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S Gustavsson

Publications and source records attributed to S Gustavsson.

At least 37 records · Page 2Linked to original sources

Impaired antibody responses in H-2Ab mice.

In murine in vivo systems, Ags administered in physiologic solutions together with specific IgE induce a significantly higher Ab response than Ags administered alone. In vitro, IgE in complex with Ag enhances B cell-mediated presentation of the Ag to T cells. Both phenomena require an intact low affinity receptor for IgE (Fc epsilon RII/CD23), suggesting that the effect on in vivo Ab responses is caused by increased Ag presentation. We here show that mice carrying the MHC class II Ab molecule (e.g., C57BL/6 and 129/Sv) do not produce Abs to BSA when immunized with BSA-2,4,6-trinitrophenyl (TNP) in complex with monoclonal IgE anti-TNP. In contrast, strains of all other MHC haplotypes tested (H-2d, H-2k, H-2p, H-2q, and H-2s) respond vigorously to IgE/BSA-TNP complexes, with Ab responses several hundred-fold higher than the responses in H-2b mice. C57BL/6 mice were unable to produce a carrier-specific response also after immunization with IgE/OVA-TNP, IgE/diphtheria toxoid-TNP, or IgE/tetanus toxoid-TNP. Although the low responsiveness mapped to the Ab region, responsiveness was not restored in C57BL/6 mice carrying transgenic Ak, suggesting that a nonclassical A-region-encoded gene product is involved. Most importantly, our data call attention to the fact that the C57BL/6 and 129 mouse strains, which are widely used for producing transgenic animals, have defective immune responses.

Animals↗

Silicone-adjustable gastric banding: disappointing results.

BACKGROUND: Silicone-adjustable Gastric banding (SAGB) has been popularized as a minimally invasive, completely reversible surgical treatment for morbid obesity. We report here our 3-year experience of SAGB with special reference to complications and side-effects. METHODS: There were 90 patients in total, of whom 72 were women. Median age was 42 (range, 20-68) years and median body mass index (BMI) was 43 (range, 34-57) kg/m2. Laparoscopy was attempted to position the band in 63 cases but had to be converted to laparotomy in 16 (25%). Twenty-seven patients were laparotomized. We used the Swedish band (AB Obtech) throughout the series. In addition to regular clinic visits, patients were followed-up with upper gastrointestinal series 6 months postoperatively and gastroscopy after 2 years or earlier when symptomatic. RESULTS: Median BMI decreased to 32 kg/m2 after 12 months and to 31 kg/m2 after 24 months. With a median follow-up time of 35 months (range, 22-48), 32 patients (35%) have been re-operated usually with removal of the balloon system and conversion into a Roux-en-Y gastric bypass. The most common reasons for re-operation were band erosion (n = 10) and erosive esophagitis (n = 14). Additional indications for re-operation included pouch dilatation, invagination of distal gastric wall through the band, leakage from the balloon, patient dissatisfaction, and severe allergic reaction. When questioned 2 years postoperatively more than half of the patients reported vomiting, heartburn and regurgitation but 78% still pronounced themselves satisfied with the operation. Esophagitis was found in 56% of the patients at gastroscopy after 2 years. CONCLUSION: SAGB could be positioned with laparoscopy in 75% of the cases but the incidence of complications and side-effects postoperatively has been high.

Adult↗

Early expansion of secondary B cells after primary immunization with antigen complexed with IgE.

IgE antibodies have potent immunoregulatory effects in vivo, and mice immunized with IgE-antigen (IgE/ Ag) complexes exhibit a several hundred-fold higher humoral Ag-specific response than mice immunized with non-complexed Ag. In vitro studies indicate that this is a result of efficient endocytosis of the IgE/Ag complexes via the low-affinity receptor for IgE (CD23) on B cells, leading to efficient antigen presentation to T cells. Previous studies of IgE-induced Ab responses in vivo have only measured serum responses. The authors have now studied the up-regulated response as the number of IgG-, IgA-, IgE- and IgM-secreting single B cells in spleen, lymph nodes and bone marrow of mice immunized with IgE-anti-TNF+BSA-TNP (2,4,6-trinitrophenylated bovine serum albumin). IgE and Ag induced a greater than 500-fold increase of specific IgG-secreting spleen cells with the peak of the response 6 days after primary immunization. The response of other Ab isotypes and the response in other lymphoid organs was marginal. The rapid increase in the number of IgG-secreting cells in the spleen suggests that IgE/Ag complexes induce a secondary type of antibody response without requirement for conventional priming.

Age Factors↗

Antibodies to murine complement receptor 1 and 2 can inhibit the antibody response in vivo without inhibiting T helper cell induction.

Administration to mice of mAb against CR1/CR2 inhibits the primary and secondary in vivo Ab response. We have addressed the question of whether induction of T helper cells, in addition to B cells, is inhibited by this treatment. A hapten-carrier system was used, where one group of mice was immunized with a monoclonal CR1/CR2-specific Ab and Ag (SRBC or keyhole limpet hemocyanin (KLH)), another with Ag alone, and a third group left nonimmunized. After 2 to 15 wk, spleen cells from these mice were transferred to irradiated syngeneic recipients, together with Ag coupled to the hapten 4-hydroxy-5-iodo-3-nitro-phenacetyl (NIP). The number of NIP-specific, IgG-producing B cells, which in this system is an indication of T cell priming, was determined in an ELISPOT assay. Although the primary SRBC- or KLH-specific IgG response was inhibited markedly (74-98%) by CR1/CR2-specific Ab, no decrease in the number of NIP-specific IgG-producing B cells was detected after secondary immunization. In sharp contrast, the SRBC- or KLH-specific secondary IgG responses were low or undetectable. These findings suggest that CR1/CR2-specific Ab can inhibit the primary Ab response without affecting T helper cells and that the induction of B cell memory is decreased markedly by this treatment.

Animals↗

CD23/IgE-mediated regulation of the specific antibody response in vivo.

We have recently reported that IgE Abs specific for TNP are able to enhance the specific IgG response in mice via the low affinity receptor for IgE, Fc epsilon RII, or CD23. In this study we show that IgE can up-regulate IgM, IgG1, IgG2a, and the IgE response, thereby indicating the possibility of a viscious circle in the maintenance of an allergic response. One of the suggested modes of action of IgE/CD23 is to increase the ability of B cells to present Ag to T cells. The involvement of T cells in IgE-mediated enhancement of the Ab response was studied in several ways: nude mice were resistant to the effect of IgE and a dramatic effect on the induction of immunologic memory was seen, both by in situ secondary immunizations and in adoptive transfer systems. Basic conditions for the ability of IgE to induce enhancement were established, demonstrating critical importance of factors such as type of Ag and temporal relationship between administration of IgE and Ag. Finally, no evidence for the requirement for CD23 for a normal (non-IgE induced) Ab response was found, although modulation of the receptor completely abrogated the IgE-induced Ab response.

Animals↗

In vivo enhancement of the specific antibody response via the low-affinity receptor for IgE.

The ability of antigen-specific IgE antibodies to modulate the in vivo antibody response was studied by comparing the antibody response in mice immunized with 2,4,6-trinitrophenyl (TNP)-specific monoclonal IgE followed by bovine serum albumin (BSA)-TNP or with BSA-TNP alone. The serum IgG antibody response against BSA, measured in enzyme-linked immunosorbent assay ELISA, was enhanced up to 100-fold in groups receiving IgE. The enhancement required specific interaction between IgE and antigen, since no effect was seen when unconjugated BSA was used as antigen. Polyclonal activation by IgE/antigen complexes did not occur. IgE given 24 h after specific antigen had no stimulatory capacity. Pretreatment of the mice with Fc epsilon receptor type II (Fc epsilon RII)-specific monoclonal antibody completely inhibited the IgE-mediated enhancement. Thus, the data demonstrate for the first time an in vivo role for Fc epsilon RII in enhancement of specific antibody production.

Animals↗

Antibody feedback regulation in MRL/lpr mice.

MRL/Mp-lpr/lpr (MRL/l) mice spontaneously develop autoimmune disease, characterized by glomerulonephritis, polyarteritis and polyarthritis. The lpr mice have defects in the Fas antigen, which plays a role in apoptosis, and it has been suggested that lack of negative selection of autoreactive T cells explains the initiation of the disease. The extremely high amount of autoantibodies may reflect additional immunoregulatory abnormalities. Antibody feedback regulation is an efficient way of up- or downregulating antibody responses. We have for the first time determined whether IgG-mediated suppression as well as IgM-mediated enhancement operates normally in these mice. MRL/l and MRL/Mp(-)+/+ (MRL/n) mice of different ages were therefore immunized with sheep erythrocyte (SRBC)-specific IgG or IgM antibodies followed by SRBC. Control groups received antigen alone. Five days later, the antigen-specific plaque-forming cell response was measured. IgG induced more than 90% suppression in both MRL/l and MRL/n in mice of all ages tested. This degree of suppression is in the same range as for other, normal mouse strains. In contrast, IgM-mediated enhancement was completely absent in 12-week-old MRL/l mice but normal in 8-week-old MRL/l as well as in MRL/n mice of all ages tested. When spleens and lymph nodes were immunohistochemically studied using a mAb specific for complement receptors 1 and 2 (CR1/CR2), an abnormal follicular structure was demonstrated in 12-week-old MRL/l mice. The antibody response of both 8- and 13-week-old MRL/l mice in vivo, after downregulation of these receptors, was inhibited by 85-96%. Thus, the presented data demonstrate that MRL/l mice with overt autoimmune disease are refractory to IgM-mediated enhancement of antigen-specific antibody production. We believe that this abnormal antibody feedback regulation is due to abnormal follicular structure in lymphoid organs of old MRL/l mice, hence the inability to localize and present antigen in a normal way.

Animals↗

13C-urea breath test for diagnosis of experimental Helicobacter pylori infection in barrier born pigs.

Previous studies with Helicobacter pylori infected barrier born pigs indicate that the infection has a patchy distribution, resulting in false negative culture results on endoscopic biopsy specimens. This study aimed to adapt the 13C-urea breath test as used in humans to diagnose H pylori infection in barrier born pigs. The breath test was also performed after bismuth as a single treatment and after triple therapy (bismuth, ampicillin, metronidazole). In control pigs the median excess of 13CO2 in expired air was 2.2 (range 0-12 n = 22) ppm. The infected pigs (n = 4) showed consistently high values (median 23 range 14-43) when examined on four occasions (n = 16) four to 10 weeks after inoculation. Biopsy specimens for culture had lower sensitivity than the breath test. No reduction in excess 13CO2 was seen after three days' single bismuth treatment, but after two weeks' triple therapy the breath test results had returned to normal. This suppression was temporary only, however, as the breath test was positive again four weeks after stopping treatment. In conclusion, the 13C-urea breath test is a simple and reliable test for determining H pylori infection and monitoring treatment effects in barrier born pigs. Because the test can be performed in awake pigs anaesthesia and gastroscopy are unnecessary.

Animals↗

Local and systemic immune response in Helicobacter pylori-associated chronic gastritis before and after treatment.

Ten patients with Helicobacter pylori-associated chronic gastritis were given combination therapy for 6 weeks with a bismuth subnitrate-containing compound and bacampicillin. The eradication rate was 40% 6 weeks after the end of treatment. Two patients remained H. pylori-negative at long-term follow-up after 6 and 17 months; that is, H. pylori was only eradicated in 20% of the patients after long-term observation. By dot blot and immunoblotting both urease and an urease-associated heat shock protein (HSP62) were found to be specific and constant immunodominant H. pylori antigens. The immunohistologic pattern showed induced expression of HLA-DR and HSP62, but not of ICAM-1, in all but two biopsy specimens of gastric epithelial cells. This study suggests i) that long-term observation is important when evaluating the efficacy of anti-H. pylori therapy; ii) that the immune defense mechanisms in the gastric mucosa differ from those in inflammatory conditions affecting other organs, where ICAM-1 and HLA-DR seem to be governed by a common regulator; and iii) that the immunopathologic effects of H. pylori may be caused by autologous and/or bacterial HSPs, which act as triggering factors in the development and persistence of the chronic inflammation in the gastric mucosa.

Adult↗

Topographic mapping of Helicobacter pylori colonization in long-term-infected pigs.

Four barrier-born pigs were inoculated with Helicobacter pylori during gastroscopy. Infection in all pigs was established after 3 weeks, and the animals were kept isolated from other pigs in ordinary experimental sites. The pigs were sacrificed and examined 3, 5, 6, and 6.5 months postinoculation. A detailed urease mapping of the pig stomachs showed a patchy distribution of H. pylori. The bacteria colonized in all pigs, with a concentration of H. pylori-positive areas in the antrum and fundus. Furthermore, the number of colonized areas tended to increase with time, and some of these areas showed a strong urease reaction, indicating a heavy colonization with H. pylori. Biopsies from these areas contained 10(2) to 10(5) CFU per 2-mm-wide biopsy. We conclude that persistence of H. pylori infection in barrier-born pigs can be demonstrated for at least 6.5 months. The patchy distribution and the variability of viable bacteria were similar to those described for humans.

Animals↗

Adhesion of Helicobacter pylori to human gastric mucosal biopsy specimens cultivated in vitro.

The therapeutic advances in Helicobacter pylori infection is hampered by the lack of suitable animal model systems. We have previously reported on successful adherence of H. pylori to pig gastric mucosa cultured in vitro. The aim of this study was to verify the technique in human biopsy specimens cultured in vitro. Mucosal samples were taken from H. pylori-negative and H. pylori-positive patients undergoing gastric surgery. The non-infected tissue was infected with H. pylori in vitro, and the infected tissue was put into culture immediately. Total number and those H. pylori firmly attached were checked throughout a 72-h culture. Viability of cultured human gastric mucosa was good and unaffected by the presence of H. pylori. The amount of bacteria adhering, increased with time from 0.01% to 2-4% after 72 h in culture. In vivo-infected specimens initially had a low number of firmly attached H. pylori, but total H. pylori increased with time in culture. It is concluded that human gastric biopsy specimens show good viability for 72 h and that viability and cell division of H. pylori were maintained in both in vivo and in vitro H. pylori-infected tissue. In both cases the total number of viable bacteria attached to the specimens increased with incubation time.

Animals↗

Comparison of iopromide versus iohexol in aortobifemoral arteriography. A Swedish multi-center study of 446 patients.

A double-blind randomized, clinical trial was conducted in 9 hospitals comparing the use of non-ionic contrast media (CM) iopromide 300 (Ultravist) and iohexol 300 (Omnipaque) during peripheral arteriography in a total of 446 patients. After premedication with morphine-scopolamine each patient was given two consecutive injections of 50 ml CM at a rate of 12 ml/s above the aortic bifurcation. Both CM were well tolerated. There were no differences between the two substances as far as general tolerance, pulse rate, blood pressure, sensation of heat or pain after CM injection were concerned.

Adult↗

Inoculation of barrier-born pigs with Helicobacter pylori: a useful animal model for gastritis type B.

At the age of 8 weeks, 15 barrier-born pigs, specific pathogen free, were inoculated intragastrically with suspensions of 10(7) to 10(10) CFU of Helicobacter pylori after pretreatment with omeprazole. The pigs were observed for up to 12 weeks, endoscopic biopsy specimens were taken, and serum samples were drawn. H. pylori was identified by routine culturing and by staining with an H. pylori-specific monoclonal antibody on cryostat sections of gastric biopsy specimens. In 11 of 15 inoculated pigs, H. pylori was detected throughout the observation period. In these infected pigs, there was an antibody response to H. pylori, as determined in serum by an enzyme immunoassay. Furthermore, the development of superficial, focal gastritis with infiltrates of mononuclear class II antigen-expressing lymphocytes was observed immunohistologically. H. pylori was never detected and an antibody response to H. pylori was not observed in two control pigs. The development of gastritis and the systemic antibody response to H. pylori support the usefulness of this animal model for studies of H. pylori-related human diseases.

Animals↗

Current palliative modalities for esophageal carcinoma. Clinical review.

Esophageal carcinoma is often advanced at diagnosis, and management consequently can only be palliative, with relief of dysphagia and its consequences as the primary aim. The various methods for palliation are reviewed and their indications, advantages and drawbacks are discussed. If resection of the tumor is not feasible, YAG laser therapy seems to be the palliative method of choice in malignant dysphagia.

Antineoplastic Agents↗