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Biomedical subjects

L Ortona

Publications and source records attributed to L Ortona.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Detection of anti-HIV antibodies in preparations of human immunoglobulins. A collaborative group study.

This paper reports the results of a study organized by the Istituto Superiore di Sanità (Rome, Italy) and carried out in collaboration with several national laboratories. Its aim was to ascertain whether diagnostic kits for detecting anti-HIV antibodies in human serum can also be used to detect the same antibodies in human immunoglobulins. Thirty-three lots of immunoglobulins supplied by six pharmaceutical companies present in Italy were examined using different procedures. On the basis of the results of this study it can be concluded that i. anti-HIV antibodies can be detected in immunoglobulins by means of commercial reagents; ii. a preliminary dilution of immunoglobulin samples should not be made; iii. Western blot method appears to be the 'reference' test; however, competitive EIA tests are equally valuable if a negative control made up of anti-HIV-negative Igs is employed; iv. Igs examination for anti-HIV antibody represents an indirect control on a correct donors' screening procedure.

Blotting, Western↗
PubMedDate not supplied

Cell-mediated cytotoxicity to rabbit liver-specific lipoprotein in chronic active hepatitis.

Cell-mediated cytotoxicity to 51Cr-labelled avian red blood cells coated by rabbit liver-specific lipoprotein was evaluated in 27 patients with untreated chronic active hepatitis (11 were HBsAg-positive). A significantly increased cytotoxicity was recorded in 10 of the 11 patients with HBsAg-positive chronic active hepatitis and in 13 of the 16 HBsAg-negative patients. The addition of rabbit LSP to the test system reduced to normal the cytotoxicity index in all the positive cases. Moreover, in order to evaluate the organ-specificity of cytotoxicity to rabbit LSP-coated cells, we added to the test system a macromolecular kidney protein fraction which was unable to block the cytoxicity in any of the positive cases. In 12 selected cases, which had previously shown an increased cytotoxicity to rabbit LSP-coated red blood cells, the incubation of their lymphocytes at 37 degrees C for 30 min in a plastic Petri dish resulted in the abolition of cytotoxicity. Our findings seem to indicate that cell-mediated cytotoxicity to LSP can also be detected with an antigen, not prepared from human liver. This is a further evidence that patients with chronic active hepatitis develop an immunological reactivity to not species-specific antigenic determinants in LSP.

Animals↗
PubMedDate not supplied

Diminished interferon gamma production may be the earliest indicator of infection with the human immunodeficiency virus.

The degree of clinical severity in human immunodeficiency virus infected patients, ranging from asymptomatic seropositive subjects to acquired immune deficiency syndrome, as well as in individuals at risk was assessed in relation to: (1) T-cell subset balance and expression of markers of T-cell activation; (2) natural killer activity; and (3) interferon gamma production. A decrease in the CD4/CD8 (helper/suppressor) ratio and an increase in the percentage of CD8+ (suppressor/cytotoxic) cells coexpressing markers of activation (HLA-DR or CD25) were closely correlated with the clinical severity of the human immunodeficiency virus infection. Natural killer activity was significantly impaired in patients with acquired immune deficiency syndrome and acquired immune deficiency syndrome-related complex but normal in asymptomatic seropositive individuals and subjects at risk. Interferon gamma production, either in response to mitogens or the antigens from infectious agents commonly affecting human immunodeficiency virus-positive individuals, was decreased in patients with acquired immune deficiency syndrome or acquired immune deficiency syndrome-related complex, with lesser involvement in human immunodeficiency virus-seropositive subjects or individuals at risk. Four of the six persons in the last group seroconverted during the ten months subsequent to evaluation of their immune status. Since production of interferon gamma was diminished in these patients while other assays of immunity were normal, measurement of this lymphokine may be a useful determinant of infection with the human immunodeficiency virus.

AIDS-Related Complex↗
PubMedDate not supplied

Alveolar macrophages from AIDS patients spontaneously produce elevated levels of TNF-alpha in vitro.

In vitro production of TNF-alpha by alveolar macrophages was investigated in 15 AIDS patients with acute interstitial pneumonia and in 4 patients with asymptomatic HIV infection (anti-HIV+) and was compared to that observed in 6 patients with chronic pulmonary disease and in 5 normal controls (undergoing a fiberoptic bronchoscopy for suspected lung malignancy), all 11 HIV negative. Our results show that unstimulated alveolar macrophages of AIDS and anti-HIV+ patients released much more TNF-alpha than subjects with chronic obstructive pulmonary disease or healthy controls did: this overproduction may play a role in the pathogenesis of lung damage infection and particularly in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[AIDS and the central nervous system: correlations between clinical, radiological and anatomo-pathological aspects. A critical review of 40 personal cases].

The authors review the cases of 40 patients with AIDS who died in 1989, in order to establish the relationships between clinical picture, neuroradiological features and neuropathological findings. Neurological involvement was present in over 75% of the patients, with HIV-related encephalopathy and toxoplasmosis as the most frequent diseases (52.5% and 20.0%). With regard to the cases of AIDS dementia complex (ADC) the authors observed a good correlation between the severity of the clinical manifestations, central nervous system atrophy as observed on computed tomography scan and pathological findings. The survival of AIDS patients with ADC was higher when compared to patients without ADC, suggesting the time-relationship of ADC. AS in the case of toxoplasma encephalitis, a strong relationship between radiological and pathological findings was observed. The presence of toxoplasma encephalitis in patients with radiologic features of healed lesions confirms the need for life-long prophylaxis.

AIDS Dementia Complex↗
PubMedDate not supplied

[Determination of HIV-RNA using in situ hybridization on myocardial tissue. Role of HIV in cardiomyopathy in AIDS].

Aim of this study was to evaluate the presence of HIV-1 and CMV genomic sequences in myocardial tissue from autopsy of AIDS patients by in situ hybridization technique and to make a correlation with clinical and/or pathological signs of myocarditis. Seven patients out of 12 (58.3%) were positive for HIV-1 (6/7 patients with pathological signs of myocarditis and 1/5 without pathological abnormalities; p = 0.029). In situ hybridization for CMV was positive in 5/12 patients (41.7%) (3 with myocarditis and 2 without myocarditis); three clinically symptomatic cases were contemporary positive for HIV-1 and CMV. Our results seem to confirm emerging data about the presence of HIV-1 in myocardial tissue and about the possible role of HIV-1 in determining cardiac pathologies. Furthermore we suggest the hypothesis of an interaction of HIV-1 and CMV in latest of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

99mTc-human immunoglobulin (HIG) in AIDS patients: first results.

Scintigraphy with 99mTc labelled human polyclonal immunoglobulin was performed in 16 patients with ascertained or suspected AIDS-related infections. 99mTc-HIG lung scanning was compared, in 11 patients, with 67Ga scintigraphy, chest X-ray and high resolution lung CT. 67Ga and 99mTc-HIG were concordantly positive in five cases of BAL-ascertained Pneumocystis carinii pneumonia (PCP), while one of them was Rx and CT negative. X-ray, 67Ga and 99mTc were concordantly negative in 5 cases. 99mTc-HIG yielded negative results in two cases of Mycobacterium infection, both of which were 67Ga and Rx positive: Mycobacterium avium in diffuse lung involvement and Mycobacterium TBC in excavated infiltrate. 99mTc-HIG was also positive in other 3 AIDS patients: 1 case of intestinal cryptosporidiosis, 1 pulmonary abscess (Staphylococcus and Candida), and 1 sacral abscess; it was negative in 1 case of Kaposi sarcoma (also 201Tl negative). In conclusion, 99mTc-HIG scintigraphy in AIDS patients is feasible, and offers some practical advantages (continuous availability, fast response time, etc.). The initial results seem similar to those of 67Ga in lung scanning (and perhaps more specific for PCP).

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[New vaccinations: compulsory or not?].

In order to contribute to the discussion of compulsory vaccinations a brief review of those vaccines that have been extensively used so far is presented. Such review reflects the urgency to update the vaccine schedule presently in use in our country, following WHO recommendations. In Italy, hepatitis B vaccination will soon be made compulsory by law for all newborns and children at the age of 12. As far as measles, mumps and rubella are concerned there is no universal agreement on whether to vaccinate the newborns or not because there is a theoretical risk of delaying the occurrence of these infections to a later age. Such risk could be easily reduced by allowing for booster doses of vaccine at the beginning of primary school. Only pilot studies would provide evidence on the effectiveness of the new vaccines for whooping cough and varicella-zoster and on the opportunity of vaccinating newborns for these infections. For all the others available and experimental vaccines it is too early to consider their inclusion among the compulsory vaccines although the rapid pace of the research in this field makes it quite likely that vaccination schedule will be soon extended.

Hepatitis B↗
PubMedDate not supplied

[Meningococcal meningitis in Italy: 1887-1986].

We report the epidemiological data relative to meningococcal meningitis observed through a century, 1887-1986, in Italy. It is evident both from mortality and morbidity data that in Italy three epidemic peaks have occurred in 1915-1918, in 1939-1943 and in 1968-1972 respectively. The first two epidemic episodes are likely to be connected with the World Wars, the third one, recorded in other european and non european countries, probably reflects a pandemic recrudescence of the disease. The case fatality rate has shown periodic fluctuations connected with the epidemics and an average value of 10% until the sixties. Since then, the case fatality rate has stably decreased below that value. The seasonal distribution of the disease is similar both in the epidemic or non-epidemic period, with the higher incidence of cases between December and April and the lowest in August. There are no substantial differences in the regional distribution of the disease among the various regions of Italy. The distribution of cases, according to the different age-groups (0-14, 14-25, greater than 25 years old), indicates that the disease is more prevalent among the first group. However, in the last decade it is evident a trend of reduction among this group and a relative increase in other groups, in particular in subjects older than 25 years. In addition, meningococcal meningitis is prevalent among the males in the first two decades of life (less than 25 years old) while, afterward, there is an equal incidence both in males and females. The higher prevalence suggests a role of various close environmental contacts, such as the military service.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Visceral leishmaniasis in patients with AIDS. Description of 2 cases].

Cell-mediated immunity plays a pivotal role in the pathogenesis and in the recovery mechanisms of visceral leishmaniasis (V.L.). This disease, observed in two patients with AIDS, has peculiar anatomical and clinical characteristics and it is usually characterized by a severe clinical course. In addition, V.L. has been proposed to be included among the relevant infections for the case definition of AIDS. We describe two cases of V.L. occurred in association with AIDS. The most relevant characteristics of our cases are the followings: Diagnosis has been achieved by the identification of Leishmania donovani in the macrophages of the bone marrow in both the patients, and of the lymph node in one patient. The detection of anti-Leishmania antibodies was positive in one patients only. A significant defect of CD4+ cells was documented in both the patients. V.L. was associated in one patient with esophageal candidiasis, disseminated tuberculosis, P. carinii pneumonia; and in the other one with cerebral toxoplasmosis, pulmonary tuberculosis, esophageal candidiasis, Kaposi's sarcoma, CMV hepatitis. Specific chemotherapy has been partially or totally ineffective in both the patients. In fact, chemotherapy led to an apparent transient recovery in one patient, followed by a symptom-free period of more than one year. We think that V.L. has been the first infection occurred in this patients, beside of HIV infection. At the time of the first observation, the clinical conditions of this patient were satisfactory and there was only a slight alteration in cellular immunity. The detection of leishmania in bone marrow was coincident with the onset of fever, the development of a wasting syndrome and a dramatic decrease in cell-mediated immunity. A second cycle of specific treatment has been ineffective and the patient died. On the contrary, the second patient did not respond to the specific treatment and died. Two important anatomo-pathological characteristics were present in our cases: a) the presence of the parasite in several organs, namely bone marrow, spleen, liver. b) the absence of granulomatous lesions which indirectly indicates the defect in cell mediated immunity.

Acquired Immunodeficiency Syndrome↗