Biomedical subjects

J K Lacki

Publications and source records attributed to J K Lacki.

45 records · Page 3Linked to original sources

PubMedDate not supplied

Does IgA-alpha1 antitrypsin complex correlate with IgM, IgG and IgA rheumatoid factor in early rheumatoid arthritis?

This study was undertaken to determine whether the rheumatoid factor (RF) isotypes affect the level of IgA-AT complex in early rheumatoid arthritis. IgA-AT complex and IgM, IgG, and IgA RF were evaluated using a double antibody enzyme-linked immunosorbent assay (ELISA) in sera of 83 (61 women and 22 men) patients. The mean level of the complex was higher in RA patients as compared with the control group (0.60 +/- 0.41 U vs 0.19 +/- 0.11 U, p < 0.05). The IgA-AT complex values exceeding the norm were found in 19 of 83 RA cases (23%), mainly in patients non-treated with DMARDs. IgM RF values judged as positive were present in 53 (64%), IgG RF in 55 (66%), and IgA RF in 56 (67%) patients. Higher RF values of IgM and IgG, but not those of IgA class, were found more frequently in patients with elevated IgA-AT levels. A good correlation was established between IgA and IgM RF (r = 0.61, p < 0.01), but not between IgA and IgG, or IgM and IgG RF in the group of patients under study. However, we did not find any significant correlation between isotypes of RF and parameters of the disease activity.

Adult↗

PubMedDate not supplied

[Immunotherapy in rheumatoid arthritis of joints].

The etiology of rheumatoid arthritis (RA) is still unknown. Among the pathogenic mechanisms being discussed, the antigen recognition seems to be of great importance. Probably the "abnormal" interaction between the presented peptide of undefined nature with CD4 T-cell, triggers the pathological events. Immunosuppressive drugs, affecting antigen presentation, are in common use in the treatment of RA. We discuss the effects of alkylating agents, antimetabolites and other immunomodulatory procedures on the course of the disease.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Immunological studies in patients with rheumatoid arthritis treated with methotrexate or cyclophosphamide.

One-hundred-and-two-patients (pts) with rheumatoid arthritis (RA) were observed for 12 months. Forty-eight pts were treated with a weekly low-dose of methotrexate (MTX), 23 pts with cyclophosphamide (CTX) (eight pts with one single intravenous dose, and 15 pts orally with a single daily dose), and 31 pts with nonsteroidal antiinflammatory drugs (NSAID) only. In all individuals acute phase response, i.e., C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) serum levels, and AGP microheterogeneity using affinoimmunoelectrophoresis with concanavalin A were evaluated. The phenotype of lymphocytes isolated from peripheral blood was characterized using immunofluorescence technique. Following treatment the increased level of CRP significantly decreased whereas AGP serum level remained unchanged. Among the patients, microheterogeneity of AGP expressed as reactivity coefficient (RC) was lower before treatment when compared with 17 controls (0.95 +/- 0.23 vs. 1.35 +/- 0.15, p < 0.01). After 12 months of MTX therapy AGP-RC rose significantly (1.19 +/- 0.13, p < 0.01). No changes were observed in AGP-RC levels in CTX and NSAID treated individuals. No significant differences were observed in the percentage of CD3+, CD4+, and CD8+ cells in all the patient groups, except in CTX intravenously treated patients. In this group of patients a decrease of CD4+ cells was noticed (60.1 +/- 11.5% and 43.8 +/- 12.5% before and after treatment respectively -p < 0.01). The percentage of CD19 positive cells decreased significantly during 12 months of treatment with MTX and CTX. The percentage of activated T cells (CD25+ cells and HLA-DR+ cells) remained unchanged in MTX treated patients and was reduced in both CTX groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Transient increase of aminotransferases in RA patients treated with methotrexate.

Sixty-two patients with rheumatoid arthritis (RA) were treated with methotrexate (MTX) for 3 months. Methotrexate was given orally in a single dose of 7.5-15.0 mg/week. At the onset of the treatment increased activity of aminotransferases has been observed. Eighteen patients (29%) displayed higher enzyme activity in the first 3 weeks. Despite the continuous drug administration the activity of aminotransferase became normal at week 12 in all but one patient. In this patient MTX had to be withdrawn.

Adult↗

PubMedDate not supplied

Intravenous cyclophosphamide combined with methylprednisolone in the treatment of severe refractory rheumatoid arthritis: the effect on lymphocytes.

The mode of action of methylprednisolone and cyclophosphamide in the treatment of rheumatoid arthritis still remains unclear. We sought to determine whether methylprednisolone and/or cyclophosphamide affect surface antigens on peripheral blood lymphocytes. Twenty-eight patients with severe refractory rheumatoid arthritis were observed for 12 months. Thirteen patients were treated with an intravenous pulse of methylprednisolone, and fifteen with methylprednisolone combined with cyclophosphamide. The surface antigens of lymphocytes and natural killer (NK) cells isolated from peripheral blood were determined using flow cytometry. The clinical improvement was observed in 16 (57%) patients (8 treated with methylprednisolone and 8 with methylprednisolone/cyclophosphamide). However, after cessation of the treatment in 9 patients, a flare up of the disease was observed. A striking decrease in total lymphocyte count was observed. The percentage of CD3+ and CD3+CD4+ cells remained unchanged. We observed a decrease in the percentage of CD3+CD8+ in patients treated with methylprednisolone/cyclophosphamide. Moreover, the percentage of activated T cells (CD25+ cells and HLA-DR+ cells) was reduced. The depletion of CD8+CD25+ cells was observed after combined treatment. The percentage of CD19+CD5+ was reduced due to the treatment. We also observed a decrease in CD16+CD56+ NK cells. Amelioration of the course of the refractory rheumatoid arthritis was observed in patients treated with both methylprednisolone and methylprednisolone/cyclophosphamide. A stronger effect on lymphocyte phenotype was observed in those given methylprednisolone/cyclophosphamide, but it was not followed by further benefit. On the other hand, the clinical improvement was more stable in methylprednisolone/cyclophosphamide-treated patients. The use of cyclophosphamide should be reserved for patients with rapidly progressing rheumatoid arthritis or life-threatening complications.

Adult↗

PubMedDate not supplied

Acute phase response in rheumatoid arthritis patients treated with immunosuppressive drugs.

We sought to investigate an influence of immunosuppressive drugs on acute phase response (APR) in rheumatoid arthritis (RA). Ninety-six patients (pts) were treated with methotrexate (MTX), or with cyclophosphamide (CTX) (9-intravenously, 19-orally), or with cyclosporin A (CSA). C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), and alpha-1 antichymotrypsin (ACT) serum levels were measured by rocket immunoelectrophoresis. AGP and ACT microheterogenities evaluated using immunoelectrophoresis were expressed as reactivity coefficient (RC). Clinical improvement was observed in 71.4% MTX pts, 77.8% CTX intravenously pts, 36.8% CTX orally pts, 60.0% CSA pts. The number of side effects was the highest in CTX oral group (57.9% left the study). CRP, AGP, and ACT serum levels were increased in all groups of RA pts as compared to healthy controls. CRP level decreased only after MTX and CTX intravenous treatment. Moreover, a decrease in ACT was observed in CTX intravenously treated pts. AGP-RC was lower in the initial population of RA pts as compared to healthy control. After 6 months of treatment RC became significantly higher in MTX pts only. In opposite ACT-RC in RA pts was found to be elevated as compared to controls. After the treatment it fell down. The decrease was found to be significant only in pts treated with MTX. From our study we can conclude that MTX is the safest and the most effective agent among immunosuppressive drugs applied in RA. CTX given orally causes a number of adverse reactions, which frequently make continuous and effective treatment impossible. CTX intravenously and CSA are attractive in the treatment of the patients with severe and refractory RA. A lack of clinical benefit is reflected in the absence of acute markers changes.

Acute-Phase Reaction↗

PubMedDate not supplied

The 5-HT3 blockers in the treatment of the primary fibromyalgia syndrome: a 10-day open study with Tropisetron at a low dose.

A 10-day open trial with Tropisetron, the selective serotonin type 3 receptor antagonist, in a dose of 5 mg daily was undertaken in 19 patients with the primary fibromyalgia syndrome (FB). Before and after the therapy, pain was assessed using a visual analogue scale and a pain score. All the patients were asked about the presence and intensity of vegetative and functional symptoms. Moreover, the tenderness at the 24 typical tender points at baseline and at the end of the therapy was evaluated. A statistically significant improvement of all examined parameters was observed after the therapy. The efficacy of Tropisetron in a dose of 5 mg daily was comparable with the results obtained in a previously reported trial with a dose of 10 or 15 mg per day, but the frequency of gastric troubles decreased (21% vs. 60%). The hypothesis about the existence of two subgroups of patients with FB is also discussed.

Adult↗

PubMedDate not supplied

Immunoglobulin A--alpha-1-antitrypsin complex in rheumatic diseases.

Immunoglobulin A-alpha-1-antitrypsin complex (IgA-AT) is a nonimmune complex formed by disulphide bonding between an active thiol group available on the cysteine residue of alpha heavy chains of IgA and a cysteine in position 232 of alpha l-antitrypsin in single polypeptide chain. The level of the complex can easy be determined using the ELISA method and findings are expressed in arbitrary units. In the healthy adults' sera the IgA-AT complex level is lower than 0.4 arbitrary unit. The elevated levels of the complex were found in a number of rheumatic diseases. In 50% of SLE patients, its levels are increased, particularly in those with current central nervous system involvement. Similarly, in approximately 50% sera derived from RA patients they are also found to be higher. Their presence correlates with anatomical progression of the disease. IGA-AT complex is found in RA (in 90% of cases) but not in the osteoarthritis synovial fluid. Our findings can be applied in clinical praxis in differential diagnosis of early rheumatoid arthritis and osteoarthritis. The IGA-AT complex can be also found in ankylosing spondylitis. The complex has been determined in a relatively large number of IgA myeloma sera. In 30% of the cases its levels were 10-fold higher than the upper limit for healthy adults.

Adult↗

PubMedDate not supplied

Prognostic value of serial serum interleukin-6 level estimation in patients with lung cancer: a preliminary report.

In the present report, we serially measured the levels of interleukin-6 (IL-6) and some acute-phase proteins (APP) in 61 lung cancer patients undergoing radiotherapy in order to investigate the relationship between the response to the treatment and the changes in parameters of systemic inflammatory response. The patients were divided into two groups depending on the response to the treatment. The first group (referred to as responders) comprised 32 patients with stable disease, partial remission or total remission. Twenty-nine patients with progression of the disease were included to the second group (referred to as non-responders). Six patients died due to the lung cancer during the study. We showed a decrease in IL-6 serum level and C-reactive protein (CRP) level in responders but not in non-responders. However, the most interesting results were obtained after retrospective analysis of the data of six deceased patients. In these patients we observed an elevation of IL-6 and CRP before the patients' deaths. Following the changes in acute-phase response and interleukin-6 serum levels in lung cancer patients seems to be helpful in prognosis of the outcome of the disease. Based on our data, we conclude that an elevation in IL-6 and/or CRP level in patients with lung cancer may serve as an adverse prognostic factor.

Acute-Phase Proteins↗