Degree of modulation of cell-surface CD3 by anti-lymphocyte therapies.
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Antibodies, Monoclonal↗
Biomedical subjects
T A Kenny
Publications and source records attributed to T A Kenny.
The immunogenicity and safety of intradermal hepatitis B vaccine.
BACKGROUND: One of the chief barriers to a greater use of hepatitis B vaccine is the high cost of the vaccine itself. A number of small research trials have shown that an adequate immune response can be induced at a much lower cost by administering one tenth of the vaccine using an intradermal technique. The purpose of this study was to ascertain whether these results could be replicated in a larger clinical trial. METHODS: Vaccine recipients included health care providers, police officers, and firefighters. Recipients were given 0.1 mL of plasma-derived hepatitis B vaccine intradermally on days 1, 30, and 180. Antibody response was measured on day 210, with seroconversion defined as a sample-to-negative (S/N) ratio of greater than or equal to 10. Any local and systemic side effects were documented. RESULTS: Six hundred sixteen individuals completed the vaccination series, and seroconversion occurred in 534 (86.7%). The rate of seroconversion in those younger than 40 years was 91.2% and in those 40 years and older was 75.1%. The mean S/N ratio was 154.9 (range 0 to 620) and decreased with increasing age (r = -.25, P = .0001). Side effects were largely limited to local reactions. CONCLUSIONS: The results support the use of the intradermal technique as a cost-effective alternative to the intramuscular route in individuals younger than 40 years. The intradermal technique may be used in older individuals if titers are obtained to assure seroconversion. Because of the restricted availability of the plasma-derived vaccine used in this study, similar trials with recombinant vaccine should be undertaken.
Adolescent↗
Mid-molecule parathyroid hormone assay comparison.
Parathyroid hormone (PTH) assays are becoming available to clinical chemistry laboratories for in-house use. We evaluated the clinical utility of two mid-molecule PTH assays in comparison to a sensitive but technically demanding component assay. A normal reference population, and an abnormal population including cases of primary and secondary hyperparathyroidism, hypoparathyroidism, and humoral hypercalcemia of malignancy were tested. PTH determinations with each assay system and total serum calcium determinations were done on all specimens. The Endocrine Metabolic Center (EMC) kit assay and the Immuno Nuclear Corp. (INC) kit assay demonstrated adequate standard curve reproducibility and precision for clinical use. With the aid of calcium determinations each assay performed well in the separation of abnormal patient groups, and in the separation of abnormal from normal PTH-calcium homeostasis. PTH values for the reference population differed among the three assays. The component assay and the EMC assay had a negative correlation with serum calcium, but the INC assay had a positive correlation with serum calcium.
Calcium↗
Adrenal function in heterozygous and homozygous hypobetalipoproteinemia.
Corticosteroid synthesis in the human adrenal cortex requires a supply of cholesterol which can be derived from both local synthesis and the uptake of plasma lipoproteins. Studies with cultured adrenal cells have shown that such uptake is mediated through the interaction of plasma low density lipoproteins (LDL) and a specific cellular receptor (the LDL receptor). In the present study we have examined parameters of adrenal corticosteroid production in a patient with phenotypic abetalipoproteinemia (on the basis of homozygous hypobetalipoproteinemia) and in three of her relatives with inherently low levels of LDL (heterozygous hypobetalipoproteinemia). These studies sought to determine whether the absence of LDL or an inherent reduction in their plasma concentration results in alterations in corticosteroid production both under basal conditions and in response to prolonged stimulation with iv ACTH. Our results document normal parameters of corticosteroid production under basal conditions in both heterozygous and homozygous hypobetalipoproteinemia, but an impaired response to ACTH in the latter. This was manifested by significantly lower serum concentrations of cortisol as well as by reduced rates of excretion of 17OHCS, 17-ketosteroids, and urinary free cortisol during ACTH infusion. By inference, our results provide in vivo support for the view that plasma LDL serve as an important source of cholesterol for adrenal corticosteroid synthesis under conditions of sustained stimulation with ACTH.
17-Hydroxycorticosteroids↗
Corticosteroid production in abetalipoproteinemia: evidence for an impaired response ACTH.
The concept that an inherent absence of plasma LDLs may be associated with a reduced synthesis of steroid hormones has been evaluated in two patients with ABL. Basal production of adrenal corticosteroids, assessed by the concentrations of serum cortisol and the rates of excretion of urinary 17OHCS and 17KS and urine free cortisol, was normal in both patients with ABL. Prolonged stimulation (24 to 36 hr) with ACTH, however, disclosed an impairment in adrenal corticosteroid production in both patients with ABL (as compared to normolipidemic controls), which was manifest by lower serum cortisol levels, reduced rates of urinary excretion of 17OHCS and 17KS and a marked decrease in the excretion of urine free cortisol. These results provide in vivo evidence to support the view that plasma LDLs serve as an important source of cholesterol for adrenal corticosteroid synthesis during prolonged stimulation with ACTH but show that a total absence of LDL does not impair adrenal steroidogenesis in the basal state.
17-Hydroxycorticosteroids↗