PubMed Health⌕ Search

Biomedical subjects

D C Kilpatrick

Publications and source records attributed to D C Kilpatrick.

At least 19 recordsLinked to original sources
PubMed1992

Soluble interleukin-2 receptors in recurrent miscarriage and the effect of leukocyte immunotherapy.

The relationship between soluble interleukin-2 receptors (IL-2R) and pregnancy outcome was investigated in women with a history of miscarriage, some of whom were treated with partner-specific leukocyte immunotherapy. IL-2R were significantly elevated in patients with a poor obstetric history possessing cardiolipin antibodies, and higher levels were also found in recurrent aborters without cardiolipin antibodies who had particularly bad histories. Furthermore, values obtained during early pregnancy were lower in patients who subsequently had successful pregnancies than in those who aborted again. Eight out of 35 patients immunised with their partners' lymphocytes, but none of 16 patients immunised with their own cells, showed a marked decrease in IL-2R levels a month later. It is possible that the minority who respond to immunotherapy with a marked drop in IL-2R may be the same minority who may derive benefit from this treatment.

Abortion, Habitual↗
PubMed1992

Cardiolipin antibody levels are not influenced by leukocyte immunotherapy in patients experiencing recurrent spontaneous abortion.

OBJECTIVE: To confirm that leukocyte immunotherapy stimulates the production of cardiolipin antibodies and to relate changes to pregnancy outcome. PATIENTS: Fifty patients with idiopathic recurrent abortion were studied. Thirty-six patients received injections of their partners' leukocytes; 14, injected with their own cells, served as controls. DESIGN: Cardiolipin antibodies were measured a month before and after leukocyte immunization. Patients who became pregnant were immunized a second time in early pregnancy, and cardiolipin antibodies were again measured a month later. RESULTS: Thirty-six patients immunized with their partners' leukocytes showed no appreciable change in cardiolipin antibody levels a month after vaccination. Twenty-nine of them subsequently became pregnant and were immunized again in early pregnancy: again, no change in cardiolipin antibody level was observed. There was no difference between the minority who aborted again and the majority who subsequently had successful pregnancies nor between those who responded to immunotherapy by producing cytotoxic antilymphocyte antibodies and those who did not. CONCLUSION: Leukocyte immunotherapy does not stimulate cardiolipin antibody production in women with normal pretreatment levels of the autoantibody.

Abortion, Habitual↗
PubMed1992

Anticardiolipin antibodies and pregnancy outcome in women with human immunodeficiency virus infection.

Abnormal anticardiolipin antibodies are associated with adverse pregnancy outcome in the general obstetric population. We studied 55 pregnancies in women infected with human immunodeficiency virus type 1 (HIV-1) to examine two hypotheses: that a substantial proportion of these women would have raised anticardiolipin antibodies, and that the affected pregnancies would be more likely to be complicated by preterm delivery and intrauterine growth retardation. Blood was taken at the initial antenatal visit, and was also taken from 15 HIV-seronegative intravenous (IV) drug users and 20 controls with no drug history. The reference for immunoglobulin G class antibodies to cardiolipin was calculated from 50 healthy young adults, and the upper limit of normal was defined as 4 standard deviations above the mean for this reference series. Twenty-four percent of the infected women, but none of the HIV-seronegative IV drug users and none of the control group, had raised anticardiolipin antibodies. There was no statistically significant relationship with birth weight, standardized birth weight, length, gestation, occipitofrontal circumference, or adverse pregnancy outcome. No women gave a history of thromboembolism or recurrent abortion, and in no pregnancy was there clinically apparent thromboembolism. We conclude that abnormal anticardiolipin antibodies provoked by HIV infection are common, but probably have a narrow specificity for cardiolipin, are unrelated to phospholipid antibody syndrome, and cannot explain adverse pregnancy outcome in HIV-infected women.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Neurological disease associated with anticardiolipin antibodies in patients without systemic lupus erythematosus: clinical and immunological features.

Anticardiolipin antibodies (aCL), one of a group of antiphospholipid antibodies which include the lupus anticoagulant (LA), may occur in association with systemic lupus erythematosus (SLE) and are less commonly detected in other diseases. We retrospectively reviewed the clinical and immunological features of 39 consecutive patients with abnormal aCL identified by one laboratory, to examine the spectrum of neurological disease in those patients without SLE. Fourteen patients in this category are described, 6 of whom did not have evidence of LA. All but 1 presented with neurological symptoms. Stroke and migraine dominated the clinical presentation, but many patients had features to suggest the presence of a hypercoagulable state. This study lends support to the concept of a primary antiphospholipid syndrome.

Adult↗
PubMed1991

Is genetic susceptibility to pre-eclampsia conferred by homozygosity for the same single recessive gene in mother and fetus?

OBJECTIVE: To determine whether any simple, purely genetic mechanism can account for susceptibility to pre-eclampsia. DESIGN: Six simple Mendelian models of inheritance were considered, and predictions concerning the incidence of pre-eclampsia in various family members of index cases were calculated for each genetic model. Data were then extracted from published family studies in which a suitable disease definition had been used, and compared to our theoretical expectations. RESULTS: Only one of the genetic models considered, in which both mother and fetus must express the same recessive gene to confer susceptibility, was consistent with the observed incidence values for relatives of index cases. This model was also consistent with the putative association with HLA-DR4, but could not account for the comparative rarity of pre-eclampsia in parous women. CONCLUSION: Homozygosity for a single recessive gene shared by mother and fetus, unlike five other genetic mechanisms tested, is consistent with published family studies in pre-eclampsia, and should be considered the best working hypothesis at present.

Disease Susceptibility↗
PubMed1990

Anti-cardiolipin antibodies and HIV infection.

Anti-cardiolipin antibodies of IgG class were found in 48% of intravenous drug users, 38% of homosexuals and 14% of heterosexuals (with no other risk factor) infected with HIV. Anti-cardiolipin antibodies were not increased in HIV-negative heterosexual partners of HIV-infected patients, but mildly elevated levels were detected in HIV-negative drug users, relative to healthy controls unselected for HIV status. Among HIV infected drug users, anti-cardiolipin antibodies were not associated with thrombocytopenia, Pneumocystis carinii pneumonia, disease progression or clinical stage. Anti-cardiolipin antibodies appear to be another non-specific marker of HIV infection which may be particularly common in male intravenous drug users infected with the virus.

Autoantibodies↗
PubMed1990

Pre-eclampsia is associated with HLA-DR4 sharing between mother and fetus.

Full HLA-A,B and DR typing was carried out on 92 women with proteinuric pre-eclampsia, 80 of their husbands and 46 of their babies. The results were compared with corresponding data from 65 normotensive pregnancies involving primiparous women. The frequency of HLA-DR4 was increased in the pre-eclamptic women (RR 3.1; p less than 0.005) and in the babies of pre-eclamptic pregnancies (RR 2.6; p less than 0.03). The strongest association, however, was with sharing of HLA-DR4 between mother and fetus (RR 4.2; p = 0.01). There was no increase in HLA antigen sharing in general between spouses or maternal-fetal pairs in pre-eclampsia. Nor did pre-eclamptic women exhibit increased homozygosity in general at any HLA locus. We conclude that genetic susceptibility to pre-eclampsia depends at least partly on fetomaternal compatibility for a gene or genes associated with HLA-DR4.

Female↗
PubMed1989

Association between susceptibility to pre-eclampsia within families and HLA DR4.

56 women who had had proteinuric pre-eclampsia and who had parous sisters were studied. In first pregnancy, proteinuric pre-eclampsia was more common in the sisters than in the maternity hospital population (8/71 [11%] vs 41/1978 [2%]); the relative risk was 6.0. The frequency of HLA DR4 was higher in sisters with pregnancy-induced hypertension than in sisters with normotensive pregnancies (8/18 [44%] vs 10/54 [19%]) and more of them shared HLA DR4 with their spouses (4/14 [29%] vs 0/29). Genetic susceptibility to pre-eclampsia is associated with HLA DR4; it may be conferred by fetomaternal sharing of a single recessive HLA-linked gene.

Adult↗
PubMed1988

Post-transfusion purpura following open heart surgery: management by high dose intravenous immunoglobulin infusion.

We present three cases of post-transfusion purpura (PTP) developing in the immediate post operative period after open heart surgery. All had developed platelet specific antibodies and severe anaphylactoid reactions occurred to platelet transfusion in two cases. Treatment with high dose intravenous immunoglobulin (IV IgG) led to complete recovery in two patients one of whom demonstrated a marked biphasic response pattern to therapy. The other died from congestive cardiac failure. PTP is a potentially fatal complication which may well become more frequent with increasing blood product usage.

Aged↗
PubMed1988

Datura lectin is both an anti-mitogen and a co-mitogen acting synergistically with phorbol ester.

The lectins from Datura stramonium, Lycopersicon esculentum, and Solanum tuberosum are structurally related and possess a similar carbohydrate specificity, yet the Datura lectin is mitogenic for human lymphocytes while the other two are not. However, the Datura lectin was found to antagonize blast transformation induced by purified protein derivative (PPD), even within the concentration range at which it was optimally mitogenic on its own. The presence of a submitogenic concentration of the phorbol ester 12-O-tetradecanoyl-phorbol-13-acetate (TPA) enormously enhanced the mitogenic activity of Datura lectin. No such synergy was observed, however, between tomato lectin or S. tuberosum agglutinin (STA) and TPA, nor between Datura lectin and the calcium ionophore A 23187.

Calcimycin↗