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Biomedical subjects

M Granström

Publications and source records attributed to M Granström.

At least 127 records · Page 7Linked to original sources

Ontogeny of IgG2 antibodies against S. aureus teichoic acid in normal and immunodeficient children.

Anti-teichoic acid antibodies of various subclasses were found to be effectively transported across the placenta during pregnancy. In adults these antibodies are mainly of the IgG2 subclass although substantial amounts of specific IgG1 antibodies may also be found. During ontogeny, specific IgG1 antibodies develop during the second year of life whereas specific IgG2 antibodies appear markedly later. In IgG2 deficient children, prolonged deficiency of specific anti-teichoic acid antibodies was observed, suggesting a lack of maturation of the appropriate idiotype(s). In children who received a bone marrow transplant from adult donors, engraftment of IgG2 producing cells could be seen, thus transferring the ability to produce specific antibodies.

Adolescent↗

Diagnosis of spirochetal meningitis by enzyme-linked immunosorbent assay and indirect immunofluorescence assay in serum and cerebrospinal fluid.

The antibody response against a spirochetal strain isolated from Swedish Ixodes ricinus ticks was determined by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence assay of cerebrospinal fluid (CSF) and serum specimens from 45 patients with chronic meningitis. Samples of CSF, serum, or both from patients with various infections of the central nervous system, multiple sclerosis, syphilis, or infectious mononucleosis and from healthy individuals served as control samples. Probable spirochetal etiology could be demonstrated for 41 of 45 (91%) patients with clinical symptoms of chronic meningitis. Approximately 25% of the patients had significantly elevated titers of antibody to the spirochete in CSF but not in serum. The highest diagnostic sensitivity, 91%, was demonstrated by measurement of CSF antibodies and calculation of a spirochetal CSF titer index, which is the ratio of (ELISA titer in CSF/ELISA titer in serum) to (albumin in CSF/albumin in serum) and which also considers the degree of blood-CSF barrier damage. The highest specificity, 98%, was obtained by calculation of a CSF titer index. Patients with short duration of disease were especially prone to be antibody negative in serum but positive in CSF. Significant rise in serum antibody titers was seldom demonstrated in patients treated with antibiotics. It is concluded that measurement of CSF antibodies, especially by ELISA, is a highly sensitive and specific method for the immunological diagnosis of spirochetal meningitis.

Anti-Bacterial Agents↗

Ixodes ricinus spirochete infection as the cause of postinfectious arthritis in Sweden.

Antibodies to Swedish Ixodes ricinus spirochete were determined by an enzyme-linked immunosorbent assay (ELISA) in sera from 298 patients with postinfectious arthritis. Sera from healthy individuals, patients with acute infectious meningitis of proven etiology and patients with multiple sclerosis served as controls. With the upper limit of normal values set at the 95 percentile of controls, 18 of 298 (6%) arthritis patients had positive serum antibody titres. Titres above the 100 percentile of controls were found in 5 of 298 (2%) arthritis patients. Two of the arthritis patients had extremely high titres--higher than any earlier found in Swedish patients with spirochetal meningitis. The clinical manifestations and laboratory findings in the 5 patients with high spirochetal antibody titres are described. It is concluded that a spirochetal etiology should be considered in patients with reactive or postinfectious arthritis of unknown origin.

Adolescent↗

Relation between antibody response to Pseudomonas aeruginosa exoproteins and colonization/infection in patients with cystic fibrosis.

Enzyme-linked immunosorbent assay (ELISA) was used to measure the antibody response to Pseudomonas aeruginosa exotoxin A, elastase, alkaline protease and phospholipase C in patients with cystic fibrosis (CF). Only the chronically colonized patients showed elevated antibody titres to phospholipase C (22/22 patients), alkaline protease (16/22 patients), exotoxin A (15/22 patients) and elastase (5/22 patients). In a few patients where serial specimens were available, rising titres were recorded to all four antigens during periods of active infection. Antibiotic treatment resulted in decrease of titres against all four antigens, but only the anti-exotoxin A and anti-elastase titres decreased to normal levels. Titres to phospholipase C were the least influenced by antibiotic treatment. The results imply different roles for these exoproteins in chronic colonization versus active infection. The levels of P. aeruginosa antibodies to exoproteins could probably be used in monitoring treatment of patients with CF.

ADP Ribose Transferases↗

Diagnosis of whooping cough--a comparison of culture, immunofluorescence and serology with ELISA.

Three methods for diagnosis of whooping cough--culture, immunofluorescence (IF) technique on nasopharyngeal secretion and serology with ELISA--were compared. 52 patients with symptoms of upper respiratory tract infection, which could not exclude pertussis as a differential diagnosis, were investigated. Pertussis infection was confirmed in 30 patients. Of these 16 (53%) were found by culture, 19 (63%) by IF and 28 (93%) by serology. It is concluded that IF analysis of nasopharyngeal secretion is a valuable tool for rapid diagnosis of whooping cough with a sensitivity similar to that of culture. Serodiagnosis with ELISA added a significant number of positive patients in which culture and IF were negative.

Adolescent↗

IgG subclass distribution of antibodies against S. aureus teichoic acid and alpha-toxin in normal and immunodeficient donors.

IgM, IgG, IgA and IgE class and IgG and IgA subclass levels were determined in 18 IgG2 deficient and six IgG3 deficient donors. IgG2 deficiency was associated with concomitant IgG4, IgA (in particular IgA2) and IgE deficiency. This pattern is compatible with a regulation defect of the downstream switch in the heavy chain locus on chromosome 14. IgG3 subclass deficiency was not associated with further deficiencies. Specific anti-teichoic acid antibodies were lacking in most IgG2 deficient donors supporting the notion that anti-teichoic acid antibodies are normally of this subclass. This was also confirmed in a subclass-specific ELISA using sera from normal donors although substantial amounts of specific IgG1 antibodies were also noted. Two IgG2 deficient donors had normal IgG titres (IgG1 in the subclass specific ELISA) and the lack of IgG1 anti-teichoic acid antibodies in most IgG2 deficient donors may suggest a lack of maturation of the appropriate idiotype. IgG antibodies to alpha-toxin, a pure protein, were within the lower normal range in a large proportion of IgG2 deficient donors but largely normal in the IgG3 deficient donors.

Adolescent↗

Enzyme-linked immunosorbent assay (ELISA) for antibodies to Clostridium difficile toxins in patients with pseudomembranous colitis and antibiotic-associated diarrhoea.

Enzyme-linked immunosorbent assay (ELISA) was established with purified toxins from Clostridium difficile as antigen to measure antibody response in patients with pseudomembranous colitis (PMC) and prolonged antibiotic-associated diarrhoea (AAD). Positive ELISA titres were defined in a control population. Antibodies of IgG class against toxin B were demonstrated in 6/88 (7%) control sera and in 31/61 (51%) sera from 11/19 (58%) patients. Antibodies of IgA class were found in one patient while antibodies of IgM class were not demonstrated. ELISA antibodies against toxin A were not demonstrated. For comparison a neutralization test was performed and neutralizing antibodies to toxin B but not to toxin A were demonstrated in 10/61 (16%) sera from 4/19 (21%) patients and in none of the controls. ELISA was found to be a more sensitive assay than neutralization. ELISA antibodies were detected from the third week of the disease while neutralizing antibodies appeared after 5 weeks. Lack of an antibody response in ELISA seemed to correlate to a more severe colitis.

Anti-Bacterial Agents↗

Enzyme-linked immunosorbent assay for antibodies against teichoic acid in patients with staphylococcal infections.

A highly purified teichoic acid preparation was used in an enzyme-linked immunosorbent assay to measure the specific immunoglobulin G (IgG) and IgM response in staphylococcal disease. Antibody determination in a normal population, showing a difference of up to 20-fold in the mean IgG titers between the youngest children and adults, was used to establish age-correlated upper normal values. IgM antibodies were found to be of little diagnostic value since their response was often low or absent. Increased IgG titers were found in 24 of 27 (89%) patients with endocarditis, in 11 of 14 (79%) with complicated septicemia, and in 10 of 20 (50%) with uncomplicated septicemia with serum samples drawn between days 7 and 30 of disease. With paired samples, the numbers of patients with increased IgG titers were 17 of 17, 3 of 4, and 6 of 7, respectively, in the same patient groups. Increased IgG titers were less often demonstrated in patients with chronic osteomyelitis (7 of 22). The enzyme-linked immunosorbent assay for teichoic acid antibodies was found to be a sensitive and specific method for diagnosing staphylococcal endocarditis and septicemia. For optimal results, both the substantial age-correlated variation in normal titers and the importance of adequately spaced samples should be considered.

Adolescent↗

Serological diagnosis of deep Staphylococcus aureus infections by enzyme-linked immunosorbent assay (ELISA) for staphylococcal hemolysins and teichoic acid.

An enzyme-linked immunosorbent assay (ELISA) was used with a purified alpha-toxin preparation to measure the serum IgG, IgM and IgA response in staphylococcal septicaemia and endocarditis. ELISA for IgG antibodies against alpha-toxin was found to be more sensitive than the neutralization test (ASTA). IgM and IgA antibody determination was found to be of limited diagnostic value. A correlation between IgG antibodies to alpha-toxin and purified beta-toxin was found in ELISA, although antibody determination to beta-toxin was a less sensitive diagnostic method. The highest diagnostic sensitivity in deep staphylococcal infections was obtained by parallel performance of ELISA to alpha-toxin and purified teichoic acid. By this approach, 32/35 (91%) patients with endocarditis, 12/14 (86%) with complicated septicaemia and 15/22 (68%) with uncomplicated septicaemia showed increased titres in samples drawn between days 7-30 of disease. Diagnostic sensitivity was further increased to 31/32 (97%) positive patients, when paired or multiple samples from patients with septicaemic staphylococcal disease were analysed.

Antibodies, Bacterial↗

Serologic diagnosis of whooping cough by an enzyme-linked immunosorbent assay using fimbrial hemagglutinin as antigen.

Diagnosis of whooping cough by an enzyme-linked immunosorbent assay (ELISA) that measures serum IgG, IgM, and IgA antibody to the fimbrial hemagglutinin of Bordetella pertussis was compared to isolation from nasopharyngeal swabs in a prospective study. Of 77 patients with upper respiratory tract infections of unknown etiology in which B. pertussis infection could not be excluded on clinical grounds, 26 were culture-positive, including one for Bordetella parapertussis. All 26 patients were positive by ELISA except one asymptomatic erythromycin-treated patient (ELISA sensitivity, 96%). Among culture-negative patients, 24 additional patients were positive by ELISA. Thus, only about one half of the patients with whooping cough were identified by culture under optimal conditions. Positive titers of IgM antibody and/or high titers of IgG antibody in the first serum sample, allowing for a rapid diagnosis, were found only in 26 (53%) of 49 serologically positive patients. By combining culture testing with serology, rapid diagnosis was obtained in 41 (82%) of 50 patients.

Adolescent↗

Purification and characterisation of a fimbrial haemagglutinin from Bordetella pertussis for use in an enzyme-linked immunosorbent assay.

The fimbrial haemagglutinin (F-HA) of Bordetella pertussis grown on solid medium was extracted with 1M sodium acetate for 72 h at 20 degree C, and partially purified by Sephacryl S-300 gel chromatography. A pooled fraction with fimbrial haemmagglutinating activity was shown to contain fimbriae haemagglutinating activity was shown to contain fimbriae of the expected morphology by electron microscopy. Chemical and biological assays showed that the F-HA fraction contained some heat-labile agglutinogen and lipopolysaccharide but no measureable lymphocytosis-promoting factor or heat-labile toxin. The F-HA fraction used as antigen in an enzyme-linked immunosorbent assay (ELISA) permitted the detection of antibodies in convalescent serum from a patient with whooping cough. The impurities, heat-labile agglutinogens and lipopolysaccharide, did not contribute to the ELISA activity. The method for preparation of the F-HA antigen is simple, reproducible and gives a high yield.

Antibodies, Bacterial↗

Detection of antibodies in human serum against the fimbrial haemagglutinin of Bordetella pertussis by enzyme-linked immunosorbent assay.

Antibody responses in human sera against Bordetella pertussis during natural infection were investigated by a microplate enzyme-linked immunosorbent assay (ELISA) with a purified fimbrial haemagglutinin preparation as antigen. Significant rises of specific IgG, IgM and IgA were demonstrated in paired sera. A secondary type of antibody response was found in most children and adults. In children, the type of response correlated with previous vaccination status; there was a primary response in unvaccinated children. A survey of antibodies in the general population showed low IgG titres in a small proportion of sera from the youngest healthy children. The titres and the number of individuals with measureable antibodies increased with age. In a limited study of the effect of vaccination, significant rises of titres were demonstrated after vaccination. The ELISA test was specific for antibodies against B. pertussis except that the test also seemed to measure antibody to B. parapertussis. A comparison between ELISA and the complement-fixation test showed a good correlation between the tests only in sera from children 1-12 years old.

Antibodies, Bacterial↗

Antibody response to cytomegalovirus: a comparison between adult patients with neurological disease and uncomplicated infection.

Cytomegalovirus (CMV) infection in adults can cause neurological diseases such as the Guillain--Barré syndrome (GBS) and myelitis. The mechanism leading to the development of neurological damage is, however, still unknown. We have investigated the possibility that an abnormal humoral immune response, either weak or hyperactive, could be the cause. The antibody response of four patients with a primary CMV followed by neurological symptoms was compared to that of four age-matched controls with an uncomplicated infection. IgG and IgM antibodies to CMV early antigens (EA), late antigens (LA), and IgG antibodies to CMV immediate early antigens (IEA) were measured in consecutive serum samples. Comparison of titers indicated a longer time lapse between the onset of CMV infection and the development of symptoms in the group with neurological disease. We found no conclusive evidence of an abnormal humoral immune response to CMV in the patients with neurological disease compared to the patients with an uncomplicated infection.

Adolescent↗

The polyclonal B cell activator dextran-sulphate induces formation of colony stimulating activity.

The effect of dextran-sulphate (DS), a polyclonal activator known to stimulate immature murine B-cells, was assayed in a culture system allowing the growth of myeloid cells. It was known that DS induced the production of a myeloid colony stimulating factor (CSF) by cells from both spleen and bone marrow. Nylonwool purified mouse spleen cells, enriched for T cells, showed a dimished CSF production in response to DS, while CSF production in response to Con A was increased. Furthermore, DS induced CSF in both spleen and bone marrow cells from nude mice. Removal of macrophages did not affect CSF production. The CSF induced was non-dialysable and no small molecular weight or lipoprotein inhibitors could be demonstrated. The results suggest that DS activates cells other than T cells or macrophages (possibly B cells or null cells) to produce a myeloid stem cell stimulating substance. These results indicate that interactions between lymphoid and myeloid cells can take place during differentiation.

Animals↗

Early diagnosis of tick-borne encephalitis (TBE) by demonstration of specific IgM antibodies.

The demonstration of specific IgM antibodies after separation of immunoglobulins was used for the early diagnosis of tick-borne encephalitis (TBE). The separation was done by sucrose-gradient density ultracentrifugation and IgM antibodies were demonstrated with the hemagglutination-inhibition (HI) test. IgM antibodies were found in 9/11 sera taken within 3 days after onset of clinical symptoms and in all sera (37/37) taken 4--15 days after onset of the disease. Most sera (22/24) were still IgM positive 3--6 weeks after onset of the disease. After this period of time IgM antibodies could no longer be defected. The demonstration of IgM antibodies also proved valuable in confirming the diagnosis in several cases where no antibody rise was found neither by the complement-fixation (cf), nor by the HI test.

Antibodies, Viral↗