Polymorphonuclear leukocyte bactericidal capacity and opsonisation in patients with functioning renal allografts.
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Biomedical subjects
Publications and source records attributed to F M Gotch.
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The effect of prednisolone on various immunological parameters was studied in patients with ulcerative colitis in complete remission. The study was designed as a double blind trial in which patients received either prednisolone or a dummy preparation and the following observations were made:(1) The mean lymphocyte count fell from 1738 cells per mm3 to 501 cells/mm3 4 hr after prednisolone was given but by 24 hr was significantly elevated to 2399 cells/mm3; thereafter it returned to normal levels. (2) Surface marker assays of lymphocytes forming spontaneous sheep cell (E), Fc (EA), and C3 (EAC) rosettes; and cells bearing surface immunoglobulin fluctuated in approximately the same pattern as the total lymphocyte count. (3) The mitotic response to a sub-maximal stimulating dose of phytohaemagglutinin (PHA) was significantly depressed 4 hr after steroid administration but returned to normal by 24 hr. (4) Spontaneous and PHA-induced lymphocyte mediated cytotoxicity fell significantly by four hours and remained depressed to the end of steroid administration. The PHA-induced cytotoxicity was still significantly depressed 7 days after steroid administration was stopped. (5) K-cell cytotoxicity did not follow the general pattern and was only slightly reduced at four hours being lowest after 24 hr and still depressed 7 days after cessation of steroid administration. (6) The number of plasma cells in the rectal lamina propria showed no significant change after one week of steroid administration. (7) No significant changes occurred in any of the above assays, in the control group. (8) Polymorphonuclear leucocyte counts rose sharply by 4 hr in the patients receiving prednisolone. There was also a smaller but significant rise in the control group. They remained elevated for 7 days in the group receiving prednisolone, and subsequently fell to normal levels. The control group had returned to initial levels by 24 hr.
Three patients are described with anorexia nervosa in whom malnutrition was present with neutropenia and a granulocyte bactericidal degect. Their peripheral blood granulocytes were found to have a reduced rate of killing of Staphylococcus aureus and E. coli in vitro. The opsonic activity of the patients' sera towards Staphylococcus aureus was normal. One of these patients had recurrent episodes of infection which stopped after she had gained 13 kg in weight. Clinical recovery was associated with a return of granulocyte function to normal. It is concluded that granulocyte bactericidal capacity towards a variety of bacteria may be reduced in patients with anorexia nervosa who have malnutrition. This type of acquired granulocyte bactericidal deficiency appears to be reversible.
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