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S J Kornfeld

Publications and source records attributed to S J Kornfeld.

12 recordsLinked to original sources
PubMed1995

Shwachman-Diamond syndrome associated with hypogammaglobulinemia and growth hormone deficiency.

Shwachman-Diamond syndrome is a rare congenital disorder of unknown etiology. Characteristic abnormalities of this disease include pancreatic insufficiency, skeletal anomalies, growth retardation, recurrent infections, and hematologic abnormalities. Significant morbidity and mortality in these patients result from respiratory infections, which are not well explained on the basis of neutrophil defects. We have had the opportunity to perform an in-depth clinical immunologic and endocrinologic evaluation of a patient with this syndrome with recurrent respiratory tract infections. She was found to have profound humoral immunologic defects, and serum thymulin was absent. In addition, endocrinologic evaluation for growth retardation revealed growth hormone deficiency. The patient responded to treatment with supplemental growth hormone and intravenous gammaglobulin with accelerated growth and cessation of infections. This case is unique in that it links growth hormone deficiency and hypogammaglobulinemia in a non-X-linked manner and may provide the basis for treatment of other patients with this rare syndrome.

Agammaglobulinemia↗
PubMed1994

Genomic organization and structure of Bruton agammaglobulinemia tyrosine kinase: localization of mutations associated with varied clinical presentations and course in X chromosome-linked agammaglobulinemia.

X chromosome-linked agammaglobulinemia is a life-threatening disease that involves a failure in normal development of B lymphocytes and is associated with missense mutations in BTK, a gene encoding a cytoplasmic tyrosine kinase (Bruton agammaglobulinemia tyrosine kinase, EC 2.7.1.112), a member of the Tec family of protein-tyrosine kinases. The genomic organization has been determined by using conventional restriction fragment mapping, extended DNA sequencing, and PCR fragment-sizing approaches. The DNA sequences of the 18 coding exons composing BTK and their flanking-region sequences are reported; an additional exon(s) encodes a 5' untranslated segment. Single-base-pair substitutions and 4-nt deletions resulted in amino acid replacement, premature termination, frameshift, and exon deletion in a group of X chromosome-linked agammaglobulinemia patients exhibiting different clinical presentations and courses. The nature of the mutations is interpreted in terms of the genomic organization of the BTK gene and the disease course in individual patients. Several examples are found in which the same mutation occurs in unrelated patients, and one of these mutations occurs at the same codon that is substituted in the murine form of BTK, resulting in X chromosome-linked immunodeficiency disease. Considerable variation in presentation and disease course in X chromosome-linked agammaglobulinemia appears associated with the nature and position of different missense mutations.

Agammaglobulinaemia Tyrosine Kinase↗
PubMed1982

Total parenteral nutrition-related infections. Prospective epidemiologic study using semiquantitative methods.

Studies of total parenteral nutrition-related infection have incorrectly relied on positive results on culture of the cannula tip to confirm the source. We undertook a prospective study of total parenteral nutrition-related infections in adult patients by obtaining blood from all total parenteral nutrition lines for pour-plate culture twice weekly and culturing intravascular line segments by the technique of Maki. Twelve of 100 courses of total parenteral nutrition (12 percent) in 69 patients resulted in infections--five (5.0 percent) had sepsis, and seven (7.0 percent) had local infection. In five of these 12, pour-plate culture gave positive results (five of 38 pour plates) with counts of 8 colony-forming units per ml (cfu/ml) for Candida tropicalis, and 25 to more than 1,000 for bacterial isolates. In nine of 12, culture of the intravascular line segment gave positive results with more than 50 cfu/ml. Pathogens isolated from intravascular line segments included Staphylococcus epidermidis (three cases), Candida species (three cases), Staphylococcus aureus (two cases), Serratia marcescens (one case) and mixed bacterial pathogens (one case). In contrast, pour-plate culture gave positive results in only seven of 88 uninfected (control) courses (318 pour plates), and culture of intravascular line segments gave positive results in two of 65 uninfected courses (p less than 0.001). No differences existed among patients with and without infection with regard to age, underlying disease, surgery, systemic antibiotic usage, or the presence of other infections. The duration of total parenteral nutrition was longer in courses without infection than in courses with infection (14.7 +/- 9.4 days versus 11.0 +/- 4.0 days; p less than 0.02). In six of 12 courses with infection, the line had been violated compared with 22 of 88 courses without infection (p less than 0.001). T-connectors for the centra administration of intralipid were associatd with infection (p less than 0.02). The value of routine pour-plate culture was illustrated in three courses in which the positive pour-plate culture results antedated positive blood culture results or line removal.

Bacterial Infections↗
PubMed1982

Relationship between the specificity of IgA proteases and serotypes in Haemophilus influenzae.

Haemophilus influenzae is one of five bacterial species known to produce IgA proteases, enzymes that specifically cleave the human IgA1 heavy chain. Strains of H. influenzae produce three distinct types of IgA proteases that cleave different peptide bonds within the IgA1 hinge region. Type 1 protease cleaves the prolyl-seryl bond at position 231-232; type 2 protease cleaves the prolyl-threonyl bond at position 235-236, the same bond attacked by Neisseria gonorrhoeae and Neisseria meningitidis type 2 proteases. Type 3 protease yields a unique double Fd cleavage pattern; the exact peptide bonds cleaved have not been determined. The type of protease produced correlates with the serotype, but not with the biotype, of the isolate; serotypes A, B, D, and F produce primarily type 1 protease, whereas serotypes C and E produce only type 2 enzyme. Each nontypable strain yields one of the three protease types. These data further extend our knowledge of the extreme specificity of the IgA proteases and suggest that IgA protease type may be useful in the taxonomy and epidemiology of H. influenzae.

Chemical Phenomena↗
PubMed1981

Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions.

Four homosexual men presented with gradually enlarging perianal ulcers, from which herpes simplex virus was cultured. Each patient had a prolonged course characterized by eight loss, fever, and evidence of infection by other opportunistic microorganisms including cytomegalovirus, Pneumocystis carinii, and Candida albicans. Three patients died; Kaposi's sarcoma developed in the fourth. All were found to have depressed cell-mediated immunity, as evidenced by skin anergy, lymphopenia, and poor or absent responses to plant lectins and antigens in vitro. Natural-killer-cell activity directed against target cells infected with herpes simplex virus was depressed in all patients. The absence of a history of recurrent infections or of histologic evidence of lymphoproliferative or other neoplastic diseases suggests that the immune defects were acquired.

Adult↗
PubMed1980

Specific proteolysis of human IgA by Streptococcus pneumoniae and Haemophilus influenzae.

Streptococcus pneumoniae and Haemophilus influenzae are among the most common bacterial pathogens responsible for respiratory tract infections in otherwise healthy humans. Thirty-six strains of S. pneumoniae, 62 strains of H. influenzae, six hospital-acquired respiratory pathogens, and a strain of Streptococcus pyogenes were examined for production of IgA protease, a bacterial enzyme whose only known substrate is human IgA1. IgA protease was produced by 100% of the isolates of S. pneumoniae and 98% of the isolates of H. influenzae. The enzyme from both species cleaved human serum and secretory IgA1 proteins, but not human IgA2, IgG, or human serum albumin. None of the hospital-acquired pathogens had detectable IgA protease activity, a finding indicating that the production of this enzyme distinguishes S. pneumoniae and H. influenzae from the opporunistic respiratory pathogens.

Antibodies, Bacterial↗
PubMedDate not supplied

Secretory immunity and the bacterial IgA proteases.

The characteristics and functions of microbial IgA proteases are reviewed. These enzymes represent a structurally heterogeneous group of proteins that are secreted into the extracellular environment by bacteria capable of causing human disease. The IgA proteases, which vary in their requirements for metal ions, are neutral endopeptidases whose role in the infectious process is not known but whose pronounced substrate specificity for human proteins of the IgA1 subclass has repeatedly been demonstrated. As reagents, the IgA proteases are useful in cleaving IgA molecules to yield intact Fc alpha and Fab alpha fragments that will allow the study of the structure and function of the two large regions of IgA immunoglobulin proteins. The role, if any, of these enzymes in promoting infection by pathogenic members of the genera Neisseria, Hemophilus, and Streptococcus is not known, although the secretory immune system is primarily mediated by antibodies of the IgA isotype, among which are IgA1 subclass proteins, and these proteins are susceptible to cleavage by IgA protease. The determination of the role of these enzymes in the pathogenesis of human infection must await clearer understanding of antigenicity and antibody function at secretory sites and of the relative roles of the two subclasses of human IgA in immune defense.

Bacteria↗