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Gene Review

EBM  -  epidermolysis bullosa, macular type

Homo sapiens

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Disease relevance of EBM

  • Intermittent EBM administration was associated with less ocular toxicity than daily EMB administration in this patient population [1].
  • In this condition, preformed EBM deficiencies could facilitate endothelial cell migration and sprout formation, leading ultimately to the sequelae of proliferative diabetic retinopathy [2].
  • We find that discontinuous EBM staining in the tumour centre is associated with poor tumour differentiation (p less than 0.005), presence of lymph-node metastases (p less than 0.02), and more advanced Dukes stage (p less than 0.02) [3].
  • To further assess the significance of EBM deficiencies in different tumour areas, we carried out a detailed study of the basement membrane laminin immunostaining patterns in 130 cases of colorectal carcinoma [3].
  • EBM/11 reactivity in malignant histiocytosis [4].

Psychiatry related information on EBM

  • EBM may better incorporate patients' values into clinical decision making, and this may be especially important in anesthesiology, where we are in need of valid evidence about important clinical issues such as preoperative testing and postoperative analgesia [5].
  • DATA SOURCES: Literature was identified using MEDLINE (1966-February 2004), EMBASE, and all EBM Reviews with the terms quinolones, substance abuse detection, opiates, cross-reactions, false-positive reactions, and each fluoroquinolone [6].
  • There is also a concern that a reliance on EBM in health policy will occur at the expense of widely shared social values like equity and solidarity [7].
  • EBM, as so far expounded, reflects a problem-solving attitude that results in a heavy concentration on RCTs and meta-analyses, rather than a broad decision making focus that concentrates on meeting all the requirements of a good clinical decision [8].
  • Four cerebral-palsied children participated in the following ABAB design: speech and motor pre-electrophysiologic behavior modification (EMB) evaluation; frontal EMG EMB, six weeks; speech and motor post-EBM evaluation; six weeks no training; speech and motor reevaluation; EMG EBM, four weeks; speech and motor evaluation [9].

High impact information on EBM

  • Expression of mRNA and protein localized to infiltrating macrophages defined by the antibody EBM/11 in adjacent sections and using 2-colour immunofluorescence [10].
  • At the tumour periphery, extensive EBM discontinuity shows no association with lymph-node involvement, but is linked with deeper local invasion (p less than 0.05) [3].
  • The latter association is strengthened by excluding cases in which numerous polymorphonuclear leukocytes (PMNs) are present adjacent to EBM breaks, suggesting that these inflammatory cells are a confounding factor [3].
  • METHODS: OSE was cultured in media 199/MDCB105 or EBM (Clonetics) with 2% or 10% fetal bovine serum with or without 10 ng/mL EGF, 1.0 microg/mL HC, and 1.0 microg/mL bovine brain extract [11].
  • Future studies to critically evaluate the practice of EBM in anesthesiology and critical care would be helpful [5].

Biological context of EBM

  • OBJECTIVE: To assess the attitudes of practicing general internists toward evidence-based medicine (EBM-defined as the process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions) and their perceived barriers to its use [12].
  • Outside of internal medicine, the literature suggesting that the practice of EBM improves outcomes is sparse, though increasing [5].
  • Thirty-four premature infants who were appropriate for gestational age and weighing less than 1500 g at birth were fed "preemie" SMA-24 formula, "preemie" SMA-24 formula manufactured to contain C20 and C22 omega 6 and omega 3 fatty acids (LCPE-SMA), or expressed milk (EBM) [13].
  • An EBM/11 positive phenotype, therefore, is shared by microglia and macrophages and suggests that microglial cells form a specialised part of the mononuclear phagocyte system [14].
  • Journal clubs and EBM in emergency medicine [15].

Anatomical context of EBM

  • We examined interspecies reactivities of eight anti-human monocyte/macrophage monoclonal antibodies (MAbs), Am-3K, PM-2K, X4, X14, Ber-MAC3, GHI/61, EBM/11, and KP1, with various animal tissues including rats, guinea pigs, rabbits, cats, dogs, goats, pigs, bovines, horses, and monkeys [16].
  • Feeding LCPE-SMA or EBM results in a balanced incorporation of C20 and C22 omega 6 and omega 3 fatty acids into phospholipids derived from the liver or perhaps the small intestine [13].
  • This study opens a new area for the specific identification by EBM/11 of mononuclear phagocyte system cells in archival biopsy specimens [17].
  • In type A vessels, ECM expansion is manifested by loosely arranged combinations of concentric PCM layers and collagen fibrils with thickened subendothelial (EBM) and pericyte (PBM) BM leaflets [18].
  • Microglial cells and osteoclasts also labelled with EBM/11 [19].

Associations of EBM with chemical compounds

  • Among spindle cells negative for the endothelial markers, there were many macrophages as a stromal reaction to tumor tissue, identified by monoclonal antibodies to macrophages (KiM 6, 7, 8 and EBM 11), acid phosphatase and alpha-naphthyl acetate esterase [20].
  • When first reported, EBM/11 reacted with mononuclear phagocyte system cells only in fresh frozen sections, but it has been shown to have similar cellular specificity in routine formalin fixed, paraffin wax embedded tissue [17].
  • EBM rating: B-3 [21].
  • EBM in AFP [22].
  • EBM/11 positivity and resistance of acid phosphatase to high doses of tartrate strongly suggest that both mononuclear and giant cells belong to the same lineage [23].

Other interactions of EBM

  • In five cases the PTCs showed weaker positive reactions for CD 68 (EBM 11) and HLA-DR than for T-zone macrophages and sinus histiocytes [24].
  • Normal and diseased human central nervous system (CNS) tissues were studied immunohistochemically by a monoclonal antibody to human macrophages (EBM/11), antisera to glial fibrillary acidic protein (anti-GFAP), and alpha-1-antichymotrypsin (alpha 1-ACT) [14].
  • It is concluded that EBM-based concepts such as NNT (number needed to treat), absolute risk and relative risk fall short in ensuring real benefit for the patient [25].
  • SEARCH STRATEGY: We searched CENTRAL (Cochrane Library Issue 3 2001), MEDLINE (1966 to November 2001), EMBASE (1980 to November 2001), PsycInfo (1887 to November 2001), CINAHL (1982 to November 2001), AMED (1985 - October 2001), Dissertation Abstracts International (1861 to March 2002) and EBM Reviews (1991 to March/April 2001) [26].
  • POM + EBM = CPD [27]?

Analytical, diagnostic and therapeutic context of EBM

  • A reverse haemolytic plaque assay, to detect and quantify LZM release by individual cells was combined with quantitative immunocytochemistry using LZM and the pan-macrophage monoclonal EBM/11 as markers [28].
  • Nevertheless, EBM will need to supplement rather than substitute for other approaches to patient care and teaching [5].
  • In this study, a reverse haemolytic plaque assay for LZM secretion is coupled with immunocytochemistry for the pan macrophage (CD68) marker, EBM/11 [29].
  • Fibrous plaques and intimal thickenings of 5 femoral and 5 iliac human arteries obtained at surgery were processed for indirect and double-labeling immunoelectron microscopy using an affinity purified rabbit IgG anti-C5b-9 neoantigen and the EBM 11 monoclonal antibody anti-human macrophages [30].
  • Meta-analysis, the next most important level of evidence in EBM, may be unreliable, sometimes giving different results to subsequent large randomised trials [31].


  1. Ethambutol ocular toxicity in treatment regimens for Mycobacterium avium complex lung disease. Griffith, D.E., Brown-Elliott, B.A., Shepherd, S., McLarty, J., Griffith, L., Wallace, R.J. Am. J. Respir. Crit. Care Med. (2005) [Pubmed]
  2. Fenestrated subendothelial basement membranes in human retinal capillaries. Carlson, E.C. Invest. Ophthalmol. Vis. Sci. (1989) [Pubmed]
  3. Relationships between epithelial basement membrane staining patterns in primary colorectal carcinomas and the extent of tumour spread. Hewitt, R.E., Powe, D.G., Griffin, N.R., Turner, D.R. Int. J. Cancer (1991) [Pubmed]
  4. EBM/11 reactivity in malignant histiocytosis. Kelly, P.M., McGovern, M., Gatter, K.C., Theaker, J.M., McGee, J.O. J. Clin. Pathol. (1988) [Pubmed]
  5. Evidence-based medicine in anesthesiology. Pronovost, P.J., Berenholtz, S.M., Dorman, T., Merritt, W.T., Martinez, E.A., Guyatt, G.H. Anesth. Analg. (2001) [Pubmed]
  6. False-positive urine opiate screening associated with fluoroquinolone use. Zacher, J.L., Givone, D.M. The Annals of pharmacotherapy. (2004) [Pubmed]
  7. Evidence-based medicine as an instrument for rational health policy. Biller-Andorno, N., Lie, R.K., ter Meulen, R. Health care analysis : HCA : journal of health philosophy and policy. (2002) [Pubmed]
  8. 'Evidence-based', 'cost-effective' and 'preference-driven' medicine: decision analysis based medical decision making is the pre-requisite. Dowie, J. Journal of health services research & policy. (1996) [Pubmed]
  9. Electrophysiologic behavior modification of frontal EMG in cerebral-palsied children. Finley, W.W., Niman, C.A., Standley, J., Wansley, R.A. Biofeedback and self-regulation. (1977) [Pubmed]
  10. Expression of tumour necrosis factor (TNF alpha) and its receptors in benign and malignant breast tissue. Miles, D.W., Happerfield, L.C., Naylor, M.S., Bobrow, L.G., Rubens, R.D., Balkwill, F.R. Int. J. Cancer (1994) [Pubmed]
  11. Effects of epidermal growth factor/hydrocortisone on the growth and differentiation of human ovarian surface epithelium. Salamanca, C.M., Maines-Bandiera, S.L., Leung, P.C., Hu, Y.L., Auersperg, N. J. Soc. Gynecol. Investig. (2004) [Pubmed]
  12. Evidence-based medicine and the practicing clinician. McAlister, F.A., Graham, I., Karr, G.W., Laupacis, A. Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine. (1999) [Pubmed]
  13. Addition of long-chain polyunsaturated fatty acids to formula for very low birth weight infants. Clandinin, M.T., Garg, M.L., Parrott, A., Van Aerde, J., Hervada, A., Lien, E. Lipids (1992) [Pubmed]
  14. Monoclonal antibody to macrophages (EMB/11) labels macrophages and microglial cells in human brain. Esiri, M.M., McGee, J.O. J. Clin. Pathol. (1986) [Pubmed]
  15. Journal clubs and EBM in emergency medicine. Kuhn, G., Cordell, W., Rowe, B., Wyer, P. The Journal of emergency medicine. (2006) [Pubmed]
  16. Interspecies reactivities of anti-human macrophage monoclonal antibodies to various animal species. Zeng, L., Takeya, M., Ling, X., Nagasaki, A., Takahashi, K. J. Histochem. Cytochem. (1996) [Pubmed]
  17. Labelling of cells of the mononuclear phagocyte system in routinely processed archival biopsy specimens with monoclonal antibody EBM/11. Greywoode, G.I., McCarthy, S.P., McGee, J.O. J. Clin. Pathol. (1990) [Pubmed]
  18. SEM and TEM analyses of isolated human retinal microvessel basement membranes in diabetic retinopathy. Carlson, E.C., Bjork, N.J. Anat. Rec. (1990) [Pubmed]
  19. Monoclonal antibody EBM/11: high cellular specificity for human macrophages. Kelly, P.M., Bliss, E., Morton, J.A., Burns, J., McGee, J.O. J. Clin. Pathol. (1988) [Pubmed]
  20. Histogenesis of Kaposi's sarcoma associated with AIDS: a histologic, immunohistochemical and enzyme histochemical study. Hashimoto, H., Müller, H., Falk, S., Stutte, H.J. Pathol. Res. Pract. (1987) [Pubmed]
  21. Has survival improved for nasopharyngeal carcinoma in the United States? Lee, J.T., Ko, C.Y. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. (2005) [Pubmed]
  22. EBM in AFP. Armstrong, E., Stello, B. Family practice management. (2004) [Pubmed]
  23. Giant cell tumor of bone: a model for the in vitro human osteoclast characterization. Campanacci, M., Bagnara, G.P., Serra, M., Giovannini, M., Tomasi, P., Pileri, S., Poggi, S., Lollini, P.L., Picci, P., Paolucci, G. Tumori. (1989) [Pubmed]
  24. Immuno- and enzymehistochemical characterization of 'plasmacytoid T-cells' in formalin-fixed paraffin-embedded tissue of reactive lymph nodes. Takeshita, M., Müller, H., Mix, D., Stutte, H.J., Schmidts, H.L. Pathol. Res. Pract. (1991) [Pubmed]
  25. Medical care for individual patients: concepts beyond evidence-based medicine. Bonelli, J., Felsenstein, K., Prat, E.H., Schwarz, M. International journal of clinical pharmacology and therapeutics. (2004) [Pubmed]
  26. Communication skills training for health care professionals working with cancer patients, their families and/or carers. Fellowes, D., Wilkinson, S., Moore, P. Cochrane database of systematic reviews (Online) (2004) [Pubmed]
  27. POM + EBM = CPD? Black, D. Journal of medical ethics. (2000) [Pubmed]
  28. Effects of ethanol on human monocyte/macrophage lysozyme storage and release. Implications for the pathobiology of alcoholic liver disease. McCarthy, S.P., Lewis, C.E., McGee, J.O. J. Hepatol. (1990) [Pubmed]
  29. Differential effects of LPS, IFN-gamma and TNF alpha on the secretion of lysozyme by individual human mononuclear phagocytes: relationship to cell maturity. Lewis, C.E., McCarthy, S.P., Lorenzen, J., McGee, J.O. Immunology (1990) [Pubmed]
  30. Cells carrying C5b-9 complement complexes in human atherosclerotic wall. Rus, H.G., Niculescu, F., Poruţiu, D., Ghiurca, V., Vlaicu, R. Immunol. Lett. (1989) [Pubmed]
  31. Evidence-based medicine: how good is the evidence? Celermajer, D.S. Med. J. Aust. (2001) [Pubmed]
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