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Biomedical subjects

H Rothberger

Publications and source records attributed to H Rothberger.

24 records · Page 2Linked to original sources

Cardiopulmonary manifestations of progressive systemic sclerosis: associations with circulating immune complexes and fluorescent antinuclear antibodies.

Sixteen patients with progressive systemic sclerosis were evaluated for cardiopulmonary manifestations of their disease and for serologic immune abnormalities. Twenty-five percent of patients had abnormal echocardiograms, and 81% had a significant reduction in pulmonary function by spirometry. Circulating immune complexes (IC) were detected in 44% of patients by using a fluorescent Raji cell assay, and these patients were more likely to have an abnormal echocardiogram (P less than 0.02). Seventy-five percent of the patients had fluorescent antinuclear antibodies (FANA) and these patients were more likely to have pulmonary disease (P less than 0.01).

Antibodies, Antinuclear↗

Increased production and expression of tissue thromboplastin-like procoagulant activity in vitro by allogeneically stimulated human leukocytes.

Intravascular coagulation, thrombosis, and fibrin deposition often produce tissue damage in allogeneic inflammatory reactions such as allograft rejection. The mechanisms which initiate blood clotting in these reactions are poorly understood. We find that allogeneic stimulation of human leukocytes in vitro increases production and expression of tissue thromboplastin-like activity. In our experiments mixed leukocyte cultures (MLC) of cells from allogeneic (unrelated) donors produced and expressed more procoagulant activity than control cultures of cells from each donor alone. After 7 days, allogeneic MLC had 5- to 50-fold more total procoagulant activity than controls, as shown by assaying lysed whole cultures. Additionally, allogeneic MLC had 8- to 240-fold more procoagulant activity expressed on leukocyte surfaces and in culture supernates than controls after 7 days, as shown by assaying intact whole cultures and cell-free supernates. These increases were largely accounted for by gains in the amounts of procoagulant activity produced and expressed per cell in MLC as compared to controls. Controls and MLC produced and expressed considerable amounts of procoagulant activity during the 1st day of culture, and there were no differential effects of allogeneic stimulation on day 1. However, after day 1, the total amount of procoagulant activity produced and the amount expressed declined steadily in controls, nearly reaching preculture levels by day 7. In contrast, the total amount of procoagulant activity in allogeneic MLC remained high, and the amount of activity expressed on cell surfaces and in supernates increased severalfold by day 7. MLC of syngeneic (identical twin) cells produced and expressed the same amount of activity as controls over a 7-day period, whereas MLC of cells from each twin and an allogeneic donor produced and expressed more activity than controls (at least 9- and 35-fold more, respectively). Thus, increases of procoagulant activity production and expression were found only in MLC of genetically dissimilar cells. Therefore, these increases must have resulted from allogeneic stimulation.

Blood Coagulation↗

Leukocyte procoagulant activity: enhancement of production in vitro by IgG and antigen-antibody complexes.

In a variety of immunologic diseases, fibrin-fibrinogen and immune complexes deposit in areas of tissue damage. However, the mechanisms which initiate fibrin-fibrinogen deposition have not been clarified. We find that the procoagulant activity of human leukocytes is markedly increased after incubation with immunoglobulin and immune complexes. This procoagulant activity is evident after 4-24 h incubation in the presence of as little as 0.1 mg/ml of autologous, isologous, or heterologous IgG. At least three of the four subclasses of IgG myeloma proteins are effective. Experiments with purified rabbit and rat antibodies demonstrate that enhancement of procoagulant activity is significantly greater with soluble antigen-antibody complexes than with immunoglobulin alone. In contrast, insoluble complexes are less affective than immunoglobulin alone. Artifacts due to endotoxin contamination of the IgG preparations were excluded on the basis of the differential sensitivities of immunoglobulin and endotoxin to heat and polymyxin B. Evidence is also presented which shows that enhancement of procoagulant activity involves the production, rather than a simple release, of leukocyte procoagulant activity in vitro.

Antigen-Antibody Complex↗

Anticardiolipin antibody: a marker of immune reactivity.

An enzyme-linked immunosorbent assay for anticardiolipin (ACL) antibody was performed on 250 consecutive antinuclear antibody (ANA) or anticytoplasmic antibody (ACA) positive sera and 50 consecutive ANA/ACA negative sera submitted to a rheumatology reference laboratory for ANA testing. Of the 250 ANA/ACA positive sera, 33 (13%) were found to be ACL antibody positive. This compared with only 2 (4%) ACL antibody positive samples among the 50 ANA/ACA negative controls. Chart review revealed only one documented case of thrombosis in ACL antibody positive patients. We conclude that among ANA/ACA positive patients, ACL antibody is a frequent finding. ACL antibody in the population studied is not associated with thrombosis. ACL antibody in this group appears to more accurately reflect immune reactivity than a thrombotic state.

Adolescent↗

Disease distributions in patients with multiple patterns of nuclear staining detected by FANA (immunofluorescent antinuclear antibody) tests.

The present study examines disease distributions in patients with multiple nuclear immunofluorescent staining patterns detected by FANA testing. Among 4003 consecutive patient sera examined, we found that 813 yielded conventional well-defined single staining patterns, while 46 produced multiple pattern combinations. Homogeneous plus nucleolar was the most prevalent combination, and 5 other combinations were identified. Multiple FANA patterns occurred independently of FANA titers and antibodies to dsDNA and Sm. Compared to control patients with single FANA patterns, patients with multiple patterns were found to have an increased frequency of SLE and diseases of the scleroderma spectrum (DDS) while rheumatoid arthritis (RA) and non-immunologic disease were reduced in frequency. These specific correlations indicate that recognition of multiple FANA patterns adds useful diagnostic information to existing antinuclear antibody testing procedures.

Adult↗