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Biomedical subjects

A Siracusano

Publications and source records attributed to A Siracusano.

At least 55 records · Page 3Linked to original sources

Immunological markers indicating the effectiveness of pharmacological treatment in human hydatid disease.

The relation of interferon-gamma (IFN-gamma), IL-4, IL-10 production and specific IgE, total IgG, IgG subclass expression to the effectiveness of pharmacological treatment in human hydatid disease (Echinococcus granulosus infection) was evaluated in 27 hydatid patients divided into four clinical groups according to their response to albendazole/mebendazole therapy (full, partial, low and non-responders). After parasite antigen stimulation, peripheral blood mononuclear cells (PBMC) from full responders produced significantly more IFN-gamma (P = 0.038), significantly less IL-4 (P = 0.001) and less IL-10 than PBMC from non-responders. PBMC from partial and low responders produced intermediate cytokine concentrations. ELISA determining immunoglobulin production showed that sera from all non-responders had IgE and IgG4 antibodies, both regulated by IL-4. In contrast to IgG4, IgE decreased rapidly in full responders. Full responders also showed the highest percentage of IgG3 reactions. Qualitative analysis of total IgG responses in hydatid patients' sera determined by immunoblotting showed that binding profiles to hydatid cyst fluid antigen differed in the four groups of treated patients. Non-responders had the highest percentage of reactions to all subunits of antigens 5 and B, and full responders had the highest percentage of reactions to antigen 5 alone. The high IFN-gamma production associated with a lack of IL-4 and low IL-10 production in the full responders, and vice versa the high IL-4 and IL-10 production associated with lack of or low IFN-gamma production in the non-responders implies Th1 cell activation in protective immunity and Th2 cell activation in susceptibility to hydatid disease. IgE may be a useful marker of therapeutic success in hydatid patients with pretreatment specific IgE antibodies. IgG subclass responses and differential immunoglobulin subclass binding pattern to hydatid antigens may also be useful in the immunosurveillance of hydatid disease.

Adult↗

In vitro production of cytokines by peripheral blood mononuclear cells from hydatid patients.

The role of cytokines in human hydatidosis (Echinococcus granulosus infection) was evaluated in immunoassays determining production of IL-4, IL-10 and interferon-gamma (IFN-gamma) in peripheral blood mononuclear cell (PBMC) cultures from 30 hydatid patients and 14 uninfected controls. In cell cultures from hydatid patients parasite and non-parasite antigen stimulation significantly increased IL-4 production (P < or 0.005). Spontaneous and mitogen-driven IL-4 production was similar in patients and controls. IL-10 and IFN-gamma production did not differ statistically in the two groups, even though some hydatid patients produced these cytokines in large amounts. Notably, antigen-driven IFN-gamma concentrations were invariably higher in patients than in uninfected controls. Data analysis showed a relationship between IgE and IgG4 responses and parasite-driven cytokine production. High IgE and IgG4 responders produced high IL-4 and IL-10 concentrations. High IgE responders showed decreased IFN-gamma production, but high IgG4 responders had IFN-gamma levels slightly higher than those of low responders. Cytokine response patterns did not relate to the clinical stage of disease. The significantly increased IL-4 and the high IL-10 concentrations found in PBMC from many hydatid patients in this study are consistent with Th2 cell activation in human hydatidosis. The presence of antigen-driven IFN-gamma production in patients with E. granulosus infection implies concurrent intervention of the Th1 or Th0 cell subset.

Antibodies, Helminth↗

Genetic variability in different Pneumocystis isolates from man and rats.

To gain further insight into the genetic variability between different isolates of Pneumocystis carinii of rat and human origin, we sequenced three DNA regions from the mitochondrial rRNA gene, the 5S rRNA gene and the dihydrofolate reductase gene (DHFR) of microorganisms isolated from three different immunosuppressed rat sources and from one HIV + patient with P. carinii pneumonia. Some point mutations and deletions were found among rat isolates in two regions (mitochondrial rRNA gene and 5S rRNA gene). Nucleotide sequence variations in these conserved regions support the hypothesis of the existence of several Pneumocystis strains infecting the same host species.

Animals↗

Use of a monoclonal antibody against the antigen B of Echinococcus granulosus for purification and detection of antigen B.

A monoclonal antibody directed against the 8 kDa subunit of antigen B of Echinococcus granulosus was raised. This antibody was used for purification of antigen B by affinity chromatography. SDS-PAGE and immunological analysis of the purified antigen B demonstrated that the 8 kDa antigen B subunit was purified to homogeneity. The purified antigen retained its strong immunoreactivity in ELISA using human hydatid sera. Furthermore, a sandwich ELISA was established for detection of antigen B from hydatid cysts. The usefulness of this test system was demonstrated by the detection of antigen B in human hydatid cyst fluids, thus confirming the diagnosis of an echinococcal disease.

Animals↗

Further evaluation of autoreactive T cells in hydatid patients.

We evaluated the peripheral autoreactive response in patients with Echinococcus granulosus who showed a negative humoral response as compared to seropositive patients and healthy controls. For this purpose, a limiting dilution analysis (LDA) of autologous mixed lymphocyte cultures was established to both estimate frequency of autoreactive T cells and, by analysing the shape of the curves, to clarify the mechanisms that underlie the autoreactive response. Different LDA curves were observed between healthy controls and patients, suggesting that different cell interactions are involved in the two populations. More interestingly, all hydatid patients, independent of their humoral response, showed a higher number of autoreactive T cells than controls. Precisely, subjects with a negative humoral response showed a range of values for autoreactive T cells exactly between the value ranges observed in seropositive and normal subjects. The present data also show that the increase of autoreactive T cells in hydatid patients correlates with the production of specific antibodies.

Adult↗

Cellular and humoral responses to antigenic subunits of Echinococcus granulosus cyst fluid in hydatid patients.

The hydatid fluid antigenic subunits which stimulate the proliferative response of T cells in PBMC isolated by hydatid patients were identified. In the same subjects, the serum IgG antibody profiles were determined by immunoblotting to compare T cell activation and IgG production. The study was carried out on 18 patients with clinically and serologically diagnosed hydatidosis and on ten healthy blood donors. To assess the proliferative response to the different antigenic subunits, sheep hydatid fluid was separated by the SDS-PAGE and the fractions were blotted onto nitrocellulose and solubilized. The comparison between immunoblotting and PBMC proliferation assay shows that the 55 and 65 kDa subunits of antigen 5 and the 12 kDa subunit of antigen B are the most reactive subunits in the two techniques. The 16 and 20 kDa subunits of antigen B are more reactive in PBMC proliferation assay than in immunoblotting, thus assigning a specific role to antigen B in cellular response.

Animals↗

Diagnosis of Pneumocystis carinii pneumonia: specificity and sensitivity of polymerase chain reaction in comparison with immunofluorescence in bronchoalveolar lavage specimens.

DNA amplification by the polymerase chain reaction (PCR) is a promising method for the detection of Pneumocystis carinii in immunosuppressed patients. The sensitivity and specificity of the PCR technique has been assessed in comparison with the immunofluorescence method (IF) on bronchoalveolar lavage fluid (BALF). Results correlated in 43 (78.8%) of 52 cases studied. P. carinii PCR gave positive results with BALF from all 32 patients found to have P. carinii pneumonia (PCP); IF gave positive results with 26 of them. PCR was more sensitive and as specific as IF. However, at the present time, we do not believe that it is clinically useful for detection of P. carinii in BALF samples. P. carinii DNA amplification by PCR should be reserved for testing IF-negative BALF samples from patients judged clinically to have PCP.

Adult↗

Simple and rapid two-step polymerase chain reaction for diagnosis of Pneumocystis carinii infection.

Two amplification steps were made to detect Pneumocystis carinii DNA by polymerase chain reaction (PCR). pAZ102-E and pAZ102-H (standard PCR), pAZ102-L2 (sense), and pAZ102-E (antisense) (two-step PCR) were used as primers. The amplification products were analyzed by ethidium bromide. After the two-step PCR, ethidium bromide detected all samples positive by oligohybridization after one amplification step. Our two-step PCR is a rapid, cost-effective, and clinically suitable method for the detection of P. carinii infection.

Bronchoalveolar Lavage Fluid↗

Limiting dilution analysis of autoreactive T cells in patients affected by hydatid disease.

We evaluated the peripheral autoreactive response in patients with Echinococcus granulosus compared with healthy individuals. A limiting dilution analysis (LDA) was performed to estimate frequency of auto-reactive T cells and to detect the complex mechanism that often underlies the autoreactive response. Different LDA curves were seen in healthy controls and patients. The control group provided a straight line passing through the origin ('single hit' kinetics), indicating that only peripheral autoreactive T cells are limiting. On the other hand, autoreactive T cell titration in hydatid patients did not follow 'single hit' kinetics, suggesting that two or more cell types are titrated. More interestingly, we observed a very high frequency of autoreactive T cells in hydatid patients (1/1,000 to 1/2,500) compared with healthy controls (1/5,000 to 1/35,000). These data suggest that chronic infection may provide adequate stimuli for the induction of autoimmune disorders and increase in autoreactive T cells.

Autoimmunity↗

Pneumocystis carinii stimulates in vitro production of tumor necrosis factor-alpha by human macrophages.

The ability of Pneumocystis carinii to induce tumor necrosis factor (TNF)-alpha release by monocytes/macrophages from immunocompetent humans was investigated. Monocytes and monocyte-derived macrophages from healthy individuals produced an increased amount of TNF-alpha when exposed to P. carinii cysts obtained from rats with steroid-induced pneumocystosis. The cysts induced increased TNF-alpha production in a dose-dependent manner; baseline TNF-alpha production was restored after addition of an anti-P. carinii hyperimmune serum. Kinetics experiments showed that the secretion of TNF-alpha occurs early and reaches a maximal peak after 8 h. Since TNF-alpha is directly lethal to P. carinii in vitro, it is suggested that the production of this cytokine in response to the cysts may be one of the mechanisms for the control of this parasitic infection.

Adult↗

Cellular immune responses of hydatid patients to Echinococcus granulosus antigens.

The reactivity of peripheral blood mononuclear cells (PBMC) from 40 hydatid patients to hydatid fluid (HF) and to two hydatid fractions (pH5PPT and pH5SUP) was evaluated by the incorporation of 3H-methylthymidine into DNA. Maximal responses were detected using 200 micrograms/ml protein after 7-9 days incubation. The three antigen preparations were inducers of PBMC proliferation, with a good correlation (r2 = 0.87) of the responses induced by HF and by the fraction pH5PPT, which contains the two major hydatid antigens (5 and B). Lymphocytes from healthy donors and non-hydatid patients showed no response to these antigens. Neither direct nor inverse correlation was found between the results of the serological tests and of the PBMC proliferation assays. The majority of the patients (75%) responded in serological and in cellular tests. Of the remaining patients, six showed high antibody response associated with a negative PBMC proliferation assay and conversely four seronegative patients were found to respond positively in the PBMC proliferation assay. No relationship of the pattern of immune responsiveness to the patient's clinical forms could be established. Use of the PBMC proliferation assay with hydatid antigens appears rational in those patients which are low antibody producers, but the test is still not to be considered applicable for routine diagnosis.

Animals↗

An evaluation of an agar gel diffusion test with crude and purified antigens in the diagnosis of hydatid disease.

The sensitivity of the indirect haemagglutination test for the diagnosis of hydatid disease, although high, is insufficient. Agar gel diffusion tests for the diagnosis of this disease have not received much attention in the past and have been considered unsatisfactory. The authors propose such a test and evaluate its results in comparison with those of the indirect haemagglutination test.

Agar↗

Detection of anti-extractable nuclear antigens in connective tissue diseases: comparison between passive hemagglutination, counterimmunoelectrophoresis and double immunodiffusion.

Antibodies to the three major components of the complex called soluble extractable nuclear antigen (ENA) were detected by passive hemagglutination (HA), counterimmunoelectrophoresis (CIE) and double immunodiffusion (DI) in 256 patients with connective tissue diseases. Anti-ENA antibodies were demonstrated by all the three employed methods in only 44.9% of the cases. These methods were not able to detect all antibodies to these antigens or any single specificity; CIE was however the most sensitive method for anti-RNP and HA for anti-Sm antibodies, while DI was the most suitable technique for serum samples with multiple anti-ENA specificities. Only in less than 50% of the cases the specificity detected by HA was comparable with that given by CIE or DI. Hence, for detecting anti-ENA antibodies a combination of these methods should be maintained, at least until more precise and reliable methods will become available.

Antibodies, Antinuclear↗