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Biomedical subjects

W Weimar

Publications and source records attributed to W Weimar.

At least 307 records · Page 17Linked to original sources

Mononuclear subsets during cytomegalovirus disease in renal transplant recipients treated with cyclosporine and rabbit antithymocyte globulin.

The effect of cytomegalovirus (CMV) disease on mononuclear subpopulations of 49 renal transplant recipients treated with cyclosporine and prednisone are reported. Clinical overt CMV infection developed in 8/21 patients treated for rejection with rabbit antithymocyte globulin. They all showed true inversions of the T helper/T suppressor-cytotoxic (Th/Ts-c) ratio. A reduction of T helper cells and increase in T suppressor-cytotoxic cells preceded clinical symptoms of CMV disease by one week. None of the 26 patients without RATG anti-rejection treatment developed CMV disease and in only three of them an inversion of Th/Ts-c ratio was found.

Antilymphocyte Serum↗

Clinical and immunological evaluation of 20 patients with advanced colorectal cancer treated with high dose recombinant leukocyte interferon-alpha A (rIFN alpha A).

A total of 20 patients with advanced colorectal cancer received recombinant leukocyte interferon-alpha A (rIFN alpha A) either chronically (group I: twice a week up to 20 X 10(6) IU/m2 i.m.) or cyclically (group II: 1-4 periods of 8 consecutive days up to 20 X 10(6) IU/m2 i.m. daily at 20-days intervals) over a period of 12 weeks. There was 1 partial response, 1 mixed response and 1 patient with stable disease, whilst 17 patients had progressive disease. Median survival was 15.5 months. Survival was significantly shorter when the extent of hepatic disease was greater than 25% (P = 0.05), extrahepatic disease was extensive (P less than 0.005), alkaline phosphatase level was greater than 2 X normal (P less than 0.02), or performance status was less than 100% (P less than 0.001). Toxicity consisting mainly of fever, fatigue, anorexia and weight loss was serious in group I and minimal in group II. Administration of rIFN alpha A led to a "short lived" augmentation of natural killer (NK) cell activity. In the cyclically treated group this was a recurrent phenomenon whereas a marked lasting depression of NK cell activity was seen in chronically treated patients. Interferon-gamma production capacity was significantly stimulated during rIFN alpha A therapy. The differences in toxicity and immunostimulatory effects between the two schedules may be of importance in the design of further studies.

Adult↗

Impairment of the immune response to influenza vaccination in renal transplant recipients by cyclosporine, but not azathioprine.

Influenza vaccination has been strongly recommended for immunosuppressed renal transplant recipients. However, immunosuppression may lead to impaired antibody responses. We studied the antibody response to an inactivated trivalent influenza vaccine in 59 renal transplant recipients with life-sustaining kidney function: 21 were on cyclosporine and prednisone, 38 on azathioprine and prednisone. Healthy volunteers (n = 29) and patients on hemodialysis (n = 28) served as controls. Despite comparable renal allograft function, cyclosporine-treated patients had a significantly lower immune response against influenza A viruses than azathioprine-treated patients, whether mean antibody levels, fourfold titer rise, or seroconversion to protective titers was analyzed. No significant differences in antibody responses were found between healthy controls and patients on azathioprine. The patients on hemodialysis showed an impaired response to vaccination. However, in contrast to the cyclosporine-treated patients, booster immunization proved valuable in this group.

Adult↗

Persistent Epstein-Barr virus infection and a histiocytic sarcoma in a renal transplant recipient.

Lymphomas occurring in renal transplant recipients are mostly large cell non-Hodgkin's lymphomas (B-cell-derived). A sarcoma with all morphologic, immunohistochemical, and ultrastructural characteristics of a tumor of the mononuclear phagocytic system (MPS) developed in a 23-year-old woman 1 year after renal transplantation. Anti-Epstein-Barr-virus antibody titers proved to be exceptionally high, even in pretransplant sera. Tumor-derived cells proved to be positive for Epstein-Barr nuclear antigen (EBNA), and hybridization showed multiple copies of Epstein-Barr virus (EBV)-DNA, suggesting a relationship between this tumor and EBV. More widespread use of immunochemical and histochemical diagnostic techniques might detect more cases, which, until now, have probably been diagnosed as B-cell-derived immunoblastic lymphomas.

Adult↗

Effects of treatment with azathioprine and cyclosporin A on interferon-gamma production by peripheral blood leukocytes of renal allograft recipients.

We have studied the concanavalin A (ConA)-induced interferon gamma (IFN-gamma) production of peripheral blood mononuclear cells (PBMC) of renal allograft recipients. Both under immunosuppressive treatment with azathioprine and with cyclosporin A (CsA) the PBMC of these patients proved deficient for IFN-gamma production when compared to those of healthy controls. After conversion from conventional azathioprine to CsA medication the ConA-induced IFN-gamma production increased.

Azathioprine↗

Leukocyte adherence inhibition, natural killer cell activity, gamma-interferon production capacity and phytohemagglutinin response in patients treated with recombinant leukocyte A interferon.

10 patients with disseminated colorectal cancer were treated either chronically or cyclically with human recombinant leukocyte A interferon (IFl-rA) for 3 months. During this period, leukocyte adherence inhibition (LAI), natural killer (NK) cell activity, concanavalin A-induced gamma-interferon production capacity (GIPCA) and phytohemagglutinin response were sequentially monitored. In both chronically and cyclically treated patients, IFl-rA therapy led to a 'short-lived' augmentation of NK cell activity. In the chronically treated patients, there was a further depression in the NK cell activity during the course of therapy. The outcome of LAI remained unaltered irrespective of the mode of IFl-rA therapy. There was an inverse correlation between GIPCA and phytohemagglutinin response.

Aged↗

Ureter obstruction as a complication of Wegener's granulomatosis.

Wegener's granulomatosis affects renal function in the majority of cases by a focal necrotizing glomerulonephritis. In this case report we describe a patient in whom ureteral obstruction due to a retroperitoneal localization preceded this renal manifestation.

Granulomatosis with Polyangiitis↗

Incidence of osteonecrosis after renal transplantation.

The incidence of osteonecrosis was 24% in 248 patients who had received 262 kidney transplants 1971-1982. However, based only on patients at risk, i.e. alive with functioning transplants, the incidence at 1, 3 and 6 years was found to be 13, 27 and 36%; after six years no new cases were found. The relative increase in body-weight at 180 days was predictive as regards risk for osteonecrosis, while the cumulative dose of steroids was not. This suggests that individual sensitivity to steroids rather than the absolute cumulative dose is involved in the development of osteonecrosis.

Body Weight↗

Phase II trial of high-dose recombinant leukocyte alpha-2 interferon for metastatic colorectal cancer without previous systemic treatment.

Ten patients with metastatic colorectal cancer after resection of the primary tumor were treated with high-dose recombinant leukocyte alpha-2 interferon. For a period of 12 weeks the patients received up to 20 X 10(6) IU/m2 im twice weekly. Follow-up varied from 6 to 11 months after stopping treatment. All ten patients were evaluable for tumor response and toxicity. There was one partial response. Nine patients showed growth of metastatic marker lesions. Only three of these patients qualified as having progressive disease (greater than 25% increase in tumor mass). The response rate was 10%, with a 95% confidence interval of 0.3%-44.5%. Toxicity proved considerable and consisted of flu-like symptoms, fatigue, anorexia, and weight loss. Fatigue was the single most important dose-limiting factor. There were no drug-related deaths. Three patients died 3, 5, and 7 months after stopping treatment. Median survival was 18 months.

Aged↗