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Biomedical subjects

U Jodal

Publications and source records attributed to U Jodal.

At least 127 records · Page 7Linked to original sources

Antibody responses to impurities of penicillin in infants and rabbits.

Antibody responses to penicilloyl were recorded in infants and children treated for about 1 week with intravenous ampicillin. In this single-blind, randomized study two commercially available preparations were compared, one of high-grade purity (less than 0.1 microgram antigen per gram) and the other slightly contaminated with high molecular weight proteinaceous material (1.5 microgram antigen per gram) according to a radioimmunoassay. The results showed no significant increase in the antibody titers in any of the patient groups. The immunogenic properties of high molecular weight proteinaceous impurities isolated from phenoxymethyl penicillin during manufacture were tested in rabbits given daily subcutaneous injections with 0.1-10 micrograms of the antigen over 10 day periods. When the 10-day period was repeated, the rabbits injected with more than 2 micrograms of antigen responded with both IgM/IgG and IgE antibodies. The clinical as well as the animal study indicates that antigen impurities in the preparations of the order of 2 micrograms per gram or less do not elicit a significant antibody response. However, the study in rabbits demonstrates that high molecular weight impurities can induce penicillin allergy if present in about 10-fold higher quantities than those usually found in the commercial penicillin preparations of today.

Ampicillin↗

Chemical and clinical studies on the interaction of Escherichia coli with host glycolipid receptors in urinary tract infection.

The role of glycosphingolipids as host receptors, and fimbriae as bacterial ligands, for the adhesive and hemagglutinating reactions of uropathogenic E. coli was assessed. Glycolipids including globotetraosylceramide and globotriaosylceramide, which contain the disaccharide Gal alpha 1 leads to 4Gal were bound by many strains isolated from patients with pyelonephritis and cystitis. The fimbriae of one strain were shown to serve as ligands for these receptors. Although most pyelonephritic E. coli recognized globotetraosylceramide, as measured by the agglutination of glycolipid coated erythrocytes, some also recognized D-mannose residues (i.e. mannose-sensitive hemagglutination). Several strains were exclusively mannose-sensitive or bound neither globotetraosylceramide nor mannose. A genetic basis for susceptibility to infection was indicated. The erythrocytes of blood group P2 have lower amounts of Gal alpha 1 leads to 4Gal containing glycolipids than individuals of blood group P1. Blood group P2 was significantly less frequent (1/28) among patients with recurrent urinary tract infection compared to the normal population (10/40, p less than 0.02). Therefore, globoseries glycolipids may be determinants of susceptibility to urinary tract infection.

Binding Sites↗

Compensatory kidney growth in children with urinary tract infection and unilateral renal scarring: an epidemiologic study.

Compensatory renal growth was estimated from repeated urograms over 8 to 15 years in 26 children with urinary tract infection and unilateral renal scarring. These children were derived from an unselected series of 596 patients followed from their first symptomatic urinary tract infection. Renal size was assessed from the renal area, length, and parenchymal thickness. The renal area proved to be a good measure of the compensatory growth of the unscarred kidney as well as of the loss of substance of the scarred kidney. In this series of children, who had been closely supervised from the time of their first infection, unilateral renal scarring was well compensated for by hypertrophy of the contralateral kidney. Thus, the total renal parenchymal area 8 to 15 years after the first investigation was 98 to 99% of the expected normal area. Interestingly, a conspicuous growth spurt was observed at puberty in some of the scarred kidneys, sometimes a decade after the original damage. Prognosis was not influenced by sex, age at onset, or complications such as vesicoureteric reflux and frequent febrile recurrences. Reflux with dilatation was compatible with compensatory renal growth. We conclude that acute febrile pyelonephritis in childhood carries a good prognosis with regard to preservation of renal parenchyma and level of GFR, if diagnosis and treatment are prompt and long-term supervision is provided.

Adolescent↗

Antibodies to lipid A during urinary tract infection.

Serum levels of antibodies to lipid A were determined with an enzyme-linked immunosorbent assay in 26 girls with their first known symptomatic urinary tract infection (UTI) and in 15 girls with asymptomatic bacteriuria (ABU). Also included were six female patients with recurrence of acute upper UTI, five of whom had renal changes after the infections; 28 female patients with renal scarring but not symptomatic UTI at the time of investigation; and uninfected individuals. IgG and IgM antibodies to lipid A were found in approximately 50% of the uninfected children older than two years of age. Girls with acute cystitis, acute pyelonephritis, or ABU showed significantly elevated levels of IgG antibodies to lipid A as compared with children with no history of UTI. High levels of IgG antibodies to lipid A may be indicative of severe renal infection and development or progression of renal parenchymal reduction. The diagnostic value of determining levels of antibodies to lipid A is discussed.

Adolescent↗

Hapten and kidney antibodies in serum from children with urinary tract infection.

The presence of antibodies against the synthetic hapten dinitrophenol (DNP) was investigated in sera from healthy children and adults. Such antibodies were found in all sera. The serum levels were significantly lower in healthy children than in adults. Serum samples from a pilot group of pediatric patients with acute E. coli urinary tract infection (UTI) contained significantly higher DNP antibody levels compared to healthy children and similar to those of the adults. Furthermore, 10 of 17 patients had a significant change in antibody levels in connection with the infection as judged from consecutive serum samples. Relations were found between age and minimum as well as maximum serum DNP antibody values. In a second group of children with E coli urinary tract infection beside DNP antibodies, antibodies against the Tamm-Horsfall urinary protein and a pool of O antigens from E. coli common in urinary tract infections were also investigated. In these patients similar findings as for the pilot group were made for the levels of the DNP antibodies. An IgG but not IgM antibody response to the Tamm-Horsfall protein was also found in sera from all the patients over 1 year with acute pyelonephritis. The highest antibody levels against Tamm-Horsfall protein were noted in patients with vesico-ureteric reflux. No relation could be recorded between the DNP antibodies and the Tamm-Horsfall protein antibodies. The antibodies to the pool of O antigens recorded did not correlate to the DNP antibodies. It was concluded that the DNP antibody formation could partly be due to polyclonally stimulatory activities of bacterial substances exposed during infections.

Adult↗

Adhesion, hemagglutination, and virulence of Escherichia coli causing urinary tract infections.

The capacity of 453 Escherichia coli strains to agglutinate erythrocytes and yeast cells and to attach to human urinary tract epithelial cells was tested. The strains were isolated from the urine of patients with acute pyelonephritis, acute cystitis, or asymptomatic bacteriuria and from the stools of healthy school children. Three main patterns of hemagglutination were found: (i) mannose-resistant agglutination of human erythrocytes alone or simultaneously with mannose-sensitive agglutination of guinea pig erythrocytes; (ii) only mannose-sensitive agglutination of guinea pig and other erythrocytes; and (iii) no agglutination. Strains with mannose-resistant agglutination of human erythrocytes alone or in combination with mannose-sensitive hemagglutination attached in high numbers to human urinary tract epithelial cells. Bacteria inducing only mannose-sensitive hemagglutination attached in low numbers, and non-agglutinating strains did not bind to the urinary tract epithelial cells. The bacterial surface antigen(s) mediating mannose-resistant hemagglutination of human erythrocytes and attachment to human urinary tract epithelial cells may be one factor selecting for E. coli from among the fecal flora which infect the urinary tract. The highest proportion of strains with this property was found among acute pyelonephritis isolates (77%), and the lowest proportion of strains with this property was found among normal fecal E. coli (16%).

Agglutination↗

Early detection of nephropathy in childhood urinary tract infection.

Early detection and treatment of nephropathy in childhood urinary tract infection is important for the planning of treatment and supervision. In patients without abnormalities of calyces or defects of kidney outline standardized measurements of the thickness of the parenchyma at three sites on each kidney are more informative in establishing early affection of the kidney than other measurable parameters available. The majority of patients who will develop focal renal scarring can be identified early after their first symptomatic infection from measurement of the appropriate dimensions of the parenchyma.

Child↗

Autoantibodies to Tamm-Horsfall glycoprotein in children with renal damage associated with urinary tract infections.

Autoantibodies to the Tamm-Horsfall (TH) protein were analyzed in sera from 116 patients with pyelonephritis. The increases in antibody levels were limited in 23 patients with radiological detected renal damage during 31 attacks of acute pyelonephritis. 8 children with abnormally low total and/or unilateral 51Cr EDTA clearance had significantly lower IgG antibody levels to TH protein, than 14 children with normal clearance rate. All 61 children with renal damage had significantly low IgG, IgA and IgM antibody levels to TH protein 6 months after last infection as compared to the reference group. For IgG antibodies, the mean was well below -2 S.D. 12 children with increased serum creatinine had significantly lower IgG antibody levels than those with

Acute Disease↗

Autoantibodies to Tamm-Horsfall protein associated with urinary tract infections in girls.

Girls with various forms of urinary tract infections and a reference material were analyzed for autoantibodies in serum to the Tamm-Horsfall glycoprotein. Such antibodies could be detected in all sera analyzed. In the control subjects cord blood contained very low IgA and IgM anti-TH, which increased significantly up to the age of 8 months. The IgG anti-TH levels in cord blood correlated with maternal levels. After the age of 2 months the IgG anti-TH followed the anti-TH levels of the other immunoglobulin classes. Among the infants aged 2 to 7 months with acute UTI, no anti-TH increases were found. In girls more than one year of age with acute nonobstructive UTI, IgG and IgA anti-TH levels were significantly higher in those with acute pyelonephritis and reflux, with or without parenchymal reduction, than in those with acute pyelonephritis and normal radiologic findings. The latter group had significantly higher levels of IgG and IgA but not IgM anti-TH than did those with acute cystitits. In contrast, girls with renal parenchymal reduction but no signs of infection at the time of testing had significantly depressed anti-TH levels compared to control values.

Adolescent↗

Attachment of Escherichia coli to urinary sediment epithelial cells from urinary tract infection-prone and healthy children.

Escherichia coli isolated from patients with recurrent urinary tract infections were tested for ability to attach to human urinary sediment epithelial cells in vitro. Higher mean capacity to bind bacteria was found for epithelial cells of the patient from whom the E. coli strain had been isolated than for epithelial cells from subjects without a history of urinary tract infection. The two populations were age matched. No relation was found between the age of the cell donor (0 to 15 years) and the capacity for E. coli attachement.

Adolescent↗

Asymptomatic bacteriuria in schoolgirls. VIII. Clinical course during a 3-year follow-up.

A 3-year follow-up of 116 schoolgirls with asymptomatic bacteriuria, treated or untreated is reported. It is concluded that bacteria isolated from girls with asymptomatic bacteriuria do not commonly cause symptomatic pyelonephritis and that the risk of developing renal damage as a result of asymptomatic bacteriuria in a schoolgirl with a roentgenographically normal urinary tract seems to be small. It is also suggested that for the majority of these patients therapy is not necessary.

Adolescent↗