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Immune function in patients treated with phenytoin.

Multiple immunologic side effects have been ascribed to phenytoin. Numerous reports in the literature discuss the possible cellular and humoral abnormalities that appear to be present in patients given phenytoin. The most consistent finding is a reduction in serum IgA found in up to 20% of patients. To resolve some of the conflicting studies on cellular immune status, 191 patients taking phenytoin were evaluated initially with an serum IgA determination, and then further immune studies were done on the 11% with IgA values lower than two standard deviations below the mean. Data collected included total lymphocyte counts, lymphocyte population studies, and responses to in vitro mitogen stimulation. Only 2 of 191 patients had serum IgA values less than 5 mg/dL, which is an incidence not significantly different than that in the population at large. The patients with decreased serum IgA values did not have an increased incidence of autoimmune phenomena, allergic disorders, gastrointestinal manifestations, or recurrent upper respiratory tract infections. Their cellular immune status showed no significant variations from control values. Thus it appears that routine monitoring of patients on phenytoin with serum IgA determinations is of limited value, and the immunologic side effects of phenytoin are not expressed as a cellular abnormality.

Adolescent↗

[Clinical observation on relationship of antioxidation criteria and immune function of erythrocyte in patients with asthenia syndrome].

Results of observation on 31 patients of Qi-Yin Deficiency Syndrome showed that as compared with normal person, the superoxide dismutase (SOD) activity of erythrocyte in patients was lowered, the content of serum lipid peroxide (LPO) increased, the rosette rate of red cell C3b receptor (RC3 bRR) lowered but that of red cell immune complex was elevated significantly (P < 0.01). There were a positive correlation between erythrocyte SOD activity and RC3bRR (r = 0.381, P < 0.05), and a negative correlation between serum LPO level and RC3bRR (r = -0.395, P < 0.05).

Aged↗

Preliminary evidence for partial restoration of immune function in HIV type 1 infection with potent antiretroviral therapies: clues from the Fourth Conference on Retroviruses and Opportunistic Diseases.

Critical advances in understanding the pathogenesis and treatment of HIV-1 infection have been made. These include the following: delineation of the replication kinetics of HIV in all stages of disease, underscoring the role of viral replication in disease pathogenesis; development of highly sensitive quantitative assays to determine viral load in infected individuals; and potent new antiretroviral drugs, the availability of which has provided a tool for the investigation of viral pathogenesis and immunopathogenesis, and has permitted the demonstration of the clinical efficacy of combination therapies. The results of studies of potent antiretroviral combination therapies presented at the Fourth Conference on Retroviruses and Opportunistic Infections (January 22-26, 1997, Washington, D.C.) demonstrate that such therapies are capable of at least partially restoring the immune system that is damaged by infection with HIV-1. This includes evidence for the ability of potent therapies to begin to reverse the abnormalities of maturation, activation, and function that are attributable directly or indirectly to the CD4+ helper T lymphocyte population.

Anti-HIV Agents↗

Dietary carotenoids and human immune function.

The colorful group of compounds known as carotenoids are present in many plants, where they provide photoprotection and act as accessory pigments in photosynthesis. Many epidemiologic studies have shown strong associations between diets rich in carotenoids and a reduced incidence of many forms of cancer, and that finding led to the suggestion that the antioxidant properties of those compounds might help protect immune cells from oxidative damage, thus enhancing their ability to detect and eliminate tumor cells. Since the early 1980s, there have been reports supporting that hypothesis. However, more recently, after large prospective studies did not show protective effects of beta-carotene supplementation, more attention has been given to studies defining optimal levels of intake that can be achieved within a well-balanced diet. The latest intervention studies have suggested that, in well-nourished, healthy individuals, a moderate level of carotenoid supplementation is neither beneficial nor harmful. However, supplementation might be appropriate in undernourished or less healthy individuals, particularly if they are elderly. Future studies comparing supplements with real foodstuffs, combined with postgenomic technologies, will help define optimal intakes for different sectors of the population.

Antioxidants↗

Strategies to enhance immune function in hematopoietic transplantation recipients who have fungal infections.

The challenges in the treatment of systemic fungal infections after HSCT include: (1) changing epidemiology as less drug-susceptible saprophytic fungi are increasingly associated with human disease; (2) the difficulty of early and correct diagnosis, even with the new generation of enzymatic immunoassays; (3) the inability to reduce or eliminate predisposing factors, especially severe immune suppression in most transplant patients with these infections and (4) the uncertain role of antifungal drug combinations and risk of drug antagonism complicating effective empiric-pre-emptive therapy. Current, developing and future immune enhancement strategies including recombinant granulocyte- and granulocyte macrophage-colony stimulating factor (GM-CSF), interferon-gamma (IFN-gamma), adjuvant pro-inflammatory cytokine therapy during mobilized donor granulocyte transfusions, therapeutic potential of pentraxin, adaptive immune transfer and dendritic cell fungal vaccines. Improved understanding of the molecular pathogenesis of fungal infections and of the complexity of host antifungal immune responses has provided the critical information to readdress existing treatment paradigms and further evaluate the role of GM-CSF and IFN-gamma early in the course of therapy against life-threatening fungal infections in high-risk patients following stem cell transplantation.

Antifungal Agents↗

In vitro effects of nickel-sulphate on immune functions of normal and nickel-allergic subjects: a regulatory role for zinc.

Nickel hypersensitivity represents a very common human disease state, mainly occurring in females, defined as allergic contact dermatitis. Ni is a transition metal whose activity may be modulated by congeners. Zinc, an essential component for living organisms, has been shown to counteract Ni effects in patients with Ni hypersensitivity. We analysed immune responses to both Ni and Zn in healthy subjects and patients with allergic contact dermatitis to Ni. Our in vitro results show that Ni modulates surface receptors expression, reduces phytohemagglutinin (PHA)-driven lymphoproliferation, and upregulates some proinflammatory cytokines production, including interferon (IFN)-gamma. Zn also induced CD4+ lymphocyte proliferation, but it abolished or reduced most Ni-mediated effects. Our data are consistent with the hypothesis that Zn and Ni, as part of the heavy transition metals, may exchange roles in immune-mediated phenomena leading to expression of allergic contact dermatitis.

Adult↗

[The effect of plasmapheresis and the plasmasorption and immunosorption of low-density lipoproteins on the humoral immunity function of patients with hereditary hypercholesterolemia].

It has been shown that prolonged use of plasmapheresis with a 7-day interval in patients with hereditary hypercholesterolemia is potentially dangerous because of possible development of immunodeficiency. LDL plasmasorption and immunosorption produce a beneficial effect on the concentration of immunoglobulins. It is assumed that immunosorption permits the elimination not only of lipoproteins but also lipoprotein-containing immune complexes from the blood channel.

Adolescent↗

An in vitro model to assess mucosal immune function and bacterial translocation.

The importance of secretory immunoglobulin A (IgA) on intestinal barrier function has gained increasing acceptance. However, due to the complexity of the intestinal microenvironment, the relative role of secretory IgA (sIgA) in mucosal defense has been difficult to study in vivo. Polarized Madin-Darby canine kidney (MDCK) epithelial cells expressing the complementary DNA (cDNA) for the polymeric Ig receptor were grown as monolayers in an in vitro two-chamber cell culture system to study the impact of sIgA on bacterial translocation (BT). Polymeric sIgA or media alone was added to the apical chambers of cell monolayers followed by apical inoculation with bacteria. The basal compartment was sampled at timed intervals thereafter to determine BT. Bacterial passage across the MDCK epithelial cell monolayers occurred in a time and bacterial inoculum concentration gradient. Addition of sIgA led to significant reductions in BT across the epithelial cell monolayers. This is a useful model for further investigation on the role of sIgA in intestinal barrier function.

Animals↗

Effects of methyl-B12 on the in vitro immune functions of human T lymphocytes.

Studies were performed using an in vitro assay system to determine whether or not methyl-B12 could affect human T-cell function. When T cells were stimulated with phytohemagglutinin and allogeneic B cells, methyl-B12 did not enhance T-cell proliferation. In contrast, remarkable enhancing effects of methyl-B12 on the proliferative response to concanavalin A (Con A) and autologous B cells at suboptimal concentrations were observed, ranging from 0.1 to 10 micrograms/ml. Concentrations of methyl-B12 sufficient to enhance cellular proliferation were able to enhance the activity of helper T cells for immunoglobulin synthesis of B cells by pokeweed mitogen. Furthermore, the presence of methyl-B12 significantly potentiated the induction of suppressor cells in Con A-activated cultures. These results suggest that methyl-B12 could modulate lymphocyte function through augmenting regulatory T-cell activities.

Antibody-Producing Cells↗

Absence of linkage between idiopathic dilated cardiomyopathy and candidate genes involved in the immune function in a large Italian pedigree.

Idiopathic dilated cardiomyopathy (IDC) is a heart disease of unknown aetiology characterised by impaired ventricular function usually associated with dilatation of the cardiac chambers. In order to test the hypothesis of an immunological cause for the disease at the genetic level, we performed linkage analysis between the putative disease locus and some of the potential candidate genes involved in the immune response or coding for the targets for autoantibodies in a large multigeneration family (63 members) from southern Italy with autosomal dominant transmission of the disease. Twenty-nine polymorphic markers on 18 different chromosomal locations were investigated, including markers linked to the genes coding for the HLA antigens, the immunoglobulin heavy and light chains, the receptors for the immunoglobulin Fc fragments, the subunits of the T cell receptor and the associated CD3, CD4, CD8, and CD45 antigens, interleukins 1, 3, 4, 5, 6, 9, and 11, the interleukin 1 and 2 receptors, and the genes coding for the beta 1 adrenoreceptor, the adenine nucleotide translocator-1, and the cardiac alpha and beta myosin heavy chains. No evidence for genetic linkage to IDC was found at any of these candidate loci. These results indicate that the still unidentified IDC gene maps outside several loci involved in the regulation of immune reactivity.

Adult↗

Complex effects of long-term 50 Hz magnetic field exposure in vivo on immune functions in female Sprague-Dawley rats depend on duration of exposure.

In previous studies we have demonstrated that 50 Hz, 100 microT magnetic field (MF) exposure of female Sprague-Dawley rats for 13 weeks significantly enhances the development and growth of mammary tumors in a breast cancer model. The present study was designed to test the hypothesis that, at least in part, the tumor (co)promoting effect of MF exposure is due to MF effects on the immune surveillance system, which is of critical importance in protecting an organism against the development and growth of tumors. For this purpose, female Sprague-Dawley rats of the same age as in the mammary tumor experiments were continuously exposed for different periods (2, 4, 8, and 13 weeks) to a 50 Hz, 100 microT MF. Control groups were sham-exposed simultaneously. Following the different exposure periods, splenic lymphocytes were cultured and the proliferative responses to the T-cell-selective mitogen concanavalin A (Con A) and the B-cell-selective pokeweed mitogen (PWM) were determined. Furthermore, the production of interleukin-1 (IL-1) was determined in the splenocyte cultures. The mitogenic responsiveness of T cells was markedly enhanced after 2 weeks of MF exposure, suggesting a co-mitogenic action of MF. A significant, but less marked increase in T-cell mitogenesis was seen after 4 weeks of MF exposure, whereas no difference from sham controls was determined after 8 weeks, indicating adaptation or tolerance to this effect of MF exposure. Following 13 weeks of MF exposure, a significant decrease in the mitogenic responsiveness of lymphocytes to Con A was obtained. This triphasic alteration in T-cell function (i.e., activation, tolerance, and suppression) during prolonged MF exposure resembles alterations observed during chronic administration of mild stressors, substantiating the hypothesis that cells respond to MF in the same way as they do to other environmental stresses. In contrast to T cells, the mitogenic responsiveness of B cells and IL-1 production of PWM-stimulated cells were not altered during MF exposure. The data demonstrate that MF in vivo exposure of female rats induces complex effects on the mitogenic responsiveness of T cells, which may lead to impaired immune surveillance after long-term exposure.

Animals↗

[The effect of carbon dioxide baths and applications of low-temperature peloids on the immune function of patients with psoriatic arthritis].

A trial of dry air effervescent baths and low-temperature peloid applications was made in 109 patients with psoriatic arthritis (PA). Marked response was achieved in patients who had received combined therapy with the above two modalities. The effect presented with lower articular index, weaker skin involvement, improvement of blood picture. These positive changes correlated with normalization of immune indices. The benefit persisted for 6-9 months.

Analysis of Variance↗