Biomedical subjects

R Patterson

Publications and source records attributed to R Patterson.

At least 577 records · Page 32Linked to original sources

PubMed1976

The corticosteroid dose graph. Use in determination of corticosteroid requirements, characterization of patients, and prevention of seasonal exacerbation in corticosteroid-dependent patients.

Sixty-three corticosteroid(CS)-dependent asthmatics were evaluated by a method which records asthmatic exacerbations as a function of change in CS dosage. This method, the Corticosteroid Dose Graph (CSDG), is a graphic representation of the patients' narrative charts. It is useful in assessing and directing the care of these patients and in evaluating the efficacy of altered therapeutic regimens in asthmatics. The CSDG categorizes cooperative patients (CP) and distinguishes these patients from those who are less cooperative (LCP). Evaluation of the progress of CP by the graphic analysis system showed that CP have fewer severe exacerbations of asthma than LCPs. Evaluation of the 63 patients by this graphic method shows a significantly increased incidence of asthmatic exacerbations in the Chicago area in October as compared to other months. The CSDG also demonstrates that some individuals experienced significantly increased numbers of asthma exacerbations at certain times of the year unique to themselves. Because the CSDG predicts exacerbations, it was shown to be applicable to prevent such exacerbations by prophylactic increase in CS dose during a high-risk season for selected CS-dependent asthmatics.

Adolescent↗

PubMed1976

Hyperimmunoglobulinemia E in a child with allergic bronchopulmonary aspergillosis and bronchiectasis.

A 12-year-old boy was hospitalized for resection of a bronchiectatic lesion. Investigation of an elevated cencentration of serum IgE led to a diagnosis of allergic bronchopulmonary aspergillosis. ABPA has rarely been described in the pediatric age group. This hypersensitivity lung disease is characterized by intermittent wheezing, fever, recurrent pulmonary infiltrates, eosinophilia, hyperimmunoglobulinemia E, and Type I (allergic) skin reactivity to aspergillus extract. Hyphae of aspergillus may also be found in expectorated brown mucus plugs. Type III (Arthus) skin test response and presence of precipitating antibody to this fungus may be demonstrated. Central bronchiectasis or pulmonary fibrosis may result from uncontrolled progression of this disease.

Aspergillosis↗

PubMed1976

Pigeon breeder's disease. II. Pigeon antigen induced proliferation of lymphocytes from symptomatic and asymptomatic subjects.

Lymphocyte reactivity to pigeon antigens was demonstrated in a patient with severe symptomatic pigeon breeder's disease (PBD). The reactivity of the lymphocytes declined subsequent to cessation of exposure to antigen and in parallel with clinical improvement. Lymphocyte reactivity was also demonstrated in another patient with PBD, in a pigeon breeder with no evidence of PBD, and in a laboratory investigator with a history of exposure to birds other than pigeons. Lymphocyte reactivity in the latter subject increased following cutaneous injection of pigeon serum with the development of delayed-type cutaneous reactivity. Although lymphocyte reactivity to pigeon antigens may be a necessary immunologic feature for production of PBD, this reactivity does not occur only in symptomatic subjects.

Animals↗

PubMed1976

Chronic hypersensitivity lung disease with recurrent episodes of hypersensitivity pneumonitis due to a contaminated central humidifer.

A child with a 4-year history of acute and chronic respiratory symptoms of unknown aetiology was investigated for hypersensitivity pneumonitis. Lung disease due to inhalation of material from a contaminated central humidifier was suggested by the clinical history, the presence of precipitating antibodies in the serum against the humidifier water, a pulmonary response to challenge with the humidifier water, and marked improvement after removal of the humidifier. No fungi were cultured from the humidifier nor were antibodies against a number of fungal antigens identified by radioimmunoassay inhibition techniques. Antigenic material was found in the humidifier water and the household water prior to its reaching the humidifier. This antigenic material was not found in laboratory tap water supplied from the same general source (Lake Michigan) but from a different pumping station. Three of the child's siblings gave histories suggestive of a single concurrent episode of acute hypersensitivity pneumonitis and one sibling had a history suggestive of chronic hypersensitivity lung disease. No association could be found between HLA-haplotypy and disease in the patient and the siblings.

Alveolitis, Extrinsic Allergic↗

PubMed1976

Immunoglobulin E in renal disease.

Samples of renal tissue from 373 patients were examined for the presence of immunoglobulin E (IgE) by immunofluorescent techniques. Only trace to ++ amounts ( on a scale of ++++) were found in 20 patients: 4/9 with post-streptococcal acute glomerulonephritis (GN), 5/30 with GN associated with systemic lupus erythematosus, 3/20 with membranous GN, 1/4 with Goodpasture's syndrome, 2/18 with recurrent microhematuria and focal GN, 1/5 with hemolytic anemia and uremia, 3/73 with renal homografts, and 1/5 with dermatomyositis. No IgE was found in 18 patients with lipoid nephrosis, 8 of whom were being treated with prednisone, nor in 5 patients with focal glomerular sclerosis and the nephrotic syndrome. Serum IgE was measured in 9 of the 20 patients with glomerular deposits of this globulin. With one exception, levels of IgE were within the range generally considered to be normal. However, they were greater than the mean of this range in all but two and near the highest limits of normal in most. Neither the amounts of serum IgE nor the degree of proteinuria could be related to the intensity of stain for IgE in the glomeruli of these patients.

Adolescent↗

PubMed1976

Effect of D2O on phytohemagglutinin-induced lymphocyte proliferation.

The effect of D2O on phytohemagglutinin (PHA)-induced proliferation of human lymphocytes in vitro was examined. A significant dose-dependent inhibition of the lymphocyte reactivity by D2O was observed. This inhibition did not require the simultaneous presence of D2O and PHA in the cultures. Both cytotoxic and cytostatic mechanisms for this inhibition are implicated.

Deuterium↗

PubMed1976

Antibodies of different immunoglobulin classes against antigens causing farmer's lung.

A solid phase radioimmunoassay technique was used to demonstrate antibodies of various immunoglobulin classes in sera against farmer's lung antigens. IgG, IgA, and IgM antibody activity in normal patients and in patients with farmer's lung were detected against Micropolyspora faeni. Only the IgG and IgA antibody activity was different in farmers and in control subjects. An asymptomatic subject could not be differentiated from symptomatic farmers by IgG antibody activity. No IgE antibody activity was detected. The radioimmunoassay technique can be used to show antibody activity against carbohydrate antigens and as a method of evaluation of antigens by inhibition analysis. Certain types of hypersensitivity lung disease can be discriminated by in vitro analysis of serum antibody of various immunoglobulin classes. This is apparent for IgE and possibly true for IgM.

Adult↗

PubMed1976

Reagin-mediated asthma in rhesus monkeys and relation to bronchial cell histamine release and airway reactivity to carbocholine.

Rhesus monkeys with persistent immediate-type cutaneous and respiratory responses (RR) to ascaris antigen (AA) were compared with rhesus monkeys with skin reactivity and no respiratory responses, and animals with no skin reactivity and no respiratory responses to inhaled antigen (NR). The RR group could not be distinguished from the nonresponding (NR) group by the cutaneous skin test titers, serum, or respiratory secretion IgE concentration. Leukocyte histamine (H) release due to anti-IgE was similar with peripheral blood leukocytes and bronchial lumen mast cells (MC) from RR and NR animals. The RR group of animals could be distinguished from the NR group by their degree of sensitivity to inhaled carbocholine and H release from respiratory MC exposed to AA. The RR group demonstrates consistent, persistent respiratory responses suitable for immunologic, pharmacologic, and physiologic studies. Finally, it was found that the IgE concentration in respiratory secretions of rhesus monkeys was comparatively higher than in serum, evidence for IgE as a secretory Ig in the respiratory tract of this species.

Aerosols↗

PubMed1976

The prevalence of tuberculosis and positive tuberculin skin tests in a steroid-treated asthmatic population.

The prevalence of active tuberculosis and positive tuberculin skin tests was assessed in 132 corticosteroid-treated asthmatics for an evaluation period that represented 620 corticosteroid-years of therapy. There was no evidence of active tuberculosis in any of these patients. Positive intermediate-strength tuberculin tests were present in 28% of patients and correlated with increased age. In patients treated with daily corticosteroids, tuberculin negativity was associated with a higher dose of corticosteroids. Positive second-strength tuberculin tests were found in 42.3% of the patients with negative intermediate-strength tests and also correlated with increased age. Based on these data as well as the prevalence of significant liver disease in older patients receiving isoniazid (INH), routine INH chemoprophylaxis for corticosteroid-treated asthmatic patients, regardless of their tuberculin cutaneous reactivity, is not indicated.

Adolescent↗

PubMed1976

IgE-mediated histamine and SRS-A release from respiratory cells and peripheral blood leukocytes of rhesus monkeys.

Peripheral blood leukocytes (PBL) and free respiratory cells (RC) of the mast cell-basophil type were obtained from normal rhesus monkeys or rhesus monkeys with defined immediate-type hypersensitivity to ascaris antigen (AA). PBL or RC from the latter were exposed to AA and the former were exposed to anti-IgE. Histamine (H) release and release of a slow reacting substance of anaphylaxis (SRS-A) occurred following exposure of the appropriate cells to AA or anti-IgE. The release of both H and SRS-A from PBL was potentiated by D2O. D2O did not potentiate release of SRS-A or H from RC due to anti-IgE to the same extent. Although potentiation of H release from RC due to AA was observed in the presence of D2O in some individual animals, this could not be demonstrated by statistical analysis of group results. We could not demonstrate potentiation of SRS-A release from RC due to anti-IgE or AA. The results suggest the possibility that there may be differences in antigen reactive cells of the respiratory tree and peripheral blood and biochemical studies may be of use in demonstrating these differences.

Animals↗

PubMed1976

Peripheral blood B-lymphocyte abnormalities associated with hyperthyroidism of Graves' disease.

Proportions of peripheral blood thymus-derived T lymphocytes (T cells) and bone-marrow-derived B-lymphocytes (B cells) were studied in twelve hyperthyroid patients and ninety-nine non-hyperthyroid control subjects including thirty-nine healthy individuals and sixty patients with various disorders. All hyperthyroid patients had Graves' disease and eight were untreated. The sheep erythrocyte (E)-rosetting technique was employed for enumeration of T cells and the immunofluorescent technique was used for identification of lymphocytes with surface immunoglobulins (SIg), a marker for B cells. The results showed that hyperthyroid patients had higher percentages of lymphocytes stainable for SIg, whereas their T-cell proportions were the same as our control values. In addition, approximately half or more of the fluorescein stainable lymphocytes reacted with each of the five antisera against individual heavy chain determinants, including the epsilon chain, indicating the presence of more than three Ig determinants on the same cell. The fluorescein-stainable cells did not form E rosettes. Blocking of the Fc receptor on lymphocytes by incubating the patients' cells with heat-aggregated human IgG or heated goat anti-bovine serum albumin (anti-BSA) failed to abolish the subsequent fluorescent staining of the cells. Incubation of patients' lymphocytes with non-fluorescent anti-epsilon inhibited the subsequent staining of cells with fluoresceinated anti-epsilon but not staining with fluoresceinated anti-mu or anti-gamma. Thus, the study revealed B-cell abnormalities associated with hyperthyroidism, manifested by the simultaneous presence of multiple Ig classes, including IgE, on a single B cell. Results of studies of incubation of the patients' plasmas with lymphocytes from health individuals and studies of SIg by overnight culture of the patients' lymphocytes with or without prior trypsinization suggested that the SIg was generated endogenously by the cell on which it resided.

Adult↗

PubMed1976

The effect of cholinergic and anticholinergic agents on the primate model of allergic asthma.

Rhesus monkeys with reagin-mediated, immediate-type respiratory responses to ascaris antigen were used for comparison with the type of responses that occur from certain pharmacologic agents. Carbacholine produces a respiratory response that is the same type as an antigen-induced respiratory response and will sensitize an animal's airway so that a dose of antigen not reactive alone will stimulate a response. Antigen and histamine will sensitize the airway so that a subthreshold dose of carbacholine will produce a respiratory response. Atropine completely inhibited the carbacholine response and reversed the increased sensitivity to carbacholine that occurs after an antigen response. Atropine did not block the antigen-induced respiratory response or the respiratory response to prostagladin F2alpha. Partial inhibition of these responses may have occurred but was not detected in the systems used in these studies. A double-antigen challenge system in the rhesus model of asthma provides a useful technique for evaluating the effect of pharmacologic agents on the reagin-mediated respiratory response.

Airway Resistance↗

PubMed1976

A comparison of immunologic asthma to two types of cholinergic respiratory responses in the rhesus monkey.

Rhesus monkeys were used to characterize the respiratory response (RR) to aerosolized physostigmine (Phy) and compare the response to the acute, reagin-mediated RR and the carbachol response. In the latter two responses, there are characteristic increases in frequency of respiration (f), pulmonary resistance (PR), and decreases in peak expiratory flow rate (PEFR), tidal volume (TV), and dynamic compliance (C). In contrast, a Phy RR characteristically shows no change in TV and f. The Phy RR is inhibited by atropine and lidocaine. The carbachol RR is inhibited by atropine but not lidocaine. The Phy RR mimics a vagally induced RR more closely than carbachol because it is inhibited by pharmacologic and physiologic vagal blockade produced by atropine and lidocaine, respectively, whereas the carbachol RR is blocked by atropine but not lidocaine. The carbachol block by atropine is primarily not a block of vagal action, but a general pharmacologic block of cholinergic action. The reagin-mediated RR is not inhibited by pharmacologic or physiologic vagal blockade. We conclude that a Phy-induced vagomimetic RR differs from a reagin-mediated, immediate-type RR. Although a minor portion, at most, of a reagin-mediated, immediate-type RR may be mediated via the vagus nerve, the major portion of a reagin-mediated RR occurs independent of the influences of the parasympathetic innervation of the lung.

Acetylcholine↗

PubMed1976

Histamine-containing cells in bronchial lavage fluid. I. Ultrastructural characterization and comparison with mast cells in three types of tissues of rhesus monkeys.

We have studied the ultrastructure of histamine-containing cells in the bronchial lavage of normal rhesus monkeys. These cells were recognized by the similarities of their specific cytoplasmic granules to those in tissue mast cells and basophilic leukocytes of other species. According to cell shape, two forms of bronchial lavage histamine-containing cells (BL-HCC) were observed. One was round and small, and the other pleomorphic and large. However, the subcellular structures, especially the specific cytoplasmic granules, were identical for both forms of HCC. With available evidence, we now consider both types of BL-HCC to be one cell species. The difference in cell shape may be an inherent variation within this cell population, or a reflection of the maturity of individual cells. Most BL-HCC had long slender pseudopods, and the majority of them were mononucleated. Some HCC appeared binucleated; multinucleated cells were not encountered. The ultrastructure of mast cells, in tissue fragments biopsied from three sites, was in many ways similar to that of BL-HCC, but there were clear morphological dissimilarities between these two cell groups. It is unlikely that tissue mast cells are the direct precursors of BL-HCC. Attempts to compare BL-HCC with blood basophilic leukocytes were unsuccessful due to the failure to detect the latter in monkey peripheral blood with electron microscopy in the present study. The possible origin of BL-HCC is discussed.

Animals↗

PubMed1976

In vitro production of IgE by human peripheral blood lymphocytes: effect of cholera toxin and beta adrenergic stimulation.

Peripheral blood lymphocytes from two human donors with elevated serum IgE concentrations were maintained in short term tissue culture preparations. Repeated culture preparations demonstrated that IgE was produced in vitro in amounts that could be measured by the double antibody radioimmunoassay technique. The amount of IgE produced by replicate cultures of cells from a single bleeding of the donor was similar when the cultures were simultaneously prepared. In contrast, IgE production by the same donor's lymphocytes varied when the culture preparations were initiated from separate bleedings. The results of simultaneous cultures of a single bleeding were sufficiently consistent to provide a means of testing the effect of pharmacologic agents on the in vitro production of IgE. Cholera toxin effected a marked reduction in production of IgE by lymphocytes of both cell donors. Isoproterenol showed marked inhibition of IgE production at 10(-3) M but cell viability studies suggested that this may have been due to decreased cell viability. At lower, nontoxic concentrations of isoproterenol (10(-4) M-10(-6) M) slight but definite inhibition of in vitro IgE production was evident. This inhibition was more pronounced subsequent to the first 24 hr of exposure of the cells to isoproterenol.

Cell Survival↗

PubMed1976

Pigeon breeders disease. III. A study of a family exposed to doves.

A family of five individuals exposed to doves in their home were studied to evaluate possible factors leading to sympotmatic hypersensitivity pneumonitis documented in one member of the family, while the other exposed members remained asymptomatic. Antbodies against pigeon serum were domenstrated by radioimmunoassay in all subjects, and significant lymphocyte reactivity against pigeon antigens was demonstrable in three of the five members. The presence of serum antibody activity or lymphocyte reactivity against avian antigens or both did not differentiate the sick from the well family subjects. However, the possibility that increased exposure to antigen may correlate with higher degrees of antibody and lymphocyte reactivity as well as clinical disease is suggested from observation made in this family. No correlation was found between HL-A type and either symptomatic disease or immunological reactivity in these subjects.

Adolescent↗

PubMed1976

Uptake and catabolism of antigen by alvelar macrophages of dogs with respiratory hypersensitivity. Processing of antigen by alveolar macrophages.

The ability of alveolar macrophages of dogs to bind and metabolize two antigens was studied. The antigens were ragweed antigen E (AgE) and keyhole limpet haemocyanin (KLH). These antigens were chosen because of the availability of dogs with respiratory hypersensitivity to them and because they are of very different molecular weights. It was shown that: (1) antigen processing was identical using macrophages from hypersensitive as compared with normal dogs; (2) in comparison with AgE, much more of the higher molecular weight antigen, KLH, was bound to macrophages and much less degraded during subsequent incubation, leaving a greater proportion of the antigen bound to the cell membrane; (3) respiratory cells which had taken up AgE at 0 degrees C instead of 37 degrees C and were then incubated at 37 degrees C were much more active in catabolizing bound antigen with consequently less membrane bound antigen remaining; (4) increases in catabolism of bound AgE were also found in cells from relatively recently lavaged animals; (5) there was no evidence that cytophilic antibody contributed to the uptake of AgE.

Animals↗

PubMed1976

Elevated IgM levels, edema, and fatigue syndrome.

Two patients with nonpitting edema associated with extreme fatigue were found to have hyperimmunoglobulinemia M and eosinophilia. Additional laboratory abnormalities included an elevated ESR and the presence of rheumatoid factor. One patient had the symptom complex continually, and it was controlled with minimal amounts of prednisone. The other patient had intermittent symptoms, with eosinophilia in the asymptomatic state and decreased eosinophil counts while symptomatic. His symptomatic episodes were diminished in duration by methylprednisolone. We believe these cases, which have been evaluated for eight and four years, respectively, constitute a new syndrome that has substantial morbidity, but that is apparently benign and that can be controlled with corticosteroids.

Adult↗