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Biomedical subjects

P M Burkholder

Publications and source records attributed to P M Burkholder.

At least 19 recordsLinked to original sources
PubMed1986

Immunopathology of renal disease.

The reviewed information implicates immune mechanisms in a variety of renal glomerular and tubulointerstitial diseases. Antibodies reactive with intrinsic structural or planted endogenous or exogenous antigens, and with circulating endogenous or exogenous antigens can initiate inflammatory capillary injury by localization in glomerular capillary tufts or along tubular basement membranes. This results in activation of mediator systems, including complement, neutrophils and other leukocytes, amines, peptides, and proteases, which result in vascular and tissue alterations. In some instances, nonimmune activation of complement (for instance, by the properdin system) and other mediators of vascular injury may be involved. A role of cellularly mediated immunologic injury in glomerular disease is not clear and remains the subject of considerable current research. More clearly, there is involvement of lymphocytes in tubulointerstitial and interstitial diseases as well as allograft rejection reactions. A rich armamentarium of in-vitro immunologic tests for specific antibodies, immune-complexes, serum complement levels, and renal tissue analysis provides opportunity for enhanced precision of diagnosis and monitoring progress of disease or treatment. Unfortunately, at the present time, there are not many effective therapies specific for most renal glomerular diseases; perhaps in the future better identification of offending environmental or host antigens will result in more effective prevention and treatment. Application of knowledge concerning renal glomerular diseases to the study of hypersensitivity induced tubulointerstitial injury has resulted in increasing understanding of the pathogenesis of interstitial inflammatory disease of the kidney.

Amines↗
PubMed1981

Glomerular disease in captive galagos.

A captive colony of galagos that for several years lived under poor housing conditions and suffered a variety of chronic illnesses showed a high incidence of renal glomerular disease. Several patterns of glomerular disease were seen: four types of proliferative lesions included a mild stalk glomerulitis, more severe stalk-lobular proliferative glomerulonephritis, diffuse proliferative glomerulonephritis, diffuse proliferative glomerulonephritis, and diffuse proliferative and sclerotic glomerulonephritis; and a form of glomerular capillary basement membrane thickening. Glomerular localization of immunoglobulin and the third component of complement as well as some unusual ultrastructural observations in diffuse proliferative and sclerotic glomerulonephritis suggest an immunopathogenesis for this disease.

Animals↗
PubMed1980

Clinicopathologic, enzymatic, and genetic features in a case of Fabry's disease.

We report renal lesions and functional alterations in a 32-year-old man with Fabry's disease (ceramidetrihexosidase deficiency). By light microscopy of a renal biopsy specimen, distinctive "foamy" cytoplasmic alterations were observed in renal glomerular, tubular, vascular, and interstitial cells. Histochemical analysis of vacuolated epithelial cells showed glycolipid- and phospholipid-like material. Ultrastructurally, dense osmiophilic as well as stacked and concentric laminated profiles were observed within these epithelial cells. In addition, glomerular endocapillary, parietal, and vascular epithelial cells contained opaque osmiophilic granular deposits with paracrystalline arrays. Renal function studies indicated a glomerular filtration rate of 86.1 mL/min/1.73 sq m, effective renal plasma flow of 415 mL/min/1.73 sq m, tubular reabsorption of glucose of 356 mg/min/100 glomerular filtration rate, and maximal urinary concentrating and diluting ability of 568 and 46 mOsm/kg, respectively. Serum ceramide hexosidase activity was 0.18 nmole/hr/mL (normal, 8 to 15). We conclude that renal dysfunction associated with Fabry's disease is associated mainly with accumulation of glycolipid and phospholipid compounds in the walls of blood vessels and distal nephrons.

Adult↗
PubMed1980

Vasculitis in Goodpasture's syndrome.

Because of differing diagnostic criteria, a controversy exists as to whether vasculitis may occur in patients with Goodpasture's syndrome. Using strict criteria (pulmonary hemorrhage, glomerulonephritis, and antiglomerular basement membrane antibody), we found histological evidence of vasculitis in two of 18 patients with Goodpasture's syndrome. The vasculitis was found in kidney biopsy specimens. Clinically, these two patients did not differ from other patients who have Goodpasture's syndrome without vasculitis. The presence of vasculitis should not exclude the diagnosis of Goodpasture's syndrome.

Adolescent↗
PubMed1979

Culture of human glomerular cells.

Human glomeruli were routinely cultured in Waymouth's medium supplemented with insulin and conditioned medium. Three cell types were seen in the culture of both adult and infant kidneys, but the morphology of the glomerular cellular outgrowths depended on the age of the patient from which the kidney was obtained. Cultures of glomeruli from older individuals resulted in more "differentiated" cells, but both adult and infant glomerular cells rapidly became "dedifferentiated" as the length of time in culture increased. Outgrowths of cultured glomeruli did not contain fibroblasts or tubular cells. Finally, synthesis of basement membrane material by these cultured glomerular cells was demonstrated.

Adult↗
PubMed1978

Pressure-flow relationships and pathological changes during renal preservation.

The renal pedicle of one kidney from each of four dogs was ligated for one hour. The contralateral kidney served as a control. Both kidneys were removed and perfused using the "Belzer" technique. Pressure-flow relationships were determined and biopsy samples taken. The vasculature was then injected with silicone rubber. Perfusion resistance, vascular filling with silicone rubber and observations made by electron microscopy were compared.

Animals↗
PubMed1978

Myocardial infarct in a child with systemic lupus erythematosus.

An unusual case of systemic lupus erythematosus (SLE) in a young child is reported with sudden death from myocardial infarction. The diagnosis of lupus erythematosus in this patient was made by renal biopsy at the age of 3 years. Atherosclerosis of the coronary arteries and aorta was found at autopsy with occlusion of the anterior descending branch of the left coronary artery. It is suggested that the vascular changes in this case were related to hypertriglyceridemia and prolonged prednisone therapy superimposed on a hypersensitivity vasculitis related to SLE.

Child, Preschool↗
PubMed1978

Cadmium, a metallic inhibitor of antibody-mediated immunity in mice.

Chronic administration of cadmium chloride to B10-A-2R mice was discovered to severely depress the numbers and to delay the onset of appearance of splenic IgG and IgM plaque-forming cells (PFC) following injection of sheep erythrocytes. A recovery period of at least 1 month following cessation of administration of CdCl2 resulted in no increase in IgM PFC and only a minimal increase in IgG PFC. An apparent cadmium-induced splenomegaly was also noted in the intoxicated mice. Application of immune adherence and rosetting techniques as well as immunofluorescence to study the cellular morphology of these spleens indicated that the cell type most responsible for the increased spleen size had Fc and complement receptors as well as surface or cytoplasmic immunoglobulins. Populations of polymorphs and macrophages were not found to significantly contribute to the hyperplasia observed.

Animals↗
PubMed1978

Enumeration and ultrastructure of C4-producing free alveolar cells from guinea pig lung.

Free alveolar cells from guinea pig lung producing the fourth emoponent of C (C4) were identified, enumerated, and characterized by using anti-C4 Fab-peroxidase conjugates in conjunction with transmission electron microscopy. The C4-producing cell population consisted of: 1) alveolar macrophages (AM); 2) less well differentiated phagocytes similar in morphology to exudate macrophages; and 3) weakly phagocytic secretory cells with numerous profiles of rough-surfaced endoplasmic reticulum (ER). Internal immunolabeling allowed the visualization of C4 in the ER, perinuclear space, and Golgi complex of producer cells and its release at cell surfaces; synthesis of C4 in vitro was sensitive to inhibitors both of protein synthesis and messenger RNA function. The percentage of free alveolar cells from normal animals competent for C4 production as indicated by cell surface immunolabeling was approximately 1% of the total cells obtained by lavage. Transnasal infection with Listeria monocytogenes, generation of a pulmonary granulomatous reaction by i.v. injection of heat-killed BCG, and aerosol infection of nonvaccinated animals with Myco-bacterium tuberculsois each resulted in an increase in numbers of AM and exudate macrophage-like free alveolar cells competent for C4-production.

Animals↗
PubMed1977

Immunohistologic features of minimal-change nephrotic syndrome.

To assess the role of immune mechanisms in the pathogenesis of minimal-change nephrotic syndrome (MCNS), immunohistologic studies were performed on renal biopsy specimens from 31 patients. Glomerular immunoglobulin and/or complement (C3) deposition was present in 20 specimens. Deposits were usually minimal to moderate, granular, and focal in nature. IgM was present in 17 specimens, C3 in 10, IgG in 8 and IgA in only 3. With a mean follow-up of 5 1/2 years, there is no difference in the response to therapy of patients with no glomerular immunoglobulin or C3, those with glomerular immunoglobulin without C3, and those with glomerular C3. These findings indicate that glomerular immune deposits can be seen in a substantial percentage of patients with MCNS, but the minimal and focal nature of the deposits and lack of correlation with response to therapy suggest that immunoglobulin and C3 deposits are nonspecific and have no pathogenetic role.

Adolescent↗
PubMed1977

Immune adherence in renal glomeruli. Complement receptor sites on glomerular capillary epithelial cells.

Several very recent reports have indicated the presence of receptor sites for the third component of complement in human but not other vertebrate renal glomeruli. The present study constitutes a demonstration that the glomerular capillary epithelial cell bears this receptor, detectable with either EAC complexes (EAC1423b) or fluores ceinated zymosan-C3 (ZC3b) complexes, Fresh, unfixed frozen sections of normal or diseased human kidneys, mechanically isolated human glomeruli, dissociated glomerular cells, and glomeruli and golmerular cells maintained in tissue culture were examined with various EAC complexes or ZC3b and examined by phase light microscopy, fluorescence microscopy, or transmission and scanning electron microscopy. Clearly, by scanning electron microscopy it was determined that glomerular capillary epithelial cells bind the immune-adherence EAC indicator cells. Because glomeruli or glomerular epithelial cells did not bind E, EA, EACI, EAC14, or EAC142 but did bind EAC1423b or ZC3b, it is concluded that C3b (activated bound fragment of the third component of complement) is responsible for the immune-adherence reaction in glomeruli. Preliminary examination of diseased renal biopsies indicates that sclerotic glomeruli, focal segmental sclerotic or proliferative glomerular capillary lesions, and proliferative epithelial crescents are immune-adherence negative. Furthermore, a clear or consistent inverse relationship between glomerular capillary deposits of C3 which presumably might block epithelial C3 receptor sites, and immune-adherence reactivity with EAC in vitro was not as evident in this study as reported previously by other investigators. Nevertheless, it is still attractive to conceive that glomerular C3 receptor sites might be responsible for binding of antigen-antibody-complement complexes and formation of immune-complex deposits, at least on the epimembranous (subepithelial) surface of glomerular capillary walls. Inability to demonstrate this immune-adherence phenomenon in glomeruli of other vertebrate animals suggests among other things that more investigation is necessary before ascribing a unique or universal significance to the C3 receptors identified in human glomeruli.

Animals↗