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J Altorfer

Publications and source records attributed to J Altorfer.

63 records · Page 4Linked to original sources
PubMed1981

Acute viral hepatitis B with bridging necrosis: a follow-up study.

Forty patients with bridging necrosis (BN) on biopsies taken during the course of acute viral hepatitis B were included in a prospective study to assess the prognostic significance of this lesion. Of the 22 patients with complete clinical, biochemical and histological follow-up (histological follow-up 5-33 months), only two failed to eliminate HBs- and HBe-antigen in serum, a finding paralleled by transition to chronic active hepatitis and by the persistence of focal HBc- and HBs-antigen expression in liver tissue. Nineteen of 22 patients showed complete histological healing; one developed inactive cirrhosis. It is concluded that, in the setting of acute viral hepatitis B, the histological lesion of BN is of no particular prognostic significance, and that transition to chronic liver disease is much less frequent than has been assumed from previous studies of etiologically heterogeneous patient populations. Markers of poor prognosis are the failure of serological elimination of HBs- and HBe-antigen and the persistence of spotty expression of HBc- and HBs-antigen on immunofluorescence histology.

Acute Disease↗
PubMedDate not supplied

Prevalence and significance of anti-HBc IgM (radioimmunoassay) in acute and chronic hepatitis B and in blood donors.

Anti-HBc IgM was determined by a modified radioimmunoassay (RIA) in 35 patients with acute hepatitis B, 35 patients with chronic hepatitis B (7 with chronic persistent, and 28 with chronic active hepatitis), 157 HBsAg positive blood donors, and in 143 HBsAg negative but anti-HBc positive donors. The results of the RIA test were compared with those obtained by an ELISA technique. In chronic hepatitis, anti-HBc IgM was correlated with the occurrence of HBeAg, anti-HBe, Dane particles in the serum, HBsAg, and HBcAg in liver tissue and with biochemical and histological degrees of hepatic inflammatory activity. In acute self-limited hepatitis B, anti-HBc IgM (RIA and ELISA) was initially positive in all 35 patients. Twelve months after the acute illness, 94% of the patients were negative for anti-HBc IgM in the RIA test with only one patient showing a persistence of up to 18 months, whereas in the ELISA test anti-HBc IgM persisted in 17% of the patients over 2 years. In chronic hepatitis, the occurrence of anti-HBc IgM (RIA) showed a strong relation with the inflammatory activity, the anti-HBc IgM positive patients revealing a significantly more severe liver disease than did anti-HBc IgM negative patients. Anti-HBc IgM (RIA), however, did not correlate with the occurrence of HBeAg and Dane particles in the serum and HBcAg in liver tissue of patients with chronic hepatitis. Of the 157 HBsAg positive blood donors, anti-HBc IgM (RIA) could be demonstrated in 10 (6%), but in none of the 143 HBsAg negative, but anti-HBc positive donors, as compared to 43 (27%) and 9 (6%), respectively, in the ELISA test. Comparing the two test methods, the RIA exhibits higher specificity than did the ELISA due to a better blocking of nonspecific reactions, but possibly somewhat lower sensitivity. In this form, however, the RIA test is a more useful tool in the diagnosis of the different forms of hepatitis B virus infection and in determining the severity of chronic hepatitis B.

Blood Donors↗
PubMedDate not supplied

Nuclear particles of non-A, non-B type in healthy volunteers and patients with hepatitis B.

In an electron microscopic study, nuclear aggregates of virus-like spherical and tubular particles measuring 20 to 29 nm in diameter were found in 5 of 7 clinically healthy volunteers with normal liver histology, 6 of 10 patients with hepatitis B and 17 of 18 patients with hepatitis non-A, non-B. The incidence of hepatocytes containing nuclear particles was approximately 0.5 to 2% in all three groups. We conclude that these nuclear particles are not specific ultrastructural markers of hepatitis non-A, non-B in man as originally claimed for experimental hepatitis non-A, non-B in chimpanzees.

Adolescent↗
PubMedDate not supplied

Pneumococcal vaccination: the response of patients with alcoholic liver cirrhosis.

Patients with cirrhosis have an increased risk of dying from pneumococcal pneumonia. Their immunological response to pneumococcal vaccination is not known. We compared the antibody response to challenge with a 14-valent purified pneumococcal polysaccharide vaccine in 15 patients with biopsy-proven alcoholic liver cirrhosis, 10 healthy volunteers and 10 patients with chronic obstructive pulmonary disease. Preimmunization levels for Danish type 1 pneumococcal polysaccharide were lower among cirrhotics than patients with chronic obstructive pulmonary disease. Four and 12 weeks after immunization, no significant differences were found in antibody concentrations between the three groups. We conclude that patients with alcoholic cirrhosis can produce an adequate antibody response to pneumococcal polysaccharide antigen.

Adult↗
PubMedDate not supplied

Absence of detectable serum interferon in acute and chronic viral hepatitis.

Amounts of interferon were measured in sera from 59 patients with acute viral hepatitis and 49 patients with chronic hepatitis B and compared to those from patients with nonviral liver disease or influenza, and from healthy controls. In all patients with acute and chronic viral hepatitis, no serum interferon could be detected, confirming data from earlier studies of acute viral hepatitis in which no circulating interferon was found. Our results disprove the view that the amounts of serum interferon, detected at the time of the acute clinical illness, may be a determinant of outcome.

Acute Disease↗
PubMedDate not supplied

Synthesis and biliary secretion of immunoglobulins by rat liver.

In this manuscript, we have attempted to first present an overview of the fundamentals of IgA secretion into rat bile via a receptor mediated process which involves the formation of vesicles and their vectorial movement to the bile canaliculus by a microtubule network. This transcellular pathway is used by all IgA secreting cells. The process is unique in that the transport vesicles do not pass through the Golgi-lysosomal region of the cell and therefore the ligand is allowed to enter the secretions intact with a portion of its receptor providing protection against proteases in the external environment. We also have demonstrated that the liver provides an early response to intestinal luminal antigen presentation. Stimulated B cells that are produced in the Peyer's patches in rodents home first to the liver. Only after boosting and the establishment of long term immunity are specific antibody producing cells found in other organs such as the intestine. Data are presented which would suggest that non-receptor mediated Ig transport into bile is by passive transport across tight junctional complexes between liver cells and by fluid phase vesicles. This observation may account for the small but consistent amount of IgA and IgG unattached to receptors that are found in the bile in humans. Exciting new evidence would indicate that the tight junctions can be made leaky by modifications in the hormonal environment. These observations may have wide range implications for understanding of how a variety of compounds enter the external secretions.

Animals↗