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Biomedical subjects

W Kullich

Publications and source records attributed to W Kullich.

At least 19 recordsLinked to original sources
PubMed2005

Preferential type 1 chemokine receptors and cytokine production of CD28- T cells in ankylosing spondylitis.

OBJECTIVE: To examine serum levels of type 1 and type 2 chemokines and lymphocytic expression of chemokine receptors, and to compare the results with lymphocytic cytokine production in patients with ankylosing spondylitis (AS). METHODS: Twelve patients with AS (mean (SD) age 44.9 (14.7) years) and 27 healthy controls (46.4 (12.8) years) were enrolled into the study. The expression of chemokine receptors (CCR-5, CXCR-3, CCR-4) and cytokines (interferon gamma (IFNgamma), interleukin (IL)2, IL4, IL10, tumour necrosis factor alpha (TNFalpha)) on CD28(+) and CD28(-) T cell subtypes was analysed by a three colour FACS technique of peripheral blood samples. Serum ELISAs were performed to detect the CCR-5 ligands CCL-5, CCL-3; the CXCR-3 ligands CXCL-10, CXCL-9; and the CCR-4 ligand, CCL-17 before and after administration of the TNFalpha blocking agent infliximab. RESULTS: CD4(+)CD28(-) T cells had higher ratios of CXCR-3 to CCR-4 than CD4(+)CD28(+) T cells. Both, CD4(+) and CD8(+)CD28(-) T cells of patients with AS produced more IFNgamma, TNFalpha, and IL10 than their CD28(+) counterparts (p<0.05), and lacked the production of IL2 and IL4. Serum levels of CXCL-9 were increased in patients with AS to 59.2 pg/ml (34.1-730.5) compared with 32.5 pg/ml (20.0-79.5) in healthy controls (p = 0.016). The levels of both type 1 (CCL-5, CXCL-9) and type 2 chemokines (CCL-17) decreased under blockade of TNFalpha (p<0.05). CONCLUSIONS: The profile of chemokine receptor expression and cytokine production by CD28(-) T cells suggests a type 1 immune reaction in AS, although IL10 is frequently produced by CD28(-) T cells. Treatment with TNFalpha blocking antibodies decreased both types of chemokines in patients' sera.

Adult↗
PubMed2002

[Cardiovascular manifestations in inflammatory rheumatic diseases].

Inflammatory rheumatic diseases show an increased cardiovascular mortality. The reasons for this are unclear. Possible associations between atherosclerosis and autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus can be illustrated.

Arthritis, Rheumatoid↗
PubMed1999

Association between serum pepsinogen A and C levels, serum gastrin concentrations and Helicobacter pylori antibodies.

Pepsinogen A and C as well as gastrin were measured in the serum of 117 patients with rheumatic diseases. Moreover, the patients were divided up in groups by aids of a semiquantitative, rapid enzyme immunoassay for detection of Helicobacter pylori: 20 patients without H. pylori antibodies (AB) negative, 18 positive + (= weak AB-titre), 21 positive +2 (medium AB-titre), and 58 positive +3 (high AB-titre). The semiquantitative determinations of H. pylori-AB correlated with pepsinogen A, C and gastrin. Patients with H. pylori-AB positive +3 showed significantly higher values of pepsinogen C (p < or = 0.01) as well as pepsinogen A and gastrin (p < or = 0.05) than H. pylori-AB negative patients. Significantly increased levels of pepsinogen A (> 150 ng/ml) and C (> 25 ng/ml) were found to occur in 39% and 100% of patients with high H. pylori-AB titres. The measurement of serum pepsinogen C concentrations may provide additional diagnostic information of the extent of mucosal lesions in patients with positive H. pylori-AB titres treated with antirheumatic drugs. Our findings suggest that the semi-quantitative classification of positive AB-results can be useful in cases determining H. pylori infection and mucosal irritation if other investigations are not available.

Adult↗
PubMed1999

[Adhesion molecule ICAM-1 in patients with chronic polyarthritis--effects of inpatient rehabilitation].

In rheumatoid arthritis (RA) the adhesion molecule ICAM-1 mediates the adhesion of leucocytes following subsequent transendothelial migration including interactions and adhesion of several cell types such as fibroblasts, T-lymphocytes and synoviocytes. Significantly increased ICAM-1 levels were measured in the acute phase of RA. The correlation of ICAM-1 levels with the pteridine neopterin (p < or = 0.01) may reflect the role of this adhesion molecule in modulation of immune responses. Despite the significantly higher levels of acute phase reactions parallel to the elevated ICAM-1 levels, no correlations were found between ICAM-1 and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum-Amyloid A (SAA). During an in-patient multidisciplinary rehabilitation programme the levels of ICAM-1 in serum and the majority of all investigated laboratory and clinical parameters such as ESR, CRP, SAA, fibrinogen, pain, swollen and painful joint count, morning stiffness and health assessment questionnaire improved.

Acute-Phase Proteins↗
PubMed1999

[Results of a multidisciplinary rehabilitation concept in patients with chronic lumbar syndromes].

The aim of our pilot study was to evaluate the influence of a multidisciplinary rehabilitation programme on various parameters of pain and function in 88 patients suffering from chronic low back pain caused by disc herniation (46 patients) or after lumbar discectomy (42 patients). We used an exercise-based multidisciplinary programme during a four-week in-patient treatment: active physiotherapy, exercise training and back school, organized in group therapies combined with passive techniques of physiotherapy (heat, massage, electrotherapy, medicated bath) with a daily duration of treatment exceeding three hours. Symptoms and functions improved simultaneously with the reduction of pain. The results of the visual analogue scale improved significantly in both groups (conservatively treated group p < 0.0001, after lumbar discectomy p < 0.005). As for the McGill pain questionnaire, however, only the group with conservatively treated disc herniations changed significantly for the better. We found an improvement in Roland-Morris' disability questionnaire in both groups, which reached statistical significance only in the group after lumbar discectomy. Forward-backward bending (kyphometer measurement as described by Debrunner), ameliorated significantly in both groups. Our results indicate that an exercise based multidisciplinary rehabilitation programme can improve pain and function even in patients suffering from definitely chronic low back pain caused by disc herniation or after lumbar discectomy.

Adult↗
PubMed1999

[Reducing pain by oral enzyme therapy in rheumatic diseases].

Proteolytic enzymes have analgesic, effects, besides the wellknown antiinflammatory and edema-reducing properties. These analgesic effects are based on the inhibition of inflammation and in addition to that on direct influences on the nociceptors. All that explains the therapeutical effects of such enzymes in degenerative-rheumatic and soft tissue rheumatic diseases in which inflammatory or immunologic processes are not in the forefront. In recent years a significant reduction of pain in various rheumatic diseases, concerning these aspects, was shown in several clinical studies. The clinical trial in patients with periarthritis of shoulder showed statistical equivalence of pain reduction, whether they were treated with phlogenzym or diclofenac. Likewise in the trial of patients suffering from painful osteoarthritis of the knee, there was a statistical equivalence of the pain-scores, comparing diclofenac and enzymes. The study of painful vertebral syndromes again resulted in equivalence of the treatment with NSAIDs compared to therapy with enzymes.

Adult↗
PubMed1998

[Results of inpatient postoperative rehabilitation after hip replacement].

The study was performed as a pilot study evaluating the benefit of a 4-week inpatient postoperative rehabilitation programme. We examined 177 patients admitted after total hip replacement. We found statistically significant improvements of joint mobility, muscle power, gait, walking distance and a significant reduction of various pain parameters. The decline in usage of crutches, improvements in the activities of daily living and the positive patients' assessments were of striking evidence. A short time inpatient postoperative rehabilitation programme achieved significant success through an acceptable expenditure of treatment and resulted in substantially increased mobility and autonomy of the patients.

Activities of Daily Living↗
PubMed1997

Correlations between endotoxin, interferon-gamma, biopterin and serum phospholipase A2-activities during lethal gram negative sepsis in rats.

OBJECTIVE: To establish a standardised reproducible animal model of intraperitoneal sepsis, and to investigate early immunoserological responses to find a mediator-based system for evaluation and grading of diffuse peritonitis in patients DESIGN: Prospective experimental study SETTING: 4 Teaching hospitals, Germany and Austria MATERIAL: 42 LEW. 1W rats, 12 of which acted as controls INTERVENTIONS: Gram negative sepsis was induced by intraperitoneal injection of 6 ml of a mixture of Escherichia coli (K1:H+) 10(10) organisms/ml, autogenous haemoglobin 2.9 ml (haemoglobin concentration 3%), 0.9% sodium chloride 3 ml, and suspension 0.1 ml. Control rats were given physiological saline 6 ml alone. MAIN OUTCOME MEASURES: Concentrations of endotoxin, interferon gamma (IFN-gamma), and biopterin, and serum phospholipase A2 (PLA2) activity. RESULTS: There were significant differences between the septic and control rats in concentrations of endotoxin (EU/ml) (median (interquartile range) 21.85 (2.02-159.5) compared with 0, p < 0.0001; IFN-gamma (pg/ml) 1263.0 (271.0-7575.0) compared with 101.0 (89.0-141.0), p < 0.0001; biopterin (nmol/L) 111.0 (66.4-156.3) compared with 53.7 (38.3-67.6), p < 0.001; and PLA2 (U/L) 163.0 (125.8-209.0) compared with 112.5 (88.5-126.5) p < 0.01. CONCLUSIONS: Measurements of concentrations of endotoxin, IFN-gamma, pteridines, and PLA2 activity may well be adequate markers for early recognition of sepsis, and perhaps for grading it during the first 6 hours after induction. The allow a clear distinction to be made between septic and non-septic disorders in 87% of cases.

Animals↗
PubMed1997

[Therapy of hyperuricemia and gout].

Therapy of hyperuricemia and gout has to depend on pathogenesis and stage of the disease. Dietary regimen are in the forefront in treatment of asymptomatic hyperuricemia. Uric acid lowering drugs can only be supported in repeated serum-measures from 9 mg/dl up. The therapy of an acute attack of gout primarily is done with non-steroidal antiinflammatory drugs, in rare cases with colchicine or corticoids. Gouty arthritis in intermission, independent of the extent of hyperuricemia, as well as chronic gout are indications for an uric acid lowering pharmacotherapy, usually for life. A special therapeutic challenge arises out of renal complications and the frequent association with the metabolic syndrome.

Acute Disease↗
PubMed1996

[Possible effect of hormones on immune and inflammatory processes in female patients with chronic polyarthritis].

The influence of gender on the prevalence of rheumatoid arthritis (RA) is well known. We examined 40 female patients with RA to show the possible influence of androgen hormones on inflammation and immune system. We measured blood count, blood sedimentation rate, C-reactive protein routinely and free and bound testosterone, dehydroepiandrosterone-sulfate (DHEA-S), prolactin, insulin like growth factor-1 (IGF), IgA-rheumatoid factor (IgA-RF) and the monocyte marker CD 14 of radioimmunoassays and enzymeimmunoassays. The female patients with RA had lower androgen levels correlating with higher inflammatory markers which are not rising significantly with higher age. The significantly raised IgA-RF with abnormal low testosterone levels points out a poor prognosis for developing joint erosions. The simultaneously reduced levels of prolactin may be rather caused by cytokines and could have additional connections to the anemia in RA. Somatomedin correlated inversely to the degree of inflammation, measured by BSR, CRP and CD 14, a fact which could indicate a reduced, Somatomedin-induced, synthesis in matrix and collagen of cartilage in "active" RA. The results point to the existence of a reciprocal connection of the endocrine system with the immune system.

Adult↗
PubMed1996

[Gastroduodenal tolerance and clinical effectiveness of therapy with lonazolac-calcium in rheumatic diseases].

Most undesired side effects in therapy with non-steroidal antiinflammatory drugs (NSAID) mainly effect the gastric and duodenal mucosa. The radioimmunological determination of pepsinogen A and C (pepsinogen group I and II) is qualified for inclusion of the functional and morphologic state of the gastroduodenal mucosa. By determination of the pepsinogens group A and C the influence and the gastroduodenal compatibility of the non-steroidal antiinflammatory drug lonazolac Ca (LCa) [Irritren] were examined in a dosage of 600 mg/d during a 2-weeks therapy. 31 patients with various painful rheumatic diseases and 10 healthy probands as a control group were examined. The results show that the treatment with LCa did not significantly effect mean and median of pepsinogen A- and -C levels in serum. Only in 3.7% of the cases a contemporary increase of pepsinogen A and C occurred, which could be estimated as a beginning superficial gastritis. In addition the beneficial clinical efficacy of LCa was documented by a significant decrease of a tripartite pain score from 2.1 to 1.4. The results point to a very good proportion of clinical efficacy and gastroduodenal side-effects of LCa.

Adult↗
PubMed1994

[The significance of lipoprotein(a) in assessment of risk for atherosclerosis].

Lipoprotein(a) [Lp(a)] consists like the low-density-lipoprotein (LDL) in the structure protein apolipoprotein B, but is additionally connected with apolipoprotein(a), which is highly homologous to plasminogen. The physiological function of Lp(a) is yet not entirely clear. Lp(a) is established to be an independent factor in the genesis of atherosclerosis however. With occurrence of high Lp(a) Lp(a) plasma levels and other atherogenous risk factors at the same time a potentiation of their effects on genesis of atherosclerosis is observed. Unfortunately the therapeutic possibilities of counteracting the high atherogenicity of Lp(a) are still limited, because LDL apheresis as the only known effective technique today cannot be applied in all cases. In several studies it has been shown, that Lp(a) concentrations can be reduced mainly by long term treatment with lipid-lowering sustained-release bezafibrate, ACE-inhibitor fosinopril, alpha-tocopheryl-nicotinate and N-acetylcysteine. Because of the synergistic effects of atherogenous risk factors patients with high Lp(a) concentrations should avoid additional risk factors such as hypertension, smoking, diet increasing LDL, etc.

Arteriosclerosis↗
PubMed1994

[IgA rheumatoid factor formation in connection with complement activation and circulating immune complexes in chronic polyarthritis].

The IgA-rheumatoid factor (IgA-RF) as well as the complement component C3a in plasma and serum levels of circulating immune complexes (CIC) (C1q binding assay and Raji Cell Replacement assay) were measured with enzyme immunoassays in 81 patients with established rheumatoid arthritis. The serum levels of the complement component C3a were found significantly higher (p < 0.02) in the cases with high IgA-RF (> 6 AU/ml) than in those with low IgA-RF. Distinct significant correlations (r = 0.38; p < 0.001) were observed between production of IgA-RF and activation of the complement fragment C3a, which might be associated with production of antibodies and with complement activation accompanying inflammatory processes. A weaker correlation between CIC and IgA-RF-levels indicates CIC not to be closely related to the production of IgA-RF in the examined R.A.-patients. However, an indirect connection by the way of inflammation and activation of T-cells is possible.

Adult↗
PubMed1994

[Determination of serum pepsinogen I and II for assessment of gastroduodenal tolerance of S(+) ibuprofen].

Therapy with non-steroidal anti-inflammatory drugs often causes gastroduodenal side effects. Changes in the gastric mucosa were studied by determination of serum pepsinogen I and pepsinogen II by the means of radioimmunoassay. 41 patients with degenerative rheumatic diseases were divided into two groups, 21 patients receiving 600 mg S(+) ibuprofen daily (3 x 200mg) and 20 patients receiving 900 mg S(+) ibuprofen daily (3 x 300 mg) over a 14-day period. No significant increase occurred in mean and median values of pepsinogen I and II. Indeed, no changes in serum pepsinogen I and II were noted in 80% of the patients in the higher dosage group and in more than 90% of the lower dosage group. None of the gastroduodenal side effects frequently reported during therapy with non-steroidal anti-rheumatic drugs occurred.

Adult↗
PubMed1993

Correlation of interleukin-2 receptor and neopterin secretion in rheumatoid arthritis.

In rheumatoid arthritis (RA) an immuno dysregulation alters the release of neopterin from human monocytes/macrophages, probably by activation of a feed-back regulation mechanism in pterin metabolism. With the overactivation of T-lymphocytes, the secretion of interleukin-2 and its receptor (IL-2R) is influenced. Investigation on 84 RA patients has shown that this immunoactivation is accompanied by an increased secretion of neopterin and soluble IL-2R in the serum, and that both parameters are very suitable for detection of inflammatory disease activity. The significant correlation between neopterin and IL-2R (r = 0.65; p < or = 0.001) in RA points out a possible connection in pathomechanisms of the immune system.

Adult↗