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R J Engler

Publications and source records attributed to R J Engler.

28 records · Page 2Linked to original sources
PubMed1992

Venezuelan equine encephalitis-specific immunoglobulin responses: live attenuated TC-83 versus inactivated C-84 vaccine.

Venezuelan equine encephalitis (VEE)-specific immunoglobulin responses to the two vaccines, TC-83 (a live attenuated vaccine) and C-84 (a formalin inactivated vaccine derived from the TC-83 strain of virus) were evaluated using an antigen and isotype-specific enzyme-linked immunoadsorbent assay (ELISA). The VEE-specific ELISA for IgG, IgG subclasses, IgA and IgM were developed and standardized using sera from vaccine-exposed and unexposed human subjects. Paired human sera (before and 28 days after immunization) were tested from laboratory workers vaccinated with either TC-83 (Group A: 20 paired sera from subjects receiving a single TC-83 vaccine and with no prior history of vaccination) or C-84 in varying schedules (Group B: 19 paired sera from subjects who had a distant vaccination history to TC-83 but no evidence of neutralizing antibody; Group C: 19 paired sera from subjects receiving their first C-84 vaccination and no prior documented history of vaccination; Group D: 15 paired sera from subjects receiving a C-84 booster vaccination with prior history of C-84 but no TC-83 exposure). Sera were all tested for viral neutralization in vitro using a Vero cell monolayer for culturing virus and establishing 80% plaque reduction for each serum tested. All pre-sera tested demonstrated no plaque reduction neutralization at a level of 80% for a dilution of 1:10. ELISA antibody titers for all pre-sera with no prior VEE exposure through vaccination or possible environmental factors were negative at a titer of 1:160 for IgM, 1:80 for IgG, IgA, and G subclasses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Bird antigen persistence in the home environment after removal of the bird.

Hypersensitivity pneumonitis (HP) secondary to bird exposure is treated with glucocorticosteroids and avoidance. Despite therapy, symptoms may persist for a prolonged time. Just as cat antigen, Fel d 1, may persist for greater than 20 weeks after cat removal, there may be persistent bird antigen to explain prolonged symptoms in bird HP. It was the intent of this study to determine household distribution and persistence of bird antigen after removal of the bird from the patient's home. The homes of patients with birds were followed serially after bird removal with multiple samples collected using a hand-held vacuum cleaner. Bird antigen levels were determined by an inhibition enzyme-linked immunoassay. In five homes the antigen declined gradually despite extensive environmental control measures, with high levels still detectable at 18 months in one home. This data suggests that high levels of bird antigen can be detected for prolonged periods of time after bird removal and environmental cleanup. The antigen may account for the persistence of disease in some patients with HP. In severe HP, the preferred therapy may be temporary relocation of the patient away from the room in which the bird was housed, in addition to corticosteroids, until the patient's environment is demonstrated to be relatively bird antigen-free.

Air Pollution↗
PubMed1991

Improved in vitro antigen-specific antibody synthesis in two patients with common variable immunodeficiency taking an oral cyclooxygenase and lipoxygenase inhibitor (ketoprofen).

In the process of performing a previously published study examining B cell function in 16 patients with common variable immunodeficiency (CVI)(J Allergy Clin Immunol 1991; 87:1138-49), we noted improved in vitro antibody (Ab) synthesis in a patient, H. B., while he was taking a cyclooxygenase and lipoxygenase inhibitor, ketoprofen. Addition of ketoprofen in vitro to B cells from patients with CVI resulted in improved proliferation and differentiation in four of five additional patients with CVI studied. One patient, besides H. B., M. K. B., whose B cells secreted increased amounts of antigen (Ag)-specific Ab in response to in vitro ketoprofen, underwent a trial of oral ketoprofen M. K. B., like H. B., demonstrated improved in vitro Ag-specific Ab production while she was taking oral ketoprofen. No increase in serum Ab levels was noted in either patient taking ketoprofen, but both patients remained infection free during the time of their ketoprofen trials (H. B., 9 months, and M. K. B., 36 months). No improvement in in vitro Ag-specific Ab synthesis was noted when H. B. and M. K. B. took oral cyclooxygenase inhibitors (naproxen or ibuprofen). Thus, additional study is warranted to examine the role of lipoxygenase products of arachidonic acid in the B cell dysfunction of CVI.

Administration, Oral↗
PubMed1991

Abnormal response to a human B cell growth factor in patients with common variable immunodeficiency (CVI).

Patients with common variable immunodeficiency (CVI) generally fail to produce antigen-specific IgG. We have identified a lymphokine called high molecular weight B cell growth factor (HMW BCGF) that expands an IgG-producing subpopulation of B cells. The B cells from 15 of 16 patients with CVI evaluated in this study failed to proliferate to HMW BCGF, although they proliferated normally to another BCGF, low molecular weight BCGF (LMW BCGF). Nevertheless, 11 patients had more than normal numbers of B cells expressing HMW BCGF receptors. The HMW BCGF receptors on the B cells of three patients with CVI studied were the same molecular weight as the normal HMW BCGF receptor. Examination of B cells from four patients with CVI for intracellular signals produced in normal B cells after stimulation with HMW BCGF revealed that B cells from patients with CVI failed to developed significant increases in cyclic adenosine monophosphate or phosphoinositides after HMW BCGF stimulation. However, cytoplasmic phosphoinositides in the B cells from all four patients with CVI were already increased above what is observed in normal B cells before stimulation with HMW BCGF (either freshly isolated or Staphylococcus aureus Cowan I-activated B cell). Thus, the failure of B cells from patients with CVI to respond to HMW BCGF may be related to their abnormal activation in vivo. Since HMW BCGF expands a subpopulation of memory B cells, the inability of CVI B cells to respond to HMW BCGF may contribute to their abnormal secondary responses to antigens.

Adolescent↗
PubMed1986

Comprehensive immunization delivery in conjunction with influenza vaccination.

All patients and employees presenting for influenza A and B vaccination were studied for the need for other immunizations or tests, based on criteria of the Immunization Practices Advisory Committee. More than 72% of patients and employees needed at least one other vaccine or test. During a 4 1/2-month period, 1,353 doses of influenza virus vaccine, bivalent, types A and B, were prescribed. Health care providers ordered doses of diphtheria and tetanus toxoids (adult) for 36.8% of these recipients, pneumococcal vaccine, polyvalent 23, for 42.1%, and a tuberculin skin test for 36.3%. Determinations of hepatitis B titers or hepatitis B vaccine doses were ordered for 140 individuals. Patients older than 60 years needed additional immunizations with greater frequency. Rates of delayed adverse reactions (35.9%) and subsequent self-medication (11.7%) were recorded. The systemic adverse reaction rate was 17.3%. Annual influenza vaccination programs are valuable public health opportunities to determine immunizations needed by patients who might not otherwise receive a comprehensive, individualized review of the status of their immunization protection.

Adolescent↗
PubMed1986

Hypersensitivity to chromated catgut sutures: a case report and review of the literature.

Chromated catgut sutures are used extensively in general surgical procedures. Although delayed hypersensitivity reactions to this material are difficult to diagnose post-operatively--ie, they may be interpreted as non-specific complications of surgery--the condition can be readily evaluated by patch testing with chromate or intracutaneous placement of the actual suture material. Multiple reports in the literature suggested that there was an increased frequency of post-operative adhesions, wound dehiscence, infection, and even intestinal obstruction along the line of suture material to which the patient had been sensitized during a previous surgery. Particularly with the widespread availability of fully synthetic suture materials, which appear to be less sensitizing, an increased awareness of chromate hypersensitivity in patients undergoing repeated surgical procedures may decrease the frequency of subsequent inflammatory post-operative complications. We report a patient with a history of multiple abdominal surgical procedures, eosinophilic cystitis surrounding the suture material, prolonged post-operative pain, and inflammatory masses at the sites of previous surgery associated with a positive delayed hypersensitivity skin reaction to patch test chromate and to intradermal chromic catgut.

Abdomen↗
PubMed1985

The effects of triacetyloleandomycin and oleandomycin phosphate on the glucocorticoid receptor in cultured skin fibroblasts.

Triacetyloleandomycin (TAO) has been described as a "steroid-sparing" drug in that poorly controlled asthmatic patients can be stabilized or improved with the addition of TAO despite decreasing dosages of steroids, specifically methylprednisolone (MP). It is not clear whether the beneficial effects of TAO are due to decreased MP clearance or are due to enhanced glucocorticoid effect peripherally. We tested the latter possibility by studying the interaction of TAO and oleandomycin phosphate (OLEO), the active metabolite of TAO in vivo, with glucocorticoid receptors in dispersed, intact cultured human skin fibroblasts. With the use of cells incubated with [3H]dexamethasone at 22 degrees C, we examined the competitive binding properties of TAO and OLEO (at varying concentrations) with and without MP as compared with several other steroids and MP alone. We also studied the effects on cellular glucocorticoid receptor number and affinity when TAO at a concentration of 4 X 10(-5) alone, at 10(-5) M in combination with a receptor saturating concentration of MP (5 X 10(-8) M), with MP alone, or with OLEO (10(-5) M) combined with MP was added to fibroblasts in the growth phase 1 wk before assay. TAO and OLEO did not compete for the binding of [3H]dexamethasone to the fibroblast glucocorticoid receptor, nor did they alter the binding properties of MP. With prolonged cellular exposure, TAO alone did not alter the number of glucocorticoid receptors (per cell) or their affinity for [3H]dexamethasone. Interestingly, prolonged exposure to saturating concentrations of MP alone decreased glucocorticoid receptor density; this effect was not altered by the presence of TAO or OLEO.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Count↗
PubMed1984

Anaphylaxis following psyllium ingestion.

Psyllium is a hydrophilic agent found in many bulk laxative preparations. We report the occurrence of an anaphylactic reaction in a patient after ingestion of a psyllium-containing laxative. IgE mediation of the reaction was suggested by a positive immediate skin test to psyllium, positive passive transfer skin test, lack of skin response during passive transfer with heat treated serum, and an elevated IgE (RAST) to psyllium seed.

Adult↗
PubMed1984

Antigen-stimulated human B cell clones are committed to the production of a single class of antibody in vitro.

We have investigated the isotype(s) of antibody produced in vitro by antigen-stimulated human B cell clones. An analysis of the class(es) of antibody produced in multiple replicate cultures containing a mean of less than one precursor B cell per well was consistent with the hypothesis that individual B cell precursors produced a single class of antibody. This result was obtained by using cells isolated from either the peripheral blood or tonsils. Thus, under the culture conditions utilized, no intraclonal isotype switching was detected.

Antibodies, Viral↗