Search PubMed⌕ Search

Biomedical subjects

M Abu-Shakra

Publications and source records attributed to M Abu-Shakra.

69 records · Page 4Linked to original sources

Parasitic infection and autoimmunity.

The studies summarized in this paper indicate that parasitic infections can serve as a trigger factor of autoimmune reactivity by several mechanisms. The relationship between parasites and autoimmunity could be manifested by the presence of autoantibodies or T-cells with autoreactivity. In spite of the evidence that has accumulated, the specific association between infection and autoimmunity is still obscure. The reasons for tissue damage in parasitic diseases are controversial. Some believe it is the result of pathogenic autoantibodies or autoreactive T-cells. Others argue against the causative role of autoimmunity in the formation of tissue lesions. The parasite itself could be the cause of tissue destruction, thus releasing high amounts of self antigens which might stimulate the autoreactivity. There is now little doubt that some degree parasite/host cross-reactivity occurs, and definition of cross-reacting antigens and epitopes is now taking place. It seems likely that a combination of events could result in cross-reactivity including: parasites themselves have cross reactive molecules and altered self antigens by adsorbing of parasite material to surrounding host cells. The mechanisms involved in parasites autoimmunity are complex and numerous, requiring a rigorous experimental approach to rationalize each step and determine its clinical importance. The developed methods in immunochemistry, monoclonal antibodies and hybridoma technology, and recombinant DNA research not only facilitate this kind of approach but also allow optimism for a successful outcome.

Autoimmunity↗

The frequency of a common anti-DNA antibody idiotype (16/6) in different populations of patients with systemic lupus erythematosus.

The 16/6 anti-DNA idiotype (id) is a pathogenic idiotype first identified on a human hybridoma antibody derived from a patient with systemic lupus erythematosus (SLE). The SA-1 anti-DNA, which antibody was established in a similar fashion from a patient with polymyositis, also carries the 16/6 id, although it has a greater reactivity with dsDNA. The presence of the 16/6 id as defined by anti-16/6 and anti-SA-1 was determined in 3 distinct populations of patients with SLE: 502 Mexicans, 98 English (including Caucasians, West Indians, Chinese, Asians) and 93 Israelis. A similar prevalence (around 20%) of the 2 idiotypes was found, with a significant overlap. The latter finding was supported by a significant correlation noted between the prevalence of the 2 idiotypes (r = 0.58 p less than 0.001). Despite the fact that 16/6 antibody is most probably encoded by a germline gene, thus being genetically determined, no distinction in the prevalence of the ids could be detected between completely different populations of patients with SLE. This finding may support the independent pathogenic role ascribed to the 16/6 id.

Antibodies, Antinuclear↗

Chronic infections and autoimmunity.

The studies summarized in this chapter indicate that chronic bacterial, viral, and parasitic infections can serve as a trigger factor of autoimmune reactivity according to various mechanisms. The relationship between microbes and autoimmunity could be manifested by the presence of autoantibodies, autoimmune complexes, or T cells with autoactivity. The presence of autoimmune phenomena in chronic infections could be related to polyclonal B-cell activation, molecular mimicry between microbial and host antigens, altered self, abnormal expression of immunoregulatory molecules, and the anti-idiotypic network. In most cases, the appearance of self-reactivity in the sera of patients with chronic infections is not associated with clinical manifestations. These findings suggest that autoimmune disease is the result of a combination of factors including immunologic, genetic, hormonal, and environmental. Infectious agents have a role in the breakdown of tolerance and the appearance of autoreactivity. However, only patients with the proper immunogenetic and hormonal background may develop clinical manifestations of autoimmune disease. In spite of the extensive knowledge that has accumulated, the specific relationship between infections and autoimmunity is still obscure. Clearly, additional studies are required to clarify the relevance of microbes to the pathogenesis of autoimmune diseases.

Acquired Immunodeficiency Syndrome↗

Anti-Sm-RNP activity in sera of patients with rheumatic and autoimmune diseases.

The sera of various rheumatic and autoimmune diseases were examined for the presence of anti-RNP/Sm activity. An enzyme-linked immunosorbent assay (ELISA) was employed. Anti-RNP Ab's were detected in 18%, 20%, 28%, 16% of the sera of SLE, myasthenia gravis (MG), rheumatoid arthritis (RA) and thyroid diseases respectively. The anti-RNP Ab's belonged to the IgG and IgM isotypes. Most of the IgG anti-Sm antibodies were detected in SLE sera, but they were found also in two sera of MG and in one sera of RA patients. IgM anti-Sm antibodies were not found in SLE sera, but they were detected in low titer in MG, RA and autoimmune thyroid diseases. The activity against RNP and/or Sm was further confirmed by employing immunoblotting assays. In none of the patients, except those with SLE, was any clinical manifestation of SLE noted. The mere presence of anti-Sm antibodies of the IgG isotypes is not sufficient for the development of SLE, however, its presence is highly specific for SLE.

Adult↗

[Tuberculosis in a general hospital 1987].

Tuberculosis (TB) was diagnosed in 15 patients admitted during a 1-year period starting November 1986. 4 had been treated with corticosteroids prior to diagnosis. Most were admitted with exacerbation of chronic obstructive pulmonary disease, acute respiratory failure and prolonged fever. The most frequent X-ray findings were infiltrates in the lower lobes and the middle lobe. Sputum cultures were positive for TB in only 4 patients, while culture of gastric aspirates was diagnostic in 9. Our findings point to an increase in the detection of TB in the Negev. It must be ruled out in patients with diabetes, those undergoing prolonged corticosteroid therapy and in Bedouin and Yemenite patients in whom there is a greater incidence of the disease. Culture of gastric aspirates should be included in the workup for TB.

Hospitals, General↗

[Recurrent avascular bone necrosis in systemic lupus].

Ischemic necrosis of the bones in systemic lupus erythematosus (SLE) usually appears when treatment with corticosteroids is initiated. The most frequent site is the hip, while the knee and shoulder are less frequently involved. A 21-year-old man was admitted because of bilateral shoulder pain 3 years after diagnosis of SLE. The skin, joints, brain, small intestine and kidneys were also involved and corticosteroid therapy was started. 1.5 years before his last admission, severe knee pain developed with limitation of range of movement but without effusion or soft tissue swelling. Bone scan confirmed the diagnosis of aseptic necrosis of the femur and tibia of both knees. He also developed bilateral shoulder pain accompanied by limitation of the range of internal and external rotation. X-ray of the shoulders demonstrated bilateral ischemic necrosis. Since synovitis is relatively rare in SLE treated with corticosteroids, aseptic necrosis of the bone should always be suspected when arthralgia develops in this condition.

Adrenal Cortex Hormones↗

Serum monoclonal antibodies derived from patients with multiple myeloma react with mycobacterial phosphoinositides and nuclear antigens.

The sera of 46 patients with multiple myeloma were examined for the presence of anti-tuberculosis (TB) glycolipids antibodies. In positive sera samples, anti-polynucleotides, anti-histones, anti-cardiolipin, anti-Sm and anti-RNP activities were sought. Antibodies against three different mycobacterial glycolipids were detected in 10 of the 46 sera. Three (P429, P557, P5) showed high titres of antibodies against all three different TB glycolipids. Of the 10 reactive samples, two antibodies were purified (P429, P557). P557 reacted with various polynucleotides and other antigens tested (Sm, RNP, cardiolipin, histones). One immunoglobulin (P207) which showed high activity against Sm and RNP had no activity against TB glycolipids and was employed as a control. The cross-reactivity between mycobacterial glycolipids and the nuclear antigens was further established by bi-directional competition assays with P429 and P557. Our study shows a high incidence (22%) of anti-TB glycolipids antibodies in sera of patients with monoclonal gammopathies, some of which show anti-DNA and other anti-nuclear antigens activities. This is additional evidence for the mycobacterial-nuclear antigen cross-reactivity which may suggest a possible role of infection (e.g., tuberculosis) in autoimmune diseases.

Antibodies, Antinuclear↗

The dual association between lymphoma and autoimmunity.

Autoimmune rheumatic diseases and lymphocytic malignancies are related and this association is bidirectional. Lymphomas occur more frequently in the course of autoimmune disease and autoimmune rheumatic manifestations occur in the course of lymphocytic malignancies. An increased incidence of malignant lymphocytic diseases is present in patients with rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, and autoimmune thyroid disease. Descriptions of lymphocytic malignancies among other autoimmune rheumatic disease have been published. In some patients, the malignant disease is diagnosed months or years before the appearance of the rheumatic disease.

Antigens, Neoplasm↗

Living with a child with familial Mediterranean fever: does it affect the quality of life of the parents?

OBJECTIVE: The aim of the present study was to assess the quality of life (QOL) and the psychological status of parents of children with familial Mediterranean fever (FMF). METHODS: The QOL, anxiety and depression of the parents of 35 children with FMF were evaluated and compared to the parents of 23 healthy children. RESULTS: Mothers of FMF children had lower QOL scores than mothers of healthy children: 5.5 +/- 1.1 versus 6.0 +/- 0.6 (p = 0.048). They also expressed higher levels of anxiety and depression. Within each group, mothers were more anxious and depressed than fathers. Parents with several FMF children were not significantly different from parents with only one FMF child. CONCLUSION: The QOL and psychological well being of parents with FMF children were found to be slightly impaired, especially that of the mothers.

Adolescent↗

Features of SLE in various ethnic groups in Israel.

OBJECTIVE: To assess the association between the ethnic origin of patients with SLE living in Israel, and the clinical and laboratory features of SLE. METHODS: A retrospective review of medical records was carried out. Patients were classified into 3 groups based on their ethnic origin: a) Ashkenazi Jews, b) Sepharadic Jews and c) Arabs. RESULTS: The study included 74 consecutive SLE patients, 69 (93%) women and 5 (7%) men. Their mean age at diagnosis was 32 years and their mean disease duration was 6.4 years. There were 21 (28%) Ashkenazi Jews, 31 (42%) Sepharadic Jews and 22 (30%) Arabs. The demographics, the frequency of various clinical and laboratory variables of SLE, and the mean disease activity index score (SLEDA1) of the three groups were not statistically different. CONCLUSION: The ethnic origin of SLE patients living in Israel is not associated with the clinical and laboratory features of the disease.

Adult↗