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PubMed1991

[Intrauterine and postnatal pneumonia in acquired immunodeficiency of infants].

The autopsy material of 15 children aged from 2 months to 3 years from the zonal group of increased risk of the ecologic pathology, acquired immunodeficiency and viral infections was assessed morphologically and clinically. Decreased number of T-cells (T4, T8), an increase of the level of serum IgA, IgE and immune complexes, HIV-antibodies (4 cases) were found in the patients. The method of the molecular hybridization by means of virus-specific 32P-DNA probes was used. Bronchopneumonia was the cause of death. Severe deficiency of the organs and cells of the immune system, alternative-proliferative lung inflammation, mainly in the form of pneumonitis and alveolitis, were found. The latter differed either individually or as a result of the predominant infectious agent (RNA- or DNA-viruses, pneumocysts, bacterial flora, fungi). Considerable immunity dysfunctions enhanced the intensity of the specific features in pneumonia morphology.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Determination of lymphocyte lipid peroxide in patients with hepatitis B and its immunological significance].

Lipid peroxide (Lpo) of peripheral blood lymphocytes was measured with fluorescent method in 69 cases of hepatitis B and 35 normal subjects. The lymphocyte Lpo in patients with chronic active and severe hepatitis B was much higher than that in the normal subjects (P less than 0.01). Furthermore, the value of lymphocyte Lpo showed negative correlation with the number of peripheral blood lymphocytes (P less than 0.05) and the activity of interleukin 2 (P less than 0.01) in patients with severe hepatitis B. It also showed negative correlation with the latter in cases with chronic active hepatitis B (P less than 0.05). These data suggest that lipid peroxidation of peripheral blood lymphocytes may be one of the causes of immune dysfunction in patients with hepatitis B.

Adolescent↗
PubMed1990

Immunoglobulins in hemophilia: correlation between IgG subclasses, IgE and HIV antibody.

Twenty-two patients with hemophilia who had received factor VIII concentrate were evaluated. Only 12 of 22 were seropositive for HIV. Elevation of IgG, IgG1, IgM and IgE was not related to HIV seropositivity. Means of IgG1, IgG2, and IgG3 were significantly higher in patients with elevated IgG. Means of IgG2 and IgG3 were significantly lower in patients with elevated (greater than or equal to 251) serum IgM. Seven of the 22 patients demonstrated elevated (greater than or equal to 100) serum IgE; mean serum IgA was significantly lower, though in normal range, in these seven patients. Alterations in serum immunoglobulins in patients with Hemophilia are frequently seen, however, like other immune-dysfunction in these patients, these abnormalities can not be attributed to their HIV status.

Adolescent↗
PubMed1990

HIV-gp120 can block CD4-class II MHC-mediated adhesion.

A possible component of the immune dysfunction associated with infection by HIV is the inhibition of CD4 function resulting from the avid binding of soluble HIV envelope glycoprotein (gp120) to cell surface CD4. We assessed CD4 function by measuring the ability of CD4+ T cells to form conjugates with cell size lipid vesicles, artificial target cells (ATC), bearing the natural ligand for CD4, MHC class II proteins. Conjugate formation was a transient process with the greatest number of specific cell to ATC conjugates found after approximately 30 min of incubation at 37 degrees C. Addition of gp120 specifically blocked conjugates between CD4+ cells and class II ATC in a concentration-dependent manner. These data indicate that T lymphocyte adhesion mediated by CD4 is a dynamic event and that binding of gp120 to CD4 is able to disrupt the normal progression of the interaction between CD4+ T lymphocytes and class II+ APC.

CD4 Antigens↗
PubMed1990

HIV prevalence estimates and AIDS case projections for the United States: report based upon a workshop.

This document presents conclusions and recommendations from a workshop convened to discuss national estimates of human immunodeficiency virus (HIV) prevalence, acquired immunodeficiency virus (AIDS) case projections, and the proportion of HIV-infected persons with laboratory evidence of immune dysfunction. Appendices describe analyses performed before and after the workshop to estimate HIV prevalence and to predict future AIDS cases, the prevalence of persons with AIDS, and deaths among persons with AIDS. On the basis of these analyses, CDC estimates that approximately 750,000 persons in the United States were infected with AIDS at the beginning of 1986 and that approximately 1,000,000 Americans are currently infected with HIV. At least 40,000 new HIV infections occur each year among adults and adolescents, and an estimated 1,500-2,000 new infections occur each year among newborns as a result of perinatal HIV transmission. Approximately 60% of the estimated 1,000,000 HIV-infected persons in the United States may have T-helper lymphocyte (CD4+ cell) counts of less than 500/mm3 of blood and may benefit from early treatment with zidovudine. The number of AIDS cases will continue to increase over the next 4 years, with a projection of 52,000-57,000 cases to be diagnosed in 1990. Both AIDS case projections and HIV-prevalence estimates are influenced by the slowing of the rapid upward trend in AIDS incidence that occurred in 1987, particularly among homosexual and bisexual men who are not intravenous drug users. Data available during and after the workshop suggest that medical therapy or a decline in the incidence of new HIV infections among homosexual men in the early 1980s could have contributed to this change in trend, but the relative contributions of these and other factors (including changes in the completeness or timeliness of AIDS case reporting) require further study.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Analysis of aqueous humor immunoglobulin G in uveitis by enzyme-linked immunosorbent assay, isoelectric focusing, and immunoblotting.

Immunoglobulin G (IgG) in aqueous humor from patients with various uveitis syndromes was analyzed using a number of immunologic techniques. Sixty-five percent of patients with Fuchs' heterochromic cyclitis (FHC), 70% of patients with other forms of uveitis, and 44% of controls showed local synthesis of IgG, as demonstrated by an elevated IgG:albumin relative concentration ratio. Using an enzyme-linked immunosorbent assay to measure the concentration of IgG subclasses 1-4, a relative excess of IgG1 was found in the aqueous compared with the serum in FHC. Isoelectric focusing and immunoblotting studies revealed oligoclonal IgG bands in the aqueous of 13 of 23 (57%) patients with FHC, most being of the IgG1 subclass. Oligoclonal bands were not found in 18 patients with other types of uveitis or 13 patients undergoing surgery for senile cataract. These findings indicate intraocular production of IgG of restricted specificity in FHC, providing further evidence for local immune dysfunction in this condition. As yet the antigenic stimulus for this oligoclonal B-cell response has not been identified.

Adult↗
PubMed1990

Persistent immune deficiency in patients with alcoholic hepatitis.

T-lymphocyte subset numbers, recall-antigen skin test responses and mitogen-induced lymphocyte proliferation assays were investigated in 12 patients with severe alcoholic hepatitis (AH). Serial studies of these parameters were obtained at intervals of 1 or 2 wk. Patients with AH had lower peripheral blood lymphocyte counts with corresponding decreases in T-cell subset numbers that were persistent in the serial evaluations. T8 cells were disproportionately decreased, with a significant resultant increase in the T4:T8 ratios. Compared with controls, AH patients had significantly smaller cutaneous responses to Candida albicans antigen (p less than 0.05) and mumps antigen (p less than 0.005). Fifty-eight percent of patients were anergic when tested with a battery of four antigens. Patients with AH had increased concanavalin A-, but not phytohemagglutinin-induced lymphocyte proliferative responses. These serial analyses confirm previous observations of cell-mediated immune dysfunction in patients with severe AH. Moreover, there is a persistence of these abnormalities for at least 6 wk after withdrawal from alcohol.

Hepatitis, Alcoholic↗
PubMedDate not supplied

Assessing social support of people with AIDS.

Research indicates that social support has a direct effect on health, buffers the effects of physical and emotional stress, and mediates immune dysfunction. Although nurses frequently incorporate social support needs during patient assessment, it may not be specific or systematic. Assessment of social support for the person with AIDS is important because of the devastating psychosocial consequences of the disease. Using the nursing process as a framework, this article presents tools for assessment and practical suggestions for diagnosis, goal setting, interventions, and evaluation of social support needs. Nurses can make a valuable contribution to health promotion for the person with AIDS by specifically and systematically assessing social support needs.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Value of anthropometric techniques in pediatric otology].

The recurrent and severe infections of the ENT region during childhood are frequently related to cranio-facial malformations or/and deficiency of the immune system. The cranio-facial abnormalities are at risk to be complicated by transmission deafness either primary or secondary through recurrent middle ear infections. In our pediatric out-patient clinic, most of the patients suffering severe recurrent ENT problems show variable malformations: abnormal implantation or shape of the external ear, a microretrognathism, cervical or facial branchial fistulae, high or ogival palate with anomalies of the dental occlusion or a bifid uvula. All these abnormalities share their origins in a pathological development of the first branchial arch. These developmental anomalies may directly lead to deafness (especially due to an abnormal middle car ossicular development since they are derived in part from the first arch). They may also favor secondary pathologies (middle ear otitis, abnormal soft palate). Moreover the development of the immune system is also dependent of a normal function of the endoblastic epithelium of the pharyngeal pouches which is a part of the branchial system. Immune dysfunctions may therefore accentuate the severity of the ENT Infections.

Anthropometry↗
PubMedDate not supplied

Alterations of pineal gland and of T lymphocyte subsets in metastatic cancer patients: preliminary results.

Melatonin (MLT), the main hormone produced by the pineal gland, has been seen to play a role in antineoplastic activity either by exerting a direct inhibitory effect on cancer cell growth, or by stimulating the immune system. Moreover, MLT blood levels have been shown to be often increased in cancer patients. On the basis of these data, a study was started to evaluate what relation exists between MLT levels and T lymphocyte subsets in patients with metastatic solid neoplasm. The study included 28 patients (breast: 10; non-small cell lung: 18). None of the patients was previously treated for their metastatic disease. Abnormally high MLT levels and a low T helper/suppressor ratio (CD4/CD8) were seen in 10/28 and in 11/28 patients, respectively. Serum mean levels of MLT were significantly higher in patients with low CD4/CD8 ratio than in those with a normal ratio. These results would suggest that immune dysfunctions may represent a signal for MLT release from the pineal in patients with metastatic solid neoplasm.

Adult↗
PubMed1989

Acquired immune deficiency, myelodysplasia, and acute nonlymphocytic leukemia associated with monosomy 7 and t(3;3) (q21;q26) in a child with Langerhans cell histiocytosis.

A case of therapy-related myelodysplasia followed by acute nonlymphocytic leukemia in a 5-year-old child successfully treated for diffuse Langerhans cell histiocytosis is described. A syndrome of severe cell-mediated immune deficiency and persistent Epstein-Barr virus (EBV) infection coincided with the evolution of myelodysplasia. Specific abnormalities of chromosomes number 7 and 3 were associated with the onset of myelodysplasia and acute nonlymphocytic leukemia and are believed to be linked to the patient's immune dysfunction and compromised ability to contain viral infection.

Chlorambucil↗
PubMed1985

Leukocyte tubuloreticular inclusions in Reye's syndrome.

Tubuloreticular inclusions (TRI) have been observed in the rough endoplasmic reticulum of blood lymphocytes and monocytes in two cases of Reye's syndrome initiated by influenza infections. Tubuloreticular inclusions are seen in these mononuclear leukocytes during the acute phase of illness, but not during convalescence. Since TRI have been demonstrated in peripheral mononuclear leukocytes in patients with acquired immunodeficiency syndrome, systemic lupus erythematosus, and certain viral infections including T-cell leukemia, it may be that the finding of TRI in Reye's syndrome reflects a viral infection and/or immune dysfunction, if such association is not proved to be fortuitous.

Acute Disease↗
PubMed1989

Cerebral nocardiosis in immunosuppressed patients: five cases.

Five cases of 'primary' cerebral nocardiosis are described. All occurred in patients already affected by factors carrying a poor prognosis for nocardial infections. These included primary immune dysfunction, immunosuppressive drug therapy including high-dose prednisolone and the presence of cerebral nocardial abscesses. Three of the five patients died, but only two had evidence of continued nocardial infection at necropsy. This compares with mortality of 90 per cent reported in other studies. Therefore aggressive surgical and antibiotic treatment of cerebral nocardial abscesses may reduce the mortality rate in the immunocompromised to the rate seen in immunocompetent patients. We suggest that investigations of non-specific pulmonary symptoms in the immunocompromised should include a search for nocardial colonization as this is indicative of infection. Diagnosis of nocardial infection at the pulmonary stage rather than when central nervous system abscesses are present would lead to an improvement in prognosis.

Brain↗
PubMed1989

Antinuclear autoantibodies in chronic liver diseases.

Circulating autoantibodies are often observed in liver disorders, especially in those thought to have an autoimmune etiology-such as primary biliary cirrhosis (PBC) and chronic active hepatitis (CAH). The pathophysiologic role of these antibodies, however, remains obscure. The present study was performed to evaluate the incidence and diagnostic value of different antinuclear antibodies in chronic liver diseases, and to assess whether the antibodies are a non-specific expression of the hypergammaglobulinemia observed in these disorders. We measured six different antinuclear and closely related antibodies (against ssDNA, dsDNA, Poly (I), Poly (dT), RNA and cardiolipin) and their IgG, IgA and IgM isotypes in the sera of 86 patients with autoimmune, as well as other chronic liver diseases--namely, PBC, CAH, alcoholic (AC) and cryptogenic cirrhosis (CC). Antibodies against all the various nuclear antigens were detected in all diseases studied. The incidence ranged from 4% (anti-cardiolipin-IgG in CC) to 74% (anti-Poly (dT)-IgM in PBC). Although the antibody profiles differed among the various disease entities, they were not distinct enough to be of any clinical diagnostic value. In alcoholic cirrhosis antibody levels correlated with corresponding immunoglobulin isotype levels (notably IgA), suggesting a non-specific expression of hypergammaglobulinemia. In the other liver diseases such a correlation was lacking, favoring the existence of an underlying specific antigenic stimulation, or some other more specific immune dysfunction.

Adult↗
PubMed1989

[Castleman's disease (angiofollicular hyperplasia) in children].

This unusual clinicopathologic entity was first recognized by Castleman. Onset is usually in adolescence or early adulthood, occasionally childhood. A single, large mass with no tendency to compress develops, usually in the mediastinum, occasionally at other lymph node sites (superficial, retroperitoneal, abdominal), and exceptionally in extranodal locations. A variety of systemic manifestations may be found, including fever, anemia, hypergammaglobulinemia, and a broad spectrum of inflammatory and autoimmune disorders, presumably associated with specific humoral factors produced by the tumor. Histologic examination shows the characteristic features of angiofollicular lymph node hyperplasia. Two variants have been described, i.e., the plasma cell type (active stage) associated with systemic manifestations, and the hyaline vascular type (quiescent stage). Surgical removal of the tumor ensures permanent (local and systemic) recovery in the overwhelming majority of cases. A role of microorganisms in the etiology of this condition has been suggested. Identical histologic changes can be found in adults with immune dysfunction syndromes. The etiology, pathogenesis and nosology of this very benign disease are still poorly known.

Adolescent↗
PubMed1989

Immunological effects of zinc deficiency in sickle cell anemia (SCA).

Zinc deficiency occurs frequently in SCA subjects. Our studies have shown that several parameters of cellular immune functions may be altered in SCA subjects and related to a deficiency of zinc. These include anergy to certain common antigens, which was reversible following zinc supplementation, decreased activity of natural killer (NK) cells, decreased production of interleukin (IL-2), decreased T4/T8 ratio and serum thymulin. Inasmuch as we have observed similar immunological changes in human volunteers (non-SCA) in whom we restricted only zinc intake and produced a mild specific deficiency of zinc, we conclude that the above changes in SCA were due to zinc deficiency. Although it is well known that susceptibility to infections is a common problem in SCA subjects, the pattern of infections related to cell mediated immune dysfunction has not been well documented. Whether or not supplementation with zinc will alter the pattern of infection and decrease morbidity in SCA on a long-term basis remains to be determined.

Adult↗
PubMed1989

Population-based epidemiology of human immunodeficiency virus infection in Western Australia. Western Australian AIDS Advisory Committee.

A total of 328 cases of infection with human immunodeficiency virus (HIV) in Western Australia in 1983-1987 was studied with respect to demographic factors, the risk profile, the clinical progression of disease, the utilization of inpatient services and trends in incidence over time. The crude incidence rates were 8.8 cases/100,000 person-years in men and 0.4 cases/100,000 person-years in women. Age-specific rates peaked at 25 to 29 years of age in men. The risk of HIV infection was associated with metropolitan residence, low socioeconomic level, and two specific occupational groups. Homosexual and bisexual men constituted 86% of all cases; the incidence rate of HIV infection in such men was approximately 1000-times higher than was the incidence rate by apparent sexual transmission in heterosexual persons. However, the proportion of cases that occurred in women or that apparently was caused by heterosexual sexual transmission increased from zero in 1983-1984 to 7.5% and 5.4%, respectively, in 1987. After two years of follow-up, 71% of preclinical (category-C) patients had developed signs, symptoms or evidence of immune dysfunction, and 12% of those patients with lymphadenopathy or with other early clinical features of disease (category-B) had progressed to the acquired immunodeficiency syndrome (AIDS). At 21 months of follow-up, the survival rate with AIDS was 9%. Patients with AIDS utilized an average of 68.9 short-stay hospital bed-days per person-year, while category-B patients used 11.5 hospital bed-days per person-year. Notifications of HIV infection increased each year from 1983 to 1986, but fell by 22% in 1987. The latter may have been as a result of chance, a screening artefact or a real reduction in the incidence rate.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The interaction of the xid and me genes.

The murine "motheaten" (me) mutation has been bred onto the NFS background and combined with the X-linked immunodeficiency (xid) mutation to investigate the effect of the xid-induced B cell maturational block on the widespread immune dysfunction, high levels of autoantibodies, and early mortality found in the motheaten mice. The xid markedly reduced spontaneous IgM secretion by spleen cells, serum IgM, anti-ssDNA antibodies, anti-bromelain-treated-erythrocyte antibodies, and T cell binding (but not thymocytotoxic) antibodies; however, neither phenotype nor mortality was affected, suggesting that other factors are responsible for early death. Marked expansion of the Ly-1+ B cell pool was prevented by xid in the motheaten mouse leaving only a very small population of sIgM-positive B cells. This failure of non-Ly-1+ B cell development in me/me X xid mice suggests that me/me leads to inhibition of non-Ly-1+ B cells and preferential expansion of Ly-1+ B cells in motheaten mice, perhaps as a result of their high levels of maturation and activation factors.

Animals↗