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Biomedical subjects

Sonja Klebe

Publications and source records attributed to Sonja Klebe.

5 recordsLinked to original sources

Molecular and clinical spectrum of type I plasminogen deficiency: A series of 50 patients.

Severe type I plasminogen (PLG) deficiency has been causally linked to a rare chronic inflammatory disease of the mucous membranes that may be life threatening. Here we report clinical manifestations, PLG plasma levels, and molecular genetic status of the PLG gene of 50 patients. The most common clinical manifestations among these patients were ligneous conjunctivitis (80%) and ligneous gingivitis (34%), followed by less common manifestations such as ligneous vaginitis (8%), and involvement of the respiratory tract (16%), the ears (14%), or the gastrointestinal tract (2%). Four patients showed congenital occlusive hydrocephalus, 2 with Dandy-Walker malformation of cerebellum. Venous thrombosis was not observed. In all patients, plasma PLG levels were markedly reduced. In 38 patients, distinct mutations in the PLG gene were identified. The most common genetic alteration was a K19E mutation found in 34% of patients. Transient in vitro expression of PLG mutants R134K, delK212, R216H, P285T, P285A, T319_N320insN, and R776H in transfected COS-7 cells revealed significantly impaired secretion and increased degradation of PLG. These results demonstrate impaired secretion of mutant PLG proteins as a common molecular pathomechanism in type I PLG deficiency.

Animals↗

Delayed surface opacification of a hydroview intraocular lens.

The insertion of an intraocular lens during cataract surgery is routine but delayed opacification of hydrophilic foldable intraocular lenses (IOLs) has been increasingly noticed as a late post-operative complication. Such opacification may present with reduced visual acuity and can be diagnosed with slitlamp biomicroscopy. Lens explantation may be required. We report an 89-year-old female presenting with opacification of a Hydroview IOL and correlate the clinical findings of the lens in situ with the light microscopy of the explanted lens, as well as transmission electron microscopy (TEM), scanning electron microscopy (SEM) and elemental analysis. Pathological analysis of an explanted IOL may assist in a better understanding of the condition and may become relevant in medico-legal proceedings.

Aged, 80 and over↗

Prolongation of sheep corneal allograft survival by transfer of the gene encoding ovine IL-12-p40 but not IL-4 to donor corneal endothelium.

Immunological rejection is the major cause of human corneal allograft failure. We hypothesized that local production of IL-4 or the p40 subunit of IL-12 (p40 IL-12) by the grafted cornea might prolong allograft survival. Replication-deficient adenoviral vectors encoding ovine IL-4 or p40 IL-12 and GFP were generated and used to infect ovine corneas ex vivo. mRNA for each cytokine was detected in infected corneas, and the presence of secreted protein in corneal supernatants was confirmed by bioassay (for IL-4) or immunoprecipitation (for p40 IL-12). Sheep received uninfected or gene-modified orthotopic corneal allografts. Postoperatively, untreated corneas (n = 13) and corneas expressing GFP (n = 6) were rejected at a median of 21 and 20 days, respectively. Corneas expressing IL-4 (n = 6) underwent rejection at 18.5 days (p > 0.05 compared with controls) and histology demonstrated the presence of eosinophils. In contrast, corneas expressing p40 IL-12 (n = 9) showed prolonged allograft survival (median day to rejection = 45 days, p = 0.003). Local intraocular production of p40 IL-12 thus prolonged corneal graft survival significantly, but local production of the prototypic immunomodulatory cytokine IL-4 induced eosinophilia, inflammation, and rejection. These findings have important implications for the development of novel strategies to improve human corneal graft survival.

Adenoviridae↗

A practical approach to interpretation of corneal specimens.

Corneal specimens form only a small part of the routine practice for most histopathologists but their assessment often requires considerable effort and specialized knowledge. The most common corneal specimens, full-thickness corneal discs and corneal biopsies, are discussed in this review. Corneal discs removed at keratoplasty are non-urgent specimens, as definitive treatment has already been undertaken, and while the pathologic diagnosis may change the prognosis for the graft, it rarely affects immediate treatment. Accurate diagnosis is still important, and will affect counseling of the patient, but referral to a colleague with a special interest is possible if necessary. Conversely, small partial-thickness corneal biopsies, which are mostly undertaken for culture negative keratitis with underlying suspected infection, are very urgent. Infectious keratitis can follow an extremely aggressive course, resulting in destruction of the cornea within hours. Accurate diagnosis is imperative. Due to the urgency of such specimens and the importance of diagnosis for immediate treatment, referral is not usually possible. It is the role of the pathologist to make optimal use of a small specimen to reach the relevant diagnosis in the minimum space of time.

Biopsy↗