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Biomedical subjects

R V Heatley

Publications and source records attributed to R V Heatley.

At least 109 records · Page 6Linked to original sources
PubMed1985

Natural killer cells in coeliac disease.

Lymphoma is a well recognized but unexplained complication of coeliac disease. Natural killer (NK) cells are a distinct population of lymphocytes with the capacity to lyse some tumour cell-lines in vitro and there is evidence that they may play a role in immune surveillance and protection against the development of malignancy. Using a monoclonal antibody (Leu 11b) and a functional assay, we have measured NK cell numbers and activity in 32 patients with treated coeliac disease (9 of whom had evidence of hyposplenism), 10 splenectomized subjects, 14 biopsied, control patients and 26 normal subjects. The proportions (mean +/- SD) of Leu 11b + cells in normals (17 +/- 5%) and coeliac patients (19 +/- 7%) were similar. NK activity in all the coeliac patients (34 +/- 15%) was not significantly different from normal (31 +/- 15%) and control (26 +/- 15%) subjects. NK activity was correlated with % Leu 11b + cells (r = 0.64; p less than 0.01). The NK activity in patients with hyposplenism associated with coeliac disease (32 +/- 18%) and after splenectomy (29 +/- 15%) was similar to that in normals. We conclude that the increased risk of malignancy in patients with coeliac disease is not due to deficient NK cell numbers or activity.

Adolescent↗
PubMed1984

Precision of anthropometric measurements: the value of mid-arm circumference.

A study was carried out to examine how reproducible anthropometric measurements were within and between two observers on a group of 24 normal subjects and 20 obese individuals. A further study was performed on 28 malnourished patients with Crohn's disease undergoing a controlled trial of nutritional therapy to assess how weight change correlated with other anthropometric parameters. The measurement that was most reproducible and correlated most with weight change was mid-arm circumference. As it is the simplest measurement to perform, we recommend that it is used more often in nutritional studies.

Journal Article↗
PubMed1984

Influence of nutritional status on immune functions in patients with Crohn's disease.

Nutritional status and immune function were correlated with clinical features in 56 patients with Crohn's disease. These were divided arbitrarily into either undernourished or well nourished groups according to whether their midarm circumference was below or above 90% of ideal standard. Results were also compared with 33 patients with ulcerative colitis and 28 normal subjects. Undernourished patients with Crohn's disease had significantly reduced total lymphocyte and T lymphocyte counts and a reduced proportion of monocytes that ingested latex particles. Well nourished patients with Crohn's disease were similar to the two control groups. Twenty one undernourished patients with Crohn's disease were also followed during the course of two to four months' nutritional treatment with an enteral supplement. Nutritional therapy was associated with significant anthropometric gains as well as significant rises in total lymphocyte and T lymphocyte counts. Serum orosomucoids were significantly higher in undernourished patients and decreased significantly during nutritional therapy. The results show that undernutrition and disease acuity may be associated with reduced immunological competence in patients with Crohn's disease, but all these measurements can be improved by short term nutritional treatment.

Adult↗
PubMed1984

Antigen-antibody complexes in inflammatory bowel disease.

One hundred and sixty patients have been studied to assess the significance of circulating antigen-antibody complexes in inflammatory bowel disease (IBD). Sera from patients with ulcerative colitis and Crohn's disease were assayed for Clq-binding antigen-antibody complexes (CIC) and the results compared with those obtained from 52 patients with other inflammatory gastrointestinal diseases (GI controls) and 26 normal volunteers (normal controls). Significantly elevated CIC levels were found in patients with active IBD compared with inactive IBD or normal controls. However, similar high levels were also found in the GI control group. CIC levels in a group of undernourished patients with Crohn's disease fell significantly after treatment with an oral nutritional supplement. The results suggest that CIC-mediated inflammation is likely to be associated with intestinal mucosal disease in a non-specific manner.

Antigen-Antibody Complex↗
PubMed1984

Association between iron deficiency anaemia and mid-arm circumference in Crohn's disease.

The relation between nutritional anthropometry and haematological disturbance was studied in 55 outpatients with Crohn's disease and 30 healthy subjects. Patients with Crohn's disease were divided into undernourished (25) and well-nourished (30) groups, depending on whether their mid-arm circumference was below or above 90 per cent ideal standard. Undernourished patients with Crohn's disease had significantly reduced haemoglobin and red cell indices compared with well-nourished patients who were similar to the control group. In malnourished patients serum ferritin levels were usually below 50 micrograms/l and this level, rather than 15 micrograms/l indicates possible iron deficiency in patients with active inflammation. Results suggest that undernourished patients with Crohn's disease whose mid-arm circumference is less than 90 per cent ideal standard should be screened regularly for iron deficiency and anaemia.

Adult↗
PubMed1984

In vitro immunoglobulin secretion by normal human gastrointestinal mucosal tissues, and alterations in patients with inflammatory bowel disease.

Intestinal mucosal immunoglobulin secretion in vitro has been studied by culture of endoscopic biopsy tissues obtained from various sites along the gastrointestinal tract. IgA and IgM were the predominant immunoglobulins produced by intestinal tissues distal to the stomach and secretion of both reached a maximum in the small intestine of normal individuals. In patients with inflammatory bowel disease, characteristic alterations in immunoglobulin production were observed in cultures of large intestinal tissue. In ulcerative colitis (UC), significant reductions in IgA secretion (P less than 0.03) occurred in the rectum during remission and IgM in the colon in active disease (P less than 0.01). However, in active Crohn's disease (CD), rectal IgM secretion was enhanced (P less than 0.004) and IgA diminished (P less than 0.01). IgG secretion was increased throughout the colon in UC especially in distal sites, due largely to significant increases in pre-formed immunoglobulin (P less than 0.02). Similar total increases were observed in colonic tissues from patients with CD, although IgG synthesis in biopsies from rectal sites was normal. These findings suggest that specific abnormalities of intestinal mucosal immunoglobulin synthesis occur in patients with both UC and CD.

Adult↗
PubMed1983

Controlled trial of supplemented oral nutrition in Crohn's disease.

28 malnourished patients with Crohn's disease completed a controlled cross-over study to examine the effect of a low-residue liquid supplement on nutrition and disease activity. Patients spent two months on an ordinary diet (control period) and for two months took the nutritional supplement in addition (treatment period): the order of treatment and control periods was randomised. All anthropometric measurements, serum proteins, creatinine height index, and circulating T lymphocyte numbers increased significantly in the treatment period, while serum orosomucoid levels dropped significantly, suggesting that disease activity was reduced. The benefits were apparently due to the higher calorie intake with the enteral supplement. The results show that enteral supplementation can be managed successfully at home and may produce improvements in nutrition and disease activity.

Blood Proteins↗
PubMed1983

Nutritional disturbances in Crohn's disease.

A wide range of nutritional disturbances may be found in patients with Crohn's disease. As more sophisticated tests become available to measure vitamin and trace element deficiencies, so these are being recognized as complications of Crohn's disease. It is important to recognize nutritional deficiencies at an early stage and initiate appropriate treatment. Otherwise many patients, experiencing what can be a chronic and debilitating illness, may suffer unnecessarily from the consequences of deprivation of vital nutrients.

Anemia↗
PubMed1983

Pokeweed mitogen stimulated immunoglobulin production by peripheral blood lymphocytes in vitro: evidence for disordered immunoregulation in patients with ulcerative colitis and Crohn's disease.

Production of immunoglobulins (G, A, M) by pokeweed mitogen stimulated peripheral blood lymphocytes was studied in 81 patients with inflammatory bowel disease and compared with 40 patients with mild gastrointestinal disorders (controls). Immunoglobulin production was dependent on the concentration of mononuclear cells in culture, being maximal at the lowest concentration used (2.5 X 10(5)/ml). Adherent monocytes exerted suppression when cultures were reconstituted with more than 20% of these cells. T lymphocyte depleted cells (B cells) demonstrated T cell helper/suppressor dependence for immunoglobulin production in an isotype specific manner, the optimal T cell concentration for 'helper' activity being lowest for IgG and highest for IgM. In patients with active ulcerative colitis (UC) there was a reduction in the T cell concentration for optimal helper activity that was not isotype specific suggesting an increase in non-specific T cell helper activity. T cell helper activity reverted toward control levels in patients with UC in disease remission, except in the case of IgA production where there was a significant diminution of IgA production and of T helper activity for IgA synthesis. Patients with Crohn's disease were distinguished from both UC and control patients by: (1) reduced immunoglobulin production at low lymphocyte concentrations; (2) reduced monocyte-mediated suppression of immunoglobulin production and (3) no shift in T cell concentration for optimal helper activity for IgG and IgA with active disease.

Adult↗
PubMed1983

Assessment of nutritional status by anthropometry: a comparison of different standards of reference.

Anthropometric measurements of mid-arm circumference, mid-arm muscle circumference, and triceps skinfold thickness were made on 318 subjects and expressed as percentages of Jelliffe's reference standards, and in relation to centile categories published by Frisancho in 1981. There was no consistent agreement between the two standards of reference, both in and between sexes, and these results show that in any nutritional assessment it must be clearly stated which standard of reference is used.

Adolescent↗
PubMed1982

Increased plasma histamine levels in migraine patients.

Whole blood and plasma histamine levels, peripheral basophil and eosinophil counts and serum immunoglobulins have been measured in a group of eighteen patients with migraine in remission and in twelve of these patients during a headache attack. Plasma histamine levels were significantly elevated (P less than 0.0005) in patients with migraine both during headache attacks and symptom-free periods.

Adult↗