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Biomedical subjects

T Reunala

Publications and source records attributed to T Reunala.

At least 181 records · Page 10Linked to original sources
PubMed1986

HLA antigens, jejunal morphology and associated diseases in children with dermatitis herpetiformis.

Forty-five Hungarian and Finnish children from 1.5 to 15 years with dermatitis herpetiformis were studied for HLA antigens, jejunal morphology on gluten-containing diet and associated diseases in the patients and their relatives. A strong association with HLA-B8 was found in patients of both nationalities, the relative risks were 12.8 and 9.6, respectively. The Hungarian patients were also typed for HLA-DR locus, and an association with DR3 but not with DR7 was observed. Patients with subtotal villous atrophy had slightly more often HLA-B8 and DR3 than those with milder intestinal lesions. Atopic eczema occurred in 20% of the patients and family history of atopy seemed to have an inverse correlation with HLA-B8 and DR3.

Adolescent↗
PubMed1986

Immunohistological evaluation of alopecia areata treated with squaric acid dibutylester (SADBE).

A total of 19 patients with alopecia areata volunteered for serial biopsies of the scalp skin during SADBE treatment. Regrowth of terminal hair was seen in 12 of the 19 patients on the side of the scalp treated with SADBE for a minimum of four months, but not on a control side treated with sodium lauryl sulphate (SLS). Immunocompetent cells were characterized with ANAE staining and monoclonal antibodies in biopsy specimen showing marked peribulbar and perivascular inflammatory cell infiltrates. Inflammatory cell subclasses were repeatedly evaluated during SADBE treatment. No specific alterations in lymphocyte subclasses and macrophages were seen in relation to the hair growth response. In immunofluorescent studies it was found that in patients with regrowth of hair, immunoglobulins, fibrin and complement, appeared in the hair bulb and along the basement membrane during the treatment. Results were negative in patients without regrowth of terminal hair and in SLS-treated skin. As we could not demonstrate that any cell-mediated mechanism was involved, we suggest that SADBE may induce terminal hair growth through as yet uncharacterized mediators.

Adolescent↗
PubMed1985

Benign mucous membrane pemphigoid with linear IgA deposits in oral mucosa.

Two patients with severe oral ulcerations and concomitant lesions in the nose, eyes and genitals were examined. The immunofluorescence (IFL) studies of buccal and genital mucosa revealed that the only deposited immunoglobulin was IgA. Immunoelectron microscopy confirmed the linear pattern of IgA deposition and localized IgA in lamina lucida in both patients. Dapsone 50 mg daily was effective in controlling the disease activity partially in the first and completely in the second patient. The results suggest that our patients had benign mucous membrane pemphigoid (BMMP) was linear IgA deposition but do not exclude a mucosal form of a newly recognized bullous skin disease termed linear IgA disease.

Aged↗
PubMed1985

Immunoelectron microscopic findings in oral mucosa of patients with dermatitis herpetiformis and linear IgA disease.

Two patients with dermatitis herpetiformis and one with linear IgA disease were examined. Two of the patients had oral lesions and all three showed IgA deposits detected by direct immunofluorescence in apparently normal buccal mucosa. To localize the target structures for IgA deposition, biopsy specimens were taken from normal appearing buccal mucosa for immunoelectron microscopy. The patients with dermatitis herpetiformis had distinct IgA deposits in the upper connective tissue. These were often associated with elastic fibers and occasionally also with capillary walls. In contrast, the patient with linear IgA disease had IgA deposition at the subbasal lamina. Though the clinical expressions may be similar the present immunoelectron microscopic findings in oral mucosa clearly differentiate dermatitis herpetiformis from liner IgA disease.

Adult↗
PubMed1985

Immunologic findings of oral lichen planus.

Immunofluorescence (IFL) examination in lichen planus (LP) often reveals fibrin deposition in the basement membrane (BM) zone and colloid bodies (CB) giving a positive IgM fluorescence. Oral biopsies were taken from the involved buccal mucosa of 10 LP patients. IFL examination showed fibrin deposition in the BM area of all patients but in none of the seven controls. CB were found in the upper connective tissue of 5/10 oral and 3/3 skin specimens and they were always positive for fibrin, IgM and keratin. Positive staining with keratin antiserum suggests the epithelial origin of CB but the importance of fibrin and IgM staining remains unknown. Double IFL staining revealed that in areas of heavy fibrin deposition and CB formation the laminin and fibronectin staining was absent, suggesting a damage to BM. Moreover, IFL examinations with serum amyloid P (SAP) antiserum and basic fuchsin (BF) showed alterations indicating that upper connective tissue elastic fiber system is also involved in oral LP.

Colloids↗
PubMed1985

Demonstration of antibodies to mosquito antigens in man by immunodiffusion and ELISA.

Cutaneous reactions to mosquito bites are believed to be immunologically mediated, but knowledge of the underlying mechanisms is very limited. In the present work, comprising 598 subjects, we show that precipitating and ELISA-reactive IgG-class antibodies occur frequently in the adult population. The operating antigen(s) were found in whole-body extracts of Aedes mosquitoes and also in a continuous mosquito cell line culture. The appearance of antimosquito antibodies seems to be correlated with the exposure to mosquito bites; however, massive exposure at an early age may result in a suppressed response.

Aedes↗
PubMed1985

Antigliadin antibodies and gluten-free diet in dermatitis herpetiformis.

IgA and IgG class antigliadin antibodies (AGA) were analysed with ELISA technique from serum samples of 30 dermatitis herpetiformis patients. Jejunal biopsies were performed to all patients before any treatment and high levels of IgA class AGA were found to be associated with subtotal villous atrophy. Fourteen patients started gluten-free diet (GFD) which caused a significant decrease in both IgA and IgG class AGA. The decrease of IgA AGA was faster than that of IgG AGA and IgA antibody levels fell to normal range during the GFD treatment in all but one patient. In contrast, 5 out of 8 patients followed on normal died showed increasing IgA AGA levels and all of them had a rise in IgG AGA. IgA and IgG class antibodies to cow's milk were also measured in these patients but in contrast to AGA the diets had no clearcut effect on these antibodies.

Adolescent↗
PubMed1985

IgA class reticulin antibodies in dermatitis herpetiformis: a good indicator of jejunal damage.

Fifty patients with dermatitis herpetiformis (DH) were examined. Reticulin antibodies (RA) were found in 34 (68%) patients; 25 (73%) of them had IgA class RA, seven (21%) had IgA and IgG class RA, and two (6%) had IgG class RA. A good correlation was found between the occurrence of RA and the presence of jejunal villous atrophy. Twenty-four (96%) of the patients with subtotal villous atrophy and nine (82%) with partial villous atrophy had RA as compared to only one (7%) of the 14 patients with normal jejunal mucosa. Gluten-free diet treatment caused disappearance of RA in every patient, suggesting that RA measurements can also be used in DH for monitoring adherence to the diet treatment.

Adolescent↗
PubMed1985

Comparison of trioxsalen bath and oral methoxsalen PUVA in psoriasis.

Fifty patients with chronic plaque psoriasis were treated with trioxsalen bath PUVA and 43 patients with oral methoxsalen PUVA. The two treatment regimens gave similar results; 75% and 77% of the patients had excellent or good clearing and a follow-up of one year revealed relapses in 61% and 58% of the patients, respectively. The cumulative UVA dose remained significantly lower in bath PUVA (mean 23.5 J/cm2) than in oral PUVA (mean 131 J/cm2). Nausea and headache occurred in 21% of the patients receiving oral PUVA but in none in the bath PUVA group. Local side-effects were found in 30% of the patients receiving bath PUVA and in 17% of the patients in the oral PUVA group.

Adult↗
PubMed1984

Immunocompetent and accessory cells in dermatitis herpetiformis.

Monoclonal antibodies were used in conjunction with the biotin-avidin immunolectin method and the indirect immunofluorescence method to detect lymphocyte subsets in patients with dermatitis herpetiformis (DH) in 50% potassium iodide (KI)-induced skin lesions and in density-gradient-isolated peripheral blood. The proportions of T3-, T4-, and T8-positive lymphocytes in peripheral blood in patients with DH were 76 +/- 6, 48 +/- 7, and 28 +/- 4% and did not differ significantly from those in healthy controls. Among the inflammatory cells in situ in the reticular dermis, 82 +/- 5% were T3-positive lymphocytes, indicating a T-lymphocyte dominance in mature KI-induced DH lesions. The difference in the proportion of T4-positive lymphocytes in mature DH skin lesions and in patient blood was significant (63 +/- 9 and 48 +/- 7%, respectively (P less than 0.001), indicating that the composition of the dermal infiltrate does not reflect nonselective entrapment of blood mononuclear cells in situ. Studies of the kinetics of the local inflammatory response disclosed that at the preblister stage endogenous peroxidase-positive cells and granular, extracellular peroxidase were observed in the dermal papillae only 6 hr after induction, suggesting locally released proteinases as possible complement-degrading factors. Second, at the same time 63 +/- 15% of the inflammatory round cells in the dermis were Ia-positive, endogenous peroxidase-negative, T3- and T6-negative cells, indicating a pathomorphogenetic role for an early event no longer observable in the mature DH skin lesion.

Dermatitis Herpetiformis↗
PubMed1984

Immunity in herpes gestationis: inhibition of mixed lymphocyte culture by patients' sera.

The families of four patients with herpes gestationis (HG) (pemphigoid gestationis) and five patients with polymorphic eruption of pregnancy (PEP) were HLA typed. Anti-HLA-D antibodies in the maternal sera were sought using mixed lymphocyte culture (MLC) inhibition test. Two of the four patients with HG had Dw3, one of which was combined with Dw4. One of the fathers had Dw2. The sera of the four patients with HG strongly inhibited (48-100%) the MLC reaction of maternal cells against cells of the father or the child. This kind of inhibition could not be shown in the patients with PEP. We conclude that patients with HG often seem to have MLC inhibiting factors which obviously are antibodies directed against HLA-D region determinants. Their pathogenic role is still obscure.

Female↗
PubMed1984

Localized heat urticaria associated with a decrease in serum complement factor B (C3 proactivator).

A case of localized heat urticaria is reported in a 51-year-old woman who within a few minutes of contact with warm water developed erythema and swelling sharply localized to the heated area. After a hot bath urticarial lesions appeared over large areas of her body, accompanied by a feeling of weakness, but no other systemic symptoms. After challenge with heat by immersing her left arm in water heated to 42 degrees C, a rapid decrease of her serum complement level of factor B was demonstrated, suggesting that activation of an alternative complement pathway plays a role in this form of urticaria. Biopsies for immunofluorescent study of complement and immunoglobulins were negative at 30 and 180 min after heat challenge. The dermal fibres and endothelial cells of dermal vessels were capable, in vitro, of complement binding before and after exposure to heat.

Complement Factor B↗
PubMed1984

IgA deposits in the oral mucosa of patients with dermatitis herpetiformis and linear IgA disease.

The oral mucosa of seven patients with dermatitis herpetiformis (DH) and one with linear IgA disease was studied. None of the patients with DH showed any macroscopic oral lesions, but direct immunofluorescence (IFL) examination of the buccal mucosa revealed granular IgA deposits in all patients. IgA deposits were found just below the basement membrane zone or slightly deeper in the connective tissue, i.e. a deposition pattern which is pathognomonic to DH. In three patients C3 deposits occurred in the same area as IgA. The patient with linear IgA disease had small white erythematous patches, nonspecific both clinically and histologically, on the palatal mucosa. However, oral IFL specimens showed heavy linear IgA deposits in the basement membrane zone, indicating that the oral mucosa is also involved in this rare disease. Buccal mucosal biopsy specimens were stained with four FITC-conjugated lectins (Ulex europaeus I, soybean, peanut and lentil). The lectin staining was similar in patients with DH and linear IgA disease and did not markedly differ from normal oral mucosa. Our results show that buccal IFL examination is a useful diagnostic aid in both DH and linear IgA disease.

Adult↗
PubMed1984

Dermatitis herpetiformis: jejunal findings and skin response to gluten free diet.

Fifty seven children with dermatitis herpetiformis, 18 from Finland and 39 from Hungary, were studied. Diagnostic criteria included the finding of granular IgA deposits in the skin of all patients. The mean age at onset of the rash was 7 X 2 years and favoured sites were the elbows, knees, and buttocks. Symptoms suggesting small intestinal disease were rare but in 35 (61%) of the children subtotal villous atrophy and in 16 (28%) partial villous atrophy were found on jejunal biopsy. Eighteen children underwent a second biopsy after a mean of 21 months on a gluten free diet; villous height was found to be increased and the intraepithelial lymphocyte count decreased in all these patients. Gluten challenge caused a reversal in the two children who underwent a third biopsy. The effect of the gluten free diet on the rash was examined in Finnish children by observing the daily requirements of dapsone, a drug used to control the rash at the beginning of the diet. Eight (67%) of the 12 children were able to stop taking dapsone after a mean of 11 months on the diet and all three patients treated with diet alone became asymptomatic after three to 6 months on the diet. These results confirm that most children with dermatitis herpetiformis have jejunal villous atrophy, though they rarely have gastrointestinal symptoms. The central role of gluten in childhood dermatitis herpetiformis is evidenced by the fact that a gluten free diet helps the damaged jejunal mucosa to recover and controls the rash even in those children who do not have an abnormal jejunal biopsy.

Adolescent↗