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Biomedical subjects

J C Yernault

Publications and source records attributed to J C Yernault.

At least 19 recordsLinked to original sources
PubMed1992

Abnormal humoral immune response to mucosal antigenic stimulation in patients with lung cancer.

Previous studies have suggested an inverse relationship between atopy and cancer of mucosal surfaces. Atopy is classically assessed by detecting specific immunoglobulin E (IgE) antibodies against inhalant allergens. However, Platts-Mills recently proposed that atopy is the ability of an organism to recognize and to respond to limited doses of allergens presented at the mucosal level by producing not only IgE, but also immunoglobulin A and immunoglobulin G (IgG) antibodies. The authors compared the prevalence of atopy in 103 patients with lung cancer (a model of mucosal cancer), 51 patients with chronic obstructive pulmonary disease matched for age, sex, and smoking habits with patients with lung cancer, and 102 healthy control subjects. The authors investigated whether the IgG response to antigens presented at the mucosal level, exacerbated in atopic subjects, might inversely be decreased in patients with lung cancer. Serum IgE antibodies against five common inhalant allergens (Dermatophagoides pteronyssinus [Der p1], Aspergillus fumigatus, grass pollen, and cat and dog danders) were detected through a radioallergosorbent test assay. Serum IgG antibodies against allergens naturally presented at the mucosal level (respiratory mucosa with Der p1 and digestive mucosa with betalactoglobulin [BLG] and soya proteins [SP]) were measured through a solid phase enzyme-linked immunosorbent assay test. Atopic status was assessed in 19 patients (18.4%) with lung cancer, 9 patients (17.6%) with chronic obstructive pulmonary disease (COPD), and 18 healthy control subjects (17.6%). Distributions of specific IgG levels were represented on frequency histograms after natural logarithmic transformation and showed reduced levels of anti-Der p1 and anti-BLG IgG in the cancer population compared with the control populations but similar levels of anti-SP IgG. Influence of sex, age, smoking habits, histologic type of cancer, and its extent could be excluded. The authors' results show no difference in the prevalence of atopy between the three groups. They document a selective, rather than general, defect in the immune response initiated at the mucosal level in patients with lung cancer, the most frequent mucosal cancer in man.

Administration, Inhalation↗
PubMed1992

The humoral immune response after BCG vaccination: an immunoblotting study using two purified antigens.

The specific IgG response induced by BCG vaccination was investigated in 27 adults using two purified BCG antigens in a dot immunoblotting assay. The reflectance values increased significantly after vaccination when P64 but not when P32 was used as the antigen. The values measured after vaccination were compared with those obtained when testing sera from patients with tuberculosis. We observed that the level of anti-P64 IgG reached after BCG immunization was high enough to preclude a serological differential diagnosis with tuberculosis.

Adult↗
PubMed1992

Isoelectrophoretic characterization of protein antigens present in mycobacterial culture filtrates and recognized by monoclonal antibodies directed against the Mycobacterium bovis BCG antigen 85 complex.

Nine monoclonal antibodies (MoAbs) were produced against Mycobacterium bovis BCG antigen 85 complex. Using isoelectric focusing combined with Western (immunoblot) blot analysis, antigenically related proteins could be identified in culture filtrates from M. tuberculosis, M. bovis, M. Kansasii, M. avium, M. xenopi, M. gordonae, M. fortuitum, M. phlei and M. smegmatis. Most of the MoAbs were found to be broadly cross-reactive between the various mycobacterial species, albeit some minor differences were observed. These MoAbs reacted generally, in each species, with different components. One MoAb (VID1-14) was found to be specifically directed only against antigen 85B from M. bovis, M. tuberculosis and M. kansasii.

Animals↗
PubMed1992

Humoral responses against the 85A and 85B antigens of Mycobacterium bovis BCG in patients with leprosy and tuberculosis.

Immunoglobulin G antibodies against the 85A and 85B components of the Mycobacterium bovis BCG antigen 85 complex separated by isoelectric focusing were investigated in serum samples from 129 patients representing the major forms of leprosy, 111 tuberculous patients, and 153 healthy subjects. For both of the antigens, a higher degree of staining was observed for lepromatous leprosy patients and patients with active tuberculosis than for the other groups. Because sera from some healthy subjects recognized the 85A antigen, we suggest that antigen 85B is the most useful component of the antigen 85 complex for the serodiagnosis of the multibacillary forms of leprosy or of the active forms of tuberculosis.

Antibodies, Bacterial↗
PubMed1992

Dyspnoea assessed by visual analogue scale in patients with chronic obstructive lung disease during progressive and high intensity exercise.

BACKGROUND: A study was carried out to determine whether rating of dyspnoea by means of a visual analogue scale during a progressive exercise test is affected by the subject's awareness of the progressive nature of the protocol. METHODS: Nineteen patients with chronic obstructive lung disease (FEV1 mean (SE) 1.06 (0.07) 1) were studied. A preliminary incremental test was carried out with a work rate increasing by 10 watts every minute until the subject could no longer exercise, to determine the maximum work load (Wmax) and to anchor the upper end of the visual analogue scale. This was followed by two exercise tests performed one day apart in randomised sequence, with two different protocols. One was a 12 minute protocol that included two sudden bursts of three minute high intensity exercise, up to the subject's Wmax, each preceded by three minutes of low level exercise. The other test was a conventional three minute incremental test lasting 12 minutes. On both study days the only information given to the subject about the temporal profile of load was that a change would be made every three minutes. The relation between dyspnoea, as assessed by the visual analogue scale, and ventilation, measured during high intensity or progressive exercise, was studied. RESULTS: The mean (SE) rates of increase of dyspnoea with increasing ventilation (% of line length 1(-1) min) obtained by linear regression analysis were similar for the two tests (2.86 (0.20) for progressive exercise and 2.87 (0.25) for high intensity exercise); it was 2.59 (0.25) for the initial burst of high intensity exercise when the data on this were analysed separately. In six subjects with stable disease studied again two months later the reproducibility of the rating of dyspnoea was reasonably good for both protocols. CONCLUSION: The results suggest that in most patients with chronic obstructive lung disease the assessment of exercise induced dyspnoea by means of a visual analogue scale during a progressive exercise test is not affected by the subject's awareness of the progressive increase in work intensity.

Awareness↗
PubMed1992

Acute and long term respiratory damage following inhalation of ammonia.

A lifelong non-smoker who was the victim of a massive accidental exposure to anhydrous ammonia gas was followed up for 10 years. In the acute phase the patient presented with severe tracheobronchitis and respiratory failure, caused by very severe burns of the respiratory mucosa. After some improvement he was left with severe and fixed airways obstruction. Isotope studies of mucociliary clearance, computed tomography, and bronchography showed mild bronchiectasis. It is concluded that acute exposure to high concentrations of ammonia may lead to acute respiratory injury but also to long term impairment of respiratory function.

Accidents, Occupational↗
PubMed1992

Abdominal muscle use during breathing in patients with chronic airflow obstruction.

To assess the pattern of abdominal muscle contraction in stable patients with chronic obstructive pulmonary disease (COPD), we studied electromyograms of the rectus abdominis, external oblique, and transversus abdominis muscles in 40 patients with variable degrees of chronic airflow obstruction (FEV1 between 17 and 82% of predicted); 12 control subjects with normal pulmonary function tests were studied for comparison. The subjects were studied during resting breathing in the supine posture, and the electromyograms were recorded with concentric needle electrodes implanted with the aid of a high-resolution ultrasound. The rectus abdominis and external oblique were silent in virtually all patients. In contrast, 17 patients had invariable phasic expiratory activity in the transversus abdominis, and 11 additional patients had intermittent transversus expiratory activity. Expiratory contraction of the transversus was related to the degree of airflow obstruction (p less than 0.005), and when present, it persisted in the seated posture. We conclude that (1) when breathing at rest, many stable patients with severe chronic airflow obstruction contract the abdominal muscles during expiration, and (2) this expiratory contraction is usually confined to the transversus muscle. These observations also indicate that the physiology of dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP) in such patients should be reevaluated.

Abdominal Muscles↗
PubMed1992

Inert gas single-breath washout and structural alteration of respiratory bronchioles.

With the perspective of establishing a link between a respiratory function test and alterations of membranous bronchioles, respiratory bronchioles, and alveolar ducts, we performed forced expirations and four kinds of single-breath washout maneuvers on 27 men due to undergo a lobectomy for peripheral bronchial carcinoma. For the single-breath washouts, the inhaled gas mixture consisted of 90% O2, 5% He, 5% SF6. The four maneuvers were the standard vital capacity test and three successive inhalations of 0.5, 1, and 1.5 L from functional residual capacity. The slopes of N2, He, and SF6 for each maneuver were computed, as well as a new index (I2) describing the relative decrease of the difference between the SF6 and the He slopes induced by a larger inspiratory volume. The histologic analysis focused on pigmentation, inflammation, and fibrosis of membranous bronchioles, respiratory bronchioles, and alveolar ducts. There was a linear relationship with a highly significant correlation coefficient between the new index I2 and the degree of inflammatory (r = 0.73) and fibrotic (r = 0.63) changes of the respiratory bronchioles; this correlation persisted in patients with a normal FEV1/VC ratio. These preliminary data open the way to finding a test for early peripheral (intraacinar) airway dysfunction.

Adult↗
PubMed1992

Perceived effect on shortness of breath of an acute inhalation of saline or terbutaline: variability and sensitivity of a visual analogue scale in patients with asthma or COPD.

The purpose of the study was to validate a bipolar visual analogue scale (VAS) to assess the perceived effect on shortness of breath of an acute inhalation and to search for differences in perception between asthmatics and subjects with chronic obstructive pulmonary disease (COPD). Thirty two subjects with airway obstruction and a diagnosis of either asthma (n = 16) or COPD (n = 16) received three consecutive inhalations of isotonic saline, followed by two inhalations of 400 micrograms terbutaline. Saline was perceived by asthmatics as a slight improvement: VAS (median, 95% confidence interval) 9%, 0-18% of line length. COPD subjects could be separated into two subgroups: "high perceivers" (n = 8, VAS 43%, 33-53%) and "low perceivers" (n = 8, VAS 5%, 3-7%). The median intrasubject coefficient of variation of the three post-saline VAS ratings was 19.4% (asthma), 12.5% (COPD high perceivers), and 14.5% (COPD low perceivers). After terbutaline, asthmatics had, by selection, a larger increase in forced expiratory volume in one second (FEV1) than COPD subjects. However, for other indices (expiratory specific resistance, inspiratory vital capacity and maximal inspiratory flow at 50% forced vital capacity) the changes were smaller in COPD low perceivers than in both asthmatics and COPD high perceivers. The parallel improvement in VAS was 24%, 20-39% (asthma), 15%, 6-25% (COPD high perceivers) and 1%, -1-8% (COPD low perceivers). The most sensitive index was FEV1 in asthmatics, vital capacity in COPD subjects, VAS being among the most sensitive indices in the former, but among the least sensitive in the latter. We conclude that the sensitivity of this VAS to bronchodilation is better in asthmatics than in COPD subjects. The latter can however be separated into subgroups with high and low level of perception.

Asthma↗
PubMed1992

Tumour-like presentation of pulmonary sarcoidosis.

We report a case of pulmonary sarcoidosis, which initially presented as a left apical infiltrate. The later course mimicked a pulmonary neoplasm, with left upper lobe atelectasis secondary to bronchial stenosis, resulting from both endobronchial sarcoidosis and extrinsic compression by enlarged lymph nodes. Extrinsic pressure from sarcoid nodes on the left main pulmonary artery and recurrent laryngeal nerve, also caused a reduction in pulmonary parenchymal perfusion and left vocal cord paresis.

Diagnosis, Differential↗
PubMed1992

[Acute pneumopathies in the aged].

Acute infectious pulmonary diseases have a particular importance in elderly subjects because of their frequency and severity. This particular sensitivity to respiratory infections is linked to the global reduction in defense immune mechanisms: reduction in T-lymphocyte response in the presence of mutagens, reduction of the late hypersensitivity reactivity, alteration of B- and T-lymphocytes cooperation, reduction in bacterial opsonization. The presence of associated chronic diseases like chronic obstructive airway diseases, cardiovascular diseases, diabetes, renal failure or cancers is, for a large part, responsible for these infections. The diagnosis is often difficult because of the paucity and the lack in specificity of clinical signs. Radiological and, eventually, bacteriologic investigations are most often necessary to limit the prescription of multiple antibiotic treatments that are responsible of serious side effects direct and/or related to possible drug interactions. These risks are indeed increased because of the modification in metabolism and the pharmacokinetics of antibiotics in elderly subjects. Criteria for hospitalizing elderly subjects with an acute pulmonary infection are not different from those which apply in younger patients, but they imply more awareness. It is also important to take into account socioeconomic conditions and the individual functional capacities in the initial assessment of the severity of the condition. In conclusion, the multiple aspects and the potential severity of pulmonary infections in older subjects require a particular awareness, a more precise diagnosis and the initiation of antibiotics based on a probabilistic judgment, most often during an hospitalization.

Age Factors↗
PubMed1991

An isoelectric focusing method for the study of the humoral response against the antigen 85 complex of Mycobacterium bovis BCG in the different forms of leprosy.

Isoelectric focusing was used to separate the three components of the antigen 85 complex of Mycobacterium bovis BCG. Antibody responses of leprosy patients against each Mycobacterium bovis BCG. Antibody responses of leprosy patients against each component were quantitated by densitometric analysis of immunoblot assays. The 85A component was recognized by 40% (8/20) of the lepromin positive and negative healthy subjects, by 76% (19/25) of the tuberculoid and by 96% (24/25) of the lepromatous leprosy sera. In contrast, the 85B component was not stained by the control sera, nor by the tuberculoid leprosy sera but by 64% (16/25) of the lepromatous leprosy sera. The results suggest that antigen 85B contains one or several epitopes that are specifically recognized by sera of lepromatous leprosy patients only.

Antibodies, Bacterial↗
PubMed1991

Humoral immune response of tuberculous patients against the three components of the Mycobacterium bovis BCG 85 complex separated by isoelectric focusing.

An isoelectric-focusing technique followed by Western blot (immunoblot) analysis was used to investigate the immunoglobulin G response of tuberculous patients against each of the three components of the Mycobacterium bovis BCG antigen 85 complex. The 85A component was stained by the tuberculous as well as the non-tuberculous sera. In contrast, the 85B and the 85C proteins of the complex were not stained by the control sera but were stained by 20 of 28 tuberculous serum samples.

Adult↗
PubMed1991

Antibody levels to whole culture filtrate antigens and to purified P32 during treatment of smear-positive tuberculosis.

Antimycobacterial IgG levels were measured repeatedly during treatment in 12 patients with moderate or severe pulmonary tuberculous disease using a dot immunobinding assay. We used reflectance densitometry equipment to quantify the immunoperoxidase staining and a Mycobacterium bovis BCG culture filtrate and the purified P32 protein as antigens. Antibody response against whole culture filtrate and P32 antigen increased after a three-month period of treatment. After this antibiotherapy was completed, the estimated amount of antibodies directed against the P32 decreased while those against the whole culture filtrate remained at the same level. A serologic test using P32 as the antigen seems to allow a better discrimination between active and healed tuberculosis.

Antibodies, Bacterial↗
PubMed1991

Occupational asthma to spores of Pleurotus cornucopiae.

We report the case of a young man who developed severe asthma a few months after starting work in a factory producing a single type of mushroom: Pleurotus cornucopiae (a basidiomycete). Immunological investigations, performed with material recovered from the filtering devices of the mushroom's bed, led to demonstration of specific IgE and IgG against spore extracts and to isolation of one discriminant antigen (molecular weight: 10.5 kd). Current data concerning the underestimated role of the basidiomycetes in allergic asthma are reviewed.

Adult↗