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PubMed2003

[Immunity in children with acquired scarred stenosis of the larynx and cervical trachea].

Humoral immunity was studied in 63 children with acquired laryngotracheal stenosis 1 year 9 months to 14 years 8 months of age. The study discovered humoral immunity dysfunction which was most pronounced in patients who developed scary stenosis after critical care for acute stenotic laryngotracheobronchitis. It was found that if a child has allergy (atopy) in conduction of critical care requiring long-term nasotracheal intubation, he/she is at risk to develop scary stenosis.

Adolescent↗
PubMed1992

CD4+CD7-CD57+ T cells: a new T-lymphocyte subset expanded during human immunodeficiency virus infection.

CD7 and CD57 are two cell surface molecules related to the differentiation or functional stages of CD4+ T cells. The CD4+CD7- T cells represent a minor subset of CD4+ cells in normal individuals and are considered to contain the normal counterpart of Sézary T cells; the CD4+CD57+ peripheral blood lymphocytes (PBL) are detectable in long-term renal allograft recipients. We compared the cell surface expression of these CD7 and CD57 markers on CD4+ T lymphocytes in peripheral blood and lymphoid organs from normal individuals and human immunodeficiency virus (HIV)-infected patients. Our results indicate that CD4+CD7- T cells in normal PBL do not express CD57 and were poorly responsive to anti-CD3 monoclonal antibody (MoAb), the activation being restored by addition of anti-CD28 MoAb. This CD4+CD7- cell subset is increased in peripheral blood during HIV infection, and its progressive expansion mirrors both the absolute and relative decrease of CD4+ T cells. The lack of CD7 expression is correlated with CD57 acquisition on CD4+ T cells because CD4+CD7-CD57+ cells represent a major component of the CD4+CD7- subset in HIV-infected patients. Our results suggest that the presence and the expansion of CD4+CD7-CD57+ T lymphocytes, which do not behave as previously defined helper subsets, may participate to the immune dysfunction observed during HIV infection.

Antigens, CD↗
PubMed1992

[Research of the relation between the type of asthenia of the spleen and kidney and platelet associated antibodies and T-lymphocyte subsets in idiopathic thrombocytopenic purpura].

Idiopathic thrombocytopenic purpura (ITP) is a kind of disease associated with immunity. At present a great quantity of study on ITP has been made on humoral and cellular immunity. But there are few reports about the relationship between the types based on the differential diagnosis of TCM and immune rationale of ITP. In order to deeply explore the relationship between the types based on differential diagnosis of TCM and immune rationale of ITP., the authors measured PAIg and T lymphocyte subsets of 34 ITP patients of asthenia of both Spleen and Kidney. The value of PAIgG increased in both types of Spleen failing to control blood (SFCB) and deficiency of Spleen-yin and Kidney -yin (DSYKY), and the value of PAIgG of the type of DSYKY was significantly higher than that of SFCB (P less than 0.01). OKT3, OKT4/OKT8 of the type of SFCB remarkably decreased (P less than 0.05), OKT4, OKT4/OKT8 of DSYKY also remarkably decreased (P less than 0.001), while OKT8 significantly increased (P less than 0.001). The above results suggested that the type of DSYKY has more serious immune dysfunction than the type of SFCB, and the types of SFCB and DSYKY has close relationship with PAIg T lymphocyte subsets.

Adolescent↗
PubMed1992

Serum beta 2 microglobulin levels in HIV seropositive persons.

As beta 2 microglobulin (B2M) has been found to be elevated in immunological disorders and also in HIV infection, its levels were studied in 475 HIV seropositive, asymptomatic persons; 101 HIV seronegative persons from high risk groups for HIV and 99 healthy controls. The B2M levels in asymptomatic HIV seropositives are found to be significantly higher than healthy controls (1.0 mg/1 to 2.7 mg/1, P less than 0.001) and HIV seronegatives from high risk groups (1.1 mg/1 to 2.7 mg/1, P less than 0.001). Two hundred and thirty four (49.26%) seropositives showed increased levels of serum B2M. Thus, quantitative analysis of B2M may be useful as an early nonspecific marker of HIV infection and immune dysfunction. The prognostic value of B2M was assessed in a follow up study of 54 HIV seropositives in a 2 yr period. Within this period, B2M levels were found to be significantly increased in these subjects (1.2 mg/1 to 4.6 mg/1, P less than 0.001). Three of the subjects who showed high increase in the B2M levels, progressed to AIDS-related condition, whereas one progressed to persistent generalised lymphadenopathy. Thus, the rising levels of B2M appears to correlate well with disease progression.

Follow-Up Studies↗
PubMed1992

[3 cases of polyarthritis treated with recombinant alfa interferon].

Bilateral symmetrical polyarthritis occurred in three patients (2 males and 1 female), with no previous history of inflammatory rheumatologic disease, given alpha-interferon for 1 1/2, 7, and 10 months as treatment of chronic non A-non B hepatitis, myelofibrosis, and thrombocytopenia with myeloproliferative disorder, respectively. Joint manifestations developed 1 1/2, 3, and 10 months after initiation of alpha-interferon in a dosage of 3.10(6) U three times a week, 4.5.10(6) U per day, and 8.10(6) U three times a week. Polyarthritis persisted following withdrawal of alpha-interferon in the two last patients of whom one had rheumatoid nodules and positive rheumatoid serology and the other had scleritis, exanthema, and negative rheumatoid serology. Erosive rheumatoid arthritis was diagnosed after 28 months and 12 months, respectively, in two patients who required systemic corticosteroids with antimalarials (1 case) or azathioprine after failure of methotrexate (one case). Follow-up in the third case (12 months) is too short to allow differentiation of systemic lupus erythematosus (ANA: 1/1500 H with anti-DNA antibodies 58 U/ml) and chronic autoimmune hepatitis. Reports of chronic inflammatory rheumatologic disease during alpha interferon therapy are exceedingly few in number. In the cases reported herein, alpha-interferon may have either triggered or revealed the joint disease. To prevent occurrence of this complication, exclusion from alpha-interferon therapy of patients with autoantibodies or a positive history for clinical evidence of immune dysfunction may be considered.

Adult↗
PubMed2003

[Interleukin-18 and its related cytokines in plasma of patients with idiopathic thrombocytopenic purpura].

To explore the role of immune regulating cytokines in pathogenesis of the idiopathic thrombocytopenic purpura (ITP) and its clinical significance, the levels of IL-18, TNF-alpha and Sc5b-9 in plasma of 32 ITP patients and 18 normal individuals were detected using ELISA methods. The results showed that IL-18, TNF-alpha and sC5b-9 levels in plasma of ITP patients were higher than that in normal individuals. The level of IL-18 was positively correlated with the levels of TNF-alpha and sC5b-9. In conclusion, The rising levels of the IL-18, TNF-alpha and sC5b-9 were correlated with disorder of Th1/Th2 subsets, and may contribute to the immune dysfunction in ITP patients. The dynamic observation of these cytokines may be useful in directing the clinical treatment for ITP patients.

Adolescent↗
PubMed2003

The pathogenesis of systemic lupus erythematosus.

SLE is a complex, heterogeneous disease, the precise pathogenesis of which remains something of a mystery. In recent years our understanding has been advanced by the development of novel genetic and immunological techniques. Susceptibility to SLE has a genetic component and multiple putative genes are being investigated. The genes involved are likely to play a part in immune regulation. Central to the immune dysfunction seen in SLE is the presence of autoreactive B cells, which predominantly target nuclear antigens. In addition to evidence of aberrant B and T cell behaviour, lupus is associated with complement deficiencies, and abnormal cytokine function. A number of environmental triggers exist, and likely candidates include viral infection and exposure to UV light. Finally, evidence is accumulating that implicates apoptosis as a mechanism by which disease may be provoked and propagated.

Humans↗
PubMed1992

Blood antiphospholipid antibody levels are influenced by age, sex and HLA-B8,DR3 phenotype.

Antiphospholipid antibodies (APA) are known to be associated with a number of seemingly heterogeneous pathological conditions that are part of the antiphospholipid syndrome, formerly called anticardiolipin syndrome. Recent studies on the mechanism of action of these autoantibodies suggest that we are dealing with a new autoimmune syndrome which may occur either in a primary form or in the context of other autoimmune diseases, mainly systemic lupus erythematosus (SLE). Moreover, increased levels of APA have been found in elderly subjects, who are known to display increased frequency of autoimmune phenomena. It is well known that many autoimmune diseases, including SLE, are associated with HLA antigens, particularly with HLA-B8,DR3 phenotype. In our study, APA serum levels were analyzed in 26 old subjects and in 56 young ones. The results demonstrate that HLA-B8,DR3-positive young females display significantly higher levels of APA than HLA-B8,DR3-negative ones. Interestingly, the same is true for elderly subjects on the whole with respect to young individuals. These data are consistent with previous findings demonstrating that HLA-B8,DR3-positive subjects (mainly female) as well as old subjects display (also in the absence of any clinical manifestation), multiple immune dysfunctions that may underlie the predisposition to autoimmunity.

Adult↗
PubMed2003

Eosinophilic granuloma of the orbit: a paradox of aggressive destruction responsive to minimal intervention.

PURPOSE: To describe the findings and outcomes in eosinophilic granuloma (unifocal Langerhans cell histiocytosis [LCH]) of the orbit, and to explain the paradox of aggressive bone destruction responsive to minimal intervention. METHODS: Retrospective, consecutive, interventional case series of patients treated from 1985 through 2001. Minimum inclusion criteria were demonstration of CD1a positivity or Birbeck granules, treatment by a single surgeon, systemic evaluation by a pediatric oncologist, and follow-up of 12 months. A pathogenetic construct was assembled from general LCH concepts and the specific orbital findings. RESULTS: Seven patients met study criteria. All were male, 2 to 16 years of age. All had eyelid or forehead swelling and osteolytic defects, with symptoms of 2 to 6 weeks' duration. All underwent incisional biopsy, with frozen-section examination suggestive of LCH in 6 of 7 cases. The 2 earliest patients received low-dose irradiation after simple biopsy. The 5 most recent patients had subtotal curettage at the time of biopsy; 4 of 5 received simultaneous intralesional corticosteroid injection. In all cases, systemic evaluation showed no other focus of LCH, reossification was timely, and no local recurrence or additional focus was noted in follow-up of 1 to 17 years. CONCLUSIONS: Transient immune dysfunction may provoke the cytokine-mediated proliferation of pathologic Langerhans cells within the hematopoietic marrow of the anterolateral frontal bone. These cells cause osteolysis through elaboration of interleukin-1 and prostaglandin E2. Corticosteroids can inhibit the mediators. We recommend incisional biopsy, frozen-section provisional diagnosis, subtotal curettage, intralesional corticosteroid instillation, postoperative systemic evaluation, and long-term follow-up.

Adolescent↗
PubMed2004

Zinc for prostate disease and other conditions: a little evidence, a lot of hype, and a significant potential problem.

Dietary and supplemental zinc, especially in excess, has received much attention in numerous alternative medicine resources. There is a small amount of medical evidence that zinc may alleviate some mostly rare medical conditions (such as Wilson's disease). However, in prostate conditions, such as BPH, large concentrations of zinc are found in the prostate gland. Excess intake of zinc, especially with individual supplements, has the potential to encourage the growth of prostate conditions from BPH to cancer. In fact, one large study found a significantly higher risk of advanced prostate cancer in men consuming large intakes of these supplements. Large doses of zinc can inhibit the benefits of bisphosphonate drugs, increase testosterone level, increase cholesterol, reduce levels of "good cholesterol" or HDL, and can promote immune dysfunction. More research is needed in this area, but in the meantime, the time seems more than ripe to discourage or immediately discontinue the intake of larger concentrations of zinc for most individuals until adequate research resolves this controversial issue.

Dietary Supplements↗
PubMed2004

[Procalcitonin as an indicator of infection in patients with liver cirrhosis].

Incidence of bacterial infections in hospitalised patients with liver disease is high. Due to a liver dysfunction immune reactivity is significantly impaired and bacterial infections are more frequent. Also incidence of nosocomial infections is higher in patients with liver disease compared to patients hospitalised for other conditions. To make a differential diagnosis of infectious and non-infectious aetiology of an inflammation is very difficult. Characteristic laboratory tests for bacterial infection include test of a number of leucocytes in peripheral blood, differential count of leucocytes, erythrocyte sedimentation, procalcitonin, C-reactive protein, tumor necrosis factor alpha, interleukin-1, interleukin-6, interleukin-8, and complement fragment C3a. Clinically the most significant are C-reactive protein test and procalcitonin test. Procalcitonin is a protein, a calcitonin precursor, which is in healthy individuals produced by cells of thyroid gland. A half-life of procalcitonin in serum is 20-24 hours which makes it suitable for daily monitoring and enables to control a course of treatment and to distinguish bacterial infection from other types of inflammations. Procalcitonin levels rise in bacterial, parasite, and yeast infections. Elevated procalcitonin levels appear only in inflammations of an infectious etiology with systemic signs. In patients with liver cirrhosis bacterial infections are more frequent. They usually include spontaneous bacterial peritonitis, infection of the respiratory system, urinary infections, and bacteremia. A timely proof of a bacterial infection and an appropriate and effective antibiotic therapy lead to an improvement of the general state of a patient and to his/her better prognosis. Procalcitonin determination is appropriate for diagnosing infections and control of treatment.

Bacterial Infections↗
PubMed1992

HIV-associated papulosquamous diseases.

Persons infected with the human immunodeficiency virus (HIV) can develop a variety of dermatoses in which the primary lesions are scaly papules or plaques. These dermatoses can be the presenting clinical manifestations of HIV infection. Depending on the degree of immune dysfunction, the clinical and histopathologic appearance may be typical or quite unusual.

HIV Infections↗
PubMed2004

Body mass index, leptin and leptin receptor polymorphisms, and non-hodgkin lymphoma.

In a population-based case-control study, obesity was associated with elevated odds ratios (ORs) for non-Hodgkin lymphoma (NHL), and the two major subtypes, diffuse large cell (DLCL) and follicular lymphoma (FL). Those who were obese (body mass index >/= 30) were up to three times more likely to develop NHL or its major subtypes than persons with body mass index of 20 to <25. Obesity-related genetic factors including common polymorphisms in the leptin gene (LEP A19G and G-2548A) and its receptor (LEPR Q223R) were investigated in DNA available for 376 patients and 805 controls. Leptin is an adipocyte-derived hormone that regulates food intake and modulates immune and inflammatory responses through its receptor. Among those with the LEP 19G allele, an increased risk estimate was found for all NHL [OR = 1.6, confidence interval (CI) 1.1-2.3], DLCL (OR = 1.6, CI 0.86-3.0), and FL lymphoma (OR = 1.9, CI 0.98-3.6). Gene-gene interaction existed between the -G2548A and LEPR Q223R polymorphisms. Specifically, among those with LEPR 223RR, the risk estimate for NHL was increased in LEP -2548GA (OR = 1.7, CI 0.88-3.1) and LEP -2548AA (OR = 2.3,CI 1.1-4.6) relative to LEP -2548GG genotypes. These results suggest that genetic interactions between leptin and its receptor may promote immune dysfunction associated with obesity and NHL and that the emerging obesity epidemic is consistent with the increasing incidence of NHL in developed countries.

Adult↗
PubMed2004

[Necrotizing ulcerative periodontitis. Diagnosis, treatment and follow-up--a case report].

Necrotizing ulcerative gingivitis (NUG) and necrotizing ulcerative Periodontitis (NUP) share many clinical and etiologic characteristics. Both forms are characterized by necrotic gingival tissues, bleeding and pain. Malodor and malaise may be also present. NUG is an infection limited to the gingiva whereas NUP also involves the attachment apparatus. Predisposing factors may include immune dysfunction, poor oral hygiene, cigarette smoking and emotional stress. NUG and NUP might possibly be different stages of the same infection. This case report shows the successful treatment of a patient suffering from NUP.

Adult↗
PubMed1992

Chronic fatigue syndrome.

Fatigue is one of the most common complaints among patients seen in the primary care setting. Chronic fatigue syndrome, which has recently been called chronic fatigue immune dysfunction syndrome, is distinctive, with an abrupt onset of symptoms that wax and wane for at least six months. Usually there is low-grade fever, pharyngitis and tender, but not enlarged, lymph nodes. The fatigue can be disabling and is often made worse by physical activity. Some patients with this disorder have also been found to have highly characteristic immunologic abnormalities. Treatment can be rewarding and is based on patient education and support, exercise and symptomatic therapies for abnormal sleep patterns, musculoskeletal pain and other symptoms.

Adolescent↗
PubMed1992

Taenia solium ocular cysticercosis: findings in 30 cases.

We found the following results in 30 patients with intraocular cysticercosis: (1) a higher incidence in the first two decades of life compared with neurocysticercosis, (2) living cysticerci concomitant with inflammatory reactions, (3) diseases related to immune dysfunction in 17% of the cases, (4) anticysticercus antibodies in 57% of cases, (5) blindness in 81% of patients despite proper surgery, and (6) adult Taenia solium infection in a higher frequency of cases than expected for the Mexican population. We discuss these findings in light of recent and established knowledge regarding this disease.

Adolescent↗
PubMed2004

A clinical audit of presentation and outcome of Salmonella septicaemia.

INTRODUCTION: Enteric fever is imported to developed countries while non-typhoidal salmonella infections occur globally. Clinicians and trainees need to recognise the varied presentations of serious salmonella infections. MATERIALS AND METHODS: We reviewed the clinical presentations, hospital course, complications and outcomes of 50 patients who were blood culture positive for Salmonella spp seen in 2 years. RESULTS: Nineteen of 24 patients with enteric fever had recently travelled to Asian countries. All the enteric fever patients recovered fully. Out of 26 patients with non-typhoidal salmonellosis, 10 had malignancies, 7 had immune dysfunction states and 3 had aortic aneurysms. Five patients had recurrent episodes of salmonellosis. Eight of these patients who had cancer (4), diabetes mellitus with renal failure (2) and gastric diseases (2) died. Fatal cases were older with multiple admissions and co-morbidities (median, 3) and presentation followed immunosuppressive interventions, often with no fever (4). Onset was sudden with a short and fatally unresponsive course despite effective antimicrobial agents with microbiologic diagnosis made posthumously (4). Death resulted rapidly from overwhelming sepsis and aneurysmal complications. Antibiotic resistance to ampicillin, cotrimoxazole and chloramphenicol was noted. CONCLUSION: Enteric fever should be considered in travellers returning from Asian countries with fever, and third-generation cephalosporins or quinolones should be used for empiric treatment. Given the presentation of non-typhoidal salmonella septicaemias, clinicians need to have a high index of suspicion and to consider preemptive therapy in patients with prior infection who are likely to develop severe immunosuppression following interventions.

Adult↗
PubMed2004

Thymalfasin: an immune system enhancer for the treatment of liver disease.

Thymalfasin (thymosin-alpha 1) is an immunomodulating agent able to enhance the Thl immune response. It has been evaluated for its immunomodulatory activities and related therapeutic potential in several diseases, including chronic hepatitis B and C, AIDS, primary immunodeficiency diseases, depressed response to vaccination and cancer. The basis for effectiveness in these conditions is primarily through modulation of immunological responsiveness, as thymalfasin has been shown to have beneficial effects on numerous immune system parameters and to increase T-cell differentiation and maturation. Thymalfasin is responsible for reconstitution of immune function when thymic tissue is given back to thymectomized animals. In addition, thymalfasin has been shown to have efficacy in multiple experimental models of immune dysfunction, mainly, infectious diseases such as hepatitis (woodchuck) and influenza (mouse), and cancer such as melanoma (mouse) and colorectal carcinoma (rat) where thymalfasin has shown antitumor effects.

Adjuvants, Immunologic↗