[Respiratory function changes in multiple myeloma].
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Aged↗
Biomedical subjects
G Iodice
Publications and source records attributed to G Iodice.
[Immunological deficiency syndromes, immunosuppression by drugs and occurrence of neoplasms: a casual association?].
Although supported by a number of experimental models, the assumption assigning a crucial role to the immune system in the antineoplastic defense mechanisms has not been convincingly demonstrated so far for human tumors. Should the theory be correct, severe functional impairment of the immune system would obviously result in the occurrence of tumors with abnormally high frequency. Registry holdings systematically collecting pertinent information on the malignancies developed in patients with primary immunodeficiency diseases or in organ transplant recipients maintained on therapeutically-induced immune depression, as well as the observation of tumors occurring in patients treated with immunosuppressive agents and of second malignancies arising after radio- and/or chemotherapy of the primary tumor consistently indicate that depressed immunity is usually associated with an increased incidence of cancer as compared with that expected in the general control populations. However, not all types of tumors are increased to the same extent, in that lymphoreticular neoplasias (especially non-Hodgkin's lymphomas), acute leukemias as second tumors and, among solid neoplasms, squamous cell carcinomas are those most frequently reported. These observations suggest that even deeply impaired tumoricidal immune mechanisms may facilitate the growth of certain tumors only, especially of those arising from the cells of the immune system itself, in remarkable contrast with their frequency in the general population. Oncogenesis may be favoured in various states of depressed immunity by a number of ways. Their elucidation might have bearing on the comprehension of the more general phenomenon of the neoplastic transformation.
Carcinoma, Squamous Cell↗
Arginine thiazolidinecarboxylate in the treatment of chronic active hepatitis: double-blind comparison with placebo.
Forty-four patients with chronic active hepatitis were given arginine thiazolidinecarboxylate (800 mg/day per os for 40 days) or placebo in a randomized, double-blind trial. The most important liver function parameters were measured in each patient at the beginning of the trial, after 20 days, and at the end of the trial. The active drug lessened the parameters of necrosis and cholestasis while protein synthesis improved in liver cells. The differences between ATCA and placebo groups were highly significant. No treatment-related side-effects were reported.
Adolescent↗
Prophylactic sclerotherapy of high-risk esophageal varices: results of a multicentric prospective controlled trial.
In this prospective, multicenter trial, 140 cirrhotic patients with no previous upper gastrointestinal bleeding and with esophageal varices endoscopically judged to be at high risk of hemorrhage were randomized to receive either sclerotherapy or conservative treatment for the prevention of first variceal bleeding. The end-points of the study were bleeding and death. Life table curves showed that prophylactic sclerotherapy significantly diminished the incidence of variceal hemorrhage (p less than 0.001) and overall mortality (p less than 0.01). Two-year cumulative bleeding rate was 18% in the sclerosis group (95% confidence interval = 10 and 31) and 57% (95% confidence interval = 40 and 72) in the control group. Two-year cumulative mortality rate was 30% (95% confidence interval = 19 and 45) in the sclerotherapy group and 56% (95% confidence interval = 39 and 72) in the controls. One patient died after hemorrhage from an ulcer secondary to sclerotherapy. Analysis by the Cox model of the factors potentially confounding or interacting with the effect of sclerotherapy suggested that sclerotherapy was more efficient in preventing first bleeding in patients with decompensated disease (Child B and C) than in those in good condition (Child A). However, the 2-year cumulative bleeding rate of untreated Child A patients was only 19%, showing how in this group the endoscopic findings were unreliable in selecting high-risk varices and explaining why after a 2-year follow-up prophylactic sclerosis did not show any benefit in such patients. We conclude that sclerotherapy can decrease the incidence of first variceal bleeding and death for a period of 2 years in cirrhotic patients with high-risk varices.
Adult↗
Analogues in immunology.
A number of immunological functions has been found to be endowed with biological rhythmicity. Variations of peripheral blood lymphocytes, immediate and delayed hypersensitivity responses, and reactivity of the immune system to antigenic challenge have consistently shown circadian bioperiodicity. By employing a panel of monoclonal antibodies specific for the various lymphocyte subsets, we have been able to detect rhythmic variations in the number of total T lymphocytes, as well as of the T helper (TH) and the T suppressor/cytotoxic (Ts) subsets. Available evidence clearly indicates such circadian variations to be due to compartmentalization of circulating lymphocytes in several lymphoid organs. Biological rhythms (circadian, circaseptan, etc.) have been demonstrated in several immunological situations of clinical interest, including variations of TH and Ts cells in patients with rheumatoid arthritis incidence of allograft rejections, antitumoral effectiveness of chemoimmunotherapy, and allergic symptoms. In addition, the recent availability of synthetic analogues of some thymic peptide hormones and of the synthetic ACTH 1-17 (Synchrodyn 1-17 is greatly contributing to the elucidation of the role of such hormones in the immune regulation process. A preliminary account is reported of the experiments performed with the aim of raising conventional rabbit antisera to the peptide analogue ACTH 1-17, as well as of the consistently negative results which were obtained when 578 human serum samples (from patients treated with such synthetic peptide) were screened by a radioimmunoassay for the occurrence of anti-ACTH 1-17 antibodies. It is emphasized that the recognition of the rhythmic variations of several immunological mechanisms and of the crucial role played by the analogues of adrenal corticotropic and thymic hormones in immune regulation has favoured significant advances in the fast growing area of chronoimmunology.
Adrenocorticotropic Hormone↗
[Idiopathic CD4+ lymphocytopenia: a case report].
We present the case of a 47-year-old patient who was seen for recurrent opportunistic infections. Immunophenotypic analyses disclosed severe reduction of CD4+ T cells. Repeated Elisa, Western blot and polymerase chain reaction tests for HIV were negative. The low CD4+ T lymphocyte count unaccompanied by increased CD8+ T lymphocytes and hypergammaglobulinemia, along with negativity for HIV infection, suggested the diagnosis of idiopathic CD4+ lymphocytopenia (ICL). The patient's clinical manifestations and laboratory results conformed with the case definition of ICL established in 1992 by the Centers for Disease Control of Atlanta, i.e., CD4+ T cells < 300/mm3 on two occasions and no evidence of HIV infection. In vitro analyses evidenced depressed lymphoproliferative responses to mitogens such as concanavalin A and pokeweed mitogen, while the expression of Fas antigen on peripheral lymphocytes and the percentage of apoptotic cells after propidium iodide staining were increased. Since in vitro concanavalin A stimulation inhibits T cell proliferation and induces apoptosis, these results suggest that the patient's lymphocytes are susceptible, in vivo, to an apoptotic signal.
Apoptosis↗