphocyte cultures in staging patients with Hodgkin's disease may refine the prognostic information supplied by age, stage, and symptomatology.

Adolescent↗
PubMed1986

The relevance of IgA deposits in vessel walls of clinically normal skin. A prospective study.

Granular deposits of IgA are known to occur in the walls of superficial vessels in apparently healthy skin of patients with primary IgA nephropathy, Henoch-Schönlein purpura, or alcoholic liver disease, but the specificity of the finding is still a matter of debate. We investigated the disease specificity of these deposits in the skin of patients with kidney and liver diseases. The sensitivity of the finding for the diagnosis of primary IgA was 75%, the specificity was 88%. The sensitivity for the diagnosis of alcoholic liver disease was 71%, but the specificity was only 60%. The specificity for the diagnosis of Henoch-Schönlein purpura, primary IgA nephropathy, or alcoholic disease (in a group of 1,030 patients with various diseases) was 94%. Immunoelectron-microscopic investigation showed the IgA deposits localized within the endothelial cell and in the subendothelial rim.

Capillaries↗