Opsonic Requirements for Intravascular Clearance after Splenectomy
We investigated the opsonic requirements for intravascular clearance of pneumococci in guinea pigs and of sensitized erythrocytes in human beings after splenectomy. The impaired clearance of injected pneumococci in splenectomized guinea pigs was corrected by immunization. This improvement in clearan...
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| Veröffentlicht in: | The New England journal of medicine 1981-01, Vol.304 (5), p.245-250 |
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| creator | Hosea, Stephen W Brown, Eric J Hamburger, Max I Frank, Michael M |
| description | We investigated the opsonic requirements for intravascular clearance of pneumococci in guinea pigs and of sensitized erythrocytes in human beings after splenectomy. The impaired clearance of injected pneumococci in splenectomized guinea pigs was corrected by immunization. This improvement in clearance was due to increased hepatic sequestration of organisms. There was a significant delay in antibody-mediated clearance of autologous erythrocytes sensitized with IgG (P |
| doi_str_mv | 10.1056/NEJM198101293040501 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_75534807</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4315773051</sourcerecordid><originalsourceid>FETCH-LOGICAL-c401t-ce444130e30af20d885213132969260f2876140d09faf31b07352b0cf67120ec2</originalsourceid><addsrcrecordid>eNp9kNtKw0AQhhdRaq0-gQgBwRuJzuwhm1xqqSeqBQ_XYbudhZQc2t1E6NsbafFCxLmZi_n-n-Fj7BThCkEl1y-Tp2fMUgTkmQAJCnCPDVEJEUsJyT4bAvA0ljoTh-wohCX0gzIbsIGWkmuVDNntbBWaurDRK627wlNFdRsi1_josW69-TTBdqXx0bgk401tKTKuJR-9rUqqybZNtTlmB86UgU52e8Q-7ibv44d4Ort_HN9MYysB29iSlBIFkADjOCzSVHEUKHiWZDwBx1OdoIQFZM44gXPQQvE5WJdo5ECWj9jFtnflm3VHoc2rIlgqS1NT04VcKyVkCroHz3-By6bzdf9bjqnuFfBEQE-JLWV9E4Inl698URm_yRHyb7_5H3771Nmuu5tXtPjJ7IT298vtvapCXtOy-rftC2Ocf0U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1870012630</pqid></control><display><type>article</type><title>Opsonic Requirements for Intravascular Clearance after Splenectomy</title><source>MEDLINE</source><creator>Hosea, Stephen W ; Brown, Eric J ; Hamburger, Max I ; Frank, Michael M</creator><creatorcontrib>Hosea, Stephen W ; Brown, Eric J ; Hamburger, Max I ; Frank, Michael M</creatorcontrib><description>We investigated the opsonic requirements for intravascular clearance of pneumococci in guinea pigs and of sensitized erythrocytes in human beings after splenectomy. The impaired clearance of injected pneumococci in splenectomized guinea pigs was corrected by immunization. This improvement in clearance was due to increased hepatic sequestration of organisms. There was a significant delay in antibody-mediated clearance of autologous erythrocytes sensitized with IgG (P<0.001), although the rate of complement-mediated clearance in splenectomized patients was normal. A fourfold increase in sensitizing antibody resulted in a significant improvement in clearance that was due to increased hepatic sequestration (P<0.005). One patient who had an intact spleen and who had previously received Thorotrast (thorium oxide) had impaired antibody-mediated clearance despite increased sensitization. These observations suggest that, after splenectomy the remaining macrophages of the reticuloendothelial system require increased amounts of antibody to mediate efficient intravascular clearance of opsonized particles. (N Engl J Med. 1981; 304:245–50.)
MANY studies of the function of the reticuloendothelial system have emphasized the critical role of the spleen as an efficient filter of blood-borne particles.
1
2
3
Moreover, it is known that removal of the spleen predisposes a patient to the development of overwhelming sepsis
4
characterized by the catastrophic onset of high-grade bacteremia without a primary site of infection.
5
Concomitant clinical features include shock, disseminated intravascular coagulation, and the adult respiratory-distress syndrome. Pneumococci are the predominant pathogens, although
Haemophilus influenzae
, neisseria species,
Escherichia coli
, and
Staphylococcus aureus
are occasionally isolated.
6
Predisposition to this unique syndrome suggests that the spleen is essential . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198101293040501</identifier><identifier>PMID: 7442756</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Animals ; Antibodies, Bacterial - immunology ; Bacterial Infections - etiology ; Colony-Forming Units Assay ; Complement C3b - immunology ; Complement system ; Complement System Proteins - immunology ; Erythrocytes ; Erythrocytes - immunology ; Female ; Guinea Pigs ; Humans ; Immunity, Innate ; Immunization ; Immunoglobulin G ; Immunoglobulin G - immunology ; Immunoglobulin M - immunology ; Laboratories ; Liver ; Liver - immunology ; Macrophages ; Opsonin Proteins - physiology ; Opsonization ; Patients ; Reticuloendothelial system ; Sepsis ; Spleen ; Splenectomy ; Splenectomy - adverse effects ; Streptococcus infections ; Streptococcus pneumoniae - immunology ; Thorium</subject><ispartof>The New England journal of medicine, 1981-01, Vol.304 (5), p.245-250</ispartof><rights>Copyright Massachusetts Medical Society Jan 29, 1981</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c401t-ce444130e30af20d885213132969260f2876140d09faf31b07352b0cf67120ec2</citedby><cites>FETCH-LOGICAL-c401t-ce444130e30af20d885213132969260f2876140d09faf31b07352b0cf67120ec2</cites></display><links><openurl>$$Topenurl_article</openurl><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7442756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hosea, Stephen W</creatorcontrib><creatorcontrib>Brown, Eric J</creatorcontrib><creatorcontrib>Hamburger, Max I</creatorcontrib><creatorcontrib>Frank, Michael M</creatorcontrib><title>Opsonic Requirements for Intravascular Clearance after Splenectomy</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>We investigated the opsonic requirements for intravascular clearance of pneumococci in guinea pigs and of sensitized erythrocytes in human beings after splenectomy. The impaired clearance of injected pneumococci in splenectomized guinea pigs was corrected by immunization. This improvement in clearance was due to increased hepatic sequestration of organisms. There was a significant delay in antibody-mediated clearance of autologous erythrocytes sensitized with IgG (P<0.001), although the rate of complement-mediated clearance in splenectomized patients was normal. A fourfold increase in sensitizing antibody resulted in a significant improvement in clearance that was due to increased hepatic sequestration (P<0.005). One patient who had an intact spleen and who had previously received Thorotrast (thorium oxide) had impaired antibody-mediated clearance despite increased sensitization. These observations suggest that, after splenectomy the remaining macrophages of the reticuloendothelial system require increased amounts of antibody to mediate efficient intravascular clearance of opsonized particles. (N Engl J Med. 1981; 304:245–50.)
MANY studies of the function of the reticuloendothelial system have emphasized the critical role of the spleen as an efficient filter of blood-borne particles.
1
2
3
Moreover, it is known that removal of the spleen predisposes a patient to the development of overwhelming sepsis
4
characterized by the catastrophic onset of high-grade bacteremia without a primary site of infection.
5
Concomitant clinical features include shock, disseminated intravascular coagulation, and the adult respiratory-distress syndrome. Pneumococci are the predominant pathogens, although
Haemophilus influenzae
, neisseria species,
Escherichia coli
, and
Staphylococcus aureus
are occasionally isolated.
6
Predisposition to this unique syndrome suggests that the spleen is essential . . .</description><subject>Animals</subject><subject>Antibodies, Bacterial - immunology</subject><subject>Bacterial Infections - etiology</subject><subject>Colony-Forming Units Assay</subject><subject>Complement C3b - immunology</subject><subject>Complement system</subject><subject>Complement System Proteins - immunology</subject><subject>Erythrocytes</subject><subject>Erythrocytes - immunology</subject><subject>Female</subject><subject>Guinea Pigs</subject><subject>Humans</subject><subject>Immunity, Innate</subject><subject>Immunization</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin G - immunology</subject><subject>Immunoglobulin M - immunology</subject><subject>Laboratories</subject><subject>Liver</subject><subject>Liver - immunology</subject><subject>Macrophages</subject><subject>Opsonin Proteins - physiology</subject><subject>Opsonization</subject><subject>Patients</subject><subject>Reticuloendothelial system</subject><subject>Sepsis</subject><subject>Spleen</subject><subject>Splenectomy</subject><subject>Splenectomy - adverse effects</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae - immunology</subject><subject>Thorium</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>false</fulltext><rsrctype>article</rsrctype><creationdate>1981</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kNtKw0AQhhdRaq0-gQgBwRuJzuwhm1xqqSeqBQ_XYbudhZQc2t1E6NsbafFCxLmZi_n-n-Fj7BThCkEl1y-Tp2fMUgTkmQAJCnCPDVEJEUsJyT4bAvA0ljoTh-wohCX0gzIbsIGWkmuVDNntbBWaurDRK627wlNFdRsi1_josW69-TTBdqXx0bgk401tKTKuJR-9rUqqybZNtTlmB86UgU52e8Q-7ibv44d4Ort_HN9MYysB29iSlBIFkADjOCzSVHEUKHiWZDwBx1OdoIQFZM44gXPQQvE5WJdo5ECWj9jFtnflm3VHoc2rIlgqS1NT04VcKyVkCroHz3-By6bzdf9bjqnuFfBEQE-JLWV9E4Inl698URm_yRHyb7_5H3771Nmuu5tXtPjJ7IT298vtvapCXtOy-rftC2Ocf0U</recordid><startdate>19810129</startdate><enddate>19810129</enddate><creator>Hosea, Stephen W</creator><creator>Brown, Eric J</creator><creator>Hamburger, Max I</creator><creator>Frank, Michael M</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19810129</creationdate><title>Opsonic Requirements for Intravascular Clearance after Splenectomy</title><author>Hosea, Stephen W ; Brown, Eric J ; Hamburger, Max I ; Frank, Michael M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c401t-ce444130e30af20d885213132969260f2876140d09faf31b07352b0cf67120ec2</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1981</creationdate><topic>Animals</topic><topic>Antibodies, Bacterial - immunology</topic><topic>Bacterial Infections - etiology</topic><topic>Colony-Forming Units Assay</topic><topic>Complement C3b - immunology</topic><topic>Complement system</topic><topic>Complement System Proteins - immunology</topic><topic>Erythrocytes</topic><topic>Erythrocytes - immunology</topic><topic>Female</topic><topic>Guinea Pigs</topic><topic>Humans</topic><topic>Immunity, Innate</topic><topic>Immunization</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulin G - immunology</topic><topic>Immunoglobulin M - immunology</topic><topic>Laboratories</topic><topic>Liver</topic><topic>Liver - immunology</topic><topic>Macrophages</topic><topic>Opsonin Proteins - physiology</topic><topic>Opsonization</topic><topic>Patients</topic><topic>Reticuloendothelial system</topic><topic>Sepsis</topic><topic>Spleen</topic><topic>Splenectomy</topic><topic>Splenectomy - adverse effects</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumoniae - immunology</topic><topic>Thorium</topic><toplevel>peer_reviewed</toplevel><creatorcontrib>Hosea, Stephen W</creatorcontrib><creatorcontrib>Brown, Eric J</creatorcontrib><creatorcontrib>Hamburger, Max I</creatorcontrib><creatorcontrib>Frank, Michael M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>no_fulltext</fulltext></delivery><addata><au>Hosea, Stephen W</au><au>Brown, Eric J</au><au>Hamburger, Max I</au><au>Frank, Michael M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Opsonic Requirements for Intravascular Clearance after Splenectomy</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1981-01-29</date><risdate>1981</risdate><volume>304</volume><issue>5</issue><spage>245</spage><epage>250</epage><pages>245-250</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>We investigated the opsonic requirements for intravascular clearance of pneumococci in guinea pigs and of sensitized erythrocytes in human beings after splenectomy. The impaired clearance of injected pneumococci in splenectomized guinea pigs was corrected by immunization. This improvement in clearance was due to increased hepatic sequestration of organisms. There was a significant delay in antibody-mediated clearance of autologous erythrocytes sensitized with IgG (P<0.001), although the rate of complement-mediated clearance in splenectomized patients was normal. A fourfold increase in sensitizing antibody resulted in a significant improvement in clearance that was due to increased hepatic sequestration (P<0.005). One patient who had an intact spleen and who had previously received Thorotrast (thorium oxide) had impaired antibody-mediated clearance despite increased sensitization. These observations suggest that, after splenectomy the remaining macrophages of the reticuloendothelial system require increased amounts of antibody to mediate efficient intravascular clearance of opsonized particles. (N Engl J Med. 1981; 304:245–50.)
MANY studies of the function of the reticuloendothelial system have emphasized the critical role of the spleen as an efficient filter of blood-borne particles.
1
2
3
Moreover, it is known that removal of the spleen predisposes a patient to the development of overwhelming sepsis
4
characterized by the catastrophic onset of high-grade bacteremia without a primary site of infection.
5
Concomitant clinical features include shock, disseminated intravascular coagulation, and the adult respiratory-distress syndrome. Pneumococci are the predominant pathogens, although
Haemophilus influenzae
, neisseria species,
Escherichia coli
, and
Staphylococcus aureus
are occasionally isolated.
6
Predisposition to this unique syndrome suggests that the spleen is essential . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>7442756</pmid><doi>10.1056/NEJM198101293040501</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 1981-01, Vol.304 (5), p.245-250 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE |
| subjects | Animals Antibodies, Bacterial - immunology Bacterial Infections - etiology Colony-Forming Units Assay Complement C3b - immunology Complement system Complement System Proteins - immunology Erythrocytes Erythrocytes - immunology Female Guinea Pigs Humans Immunity, Innate Immunization Immunoglobulin G Immunoglobulin G - immunology Immunoglobulin M - immunology Laboratories Liver Liver - immunology Macrophages Opsonin Proteins - physiology Opsonization Patients Reticuloendothelial system Sepsis Spleen Splenectomy Splenectomy - adverse effects Streptococcus infections Streptococcus pneumoniae - immunology Thorium |
| title | Opsonic Requirements for Intravascular Clearance after Splenectomy |
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