Methotrexate in rheumatoid arthritis: a prospective study in Israeli patients with immunogenetic correlations

In a prospective open study 44 Israeli patients with rheumatoid arthritis were treated with weekly low dose methotrexate (MTX) for up to 36 months. Nine patients withdrew from the study: six because of side effects and three due to inefficacy. One patient died of septicaemia following septic arthritis. Significant improvement, graded by Ritchie articular index, grip strength, physician's global assessment, erythrocyte sedimentation rate (ESR), and platelet counts, was noticed in response to treatment. Seronegative patients had a better clinical response. Transient gastrointestinal symptoms were common and correlated with increases of serum aspartate transaminase (AST). HLA-DR1 and DR7 were significantly associated with increased serum AST concentrations.

Timing of orthodontic tooth movement in a case with traumatized and avulsed anterior teeth

A traumatic injury to a patient undergoing orthodontic treatment resulted in avulsion, dislodgement, and fracture of upper anterior teeth. Deciding when to institute endodontic treatment and when to resume orthodontic treatment was based upon minimizing the changes for ankyloses and root resorption. Endodontic treatment was carried out two weeks after trauma, and orthodontic treatment continued three weeks after trauma. Radiographs taken six months, one year, and two years after orthodontic completion showed progressive root resorption to the avulsed tooth and minimum root resorption to the remaining anterior teeth.

Association of HLA-B35 with mucocutaneous lesions in Israeli patients with rheumatoid arthritis receiving gold treatment

Seventy-four Israeli patients with rheumatoid arthritis (RA) were studied for possible association between HLA antigens and adverse reactions to gold treatment (aurothioglucose). HLA-B35 was significantly increased in patients who developed gold induced mucocutaneous lesions. These results are in accord with earlier reports, despite the different genetic background of the Israeli RA population and the different type of gold compound used.

T6 positive cells in the peripheral blood of burn patients: are they Langerhans cells precursors?

Peripheral blood mononuclear cells of 14 patients suffering thermal injury were separated by affinity chromatography on peanut agglutinin (PNA) coupled to Sepharose macrobeads. The resulting PNA positive subset was 14% of the total mononuclear population. About 30% of these cells were found to coexpress T6(CD1), Ia-like and the myeloid differentiation antigens My4(CDw14) and Mo1(CD11). In comparison, the PNA+ subset from normal blood donors (about 5% of total mononuclear cells) contained mature monocytes that were found to be T6 negative. Electron microscopic studies using immunogold labeling showed that the T6 positive cells were slightly smaller than monocytes but larger than the classical lymphocytes and had common morphologic features with the Langerhans cells of the skin. Considering that patients suffering extensive damage of the epidermis require fast renewal of all skin elements, it is possible that the cells we identified in their peripheral blood are the precursors of the Langerhans cells of the skin en route from bone marrow to the epidermis.

Lymphocytes modulated by beta interferon express new non-HLA-A,B,C class I antigens

Peripheral blood lymphocytes were cultured with recombinant beta interferon (INF-lymph). Three days in culture and 5 X 10(4) units/ml produced the best modulatory effect. Platelet absorbed alloantisera previously shown to contain non-HLA-A,B,C class I antibodies were tested with the INF-lymph. The serologic reactivity could be blocked by turkey sera to human B2-microglobulin but not by turkey anti-Ia-like. Absorption studies with INF-lymph obtained from donors expressing different HLA antigens indicated that the serologic reactivity is not due to HLA. Fourteen sera appeared to cluster in three groups, only one of which was found to be associated with HLA (HLA-A1). Antigenic modulation of INF-lymph obtained from HLA-A1+ individuals with HLA-A1 typing alloantisera eliminated subsequent lysis mediated by HLA-A1 alloantibodies and complement but not lysis with platelet absorbed antibodies included in the cluster associated with HLA-A1. These findings suggest independence from HLA-A1 and coexpression of HLA-A1 and A1-associated class I antigens. Family studies indicated that the reactivities segregated with HLA thus mapping it to chromosome VI. Similar to what we have described with PHA, beta interferon modulates lymphocytes and induces the expression of new class I differentiation antigens probably analogous to the murine Qa-T1a antigens.

Mandibular growth and histologic changes in condylar cartilage of rats intoxicated with vitamin D3 or 1,25(OH)2D3 and pair-fed (undernourished) rats

The mandibular condyles of 1,25(OH)2D3 or Vitamin D3 intoxicated rats were studied and compared with those of normal as well as pair-fed controls. Experimental animals were injected with either Vitamin D3 (2 mg/kg/day) or 1,25(OH)2D3 (400 ng/kg/day) for 19 days. Controls were given the solvent only, while pair-fed animals were restricted in their food intake for the same period of time, so that they exhibited a weight-curve similar to that of the experimental rats. The length of the mandibular ramus was measured in lateral radiographs of all mandibles. Demineralized coronal sections were obtained from all mandibular condyles and were stained with Mallory's connective tissue stain. The width of each zone within the condylar cartilage was measured. Experimental animals showed significant reduction in width of all layers within the condylar cartilage, with total lack of distinction between the maturation and hypertrophic zones. They also exhibited a significant retardation in growth of the mandible. Pair-fed animals had a normal width of the chondroprogenitor layer but significantly smaller maturation + hypertrophic zones (vs. controls). They also exhibited a significant retardation in mandibular growth but not to the same degree as did the intoxicated animals. Reduction in growth attributed to 1,25(OH)2D3 or Vitamin D3 intoxication is partly caused by undernutrition, which is a by-product of this condition. A further kinetic study is indicated to elucidate the mechanism of growth retardation and the differential effect on the various cartilage layers.

Alteration of antigenic expression of human myeloid precursor cells (CFU-GM) in long-term cultures

Comparison of myelopoiesis in continuous human bone marrow and cord blood cultures was performed. The presence of major histocompatibility complex (MHC) antigens on myeloid precursors (CFU-GM) from cord blood was confirmed using monoclonal antibodies (MoAb) defining class I (i.e., anti-beta 2-microglobulin (B2, MG1) anti-HLA-A,B heavy chain (W6/32), and anti-HLA locus B(4E), and class II (HLA-DR (7,2] antigens. The effect of long-term culture on the expression of these antigens was investigated. Our studies indicate that following prolonged in vitro culture there is a decrease in the expression of MHC antigens on CFU-GM. Our observations provide a rationale for considering the use of cord blood leukocytes subjected to long-term culture as an alternative to allogeneic hematopoietic cell transplantation.

The effects of Con A-induced lymphokines from the T-lymphocyte subpopulations on human monocyte leishmanicidal capacity and H2O2 production

The effects of concanavilin A (Con A)-induced lymphokines from human peripheral blood mononuclear cells, enriched helper and suppressor lymphocyte populations and recombinant interferon-gamma (IFN-gamma) on the ability of monocytes to promote killing of intracellular Leishmania major (L. major) amastigotes and to induce the production of hydrogen peroxide (H2O2) was examined. All these mitogen-induced supernatants contained active IFN-gamma. There were no differences in the ability of these supernatants or IFN-gamma to promote the monocyte killing of the L. major amastigotes or H2O2 production. An increase in H2O2 production by monocyte monolayers was observed following the addition of either of these supernatants or IFN-gamma alone. In addition, a marked increase in the production of H2O2 was observed following priming with either of these mitogen-induced supernatants or IFN-gamma and the addition of a second stimulus, phorbol myristate acetate (PMA). Monoclonal antibody to IFN-gamma abrogated the increase in production of H2O2 by all these mitogen-induced supernatants; however, this antibody only resulted in partial inhibition of the leishmaniacidal effect of these lymphokines on human monocytes. These results would suggest that IFN-gamma is the component of the lymphokine that is largely or exclusively responsible for H2O2 production, while other factors in addition to IFN-gamma are important in promoting oxygen-independent mechanisms for the killing of intracellular L. major amastigotes.

Fractionation of human bone-marrow mononuclear cells with peanut agglutinin: phenotypic characterization with monoclonal antibodies

Bone marrow mononuclear cells were fractionated by affinity chromatography on immobilized peanut agglutinin (PNA). The resulting PNA+ fraction represented 10% of the total cell number. Twenty percent of the cells within the PNA+ compartment coexpressed the T6, Ia, Mo1, and My4 differentiation antigens and possessed Fc and C3 receptors. The similarity in cell surface antigen phenotype led us to hypothesize that this subset may be a cellular precursor of dendritic cells found in the skin (Langerhans cells) or in the parenchimal organs of the body (D-cells).

Differentiation of bone marrow cells from myelodysplastic patients in the presence of 1,25 dihydroxyvitamin D3 or 13-cis retinoic acid

The separate effects of vitamin D3 (1,25(OH)2D3) and 13-cis retinoic acid on the differentiation in liquid culture of marrow cells from seven patients with myelodysplastic syndrome (MDS) were studied. Following incubation with 1,25(OH)2D3, an increasing number of myeloid cells acquired the morphological appearance of mature monocyte-macrophages and reacted positively to fluoride-sensitive naphthyl acetate esterase and specifically bound My4 monoclonal antibody (McAb). Incubation of bone marrow cells with 13-cis retinoic acid enhanced the number of cells with the morphological appearance of metamyelocytes and mature granulocytes as well as those that reacted positively with AS-D naphthol chloroacetate esterase. The results suggest that the differentiation pattern of myeloid precursor cells from MDS patients can be modulated by 1,25(OH)2D3 and 13-cis retinoic acid.

Reproducibility of occlusal marking techniques

Our study was designed to (1) test clinically the reproducibility of the NPT by comparing two consecutive occlusal records and records made at 1-month intervals (2) test the reproducibility of a color-marking technique under the same conditions, and (3) compare the location of occlusal contacts as registered by these two techniques. Results showed that neither technique is highly reproducible. However, the NPT is more reproducible than the CMT. The advantages and disadvantages of the NPT and the CMT were described. It was suggested that more research should be conducted to improve the accuracy of occlusal record techniques.

Effect of cytosine arabinoside on differentiation of normal human bone marrow cells

Human normal bone marrow cells were evaluated for alteration of differentiation after exposure for seven days to 10(-12)-10(-9) M cytosine arabinoside (ARA-C) in liquid culture. An increased number of induced cells had the morphologic appearance of mature monocytes-macrophages; they adhered to petri dishes, reacted positively to fluoride-sensitive naphthyl acetate esterase, and specifically bound My4 monoclonal antibody (MCAb). Assessment of phagocytosis and killing of Candida albicans (CA) by cultured monocytes-macrophages exposed to ARA-C demonstrated that treated cells had the same capacity to phagocytose and kill CA as did untreated cells. In semisolid culture, low doses of ARA-C did not affect myeloid colony growth. These studies indicate that ARA-C enhances monocytic differentiation of normal human bone marrow cells in liquid culture.

A subset of human cord blood mononuclear cells is similar to Langerhans cells of the skin: a study with peanut agglutinin and monoclonal antibodies

Mononuclear cells were fractionated from human cord blood by affinity chromatography on immobilized peanut agglutinin, as previously described (Rosenberg et al., Hum Immunol 7:67, 1983). The PNA+ subset was found to be composed mainly of a population of cells phenotyped as Ia+, T6+, M01+, and MY4+. The presence of mononuclear cells coexpressing these antigens was demonstrated by three techniques: double labeling immunofluorescence using FITC and rhodamine conjugated goat antimouse IgG; fluorescence activated cell sorter (FACS); and by direct counting (under the microscope) of cells stained by either individual or a combination of a variety of monoclonal antibodies. The PNA+ cells expressed cytoplasmic structures similar to Birbeck granules. In view of the fact that Langerhans cells of the skin share a similar phenotype and express Birbeck granules, we suggest that this subset may be the precursor of the Langerhans cells of the skin. In addition, these cells may also be the precursors of the dendritic cells found in the spleen, lymph nodes, thymus, and liver.

Occlusal contacts following orthodontic treatment. Measured by a photocclusion technique

Measurement of occlusal contacts on 12 orthodontically treated patients were measured by the photocclusion technique finds a mean increase of 56% in the number of contacts in the first year following treatment.

Mandibular dysfunction in 10-18 year old school children as related to morphological malocclusion

An association was sought between certain morphologic characteristics of malocclusion--Angle classification, over-bite, over-jet, open-bite, cross-bite and crowding--and the presence or absence of three cardinal symptoms of mandibular dysfunction--joint sounds, joint sensitivity to palpation and muscle sensitivity--in a sample of 369 Israeli school children. In addition, two additional independent variables, 'occlusal wear' and 'previous orthodontic treatment' were introduced into the statistical analysis. Occlusal wear and abnormal overbite were the only factors found to increase significantly the presence of dysfunction symptoms.