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Ilan Krause

Publications and source records attributed to Ilan Krause.

9 recordsLinked to original sources

Prevalence and clinical aspects of Behcet's disease in the north of Israel.

Behcet's disease (BD) has a higher prevalence in countries along the ancient silk route, but the actual prevalence in Israel is unknown. We evaluated the occurrence and clinical expression of BD in the northern region of Israel: in the whole population and by ethnic groups. The sample included all adult patients with BD (International Study Group criteria) treated at three medical centers in northern Israel. Patient data were collected by file review and physician survey. Relevant demographic data for the population served by the medical centers were obtained from the official Israeli authorities. A total of 112 patients were identified. The overall prevalence of BD was 15.2/100,000 and was similar in men and women. The prevalence rates among the Jewish, Arab, and Druze populations were 8.6, 26.2, and 146.4 per 100,000, respectively. Age at disease onset was similar in all ethnic groups and significantly lower in males (28.6+/-9.7 vs 32.9+/-11.3, p=0.03). There were no differences in disease manifestations by sex or ethnicity. All Druze patients were HLA-B5 positive, compared to 80.8% of the Arab patients and 72.0% of the Jewish patients. Recurrent oral ulcers in family members were more common in Arab patients (p=0.004). The BD severity index was significantly lower in Druze patients (p=0.05), mainly in males (p=0.03). This study confirms the high prevalence of BD in Israel and the variability in disease rates and expression by ethnic origin. Our findings, particularly regarding the Druze population, call for further field surveys and genetic studies.

Adult↗

The association of thrombocytopenia with systemic manifestations in the antiphospholipid syndrome.

Thrombocytopenia is frequently found in patients with the antiphospholipid syndrome (APS), yet data concerning clinical associations of thrombocytopenia in patients with APS are still scarce. We evaluated possible associations between thrombocytopenia and various APS-related manifestations in a large group of APS patients. Three hundred and seven APS patients were retrospectively evaluated, 259 women and 48 men. Most patients had primary APS (PAPS) (n=173, 56.1%). APS was associated with systemic lupus erythematosus (SLE) in 104 patients (33.9%). All patients underwent detailed medical interview and routine physical examination. Further data were obtained from patients' medical files regarding the expression of various clinical manifestations of the disease. There were 90 patients with thrombocytopenia (29.3%), the rate was significantly higher in SLE compared to PAPS patients (41.9% vs. 23.1%, p=0.001). Similar rates of thrombocytopenia were found in male (29.2%) and female (29.3%) patients. Significant associations were found between thrombocytopenia and cardiac valves thickening and dysfunction, epilepsy, chorea, arthritis, livedo reticularis and skin ulcerations. In contrast, the rates of thrombotic episodes as well as obstetric complications were similar in patients with and without thrombocytopenia. Our data suggest the presence of thrombocytopenia may be a risk factor for cardiac, neurological, articular and cutaneous complications in APS.

Abortion, Habitual↗

Intravenous immunoglobulin treatment for fibrosis, atherosclerosis, and malignant conditions.

We describe our experience with intravenous immunoglobulin (IVIg) treatment in fibrotic conditions and our results and experience with the effect of IVIg therapy to prevent metastases in malignancy. We have delineated the mechanisms by which IVIg can affect atherosclerosis (i.e., effect on MMP-9, antiidiotypes to anti-OxLDL), which led to reduced atherosclerosis in animal models. The effect of IVIg on skin fibrosis was assessed in a murine model of scleroderma-like disease. Collagen expression was decreased in the skin of mice treated with mouse IVIg, associated with decreased type I collagen gene expression, and accompanied by inhibition of transforming growth factor (TGF)beta and interleukin (IL)-4 secretion by splenocytes. We also described a favorable response to IVIg treatment in patients with either systemic sclerosis or myelofibrosis. The administration of IVIg to mice inoculated with melanoma or sarcoma cells induced a statistically significant inhibition of metastatic lung foci and prolongation of survival time. IVIg was found to stimulate the production of IL-12, an anti-tumor and anti-angiogenic cytokine. Positive staining of the cytoplasm, cell membrane, and nuclear membrane of several types of malignant tumors by IVIg was immunohistochemically demonstrated.

Animals↗

i.v.IG for autoimmune, fibrosis, and malignant conditions: our experience with 200 patients.

Intravenous immunoglobin (i.v.IG) is generated from the plasma of more than 10,000 healthy subjects. Originally i.v.IG was employed to supplement the missing Igs in subjects with immune-deficiencies. Later on it was given successfully to patients with autoimmune conditions, in some of which the benefits were confirmed by double blind studies (i.e.polymyositis), while in others remarkable case reports and series of patients have alluded to its beneficial effects. Especially when conventional therapies failed. Recently, due to multiple mechanisms, i.v.IG was found to be useful in reducing collagen deposition (i.e.scleroderma) and to prevent metastatic spread. When given properly (not more than 0.4 g/Kg. B.W. 5 day), side effects are minimal. Yet, its high price (> 3000 US dollars per monthly course) precludes the application of i.v.IG more frequently.

Abortion, Habitual↗

Induction of oral tolerance in experimental antiphospholipid syndrome by feeding with polyclonal immunoglobulins.

Intravenous immunoglobulins (IVIG) contain a wide spectrum of anti-idiotypes associated with autoimmune diseases. Since part of these anti-idiotypes may bear an internal image of the eliciting antigen, IVIG might be suitable for induction of oral tolerance. In the current study we attempted to induce tolerance in an experimental model of anti-phospholipid syndrome (APS) by oral administration of IVIG. Naive mice were fed with IVIG, or anti-beta 2GPI-specific anti-idiotypic IVIG(alpha Id). Significantly diminished humoral response was noted in mice IVIG/ IVIG-F(ab')(2)or IVIG(alpha Id)-tolerized mice, accompanied by a significant attenuation of clinical manifestations. The maximal effect was achieved in the mice tolerized before disease induction. Abrogation of T lymphocyte proliferation to beta 2GPI was detected in the mice fed with IVIG prior to beta 2GPI immunization, mediated by TGFbeta and IL-10 secretion. The tolerance induced by IVIG-feeding was nonspecific and could be adoptively transferred to syngeneic mice by CD8alpha (+) cells. These CD8alpha (+) T cells, were found to secrete high levels of TGFbeta and IL-10. In summary, IVIG-induced oral tolerance has a nonspecific immunomodulatory effect in experimental APS, mediated by TGFbeta and IL-10-secreting CD8alpha (+) cells. Our results point to a possible application of IVIG in the induction of oral tolerance against various autoimmune diseases.

Administration, Oral↗

Brief report: immune factors in autism: a critical review.

Pervasive developmental disorders represent a group of neurodevelopmental disorders that affect children early in their development. Autistic disorder is the best described of these disorders, yet even this term covers a broad group of clinical presentations. Various immune system abnormalities, including autoimmunity and defects in different subsets of immune cells, have been reported in children with autistic disorder, suggesting that immune factors may play a role in the development of autism. Based on anecdotal observation, vaccination was proposed to cause autism in some children, but several controlled studies have failed to support this claim. Intravenous immunoglobulin infusions has been tested as immunotherapy for autism, although the preliminary results are inconclusive and there is a risk of potentially fatal transmission of blood-borne pathogens. To examine this issue, intensive well-controlled epidemiological and bench studies need to be carried out in defined and carefully controlled study subjects to establish the cellular and molecular basis of autism, against which the effects of each proposed immune factor can be examined.

Autistic Disorder↗

Bacterial induction of autoantibodies to beta2-glycoprotein-I accounts for the infectious etiology of antiphospholipid syndrome.

The antiphospholipid syndrome (APS) is characterized by the presence of pathogenic autoantibodies against beta2-glycoprotein-I (beta2GPI). The factors causing production of anti-beta2GPI remain unidentified, but an association with infectious agents has been reported. Recently, we identified a hexapeptide (TLRVYK) that is recognized specifically by a pathogenic anti-beta2GPI mAb. In the present study we evaluated the APS-related pathogenic potential of microbial pathogens carrying sequences related to this hexapeptide. Mice immunized with a panel of microbial preparations were studied for the development of anti-beta2GPI autoantibodies. IgG specific to the TLRVYK peptide were affinity purified from the immunized mice and passively infused intravenously into naive mice at day 0 of pregnancy. APS parameters were evaluated in the infused mice on day 15 of pregnancy. Following immunization, high titers of antipeptide [TLRVYK] anti-beta2GPI Ab's were observed in mice immunized with Haemophilus influenzae, Neisseria gonorrhoeae, or tetanus toxoid. The specificity of binding to the corresponding target molecules was confirmed by competition and immunoblot assays. Naive mice infused with the affinity-purified antipeptide Ab's had significant thrombocytopenia, prolonged activated partial thromboplastin time and elevated percentage of fetal loss, similar to a control group of mice immunized with a pathogenic anti-beta2GPI mAb. Our study establishes a mechanism of molecular mimicry in experimental APS, demonstrating that bacterial peptides homologous with beta2GPI induce pathogenic anti-beta2GPI Ab's along with APS manifestations.

Animals↗