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Antinuclear antibodies in scleroderma, mixed connective tissue disease and "primary" Raynaud's phenomenon.

The diversity of antibodies in patients with scleroderma, mixed connective tissue disease or "primary" Raynaud's phenomenon could be used as a laboratory aid in the clinical diagnosis. In serum samples of 75 patients we screened for antinuclear antibodies (HEp 2 cells), anti DNA, soluble nucleoprotein and extractable nuclear antigens (Sm, rRNP, U1-nRNP, SSA/Ro, SSB/La and Scl-70). Distinctive antinuclear antibodies pattern was identified in each group of patients. This immunologic profile is valuable for clinical diagnosis and the preferential association of certain autoantibodies with some diseases and not with others, suggest an antigen-driven stimulus for its production.

Adult↗

Objective measures of swallowing in patients with primary Sjogren's syndrome.

Primary Sjogren's syndrome (SS) is an autoimmune disorder primarily affecting salivary and lacrimal glands. Durational measures of the oral phase of swallowing were obtained on 34 patients with primary SS and 34 age-matched controls from analyses of ultrasound scans. Two conditions were examined: a basal (BA) swallow (only endogeneous secretions present in the subjects' mouths) and a 10 ml water bolus (WB) swallow. The patients with SS produced swallowing durations significantly longer (p less than 0.05) than those of the controls for each of the two conditions. Moreover, unlike normals, over 40% of the patients with SS produced WB swallows that were longer than their BA swallows. For further analyses, patients with SS were classified into two groups based on the difference in duration between their BA and WB swallows. These two groups differed from each other on clinical evaluations of oral motor function and presenting complaints. No significant differences were found between these two groups for salivary function or immunologic profile. These findings support the hypothesis that dysphagia can result from conditions leading to salivary gland dysfunction and document the need for the assessment of swallowing function in patients with Sjogren's syndrome.

Adult↗

Pharmacokinetic and immunogenic behavior of three recombinant human GM-CSF-EPO hybrid proteins in cynomolgus monkeys.

MEN 11,300, MEN 11,301, and MEN 11,303 are three recombinant human hybrid proteins that, as has recently been described, induce in vitro erythroid differentiation. This article provides data on their pharmacokinetic and immunogenic behavior after repeated i.v. administration to cynomolgus monkeys at 0.8 or 1.6 micrograms/kg doses. Pharmacokinetic data, obtained after the first administration, showed that the half-life (t1/2) and clearance (CL) values are dose dependent, with no significant differences among the three hybrid proteins. After the tenth administration, MEN 11,300 and MEN 11,301, both a high and low dose, and MEN 11,303 at high dose were undetectable in plasma, whereas MEN 11,303 at the lower dose showed no alteration in its pharmacokinetic profile. Immunologic analyses of plasma provided an explanation for this different pharmacokinetic behavior. In fact, plasma samples from animals treated repeatedly with MEN 11,300 and MEN 11,301 showed specific antibody formation in response to both the high- and the low-dose regimens. These antibodies exerted in vitro a strong neutralizing activity of the hybrid proteins, with a predominant specificity for the erythropoietin (EPO) portion. By contrast, MEN 11,303 at the lower dose did not induce a detectable antibody response whereas the antibodies observed on the high-dose regimen did not exert neutralizing activity against the hybrid proteins nor against granulocyte-macrophage colony-stimulating factor (GM-CSF) or EPO. Hematologic parameters were not affected by the treatments, thus indicating that the anti-EPO neutralizing antibody response does not cross react with the endogenous monkey cytokine. The overall immunogenicity data suggest that among the three fusion proteins, MEN 11,303 could have a lower immunogenic potential.

Animals↗

The immunological diagnosis of HBsAg liver disease by combined screening for the e system in the serum and the HB core and surface antigens in liver biopsy samples.

Serological screening for HBeAg and anti-HBe, combined with the immunohistochemical localization of the hepatitis B core and surface antigen in 110 HBsAg carriers, established different immunological profiles indicative of the liver status and prognostic of the future absence or progression of the disease. Intrahepatic HBcAg and serum HBeAg appeared the most sensitive indexes of chronic and progressive liver disease, anti-HBe and large amounts of cytoplasmic HBsAg suggest, instead, the asymptomatic carrier state without liver damage. Only the nuclear localization of HBcAg in immunohistochemical studies was a reliable prognostic indicator of transition to chronicity; absence or presence of serum HBeAg was of no help in predicitng the outcome of acute HBsAg hepatitis.

Acute Disease↗

Human melanoma-associated antigens identified with monoclonal antibodies.

Using monoclonal antibodies three types of membrane-bound tumour-associated antigens have been identified on human melanoma cells. The tissue distribution, the immunological profile and the structural properties of these melanoma associated antigens (MAA) are described. The applications of the monoclonal antibodies to one of the MAA in the area of immunodiagnosis and immunotherapy are discussed.

Animals↗

Partially compensated hypoadrenalism presenting with persistent skin pigmentation.

A 33-year-old female presented in 1966 with striking pigmentation, typical of Addison's disease, and amenorrhea. Endocrine assessment then showed normal basal serum cortisol and urinary hydroxysteroid levels, but serum cortisol did not respond to stimulation with either exogenous ACTH or lysine vasopressin. Steroid replacement treatment was started. Treatment was discontinued by the patient on her own initiative and after some yr she was lost to follow-up. Reassessment in 1986 showed a pigmented patient who had continued in good health. She had a normal basal serum cortisol level with circadian variation. Plasma ACTH levels were high but showed diurnal rhythmicity and suppressed incompletely with 2 mg or 8 mg of dexamethasone/24 h. Plasma aldosterone levels were normal and showed appropriate postural changes, but plasma renin levels were high. This patient has an immunological profile of autoimmune disease with positive adrenal, thyroid microsomal and gastric parietal cell antibodies with a history of a premature menopause which may also be of autoimmune origin. She has been seen over a 20-yr period and despite her appearance still has no biochemical evidence of glucocorticoid or mineralocorticoid deficiency. It is suggested that the patient had compensated hypoadrenalism, with serum cortisol levels maintained in the normal range by high plasma ACTH levels and serum aldosterone levels maintained by high renin levels. The long term result of the high ACTH levels was increased skin pigmentation.

Adrenal Insufficiency↗

A high prevalence of parvovirus B19 DNA in patients with psoriasis.

Psoriasis is a common inflammatory skin disease. Infectious models are considered to be of pathophysiological importance in psoriasis. The immunological profile of stable psoriasis plaques suggests that viral antigens may be important. Human parvovirus B19 (PVB19) is a single-stranded DNA virus that causes various clinical symptoms. Several case reports have suggested associations between PVB19 infection and various chronic autoimmune and dermatologic diseases. There has so far been no information regarding the role of PVB19 in psoriasis, except psoriatic arthritis. In this report, to investigate the role of PVB19 in psoriasis, we analyzed PVB19 DNA of peripheral blood from psoriatic patients (n = 47) in comparison with blood donors (n = 20). We also determined the presence of anti-PVB19 IgG and IgM antibodies by using enzyme-linked immunosorbent assay (ELISA). We found that the presence of PVB19 DNA in patients with psoriasis (38%) was significantly higher than in controls (0%, P < 0.01). Anti-PVB19 IgG antibodies were detected in 79% of the cases while only 6% had anti-PVB19 IgM antibodies. PVB19 DNA presence was associated with seropositivity for anti-PVB19 IgG (P < 0.05) but not with IgM antibodies, indicating subclinical activation of latent infection. No correlation was found between the presence of PVB19 DNA and a patient's age, sex, type of psoriasis, or psoriasis area and severity index. The data demonstrated a statistically significant association between psoriasis and PVB19. Therefore, we suggest that PVB19 infection may be of pathophysiological importance in psoriasis.

Adolescent↗

Evaluation of a commercial IgG/IgM Western blot assay for early postnatal diagnosis of congenital toxoplasmosis.

The aim of this study was to evaluate a commercial Western blot IgG/IgM assay for use in the early serological diagnosis of congenital toxoplasmosis. This assay compares the immunological profile of mother and infant and allows differentiation between passive transmitted maternal antibodies and newly synthesized antibodies of the infant within the first 3 months of life. Over a 6-year period (1995-2001), the sera from 169 mothers and their 175 offspring (6 had twins) were examined for specific anti- Toxoplasma gondii IgG, IgM and IgA antibodies with an enzyme-linked immunosorbent assay or an immunosorbent agglutination assay. All mothers had primary Toxoplasma infection during pregnancy. Serological and clinical follow-up of the infants during the first year of life confirmed 36 cases of congenital toxoplasmosis. In 139 cases, infection could be ruled out. Three hundred fifty-one paired samples from 175 mother-child pairs were tested retrospectively for IgG and IgM patterns by Toxoplasma Western blot IgG/IgM (LDBIO Diagnostics, France). The results of conventional serological analysis (immunosorbent agglutination assay or enzyme-linked immunosorbent assay) to detect IgM or IgA were compared with the results of the Toxoplasma Western blot IgG/IgM on samples obtained within the first 3 months of life. The performance of the combination of the two methods was also assessed. At birth, the sensitivity values of conventional serological analysis and the Toxoplasma Western blot were 52% and 67%, with specificity values being 99% and 96%, respectively. Combination of the Western blot and conventional serological analysis increased the sensitivity at birth to 78% and within the first 3 months of life to 85%. Overall, the combination of both methods detected 94% of congenital infections. Therefore, this commercial Western blot represents a useful tool for early postnatal diagnosis of congenital toxoplasmosis.

Animals↗

Alveolar hemorrhage associated with a membranoproliferative glomerulonephritis and smooth muscle antibody.

Alveolar hemorrhage along with glomerulonephritis developed in a 31-year-old black man. Renal biopsy demonstrated a granular pattern of immunofluorescence along basement membrane glomeruli, suggesting an immunologically mediated illness; however, light microscopy revealed a pure membranoproliferative glomerulonephritis, which has not been described to date in association with the alveolar hemorrhage syndromes. The patient's immunologic profile revealed a positive antinuclear antibody titer along with the presence of smooth muscle antibodies.

Adult↗

Immune dysfunction in patients with unexplained repeated abortions.

OBJECTIVES: To examine the immunological profiles by antiphospholipid antibodies IgG, IgM, IgA immunoglobulins ACA, as well as C3, C4 complement component levels. METHODS: A group of 44 women with a history of three or more consecutive pregnancy losses was compared with 34 normal women. RESULTS: Our results showed lower levels of IgG immunoglobulins for the patient group (P < 0.001) while the C3, C4 complement component levels remained unaltered. Anticardiolipin antibodies were positive in ten patients for IgG or IgM isotypes or for both presenting a prevalence of 22.7% while none of the control subjects had ACA positive titers. The lupus anticoagulant was not detected in either group. Ten patients (22.7%) presented positive autoantibody tests as compared with only 3 (8.8%) of the control group. No statistical differences were found between the two groups when the frequency of each autoantibody's positive tests were examined separately. CONCLUSIONS: An inconsistent immune derangement seems to be present in recurrent aborters with the presence of anticardiolipin antibodies as the stronger representative marker of immune alteration.

Abortion, Habitual↗

Premature ovarian failure. II: Considerations of cellular immunity defects.

Twenty-three patients with premature ovarian failure (POF), were investigated on the basis of cell-mediated immunity. An increase in T-cells and especially T-helper cells was found in the group of POF patients, while T-suppressor cells and B-cells did not exceed the counts compared to healthy controls matched for age and sex. The macrophage migration inhibition factor (MIF) assay showed a decreased activity towards Haemophiles influenza. Candida albicans and Varidase antigens in the POF group. Levels of immunoglobulins (IgG, IgA, IgE and IgM) did not exceed the normal levels. The relationship between the hormonal status of POF patients and their immunological profile is discussed.

Adolescent↗

Auranofin: a unique oral chrysotherapeutic agent.

Auranofin is a chemically unique gold coordination complex with demonstrated antiarthritic properties on oral administration. Its pharmacokinetic and immunologic profiles are distinct from injectable gold compounds. When auranofin is added to a regimen of salicylates and/or a nonsteroidal antiinflammatory drug for the treatment of RA, significant additional therapeutic benefit is observed. Published studies indicate that auranofin given 6 mg per day approaches the efficacy of parenteral gold salts in the treatment of rheumatoid disease. Noticeable improvement in clinical and laboratory parameters of disease activity has been observed by the third month of auranofin therapy. Further benefit occurs in some patients during the remainder of the first year of treatment. In the more than 3,000 patients treated with auranofin, the most frequently reported side effects were gastrointestinal (mainly diarrhea) and mucocutaneous. Most side effects were mild in nature and the withdrawal rate due to all adverse reactions averaged 11%. Auranofin differs from injectable gold by producing more gastrointestinal but fewer mucocutaneous reactions. The severity of these reactions is less with auranofin and causes fewer withdrawals from therapy.

Anti-Inflammatory Agents↗

Age and differentiation-related differences in neuron-specific tubulin immunostaining of olfactory sensory neurons.

Olfactory sensory neurons (OSNs) are unusual mammalian neurons because they are produced continually throughout adult life and because their production is upregulated after injury. Because OSNs also have an unusual immunological profile and do not bind the commonly used antibody markers for neurons, we sought new antibody markers for studies of OSN regeneration. In this report, we characterize the staining patterns of antibodies to the Class III beta, neuron-specific, tubulin (NST) in rat olfactory tissue sections, to determine if these antibodies specifically label OSNs. In tissue sections from newborn rats, monoclonal antibodies to NST labeled cell bodies and processes of both immature (olfactory marker protein, OMP, -negative) and mature (OMP-positive) OSNs. In tissue sections from adult rats, immature OSNs showed both cell body and dendrite staining with anti-NST, while mature OSNs showed little or no cell body staining. Mature OSNs appeared to have both axonal and dendritic anti-NST staining. Axonal staining was suggested by the complete labeling of the olfactory nerve bundles and the nerve fiber layer of the olfactory bulb. The extent of labeling was judged by comparison with anti-OMP staining. Mature OSN dendritic staining was suggested because a much higher number of dendrites were anti-NST stained in the epithelium than cell bodies. These changes suggest both age and differentiation-related changes in subcellular distribution of NST in OSNs. NST antibodies are thus good markers for all OSNs in the newborn rat, but selective markers for immature OSNs and mature OSN processes in the adult rat. NST antibodies may also be useful probes for beta III tubulin function in neurons.

Age Factors↗

Acute lymphoblastic leukemia in an XYY male.

A case of acute lymphoblastic leukemia (ALL) in a 16-year-old male with a 47,XYY karyotype is reported. This chromosome aneuploidy was found in both bone marrow (BM) cells and mitogen-stimulated lymphocytes. Immunologic profile of leukemic cells showed a null phenotype. To our knowledge, this is the fifth case reported in the literature.

Adolescent↗

Subpopulation of adenoidal lymphocytes of recurrent infection in the upper respiratory tract.

A subpopulation of adenoidal lymphocytes was determined by the E- and EAC-rosetting techniques in order to study an immunological profile of adenoids in 61 children with recurrent otitis media, rhinosinusitis or recurrent tonsillitis. Though there was no significant difference in E- and EAC-rosette forming cells of adenoid tissues from children with recurrent infection in the upper respiratory tract, our results indicated the following. (1) A higher proportion of EAC-rosette forming cells (EAC-RFC) without a change of E-RFC was found in the adenoids of children with recurrent tonsillitis than those without it. (2) The percentage of EAC-RFC appears to increase proportionally to the size of adenoid viewed on the X-ray film. (3) The higher percentage was more remarkable in cases with rhinosinusitis and recurrent otitis media. From the data obtained it is concluded that adenoids may play some part in immunity responses against infection in the upper respiratory tract reflecting adenoidal hypertrophy.

Adenoids↗

Dissociation of immunosuppression by chlorpromazine and trifluoperazine from pharmacologic activities as dopamine antagonists.

Neuroleptic compounds may affect the immune system through a variety of mechanisms. Most possess a complex pharmacology, which makes specific, causal relationships difficult to discern. In this study, a series of experiments was performed to examine the effects of dopamine antagonists on a battery of immunologic parameters. Mitogen-induced lymphocyte proliferation in vitro was inhibited by haloperidol, chlorpromazine, and trifluoperazine at 10, 1 and 1 microM concentrations, respectively. Sulpiride and metoclopramide had no direct effect in vitro. In vivo lymphocyte proliferation was significantly reduced by chlorpromazine at the highest tested doses (12.5 and 15 mg/kg) and by trifluoperazine at the highest tested dose (30 mg/kg). All other dopamine antagonists had no significant effect on in vivo lymphocyte proliferation. A murine graft vs host (GVH) response was unaffected by haloperidol, sulpiride, and metoclopramide. Chlorpromazine and trifluoperazine exhibited significant inhibition of the GVH response at the highest doses only (15 and 30 mg/kg, respectively). In a picryl chloride induced delayed type hypersensitivity (DTH) assay, haloperidol, metoclopramide, and sulpiride had no effect. However, both chlorpromazine and trifluoperazine significantly reduced DTH-induced paw swelling at the higher doses (7.5 mg/kg, and 10 and 30 micrograms/kg, respectively). These studies indicate that the more specific dopamine antagonists (e.g. sulpiride, metoclopramide, and haloperidol) do not share the immunologic profiles of chlorpromazine and trifluoperazine, suggesting that these effects of chlorpromazine and trifluoperazine are not related to their dopamine antagonist properties.

Animals↗

[Subacute cutaneous lupus erythematosus in childhood: a case report].

Subacute cutaneous lupus erythematosus is extremely rare in childhood. We report the case of a 7 year-old girl who presented annular erythematous infiltrated lesions on sun exposed areas since the age of 2 months. Histopathologic examination showed orthohyperkeratosis, epidermal atrophy, widespread hydropic degeneration of epidermal basal cell layer, and a dermal lymphohistiocytic infiltrate. The lupus band test was negative. The immunological investigations (antinuclear antibodies) were negative. Treatment with antimalarials, topical steroids and sun protection allowed clearance of the cutaneous lesions. Lesions relapsed after antimalarials discontinuation and sun exposure. Four years later, at the age of 11, the antinuclear antibodies became positive. The diagnosis of subacute cutaneous lupus erythematosus is based on the clinical aspect of lesions, topography, histological finding, evolution and immunological profile of the patient.

Antimalarials↗

Immunophenotyping of blood lymphocytes at birth, during childhood, and during adulthood in HIV-1-uninfected Ethiopians.

To obtain more insight into blood lymphocyte subpopulations of Ethiopians, we studied the immunologic profile of children and neonates and compared these data with those obtained from adults. Peripheral blood mononuclear cells (PBMCs) and cord blood mononuclear cells (CBMCs) were collected from 137 HIV-1-uninfected subjects aged 0 (cord blood) up to 40 years. Lymphocyte subsets (T, B, and NK cells, CD4+ and CD8+ T cells) were determined and T cell activation (CD38 and HLA-DR) and differentiation (CD45RO and CD27) markers were measured on CD4+ and CD8+ T cells. The absolute number and percentage values of most lymphocyte subpopulations differed substantially with age. Neonates and children were found to have significantly higher CD4+ T cell counts compared to adults. The median absolute CD4 count at birth was comparable to those reported for Caucasians. At birth 97% of the CD4+ T cells were naîve and this proportion significantly declined to 14.2% during adulthood. In addition, activation of both CD4+ and CD8+ T cells, as determined by the double expression of HLA-DR and CD38, was observed in children under the age of 16 and adults, but not in neonates. A more differentiated phenotype (CD27-) was observed in adults compared to children for both CD4+ and CD8+ T cells. The immune alterations including the remarkably low CD4 count with highly depleted naîve phenotype and a persistently activated immune system seen in adult Ethiopians are not apparent at birth, but rather develop over time.

ADP-ribosyl Cyclase↗