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Biomedical subjects

E H Beutner

Publications and source records attributed to E H Beutner.

At least 55 records · Page 3Linked to original sources
PubMed1989

A simple method for elution of IgA deposits from the skin of patients with dermatitis herpetiformis.

To better understand the role of autoimmunity in the pathogenesis of dermatitis herpetiformis, linear IgA bullous dermatosis or other skin disorders, the antigenic specificity of the immune reactants bound in vivo in the skin must be identified. In order to do so, one must first be able to elute these immune reactants from the skin. We describe here a simple method of eluting not only specifically bound IgG, but also IgA and other immunoglobulins and complement components from skin biopsy material. The method involves cutaneous washing of the entrapped serum proteins in PBS pH 7 and pH 5 buffers followed by specific immunoglobulin elutions at pH 3 and 2. The IgA deposits which could not be removed by this treatment were eluted by a combination of low pH (0.5 M citrate pH 2) and a chaotropic agent (2 M NaCl). The relative concentration of IgA in eluates when quantitated by fluoroimmunoassay were three- to five-fold higher in dermatitis herpetiformis skin biopsy specimens, than in eluates of bullous pemphigoid or normal skin biopsy specimens.

Buffers↗
PubMed1989

IgA pemphigus foliaceus. Report of two cases and a review of the literature.

The cases of two patients with vesiculobullous lesions were diagnosed clinically and histopathologically as pemphigus foliaceus; unexpectedly, both revealed intercellular IgA, but not IgG, in the upper epidermis by direct immunofluorescence. Such histologic and immunofluorescence findings have been reported in eight other cases. In our cases no circulating IgA or IgG intercellular antibodies could be detected; in four of eight other reported cases IgA antibodies showed intercellular staining like that of pemphigus antibodies. Subcorneal acantholytic lesions occurred in both our cases; of the other cases reported, five had essentially identical histopathologic findings. The clinical and histopathologic features of pemphigus, as well as the recent findings of circulating IgA intercellular antibodies alone or with IgG antibodies, appear to place this disease into the spectrum of pemphigus. The 10 IgA pemphigus cases reported to date fall into one of two groups, the IgA pemphigus foliaceus (including our two cases) and IgA pemphigus of the intraepidermal neutrophilic type, which seems to be less common.

Adult↗
PubMed1988

Aggressive gluten challenge of dermatitis herpetiformis cases converts them from seronegative to seropositive for IgA-class endomysial antibodies.

The responses to aggressive gluten challenge of two dermatitis herpetiformis patients with normal gut mucosa and negative serum findings for IgA endomysial antibodies while on normal diets indicate that these patients have a latent gluten-sensitive enteropathy. This was shown further by the control of skin lesions in both cases and in one case by the clearance of the induced gut lesions with a gluten-free diet. Specifically, for 12 to 20 weeks, aggressive gluten challenge (1 to 2 gm/kg/day) of these two patients was followed by both the appearance of and a rise in titer of IgA endomysial antibodies with an exacerbation of skin lesions. After 27 weeks of gluten challenge, histologic studies of the gut showed grade III flattening of the jejunal mucosa in the patient who developed IgA endomysial antibodies 19 weeks before biopsy was performed but not in the patient in whom IgA endomysial antibodies appeared 7 weeks before biopsy was performed. When both patients were placed on a gluten-free diet, IgA endomysial antibodies titers showed negative findings and the skin lesions subsided. It was possible to discontinue dapsone treatment after 30 weeks on a gluten-free diet in one patient and after 33 weeks in the other. It is important to note in the patient who developed grade III (significant) gut pathology after gluten challenge that a third biopsy taken 59 weeks after starting a gluten-free diet revealed a return to a grade II (insignificant) level of villus atrophy. Thus if sulfones are contraindicated in such cases, patients can be treated successfully with a gluten-free diet.

Child↗
PubMed1988

Identification of IgA subclasses in skin of dermatitis herpetiformis patients.

There is a controversy as to the origin and to the subclass of IgA in dermatitis herpetiformis (DH) skin. The present study was undertaken to reexamine the subclasses of IgA and the presence of J-chain in biopsies of DH patients. Skin biopsies from 12 DH patients were examined for IgA, its subclasses and for J-chain by a modified direct immunofluorescence (IF) method. All DH skin biopsies were positive for IgA. Ten of the twelve biopsies were positive for IgA1. IgA2 was detected in only 3 cases, notably in those which gave the strongest IgA reactions. In general, the fluorescent staining intensity for IgA2 was weaker than IgA1 and IgA1 was less than the total IgA. This may be due to differences in the concentrations of the immunoglobulin subclasses in the skin and may also be due to the restricted specificity of antisera used in the study. Direct IF studies of the presence of J-chain yielded negative findings in all DH cases examined including those which were positive for IgA2. The higher frequency of IgA1 over that of IgA2 and the absence of J-chain indicate that the IgA immune deposits in the DH skin may not necessarily be of mucosal origin.

Dermatitis Herpetiformis↗
PubMed1988

Action of topically applied arachidonic acid on the skin of patients with psoriasis.

Concentrations of arachidonic acid ranging from 0.1% to 2% were applied under occlusive dressings to psoriatic plaques in 45 patients. Alleviation of the clinical symptoms of psoriasis including complete clearing in some cases was obtained with the use of 0.5% to 2% arachidonic acid applied under occlusion every 24 to 48 hours five to seven times. Histologic examination showed polymorphonuclear leukocytes penetrating into the stratum corneum and formation of microabscesses or wide-spread accumulations of polymorphonuclear leukocytes in the stratum corneum, with its eventual destruction. The parakeratotic horny layer became detached; this was followed by restoration of the granular layer and an apparently normal stratum corneum. While arachidonic acid metabolites can be proinflammatory and proproliferative, they may also be important in the healing process for psoriasis.

Administration, Topical↗
PubMed1988

Scl-70 antigen stability and its effect on antibody detection in scleroderma.

We examined 38 patients with scleroderma, 10 with systemic lupus and 10 normal subjects for Scl-70 antibodies by the gel precipitation and by the immunoblot methods. Increased incidence of Scl-70 antibodies in scleroderma were found by the immunoblot method (55%) compared to the gel precipitation methods (40 or 42% depending on the test kits used). Immunoblot analysis of the antigen prepared with 4.0 M NaCl extraction of rabbit thymus acetone powder revealed antigen to be 100, 86, 80 and 70 kDa. However, mainly a single band of 70 kDa was obtained upon extraction of rabbit thymus with 0.3 M NaCl and of calf thymus antigen. Our data support the suggestion that different molecular species of the Scl-70 antigen have variable binding affinities to nuclear DNA. We suggest that the presence of various molecular forms of the antigen may be a result of this differential binding affinity to DNA and the partial proteolytic digestion of 100 kDa from the antigen as reported by others.

Adult↗
PubMed1987

Antiendomysial antibody--useful serological indicator of dermatitis herpetiformis.

Antiendomysial antibodies (EmA) of the IgA class are directed against reticulin components of the primate smooth muscle and are markers of gluten-sensitive enteropathy. These antibodies occur in essentially all active cases of celiac disease and in about 70% of dermatitis herpetiformis (DH) patients. IgA deposits in the dermal papillae of the skin are the hallmark of DH and are employed routinely in establishing its diagnosis. The incidence of IgA deposits in skin varies depending upon the site and type of biopsy specimen taken. We studied sera and skin biopsy specimens for EmA and for IgA deposits in the skin from 11 DH patients. EmA were detected in the sera of 10 of the 11 cases. Of these 11 patients, 9 were positive for IgA deposits in their skin, as revealed by direct immunofluorescence (IF). The immune deposits were detected in the normal, and not in the lesional skin. DH cases that were initially negative on biopsy and serum positive for EmA were found to be positive when a repeat biopsy of the normal skin was performed. Thus, serological studies in conjunction with direct IF studies of the normal skin are useful in making a diagnosis of DH.

Adult↗
PubMed1987

Comparison of commercial kits for the detection of anti-nDNA antibodies using Crithidia luciliae.

The reactions of sera from 15 selected patients with connective tissue diseases and 4 selected control people were compared with the use of five commercial kits detecting anti-nDNA antibodies by indirect immunofluorescence on Crithidia luciliae. The cases with systemic lupus erythematosus (SLE) and a related condition reacted with the kinetoplasts of the C. luciliae in each kit tested with one exception, notably a case of drug-induced LE. The four control cases selected for a trace of staining of the nuclei of C. luciliae gave negative reactions with the kinetoplasts. The titer for each individual positive serum varied from 1.36 to 2.67 (mean SG 2.04) geometric standard deviation units. The staining pattern of sera positive for anti-nDNA antibodies on C. luciliae included reactivity of the kinetoplast with or without nuclear staining. The drug-induced LE serum produced only nuclear staining with no significant kinetoplast staining, i.e., a negative test for anti-nDNA antibodies. Patient control sera stained only the nucleus when any reactivity on C. luciliae was present. Generally, there were no major differences in titers and patterns of sera when comparisons were made between manufacturers. The sera were also tested by the Farr radioimmunoassay and the latex nucleoprotein test. The results of both of these assays correlated in most cases with the C. luciliae reactions.

Antibodies, Antinuclear↗
PubMed1987

Substrate specificity of anti-epithelial antibodies of pemphigus vulgaris and pemphigus foliaceus sera in immunofluorescence tests on monkey and guinea pig esophagus sections.

The indirect immunofluorescent (IF) reactivity of the pemphigus antibodies in sera of 21 cases of pemphigus vulgaris (PV), 15 cases of pemphigus foliaceus (PF), and 14 cases of Brazilian PF (BPF) was compared on 2 substrates, notably monkey esophagus (ME) sections and guinea pig esophagus (GPE) sections. The IF reactions of the pemphigus antibodies of PV could be distinguished from those of PF or BPF by differences in their reactivity on ME and GPE sections in 98% of the cases examined in this study. In most cases, the pemphigus antibodies of PV cases gave higher titers and stronger IF staining reactions on ME sections, while those of PF and BPF cases gave stronger reactions on GPE sections. In addition, most (13 of 21) PV sera react with the lowest 3-4 cell layers of ME sections, while most (13 of 15) PF sera failed to do so but did react with the upper layers of the sections. Importantly, in 8 of the 50 cases examined by IF, the choice of substrate affected the detectability of the pemphigus antibodies, i.e., 4 of 15 PF and 2 of 14 BPF sera reacted only with GPE and 2 of 21 PV sera reacted only on ME. These research findings point to the need for an evaluation of the combined use of ME and GPE in routine diagnostic studies of pemphigus antibodies.

Animals↗
PubMed1987

IgA anti-endomysial antibodies in dermatitis herpetiformis: correlation with jejunal morphology, gluten-free diet and anti-gliadin antibodies.

Circulating IgA-class anti-endomysium antibodies (EmA) can be detected by indirect immunofluorescence on monkey oesophagus sections. We found EmA in 22 (76%) of 29 patients with dermatitis herpetiformis (DH) on a normal, gluten-containing diet. The highest frequency (100%) of EmA was observed in patients with sub-total villous atrophy. IgA-class antigliadin antibodies (AGA) were found using an ELISA method in 59% of 29 DH patients and in 86% of those with sub-total villous atrophy. There was a significant correlation between EmA titres and AGA levels in individual patients. Gluten-free diet (GFD) treatment caused a rapid decrease in EmA titres; only three of the 12 patients still showed raised EmA after 6-12 months on a GFD and two of these three had failed to adhere to a strict diet. In contrast, no decrease in EmA titres occurred in four patients maintained on a normal diet, and two of the three patients with initially negative EmA developed positive titres when continuing on a normal diet. These results show that both IgA-class EmA and AGA are good indicators of jejunal damage in DH. The rapid fall of EmA titres after gluten withdrawal indicates that this test is also useful for monitoring a patient's adherence to a GFD.

Adolescent↗
PubMed1987

Detection of antigliadin antibodies in bullous diseases and their recognition of similar antigenic polypeptides.

The presence of antigliadin antibodies (AGA) in dermatitis herpetiformis (DH) has been associated with gluten-sensitive enteropathy. Because of the discrepancies in the specificity of AGA, we examined the sera of patients with DH, pemphigus and pemphigoid for AGA both by enzyme immunoassay and by immunofluorescence. Approximately 80-90% of sera of patients with DH had AGA. AGA were not disease-specific, they also occurred in about 40-80% of patients with pemphigus and pemphigoid depending on the method employed. In addition, AGA were also present in normal subjects. The incidence of AGA increased with age. AGA from patients with various bullous diseases recognized the same polypeptides thus suggesting that the presence of AGA cannot be regarded as a serological marker of DH.

Antibody Specificity↗