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Biomedical subjects

M Borok

Publications and source records attributed to M Borok.

9 recordsLinked to original sources

Relationship of human herpesvirus 8 peripheral blood virus load and Kaposi's sarcoma clinical stage.

OBJECTIVE: To determine the relationship between human herpesvirus 8 (HHV-8 or Kaposi's sarcoma-associated herpesvirus) peripheral blood virus load and Kaposi's sarcoma (KS) clinical stage. DESIGN: Blinded, cross-sectional analysis of peripheral blood HHV-8 DNA levels in persons with AIDS-related KS in Harare, Zimbabwe. METHODS: Subjects were stratified by KS clinical stage. The amount of HHV-8 DNA in plasma and peripheral blood mononuclear cells (PBMC) was determined by quantitative real-time PCR amplification of the HHV-8 open reading frame 26. RESULTS: Thirty-one HIV-1/HHV-8-coinfected persons were studied: 26 subjects had histologically confirmed KS (one stage II, 11 stage III and 14 stage IV) and five subjects had antibodies to HHV-8 but did not have KS. The age, CD4 lymphocyte count and plasma HIV-1 RNA levels were similar in all groups. HHV-8 DNA was detected in the plasma of all HHV-8-infected subjects (range < 2.4 to 5.2 log10 copies/ml), but plasma HHV-8 DNA levels were not associated with KS disease stage. In contrast, the amount of HHV-8 DNA in PBMC (range < 0.7 to 4.5 log10 copies/microg) was strongly associated with KS clinical stage (P = 0.005). Among stage IV KS cases, there was a linear relationship between plasma and PBMC HHV-8 DNA levels (r2 = 0.42; P = 0.01). CONCLUSION: The strong association observed between the extent of KS disease and the levels of HHV-8 DNA in PBMC provides further evidence for a relationship between HHV-8 virus load and KS pathogenesis.

Adult↗

Detection of Kaposi's sarcoma-associated herpesvirus in oral and genital secretions of Zimbabwean women.

Kaposi's sarcoma-associated herpesvirus (KSHV) in oral and genital secretions of women may be involved in horizontal and vertical transmission in endemic regions. Nested polymerase chain reaction assays were used to detect KSHV DNA sequences in one-third of oral, vaginal, and cervical specimens and in 42% of peripheral blood mononuclear cell (PBMC) specimens collected from 41 women infected with human immunodeficiency virus type 1 who had Kaposi's sarcoma (KS). KSHV DNA was not detected in specimens from 100 women without KS, 9 of whom were seropositive for KSHV. A positive association was observed between KSHV DNA detection in oral and genital mucosa, neither of which was associated with KSHV DNA detection in PBMC. These data suggest that KSHV replicates in preferred anatomic sites at levels independent of PBMC viremia. Detection of genital-tract KSHV only among relatively immunosuppressed women may provide an explanation for infrequent perinatal transmission of KSHV.

AIDS-Related Opportunistic Infections↗

Effects of 13-cis retinoic acid therapy on human antibody responses to defined protein antigens.

We have evaluated the in vivo effects of 13-cis retinoic acid (13-cis RA) on human antibody responses to immunization with tetanus toxoid (TT) and keyhole limpet hemocyanin (KLH). Subjects with severe cystic acne were immunized with suboptimal doses (10 micrograms) of KLH 7 d and 3 months after starting retinoid therapy (13-cis RA, 1 mg/kg/day for 4 mo). A standard booster immunization with TT was given along with the initial KLH sensitization. A control group of acne patients received identical immunization regimens, but no 13-cis RA. Plasma retinoid levels were evaluated by reverse-phase HPLC and confirmed that blood-level concentrations of 13-cis RA and metabolites in these acne patients reached values previously demonstrated to be immunomodulatory in vitro. The retinoid had no effect on responses to TT as reflected by the characteristics of increased anti-TT IgG levels or the isotype distribution of the antibody. In contrast, the anti-KLH response was significantly enhanced in the 13-cis-RA-treated group. Whereas anti-KLH antibody was detected in only 4 of 13 control subjects after the secondary immunization, 10 of 13 retinoid-treated subjects had measurable levels of anti-KLH IgG (p less than 0.05). Among the responders, no differences were noted in the isotype distribution of anti-KLH antibody. These results showing enhanced anti-KLH responses induced by 13-cis RA therapy represent the first demonstration in humans that in vivo administration of a retinoid can modulate antigen-specific immune responses.

Acne Vulgaris↗

Pityriasis rubra pilaris. Further observations of systemic retinoid therapy.

We report a retrospective review of 18 patients with pityriasis rubra pilaris treated with isotretinoin or etretinate, or both. Of patients treated with only isotretinoin, 60% have achieved sustained resolution. Of four patients treated with etretinate, three have cleared completely and the other patient has shown substantial improvement. Our data suggest that etretinate may be superior to isotretinoin in the treatment of adult-onset pityriasis rubra pilaris.

Adolescent↗

Phototherapy units: comparison of fluorescent ultraviolet B and ultraviolet A units with a high-pressure mercury system.

Comparison in ultraviolet (UV) dosimetry is reported for three different phototherapy machines. Two of the machines used UV-emitting fluorescent tubes in a standard upright cabinet formation. One of these machines was equipped with predominantly UVB-emitting fluorescent tubes and the other with predominantly UVA-emitting tubes. The third machine consisted of a series of vertically mounted high-pressure mercury halide lamps equipped with two different filters for selection of wavelengths between 295 and 400 nm or 320 and 400 nm. The horizontal UV output of the mercury halide and UVB fluorescent units was reduced between the UV-emitting areas, and it is advised that patients rotate when using these units. It was determined that the vertical uniformity and intensity of UV emission was superior in the mercury halide unit compared with the fluorescent tubed units.

Fluorescence↗

Epidermolysis bullosa acquisita in an 8-year-old girl.

Epidermolysis bullosa acquisita is an autoimmune blistering disease with the distinct feature of having an autoantibody directed against an antigen located below the basement membrane of human skin and mucous membrane. We identified this disease in an 8-year-old girl, the youngest patient documented by immunoelectron microscopy.

Child↗

Recurrent cutaneous leishmaniasis.

A patient is presented who has a 71-year history of recurrent cutaneous leishmaniasis, despite treatment with antimonials, antituberculous drugs, and surgery. Classification and treatment of cutaneous leishmaniasis are discussed.

Aged↗