Suppression of Immunologic Responsiveness in Uremia
1965; American College of Physicians; Volume: 62; Issue: 1 Linguagem: Inglês
10.7326/0003-4819-62-1-1
ISSN1539-3704
Autores Tópico(s)Pediatric health and respiratory diseases
ResumoArticle1 January 1965Suppression of Immunologic Responsiveness in UremiaW. E. C. WILSON, M.D., CHARLES H. KIRKPATRICK, M.D., DAVID W. TALMAGE, M.D.W. E. C. WILSON, M.D., CHARLES H. KIRKPATRICK, M.D., DAVID W. TALMAGE, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecent developments in surgery have resulted in technically successful transplantation of human kidneys prior to the solution of many fundamental problems in transplantation immunology. The consequence has been a spectrum of clinical observations that varies from generally successful renal transplantation between identical twins to less frequent success when a genetically dissimilar donor is employed. Nevertheless, when comparison is made with the fate of other transplanted organs that elicit an immune response, a remarkable degree of success has been achieved with human kidney allografts. These favorable results suggested that the chronically uremic patient may have a unique alteration of his immunologic...References1. KIRKPATRICKWILSONTALMAGE CHWEDW: Immunologic studies in human organ transplantation. I. Observation and characterization of suppressed cutaneous reactivity in uremia. J. Exp. Med. 119: 727, 1964. CrossrefMedlineGoogle Scholar2. ROWLANDSWILSONKIRKPATRICK DTWECH: Immunologic studies in human organ transplantation. II. The histology of passively transferred delayed hypersensitivity. J. Allerg. 35: 242, 1964. CrossrefMedlineGoogle Scholar3. WILSONKIRKPATRICKTALMAGE WECHDW: Immunologic studies in human organ transplantation. III. The relationship of delayed cutaneous hypersensitivity to the onset of attempted kidney allograft rejection. J. Clin. Invest. 43: 1881, 1964. CrossrefMedlineGoogle Scholar4. WELCHSTUART HCA: A rapid slide test for the serologic diagnosis of typhoid and paratyphoid fevers. J. Lab. Clin. Med. 21: 411, 1936. Google Scholar5. HENSHAWFELDMAN HCWH: The histology of intracutaneous tuberculin reaction in human skin. J. Invest. Derm. 2: 243, 1939. Google Scholar6. LAWRENCE HS: The transfer of hypersensitivity of the delayed type in man, in Cellular and Humoral Aspects of the Hypersensitive States, edited by LAWRENCE, H. S., Hoeber (Harper Bros.), New York, 1959, p. 279. Google Scholar7. NAJARIANFELDMAN JSJD: Skin homograft rejection by a humoral agent. Fed. Proc. 22: 274, 1963. Google Scholar8. HUMEMERRILLMILLERTHORN DMJPBFGW: Experiences with renal homotransplantation in the human: report of nine cases. J. Clin. Invest. 34: 327, 1955. CrossrefMedlineGoogle Scholar9. DAMMINCOUCHMURRAY GJNPJE: Prolonged survival of skin homografts in uremic patients. Ann. NY Acad. Sci. 64: 967, 1957. CrossrefMedlineGoogle Scholar10. MANNICKPOWERSMITHOEFERFERREBEE JAJHJJW: Renal transplantation in azotemic dogs. Surgery 47: 340, 1960. MedlineGoogle Scholar11. SMIDDYBURWELLPARSONS FGRGFM: Influence of uremia on the survival of skin homografts. Nature (London) 190: 732, 1961. CrossrefGoogle Scholar12. HAMBURGERVAYSSECROSNIERAUVERTLALANNEHOPPER JJJJCMJ: Renal transplantation in man after radiation of the recipient. Amer. J. Med. 32: 854, 1962. CrossrefMedlineGoogle Scholar13. HUMEMAGEEKAUFFMANRITTENBURYPROUT DMJHHMMSGR: Renal homotransplantation in man in modified recipients. Ann. Surg. 158: 608, 1963. CrossrefMedlineGoogle Scholar14. MURRAYHARRISON JEJH: Surgical management of fifty patients with kidney transplants including eighteen pairs of twins. Amer. J. Surg. 105: 205, 1963. CrossrefMedlineGoogle Scholar15. STARZL TE: Experiences in Renal Transplantation, W. B. Saunders, Philadelphia, 1964, p. 4. Google Scholar16. SONESISRAEL MHL: Altered immunologic reactions in sarcoidosis. Ann. Intern. Med. 40: 260, 1954. LinkGoogle Scholar17. SCHIERROTHOSTROFFSHRIFT WWAGMH: Hodgkin's disease and immunity. Amer. J. Med. 20: 94, 1956. CrossrefMedlineGoogle Scholar18. LO SPALLUTOMILLERDORWARDFINK JWBCW: The formation of macroglobulin antibodies. I. Studies on adult humans. J. Clin. Invest. 41: 1415, 1962. CrossrefMedlineGoogle Scholar19. BALCH HH: The effect of severe battle injury and of post-traumatic renal failure on resistance to infection. Ann. Surg. 142: 145, 1955. CrossrefMedlineGoogle Scholar20. STOLOFFSTOUTMYERSONHAVENS ILRRMWP: Production of antibody in patients with uremia. New Eng. J. Med. 259: 320, 1958. CrossrefMedlineGoogle Scholar21. GOWLANDSMIDDY GFG: The effect of acute experimental uremia on the immunological responses of the rabbit to bovine serum albumin. Brit. J. Urol. 34: 274, 1962. CrossrefMedlineGoogle Scholar22. TALMAGECLAMAN DWHN: Cell potential—its mutation and selection. A theory of differentiation based on antibody production, in The Thymus in Immunobiology, edited by GOOD, R., GABRIELSON, A., Harper and Rowe, New York, 1964, p. 49. Google Scholar23. FELDMANNAJARIAN JDJS: Dynamics and quantitative analysis of passively transferred tuberculin hypersensitivity. J. Immunol. 91: 306, 1963. MedlineGoogle Scholar24. WHITE RG: Factors affecting the antibody response. Brit. Med. Bull. 19: 207, 1963. CrossrefMedlineGoogle Scholar25. URBACHSONESISRAEL FMHL: Passive transfer of tuberculin sensitivity to patients with sarcoidosis. New Eng. J. Med. 247: 794, 1952. CrossrefMedlineGoogle Scholar26. KELLYLAMBVARCOGOOD WDDLRLRA: On investigation of Hodgkin's disease with respect to the problem of homotransplantation. Ann. NY Acad. Sci. 87: 187, 1960. CrossrefMedlineGoogle Scholar27. CUMMINGSHUDGINS MMPC: The influence of cortisone on the passive transfer of tuberculin hypersensitivity in the guinea pig. J. Immunol. 69: 331, 1952. MedlineGoogle Scholar28. WARWICKGOODSMITH WJRART: Failure of passive transfer of delayed hypersensitivity in the newborn human infant. J. Lab. Clin. Med. 56: 139, 1960. MedlineGoogle Scholar29. LOGELANGEMOORE JPRDCV: Characterization of the anemia associated with renal insufficiency. Amer. J. Med. 24: 4, 1958. CrossrefMedlineGoogle Scholar30. CALLENLIMARZI IRLR: Blood and bone marrow studies in renal disease. Amer. J. Clin. Path. 20: 3, 1950. CrossrefMedlineGoogle Scholar31. JENSSON O: Observations on the leucocyte blood picture in acute uremia. Brit. J. Haemat. 4: 422, 1958. CrossrefMedlineGoogle Scholar32. RIISSTOUGAARD PJ: The peripheral blood leukocytes in chronic renal insufficiency. Danish Med. Bull. 6: 85, 1959. MedlineGoogle Scholar33. MILLER JF: The thymus and the development of immunologic responsiveness. Science 144: 1544, 1964. CrossrefMedlineGoogle Scholar34. CASTLEMAN B: Pathology of the thymus gland in myasthenia gravis, in Thymectomy for Myasthenia Gravis, edited by VIETS, H. R., SCHWAB, R. S., Charles C Thomas, Springfield, Ill., 1960, p. 51. Google Scholar35. MACKAYMOSELBURNET IRMFM: Thymic abnormality in systemic lupus erythematosus. Aust. Ann. Med. 13: 5, 1964. MedlineGoogle Scholar36. GITLINROSENJANEWAY DFSCA: The thymus and other lymphoid tissues in congenital agammaglobulinemia. II. Delayed hypersensitivity and homograft survival in a child with thymic alymphoplasia. Pediatrics 33: 711, 1964. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: W. E. C. WILSON, M.D.; CHARLES H. KIRKPATRICK, M.D.; DAVID W. TALMAGE, M.D.Affiliations: Denver, ColoradoFrom the University of Colorado Medical Center, Denver, Colo.This work was supported by grant AI-04152 from the U. S. Public Health Service, Bethesda, Md.Dr. Wilson is a Research Fellow of the American College of Physicians, 1962-1965; and Dr. Kirkpatrick is a Special Post-doctoral Fellow of the U. S. Public Health Service.Requests for reprints should be addressed to Charles H. Kirkpatrick, M.D., Department of Medicine, University of Kansas Medical Center, Kansas City, Kan. 66103. 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Relationship of glomerular filtration rate to depression of immune potential.Etiology and prognosis in acute post-transplant renal failureThe effect of uremia and transplantation on lymphocyte subpopulationsCytomegalovirus infection and immunity in renal allograft recipients: assessment of the competence of humoral immunityUnterschiede im Krankheitsverlauf der Hepatitis B bei Dialysepatienten und dem Personal einer DialysestationToxicity of Antineoplastic Agents in Man: Chromosomal Aberrations, Antifertility Effects, Congenital Malformations, and Carcinogenic PotentialUremia as a State of Immune DeficiencyHepatitis-B: A reviewSuccessful renal transplantation in patients with prior history of malignancyT-rosettes in hemodialysis patients and renal allograft recipientsTHE IMMUNOLOGICAL POTENTIAL OF HUMAN LYMPH NODES IN UREMIA AND DURING EXTRACORPOREAL IRRADIATION OF THE BLOODInhibition of Cell Proliferation in Renal Failure and its Significance to the Uraemic Syndrome: A ReviewRADIOIMMUNOASSAY OF HEPATITIS B ANTIGEN AND ANTIBODY IN DIALYSIS AND TRANSPLANT PATIENTSROLE OF HBsAb IN DEVELOPMENT OF HEPATITISImmunmechanismen bei Ur�mieINCREASED INCIDENCE OF MALIGNANCY DURING CHRONIC RENAL FAILUREMicrobiology of TraumaZur Monocyten-Funktion bei Kranken mit terminaler NiereninsuffizienzOver 95% Sensitization against Allogeneic Leukocytes Following Single Massive Blood TransfusionLymphocytotoxins in a Chronic Hemodialysis PopulationImmunological Studies of Anergic PatientsTissue Sensitivity to Drugs in Disease StatesInfluenza Vaccination of Patients with Glomerular Diseases Effects on Creatinine Clearance, Urinary Protein Excretion, and Antibody ResponseRUFINO C. 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CHIN, M.D.Serumproteinver�nderungen bei chronischer Azot�mie und nach NierentransplantationInfectious risk factors in the immunosuppressed hostImmunological Responses to Sheep Red Blood Cells in Experimentally Induced Chronic Uremia of RatsThe influence of urea on protein synthesis of stimulated lymphocytesSuppression of in Vitro Lymphocyte Function by Uremic ToxinsDevelopment of Lymphocytotoxic Antibodies in Hemodialysis PatientsEVALUATION OF THE PRIMARY IMMUNE RESPONSE IN UREMIA AND AFTER EXTRACORPOREAL IRRADIATION OF THE BLOODLYMPHOCYTE TRANSFORMATION TESTS BEFORE, DURING AND AFTER EXTRACORPOREAL IRRADIATION OF THE BLOODAdverse reactions associated with the administration of a tricarbocyanine dye (Cardio-Green) to uremic patientsSTUDIES ON ANTIBODY PRODUCTION IN URAEMIATHE VARIATION IN TWENTY-ONE SERUM PROTEINS BEFORE AND AFTER RENAL TRANSPLANTATIONI. 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SANFORD, M.D., F.A.C.P.An Epidemic of Hepatitis in a Chronic-Hemodialysis UnitThrombozyten-TransfusionCutaneous anergy without systemic diseaseERYTHROCYTE PRODUCTION AND METABOLISM IN ANEPHRIC AND UREMIC MENAkute und chronische Wirkung hochdosierter Diuretika bei terminaler NiereninsuffizienzEffect of Renal Homotransplantation on the Metabolism of the Light Chains of ImmunoglobulinsWALLACE V. EPSTEIN, M.D., F.A.C.P., PAUL F. GULYASSY, M.D., MARGARET TAN, M.S., ANGUS I. RAE, M.B.Systemic fungal infections complicating renal transplantation and immunosuppressive therapyCutaneous Manifestations of Hyperlipidemia and UremiaHypogammaglobulinemia, primary and secondary: Immunoglobulin levels (γG, γA, γM) in one hundred and twenty-five patientsChronic pulmonary disease and immunologic deficiencyGlobulin Synthesis by Human Peripheral Lymphocytes In Vitro Measurements Using Lymphocytes from Normals and Patients with DiseaseI. J. FORBES, M.D., D. W. HENDERSON, M.B.The Role of Organ Transplantation in PediatricsAN ASSESSMENT OF THE MIXED LEUCOCYTE REACTION IN RENAL FAILURE 1 January 1965Volume 62, Issue 1Page: 1-14KeywordsAntigensKidneysMedical servicesMonozygotic twinsRenal transplantationSalmonellaSurgeryTransplantationTransplantation immunologyTyphoid ePublished: 1 December 2008 Issue Published: 1 January 1965 Copyright & PermissionsCopyright ©, 1965, by The American College of PhysiciansPDF downloadLoading ...
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