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81.
Autoantibodies against bactericidal/permeability-increasing protein in patients with cystic fibrosis 总被引:5,自引:0,他引:5
Zhao MH; Jayne DR; Ardiles LG; Culley F; Hodson ME; Lockwood CM 《QJM : monthly journal of the Association of Physicians》1996,89(4):259-265
Cystic fibrosis (CF), a genetic disorder, is characterized by chronic
pulmonary infection/inflammation which leads to respiratory failure. The
presence of anti-neutrophil cytoplasmic autoantibodies (ANCA) has
previously been observed in the sera of patients with CF. In view of the
known relationship of ANCA with primary vasculitis and of their putative
pathogenetic role in these disorders, we studied the presence, specificity
and isotype of ANCA and their clinical associations in 66 adult CF
patients. None of the 66 CF samples had autoantibodies to the major ANCA
antigens, proteinase 3 or myeloperoxidase. However, 60/66 (91%) CF samples
contained IgG and 55/66 (83%) IgA, autoantibodies to
bactericidal/permeability increasing protein (BPI), a recently
characterized ANCA specificity. All the IgA anti-BPI-positive samples were
also IgG anti-BPI-positive. The autoantibody specificity was confirmed by
inhibition assay and immunoblotting of CF sera against a neutrophil granule
preparation. Furthermore, in this cross-sectional study, anti-BPI levels
were inversely correlated with the observed reductions in FEV1 and FVC (IgA
anti-BPI and FEV1: r = 0.508, <it>p</it> < 0.0001), and
both IgG and IgA anti-BPI levels were higher in CF patients with secondary
vasculitis (<it>n</it> = 6) than in those without
(<it>p</it> < 0.05). ANCA with specificity for BPI were
present in the majority of CF sera in this study and autoimmune processes
may be associated with the development of pulmonary injury in CF.
相似文献
82.
The authors developed quantitative radioimmunoassays to allow direct measurement of total human IgG and individual IgG subclasses among antibodies bound to cell surfaces. The assays use four mouse monoclonal radioiodinated antibodies, one that reacts equally well with all four human IgG subclasses and three that are specific for human IgG subclasses 1, 2, or 3. The assays were used to analyze IgG subclass composition in 21 high-titer anti-D samples from Rh-negative volunteers immunized for Rh immunoglobulin production. Anti-D activity was restricted primarily to the IgG1 and IgG3 subclasses. Eleven of 21 sera demonstrated red cell antibodies with a marked predominance of IgG1 (87 +/- 3.6% of total IgG antibody, +/- SEM) and low levels of IgG3 (1.4 +/- 0.73%). In the remaining 10 sera, IgG3 made up a greater proportion of total IgG antibody (32 +/- 3.8%), although IgG1 was still predominant (61 +/- 4.1%). This observed dichotomy in the IgG subclass profiles of different anti-D sera may be a consideration in the selection of anti-D sera for the production of the immunoglobulin used in the prophylaxis of Rh-incompatible pregnancies. 相似文献
83.
Patrick G. Yong BSEE Leslie A. Geddes ME PhD FACC 《Journal of clinical monitoring and computing》1987,3(3):155-159
The importance of cuff deflation rate in the auscultatory method of measuring blood pressure was investigated using a computer-based model. To determine the relationship between the cuff deflation rate and the measurement error, two cuff deflation protocols were used, one based on heart rate (mm Hg per heartbeat), the other on a constant rate (mm Hg per second). The different deflation protocols and rates were tested using a constant blood pressure of 120/80 mm Hg and heart rates ranging from 40 to 120 beats/min. It was confirmed that a cuff deflation rate that is time based will introduce larger errors at low heart rates. Using heart rate as a basis for cuff deflation rate yields a constant error that is independent of heart rate. The currently used standard of 3 mm Hg/s could result in a maximum error of 2.5 mm Hg in both systolic and diastolic pressures at a heart rate of 72 beats/min. The maximum systolic and diastolic errors increase to more than 4 mm Hg at 40 beats/min. A deflation rate of 2 mm Hg/beat, however, yields a maximum error of 2 mm Hg for both systolic and diastolic pressures, independent of heart rate. A cuff deflation rate based on heart rate is recommended to help minimize changes in measurement error when measuring blood pressure if a wide range of heart rates will be encountered.Supported by grants from IVAC, San Diego, CA, and Physio Control, Redmond, WA. 相似文献
84.
Dr Nikolaus Gravenstein MD Samsun Lampotang ME Jan E. W. Beneken PhD 《Journal of clinical monitoring and computing》1985,1(1):6-10
The Bain circuit provides continuous fresh gas flow near the airway. The potential mixing of this fresh gas with expired gas may prevent reliable analysis of expired gas. We therefore investigated the interaction of sampling site, fresh gas flow rate, expiratory flow rate, and sampling flow rate on expiratory capnography. Sampling near the fresh gas outlet yielded inaccurate results under several of these conditions. The magnitude of the error was related to the fresh gas and expiratory flow rates. A reliable sampling region near the endotracheal tube was identified. 相似文献
85.
Transfusion-related acute lung injury caused by an NB2 granulocyte- specific antibody in a patient with thrombotic thrombocytopenic purpura 总被引:3,自引:0,他引:3
HLA and granulocyte-specific antibodies have been implicated in the production of transfusion-related acute lung injury (TRALI). Reported here is a case that suggests that the patient's preexisting condition may play an important role in determining whether TRALI develops upon transfusion of blood products containing anti-white cell (WBC) antibodies. A 29-year-old woman with thrombotic thrombocytopenic purpura (TTP) underwent an uneventful 1.5-volume plasma exchange, which was followed by the transfusion of 2 red cell (RBC) units. At the end of the second RBC transfusion, the patient developed clinical signs and symptoms of noncardiogenic pulmonary edema. Serologic studies demonstrated that the serum from the second RBC donor had no HLA antibodies but did have a granulocyte-specific antibody (anti-NB2) that caused the agglutination of the recipient's granulocytes, which were NB2 positive. Serum from the donor of the first RBC unit and serum from the donors of units used in the exchange had no HLA or granulocyte-specific antibodies that reacted with the recipient's WBCs. Because the donor implicated in this reaction had a history of 21 blood donations, none of which had been associated with a transfusion reaction, we suggest that the patient's preexisting condition played a significant role in this episode of TRALI, owing to the granulocyte-specific antibody. 相似文献
86.
Wallace R. Elliott MS CCE Anne E. Harris MD James H. Philip ME MD 《Journal of clinical monitoring and computing》1989,5(2):100-104
In clinical practice, the addition of positive end-expiratory pressure (PEEP) into a standard anesthesia circle circuit decreases the delivered tidal volume (DTV) to a patient. We studied the magnitude of the DTV/PEEP relationship in two commonly used anesthesia systems. In addition, the magnitude of the DTV/PEEP relationship varies with both pulmonary compliance and volume of gas contained in the patient's breathing system between the ventilator and PEEP valve site, and this was also evaluated. Routine monitoring of expired tidal volume should be used whenever PEEP is added to an anesthesia circuit. 相似文献
87.
There is abundant evidence of immune modulation induced by exposure to blood transfusions. Some studies have demonstrated a detrimental effect of transfusion on the recurrence of malignant disease and survival. We retrospectively studied the impact of blood transfusion exposure on 229 patients with breast cancer who were seen from July 1973 to September 1980, had at least 5 years' follow-up and had been randomized by therapy at the time of diagnosis. The patients were divided into four groups according to transfusion history: Group 1 (111 patients), no transfusion; Group 2 (34 patients), first transfusion after mastectomy; Group 3 (41 patients), first transfusion at mastectomy; and Group 4 (43 patients), first transfusion before mastectomy. All transfused patients received red cells or whole blood or both. At the time of analysis, 124 (54%) of the patients had died. Only Group 2 was statistically associated with decreased survival; recurrence of disease was 85 percent in this group, compared with 53 percent to 61 percent in the other three groups (p = 0.006, log-rank test). In general, Group 2 patients received transfusions because of recurrent disease. We conclude that transfusions before or at mastectomy are not associated with increased recurrence or reduced survival in patients with breast cancer. 相似文献
88.
89.