Biomedical subjects

J Litzman

Publications and source records attributed to J Litzman.

At least 19 recordsLinked to original sources

PubMed2007

T and B lymphocyte subpopulations and activation/differentiation markers in patients with selective IgA deficiency.

Selective deficiency of immunoglobulin A (IgAD) and common variable immunodeficiency (CVID) are genetically closely related diseases, both of unknown pathogenesis. A plethora of abnormalities in lymphocyte subpopulations and expression of activation markers were repeatedly documented in CVID patients, while almost no data are available about lymphocyte subpopulations in IgAD patients. We determined basic lymphocyte subpopulations and those subpopulations that were reported to be abnormal in CVID patients (CD25, human leucocyte antigen (HLA)-DR CD45RA, CD45RO, CD27, CD28 and CD29 on both CD4(+) and CD8(+) cells, CD57 and CD38 on CD8(+) cells, CD21, CD27, IgM, IgD on B lymphocytes) in 85 patients with IgAD, 47 patients with CVID and in 65 healthy controls. Statistical analysis was performed by the Mann-Whitney U-test; significant P-values were determined by means of Bonferoni's correction. Our results showed an increase in the relative number of CD8(+) cells and a decrease in the absolute number of CD4(+) cells compared to healthy people, but similar abnormalities in CVID patients were much more expressed. IgAD patients had significantly decreased expression of HLA-DR and increased expression of CD25 on CD4(+) lymphocytes, also CD29 expression was decreased on CD8(+) cells, while other activation/differentiation markers on T cells (including the expression of CD45RA and CD45RO antigens) were not changed. There were no statistically significant abnormalities in B lymphocyte developmental stages in IgAD patients compared to healthy controls. Our observation showed that the majority of T and B lymphocyte subpopulation abnormalities described previously in CVID are not present in IgAD patients.

Adolescent↗

PubMed2006

Age dependency and mutual relations in T and B lymphocyte abnormalities in common variable immunodeficiency patients.

Common variable immunodeficiency (CVID) is primary hypogammaglobulinaemia with an unknown aetiopathogenesis. Although various abnormalities of T and B cells have been described, their pathogenetic roles are unclear. We determined T and B lymphocyte subsets known to be abnormal in CVID in order to disclose possible relations between numerical abnormalities in those cells. Markers associated with B cell development (CD21, CD27, IgM, IgD) were determined on B lymphocytes (CD19+); T lymphocyte development (CD45RA, CD45RO, CD62L) and activation markers (CD25, CD27, CD28, CD29, CD38, CD57, HLA-DR) were determined on CD4+ and CD8+ T lymphocytes in 42 CVID patients and in 33 healthy controls. Abnormalities in CD4+ T lymphocyte activation markers (increase in CD29, HLA-DR, CD45RO, decrease in CD27, CD62L, CD45RA) were observed particularly in patients with a decreased number of memory (CD27+) and mature (CD21+) B cells (group Ia according to the Freiburg group's classification), while abnormalities observed in CD8+ cells (increase in CD27 and CD28 and decrease in HLA-DR, CD57 and CD38) did not depend upon grouping patients together according to B lymphocyte developmental subpopulations. We observed correlations between immature B cells (IgM+ CD21-) and expression of CD27, CD62L, CD45RA, CD45RO and HLA-DR on CD4+ T cells in CVID patients but not in the control group. The expression of CD27 and CD45RA on CD4+ T lymphocytes, such as the percentage of IgD+ CD27- and IgD+ CD27+ cells in B lymphocytes, showed age dependency to be more significant than in the control group. Our study demonstrates that T and B lymphocyte abnormalities in CVID are partially related to each other. Some of those abnormalities are not definite, but may evolve with age of the patient.

Adult↗

PubMed2003

A concurrent occurrence of cutis laxa, Dandy-Walker syndrome and immunodeficiency in a girl.

UNLABELLED: We report on a 17-y-old girl with inherited cutis laxa, immunodeficiency and Dandy-Walker syndrome. Immunodeficiency manifested itself by decreased and fluctuating levels of IgG, IgA and IgM and intermittent leucopenia causing increased susceptibility to respiratory tract infections. Dandy-Walker syndrome (agenesis of the cerebellar vermis with a large posterior fossa cyst communicating with an enlarged 4th ventricle) was shown on a CT scan but with the exception of macrocrania, no typical signs or symptoms were observed at the age of 17. Loose hyperextensible skin with pendulous skinfolds as a manifestation of cutis laxa was observed from birth. Anomalies of the right pulmonary artery, abnormal branching of the left arteria subclavia (arteria lusoria) from the left aortic arch and bicuspidal aortic valve were also present. CONCLUSION: The combination of the rare disorders cutis laxa, Dandy-Walker syndrome and immunodeficiency is reported here for the first time.

Adolescent↗

PubMed2001

[Role of aspartic acid at position 57 of the HLA-DQ beta chain in sporadic and familial forms of selective IgA deficiency].

BACKGROUND: Selective IgA deficiency (IgAD) is the most frequent primary immunodeficiency in Caucasians. A protective effect of an aspartic acid residue at position 57 of the DQ beta chain against IgAD has been repeatedly described. The aim of our study was to determine, whether the genetic effect of non-aspartic acids (non-Asp) at position 57 of the DQ beta chain is different in familial and non-familial forms of IgAD. METHODS AND RESULTS: Codon 57 genotyping was performed in 59 patients with sporadic from in 28 patients with familial forms of IgAD, and in 162 control persons. Significantly increased occurrence of the non-Asp residues at position 57 in IgAD patients compared to control persons was found, but there was no difference between familial and sporadic forms of IgAD. The association was not proved in six IgAD patients who were relatives of CVID patients. CONCLUSION: The protective effect of non-aspartic acid at position 57 of the DQ beta chain is present in both sporadic and familial form of IgAD. This effect was not observed in IgAD relatives of CVID persons showing that a genetic background of this form might be different than in other forms of IgAD.

Amino Acid Sequence↗

PubMed2001

[Autoantibodies in relatives of IgA-deficient patients].

Selective IgA deficiency is frequently associated with autoimmune phenomena. We addressed the question, whether autoantibodies are more frequent in relatives of IgA deficient persons. Fifteen first-degree relatives of patients with a familial form of IgA deficiency and 129 first-degree relatives of patients with a sporadic form of IgA deficiency were evaluated. Following autoantibodies were detected: antinuclear, anti-thyreoglobulin, anti-thyroid microsomal, anti-gastric parietal cell, anti-reticulin, anti-smooth muscle, anti-mitochondrial, anti-neutrophil cytoplasmatic, anti-cardiolipin, rheumatoid factor and antibodies against gliadin. We did not find increase in any of the autoantibodies evaluated in any groups of patients. Our results do not support a significant genetic influence in autoantibodies formation in selective IgA deficiency.

Adolescent↗

PubMed2000

IgA deficiency in Czech healthy individuals and selected patient groups.

BACKGROUND: Selective IgA deficiency (IgAD) is the most common immunoglobulin deficiency with a variety of clinical manifestations. The frequency of IgAD differs depending on the ethnic origin and clinical symptoms of investigated persons. METHODS: The prevalence of IgAD (serum IgA level <0.05 g/l) was determined in 5,310 Czech blood donors, 10,326 patients who had undergone immunological investigation, and 246 first-degree relatives of IgAD and common variable immunodeficiency (CVID) patients. RESULTS: IgAD was detected in 13 (1/408; 0.24%) of the blood donors. The prevalence of IgAD was increased both in children (48/3,113; 1.5%) and adults (33/3,824; 0.9%) referred for frequent respiratory tract infections (in both cases p<0.001) compared to the healthy population. The frequency of IgAD was 12/189 (6%) in first-degree relatives of IgAD patients and 9/57 (16%) in relatives of CVID patients, with the highest frequency observed in children of CVID patients. CONCLUSIONS: The prevalence of IgAD in the Czech healthy population is comparable to that in other Caucasians. The frequency is increased in children with recurrent respiratory tract infections and especially in relatives of patients with immunoglobulin deficiencies.

Adolescent↗

PubMed2000

[IgG subclasses and autoantibodies in adult patients with selective IgA deficiency].

Selective IgA deficiency is the most common primary immunodeficiency disease, but the etiopathogenesis is unknown. In a portion of patients disturbed IgA production is accompanied by various immunological abnormalities. Serological laboratory results of 30 female and 22 male adult patients with selective IgA deficiency were compared with sex- and age-matched healthy controls. Hypergammaglobulinemia IgG was observed in 31 patients and only in 2 control persons. Serum IgG1 was increased in 12 and/or IgG3 in 18 patients, the increase in IgG2 was less common (6 persons). The number of persons with increased IgE did not differ from the control group. The occurrence of autoantibodies (antinuclear antibodies, rheumatoid factor, antithyroglobulin and anti-thyroid microsomal antibodies, anti-gastric parietal cells, reticulin, smooth muscle, anticardiolipin, and anti-gliadin antibodies) did not differ significantly from the control group. IgG hypergammaglobulinemia, which, according to our results, is the most frequent accompanying serological abnormality in IgA deficiency, may be caused by compensatory increased production, but may also reflect more profound immunological dysregulation in the disease.

Adolescent↗

PubMed1999

Isoprinosine does not protect against frequent respiratory tract infections in childhood.

UNLABELLED: Isoprinosine, an in vitro immuno-enhancing agent principally acting by stimulating T-lymphocytes, is one of a number of agents sometimes used in an attempt to prevent recurrent respiratory infections in children, although there are no formal trials for this particular drug. We performed a placebo-controlled double-blind trial to assess the efficacy of isoprinosine (50 mg/kg per day) for 6 weeks followed by 50 mg/kg per day twice weekly for 6 weeks in the prevention of frequent acute respiratory tract infections in 102 children aged 4-8 years. A total of 43 children treated with isoprinosine and 41 with placebo finished the study. Despite a transient increase in the total number of CD3+, CD4+ and CD8+ T-lymphocytes after 6 weeks of daily isoprinosine treatment, there was no difference in the number and length of duration of acute respiratory infections, number of antibiotic courses and number of days with cough, pharyngitis, rhinitis and increased body temperature (> or = 37.0 degrees C and > or = 38.0 degrees C). There were no changes in markers of T- or B-lymphocyte activation (CD25, HLA-DR, CD45RA/RO, CD23). CONCLUSION: Attempts at immunomodulation using isoprinosine in the dose and for the duration used may increase the total numbers of both CD4 and CD8 T-lymphocytes but is ineffective in prevention of respiratory tract infections in childhood.

Acute Disease↗

PubMed1999

[Serum neopterin in IgA deficiency and common variable immunodeficiency].

Serum neopterin levels were determined in 31 children and 18 adults with the selective IgA deficiency and in 17 adult patients with a common variable immunodeficiency. The results were compared with serum neopterin levels of 41 children and 26 adult controls. All sera were obtained in an infection-free period. We observed significantly increased serum neopterin levels in common variable immunodeficiency patients; this increase was observed namely in patients with a severe course of the disease. No increase in serum neopterin levels was observed neither in IgA deficient patients prone to respiratory tract infections nor in IgA deficient persons examined for other reason (allergy, rheumatoid disease, etc.). The results stand against macrophage activation in the selective IgA deficiency.

Adolescent↗

PubMed1998

[Chronic fatigue syndrome].

A great concern is recently given to the chronic fatigue syndrome in the Czech Republic. Unfortunately, published data allow us to state neither the etiologic agent nor the pathophysiology of the disease. Although many authors published various laboratory abnormalities, these changes are inconstant and do not allow to state a diagnosis of the chronic fatigue syndrome by a single laboratory test, and effective therapy is not known either. Psychotherapy, and in some cases antidepressants, are recommended by some authors to alleviate patient's symptoms. Neither immunological nor antiviral therapy showed positive results in controlled trials and are not generally used in most centers.

Fatigue Syndrome, Chronic↗

PubMed1998

Agammaglobulinaemia in a girl with a mosaic of ring 18 chromosome.

A patient with a mosaic karyotype 45,XX,-18/46,XX,dic r(18)/46,XX,r(18) with multiple phenotypic abnormalities and immunodeficiency was presented at the age of 14 years. Immunological investigation revealed markedly decreased IgG, IgA and in two of three evaluations also IgM levels. Although selective IgA deficiency is frequent in patients with a ring chromosome 18, this is the third patient described with decreased levels of other immunoglobulin isotypes. The association of chromosome 18 partial deletions and immunoglobulin abnormalities suggests the presence of an as yet unrecognised gene with a pivotal role for immunoglobulin production on chromosome 18.

Adolescent↗

PubMed1997

Antigen presentation by common variable immunodeficiency (CVID) B cells and monocytes is unimpaired.

CVID is a primary immunodeficiency syndrome comprising a heterogeneous group of patients with hypogammaglobulinaemia and defective formation of specific antibodies. Previous studies demonstrated defective T cell responsiveness to antigen in a major subgroup of patients. In the present study we investigated the capacity of peripheral blood monocytes and Epstein-Barr virus (EBV)-transformed B cell lines from seven patients with CVID, including two patients expressing an extended MHC haplotype described to be associated with CVID, to present antigen (Tet. Tox.) to CD4+ antigen-specific T cell lines from healthy controls. The results presented show an unimpaired capacity of peripheral blood monocytes to present antigen in all patients studied. In addition, the present study demonstrates for the first time that CVID B cells function normally as antigen-presenting cells (APC). These findings indicate that expression of a certain MHC phenotype in CVID is not associated with a defect in the presentation of recall antigen by monocytes and B cells. Based on these studies, uptake, processing and re-expression of recall antigen in association with MHC class II molecules on the APC surface are functional and there is no indication for structural abnormalities of the MHC class II molecules expressed by the patients studied that could be essential for their function in antigen binding and presentation.

Antigen Presentation↗

PubMed1997

Defective integration of activating signals derived from the T cell receptor (TCR) and costimulatory molecules in both CD4+ and CD8+ T lymphocytes of common variable immunodeficiency (CVID) patients.

CVID is characterized by hypogammaglobulinaemia and impaired antibody production. Previous studies demonstrated defects at the T cell level. In the present study the response of purified CD4+ and CD8+ T lymphocytes to stimulation with anti-TCR monoclonal antibody (the first signal) in combination with anti-CD4 or anti-CD8, anti-CD2 and anti-CD28 MoAbs (the costimulatory signals) was investigated. Both CD4+ and CD8+ T cells from the patients showed significantly reduced IL-2 release following stimulation via TCR and costimulation via CD4 or CD8 and CD2, respectively. However, normal IL-2 production following TCR plus phorbol myristate acetate (PMA) costimulation and normal expression of an early activation marker, CD69, after TCR+CD28 stimulation indicated that TCR was able to transduce a signal. Furthermore, both IL-2 and IL-4 release were impaired in CD4+ lymphocytes following TCR+CD28 stimulation. In addition, stimulation via TCR+CD28 resulted in significantly decreased expression of CD40 ligand in the patients. These results suggest that the integration of activating signals derived from the TCR and costimulatory molecules is defective in CVID patients; the defect is not confined to costimulation via a single molecule, or restricted to cells producing Th1-type cytokines such as IL-2, and is expressed in both CD4+ and CD8+ T cell subsets.

CD28 Antigens↗

PubMed1997

Serum IgD levels in children under investigation for and with defined immunodeficiency.

BACKGROUND: The function and regulation of circulating IgD are unclear. Serum IgD levels were increased in a wide range of immunological diseases but these associations did not give a clue to the regulation of serum IgD production. METHODS: Serum IgD levels in 131 children with various non-HIV-related immunodeficiency diseases were investigated to examine their relationship with immunoglobulin or antibody production and activation of the immune system. Data from a group of 109 nonimmunodeficient children were also available for comparison. RESULTS: There was a bimodal distribution of serum IgD levels. In 87 patients IgD levels fell below the limit of detection of 5 IU/ml, while the remainder showed an approximately normal distribution skewed to the right after log transformation. The proportion of children with undetectable IgD levels (< 5 IU/ml) was significantly increased in immunodeficient children (87/131 vs. 28/109, p < 0.001). No difference in the occurrence of immunoglobulin or antibody deficiencies was demonstrated in immunodeficient children with detectable and nondetectable IgD levels. There was a positive correlation of serum IgD with age, serum IgA and IgE, white blood count and CD4+CD25+ lymphocytes but not with other immunoglobulin isotypes or immune activation markers. CONCLUSION: Determination of serum IgD levels did not seem to be of particular clinical benefit in the investigation of HIV-negative immunodeficient children and serum IgD levels were not associated with the general picture of immune activation. Observed distribution patterns and associations may have implications for the regulation of serum IgD production.

Age Factors↗

PubMed1997

[Successful gamma globulin therapy in a patient with anti-IgA antibodies].

A case report of a patient suffering from common variable immunodeficiency with anti-IgA antibodies is described. These antibodies were probably the cause of repeated anaphylactic reactions during substitution gammaglobulin treatment, and lead to discontinuation the therapy lasting 4 years. The reintroduction the therapy was enabled by the therapy with low-IgA contents intravenous immunoglobulin (Endobulin, Immuno Vienna).

Antibodies, Anti-Idiotypic↗

PubMed1996

[Primary immunodeficiencies. I. Classification and new etiopathogenic findings].

A current system of classification of primary immunodeficiency diseases, together with some recent discoveries in this field, are described. The most important development in elucidating the pathogenesis of primary immunodeficiencies was achieved in X-linked immunodeficiencies. This progress was made possible especially by the discovery of genes of most X-linked immunodeficiency diseases.

Humans↗

PubMed1996

[Primary immunodeficiencies. II. Current therapeutic possibilities].

The possibilities of the influence of the immune system in patients with primary immunodeficiencies are nowadays limited. Bone marrow transplantation is the only causal treatment at present, but it is used only in patients with the most severe diseases. Gene transplantation is a possible approach in diseases with known genetic defects, but the experience is still very limited. As a replacement therapy, immunoglobulin is the most frequently used, while enzyme replacement therapy has only a restricted applicability. Adequate antibiotic therapy is an essential part of the treatment of the patients with primary immunodeficiencies, both as an adequate and rasant antibiotic treatment of acute infections and also as a long-term antibacterial, and in some cases also anti-viral and anti-fungal prophylaxis.

Humans↗

PubMed1996

Intravenous immunoglobulin, splenectomy, and antibiotic prophylaxis in Wiskott-Aldrich syndrome.

AIM: To assess the results of supportive treatment with intravenous immunoglobulin (IVIG) and antibiotic prophylaxis in combination with splenectomy in patients with Wiskott-Aldrich syndrome. STUDY DESIGN: Retrospective review of case records of 21 patients from March 1984 to February 1996. RESULTS: Thrombocytopenia was cured in 14 of 15 patients who had splenectomy, but it recurred intermittently in three. Mean platelet volume (MPV) was normal transiently in some patients, but all MPV values were subnormal 8-23 months after splenectomy. Antibiotic and IVIG prophylaxis may have contributed to the lack of a detectable increase in the number of severe acute bacterial infections in the 451 months after splenectomy. Four patients died in 2205 months of observation before and after splenectomy (median 82, range 16-248): two of cerebral B cell lymphoma, one of progressive multifocal leucoencephalopathy, and one with severe chronic chest disease of pneumonia. CONCLUSION: Adequate supportive treatment with IVIG and antibiotic prophylaxis together with splenectomy enables good survival and quality of life in the short and medium term in patients with Wiskott-Aldrich syndrome. Persistence of infection, bleeding, and vasculitic and allergic symptoms in a significant minority and the risk of development of lymphoma, however, suggest that bone marrow transplantation may be indicated if an HLA identical donor is available.

Anti-Bacterial Agents↗