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Biomedical subjects

E H Beutner

Publications and source records attributed to E H Beutner.

At least 73 records · Page 4Linked to original sources
PubMed1987

Reticulin and endomysial antibodies in bullous diseases. Comparison of specificity and sensitivity.

Reticulin antibodies of IgG- and IgA-class and endomysial antibodies, which are of the IgA class, were studied by indirect immunofluorescence in 30 normal subjects, and in 45 patients with dermatitis herpetiformis (DH), 31 with pemphigoid, and 30 with pemphigus. Endomysial antibodies were present in 65% of patients with DH maintained on a normal diet and were absent in those on a gluten-free diet and in those with other diseases and in normal controls. Reticulin antibodies of the IgA class were disease specific for DH and occurred in only 25% of such patients. IgG-class reticulin antibodies, on the other hand, were not specific for DH, as they occurred in similar frequencies in patients with pemphigoid and pemphigus and in normal subjects. IgA-class reticulin antibodies occurred primarily in those patients with DH who had high titers of endomysial antibodies. None of the 20 such patients who were negative for endomysial antibodies had IgA-class reticulin antibodies. These studies indicate the high degree of specificity and sensitivity of endomysial antibodies.

Dermatitis Herpetiformis↗
PubMed1986

Anti-endomysial antibodies. A serologic marker of dermatitis herpetiformis.

Direct immunofluorescence (IF) studies of skin biopsies are of value in the diagnosis of most, but not all, cases of dermatitis herpetiformis (DH). Similarly, histologic studies are of help but may be questionable or completely nonspecific. Serologic studies for the presence of IgA-class anti-endomysial antibodies are very specific and are found in 70% of patients with DH and in all untreated patients with celiac disease. The titers of these antibodies are directly associated with the degree of gut disease in these patients. Thus, the presence of these antibodies even in the absence of classic direct IF and histologic findings are diagnostically important. We encountered three cases in which both direct IF and histologic studies were equivocal toward confirming the clinical diagnosis of DH. Serologic studies for the presence of IgA-class anti-endomysial antibodies provided evidence for the diagnosis of DH, and, in each case, results were confirmed by further direct IF studies. Since these antibodies are disease specific for DH and celiac disease and are found in most active cases of DH, they may be considered an adjunct to the direct IF and histologic studies of the skin.

Aged↗
PubMed1986

Intercellular complement C3 binding in normal skin of patients without pemphigus.

We report here direct immunofluorescence studies of normal skin biopsies that exhibited only complement C3 staining in intercellular areas of epithelium with a view toward evaluating the significance of such findings. During a 5-year period, 11,000 skin biopsy specimens were examined for in vivo binding of immunoglobulins, fibrin, and complement C3 by means of defined direct immunofluorescence methods. Four of ten patients demonstrating intercellular C3 deposits alone had drug-related reactions or erythema multiforme, and four were subsequently shown to have a connective tissue disease. Pemphigus was ruled out in all ten cases in these retrospective studies. These observations indicate that the finding of intercellular C3 deposits in the absence of IgG in normal skin is not a sign of pemphigus but, rather, a sign either of an unusual type of drug reaction or, possibly, of some connective tissue disease. However, the finding of intercellular C3 plus IgG (with or without other immunoglobulins) is a sign of pemphigus. The mechanism of C3 deposition without immunoglobulins is not clear.

Adult↗
PubMed1986

Sensitivity and specificity of IgA-class antiendomysial antibodies for dermatitis herpetiformis and findings relevant to their pathogenic significance.

The specificity and sensitivity of the recently reported IgA-class antiendomysial antibody test for gluten-sensitive enteropathy were evaluated in four double-blind studies involving the sera of fifty-seven patients with dermatitis herpetiformis who were not on a gluten-free diet and ninety-seven assorted control sera. The control sera provided by the four centers included the sera of nineteen patients with dermatitis herpetiformis and two with celiac disease who were on a gluten-free diet, the sera of five normal subjects with human lymphocyte antigens (B8 locus), the sera of thirteen patients with linear IgA bullous dermatosis, and fifty-eight other control sera, mostly from patients with other bullous diseases and other dermatoses. The frequency of IgA antiendomysial antibody in these coded studies was zero of ninety-seven control sera and thirty-four of fifty-seven sera (60%) from patients with dermatitis herpetiformis who were not on a gluten-free diet. The pathogenic role of IgA antiendomysial antibodies in dermatitis herpetiformis and celiac disease is suggested not only by their high degree of disease sensitivity and specificity but also by their formation in response to gluten challenge, their appearance before gut changes, and the in vitro binding of gliadin to the antiendomysial antibody antigen sites. These and other findings in this study and in the literature suggest that gluten-sensitive enteropathy is immunologically mediated and that IgA antiendomysial antibodies play a significant pathogenetic role.

Animals↗
PubMed1986

Scl 70 antibody--a specific marker of systemic sclerosis.

Scl 70 antibodies were tested for in 107 patients with systemic sclerosis: 68 with acrosclerosis and 39 with diffuse scleroderma. Anticentromere antibodies (ACA) and other antinuclear antibodies (ANA) were tested for by indirect immunofluorescence on HEp-2 cells. Positive results for Scl 70 antibodies were obtained in 77% of cases of diffuse scleroderma and 44% of acrosclerosis. ACA and Scl 70 antibodies were found to be mutually exclusive. If acrosclerosis cases positive for anticentromere antibodies are excluded, the percentage of acrosclerosis cases positive for Scl 70 was 63%. ACA were found to be a marker of a benign, abortive subset of acrosclerosis with almost no cutaneous involvement (CREST), whereas Scl 70 did not discriminate between acrosclerosis and diffuse scleroderma. On HEp-2 cells Scl 70 positive sera gave a characteristic, fine speckled, almost homogeneous nuclear staining pattern.

Antibodies, Antinuclear↗
PubMed1985

[Plasmapheresis in the treatment of pemphigus].

The results of small-volume plasmapheresis were favorable in cases of severe pemphigus vulgaris and foliaceus if applied simultaneously together with corticosteroids and cyclophosphamide, both on lowered doses. The patients went into long-lasting remission. A special indication for this therapy are cases that do not allow the application of large doses of prednison because of severe side-effects of steroids. The effect of plasmapheresis does not appear to depend on the removal large quantity of antibodies. Small-volume plasmapheresis as a supplementary therapy of the combined treatment with steroids and immuno-suppressors showed better effects than large-volume plasmapheresis.

Adult↗
PubMed1985

IgA anti-endomysial antibody detection in the serum of patients with dermatitis herpetiformis following gluten challenge.

This study reports the appearance of IgA-class anti-endomysial antibodies in the serum of 8 out of 12 patients with dermatitis herpetiformis who were challenged with gluten after a number of years of control of the rash with a strict gluten-free diet. Although there was no evidence for the antibodies having any pathogenic role in the rash of dermatitis herpetiformis, their presence may be related to the deterioration in the gluten-sensitive enteropathy.

Adult↗
PubMed1985

Evaluation of methods for detection of anticentromere antibodies and other antinuclear antibodies.

Our immunologic studies of twenty-five patients with acrosclerosis with severe acral involvement, twenty-seven patients with most or all of the signs of CREST syndrome, twenty-two patients with systemic lupus erythematosus as positive controls, and ninety-one blood donors as negative controls centered on an evaluation of eight antigenic substrates, including four types of human cells for the detection of anticentromere antibodies (ACA) and other antinuclear antibodies (ANA). The ACA, which occurred only among the patients with most or all of the signs of CREST syndrome, could be detected reliably on human cell lines HEp-2 and KB but not on a mouse cell line or on the three types of tissue sections examined. Comparisons of human HEp-2 and KB cell lines from four sources indicated that HEp-2 cells are the best of the substrates tested for detection of ACA. Since rodent tissue sections give negative reactions with ACA, they are indicated for confirmation. In general, results varied with the type and source of antigen used. Thus ANA findings need to be expressed not only in terms of the titers of the antibodies and the pattern(s) of their reactions but also in terms of the type of antigen or substrate used, its source, and the diagnostic significance of findings in the given test system.

Animals↗
PubMed1985

Anticentromere antibody: an immunological marker of a subset of systemic sclerosis.

Our clinical and immunological studies of 114 cases of systemic sclerosis, 54 of Raynaud's disease and 46 of other connective tissue diseases, centered on the diagnostic and prognostic significance of anticentromere antibodies (ACA). The ACA occurred in 21 of 84 patients with acrosclerosis, in four of 54 patients with Raynaud's disease but in none of 30 patients with diffuse scleroderma or transitional form, acrosclerosis-diffuse scleroderma, or 46 cases of other connective tissue diseases. The ACA-positive patients had no contracture or immobilization of the fingers, the indurations and/or indurative oedema were confined to fingers and usually no other types of ANA were detected. However, systemic involvement and the course of the disease were comparable in ACA-negative and ACA-positive acrosclerosis patients. The studies indicate that there is a subset of acrosclerosis with minimal indurations confined to the fingers, and ACA appears to be its serological marker. We propose to use the term CREST for this subset, which to date has not been exactly defined and is regarded by some authors as synonymous with acrosclerosis.

Adult↗
PubMed1985

Linear IgA bullous dermatosis. An immunologically defined disease.

Linear IgA bullous dermatosis (LABD) can mimic bullous pemphigoid (BP) and/or dermatitis herpetiformis (DH) both clinically and histologically. LABD, however, can be distinguished from BP and DH by direct immunofluorescent (IF) demonstration of linear IgA deposits along the basement membrane zone. A retrospective study of 234 cases of BP, 27 cases of LABD, 60 cases of DH, and 20 cases of cicatricial pemphigoid (CP) revealed that BP patients are significantly older than LABD or DH patients and LABD patients are significantly older than DH patients. BP and CP occur more frequently in women (65-70%) than LABD or DH (44-48%). The frequencies of C3 deposits in the basement membrane zone (BMZ) are significantly higher in BP (85%) compared with LABD (18.5%) and DH (28.3%). LABD patients varied in their response to various therapeutic agents. Some responded to corticosteroids and some to sulfones alone, whereas others required a combination of corticosteroids and sulfones.

Adolescent↗
PubMed1985

Demonstration of allospecific differences in human stratum corneum autoantibodies by blocking immunofluorescence.

Stratum corneum antibody titers of six normal human sera were determined by indirect immunofluorescence on three different epidermal substrates with and without preincubation of the substrates with one monkey serum. In three out of six human sera the reaction of stratum corneum antibodies was inhibited on all three substrates, in one serum the inhibition was noted on two out of three substrates and no effect was observed in two sera. These findings provide further evidence for the existence of allospecific stratum corneum antibodies in human sera and for the presence of both species-specific and species-nonspecific glycoprotein stratum corneum antigens in human epidermis.

Animals↗
PubMed1985

In vitro effects of enzymes of polymorphonuclear leukocytes on the antigenicity of stratum corneum.

Anti-stratum corneum (SC) antibodies of human serum bind in vitro to the SC of frozen sections of normal skin of psoriatic patients and of healthy controls. Pretreatment of skin sections with selected dilutions of acid extracts from polymorphonuclear leukocytes (PMN) prior to the incubation with serum containing anti-SC autoantibodies enhances this binding in comparison with binding to untreated sections. Pretreatment of at least some specimens with higher concentrations of the same PMN extracts brings about a reduction in their reactivity with anti-SC autoantibodies. These findings indicate that enzymes of PMN are capable of altering SC antigens by first increasing and then decreasing their reactivity with SC autoantibodies.

Antigens↗
PubMed1985

Specificity of the Crithidia luciliae method for detecting anti-DNA antibodies. Effect of absorption for lipoproteins.

Using the immunofluorescent (IF) assay with Crithidia luciliae smears, anti-native (n) DNA antibodies were detected in the sera of 12 of 20 systemic lupus erythematosus (SLE) patients, in 1 of 6 mixed connective tissue disease cases, in 2 of 38 patients with systemic sclerosis but in none of the sera from 96 normal subjects. All anti-nDNA antibodies were associated with antinuclear antibodies (ANA). However, occasionally sera were encountered in routine screening which appear to be positive for anti-DNA antibodies but negative for ANA. Studies of such sera indicate that this is a nonspecific reaction which can be abolished by treating sera with dextran sulfate or heparin. Treatment of SLE sera with these agents had no effect on their anti-nDNA antibody activity. Absorption of sera with Aerosil eliminated the false positive reactions with C. luciliae; however, this treatment also removed immunoglobulins, ANA and anti-nDNA antibodies. Evidence is reviewed which points to a role of complexes of low density lipoprotein and IgG in the nonspecific binding reactions with C. luciliae which is seen as false positive reactions for anti-nDNA antibodies.

Adsorption↗
PubMed1984

Distribution of monkey esophagus antigens reactive with IgA-class antibodies in the sera of dermatitis herpetiformis patients.

Antibodies of IgA class reactive to the lining of the smooth muscle bundles, i.e., endomysium (EmA), are present in the sera of patients with dermatitis herpetiformis and coeliac disease. These antibodies can be detected on monkey esophagus, a substrate of choice for pemphigus and pemphigoid antibodies. The amount of antigen reactive with IgA-EmA is greatest in the lower portion of the esophagus and decreases towards the uppermost part.

Animals↗