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Biomedical subjects

M Meurer

Publications and source records attributed to M Meurer.

At least 127 records · Page 7Linked to original sources
PubMed1990

Cyclosporin in localized and systemic scleroderma--a clinical study.

Four patients with systemic scleroderma and 1 patient with localized scleroderma were treated with ciclosporin (CS), given in daily doses between 2.2 and 5.6 mg/kg body weight for 3-26 months. Under this medication clinical improvement was observed in 4 patients with partial regression of cutaneous sclerosis and inflammation, healing of fingertip ulcerations or leg ulcers and improvement of articular mobility. However, in 1 patient with rapidly advancing systemic scleroderma a short-term therapy with CS in low doses (2-3 mg/kg body weight) resulted in arterial hypertension and renal dysfunction. Therefore careful selection of patients and close-meshed controls are indicated when CS is considered as anti-inflammatory treatment in scleroderma.

Acute Kidney Injury↗
PubMed1990

Dermatitis herpetiformis bodies. Ultrastructural study on the skin of patients using direct preembedding immunogold labeling.

Skin samples from three adult patients with dermatitis herpetiformis (DH) and granular IgA deposits in the papillary tips were studied using ultrastructural immunogold technique. IgA positive, so-called DH bodies were identified as amorphous clumps--most probably immunocomplex aggregates--scattered throughout the upper papillary dermis. Dermatitis herpetiformis bodies were seen underneath the basement membrane, sometimes along microfibrillar bundles, as well as adjacent to the papillary collagen fibers and within the surface (microfibrillar) region of elastic tissue. Some DH bodies, however, were not related to any fibrillar components. The collagen and elastic fibers, microfibrillar bundles, anchoring fibrils, and elastic microfibrils themselves were unlabeled. Dermatitis herpetiformis bodies were not found in normal human skin. The results of our ultrastructural study indicate that DH bodies either are bound to a nonfibrillar component of dermal connective tissue or represent deposits of immune complexes trapped in DH skin.

Actin Cytoskeleton↗
PubMed1990

[Pulmonary manifestation of progressive systemic scleroderma: prognostic value of centromere antibodies and antibodies to Scl-70 nucleoprotein].

We examined 74 patients with systemic sclerosis. 21 of them (= 28%) had Scl-70 antibodies in their blood serum and 12 (= 16%) were anticentromere antibody positive, whereas in 41 cases (= 56%) none of these antibodies could be detected. In patients with Scl-70 antibodies lung function tests showed a decrease in vital capacity (p less than 0.05), total capacity (p less than 0.01), and diffusing capacity (p greater than 0.05/n.s.) as compared to ACA-positive patients. A limitation of pulmonary function was seen in 76% of Scl-70-positive patients, in 44% of antibody-negative patients, and in only 33% in the ACA-positive group. A disabling respiratory limitation was found in 14% of Scl-70-positive patients, and in 7% of antibody-negative patients, whereas none of the ACA-positive patients had a higher degree of respiratory insufficiency. We conclude that pulmonary involvement in systemic sclerosis is most frequent and severe in patients with Scl-70 antibodies; it is relatively rare and of minor severity in ACA-positive patients. Antibody-negative patients are in between these extremes.

Adolescent↗
PubMed1989

[Sweet syndrome in chronic myeloid leukemia].

A 31-year-old woman with chronic myeloid leukemia developed bullous skin changes not responding to antibiotic therapy. A biopsy showed a sterile predominantly neutrophilic infiltrate consistent with Sweet's syndrome. These skin changes responded well to methylprednisolon. Seven months later the patient died in a blast crisis.

Adult↗
PubMed1989

Centromeric association of a microchromosome. A new category of non-random arrangement of metaphase chromosomes.

A supernumerary microchromosome measuring 0.5-1 microns found in over half of the metaphases of a CREST scleroderma patient and his daughter has been characterized by various cytogenetic techniques. The microchromosome consisted of constitutive heterochromatin and contained nuclear antigens reacting with specific anti-kinetochore antibodies. The most remarkable property of the microchromosome was its non-random position: it was closely associated with the centromere of any of the normal chromosomes in the majority of the metaphases. Furthermore, an inordinately high rate of Y chromosome aneuploidy was found in the CREST scleroderma patient. The origin and structure of the microchromosome, its possible connection with the CREST variant of scleroderma, and the phenomenon of centromeric association are discussed.

Aged↗
PubMed1989

Soluble Il-2 receptor serum levels--a marker for disease progression in patients with HIV-1 infection.

Serum levels of soluble Il-2 receptors (sIl-2R) were measured in 88 patients with HIV infection, 28 patients from high-risk groups, and 28 normal donors. Elevated sIl-2R levels were found in 46% of asymptomatic seropositive patients, in 68% of patients with persistent generalized lymphadenopathy, and in 81% of patients with AIDS. Mean sIl-2R values increased with the progression of the disease and were most pronounced in patients with AIDS. A close correlation was found between sIl-2R levels and beta2-microglobulin (p less than 0.0001) and other prognostic parameters known to parallel clinical activity. In addition to being a valuable parameter in monitoring the course of the HIV infection, elevated sIl-2R levels may also be involved in the down-regulation of Il-2-dependent immune functions in AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Antibodies to Ro/SSA detected by ELISA: correlation with clinical features in systemic scleroderma.

Anti-Ro/SSA antibodies were determined by a newly developed enzyme-linked immunosorbent assay in serum specimens from 114 patients with systemic scleroderma in order to examine the relationship between Ro/SSA antibodies and clinical subsets of scleroderma. Sera of 42 patients (37%) were positive for Ro/SSA antibodies. Clinical investigations, including Schirmer's test and enzymatic profiles, demonstrated that 60% (16 of 27) of scleroderma patients with sicca syndrome and 63% (10 of 16) with polymyositis (PM) were Ro/SSA positive. In these patients there was a significant association between Ro/SSA antibodies and rheumatoid factor. HLA-antigens DR2, DR3 and B8 showed an increased frequency in anti-Ro/SSA positive patients.

Antibodies, Antinuclear↗
PubMed1989

[Spectrum of antinuclear and anti-cytoplasmic antibodies in dermatomyositis and polymyositis overlap syndromes].

Antinuclear antibodies (ANA) of the IgG class were detected in 60% of patients with dermatomyositis. Only in 16% could we demonstrate precipitating antibodies against the nuclear Mi-2 antigen. These antibodies are considered to be serological markers of dermatomyositis. The ANA spectrum in polymyositis-overlap syndrome was considerably more heterogeneous: patients with polymyositis/progressive systemic scleroderma overlap had antibodies against the nucleolar PM-Scl antigen or the nuclear Ku antigen. Cytoplasmic antibodies to Jo-1 were present in polymyositis associated with Sjögren's syndrome and pulmonary fibrosis. Antibodies against ribosomal ribonucleoprotein were found in polymyositis with systemic lupus erythematosus and antibodies to nuclear ribonucleoprotein in polymyositis associated with mixed connective tissue disease. The investigation demonstrates that the characterization of ANA specificities helps to differentiate between dermatomyositis and distinct forms of polymyositis-overlap syndrome.

Adult↗
PubMed1988

[Virus-specific antibody profile in various stages of HIV-1 infection. Western blot analysis of 170 patients].

The western blot analysis of 170 patients with HIV-1-infection demonstrated that 47% of the patients in latent stage, 58% of the patients with lymphadenopathy-syndrome and only 25% of the patients with the full-blown picture of AIDS showed the complete pattern of HIV-specific antibody response. This antibody response is mainly directed against the env-encoded envelope proteins gp160, gp120 and gp41, against the gag-encoded core proteins p55, p24 and p17 as well as against the pol-encoded enzymatic proteins p66, p51 and p31. Antibodies against gp160 and gp120 were present in nearly all patients, whereas the prevalence of the other antibodies decreased with the stage of the disease. Statistical significant differences were found particularly between patients with LAS or AIDS respectively. Antibodies against p17 were detected in 74% of the patients with LAS but only in 25% of the patients with AIDS. The lack of antibodies against p17, p24 or p51 was significantly associated with lower mean CD4/CD8-ratios (p less than 0.007) and higher mean serum levels of IgA (p less than 0.001) and beta-2-microglobulin (p less than 0.001). One third of the patients with LAS and this reduced pattern of antibody response developed AIDS within six months. These results demonstrate that the detection of antibodies against p17, p24 or p51 is of prognostic importance. A serological profile which lacks the antibody response against at least two of those three viral antigens indicates a progression of the disease activity.

AIDS-Related Complex↗
PubMed1988

Systemic scleroderma. Clinical and pathophysiologic aspects.

Systemic scleroderma is a generalized disease of connective tissue involving mainly the skin, the gastrointestinal tract, the lungs, the heart, and the kidneys. It can be present in different forms, of which acroscleroderma, with limited cutaneous and extracutaneous involvement, and diffuse scleroderma within a more rapid progression are most characteristic. Circulating antibodies against antinucleolar antigens are present in most patients with systemic scleroderma. They are helpful for establishing a classification and for determining the prognosis of the disease; their involvement in the pathogenesis, however, is still unclear. Alterations of the blood vessels and induction of fibroblasts by potent mediators are thought to play an important role in the early phase of scleroderma. Therefore early diagnosis is required, which then can initiate vasoactive therapy. In patients with systemic scleroderma, who also suffer from additional myositis, interstitial lung diseases, or arthritis, anti-inflammatory treatment with prednisolone and azathioprine is suggested. Development and progression of fibrosis cannot yet be influenced sufficiently. Only D-penicillamine affecting cross-linking of collagen has been widely used in scleroderma and has some beneficial effect.

Anti-Inflammatory Agents↗
PubMed1988

T4/T8 ratio and absolute T4 cell numbers in different clinical stages of Kaposi's sarcoma in AIDS.

Thirty-seven men (36 homosexual or bisexual and one heterosexual) with epidemic Kaposi's sarcoma and underlying HIV infection were followed up over a period of up to 32 months. Fourteen patients (38%) died, with a median survival time of 7.2 months after the diagnosis of AIDS. Seventeen patients (46%) presented with one or more opportunistic infections, mostly Pneumocystis carinii pneumonia. Eighteen patients (49%) had lymphadenopathy syndrome according to the definition of the CDC. Using the Laubenstein-classification of Kaposi's sarcoma, all patients either remained stable or deteriorated, improvement was never observed. Absolute T4 lymphocyte counts and the T4/T8 ratio were not related to the disease stage. With the onset of B symptoms (systemic symptoms), however, the absolute T4 numbers and the T4/T8 ratio markedly decreased. Delayed type hypersensitivity also showed no relationship to the clinical stages of Kaposi's sarcoma. Thus, the clinical progression of Kaposi's sarcoma lesions seems to be largely independent of the immunological parameters investigated. However, the onset of B symptoms was observed to be related to changes in immune status.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Efficiency of acitretin in the treatment of cutaneous lupus erythematosus.

Acitretin (etretin [Ro-10-1670]) is the major metabolite of etretinate with a much shorter elimination half-life. The drug was used in the treatment of 20 patients who had cutaneous lupus erythematosus. All patients responded to treatment, but in five, the result was unsatisfactory. In 15 patients, an excellent (total clearing) or good response (marked reduction of all lesions) was seen. In seven of them, acitretin was superior to previous therapy with antimalarials and/or systemic corticosteroids. In particular, five of six patients with subacute cutaneous lupus erythematosus showed complete clearing of their lesions, usually within two to four weeks. Side effects were the same as with etretinate. It is concluded that acitretin is a highly effective and well-tolerated drug in the treatment of cutaneous lupus erythematosus.

Acitretin↗
PubMed1988

[Prognostic significance of antibodies to HIV nuclear proteins in patients with the lymphadenopathy syndrome].

A total of 219 sera from HIV-infected patients were tested by a competitive immunoassay for the presence of antibodies to env and core protein. Whereas antibodies to the HIV envelope protein (gp41) were detected in all patients, only 84% of the patients with latent infection, 73% of the patients with LAS and 48% of the patients with AIDS had antibodies to the core protein (p 24). The prognostic importance of the decline of antibody reactivity to HIV core protein was further investigated in patients with lymphadenopathy syndrome or AIDS-related complex and correlated with other serological and immunological parameters. In those patients with no detectable anti-core reactivity, we found more frequently pathological and significantly higher serum levels of beta-2-microglobulin and IgA, but significantly lower numbers of leucocytes and lymphocytes and T4/T8 ratio than in patients with both gp41 env and p24 core antibodies. These results demonstrate that the determination of antibodies to HIV core proteins in sera of HIV-infected patients, especially with lymphadenopathy syndrome or AIDS-related complex, appears to be of great value for monitoring prognosis and disease activity.

AIDS-Related Complex↗
PubMed1988

[Allergic vasculitis caused by food allergy].

In two patients with leukocytoclastic vasculitis allergic reactions to foods were shown to be of clinical relevance. Intracutaneous tests with food allergens produced not only immediate wheal and flare reactions but also distinct inflammatory reactions after 8-24 h, which showed the histological and immunopathological characteristics of leukocytoclastic vasculitis. After controlled oral provocation with specific foods exacerbation of petechial lesions was observed. A striking improvement in the patients' condition was achieved by avoidance of the relevant foods and oral administration of cromoglycate.

Adult↗
PubMed1988

Levels of type IV collagen and laminin fragments in serum from patients with progressive systemic sclerosis.

Sera from patients with progressive systemic sclerosis (PSS) were studied using immuno-assays for laminin P1 fragment and the carboxyterminal NC1 domain from type IV collagen. Compared to healthy controls, patients with PSS showed elevated serum levels of both fragments derived from basement membrane proteins. However, there was no difference when patients with and without Raynaud's phenomenon were compared and no correlation could be established with the activity of the disease or clinically defined types of scleroderma. Our data indicate that the metabolism of basement membrane proteins is involved in the course of scleroderma; however, it remains questionable whether these assays could become useful as diagnostic or prognostic tools.

Collagen↗
PubMed1987

[Subacute cutaneous lupus erythematosus: clinical aspects, immunology and therapy].

Subacute cutaneous lupus erythematosus (SCLE) is a distinct subset of cutaneous lupus erythematosus which is defined by clinical and immunological characteristics. With regard to clinical expression and prognosis, SCLE assumes an intermediate position within the spectrum of LE between purely cutaneous discoid and systemic lupus erythematosus. The main clinical characteristics of SCLE are extensive papulosquamous or anular lesions and photosensitivity. The disease is frequently associated with Sjögren's syndrome and systemic symptoms, mainly arthralgia. Renal involvement is, however, rare. Circulating Ro-antibodies represent the main autoimmune phenomenon. An immunogenetic disposition to develop SCLE is evidenced by the detection of the HLA-B8, DR3-phenotype in a large proportion of patients. Drug therapy comprises primarily glucocorticosteroids and antimalarials, but retinoids have recently also proved highly effective.

Adolescent↗