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Biomedical subjects

V Wahn

Publications and source records attributed to V Wahn.

At least 109 records · Page 6Linked to original sources
PubMed1988

Investigation of the nutritional state of children in a Congolese village. I. Anthropometrical data, plasma prealbumin, albumin, immunoglobulins, ferritin, C-reactive protein, circulating immune complexes.

The nutritional status of an unselected group of 111 children from the village of Bouansa, People's Republic of the Congo, was studied. Comprehensive clinical examinations, anthropometrical measurements and analysis of albumin, prealbumin, ferritin, C-reactive protein (CRP), IgA, IgG, IgM, IgE, IgG- and IgM-circulating immune complexes (CIC) were carried out. The results show, by anthropometrical classification, a high prevalence of moderate malnutrition. Low levels of plasma proteins and high levels of immunoglobulins and CIC were found. No correlation between anthropometrical classification and plasma proteins was established. Children with increased levels of CRP showed low prealbumin values and increased levels of ferritin. Patterns of immunoglobulins and CIC were close to those found in other studies in tropical countries. To evaluate the anthropometrical and biochemical findings it is necessary to take into consideration the apparently healthy appearance of the children, which shows the degree of adaptation to the limited availability of food and the high rate of acute and chronic infections.

Adolescent↗
PubMed1988

Density and agonist-promoted high and low affinity states of the beta-adrenoceptor on human B- and T-cells.

beta-Adrenoceptor binding on peripheral blood mononuclear cells (PBMC) of healthy adult volunteers was investigated using the radioligand 125iodo-cyanopindolol (ICYP). Saturation binding studies were performed with nine different concentrations of ICYP. Receptor density and affinity were calculated by Scatchard plots. Resolution of beta-adrenoceptors into those with high and low affinity state of the beta-adrenoceptor was obtained from inhibition curves with salbutamol using Hofstee plots. Receptor density on enriched B-cells ('B-cells') was two-fold higher than on enriched T-cells ('T-cells') (P less than 0.025). Affinity (KD values) of beta-adrenoceptors did not differ for B- and T-cells. However, when two distinct binding states for beta-adrenoceptor agonists were identified using salbutamol displacement curves, beta-adrenoceptors on T-cells presented more receptors in a high affinity state than those on B-cells (P less than 0.01). Since the ability of an agonist to activate adenylate cyclase is closely correlated with the ratio of low to high affinity states formed in the presence of the agonist, increased intrinsic activity for the beta-adrenoceptor agonist on T-cells may be postulated. In conclusion, determination of the B/T ratio is a prerequisite for interpretation of beta-adrenoceptor changes on peripheral lymphocytes in various diseases.

Adolescent↗
PubMed1988

[Pathogenesis and immunologic findings in AIDS].

As the numbers of children suffering from AIDS are slowly increasing in West Germany it is essential for pediatricians to be aware of events leading to clinically overt disease. This review summarizes events involved in viral attachment to CD4-bearing cells, intracellular replication, and destruction of both HIV-infected and non-infected cells. As a consequence of HIV-infection a profound and complex immunodeficiency is observed which is only partially explained by the loss of circulating CD4-bearing cells. Functions of antibodies, cytotoxic T-cells, natural killer cells, killer cells, as well as non-specific immune functions are discussed not only with respect to defense mechanisms in general but also with respect to the control of HIV-infection itself. Detailed understanding of these events seems to be a prerequisite for understanding the occurrence of infections and tumours in AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Gold-induced systemic lupus erythematosus].

After 10 months of treatment with sodiumaureo-thiomalate a 12 year old girl with severe exsudative polyarthritis developed pericarditis and high titers of antinuclear antibodies as well as antibodies to native double-stranded DNA. At that time the cumulative gold dose was 550 mg. After withdrawal of gold medication the clinical symptoms rapidly disappeared and did not recur after a follow-up period of now 5 years. The titers of autoantibodies decreased to normal levels within a year.

Antibodies, Antinuclear↗
PubMed1988

[Preventive long-term intravenous immunoglobulin infusion in children with acute lymphatic leukemia. II. Zymosan opsonization is decreased and is not increased by IgG infusions].

Zymosan opsonisation was determined in sera of 38 normal individuals and 20 children with acute lymphocytic leukemia (ALL). All patients underwent chemotherapy according to the CoALL 82 protocol. Intravenous gammaglobulin (ivGG) was given prophylactically to replace deficient specific antibodies. Zymosan opsonisation in normal sera ranged from 65% to 133% of a serum pool, whereas sera of children with ALL exhibited markedly decreased opsonisation ranging from 7% to 141% (of the pooled serum standard) at different times during an observation period of 20 months. No significant changes could be observed over time, neither induced by the ivGG infusion itself (short term effect) nor during the 20 months observation period (long term effect). Before ivGG therapy was initiated, a positive correlation was found between zymosan opsonisation and complement parameters (CH 50: p less than 0.01; AP 50; p less than 0.001; C3: p less than 0.05). No correlation could be noted between zymosan opsonisation and IgG concentration. Experiments with complement deficient sera clearly demonstrated the dependence of zymosan opsonisation from complement function. In contrast, sera with little or no IgG but intact complement, showed normal zymosan opsonisation. Deficient zymosan opsonisation might contribute to the immune deficiency of ALL patients. The present study suggests, that the zymosan opsonisation cannot be corrected by ivGG infusions.

Agammaglobulinemia↗
PubMed1988

[Preventive long-term intravenous immunoglobulin infusion in children with acute lymphatic leukemia. I. Anticomplementary activity of gamma globulin preparations is a function of the preparation and IgG concentration prior to infusions].

The influence of intravenous gammaglobulin infusions (ivGG) on hemolytic complement function and the concentration of serum C3 and its split product C3dg was studied in 20 children with acute lymphocytic leukemia (ALL) undergoing ivGG prophylaxis. IvGG was infused once monthly over a period of 20 months using two different preparations commercially available. Serum and EDTA-plasma were collected before initiation of ivGG therapy (time 1), after 10 and 20 months (time 2 and 3), before and immediately after the infusions. IvGG was infused in connection with chemotherapy (according to the CoAll 82 protocol). 16 of 60 sera collected prior to infusions contained less than 700 mg/dl IgG. Mean IgG concentrations could be raised to 198 mg/dl (time 1), 219 mg/dl (time 2), and 213 mg/dl (time 3), respectively. -CH 50 prior to infusions was below normal in 15 of 59 sera, afterwards in 25 of 59 sera. AP 50 before (after) infusions was decreased in 29 of 59 (36 of 60) sera, C3 in 18 of 60 (24 of 60) sera. C3dg was slightly elevated in one EDTA-plasma prior to ivGG infusions and in 5 of the plasmas following infusions. IvGG infusions resulted in a significant loss of hemolytic activity of serum complement (p less than 0.01, F-test). The effect was more profound if IgG concentrations before infusions were less than 700 mg/dl, but this was true for only one of the two used ivGG preparations. The long term follow up over two years showed no significant changes of complement functions (F-test), indicating complete recovery of complement function from short term anticomplementary effects.

Child↗
PubMed1987

Neurological manifestations in three German children with AIDS.

We report the neurological findings in two children with AIDS and one child with lesser AIDS. The first patient developed acute encephalopathy 37 months after having received a blood transfusion from a HTLV-III positive donor. CCT showed ring-enhancement and hypodense lesions with homogenous enhancement. Autopsy revealed CNS toxoplasmosis. The second child with AIDS, born to an iv drug-addicted mother, had one seizure at four months of age, but other neurologic signs were absent. She died of pneumonia due to Pneumocystis carinii at seven months of age. Postmortem examination of the brain revealed extensive nerve cell damage in the cerebral cortex and cerebellum, probably due to terminal hypoxemia and not AIDS-related. In both children clinical features of childhood AIDS like failure to thrive, lymphadenopathy, oral thrush and chronic pulmonary infiltrates were absent. The hallmark of the third child's clinical course was a progressive loss of psychomotor abilities with onset of the neurological symptoms nine months before other signs of AIDS occurred. AIDS should be suspected or excluded in children at increased risk for AIDS presenting with either acquired atypical CNS infection or unexplained developmental regression, even in the absence of other clinical symptoms of pediatric AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Persistently circulating C3 nephritic factor (C3 NeF)-stabilized alternative pathway C3 convertase (C3 CoF) in serum of an 11-year-old girl with meningococcal septicemia--simultaneous occurrence with free C3 NeF.

Hemolytic complement was found to be absent in the serum of an 11-yr-old girl (R.N.) with meningococcal septicemia. C1, C4, and C2 were slightly decreased, C3 was absent, C5-C9 within the normal range. B levels immunochemically and electrophoretic mobility of B were normal. C3d was greater than 1000% of a pooled EDTA-plasma standard indicating hypercatabolism of C3. On incubation of the patient's serum with normal human serum activation of C3 occurred even in the presence of 0.04 M EDTA. The amount of C3b generated was, however, greater without any chelating agent or in Mg-EGTA. On gel filtration of the serum two protein containing peaks were found to be responsible for activation of C3: the IgG containing peak was able to activate C3 in normal human serum without chelating agents and in Mg-EGTA but not in the presence of EDTA. The IgM-containing peak activated the third component of complement even in the presence of EDTA. The factor responsible for this phenomenon was termed C3 converting factor (C3 CoF). The IgG fraction of the patients serum caused activation of C3 in Mg-EGTA. However, in the presence of EDTA no activation of C3 could be induced even if physiological concentrations of the patients IgG were added to normal human EDTA-plasma. Thus the activity of the patient's IgG did not differ from typical C3 nephritic factor. The decay of C2 in EAC42 intermediates in the presence of the patient's IgG was uninfluenced indicating that it did not carry autoantibody activity against the classical pathway convertase C4b,2a, an activity recently termed NFc.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1987

[Formation of specific IgG antibodies in l-asparaginase treatment. Distribution of IgG subclasses].

During l-Asparaginase (l-Asp) treatment the development of specific antibodies of IgG isotype is frequently observed. In most instances elevated IgG antibodies to l-Asp activate the complement system and induce allergic reactions following l-Asp infusion. However, in some cases no adverse reactions and no activation of complement are noticed, despite the presence of elevated anti-l-Asp levels. We studied the development of specific IgG antibodies to l-Asp in different subclasses in 12 children who had produced high levels of specific IgG. Results showed that all patients had elevated levels of IgG1. In 5 cases we were able to demonstrate the development of specific IgG3 antibodies and in 1 case of IgG4 antibody. Patients with high levels of IgG3 (above 100 AU) had the highest risk for subsequent anaphylaxis. Thus, subclass-specific determination of antibodies to l-Asparaginase might improve the estimation of the risk of anaphylaxis prior to 1-Asp infusions.

Adolescent↗
PubMed1985

Anaphylaxis to L-asparaginase during treatment for acute lymphoblastic leukemia in children--evidence of a complement-mediated mechanism.

L-Asparaginase (l-Asp) is widely used as an effective drug against childhood and adult acute lymphoblastic leukemia (ALL). However, it is immunogenic in humans and may lead to hypersensitivity reactions. The immunological basis of these reactions is not clear. Since the presence of l-Asp specific IgG-antibodies seems to correlate better with clinical reactions than IgE-antibodies and IgG-antibodies are known to be able to fix and activate the complement system, we speculated that the mechanism of anaphylaxis may be complement- rather than IgE-mediated. We analyzed 24 children with ALL (age 2-15 yr) for changes in the complement system during l-Asp infusions. Chemotherapy was administered according to the CoALL 82 protocol which is derived from the CoALL 80 protocol recently published. The formation of specific antibodies of IgM and IgG classes against l-Asp was monitored by a solid phase ELISA. The immunological responsiveness of individual patients varied over a wide range but both types of antibodies were induced. Anaphylactic reactions were observed on eight occasions in eight children. The infusions in the remaining 16 patients were tolerated without clinical reactions. Significant activation of complement was demonstrated in seven of eight reaction occasions and in none of the occasions without reactions. The most important complement activation parameter monitored was the C3 split product C3d measured in EDTA-plasma. We conclude that anaphylaxis to l-Asp in patients with ALL can be explained in most instances on the basis of complement activation induced by the formation of immune complexes of l-Asp and specific antibodies of IgM and IgG classes.

Adolescent↗
PubMed1985

[Treatment of juvenile rheumatoid arthritis].

Recently interest in pediatric rheumatology has increased. This review tries to summarize our knowledge about pharmacological mechanisms, as well as practical application and adverse of antirheumatic drugs. In addition, forms of treatment which sofar lack any scientific backing are mentioned and discussed. Various data about efficacy and side effects in children are poor or lacking, and current treatment in children is based on analogy conclusions derived from experiences with adult RA. The therapeutic concept presented in this article offers a good chance to improve the functional status of the rheumatic child. However, one should be aware that several controlled trials with antirheumatic drugs in children still have to be performed. Uncertainties have to be replaced by knowledge. This is true also for the surgical treatment mentioned.

Adjuvants, Immunologic↗
PubMed1985

[Progressive-septic granulomatosis: improved prognosis with early diagnosis and targeted therapy. Report of 5 cases].

The clinical and laboratory findings in chronic granulomatous disease are illustrated by five case reports. Biochemical studies of the neutrophil bactericidal defect have revealed several molecular forms of the disease. Specific therapeutic action is nowadays possible, after early diagnosis of the condition by nitroblue-tetrazolium test and chemiluminescence. Infections are treated using antibiotics and antimycotics which penetrate well into granulocytes; additional surgical intervention or granulocyte transfusion may be necessary. Prolonged infection-free periods are achieved under prophylactic sulfamethoxazole/trimethoprim therapy, promising an improved prognostic outlook for patients with chronic granulomatous disease.

Adult↗
PubMed1984

[Four kinds of parasites in an 8-year-old boy. Therapeutic effects of praziquantel against Fasciola hepatica].

An 8-year-old Turkish boy had recurrent abdominal colics associated with marked eosinophilia. Four different kinds of parasites were isolated from stool and duodenal juice: Fasciola hepatica, Entamoeba histolytica, Ascaris lumbricoides and Lamblia intestinalis. Conventional drugs were successful in treating the latter three parasites. But because of problems connected with the treatment of F. hepatica, praziquantel was administered, 15 mg/kg five times daily for 5 days, with curative results. This is the first published successful treatment of Fasciola hepatica with this drug in Europe.

Ascariasis↗
PubMed1984

[Intravenous gamma globulin therapy. Measurement of circulating immune complexes and complement factors].

15 patients with different forms of relevant antibody deficiency syndromes were treated with gammaglobulin (Immunglobulin SRK) by intravenous route. Analysis of the complement system showed a weak activation of the C-system in vivo and a reduction of C-turnover. Prior to infusions C-turnover seemed to be increased pathoogically. In response to infusions a significant increase in immune complexes or immune complex-like material could be demonstrated, partly caused by "real" antigen-antibody-reactions and partly by the in vivo action of gammaglobulin aggregates. These "induced" immune complexes may have immunomodulatory effects. Three patients developed anaphylactic reactions to gammaglobulin. In one patient these were associated with a classical antigen-antibody reaction and complement activation, and in a second patient with a questionable antigen-antibody reaction and complement activation. A third patient had an anaphylactic reaction without any of these signs.

Anaphylaxis↗