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Biomedical subjects

R J Powell

Publications and source records attributed to R J Powell.

At least 109 records · Page 6Linked to original sources
PubMed1996

Restrictions of T cell receptor beta chain repertoire in the peripheral blood of patients with systemic lupus erythematosus.

OBJECTIVE: To investigate whether oligoclonal T cell populations occur in peripheral blood lymphocytes from patients with systemic lupus erythematosus (SLE). METHODS: RNA was extracted from the lymphocytes isolated from whole peripheral blood of five female patients fulfilling ARA criteria for SLE and two healthy female controls, and synthesised into cDNA. CDR3 length spectratyping was performed using a polymerase chain reaction (PCR) run to saturation followed by a primer extension with a radioactively labelled primer. The resulting samples, one for each of the 23 V beta families, were then run on a polyacrylamide sequencing gel to examine the T cell receptor beta chain repertoire at the level of VDJ length heterogeneity. RESULTS: The two healthy female controls showed faint oligoclonal bands in only two and three V beta families respectively. Three of the patients showed a similar degree of oligoclonality to the controls, while the other two, who had active disease as shown by SLAM scores of 17 and 19 and in one case low C4 and raised C3dg levels, showed marked oligoclonality of their T cell beta chain repertoire affecting more than 17 of the 23 V beta families analysed. CONCLUSIONS: Using the technique of CDR3 length spectratyping, restriction of T cell receptor beta chain usage by peripheral blood T cells in patients with SLE has been demonstrated for the first time.

Adult↗
PubMed1996

Transcriptional regulation of endothelin.

Three isoforms of endothelin (ET) exist, ET-l, ET-2,and ET-3.Nucleotide sequences for the three human ET genes are highly conserved. ET-l exactly matches the sequence ofET originally isolated from the condi- tioned medium of cultured bovine aortic endothelial cells (BAECs)."All three forms have been found in vascular, neural, adrenal, and kidney tissue, but are expressed in different proportions. Endothelial cells ex- clusively produce ETAll three isoforms have different vasoconstrictive potencies but are otherwise quali- tatively similar. ET-2 is the most potent vasoconstrictor, followed by ET-l and ET.

Journal Article↗
PubMed1995

Quantitating intestinal ischemia with nitroblue tetrazolium salts.

We evaluated a spectrophotometric nitroblue tetrazolium (NBT) reduction assay as a technique to quantitate experimental intestinal ischemic injury. NBT is a tetrazolium salt that is reduced by mitochondrial coenzymes to form a blue formazan dye which can be measured on a spectrophotometer. We used a rat model of progressive intestinal ischemia to compare NBT reduction with standard histologic grading by light microscopy. Isolated segments of small intestine were made ischemic for periods of 15, 30, 60, 90, and 120 min in each of five rats (no reperfusion). A portion of each segment was prepared for both NBT reduction assay and blinded histologic grading. The reproducibility of these results was then tested in a second identical study of four rats (Part 2). When compared to nonischemic segments of intestine, NBT reduction was significantly decreased after 30 min of ischemia (P < 0.05, ANOVA) and continued to decrease as ischemic time increased. These findings were reproduced in the second experimental group. Overall, NBT reduction correlated closely with duration of ischemia (r = 0.81, P < 0.001) and histologic grade (r = 0.77, P < 0.001). Based on criteria developed in Part 1, NBT reduction had a sensitivity of 100% and a specificity of 94% for detecting ischemia > or = 30 min in Part 2. We conclude that the spectrophotometric NBT assay in an accurate technique for quantitating small intestinal ischemic injury which also gives useful information about the functional status of mitochondria.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1995

Arthropathy, leucopenia and recurrent infection associated with a TcR gamma delta population.

This report documents the presence of clonal gamma delta T-cell receptor (TcR) population in the blood of a patient who presented with an arthropathy of undetermined cause, leucopenia and splenomegaly. There was no evidence for lymphoid malignancy clinically or at post-mortem. The phenotype and genotype of the clonal T-cell population were not associated with the predominant TcR delta rearrangement found in peripheral blood gamma delta cells, but were similar to those found in gamma delta TcR cells infiltrating rheumatoid synovium. The data indicate the presence of a monoclonal population of gamma delta cells TcR cells which in the face of continued immunosuppression behaved benignly. The case may represent a cytomorphologically atypical example of the large granular lymphocytes, neutropenia and arthropathy syndrome/lymphoproliferative disease of granular lymphocytes and, although the patient's clinical features were not 'classical', rheumatoid arthritis (RA) may have been the underlying primary disorder.

Arthralgia↗
PubMed1995

Enhanced expression of MHC class I molecules on cultured human thyroid follicular cells infected with reovirus through induction of type 1 interferons.

Certain viruses are known to modulate the cellular expression of MHC molecules. We have investigated whether reovirus types 1 or 3 can alter the normal MHC molecule expression on cultured human thyroid follicular cells (TFC). Primary TFC cultures were established from eight human thyroid donors and MHC class I and II expression was assessed by indirect immunofluorescence microscopy. Both types of reovirus enhanced MHC class I expression on TFC from all thyroid donors. Class II MHC protein was strongly induced by type 1 reovirus on TFC from one donor, while weak induction of expression, by either reo-1 or reo-3 virus, was noted on the TFC of five other donors. Studies on the mechanism(s) of MHC class I hyperexpression showed that mouse MoAb against the type 3 reovirus haemagglutinin (anti-HA3) reduced the ability of the virus to induce hyperexpression of class I MHC molecules on TFC. However, supernatant harvested from type 3 reovirus-infected TFC cultures maintained its ability to enhance class I expression after incubation with anti-HA3. Moreover, adding rabbit anti-sera to interferon-alpha (IFN-alpha) or IFN-beta inhibited the increased class I MHC expression on TFC by both types of reovirus. These data suggest that reoviruses (types 1 and 3) can enhance MHC class I on cultured TFC. The mechanism of MHC class I enhancement is most probably through the release of IFN-alpha and IFN-beta.

Antibodies, Monoclonal↗
PubMed1995

Interferon-gamma and urine neopterin in attacks of the hyperimmunoglobulinaemia D and periodic fever syndrome.

The hyperimmunoglobulinaemia D and periodic fever (hyper-IgD) syndrome is typified by recurrent unpredictable febrile attacks with abdominal pain, joint involvement (arthralgias/arthritis), headache, skin lesions and a polyclonal elevation of serum IgD (> 100 U mL-1). Interferon-gamma (IFN-gamma) is a major proinflammatory cytokine which could play a role in the pathogenesis of the attacks. There is a need for parameters (if possible non-invasive) to monitor disease activity. A potential candidate is neopterin which is released by monocytes/macrophages when stimulated with IFN-gamma, excreted unchanged in urine, and appears to be an early and sensitive marker for activation of the immune system. We measured rectal body temperature, serum IFN-gamma, and urine neopterin in 10 hyper-IgD patients both during and between attacks. The body temperature rose to a mean of 38.9 degrees C on the first day of the attack and normalized within 5 days. Serum IFN-gamma during the first day of the attack was 2.98 IU mL-1 and was significantly lower during remissions. The urine neopterin excretion was 268 +/- 170 mumol mol-1 creatinine between attacks and was significantly increased to 638 +/- 275 mumol mol-1 creatinine on the first day of symptoms. Maximal urine neopterin values were reached on the fourth day of the attack (1051 +/- 387 mumol mol-1 creatinine) and excretion gradually declined and attained values below 400 mumol mol-1 creatinine after 9 days. There was a good correlation between serum IFN-gamma and urine neopterin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Distribution of cases of systemic lupus erythematosus at time of first symptom in an urban area.

OBJECTIVES: To determine the geographical distribution of cases of systemic lupus erythematosus (SLE) in a defined geographical area in the East Midlands, UK, and, in particular, to search for spatial variation in cases that may implicate the role of environmental factors in SLE aetiology. METHODS: Six methods of case ascertainment were used. The postcode of the patient's domicile at time of first definite symptom of SLE was used for analysis which included case mapping, probability mapping by electoral ward, and variogram analysis. RESULTS: The study area population of 613,700 contained 200 SLE patients, 188 of whom experienced their first symptom whilst residing in the area. Case mapping revealed 12 SLE patients residing within an area of one square mile, including four men and six patients with RNP antibodies. The use of probability mapping showed five wards in close proximity to each other to have a greater number of SLE cases than would be expected by chance (p < 0.1). The 'cluster' of patients seen on the case map fell into two wards which showed a significant excess of cases only when combined (p = 0.006). The variogram of the incidence rates for each ward did not confirm any structure or pattern to the distribution of cases for the whole area. CONCLUSIONS: Some areas have a greater than expected prevalence of SLE. The normal result from variogram analysis suggests that the cause(s) for these excess number of cases does not have an effect across the whole study area.

Adolescent↗
PubMed1995

Investigation of the prevalence and clinical associations of antibodies to human fibronectin in systemic lupus erythematosus.

OBJECTIVES: To assess the prevalence of antibodies to human fibronectin (anti-Fn) in sera of patients with certain connective tissue diseases and to determine their association with disease activity and the pattern of organ involvement in patients with systemic lupus erythematosus (SLE). METHODS: A capture enzyme linked immunosorbent assay (ELISA) was developed to quantify anti-Fn antibodies in serum samples from 65 patients with well characterised SLE, 50 with rheumatoid arthritis (RA), 15 with Behçet's disease (BD), 15 with systemic vasculitis and 36 healthy subjects. An anti-Fn antibody titre greater than mean + 3SD of the healthy control log values after back transformation to the normal scale was considered positive. Disease activity in SLE patients was scored using the British Isles Lupus Assessment Group (BILAG) Index. Erythrocyte sedimentation rate (ESR), concentrations of anti-dsDNA antibody, soluble interleukin-2 receptors (sIL-2R), C3, C4, C3 degradation products (C3dg) and immunoglobulin, and antinuclear antibody (ANA) titres were measured in blood samples from SLE patients; neopterin concentration was measured in corresponding urine samples. RESULTS: Anti-Fn antibodies were found in 22 of 65 SLE patients (33.8%), seven of 50 with RA (14%), one of 15 with BD (6.6%) and none of the 15 subjects with vasculitis. Thirty SLE patients had active disease and 35 had inactive disease; their median anti-Fn concentrations were 117 u/ml (range 47-450) and 68 u/ml (range 17-334), respectively (p = 0.0001). The presence of anti-Fn did not correlate with immunoglobulin concentrations or ANA titres in these sera. No significant difference was found between SLE patients with disease activity in one major organ system compared with multiple organ involvement, as defined by BILAG (p = 0.19). However, patients with musculoskeletal manifestations had consistently greater anti-Fn concentrations compared with patients with other clinical manifestations. There were significant correlations between amounts of anti-Fn in SLE sera and ESR (rs = 0.25, p = 0.045), sIL-2R (rs = 0.28, p = 0.024) and urine neopterin (rs = 0.3, p = 0.016) but not with serum anti-dsDNA antibody titres, plasma C3, C3dg or C4. However multiple regression analysis showed a low significant correlation only with sIL-2R and BILAG score (p = 0.047 and 0.042, respectively). CONCLUSION: Anti-Fn antibodies were detected in 34% of SLE patients and in small proportions of RA and BD patients. An association between serum anti-Fn and disease activity in SLE has been identified and most SLE patients with musculoskeletal involvement had increased anti-Fn antibody concentrations.

Adult↗
PubMed1995

Diagnostic and management problems in a complex case of connective tissue disease.

A 28-year-old Nigerian woman presented with persistent pyrexia, marked pruritus, eosinophilia, myalgias, flitting arthralgias, serositis and massive splenomegaly. Intensive investigation for an infective or neoplastic aetiology proved negative. Empirical treatment for helminthic infections and tuberculosis was unhelpful. Although there were no specific clues to suggest an underlying connective tissue disease, a trial of steriods and azathioprine was introduced, with no obvious response. Her condition deteriorated to a point where it was decided that intravenous immunosuppressive therapy was needed and subsequently, her condition improved remarkably. This patient illustrates the problems in the diagnosis and management of complex disorders, particularly when classical tests for connective tissue diseases are absent. Also, we would like to report that marked pruritus can be associated with connective tissue disease.

Adult↗
PubMed1995

Skeletal muscle lymphocytic vasculitis in systemic lupus erythematosus: relation to disease activity.

Lymphocytic vasculitis (LV) characterises systemic lupus erythematosus (SLE) and this potentially reversible lesion, which may be subclinical, may imply overt systemic disease activity. Needle quadriceps muscle biopsy was performed in 26 unselected patients with SLE and the presence of LV in these muscle specimens was compared with SLE disease activity scored using the British Isles Lupus Assessment Group Index (BILAG). Ten of the 22 patients with active disease showed evidence of LV compared with none of the four patients with inactive disease. In the patient group with LV, significantly higher ESR and urine neopterin values were found with P = 0.002 and P = 0.02, respectively compared with patients without LV. Features of vasculitis (as defined by BILAG) were also significantly more common in these patients (P = 0.005). None of the other parameters, including creatine kinase, were significantly different between the two patient subgroups. Thus, LV in needle quadriceps muscle biopsy specimens is a further valuable marker of disease activity in patients with SLE and might provide histological evidence of a systemic vasculitic process in a group of patients with diverse clinical manifestations.

Adult↗
PubMed1994

Effect of endothelial cells and transforming growth factor-beta 1 on cultured vascular smooth muscle cell growth patterns.

Smooth muscle cells (SMCs) cultured alone exhibit characteristic "hill and valley" macroscopic growth features. We studied smooth muscle cells cocultured with endothelial cells and the effect of transforming growth factor beta 1 on smooth muscle cells: Bovine smooth muscle cells were plated on 13 microns-thick semipermeable membranes. Smooth muscle cells were cultured either alone (in Dulbecco's Modified Eagles Media/2.5% calf serum, four wells/group); with neutralizing anti-transforming growth factor-beta 1 antibody (10 micrograms/ml); with the protease inhibitor aprotinin (prevents plasmin-mediated activation of transforming growth factor-beta 1, 200 mg/ml); or in the presence of confluent bovine endothelial cells cocultured on the opposite side of the membrane before plating smooth muscle cells. After 72 hours in culture smooth muscle cell organizational growth characteristics were examined by light microscopy. Hill and valley formation by smooth muscle cells resulted in areas of the membrane becoming devoid of smooth muscle cells, whereas other areas developed multilayered densely populated smooth muscle cells. Computed planimetry was used to measure this bare surface area to quantitate the extent of hill and valley growth, which was compared between groups by analysis of variance. Smooth muscle cells cultured alone demonstrated prominent hill and valley formation with a bare surface area of 2.64 +/- 0.51 mm2. Smooth muscle cells exposed to transforming growth factor-beta 1 antibody had much less hill and valley formation (bare surface area 0.92 +/- 0.29, p < 0.01), whereas aprotinin virtually prevented hill and valley formation (bare surface area 0.0, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Human anti-fibronectin antibodies in systemic lupus erythematosus: occurrence and antigenic specificity.

Sera from patients with connective tissue diseases exhibit autoantibodies to a spectrum of extracellular matrix proteins. Antibodies binding to solid phase bovine fibronectin (Fn) were investigated by ELISA in patients with systemic lupus erythematosus (SLE). Sera showing binding of 2 s.d. above the mean of the normal human control were considered positive and 43/150 SLE sera (28.7%) demonstrated such binding. These antibodies were mainly IgG and IgA as determined by isotype-specific ELISA. Specificity studies on selected positive sera revealed that binding was inhibited by preincubation with soluble Fn, but not with thyroglobulin or type 1 collagen. The binding was demonstrated not to be related to interactions with rheumatoid factor, complement components or immune complexes. Additional studies to determine which Fn fragment is bound by naturally occurring anti-Fn antibodies demonstrated that the binding was predominantly to the 30-kD collagen binding domain (CBD) of Fn molecule. Inhibition studies using 120-kD, 40-kD and 30-kD Fn fragments confirmed that this binding site was the 30-kD CBD.

Adolescent↗
PubMed1994

The influence of anti-fibronectin antibodies on interactions involving extracellular matrix components and cells: a possible pathogenic mechanism.

Antibodies, directed to the 30-kD collagen binding domain (CBD) of fibronectin (Fn), have been previously demonstrated in sera from patients with systemic lupus erythematosus (SLE), and we now investigate the possible pathogenic effects of these antibodies on collagen-Fn and cell-Fn interactions. The binding of type 1 collagen to Fn was demonstrated by ELISA, and could be specifically inhibited by the preincubation of solid-phase immobilized Fn with anti-Fn antibodies from SLE sera. By using indirect immunofluorescent staining, anti-Fn antibody containing SLE sera but not normal human serum (NHS) reduced the deposition of newly synthesized collagen and Fn on living human skin fibroblasts. We also found that sera from SLE patients containing anti-Fn antibodies significantly reduced thyroid cell attachment to Fn immobilized on plastic compared with NHS. These effects were shown to be due to the presence of anti-Fn antibodies in these sera, as SLE sera depleted of anti-Fn antibodies did not reduce the deposition of collagen or Fn on cultured fibroblasts, nor did they inhibit cell attachment.

Autoantibodies↗
PubMed1994

Clinical features and race-specific incidence/prevalence rates of systemic lupus erythematosus in a geographically complete cohort of patients.

OBJECTIVES: To assess race-specific incidence and prevalence rates for systemic lupus erythematosus (SLE) using 1991 National Census data and to ascertain the frequency of clinical/laboratory features of a geographically complete cohort of patients with SLE. METHODS: Multiple methods of retrieval were used to ascertain SLE patients including screening request cards for immunology investigations. Patients were classified according to the revised ARA criteria. Multiple logistic regression analysis was used to study the effects of age at diagnosis on the frequency of clinical/laboratory SLE features. RESULTS: The overall one year period prevalence rate for SLE was 24.7 (age adjusted, 95% CI: 20.7-28.8)/100,000. Highest rates were seen in Afro-Caribbeans (207 (111-302)/100,000), followed by Asians (48.8 (10.5-87.1)/100,000), and then Whites (20.3 (16.6-24.0)/100,000). The mean age at diagnosis of SLE was 40.9 years (range: 11-83) with a mean interval between first definite SLE symptom and diagnosis of 61 months (0-518). In 85% of patients the first definite lupus feature was musculoskeletal and/or cutaneous. In this SLE cohort renal disease (22%) was observed less commonly than in previous studies and the 'classic' butterfly rash was present in only 30% of patients. Malar rash, thrombocytopaenia, positive anti-dsDNA antibodies, hypocomplementaemia (C4), and positive IgG anticardiolipin antibodies were all seen less commonly with increasing age at diagnosis. CONCLUSIONS: A closer estimate of the true frequency of clinical/laboratory SLE manifestations is likely from this geographically complete cohort of patients compared with studies that may be skewed by referral patterns.

Adolescent↗