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Biomedical subjects

Y Shoenfeld

Publications and source records attributed to Y Shoenfeld.

At least 649 records · Page 36Linked to original sources

[Recurrent avascular bone necrosis in systemic lupus].

Ischemic necrosis of the bones in systemic lupus erythematosus (SLE) usually appears when treatment with corticosteroids is initiated. The most frequent site is the hip, while the knee and shoulder are less frequently involved. A 21-year-old man was admitted because of bilateral shoulder pain 3 years after diagnosis of SLE. The skin, joints, brain, small intestine and kidneys were also involved and corticosteroid therapy was started. 1.5 years before his last admission, severe knee pain developed with limitation of range of movement but without effusion or soft tissue swelling. Bone scan confirmed the diagnosis of aseptic necrosis of the femur and tibia of both knees. He also developed bilateral shoulder pain accompanied by limitation of the range of internal and external rotation. X-ray of the shoulders demonstrated bilateral ischemic necrosis. Since synovitis is relatively rare in SLE treated with corticosteroids, aseptic necrosis of the bone should always be suspected when arthralgia develops in this condition.

Adrenal Cortex Hormones↗

[Fulminant hepatic failure due to hepatitis A].

Fulminant hepatic failure accompanied by encephalopathy is a rare complication of acute liver disease, especially infection due to hepatitis A virus. We describe a 24-year-old woman and a 27-year-old man who developed this complication. One case presented with loss of consciousness and ended fatally. In the other the presenting symptoms were mental confusion and transient asterixis. Although hepatitis due to virus A is usually mild and the course favorable, one should be aware of the possibility of severe encephalopathy as a complication.

Adult↗

The role of anti-idiotypic antibodies in the induction of experimental systemic lupus erythematosus in mice.

We have recently reported the induction of experimental systemic lupus erythematosus (SLE) in mice by a human anti-DNA monoclonal antibody (mAb) that bears a common idiotype, the 16/6 Id. In the present report we investigated the role of the idiotypic network in the induction of experimental SLE by using a murine anti-idiotypic mAb specific for the 16/6 Id. This anti-idiotypic mAb induced experimental SLE similarly to the 16/6 Id. Thus, following immunization, in addition to 16/6 Id+ antibodies, the mice produced antibodies to various nuclear antigens: single-stranded DNA, double-stranded DNA, poly(I), poly(G), Ro, La, Sm and ribonucleoproteins. Similarly to the 16/6 Id-immunized mice, the mice injected with the anti-16/6 Id mAb exhibited elevated erythrocyte sedimentation rate and leukopenia. The murine anti-16/6 Id mAb was found to be more effective than the 16/6 Id, in causing earlier onset of proteinuria and renal damage. These results suggest that the idiotypic network and particularly anti-idiotypic antibodies specific for anti-DNA common idiotypes found in SLE, play an important role in the induction of SLE in mice.

Animals↗

The role of the idiotypic network in the induction of experimental systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has been induced in C3H.SW mice by their immunization with a human monoclonal anti-DNA antibody that bears a common idiotype-16/6 Id. Following immunization, high levels of murine anti-16/6 and anti-anti-16/6 antibodies were detected in the sera of the immunized mice. Elevated titers of autoantibodies reacting with ssDNA, dsDNA, poly(I), poly(G), RNP, Ro, and La were also observed. The serological findings were associated with significant proteinuria, leukopenia, and elevated erythrocyte sedimentation rate. Immune complex deposition in the glomerular mesangium and sclerosis of the glomeruli were demonstrated. To study whether or not anti-idiotype antibodies are involved in the induction of the disease, a murine monoclonal antibody against the 16/6 Id was prepared and injected into C3H.SW mice. The anti-16/6 Id antibody induced experimental SLE similarly to the 16/6 Id with an accelerated kidney pathology. A study performed on different mouse strains indicated that the susceptibility to the induction of SLE by the 16/6 Id is strain dependent and directly correlates to their ability to produce anti-16/6 Id specific antibodies.

Animals↗

Natural killer cells and autoimmunity.

In various autoimmune diseases it appears that NK activity is impaired, and that this phenomenon is significant in disease development. Impairment of NK activity may be the result of two different mechanisms. In systemic autoimmune diseases, in which various target organs are involved (nonorgan-specific), the peripheral blood NK level is generally lower than normal. This most likely allows the expression of autoimmune phenomena such as B cell hyperactivity and polyclonal antibody production, as is seen in SLE, due to a defect in the termination of the immune response. In autoimmune diseases with more localized, organ-specific lesions one can detect increased NK activity at the target organ itself. In these instances, the cytotoxic characteristic of the NK cell is more prominent. This theory explains why both increased and decreased NK activity may be observed in autoimmune diseases. In some disorders in which decreased NK activity was suspected of being crucial, immunomodulators, known to increase NK activity, were administered. Yet it is still difficult to separate the NK activity from the effect of the remaining immune system.

Arthritis, Rheumatoid↗

Autoantibodies to histones and their subfractions in chronic liver diseases.

Sera of 78 patients with different chronic liver diseases were examined for the presence of anti-histone activity using an enzyme-linked immunosorbent assay. Eighteen patients had primary biliary cirrhosis (PBC), 20 had chronic active hepatitis, and 40 had cirrhosis. Anti-histone antibodies were detected in 34 patients (43.6%), distributed among all liver disease entities studied. When antibodies of specific isotypes (IgG, IgM, and IgA) were measured, even higher frequencies were noted--50% for IgG and 53.8% for IgA. Antibodies to histone subfractions H1, H2a, H2b, H3, and H4 were also observed in all liver disorders investigated (in 22-32% of patients)--H1 and H3 being the prominent fractions involved. Of the various disease entities examined PBC was the one disclosing the highest frequency of anti-histone antibodies.

Antibodies, Antinuclear↗

The mosaic of autoimmunity.

The term 'autoimmune' is applied to a wide spectrum of diseases, which, although they may differ in pathology, share many factors. In their review, portrayed as a mosaic, Yehuda Shoenfeld and David Isenberg illustrate the complexity of these conditions, outlining the many pieces, genetic, hormonal, immunological and environmental that contribute to auto-immunity, and show how their varying combinations lead to diverse diseases.

Animals↗

Full skin thickness burns caused by contact with the pavement in a heat-stroke victim.

A 70-year-old woman, with a previous history of heat-stroke, suffered another heat-stroke on a hot summer day (air temperature 43 degrees C (109 degrees F)). She presented the rare complication of a heat-stroke plus deep burns sustained while lying unconscious on the pavement. In addition to age, obesity, previous illness, incidental fever, drugs, dehydration and physical effort, a previous history of heat-stroke is probably an important risk factor for a second heat-stroke. Burns from contact with the pavement are uncommon but possible, especially if the patient is obese, immobile and poorly insulated.

Accidents↗

The significance of T suppressor cells in the development of autoimmunity.

Despite intensive research, autoimmune-disease pathogenesis is still an enigma, but in the past decade Ts-cell defects have assumed a central role in this pathogenesis. Ts-cell dysfunctions have been reported in numerous autoimmune diseases (e.g. SLE, autoimmune thyroid disease, myasthenia gravis) and in animal models of autoimmune diseases. Therefore, it is currently believed that Ts cells are responsible for maintaining self-tolerance and that perturbations in suppressor functions may initiate development of autoimmune diseases. Ts-cell abnormalities can result from LCTA production, intrinsic biochemical alterations, genetic susceptibility, or environmental factors. Since Ts-cells dysfunctions are believed to initiate autoimmunity, it may be possible to treat autoimmune diseases by correcting the suppressor defects, and indeed, preliminary trials in this direction are promising.

Animals↗

A common anti-DNA antibody idiotype and anti-phospholipid antibodies in sera from patients with schistosomiasis and filariasis with and without nephritis.

The serum concentration of a public idiotype (16/6 ID), originally identified on a human hybridoma-derived monoclonal anti-DNA antibody, was raised in patients with S. mansoni and filariasis with or without nephritis, compared to patients with S. haematobium (in which nephritis does not occur) or idiopathic nephritis not associated with infection. There was no significant difference in 16/6 ID levels between patients with or without renal disease, whether associated with S. mansoni or filarial infection. The 16/6 ID-positive antibodies did not bind to native or denatured DNA, using competitive fluid-phase inhibition studies. Anti-cardiolipin antibody (ACA) concentration was increased in patients with either S. mansoni or filarial infection. In filariasis, both IgG and IgM ACA isotypes were elevated, irrespective of the presence of nephritis. In S. mansoni infection, IgA ACA were limited to patients with renal disease, and IgG ACA isotype to patients without overt nephritis. Both isotypes of anti-cardiolipin antibody correlated with levels of the 16/6 ID in patients with S. mansoni or filariasis. The 16/6 idiotype was therefore a feature of chronic helminthic infection, but was not related to anti-DNA antibody levels or specificity. The occurrence of nephritis as a complication of these infections was not related to the prevalence of the 16/6 idiotype.

Antibodies, Antinuclear↗

Autoantibodies against a nuclear 56 kDa protein: a marker for inflammatory muscle disease.

Antibodies to a 56 kDa nuclear protein have been found in the sera of 85% of patients with myositis using an immunoblotting technique. This auto-antibody appears to be relatively disease-specific though more frequently detectable in both adult and childhood onset dermatomyositis. In adult patients with myositis the anti-56 kDa antibody level reflects disease activity. This antibody is thus much more frequently found than previously described disease-specific autoantibodies in patients with myositis such as the Jo-1 antibody, and may represent a useful diagnostic aid in patients with muscle weakness.

Animals↗

Antinuclear and related autoantibodies in sera of healthy subjects with IgA deficiency.

The sera of 49 healthy IgA-deficient (SIgAD) subjects were evaluated for the presence of autoantibodies directed against 10 different nuclear and cytoskeletal antigens, as well as for the presence of the common lupus anti-DNA idiotype (16/6 Id). Twenty-nine sera were from IgG subclass-deficient subjects (4 = IgG2, 25 = IgG3), and 25 from normal healthy subjects, used as controls. The incidence of antinuclear but not anti-cytoskeletal antibodies were found to be significantly greater in the SIgAD group, as compared to the IgG-deficient subjects and the normal controls. Overall, 39% of SIgAD sera demonstrated polyreactivity, namely reactivity against more than one nuclear antigen. The incidence of specific antibody detection ranged from 37% against cardiolipin to 12% against RNP in the IgA-deficient group, albeit not with statistical significance in all cases when compared to the control group. Isotype evaluation of the antinuclear and related antibodies in the SIgAD group showed a greater tendency towards IgG. This increased incidence of autoantibody production in SIgAD may preceed the development of an overt autoimmune disease in the future.

Agammaglobulinemia↗