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Immunology of a serum sickness/vasculitis reaction secondary to streptokinase used for acute myocardial infarction.

We have studied six patients who received streptokinase for acute myocardial infarction (MI). One of these patients experienced a serum sickness/vasculitis reaction nine days after receiving the drug. Immunologic investigation of serum obtained from these individuals demonstrated that IgE and IgG anti-streptokinase antibody concentrations (measured by radioimmunoassay) were significantly elevated, both pre and post (IgE antibody, 36-fold increase) drug exposure, in the individual having the serum sickness/vasculitis reaction. Two of five of the remaining MI patients receiving the drug had post-exposure elevation of IgE anti-streptokinase antibody, but no patient had the immunologic profile seen in the individual with vasculitis. One should be aware that the serum sickness/vasculitis reaction can occur late after administration of streptokinase when the acute MI patient is recuperating.

Adult↗

Immune function in ankylosing spondylitis: apparent relationship between streptococcal responses and HLA B27.

Immune function has been evaluated in 54 patients with ankylosing spondylitis (AS) and 26 controls. Cell-mediated immunity was assessed by skin testing with ubiquitous antigens, and humoral immunity by antibody responses to tetanus toxoid and Salmonella typhi vaccinations, and resting titres of anti-Streptolysin O, anti-E Coli, and isohemagglutinins. The AS patients had reduced delayed hypersensitivity responses to Candida, augmented responses to Streptococcal antigen and relatively low ASO titres. There was no generalized depression of humoral immunity, as indicated by the normal tetanus and Salmonella O responses and hyper-response to Salmonella H antigen. The E. Coli and isohemagglutinin titres were normal. These results indicate that patients with AS present a complex immunological profile, including exaggerated responses to some antigens and impaired responses to others. In view of the very high incidence of HLA-B27 in AS, it is possible that these findings are related to the effects of HLA associated immune response genes.

Adult↗

[Study of T and B lymphocytes in blood and synovial fluid during rheumatoid arthritis].

The quantitative study of lymphocyte populations is one means of approaching the immunological profile of patients with rheumatoid polyarthritis. In the present work we have studied the proportions of T and B lymphocytes in the blood and synovial fluid of 70 patients presenting classical or clearly defined rheumatoid polyarthritis. The number of T cells (E rosettes and anti HTLA serum) and B cells (membrane immunofluorescence and EAC rosettes) were found to be identical in both patients with rheumatoid polyarthritis and healthy subjects of the same age. On the other hand the number of "fast" rosettes, indicating a sub-population of T effector cells, and of EA rosettes formed at the expemnse of cells with a receptor for IgG Fc, are reduced in the blood and increased in the rheumatoid synovial fluid. In the course of rheumatoid polyarthritis there is therefore a displacement of certain lymphocytic sub-populations from the blood towards the synovial site where they are probably involved in lesional mechanisms.

Adolescent↗

Immunodetection by enzyme-linked immuno-filtration assay (ELIFA) of IgG, IgM, IgA and IgE antibodies in bird breeder's disease.

The diagnosis of bird breeder's lung (BBL) depends upon a range of epidemiological, clinical, radiological and immunological arguments. The simple detection of antibodies cannot constitute a pathognomonic criterion of BBL. We applied the enzyme-linked immuno-filtration assay (ELIFA) to the study of 50 sera chosen from 2509 samples taken from subjects exposed to avian antigens. The arc-IgAp was detected in all sera samples (n = 27) taken from symptomatic subjects (n = 16), but was only demonstrated 3 times out of 2466 samples taken from exposed asymptomatic subjects. The ELIFA method revealed IgG, IgM, IgA and IgE precipitating antibodies only in the case of clinically ill subjects. Finally, this technique demonstrated a second functional antigenic component (arc-P2) which preferentially induced specific immunoglobulins of different classes. Compared immunological profiles (CIP), established by ELIFA, seem to be highly significant for BBL, and correlate well with pathological symptoms and their evolution.

Alveolitis, Extrinsic Allergic↗

[Protection against experimental infections in mice by an oral vaccine and its combined role when administered with antibiotics].

Immunomodulator with significantly modify the immunologic response of the host. The AA. studied the immunologic profile of an oral vaccine to protect the experimental infection in mice and its effect when it was administered with antibiotics. The mice infected with S. enteritidis were protected by the vaccine administered. Also in the group of mice treated with a vaccine and antibiotic combination, the mortality rate was lower than in the untreated groups.

Administration, Oral↗

Interferon-induced surface alterations in hairy cells. A review.

Hairy cells (HCs), derived from the peripheral blood and spleen of hairy cell leukemia (HCL) patients, constantly displayed both ruffles and microvilli. HCs which were kept in culture for up to three days exhibited extremely polarized and active surfaces with elongated microvilli and exaggerated "spiked" ruffles. Cells derived from 11 cases of HCL were treated with alpha-interferon (IFN) in-vitro and examined by immuno-scanning electron microscopy (immuno-SEM). In 8 cases, up to one-third of the IFN-treated hairy cells displayed deformed surfaces with "bubbling" membrane and markedly villous bud-like formations. Monoclonal antibodies (MoAb), used in conjunction with immuno-gold labeling, facilitated better correlation between these morphological changes and the immunological profiles of the cells before and after interferon treatment in-vitro. Immuno-SEM analyses revealed no remarkable changes in the labeling of HCs with Leu-14 and Leu-M5 MoAbs before and after IFN treatment, even in cases showing membrane changes. However, a significant increase in the labeling intensity for HLA-DR and HLA-DQ was noticed in HCs from cases where IFN-induced membrane changes were evident. A review of the literature on membrane changes in IFN-treated cells proposes that such immuno-ultrastructural alterations might reflect unique interferon-induced membrane reorganization in the target malignant cells.

Humans↗

Association of Sjögren's syndrome and sarcoidosis. Report of a case.

We report a case of a 57 year-old woman with Sjögren's syndrome and pulmonary complaints. After an initial evaluation, a lung biopsy was made and disclosed sarcoid lesions. This association is very rare, and the present case does not fulfill the criteria for TASS (Thyroiditis, Addison's disease, Sjögren, and Sarcoidosis). Sarcoidosis and Sjögren can coexist since both diseases may share the same immunological profile. This case report warrants further research on the overlapping of these diseases.

Female↗

Kaposi's sarcoma in a young man in absence of AIDS or other known causes of immune suppression.

Kaposi's Sarcoma (KS) in young individuals is unusual and most often associated with cellular immunodeficiency caused by infective or other neoplastic diseases. It has recently been highly associated with the Acquired Immunodeficiency Syndrome (AIDS). We report the case of a heterosexual 29 year aged man with no evidence of underlying malignancy or infectious diseases. Antibodies to the Human Immunodeficiency Virus (HIV) were absent on repeat testing. His immunological profile demonstrated elevated number of CD8+ cells, normal number of CD3+ and CD4+ cells and hypogammaglobulinemia. These data are distinctly different from those described with AIDS associated KS. The development of KS in young individuals of mediterranean origin may reflect mild degree of immune abnormalities in the absence of infection with HIV.

Adult↗

[Histo-prognostic classification of undifferentiated carcinoma of nasopharyngeal type. Importance of the study of the stroma].

A total of 102 cases of undifferentiated carcinoma of nasopharyngeal type (UCNT) were reviewed to attempt their classification into histologic forms of different prognosis. Each slide reviewed was evaluated for predominant tumoral tissue architecture, and the quality, amount and topography of the stroma. Immunoperoxidase studies in 80 cases allowed definition of the immunologic profile of the lymphoplasmocytic stroma. For equivalent clinical stages, the different histologic types are defined as a function of the architecture: cordonal or diffuse, compact or fragmented; these forms, when combined with cytologic characteristics and quality of stroma distinguished 3 microscopic groups of different evolution. The fragmented diffuse forms appear to have the best prognosis (85.5% survival at 5 years), the compact cordonal forms the worse prognosis (13.2% survival at 5 years): the intermediate or diffuse compact forms were of fair prognosis (42.8% survival at 5 years). Application of histology to determine prognosis of UCNT should allow future adaptation of treatment (radiotherapy and/or chemotherapy) to each case.

Adolescent↗

[Dynamic sampling analysis of the immune status of breast cancer patients].

Application of a sampling-dynamic procedure for evaluation of the immunologic vigor of breast cancer patients established certain differences in the individual patient indexes in a clinically uniform study group before treatment. All members of the study group received similar treatment which produced identical end results. The "immunologic profile" obtained by means of a study of parameter interrelationship was found to differ significantly in patients who had a favorable and unfavorable course within 2 years post-treatment. A prognostic table for selection of the most likely candidates for tumor dissemination and recurrence development is presented.

Adult↗

Immunologic follow-up of infants treated with granulocyte transfusion for neonatal sepsis.

The immunologic status and the occurrence of alloimmunization against granulocytes, platelets, lymphocytes, and red cells was evaluated in 33 babies who received granulocyte transfusion because of neonatal sepsis. Nine age-matched babies were examined as control. A first group of 19 infants was examined only once between 6 and 23 months of age. Alloantibodies were searched by the following serologic methods: standard techniques for red cell antibodies; lymphocytotoxicity test; agglutination and immunofluorescence tests on granulocytes and platelets. No antibodies were demonstrated. The immunologic profile was investigated by determining the Ig levels, the percentage of E rosette-forming cells, and the lymphocyte blastic response to phytohemagglutinin and concanavalin A. Granulocyte function was studied by phagocytosis and killing of Candida. No significant differences were observed between treated and control babies. In a second group of 14 infants the occurrence of early immunization within 3 to 9 weeks after the last transfusion was investigated. No evidence of early immunization was found. The present data suggest that following neonatal granulocyte transfusion the risk of adverse immune reactions should be low.

Blood Platelets↗

Hypogammaglobulinemia due to abnormal suppressor T-cell activity in Crohn's disease.

Two patients are described who initially developed Crohn's disease followed by hypogammaglobulinemia. The immunologic profile of both was typical of acquired common variable hypogammaglobulinemia. The peripheral blood lymphocytes of neither patient were able to synthesize immunoglobulin when cultured with pokeweed mitogen in vitro nor were cultures containing mixtures of purified B cells and T cells. A potent suppressor T cell was present in the peripheral blood of both patients that was able to completely suppress immunoglobulin synthesis in cultures of normal B cells and T cells. When the patients' B cells were highly purified and appropriately stimulated in vitro, they were able to synthesize immunoglobulin, providing strong evidence that the circulating suppressor T cell was mediating the hypogammaglobulinemia. We have previously shown that many patients with Crohn's disease have a circulating "covert" suppressor T cell that is not expressed in cultures of unfractionated peripheral blood lymphocytes, but which becomes apparent after isolation of their T cells on antiimmunoglobulin columns. We conclude that these 2 patients represent instances in which the "covert" suppressor T cell of Crohn's disease has become overtly active in the systemic circulation and has resulted in hypogammaglobulinemia.

Adult↗

[Acquired immunodeficiency syndrome, Kaposi's disease and cerebral toxoplasmosis in a young man. Review of the literature apropos of a case].

We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.

Acquired Immunodeficiency Syndrome↗

[The present epizootological situation in intensively bred cattle in relation to the morbidity and mortality of calves during their rearing].

The rise and mass incidence of intestinal and respiratory infections in calves kept in large herds depend on a joint influence of infective agents and numerous endogenous and exogenous factors, mostly with non-specific action. Therefore, purely medical approach fails to provide efficient prevention. Detailed epizootological analysis is needed for taking actual measures; the analysis should concern potential respiratory and intestinal pathogens and should also cover the persistent infections such as IBR, BVD-MD and others. The immunological profile of herd, very unfavorable with the high culling rate, will improve as a result of the introduction of a purpose-oriented vaccination programme, higher level of colostral nutrition, and separate rearing of calves, isolated from the dams, in calf houses managed by the all-in-all-out system.

Animal Husbandry↗

Studies on T cell subsets and functions in leprosy.

T cell subsets and T cell functions were explored in 31 leprosy patients with the following methods: determination of the percentages of the different T cell subpopulations defined by monoclonal antibodies directed at total T cells, helper T cells and suppressor/cytotoxic T cells; measurement of the in vitro proliferative responses to mitogens; study of the concanavalin A-induced suppressive activity, assessed on MLC; measurement of delayed-type hypersensitivity by skin testing. The confrontation between immunological lepromatous patients without type-2 reaction (erythema nodosum leprosum), (2) lepromatous patients without ENL (erythema nodosum leprosum), (2) lepromatous patients was recent ENL and (3) tuberculoid patients. Unexpectedly, groups 1 and 3, although differing strongly in their clinical status and their sensitivity to lepromin (absent in group 1 and strong in group 3), showed a similar immunological profile with a normal percentage of T cells and a normal distribution of T cells among the major T cell subset contrasting with a moderate decrease of proliferative responses to mitogens and impaired delayed-type hypersensitivity reactions. Concanavalin A-induced suppressive activity was type-2 reaction) strongly differed from both other groups, showing striking abnormalities other groups, showing striking abnormalities of the repartition of the T cell subsets, with increased percentages of helper T cells and decreased percentages of suppressor T cells, and elevated proliferative responses to mitogens. Concanavalin A-induced suppressive activity was reduced in most patients of this group. It is suggested that this imbalance between T cell subsets contributes to the occurrence of ENL reactions in lepromatous patients.

Adolescent↗

[Interactions between rheumatoid factors and antinuclear autoantibodies: their occurrence in a concealed state in rheumatoid disease (arthritis); effect of D-penicillamine].

In this paper it is demonstrated that IgM rheumatoid factor (RF) can inhibit the detection of antinuclear antibodies (ANA) by the classical rat liver cryostat section method. This "inhibition" of IgG-ANA by IgM-RF may be due to the formation of high molecular weight complexes. It would be the same in vivo. This masking effect can explain interesting similarities and dissimilarities observed in the clinico-immunological profiles of rheumatoid arthritis and systemic lupus erythematosus. D-Penicillamine can restore ANA activity by dissociating ANA-RF complexes. A new technique is described for the detection of these masked ANA.

Animals↗

[Mixed connective tissue disease (Sharp syndrome)].

In the Sharp syndrome we have to do with a mixed collagenosis with symptoms of sclerodermia, erythematodes visceralis, dermatomyositis and rheumatoid arthritis. Above all are observed a Raynaud syndrome, polyarthritis and polyarthralgias, swellings of hands and fingers and myositis and myalgia, respectively. For the ascertainment of the diagnosis as independent picture of a disease the immunological profile is decisive. On the basis of three casuistic cases the author adopts a definite attitude to the Sharp syndrome as independent immunopathy. Questions of diagnostics, therapy and prognosis are discussed.

Adult↗

Invasive fungal infections in patients with chronic mucocutaneous candidiasis.

Patients with chronic mucocutaneous candidiasis have persistent Candida infection of nails, skin, and mucous membranes, but rarely, if ever, does an invasive fungal infection develop. We describe two patients with chronic mucocutaneous candidiasis who died of fungal infection; one had C albicans meningitis and the second had Cryptococcus neoformans meningitis. The cases of four other patients with chronic mucocutaneous candidiasis and invasive fungal infection, three with crytococcosis and one with histoplasmosis, have been reported previously. Immunological profiles on these six patients revealed no differences from those of other patients with chronic mucocutaneous candidiasis without invasive fungal infection. Three of the four patients who received amphotericin B were cured of their infection; three patients died, including one patient with overwhelming cryptococcosis who had received intensive antifungal therapy and transfer factor.

Adolescent↗