Search Results

You are looking at 1 - 10 of 28 items for

  • Author: Jørn Nerup x
Clear All Modify Search
Restricted access

Jørn Nerup

ABSTRACT

Sera from 106 cases of Addison's disease, 106 healthy controls matched for age and sex, 1021 other controls and 606 cases of endocrine and autoimmune diseases were examined for the occurrence of adrenal, thyroid, gastric, gonadal, salivary gland and antinuclear antibodies.

The adrenal antibody was found to be organ-specific and widely species-non-specific and occurred in about 70 % of the patients with idiopathic Addison's disease, but in no case of unequivocal tuberculous Addison's disease. The adrenal antibody was found in less than 0.1 % of the control sera and in less than 1.5 % of the other disease groups examined.

The group of patients with idiopathic Addison's disease with adrenal antibody had thyroid, gastric and gonadal antibodies in their sera with significantly greater frequency than any of the other groups.

This group was further characterized by low age at onset and a high prevalence of associated diseases.

On this basis it was suggested, that so-called idiopathic Addison's disease consists of two rather distinct subpopulations: One (25–30 %) which should still be considered idiopathic and another group (70-75 %) of autoimmune origin. The name Addison's adrenalitis is suggested for this type of primary adrenocortical insufficiency.

Restricted access

Jørn Nerup

ABSTRACT

One hundred and eight cases of Addison's disease, diagnosed in Danish medical departments between 1950 and 1972, were reviewed. The idiopathic type of Addison's disease predominated (66 %) while tuberculous Addisons's disease comprised only 17 % of the present series. The remaining 17 % were unclassifiable on clinical grounds.

One third of the cases had symptoms less than three months prior to diagnosis and 25 % of the patients were in need of immediate treatment because of manifest or impending crisis when admitted to the hospital. Idiopathic Addison's disease was diagnosed in all age groups, predominantly in females, while patients with tuberculous Addison's disease were preferably males of higher ages.

A second disease (diabetes mellitus, thyroid disorders, pernicious anaemia or gonadal insufficiency) was diagnosed in 53 % of the patients with idiopathic Addison's disease. Associated diseases were found with significantly reduced frequency in other types of Addison's disease.

Restricted access

Jørn Nerup and Christian Binder

ABSTRACT

The clinical association between diabetes mellitus and auto-immune diseases of the thyroid, the adrenals and the gastric mucosa occurs more frequently than could be expected by chance. Sera from 133 patients with diabetes mellitus and 128 controls were therefore investigated for the presence of organ-specific auto-antibodies. Thyroid microsomal antibody and gastric-parietal-cell antibody were demonstrated with significantly increased frequency – 20% and 16% respectively – in sera from patients with diabetes mellitus. Antibodies reacting specifically with tissue components of the endocrine pancreas could not be demonstrated.

From the data presented and from a review of the literature it is concluded that evidence is accumulating pointing to a disorder of the immunological system in patients with diabetes mellitus with regard to the formation of organ-specific humoral and cellular auto-immunity, and the occurrence of organ-specific auto-immune diseases.

Restricted access

Karine Bech, Jørn Nerup and Jørgen Hannover Larsen

ABSTRACT

The frequency of agglutinating antibodies to Yersinia enterocolitica (Y. ent.) serotype 3 and 9 has been studied in sera from patients with various thyroid diseases. No antibodies to Y. ent. serotype 9 were found. Titres (≧ 10) of Y. ent. serotype 3 antibodies were found significantly more frequently in thyroid patients than in controls. In patients with Graves' disease the frequency was 59.5 per cent compared with 16.6 and 27.7 % in the two control groups (P < 0.0005). High titres (≧ 80) were significantly increased in patients with Graves' disease and diffuse nontoxic goitre when compared with the control groups. The prevalence of Y. ent. antibodies decreased with the duration of the disease. In patients with recurrent Graves' disease high titres of Y. ent. antibodies were found in 25 per cent compared with 11 per cent in patients with the first attack of Graves' disease (P < 0.05).

No correlation with age, sex, exophthalmos or the presence of antibodies to thyroid antigens was found. As the O antigen of Y. ent. serotype 3 is specific the detection of these antibodies suggest an infection with Y. ent. and possibly an association between this infection and thyroid disorders, in particular Graves' disease.

Restricted access

Peter Kamp, Per Platz and Jørn Nerup

ABSTRACT

By means of an indirect immunofluorescence technique, sera from 116 patients with Addison's disease, an equal number of age and sex matched controls and 97 patients with other endocrine diseases were examined for the occurrence of antibody to steroid-producing cells in ovary, testis and adrenal cortex.

Fluorescent staining was observed in the theca cells of growing follicles, the theca lutein cells, testicular Leydig cells and adrenal cortical cells, i. e. cells which contain enzyme systems used in steroid hormone production. The "steroid-cell" antibody was present in 24 % of the patients with idiopathic Addison's disease, equally frequent in males and females, and in 17 % of the patients with tuberculous Addison's disease, but was rarely found in controls, including patients with other endocrine diseases.

Female hypergonadotrophic hypogonadism made an exception, since the "steroid-cell" antibody was found in about half the cases with this condition.

Restricted access

Jesper Johannesen, Steffen Helqvist and Jørn Nerup

Abstract.

The purpose of this study was to test the influence of different insulin secretagogues on interleukin 1β mediated injury to isolated rat pancreatic islets. Islets were exposed to interleukin 1β for 6 days. During exposure, beta-cells were stimulated with glucose ( 11 mmol/l vs 3.3 mmol/l or with non-nutrients as tolbutamide (250 μmol/l), iso-butyl 1-methyl-xanthine (50 μmol/l), or glucagon (10 mg/l). At 3.3 mmol/l of glucose, 60 000 U/l of interleukin 1β caused an inhibition of medium insulin accumulation to 62±5% of control from 48 h to 6 days of exposure, whereas islet DNA content was unaffected. At 11 mmol/l of glucose, interleukin 1β dose-dependently decreased medium insulin accumulation (e.g. 60 000 U/l of interleukin 1β, 12±3% of control) and islet content of DNA (60 000 U/l of interleukin 1β, 60±8% of control). During beta-cell stimulation with tolbutamide, interleukin 1β caused inhibition of insulin accumulation to 36±9% of control. In contrast, on islets stimulated with iso-butyl 1-methyl-xanthine or glucagon, the effects of interleukin 1 β were equivalent to those on non-stimulated islets. These differences were paralleled by differences in the interleukin 1β effect on islet morphology. In conclusion, high beta-cell activity (as measured by islet insulin release) may increase islet susceptibility to interleukin 1β, however, depending upon the intracellular pathway through which insulin secretion is activated.

Restricted access

Hans Kromann, Bent Faber Vestergaard and Jørn Nerup

ABSTRACT

Twelve weeks old inbred male C 57 mice were inoculated with the M-variant of encephalomyocarditis (EMC) virus in varying doses. Virus could be cultured from blood and from pancreas for 7 days. Animals receiving 4.5 × 102 plaque forming units EMC virus developed maximal glucose intolerance after 1 week. Animals receiving 4.5 × 106 plaque forming units EMC virus developed maximal glucose intolerance 3 weeks after the inoculation; i. e. 2 weeks after the acute viral pancreatitis had terminated. The possibility that virus elicited a cell-mediated hypersentivity reaction is suggested.

Restricted access

Peter Claes Eskildsen, Per Aaby Svendsen, Lisbeth Vang and Jørn Nerup

ABSTRACT

Treatment with bromocriptine, 30–55 mg daily, in 13 acromegalics for 1–15 months, resulted in a 60 % decrease in growth hormone secretion, as judged from the excretion of growth hormone in 24-h urine. Normal excretion was obtained in 10 patients, while 1 patient showed no response. The plasma growth hormone response to O-GTT was improved, but not normalized, in 4 of 7 patients treated for more than 6 months, and marked glucosuria disappeared in two diabetics. While the secretion of TSH, LH and FSH was unchanged, the prolactin secretion was inhibited. The urine excretion of free cortisol showed a 30 % decrease, possibly due to a direct effect of bromocriptine on the ACTH-secretion. Hypercalcaemia was never seen, but the initial hypercalcuria showed a modest decrease without measurable changes in the creatinine clearance. The subjective relief during long-term treatment was marked in 10 of 11 patients and the dominating symptoms disappeared in 40–67 %, whereas heal-pad thickness, enlarged sellae, and visual fields remained unchanged. No serious side effects were observed. Treatment with bromocriptine seems effective and should be considered as a remedy amongst others, in suitable cases of acromegaly.

Restricted access

Lise Wogensen, Jesper Reimers, Thomas Mandrup-Poulsen and Jørn Nerup

Abstract.

Previous in vitro findings suggest the involvement of interleukin 1 (IL-1) in the pathogenesis of insulin-dependent diabetes mellitus. The aims of the present study were to investigate the effects of single or repeated ip injections of recombinant IL-1β on blood glucose and glucose tolerance in vivo. Normal Wistar Kyoto rats were injected ip with a single injection of 4 μg/kg of the mature form of recombinant IL-1β (amino acids 117-269) or once daily on 5 consecutive days. Control rats were given vehicle and were fed ad libitum or pair-fed together with the rIL-1β treated rats. An ip glucose tolerance test (0.2 g D-glucose/100 g) was performed 2 h after injection of rIL-1β. A single injection of rIL-1β caused a mild depression in blood glucose and an improved glucose tolerance. Multiple injections of rIL-1 β induced a diminished weight gain, a 24-28% reduction in food intake, a lasting mild depression of blood glucose (7 days) and a transiently impaired glucose tolerance on day 5. We conclude that systemic IL-1 should be considered an important regulator of glucose homeostasis in vivo.

Restricted access

Steffen Helqvist, Pierre Bouchelouche, Henrik Ullits Andersen and Jørn Nerup

Abstract.

The controlled flux of calcium across the cell membrane is intimately linked to the release of insulin from pancreatic beta-cells, but the uncontrolled influx of calcium is a common final denominator of cell death. Because interleukin 1 has been shown to be cytotoxic to beta-cells in isolated rat islets of Langerhans and since interleukin 1 has a calcium ionophore effect on other cell types, this study was designed to test whether alterations of the calcium flux across the beta-cell membrane would influence the effects of interleukin 1 on isolated rat and mouse islets. Further, the cytosolic free Ca2+ concentration was measured by the fura-2 method in rat islets during acute interleukin 1 exposure. Treatment with 10 μmol/l of verapamil (a potent blocker of the voltage-dependent calcium channel) tended to suppress the inhibitory effect of interleukin 1 on insulin release from rat islets, suggesting protection against cytotoxicity. Conversely, a stimulatory effect of interleukin 1 on mouse islets during 6 days of exposure to interleukin 1 was turned into inhibition by high extracellular calcium concentration. Interleukin 1 did not have any acute effect on cytosolic free Ca2+ concentration. In conclusion, interleukin 1 has no specific calcium ionophore effect on beta-cells, but alterations of the calcium flux across the beta-cell membrane influence the functional effects of interleukin 1, suggesting interference with cell function and toxicity, which would likely be accompanied by an uncontrolled influx of calcium.