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E Pizzigallo

Publications and source records attributed to E Pizzigallo.

52 records · Page 3Linked to original sources

Interleukin-4 and interferon-gamma production during HIV-1 infection and changes induced by antiretroviral therapy.

Several lines of evidence indicate that a switch of the cytokine pattern from a predominant type 1 (antiviral and cell mediated response) to type 2 (polyclonal humoral immune response) occurs during the course of Human Immunodeficiency Virus-1 (HIV-1) infection, and represents a key event in the progression of immunodeficiency and dysregulated immune activation. We proposed to further investigate this immunological aspect of HIV-1 disease, in naive and in patients treated with Highly Active Antiretroviral Therapy (HAART). The prototypic cytokines chosen were Interleukin (IL)-4 and Interferon-gamma (IFN-gamma), whose in vitro production was determined in mononuclear cell cultures stimulated with different T lymphocyte mitogenic agents (anti-CD3, Phytohaemoagglutin-P -PHA-, E. coli B04/035 Lipopolysaccharide -LPS-). We classified all the patients on the basis of the number of CD4+ lymphocytes and we found a progressive, even if not significant decrease in the baseline production of IFN-gamma with the progression of the immunodeficiency. The mean value of baseline IFN-gamma in the group of patients with CD4+>500 cells/microL was 7.79 +/- 3.1 pg/mL while in the group with CD4+<200 cells/microL it was 4.66 +/- 2.22. We didn't find significant differences in the baseline production of IL-4 in these groups and in IFN-gamma and IL-4 production in LPS-stimulated cultures. We also re-assessed 12 patients after one year's follow-up. They presented a significant increase in IFN-gamma production compared to the first assessment in the LPS-stimulated cultures (baseline IFN-gamma 2.87 +/- 1.17 pg/mL, after 12 months 19.15 +/- 5.19 pg/mL; p= 0.03). In the 12 patients in follow-up IL-4 production showed a decreased in PHA-stimulated cultures with mean values of 16.65 +/- 14.32 pg/mL at baseline and 6.54 +/- 6.54 pg/mL after follow-up. These results highlight the immunorestoring effects of HAART. IL-4 production was lower in the treated subjects compared to the naive ones in PHA-stimulated cultures (mean values: IL-4=13.42 +/- 11.08 pg/mL in the naive patients and 9.75 +/- 65 pg/mL in the treated patients). The IFN-gamma values in anti-CD3 stimulated cultures were also higher in the treated patients, but this increase was not significant.

Adult↗

Study of immune alterations in patients with chronic fatigue syndrome with different etiologies.

The Chronic Fatigue Syndrome (CFS) is characterized by symptoms lasting for at least six months and accompanied by disabling fatigue. The etiology of CFS is still unclear. At the National Center for Study of the Infectious Diseases Department of the Chieti University some immune investigations were performed with the purpose of detecting markers of the disease. CD4+, CD8+, NK CD56+ and B CD19+ lymphocytes were studied in 92 male and 47 female patients and in 36 control subjects. CFS patients were divided in three groups with a post-infectious onset (PI-CFS), an non post-infectious onset (NPI-CFS) and a non post-infectious onset with associated infections (NPI-CFS + AI). Both CD4+ and CD8+ lymphocytes were reduced in the CFS patients. However, the CD4+/CD8+ ratio was increased in the CFS patients without difference between males and females. CD56+ cells of CFS patients were also reduced. In particular, blood CD56+ cells counts were significantly higher in PI-CFS patients than in the NPI-CFS subjects. These data confirm our preliminary results suggesting a key-role of a dysfunction of the immune system as a precipitating and-or perpetuating factor of the syndrome.

Adult↗

[New vaccinations: compulsory or not?].

In order to contribute to the discussion of compulsory vaccinations a brief review of those vaccines that have been extensively used so far is presented. Such review reflects the urgency to update the vaccine schedule presently in use in our country, following WHO recommendations. In Italy, hepatitis B vaccination will soon be made compulsory by law for all newborns and children at the age of 12. As far as measles, mumps and rubella are concerned there is no universal agreement on whether to vaccinate the newborns or not because there is a theoretical risk of delaying the occurrence of these infections to a later age. Such risk could be easily reduced by allowing for booster doses of vaccine at the beginning of primary school. Only pilot studies would provide evidence on the effectiveness of the new vaccines for whooping cough and varicella-zoster and on the opportunity of vaccinating newborns for these infections. For all the others available and experimental vaccines it is too early to consider their inclusion among the compulsory vaccines although the rapid pace of the research in this field makes it quite likely that vaccination schedule will be soon extended.

Hepatitis B↗

Indicative morphological myelodysplastic alterations of bone marrow in overt AIDS.

In HIV infection, numerous alterations of the hematopoietic system, with frequent cytopenias in peripheral blood and dysplasia of the bone marrow, have been observed. In order to assess the incidence of the myelodysplastic anomalies, 69 bone marrow aspirate smears from 47 patients with group IV HIV infection, as classified by CDC, have been studied. Various degrees of myelodysplastic alterations were found in all cases; however, dysgranulopoiesis was more frequent and more accentuated than other kinds of dyshematopoiesis. Intense vacuolization, especially in the granuloblastic series, was very frequent. It is felt that a bone marrow configuration that is highly indicative of overt AIDS can be sketched. The human immune deficiency virus may be either directly or indirectly responsible for myelodysplastic alterations.

Acquired Immunodeficiency Syndrome↗

[Visceral leishmaniasis in patients with AIDS. Description of 2 cases].

Cell-mediated immunity plays a pivotal role in the pathogenesis and in the recovery mechanisms of visceral leishmaniasis (V.L.). This disease, observed in two patients with AIDS, has peculiar anatomical and clinical characteristics and it is usually characterized by a severe clinical course. In addition, V.L. has been proposed to be included among the relevant infections for the case definition of AIDS. We describe two cases of V.L. occurred in association with AIDS. The most relevant characteristics of our cases are the followings: Diagnosis has been achieved by the identification of Leishmania donovani in the macrophages of the bone marrow in both the patients, and of the lymph node in one patient. The detection of anti-Leishmania antibodies was positive in one patients only. A significant defect of CD4+ cells was documented in both the patients. V.L. was associated in one patient with esophageal candidiasis, disseminated tuberculosis, P. carinii pneumonia; and in the other one with cerebral toxoplasmosis, pulmonary tuberculosis, esophageal candidiasis, Kaposi's sarcoma, CMV hepatitis. Specific chemotherapy has been partially or totally ineffective in both the patients. In fact, chemotherapy led to an apparent transient recovery in one patient, followed by a symptom-free period of more than one year. We think that V.L. has been the first infection occurred in this patients, beside of HIV infection. At the time of the first observation, the clinical conditions of this patient were satisfactory and there was only a slight alteration in cellular immunity. The detection of leishmania in bone marrow was coincident with the onset of fever, the development of a wasting syndrome and a dramatic decrease in cell-mediated immunity. A second cycle of specific treatment has been ineffective and the patient died. On the contrary, the second patient did not respond to the specific treatment and died. Two important anatomo-pathological characteristics were present in our cases: a) the presence of the parasite in several organs, namely bone marrow, spleen, liver. b) the absence of granulomatous lesions which indirectly indicates the defect in cell mediated immunity.

Acquired Immunodeficiency Syndrome↗

[Study on the immunoglobulin class of the antibody anti-e in acute HBsAg+ hepatitis and in asymptomatic carriers of HBsAg (author's transl)].

The AA. have determined the immunoglobulinic appartenence class of HBeAb in patients with acute hepatitis HBsAg+ and in asymptomatic carriers of HBsAg. In these the HBeAb belongs constantly to the IgG class, while in acute hepatitis patients this antibody results present in the IgM and IgG fractions of the sera. Especially, in patients with acute hepatitis the presence of HBeAb was observed only in some sera obtained during the tardive phase of disease.

Acute Disease↗

[Detection of HBsAg and the related antibody (HBsAb) with the radioimmunological method. Behavior of the HBeAg-HBcAb system in HBsAg-positive patients].

A radioimmunological assay was made of HBsAg and HBsAb in 183 patients during the course of acute viral hepatitis, 23 with prior HBsAg-positive hepatitis, 72 with chronic liver disease, 822 blood donors, 44 patients and 28 staff members from two dialysis centres, and the medical and paramedical staff of several high-risk departments. Microimmunodiffusion on agar was also used to determine HBeAg and HBeAb in the same 183 acute hepatitis patients, 37 HBsAg+ blood donors, 20 asymptomatic HBsAg carriers, the patients of two haemodialysis centres and the staff of departments at high risk for hepatitis B. Attention is drawn to the marked incidence (5.5%) of chronic HBsAg carriers in the blood donors, and the considerable circulation of virus B in the population examined, HBsAb-positivity (27.6%) being also an expression of this. Stress is also laid on the diagnostic and prognostic significance of the study of the HBsAg-HBsAb system during acute and chronic hepatitis. The importance of serum hepatitis B markers in the transmission of this disease in dialysis centres and other high-risk departments and in its prevention is underscored. Lastly, emphasis is laid on the appreciable progress that analysis of the e-anti-e system offers in the prognostic assessment of type B hepatitis, attention being also drawn to the fact that the dynamics of this system is even more complex and interesting than had first been thought. An assessment of this kind is useful in the differentiation of "contagious" and "non-contagious" HBsAg carriers.

Antibodies, Viral↗