A relation between HLA antigens and clinical features in patients with acquired valvular heart disease.

Analysis of the HLA antigen patterns in patients with acquired valvular heart disease showed that antigens A29 and AW30/31 occurred more often in those patients whose valvular disease was not preceeded by a history of rheumatic fever or chorea. Patients with no rheumatic history but with antigen A29 or AW30/31 had clinical features that distinguished them from others with valvular disease--namely, (a) isolated mitral valve disease and (b) the need for surgery, often at an early age, after a relatively short duration of symptoms.     

Risk of AIDS related complex and AIDS in homosexual men with persistent HIV antigenaemia.

One hundred and ninety eight men seropositive for human immunodeficiency virus (HIV) antibody and 58 HIV antibody seroconverters were studied for an average of 19.3 (SEM 0.5) months to assess the relation between HIV antigenaemia and the risk of developing the acquired immune deficiency syndrome (AIDS) and AIDS related complex. Forty (20.2%) of the 198 HIV antibody seropositive men were antigen positive at entry and remained so during follow up. Eight (13.8%) of the 58 HIV antibody seroconverters and 20 (12.7%) of the remaining 158 HIV antibody seropositive men became antigen positive during follow up, resulting in an end point attack rate for HIV antigenaemia of 14.3%. AIDS related complex was diagnosed in 25 (15.8%) of the HIV antigen negative men and in 14 (20.7%) of the HIV antigen positive men. AIDS was diagnosed in 15 men, resulting in an end point attack rate for AIDS of 23.9% in the HIV antigen positive group and 1.3% in the antigen negative group. HIV antibody seropositive men without symptoms but with persistent HIV antigenaemia are at increased risk of developing AIDS and AIDS related complex.     

Possible relation between viruses and oromaxillofacial tumors. I. Demonstration of herpes antigens and anti-herpes antibodies

Herpes virus type 1 and 2 antigens were detected in cells originating from malignant tumors with oromaxillofacial localization. A higher incidence of type 1 antigens was noted, as compared to the type 2. Investigated antigens were detected more frequently in the tumors of ectodermal origin. Antiherpesvirus FC antibodies were found in 74.5% of the tumor bearing subjects, but only in 22.3% of the controls.     

抗可提取性核抗原抗体与系统性红斑狼疮临床表现和疾病活动度的相关性研究

目的探讨抗可提取性核抗原(ENAs)抗体与系统性红斑狼疮(SLE)患者的临床表现和疾病活动指数的相关性。方法共纳入201例SLE患者(女性192例),记录其一般情况、临床表现和抗ENAs等实验室检查结果,使用SLE活动指数(SLEDAI)和英岛狼疮评定组评定表(BILAG)2种评估方法评价疾病活动度。结果抗SSA抗体与头痛(r=0.26,P=0.04)、视物模糊(r=0.31,P=0.02)、皮疹(r=0.39,P=0.01)、脱发(r=0.23,P=0.04)、口腔溃疡(r=0.37,P=0.04)和SLEDAI(r=0.27,P=0.03)呈正相关,与C3呈负相关(r=-0.29,P=0.003);抗SSA抗体与抗SSB抗体呈正相关(r=0.69,P<0.01),但与抗dsDNA、抗RNP和抗Sm抗体无相关性。抗SSB抗体与头痛(r=0.34,P=0.02)、视物模糊(r=0.27,P=0.04)、SLEDAI(r=0.36,P=0.02)和BILAG血管炎评分(r=0.23,P=0.03)呈正相关,与C3(r=-0.27,P=0.007)呈负相关;抗SSB抗体与抗RNP抗体或抗Sm抗体无相关性。抗Sm抗体与疾病病程(r=0.16,P=0.001)、肾炎(r=0.32,P=0.02)、尿蛋白定量(24 h)(r=0,23,P=0.004)、SLEDAI(r=0.37,P=0.004)和BILAG肾脏评分(r=0.31,P=0.01)呈正相关,并且与发病年龄(r=-0.31,P=0.02)、白细胞(r=-0.35,P=0.01)和C4(r=-0.23,P=0.04)呈负相关。抗RNP抗体与雷诺现象(r=0.32,P=0.04)、抗dsDNA抗体(r=0.46,P=0.007)和BILAG皮肤黏膜评分(r=0.33,P=0.01)呈正相关,与白细胞(r=-0.27,P=0.03)呈负相关。在多变量分析中,抗SSA抗体与头痛、视物模糊和C3仍相关,抗SSB抗体与C3和头痛仍相关。抗Sm抗体与疾病病程和总SLEDAI评分相关,而抗RNP抗体仅与BILAG黏膜皮肤评分相关。结论抗ENAs抗体与SLE的临床表现相关,并与疾病活动度相关,提示检测抗ENAs不仅可以反映SLE患者的临床表现,且其在疾病活动的评估方面起重要作用。     

Cardiovascular disease and toxicities related to HIV infection and its therapies

Cardiovascular manifestations of HIV vary according to disease stage, treatment regimen and geographical location. Common cardiac complications of HIV disease in patients off highly active antiretroviral therapy (HAART) include dilated cardiomyopathy, myocarditis, pericardial effusion, endocarditis, pulmonary hypertension and non-antiretroviral drug-related cardiotoxicity. However, with the introduction of HAART that has substantially modified the course of HIV disease by lengthening survival, additional cardiovascular consequences are a result of the metabolic syndrome with a propensity toward hyperlipidaemia and atherosclerotic heart disease. Because most of the world’s HIV-infected patients have not been treated with HAART, the principal HIV-associated cardiovascular manifestations of patients off HAART are reviewed and new knowledge about the prevalence, pathogenesis and treatment in the HAART era are emphasised in this review. Exercise, a nonpharmacological approach to treating HAART-associated metabolic syndrome, is also discussed.     

Cardiovascular disease and toxicities related to HIV infection and its therapies

Cardiovascular manifestations of HIV vary according to disease stage, treatment regimen and geographical location. Common cardiac complications of HIV disease in patients off highly active antiretroviral therapy (HAART) include dilated cardiomyopathy, myocarditis, pericardial effusion, endocarditis, pulmonary hypertension and non-antiretroviral drug-related cardiotoxicity. However, with the introduction of HAART that has substantially modified the course of HIV disease by lengthening survival, additional cardiovascular consequences are a result of the metabolic syndrome with a propensity toward hyperlipidaemia and atherosclerotic heart disease. Because most of the world's HIV-infected patients have not been treated with HAART, the principal HIV-associated cardiovascular manifestations of patients off HAART are reviewed and new knowledge about the prevalence, pathogenesis and treatment in the HAART era are emphasised in this review. Exercise, a nonpharmacological approach to treating HAART-associated metabolic syndrome, is also discussed.     

Serotyping clinical isolates of Pseudomonas aeruginosa in relation to infection site antibiotic susceptibility and beta-lactamase production

The present study investigates the association of O-serotype with isolation site, antibiotic resistance, and beta-lactamase production to determine the profiles of Pseudomonas aeruginosa clinical isolates circulating in a Canadian teaching hospital. The most frequently encountered serotypes of Pseudomonas aeruginosa strains isolated from inpatients at H?tel-Dieu de Montréal hospital during the period 1992-1993 were O1, O3, O5, O6, O10, and O11 (9-13%) isolated from pus, urine, sputa and other sources. Serotype O1 was the most sensitive in contrast to serotype O3 which was resistant to virtually all antibiotics tested except to imipenem and quinolone. Of the strains of Pseudomonas aeruginosa, more than 50% with the most encountered serotype produced a high level of beta-lactamase.     

Monitoring of two intravenous immunoglobulin. Preparations for immunoglobulin G subclasses and specific antibodies to bacterial surface antigens and relation with their levels in treated immunodeficient patients

Patients with antibody deficiency disorders are highly susceptible to bacterial infections. Replacement therapy with intravenous immunoglobulin preparations (IVIG) has been established in such patients for two decades. The efficacy of IVIG treatment depends on the amount of functional pathogen-specific antibodies provided. The present study was undertaken to determine the levels of immunoglobulin classes, IgG subclasses, and specific antibodies to bacterial surface antigens in two different IVIG preparations (Sandoglobulin® and Gamimmune®) and blood sera of IVIG-treated immunodeficient patients. The levels of IgG, IgA, IgM and IgG subclasses were determined in both IVIG preparations and in patients’ sera and were compared with those of healthy individuals. Sandoglobulin® contained significantly higher concentrations of IgA, IgG₂ and IgG₄ than Gamimmune®. The latter contained higher concentrations of IgG₁. Patients treated with Gamimmune® had significantly lower concentration of IgG₄ as compared with healthy individuals and Sandoglobulin®-treated patients. This finding was related to the preparation’s composition. Screening of 20 lots from each preparation for antibodies to frequent clinically isolated strains of Escherichia coli, Staphylococcus aureus, S. epidermidis, Klebsiella pneumoniae and Enterococci spp. showed a high lot-to-lot variability. In order to overcome the lot-to-lot variability and correlate the observed effects with each IVIG preparation, the administered IVIG lots were selected so that their titers were in the interval of mean value±S.D. for each pathogen. The two tested preparations showed significant differences in their content of specific antibodies that ultimately affected the levels of these antibodies in treated patients. More specifically, Sandoglobulin® contained higher levels of antibodies to E. coli and S. epidermidis strains. Infusion of this preparation maintained the respective antibodies in the recipients significantly higher than those of healthy individuals. Gamimmune® infusion led to similar and comparable levels. Both IVIG preparations had comparable antibody titers towards K. pneumoniae, provided high amounts of antibodies, and kept recipients’ specific IgG at levels significantly higher than those of the healthy individuals. Enterococci spp. specific antibodies were significantly higher in Gamimmune®, whereas titers of antibodies towards S. aureus were comparable. Levels of antibodies against both Enterococci spp. and S. epidermidis after administration of both preparations were close to those in healthy individuals. None of the patients developed infection during the time of the study. In conclusion, most of the lots of the two IVIG preparations studied, despite some quantitative differences, provide patients with sufficient amounts of antibodies to bacterial surface antigens that protect them against infections.     

No increase in antibodies to six food antigens in Japanese patients with IgA nephropathy.

It has been postulated that mucosa-related antigens are involved in the development of IgA nephropathy. The aim of this study was to elucidate whether food antigens have any relation to IgA nephropathy in Japan. Sera from 15 patients with IgA nephropathy and 15 healthy controls were examined using an enzyme linked immunosorbent assay (ELISA). IgG, IgA, and IgM antibody titers were measured against six food-derived antigens, i.e. rice, soy bean paste, soy sauce, egg yolk, egg white and gluten, all of which are frequently found in the ordinary Japanese diet. No significant differences between patients and controls were found. It was concluded that food antigens appear to have little, if any, relation to IgA nephropathy.