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PubMed1975

Adherent and non-adherent mouse peritoneal exudate cells.

Administration of proteose peptone to donors of peritoneal exudate cells resulted not only in quantitative increase in the mono-histiocytic cells but also in their activation as judged by their rapid adherence to surfaces, strong acid phosphatase reaction and increased numbers of lysosomes and phagocytic vacuoles. The three-hour adherent fraction of peritoneal exudate cells (from normal as well as peptone-stimulated mice) contains a large number of activated lymphocytes and fibroblastoid cells and is not enriched in macrophages. Moreover, the adherent cells, when collected by scraping, are unsuitable for immediate biological use since they lose the enzymatic equipment. For purification of histiocytes and macrophages by adherence, the 2-day cultivation of peritoneal cells was found to be optimal, as judged by the number of acid phosphatase positive cells. Their decrease after 4-day cultivation may indicate over-growth of the fibroblast and epithelial cell lineages. The non-adherent fraction was found to be enriched in lymphocytes as well as in mast cells; numerous macrophages were observed, too.

Animals↗

PubMed1978

Selection of antigen-specific cells by adherence to allogeneic cell monolayers: cytolytic activity, graft-vs.-host activity and numbers of adherent and nonadherent cells.

Rat lymph node cells taken at the peak of cytolytic activity following a skin allograft were separated into adherent and nonadherent fractions by incubation on monolayers of thoracic duct lymphocytes either of the same strain as the graft donor or of an Ag-B different strain. In the face of a 3-fold enrichment of cytolytic activity in the adherent cells and a 3-fold depletion in the nonadherent cells there was no detectable partition of graft-vs-host (GVH) activity. Supplementary experiments supported the simplest interpretation of this finding, namely that the antigen receptors on GVH-reactive cells did not influence their adherence in this system. Similarly, there was no partition of the GVH activity of nonimmune lymph node cells by adherence. Labeling lymph node cells with either radioactive uridine or thymidine in vitro, suggested that about 20% of DNA-synthesizing cells in the immune population adhered because of antigen recognition.

Animals↗

PubMed2003

Controlled comparison of retention and adherence in home- vs center-initiated exercise interventions in women ages 40-65 years: The S.W.E.A.T. Study (Sedentary Women Exercise Adherence Trial).

BACKGROUND: In an 18-month exercise intervention in previously sedentary older women (40-65 years), we examined whether an initial 6 months of supervised exercise leads to greater long-term retention and adherence to regular physical activity than an unsupervised home-based program and whether these outcomes are influenced by the exercise intensity. METHODS: Women (N = 126) were recruited from the community and randomly assigned to either center-based or home-based exercise three times/week. The center-based group attended supervised sessions for 6 months, while after 10 initial sessions the home-based group exercised at home. After 6 months both groups were home-based for a further 12 months. Within each arm, subjects were further randomized to exercise at either moderate or vigorous intensity. RESULTS: The center-based group had higher retention than the home-based (97, 94, 81 versus 87, 76, and 61%) at 6, 12, and 18 months, respectively (P < 0.05). At 6 months, adherence was higher in the center-based group (84 versus 63%, P < 0.001) and energy expenditure was higher at 6 (P < 0.05) and 12 (P < 0.01) months. At 18 months, retention was higher with moderate exercise (P < 0.05), while adherence was similar with both intensities. CONCLUSION: An initial 6 months of center-based exercise enhanced retention in both the short and the long term and promoted short-term adherence and energy expenditure. Long-term, moderate exercise retained more subjects, but had little influence on adherence.

Adult↗

PubMed1988

The restoration of proliferation and differentiation of peripheral blood mononuclear non-adherent cells into immunoglobulin-secreting cells by autologous synovial adherent cells from patients with rheumatoid arthritis.

The ability of enzyme-dissociated synovial adherent cells (SAC) obtained from patients with active rheumatoid arthritis to restore the proliferation and differention of peripheral blood mononuclear non-adherent cells (NAC) into immunoglobulin-secreting cells (ISC) was investigated. Autologous combinations of cells were used in this study to eliminate allogeneic reactions. Peripheral blood NAC, prepared by glass adherence and leucine methylester treatment to remove monocytes, almost completely lost their capacity to proliferate and differentiate into ISC in response to pokeweed mitogen. The response of NAC was restored by adding 12.5% of 'fresh SAC', which was obtained by glass-adherence after an overnight culture of non-rosette forming, enzyme-dissociated rheumatoid synovial cells. Although the response was also restorable by adding more than 25% fresh SAC, this was less satisfactory than adding 12.5% SAC. 'Old SAC', obtained by glass-adherence after 7 days culture of enzyme-dissociated synovial cells, did not restore the response of NAC. Immunohistochemical studies showed that 55% of fresh SAC and 3% of old SAC expressed HLA-DR antigens. When 100 units/ml of interferon gamma was present, 25% of old SAC remained HLA-DR-positive and some of these cells retained a dendritic morphology after 7 days culture. The results indicate that rheumatoid synovia contain macrophage-like cells that can effectively support the ultimate differentiation of lymphocytes to ISC.

Antibody-Producing Cells↗

PubMed1995

PGE2 induces the transition from non-adherent to adherent bone marrow mesenchymal precursor cells via a cAMP/EP2-mediated mechanism.

When mesenchymal precursor cells from bone marrow are cultured in the presence of dexamethasone, the existence of distinct non-adherent and adherent populations can be demonstrated. The addition of PGE2, forskolin, or dibutyryl-cAMP can induce a transition from the former to the latter and this may be an important mechanism in the bone anabolic effects of PGE2. On the other hand, phorbol 12-myristate 13-acetate (PMA), an activator of protein kinase C, and sulprostone, an agonist for the PGE2 receptor EP1/EP3 subtypes, had no effect. The phosphodiesterase inhibitor, isobutylmethylxanthine (IBMX), had a synergistic effect in combination with PGE2, whereas neomycin, an inhibitor of inositol phosphate activity, had no effect, and LiC1, an inhibitor of inositol triphosphate metabolism, had an inhibitory effect on the PGE2-induced transition. Consistent with this, the addition of PGE2 to non-adherent bone marrow cells caused a 100% increase in cAMP synthesis. These results suggest that the induction of the transition from non-adherent to adherent osteoblast precursor is mediated by the EP2-PGE2 receptor subtype via an increase in intracellular cAMP synthesis.

1-Methyl-3-isobutylxanthine↗

PubMed2006

Determinants of poor adherence in hypertensive patients: development and validation of the "Maastricht Utrecht Adherence in Hypertension (MUAH)-questionnaire".

OBJECTIVES: (1) To help identify patients with poor adherence and (2) to identify potential reasons that impede or facilitate adherence. METHODS: Seventeen patients who used antihypertensive drugs participated in semi-standardized interviews. Interviews were recorded and reviewed by two investigators. Forty-four items were selected. An exploratory factor analysis was performed. Convergent validity was assessed by evaluating the association between sum scores on the identified subscales and three other adherence measures: (1) the Brief Medication Questionnaire (BMQ), (2) pharmacy refill records and (3) electronic monitoring. Regression analysis was used to evaluate the magnitude of associations. RESULTS: Two hundred and fifty-five (90%) patients completed the questionnaire. Factor analysis resulted in a four-factor solution, explaining 30% of cumulative variance among respondents. The factors (scales) were labeled: positive attitude towards health care and medication (I), lack of discipline (II), aversion towards medication (III) and active coping with health problems (IV). Chronbach's alpha coefficient was 0.75, 0.80, 0.63 and 0.76 for scales I, II, III and IV, respectively. Convergent validity was partly supported by statistically significant associations that were found between sum scores of subscales 1 and II and the BMQ and electronic monitoring, respectively. CONCLUSION: The MUAH-questionnaire has excellent psychometric properties and may be useful to identify factors that impede or facilitate adherence. However, it is not clear to what extent the questionnaire measures actual adherence. PRACTICE IMPLICATIONS: Validation of the MUAH-questionnaire in other studies is needed.

Adaptation, Psychological↗

PubMed1984

Adherence of cervical, vaginal and distal urethral normal microbial flora to human uroepithelial cells and the inhibition of adherence of gram-negative uropathogens by competitive exclusion.

The adherence of the normal flora to human uroepithelial cells was examined using scanning and transmission electron microscopy and an in vitro adhesion assay. The normal flora were isolated from human cervical, vaginal and distal urethral surfaces. Human uroepithelial cells were obtained from healthy females (controls) and from female patients with recurrent urinary tract infection. The results indicate that: 1) there was no significant difference between the mean adherence of the normal flora to the uroepithelial cells from controls or patients, but there were quantitative differences between different bacterial species of the normal flora attaching to uroepithelial cells; 2) bacterial species isolated from the distal urethral and vaginal surfaces attached in larger numbers to uroepithelial cells from controls than from patients at day 10 of the menstrual cycle (peak value of adherence); 3) the adherence patterns of the cervical and vaginal microbial flora were bicyclic and appeared to be related to the human menstrual cycle; 4) complete or partial inhibition of adherence of several Gram-negative uropathogens was achieved by preincubating the uroepithelial cells with several bacterial species of the normal flora. Results from this study suggest that the normal flora of the urinary tract may play an important protective role against attachment of uropathogens to the surfaces of uroepithelial cells, and that the blocking capacity of these organisms may vary over the menstrual cycle.

Cervix Uteri↗

PubMed2001

Pharmacological comparison of LTB(4)-induced NADPH oxidase activation in adherent and non-adherent guinea-pig eosinophils.

1. Leukotriene B(4) (LTB(4)) stimulation of guinea-pig peritoneal eosinophils, induced a biphasic activation of the NADPH oxidase composed of a rapid (<3 min) phase mediated by non-adherent cells and a sustained (3 - 120 min) phase mediated by CD11b/CD18 adherent eosinophils. Studies were undertaken to compare the intracellular mechanism that mediate these responses. 2. SB 203580 and PP1, inhibitors of p38 mitogen-activated protein (MAP) kinase and the src-family protein tyrosine kinases, respectively caused concentration-dependent attenuation of both the rapid (SB203580: pD(2)=-6.31; PP1: pD(2)=-5.50) and sustained (SB203580: pD(2)=-6.50; PP1: pD(2)=-5.73) phases. Similarly, the MAP kinase kinase-1 inhibitor, PD098059 produced partial inhibition of the both phases of superoxide generation. 3. The protein kinase C (PKC) inhibitors Ro-31 8220, GF 109203X and Gö 6976 attenuated the rapid NADPH oxidase response (pD(2)s=-6.10, -6.72, -6.15 respectively) and, to a lesser extent, (pD(2)s=-5.54, -6.02, -6.51 respectively) the sustained phase. 4. An inhibitor of phosphatidylinositol 3-kinase (PtdIns 3-kinase), wortmannin caused concentration dependent attenuation of the sustained (pD(2)=-8.68) but not rapid phase of superoxide generation. In contrast, the syk kinase inhibitor, piceatannol abolished the rapid (pD(2)=-6.43) but not sustained respiratory responses. 5. This study demonstrates that LTB(4)-induced superoxide generation from adherent and non-adherent eosinophils is mediated via both common (p38 MAP kinase, MEK-1, PKC and the src kinases) and divergent intracellular pathways (syk kinases and PtdIns 3-kinase). This suggests the possibility of therapeutic intervention to selective attenuate activation of adherent tissue eosinophils.

Androstadienes↗

PubMed2001

Adherence of Aspergillus species to soft contact lenses and attempts to inhibit the adherence.

The aim of this research was to assess the adherence of various Aspergillus species (A. niger, A. fumigatus, A. flavus) to contact lenses with different water content and to attempt to inhibit the adherence of Aspergillus spp. to the contact lenses by a chitin derivative (CSE). Adherence of Aspergillus spp. to lenses with higher water content was greater. Differences were found between the adherence levels of various Aspergillus species to contact lenses with different water content. CSE significantly inhibits the adherence in vitro of A. niger, A. fumigatus and A. flavus to soft contact lenses. These findings suggest a possibility for prevention of fungal ocular infections caused by Aspergillus spp. in wearers of contact lenses.

Aspergillus↗

PubMed2000

The old problem of adherence: research on treatment adherence and its relevance for HIV/AIDS.

The international published research on patient adherence was selectively reviewed with the goal of determining its relevance for the treatment of HIV/AIDS. Results show that not adhering to treatment regimes is so widespread that no combination of sociodemographic variables is reliably predictive of patients' not following doctors' orders. Achieving 100% adherence for any treatment or patient group does not appear to be realistic. Characteristics of the patient's situation, of the given therapy, and of the disease itself affect adherence. In addition, the patient-doctor relationship and the context of the treatment are important. Often overlooked are the existential dimensions of meaning, self-determination and quality of life which are particularly important for the chronically ill. Treatment needs to be negotiated individually with each patient on the basis of an open therapeutic relationship and with the help of multidimensional interventions. Lessons from the discourse on safer sex can steer adherence research and practice away from a behavioural and reductionist approach toward the context and meaning of treatment.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Effects of a treatment adherence enhancement program on health literacy, patient-provider relationships, and adherence to HAART among low-income HIV-positive Spanish-speaking Latinos.

The impact of an adherence enhancement program for low income HIV-infected Spanish-speaking Latinos on health literacy, patient-provider relationships, and adherence to HAART was examined. Evaluations were conducted at baseline, 6 weeks, and 6 months for participants (n = 85) randomly assigned to either the intervention group or a comparison group; 69 (81%) remained in the study for the entire 6-month duration. The intervention group scored significantly better than the comparison group on 3 of 5 measures of HIV health literacy at 6 weeks and on 2 of 5 measures, at 6 months. While there was a weak trend for the intervention group to report an increase in self-efficacy of medication adherence management, baseline to 6 weeks, no other changes were significant. Perceptions of the quality of relationship and communications with their HIV-treating physicians improved both at 6 weeks (p = 0.04) and at 6 months (p < 0.001). The comparison group showed little change baseline to 6 weeks and baseline to 6 months. While there was a trend for the pilot group to report better medication adherence, these differences were not statistically significant. Further evaluation of the impact of this adherence enhancement program is needed.

Adult↗

PubMed1995

Participation in an employee fitness program: determinants of high adherence, low adherence, and dropout.

This article presents the results of a study of the determinants of adherence level in an employee fitness program. Of all 236 employees who started participating in the program the determinants of level of participation (high adherence, low adherence, and dropouts) during the program were studied by means of a pretest and posttest design. The questionnaire was based on different theoretical concepts. The determinants measured included the attitude toward an employee fitness program, self-efficacy expectation, and social support. The results show that there were no differences in determinants between the groups at the start of the program. During the second measurement the high- and low-adherence groups were most convinced of the benefits of participation in the program. The low-adherence group and the dropouts were least convinced of their ability to participate in a fitness program. Theoretical and practical implications are discussed.

Analysis of Variance↗

PubMed1989

Properties of adherence factor plasmids of enteropathogenic Escherichia coli and the effect of host strain on expression of adherence to HEp-2 cells.

EPEC adherence factor (EAF) plasmids from three strains of enteropathogenic Escherichia coli (EPEC) - E2347/69 (O127:H6), E20517 (O111:H2) and E24582 (O142:H6) - were examined. The EAF plasmids were all marked with ampicillin resistance by transposition of Tn801 to give pDEP1, pDEP2 and pDEP11, respectively. All three plasmids showed incompatibility with an FIme and an FIV plasmid and had some similarity in restriction enzyme digest patterns. Plasmid pDEP1 differed from pDEP2 and pDEP11 in being autotransferring and fertility-inhibition positive. An EAF probe consisting of a 1 kb BamHI-SalI restriction endonuclease fragment of the prototype EAF-associated plasmid pMAR2 hybridized to similar-sized SalI-BamHI fragments of pDEP1 and pDEP11 but to a different-sized fragment of plasmid pDEP2. Loss of the EAF plasmids from EPEC strains resulted in a marked reduction in the ability of these strains to adhere to HEp-2 cells. The EAF-plasmid-negative variants did not express a 94 kDa outer-membrane protein (OMP). When these EAF plasmids were reintroduced into EAF-plasmid-negative EPEC strains a high level of adherence equivalent to that of the parent EPEC strains was restored and a 94 kDa OMP was usually expressed. However, when EAF plasmids were transferred into E. coli K12 or non-EPEC E. coli the host strains either did not adhere or adhered poorly to the HEp-2 cells. These transconjugants did not express a 94 kDa OMP.

Adhesins, Escherichia coli↗

PubMedDate not supplied

Supporting medication adherence in renal transplantation (SMART): a pilot RCT to improve adherence to immunosuppressive regimens.

BACKGROUND: Although non-adherence to an immunosuppressive regimen (NAH) is a major risk factor for poor outcome after renal transplantation (RTx), very few studies have examined non-adherence intervention in this context. This pilot randomized controlled trial (RCT) tested the efficacy of an educational-behavioural intervention to increase adherence in non-adherent RTx patients. We also assessed how NAH evolves over time. METHODS: Eighteen RTx non-adherent patients (age: 45.6 +/- 1.2 yr; 78.6% male) were randomly assigned to either an intervention group (IG) (n = 6) or an enhanced usual care group (EUCG) (n = 12), the latter receiving the usual clinical care. The IG received one home visit and three telephone interviews. We assessed NAH through electronic monitoring (EM) of medication intake during a nine-month period (three months intervention, six months follow-up). RESULTS: Five of 18 patients withdrew. Inclusion in the study resulted in a remarkable decrease in NAH in both groups over the first three months (IG chi(2) = 3.97, df = 1, p = 0.04; EUCG chi(2) = 3.40, df = 1, p = 0.06). The IG showed the greatest decrease in NAH after three months, although this did not reach statistical significance (at 90 d, chi(2) = 1.05, df = 1, p = 0.31). Thereafter, NAH increased gradually in both groups, reaching comparable levels at the end of the six-month follow-up (i.e. at nine months). CONCLUSION: Our findings suggest an inclusion effect. Although the intervention in this pilot RCT appeared to add further benefit in medication compliance, a lack of statistical power prevented us from making a strong statistical statement.

Adolescent↗

PubMed1989

[Role of normal microflora in the throat in inhibition of adherence of pathogenic bacteria to host cells: in vitro competitive adherence between Corynebacterium pseudodiphtheriticum and Branhamella catarrhalis].

Our previous study showed the occurrence of Branhamella catarrhalis (B. catarrhalis) pulmonary infections which varies seasonally. To investigate the role of normal throat microflora in this seasonal variation of the occurrence of B. catarrhalis infection, seventy seven throat cultures were done in 45 patients with chronic pulmonary diseases from January to December in 1985. The isolation rate of Corynebacterium species as normal microflora was relatively higher in summer than in winter. Therefore in vitro competitive adherence to human epithelial cells between Corynebacterium pseudodiphtheriticum (C. pseudodiphtheriticum) and B. catarrhalis was done to examine bacterial interference. Preincubation or simultaneous incubation of C. pseudodiphtheriticum reduced the number of B. catarrhalis adherent to epithelial cells (p less than 0.02). The mean number of adherent C. pseudodiphtheriticum (average; 13.86) was higher than that (average; 1.22) of adherent B. catarrhalis. There was no antagonism in the growth on blood agar between C. pseudodiphtheriticum and B. catarrhalis. These findings suggest Corynebacterium species as normal throat microflora may interfere the adherence of B. catarrhalis to human epithelial cells and may protect against colonization and infection with B. catarrhalis. Bacterial interference of Corynebacterium species may be associated with the low occurrence of B. catarrhalis pulmonary infections in summer.

Adult↗

PubMed1997

Aggregative adherence fimbria II, a second fimbrial antigen mediating aggregative adherence in enteroaggregative Escherichia coli.

Enteroaggregative Escherichia coli (EAEC) has been implicated as an agent of pediatric diarrhea in the developing world. We have shown previously that EAEC adheres to HEp-2 cells by virtue of a plasmid-encoded fimbrial adhesin designated aggregative adherence fimbria I (AAF/I), the genes for which have been cloned and sequenced. However, not all EAEC strains express AAF/I. Using TnphoA mutagenesis, we have characterized a novel fimbria (designated AAF/II) which mediates HEp-2 adherence of the human-pathogenic strain 042. AAF/II is 5 nm in diameter and does not bind AAF/I antiserum, as determined by immunogold transmission electron microscopy. TnphoA identified a gene (designated aafA) which bears significant homology to aggA, the fimbrial subunit of AAF/I (25% identity and 47% similarity at the amino acid level). When hyperexpressed and purified by polyhistidine tagging, the AafA protein assembled into 5-nm-diameter filaments which bound anti-AAF/II antiserum. The cloned aafA gene complemented a mutation in the aggA gene to confer fimbrial expression from the AAF/I gene cluster, manifesting phenotypes characteristic of AAF/II but not AAF/I. The aafA mutant did not adhere to human intestinal tissue in culture, suggesting a role for AAF/II in intestinal colonization. By using DNA probes for AAF/I and AAF/II derived from fimbrial biosynthesis genes, we show that AAF/I and AAF/II are each found in only a minority of EAEC strains, suggesting that still more EAEC adhesins exist. Our data suggest that AAF adhesins represent a new family of fimbrial adhesins which mediate aggregative adherence in EAEC.

Adhesins, Escherichia coli↗

PubMed1996

Antibody response in bronchoalveolar lavage and serum of rats after aerosol immunization of the airways with a well-adhering and a poorly adhering strain of Streptococcus pneumoniae.

This study describes the antibody response to two bacterial antigens, pneumolysin toxoid (PL) and purified pneumococcal capsular polysaccharide (PPS) 19F, in bronchoalveolar lavage (BAL) and in serum in rats after aerosol immunization with whole killed Streptococcus pneumoniae. To study the importance of bacterial adherence for antibody formation, one well-adhering and one poorly adhering strain of S. pneumoniae was used. The results show local specific anti-PPS 19F IgA, IgM and IgG antibody activities after aerosol immunization. Anti-PL antibody activity in all three immunoglobulin classes was found, although the anti-PL activity was lower than the anti-PPS 19F antibody activity. The IgA anti-PPS 19F antibody activity in BAL after immunization with the well-adhering strain was higher than with the poorly adhering strain. We conclude that aerosol immunization with S. pneumoniae induces a local, specific antibody production in the lung of the rat.

Aerosols↗

PubMed2005

Drug adherence: effects of decreased visit frequency on adherence to clozapine therapy.

OBJECTIVE: To study the effects of visit frequency on drug-adherence parameters subsequent to the change in the United States Food and Drug Administration (FDA)-mandated monitoring of white blood cell counts from weekly to every 2 weeks (biweekly) after 6 months of clozapine therapy. METHODS: Paid prescription claims records for clozapine from September 1, 1995-August 31, 2001, were extracted from the Texas Medicaid Vendor Drug Program database. Two groups of subjects were identified: subjects treated before and those treated after the FDA labeling change in monitoring frequency, which occurred on April 1, 1998. Prescription claims records for each subject were assessed for 365 days after the initial 6 months of therapy. Adherence measures included persistence, medication possession ratio (MPR), and time taking clozapine. RESULTS: Subjects receiving weekly hematologic monitoring had significantly higher rates of persistence (0.79 +/- 0.35 vs 0.70 +/- 0.38, p < 0.001) and MPRs (0.75 +/- 0.36 vs 0.66 +/- 0.38, p < 0.001) and continued to take clozapine longer (p < 0.002) compared with subjects receiving biweekly monitoring. Fewer subjects in the weekly monitoring group discontinued clozapine therapy during the 1-year study period (49.4% vs 57.9%, p = 0.008). Similar results were observed when cohorts were matched according to age, sex, and index clozapine dosage. CONCLUSION: Significant effects of visit frequency on adherence to clozapine therapy were noted. For patients inadequately adherent to therapy, an increase in visit frequency may improve adherence, and based on these results, the extra visits do not need to be with a physician or have any specific purpose other than contact with a provider.

Adolescent↗