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Biomedical subjects

T Helms

Publications and source records attributed to T Helms.

4 recordsLinked to original sources

[Telemonitoring in chronic heart failure patients. Which diagnostic finding prevents hospital readmission?].

Heart failure exhibits a significant clinical and health economic problem. The implementation of new therapeutic strategies favorably affecting the course of disease is still insufficient in day-to-day practice. Thus, the usage of telemedicine offers a central instrument for service and information, so that an optimized therapy can be achieved by consequent surveillance of the patient with chronic heart disease. Predefined vital parameters are automatically transmitted to the telemedicine center; if individually predefined limits are exceeded, therapeutic means are immediately initiated. For the patient, the center is attainable 24 h throughout the year in case he experiences cardio-pulmonary symptoms. This patient-oriented usage of technology should not replace the physician-patient relationship, but improves and supports the participation and self-management of patients. Furthermore, the results show that this technology can significantly reduce the amount of emergency physician services, hospital admissions and primary care physician visits, and displays for health economics purposes a clearly more cost-effective treatment strategy, while allowing for additional costs inherent to the system. The usage of telemonitoring in chronic heart failure patients may be a trendsetting form of care, which can be used to drastically optimize the information and data flow between patient, hospital and primary care physician individually and at any time.

Blood Pressure Determination↗

Granzyme B ELISPOT assay for ex vivo measurements of T cell immunity.

A major goal in immunodiagnostics has been the development of assay systems that can measure CD8(+) T cell immunity in humans, directly ex vivo, at high resolution, and with high throughput. We established granzyme B (grB) enzyme-linked immunospot assay (ELISPOT) in conjunction with image analysis to this end. Using grB transfected and untransfected Chinese hamster ovary (CHO) cells and T cell lines, we show that the antibody pair utilized was grB-specific and that only activated T cells secrete grB. GrB release began within 4 h after antigen stimulation and stopped within 40 h. Side-by-side comparison showed grB ELISPOT assays to have a higher resolution than classic chromium-release assays in terms of signal-to-noise ratio. The linearity of the relation of the number of CD8(+) effector T cells plated to grB spots detected suggests that grB ELISPOT assays measure the frequencies of grB-secreting cells directly. Reactivity to HIV peptides was seen in grB ELISPOT assays of freshly isolated PBMC from HIV patients, consistent with the detection of peptide-specific memory cells. The higher resolution and lower labor and material investment should make grB ELISPOT assays an attractive alternative to chromium-release assays in monitoring the clonal sizes of specific CD8 memory cells in vivo.

Animals↗

Direct visualization of cytokine-producing recall antigen-specific CD4 memory T cells in healthy individuals and HIV patients.

We have used computer-assisted cytokine ELISA spot analysis to measure the frequencies, the type of cytokine, and the amount of cytokine produced by individual recall Ag-specific CD4 memory cells in freshly isolated blood. We studied the memory cells specific for tetanus toxoid and purified protein derivative in 18 healthy individuals and in 22 HIV-infected patients on highly active antiretroviral therapy (HAART). In healthy individuals, the frequency, cytokine signature, and cytokine production per cell of these memory cells were stable over time. Although it is presently unclear whether the maintenance of the memory T cell pool depends upon Ag persistence, cross-reactive Ag stimulation, or cytokine-driven bystander stimulations and expansions, our data strongly argue for a stable memory cell pool in healthy individuals. In HIV patients, however, the frequency of these memory cells was a function of the viral load. The decreased numbers of functional memory cells in patients with high viral loads might provide one mechanism behind the immunodeficient state. Although the cytokine output per cell was unaffected in most patients (20 of 24), in some patients (4 of 24) it was >100-fold reduced, which might provide an additional mechanism to account for the reduced immunocompetence of these patients. The ability to visualize directly and quantify the cytokine produced by the low frequency memory cells in freshly isolated blood that have been physiologically stimulated by Ag should aid comprehensive studies of the Ag-specific memory cell pool in vivo, in health and disease.

Adult↗