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Biomedical subjects

P Monteyne

Publications and source records attributed to P Monteyne.

30 records · Page 2Linked to original sources
PubMed1996

The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis.

As effective therapies for the treatment of herpes simplex encephalitis (HSE) have become available, the virology laboratory has acquired a role of primary importance in the early diagnosis and clinical management of this condition. Several studies have shown that the polymerase chain reaction (PCR) of CSF for the detection of herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) DNA provides a reliable method for determining an aetiological diagnosis of HSE. The use of PCR in combination with the detection of a specific intrathecal antibody response to HSV currently represents the most reliable strategy for the diagnosis and monitoring of the treatment of adult patients with HSE. The use of these techniques has also led to the identification of atypical presentations of HSV infections of the nervous system and permits the investigation of patients who develop a relapse of encephalitic illness after an initial episode of HSE. A strategy for the optimal use of the investigative laboratory in the diagnosis of HSE and subsequent management decisions is described.

Acyclovir↗
PubMed1996

The anti-Hu syndrome: a clinical and immunological study of 7 cases.

The authors describe the clinical and biological data of seven patients with anti-Hu antibodies. Six of them displayed a small cell lung carcinoma (SCLC), but no cancer was detected in the 7th patient in spite of an extensive workup. The clinical heterogeneity of the anti-Hu syndrome is emphasized. The major symptoms were linked to a severe sensory neuropathy in three cases, to cerebellitis in two cases, to dysautonomia in one case, and to gastro-intestinal pseudo-obstruction in one case. One patient also displayed EMG abnormalities characteristic of the Lambert-Eaton myasthenic syndrome. Two patients developed opsoclonus or ocular flutter associated with severe confusion in the late stage of their disease. In four patients, the neurological signs and symptoms preceded the discovery of the SCLC, and in two cases the initial detection of anti-Hu antibodies prompted the successful search for this tumor. Immunopathological events injuring the peripheral and central nervous system are briefly discussed.

Aged↗
PubMed1995

The diagnosis of tuberculous meningitis.

The incidence of tuberculosis (TB) is expected to increase substantially during the next 10 years as well as its extrapulmonary manifestations, often in association with the HIV panepidemic. TB meningitis displays some clinical and radiological characteristics but the "gold standard" for diagnosis remains the identification of Mycobacterium tuberculosis in the CSF by direct staining of culture. Direct staining, however, is rarely successful and culturing of M. Tuberculosis can take 4 to 8 weeks. Other techniques may be helpful, such as the detection of an intrathecal synthesis of antimycobacterial antibodies, or the detection in the CSF of the mycobacterial genome by the polymerase chain reaction (PCR). DNA amplification, and especially the "nested" amplification protocol, may represent a major step forward and find its place as a sensitive, specific and rapid test in the routine diagnostic laboratory.

Cerebrospinal Fluid↗
PubMed1994

Occurrence of oligoclonal IgM bands in the cerebrospinal fluid of neurological patients: an immunoaffinity-mediated capillary blot study.

We developed a highly sensitive and specific immunoaffinity-mediated capillary blot technique for the detection of oligoclonal IgM bands in CSF and sera from patients with various neurological disorders. Pre-treatment of the samples by dithiothreitol was necessary to obtain a migration of the IgM molecule into the gel of isoelectric focusing. IgM was then transferred by immunoaffinity onto a polyvinylidene difluoride sheet previously coated with anti-IgM antiserum. The limit of detection was found to be 6 ng in 15-microliters samples. The presence of CSF-restricted IgM bands was considered the result of an intrathecal synthesis and was observed in 13 out of 46 (28%) patients with MS, more frequently in acute relapses (9 out of 21, 43%), including 6 cases out of 13 presenting the first bout of the disease. Similar IgM bands were also detected in 15 out of 46 (38%) patients with CNS infections, especially in cases of neurosyphilis and neuroborreliosis. The presence of CSF oligoclonal IgM bands was linked to an increase of the IgM index in the MS group, but not in the group of infectious diseases as a whole. The occurrence of CSF-restricted oligoclonal IgM bands seems to be the most specific indicator of an intrathecal synthesis of this isotype.

Antibody Specificity↗
PubMed1994

Polyclonal and oligoclonal IgA synthesis in the cerebrospinal fluid of neurological patients: an immunoaffinity-mediated capillary blot study.

An intrathecal synthesis of IgA has been reported in various neurological disorders. However, the frequency of its occurrence and the electrophoretic characteristics of the locally produced IgA remained a matter of controversy. We developed a sensitive immunoaffinity-mediated capillary blot technique for the detection of polyclonal and oligoclonal IgA in the CSF of 115 patients with various neurological disorders. Paired CSF and serum samples containing 50 ng IgA after appropriate dilutions were submitted to isoelectric focusing in agarose gels; IgA was then blotted onto a polyvinylidene difluoride sheet coated by an anti-IgA antiserum or by infectious antigens. The immunoblots were revealed by an alkaline phosphatase-conjugated anti-IgA antiserum. Only five samples displayed CSF-restricted oligoclonal IgA bands, including two out of 33 from MS patients. In herpetic encephalitis (n = 5) and varicella-zoster meningitis (n = 2), a strong intrathecal production of virus-specific IgA antibodies was detectable. In such cases, faint oligoclonal IgA antibodies were superimposed on a polyclonal background. A weak local production of anti-Borrelia burgdorferi IgA antibodies was present in two out of four cases of neuroborreliosis.

Adolescent↗
PubMed1994

The intrathecal synthesis of virus-specific oligoclonal IgG in multiple sclerosis.

A highly sensitive antigen-mediated capillary blot technique was developed for the detection of virus-specific oligoclonal IgG in paired CSF and serum samples from patients with various neurological diseases. In multiple sclerosis, intrathecal synthesis of oligoclonal antibodies was present against measles (70%), rubella (60%), varicella zoster (40%) and mumps (30%); in most cases (75%), such synthesis involved two or more viruses. In contrast, antibodies against a non-neurotropic virus (cytomegalovirus) were rarely produced in CSF from MS patients (5%). However, this 'polyspecific' reaction was not restricted to MS samples but was also observed in neurolupus and in the late phase of infectious diseases of the central nervous system. These anti-viral antibodies could be produced without de novo replication of the corresponding viral genome and are likely mere bystanders of an ongoing immune response.

Central Nervous System Diseases↗
PubMed1994

Difference in neutralization between lactate dehydrogenase-elevating virus isolated from acutely and chronically infected mice.

Mouse infection with lactate dehydrogenase-elevating virus (LDV) leads to lifelong viraemia, despite the production of neutralizing antiviral antibodies. To test whether viral persistence correlated with the development of resistance to these antibodies, we compared the neutralization of viral particles derived from acutely and chronically infected animals, using polyclonal and monoclonal anti-LDV antibodies. Whereas virus isolated during acute infection was efficiently neutralized, titres of LDV from chronically infected mice were only slightly reduced by antiviral antibodies. In addition, LDV from animals acutely infected with such poorly neutralizable virus from chronically infected mice was resistant to anti-LDV antibodies like their parental viral particles. These results suggest that LDV variants capable of escaping neutralization by antiviral antibodies can emerge in chronically infected animals.

Acute Disease↗
PubMed1994

[Neuritis of the serratus anterior muscle associated with Borrelia burgdorferi infection].

A long thoracic nerve palsy developed in two patients with Borrelia burgdorferi infection. In both cases, pain in the shoulder preceded a scapula detachment suggesting first a diagnosis of neuralgic shoulder amyotrophia. In the first case, there was a context of typical meningoradiculitis, while the second patient had an isolated right shoulder amyotrophia without any other neurologic signs and with normal CSF analysis. A detailed anamnesis, the serology profile, and the good response to an adequate antibiotic treatment allowed us to attribute these two long thoracic nerve palsies to B. burgdorferi. This infection is important to consider as a possible etiology in cases of peripheral neuritis without other obvious causes.

Adult↗
PubMed1993

Inhibition by lactate dehydrogenase-elevating virus of in vivo interleukin 4 production during immunization with keyhole limpet haemocyanin.

Interleukin 4 (IL-4) and gamma interferon (IFN-gamma) gene expression in lymph node cells from mice immunized with keyhole limpet haemocyanin in the presence of complete Freund's adjuvant was analysed by polymerase chain reaction. This immunization clearly induced the expression of IL-4 message, whereas IFN-gamma message was only slightly increased. A concomitant infection with lactate dehydrogenase-elevating virus drastically decreased IL-4 expression whereas IFN-gamma message was not modified. Analysis of the kinetics of cytokine production indicated that the virus did not induce a mere change in the timing of lymphokine production, but a persistent inhibition of IL-4.

Actins↗
PubMed1992

Differential regulation by phorbol myristate acetate of IFN-gamma and IL-4 expression in anti-CD3 stimulated mouse spleen cells.

Expression of messenger RNA (mRNA) specific for two cytokines representative of both Th1 and Th2 cell subtypes, interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) respectively, was analysed in murine spleen cells stimulated in vitro with an anti-CD3 monoclonal antibody (mAb). This stimulation induced predominantly an IFN-gamma message. In contrast, in the presence of phorbol myristate acetate (PMA), the expression of IFN-gamma was decreased whereas the IL-4 message was dramatically enhanced. These results were confirmed by Polymerase Chain Reaction (PCR) analysis and extended to include another T-cell activator [Concanavalin A (Con A)]. The results suggest the existence of a differential pathway of activation for the Th subpopulations or a differential regulation of the T helper lymphokine gene expression by PMA-induced signals.

Animals↗
PubMed1991

IL-1 serves as a secondary signal for IL-9 expression.

IL-9 is produced in vitro by activated CD4+ T cell lines of the Th2 subtype and by naive CD4+ T cells. Here we show that T cell lines stimulated with Con A in the presence of accessory cells (AC) such as irradiated spleen cells or bone marrow-derived macrophages produced substantially more IL-9 than T cells stimulated with Con A alone. These data suggest that AC influence the production of IL-9 through accessory signals that result in an at least 10-fold increase of IL-9 secretion by the respective T cells. Addition of IL-1 to T cells activated by Con A, PHA, or anti-CD3 antibodies revealed that this monokine was responsible for the potentiation of IL-9 production. This finding was confirmed by applying anti-IL-1 antibodies. The production of other lymphokines, namely, IL-3, IL-4, and IL-6, by activated T cells was not or only marginally enhanced in the presence of AC or IL-1, thus indicating that the synthesis of IL-9 is regulated differently from that of other Th2-derived lymphokines. Furthermore, it was demonstrated by Northern blot analysis that IL-1 increases IL-9 expression at the pretranslational level. Because IL-1 alone failed to induce the production of IL-9 by T cells, this monokine acts as a costimulator in combination with a T cell receptor-mediated signal.

Animals↗