Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the role of immunoglobulins, complement, circulating immune complexes (CIC), heart antibodies (HAb) and rheumatoid factor (RF) in infective endocarditis, we studied 28 consecutive patients before and after therapy. Statistically significant elevation was seen in IgG (p less than 0.001) and IgA (P less than 0.001) level prior to initiation of therapy as compared to a control group. Following drug treatment a fall was noted in IgA (P less than 0.01) and IgM (p less than 0.01) level as compared to basal values. Low C3 levels were seen in those with renal involvement (p less than 0.05). CIC levels estimated by 4% PEG precipitation assay were found to be elevated in 64% of patients. Patients with shorter duration of illness (less than three months) had higher levels of CIC containing IgG (P less than 0.005), IgA (P less than 0.05) and IgM (P less than 0.05), as compared to those with a longer duration. Initial CIC levels did not predict the clinical course and were found to be of no value in prognosis, although an improvement in congestive heart failure was associated with a rise in C3 (P less than 0.05) and IgM (P less than 0.05) containing CIC and an overall clinical improvement with a rise in IgA (p less than 0.05) containing CIC. There was no statistically significant difference in CIC level, for the entire group studied, before and after therapy. Patients who had rheumatoid factor in their initial serum sample demonstrated a fall in IgG, IgA and IgM containing CIC and a rise in C3 with therapy. The converse was true for those who lacked RF.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunologic parameters in infective endocarditis: a prospective study. 180 Mar 4

A patient with cutaneous vasculitis during infective endocarditis due to Lactobacillus casei was studied. Immune complexes (IC) were isolated from serum at the time of diagnosis and after 4 wk of therapy. Purification of IC used differential polyethylene glycol precipitation and competitive binding to staphylococcal protein A. In situ radioiodination of IC was performed, followed by SDS-polyacrylamide gel electrophoresis (PAGE). Anti-IC antisera were raised in rabbits by immunization with purified IC. IC were characterized by SDS-PAGE followed by electrophoretic transfer to nitrocellulose, incubation with antiserum and then with 125I protein A, and autoradiography. Although early and late IC differed quantitatively, there were no differentiating immunochemical features. Both IC contained a 60,000 dalton component that did not react with preimmune serum nor with anti-normal human serum. This component reacted with antiserum rendered specific for L. casei by affinity chromatography. The restricted antigen-antibody representation in IC contrasted with a wider panel of antibody activity in patient serum. The Western blot analysis proves to be an ideal method for the characterization of IC because of its sensitivity, dissociative capability, and preservation of immunoreactivity. IC isolated at a time removed from the original antigenic challenge may provide insight into the nature of the inciting antigen.
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PMID:Characterization of sequential immune complexes in infective endocarditis by Western blot analysis. 642 35

The presence of circulating immune complexes (IC) in patients with infective endocarditis has been well documented but the contributions of host and bacterial components to these IC have not been defined. To study this question, IC were isolated from serum of a patient with Streptococcus faecalis endocarditis by differential polyethylene glycol precipitation and competitive binding to staphylococcal protein A. A rabbit antiserum raised against the purified IC had reactivity by crossed immunoelectrophoresis primarily with an antigen derived from the cytoplasm of the infective organism. The antigen was a protein with a 12,000-dalton molecular mass. In situ radiolabeling of the IC bound to the protein A demonstrated a component of the same molecular mass as the bacterial antigen recognized by the antiserum. The patient serum had multiple antibody specificities reactive with bacterial antigens, including the antigen recognized by the rabbit anti-IC antiserum. These techniques for isolation and characterization of circulating IC may have value in the study of IC diseases in which the inciting antigens are not known.
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PMID:Identification of bacterial antigens in circulating immune complexes of infective endocarditis. 680 25

An enzyme-linked immunosorbent assay was developed for the detection of circulating free and complexed staphylococcal antigens in various clinical categories of staphylococcal infections. Circulating immune complexes were studied by the polyethylene glycol precipitation method. Circulating immune complexes and staphylococcal antigen (at titers of greater than or equal to 1:32) dissociated from the complexes were found in 7 of 8 patients (87.5%) with staphylococcal endocarditis and in 4 of 20 patients with staphylococcal bacteremia (20%). Although the majority of patients did not have detectable free staphylococcal antigen, it was found in three patients with staphylococcal pneumonia. We conclude that detection of complexed antigen in high titer may differentiate patients with staphylococcal endocarditis from those with other forms of staphylococcal infection or transient bacteremia.
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PMID:Detection of circulating free and complexed staphylococcal antigens by enzyme-linked immunosorbent assay. 716 70

Serial circulating immune complex (IC) determinations were performed in 24 patients with infective endocarditis (IE) using the solid phase Clq, solid phase conglutinin and 3.5% polyethylene glycol precipitation assays. Circulating IC were detected in 67% of IE patients at presentation, but in only 7% of valve lesion controls. Serial determinations produced a 75% prevalence of IC in IE. The presence of circulating IC correlated with "subacute" disease, the presence of tissue deposits of immunoglobulin and/or complement components and with certain extravalvular manifestations (immune complex type glomerulonephritis cutaneous vasculitis and musculoskeletal manifestations). Effective therapy was associated with a fall in circulating IC levels, an effect which was well demonstrated by 3 patients in whom IC rapidly fell to zero following artificial valve replacement. The results support a role for circulating IC in the pathogenesis of this disorder, and suggest that serial IC determinations are useful in following clinical progress, particularly in culture negative endocarditis.
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PMID:Serum and tissue immune complexes in infective endocarditis. 720 36

Two percent polyethylene glycol (PEG) precipitation was found to be a useful method for detecting circulating immune complexes (CIC) and could be used diagnostically to implicate infective endocarditis. Complexes consisting of a least Clq, IgG, and IgA were typically detected in sera from patients with infective endocarditis. Serial studies showed that CIC detection and measurement could be used to monitor clinical progress. Successful clinical improvement was reflected by decreasing CIC levels and the disappearance of rheumatoid factor, and, where increasing amounts of CIC were found, this may indicate situations where treatment was insufficient or inappropriate. There was specific free antibody demonstrable in the serum of six out of nine patients against their own infecting organisms, but attempts to identify the specificity of the complexed antibody as being directed against these organisms or their extracellular products failed. We could not detect any radioactive precipitin arcs, indicative of the free antibody also being in the complex, between the F(ab')2 preparation from the complex and the electrophoresed bacterial antigens in a radio-immunoelectrophoresis system. Eleven out of 13 sera that contained Clq, IgG, and IgA in their complexes also contained rheumatoid factor. Immunisation against the patient's own persisting CIC may explain this phenomenon.
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PMID:Nature of circulating immune complexes in infective endocarditis. 743 Mar 71

There are two situations when antibiotic prophylaxis is recommended. The first is associated with procedures known to be followed by high rates of bacteraemia, involving organisms prone to cause endocarditis. These include oesophageal dilatation, variceal sclerotherapy and laser therapy in the upper gastrointestinal tract. As bacteraemia following these procedures is usually harmless in average risk patients antibiotic prophylaxis is recommended only for a patient with a lesion susceptible to endocarditis or one who is at increased risk of symptomatic bacteraemia due to neutropenia or immunosuppression. In most cases parenteral amoxycillin and gentamicin is recommended plus metronidazole for neutropenic patients. Vancomycin or teicoplanin replace amoxycillin in a case of allergy. The second situation concerns procedures with a high incidence of local infection or which may lead to serious sepsis. These include therapeutic retrograde cholangiopancratography and percutaneous endoscopic gastrostomy where antibiotic prophylaxis is recommended even in average risk patients. Several antibiotics are recommended including oral ciprofloxacin or parenteral gentamicin or quinolone for ERCP and amoxycillin for PEG or cephalosporin or ureidopenicillin for both.
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PMID:Guidelines of the European Society of Gastrointestinal Endoscopy (E.S.G.E.) antibiotic prophylaxis for gastrointestinal endoscopy. European Society of Gastrointestinal Endoscopy. 961 88

Staphylococcus aureus is a major infectious agent responsible for a plethora of superficial skin infections and systemic diseases, including endocarditis and septic arthritis. Recent epidemiological data revealed the emergence of resistance to commonly used antibiotics, including increased numbers of both hospital- and community-acquired methicillin-resistant S. aureus (MRSA). Due to their potent antimicrobial functions, low potential to develop resistance, and immunogenicity, antimicrobial peptides (AMPs) are a promising alternative treatment for multidrug-resistant strains. Here, we examined the activity of a lysine-rich derivative of amphibian temporin-1CEb (DK5) conjugated to peptides that exert pro-proliferative and/or cytoprotective activity. Analysis of a library of synthetic peptides to identify those with antibacterial potential revealed that the most potent agent against multidrug-resistant S. aureus was a conjugate of a temporin analogue with the synthetic Leu-enkephalin analogue dalargin (DAL). DAL-PEG-DK5 exerted direct bactericidal effects via bacterial membrane disruption, leading to eradication of both planktonic and biofilm-associated staphylococci. Finally, we showed that accumulation of the peptide in the cytoplasm of human keratinocytes led to a marked clearance of intracellular MRSA, resulting in cytoprotection against invading bacteria. Collectively, the data showed that DAL-PEG-DK5 might be a potent antimicrobial agent for treatment of staphylococcal skin infections.
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PMID:The Bactericidal Activity of Temporin Analogues Against Methicillin Resistant Staphylococcus aureus. 3155 17