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Biomedical subjects

G Giraudo

Publications and source records attributed to G Giraudo.

13 recordsLinked to original sources

Classic and perinuclear anti-neutrophil cytoplasm antibodies and antimyeloperoxidase antibodies in rapidly progressive glomerulonephritis.

Classic anti-neutrophil cytoplasm antibodies (cANCA), perinuclear ANCA (pANCA) and antibodies directed against myeloperoxidase (MPO-Ab) were evaluated in 25 patients with either idiopathic or secondary rapidly progressive glomerulonephritis (RPGN). While cANCA were found almost exclusively in Wegener's granulomatosis, pANCA were detectable in several disorders, including microscopic polyarteritis (mPA), but also idiopathic RPGN. MPO-Ab were frequently found in sera from patients with all types of idiopathic but not of secondary RPGN. These results support the hypothesis that some cases of RPGN are early or limited forms of systematic vasculitis. We then looked for the presence of IgA-ANCA in Henoch-Schoenlein purpura (HSP): we found IgA-ANCA with immunoenzymatic assay but not with immunofluorescence in HSP, in primary IgA-GN and in membranous GN as well, thus suggesting the poor specificity of this type of ANCA. The possible pathologic implications of ANCA were examined in vitro. Serum samples from several patients with ANCA were assessed for their capacity to enhance chemiluminescence generation from resting or PMA-stimulated macrophages. Sera from RPGN and mPA patients displaying anti-MPO activity induced granulocytes to enhance the production of oxygen free radicals, thus suggesting a phlogistic effect of MPO-Ab positive sera.

Adult

Acute effects of hemodialysis on erythrocyte sodium fluxes in uremic patients.

The acute effects of both acetate and bicarbonate hemodialysis on erythrocyte transmembrane sodium fluxes were investigated in 15 patients with chronic uremia. We observed a significance (p less than 0.01) stimulation of the Na+,K+ pump in both procedures, with a significant correlation to the amount of fluid removed during hemodialysis (r = 0.56, p less than 0.03). Outward Na+ cotransport fluxes significantly rose (p less than 0.05) after acetate hemodialysis and decreased (p less than 0.05) after bicarbonate hemodialysis. Minor and not significant pre- and posthemodialysis bidirectional changes were observed as regards the intraerythrocyte Na+ and K+ concentration, passive Na+ and K+ permeability, and Na+,Li+ countertransport. Hemodialysis may acutely affect the erythrocyte sodium pump and cotransport fluxes, possibly through the modulation of hormonal factors triggered by the extracellular volume changes.

Acetates

The immunological state in chronic renal insufficiency.

To evaluate the immunological state in chronic renal insufficiency, the Authors studied cellular and humoral immunity in 292 patients with chronic renal failure. They were divided into 3 groups: 1) 37 with creatinine clearance between 50 and 20 ml/min; 2) 57 with creatinine clearance between 20 and 8 ml/min; 3) 178 treated by hemodialysis. In vivo and in vitro tests, that is DNCB, PPD skin tests, spontaneous, active and EAC rosettes, surface membrane immunoglobulin test, complement (C3, C4) and serum immunoglobulins were taken as markers of the immune response. Cell-mediated immunity was found to be significantly impaired in patients with terminal renal insufficiency or on hemodialysis and also markedly reduced in patients with non-terminal renal insufficiency. Humoral immunity produced less significant results: the B lymphocyte count and serum immunoglobulins were normal; only C3 levels were found below normal range. Thus it would seem that cell-mediated immunodeficiency appears in an early stage of chronic renal failure and that hemodialysis does not improve this deficiency.

Adult

Effects of blood transfusion on cellular immunity.

To evaluate the effect of transfusion on immunity, 14 uraemic patients treated with 3 blood transfusions from a single donor, at weekly intervals, were studied: in 5 cases HLA-A,B were compatible, in 9 cases they were not. As markers of cellular and humoral immunity DNCB, PPD skin tests, spontaneous and active E-rosettes, EAC-rosettes, surface membrane immunoglobulins, C3, C4, C3d, serum immunoglobulins, circulating immune complexes and C-reactive protein were investigated. This protocol was applied before transfusions, 1 week after each transfusion (day +7, +14, +21) and 20 weeks later (day +80). Before transfusions 8/14 patients were DNCB negative; both spontaneous and active E-rosettes were below normal range. The other parameters were normal. On day +7 T and B lymphocytes were increased, while the other parameters were unmodified. On day +21 there was a significant reduction (p less than 0.5) in T lymphocytes in patients treated with compatible transfusions. On day +80 3/3 DNCB positive patients, treated with compatible transfusions, became negative and 1/3 DNCB positive patients, treated with random transfusions, also became negative. Three/fourteen patients showed a decrease in B lymphocytes. The other results were unchanged. Our preliminary results suggest that transfusions, either from an HLA compatible donor or not, can impair lymphocyte function.

Adult

[Course and significance of various biochemical parameters in 1,25-dihydroxyvitamin D3 therapy of uremic osteodystrophy].

Thirty-seven osteodystrophic and chronically haemodialyzed patients have been treated for 1-22 months by means of 1,25(OH)2D3. Under treatment a marked improvement of symptomatology and radiographic findings has been observed in the majority of cases; from the haematochemical viewpoint a rise of calcemia and phosphoremia, a fall in alkaline phosphatase and a variable course of PTH have been observed. Several episodes of asymptomatic hypercalcemia ceased with posology reduction; only 3 cases needed stopping the treatment for this reason, one of them definitively; 12/37 cases needed hypophosphoric diets and increase in oral aluminium hydroxide doses to control hyperphosphoremia. The Authors conclude that, to achieve a correct management of a 1,25(OH)2D3 therapy for renal osteodystrophy, is mandatory a strict and accurate biochemical control: in this way is possible to obtain an effective modulation of the posology avoiding the appearance of side-effects as hypercalcemia and ectopic calcifications.

Adult

[Specificity, sensitivity and reproducibility of 2 methods of determining serum immunocomplexes (solid-phase C1q and polyethylene glycol precipitation)].

In the last years a few tests for the detection of circulating immune complexes (CIC) have been published. Nevertheless the data concerning their sensitivity and reproductibility are often partial. The Authors have here analysed, following this point of view, two methods for the detection of CIC, based on different mechanisms and therefore able to identify different kinds of CIC; the tests are: the PEG precipitation test and the C1q solid phase method. The reproductibility of the two methods is good, even when the samples have been many times thawn or kept at 20 degrees C for a few weeks; C1q test sensibility appears distinctly better than PEG test sensibility. By the two methods, but particularly with the PEG, it is possible to identify fluctuation of the IC levels during the day. The contemporaneous use of these two techniques can give results really useful to clinically monitorize some immune complexes diseases, such as many human glomerulonephrites.

Antigen-Antibody Complex

[Quantitative and qualitative determinations and clinical and histological correlations of cryoglobulins in glomerulonephritis].

The Authors have investigated the presence of cryoglobulins in sera from 91 GN patients, 69 of whom had a renal biopsy. Cryoglobulins have been found in 12.5% of the idiopathic glomerulonephritis (GN), in 22.2% of the ones related to systemic diseases. Also 4 cases of GN with mixed essential cryoglobulinemia have been studied. Quantitative analysis has shown a IgG and IgM prevalence, the last ones of monoclonal type in 77.8% of the cases, with anti IgG activity in 44.4%. Concerning cryoglobulins found in idiopathic GN, the Authors observed a high incidence in the forms with cellular proliferation and glomerular exudation, as rapidly progressing GN, the acute post-infectious GN, and the mesangio-capillary GN. Among the GN related to systemic diseases, high incidence of cryoglobulins has been observed in lupus nephritis and polyartheritis. In both diseases (idiopathic GN and GN related to systemic diseases) a good correlation was found between clinical-ordinary activity and immunological parameters such as circulating immune complexes and complement breakdown products. The correlation between cryoglobulins level and disease activity is less evident in the mixed essential cryoglobulinemia G.N. Furthermore the Authors discuss here the pathogenesis of cryoglobulins in human G.N.

Antigen-Antibody Complex

[Rosette E and active rosette E tests in the evaluation of cell-mediated immunity in uremic patients].

To evaluate cellular immunity in uremia, we studied 235 uremic patients (178 on regular hemodialysis and 57 on medical treatment). E-rosettes were significantly lower (p less than 0.01) in all patients. The active E-rosettes test was found less significant to study T lymphocyte markers. The kind of correlations made with primary disease, small molecule levels, rehabilitation, suggests that cell-mediated immunodeficiency in uremia is a premature phenomenon and scarcely influenced by adequate hemodialysis treatment.

Adolescent

[Solid-phase conglutinin tests for circulating IgA immunocomplexes].

In some renal, gastroenterological and dermatological diseases the pathogenic role of circulating immune complexes (CIC) of IgA type has been defined. The methods so far proposed to investigate CIC are for the most part able to identify IgGIC, while only few can do the same for IgAIC. The Authors discuss in details the technique and the sensibility and specificity of a new test for IgAIC based on the linkage with the conglutinin in solid phase and propose this test for the clinical study of IgA diseases.

Antigen-Antibody Complex