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J Sutherland

Publications and source records attributed to J Sutherland.

96 records · Page 6Linked to original sources
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Cold agglutinin activity is common among human monoclonal IgM Rh system antibodies using the V4-34 heavy chain variable gene segment.

BACKGROUND: The V4-34 gene segment is commonly used by human monoclonal IgM alloantibodies against blood group antigens and by cold-reactive red cell autoantibodies with anti-I or anti-i specificity. This study was conducted to determine whether cold agglutinin activity is found among the V4-34-encoded alloantibodies. STUDY DESIGN AND METHODS: Fifty-four human IgM monoclonal antibodies (MoAbs) against Rh system antigens were tested for cold agglutinin activity against red cells lacking the relevant Rh system antigen and for reactivity with tissue I and/or i antigens using immunohistochemistry. The findings were correlated with the utilization of the V4-34 segment as determined in an enzyme-linked immunosorbent assay with an antibody (9G4) that is specific for this gene product and were also correlated with other serologic properties. RESULTS: Of the MoAbs, 59 percent were 9G4-positive. Of the 9G4-positive subset, 16 and 44 percent agglutinated native adult (express I) and cord (express i) cells, respectively, at 4 degrees C; these levels rose to 84 and 94 percent, respectively, with the use of papain-treated cells. The red cell antigens recognized at 4 degrees C were cleaved by endo-beta-galactosidase, which is consistent with their being I and i. Of the 9G4-positive subset, 53 percent bound to tissue i antigen. These reactivities were not found among 9G4-negative MoAbs. Endo-beta-galactosidase treatment of red cells enhanced Rh system antibody agglutination by 9G4-negative MoAbs. CONCLUSION: Anti-I/i reactivity is common among IgM Rh system MoAbs and is shown only by the V4-34-encoded subset. This finding has implications for the use of MoAbs for Rh system typing of blood.

Agglutinins↗
PubMedDate not supplied

Hypertension: current management strategies.

BACKGROUND: Hypertension affects 50 million persons in the United States and is the most common reason for office visits and prescriptions. This report reviews the epidemiology, diagnosis, and treatment of this condition and provides special attention to concomitant risk factors and issues of adherence. METHODS: A literature search was performed using MEDLINE files dating back to 1986. The key words were "hypertension," "antihypertensive agents," "patient compliance," "cardiovascular risk factors," "isolated systolic hypertension," and "JNC." Additional references were accessed by cross-referencing the bibliographies of the articles obtained in this search. RESULTS AND CONCLUSIONS: Effective therapeutic pharmacologic and nonpharmacologic management of hypertension, including stage 1 as reclassified by the Fifth Report of the Joint National Committee (JNC-V), can greatly reduce mortality for patients. Despite extensive national efforts, 35 percent of hypertensive patients remain unknown, and only 7 percent have their hypertension adequately controlled. Any additional cardiovascular risk factors compound the risk of adverse outcome and can be adversely affected by treatment. JNC-V recommendations regarding equally effective pharmacologic agents are flexible but controversial. The favorable cardioprotective effects of angiotensin-converting enzyme inhibitors, calcium channel blockers, alpha-blockers, and alpha-beta-blockers often make them a more appropriate choice than diuretics or beta-blockers. Practical techniques for improving patient adherence to treatment regimens are also important and should begin when the diagnosis of hypertension is made.

Adolescent↗