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E Novák

Publications and source records attributed to E Novák.

At least 19 recordsLinked to original sources

Hepatitis B surface antigen circulating immune complexes (HBsAg-CICs) in patients with bleeding disorders.

Approximately 90% of 67 multi-transfused patients with bleeding disorders were positive either for anti-HBs (85%) or HBsAg (45%). Using a polyethylene glycol trypsinization assay, we found anti-HbsAg-containing specific circulating immune complexes (HBsAg-CICs) in 3 of the 57 HBsAg-negative haemophiliacs possessing anti-HBs. The occurrence of HBsAg-CICs may be a regular event in the conversion phase of HBs infection. Circulating immune complexes as detected by the anticomplementary assay were found in 32 of the 67 (48%) patients.

Alanine Transaminase↗

Hepatitis B surface antigen circulating immune complexes (HBsAg-CICs) in patients with hepatitis B and asymptomatic HBsAg carriers.

The PEG-trypsinization assay detected HBsAg-CICs in 31 out of 44 (70%) patients with acute hepatitis B, in five out of 107 (5%) asymptomatic HBsAg carriers and, in addition, in both patients with HBsAg-positive chronic liver disease. A close correlation between the levels of HBsAg-CICs and disease activity was observed. The clinical course, parameters of liver function tests and outcome of the disease in patients without HBsAg-CICs (group A) and in patients with transient HBsAg-CICs (group B) were essentially similar. In contrast, patients with persistent HBsAg-CICs (group C) had a poor prognosis, particularly those who received corticosteroids. The method appeared to be a valuable tool in monitoring disease activity and prognosis, and in evaluating the efficacy of corticosteroid treatment. The role of HBsAg-CICs in the pathogenesis of liver damage and clearance of circulating HBsAg is discussed.

Acute Disease↗

Detection and quantitation of hepatitis-B surface antigen immune complexes (HBsAg-ICs) by an antigen-specific method. I. Detection and quantitation of in vitro prepared HBsAg-ICs.

An antigen-specific method has been developed for direct detection and quantitation of HBsAg-ICs. The method involves (1) precipitation of HBsAg-ICs with 3.5% PEG; (2) dissociation of the PEG precipitated ICs by treatment with NaSCN, NaI, KBr, low or high pH buffers, trypsin or papain; and (3) detection and titration of HBsAg and/or anti-HBs liberated from ICs. Treatment with 2 M and 3 M NaSCN, papain or trypsin liberates HBsAg, while following treatment with 3 M and NaI free anti-HBs is detectable. Trypsin digestion (2 mg/ml, 30 min at 37 degrees C) proved to be most effective for disrupting HBsAg-ICs formed at equivalence as well as in excess of antigen or antibody. After trypsin digestion of the sample RPHA, RIA and ELISA may be used as a third step. Th

Antibodies↗

Detection and quantitation of hepatitis B surface antigen immune complexes (HBsAg-ICs) by an antigen-specific method. II. Circulating immune complexes (CICs) in patients with hepatitis B and asymptomatic HBsAg carriers.

Using the PEG-trypsinisation assay, HBsAg-CICs were detected in 70% of patients with acute hepatitis B, in 5% of the asymptomatic HBsAg carriers and, in addition, in each of the 2 cases of chronic hepatitis B virus infection. In serial examinations, the complexed HBsAg levels in 77% of patients with acute hepatitis B decreased progressively in parallel with the free HBsAg levels, and persisted in the remaining 23%. In 19% of patients positive for HBsAg-CICs, the complexed HBsAg levels were higher than those of free HBsAg. No correlation was observed between results of PEG-trypsinisation and an anticomplementary assay. Artificial HBsAg-ICs in antigen excess were found to be poorly anticomplementary. C3 concentrations were normal or elevated in the majority (88%) of sera positive for HBsAg-CICs. These findings suggest that HBsAg-CICs in antigen excess are unlikely to be complement-activating. The method is useful for clinical investigation and for routine examination for HBsAg-CICs.

Adolescent↗

Serological differential diagnosis of viral hepatitis in adults.

Serum samples from different groups of adults were tested for HBsAg and IHxAg, using a complement-fixation microtest and the Indian-ink immune reaction, respectively. (i) In healthy men 18-24 years of age, living in camps in closed communities, HBsAg was demonstrated in 1.5%, IHxAg in 12.2%, and both antigens in 0.7%. The incidence of HBsAg positivity seems to be age-dependent and influenced by environmental factors. (ii) For patients hospitalized with liver and/or biliary-tract diseases other than hepatitis, the respective percentages were 10, 13.5 and 4.5%. (iii) Of the cases clinically diagnosed as infectious hepatitis (IH, hepatitis A) or serum hepatitis (SH, hepatitis B), 14% were positive for both antigens whereas 10% were double-negative; 76% were positive for either HBsAg or IHxAg. In two-thirds of the single-positive cases the demonstrated antigen agreed with the clinical diagnosis, in one-third the unexpected antigen was present. (iv) SGPT and thymol turbidity values agreed better with the serological findings that with the clinical diagnosis. The number of days in hospital appeared to be related to both the serological findings and the clinical diagnosis. The clinical course was the most severe for those having both antigens in blood. (v) IHxantibodies from early convalescence were sensitive, those from a later stage were resistant, to 2-mercaptoethanol. (vi) No correlation was found between the presence of IHxAg and that of the rheumatoid factor. (vii) The IHx Indian-ink reaction is disturbed by the presence of labile serum proteins while the essentially similar reverse passive haemagglutination reaction was not affected by them. (viii) Testing for IHxAg seems to be a procedure valuable in the differential diagnosis of IH and SH, though the results are less convincing in adult age than in childhood.

Adolescent↗

Immune-indian ink method for detection of hepatitis A associated antigen and antibody.

TIndian-ink grains coated with commercial gamma globulin (immune-Indian-ink) were agglutinated by 3 percent of sera from healthy volunteer blood donors; by 4 percent of those from hospital staff in contact with patients suffering from hepatitis; and by 10 percent of those from patients with viral diseases other than hepatitis, In contrast, the rate of positive reactions was 86 percent in the case of sera taken from patients in the acute phase of an illness diagnosed as hepatitis A on the basis of epidemiological and clinical data. Investigation of serum samples taken serially from patients positive in the acute phase of illness revealed that the immune-Indian-ink agglutinating factor does not persist for long in majority of cases. Two months after discharge from the hospital it was present in 18 percent of the patients only. The reaction proved negative when a limited number of cases diagnosed as hepatitis B were investigated. The immune-Indian-ink agglutinating factor was inhibited by all but one of 36 sera taken in the convalescent phase from patients with a diagnosis of hepatitis A. Some sera displaying agglutination with immune-Indian-ink gave a reaction with uncoated Indian-ink, too. Efforts to free the sera from non-specific agglutinating factor by starch-block electrophoresis have led to partial success. Fractionation on Sephadex G-200 columns suggested that in molecular weight (or particle size) the immune-Indian-ink agglutinating factor is smaller than HBsAg and larger than the non-specific agglutinating factor. On the basis of these results it is assumed that the immune-tindian-ink reaction is suitable for detecting an antigen tentatively called IH chi Ag and its antibody (IH chi Ab) specific to hepatitis A.

Acute Disease↗