Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The illegitimate glycosphingolipid antigens of the P blood group system and of the Forssman (Fs) tissue antigen in adenocarcinoma which are foreign to the host suggest the self-nonself concept which applies also to numerous other diseases such as rheumatoid arthritis, lupus, gluomerulonephritis, and idiopathic acute hemolytic anemia. In the presence of the glycosphingolipid antigens such as ABO, P, and Fs, the normal serum of the homozygote recessive precursor contains antibodies for the missing antigen(s). The expected antibody to the Fs antigen was present in about 75% of normal men and women. In cancer sera, the incidence of anti-Fs was decreased to about 35-40%. On testing the normal population anti-Fs was present in 90% of the sera in the youngest group, and this value gradually diminished in the older groups; the incidence of the antibody in the 70-year age group was to about 60%. The rate of loss of anti-Fs with increasing years appears to parallel the gradual loss of anti-A and anti-B isoagglutinin titers. This phenomenon may be associated with the gradual diminution of protein synthesis with aging or the continuous accumulation of soluble immune complexes in the serum, or both. It is suggested that the self-nonself concept is also the basis for the pathogenesis of rhematoid arthritis, lupus erythematosus, idiopathic acute hemolytic anemia, and numerous other conditions classified as "autoimmune" diseases. Some of these diseases are induced by viruses or drugs or both. When a virus or drug attaches itself to the membrane of a tissue cell, the self is converted to nonself which, in rheumatoid arthiritis, alters its self Ig to nonself Ig.
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PMID:Self-nonself concept for cancer and diseases previously known as "autoimmune" diseases (illegitimate transferases/plasma exchange). 28 17

In order to assess the importance of glycosphingolipids (GSL) in the immunology of the platelet, serum antibody binding to immobilized, purified platelet GSLs have been quantitatively measured via high-performance thin-layer chromatography (HPTLC), 125I-radio-immunolabeling, autoradiography, and densitometry. Thirteen neutral GSL bands were detected at Rf.03 through .64 (CHCl3-CH3OH-H2O, 65:25:4) after extraction and chromatography (DEAE-Sephadex and Bio-sil A). Both IgM and IgG serum antibody binding was determined for 50 subjects from four groups: normal blood donors (NBD, n = 18); leukemia patients with nonimmune thrombocytopenia (NIT, n = 10); patients with systemic lupus erythematosus (SLE, n = 10); and patients with chronic autoimmune thrombocytopenia (CATP, n = 12). The ABO typing of these 50 subjects also allowed correlation of serum antibody binding with A blood group antigen expression. These studies reveal: (1) anti-GSL binding at band .06 is associated with blood group A alloantigen expression for both IgG and IgM (P less than .0001) antibodies; (2) binding at bands .17, .27, and/or .46 is associated with general autoimmunity (SLE and CATP) for IgM (P less than .0001); (3) binding at bands .35 and/or .38 is associated with platelet-specific autoimmunity (CATP) for IgG and/or IgM (P less than .005); and (4) binding at bands .03, .20, .23, and/or .43 is frequently observed for sera from all groups. The platelet specificity of bands .35 and .38 was confirmed by comparative studies with human intestinal smooth muscle GSLs. Quantitation of the intensity of CATP-associated anti-GSL binding (86 +/- 88 mm2) is comparable to anti-A alloantigen binding (57 +/- 52 mm2). Two of the GSL bands associated with SLE and CATP appear to be the long-chain fatty-acyl forms of globotriaosyl ceramide (.27) and globotetraosyl ceramide (.17), which are the Pk and P blood group antigens, respectively. These studies indicate that neutral GSLs may be important antigens in both autoimmune and alloimmune processes involving the blood platelet.
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PMID:Antibodies against platelet glycosphingolipids: detection in serum by quantitative HPTLC-autoradiography and association with autoimmune and alloimmune processes. 275 15

The author presents information on the use and clinical efficacy of extracorporeal therapeutic methods in various diseases. The main difficulties in the assessment of the efficacy of these therapeutic methods have been unraveled. The results of the use of immunosorption in systemic lupus erythematosus, cancer, hemophilia, diabetes mellitus, ABO-incompatibility and bronchial asthma indicate the promise of this approach to the performance of specific therapeutic programs.
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PMID:[Extracorporeal immunosorption in the treatment of atopic bronchial asthma]. 294 Jul 19

5 patients with autoimmune haemolytic anaemia (AIHA) of warm type (4 idiopathic, 1 associated with systemic lupus erythematosus and thrombocytopenia) were treated with high doses of i.v. immunoglobulin (IgG; Sandoglobulin; 2.0 g/kg body weight). IgG therapy was ineffective in all 5 cases as indicated by a lack of clinical improvement, continuous signs of accelerated red blood cell (RBC) destruction, and an unchanged survival rate of 51Cr-labelled autologous RBC in 4 patients studied. IgG infused at equivalent doses into 5 healthy volunteers led to an increase of IgG coating of autologous RBC (irrespective of the ABO blood groups) without concomitant changes of haemoglobin, haematocrit or reticulocytes, increase of serum IgM in 3/5, a decrease of serum C4 in 5/5, and a decrease of serum haptoglobin in 2/5 individuals. We conclude that IgG at a dose of 2.0 g/kg body weight is ineffective in AIHA. This may be caused by an increased, though clinically inapparent, interaction of IgG-coated autologous RBC with the mononuclear phagocyte system.
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PMID:Lack of efficacy of high-dose intravenous immunoglobulin in autoimmune haemolytic anaemia: a clue to its mechanism. 401 19

The remarkable history of the 1951 pp 66 year old woman with gastric adenocarcinoma is reviewed. After subtotal gastrectomy she survived for 22 years without any metastases. Presumably the artificially induced high titer IgG, anti-P1 proved to be cytotoxic in two stages: (1) binding of anti-P1 to the terminal fifth sugar, galactose, and (2) the action of cellular immunity in the form of killer T derived lymphocytes containing receptors for IgG molecules. An identical mechanism may be operative in inducing abortions in the pp pregnant woman with a P1 fetus. P1 illegitimate glycolipid (GL) red cell antigen and Forssman (Fs) tissue in adenocarcinoma suggest the self-nonself concept because these are genetically foreign to the host. This concept applies also to numerous "autoimmune" diseases such as RA, lupus, glomerulonephritis, Coombs positive hemolytic anemia and other diseases with immune complexes (ICs) of 20--22 Svedberg units deposited as lesions with tissue damage. In the presence of the GL antigens (ABO, P, Fs), the normal serum contains antibodies for the missing antigen(s). The predicted anti-Fs was present in about 80% of normal employees of ages 18--70. In cancer sera the incidence was 35--40%. On testing normal sera by age in terms of decades anti-Fs was present in 93% in the youngest, and only 55% in the oldest group. This may be associated with the gradual loss of protein synthesis with aging and/or the accumulation of soluble ICs which bind the C1q portion of the C added to the test mixture of heat-inactivated serum (1 : 8) g.p. C (1 : 30) and srbc. In "autoimmune" diseases there is an active immune response to viral or bacterial infections or infestations or drugs which attach to rbc and/or tissue cell membranes. This results in the deposition in selected organs of ICs of 20--22 S units with lesions and tissue damage. For therapy plasma (from young donors) exchange has been recommended to compensate for the loss of IgG antibodies and C.
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PMID:The self-nonself concept as a basis for immune complex to replace "autoimmune diseases". 616 23

The administration of intravenous immunoglobulin (IVIG) in immune and autoimmune diseases led us to use this agent to ameliorate or prevent the consequences of non-ABO incompatible transfusions in patients who need this form of therapy. IVIG (400 mg/kg/day) was infused within 24 h of transfusion in 5 patients with: (1) intestinal angiodysplasia, gastrointestinal bleeding, and anti-Kpb; (2) paroxysmal nocturnal hemoglobinuria, anti-c, anti E, anti Fyb, anti-K and autoantibodies; (3) lymphoma and autoimmune hemolytic anemia (AIHA); (4) systemic lupus erythematosus (SLE), AIHA, and anti-D, and (5) SLE and AHIA. A sustained increase in hematocrit was noted and no transfusion reaction developed in any of the cases. A single dose of pretransfusion IVIG may therefore be a useful therapeutic alternative in patients for whom no compatible blood is available. Patients with severe anemia, allo- and autoantibodies, either showing hemolysis in their pathophysiology or not, cause a serious problem in any transfusion center, especially when dealing with emergencies. In order to reduce the risks of incompatible transfusions, different modalities have previously been attempted, all with poor results. In 1989 we reported the successful use of pretransfusional high-dose intravenous immunoglobulin (IVIG) in a patient with gastrointestinal bleeding and anti-Kpb. The transfusion of incompatible red blood cells improved the anemia and allowed the exploratory laparotomy to take place. A protocol was then developed based on this case administering pretransfusion IVIG in high doses for patients for whom no compatible blood (non-ABO) is available.
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PMID:High-dose intravenous immunoglobulin in non-ABO transfusion incompatibility. 780 11

Hematopoietic stem cell transplantation (HSCT) is a treatment option for autoimmune diseases but can also cause clinical features similar to those of autoimmune diseases. In some of these cases the autoimmune-like condition is associated with autoimmune cytopenia, a complication that can be unresponsive to established treatment strategies and which may be fatal. The majority of cases reported on immune hemolytic anemia have been of alloimmune origin due to ABO red blood cell antigen incompatibilities between donor and recipient. We now report a patient with a lupus-like syndrome, presenting with severe thrombocytopenia and hemolytic anemia 9 months after HLA-mismatch, ABO compatible-related PBSCT who experienced no response to high-dose steroids, but who had a sustained response to repeated IvIG therapy.
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PMID:Successful treatment of thrombocytopenia and hemolytic anemia with IvIG in a patient with lupus-like syndrome after mismatched related PBSCT. 1127 84

In the last 40 years, therapeutic plasmapheresis techniques have been improving considerably. These include cryofiltration technologies providing novel ways of removing large amounts of cryoproteins from plasma. The concept of cryofiltration involves exposure of plasma to below core (37 degrees C) and room temperatures (25 degrees C) without freezing. It was initially used to treat diseases such as cryoglobulinemia with systemic vasculitis, rheumatoid arthritis, systemic lupus erythematosus, and ABO-incompatible transplants. There are 2 basic types of cryofiltration. The first method removes cryoproteins, namely cryoglobulins that precipitate at 4 degrees C. Several filters have been used for this procedure like the AP06M (Asahi Medical, Tokyo, Japan) with a 0.2 microm pore size, a 0.65 m2 surface area, and a cellulose diacetate (CDA) membrane. It has been used in the United States and Japan for treatment of rheumatoid arthritis and cryoglobulinemia. A major disadvantage was frequent filter plugging, which was cumbersome and it is no longer used in the United States. The G3 cryofilter (Gelman Sciences, Ann Arbor, MI, U.S.A.) with a 3 microm pore size was tried in vitro but proved inadequate by design. Currently in our institution, the cryoglobulin filter (Pall Medical, Ann Arbor, MI, U.S.A.) is used with a 4.3 microm pore size, a 0.135 m2 surface area, and an acrylic co-polymer pleat membrane. We performed over 1,200 procedures in 40 patients in the last 8 years. The second type of cryofiltration removes cryogel, which is an agglutination complex of fibrinogen, fibronectin, fibrin split products, and cold insoluble proteins with a heparin core, at temperatures between 2 and 10 degrees C. The AP06M, the AC1740 (Asahi Medical) with a 0.02 microm pore size, a 1.70 m2 surface area, and a CDA membrane, and the Evaflux-4A (Kuraray Company, Osaka, Japan) with a 0.03 microm pore size, a 2 m2 surface area, and an ethylene vinyl alcohol membrane are used to remove cryogel to treat ABO-incompatible transplants as well as rheumatoid arthritis and other previously mentioned diseases. This article will discuss each cryofiltration treatment modality.
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PMID:Current topics on cryofiltration technologies. 1172 13

Rituximab, chimeric anti-human CD20, is approved for treatment of B-cell lymphoma in adults. It is being used experimentally in other various immune-related diseases such as immune thrombocytopenic purpura, systemic lupus erythematosus, myasthenia gravis and rheumatoid arthritis. In transplant recipients, it is used for treatment of post-transplant lymphoproliferative disease, to anecdotally reduce pre-formed anti-HLA and anti-ABO antibodies and for the prevention and treatment of acute rejection. This article primarily reviews the science behind rituximab: its history, pharmacokinetics and potential mechanism of action. A need for controlled clinical trials is clearly indicated before the widespread use of this drug in transplant.
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PMID:Rituximab, an anti-cd20 monoclonal antibody: history and mechanism of action. 1661 21

Plasmapheresis has been used in the management of immunologic renal disease for the last 40 years. The rationale behind this approach is to remove pathogenic immune mediators, such as autoantibodies and immune complexes, from the circulation. There may also be benefit in depleting proinflammatory molecules, such as complement components and coagulation factors. Initial experience was gained in Goodpasture's disease, in which antiglomerular basement membrane antibodies were known to be pathogenic. More recently, a role for autoantibodies has become clear in small-vessel systemic vasculitis and some cases of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. Removal of immune complexes is thought to be important in cryoglobulinemia and systemic lupus erythematosus. Plasmapheresis is used in renal transplantation for the treatment of acute antibody-mediated rejection, and for desensitization of patients with preformed anti-HLA antibodies or those receiving an ABO-incompatible transplant. Although many of the early studies were uncontrolled, there has been an increasing number of randomized controlled trials in recent years. The aim of this article is to summarize current indications for the use of plasmapheresis in immunologic renal disease.
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PMID:Plasmapheresis in immunologic renal disease. 2226 18


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