[Serum 25-OH-vitamin D in patients with hyperthyroidism].
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Biomedical subjects
Publications and source records attributed to W Hunstein.
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We studied the influence of chrysotherapy on lymphocytes, B-cells, T-cells, and T-lymphocyte subpopulations in 9 rheumatoid-factor-positive female patients with rheumatoid arthritis (RA). After chrysotherapy, the white blood cell count decreased within 1 month; the percentage of lymphocytes, T-cells, and B-cells did not change significantly, nor did the proportion of helper cells as determined by reactivity with monoclonal antibody OKT4. In contrast, the percentage of suppressor T-cells reactive with OKT8 was significantly decreased (p less than 0.05) after 6 months. As a consequence, the helper/suppressor ratio, which was significantly higher than in age- and sex-matched controls (p less than 0.02), showed an even more pronounced deviation from normal values than before therapy. The implications of these findings in regard to a possible immunological mechanism of action of gold and the significance of the disturbance of the "immunoregulatory balance" between helper and suppressor mechanisms for the pathogenesis of RA are discussed.
Samples of peripheral blood of 27 patients with seropositive rheumatoid arthritis (RA) and 27 healthy age- and sex-matched controls were coded and studied for lymphocyte subpopulations. Monoclonal antibodies and indirect immunofluorescence were used to analyse subpopulations of purified T cells: OKT3 reacts selectively with all peripheral human T cells, OKT4 defines the helper/inducer subpopulation and OKT8 the suppressor/cytotoxic T cells. RA patients had a significantly lower relative lymphocyte count (p less than 0.001). whereas the percentage of all T cells was similar in patients and controls, RA patients had a significantly higher proportion of helper/inducer cells (62 +/- 1.3 vs. 56 +/- 1.0, p less than 0.005) and significantly decreased suppressors/cytotoxic cells (25 +/- 1.5 vs. 32 +/- 1.0; p less than 0.001). This resulted in an increased "immunoregulatory ratio" of helper to suppressor cells in RA patients (2.68 +/- 0.17) compared to their normal controls (1.83 +/- 0.10; p less than 0.001). The proportions of T cells expressing HLA-D-like antigens (defined by a monoclonal antibody to human Ia) was not different in patients and controls. These findings confirm conclusions derived from our previous study of T cell subsets defined by the expression of Fe-receptors (Tm and Tg), that in the peripheral blood of patients with RA, helper mechanisms predominate over suppressor mechanisms. This derangement of the immunoregulatory balance may have an important role in the pathogenesis of seropositive RA.
Immunofluorescent and light-microscopic investigations of the temporal artery were carried out in 36 patients with polymyalgia rheumatica. An arteritis was seen in 21 patients. Depositions of fibrin, immunoglobulins, and complement were found in the wall of the temporal artery and/or the vasa vasorum in 24 patients. 14 control patients showed neither an arteritis nor depositions of complement. Positive results were obtained in 91.6% of the patients with polymyalgia rheumatica when simultaneous light-microscopic and immunofluorescent examinations of the temporal artery were carried out.
Tumor necrosis factor is an important mediator of the pathophysiologic events in synovitis. The expression of the p75 and p55-TNF-receptors in rheumatic diseases was investigated. Synovial mononuclear cells (SMNC) of patients with rheumatoid arthritis and spondylarthropathies express p75 TNF receptors in all cases, whereas SMNC of patients with traumatic synovitis do not. In 4/9 patients with rheumatoid arthritis and in 6/11 patients with spondylarthropathies SMNC also expressed the p55 TNF receptor. Differential analysis of lymphocytes and monocytes/macrophages revealed that both predominantly expressed the p75 TNF receptor. The highest concentrations of both soluble TNF receptors which may act as TNF antagonists were found in synovial fluids of rheumatoid arthritis patients.