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Biomedical subjects

H Ström

Publications and source records attributed to H Ström.

At least 37 records · Page 2Linked to original sources

Clinical, HLA, and roentgenological follow up study of patients with juvenile arthritis: comparison between the long term outcome of transient and persistent arthritis in children.

Fifty two patients with juvenile chronic arthritis (JCA) and 22 patients with arthritis of short duration (transient arthritis, TA) were studied in a follow up investigation. Nineteen (37%) of the patients with JCA had peripheral arthritis or sequelae in the form of contractures at follow up, and in addition one patient was treated with corticosteroids. In contrast, only one (5%) of the 22 patients with TA had peripheral arthritis at follow up. Back pain or limitation, or both, was registered in many of the men. Sacroiliitis, verified by x ray, was often found both in JCA (39/46, 85%) and in TA (16/21, 76%). For JCA an association was confirmed with HLA-A2 and HLA-DRw8 and a negative association with HLA-DR4, and in pauciarticular JCA, in addition, a decrease of DR7. A new finding was a low prevalence of HLA-B27 in women with JCA and grade 3 or 4 sacroiliitis (2/14, 14%).

Adolescent↗

A DR4-associated DR-DQ haplotype is significantly associated with rheumatoid arthritis.

Forty-three patients with seropositive, erosive rheumatoid arthritis (RA) and 24 members of 5 RA multicase families were studied for HLA class II gene polymorphism, using restriction fragment analysis with complementary DNA probes for DR beta and DQ beta chains. This method generates HLA-DR-DQ haplotypes that are highly correlated with HLA-DR serology. Thirty-five of the 43 RA patients (81%) were positive for one or for both of the DR4-associated DR-DQ haplotypes, 4.1 and 4.2. Among these patients, the 4.1 haplotype was found significantly more often than in DR4+ controls (P less than 0.01). The haplotype segment C3;B15;DR4 was present in all RA patients in 4 of the 5 families, and included the DR-DQ4.1 haplotype.

Adult↗

Biological characterization of T cell-replacing factor in the synovial fluid of rheumatoid arthritis patients.

The synovial fluid of patients with rheumatoid arthritis (RA) contains a biologically active factor which has the ability to replace T cells for the induction of antibody secretion by human blood lymphoid cells stimulated by pokeweed mitogen (PWM) in vitro. This factor, which will be referred to as RA-SF (synovial fluid), also has the capacity to act as a B cell-stimulatory factor of mouse splenic lymphocytes in the presence of lipopolysaccharide (LPS). Using a test system developed for the definition of interleukin 4 (IL-4), which is a B cell-stimulating lymphokine which preferentially activates the synthesis of selected Ig classes in mouse lymphoid cells, we have shown that RA-SF has properties similar to IL-4 in that it induces differentiation of antibody secretion in the LPS-pretreated mouse cell, but unlike IL-4, which gives IgG1 and IgE, it selectively induces IgG2b synthesis. The present study demonstrates that RA-SF has a biological activity that is reminiscent of other B cell-stimulating mouse lymphokines, but it is biologically distinct from IL-2, IL-4, and IL-5. Recent data also indicate that it is distinct from gamma interferon (IFN-gamma). Therefore, we conclude that the biological activity of RA-SF has properties in common with a T-cell replacing (TRF) and B-cell differentiation factor (BCDF) and probably represents yet another biological activity which so far lacks an experimental counterpart. The relevance of this factor for autoantibody synthesis is discussed.

Animals↗

HLA antigens and adverse drug reactions to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis.

The association between HLA antigens and adverse drug reactions (ADR), (e.g. proteinuria, haematological abnormalities, stomatitis, diarrhoea and dermatitis) in rheumatoid arthritis (RA) to sodium aurothiomalate (gold) and to D-penicillamine (PA) were studied in 32 patients. Thirty-eight RA patients treated with gold and PA, and with no ADR to these drugs, were used as controls. The frequency of HLA B8 was significantly (p less than 0.05) increased among RA patients with ADR compared to plasma donors. DR3 was also significantly increased (p less than 0.05) in RA patients with haematological ADR compared to plasma donors. Haematological ADR occurred significantly (p less than 0.05) more often in DR3 positive patients (55%) than among DR3 negative RA patients (27%).

Adult↗

HLA genotypes in two three-generation families with rheumatoid arthritis.

Two three-generation families from Northern Sweden with rheumatoid arthritis (RA) were clinically examined. Tissue typing was performed for HLA-A, -B, -C, and -DR antigens. No disease-associated haplotype could be defined within these families. Six of nine members with RA were HLA-DR4 positive. Both families had a HLA-DR4 containing haplotype in the first generation and second-generation members married DR4 positive individuals, which probably increased the risk to develop RA in the third-generation members.

Adolescent↗

Effect of drug therapy on circulating and synovial fluid Ig-secreting cells in rheumatoid arthritis.

A common immunological abnormality in rheumatoid arthritis (RA) is an increased spontaneous polyclonal B cell activation. In order to study the influence of drug therapy in RA on the functional activity of B cells we enumerated spontaneous plaque-forming cells (PFC) in peripheral blood lymphocytes (PBL) and synovial fluid lymphocytes (SFL) by a reverse haemolytic plaque assay. Spontaneous IgG-, IgM-, and IgA-PFC in PBL of 26 patients with classical erosive RA receiving either gold salts or D-penicillamine were similar to those observed in 20 healthy controls. In contrast, significantly higher numbers of IgG- and IgA-PFC, but not IgM-PFC, were found in PBL of nine patients with classical erosive RA receiving non-steroidal anti-inflammatory drugs (NSAID) alone. Furthermore, spontaneous PFC in SFL from 16 consecutive patients with RA receiving second-line drugs, as well as 17 patients with other forms of arthritis (non-RA) were generally low and significantly less than those observed in 20 RA patients on NSAID alone. Moreover, a wide individual variation in PFC, especially in relation to the IgG class, was recorded in the synovial lymphocytes. These studies imply that treatment with second-line drugs is associated with normalisation of B cell activity in RA patients, and that the effect can be detected at the cellular level both in blood and synovial fluid.

Adult↗

HLA antigens in rheumatoid arthritis patients with and without a family history of polyarthritis.

The HLA antigens, A, B and DR, were studied in 141 patients with erosive, seropositive rheumatoid arthritis (RA). The frequency of the B27 antigen was significantly increased among patients with a family history of symmetrical polyarthritis compared with blood donor controls (p less than 0.001) and with patients without a family history of polyarthritis (p less than 0.005). The frequency of DR4 was significantly (p less than 0.001) increased among the RA patients, but there was no significant association between DR4 and a family history of polyarthritis.

Arthritis↗

Clinical symptoms and HLA antigens in a family with Reiter's disease.

A clinical and immunogenetic study was performed on a three-generation family with Reiter's disease (RD). Twelve of 56 members of the family (33 clinically examined) including one in-law, had symptoms of arthritis, urethritis, conjunctivitis, uveitis, and/or mucocutaneous manifestations, but only one had the complete triad of Reiter's syndrome (RS). Radiographic sacro-iliitis was found in 7 individuals, and monoarticular onset was reported in 5 out of 7 with peripheral arthritis. HLA B27 was found in 26 of the 37 family members who were tissue typed (including one in-law). All individuals with RD were B27-positive. Seven different B27 phenotypes were identified. This finding suggests that RD is associated with the B27 antigen itself, and not to a gene closely linked to B27. From a pedigree analysis of this family an autosomal dominant inheritance with incomplete penetrance or multifactorial inheritance seemed the most probable alternatives. The family history is a useful adjunct in the diagnosis of RD.

Adolescent↗

HLA haplotypes in a family with ankylosing spondylitis and rheumatoid arthritis.

HLA haplotypes (including A, B, C and DR loci) were studied in a family with members who had both rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Sacroiliitis was found in 7 family members, one of whom had AS and 2 others erosive, seropositive RA. They carried the B27-DR4 haplotype, suggesting a possible dual genetic association of the same haplotype in both RA and AS. Three other different HLA-B27 containing haplotype were found, 2 of which could be associated with sacroiliitis/AS. Within this family sacroiliitis and/or AS rather seemed associated with the B27 antigen itself than with the same haplotype.

Adult↗

Demonstration of a helper factor(s) with T-cell-replacing activity in synovial fluid.

Cell-free synovial fluid (SF) obtained from patients with rheumatoid arthritis contains a helper factor(s) capable of augmenting the generation of plaque-forming cells (PFC) in pokeweed mitogen (PWM)-stimulated normal peripheral blood mononuclear cells (PBMC). This helper factor behaves like a polyclonal B-cell activator, in that it triggers the formation of IgM, IgG, and IgA PFC. However, SF has little or no effect on the proliferation of PWM-activated PBMC. Furthermore, SF was capable of replacing T cells for PWM-induced differentiation but not proliferation of enriched human blood B lymphocytes. No helper factor or T-cell-replacing activity was found in SF from patients with traumatic synovitis. Fractionation of SF containing helper activity on staphylococcal protein A column indicated that the activity is induced by biologically active molecules distinct from materials that preferentially bind to protein A such as IgG immune complexes. We conclude that the present activity has striking similarities to the recently described B-cell differentiation factor that is produced by specifically activated T-cell lines in vitro.

Arthritis, Rheumatoid↗

No demonstrable association between HLA DR4 and in vitro collagen reactivity as determined by the production of leukocyte inhibition factor.

Eight HLA DR4 positive and 9 HLA DR4 negative healthy volunteers as well as 2 DR4 positive and 1 DR4 negative patients with rheumatoid arthritis (RA) were compared for leukocyte inhibition factor (LIF) production and lymphocyte proliferation in response to native and denatured collagen types II and I/III. Purified protein derivative (PPD) of tuberculin served as a positive control in the LIF assay and PPD and phytohaemagglutinin (PHA) in the lymphocyte proliferation test. No significant difference in responsiveness to collagen was detected between these two HLA groups. The reactivity to collagen was not affected by removal of OKT8+ lymphocytes. The present results are in conflict with earlier reports by Solinger et al. (1981) and Solinger & Stobo (1982). The reason for the discrepancy has not been resolved.

Antibodies, Monoclonal↗

B cell differentiation factor in synovial fluid of patients with rheumatoid arthritis.

In this paper we have summarized our findings on immune activity in patients with Rheumatoid Arthritis. RA is characterized not only by the formation of various autoantibodies but also of a hyperreactivity of the B cell system, shown as an increased DNA synthetic rate of blood non-T, non-monocytic lymphocytes as well as an increased number of actively antibody secreting cells both in the blood and the synovial fluid. Synovial fluid contains biological activity which synergizes with PWM for the induction of Ig-secreting cells in blood from healthy controls. The factor can also substitute for T cells in the PWM-induced antibody synthesis in vitro. This activity fits well with the finding that SF contains a factor which induces increased formation of IgG in LPS-pretreated mouse cell cultures. Experiments show that the factor leads to a preferential increase in the production of IgG2b antibody secreting cells. Therefore, we conclude that synovial fluid contains a B cell differentiating factor with a selective effect on the induction of a particular IgG subclass.

Antibody Formation↗

Fetal scalp catecholamines during labor.

Samples of scalp blood were collected from 129 fetuses during the first stage of labor for analysis of plasma norepinephrine and epinephrine concentrations by high-performance liquid chromatography. The catecholamine levels were related to scalp blood pH and fetal heart rate patterns during the 20-minute period preceding the collection of scalp blood. The median norepinephrine level was 9.2 nmol/L (range, 1.3 to 99.7), and the median epinephrine level was 0.5 nmol/L (range, less than 0.5 to 19.2) (n = 111) during the first stage of labor when the pH was above 7.25. The norepinephrine level was considerably higher than that in the resting adult. Significantly higher concentrations of catecholamines were found when scalp blood pH was below 7.26 (p less than 0.001). Maternal analgesia did not influence the fetal catecholamine levels in uncomplicated labor. Significantly higher concentrations of norepinephrine were found during the appearance of abnormal fetal heart rate patterns.

Analgesics↗

Spontaneous DNA synthesis in rheumatoid arthritis: evidence of enhanced circulating non-T-cell proliferation.

3H-thymidine incorporation in cultures of peripheral blood mononuclear cells from patients with seropositive rheumatoid arthritis (RA) and healthy controls was measured in vitro in the absence of added stimulants. A significantly higher level of spontaneous DNA synthesis was found in cultures of mononuclear cells from patients with clinically active RA than from patients with inactive disease and normal controls. This activity was more apparent in 24-h cultures than in 72-h cultures. There was no correlation between DNA levels and IgM rheumatoid factor (RF) titres. When T- and non-T-cell populations were separated and cultured simultaneously with unfractionated cells, only non-T cells maintained high levels of DNA synthesis, and enrichment of surface membrane Ig+ (SmIg) cells was generally associated with enhancement of 3H-thymidine incorporation. Furthermore, no difference was found in spontaneous DNA synthesis between cultures either containing or depleted of phagocytic cells. Moreover, the addition of graded numbers of autologous monocytes to highly purified T- and non-T-cell populations did not alter the background DNA synthesis. Thus, endogenously activated cells in RA patients are neither T lymphocytes nor monocytes. A regulatory influence by monocytes could not be demonstrated. It is suggested that cells actively engaged in DNA synthesis in RA blood are non-T cells in origin, most probably B lymphocytes.

Adult↗

Plasma estriol in late pregnancy in relation to fetal outcome.

The study is a retrospective report on the capacity of plasma (P-) estriol (E3) determinations in late pregnancy to detect abnormal fetoplacental state at delivery. From the material of cases with P-E3-determinations, two extreme groups were chosen for comparison: those with absolutely normal fetoplacental status at parturition and those with severe disturbances of the fetoplacental status at delivery. The predictability of a single P-E3 value was generally low, especially at the end of pregnancy. Consecutive (at least 3) high or low values, respectively, in the individual case, proved to have a predictable value that might complement other clinical methods for assessing fetoplacental function.

Apgar Score↗

Psoriasis, peripheral arthritis, sacroiliitis and juvenile chronic arthritis: a family study in relation to segregation of HLA antigens.

A family consisting of 30 individuals has been examined for the presence of psoriasis, peripheral arthritis and sacroiliitis. These clinical conditions have been studied in relation to the inheritance of the HLA-A,B,C and D genetic markers. Eleven out of 15 with the proband's haplotype A1,C-,B37,DW2, have psoriasis and/or arthritis. Asymptomatic sacroiliitis was a common finding. Arthritis was also found among other family members possessing other haplotypes. One young child has been included because she had juvenile chronic arthritis. However, she did not carry the proband's psoriasis associated haplotype.

Adolescent↗

High incidence of spontaneous Ig-producing lymphocytes in peripheral blood and synovial fluid of patients with active seropositive rheumatoid arthritis.

Numbers of in vitro spontaneous IgG, IgM and IgA plaque-forming cells (PFC) as assessed by a modification of the protein A haemolytic plaque assay were determined in the blood and synovial fluid of patients with seropositive rheumatoid arthritis (RA) and compared with those of control groups. The total numbers of PFC were significantly higher in the peripheral blood of patients with active seropositive RA than in that of normal controls. In addition, most B lymphocytes in the synovial fluid of patients with active seropositive RA were active immunoglobulin (Ig) producers, whereas synovial fluid lymphocytes from patients with inactive seropositive RA and seronegative arthritis were not. In general, IgA PFC were relatively high in blood, whereas IgG PFC dominated in the synovial fluid. IgM PFC appear to be relatively low in blood and synovial fluid. However, a relative increase of IgG PFC was noted in the peripheral blood of patients with active RA. To test for polyclonality of the increased Ig synthesis, we tested the sera of patients and controls for the presence of polyclonal antibodies against sheep erythrocytes (SRBC) and SRBC modified by fluorescein isothiocyanate (FITC) and trinitrophenyl (TNP). No differences were observed with SRBC and TNP-SRBC agglutinin titres between patients and controls, but patients with RA had higher titres of FITC-SRBC agglutinins than normal sera. This finding supports the concept of a polyclonal nature of antibody production in RA patients.

Adult↗