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Biomedical subjects

M Viander

Publications and source records attributed to M Viander.

At least 19 recordsLinked to original sources

Stability of Candida albicans allergens during storage.

Stability of Candida albicans allergens was studied under various storage conditions. Lyophilized extract was reconstituted with human serum albumin (NSA) diluent, glycerol-free and in the presence of 10% or 50% glycerol and stored at various temperatures for different time periods. All extracts were tested at the same time with immunoblotting using C. albicans allergic patient sera and galactosidase-labelled anti-IgE. The highest number of detected allergens in the immunoblotting pattern was found in the presence of 50% glycerol at +6 degrees C. The most important allergen of C. albicans, the 46 kD protein allergen was stable up to 10 weeks at +6 degrees C in the presence of 50% glycerol but thereafter began to lose its IgE-binding capacity. After 30 weeks more than 50% of the IgE binding had disappeared. The 27 kD protein, another important allergen, was also labile but retained the allergenicity better than the 46 kD one. The 29 kD protein allergen was stable at all storage conditions, except +37 degrees C tested even after one year. More than 6 months storage at +6 degrees C or higher temperature is, however, unacceptable even in the presence of the 50% glycerol. These findings have particular importance in the diagnosis and treatment of allergic diseases.

Allergens

Rheumatic complaints as a presenting symptom in patients with coeliac disease.

Twenty-three cases of coeliac disease were found after a small bowel biopsy had been carried out on seventy patients with various rheumatic complaints. The prevalence of coeliac disease in patients with rheumatic disorders was estimated to be 1 in 243. The majority (19) of these cases were found by screening patient sera with a reticulin antibody test. Sjögren's syndrome was the most frequent rheumatic diagnosis, with a total of six cases. Coeliac disease may occur concomitantly with various rheumatic complaints, and serological screening is advisable.

Adult

Serological markers and HLA genes among healthy first-degree relatives of patients with coeliac disease.

Coeliac disease may remain undiagnosed because of the non-specific nature of the presenting symptoms. Several antibody tests are claimed as markers for this condition but a direct comparison of the available tests has not been reported. The probands and healthy first-degree relatives of 42 families with coeliac disease were studied. Histological examination of biopsy specimens revealed jejunal mucosal villous atrophy compatible with coeliac disease in 13 of 122 relatives. Reticulin-antibody-positive relatives with or without jejunal mucosal atrophy were genetically similar to the probands of the families (DR3 gene frequencies 55.3%-60.0%). Gliadin-antibody-positive relatives with normal mucosa were genetically different from the probands (DR3 gene frequency 16.7% versus 55.3%). IgA reticulin and endomysium antibodies detected 92.3% of subjects with silent coeliac disease. The only case that was missed had selective IgA deficiency and was positive for IgG-class reticulin antibodies. By contrast, gliadin antibodies detected only half of the cases. Follow-up of the 7 reticulin-antibody-positive relatives with normal mucosa revealed 2 further cases of coeliac disease and 1 of dermatitis herpetiformis during the next three years. Our family study shows that healthy reticulin-antibody-positive first-degree relatives of coeliac disease patients, irrespective of the state of the jejunal mucosa, are genetically similar to known coeliac disease patients. Reticulin-antibody positivity is an indicator of both silent and latent coeliac disease.

Antibodies

Use of the extended Phadebas RAST panel in the diagnosis of mould allergy in asthmatic children.

The clinical significance of mould allergens in Phadebas RAST panel was investigated in 121 asthmatic children. They were selected from a total population of 1649 patients. The patients were distributed into four groups, based on the combination of positive or negative skin prick tests (SPT) together with symptoms suggestive or not of mould sensitivity. Mould-specific IgE antibodies were investigated using the original RAST panel (Alternaria, Aspergillus, Candida, Cladosporium, Mucor and Penicillium) and a set of 10 additional mould-allergen discs (Aureobasidium, Botrytis, Curvularia, Epicoccum, Fusarium, Helminthosporium, Phoma, Rhizopus, Stemphylium and Trichoderma). The set of additional RAST discs revealed patients with mould-reaginic antibodies not found with the original RAST panel. This occurred in four of 49 (8.2%) RAST positive (class greater than or equal to 2) patients. The allergens most frequently positive were Cladosporium (in 28% of the patients), Candida (28%) and Helminthosporium (26%). A remarkable degree of simultaneous reactivity to almost all moulds tested was observed. Patients with multiple (greater than or equal to 7) mould sensitization were effectively pinpointed using any duplicate combination of Aureobasidium, Botrytis, Candida, Cladosporium, Helminthosporium, Penicillium and Stemphylium.

Adolescent

IgE, IgA and IgG antibodies and delayed skin response towards Candida albicans antigens in atopics with and without saprophytic growth.

Immunoblotting and RAST were used to analyse IgE, IgA and IgG responses to antigens of Candida albicans. These were compared with the delayed skin response and C. albicans carriage in 40 atopic subjects. The majority of the atopic patients showed a strong IgG and IgA antibody response towards mannan, a carbohydrate, but only occasionally to proteins. Altogether 22 of the 40 patients showed specific IgE towards C. albicans by immunoblotting. The IgE response was mainly towards proteins, particularly to ones with molecular weights of 29 kD and 46 kD, and only in eight out of 22 IgE-positive subjects towards mannan. The IgG and IgA responses to mannan and the total IgE response towards C. albicans assessed by RAST showed an association with C. albicans carriage, whereas the delayed skin response showed an inverse relationship. The immunological parameters characteristic of C. albicans carriage were found to be C. albicans-specific depressed delayed skin response and elevated IgE, IgA and IgG responses. This situation in the atopics presenting such parameters may favour simultaneous sensitization and exposure by colonization. The degree of sensitization may be sufficiently high to produce symptomatic allergy, such as asthma, in some individuals during occasional overgrowth of C. albicans, e.g. due to antibiotic therapy.

Adolescent

Immunoblotting analysis of concanavalin A-isolated allergens of Candida albicans.

The carbohydrate-containing fraction of Candida albicans was isolated from the crude extract with ConA Sepharose affinity chromatography and studied by IgE-immunoblotting with individual and pooled sera from C. albicans-allergic subjects. In the ConA-bound fraction there was a diffuse IgE binding in the high molecular weight area which also gave a carbohydrate stain (PAS). A distinct band corresponding to a molecular weight of 70 kD bound specific IgE antibodies. This glycoprotein, presumably a mannoprotein, gave a weak carbohydrate staining and a strong protein staining. Further biochemical studies are needed to reveal the exact nature of the epitopes in the ConA-bound mannose-containing fraction of C. albicans.

Allergens

Distribution of watersoluble antigens and allergens of Candida albicans in blastospore cell extract fractions.

Watersoluble antigens of Candida albicans were sequentially extracted from intact and disrupted yeast cells grown on protein-free agar, and analysed on immunoblots after SDS-PAGE. Washing of the cells in saline before proper extraction resulted in loss of 47.2% of the total carbohydrate and 1.5% of the total protein. The protein fraction contained 14 antigenic bands when analysed with hyperimmune rabbit antisera. Four of these bound IgE when probed with a RAST-positive serum pool and beta-galactosidase-labelled anti-IgE. Extraction of the disrupted cells resulted in 15% of the total carbohydrate and 94% of the total protein. The cytoplasmic protein fraction showed 69 antigenic bands, 13 of which bound IgE. The carbohydrate fraction contained mannan, which was found in the washing solutions and in the surface extract as well as in the cytoplasmic extract. Allergens found in washing solutions were also present in cytoplasmic fraction. This study suggests that the rapid release of allergens from saprophytic C. albicans cells on mucous membranes of the body may cause continuous exposure and result in sensitization.

Allergens

IgE-, IgA- and IgG-antibody responses to carbohydrate and protein antigens of Candida albicans in asthmatic children.

Analysis of IgE, IgA and IgG antibodies directed against Candida albicans antigens in 28 asthmatic children was performed with immunoblotting after SDS-PAGE. Analysis with the purified cytoplasmic protein fraction revealed a major protein allergen with an MW of 46 kD. In addition to the major allergen, 15 other antigenic bands with molecular weights between 16 and 135 kD bound IgE. Ten of 13 anti-C. albicans IgE-positive children had IgE towards the 46 kD major allergen. None of the subjects in the study group or in the non-atopic controls had IgA or IgG antibodies towards this protein. Analysis of the crude surface extract showed that mannan, a carbohydrate, was an intermediate allergen contrary to being the major antigen in IgA and IgG antibody responses.

Adolescent

Atypical coeliac disease found with serologic screening.

Eighteen patients with coeliac disease were found by screening for reticulin antibodies of unselected sera at the time when determination of various tissue antibodies was requested. Joint disease, allergic and pulmonary disorders, and diabetes were particularly observed. IgA class reticulin antibody, in particular, proved to be specific for coeliac disease. Most patients with coeliac disease also had positive serum gliadin antibodies. Abdominal symptoms and signs of malabsorption were slight and infrequent. In most patients a gluten-free diet resulted in the improvement of jejunal mucosal histology, and serum reticulum and gliadin antibody titres decreased simultaneously, reflecting the appropriateness of the diet. Coeliac disease often has mild and atypical symptoms, and, particularly in certain disease groups, screening with reticulin antibody test seems to be appropriate.

Adult

Circulating immune complexes during immunotherapy in allergy to dog.

Circulating immune complexes (CIC) were determined from dog-allergic asthmatic children (n = 35) receiving immunotherapy with dog dander and hair extract. The results from CIC are expressed in SDU (standard deviation units) and presented as follows: pretreatment results (n = 20), rush results (n = 11), mid-schedule results (n = 20), maintenance results (n = 15) and the results of the placebo-treated group (n = 12). The results of the placebo-treated group (n = 12) and those of the untreated atopic (n = 12) and non-atopic (n = 14) were controls. CIC levels were analysed by means of KgB-ELISA (conglutinin binding enzyme linked immunosorbent assay), C1qB-ELISA (C1q-binding enzyme linked immunososrbent assay), RFb-ELISA (rheumatoid factor binding enzyme linked immunosorbent assay) and by PIPA (platelet 125J-labelled staphylococcal protein-A test). The CIC level determined by KgB-ELISA in dog-allergic asthmatic children was higher than that of the atopic controls (P less than 0.05) already before the onset of the hyposensitization. During conventional hyposensitization with dog dander and hair the CIC level remained the same as before treatment. On day 5 of rush hyposensitization the mean level of CIC showed no increase when compared with the pretreatment values. A statistically significant correlation (P less than 0.01) was observed between the dog dander and hair-specific IgG antibodies and the CIC level measured by KgB-ELISA during the maintenance period of conventional immunotherapy. The samples of sera to measure this correlation were collected before the injection of allergen and after 2 weeks of injection during maintenance treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Postpubertal gluten challenge in coeliac disease.

Altogether 38 postpubertal children with coeliac disease were rebiopsied. Mucosal abnormality in nine (24%) of them indicated poor adherence to the diet. Gluten challenge with a diet containing a normal amount of gluten was performed in those 29 patients with a normal mucosa. During challenge, rebiopsy was done when reticulin antibodies turned positive (mean 0.6 years, range 0.2-2.0) or at the end of the two year study. Histologically a clear relapse into coeliac disease was seen in all 23 patients who were positive for reticulin antibodies. At this time gliadin antibodies were positive in all but two. Sixteen (70%) of those who relapsed were completely asymptomatic. Three girls and one boy did not relapse within two years, indicating the possible recovery from coeliac disease to be 11%. All four had undergone gluten challenge earlier in childhood, after initial diagnosis and mucosal recovery, and this had resulted in mucosal relapse. To establish definite postpubertal recovery from coeliac disease in cases with normal mucosa at two years from challenge, further follow up studies of reticulin antibodies and later rebiopsy are needed. The reticulin antibody test seems to be suitable for prediction of mucosal relapse in coeliac disease.

Adolescent

Allergenic variability of different strains of Candida albicans.

The allergenic variation of six Candida albicans strains was studied by immunoblotting with pooled sera from 20 C. albicans-RAST-positive subjects. The presence of a 46-kilodalton (kD) protein, the major allergen, and a 29-kD protein, an intermediate allergen, was shown in crude extracts from disrupted cells (six strains). There was a significant variation in the content of the major C. albicans allergen (46 kD) between the different strains. Surface extracts of all six C. albicans strains contained mannan. Immunoblotting of cell wall extracts of intact C. albicans (agar plate) of different age revealed the strongest IgE binding in cultures incubated for 36-50 h. Due to the varying proportions of allergens demonstrated in the different strains of C. albicans, the starting source material for extract production should be a pool of individual strains, which all should be analysed prior to pooling. Special attention should be paid to the selection of C. albicans strains, and a parameter such as the breakability of the strain should be considered.

Allergens

Circulating antibodies and immune complexes in oral mucosal diseases.

This paper reviews the use of measurement of circulating auto-antibodies and antibodies to food proteins, and of circulating immune complexes (CIC) for diagnosis of various systemic diseases with oral involvement. Results of a study of 29 patients suffering from chronic oral mucosal disease, in which such methods were applied are reported. Auto-antibodies against epithelial intercellular substance (AICSA) were found in three patients, two of whom had pemphigus. Only one of the two patients diagnosed as having pemphigoid had circulating antibodies to basement membrane zone (ABMZA). Auto-antibodies to reticulin (IgA-ARA) were found in one patient in whom a diagnosis of coeliac disease (CD) was confirmed by intestinal biopsy. In addition to the patient with CD, another patient had IgA class antibodies against gliadin (IgA-AGA). IgG-AGA were found in five other patients, in one of whom dermatitis herpetiformis (DH) was diagnosed. Antibodies to cow's milk (ACMA) were detected in 10 patients and CIC in 4 patients. Case reports are given to illustrate the important role of antibody determination coupled with histopathological and immunofluorescence examination of tissue biopsy material in the diagnosis of serious oral disease.

Adolescent

PUVA treatment of nickel contact dermatitis: effect on dermatitis, patch test sensitivity, and lymphocyte transformation reactivity.

Five females with nickel contact allergy and longstanding hand dermatitis were treated with oral methoxsalen and a series of whole-body UVA irradiations with a cumulative UVA dose of 30 to 58 J/cm2. Lymphocyte stimulation to nickel sulphate was determined prior to PUVA therapy, and monitored during the treatment and at 1 year after treatment. In 4 patients the cutaneous threshold to nickel sulphate patch testing was determined immediately post-PUVA and at 1 year. In all cases, the dermatosis cleared during the PUVA treatment. In 2 patients the immediate post-PUVA skin nickel reactivity was low compared with the 1-year follow-up value, while in 2 patients a progressive diminution of the skin reactivity was noticed. One patient was in clinical remission and had negative skin test at 1-year follow-up. In spite of diminished cutaneous sensitivity and/or clinical remission, the sensitivity of blood lymphocytes to nickel was approximately the same or increased, as determined by the lymphocyte transformation test. Thus no evidence was found to indicate that systemic, nickel-specific suppressive immune regulative mechanisms would have been activated by the treatment.

Adult

Kawasaki disease: monitoring of circulating immune complexes.

We followed the levels of circulating immune complexes (CIC) in 27 patients with Kawasaki disease (KD) from the acute stage of the disease through convalescence, using the test for platelet-reactive IgG-IC, and C1q-binding and conglutinin-binding enzyme immunoassays. CIC were detected by one or more techniques in all but one patient. Positive results were obtained most often with the test for platelet-reactive IgG-IC. Measurement of complement components C3 and C4 in 14 patients revealed an increase in C3 levels during the first few weeks of the disease and normal levels of C4. The blood platelet count correlated directly with the level of platelet-reactive IgG-IC. The highest levels of CIC were found during weeks 3 through 7 after the onset of disease. Measurement of CIC is, however, not applicable to the clinical follow-up of patients with KD.

Antigen-Antibody Complex

Allergenic cross-reactivity of yeasts.

Yeast allergen extracts of Candida albicans, C. pseudotropicalis, C. krusei, C. parapsilosis, C. tropicalis, C. guilliermondi, C. humicola, C. norwegica, C. utilis, Cryptococcus albidus, Geotrichum candidum, Pityrosporon pachydermatis, P. ovale, Rhodotorula minuta, R. rubra, Saccharomyces cerevisiae, Torulopsis glabrata and Trichosporon cutaneum were investigated regarding their common allergenic properties. The enzyme immunoassay (EIA) using rabbit anti-Candida albicans antiserum showed remarkable immunological cross-reactivity only between the Candida species. However, there was a significant multiple sensitivity to the extracts of C. albicans, C. utilis, Cr. albidus, R. rubra and S. cerevisiae in skin prick testing in atopic patients, suggesting the possible presence of one or more common skin reactive allergens.

Allergens

Relationship of immediate and delayed hypersensitivity to nasopharyngeal and intestinal growth of Candida albicans in allergic subjects.

The growth of C. albicans yeast in the nasopharynx and in the anus as well as allergy symptoms were followed up for 8 months in 67 patients with bronchial asthma, allergic rhinitis and/or atopic eczema. 38 of the patients were skin prick test positive and 29 negative to C. albicans allergen extract. 32 of the patients had positive and 19 negative delayed skin reactions. The nasal, bronchial and skin symptoms of the yeast-sensitive allergic patients were not associated with the nasopharyngeal nor anal occurrence of C. albicans or other yeasts. The use of nasal or inhaled steroids had no effect on the occurrence of Candida in the nasopharynx. It was observed that immediate skin sensitivity had a positive correlation and the delayed sensitivity a negative correlation with the occurrence of C. albicans growth in nasopharynx and anus. These findings are in agreement with the concept that impaired cell-mediated immunity to C. albicans may lead to increased IgE response. This may explain the increased liability towards C. albicans nasopharyngeal and gastrointestinal "saprophytic" growth.

Adult