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Biomedical subjects

E Lindberg

Publications and source records attributed to E Lindberg.

At least 19 recordsLinked to original sources

IgG subclass distribution in serum and rectal mucosa of monozygotic twins with or without inflammatory bowel disease.

Serum samples from 26 monozygotic twin pairs concordant or discordant with regard to inflammatory bowel disease, and rectal biopsies from 42 twins of the same subject group, were examined for IgG subclasses. They were all compared with normal controls. Almost all affected twins were in clinical remission. Paired immunofluorescence staining of the rectal mucosa showed that those with ulcerative colitis had a significantly higher (p < 0.01) proportion of IgG1 producing mucosal immunocytes than normal controls (78.1% v 55.9%). Conversely, the IgG2 cell fraction was significantly reduced (15.9% v 34.6%). Healthy twins from ulcerative colitis pairs tended to show a raised proportion of IgG1 cells and the IgG2 cell fraction was significantly reduced (p < 0.05). In discordant ulcerative colitis twin pairs, no difference appeared in the cellular IgG subclass pattern between healthy and affected twins. Furthermore, the proportion of IgG1 in these healthy and diseased twins showed good correlation (T = 0.867). The results in rectal mucosa of twins with Crohn's disease were widely scattered and affected twins did not differ significantly from normal controls. Healthy twins, however, showed a marginally raised IgG1 cell proportion, but no correlation was seen between the IgG subclass fractions in discordant Crohn's disease twin pairs. The serum concentrations of IgG1 and IgG2 did not differ from normal controls in twins of either category. These results suggested that in ulcerative colitis, the aberrant mucosal production of IgG1 and IgG2 does not depend on active disease, but is apparently at least partially explained by a genetic impact. Conversely, the mucosal IgG subclass pattern in Crohn's disease appears to be determined mainly by exogenous variables.

Adult

Smoking in Crohn's disease: effect on localisation and clinical course.

The effects of smoking on the localisation and clinical course of Crohn's disease is evaluated in 231 patients. Heavy smokers (greater than 10 cigarettes/day) had an increased risk of operation at least once--odds ratios for heavy smokers compared with never smokers after five and 10 years were 1.14 and 1.24 respectively (p = 0.03 and p = 0.017). The risk of further operations was even higher and after 10 years the odds ratio was 1.79 (p = 0.015). The accumulated number of fistulae and/or abscesses was higher for smokers than for never smokers (p = 0.046). Patients with a high life time tobacco exposure (greater than 150 cigarette years) and heavy smokers (greater than 10 cigarettes/day) had small bowel disease more often than patients with lower life time exposure (less than or equal to 150 cigarette years) and patients smoking less than or equal to 10 cigarettes/day (p = 0.002 and p = 0.045 respectively). The course of Crohn's disease analysed in different ways was unfavourable for smokers, especially heavy smokers. Patients with Crohn's disease should be dissuaded from smoking.

Abscess

Antibody (IgG, IgA, and IgM) to baker's yeast (Saccharomyces cerevisiae), yeast mannan, gliadin, ovalbumin and betalactoglobulin in monozygotic twins with inflammatory bowel disease.

To assess whether dietary antigens play a role in inflammatory bowel disease, 26 monozygotic twin pairs with inflammatory bowel disease and 52 healthy controls were investigated for serum antibodies (IgA, IgG, IgM) against ovalbumin, betalactoglobulin, gliadin, whole yeast (Saccharomyces cerevisiae) and yeast cell wall mannan. The twins were made up of five pairs concordant and nine pairs discordant for Crohn's disease, and two pairs concordant and 10 pairs discordant for ulcerative colitis. Two patients with Crohn's disease had a slight increase in disease activity, the others were in clinical remission. Two striking observations were made: first, individuals with ulcerative colitis were indistinguishable from healthy twins, and controls except for the response to gliadin. Both healthy and diseased twins had higher IgA levels to gliadin than controls. Second, twins who had developed Crohn's disease displayed higher antibody titres towards yeast cell wall mannan in particular, but also to whole yeast (Saccharomyces cerevisiae) of all antibody types (IgA, IgG, and IgM). In contrast, the response to gliadin, ovalbumin, and betalactoglobulin did not differ from healthy twins and was even lower than in the controls. The results argue against an increased systemic antigen presentation caused by an impaired mucosal barrier in the inflammatory bowel disease. Rather, they suggest that yeast cell wall material--that is, mannan, or some antigen rich in mannose and cross reacting with mannan, may play an aetiological role in Crohn's disease, but not in ulcerative colitis. The increases in IgA and IgM, as well as IgG suggest that local and systemic immune systems are selectively activated by antigen(s) present in the cell wall of baker's yeast.

Adult

Three rapid immunoassays for the determination of creatine kinase MB: an analytical, clinical, and interpretive evaluation.

We present analytical and clinical studies of three commercial immunoassays for the determination of the creatine kinase MB isoenzyme (CK-MB). All methods are compared with the presently-accepted reference method, agarose gel electrophoresis. We find that each of the immunoassay methods offers diagnostic sensitivity and specificity similar to those of electrophoresis, while none experiences detectable interference from high concentrations of the creatine kinase BB isoenzyme (CK-BB) or the so-called "atypical" bands. The presence of atypical bands can cause electrophoresis to yield inaccurate quantification or even misidentification of CK-MB. Because the immunoassay approaches are more rapid than electrophoresis and require less technical expertise, it is possible to evaluate patients in a more timely and cost-effective manner. Further, since immunoassay results can be available in approximately 1/2 hour, rapid real-time decisions can be made regarding the desirability of initiating or continuing such valuable but dangerous procedures as thrombolytic therapy.

Antibodies, Monoclonal

Colonic glycoproteins in monozygotic twins with inflammatory bowel disease.

Colonic glycoprotein composition was evaluated in monozygotic twins with inflammatory bowel disease using ion-exchange chromatography. Fifty-three individuals, 12 pairs and 1 single twin with ulcerative colitis and 14 pairs with Crohn's disease, were evaluated. Seven twin pairs were concordant for the presence of ulcerative colitis or Crohn's disease, whereas twin siblings of 10 ulcerative colitis probands and 9 Crohn's disease probands were not known to have inflammatory bowel disease. Content of one chromatographically defined component of colonic mucin, designated HCM species IV, was reduced in both patients with ulcerative colitis (1040 +/- 300 cpm/10,000 cpm total HCM) and their apparently healthy twins (1340 +/- 540 cpm/10,000 cpm total HCM) compared with control subjects (4030 +/- 1,000 cpm/10,000 cpm total HCM). Composition of mucin in Crohn's disease patients and their nonaffected twins was not significantly different than in controls. These observations suggest that altered profiles of mucin glycoprotein may be present before the onset of ulcerative colitis and may be genetically defined. Conversely, it appears that alterations in glycoproteins only are not sufficient to initiate mucosal inflammation.

Adolescent

The incidence of Crohn's disease is not decreasing in Sweden.

An epidemiologic study of the incidence of Crohn's disease during the 25-year period 1963-1987 within a geographically well defined area has been performed. The mean annual incidence during the 25 years was 6.1/10(5) inhabitants. During the first quinquennium the incidence was 4.3/10(5) inhabitants, but during the next four quinquennia the incidence was very stable around 6.6/10(5) inhabitants. The point prevalence on 31 December 1987 was 146/10(5), with a male to female ratio of 1:1.15. An analysis of birth cohorts could not reveal any cohort more prone to develop the disease. Of the 246 incidence cases 5 patients had died of Crohn's disease. The percentage of small-bowel disease only was very stable during the whole study period. The proportion of large-bowel disease decreased only slightly, and combined small- and large-bowel disease increased somewhat towards the end of the study period, probably because of better diagnostic methods.

Adolescent

Urinary excretion of chromium in chromeplaters after discontinued exposure.

In a previous study [Lindberg and Vesterberg, 1983a], excretion of chromium in urine (U-Cr) in chromeplaters was proposed for biological monitoring of ongoing exposure. Published reports were found about the decline of U-Cr after discontinued exposure in welders working in chromium-alloyed stainless steel, but not in chromeplaters. In this study, half-times (t1/2) were calculated for ten chromeplaters over a weekend, and for 23 chromeplaters over 31 days vacation. The results suggest that the excretion of chromium can be approximated to a two-compartment model. Estimated from the median values, an initial rapid phase with an assumed t1/2 of 2-3 days is followed by a phase with a t1/2 of approximately a month. Differences between the decline of U-Cr in chromeplaters and welders are discussed.

Chromates

Smoking and inflammatory bowel disease. A case control study.

A population case controlled study of smoking habits at the time of diagnosis was done in 260 patients with ulcerative colitis and 144 with Crohn's disease. Smokers had a decreased risk of acquiring ulcerative colitis in comparison with never smokers (relative risk 0.7) which appeared to be dose dependent. In former smokers a rebound effect was seen, especially in former heavy smokers, where the risk was sharply increased (relative risk 4.4). No sex difference was recorded. Smoking doubled the risk of acquiring Crohn's disease without any dose dependent pattern. In former smokers a non-significantly increased risk was observed. This might be caused by a carry over effect after stopping smoking, however, which possibly is reduced by time. No sex difference was seen.

Adult

Ulcerative colitis and Crohn's disease in an unselected population of monozygotic and dizygotic twins. A study of heritability and the influence of smoking.

By running the Swedish twin registry containing about 25,000 pairs of twins of the same sex together with the central national diagnosis register of hospital inpatients, 80 twin pairs suffering from inflammatory bowel disease were found. In the ulcerative colitis group one of 16 monozygotic pairs was concordant for the disease, but all the other 20 pairs (dizygotic or unknown zygosity) were discordant. In the Crohn's disease group eight of 18 monozygotic pairs and one of 26 dizygotic pairs were concordant. The proband concordance rate among monozygotic twins was 6.3% for ulcerative colitis and 58.3% for Crohn's disease. The calculated heritability of liability based on monozygotic pairs was 0.53 and 1.0 respectively. Thus heredity as an aetiological factor is stronger in Crohn's disease than in ulcerative colitis. Monozygotic twins with Crohn's disease were more likely to be smokers than monozygotic twins with ulcerative colitis. Smoking did not explain the discordance of twin pairs with either ulcerative colitis, or Crohn's disease. The combination of identical heredity and similar smoking habit is not sufficient to cause disease.

Adolescent

Experiences in the psychotherapy of rheumatoid arthritis.

According to the relevant literature, psychological factors may play an important role in the onset and clinical course of rheumatoid arthritis. This is the first study reported in which the treatment of rheumatoid arthritis is based on such factors. Twenty-seven arthritics were treated psychotherapeutically and a close connection was seen between the course of the psychotherapy and the development of the somatic disease.

Arthritis, Rheumatoid

beta 2-Microglobulinuria among workers previously exposed to cadmium: follow-up and dose-response analyses.

Sixty workers (58 males, 2 females) who had previously been exposed to cadmium in connection with the use of cadmium-containing solders were examined. Exposure times ranged from 4 to 24 years. For each worker a cumulative cadmium dose estimate was calculated. This ranged from 0.35 to 9.9 mg/m3 X year. The prevalence of slight (U-beta 2 greater than 0.034 mg/mmole creatinine) and more pronounced (U-beta 2 greater than 0.1 mg/mmole creatinine) beta 2-microglobulinuria in the whole group was 40% and 23%, respectively. The prevalence of beta 2-microglobulinuria was strongly related to the cumulative dose estimate and to urinary cadmium level. Among workers with a cumulative dose estimate below 1 mg/m3 X yr there were only a few cases with slight tubular proteinuria, whereas for workers who had a cumulative dose estimate exceeding 3 mg/m3 X yr the prevalence of slight and pronounced beta 2-microglobulinuria was 77% and 54%, respectively. There was no significant relationship between the concentration of beta 2-microglobulin in serum and urine. This indicates that the beta 2-microglobulinuria is due to tubular damage and is not secondary to an increased endogenous production. Repeated examinations of 19 workers between 1976 and 1983 revealed that in almost all cases the beta 2-microglobulinuria was irreversible.

Adult

Assessment of renal function in workers previously exposed to cadmium.

Cadmium induced renal effects were examined in 60 workers (58 men, 2 women) previously exposed to cadmium. Tubular damage in the form of beta 2-microglobulinuria was found in 40%, and urinary albumin and orosomucoid increased significantly with increasing urinary cadmium and increasing relative clearance of beta 2-microglobulin. It is suggested that increased albumin excretion is secondary to the tubular damage. In no case was typical glomerular proteinuria found that could be related to cadmium. Histories of renal stones were more common among the workers with high urinary cadmium concentrations. The glomerular filtration rate was measured in 17 of the workers who had pronounced tubular dysfunction. The average glomerular filtration rate for these men was less than the age adjusted predicted value (mean = 84%). Furthermore, there was a significant (p less than 0.05) correlation (r = -0.47) between tubular reabsorption loss and a decreased glomerular filtration rate.

Adult