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Biomedical subjects

B Hitzschke

Publications and source records attributed to B Hitzschke.

At least 19 recordsLinked to original sources

Immunoadsorption and plasma exchange in multiple sclerosis: complement and plasma protein behaviour.

Three groups of patients suffering from acute attacks or progressive multiple sclerosis (MS) are under investigation. First results revealed remarkable clinical improvements of patients with acute attacks in the groups treated by therapeutic plasma exchange (TPE) and immunoadsorption (IA). Only slight or no improvements were seen in the patients of the control group treated only with steroids. Plasma protein levels (IgG, IgM, IgA, fibrinogen) were considerably reduced in patients of the TPE group after each treatment procedure as expected. The same holds true concerning the total hemolytic capacities (THC) of the complement of the classic (CP) and the alternative (AP) pathway. On the other hand in the IA group only slight decreases of plasma proteins (about 20%) were observed, but the behaviour of THC's were quite similar than those seen in the patients of the TPE group. The THC decreases in both groups can be explained by removal of all complement factors (TPE group) or by the adsorption of single factors (IA group) of both complement pathways according to earlier in vitro investigations. The THC decreases in patients of both groups suffering from acute MS attacks could mean an "antiinflammatory" effect and could--at least partially--contribute to the clinical improvements of these patients.

Blood Proteins↗

[Effect of pulsating electromagnetic field therapy on cell volume and phagocytosis activity in multiple sclerosis and migraine].

PEMF treatment was studied in 10 patients with multiple sclerosis and 10 patients with migraine. In both patients' groups a single treatment induced a significant rise of yeast particle uptake by blood granulocytes. The percentage of phagocytizing cells was increased in migraine patients only. In both patients' groups 20 PEMF treatments caused a reduction of particle uptake, whereas the percentage of phagocytizing cells remained unchanged. In migraine patients the opsonic capacity of serum and the mean cell volume of erythrocytes, lymphocytes and granulocytes were initially reduced, but increased during the course of 20 PEMF treatments. The biphasic changes of cell volume and phagocytic activity are interpreted as a result of counter-regulation of the organism in response to the primary PEMF effect.

Electromagnetic Fields↗

[Effect of ultraviolet irradiation of autologous blood on cell volumes, cell adhesion and phagocytosis in normal probands and patients with multiple sclerosis].

UVB induced changes of blood cell properties were investigated in 12 MS patients and in 10 healthy volunteers serving as normal controls. The mean cell volume (MCV) was determined by electronic sizing, the granulocyte and lymphocyte adherence was estimated in a capillary assay, and the phagocytic activity of granulocytes was measured in a test system based on the incorporation of opsonized baker's yeast (Saccharomyces cerevisiae). In MS patients the MCV of red cells and lymphocytes decreased rapidly within 6 UVB treatments. In contrast, the reduction of the granulocyte volume was delayed (between the 6th and 12th UVB). In the control group the mean value of the red cell and lymphocyte MCV remained rather unaffected. There was a slight rise of the granulocyte volume after the 6th UVB. The only significant change of adherence was an increase of granulocyte adherence in MS patients. Untreated patients had a significantly enhanced phagocytic activity in comparison to the control group. 6 UVB treatments included a significant reduction of the phagocytic activity in MS patients. However, subsequently the percentage of phagocytizing cells increased again, whereas the particle uptake per cell continued to decrease. In the control group only minor UVB induced changes of phagocytosis were observed. The in vitro UV irradiation caused an enhanced phagocytosis in the majority of cases in both controls and MS patients. In general, under the UVB treatment all parameters examined changed in the sense of a normalisation, in that the measured values reached a new level lying between the extreme pretreatment values accompanied by a reduced standard deviation. The effect of UVB was more pronounced in MS patients when compared with normal controls. This could result from an enhanced sensitivity to the influence of UVB of pathologically altered cells in MS patients. The monitoring of the MCV of red cells and lymphocytes as well as the repeated testing of granulocyte phagocytosis are recommended for supportion of therapy planning and follow-up of MS patients.

Blood↗

[Forms of disease progression and prognostic factors in multiple sclerosis].

Basing on the diagnostic criteria, an analysis of 687 cases of multiple sclerosis (MS) is represented according to the different forms of course, their frequency and the degree of severity. For the progressive course--either secondary after attacks or primary--a higher proportion of disease with severe disturbances resp. comparatively malignant forms have been found; furthermore, a critical time of progression could be ascertained. The determination of the disability status (using the EDSS) during a longer space of time showed a more unfavourable prognosis for the males. The development of disability was more distinct at onset of disease in the elder-aged groups. The problems of uncertain factors influencing the course and prognosis of disease are pointed out in connection with the heterogeneity of MS, basing on the pathogenetic components.

Adult↗

[The problem and value of therapy in multiple sclerosis].

Some fundamental problems of therapy in multiple sclerosis (MS) and the difficulties in assessing the results of treatment are represented. Basing on a survey of several principles of therapy, the findings of own therapeutic trials using corticosteroids, immunosuppressive agents (azathioprine, cyclophosphamide, antihumanlymphocyte globulin) are pointed out; in particular, the analysis of a longer period of the course of disease produced few favourable effects. In further therapeutic studies, i.e. plasmapheresis and immunoadsorption, a long lasting observation of the course is lacking; this likewise concerns the study on ultraviolet irradiation of blood. As to the aspects of a multi-stage pathogenesis of MS an appraisal of therapeutic conceptions and procedures is given; in critical evaluation their efficacy is little convincing.

Adult↗

Family studies in multiple sclerosis: HLA haplotypes of affected sib-pairs.

The occurrence of multiple sclerosis (MS) in several members of families has been observed in 4.8% of 105 MS patients from a limited epidemiological area of Rostock. Typing of the HLA antigens in 4 affected sib-pairs showed two identical HLA haplotypes in 3 of the pairs: 1 pair shared one haplotype. These findings point to a dominant mode of inheritance of the disease susceptibility gene together with the HLA haplotype. The assessment of family studies in MS is discussed.

Adult↗

[Degree of malignancy in multiple sclerosis: clinicopathologic mortality study].

Basing on the neuropathologic findings (acute, subacute resp. chronic demyelination) in 58 cases with multiple sclerosis (MS) the determination of the degree of defect in relation to the duration of working capacity and disability has been carried out in comparison with an index made up for progression and malignancy of the disease. In the final phase of illness an acute exacerbation was noteworthy from the morphological point of view in 48.3% of the patients; in these cases was established a hightened index of malignancy. Differences of sex distribution a. o. pointed to a longer lasting defective (chronic) stage in women. The assessment of progression after a five-year period of examination by a limiting malignancy-index allows a probable prognosis to the chances and the risk of the developing process of disease and may be of importance for care.

Adult↗

[Encephalomyelitis syndrome in the cerebrospinal fluid in correlation to disease course criteria in multiple sclerosis].

Basing on a classification of the dynamic forms of multiple sclerosis according to prognostic-social aspects and in view to different degrees of defect the incidence of the five possible syndromes of cerebrospinal fluid were subjected to a correlation in 345 cases. In moderate till severe grades of neurologic disturbances and courses of illness an immunoreactive syndrome of cerebrospinal fluid - typically complete to incomplete - was doing found (in ca 40%). The slighter forms of the disease predominantly presented the whole spectrum of possible findings of cerebrospinal fluid; in it the syndromes with unimportant deviations were prevailing. In the course of multiple sclerosis alterations in the constellation of cerebrospinal fluid in manner of a retrograde tendency were scarcely noted. An increase of pathologic parameters in cerebrospinal fluid did rather show the slighter forms, in the severe progredient courses the syndromes turned out to be comparatively constant.

Cerebrospinal Fluid↗

Multiple sclerosis--relation between HLA haplotype A25, B18 and disease progression.

The HLA typing of 100 patients with multiple sclerosis (MS) and their differentiation according to the dynamics of the disease, the type of course and the degree of defect showed the following results: a significant increase in frequency of HLA B7 (P less than 0.05), independent of the severity of illness, a 4-fold increased frequency of the HLA haplotype A25, B18 with augmented occurrence in slight to moderate severity of the disability degree (P less than 0.05), less so in the dynamics of the disease, and only partially so in the relapsing-remittent course. These HLA constellations provide only a hint at the prognosis of MS; the findings could be an expression of the heterogeneity of the disease.

Gene Frequency↗

Immunodiagnostic of multiple sclerosis by estimation of lymphokines in vitro and in vivo.

The basis of our investigations is a hypothesis about immunomechanisms responsible for aetiopathogenesis of multiple sclerosis including immungenetic connection (predisposition) and autoimmunity (pathogenesis). Some new results about cellular immunity using cell electrophoresis mobility technique, especially sensitization against normal brain tissue antigen (NTA) and investigations of lymphokines in cerebrospinal fluid are represented. The intention of this paper is to demonstrate a combined diagnostic regime for early detection of multiple sclerosis as well as for follow-up studies in course of treatment.

Antigens↗

[Contribution to the subacute necrotic myelitis (Foix-Alajouanine) (author's transl)].

A case of a 54 years old man with an acute lumbalgia in result of heavy labour is described. With in 7 years he developed a progressive paralysis of the upper and lower motor neuron type and an insensibility of the inferior extremities. The protein content of the cerebrospinal fluid was increased. The cells were insignificantly increased in number. No tumour was detected. The man died at the age of 62 on intoxication by infected decubitus and focal pneumonia. Autopsy revealed subacute necrotic myelitis (Foix-Alajouanine) with enlarged, varicose, and thickened extramedullary veins of the sacral, lumbal, and lower thoracic spinal cord, which was soft and diminished in size. In the grey and white matter of the cord, there were found more numerous and more prominent vessels like an angioma capillare et venosum; complete and incomplete necrosis was observed, partially with plasmatic infiltration. Some nerve cells were still present. Nerve fibres without myelin mantle were found in the spinal cord as well as in the spinal roots. The authors support the suggestion that the subacute necrotic myelitis results from a dysgenesis of the spinal venous vessels.

Autopsy↗

[Aspects of the value of humoral antibodies in encephalomyelitis of neuroallergic origin].

The importance of humoral antibodies formed in the course of neuroallergic diseases characterized by a cytergic type of reaction and especially in the course of experimental allergic encephalomyelitis (EAEM) is discussed, special attention being given to the importance of pathogenetic, immunodynamic, diagnostic, and therapeutic factors. The circulating antibodies of EAEM induced by cellular and humoral immunoprocesses are assumed to produce either intensifying or mitigating effects. Among the most important functions are the influence of immune globulins on the blood/brain boundary lesion, the gliotoxic and myelinotoxic effects, and the detection of a blockade of the intraneural transmission. The therapeutical effect to be discussed in the light of the protective effects of humoral antibodies is a mere conception in view of incompletely understood mechanisms including those governing the chronology and dynamics of immunoprocesses associated with multiple sclerosis, especially since the antigen-specific induction of tolerance appears to be far more essential.

Animals↗

[Experimental prevention and suppression of neuroallergic diseases].

For concepts of therapy for neuro-allergic diseases, especially of the encephalomyelitis disseminata type the experimental allergic encephalomyelitis (EAEM)--as a neuro-immunological disease of the first order and a classic pattern for the specification of immunological processes--can be used for more and more extensive testing. After an exposition of the different forms of treatment (prevention, suppression and therapy) and their value the possibility of inducing tolerance a versus the encephalitogenic protein is discussed following the EAEM example--taking the view that all measures taken up to now in the case of neuro-allergic diseases have been unspecific and consequently not set down. In addition emphasis was laid on the assumption of tolerance induction after sensitization which is important to the formation of a therapy for encephalomyelitis disseminata.

Animals↗