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Biomedical subjects

S Kontiainen

Publications and source records attributed to S Kontiainen.

At least 19 recordsLinked to original sources
PubMed1992

Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy.

Seventy-four cases of systemic listeriosis occurring from 1971 to 1989 in the greater Helsinki area in Finland are reviewed with a special interest in the effect of preceding immunosuppressive therapy on the clinical presentation. Of these patients, 66% had an underlying disease, most commonly malignancy, diabetes mellitus, or renal transplantation, and 43% had received immunosuppressive therapy within 1 week before onset of listeriosis. Bacteremia and central nervous system infections (both in 43% of cases) were the most common clinical entities. The percentage of patients with meningitis was not greater among immunosuppressed patients (13/32, 41%) than among patients with underlying diseases not treated with immunosuppressive agents (9/16, 56%) or among previously healthy nonpregnant hosts (7/11, 64%). Immunosuppressed patients did not die more frequently than did those with underlying diseases not treated with immunosuppressive therapy (case fatality rate, 29% vs. 38%, respectively). However, all previously healthy non-neonatal patients survived, whereas 32% (15/47) of those with any kind of underlying disease succumbed.

Adolescent↗
PubMed1992

Anti-endothelial cell antibodies in insulin-dependent diabetes mellitus.

The prevalence of IgG class antibodies to endothelial cells (AECA) was studied in 136 young patients with insulin-dependent diabetes mellitus by an enzyme immunoassay using human umbilical cord vein endothelial cells. The patients were divided into four groups according to the time between diagnosis and study and their results were compared with those in control children and blood donors. AECA became progressively more frequent with the duration of diabetes, being 4% in diabetics tested within 2 weeks of diagnosis and reaching 34% after an average disease duration of 11.2 years. They were not more common in patients with neuropathy, retinopathy or nephropathy than in patients without these complications, but were associated with co-existing thyroid disease and IgA deficiency. The results suggest that in insulin-dependent diabetes mellitus AECA are associated with co-existing autoimmune disorders but not with diabetic microvascular disease.

Adolescent↗
PubMed1992

Thyroid peroxidase antibodies in children with autoimmune thyroiditis.

AIMS: To compare the prevalence of thyroid peroxidase antibodies in 25 children with autoimmune thyroid disorders and in 41 children and young adults with type 1 diabetes, and to test the prevalence of thyrotropin receptor antibodies. METHODS: Two commercially available radioimmunoassays for antibodies to thyroid peroxidase, a commercially available agglutination test of particles coated with thyroid microsomal antigens, and a radioimmunoassay for thyrotropin receptor antibodies were used. Patients and controls were studied. RESULTS: One of the radioimmunoassays detected thyroid peroxidase antibodies not only in all children with autoimmune thyroid disorders and children and young adults with type 1 diabetes and thyroid microsomal antibodies, but also in 20% of healthy control children without microsomal antibodies. With this thyroid peroxidase assay and with microsomal agglutination, 94% of the children with autoimmune thyroiditis, 71% of those with Graves' disease, and over 90% of those with type 1 diabetes and thyroid dysfunction tested positive. In the other radioimmunoassay for thyroid peroxidase antibodies thyroid peroxidase antibody titres in half or more of the children with microsomal antibodies failed to reach the level of positivity given by the producers. Eighty five percent of children with Graves' disease and 71% of those with autoimmune thyroiditis had thyrotropin receptor antibodies but so did 35% of children studied for other endocrinological disorders such as delayed growth or puberty. CONCLUSIONS: Testing patients with well characterised disorders of thyroid function and with other endocrine disorders is important in evaluating the efficacy of new diagnostic tests for thyroid autoantibodies.

Adolescent↗
PubMed1991

Selective activation of T cells in newly diagnosed insulin-dependent diabetic patients: evidence for heterogeneity of T cell receptor usage.

Cell surface phenotyping of 58 newly diagnosed diabetic children and 25 controls confirmed the presence of activated T cells, expressing HLA class II antigens or receptors for interleukin-2 (IL-2R, CD25) in the majority of the patients. Some of these cells putatively include those involved in islet cell destruction, as reported previously. Monoclonal antibodies recognizing three families of the variable regions of the beta chain (V beta) of the T cell receptor were used to determine the percentage of peripheral blood cells expressing those specific gene segment products. The number of the activated T cells from each V beta family was compared with that of the resting T cells of the same family in the patients and the controls. In 18 out of 58 (31%) of these patients there was evidence of oligoclonal proliferation of activated T cells as judged by marked increases in cells expressing a V beta family in the IL-2R+ T cell pool, compared with the total T cell pool. However, different V beta families were augmented in individual patients, indicating considerable heterogeneity of T cell activation in different patients. These results are in contrast to murine models of autoimmunity, where virtually monoclonal T cell activation, restricted to a single V beta family has been reported.

Adolescent↗
PubMed1991

Human islet cell induced T cell lines and clones from diabetic children.

T cell lines and clones were derived by coculturing peripheral blood mononuclear cells from young children with newly diagnosed insulin dependent diabetes mellitus (IDDM) with sonicates of HLA-DR haploidentical human islet cells. These cells proliferated in response to human islet cell sonicates but failed to do so when stimulated with sonicates of human exocrine pancreas or thyroid gland. Preparations of islet cells obtained by repeated freezing and thawing also stimulated proliferation of the lines but purified membrane or protein preparations of the islet failed to induce proliferation, suggesting that determinants recognized by T cells were lost on further purification. This method of deriving T cell lines and clones appears to be significantly easier and quicker than non-antigen cloning using anti CD3.

Antigens, Differentiation↗
PubMed1991

Frequencies of HLA-DR3, -DR4, -B8 and -Bw62 in diabetic children diagnosed between 1960 and 1990.

An analysis of the HLA-types of 351 children in whom a diagnosis of insulin dependent diabetes mellitus (IDDM) had been made between 1960 and 1990 revealed that although the frequencies of HLA-DR3, -DR4, -DR3/4, -B8 and -Bw62 were increased there was, depending on the year of diagnosis, a marked fluctuation in the frequencies of these HLA-antigens and in the frequency with which -B8 was associated with -DR3 and -Bw62 with -DR4 suggesting heterogeneity/variation in agents initiating/triggering IDDM.

Chickenpox↗
PubMed1990

Immune responses to insulin and lymphocyte subclasses at diagnosis of insulin-dependent diabetes and one year later.

Insulin induced proliferation of blood mononuclear cells, numbers of blood B and T cells, of blood lymphocytes bearing interleukin 2 receptors or HLA class II molecules were assayed at diagnosis and one year later in children with insulin-dependent diabetes mellitus (IDDM) and in healthy children. Insulin and islet cell antibodies were also studied. The numbers of lymphocytes expressing HLA class II molecules and NK cells were increased at diagnosis. T cells of the helper/inducer (CD4+) phenotype and interleukin 2 receptor positive lymphocytes were increased both at diagnosis and one year later. At diagnosis, insulin induced proliferation of blood mononuclear cells in 65% and one year later in 50% of the patients. Insulin antibodies were detected in 10% and islet cell antibodies in 90% of patients at diagnosis, and in 67% and 78%, respectively, one year later.

Adolescent↗
PubMed1990

Autoantibodies and autoimmune diseases in young diabetics.

Another autoimmune disease was found to accompany insulin dependent diabetes mellitus (IDDM) in 14% of the young diabetics (n = 14) studied. Thyroid autoimmune disease was the most common of the accompanying autoimmune diseases, and was detected in 11% (n = 15) of the patients. Two thirds of the IDDM patients with autoimmune thyroiditis were hypothyroid, one was hyperthyroid, and 20% lacked detectable thyroid antibodies when thyroid disease was diagnosed. Coeliac disease was found in 2% of the patients, and one had Addison's disease. Autoantibodies were found in one third of the patients. Thyroid microsomal antibodies were detected in 22% of the patients, IgA anti-gliadin in 11%, gastric parietal cell antibodies in 3% and rheumatoid factor in 7%. Autoimmune disease and the relevant autoantibodies coexisted in 11% of the patients. Autoimmune disorders and autoantibodies were not associated to any particular HLA type. The distribution of the HLA-types in the patients was unusual in that the frequency of HLA-DR3 was not increased. The value of autoantibody tests in the diagnosis of functional disorders of the thyroid and of coeliac disease are discussed.

Adult↗
PubMed1989

Thyroid-infiltrating lymphocytes, thyroid function, and HLA-DR in juvenile autoimmune thyroiditis.

Eighteen patients with juvenile autoimmune thyroiditis were studied. At diagnosis 8 (44%) of the patients were euthyroid and 10 hypothyroid, whereas at the end of 6 to 12 months follow-up, 12 (66%) were euthyroid and 6 hypothyroid. All the patients were HLA-typed. The frequency of HLA-DR4 was increased in the patients when compared with the normal population, 63 vs 28% (p less than 0.01). An analysis of thyroid-infiltrating mononuclear cells revealed that the majority of the thyroid-infiltrating lymphocytes were T cells. More T lymphocytes and fewer B lymphocytes and HLA class II positive lymphocytes were found among the thyroid-infiltrating mononuclear cells in euthyroid than hypothyroid patients. The numbers of thyroid-infiltrating B lymphocytes correlated with the levels of thyroid microsomal antibodies. No correlation was found between thyroid function and thyroid antibodies.

Adolescent↗
PubMed1989

Antibodies against gastrointestinal carcinoid tumors in IDDM.

In this study, 92% of patients' serums known to contain antibodies against islet cells, including the Juvenile Diabetes Foundation provisional reference serum, had antibodies reacting with gastrointestinal carcinoid tumors. Twelve percent of the control serums from healthy individuals bound to carcinoid cells, and 2% bound to islet cells. Seventy-five percent of the children with newly diagnosed insulin-dependent diabetes mellitus had carcinoid tumor antibodies, and 83% had islet cell antibodies. These findings suggest that antigenic determinants are shared between endocrine cells of islets of Langerhans and neuroendocrine tumors of the same embryological derivation. Carcinoid tumors may not only provide an alternative source for islet cell antibody assays but also supply material for isolation of antigens possibly involved in the immunopathogenesis of diabetes.

Adult↗
PubMed1988

Reactive arthritis associated with Shigella sonnei infection.

Several studies have failed to show an association between Shigella sonnei dysentery and reactive arthritis. We describe 3 patients who had reactive arthritis and a recent or concurrent S sonnei infection. To our knowledge, this is only the second study to suggest this association. We propose that S sonnei should be considered as a triggering agent for reactive arthritis.

Adult↗
PubMed1988

Thyroid infiltrating cells in juvenile autoimmune thyroiditis: a follow-up of 1 year.

The composition of the cellular infiltrate in thyroid glands of 12 patients with juvenile autoimmune thyroiditis (JAIT) was followed for a period of 1 year. The diagnosis of JAIT was based on a firm goiter and on cytologic criteria of lymphocytic thyroiditis. Samples from the thyroid gland were obtained by fine-needle aspiration biopsy three times at 6-month intervals. Lymphocytes with a few lymphoid blasts and plasma cells dominated the cellular infiltrate. The relative number of the different cell types remained unchanged during the follow-up time of 1 year. Analysis of the lymphocytes revealed that about 60% of the infiltrating lymphoid cells were T cells and about 30% expressed B-cell markers. The T helper/suppressor ratio was significantly higher in the thyroid (2.2) than in the corresponding blood sample (1.2). Practically no changes were seen in the proportions of lymphocyte subclasses either in the gland or in the blood of the patients during the follow-up. At the time of diagnosis more than half of lymphocytes in the thyroid were HLA class II positive as were most of the glandular epithelial cells. The proportion of cells expressing class II was similar in samples taken at diagnosis and 6 and 12 months later, indicating a continuous state of immunoactivation in the thyroid gland.

Adolescent↗
PubMed1988

HLA-antigens and immunity to insulin in insulin-dependent diabetics with or without diabetic neuropathy.

In order to define genetic, immunological and metabolic risk factors and markers associated with diabetic neuropathy (DN) 47 insulin-dependent diabetic patients with neuropathy were compared to 30 age-matched insulin-dependent diabetes mellitus (IDDM) patients without neuropathy. Patients with diabetic neuropathy more often had proliferative retinopathy and Albustix positive proteinuria than patients without neuropathy. Judged by haemoglobin A1 (HbA1) concentrations measured during the preceding two years glycaemic control was worse in patients with than without diabetic neuropathy. The frequency of HLA-antigens DR3, DR4, DR3/DR4, B8, and B15 were increased and those of DR2 and B7 decreased in the diabetic patients. The frequency of any of these HLA-antigens did not differ in patients with or without diabetic neuropathy. There were no significant differences in the frequencies of insulin antibodies or proliferative responses to insulin antigens between patients with or without diabetic neuropathy. However, patients who were HLA-DR3/DR4 heterozygotes and had diabetic neuropathy responded to insulin antigens more often by proliferation than DR3/DR4 positive patients without diabetic neuropathy. Thus poor glycaemic control is associated with an increased risk for diabetic neuropathy. Patients with DR3/DR4 heterozygocity and failing to respond to insulin antigens by proliferation seem to be less prone to develop diabetic neuropathy.

Adult↗
PubMed1988

Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment.

The microbiology and treatment of apical periodontitis was studied in 62 patients, followed-up for 1 year. The clinical treatment and the radiological technique were standardized. One third of the patients received no systemic antibiotics, one third received phenoxymethylpenicillin for 1 week, and one third for 3 months. On the average, 0-2 facultatively anaerobic and 4-6 anaerobic bacteria were isolated from periapical infections. The genera Bacteroides and Fusobacterium in addition to anaerobic gram-positive cocci were found most frequently. Minimum inhibitory concentrations of benzylpenicillin against 269 strains were tested. 12 strains were resistant at the concentration 2.4 micrograms/ml, including 4 strains of Fusobacterium sp. All patients were free of symptoms 1 month after the admission. Only 1 patient failed to show any progress in radiological healing. No differences between the groups in relation to penicillin therapy were found.

Adult↗
PubMed1988

Bacteria in ulcera crurum.

Bacterial cultures derived from 432 chronic leg ulcers were analysed retrospectively to determine which bacteria are most commonly found in these ulcers. The study covered a 2-year period. Two-thirds of the patients were over 70 years of age. Staphylococcus aureus was found in nearly half of the ulcers studied, Pseudomonas sp. in one-third, pyogenic streptococci and enterococci in every fifth and Proteus sp. in every tenth. The frequency by which pyogenic streptococci were isolated was about 10 to 20 times as high as previously reported. Obligate anaerobic bacteria were also frequently isolated. The sensitivity of the isolates from the second year to antimicrobial agents likely to be chosen if systemic therapy were required is also reported. The results are discussed in relation to previous findings.

Aged↗
PubMed1988

The majority of the activated T cells in the blood of insulin-dependent diabetes mellitus (IDDM) patients are CD4+.

Twenty-five recently diagnosed insulin-dependent diabetic patients were screened for the presence of activated T lymphocytes using the anti-IL-2 receptor monoclonal antibody; thirteen had elevated levels of activated T lymphocytes. The activated cells were mostly confined to the CD4 subset, with the CD4/CD8 ratio in IL-2 receptor expressing cells averaging 5 +/- 1 (s.d.) compared with 1.3 +/- 0.3 for all T cells. In recent onset insulin-dependent diabetes blood there was no lack of CD4 CD45R+ (suppressor/inducer) T cells. The activated IL-2 receptor, expressing cells belonged to both CD4 subsets, 'helper inducer' (CD44B4) and 'suppressor inducer', (CD42H4).

Adolescent↗