[HTLV infections in women--a review].
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Biomedical subjects
Publications and source records attributed to K Lidman.
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Human immunodeficiency virus (HIV) has been isolated from plasma in 6 of 7 patients showing clinical symptoms of a primary HIV infection. Parallel cultures from peripheral blood mononuclear cells (PBMC) yielded virus in 5 patients. In one case, virus could only be isolated from the cerebrospinal fluid but not from peripheral blood. Detectable viremia was transient and preceded the appearance of HIV specific antibodies. After cessation of acute symptoms, the frequency of HIV isolations was similar to that of asymptomatic carriers (23 and 26%, respectively). The role of the immune response in terminating detectable viremia remains to be established.
Hepatitis B markers were determined by radioimmunoassay in 383 adults from different areas of Somalia and in 135 pregnant females and 428 children from Mogadishu. The highest incidence of HBsAg among adults was among nomadic males (20/85; 23%). The frequencies were lower in males from the agricultural and coastal area, i.e. 16/93 (17%) and 14/98 (14%) respectively. The lowest frequency of HBsAg was among women from the coastal area (6/72; 8%). Among the pregnant women 14 were positive for HBsAg, none of whom had HBeAg. Low levels of positivity for HBsAg were found both among children under 4 years and among those between 4 and 13 years of age - 3/94 (3%) and 5/128 (4%) respectively. In the age group 15-19 years, 50% showed seroconversion from HBeAg to anti-HBe. 7 out of 41 HBsAg carriers of ages over 20 had HBeAg. Early seroconversion from HBeAg to anti-HBe and a low level of HBsAg positivity in children indicate that vertical transmission is not important in Somalia. The low frequency of HBsAg in Mogadishu children may have one of the following explanations: (i) the infection occurs during adolescence, (ii) Mogadishu is a low-prevalence area and the examined adults were not born in Mogadishu, or (iii) a change in hepatitis B epidemiology has taken place in the area during the last 2 decades and the relatively higher prevalence of HBsAg in adults might reflect higher rates of infection in their childhood.
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T-lymphotropic viruses were isolated from 31 patients with different clinical manifestations of human immunodeficiency virus (HIV) infection. Lymphocyte cultures from patients with the acquired immunodeficiency syndrome (AIDS) or pre-AIDS yielded virus rapidly, as indicated by high levels of reverse transcriptase (RT) activity in culture fluids. These viruses were able to establish a persistent infection in several T4-antigen-positive tumour cell-lines. In contrast, lymphocyte cultures from patients with mild or no symptoms yielded virus more slowly and the RT activity was low. Co-cultivation of slow/low-yielding lymphocytes with T4-positive tumour cell-lines showed no or only transient virus production. In 14 out of 23 cases virus could be detected by their fatal cytopathic effects on tumour cells. The relation between severity of illness and in-vitro replication potential of the viruses suggests that in the course of an infection selection may occur for HIV variants that replicate efficiently in T4 cells.
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All of 15 sera containing anti-mitochondrial antibodies (AMA), type M 5, reacted in ELISA with ssDNA, whereas only four had anti-nuclear antibodies as demonstrated by immunofluorescence technique. Twelve of 15 had biological false-positive seroreaction for syphilis and seven of 11 cases investigated had a positive lupus anti-coagulant test. Cold agglutinins were present in 11 sera. Hyper-gamma-globulinaemia was not a prominent finding, but C4 values below the lower limit were common in spite of C3 within the normal range. Absorption of IgG fractions from three different sera with cardiolipin eliminated the reaction with ssDNA and mitochondria, supporting a certain degree of cross-reactivity among the antibodies. The presence of AMA, type M 5, seemed to discriminate a group of patients with symptoms often consistent with SLE although some of the most prominent findings were often absent.
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Six girls and one boy with cronic active hepatitis (CAH) of unknown etiology were between 9 and 15 years at the clinical onset of their illness. After beginning immunosuppressive therapy the course of their disease was followed from one to ten years. All had markedly increased IgG, high titres of smooth muscle antibodies (SMA) and antinuclear antibodies of IgG class in the earliest serum specimens tested. Therapy resulted in an improved sense of well-being and a decrease in SGOT, IgG and titres of SMA. Very high titres of measles antibodies were observed in all cases. In one of the cases CAH manifested itself after measles and in another after rubella infection. The first case in our series of patients died of liver failure after 5 years of illness. The other patients have survived and are able to live a normal life. The possibility of CAH should be considered when children develop symptoms of hepatitis. Longterm immunosuppressive treatment with regular clinical and laboratory evaluation is important. Estimation of titres of SMA is an additional parameter of value in following of the activity of CAH in these young patients.
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The staining pattern of anti-actin sera on various cells smeared on glass was compared to the relative amount of cellular actin estimated by SDS-polyacrylamide-gel electrophoresis with subsequent scanning of the gel. Although the cells showed a varying stainability the actin content was fairly constant. Thus, the staining differences reflected changes in the organization of cellular actin rather than actual differences in the amount of actin.
Out of 17 109 sera tested for autoantibodies by indirect immunofluorescence, 236 contained smooth muscle antibodies (SMA) with a titre of greater than or equal to 1/25. The majority of these sera, from 190 patients, reacted both with smooth muscle and renal glomeruli and the specificity of these SMA is against actin. 91% of high-titred sera (greater than or equal to 1/100) with IgG antibodies giving this staining pattern were derived from patients with chronic inflammatory liver disease, mainly chronic active hepatitis. In the group with a titre of 1/25, non-liver diseases such as joint diseases were more common and liver conditions occurred only in 55%. Sera with SMA of IgM class weremostly derived from patients with acute viral hepatitis.
In the diagnostic routine for tissue antibodies, using indirect immunofluorescence on cryostat sections of human thyrotoxic thyroid, rat stomach and kidney, ninety-six out of 48,388 sera showed a marginal staining of the membrane region of thyroid epithelial cells but no other reaction. Twenty-six of these sera were from patients with acute Yersinia enterocolitica serotype 3 infection but without signs of thyroid disease. Fifty of sixty-three sera with agglutinins against Y. enterocolitica serotype 3 and three out of four sera with agglutinins against Y. enterocolitica serotype 9 also showed this reaction on thyroid sections. It was due to antibodies, mostly of the IgG class, occurring in low titre, which react with intracytoplasmic antigens in thyroid, as staining of live thyroid epithelial cells was negative. The pattern of immunofluorescence on thyroid sections caused by these antibodies could not be distinguished from that caused by smooth muscle antibodies by appearance only. However, smooth muscle antibodies react also on other tissue sections and extracts of contractile proteins which absorb out these, did not change the reaction on thyroid of Y. enterocolitica sera. Absorption with sonicated Y. enterocolitica 3 and 9 antigens, but not with heat-killed whole bacteria, extinguished the reaction on thyroid. This indicates the presence of a cross-reactivity between antigens in these bacteria, different from the O antigen, and antigens in thyroid epithelial cells. Knowledge of this pattern of immunofluorescence on thyroid sections can be of diagnostic significance.
Thirty sera reacting by IFL technique in titres greater than or equal to 100 with smooth muscle fibres of rat stomach, rat renal glomeruli, and with the membrane region of thyroid cells were randomly chosen among sera sent in for routine testing of tissue antibodies. All sera but one were found to be derived from patients with chronic active hepatitis. The smooth muscle and other relevant cell staining were abolished after absorption of sera with actin, prepared from rabbit skeletal muscle and found to be homogeneous by SDS gel-electrophoresis and by electron microscopy. The actin anti-bodies were purified by precipitation of sera with F-actin and elution of the precipitates at acid pH. The purified antibodies stained all tissues in the same way as the original sera. In double immunodiffusion tests all thirty sera gave precipitation with actin. Thus, it was concluded that these broad-reacting SMA are directed against actin. The finding of high-titred SMA is of diagnostic value and supports the clinical diagnosis of active chronic hepatitis. In addition, anti-actin antibodies eluted from human sera are a suitable tool for studying actin-containing cellular structures.
Seventeen human hematopoietic cell lines were tested by indirect immunofluorescence (IF) for reactivity with human serum containing smooth-muscle antibodies (SMA). The correlation of the IF pattern to the cell surface ultrastructure was revealed by scanning electron microscopy (SEM). Lymphoma cells, viewed by SEM, had short villi over the entire cell surface, but, by IF, showed a type of membrane fluorescence. Cells of lymphoblastoid lines had thin, long surface villi, sometimes asymmetric but most often distributed over the whole cell surface. Myeloma and leukemia cells, which had few membrane villi but a surface covered by "blebs" as revealed by SEM, demonstrated, by IF, only a few stub-like projections extending from the surface. Time-lapse cinematography revealed that the intensity and pattern of SMA staining were also correlated to the degree of motility. Indirect IF with human SMA-positive serum might be used in the classification of cell lines derived from human hematopoietic tissue.