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[Changes in the immunologic profile of newly-diagnosed diabetic patients during the first year of the disease].

Immunological markers including ICA-IgG, CF-ICA, other non organ specific autoantibodies, circulating immune complexes (CIC), IgG, IgA, IgM, C3, C4 and lymphocyte subpopulations (OKT3, OKT4, OKT8) were studied at onset in 32 insulin dependent diabetic patients (16 males, 16 females, aged 1-21 yr.). Other non organ specific autoantibodies, CIC, IgG, IgA, IgM, C3, C4 and OKT3, OKT4, OKT8 were also studied after a 6-12 months follow-up in the same group of patients. ICA-IgG and CF-ICA were also studied in a control group of 19 insulin dependent diabetic patients with an over 3 year history of diabetes. ICA IgC, CF-ICA, other autoantibodies and CIC were detected at diagnosis in 65%, 19%, 33%, and 50% of patients respectively. ICA-IgG and FC-ICA were detected respectively in 15% and zero of the control group of 19 long standing diabetes. No alterations in IgG, C3 and C4 levels and in T cells subsets have been found at onset. C4 levels significantly decreased at the successive observation. A significant elevation of IgG levels and helper/suppressor ratio were also observed at follow-up. Autoantibodies and CIC positive sera at diagnosis support the concept that a previous autoimmune disorder exists before clinical manifestations of diabetes. Other immunological abnormalities including relative hypogammaglobulinemie, lower C4 and higher helper/suppressor ratio, observed by other authors (Kanakoudi 1984, Vergani 1985, Lernmark 1985) represent an aspecific alteration due to metabolic imbalance or to an earlier immunological disorder.

Adolescent↗

alpha-Interferon therapy in patients with chronic active hepatitis B: immunological profile.

The effect of interferon-alpha 2b (IFN) on viral markers, liver function and immunological parameters (CD3, CD4, CD8, B, NK, II-2 receptor and HLA-DR positive cells in blood and T cell proliferation) was studied in 9 patients with HBsAg(+), HBeAg(-) chronic active hepatitis (CAH). Three patients were HBV-DNA(+) and 6 also had complications of cirrhosis of the liver (LC). IFN was given at a dose of 2.5 mil IU x 3 weekly for 6 months. One patient with LC developed hepatic coma and died 2 months later. Severe leukopenia limited duration of treatment to 2 and 4 months in another 2 patients. By the end of treatment, the 8 patients were in good clinical status, SGOT, SGPT levels and prothrombin time were decreased, HBV-DNA became negative in 2 out of 3 patients and proportions of CD3, CD4, B, NK and activated cells were significantly decreased. When compared to controls, NK and activated cells were significantly increased in patients before and were gradually decreased by the end of treatment. In contrast, T transformed cells were significantly decreased before and ranged in normal levels by the end of treatment. These findings suggest that immunomodulatory activity possibly contributes to the beneficial effect of IFN therapy.

Adult↗

[Immunological profile of Whipple's disease evolving over a period of 17 years].

This report describes an immunological study made on a 58 years old patient with a Whipple disease diagnosed in 1969 and treated with different antibiotics. All attempts to stop the antibiotherapy resulted in reappearance of clinical symptoms. Further, this patient suffered anguillulosis infection in 1954 and this persists despite thiabendazole therapy, as shown by periodical creeping lunear dermatitis (larva currens). Laboratory investigations displayed low IgM levels and lack of cutaneous reactivity to conventional antigenic challenge. In vitro studies on granulocyte and monocyte phagocytic activity did not display any clearcut deficiency. Finally, this patient displayed peripheral lymphopenia and decrease of the T4+ (CD4) lymphocyte subpopulation. The proliferative response of lymphocytes to phytohemagglutinin stimulation (a cellular T-cell function) was drastically decreased in assays performed during the 16 month duration of patient's exploration. This proliferative defect seems to be due to increased PGE2 release (a 3-5 fold increase was demonstrated), resulting in inhibition of interleukin 2 (IL2) synthesis and activity. Further, patient's lymphocyte normally expressed IL2 receptor. When the B lymphocyte dependent humoral response was assayed, normal B lymphocyte differentiation into plasmocytes was found. However the pokeweed mitogen induced proliferative response of B lymphocyte displayed major decrease in four sequential tests. This might be due to a lack of B cell growth factor (BCGF) activity, since this interleukin involved in T lymphocyte, B lymphocyte cooperation was not found in supernatants of patient's cell. Further, interleukin 1 (involved in macrophage lymphocyte cooperation) was normally produced. In conclusion, no deficiency of in vitro phagocytose was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Differentiation↗

Immunological profile of patients with recurrent respiratory infections.

The authors present an analysis of the results of laboratory immunological examination of 52 patients suffering from recurrent respiratory infections. Besides the typical laboratory correlates of chronic inflammation, several findings indicated the depressed function of cellular and partially humoral immunity. The immunological parameters, most frequently decreased in comparison with normal values, were as follows: the response to the recall antigens of Imunoskintest (lower in 54% of patients), the relative number of CD3+ lymphocytes (35%), the CD4/CD8 ratio (37%), phagocytic activity (37%) and also serum IgA (12%). This means that more than two thirds of patients displayed at the time of examination a substantial alteration of one or more immunological parameters, the depression of cellular immunity was much more pronounced. It is concluded that the laboratory immunological examination of patients with recurrent respiratory infections is very important for revealing of an underlying cause of the disease and for indicating the adequate immunomodulatory treatment.

Adult↗

Respiratory health and immunological profile of poultry workers.

OBJECTIVES: To examine work-related respiratory symptoms in poultry workers, and to test for immunologically mediated responses to poultry-related agents. DESIGN: A cross-sectional survey of differentially exposed poultry workers and unexposed blue-collar workers. SETTING: Three poultry farms and a poultry plant in Gauteng (exposed workers) and a municipal workers' clinic in Johannesburg (controls). PARTICIPANTS: 134 poultry workers (85.4% of all eligible workers) and 122 controls (> 95% response rate). OUTCOME MEASURES: Respiratory symptoms plus allergy and hypersensitivity to poultry agents identified by skin-prick tests, and by the presence of specific IgE and IgG enzyme-linked immunoflow assay and nonspecific (radial immunodiffusion) antibodies. RESULTS: Smoking habits and atopic status were similar in the poultry workers and the controls. Symptoms were very common in poultry workers, for example work-related cough in 32% and work-related wheeze in 23% of highly exposed workers. Significantly more poultry workers than controls complained of chest symptoms (increasing with increasing exposure), and of eye, skin and nose irritation at work. More poultry workers than controls had symptoms consistent with asthma (e.g. 3%, 4%, 13% and 11% in controls and subjects with low, medium and high exposure, respectively), and symptom complexes associated with organic dust exposure. Five poultry workers had positive skin-prick test reactions to poultry-specific antigens, but none of the unexposed controls reacted. More poultry workers than controls had positive immunodiffusion test reactions to chicken feed, feathers and serum, and IgE to chicken faeces. There was no association between immunological status and respiratory symptoms. CONCLUSION: We found a very high prevalence of exposure-related symptoms in poultry workers; improved hazard control is strongly indicated. Tests of allergy and hypersensitivity were associated with exposure, but not with disease. The possibility of useful tests of sensitisation has not been excluded; a prospective study design is likely to be more rewarding than cross-sectional approaches such as in this study.

Air Pollutants, Occupational↗

[Erythema nodosum leprosum case series report: clinical profile, immunological basis and treatment implemented in health services].

Erythema nodosum leprosum is an acute inflammatory event in the chronic course of leprosy. It is considered an immunological disorder and an important cause of morbidity and disability. We evaluate the clinical profile, serology and histopathology 58 erythema nodosum leprosum patients sequentially recruited, from July- December 2000, in an endemic area in Central Brazil (Goiás State). Half of the reactins were considered severe and 66% of the cases had the first episode of reaction during specific treatment. The majority of patients and controls were positive to anti-PGL-I IgM. The more frequent histopathological findings in erythema nodosum leprosum were presence of intracellular acid-fast bacilli, perivascular/peradnexial mononuclear inflammatory infiltrate, and neural aggression. Ninety six percent of the patients were treated with systemic steroid in the first episode. The results point out to the association between ENL and neuritis and the rare adoption of thalidomide as a solely medication in the health services.

Adrenal Cortex Hormones↗

[HCV genotypes. Liver histopathology and immunologic profile in four groups of patients].

AIM: Study on the prevalence of MCV genotypes, and correlation with liver pathology and immunological parameters. PATIENTS AND METHODS: 77 chronic hepatitis C patients (52 males, 25 females), mean age 44 +/- 14 years, belonging to four groups: (1) 23 (11 males) without other aetiology, (II) 19 (18 males) excessive drinkers, (III) 18 (12 males) haemodialysed, (IV) 17 (11 males) renal transplantation patients Genotyping was done by PCR (primers of the core, and hybridisation with specific probes). Serum Igs A, G, and M (by nephelometry), and peripheral blood lymphocyte (PBL) subsets (by flow cytometry) were determined. RESULTS: One genotype was found in 62 patients (1b 69.2%, 1a 21.5%, 2a 3.1%, 2b 3.1%, 3a 9.2%), and two genotypes in 4 patients (1b + 3a in 1 of group 1, 1b + 2a in 2 and 1a + 3a in 1 of group 111). Twelve cases (15.6%) were not identified (NI). Relative prevalence was not different in the four groups, but in 7 drug addicts 1 b was not found (Ia in 71.4%, 3 a 28.6%) The relationship between genotypes and age was significant (p < 0.05): in the 34 patients with less than 40 years, 1b was found in 38.2%, in the others in 41.2%, and NI in 20.6%; in those with 40-60 years, 1b was found in 68.8%, in the others in 15.6%, M in 15.6%; in those above 60 years, 1b was found in 90.9%, in the others in 9.1%. Of those identified, only genotype 1 (1a and 1b) was associated to moderate or severe activity, and infected 11/13 cases of cirrhosis or severe fibrosis. IgM (g/dL) was lower in 1b than in the others: 1.58 + 1.23 vs. 2.53 + 1.93 (p < 0.01). PBL (per mm3) were lesser in 1b than in the others, with significance for the CD8+: 540t239 vs. 739 + 420 (p < 0.01). CONCLUSIONS: Genotype 1b was the most prevalent in Portuguese patients, more significantly in the elderly, and was absent in drug addicts. The prevalence of genotypes is similar in general patients, in chronic haemodialysed, in renal transplantation recipients and in alcoholics. More severe liver pathology was associated with 1b and 1a genotypes. IgM and CD8+ had lower mean values in 1b infected patients. Other genotypes are certainly important in Portugal.

Adolescent↗

Immunological profile changes following perioperative autologous vs. homologous blood transfusion in oncologic patients.

To determine the effect of perioperative blood transfusion on immunological parameters, T cells, T-cell subsets, and concanavalin A-induced suppression were measured in 25 patients with colorectal and breast cancer. During the operation, 15 patients received autologous blood and 10 patients had homologous transfusion. The immunological status was again determined after curative surgery. Before surgery, normal percentage of T lymphocytes, decreased ratios of helper/suppressor cells, and impaired con A-induced suppression were found. Following the operation, the helper and suppressor cell percentages reversed to normal, whereas the con A-induced suppression remained impaired. This change was significantly more pronounced in patients who received autologous blood transfusion than in the other group. Autotransfusion has an impact on immune parameters that might prove less detrimental to the clinical outcome in oncologic surgery than homologous transfusion.

Adult↗

Combined evaluation of circulating immune complexes and antibodies to Pseudomonas aeruginosa as an immunologic profile in relation to pulmonary function in cystic fibrosis.

We developed a solid-phase radioimmunoassay with a reference standard pseudomonas antigen and used this with 125I-labeled anti-human immunoglobulin to evaluate specific antibodies to Pseudomonas aeruginosa, qualitatively and quantitatively, in sera from children with cystic fibrosis (CF) whose lungs were colonized by this bacterium. The results of this IgG assay correlated with the number of precipitin antibodies to the standard reference antigen determined by cross-immunoelectrophoresis in the same sera. Forced expiratory volume (FEV1; percentage predicted), determined as an indicator of lung injury in CF, was evaluated as an immunologic response to pseudomonas, against a profile derived from combined serial data on both the circulating immune complexes (CIC) and the Ps. aeruginosa antibodies (N = 25 CF patients; 108 sera). This revealed that in CF patients who had no specific IgG antibodies to Ps. aeruginosa and no IgG-CIC had the best pulmonary function (FEV1 = 115 +/- 14.52%) and those with high levels of antibodies to this organism and high IgG-CIC levels had the poorest lung function (FEV1 = 69.75 +/- 10.99%) (P less than 0.05). We believe that this indicates an immunologic basis for lung injury in cystic fibrosis.

Antibodies, Bacterial↗

[Immunologic profile of patients with carcinoma of the colorectum in the aged].

The authors, after explaining why they were persuaded to effect a study about the immunological outline of patients in geriatric age, suffering from colorectal carcinoma in different stages, state the methods they adopted for the in vivo and in vitro study of the cellular and humoral immunity. In order to better characterize these subjects, the authors also dosed tumoral markers, specific enough for the large intestine carcinoma, such as CEA and AFP. After reporting the results of their research, the authors, as a conclusion, assert there is certainly a straight correlation between immunity faults, bound to ageing, and neoplastic disease; therefore, the study of the immunological outline in aged patients is very useful, not only for prognostic purposes, but also to monitoring the immunitary state, mot inclined to meet depression in such patients as a consequence of the different therapies performed.

Age Factors↗

Immunopathology of periodontal disease. I. Immunologic profiles in periodontitis and juvenile periodontitis.

Eleven patients with periodontitis, ten patients with juvenile periodontitis and ten control subjects were studied to compare systemic and local immunologic responses and various other blood parameters. A more intensified immunologic response was seen in juvenile periodontitis as compared to periodontitis or controls as evidenced by: (1) greater number of plasma cells and lymphocytes in biopsy specimens of involved gingiva stained by Harris hematoxylin and eosin; (2) significant decrease in serum C4 levels and slightly elevated serum IgG levels as determined by radial immunodiffusion; (3) marked increase of positive fluorescing cells in biopsy specimens stained with antihuman immunoglobulin conjugate and an increase in complement deposition in the same tissues as determined by immunofluorescence. No significant differences among the two groups of patients and control subjects were observed with respect to complete blood counts, coagulation studies, or blood glucose levels. These findings suggest that the immunologic responses in periodontitis and juvenile periodontitis are qualitatively similar, but that the intensity of the response is greater in juvenile periodontitis.

Adolescent↗

Immunologic profile of highly exposed yet HIV type 1-seronegative men.

The host immune factors that determine susceptibility to HIV-1 infection are poorly understood. We compared multiple immunologic parameters in three groups of HIV-1-seronegative men: 14 highly exposed (HR10), 7 previously reported possibly to have sustained transient infection (PTI), and a control group of 14 low risk blood bank donors (BB). Virus-specific cellular immune assays were performed for CD4(+) T helper cell responses, CD8(+) cytotoxic T lymphocyte activity, CD8(+) cell chemokine release, and CD8(+) cell-derived antiviral soluble factor activity. General immune parameters evaluated included CCR5 genotype and phenotype, interferon alpha production by PBMCs, leukocyte subset analysis, and detailed T lymphocyte phenotyping. Comparisons revealed no detectable group-specific differences in measures of virus-specific immunity. However, the HR10 group differed from the BB group in several general immune parameters, having higher absolute monocyte counts, higher absolute CD8(+) T cell counts and percentages, lower naive and higher terminal effector CD8(+) cells, and lower levels of CD28(+)CD8(+) cells. These changes were not associated with seropositivity for other chronic viral infections. The PTI men appeared to have normal levels of monocytes and slightly elevated levels of CD8(+) T cells (also with increased effector and decreased naive cells). Although we cannot entirely exclude the contribution of other chronic viral infections, these findings suggest that long-lived systemic cellular antiviral immunity as detected by our assays is not a common mechanism for resistance to infection, and that resistance may be multifactorial. General immune parameters reflected by CD8(+) T cell levels and activation, and monocyte concentrations may affect the risk of infection with HIV-1, and/or serve as markers of exposure.

Adult↗

Acquired immune dysfunction in homosexual men: immunologic profiles.

Homosexual men with Kaposi sarcoma, lymphadenopathy syndrome, opportunistic infection, and nonhomosexual traditional Kaposi sarcoma were evaluated for B cell, T cell, and complement immunity and compared to normal controls and homosexual controls. No significant immunologic abnormalities were found in the traditional Kaposi group. All homosexual groups, including the homosexual controls, had a significant decrease in the helper/suppressor cell ratio. Functional abnormalities of T-cell immunity were observed in the homosexual Kaposi sarcoma, lymphadenopathy syndrome, and opportunistic infection groups. Significant elevations of IgG, IgM, IgA, and IgE were found in the lymphadenopathy group, while only IgG and IgA were elevated in the Kaposi sarcoma group. C3, C4, and immune complexes were normal, while total hemolytic complement activity was increased in the Kaposi sarcoma and lymphadenopathy syndrome groups.

Acquired Immunodeficiency Syndrome↗

Immunologic profiles of HIV-infected and uninfected commercial sex workers in the Vellore region of Southern India.

Female commercial sex workers (CSW) play a major role in the transmission of HIV infection in India. Their immunology has not been characterized. To determine HIV-related immunologic changes and establish baseline data for CSW, blood cell counts and serum immunoglobulin levels of 35 HIV-positive, asymptomatic CSW; 37 HIV-negative CSW, and 35 age-matched, non-CSW, healthy women controls were compared. The CSW, irrespective of their HIV status, had abnormalities that included high eosinophil, lymphocyte, and CD8 counts and low CD4:CD8 ratios. The only significant difference between the HIV-positive and HIV-negative CSW was in their neutrophil and CD8 counts (p < 0.05, ANOVA). Compared with normal controls, the CSW had significantly elevated serum IgG, IgA, and IgM levels; however, no significant difference was shown between CSW who tested positive for HIV and those who did not. These results suggest that the CSW of Vellore region in Southern India have hyperimmunoglobulinemia irrespective of their HIV status and thus highlight the need to use appropriate controls when immunologic evaluation studies are done.

Adult↗

Binding, pharmacological and immunological profiles of the delta-selective opioid receptor antagonist HS 378.

HS 378 is a recently developed indolomorphinan with high selectivity and antagonist potency at the delta-opioid receptor. The present study was performed to characterize the opioid binding properties and pharmacological and immunological activity of HS 378 and to compare them with those of two well-known delta-opioid receptor antagonists, naltrindole (NTI) and naltriben (NTB). In vitro opioid receptor binding profiles were determined in rat brain homogenates. HS 378 showed 4.7- and 2.4-fold higher mu/delta selectivity compared to NTI and NTB, respectively. In the [35S]GTPgammaS functional assay carried out in cell lines expressing cloned human opioid receptors, HS 378 was found to be a pure delta-opioid receptor antagonist. In vitro, exposure of HS 378 resulted in an apparent dose-related suppression of concanavalin A induced rat T-lymphocyte proliferation with an IC50 value of 0.54 microM. NTI showed also immunosuppression with an IC50 value of 6.93 microM, whereas NTB had no effect. The IC50 of HS 378 was 13 times lower than that of NTI and 8 times higher than that of cyclosporin A. Taken together, our findings indicate that the small molecule HS 378 has properties that may be of therapeutic value in the setting of human inflammatory diseases.

Animals↗

Virological and immunological profiles among patients with undetectable viral load followed prospectively for 24 months.

OBJECTIVE: To quantify HIV-RNA in plasma, in lymphoid tissue and proviral DNA in peripheral blood mononuclear cells and to relate these to immunological markers among patients with plasma viral load counts of </= 200 HIV-RNA copies/mL. METHODS: A prospective study of one hundred and three patients was undertaken with an inclusion criteria of plasma viral load of </= 200 copies/mL. The patients had advanced HIV infection; 25% had developed AIDS. Patients were seen every 6 months for a period of 2 years. RESULTS: The median plasma viral load was < 20 copies/mL with no increase during follow-up. Thirty-one per cent had plasma viral load of </= 20 copies/mL at all visits, 44% had >/= 1 measurement with 21-200 and 25% had >/= 1 sample with plasma HIV-RNA > 200 copies/mL. Lymphoid tissue viral load was low at enrolment and declined further during follow-up. Baseline HIV-DNA and immunoglobulin (IgA) differed significantly between the plasma viral load rebound groups (P < 0.05). CONCLUSION: In this cohort, selected solely on the basis of having a plasma viral load of </= 200 copies/mL, we found stable or declining viral loads in the measured compartments during 2 years of follow-up. Baseline HIV-DNA and IgA levels were higher among patients with less complete virological suppression relative to patients with persistently undetectable plasma HIV-RNA. Hence, a high cellular level of HIV-DNA and high plasma IgA may predict subsequent development of low-grade viraemia.

Adult↗

Immunological profile of DL111-IT, a new immunosuppressant agent.

The immunosuppressive properties of the non-hormonal contragestional agent 3-(2-ethylphenyl)-5-(3-methoxyphenyl)-1H-1,2,4-triazole (DL111-IT) were evaluated on different immunological functions. The compound displayed significant immunosuppressive activity on both humoral and cellular immunity when administered during the inductive phase of the immune response. In experimental models autoimmunity and skin transplantation, DL111-IT was able to reduce the production of auto-antibodies and prolong skin graft survival. The compound, even at doses much higher than those effective inhibiting immune responses, did not influence the survival time of some haematological tumors in mice. This suggest that DL111-IT does not act by a general cytotoxic mechanism.

Animals↗