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Biomedical subjects

A Escobar-Gutiérrez

Publications and source records attributed to A Escobar-Gutiérrez.

At least 19 recordsLinked to original sources
PubMed2003

Tuberculosis is still a major cause of cervical lymphadenopathies in adults from developing countries.

To establish the frequency of infectious aetiology in Mexican adult patients with cervical lymphadenopathies (CLAs), 87 consecutive patients with enlarged cervical lymphatic nodes, HIV negative and without anti-tuberculous treatment, were selected from a tertiary-level speciality concentration hospital. Histopathological studies, investigation of acid-fast bacilli, cultures in Löwenstein Jensen and Mycobacterium growth indicator tube (MGIT) media, and in-house polymerase chain reaction (PCR) with IS6110-based primers for Mycobacterium tuberculosis complex were performed in resected lymphatic nodes. Non-infectious aetiology corresponded to 45 cases (52 %). Tuberculosis was suspected in 42 cases (48%) by histology and confirmed positive results were obtained by staining in 8 (19%), by culture in 23 (55%), and by PCR in 34 (81 %) patients. All were confirmed after therapeutic success. In addition to the epidemiological transition process occurring in Mexico, tuberculosis remains an important cause of CLA. Histopathology with confirmatory studies including PCR can detect tuberculous aetiology.

Adolescent↗
PubMed2000

Underestimation of Mycobacterium tuberculosis infection in HIV-infected subjects using reactivity to tuberculin and anergy panel.

BACKGROUND: This study aimed to evaluate purified protein derivative (PPD) reactivity and its interrelationship with anergy panel and CD4+ lymphocytes in HIV-infected subjects as compared to PPD reactivity in HIV-uninfected individuals in a tuberculosis endemic and high Bacillus Calmette-Guérin (BCG) coverage environment. METHODS: Clients of four Mexico City HIV detection centres were screened for HIV-1 antibodies (ELISA or haemagglutination, Western Blot); reactivity to PPD (Mantoux PPD, 5TU RT-23), Candida (1:1000, 0.1 ml), and tetanus toxoid (10Lf, 0.1 ml); and CD4+ T cells. Active tuberculosis was excluded. Informed consent was obtained. RESULTS: From 5130 clients 1168 subjects were enrolled; of these 801 (68.6%) were HIV positive. Reactivity to PPD among HIV-positive subjects was found in 174 (22%), 261 (32.6%), and 296 (37%), at PPD cutoff levels of > or =10 mm, > or =5 mm, and > or =2 mm as compared to 224 (61%) of 367 HIV-negative individuals' reactors to PPD (> or =10 mm) (P < 0.001). After exclusion of anergic individuals using two cutoff levels for cutaneous allergens (< or =2 mm and < or =5 mm), PPD reactivity between HIV-infected and uninfected individuals continued to be significantly different. Only HIV-infected individuals with CD4+ T cells > or =500 cells/mm3 had similar reactivity to PPD as HIV-uninfected individuals. Variables associated with PPD reactivity were CD4+ T cell counts, BCG scar, HIV infection and age. CONCLUSIONS: PPD reactivity was useful to diagnose tuberculosis infection only among HIV-infected individuals with CD4+ counts > or =500 cells/mm3. Among individuals with lower counts, lowering cutoff levels or using anergy panel did not permit comparable reactivity as that observed among HIV-uninfected individuals.

AIDS-Related Opportunistic Infections↗
PubMed1998

Antibody response to Klebsiella pneumoniae 60 kDa protein in familial and sporadic ankylosing spondylitis: role of HLA-B27 and characterization as a GroEL-like protein.

OBJECTIVE: To study the antibody response of HLA-B27+ patients with ankylosing spondylitis (AS) and their first degree relatives to the 60 kDa protein of Klebsiella pneumoniae and to characterize this protein. METHODS: Sera from 84 individuals were analyzed by ELISA to determine the titer of antibodies against the 60 kDa protein of K. pneumoniae. Subjects were divided into 3 categories: Group 1: 44 HLA-B27+ AS related individuals (35 patients, 9 healthy controls); Group 2: 28 healthy B27- AS related individuals; and Group 3: 12 healthy B27- non-AS related subjects. The 60 kDa protein of K. pneumoniae was induced at 45 degrees C and purified by electroelution from sodium dodecyl sulfate-polyacrylamide gel electrophoresis. It was characterized as a GroEL-like heat shock protein (HSP). The recognition of GroEL-like protein was confirmed by immunoblot of 2 dimension electrophoresis. The response to GroEL-like protein from other bacteria and the response to lipopolysaccharide (LPS) was also analyzed by immunoblot. RESULTS: HLA-B27+ individuals (Group 1), independent of their disease status, showed a significant higher response to the 60 kDa protein of K. pneumoniae than HLA-B27- subjects from Groups 2 and 3 (p < 0.0001). This protein was characterized as a HSP of the GroEL family and designated HSP60Kp. The GroEL of other enterobacteria as well as that of Mycobacterium leprae were recognized by HLA-B27+ individuals by immunoblot, whereas HLA-B27- individuals did not. LPS was not recognized by HLA-B27 positive or negative subjects. CONCLUSION: These findings suggest a relationship between HLA-B27 and the response to a GroEL-like protein that could have implications in AS.

Bacterial Proteins↗
PubMed1997

[Importance of molecular methodology in diagnosis].

The National Institute for Epidemiological Diagnosis and Reference (INDRE) partially supports epidemiological surveillance programs through the identification of most infectious agents prevalent in the country. The success of a program for the control or eradication of a particular infectious disease mainly depends on the opportune and accurate identification of the corresponding etiologic agent. For laboratory diagnosis at INDRE, both conventional methodology using direct or microscopic examinations of specimens or growth in culture media followed by physiological or immunological characterization of the isolate, as well as new techniques based in biochemical, immunochemical and molecular biology procedures are carried out. Antigens can be detected in clinical samples by ELISAs with polyclonal or monoclonal antibodies. Specific nucleic acids can be extracted, identified and typed with techniques like electrophoresis, hybridization with genomic probes, polymerase chain reaction or fragment restriction length polymorphism. Recombinant molecules or highly purified antigens are being obtained and used for the determination of antibodies, mainly with indirect ELISA, IgM capture-ELISA and Western Blot. The better performance, specificity and sensitivity of these laboratory procedures, provide faster results, with equal or greater accuracy than traditional ones, at lower cost.

Blotting, Western↗
PubMed1994

Cytokines and the immune response.

The recent massive growth and development of clinical immunology has been enriched by the discovery of a new family of molecules, the cytokines, which consist of various groups of polypeptide mediators involved in the communication network of the cells of the immune system. This article provides an overview of the immune system and the current status of the cytokines and their clinical application.

Antigen Presentation↗
PubMed1993

Comparative assessment of the leprosy antibody absorption test, Mycobacterium leprae extract enzyme-linked immunosorbent assay, and gelatin particle agglutination test for serodiagnosis of lepromatous leprosy.

A comparative assessment of three serological methods for leprosy diagnosis (the fluorescent leprosy antibody absorption [FLA-ABS] test, the Mycobacterium leprae soluble-extract enzyme-linked immunosorbent assay [ELISA], and the M. leprae particle agglutination [MLPA] test) was carried out. The objective was to identify their performance in clinical and epidemiological diagnosis of leprosy. The study group included 45 lepromatous leprosy patients under treatment. Specificity was > 95% for all three assays, and sensitivity was 95, 58, and 74% for the FLA-ABS test, the MLPA test, and the ELISA, respectively. The only cross-reactivity for M. tuberculosis-infected patients was with the soluble-extract ELISA. Although the FLA-ABS test displayed the highest specificity and sensitivity values, it can only be used in well-developed laboratories, and the patient's clinical and epidemiological background must be considered when results are interpreted because the test remains positive after therapeutic success and could be positive for some household contacts. The MLPA test is easier to perform and interpret, and it is adequate for small laboratories and epidemiological studies intended to detect active untreated or irregularly treated leprosy cases. Therefore, the FLA-ABS and MLPA tests are complementary, and both should be used for serodiagnosis of leprosy.

Agglutination Tests↗
PubMed1990

Prospective immunological follow-up in household contacts of Mexican leprosy patients.

A 6-year prospective study of 79 household contacts of leprosy cases was made in order to correlate the development of the disease with their specific T-cell immunity, measured by the Mitsuda test, and levels of anti-Mycobacterium leprae antibodies determined in three consecutive observations with the FLA-ABS test. Overall in the contacts, 71.7% were Mitsuda positive and 93.6% showed seropositivity, without regard to their age, sex, or leprosy type of their index case. Households were divided into lower-risk and higher-risk groups according to either the paucibacillary or multibacillary character of their index case. The lower-risk group consisted of 19 contacts of 2 tuberculoid (TT) and 5 indeterminate cases. The higher-risk group was made up of 60 household contacts of 18 active lepromatous (LL) cases. All but two contacts in the former group had a positive Mitsuda reaction; the most common antibody titer was 1:160, with a tendency to stabilize or decrease over time. In the two Mitsuda-negative contacts, increased antibody levels were observed. In the higher-risk group, 61.6% were Mitsuda positive and showed a humoral profile similar to those Mitsuda positive in the lower-risk group. In most of the Mitsuda-negative LL contacts, the antibody levels remained constant or progressively increased, suggesting a high probability of active subclinical infection. This assumption was partially supported by the finding of a new borderline lepromatous (BL) leprosy case in the Mitsuda-negative LL contact group. Nevertheless, the contribution of the close and extensive contact with a multibacilliferous case as a risk factor was difficult to evaluate because of the small size of the sample studied.

Adolescent↗
PubMed1990

[Phagocytic capacity of peritoneal exudate cells from rats immunized with a ribosomal preparation of Ty2 Salmonella typhi].

It was compared the activity of exudate peritoneal cells (EPC) obtained from CFW mice immunized either with Salmonella typhi Ty2 ribosomal fraction or whole-cell heat inactivated vaccine, both in comparison with EPC from sham-immunized. In the group which received ribosomal preparation, a subcutaneous dose equivalent to 100 micrograms of RNA in incomplete Freund's adjuvant (IFA) was initially used and 14 days after a booster of the same dose in IFA was given. A single dose of whole-cell heat inactivated vaccine, with 10(6) bacteria in IFA was employed subcutaneously in animals of the second group. EPC from controls and immunized mice were withdrawn at periods of 7, 11, 14, 18, 22, 25, 29 and 31 days after immunization and each sample was incubated in vitro in presence of live virulent non-opsonized S. typhi Ty2 in 1:200 cell-bacteria relation. Twenty four hours after cultivation, EPC bacterial capacity was determined after cell disruption and enumeration of survival bacteria were made through viable counts. Results have shown that EPC from mice immunized were more efficient in eliminating intracellular bacteria than those which came from sham-immunized animals. Also, it was found that EPC from mice immunized with ribosomal preparation were more efficient (maximum P = 0.005) than EPC from the mice which received killed whole bacteria.

Animals↗
PubMed1988

Demonstration of acid-fast bacilli in skin biopsies from indeterminate leprosy cases.

Because the correct diagnosis of indeterminate leprosy (IL) requires the finding of acid-fast bacilli in skin lesions from clinically and histopathologically suggestive cases, it is necessary to develop a reliable method for this purpose. This paper presents a simple procedure, available to every general laboratory, which consists in obtaining 2 suspensions: SI, by mincing and grinding the tissue in phosphate-buffered saline; and SII, after treating SI with NaOH solution and digesting with trypsin. In 22 IL skin biopsies, bacilli were directly observed in only 3 with the Ziehl-Neelsen (ZN) stain; and with the peroxidase-antiperoxidase method it was impossible to differentiate between nonspecific precipitate and true positive reactions. In contrast, 18 positive results from the same 22 samples were obtained when both SI and SII were evaluated with ZN stain. The logarithmic bacterial index was also increased in at least 7 cases.

Humans↗
PubMed1987

Sensitivity and specificity of the FLA-ABS test for leprosy in Mexican populations.

The epidemiological surveillance for leprosy must include several clinical and laboratory procedures. The FLA-ABS test of Abe could be a useful tool for this purpose because it allows the demonstration of an effective contact with Mycobacterium leprae. In order to establish the specificity, sensitivity, and predictability of the FLA-ABS test under Mexican conditions, we studied sera collected from six groups of individuals: 60 healthy donors from a nonendemic area, 57 cases hospitalized for conditions other than infectious diseases from a general hospital in a nonendemic area, 72 patients with active pulmonary tuberculosis, 26 healthy individuals from an endemic area, 100 patients with polar lepromatous leprosy (LLp), and 123 household contacts of patients with LLp. The FLA-ABS test was negative with sera from the first four groups. Strong positive reactions were found in all LLp patients except one; the false-negative results could be attributed to successful treatment and a long-standing cure in this patient. Analysis of these results shows 100% specificity, 99% sensitivity, and predictability values of the test of 100% for positive results and 99% for negative ones. In addition, none of the 20 randomly selected sera from LLp patients were positive with crossreacting mycobacteria. Because 87.8% of the household contacts were positive in the absence of clinical manifestations of leprosy, it is possible to conclude that a positive result by itself is not enough to establish an early diagnosis of the disease, especially among inhabitants of endemic areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMed1985

The HLA system in the prevalent Mexican Indian group: the Nahuas.

Results of HLA-A, B and C typing as well as haplotype frequencies in the Nahuas, who are the predominant Indian group in Mexico are presented. ABO and Rh blood groups show the genetic homogeneity of this population, since all of them were group O and Rh+. The most frequent antigens and haplotype are in general, the same as in some, but not all Amerindian tribes (Papago, Pimas, Zuñi from North America and Ixils from Guatemala). When compared to other Mongoloids, the HLA pattern is very close to the Japanese population. Antigens Bw39 and Cw4 look like markers of Nahuas and because Bw16 cells from four individuals could not be assigned either as Bw38 or Bw39, and 6 subjects did not type for any of the Bw22 splits, new subtypes of these antigens are probable.

Female↗
PubMed1983

HLA-DR antigens in Mexican patients with Guillain-Barré syndrome.

The distribution of HLA-DR antigens was investigated in 38 Mexican Mestizo patients with Guillain-Barré syndrome (GBS) and in 100 healthy controls belonging to the same population. IgG, IgM, IgA, CH50, C3, C4 and the number of T and B lymphocytes were also evaluated in the patients. Only DR3 was significantly increased in the patients (Yates' chi 2 = 9.943, Pc = 0.014) and the relative risk for developing the disease was 3.49. These findings support the hypothesis that DR3 or a closely linked Ir gene may play some role in the susceptibility to GBS.

Adolescent↗
PubMed1979

HLA frequencies in a Mexican Mestizo population.

The aim of the present study was to reevaluate the distribution of HLA antigens in Mexican Mestizos since, in our previous report, very few specificities were explored for this population. The Mestizos are primarly a mixture of Caucasians (Spaniards) and Mexican Indians and account at the present time for about 95% of the total Mexican population. A and B antigens were typed on isolated cells using a microlymphocytotoxicity technique. Antigen, gene and haplotype frequencies were calculated including the significance for delta values. The results clearly showed that the HLA distribution differs from other ethnic groups and the predominant antigens are A2, A9, B5, Bw35 and B40, but the general pattern clearly shows the participation in genetical composition of Spanish and Mexican Indian backgrounds. The most frequent haplotypes were A2-B5, A9-Bw35, A9-B40 and A2-B40, which are also the most common in some Mongoloid populations.

Alleles↗