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Biomedical subjects

F Speranza

Publications and source records attributed to F Speranza.

47 records · Page 3Linked to original sources

Dermatologic manifestations of AIDS in children.

A wide variety of clinical expressions of the acquired immunodeficiency syndrome (AIDS) has been apparent from the earliest case reports in adult patients and pediatric patients. Both human immunodeficiency virus (HIV) infection and AIDS in children are associated with an increased prevalence of several dermatologic manifestations. In this article we present a review of the recent literature describing the cutaneous manifestations of pediatric AIDS. The cutaneous manifestations of AIDS in children can be divided into three categories: (1) neoplastic manifestations; (2) viral, bacterial and fungal manifestations, and (3) vascular lesions and other manifestations. Pediatricians as well as dermatologists may be the first physicians to recognize and to treat the clinical manifestations of AIDS.

Acquired Immunodeficiency Syndrome↗

Chemotactic activity of pertussis toxin on murine lymphocytes. Its potential role on lymphocyte accumulation in the lung.

The effects of pertussis toxin on lymphocyte migration were studied in vitro. In this study pertussis toxin significantly stimulated lymphocyte migration at concentrations of 0.1 and 1 microgram ml-1 using a microchamber and the leading-front method. Checkerboard analysis demonstrated that pertussis toxin causes directed migration of lymphocytes (chemotaxis). Heat-treatment pertussis toxin abolished its capacity to cause this migration. When murine lymphocytes were preincubated with different concentrations of pertussis toxin, an inhibition of chemotaxis at the dosages of 0.1 and 1 microgram ml-1 was observed. On the other hand, lymphocytes derived from mice treated with pertussis toxin were not inhibited after subsequent exposure to pertussis toxin in vitro. Since lymphocyte accumulation in the lungs of mice treated with pertussis toxin has been well demonstrated, the results of our study could suggest a chemotactic activity of pertussis toxin in determining accumulation of lymphocytes in this organ.

Animals↗

Effects of recombinant human interleukin-1 beta on accumulation of inflammatory peritoneal macrophages in mice treated with pertussis toxin.

In this study we report that treatment with recombinant human interleukin-1 beta (rIL-1 beta) (10 U per mouse, intraperitoneally) significantly increased the number of inflammatory macrophages in the peritoneal cavity of mice treated with pertussis toxin (PT) (1 micrograms per mouse, intravenously). The administration of rIL-1 beta in a single intraperitoneal dose (10 U per mouse) 1 or 2 days before challenge with PT did not prevent the decrease in the number of inflammatory macrophages in the peritoneal cavity of mice. On the other hand, the simultaneous administration of rIL-1 beta and PT, as well as the administration of rIL-1 beta 24 h after injection of PT, significantly counteracted the inhibitory effect of PT on inflammatory peritoneal macrophages.

Animals↗

Cyclic AMP levels in lung and spleen tissue of mice treated with pertussis toxin.

The effects of pertussis toxin (PT) on cyclic adenosine monophosphate (cAMP) metabolism in lung and spleen tissue of mice were studied. We observed a marked lymphocyte accumulation and concomitant weight increase in the lungs of mice treated with PT. On the contrary, a rapid lymphocyte depletion was observed in the spleens of PT-treated mice. The effects of PT on cAMP metabolism were partially evident in the lungs where early increased levels of cAMP were observed. On the other hand, decreased levels of cAMP in spleen tissues were observed at the time of maximum lymphocyte depletion of such organ.

Animals↗

Levels of nitric oxide, gamma interferon and interleukin-12 in AIDS patients with toxoplasmic encephalitis.

The production of nitric oxide (NO) by macrophages is important for the killing of intracellular pathogens, such as Toxoplasma gondii. Gamma interferon (IFN-gamma) and lipopolysaccharide stimulate NO production. The aim of this study was to investigate the importance of NO, IFN-gamma and interleukin-12 (IL-12) in the host immune response in AIDS patients suffering from toxoplasmic encephalitis (TE). It was demonstrated that the production of NO, detected as nitrite/nitrate in the sera and in the cerebrospinal fluid (CSF) of 32 AIDS patients with TE, was normal. In addition, levels of IFN-gamma in the sera and in the CSF of patients with TE were not increased. In contrast, serum levels of IL-12 in these patients were significantly increased (6.5 +/- 7.1 pg/ml; P = 0.0368), compared to the control patients (1.7 +/- 3.5 pg/ml). Furthermore, increased but not significant levels of IL-12 were also observed in the CSF of patients with TE (2.2 +/- 4.7 pg/ml; controls: 0.5 +/- 1.9 pg/ml). The results of this study indicate that reactivation or recurrence of T. gondii infection in HIV-1-infected patients is probably due to a down-regulation of IFN-gamma along with a resulting non-optimal NO activity.

AIDS-Related Opportunistic Infections↗

Meningoencephalitis caused by human herpesvirus-6 in an immunocompetent adult patient: case report and review of the literature.

Human herpesvirus-6 (HHV-6) is the etiologic agent of roseola infantum, and has been implicated as a possible cause of encephalitis in pediatric and adult patients. A case of meningoencephalitis in an otherwise healthy, immunocompetent 59-year-old woman is described. The diagnosis of HHV-6 meningoencephalitis was confirmed by detecting viral DNA in cerebrospinal fluid collected in the acute stage of the disease by polymerase chain reaction. The patient was treated with acyclovir and recovered without any sequelae. The current knowledge of the pathophysiology, clinical course and outcome of HHV-6 meningoencephalitis in immunocompetent adult patients is also reviewed.

Diagnosis, Differential↗

Levels of circulating nitrate/nitrite and gamma interferon not increased in uncomplicated malaria.

The purpose of this study was to evaluate nitric oxide (NO) activity in patients with uncomplicated malaria. Lipopolysaccharide and gamma interferon (IFN-gamma) are potent inducers of NO by inducing production of NO synthase. NO activity was determined by measuring serum levels of nitrite/nitrate (metabolic end products of NO), and IFN-gamma in patients with uncomplicated malaria, mostly caused by Plasmodium falciparum. Neither serum levels of nitrite/nitrate nor of IFN-gamma were significantly increased in patients with uncomplicated malaria, especially in patients with P. falciparum infection, and in those with high parasitaemia. These results show that NO cannot play a role in uncomplicated malaria, and it is still debatable if NO production in this infection has beneficial or detrimental effects.

Adult↗

Nevirapine or efavirenz combined with two nucleoside reverse transcriptase inhibitors compared to HAART: a meta-analysis of randomized clinical trials.

PURPOSE: A meta-analysis of randomized controlled trials (RCTs) was performed to evaluate effectiveness and tolerability of triple antiretroviral therapy regimens in HIV-infected patients. METHOD: RCTs including the nonnucleoside reverse transcriptase inhibitors (NNRTIs) nevirapine (NVP) or efavirenz (EFV) compared to two nucleoside reverse transcriptase inhibitor (NRTI) regimens and to three-drug regimens based on two NRTIs and one protease inhibitor (PI; highly active antiretroviral therapy [HAART]) were analyzed by Peto's method. RESULTS: A significant virological response was observed in patients treated with NNRTIs (odds ratio [OR] 3.6; 95% CI, 2.2-6.0), particularly in naïve patients (OR 7.4; 95% CI, 4.1-13.5). A fair reduction of HIV disease progression was also observed in patients treated with NNRTIs (OR 0.8; 95% CI, 0.6-1.0). Moreover, a significantly lower rate of HIV progression was observed in patients with a CD4 + lymphocyte count below 100/mm(3). Five RCTs comparing two NRTIs and one NNRTI to HAART were subsequently evaluated. A slightly higher rate of virological response was observed with NNRTIs (OR 1.6; 95% CI, 1.1-2.1), whereas no difference was observed concerning progression of HIV disease. CONCLUSION: Antiretroviral therapy including NVP or EFV was more effective in reducing viral load than therapy with only two NRTIs and was slightly more effective than HAART. Effectiveness in delaying HIV disease progression was less evident, even though lower rate of progression was observed in patients with advanced HIV infection compared to two NRTIs alone.

Alkynes↗

Serum levels of interleukin-18 in patients with uncomplicated Plasmodium falciparum malaria.

Interleukin (IL)-18, a newly discovered cytokine produced primarily by macrophages, has been shown to induce gamma interferon (IFN-gamma) production by natural killer cells, to induce the T helper type 1 response. To further elucidate the role of this cytokine in uncomplicated malaria caused by Plasmodium falciparum, serum levels of IL-18, and gamma interferon (IFN-gamma), determined by an immunoenzymatic assay, were analyzed in 40 adult patients, and in 15 healthy control subjects. A significant increase in serum levels of IL-18 was observed in patients with uncomplicated P. falciparum malaria on admission, whereas serum levels of IFN-gamma tended to increase although not significantly. Serum levels of IL-18 decreased three days later, but still remained significantly high, whereas IFN-gamma levels returned to normal levels compared to the controls. No significant correlation was found between parasitemia and serum levels of IL-18 and IFN-gamma. The increase of IL-18 levels during acute and recovery phases of uncomplicated P. falciparum malaria may reflect a proinflammatory role of IL-18 in these patients. An early and effective immune response regulated by proinflammatory Th1 cytokines, including tumor necrosis factor (TNF), interleukin (IL)-12, and possibly IFN-gamma may limit the progression from uncomplicated malaria to severe and life-threatening complications.

Adult↗

Effects of interleukin-8 on suppression of human lymphocyte polarization and migration by anti-LFA-1 antibody.

We investigated the role of lymphocyte function-associated antigen 1 (LFA-1) in human T cell polarization and migration assay by using monoclonal antibody specific to beta chain (CD18) and alpha chain (CD11a). T cell polarization in response to fetal calf serum (FCS) and colchicine was suppressed by the addition of CD18 and CD11a antibodies. Furthermore, T cell migration in response to lymphocyte chemotactic factor (LCF) and casein was markedly depressed by the addition of CD18 and CD11a antibodies. Additional studies to evaluate effects of interleukin 8 (IL-8) on polarization and migration of T cells preincubated with CD18 or CD11a antibody showed that IL-8 restored the capability of migration of T cells, whereas did not restore polarization activity of such cells. These studies indicate that LFA-1 plays a role in the polarization and migration of T cells and that IL-8 may positively interfer with LFA-1-adhesion molecules.

Antibodies, Monoclonal↗