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Biomedical subjects

E Diaz-Jouanen

Publications and source records attributed to E Diaz-Jouanen.

18 recordsLinked to original sources
PubMed2000

Multidrug resistance-1 (MDR-1) in rheumatic autoimmune disorders. Part I: Increased P-glycoprotein activity in lymphocytes from rheumatoid arthritis patients might influence disease outcome.

BACKGROUND: Multidrug resistance (MDR) is characterized by overexpression of P-glycoprotein, a pump molecule that decreases intracellular drug concentrations by increasing drug efflux from cells. OBJECTIVE: To look for correlations between clinical status and P-glycoprotein activity and/or TNF-alpha mRNA levels in patients with rheumatoid arthritis. METHODS: Sixteen patients were studied. Based on response to therapy, eight were refractory and eight nonrefractory to treatment. Findings were compared to those in 24 healthy controls. Flow cytometry was used to evaluate P-glycoprotein activity in peripheral blood mononuclear cells isolated by gradient centrifugation and incubated with the P-glycoprotein substrate daunorubicin. TNF-alpha mRNA levels were determined using quantitative PCR. RESULTS: Patients with rheumatoid arthritis showed an increased number of lymphocytes with high P-glycoprotein activity (p = 0.0001) as compared to the normal controls. P-glycoprotein activity was higher in the refractory than in the non-refractory patient subgroup (p = 0.006). Also, TNF-alpha mRNA levels were markedly higher in the refractory subgroup than in the nonrefractory subgroup, and were undetectable in the normal controls. CONCLUSIONS: Enhanced P-glycoprotein activity may be closely related to an unfavorable clinical course and a poor response to treatment. Increased TNF-alpha expression and chronic exposure to various drugs, including glucocorticoids, may contribute to increase P-glycoprotein activity. Both high P-glycoprotein activity and excessive amounts of TNF-alpha seem associated with poor outcome in rheumatoid arthritis.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1995

Risk factors for operative morbidity in patients with systemic lupus erythematosus: an analysis of 63 surgical procedures.

The surgical morbidity rate of patients with Systemic Lupus Erythematosus is considered very high; however, the experience in the literature is small. This study will determine the rate of surgical morbidity and the existence of predictive factors in patients with such a disease. The medical records of 53 patients with Systemic Lupus Erythematosus who underwent 63 major operations were analyzed retrospectively. The rate and causes of operative morbidity were registered. Univariate and multivariate statistical analysis was performed to ascertain the existence of predictive factors for morbidity. The overall morbidity and mortality were 16% and 6% respectively. Lymphopenia, hypoalbuminemia, increased SGOT and SGPT, urgent indication of operation, the physical status of the American Society of Anesthesiology, as well as a shorter duration of Systemic Lupus Erythematosus showed a significant correlation with operative morbidity in the univariate analysis; high blood urea nitrogen showed marginal significance. Physical status, urgent indication, and blood urea nitrogen remained as significant variables with the multivariate logistic regression analysis. The surgical morbidity rate of these patients may be lower than previously estimated. The physical status, urgency of operation, and level of blood urea nitrogen seemed to be the most useful independent predictors for surgical morbidity risk in patients with Systemic Lupus Erythematosus.

Adult↗
PubMed1988

Deforming arthropathy of the hands in systemic lupus erythematosus.

Forty-one of 858 patients with systemic lupus erythematosus (SLE) developed clinical deformity of their hands. This deformity was clinically and radiologically different from that found in 40 patients with classical or definite rheumatoid arthritis (RA), and tended to appear early in the course of disease. Characteristics of this arthropathy included nonerosive carpal collapse; exceptional erosion of the styloid processes; Z deformity of the thumb; nonerosive ulnar deviation and subluxation of MCP joints; parametacarpophalangeal joint hook formation; scant and asymmetric joint erosions; and swan neck deformity of the fingers. Most of these changes seemed to be due to involvement of the ligaments rather than to the destructive effect of synovitis. Patients with SLE with deforming arthropathy had a higher frequency of rheumatoid factor positivity, sicca symptoms and antibodies to native DNA, whereas they had lower incidence of facial rash and photosensitivity than did those without. Other manifestations did not differ. We propose that most patients with SLE with deforming arthropathy belong to a subset of SLE rather than representing the coexistence of SLE and RA.

Adolescent↗
PubMed1986

Changes in anti-lymphocyte and anti-Ia antibodies during pregnancy in systemic lupus erythematosus.

Anti-lymphocyte antibodies reactive with monocyte-depleted lymphocytes, T cells, or B cells were studied in 43 nonpregnant and 23 pregnant systemic lupus erythematosus (SLE) patients. Anti-Ia specificity was assayed in an enzyme-linked immunosorbent assay system. No difference in mean lymphocytotoxicity was noted between pregnant and nonpregnant SLE patients; however, anti-Ia lymphocyte antibody associated with disease activity was lower (P less than 0.01) in pregnant than in nonpregnant SLE patients. Lymphocytotoxic or anti-Ia antibody activity did not reliably predict the outcome of individual pregnancies.

Antilymphocyte Serum↗
PubMed1985

A multi-systemic disease (lupus-like) preceding bronchioloalveolar carcinoma.

A patient with a multi-systemic disease (lupus-like) that preceded the onset of a bronchioloalveolar carcinoma is described, and a brief review of the literature is presented. We suggest that this tumor be listed among the neoplasms responsible for multi-systemic diseases with lupus-like characteristics.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1985

Fatal pulmonary hemorrhage in systemic lupus erythematosus. Occurrence without hemoptysis.

We describe 12 patients with systemic lupus erythematosus (SLE) who developed massive pulmonary hemorrhage with very active disease. Other causes of pulmonary bleeding were excluded. Eleven of the 12 patients died, but only 4 had hemoptysis. Massive pulmonary hemorrhage should be suspected, even in the absence of hemoptysis, in severely ill patients with lupus who develop acute respiratory distress with bilateral pulmonary infiltrates and a drop in hemoglobin of 3 or more g/dl. Because of the deadly nature of this complication of SLE, when it is suspected, intensive corticosteroid and immunosuppressive treatment should be instituted.

Adolescent↗
PubMed1983

Joint contractures and scleroderma-like skin changes in the hands of insulin-dependent juvenile diabetics.

We studied 34 unselected insulin-dependent juvenile diabetics by seeking contractures at the proximal interphalangeal (PIP) joints and scleroderma-like changes of the hands or elsewhere. We found 14 contractures of only the 5th PIP in 7 and of the PIP of other fingers as well in the others. Nine of these patients also had scleroderma-like skin changes. Only one of 34 age and sex matched healthy controls had a minimal contracture of the 5th PIP joint but had no skin changes. All patients found to have these abnormalities had had diabetes for 6 or more years and the difference in the disease duration between those with hand changes and those without was significant (p less than 0.01). There was no correlation of these changes with renal or ocular vascular changes in this small group of patients.

Adolescent↗
PubMed1978

Human lymphocyte subpopulations defined by double surface markers.

Subpopulations of human peripheral blood lymphocytes were studied with single and double surface marker assays. The markers employed were as follows: (1) Fc receptor, using EA, mean 21.4%; (2) C3 receptor, using Zy-C3, mean 14.6%; (3) Slg, using a fluoresceinated F(ab')2 anti-F(ab')2 mean 8.9%; and (4) T lymphocytes forming E-rosette, mean 69.3%. The proportions of lymphocytes with any given surface marker which also have another surface marker were as follows: (1) EA + Slg/EA = 0.14, (2) EA + Zy-C3/EA = 0.22, (3) Slg + Zy-C3/Slg = 0.83, (4) Zy-C3 + E-rosette/E-rosette = 0.02, (5) EA + E-rosette/E-rosette = 0.06, (6) Slg + E-rosette/E-rosette = 0. The relative percentages of cells which were Slg+EA-, EA+Slg-, and EA+Zy-C3- were confirmed by EA rosette depletion via gradient centrifugation. On the basis of these observations, calculations were made of the theoretical numbers of lymphocytes with triple markers (EA+Slg+Zy-C3+ = 3.0%) and lymphocytes with only a single surface marker (EA+ only = 12.5%, Zy-C3+ only = 1.5%, Slg+ only = 1.5%). Finally a schematic representation of the multiple subpopulations of lymphocytes with various surface markers is presented.

B-Lymphocytes↗
PubMed1977

Cold-reactive lymphocytotoxic antibodies in mixed connective tissue disease.

Eighty-one sera from 18 patients with mixed connective tissue disease (MCTD) and high titers of antibody to ribonucleoprotein (RNP) were investigated for the presence of lymphocytotoxic antibodies. These were found in 59% sera from 14 patients but in only one of 40 normal subjects. Although lymphocytotoxic activity tended to be higher when the disease was active or there was lymphopenia, the correlation was not statistically significant. The lymphocytotoxic antibodies were found to be cold-reactive, and located in the IgM and/or IgG-containing elution fractions from DEAE cellulose columns. IgM-containing fractions tended to be more cytotoxic. Lymphocytotoxic antibodies were partially absorbed out with cerebral cortex but not with ENA-coated sheep red blood cells. Although attention has been focused on the anti-RNP antibodies found in MCTD, other autoantibodies are also present in a high proportion of patients.

Adolescent↗
PubMedDate not supplied

Antibody-mediated lymphocytotoxicity in rheumatoid arthritis and systemic lupus erythematosus.

Lymphocyte-dependent antibody cytotoxicity (LDAC) was studied using peripheral blood and in some instances synovial fluid cells from patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). No difference from normal controls was observed with peripheral blood lymphocytes from either RA or SLE. Marked decrement in LDAC effector cell activity was present particularly with RA synovial fluid cells. Sera from patients with RA or SLE as well as RA synovial fluids markedly inhibited LDAC.

Adult↗
PubMedDate not supplied

Protein-caloric malnutrition and systemic lupus erythematosus.

We report 5 patients with systemic lupus erythematosus (SLE) who presented with severe protein-caloric malnutrition that overshadowed the clinical picture of SLE. All 5 patients had severe anemia, extreme lymphopenia and hypoalbuminemia, but all 5 also had striking hypergammaglobulinemia with high titers of autoantibodies. These patients show that SLE may occur in subjects with endemic malnutrition and suggest that the production of autoantibodies in SLE patients overrules the requirements for the production of other proteins.

Adolescent↗
PubMedDate not supplied

Systemic lupus erythematosus. Differences between patients who do, and who do not, fulfill classification criteria at the time of diagnosis.

We compared 31 patients who did, and 31 patients who did not, fulfill 4 or more criteria for the classification of systemic lupus erythematosus (SLE) at the time of diagnosis. Twenty-one of the latter 31 patients eventually developed enough manifestations to fulfill classification criteria. Ten never did despite average follow-up of 41 months. Patients who did not fulfill criteria at the time of diagnosis frequently had more thrombocytopenia and/or hemolytic anemia and continued to have fewer manifestations during the course of their disease than those who did. Failure to include this subject of SLE in studies with series of SLE patients may give a distorted picture of the disease.

Adolescent↗