Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004623 (bacterial infection)
 15,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sensitive ELISA were devised to examine the specificity of circulating IgM and IgA autoantibodies for whole human IgG, Fc and Fab fragments of human IgG. Sera from patients with autoimmune and infectious conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), tuberculosis (TB), infectious mononucleosis (IM) and cystic fibrosis (CF) were studied. Results of the ELISA assays using whole human IgG as antigen revealed that a proportion of patients in each of the groups studied had circulating IgM and IgA rheumatoid factors (RF). Fifteen normal individuals studied were negative. In the latex positive RA group, IgM RF and IgA RF had primarily anti-Fc reactivity (100% and 93% respectively), although 3/15 patients also showed IgM anti-Fab reactivity and one patient had high IgA anti-Fab activity. Patients with SLE and TB who had detectable RF levels also revealed predominantly anti-Fc specificity. In contrast, examination of 25 patients with IM showed positivity for IgM RF activity in 8% of patients using whole IgG as antigen, 24% positivity using purified Fc fragments as antigen and 45% positivity when plates were coated with Fab fragments. Similarly, a large number of CF patients (54%) also showed predominantly IgM anti-Fab activity. Of interest, 69% of the CF patients who were all studied at the time of bacterial infection had detectable IgA RF levels, with 46% of these patients showing both IgA anti-Fc and anti-Fab activity. These findings suggest that autoantibody specificities in autoimmune and infectious diseases are different.
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PMID:Prevalence of anti-Fab antibodies in patients with autoimmune and infectious diseases. 151 58

Between March 1988 and March 1991, 17 patients underwent bilateral lung transplantation for end-stage lung disease caused by cystic fibrosis. There were 11 male and six female patients. Ages ranged from 19 to 41 years (mean age 28 years). Preoperative mean arterial oxygen tension with the patient breathing room air was 54 +/- 6 mm Hg; forced vital capacity, 1.8 +/- 0.7 L; forced expiratory volume in 1 second, 0.9 +/- 0.3 L; and 6-minute walk test, 506 +/- 44 m. Immunosuppression consisted of cyclosporine, azathioprine, and prednisone. Induction immunosuppression was obtained with Minnesota antilymphocyte globulin. All patients received perioperative antibiotics according to sputum cultures and sensitivities. There were six operative deaths, four of which resulted from bacterial infection. Two patients required a second transplantation, one receiving a single lung and one undergoing bilateral lung replacement. Significant functional improvement was observed in all survivors. At 3 months follow-up, mean arterial oxygen tension on room air was 95 +/- 6 mm Hg (p less than 0.01); forced vital capacity, 3 +/- 0.8 L (p less than 0.01); forced expiratory volume in 1 second, 2.6 +/- 0.9 L (p less than 0.01); and 6-minute walk test, 678 +/- 47 m (p less than 0.01). The actuarial survival rate was 66% at 3 months and 58% at 6, 12, and 24 months. The most frequent cause of morbidity and mortality was acute pneumonia resulting from Pseudomonas cepacia. For patients with respiratory failure caused by cystic fibrosis, bilateral lung transplantation is an effective treatment option associated with significant functional improvement.
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PMID:Bilateral lung transplantation for cystic fibrosis. The Toronto Lung Transplant Group. 173 95

The tracheobronchial secretions from patients with cystic fibrosis often contain high amounts of free proteases. To evaluate whether human leucocyte elastase (HLE) can favour the persistence of bacterial airways infection, we exposed the frog palate mucosa to HLE and then to radiolabelled Pseudomonas aeruginosa and followed the sequence of events by scanning electronmicroscopy. In response to HLE there was a marked outpouring of mucus and a desquamation of the epithelium. P. aeruginosa was shown to adhere to recently secreted granules of mucus and to the exposed submucosal underlying connective tissues. For the eight different bacterial strains studied, a significative adherence to HLE-injured mucosa was observed only in strains that possessed internal haemagglutinating activity. Neither the presence of fimbriae, nor of the mucoid exopolysaccharide, nor of the bacterial surface haemagglutinating activity could be related to adherence of P. aeruginosa to the injured mucosa. These results support the hypothesis that HLE enhances bacterial infection of the respiratory mucosa both by inducing mucus hypersecretion and by exposing receptors to the microbial adhesins. It is also suggested that P. aeruginosa internal lectins may be implicated in adherence to host tissues.
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PMID:Adherence of Pseudomonas aeruginosa to respiratory epithelium and the effect of leucocyte elastase. 257 49

Eradication of the bacterial pathogen, resolution of the local and systemic inflammatory signs, and recovery of organ function are the main criteria by which antibiotic treatment is evaluated. In cystic fibrosis (CF) the pathogen is seldom eradicated and systemic markers of inflammation are not always present. The main criterion for assessing the results of antimicrobial therapy in CF is therefore clinical improvement. The use of clinical scoring systems and double-blind design in therapeutic trials can reduce bias in evaluation of outcome. Assessment of the contribution of antibiotic therapy to the outcome requires greater knowledge of the role of bacterial infection in the pathogenesis of pulmonary exacerbations and could be improved by the development of quantifiable markers in respiratory secretions for inflammation.
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PMID:Antibiotic therapy in cystic fibrosis. Evaluation of efficacy. 313 60

To examine the possible pathophysiologic role of circulating immune complexes in patients with cystic fibrosis and other inflammatory lung diseases, we studied the reticuloendothelial clearance of IgG-sensitized autologous erythrocytes in 15 patients with cystic fibrosis, 6 with chronic obstructive lung disease not related to cystic fibrosis, 7 with immunodeficiencies, 5 with systemic lupus erythematosus, 4 who had previously undergone a splenectomy, and 10 normal subjects. Patients with chronic inflammation and recurrent infections (i.e., those with cystic fibrosis, chronic obstructive lung disease, and immunodeficiencies) had significantly faster clearance rates (P less than 0.05, less than 0.01, and less than 0.005, respectively) than normal subjects. In contrast, patients with systemic lupus erythematosus (a classic immune complex-mediated disease) and those who had undergone a splenectomy had delayed clearance. The accelerated reticuloendothelial clearance in patients with chronic inflammatory pulmonary disease associated with cystic fibrosis was similar to that observed in stimulated laboratory animals. The rapid clearance rate may account for the rareness of septicemia in such patients despite chronic, persistent local bacterial infection.
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PMID:Reticuloendothelial clearance in cystic fibrosis and other inflammatory lung diseases. 339 95

We treated a patient with cystic fibrosis who experienced recurrent episodes of palpable purpura and arthralgias associated with exacerbations of her pulmonary disease. Skin biopsy demonstrated the classic findings of leukocytoclastic vasculitis, and C3 deposits were detected in the dermal blood vessels. Chronic bacterial infection and antibiotics are possible sources of antigen involved in immune complex formation in patients with chronic lung diseases.
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PMID:Recurrent cutaneous vasculitis in cystic fibrosis. 365 32

The proximity of the maxillary sinus floor to the first, second, and third molar teeth predisposes it to contiguous dental disease. Infections of dental origin are usually mixed bacterial growth with anaerobic species predominating; extended-spectrum penicillins or cephalosporins are recommended. The patient with atopic allergy is susceptible to bacterial infection; combined therapy with antimicrobials, corticosteroids, and antihistamines is advised. The large solitary antrochoanal polyp is successfully managed with maxillary sinus surgery alone. Multiple ethmoidal polyps in children suggest cystic fibrosis, and in adults, the asthma triad syndrome. Thorough surgical management of the sinuses combined with antimicrobial and topical corticosteroid therapy is recommended.
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PMID:Dental and allergic aspects of sinusitis and nasal polyposis: a review. 613 2

The activity of lysozyme in saliva and serum was determined in 51 patients with cystic fibrosis. Measurements were made on two occasions at least 1 month apart and compared to those of 25 normal healthy individuals of the same ages, sex, and race. The mean serum lysozyme activity of normal individuals was 5.8 micrograms/ml (S.E. = 0.4), whereas that of cystic fibrosis patients was 10.8 micrograms/ml (S.E. = 0.5). The difference is significant (P less than 0.05). Initial mean values compared to those of repeated samples from the cystic fibrosis group were similar, whereas individual fluctuations occurred between test periods. The mean lysozyme activity of the saliva sample of normal individuals was 63.5 micrograms/ml (S.E. = 9.3) and the mean value from cystic fibrosis patients was 82.7 (S.E. = 6.9). This difference was not significant (P greater than 0.1). Mean values from specimens obtained a month or longer after the initial saliva samples were similar for the two episodes. There was no correlation between the serum and salivary values and the age, sex or race of the subjects, the Shwachman-Kulczycki scores, colonization with Pseudomonas aeruginosa, Staphylococcus aureus or Haemophilus influenzae or absolute white blood cell counts. In vitro studies failed to demonstrate bactericidal activity for mucoid and nonmucoid strains of P. aeruginosa or for S. aureus. Elevated lysozyme activity in cystic fibrosis may be related to either an increased granulocyte turnover because of chronic bacterial infection of the respiratory tract or to a basic defect in the lysosomal membrane allowing an increased release of the enzyme, or a combination of both.
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PMID:Lysozyme activity in cystic fibrosis. 714 10

As lung transplantation has become more successful, the selection criteria have broadened; however, some relative contraindications to lung transplantation are controversial. Some programs consider mechanical ventilation to be a major contraindication to lung transplantation because airway colonization with bacteria may lead to nosocomial infection and respiratory muscle deconditioning may necessitate prolonged postoperative ventilatory support. We report our experience of seven double lung transplant procedures on six patients requiring mechanical ventilation. Five patients with cystic fibrosis required preoperative mechanical ventilation for 7 to 19 days (mean, 10.7 days). One patient with acute lung injury required 115 days of preoperative mechanical ventilatory support. Only the latter patient required prolonged (27 days) postoperative mechanical ventilation because of respiratory muscle weakness; the others were extubated in 1 to 19 days (mean, 7.8 days). No early complications related to bacterial infection were seen. Two patients required temporary hemodialysis for transient kidney failure. Three patients had postoperative neurologic residua; one patient had a transient hemiparesis, and seizures developed in two patients. One patient died 3 months after transplantation from severe central nervous system complications with no evidence of pulmonary problems; and two patients died 17 months after transplantation, one of them receiving a second double lung transplant for obliterative bronchiolitis. Except for the patient who required prolonged preoperative ventilatory support, mechanical ventilation did not appear to play a role in the outcome of these patients. The posttransplantation hospital stay and hospital charges for patients requiring pretransplantation ventilatory support were not significantly different from those for other lung transplant recipients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lung transplantation for mechanically ventilated patients. 751 85

Cystic fibrosis (CF) is an autosomal recessive disease that reflects mutations in the CFTR gene. Multiple mutations in this gene have been detected that lead to a protein (CFTR) that is abnormally metabolized, dysfunction, or both. The full spectrum of the activities of the gene product have not been defined, but it is clear that CFTR can act as a cAMP-regulated Cl- channel. This type of defect is consistent with the physiologic characterization of CF epithelia, which has revealed abnormalities in salt and water transport. In the lung, abnormalities in epithelial salt and water metabolism lead to abnormal mucociliary clearance. This defect in clerance represents a major failure of lung defense and leads ultimately to infection of the lung with Staphylococcus aureus, Pseudomonas aeruginosa, and other bacterial organisms. The chronic inflammatory response to this persistent intraluminal bacterial infection leads to protease-induced destruction of airway walls and finally, lung failure. More than 95% of CF patients die of lung disease. The clinical therapy of CF lung disease is limited to agents designed to promote clearance of secretions from the lung and antibiotics to treat the chronic bacterial infection. Recent laboratory demonstrations that introduction of the normal CFTR cDNA into CF cells corrects the ion transport defects of these cells has led to the hypothesis that gene therapy in the lung can be an effective, novel mode of therapy for this lung disease. The classic gene transfer vectors, e.g., retroviruses, appear to be not well suited for therapy of lung disease because of the low proliferation rate of airway epithelia in vivo. Recently, adenoviruses, which have a natural tropism for airway epithelia, have been genetically modified (E1-deleted) in an attempt to reduce potential toxicity of this virus and provide space for the CFTR cDNA. A series of in vitro studies have shown that this vector is highly efficient for transferring CFTR into airway epithelial cells in culture and correcting the CF defect. Further, studies in whole animals appear to indicate that this mode of gene transfer is associated with a low degree of toxicity. The present study is a dose-effect study designed to test for the safety and efficacy of E1-deleted recombinant adenovirus containing the CFTR cDNA under a CMV-beta-actin promoter in CF nasal epithelia.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Gene therapy for cystic fibrosis using E1-deleted adenovirus: a phase I trial in the nasal cavity. The University of North Carolina at Chapel Hill. 751 85


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