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Biomedical subjects

I C Chikanza

Publications and source records attributed to I C Chikanza.

13 recordsLinked to original sources

Enumeration of interleukin-1 alpha and beta producing cells by flow cytometry.

A technique for intracytoplasmic immunofluorescence staining to detect and quantify human interleukin-1 alpha (IL-1 alpha) and beta (IL-1 beta) in CD4, CD8, and CD14 positive lymphoid cells is described. Mononuclear cells stimulated in vitro with PHA to produce IL-1, were fixed and made permeable to antibodies by sequential exposure to paraformaldehyde and the detergent n-octyl-glucoside. Cytoplasmic and surface staining of both forms of IL-1 were demonstrated by indirect fluorescence using IL-1 beta and IL-1 alpha specific mouse monoclonal antibodies and quantified with flow cytometry.

Antigens, CD

Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis.

OBJECTIVE: To determine the integrity of the hypothalamic-pituitary-adrenal (HPA) axis responses to immune/inflammatory stimuli in patients with rheumatoid arthritis (RA). METHODS: Diurnal secretion of cortisol and the cytokine and cortisol responses to surgery were studied in subjects with active RA, in subjects with chronic osteomyelitis (OM), and in subjects with noninflammatory arthritis, who served as controls. RESULTS: Patients with RA had a defective HPA response, as evidenced by a diurnal cortisol rhythm of secretion which was at the lower limit of normal in contrast to those with OM, and a failure to increase cortisol secretion following surgery, despite high levels of interleukin-1 beta (IL-1 beta) and IL-6. The corticotropin-releasing hormone stimulation test in the RA patients showed normal results, thus suggesting a hypothalamic defect, but normal pituitary and adrenal function. CONCLUSION: These findings suggest that RA patients have an abnormality of the HPA axis response to immune/inflammatory stimuli which may reside in the hypothalamus. This hypothalamic abnormality may be an additional, and hitherto unrecognized, factor in the pathogenesis of RA.

Adult

Treatment of rheumatoid arthritis with single dose or weekly pulses of chimaeric anti-CD4 monoclonal antibody.

The aetiology of rheumatoid arthritis is unknown but CD4+ T cells are known to be involved in its pathogenesis. Because of this, anti-CD4 monoclonal antibody has been used in open studies with clinical benefit in up to 60% of patients. We have used a chimaeric anti-CD4 monoclonal antibody (cM-T412, Centocor) in a randomized, double-blinded, placebo controlled trial as treatment for rheumatoid arthritis. Nine patients with active rheumatoid arthritis resistant to traditional disease-modifying drugs were recruited. Four received an intravenous 50 mg bolus of antibody, and three received 50 mg weekly for four consecutive weeks. Two patients received placebo. Despite a marked reduction (P less than 0.001) in peripheral blood CD4+ lymphocytes, there was no significant clinical improvement in any of these patients. The decrease in CD4+ lymphocyte number lasted one week after a single 50 mg dose of cM-T412 but was more prolonged in the patients who received four infusions. CD8+ T cells, CD16+ cytotoxic cells and CD14+ monocytes showed only a transient reduction. It may be concluded that the therapeutic efficacy of anti-CD4 therapy is not directly related to CD4+ T-cell lymphopenia.

Adult

Monoclonal antibody treatment in rheumatoid arthritis: the clinical and immunological effects of a CD7 monoclonal antibody.

Six patients with rheumatoid arthritis were treated with a CD7 mouse monoclonal antibody, RFT2, daily for 15 days. Only two patients had a significant improvement in clinical disease activity which lasted 7-14 days. No serious adverse effects occurred although all patients developed antibodies against mouse immunoglobulin. During treatment T-lymphocyte numbers decreased and T-lymphocyte CD7 expression was absent in all but one patient.

Adult

Intramuscular depot methylprednisolone induction of chrysotherapy in rheumatoid arthritis: a 24-week randomized controlled trial.

Fifty-nine patients commencing intramuscular sodium aurothiomalate therapy were randomized to receive three doses of 120 mg intramuscular depot methylprednisolone acetate or matching placebo at weeks 0, 4, and 8 in addition to chrysotherapy. The group receiving methylprednisolone had more rapid disease improvement. This advantage persisted for up to 12 weeks, although by 24 weeks both groups exhibited similar benefits due to continued improvement in the group treated with gold alone. Withdrawals secondary to gold-induced side-effects occurred later in the steroid group (median time to withdrawal: 15 weeks steroid; 4.5 weeks placebo, P less than 0.05), and there were fewer withdrawals due to a lack of effect in the steroid group (one steroid versus three placebo, P NS). We conclude that glucocorticoids given as intermittent, intramuscular depot injections have a significant short term benefit which can be maintained by concomitant administration of intramuscular gold.

Adolescent

Chlorpromazine and frusemide in the acute management of severe hypertension.

Fifty two patients with severe hypertension were treated with parentral chlorpromazine and frusemide. There was a gradual reduction of blood pressure without reflex tachycardia in 92.4% of the cases. No serious side effects were observed. This therapeutic manoeuvre is simple, effective and a safe alternative for the management of hypertensive emergencies, especially when continuous monitoring cannot be guaranteed. this drug regimen must not be administered concurrently with methyldopa as this exerts an additive effect leading to severe hypertension. These results compare very well with those obtained with the use of repeated small bolus injections or graded infusions of labetolol.

Acute Disease

Typhoid colitis.

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Adult