Biomedical subjects

T A Out

Publications and source records attributed to T A Out.

At least 73 records · Page 4Linked to original sources

PubMed1991

Influx of urea during bronchoalveolar lavage depends on the permeability of the respiratory membrane.

In 6 healthy controls and 23 patients with pulmonary diseases the influx of urea during bronchoalveolar lavage was measured by comparing the concentrations of albumin and urea in the sequential samples recovered. It varied between -28 and 151 mumol/l. In the bronchoalveolar lavage fluid and serum we measured alpha-2-macroglobulin (A2M) and ceruloplasmin (CP). The bronchoalveolar lavage fluid to serum ratios were calculated (QCP and QA2M). QA2M/QCP was taken as a measure of the respiratory membrane permeability; it varied between 0.05 and 0.53. Influx of urea during lavage was higher according as the QA2M/QCP ratio was higher. We conclude that concentrations of substances in the epithelial lining fluid calculated with the urea correction method have to be corrected for the influx of urea.

Albumins↗

PubMed1991

Lactoferrin and secretory IgA in the bronchoalveolar lavage fluid from patients with a stable asthma.

We have measured lactoferrin and secretory IgA (sIgA) in the unconcentrated bronchoalveolar lavage fluid (BALF) from nonsmoking healthy volunteers (n = 10) and nonsmoking patients with stable asthma (n = 14). The median concentrations and the ranges of lactoferrin were controls, 0.13 mg/L (0.01-0.43 mg/L); asthma, 0.41 mg/L (0.07-7.51 mg/L). For sIgA the results were controls, 0.48 mg/L (0.12-1.47 mg/L); asthma, 1.29 mg/L (0.65-14.6 mg/L). The concentrations in the epithelial lining fluid (ELF) were calculated on the basis of urea in BALF and serum. SIgA and lactoferrin levels in the BALF and ELF from the patients with asthma were higher than in controls (Mann-Whitney U-test, p less than 0.03). Our results indicate that in patients with stable asthma the airway epithelial cells are activated, resulting in an enhanced secretion of lactoferrin and enhanced secretory transport of sIgA into the airway lumen.

Adolescent↗

PubMed1991

IgG subclasses in bronchoalveolar lavage fluid from patients with asthma.

We have measured Immunoglobulin G (IgG) subclasses in serum and bronchoalveolar lavage fluid (BALF) from 12 non-smoking patients with stable asthma and 9 non-smoking healthy volunteers to obtain information on their possible role in local immunological reactions. The quotients (concentration of IgG subclass in BALF)/(concentration of IgG subclass in serum) were calculated. In controls QIgG3 were lower than QIgG1, QIgG2 and QIgG4. The IgG subclasses in BALF and epithelial lining fluid (ELF) from patients with asthma were significantly higher than in controls, mainly due to increased leakage from the blood. Again QIgG3 were lower than Q of other subclasses. In the analysis of local production of IgG, albumin or ceruloplasmin was used as reference protein. Several patients showed a local production or a preferential accumulation of one or more IgG subclasses. We conclude that in healthy persons the IgG subclasses in ELF originate from the systemic circulation by passive permeation. In patients with asthma, the permeability of the respiratory membrane may be increased resulting in increased concentrations of subclasses in lung-lining fluid. In some patients with asthma, an additional local production of IgG subclasses occurs.

Adolescent↗

PubMed1991

IgM in the airways of asthma patients.

In order to obtain information on the role of IgM in the pathogenesis of asthma, we assayed IgM in the broncho-alveolar lavage fluid (BALF) from 14 non-smoking patients with asthma and 9 non-smoking healthy persons, using an ELISA. The concentrations of IgM in the epithelial lining fluid (ELF) were calculated on the basis of urea in serum and BALF. The concentrations of IgM in ELF after correction for serum IgM, cQIgM, from the patients as a group were higher than those from controls (Mann-Whitney U test, p less than 0.05). The IgM in BALF and serum, analysed by sucrose density gradient centrifugation was pentameric. The transudation of IgM from blood into ELF was compared with that of alpha 2 macroglobulin (A2M), a protein with a similar molecular mass. In 6 patients the cQIgM/cQA2M value was above the upper value of the range for controls suggesting abnormal local production of IgM. The presence of the secretory component (SC) linked to IgM was determined by ELISA. The percentage of SC-IgM in BALF was increased in 5 out of 7 patients tested. The increased local IgM concentrations and its increased local production may suggest a role for local IgM-mediated reactions in the inflammatory events associated with asthma.

Adolescent↗

PubMed1991

Respiratory membrane permeability and bronchial hyperreactivity in patients with stable asthma. Effects of therapy with inhaled steroids.

In patients with stable asthma, we assayed plasma proteins in the bronchoalveolar lavage fluid to obtain information on plasma exudation into the airways. Fourteen nonsmoking patients with asthma who were in a stable period of their disease and eight nonsmoking healthy volunteers were studied. The ratios of the concentrations of albumin, ceruloplasmin (CP), and alpha-2-macroglobulin (A2M) between blood and epithelial lining fluid were calculated (cQalb, cQCP, and cQA2M). The cQalb was increased in the patients (Mann-Whitney U test, p less than 0.05). In 10 patients the bronchial hyperreactivity was assessed with histamine provocation tests. Significant relationships between the cQalb, cQCP, and cQA2M on the one hand and PC15 on the other hand were found (Spearman's rank correlation: r = -0.62, p less than 0.05; r = -0.61, p less than 0.05; r = -0.79, p less than 0.01, respectively). Fourteen patients were treated with two inhalations of 200 micrograms glucocorticosteroids per day in a 3-month prospective study. Three of them were excluded from further study because of an intercurrent exacerbation of asthmatic symptoms during therapy. In the 11 patients with stable asthma, the cQalb and cQA2M decreased after treatment with inhaled steroids (Wilcoxon's matched pairs signed rank test, p less than 0.03). Our results show that in patients with stable asthma, there is an increased plasma exudation into the airways, most likely caused by an increased respiratory membrane permeability. The plasma exudation correlated with the bronchial hyperreactivity to histamine, and it decreased after corticosteroid therapy.

Administration, Inhalation↗

PubMed1991

Permeability or local production of immunoglobulins and other inflammatory proteins in asthma.

Immunoglobulins in the epithelial lining fluid of the respiratory tract either originate from the systemic circulation or they are locally produced by plasma-cells in the mucosa. For polymeric immunoglobulins (dimer IgA and IgM) specific receptors on the surface of epithelial cells allow facilitated transport of these immunoglobulins into the lining fluid. Local inflammatory reactions in the lung will damage the respiratory membrane, which results in an increased leakage of proteins into the lining fluid. This increased leakage complicates the differentiation between local production of immunoglobulins and passive permeation. In asthma patients inflammation of the respiratory epithelium is found. This inflammation may be the result of non-immunologically triggered processes as well as of immunological reactions. In the experimental part of this paper we analyse possible local production of immunoglobulins and other proteins within the lungs of patients with asthma. This is performed with the use of steady-state protein concentrations in serum and bronchoalveolar lavage fluid. Information on the permeability of the respiratory membrane can be obtained by the measurement of proteins that are not produced within the lungs. Information on local production can be obtained by comparing the epithelial lining fluid to serum concentration ratios of proteins with identical molecular masses.

Adolescent↗

PubMed1990

The measuring of "respiratory-membrane permeability" and local production of immunoglobulins and antibodies by means of an analysis of sputum.

When measuring the exudation of serum proteins and the local production of immunoglobulins and antibodies within the lung by means of an analysis of sputum, the permeability properties of the respiratory membrane should be taken into account. In this paper, we describe the "loss of size selectivity" that usually accompanies an increased permeability on the part of the respiratory membrane. This phenomenon enables us to measure respiratory membrane permeability independently of the sputum water content. Consequences with regard to discrimination between leakage from the circulation and/or local production of immunoglobulins and antibodies are discussed. Sequential studies which take these factors into account may provide insights into the extent of local inflammatory reactions in individual patients.

Antibody Formation↗

PubMed1989

Clinical and immunological studies in patients with an increased serum IgD level.

Increased levels of serum IgD can be found in single patients with a variety of clinical syndromes and in the disease entity designated hyper-IgD syndrome which is associated with periodic fever and lymphadenopathy. We investigated 17 patients, both children and adults, with high serum IgD levels ranging from 220 to 5300 IU/ml. Eight patients had periodic fever and lymphadenopathy, four showed a humoral immunodeficiency, and the remainder had a variety of clinical abnormalities. Serum IgA levels were consistently high in all patients except in those with an immunodeficiency. Serum IgD complexes were detectable in each serum, which indicates that the occurrence is not pathognomic for the syndrome of periodic fever. Antibody formation against the primary antigen Helix pomatia hemocyanine and the secondary antigen tetanus toxoid showed no abnormalities in the patients without an immunodeficiency. Bone marrow origin of serum IgD was strongly suggested by enumeration of IgD-containing plasma cells. We conclude that no apparent relationship exists between the several clinical syndromes and increased serum IgD.

Adolescent↗

PubMed1989

The influence of immunosuppressive treatment on immune responsiveness in vivo in kidney transplant recipients.

In this study, we have compared the influence of CsA and pred/aza on the immunocompetence in man. Therefore, kidney-transplant recipients were tested for their primary keyhole limpet hemocyanin and secondary (tetanus and KLH) humoral immune responses and their primary dinitrochlorobenzene and secondary (recall antigens) cellular immune responses. We demonstrate that primary immune responses are inhibited by CsA, whereas secondary immune responses are relatively resistant. Pred/aza therapy seems to inhibit all cellular immune responses, as we demonstrated before, as well as the primary humoral immune responses. Secondary humoral immune responses are only slightly affected by pred/aza. Our results provide a strong argument for starting immunosuppression with CsA, either with or without a low-dose pred.

Antibody Formation↗

PubMed1989

Cellular and humoral immunity in various cohorts of male homosexuals in relation to infection with human immunodeficiency virus.

The relationship between infection with human immunodeficiency virus (HIV) and various immunological parameters was studied in: (a) healthy controls; (b) homosexual individuals from the AIDS risk group without anti-HIV antibodies; (c) idem, but with anti-HIV antibodies; (d) patients with persistent generalized lymphadenopathy (PGL); (e) patients with AIDS-related syndrome; (f) patients with AIDS and opportunistic infections. In each group, consisting of 15-20 individuals, the following parameters were studied: absolute numbers of CD4+ and CD8+ cells; ratio CD4+/CD8+; cellular immune responses as measured in vivo by delayed-type hypersensitivity (DTH) and in vitro; and antibody response in vivo after immunization with a low dose of keyhole limpet haemocyanin. Healthy HIV antibody-positive individuals and patients with persistent generalized lymphadenopathy already showed a decreased CD4+/CD8+ ratio, mainly due to an increase in the number of CD8+ cells. The ratio in the AIDS-related syndrome and AIDS groups was even lower, but this was now due to low numbers of CD4+ cells while the number of CD8+ cells was normal. The lymphocyte proliferative response was low in the HIV antibody-positive group, normal in the group with persistent generalized lymphadenopathy and profoundly decreased in the AIDS-related syndrome and AIDS groups. DTH was enhanced in the PGL group and diminished in both ARC and AIDS. Compared to healthy controls, the antibody response upon immunization with a low dose of keyhole limpet haemocyanin was depressed (although not absent) in all groups studied, even in HIV antibody-negative homosexuals. In the HIV antibody-positive group, the severity of the impairment of the various parameters of immunocompetence was not related to the presence of HIV antigenaemia.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Production of mouse monoclonal antibodies for the analysis of idiotypes in serum of patients with chronic lymphatic leukaemia.

In this report a simple procedure for the production of murine monoclonal antibodies (MoAb) against the idiotype of malignant B cells is described. Mice were immunized with lymphoid cells from patients with B-cell chronic lymphocytic leukaemia (B-CLL). After fusion of the spleen cells, hybridoma supernatants were screened for anti-idiotypic MoAb in ELISA with immunoglobulins obtained from tumour-cell lysates, xenohybridomas and patients' sera. The anti-idiotypic MoAb were used to study tumour cells and serum immunoglobulins (Ig) from four different patients with B-CLL. It was found that the serum IgM and IgD in one patient shared the same idiotype. Evidence is presented that IgG-secreting cell populations are not restricted to lambda-Ig-light chain-expressing B-CLL cells. With the help of anti-idiotype MoAb accurate measurements of total and idiotype-positive serum immunoglobulin levels during chemotherapy were possible.

Animals↗

PubMed1988

[The significance of determining humoral defense factors: Ig isotypes, specific antibodies and complement].

The diagnosis of an immunodeficiency is made after detailed clinical and laboratory investigations. To guide these investigations the Dutch Working Group on Immunodeficiencies had made a protocol for evaluating the functioning of the immune system of patients. The protocol is based on the report 'Immunodeficiency' from a WHO scientific group. This paper discusses the value of laboratory investigations on the following aspects of the immune system: immunoglobulins and their subclasses, primary and secondary antibody responses in vivo, and the complement system. The evaluation of these components of the defense system can firmly establish possibly occurring severe immunodeficiency states. Some cases of chronic and/or recurrent infections, however, remain enigmas that have to be resolved by future investigations on the interactions of infectious agents with the immune system.

Antibodies↗

PubMed1987

Evaluation of a method of production and purification of monoclonal antibodies for clinical applications.

A procedure is described for the purification of monoclonal antibodies (Mab) from ascitic fluids, which meets the quality control required for in vivo applications of immunoglobulins (Ig) in man. Additional assays were performed to calculate viral and DNA content of the purified Mab. These studies are important to prevent the possible side effects, oncogenic events and virus-related diseases which could follow immunotherapy with Mab.

Animals↗

PubMed1987

ELISA of ceruloplasmin and alpha-2-macroglobulin in paired bronchoalveolar lavage fluid and serum samples.

Bronchoalveolar lavage fluid (BALF) was analysed to obtain information on leakage of proteins from the blood into the respiratory lumen and on local synthesis. Albumin, ceruloplasmin and alpha-2-macroglobulin were measured in paired BALF and serum samples from patients with acute pneumonitis or asthma. Ceruloplasmin (CP) and alpha-2-macroglobulin (A2M) were measured by ELISAs thereby avoiding concentration of BALF. The quotients 10(3) ([protein]BALF)/(protein]serum), Qprotein, were calculated as well as the relative coefficients of excretion, RCE: Qprotein/Qalbumin. The QCP and QA2M increased parallel to Qalbumin in patients with pneumonitis and QCP increased parallel with Qalbumin in the asthma patients. This indicates that abnormal leakage of proteins from the blood rather than local synthesis cause the increased concentrations of these proteins in the BALF. Increased values for the RCE of CP and A2M were observed at normal Qalbumin. We therefore conclude that the determination of CP and A2M yields more detailed information on leakage of proteins from the blood into the airway compartment than that of albumin.

Adolescent↗

PubMed1987

Immunoglobulin D in cerebrospinal fluid.

Immunoglobulin D (IgD) was measured by radioimmunoassay in paired cerebrospinal fluid and serum samples from patients with various neurological diseases. The IgD index was calculated for every patient and compared with the IgG index. An increased IgD index was found in 18 out of 41 patients suffering from multiple sclerosis and in 52 out of all 122 patients investigated. An increased IgD index did not always coincide with an increased IgG index. An increased IgD index suggests an abnormal intrathecal synthesis of this immunoglobulin within the central nervous system. We conclude that the determination of IgD in the cerebrospinal fluid yields additional information on immunological reactions within the central nervous system.

Humans↗

PubMed1986

Immunological investigations in individuals with selective IgA deficiency.

Concentrations of IgG2, IgG4 and IgE were low in 16, 24 and 20% of 25 persons with selective IgA deficiency. Fifty-two per cent had IgD concentrations below 5 iu/ml. Trends for association between any of these parameters and the presence of clinical symptoms were not significant. All patients, except one, had normal amounts of Ig-bearing lymphocytes in the blood. IgG1 antibodies against casein were increased in titre and frequency, whereas IgG4 antibodies were normal. Similar results were found in other sera from persons with selective IgA deficiency.

Adolescent↗

PubMed1985

The determination of the complement components C1q, C4 and C3 in serum and cerebrospinal fluid by radioimmunoassay.

Non-competitive 2-site radioimmunoassays (RIA) for the determination of the complement proteins C1q, C4 and C3 in cerebrospinal fluid (CSF) are described. The quantitative results of the RIAs were the same as those obtained by other assay methods: radial immunodiffusion and turbidimetry and, in the case of C4, the haemolytic assay. The concentrations of the complement proteins in paired CSF and serum samples from a group of 60 patients were measured, as well as those of albumin and IgG. The ratios (concentration in CSF)/(concentration in serum) of the complement proteins correlated poorly with that of albumin. In contrast, the ratio of IgG was significantly correlated with that of albumin. The ratios of the complement proteins were higher than might be expected on the basis of their molecular masses. This suggests that these proteins may be synthesized within the normal central nervous system.

Adolescent↗

PubMed1984

The effect of reduction of IgM on the quantitative determination of IgM by radial immunodiffusion and turbidimetry.

The behaviour of different IgM proteins in radial immunodiffusion was investigated. In agreement with earlier findings differences were observed between various IgM preparations, which disappeared after reduction of IgM. The amount of IgM in several standard sera, that are used for the quantitative determination of IgM, was measured by radial immunodiffusion after reduction of IgM, and was found to be lower than hitherto accepted. It was observed that it was not necessary to perform reduction of IgM before its quantitation when a turbidimetric immunoassay was used. We conclude that (1) the standard sera that are used for the determination of IgM have to be calibrated in radial immunodiffusion after reduction of IgM and (2) the absolute amount of IgM in sera is about 0.6 times the amount that is commonly accepted.

Antibodies, Monoclonal↗