Biomedical subjects
Publications and source records attributed to P M Sprinkle.
The purpose of our paper is to propose a possible mechanism involving an immune-mediated disease process. A microbiological, biochemical and immunological approach to substantiate such a mechanism is presented.
Numerous investigators have observed a depression of cell-mediated immunity in patients with carcinoma of the head and neck using a variety of in vitro and in vivo assays. This report presents the data obtained when a group of head and neck cancer patients were evaluated for reactivity in an in vitro lymphocyte blastogenesis assay using polyclonal mitogens and specific antigens, numbers of peripheral blood T-lymphocytes, and levels of circulating immune complexes. Such an immunological monitoring protocol revealed a depressed reactivity of the cancer patients in the lymphocyte blastogenesis assay when compared to normal age-matched controls. We also observed that 75% of these patients had circulating soluble immune complexes in their sera before and after therapy. These preliminary data indicate that further research is needed to examine the potential role of soluble immune complexes in modulating the host's immune response.
With the recent demonstration of circulating immune complexes in a variety of malignant and nonmalignant diseases, we have examined the sera of head and neck cancer patients for evidence of soluble immune compleses. Using the Raji, cell test, we have shown that immune complexes are present in over 80% of the cancer sera examined as compared to less than 10% of normal control sera, and that these complexes persist following treatment of the patients by surgery or radiation therapy. These complexes may be acting as blocking factors which would account for the anergic state of these patients.
Seventy-seven paired serum samples from patients with known idiopathic sudden hearing loss (ISHL) were surveyed using viral serologic methods. Fifteen different viruses and Mycoplasma pneumonia were the agents tested. We determined an incidence of 65% (49/77) of documented significant seroconversions to one or more of the agents surveyed. Multiple agents were involved in 24 of the 49 positive cases we studied. Influenza virus Group B in 14 (18%) and rubeola in 12 (16%) were the most prevalent, followed by Herpes simplex type 1 in 6 (8%), mumps in 6 (8%), influenza Group A3 in 6 (8%), rubella in 5 (7%), and cytomegalovirus (CMV) in 5 (7%).
Once acquired, Epstein-Barr virus (EBV), a latent virus, remains in the body for what appears to be the lifetime of the human host. Circumstantial data suggest EBV is involved in clinical disease including malignancies far more often than previously recognized. A serologic test for early antigen (EA) is more specific for diagnosing active EBV disease than the monospot or heterophile test. A case study of active Epstein-Barr infection is reported showing persistently elevated early antigen titers prior to and following malignant transformation.
Eight pediatric patients with acute cervical lymphadenitis or neck mass, alone or in association with nonspecific upper respiratory complaints, were screened for the presence of a primary or reactivation Epstein-Barr virus infection. All were found to have elevated antibodies to the early antigen (EA) and 75% (6) of these were found to be reactivations. Only one had a positive heterophile. Half of the patients had elevation of the EA-specific IgA, and 75% (6) had elevation of viral capsid antigen-specific IgA. All had elevated levels of soluble immune complexes. There was not a direct relationship between the EA titer or soluble immune complex level and severity of disease.
This report is concerned with acute exudative tonsillitis as a pathologic response to the Epstein-Barr virus (EBV). The concept of a bacterial-viral etiology etiology for tonsillitis has been suggested, and previous studies implicate EBV as a major pathogen in exudative tonsillitis. A prospective study of 16 patients with this diagnosis was conducted. EBV serologic data plus viral and bacterial throat cultures were compiled and evaluated. EBV as a casual agent alone or concurrent with other organisms was seen in 56% (9) of the patients under study. EBV activation was associated with infection by other organisms in 19% (3) of the cases. The overall total incidence of EBV in association with severe acute exudative tonsillitis was 75% (12). The data further documents EBV as a significant causal or associative agent in acute exudative tonsillitis.
In characterizing the immunochemical and biochemical nature of middle ear effusions (MEE) of chronic serous otitis media (SOM), we have previously shown that MEE contain all major immunoglobulin classes, increased levels of several lysosomal enzymes, decreased total complement, but increased levels of C3. This report extends these observations by showing that MEE also contains C3 proactivator (C3PA) that can be activated by those organisms involved in acute otitis media, which confirms a functional alternate complement pathway. Furthermore, we have demonstrated the presence of soluble immune complexes in MEE using the Raji cell test. These data further support an immune complex mediated etiopathogenesis for chronic SOM.
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