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Biomedical subjects

M S Gottlieb

Publications and source records attributed to M S Gottlieb.

At least 73 records · Page 4Linked to original sources
PubMed1984

Differences in risk of insulin-dependent diabetes in offspring of diabetic mothers and diabetic fathers.

To examine the role of heritable factors in insulin-dependent diabetes mellitus (IDDM), we studied the incidence of IDDM in the offspring of patients with the disease who were identified by the medical records of the Joslin Diabetes Center from 1928 to 1939. We found 187 survivors who, after the diagnosis of IDDM, had produced 419 offspring for whom information about diabetes status was available. By the age of 20, 6.1 per cent of the offspring of the 88 men had diabetes; in contrast, only 1.3 per cent of the offspring of the 99 women had the disease by the age of 20 (P less than 0.05). Daughters and sons of the men with IDDM were affected equally (there were insufficient numbers of affected offspring of diabetic women to permit determination of whether the sexes were equally affected). We conclude that IDDM is transmitted less frequently to the offspring of diabetic women than to those of diabetic men. More study is required to determine whether this difference reflects a genetic mechanism or, instead, selective perinatal loss of the affected offspring of diabetic mothers.

Adult↗
PubMed1984

Lymphadenopathy associated virus infection of a blood donor--recipient pair with acquired immunodeficiency syndrome.

A retrovirus isolated from three patients with the acquired immunodeficiency syndrome (AIDS) in the United States was morphologically and antigenically identical to lymphadenopathy associated virus isolated in France. Two of these isolates were from a blood donor-recipient pair, each of whom developed AIDS. Lymphadenopathy associated virus was isolated from the blood donor's lymphocytes 12 months after his onset of AIDS symptoms and from the blood recipient's lymphocytes 1 month after her onset of AIDS symptoms. Two isolates from the blood donor-recipient pair and an isolate from an epidemiologically unrelated homosexual man were examined by competitive radioimmunoassay to determine their antigenic relatedness to each other and to other human retroviruses. The major core proteins (p25) of the isolates were antigenically identical and all three isolates were identical to prototype lymphadenopathy associated virus isolated in France.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The relation of cytomegalovirus and Epstein-Barr virus antibodies to T-cell subsets in homosexually active men.

Eighty-nine homosexual men participated in a study of sexual practices, T-cell subsets, and antibody titers to cytomegalovirus (CMV) and Epstein-Barr virus (EBV). The prevalence of antibody to CMV was 96% and to EBV, 94%. Titers to CMV were higher in those practicing receptive anal intercourse. The CMV antibody titers were positively correlated with the T-helper/suppressor ratio, number of partners and venereal disease episodes, number of T-suppressor cells, and EBV titers. Twelve percent of the participants had a low ratio only, 18% T-suppressor augmentation, and 3% T-helper deficiency. The CMV titer and prevalence of receptive anal intercourse were higher in those with a low ratio only, T-suppressor augmentation, and T-helper deficiency. These results suggest that CMV infection is acquired through receptive anal intercourse and is associated with an increase in T-suppressor cells and, in some persons, a decrease in T-helper cells.

Adult↗
PubMed1984

HLA studies in acquired immune deficiency syndrome patients with Kaposi's sarcoma.

To investigate the possible contribution of genetic susceptibility to Kaposi's sarcoma associated with acquired immune deficiency syndrome (AIDS-KS), 21 patients were typed for HLA-A, B, C, and DR antigens. Significantly increased frequencies of HLA-Aw23, and HLA-Bw49 antigens were observed in the Caucasian AIDS-KS group. In this same group, the frequencies of HLA-DR5 and HLA-Bw44 antigens were increased at the P less than 0.1 level. Increased frequencies of HLA-A29 and HLA-Cw4 antigens and a decreased frequency of HLA-B8 antigen were also noted, but with P greater than 0.1, in the Caucasian AIDS-KS group.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Recombinant alpha-2 interferon therapy for Kaposi's sarcoma associated with the acquired immunodeficiency syndrome.

In a randomized prospective study we tested the toxicity and efficacy of recombinant alpha-2 interferon in the treatment of Kaposi's sarcoma associated with the acquired immunodeficiency syndrome. High doses (50 X 10(6) U/m2 body surface area, intravenously) or low doses (1 X 10(6) U/m2, subcutaneously) of recombinant alpha-2 interferon were administered to 20 patients for 5 days/wk, every other week, for four treatment cycles. Therapy was well tolerated subjectively and caused only mild hematologic and hepatic toxicity at both dose levels. No consistent or sustained changes were seen in immunologic variables during or after treatment. Six patients with Kaposi's sarcoma, four at high dose and two at low dose, had objective responses (complete or partial) to treatment. However, therapy did not appear to eradicate cytomegalovirus carriage or prevent opportunistic infections related to cytomegalovirus.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Relation between sexual practices and T-cell subsets in homosexually active men.

27% of 89 young, non-ill, homosexually active men in Los Angeles had a Leu-3(OKT4)/Leu-2(OKT8) ratio less than or equal to 0 . 8. The low ratio was due to a significantly raised mean number of Leu-2 cells, whereas individuals with acquired immune deficiency syndrome had a decrease in both Leu-3 and Leu-2 cells. The term "acquired immune augmentation" may be appropriate for those with a low ratio due to raised numbers of Leu-2 cells. Those practising passive (receptive) anal intercourse had a significantly higher mean number of Leu-2 cells than did those practising only active (insertive) anal intercourse or no anal intercourse. The results of this study suggest that two distinct conditions occur in homosexually active men. Whether acquired immune augmentation is a precursor of the rarer acquired immune deficiency syndrome or is an unrelated disorder needs to be determined. In this study passive anal intercourse was associated with acquired immune augmentation.

Acquired Immunodeficiency Syndrome↗
PubMed1983

CNS toxoplasmosis in acquired immunodeficiency syndrome.

Several distinct patterns of neurological involvement occur in epidemic acquired immune deficiency syndrome (AIDS). Two patients with this disorder had Toxoplasma gondii encephalitis, one suspected and one proved. Computed tomographic (CT) scanning showed focal lesions in both patients. Spinal fluids were remarkable for elevated protein, hypoglycorrhachia, and absence of pleocytosis. In patients with AIDS, focal CT scan findings and serum indication of past T gondii infection should prompt strong consideration of the diagnosis of CNS toxoplasmosis. The absence of specific IgM antibody or rise in IgG antibody titer to T gondii does not exclude this condition in the immune compromised host. In the patient with AIDS, CNS lesions mimicking brain abscess warrant biopsy or empiric therapy for T gondii. Early recognition and initiation of a prolonged or indefinite course of pyrimethamine plus sulfonamide therapy could reduce the mortality associated with this infection in AIDS. Computed tomographic scans, repeated frequently, appear, at present, to be the best guide to monitor the status of CNS involvement.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Immunoregulatory T cells in men with a new acquired immunodeficiency syndrome.

We have evaluated the functional properties of the OK-T8+/OKT4+ T-cell subpopulations in nine patients with a new syndrome of acquired immune deficiency (AIDS). Despite polyclonal hypergammaglobulinemia in the sera of these patients, their peripheral blood lymphocytes (PBL) produced negligible quantities of immunoglobulin (Ig) when cultured in vitro for 8 days in the presence of pokeweed mitogen (PWM). Patient B cells, however, synthesized normal quantities of immunoglobulin when cocultured with T cells from healthy donors, indicating preservation of B-cell function. Unfractionated PBL or T cells of patient origin mediated marked suppression of pokeweed mitogen-driven immunoglobulin production by T and B cells from healthy donors. The suppressive activity was contained within the population of T cells bearing the OKT8 antigen and was sensitive to in vitro irradiation. On a per-cell basis, patient OKT8+ cells appeared to have greater suppressive activity than normal control OKT8+ cells. In addition, OKT4+ cells from patients had less helper activity for induction of immunoglobulin synthesis than control OKT4+ cells. Increased T suppression and reduced T help are probably a consequence of one or more viral infections and may contribute to progressive immune deficiency and susceptibility to malignancy in patients with the acquired immuno deficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Serial changes in markers of disease activity with corticosteroid treatment in sarcoidosis.

Serial changes in various markers of disease activity with corticosteroid therapy were assessed in 12 patients with active sarcoidosis. After six weeks of treatment with 40 mg daily of prednisone, all but one patient demonstrated symptomatic and radiographic improvement. For the entire patient group, there were corresponding improvements in forced vital capacity, from 59.2 +/- 5.5 to 70.5 +/- 5.3 percent of the predicted value (p less than 0.001, Student paired t test), serum angiotensin-converting enzyme levels, from 66.0 +/- 12.1 to 28.2 +/- 4.0 U/ml (p = 0.003), 67gallium lung scanning scores, from 3.6 +/- 0.2 to 0.8 +/- 0.3 (p less than 0.001), serum gamma globulin levels, from 2.40 +/- 0.2 to 1.5 +/- 0.1 g/dl (p less than 0.001), and erythrocyte sedimentation rate, from 26.8 +/- 2.7 to 14.8 +/- 3.0 mm per hour (p less than 0.001). Changes in percent of bronchoalveolar lavage fluid lymphocytes were less impressive (from 28.7 +/- 4.9 to 21.2 +/- 5.1, p = 0.034), but the geometric mean number of bronchoalveolar lavage fluid-IgG-secreting cells decreased from 23,861 to 3,830 (p = 0.013). Serial evaluations in five patients treated with decreasing doses of alternate-day prednisone for an additional 10 1/2 months indicated that changes in 67gallium lung scanning scores corresponded most closely to the clinical course in five of five patients. Determination of serum angiotensin-converting enzyme levels also closely paralleled the clinical course in four of five patients, whereas the other parameters measured were more variable markers of clinical response. However, abnormalities of bronchoalveolar lavage fluid-IgG-secreting cells often persisted in the absence of clinically evident disease, and the percentages of bronchoalveolar lavage fluid lymphocytes were frequently normal in patients who responded subsequently to corticosteroids. Larger prospective studies are warranted to more extensively evaluate various measurements of disease activity, especially bronchoalveolar lavage fluid analysis, in sarcoidosis.

Adult↗
PubMed1983

Immunological studies of homosexual men with immunodeficiency and Kaposi's sarcoma.

Acquired immunodeficiency and Kaposi's sarcoma are epidemic among homosexual men in the United States. We have identified three clinically distinct disease syndromes in homosexually active men: a syndrome of severe cellular immunodeficiency including infection with Pneumocystis carinii and other opportunistic pathogens, a syndrome of chronic benign lymphadenopathy without severe opportunistic infections, and Kaposi's sarcoma. All 46 patients which we have studied with these three disease syndromes shared a common immune abnormality, that being a reduction in the circulating T-lymphocyte subpopulation bearing the Leu-3/OKT-4 antigen. The second major T-lymphocyte subpopulation, which bears the Leu-2/OKT-8 antigen, was numerically normal in all the disease syndromes, but increased as a percentage of all circulating lymphocytes. These abnormalities resulted in an inversion of the normal ratio of these two lymphocyte subpopulations. A similar, but less pronounced imbalance in circulating T-lymphocyte subpopulations was observed in a group of healthy homosexual men. The immune deficiency in these patients was most evident in the T-cell component of the immune system. Percentages of B cells, circulating immunoglobulin levels, and natural killer (NK) and antibody-dependent cell-mediated cytoxic (ADCC) functions were normal. Proliferative responses to antigen and mitogen were typically decreased in patients with the acquired immunodeficiency syndrome and some Kaposi's sarcoma patients, but not those with the prolonged lymphadenopathy syndrome or a control group of healthy homosexual men. Possible causes or factors contributing to the immunodeficiency and interrelationships among the three disease manifestations are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Acquired immune deficiency syndrome. Ocular manifestations.

The acquired immune deficiency syndrome (AIDS) is a recently described disorder of cellular immunity in homosexuals, intravenous drug abusers, and Haitians. Manifestations include Kaposi's sarcoma, Pneumocystis carinii pneumonia, and other opportunistic infections. Ophthalmic and autopsy examinations of 30 patients at UCLA revealed frequent ocular abnormalities. Findings included cotton-wool spots (16 patients), cytomegalovirus retinitis (eight patients), conjunctivitis and keratitis (four patients), conjunctival Kaposi's sarcoma (three patients), Mycobacterium avium intracellulare choroidal granulomas (one patient), and retinal periphlebitis (one patient). We feel that the presence of cotton-wool spots in patients with this syndrome indicates a poor prognosis. Immunologic and electronmicroscopic studies of cotton-wool spots revealed no infectious agents or immunoglobulin deposition. Cytomegalovirus retinitis always was associated with a fatal outcome. The retinitis was characterized by an acute inflammatory reaction in 50% of patients. Ophthalmologists should be aware of the syndrome and its ocular manifestations.

Acquired Immunodeficiency Syndrome↗