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Biomedical subjects

M Andary

Publications and source records attributed to M Andary.

35 records · Page 2Linked to original sources

Immunomodulating effect of human placenta-eluted gamma globulins in rheumatoid arthritis.

Patients who had active and severe rheumatoid arthritis (RA) were treated with human placenta-eluted gamma globulins (PEGG) composed of purified IgG eluted from trophoblastic cells. A control group of RA patients received retroplacental gamma globulins with no clinical effects. Seven of eleven treatments with PEGG showed good (4 patients) or very good (3 patients) clinical results. All patients had immunologic modifications demonstrated by a significant increase in active E-rosette-forming cells and mitogen responsiveness. The precise mechanism of immunomodulating effect of PEGG should be further investigated.

Adult↗

Immunological aspects of psoriasis: V. T. cell subsets and suppressor cell functions regulating immune responses in peripheral blood.

T cell subsets bearing Fc-receptors for either IgG (TG) or IgM (TM), and suppressor cell activity of peripheral blood mononuclear cells on in vitro lymphoproliferative responses were studied in patients with untreated psoriasis. The proportions of TG and TM cells were unmodified in 15 patients compared to 15 control subjects studied in parallel experiments. The concanavalin A-induced suppressor cell activity, as well as the spontaneous suppressor cell function of in vitro short-lived adherent cells, were in the normal range for 7 out of 8 psoriatic patients investigated. The data argue against the possibility that a generalized suppressor cell defect occurs in psoriasis.

Adolescent↗

Immunological aspects of psoriasis. IV. Presence of circulating immune complexes in patients before and after PUVA therapy; correlations with T-cell markers.

We investigated sixteen patients before and after 1 month of PUVA therapy (three times a week) for circulating immune complexes (CIC) and T-cell markers. CIC were detected by the PEG-C4 assay, using a laser nephelometry determination of polyethylene glycol (PEG, 3.5%) precipitated endogenous C4. T cells were evaluated by E rosettes, active E rosettes, anti-HTLA serum and ox EA gamma-rosettes. This latter method investigated mainly T cells bearing Fc receptors for IgG (Tgamma-cells). After 1 month of PUVA-therapy: (a) the cutaneous lesions markedly improved; (b) the mean percentages of E rosettes, active E rosettes, and HTLA bearing cells, depressed before treatment, returned to normal; (c) CIC were found in higher amounts; (d) T gamma-cell numbers decreased simultaneously. The improvement of T-cell levels assessed by E rosettes, active E rosettes and HTLA values was correlated with clearing of skin lesions, as previously reported by others. However, the increase of CIC during PUVA therapy, their correlation with T gamma-cell decrease, and their possible role in the pathogenic chain of psoriasis remains uncertain.

Adolescent↗

[Cellular immunity during ankylosing spondylitis].

A study of cell immunity was carried out in 23 patients with ankylosing spondylitis, 17 HLA B27 +, 6 HLA B27 --, 5 donors of normal blood carrying HLA B27 antigen and 50 controls, 7 methods were used together for a study of the markers of the blood lymphocyte membranes: rosette E, rapid rosette E, anti HTLA + X, surface immunoglobulins, PEA gamma and BEA gamma rosettes, determination of the monocytes after peroxidase staining. Stimulation of lymphocytes with mitogens (PHA, Con A, PWM) were carried out. There exists an increase in blood lymphocytes carrying HTLA + X in patients with ankylosing spondylitis HLA B27 and also in healthy carriers of the same antigen. During ankylosing spondylitis with HLA B27 --, a statistically significant reduction in T lymphocytes forming E and E rapid rosettes was observed; finally, a rise in the levels of circulating immune complexes detected by the PEG --C4 method was noted. The significance of these facts is discussed.

Adult↗

Circulating lymphocyte subpopulations in juvenile insulin-dependent diabetes. Correction of abnormalities by adequate blood glucose control.

Circulating lymphocytes from 39 juvenile insulin dependent diabetics of recent onset were studied by six membrane marker techniques and mitogen stimulation. Well controlled (n = 14) were grouped separately from poorly controlled (n = 25) patients. The total lymphocyte counts were not different from 50 control subjects. The percentage of T-cells detected by erythrocyte rosettes and B-cells detected by erythrocytes--antibody--complement rosettes was significantly decreased only in poorly-controlled diabetics (64.1 +/- 1.3 and 9.7 +/- 1.8, vs 71.0 +/- 1.0 and 15.3 +/- 0.6 in controls). Cells bearing receptors for the Fc fragment of IgG immunoglobulins were decreased in both groups. Mitogen stimulation was not different from controls but was significantly lower in poorly controlled than in well controlled diabetics. Optimal blood glucose control for 5 +/- 2 days using an external artificial pancreas led to a rapid normalisation of membrane marker values and mitogen responsiveness of lymphocytes from previously poorly controlled diabetics. Separate in vitro experiments showed that glucose had an inhibitory effect on mitogen stimulation at concentrations greater than or equal to 8.3 mmol/l and on T- and B-lymphocyte numbers at concentrations greater than or equal to 55.6 mmol/l. DL 3-hydroxybutyrate tested at 17.1 and 34.2 mmol/l only depressed mitogen responsiveness. Such results suggest a rapidly reversible T-cell defect closely linked to the existing metabolic disturbances.

Adolescent↗

[Suppressor cells of mitogen responses during rheumatoid polyarthritis].

The suppressor activity of mononuclear cells of the peripheral blood (MCPB) during rheumatoid polyarthritis (RP) was studied using experimental protocole. The MCPB stimulated in vitro by concanavaline A (Con A) are capable of suppressing the mitogenis response of autologus cells; moreover, the short-lived spontaneous suppressor cells disappear during 24 hour in vitro incubation that determines an increase in the proliferative response of the incubated cells for 24 hours. In two of the six RP studied, the suppressor activity generated Con A and the spontaneous suppressor activity are nul. Culture experiments with the MCPB of PR and control subjects show that this defect in suppressor activity is more related to a problem in the generation of suppressor cells than to a deficiency in the response to suppressor signals.

Arthritis, Rheumatoid↗

Immunologic aspects of psoriasis. III. Fc-gamma-receptor bearing mononuclear cells in peripheral blood.

An anti-IgG activity has previously been reported at the cellular level in patients with psoriasis. This activity was demonstrated by the so-called 'rheumatoid' rosette test. In the present work the nature of 'rheumatoid' rosette-forming cells was studied in comparison with other EA rosette techniques. The use of purified cell populations showed that the lymphocytes participating in the 'rheumatoid' rosette phenomenon were lacking conventional T and B cell membrane markers, and were thus referred to as null cells. Such mononuclear cells bearing a receptor for the Fc part of IgG were able to act as killer cells to IgG-coated target cells. The cytotoxic activity was mainly restricted to a small proportion of lymphocytes forming 'rheumatoid' rosettes which had a high avidity for EA complexes. Such cytotoxicity could contribute to the aetiology of lesions in psoriasis.

Antibody-Dependent Cell Cytotoxicity↗

[Fc-gamma-receptor cells and rheumatoid arthritis].

Certain blood lymphocytes of patients suffering from rhumatoid arthritis (RA) and or control subjects, can be detected using a rosette technique in the presence of erythrocyte antibody compounds (EA). The EA rosettes demonstrate the presence of cells having a receptor for the Fc fragment of the IgG's (Fc-receptor). A significant increase in highly active EA rosettes during RA was demonstrated using six EA compounds differing according to the type of erythrocyte and the quantity of sensitizing antibody. These highly active EA rosettes correspond to the case in which few antiserum molecules cover the erythrocytes. Their high level in RA may correspond to an increased number of Fc-receptor cells or to a stronger linkage of EA compounds. The cells forming EA rosettes are responsible for the resulting cell antibody cytotoxicity that seems to change little during rhumatoid disease. However, the very special behavior of Fc-receptor lymphocytes incubated in vitro suggests that the IgG receptors are modulated by the immune compounds present during RA.

Adult↗

In vitro immunological studies in atopic and contact dermatitis.

Serum immunoglobulins, five lymphocyte markers and three mitogen assays were used in an investigation of 20 patients with atopic dermatitis. A slight impairment of the cell-mediated immunity was detected. Ten patients suffering from contact dermatitis had sub-normal lymphocyte reactivity.

Adolescent↗

[Thyroiditis].

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Acute Disease↗

Effect of history and exam in predicting electrodiagnostic outcome among patients with suspected lumbosacral radiculopathy.

OBJECTIVE: To determine the extent to which the history and physical examination predict the outcome of the electrodiagnostic (EDX) evaluation in patients with suspected lumbosacral radiculopathy. DESIGN: Data for 170 subjects referred for low-back and lower limb symptoms were prospectively collected at five EDX laboratories. The sensitivity, specificity, positive and negative predictive values, and odds ratios were determined for symptoms and neurologic signs. RESULTS: Symptoms were not significantly associated with an EDX study or a lumbosacral radiculopathy. The physical examination was better at predicting that an EDX study would be abnormal in general than it was at predicting a lumbosacral radiculopathy in particular. Of those subjects with normal physical examinations, 15%-18% still had abnormal EDX findings. CONCLUSIONS: In a population of patients referred for an EDX study, the history and physical examination alone cannot reliably predict electrodiagnostic outcome.

Adolescent↗

Symptom duration and spontaneous activity in lumbosacral radiculopathy.

OBJECTIVES: A long-held notion in the electrodiagnostic literature is that paraspinal muscles tend to show spontaneous activity (fibrillations and positive sharp waves) on needle electromyography, early on in a lumbosacral radiculopathy, and that more distal muscles become abnormal later in the disease process. The purpose of this study was to determine whether paraspinal muscle and other major proximal and distal muscle spontaneous activity is related to a lumbosacral radiculopathy symptom duration. METHODS: A multicenter, prospective study that collected standard information on history, physical examination, and electrodiagnostic findings in patients with electrodiagnostically confirmed lumbosacral radiculopathies was undertaken. RESULTS: Multivariate probit analyses of 96 patients identified with a lumbosacral radiculopathy showed no evidence of correlation between spontaneous activity in the paraspinal muscles and symptom duration. Symptom duration was also nonsignificant in nine of the remaining ten lower limb muscles analyzed. CONCLUSION: These findings emphasize the limitations of using symptom duration when interpreting electrodiagnostic findings in lumbosacral radiculopathy.

Action Potentials↗

Identifying lumbosacral radiculopathies: an optimal electromyographic screen.

OBJECTIVE: The objective of this study was to determine prospectively the optimal electromyographic screening examination of the lower limb that ensures identification of those lumbosacral radiculopathies that can be electrodiagnostically confirmed, yet minimizes the number of muscles studied. DESIGN: A prospective multicenter study was conducted from May 1996 to September 1997. Patients with suspected lumbosacral radiculopathy referred to participating electrodiagnostic laboratories were recruited and examined by needle electromyography using a standard set of muscles. Patients with electrodiagnostically confirmed lumbosacral radiculopathies were selected for analysis. Various muscle screens were tested against this group of patients with radiculopathies to determine the frequency with which each screen identified the patient with radiculopathy. RESULTS: There were 102 patients identified. When paraspinal muscles were one of the screening muscles, four-muscle screens identified 88-97% of the radiculopathies, five-muscle screens identified 94-98%, and six-muscle screens 98-100%. When paraspinal muscles were not part of the screen, identification rates were lower for all screens, and eight distal muscles were necessary to identify about 90% of the radiculopathies. CONCLUSIONS: Six-muscle screens with paraspinal muscles yielded consistently high identification rates. Studying additional muscles produced no improvements in identification.

Adult↗

[Acute lymphoblastic leukemia in children. The use of antisera specific for lymphocyte populations in a classification trial].

Mononuclear cells from 14 children with acute lymphoblastic leukaemia (ALL) were studied using several lymphocyte membrane markers: E-rosettes, "active" E-rosettes, surface immunoglobulins, EA-rosettes. The use of these techniques and of three specific heterologous antisera directed against T and B cell antigens enabled the discrimination of three different ALL types according to the stage of cell maturation at which it is likely that neoplastic differention occured: T-cell ALL, pre-thymic cell ALL, and "non-T non-B" cell ALL showing only HLA-DR antigens.

B-Lymphocytes↗

Arthritis associated with primary agammaglobulinemia: new clues to its immunopathology.

Primary agammaglobulinemia is a rare disorder which is associated with articular symptoms in 11% of patients. Septic arthritis may occur, but often patients complain of chronic oligoarthritis and have a clinical presentation similar to rheumatoid arthritis. We report 2 cases of primary agammaglobulinemia in adults, associated with non-erosive chronic arthritis. Peripheral blood lymphocyte phenotyping showed a predominance of CD8 lymphocytes with a CD4/CD8 ratio < 1. We did not find any abnormalities in cellular immunity. A histological study of the synovium showed chronic synovitis with perivascular CD8 lymphocyte infiltrates. Intravenous infusion of immunoglobulins resulted in a dramatic improvement in the arthritis in both cases. In one patient we noticed a decrease in CD8 lymphocytosis. These results suggest that CD8 lymphocytes are involved in the pathogenesis of the arthritis associated with agammaglobulinemia.

Adult↗