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11.
  • Ekerfelt, Christina, 1957- (författare)
  • Interferon-Υ and interleukin-4 in health and disease : Studies on Borrelia infection, inflammatory polyneuropathies and normal pregnancy
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: The immune system needs stringent regulation in order to effectively eliminate infecting agents and, at the same time, protect the body from immunemediated tissue destruction. T cells have a major role in this regulation by secreting cytokines. Interferon-y (IFN-y) and interleukin-4 (IL-4) exert antagonistic regulatory functions and are mutually inhibitory. Thus, immune responses are generally functionally dominated by IFN-y or IL-4, a balance which is believed to be decisive for the outcome. Besides providing protection against pathogens, the immune system also has impact on several other conditions, e. g. reproduction and inflammatory diseases. Much is known about the role of IFN-y and IL-4 in animal models of these conditions, but less data are available from studies in humans. Data on IL-4 secretion are particularly rare, since this cytokine is extremely hard to detect.Material and methods: Antigen-specific secretion of IFN-y and IL-4 was detected with ELISPOT -technique in different human conditions, including Borrelia-infection, inflammatory diseases in the peripheral nerves (the Guillain-Barre syndrome [GBS] and polyneuropathy associated with monoclonal gammopathy [PNMGUS]) and normal pregnancy. A novel assay was developed for the detection of fetus-specific cytokine secretion during pregnancy. Finally, a therapeutical approach for selective redirection of inappropriate IFN-y secretion to IL-4 secretion was developed in an experimental model of GBS.Results: Predominant Borrelia-specific secretion of IFN-y and low or absent IL-4- secretion was found, both in patients with clinical Borrelia-infection and resistant individuals. A compartmentalization of this secretion to the central nervous system was evident in patients with neuro-borreliosis. There were indications that the specific IL-4 secretion increased over the disease course, and of lower numbers of Borrelia-specific IL-4 secreting cells in patients that did not fully recover compared with those who did. This suggests that Borrelia-specific IL-4 secretion might be necessary to down-regulate the inflammatory responses generated by IFN-y. Patients with a chronic disease course appeared to have a larger proportion of spontaneously IL-4 secreting cells compared with resistant individuals. Thus, individuals who develop chronic borreliosis may have limited ability to mount strong IFN-y secretion, which may be needed initially in the infection for eradication of the Borrelia bacteria.An increase in the secretion of IL-4 in response to paternal but not to unrelated anaantigen was found in the blood of pregnant women. This is an extraordinary finding, since allo-reactivity usually is predominated by IFN-y secretion. The secretion of IL-4 exclusively to paternal allo-antigen, suggests that this is primarily selective for the fehls. Thus, responses to antigens that are not present at the maternal-fetal interfaCe may well be IFN-y predominated, which is needed to combat common infections. Auto-reactive secretion of IFN-ywas found in PNMGUS, which is a chronic disease. Conversely, autoreactive secretion of IL-4, associated with recovery, was detected in the self-limiting disease GBS. This supports the hypothesis that auto-reactive IFN- )' secretion is involved in the pathogenesis of organ-specific inflammatory diseases, whereas IL-4 secretion is beneficial.Transfer of syngenic disease-specific cells, which had been ex vivo deviated to predominant secretion of IL-4, significantly ameliorated the disease in the experimental model of GBS. This may become a feasible approach for therapeutic intervention of organ-specific inflammatory diseases.Conclusions: The ELISPOT-technique successfully detected alterations in the spontaneous as well as the antigen-induced secretion of IFN-y and IL-4, which a1so in humans appears to have implications for health and disease.
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12.
  • Fall, Per-Arne, 1943- (författare)
  • Aspects of Parkinson's disease. Epidemiology, risk factors and ECT in advanced disease
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • The purpose was to investigate some aspects of epidemiology, risk factors and treatment with ECT in advanced Parkinson’s disease (PD).In study I, we performed a descriptive epidemiologic population-based survey in the Central Health Care District in Östergötland in south-east Sweden, with a population of almost 150,000 inhabitants 1989. The case finding was accomplished in three ways: 1. Collection of all prescriptions for Parkinson’s disease. 2. Search in medical files. 3. Checking with all nursing homes in the area. The crude prevalence was found to be 115 per 100,000 inhabitants. When we used the European Standard Population as a tool for easy comparisons of PD prevalence between different areas and time periods 76 PD-cases per 100,000 inhabitants were found. The corresponding incidences were 11.0 (crude) and 7.9 (age standardised) per 100,000 person-years. Mean age at onset was 65.6. A low prevalence and a high age at onset suggested that e.g. environmental factors could influence the occurrence of PD, and the results implies that only few such factors were present in the investigated area.The findings led to study II, a case-control study which investigated the possible impact of nutritional and environmental risk factors for idiopathic Parkinson’s disease (IP), including 113 cases and 263 control subjects. Dietary, drinking, and smoking habits, as well as previous occupation, were requested in a structured questionnaire. No increased risk was found for any of the nutrients. A reduced risk was found for coffee, wine, and spirits but also for broiled meat, smoked ham or meat, eggs, French loaf or white bread, and tomatoes. These findings could indicate an antioxidant effect. Frequency of preceding and present smoking was reduced in IP patients. Possible mechanisms are discussed. Various occupational groups and exposures were analysed and increased risks of IP in men were found for agricultural work, pesticide exposure, male carpenters, and in female cleaners.In advanced PD there is a need for further therapeutic improvements, and electroconvulsive therapy (ECT) is one insufficiently explored and evaluated method. In study III ECT 16 non-depressed, nondemented PD patients with advanced disease were treated with ECT. In all patients an antiparkinsonian effect of ECT was seen, lasting between a few days and 18 months. Five patients, all with signs of blood brain barrier damage, developed transitory mental confusion after ECT. The results indicated that ECT could cause increased dopaminergic activity, which led us to study IV. Single photon emission computed tomography (SPECT) with the cocaine analogue [123I]-β-CIT was used in order to visualise dopaminergic neurones in the brain. Six patients with PD were examined before and after a series of ECT, and in three cases SPECT was also repeated after one year. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with most pronounced symptomatology. No significant change in uptake of [123I]-β-CIT was seen after ECT, although all patients improved and the most pronounced improvement was seen in patients with less advanced PD.Study V points at two new positive observations with maintenance ECT (MECT). i.e. repeated ECT treatment of PD. One patient had either severe mental side effects on higher L-dopa doses or intolerable parkinsonian symptoms on lower doses. MECT implied marked improvement in parkinsonian symptoms without mental side effects. Another PD patient, who also had a mental depression, showed slight improvement of motor symptoms on a series of ECT. When treated with MECT further antiparkinsonian effects were seen.
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13.
  • Garpenholt, Örjan (författare)
  • Vaccination against Haemophilus influenzae type b in Sweden : Aspects of epidemiology, economy and the process of introduction
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Since 1992-1993 vaccination against Haemophilus influenzae type b (Hib) with conjugated vaccines is included in the general Swedish childhood vaccination programme. In this thesis the introduction of Hib vaccination has been evaluated.The epidemiology and clinical spectrum of invasive H. influenzae disease was prospectively studied during the pre-vaccination period in a well-defined population of Sweden 1987-1992. The incidence (cases/100 000/personyear) was 5.9 for all ages and 55 in children 0 to 4 years of age. Serotype b was the dominating type, especially in children. Three patients died in connecting with illness and six developed permanent sequelae.In national studies, the incidence before and after introduction of the Hib vaccination programme was compared. The source for the studies was the report system from the clinical microbiology laboratories to the Swedish Institute of Infectious Disease Control. Already within one year after introduction a decreased incidence was observed. In the prevaccination period the incidence was 34 in 0 to 4 years old children. In 1998 the incidence had decreased to 1.6 in the same age group. Thirteen children were identified with invasive Hib disease in spite of vaccination. Effectiveness, which take in account both direct and indirect effects of vaccination in 0 to 4 years old children was calculated to 96.0% (95 %Cl, 94.2-97.4). To study the impact of Hib vaccination in the on the diagnosis epiglottitis a national register of all patients treated at Swedish hospitals was used. In the age group 0-4 year the incidence decreased with 95 % after introduction of Hib vaccination. Even in older ages a decrease was observed but this trend did not reach statistically significance.An evaluation of the economic consequences of a general childhood vaccination programme against Hib in Sweden was conducted. A retrospective prevaccination annual cohort of 0-4 year old children was compared with an annual cohort of the same age group after a completely implemented vaccination programme against Hib. The cost analysis shows that vaccination against Hib is cost saving when indirect costs are included in the analysis. In the cost-benefit analysis it is shown that society will gain -88 million Swedish Crowns annually when Hib vaccination is totally implemented.The process of introducing general childhood Hib vaccination was studied. The critical factors for implementation of the immunisation programme were found to be the vaccine product, conception of the disease, government economy and public decision-making. Five activity systems were found to be involved in the implementation process, the systems of vaccine production, government administration, news distribution, science, and disease prevention. To structure the results a theoretical framework was used, Culture Historical Activity Theory. The study shows that a broad range of aspects must be considered before an intervention such as a general vaccination programme can be implemented in society.
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14.
  • Henriksson (Lysholm), Marketta (författare)
  • Rehabilitation and Evaluation after Anterior Cruciate Ligament Injury : Function, Stability and Postural Control
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Traditionally, the success of treatment after anterior cruciate ligament (ACL) injury has been judged from the recovery of muscle strength and knee range of motion (ROM), but also from the static knee stability after ACL reconstruction. However, since the sensory role of the ACL and surrounding tissues for the functional stability of the knee has been documented, the measurement of proprioceptive function related to knee stability is likely to become important in this evaluation.The main purpose of this thesis was to critically examine some generally accepted principles in the treatment after ACL injury and in the way the outcome of this treatment is judged. In addition, we introduce a dynamic posturography system in order to functionally assess the peripheral contribution to postural control in patients with a chronic ACL insufficiency and in patients after ACL reconstruction.The hypothesis tested was that dynamic measurement of anterior-posterior (AlP) laxity would be of greater value than the currently used measurement of static AlP laxity for assessing the result of ACL reconstruction and that these measurements could also be used for selection of rehabilitation exercises. We found that open kinetic chain exercises provoked larger sagittal plane translation than closed kinetic chain exercises and therefore should be avoided in early ACL rehabilitation. The present study furthermore shows that dynamic laxity measurements may be clinically useful to identify ACL injured patients, who are unable to limit the anterior translation of tibia during dynamic exercise.A prospective randomized comparison in patients after ACL reconstruction did not reveal any differences with respect to ROM, static total AlP laxity and subjective knee score and activity level between patients postoperatively treated with an early ROM training and patients treated with five weeks immobilization in plaster. On the contrary, at the 2-year follow-up, the strength deficit in the hamstring and quadriceps muscles tended to be larger in the early ROM trained than in the plaster group (p<0.05 for hamstrings and p=0.07 for quadriceps), possibly related to the greater need for involvement of the physical therapist in the plaster group.It was found that still several years after injury, non-operated ACL injured patients had a significantly greater body sway while standing on the injured limb but also on the uninjured limb on a stable surface. Furthermore, the measurements during perturbations in the sagittal plane showed a longer reaction time and a greater sway amplitude in the single-limb stance among patients than among c:ontrols, with no difference between the injured and the uninjured leg. On the other hand, following ACL reconstruction most measurements of postural control were not different in patients than in controls (36 months postoperatively). The normalization of postural control as well as in subjective knee score and activity level occurred in spite of the total sagittal laxity being significantly higher in the ACL reconstructed knee than in the uninjured knee and in the control group. However, the patients still had significantly longer reaction times for the postural responses to perturbations forwards and backwards, with no difference between the patients' ACL reconstructed and healthy leg. The impaired postural control in ACL deficient patients both while standing on the injured limb and on the uninjured limb, as well as the lack of correlation between the measured laxity of the reconstructed knee and any of the variables in perturbations provide evidence that rehabilitation with proprioceptive and agility training is an important part of the treatment to condition the dynamic restraints and thus improve the functional stability in the ACL reconstructed knee.
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15.
  • Holmlund, Gunilla, 1951- (författare)
  • The polymorphism of the minisatellite system D2S44
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • The polymorphism of the minisatellite system D2S44 comprises all the polymorphisms typical for a minisatellite sequence; from variation in fragment length caused by a restriction site polymorphism or due to variation in the number of a repeated core sequence, to a core sequence polymorphism comprising four variants and variation in the order in which these variants are iterated in tandem. All these polymorphisms can be utilised in paternity investigations, and analysis of the order of variant repeats in parent-child combinations showed that the D2S44 incompatibilities found are due to a mutation in the parental allele.The length polymorphism comprise fragments between 1.4 and 12 kbp, forming two size clusters. Different internal orders of the variant core sequences with a conserved motif at one end of the alleles can be used to group the alleles into three types. Alleles belonging to these types can be considered to be of separate ancestry and are named ancestor alleles of the red, green and yellow type. The red allele type is mainly found in one of the size clusters and the green-type in the other, while the yellow-type alleles are found in both clusters. The presence of different types of ancestor alleles might be the reason for the bimodal distribution.Analysis of 30 mutations showed that short alleles gain repeats and long ones lose repeats. The three allele types also have their ·own individual mutation patterns. Mutations in the red- and the green-type alleles are found at on end of the alleles, and in the yellow-type alleles along the whole array. In five mutations with gains of repeats the gains had most probably been generated by intra-allelic duplications. In the remaining gain mutations the origin of the repeats is not known. There is thus no clear evidence for inter-allelic exchange and mutations in the D2S44 system may mainly be caused by an exchange of sequences between sister-chromatides.VNTR polymorphism was also found in the chimpanzee but with a tandem iteration of a different non-variant core sequence, positioned upstream relative to the tandem array in man. The gorilla seems not to contain tandem repeats.The D2S44 minisatellite system, with a vast number of fragment lengths comprises astonishingly little sequence polymorphism with only a few core sequence variants and only three main allele types compared to other minisatellites. In essence it is a true VNTR marker.
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16.
  • Jansson, Kjell, 1956- (författare)
  • Treatment in Dilated Cardiomyopathy : with special emphasis on beta-adrenergic receptor blockade and angiotensin-converting enzyme inhibition
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Dilated cardiomyopathy (DCM) is a heart muscle disease of unknown origin, characterised by ventricular dilatation and impairment of systolic function. The basic treattnent is medical, according to different pharmacological principles. Evaluation of the severity of the disease and the effects of medication are important for optimal management.Fifty-four patients (42 male and 12 female) with DCM were randomized to receive treatment with either a beta-adrenergic receptor blocker (metoprolol) or an angiotensin-converting enzyme (ACE) inhibitor (captopril). Almost all patients had a history of congestive heart failure and were therefore treated with furosemide. Baseline characteristics and the effects of therapy were studied by invasive haemodynamics, echocardiography, neurohormonal function, heart rate variability and quality of life evaluation.There were favourable effects on left ventricular (LV) function with both drugs but metoprolol seemed to be superior to captopril in improving LV stroke volume and reducing LV filling pressure. There was a reduction in both systolic and diastolic dimensions and the non-invasive findings were in accordance with invasive results. Neurohormonal activation was less than expected and the levels of plasma renin activity and angiotensin II were within the normal range while the levels of atrial natriuretic peptide were increased. Urinary excretion of Aldosterone was reduced with both metoprolol and captopril therapy, but treatment with petoprolol reduced the level of ANP during exercise.Both drugs increased heart rate variability but petoprolol was superior to captopril in increasing totaol power and power in the low and very low frequency.Quality of life was assessed by a disease-specific questionnaire and wsa improved in the dimension "emotion" in both groups during treatment. In the captopril group there were also improvements in total score and in the dimension "physical activity". Improvements in quality of life dimensions, however, did not correlate to improvement in LV function.In conclusion both metoprolol and captopril were well tolerated. There were effects of beta-adrenergic receptor blockade on LV performance that were not obtained, at least not equally, during therapy with ACE inhibitor. Itreatment of patients with DCM should therefore include a beta-receptor blocker. Carefully performed, non-invasive methods can be used to evaluate the effects of therapy.
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17.
  • Jenmalm, Maria C., 1971- (författare)
  • Development of IgG subclass antibodies to allergens in early childhood
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: Immune responses to allergens in young children include both Thl and Th2 like immunity, which may regulate the secretion of IgG subclass antibodies differently. The time, route and level of exposure to an allergen, as well as maternally transferred immunity, may be decisive whether sensitisation or tolerance will ensue. To study this, we established sensitive methods and investigated the development of IgG subclass antibodies to food and inhalant allergens during childhood.Material and Methods: The study group comprised a cohort of 96 children participating in a prospective study. IgG subclass antibodies to ß-lactoglobulin, ovalbumin, Bet v 1 and cat dander were analysed at birth, 6 and 18 months and 8 years by ELISA. At 8 years of age, PBMC from 55 of the children were stimulated with birch and ß-lactoglobulin. Production of IL-5, IL-6, IL-10, IL-13 and IFN-y was analysed by ELISA and expression of IL-4 and IL-9 mRNA by semiquantitative RTPCR.Results: High cord blood levels of IgG antibodies to inhalant, but not to food, allergens were associated with less development of atopy in the children during the first eight years of life. IgG subclass antibody responses to allergens were commonly detected during childhood and were largely restricted to the IgG1 subclass. The production of this opsonising and complement activating subclass was associated with Thllike immunity at 8 years of age. IgG subclass antibodies to food allergens peaked in infancy, whereas antibodies to the inhalant perennial allergen cat, but not the inhalant seasonal allergen birch, increased with age. Exposure to cow's milk during the first three months of life was associated with high IgG subclass antibodies to ß-lactoglobulin up to eight years. Exposure to cat and birch tended to be associated with high antibody levels to those allergens, whereas antibody levels to ovalbumin were not related to the introduction of egg in the diet. Atopic symptoms and the presence of positive skin prick tests and circulating IgE antibodies to allergens were associated with high levels of IgG subclass, especially Th2 associated IgG4, antibody responses to allergens. For the food allergens, the differences were mostly marked early in life. Birch induced IL-4 expression may be the major factor determining IgE antibody formation to that allergen, while allergen induced IL-5, IL-6 and IL-10 secretion in PBMC was associated with atopic symptoms.Conclusions: Maternally derived antibodies may modulate immune responses. The tolerance-inducing mechanisms in the intestinal mucosa may be less effective during the first months of life. Responses to food and inhalant allergens show different kinetics. Thl like associated IgG1 antibodies to allergens are commonly observed in both atopic and non-atopic children, whereas Th2 like associated IgG4 responses are more atopy dependent.
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18.
  • Jiang, Chong-He (författare)
  • Prolonged Modulation of the Micturition Reflex by Electrical Stimulation
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Intravesical electrical stimulation (IVES) has been used in treatment of patients with urinary bladder dysfunctions for more than four decades. While some investigators have reported excellent results others have observed less convincing effects or outright failures. The discrepancies may reflect differences in patient selection or stimulation procedure. A better theoretical understanding of the IVES working mechanism might help to improve the success rate of the treatment. The aims of the present study were to provide such information.Experiments were performed on adult female cats and rats under /alpha/-chloralose anesthesia. IVES was delivered by a catheter electrode in the bladder. At proper intensity and frequency, IVES evoked reflex detrusor contractions that were abolished by bilateral rhizotomy of sacral dorsal roots. Stimulation parameters and response characteristics revealed that bladder mechanoreceptor A/delta/ afferents were activated by the IVES, the same afferents that drive the normal micturition reflex.Five minutes of continues IVES at 20 Hz induced a prolonged, significant decrease in the micturition threshold volume of anesthetized rats. Similarly, selective bladder A/delta/ afferent stimulation induced a long-lasting enhancement of micturition reflex discharges in cats. A comparable prolonged inhibitory effect on the micturition reflex was demonstrated after ano-genital afferent stimulation. Both modulatory effects occurred without changes in response sensitivity of stimulated afferents. The IVES induced modulation was prevented by transient exposure of the bladder to a local anesthetic and by systemic administration of a glutamate NMDA receptor antagonist.In conclusion, IVES induces a prolonged modulation of the micturition reflex by an LTP like enhancement of excitatory synaptic transmission in the central micturition reflex pathway. The findings provide an experimental explanation for the neuronal mechanisms underlying the curative effect of IVES in patients with bladder evacuation problems.
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19.
  • Lundgren, Anna (författare)
  • Perifer intravenös infart i klinisk rutin : Utveckling av omvårdnadsrutiner för att minska risken för komplikationer
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • The general aim was to study the way nurses plan, take care of and document a peripheral intravenous cannula (PIV) line related to complications, and to give a basis for quality assurance in surgery and internal medicine wards. The methods used were examination of patients' records, interview of patients and nurses, and observation of the cannula and its insertion area. An analysis of risk factors was also performed. The sample included 300 patients with 501 inserted peripheral cannulae, as well as nurses. The patients were followed from the day of insertion until the day the insertion area and the vein were free from symptoms.A significantly higher frequency of thrombophlebitis and severe long-term problems were found in patients treated by nurses without special training than among those with (p<0.001 ). The complication risks increased after long time in situ and were especially high when hypertonic drugs, solutions, or anticoagulants were given. Complications could exist up to six months. The care and handling decreased with time in situ and the cannulae were not always removed or documented. The intention was that a cannula should be inserted less than three days, but nurses were aware that the PIV remained in situ longer. Bad routines and neglected areas were said to be the reasons. Discomfort reported by the patients could be directly referred to technical mistakes or/and bad routines. When asked what governed the work with PI Vs the most decisive factors in the case of PIV were said to be knowledge 86%, experience 83%, and routine 32%. Educated nurses performed more satisfactory care and handling. No significant difference could be found between the nurses· years of experience and care and handling of PIV.A gap was shown between nursing research and nurses practice. The findings were not in accordance with, or based on, well-tried experience or scientific performance and diverges from "good knowledge" and '"good care". Reflection over current routines should be of value. One example of a good routine to reduce infections is daily change of the cannula. The conclusion is that the nurse has to be technically and theoretically acquainted with the subject.Nursing care demands special competence and relevant knowledge to enable nurses to assess and give satisfactory care in relation to patients" needs. Good nursing care should include prevention of pain and discomfort, be planned and implemented in a secure way, and also follow research and development in this area so that new knowledge and experience can be brought into the profession.
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20.
  • Löfgren, Ragnhild (författare)
  • Phagocytic-receptor signaling in human neutrophils
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • The neutrophil granulocyte is one of the most mobile cells in the body and through a number of functions represents the first line of defense against invading pathogens. Adhesion and chemotactic receptors on the cell surface work together through modulation of the cytoskeleton, thereby enabling cell movement. Engulfment is facilitated by opsonization of the microbes with C3b or C3bi complement fragments or with immunoglobulins, proteins that respectively bind to complement receptors (CR) and Fey receptors (FcyR) on the neutrophil. The aim of the present study was to investigate the signal transduction properties of CR and FcyR on human neutrophils. In particular, the investigations focused on second messengers of importance for regulating actin polymerization and NADPH-oxidase activity. This was approached by selective activation of each receptor on non-adherent human neutrophils using specific antibodies that were either cross-linked or prefixed on bacterial particles.Both stimulation with f.MetLeuPhe and engagement of CR3 caused an increase in filamentous actin (F-actin) and activation of phosphatidylinositol 3-klnase with the subsequent formation of phosphatidylinositol trisphosphate (PIP,). We found that the F-actin response mediated by fMetLenPhe and CR3 were different. The F-actin response induced by fMetLeuPhe declined rapidly whereas the response induced by engagement of CR3 was more sustained. This is hypothesized to be due to the inability of CR3 to induce a cAMP signal, since direct addition of cAMP and 1-isobutyl-methylxantine (IBMX, a phosphodiesterase inhibitor) to electropermeabilized neutrophils caused a prompt reversal of the CR3-induced F-actin elevation.Engagement of CR3 and CR1 by antibody cross-linking induced a Ca2+ signal and phospholipase D (PLD) activation. Furthermore, the PLD response was potentiated by PMA pretreatment and was dependent on the form of ligand presentation. Both FcyR (FcyRITA and FcyRIIIB) and CR3 induced activation of NADPH-oxidase, a response that was dependent on intracellular Ca2+, tyrosine kinase activation and PLD activity. However, only FcyRllA induced a strong phosphorylation of p72''\ indicating that CR3 and FcyRliA might use different pathways leading to NADPH-oxidase activation.
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