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Biomedical subjects

T Hemachudha

Publications and source records attributed to T Hemachudha.

At least 37 records · Page 2Linked to original sources

Human immune response to rabies nucleocapsid and glycoprotein antigens.

Antibodies to two components of rabies virus, nucleocapsid (N) and glycoprotein (G), were compared in 11 rabies patients with those in nine recipients of Vero cell rabies vaccine. All rabies vaccinees had antibodies to N and G components by day 10 after the first vaccine injection. A similar but not identical response was observed in three out of 11 rabies patients. Serum antibodies appeared in rabies patients as early as 3 days after onset of the first symptoms of the disease. In these antibody-positive rabies patients, levels of both antibodies, but particularly of anti-N antibody, were lower than in the vaccinated group. Our results suggest that the process of immune recognition and of antibody development in human rabies is more likely to occur early in the pre-clinical phase, and that reactivity to N protein may be crucial for elicitation of neutralizing antibody.

Adult↗

Plasma C3c in immune-mediated neurological diseases: a preliminary report.

Plasma C3c levels were examined in 56 patients with immune (27) and non-immune (29) mediated neurological diseases by crossed immunoelectrophoresis. Plasma samples were collected during the active phase of illness in both groups, usually within 7 days of admission. 11 patients (4 Guillain-Barré Syndrome-GBS, 3 chronic inflammatory demyelinating polyneuropathy-CIDP, 4 myasthenia gravis-MG) had their plasma saved sequentially during the active and the recovery phase. Plasma C3c levels were elevated in the group with immune mediated diseases when compared with those of non-immune mediated diseases. The sensitivity and specificity of C3c as a diagnostic test for immune mediated neurological diseases were 61.4 and 100% respectively with a positive and negative predictive value of 100 and 41%. the C3c levels in plasma correlated well with disease severity in MG and GBS patients. Such a correlation was also evident in all CIDP patients except one that had persistent elevation in the presence of clinical improvement. Results suggest that the plasma C3c level may be useful for differentiating immune from non-immune mediated neurological diseases. Plasma C3c may also be used for monitoring disease severity, particularly in myasthenia gravis.

Autoimmune Diseases↗

Anticardiolipin antibodies in patients with rabies vaccination induced neurological complications and other neurological diseases.

We reported the occurrence of anticardiolipin antibodies (ACA) by using an enzyme-linked immunosorbent assay (ELISA) in sera of patients with neurologic complications from Semple rabies vaccination. There was a correlation between the presence of ACA and the disease severity. Sixteen of 25 patients (64%) with major neurological complications, 2 of 21 patients (10%) with minor complications, and non of the normal vaccinees had an ACA response. In comparison to this, ACA was found in 10/43 (24%) of patients with post-infectious encephalitis (PIE), Guillain-Barré syndrome (GBS) and multiple sclerosis (MS), 5/22 (23%) and 4/31 (13%) of patients with degenerative neurological diseases and central nervous system (CNS) infections, respectively. There was no specific restriction to any particular isotype. Frequency difference of ACA responses was unremarkable in systemic lupus erythematosus (SLE) patients with (3/9) and without (3/10) CNS involvement. It is not conclusive about the pathogenetic role of ACA. This remains to be determined.

Antibodies↗

Antibody to peptides of human myelin basic protein in post-rabies vaccine encephalomyelitis sera.

Development of neurologic complications after Semple rabies vaccine is closely linked to development of antibody to myelin basic protein (MBP). The portions of MBP against which the antibodies are directed were analyzed by enzyme immunoassay in sera and cerebrospinal fluid from 27 patients with vaccine complications. Most of the antibody was directed to regions of MBP peptides 45-89 and 90-170. There was no apparent correlation between antibody specificity for MBP peptides 1-44, 45-89 and 90-170 and the type of post-vaccinal neurologic complication. We conclude that the immunoglobulin repertoire in human B lymphocytes for responding to human MBP favors the portion of the MBP molecule containing residues 45-170.

Antibodies↗

Regional distribution of rabies viral antigen in central nervous system of human encephalitic and paralytic rabies.

We studied the distribution of rabies viral antigen in the brain and spinal cord of 7 patients with rabies by immunohistochemical techniques. Four patients presented with encephalitis, the remaining 3 had paralysis. Neither the rabies viral antigen distribution nor inflammation paralleled clinical presentations. Patients who had survival times of 7 days or less (4/7) had a greater amount of antigen-positive neurons in brainstem and spinal cord regardless of the clinical type. Neuroglial cells were also found to contain rabies antigen. Our findings suggest that virus localization may not account for the difference in clinical manifestations.

Adolescent↗

Failure of rabies postexposure treatment in Thailand.

Three failures of postexposure rabies treatment using imported purified duck embryo cell and Vero cell rabies vaccines are reported from Thailand. Reference is made to eight additional previously reported Thai patients, six of whom had received human diploid cell vaccine. An analysis of these cases reveals that there were serious flaws in management in all of these patients. It is stressed that 45% of human rabies deaths in Thailand occur within 20 days of being bitten and 71% are dead within 28 days. This short incubation period does not allow much time to start immunotherapy. Of Bangkok dogs found to have rabies at autopsy, approximately 8% have a rabies immunization history. Once a dog has bitten a patient immunotherapy should not be delayed in countries with a high incidence of dog rabies. Patients with chronic disease, alcoholics and drug addicts may have an impaired immune response to postexposure rabies vaccines.

Adolescent↗

Lymphocyte subsets in human encephalitic and paralytic rabies.

Lymphocyte subsets of 7 patients with encephalitic and paralytic rabies were determined by immunocytochemical techniques using mouse monoclonal antibodies. Almost all patients had diminished mononuclear cells of Leu 7 phenotype (natural killer cells). Cells of Leu 12 marker (B cells) were decreased in 3 paralytic rabies patients compared with those of 4 patients in the encephalitic group.

Adolescent↗

Plasma C3c changes in myasthenia gravis patients receiving high-dose intravenous immunoglobulin during crisis.

Fast-migrating C3c, a sensitive index of complement activation, was assayed in the plasma of 2 myasthenia gravis (MG) patients in crisis who received high-dose IV immunoglobulin therapy. Dramatic responses were observed in both patients. Clinical improvement paralleled a decrement in C3c levels, suggesting that regulation of complement activation may be one possible mechanism of IV immunoglobulin treatment in MG.

Adolescent↗

Respiratory insufficiency associated with acute hepatic porphyria.

We reported two patients with acute hepatic porphyria with acute respiratory failure. The acute porphyrias are characterized biochemically by increased excretion of porphyrins and porphyrin precursors, ALA and PBG. It has been shown to be due to partial enzyme blockage along the haeme biosynthetic pathway which results in secondary increased ALA synthetase activity. They are characterized clinically by episodes of acute neurological involvement. Neurological manifestations could be related to either a decrease in essential haemeproteins, or to a toxic effect of ALA and PBG. The first patient illustrated a diagnosis of either variegated or hereditary coproporphyria. The second patient had acute intermittent porphyria. Eventhough, the disease is uncommon in Thailand, many drugs can aggravate an acute attack. Thus, we should be careful not to use such drugs in these patients.

Adult↗

Serum antibodies to HTLV-I in Thai patients with chronic progressive myelopathy, multiple sclerosis, myopathy and in HIV-seropositive intravenous drug abusers.

Antibodies to HTLV-I were assayed in sera of 9 patients with progressive myelopathy, 11 with multiple sclerosis, 5 with myopathy and in 10 HIV-seropositive intravenous heroin abusers. Clinical features in 9 cases with progressive myelopathy were not different from those previously described in tropical spastic paraparesis associated with HTLV-I infection. No detectable HTLV-1 antibody was found in the sera of any of the 35 patients studied.

Adult↗

Enhanced antibody response to rabies virus in patients with neurologic complications following brain tissue-derived rabies vaccination.

Sera from 26 patients with major neurologic complications, 19 patients with minor complications and 23 patients with no complications induced by Semple rabies vaccine were assayed for neutralizing antibody to rabies virus. Seroconversion to the protective level (greater than or equal to 0.5 IU/ml) was found in 21 of 22 patients (95%) with major complications, and in 7 of 19 (37%) with minor complications, occurring during the first 14 days of vaccination. This was in contrast to 42% (5/12) seroconversion in uncomplicated recipients after 14 daily injections. After initiation of dexamethasone treatment, 13 of 18 patients with major complications showed a diminution in their rabies antibody levels on day 4 or 7.

Antibodies, Viral↗

Intermittent exophthalmos.

A 28-year-old woman is reported with intermittent exophthalmos and acute orbital hemorrhage which developed after a warning symptom of recurrent positional headache. The cause was proven to be a primary orbital varix. Conservative measure was considered in this case. The characteristics of the primary orbital varix are presented and the problems of diagnosis and treatment are discussed.

Adult↗

Immunologic study of human encephalitic and paralytic rabies. Preliminary report of 16 patients.

Lymphocyte proliferation tests to rabies antigen and myelin basic protein were performed on peripheral blood lymphocytes from nine patients with the encephalitic form and on seven with the paralytic form of human rabies. Six of the nine patients with encephalitis had proliferative responses to rabies antigen, whereas all of the patients with paralysis had no response. Two patients in each group also had a proliferative response to myelin basic protein. The myelin basic protein-reactive patients had a more rapidly fatal disease than the non-reactive patients. This preliminary study suggests that host immune responses may influence the clinical manifestations and course in human rabies.

Adolescent↗

Immunologic studies of patients with chronic encephalitis induced by post-exposure Semple rabies vaccine.

Neurologic complications of brain tissue-derived rabies vaccine may be chronic or progressive. Lymphocytes and serum from three patients with this form of encephalitis were studied. Two patients had positive lymphoproliferation to purified myelin, two had antibody to white matter, and one had antibody to myelin basic protein. No patient had antibody to proteolipid protein, myelin-associated glycoprotein, or cerebroside.

Antibodies↗

Immunologic studies of rabies vaccination-induced Guillain-Barré syndrome.

Patients with Guillain-Barré syndrome (GBS) induced by rabies vaccines prepared from either suckling mouse brain (SMB) or mature sheep brain (Semple vaccine) and patients with sporadic, idiopathic GBS were studied for antibody to myelin basic protein (MBP), P2 protein, and Schwann cells. Sera from all four Semple vaccine- and one of five SMB vaccine-induced GBS patients, but none of the sporadic GBS patients, had antibody to MBP. Sera from Semple vaccinees also had antibody to fixed, transformed Schwann cells, but similar amounts of antibody were found in sera from Semple vaccinees with CNS complications and with minor non-neurologic complications, suggesting that this antibody was not specifically linked to the development of polyneuritis. None of the sera had detectable antibody to P2 protein. We conclude that patients with GBS constitute a heterogeneous population and that different target antigens may serve as a focus for this presumed autoimmune disease.

Animals↗