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1.
Lupus ; 21(1): 3-12, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21976401

ABSTRACT

African-American recipients of kidney transplants with lupus have high allograft failure risk. We studied their risk adjusting for: (1) socio-demographic factors: donor age, gender and race-ethnicity; recipient age, gender, education and insurance; donor-recipient race-ethnicity match; (2) immunologic factors: donor type, panel reactive antibodies, HLA mismatch, ABO blood type compatibility, pre-transplant dialysis, cytomegalovirus risk and delayed graft function (DGF); (3) rejection and recurrent lupus nephritis (RLN). Two thousand four hundred and six African-, 1132 Hispanic-, and 2878 Caucasian-Americans were followed for 12 years after transplantation. African- versus Hispanic- and Caucasian-Americans received more kidneys from deceased donors (71.6%, 57.3% and 55.1%) with higher two HLA loci mismatches for HLA-A (50%, 39.6% and 32.4%), HLA-B (52%, 42.8% and 35.6%) and HLA-DR (30%, 24.5% and 21.1%). They developed more DGF (19.5%, 13.6% and 13.4%). More African- versus Hispanic- and Caucasian-Americans developed rejection (41.7%, 27.6% and 35.9%) and RLN (3.2, 1.8 and 1.8%). 852 African-, 265 Hispanic-, and 747 Caucasian-Americans had allograft failure (p < 0.0001). After adjusting for transplant era, socio-demographic-immunologic differences, rejection and RLN, the increased hazard ratio for allograft failure of African- compared with Caucasian-Americans became non-significant (1.26 [95% confidence interval 0.78-2.04]). African-Americans with lupus have high prevalence of risk factors for allograft failure that can explain poor outcomes.


Subject(s)
Black or African American , Graft Rejection/immunology , Hispanic or Latino , Kidney Transplantation/immunology , White People , Adult , Ethnicity , Female , Graft Survival/immunology , Humans , Middle Aged , Risk Factors , Transplantation, Homologous/immunology , Treatment Outcome , Young Adult
2.
Phys Rev Lett ; 105(20): 203005, 2010 Nov 12.
Article in English | MEDLINE | ID: mdl-21231229

ABSTRACT

We demonstrate the creation of vortices in the electronic probability density of an atom subject to short electric field pulses, how these vortices evolve and can be manipulated by varying the applied pulses, and that they persist to macroscopic distances in the spectrum of ejected electrons. This opens the possibility to use practical femtosecond or shorter laser pulses to create and manipulate these vortex quasiparticles at the atomic scale and observe them in the laboratory. Within a hydrodynamic interpretation we also show, since the Schrödinger equation is a particular instance of the Navier-Stokes equations, that for compressible fluids vortices can appear spontaneously and with a certain time delay, which is not expected to occur from the conventional point of view, illustrating applicability of the present study to vortex formation more broadly.

3.
Lupus ; 19(5): 557-74, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20089610

ABSTRACT

Systemic lupus erythematosus may present with renal manifestations that frequently are difficult to categorize and lupus nephritis is an important predictor of poor outcome. The type and spectrum of renal injury may remain undiagnosed until full-blown nephritic and/or nephrotic syndrome appear with increased risk of end-stage renal disease. These abnormalities occur within the first few years after the diagnosis of lupus is made on clinical grounds and with the support of laboratory tests in high risk patients. An early renal biopsy is helpful in patients with an abnormal urinalysis and/or reduced glomerular filtration rate and the results form the basis for therapeutic decisions. The biopsy also provides vital prognostic information based on histological categorization of different types of lupus nephritis, the degree of activity, chronicity and the immunopathogenesis. In the current armamentarium, the use of cyclophosphamide and azathioprine and recently mycophenolate mofetil, reduce morbidity and maintenance therapies reduce the risk of end-stage renal disease. Clinical trials underway promise new, effective and safe immunosuppressive regimens for the treatment of proliferative lupus nephritis.


Subject(s)
Lupus Nephritis , Humans , Lupus Nephritis/classification , Lupus Nephritis/drug therapy , Lupus Nephritis/epidemiology , Lupus Nephritis/etiology , Lupus Nephritis/pathology , Practice Guidelines as Topic , Prognosis
4.
Science ; 214(4520): 557-8, 1981 Oct 30.
Article in English | MEDLINE | ID: mdl-6270789

ABSTRACT

Receptors for the activated third component of complement and for the Fc portion of immunoglobulin G are not expressed by apparently normal bovine pulmonary endothelial cells, but are expressed when the cells are exposed to white cell lysates or are infected with influenza or cytomegalovirus. The unmasking of these latent receptors may contribute to the pulmonary inflammatory response characteristic of, for example, anaphylaxis and to those lung diseases characterized by the deposition of immune complexes.


Subject(s)
Pulmonary Artery/cytology , Receptors, Complement/metabolism , Receptors, Fc/metabolism , Animals , Cattle , Cells, Cultured , Complement C3b/metabolism , Cytomegalovirus Infections/physiopathology , Endothelium/metabolism , Orthomyxoviridae Infections/physiopathology
5.
Science ; 208(4445): 748-9, 1980 May 16.
Article in English | MEDLINE | ID: mdl-7367890

ABSTRACT

Bovine pulmonary endothelial cells do not possess receptors for the 3b component of complement (C3b) or for the Fc portion of immunoglobulin G. The lack of these receptors may help explain the nonthrombogenic function of endothelial cells. Our findings rule out the possibility that endothelial cells participate in pulmonary immune complex disease through the binding of C3b or Fc fragments.


Subject(s)
Pulmonary Artery/immunology , Receptors, Complement/metabolism , Receptors, Fc/metabolism , Animals , Cattle , Cells, Cultured , Complement C3b/metabolism , Endothelium/immunology , Pulmonary Artery/metabolism , Rosette Formation
6.
Radiat Prot Dosimetry ; 122(1-4): 22-5, 2006.
Article in English | MEDLINE | ID: mdl-17132666

ABSTRACT

The use of heavy ion beams for microbeam studies of mammalian cell response leads to a need to better understand interaction cross sections for collisions of heavy ions with tissue constituents. For ion energies of a few MeV u(-1) or less, ions capture electrons from the media in which they travel and undergo subsequent interactions as partially 'dressed' ions. For example, 16 MeV fluorine ions have an equilibrium charge of 7(+), 32 MeV sulphur ions have an equilibrium charge of approximately 11(+), and as the ion energies decrease the equilibrium charge decreases dramatically. Data for interactions of partially dressed ions are extremely rare, making it difficult to estimate microscopic patterns of energy deposition leading to damage to cellular components. Such estimates, normally obtained by Monte Carlo track structure simulations, require a comprehensive database of differential and total ionisation cross sections as well as charge transfer cross sections. To provide information for track simulation, measurement of total ionisation cross sections have been initiated at East Carolina University using the recoil ion time-of-flight method that also yields cross sections for multiple ionisation processes and charge transfer cross sections; multiple ionisation is prevalent for heavy ion interactions. In addition, measurements of differential ionisation cross sections needed for Monte Carlo simulation of detailed event-by-event particle tracks are under way. Differential, total and multiple ionisation cross sections and electron capture and loss cross sections measured for C(+) ions with energies of 100 and 200 keV u(-1) are described.


Subject(s)
Biopolymers/chemistry , Biopolymers/radiation effects , Heavy Ions , Models, Chemical , Models, Molecular , Radiation, Ionizing , Radiometry/methods , Computer Simulation , Linear Energy Transfer , Monte Carlo Method , Radiation Dosage , Static Electricity
7.
Mol Immunol ; 19(12): 1681-9, 1982 Dec.
Article in English | MEDLINE | ID: mdl-7162523

ABSTRACT

The lectin of Euonymus europaeus at concentrations of 5-21 micrograms/ml causes activation of the classical complement (C) pathway (C1, C4, C2) when added to normal human serum at 37 degrees C. At higher concentrations, C3 is also consumed. The effect is dependent on a 'natural antibody' in serum of the IgM class which reacts with an epitope of the lectin. With physicochemical methods, the carbohydrate of the lectin was shown to be involved in the activation of C, but not involved in the agglutination of group B erythrocytes. Removal of N-acetyl-D-glucosamine from the lectin with an exoglycosidase greatly reduced the activation of C in serum, but it did not affect erythroagglutination. Using competitive binding studies with various sugars, it was confirmed that N-acetyl-D-glucosamine is the dominant specificity of a determinant for activation of the classical C pathway in serum.


Subject(s)
Complement Activation , Complement Pathway, Classical , Lectins/pharmacology , Binding, Competitive , Carbohydrates/pharmacology , Complement C2/metabolism , Complement C4/metabolism , Complement Pathway, Classical/drug effects , Glycolysis , Glycoside Hydrolases , Hemagglutination , Humans , Immunoglobulin M/metabolism , Trisaccharides/pharmacology
8.
Neurology ; 27(11): 1095-6, 1977 Nov.
Article in English | MEDLINE | ID: mdl-563006

ABSTRACT

A patient with confirmed western equine encephalitis had the rapid onset of postencephalitic parkinsonian sequelae. This observation corroborates similar previous but rare reports. Response to therapy with levodopa, dopa decarboxylase inhibitor, and trihexyphenidyl was dramatic. However, remission maintained for 12 months without medication suggests that the parkinsonism would have remitted spontaneously. In either case, this has not previously been reported with the western equine togavirus.


Subject(s)
Encephalomyelitis, Equine/complications , Parkinson Disease/etiology , Adult , Carbidopa/therapeutic use , Encephalitis Virus, Western Equine , Female , Humans , Levodopa/therapeutic use , Parkinson Disease/drug therapy , Trihexyphenidyl/therapeutic use
9.
Am J Med ; 87(3N): 22N-29N, 1989 Sep.
Article in English | MEDLINE | ID: mdl-2484793

ABSTRACT

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder characterized by intermittent hemolytic anemia. Membrane abnormalities of blood cells from patients with PNH are the reason for the unusual sensitivity to lysis by autologous plasma complement. A patient with typical clinical disease consistent with PNH is described together with a few strategies and pitfalls for treatment. Commonly used in vitro assays are discussed that document the complement-mediated lysis of aberrant PNH erythrocytes. Membrane-associated proteins that are abnormal in PNH cells, the characteristics of these proteins, and their mechanism(s) of action are described; these include the decay accelerating factor that inhibits the C3/C5 convertases of both complement pathways on cell surfaces, the C8 binding protein that modulates a step in terminal complement lysis, and other proteins that regulate complement-mediated lysis at early or late steps of the complement cascade.


Subject(s)
Blood Proteins/deficiency , CD59 Antigens , Carrier Proteins/physiology , Complement Inactivator Proteins/deficiency , Erythrocyte Membrane/chemistry , Hemoglobinuria, Paroxysmal/blood , Membrane Proteins/deficiency , Receptors, Complement/deficiency , Adult , Blood Proteins/immunology , Blood Proteins/physiology , CD55 Antigens , Carrier Proteins/immunology , Complement C3/analysis , Complement C4/analysis , Complement Inactivator Proteins/immunology , Complement Inactivator Proteins/physiology , Female , Hemoglobinuria, Paroxysmal/immunology , Hemoglobinuria, Paroxysmal/physiopathology , Humans , Membrane Proteins/immunology , Membrane Proteins/physiology , Receptors, Complement/immunology , Receptors, Complement/physiology , Receptors, Complement 3b
10.
Am J Med ; 58(3): 431-7, 1975 Mar.
Article in English | MEDLINE | ID: mdl-1078754

ABSTRACT

A 37 year old woman with extravascular hemolytic anemia had a positive Monospot test associated with positive antiglobulin and anticomplement Coombs' tests, cold agglutinins and warm autoantibodies. IgG-kappa (k) antibodies, which reacted with all panel red cells at 37 degrees C, were eluted from her circulating red cells. However, neither immunoglobulins nor C3 was detected after her serum was adsorbed with heterologous red cell stroma at 37 degrees C and eluted at the same temperature in glycine buffer. In contrast, IgM-kappa and IgM-lambda (lambda), IgG-3-kappa, IgG4-lambda, IgA-lambda and C3 were eluted at 37 degrees C from heterologous red cell stroma after adsorption with her serum at 0 degrees C. Thus, antibodies of several types, which were present in the patient's serum, reacted optimally with red cell antigens at low temperature. Cold-reactive IgG3-kappa antibodies, which also capable of interacting with red cells at 37 degrees C, probably accounted for the IgG-kappa antibodies eluted from the patient's circulating red cells. The patient's serum C4 titers were decreased, with low normal to moderately depressed C3 and low normal C5, indicating that the anti-red cell IgM and/or IgG3-kappa antibodies probably fixed complement. A localized cold stress test resulted in a transient increase in plasma hemoglobin and a decrease in serum C3 titer. These findings, and the beneficial clinical response obtained with small doses of prednisone, suggest that both the cold-reactive antibodies and the IgG-kappa on circulating red cells were pathophysiologically significant. This is the first report of a patient with multiple red cell autoantibodies in whom serum complement component titers were determined in conjunction with characterization of the anti-red cell immunoglobulins. Subclinical infectious mononucleosis may have preceded the prolonged hemolytic episode. Clinical evidence of systemic lupus erythematosus has not appeared.


Subject(s)
Anemia, Hemolytic/immunology , Autoantibodies , Complement System Proteins/analysis , Adsorption , Adult , Agglutinins/analysis , Animals , Antibodies, Anti-Idiotypic , Antigens , Autoantibodies/analysis , Cold Temperature , Coombs Test , Erythrocytes/immunology , Female , Goats/immunology , Hemolysis , Hot Temperature , Humans , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M
11.
Am J Med ; 58(4): 567-75, 1975 Apr.
Article in English | MEDLINE | ID: mdl-804814

ABSTRACT

A patient with Walderström macroglobulinemia associated with nephrotic syndrome is described. Serum cryoglobulin and rheumatoid factor were absent. Intramembranous electron-dense deposits were demonstrated in kidney biopsy material by electron microscopy. Deposits of immunoglobulin G (IgG), M (IgM) and the third component of complement (C3) were identified in kidney biopsy tissue by immunofluorescent staining methods. The serum immunoglobulins were characterized by chromatographic and immunochemical methods and showed a monocional IgM-K, IgG-K and gamma-chain piece of undefined structure. Free K- and gamma-chains were found in the urine. The IgM was not complexed to the IgG or vice versa, but the IgG was in an affregated form. Although it is not known which immunoglobulin initiated the tissue injury, IgG, IgM and complement deposits probably contributed to the renal dysfunction. The nephrotic syndrome diminished after treatemnt with chlorambucin and corticosteroids.


Subject(s)
Glomerulonephritis/complications , Nephrotic Syndrome/etiology , Waldenstrom Macroglobulinemia/complications , Animals , Biopsy, Needle , Chromatography, Gel , Complement System Proteins , Fluorescent Antibody Technique , Glomerulonephritis/immunology , Glomerulonephritis/metabolism , Goats/immunology , Humans , Immunoelectrophoresis , Immunoglobulin G , Immunoglobulin M , Kidney/pathology , Kidney Glomerulus/immunology , Male , Microscopy, Electron , Nephrotic Syndrome/immunology , Nephrotic Syndrome/metabolism , Proteinuria/etiology , Waldenstrom Macroglobulinemia/immunology , Waldenstrom Macroglobulinemia/metabolism
12.
Semin Arthritis Rheum ; 26(5): 724-39, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9144849

ABSTRACT

Great progress has been made within the past 10 years in characterizing, assaying, and describing mechanism(s) of action in vitro of antiphospholipid antibodies (a-PL Abs); three prominent members are reagin, anticardiolipin antibodies (a-CL Abs), and the lupus anticoagulants (LAC). The major focus of this review is on basic and current biochemical and immunologic research. First, the biochemistry, structural composition, and sources of anionic and dipolar ionic (zwitterionic) phospholipids are discussed together with several serum antibodies directed to these phospholipids. Cardiolipin, the most acidic phospholipid (net negative charge of 2 at pH 7.0) has been historically important as an antigen for testing reagin in syphilis serology, and currently is part of the antigenic composition used in the Venereal Disease Research Laboratory (VDRL) tests. In this connection, the chronic biological false-positive test for syphilis and the LAC are discussed in association with autoimmune disorders such as systemic lupus erythematosus. Second, a naturally occurring plasma anticoagulant in vitro and a critical cofactor for binding of purified autoimmune a-CL Abs to cardiolipin is considered, the beta 2-glycoprotein I (beta 2-gpI). This single-chain plasma polypeptide is highly glycosylated, has 326 amino acids, a molecular weight of 50 kD, and is characterized by repeating amino acid motifs or domains that structurally resemble multiple loops. The highly cationic C-terminal fifth domain binds to anionic phospholipids. The beta 2-gpI is a member of the short consensus repeat superfamily of proteins, and is compared with other proteins with similar domains. Third, experiments are detailed for defining LAC and distinguishing it from other a-CL Abs. Cofactors are also associated with LAC and include beta 2-gpI, prothrombin, protein C, protein S, tissue factor, and factor XI. Thus, LAC antibodies are heterogeneous, and no individual assay can detect all LACs. Because patients with syphilis and other infectious diseases have no cofactor associated with a-CL Abs, their plasma LACs are negative. The a-CL Abs found in infection are not associated with the clinical features of the antiphospholipid syndrome. LAC assays are important because of the pathogenetic association with clinical observations of venous and arterial thrombosis, thrombocytopenia, and recurrent fetal loss. Finally, reports leading to development of currently used direct solid-phase enzyme-linked immunosorbent assays (ELISA) for testing a-PL Abs are outlined; these developments have greatly increased understanding of the basic immunology of target antigens and their respective antibodies. Of significance, a-CL Abs cross-react with other anionic phospholipids. Additionally, the results of these assays led to the realization that high levels of circulating a-PL Abs over long periods are associated with a number of clinical problems now known collectively as the antiphospholipid syndrome.


Subject(s)
Antibodies, Antiphospholipid/analysis , Antibodies, Antiphospholipid/immunology , Animals , Anions/immunology , Glycoproteins/chemistry , Glycoproteins/immunology , Humans , Immunization , Lupus Coagulation Inhibitor/immunology , Molecular Conformation , Phospholipids/immunology , beta 2-Glycoprotein I
13.
Semin Arthritis Rheum ; 29(5): 267-85, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10805352

ABSTRACT

OBJECTIVES: To characterize antineutrophil cytoplasmic antibodies (ANCA), their major autoantigens, disease associations, and pathophysiology in systemic vasculitides. To describe a patient with a novel de novo ANCA-associated vasculitis after kidney transplantation. METHODS: We reviewed and compiled the literature on ANCA-related topics and systemic vasculitis. Laboratory and clinical data from a cadaveric kidney transplant patient who developed necrotizing vasculitis involving glomerular capillaries, with crescent formation associated with P-ANCA and myeloperoxidase, were analyzed. RESULTS: Large-scale multi-center testing of patient and normal sera by the European ANCA Assay Standardization Project using immunofluorescence assays and enzyme immunoassays indicate the assays have good sensitivity and specificity, and diagnostic utility for ANCA-associated vasculitis. A few investigations covering basic and clinical research with ANCA remain controversial: whether endothelial cells do or do not express a 29-kd neutral serine protease termed proteinase-3 (PR-3), the target of ANCA in most individuals with Wegener's granulomatosis, and whether anti-myeloperoxidase (MPO) ANCAs recognize a restricted number of epitopes on MPO. This issue has relevance for using monoclonal antibodies to treat patients with vasculitis who have adverse effects from immunosuppressive drugs. The two allelic forms of FcgammaRIIa (H131/R131) and the two of FcgammaRIIlb (NA1/NA2) are discussed as possible inheritable genetic elements for vasculitic disorders and for signaling responses. Stimulatory and costimulatory molecules, and cytokine profiles of T lymphocytes are characterized to show that these cells are actively involved in the ANCA-associated vasculitides. The patient described had a de novo ANCA associated small vessel vasculitis which developed after renal transplantation. CONCLUSIONS: There have been significant advances in the development of sensitive and specific ANCA assays. The immunopathogenetic mechanism of ANCA involves the constitutive FcgammaRs, ligands, and signaling responses to activate cytokine-primed neutrophils. This may lead to the generation of reactive oxygen intermediates, degranulation, and secretion of intracellular granule contents, and ultimately inflammation and vasculitis.


Subject(s)
Antibodies, Antineutrophil Cytoplasmic/physiology , Autoantigens/immunology , Glomerulonephritis/physiopathology , Kidney Transplantation/adverse effects , Vasculitis/physiopathology , Adult , Enzyme-Linked Immunosorbent Assay , Female , Fluorescent Antibody Technique, Indirect , Glomerulonephritis/etiology , Glomerulonephritis/immunology , Humans , Myeloblastin , Peroxidase/immunology , Receptors, IgG/immunology , Sensitivity and Specificity , Serine Endopeptidases/immunology , Vasculitis/etiology , Vasculitis/immunology
14.
Semin Arthritis Rheum ; 22(6): 357-74, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8342043

ABSTRACT

The rheumatic diseases (RDs) are characterized by acute and chronic inflammation, and autoimmunity plays a major role in their pathogenesis. RDs are for the most part of unknown etiology, but recent evidence indicates that heat shock or stress proteins (HSPs) may have an important role in the etiology/pathogenesis of RDs. HSPs are produced by prokaryotic and eukaryotic cells and are grouped according to molecular weight. Phylogenetically, HSPs are very old and are remarkably conserved molecules in evolution from bacteria to humans. HSPs are induced by a variety of cellular stresses in addition to heat; cognates are expressed constitutively and are essential in a number of normal functions. Some HSPs serve as molecular chaperones, the latter defined as proteins that mediate folding of other polypeptides and either promote their assembly into oligomeric structures or disassemble the final product. Conservation of structure and function of many HSPs may provide a link between immunity to infection and the autoimmune features of RDs. Evidence is reviewed from clinical and laboratory observations that diverse microbial agents, including viruses, bacteria, and parasites, may have putative roles in the development and pathogenesis of some RDs. HSPs also are discussed in relation to the major histocompatibility complex, HLA antigens, and disease associations and how they may alter the balance between tolerance and autoimmunity. Studies are reviewed that are supportive or nonsupportive of the concept of microbial infection associated with autoimmunity; individuals first react to microbial immunizations or infections with enhanced cellular/humoral responses to the agent's HSPs. With the enhanced immune response, cross-reactivity may occur with an HSP of the stressed host because of structural similarities to the microbial HSP. If all of these events occur, the host's homologous HSP or stressed cells now become true autoantigen(s). This sequence has implications for the etiology of immune-mediated RDs, the concept of epitope sharing, and the accompanying autoimmunity. A recurring theme emphasized in some reports to understand better the role of HSPs in autoimmunity is the need to select patients with early-onset disease. A minor subpopulation of T lymphocytes express a CD3-associated T-cell receptor (TCR) heterodimer composed of gamma and delta polypeptide chains. The gamma delta + T cells have several unique features. When analyzed by the polymerase chain reaction, lymphocytes with TCR-gamma delta appear to reflect the polyclonal expansion of preexisting gamma delta clones. They are found in peripheral lymphoid tissue in very low percentage (< 5%) but may represent the majority of T cells within epithelial tissue.(ABSTRACT TRUNCATED AT 400 WORDS)


Subject(s)
Autoimmune Diseases/immunology , Bacterial Proteins/immunology , Heat-Shock Proteins/immunology , Lymphocyte Subsets/immunology , Rheumatic Diseases/immunology , T-Lymphocytes/immunology , Amino Acid Sequence , Antibody Formation , Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Escherichia coli/chemistry , Escherichia coli/genetics , Heat-Shock Proteins/chemistry , Heat-Shock Proteins/metabolism , Humans , Molecular Sequence Data , Rheumatic Diseases/metabolism
15.
Semin Arthritis Rheum ; 25(3): 143-59, 1995 Dec.
Article in English | MEDLINE | ID: mdl-8650585

ABSTRACT

Antineutrophil cytoplasmic antibodies (ANCA) are important serological markers for the primary systemic vasculitides, including microscopic polyarteritis and necrotizing crescentic glomerulonephritis. Numerous reports have established the clinical utility of ANCA titer in monitoring disease activity, relapses, and response to treatment. ANCA, detected by indirect immunofluorescence (IIF) assays using patient's serum and ethanol-fixed human neutrophils, produce two common fluorescent staining patterns: cytoplasmic (C-ANCA), involving a 29-kD neutral serine protease termed proteinase 3 (PR3), and perinuclear (P-ANCA), the result mainly of myeloperoxidase (MPO), but occasionally by other components of the azurophilic granules including lysozyme, elastase, cathepsins, and lactoferrin. Some sera contain granulocyte-specific antinuclear antibodies (GS-ANA), which require formaldehyde fixation of neutrophils to cross link cytoplasmic antigens for distinguishing between ANCA and the GS-ANA by IIF. Positive IIF is confirmed by Western blot analysis or specific enzyme-linked immunosorbent assay for PR3, MPO, and other neutrophil granule antigens. The C-ANCA pattern is highly specific for Wegener's granulomatosis, a disease characterized by granulomatous inflammation, necrotizing and crescentic glomerulonephritis, and vasculitis; P-ANCA is found in sera of individuals with vasculitis, glomerulonephritis, and several other diseases. ANCA are predominantly immunoglobulin (Ig)G isotype, but may be IgM and IgA. Various pathophysiologic mechanisms have been proposed involving ANCA-mediated neutrophil activation in a hypothetical model of vasculitic diseases: positive signals via the FcgammaRII (CD32) receptor after IgG-ANCA binding to membrane-associated PR3, relevant cytokines, production of adhesion molecules on both activated neutrophils and endothelial cells, and the release of neutrophil reactive oxygen species and degranulation causing endothelial cell damage. Interference of C-ANCA with PR3 proteolysis and PR3 inhibition physiologically by the alpha1-proteinase inhibitor may have a pathogenic role. No convincing data have been reported for the existence of autoreactive T lymphocytes reactive to any degree with the neutrophil azurophilic enzymes. Studies of various drug- and infectious agent-related diseases and ANCA may contribute to understanding the mechanism(s) involved in some vasculitides.


Subject(s)
Arthritis/immunology , Autoantibodies/immunology , Autoantigens/immunology , Vasculitis/immunology , Antibodies, Antineutrophil Cytoplasmic , Arthritis/physiopathology , Biomarkers , Granulomatosis with Polyangiitis/immunology , Humans , Vasculitis/physiopathology
16.
Semin Arthritis Rheum ; 20(3): 129-47, 1990 Dec.
Article in English | MEDLINE | ID: mdl-1705051

ABSTRACT

Four plasma proteins, referred to as positive acute phase proteins because of increases in concentration following inflammatory stimuli, are reviewed: C-reactive protein (CRP), serum amyloid A protein (SAA), alpha 1-acid glycoprotein (AAG), and fibrinogen. The CRP and SAA may increase in concentration as much as 1000-fold, the AAG and fibrinogen approximately twofold to fourfold. All are synthesized mainly in the liver, but each may be produced in a number of extrahepatic sites. The role of cytokines in induction of the acute phase proteins is discussed, particularly the multiple functional capabilities of interleukin-6 (IL-6). Other cytokines that regulate acute phase gene expression and protein synthesis include IL-1, tumor necrosis factor alpha, interferon gamma, as well as other stimulatory factors and cofactors. The physicochemical characteristics of each protein are reviewed together with the molecular biology. For each protein, the known biological effects are detailed. The following functions for CRP have been described: reaction with cell surface receptors resulting in opsonization, enhanced phagocytosis, and passive protection; activation of the classical complement pathway; scavenger for chromatin fragments; inhibition of growth and/or metastases of tumor cells; modulation of polymorphonuclear function; and a few additional diverse activities. The role of plasma SAA is described as a precursor of protein AA in secondary amyloidosis; other functions are speculative. AAG may play an immunoregulatory role as well as a role in binding a number of diverse drugs. In addition to clot formation, new data are described for binding of fibrinogen and fibrin to complement receptor type 3. Finally, the concentration of each protein is discussed in a wide variety of noninfectious and infectious disease states, particularly in connective tissue diseases. The quantification of the proteins during the course of various acute and chronic inflammatory disorders is useful in diagnosis, therapy, and in some cases, prognosis.


Subject(s)
Acute-Phase Proteins/physiology , Acute-Phase Reaction/physiopathology , Animals , C-Reactive Protein/physiology , Cytokines/physiology , Fibrinogen/physiology , Humans , Orosomucoid/physiology , Serum Amyloid A Protein/physiology
17.
Immunobiology ; 176(4-5): 374-93, 1988 Mar.
Article in English | MEDLINE | ID: mdl-3391636

ABSTRACT

The second component of human complement (C2) in pseudoglobulin prepared from normal plasma eluted as a single peak at high conductivity (30 mS) and pH 4.5 from the cationic exchangers S-Sepharose or Mono S in the Fast Protein Liquid Chromatography (FPLC) System. The C2 was stable at pH 4.5 and 0 degrees C if enzyme inhibitors were used and the pH was raised to 6.0 after elution from the columns. After rechromatography on Mono S in the FPLC System at the median isoelectric point of 5.5 or pH 6.0, the C2 eluted as two distinct hemolytic forms: the first peaked at 16 mS, the second at 30 mS. The two forms of C2 did not correlate with the allotypic variant of C2 in individual, normal human plasmas. After elution at pH 4.5 from S-Sepharose and rechromatography at pH 5.5 or 6.0 on Mono S, the hemolytic activities of the two forms in individual plasmas eluted in 3 patterns: 1) high activity at 16 mS, low activity at 30 mS; 2) low activity at 16 mS, high activity at 30 mS; 3) high activity at 16 mS, high activity at 30 mS. The specific activities of both forms were approximately the same; both eluted the same after gel filtration at pH 5.5, and both had the same pattern on SDS-PAGE and immunoblots. The pattern of elution was characteristic for each individual plasma, and the first hemolytic form appeared to elute independent of the second form. At pH 4.5, C2 was completely separated from Factor B, a functionally and structurally similar protein of the alternative complement pathway, whereas at pH 5.5 or 6.0, the two proteins eluted together. From these results, the two forms of hemolytic C2 can be purified for structural and functional analyses.


Subject(s)
Complement C2/immunology , Hemolysis , Chromatography, Ion Exchange , Complement C1 Inactivator Proteins/isolation & purification , Complement C2/isolation & purification , Complement C4/isolation & purification , Enzyme-Linked Immunosorbent Assay , Humans , Hydrogen-Ion Concentration
18.
Immunobiology ; 176(4-5): 394-409, 1988 Mar.
Article in English | MEDLINE | ID: mdl-3391637

ABSTRACT

The two forms of human plasma C2 that were described in the preceding report (1) were investigated for their functional and biochemical differences. Incubation with the neuraminidase (NAN'dase) of Clostridium perfringens at 37 degrees C resulted in a four- to fivefold increase in the hemolytic activity of both forms. The increase in activity was different than the increase caused by treatment with iodine. The mechanism of increased activity of NAN'dase-treated C2 was the generation of increased molecules of activated C3 (C3b), resulting in more molecules of C5 binding to (C4b, 2a, 3b)n. Removal of N-acetyl-neuraminate from C2 did not alter its binding to a cationic exchanger. Nonenzymatic glucosylation was used to distinguish the two forms of C2. Incubation of highly pure C2 with 14C-D-glucose resulted in the gradual accumulation of radioactivity in acid-precipitable material. The two forms of C2 were glucosylated in vitro for seven days with 14C-D-glucose in phosphate-buffered saline at 25 degrees C. Form 2 bound twice as much 14C-D-glucose as form 1. Glucosylated form 2, but not form 1, lost some of its affinity to bind to a cationic exchanger. Since the interaction between glucose and protein occurs at free amino groups, we conclude that form 2 of C2 has approximately twice as many free amino groups as form 1. This explains the reason for the existence of two forms of C2 in plasma independent of the allelic variant.


Subject(s)
Complement C2/metabolism , Complement C2/isolation & purification , Glycoside Hydrolases , Glycosylation , Humans , Iodine , Kinetics , Neuraminidase
19.
Immunobiology ; 185(1): 90-102, 1992 Jun.
Article in English | MEDLINE | ID: mdl-1398744

ABSTRACT

The fourth component of human complement (C4) is encoded at two separate but closely linked loci within the MHC on the short arm of chromosome 6. Thus, there are two types of C4 protein in most individual and pooled normal human sera (NHS): C4A and C4B. Incubation of individual sera, pooled NHS, or purified heterogeneous C4 (C4A/C4B) with bacterial sialidase at 37 degrees C increased C-mediated hemolysis of antibody-sensitized sheep erythrocytes 1.54- to 1.93-fold. Comparative studies of Tmax of human C2, using asialo-C4 or buffer-treated C4 on EAC1gp and extrapolation to time 0 indicated a z value 4-fold higher with asialo-C4. This indicated that more hemolytically active C42 complexes are available with sialidase-treated C4 compared to untreated C4. There was no appreciable difference in the % 125I-C4 bound to EAC1gp (sialidase- or buffer-treated). Sera from two different blood donors with C4A3 phenotype (C4BQ0), two different donors with C4B1 phenotype (C4AQ0), and serum from an individual heterozygous deficient at both C4A3 and C4B1 regions (A3, AQ0; B1, BQ0) were investigated. The C4 allotypes, purified from these sera, were treated with sialidase; the C4A3 was enhanced in hemolytic assays by sialidase-treatment (1.52- to 2.3-fold), whereas the C4B1 allotype was not enhanced. Fluorometric determinations revealed that approximately the same percentage of sialic acid was released from sialidase-treated C4A3 and C4B1. Therefore, the increase in hemolytic titer observed after treatment of NHS or purified heterogeneous C4 with sialidase is a property of C4A3 but not a property of C4B1.


Subject(s)
Asialoglycoproteins/physiology , Complement C4/physiology , Asialoglycoproteins/isolation & purification , Buffers , Complement C2/drug effects , Complement C2/physiology , Complement C4/drug effects , Complement C4/isolation & purification , Complement C4a/physiology , Complement C4b/physiology , Dose-Response Relationship, Immunologic , Humans , Neuraminidase/pharmacokinetics , Neuraminidase/pharmacology
20.
Toxicon ; 22(5): 783-9, 1984.
Article in English | MEDLINE | ID: mdl-6084345

ABSTRACT

Specific antibodies directed against Ptychodiscus brevis 'brevetoxins' have been produced in a goat. The haptenic toxin T34 was chemically reduced to toxin T17, covalently-linked to succinic acid via anhydride coupling, and coupled to bovine serum albumin using standard carbodiimide condensation procedures. The hapten coupling efficiency ranged from 10.4 to 13.5 moles of toxin bound per mole of protein. Antibody titers were directly related to the frequency of immunization, and weekly intervals appeared optimum for maintaining adequate titers. [3H]Brevetoxin T17 is displaced in a competitive manner from the antibody-antigen complexes by unlabeled toxin, but the antibodies do not distinguish between T17 and T34. The sensitivity achieved, using purified brevetoxins as competitive inhibitors of [3H]T17 binding, was 600 picograms. The assay linearity ranged from 1.5 to 48 ng.


Subject(s)
Dinoflagellida/immunology , Marine Toxins/immunology , Animals , Antibody Formation , Antibody Specificity , Goats , Haptens/chemical synthesis , Radioimmunoassay , Time Factors , gamma-Globulins/isolation & purification
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