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Biomedical subjects

M L Snaith

Publications and source records attributed to M L Snaith.

At least 55 records · Page 3Linked to original sources

Inappropriate peripheral blood lymphocyte responses to herpes viruses in patients with Behçet's syndrome.

Specific antibody production and the proliferative response of peripheral blood lymphocytes (PBLs) to a variety of viruses, including herpes simplex virus-type-1 (HSV-1) and varicella zoster (VZ), were studied in 7 patients with Behçet's syndrome. None of the patients produced an antibody response against HSV-1 or VZ. Furthermore, none of the patients showed a proliferative response to VZ, and three of them also failed to mount a response to HSV-1. These results suggest that the PBLs of patients with Behçet's syndrome make an inappropriately poor antibody and proliferative response when stimulated by HSV-1 and VZ.

Adult↗

Effect of high-dose methylprednisolone therapy on phagocyte function in systemic lupus erythematosus.

Circulating phagocytes play a major role in the defence of the host against microbial infection. In an attempt to identify the reason for the unusual susceptibility to infection of patients with systemic lupus erythematosus (SLE) various parameters of phagocytic cell function were assessed kinetically in whole blood, and the accumulation of cells in areas of inflammation was studied in vivo with the skin window technique. The effect on these parameters of conventional therapy with glucocorticoids and pulse therapy with large doses of methylprednisolone were examined. Patients on conventional doses of steroids had no abnormality of phagocyte function that might have predisposed to infection, apart from a reduced accumulation of monocytes in areas of inflammation and decreased lactoferrin secretion. Pulse therapy with methylprednisolone considerably delayed the secretion of lactoferrin and the adherence of neutrophils in most of the patients, as well as impairing bacterial killing and digestion.

Adult↗

Microvascular filtration in subjects with connective tissue disorders.

A simple non-invasive method for studying microvascular filtration in the non-articular tissues of the forearm is described. Rates of filtration under a standard hydrostatic pressure were measured in 20 normal female subjects and 44 female subjects with connective tissue disorders. An increased mean filtration rate was found in 14 subjects with rheumatoid arthritis. In 20 subjects with systemic lupus erythematosus and 10 subjects with scleroderma no such generalised increase in filtration rates was seen, but isolated cases had very high filtration rates, suggesting a more heterogeneous physiological disturbance. Increased filtration was not associated with the presence of oedema. This confirms doubts raised by other workers about the importance of filtration in the genesis of clinical oedema.

Adult↗

Specific allogeneic help by T lymphocytes from patients with systemic lupus erythematosus.

Unfractionated mononuclear cells from patients with systemic lupus erythematosus (SLE) immunized with influenza vaccines do not produce a secondary in vitro anti-influenza antibody response when challenged with virus antigen. Irradiated T lymphocytes from normal, disease control and from SLE donors whether vaccinated or not, help allogeneic normal non-T cells to produce specific anti-influenza antibody in vitro. Irradiated normal T cells, however, do not help allogeneic non-T cells from SLE donors. Non-irradiated T cells from 40% of the SLE patients, irrespective of whether or not they had been vaccinated, also provide specific help for MLC incompatible normal non-T cells in the influenza antibody response. This non-restricted interaction was not seen using non-irradiated T cells from any normal or disease control donor. No anti-DNA antibodies were produced in virus stimulated cultures of non-irradiated or irradiated SLE T cells with allogeneic normal non-T cells.

Antibodies, Antinuclear↗

Classifying lupus.

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Antibodies, Antinuclear↗

The use of C3d as a means of monitoring clinical activity in systemic lupus erythematosus and rheumatoid arthritis.

Plasma samples from 44 patients with systemic lupus erythematosus (SLE) and 43 with rheumatoid arthritis (RA) were assayed for C3d, a breakdown product of the third component of complement (C3), which was also measured in parallel. Levels of C3d varied in direct proportion with disease activity in RA, whereas C3 showed little change. Although C3d values also increased with worsening clinical condition in SLE, this trend was not considered to be sufficiently clear to be useful and did not provide any advantage over the routinely performed C3 assay.

Arthritis, Rheumatoid↗

A study of migraine in systemic lupus erythematosus.

An increased prevalence of classical migraine was found in 30 female patients with systemic lupus erythematosus (SLE) compared with an age and sex-matched control group by means of a detailed questionnaire. No significant difference were found between the patients and controls, who had classical and common migraine or visual auras without headache, with regard to a family history of migraine, the age of onset of the migraine, Raynaud's phenomenon, or use of oral contraceptives. Increased activity of the lupus was not generally associated with an increase in migraine attacks. It is suggested that migrainous phenomena may be a feature of SLE.

Adolescent↗

Neutrophil function in systemic lupus erythematosus and other collagen diseases.

Using a whole blood technique we assessed neutrophil migration, phagocytosis, and killing in a group of 20 patients with systemic lupus erythematosus (SLE) and in 8 patients with other connective tissue disorders. In the untreated cases of SLE neutrophil migration was significantly depressed, but it was usually normal in the treated group. This may be attributable either to an intrinsic neutrophil abnormality or to a humoral factor. Although isolated abnormalities of phagocytosis and killing were observed in SLE, these functions were normal when the patients were considered as a group. The treated patients with other collagen diseases showed enhanced migration in both autologous and control plasma, normal phagocytosis, and enhanced killing in autologous plasma only. The small group of untreated, non-SLE patients showed some depression of all 3 functions. There was no correlation between neutrophil function and clinical activity of disease. In the SLE patients there was no correlation between neutrophil function and circulating immune complexes.

Blood Bactericidal Activity↗

Methyl prednisolone pulse therapy in the treatment of systemic lupus erythematosus.

Twenty patients with active systemic lupus erythematosus (SLE) were treated with methyl prednisolone pulse therapy (MPPT) and followed up for up to 24 weeks (mean 18 weeks). Beneficial effects of MPPT were observed principally on arthralgia, pleuritic pain, vasculitic skin rash, pyrexia, and lymphadenopathy. The serological tests showing the most improvement were ds DNA binding and the serum C3 level. MPPT was found to be both safe and easy to administer. It may be of value in treating patients with SLE whose disease is not controlled by moderate doses of corticosteroids and may also enable the dose of maintenance corticosteroids to be reduced appreciably.

Female↗

Studies on autoantibodies to poly (adenosine diphosphate-ribose) in SLE and other autoimmune diseases.

Sera from 41 patients with systemic lupus erythematosus (SLE), 87 controls with various diseases, and 30 normal subjects were examined for poly (adenosine diphosphate-ribose) and ds DNA binding. Elevated levels of poly (ADP-ribose) binding were found in 73% of the SLE patients compared with 58% who had raised ds DNA binding. In a further study of 160 sera from 27 patients with SLE, levels of antipoly (ADP-ribose) antibodies were shown to correlate with clinical activity better than either anti-ds DNA or ss DNA antibodies.

Adult↗

Inhibition of proliferative and suppressor responses in the autologous mixed lymphocyte reaction by serum from patients with systemic lupus erythematosus.

Serum from patients with systemic lupus erythematosus (SLE) prevents the proliferative response of normal T cells when stimulated by autologous or allogeneic non-T cells. The abrogation of proliferation in an autologous mixed lymphocyte reaction (AMLR) with SLE serum is associated with a lack of suppressor T cell generation. Fractionation of SLE sera on sucrose gradients reveals an 18-12 S peak of Raji cell binding material. Fractions with an S value of </=12 S show inhibitory activity in an AMLR.

Adult↗

Haematological aspects of systemic lupus erythematosus: a reappraisal using automated methods.

Twenty-two haematological parameters were measured in 30 patients with systemic lupus erythematosus (SLE) at 110 patient attendances. Using a 10,000 cells per sample automated differential counter, the major abnormalities demonstrated were: lymphopenia, monocytopenia, eosinophilopenia (each of which showed strong correlation with steroid therapy) and increased numbers of cells of high peroxidase activity. Despite the common lymphocytopenia elevation of large unstained cells was noted in 20% of patients. However, no patient with severe disease had a lymphocyte count above 1.9 X 10(9)/l or a haemoglobin above 11.7 g/dl.

Basophils↗

Insensitivity to interferon of NK cells from patients with systemic lupus erythematosus.

Natural cytotoxicity (NK) by fresh E-rosette-negative (ER-) cells from normal donors was increased after overnight incubation with purified IFN alpha and with supernatants containing IFN gamma. ER- cells from 61% of 23 patients with systemic lupus erythematosus did not show increased cytotoxicity after treatment with IFN alpha. Similarly, ER- cells from nine of 18 patients that were treated with IFN gamma-containing supernatants failed to show increased cytotoxicity. The patients who did not show enhanced cytotoxic responses to IFN had higher mean indices of disease activity than responding patients.

Adult↗

Useful laboratory measurements in the management of systemic lupus erythematosus.

Thirty-five patients with systemic lupus erythematosus (SLE) have been monitored clinically and serologically for up to three and a half years. The data collected was analysed by computer using the Statistical Package for the Social Sciences Program. The patients were categorized into severely active, moderately active and inactive disease groups and associations between clinical state and laboratory tests were sought. No single test was found to distinguish, reliably, the clinical groups but levels of circulating immune complexes (by polyethylene glycol precipitation), platelet count and ESR were shown to distinguish inactive from active disease (p less than 0.05). Severely active disease was distinguished from the less active forms by circulating immune complex levels (Clq solid phase assay) double-stranded DNA binding, lymphocyte count, and CH50 estimations (p less than 0.05). Tests were found to differ considerably in their ability to reflect disease activity when patients were separated into sub-groups according to the major clinical features (eg. arthralgia, renal disease and vasculitic rash). However, those patients with cerebral manifestations and thrombocytopenia proved to be the most difficult to assess. Discriminant function analysis showed that a maximum of 44 per cent of cases could be correctly classified into their clinical grades when combinations of four out of five laboratory tests were used. These results emphasise the continuing need for better tests to monitor the course of SLE.

Adolescent↗

Kinetics of specific anti-influenza antibody production by cultured lymphocytes from patients with systemic lupus erythematosus following influenza immunization.

Specific antibody responses to influenza viral antigens produced by cultured peripheral blood mononuclear leucocytes stimulated with influenza virus or pokeweed mitogen (PWM) have been measured in seven patients with systemic lupus erythematosus (SLE) before and at time intervals after influenza immunization. Cells from two patients stimulated with influenza virus in vitro produced high levels of specific antibody 7 days after immunization. Cells from a third patient produced small amounts of specific antibody at day 14. No antibody was produced by cells from the remaining four patients. Responses were of short duration and were not detectable 1 month after immunization. Specific anti-influenza antibody was induced by PWM only from cells of those patients who responded to virus antigen although absolute levels of antibody produced were not as high. In six patients serum haemagglutination inhibiting antibody to influenza virus was measured, and all six had a greater than four-fold increase. The disparity between in vitro antibody production by peripheral blood mononuclear leucocytes and changes in serum antibody suggests that in patients with systemic lupus erythematosus, in vitro functions of peripheral blood lymphocytes do not reflect the immune system as a whole.

Antibodies, Viral↗

Cyclosporin A for the treatment of systemic lupus erythematosus.

Cyclosporin A (CyA) was given to five patients with active systemic lupus erythematosus (SLE) at a dose of 10 mg/kg/day orally. No patient was able to take the drug for longer than seven weeks because of side effects including nephrotoxicity. Angio-oedema was noted in three patients and serum C1 esterase inhibitor levels were shown to be depressed in four out of five patients whilst taking CyA. Two patients did experience an improvement in their arthralgia but given the side effects induced we cannot, at present, recommend CyA for the treatment of SLE.

Adult↗

Plasma exchange in systemic lupus erythematosus.

Eight out of 10 patients studied longitudinally received benefit from plasmapheresis. The patients were used as their own controls, being treated in a steady state as far as was possible. Levels of circulating complexes did not bear a close relationship with clinical results. On the evidence plasma exchange alone does not appear to represent an important part of the long-term management of patients with systemic lupus erythematosus but may well be of value in combination with other therapy.

Adult↗