Clinical studies of vernal keratoconjunctivitis (VKC) patients show that total IgE serum levels are increased even in the absence of IgE antibodies to common allergens. Activated eosinophils are also a constant feature of VKC at both the circulation (cytofluorimetry) and tissue (tear cytology and conjunctival scrapings) levels. Moreover, allergen challenge induces a prolonged inflammatory reaction with a prevalent participation of eosinophils, lymphocytes and possibly basophils. Immunohistochemical studies of VKC biopsies show a multicellular inflammatory infiltrate with prevalence of activated eosinophils, mast cells and CD4 lymphocytes in both epithelium and subepithelium. Mediator studies indicate that eosinophil products (eosinophil peroxidase, eosinophinal cationic protein and eosinophil-derived neurotoxin/eosinophil protein X) are increased in both serum and tears, where tryptase and interleukin (IL)-5 are also detectable in higher amounts than in controls. On the basis of these findings, we postulate that VKC can represent a phenotypic model of up-regulation of the cytokine gene cluster on chromosome 5q which through its products (IL-3, IL-4, IL-5 and granulocyte/macrophage-colony-stimulating factor) regulates Th2 prevalence, IgE production as well as mast cell and eosinophil growth and function in VKC.

Allergens↗

PubMedDate not supplied

Usefulness of (13)C-urea breath test in the diagnosis of gastric helicobacter pylori infection.

Helicobacter pylori chronically infects half of the human population and is associated with gastritis, peptic ulcer and gastric cancer. (13)C-urea breath test (UBT) is the main in vivo tool for the diagnosis of H. pylori infection. In this study, the safety and the accuracy of UBT were evaluated. A group of 492 dyspeptic patients was studied by UBT, the results were expressed as the difference over baseline at 30 min (DOB30). All patients were evaluated for systemic, gastrointestinal or allergic-type adverse reactions after ingestion of 75 mg (13)C-urea and citric acid in aqueous solution. The first 256 patients enrolled also underwent endoscopy and gastric biopsy. Patients positive on histology were considered infected. UBT was well tolerated and none of the 492 patients had any systemic or allergic-type adverse reaction. Among the 256 patients studied with histology, 116 were H. pylori positive on biopsies. Using 4 %o as cut-off value for DOB30,115 out of the 256 patients were positive on UBT, with only 2 false positive and 3 false negative. With this threshold, the sensitivity, specificity, and accuracy of the UBT were 97.4%, 98.5%, and 98.0%, respectively. (13)C-UBT has proven to be a safe and simple, yet accurate, test for the non-invasive diagnosis and monitoring of H. pylori infection.

Journal Article↗

PubMedDate not supplied

Pure traumatic dislocation of the elbow.

A total of 89 patients with simple traumatic dislocation treated at the Rizzoli Orthopaedic Institute between 1975 and 1986 were reviewed. The authors considered trauma mechanism, treatment, and results. The evaluation showed that elbow dislocation without joint fracture has a favorable prognosis with return to complete functions. Frequently, para-articular calcifications do not negatively affect joint function. Immediate reduction and plaster immobilization for 2 to 3 weeks are required to obtain soft tissue repair, and in order to avoid functional restriction as a result of prolonged immobilization. After removal of plaster active mobilization is sufficient to obtain complete joint function.

Adolescent↗

PubMedDate not supplied

Soluble CD30 and lymphocyte activation gene-3 (CD223), as potential serological markers of T helper-type cytokine response induced by acellular pertussis vaccine.

T cell responses are involved in vaccine-induced immunity to pertussis but no easy-to-monitor, serological markers are available to assess these responses. The lymphocyte activation gene-3 (CD223) molecule is present on, and released by, activated T helper (Th) 1 cells, whereas CD30 molecules have been associated with Th2 immune responses. Starting from the recent knowledge of the cytokine profile induced by pertussis vaccination, we examined the levels of soluble (s)CD223 and sCD30 proteins in child recipients of acellular pertussis (aP) and diphtheria-tetanus (DT) vaccines and in children receiving DT vaccine only, as control. The correlation of the two proteins with specific antibody and T cell responses was assessed. The main findings are: i) sCD223 and sCD30 levels are inversely related, suggesting that the two markers are the expression of different and counter-regulated T-cell responses; ii) sCD30 level correlated with induction of T cell proliferation to pertussis vaccine antigens and antibody response to pertussis toxin. Overall, sCD30 and sCD223 levels seem to be promising candidate markers to assess the induction of Th-type responses in vaccine recipients.

Antibodies, Bacterial↗

PubMedDate not supplied

Serological markers of pulmonary tuberculosis and of response to anti-tuberculosis treatment in a patient population in Guinea.

The aim of the study was to evaluate serological correlates of active tuberculosis and of response to antituberculosis treatment in a cohort of HIV-negative patients with pulmonary tuberculosis studied at diagnosis and during treatment at the Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea. Two similar cohorts of HIV-negative healthy households of patients and healthy community controls were included in the study. Plasma samples were obtained from 168 untreated tuberculosis patients, 167 healthy household controls, and 168 healthy community controls. Serial plasma samples were also obtained from the tuberculosis patients at 2 and 8 months after initiation of chemotherapy. IgG antibody levels were measured by an enzyme-linked immunosorbent assay (ELISA) using ten purified M. tuberculosis antigens. ELISA results were analysed by comparing geometric means of data. Of the ten antigens tested, five (14kDa Ag, 19kDa Ag, AlaDH, MS, and MPT83) elicited similar antibody responses in untreated TB patients and controls. In contrast, levels of three antibodies (ESAT-6, LAM, and 38kDa Ag) were higher in untreated TB patients than in household or community controls (p<0.0001). Levels were higher in untreated patients than in community controls also for the anti-Rv2626c antibody (p = 0.0001) and, at a lower significance level, for the anti-FdxA antibody (p<0.025). Antibody levels against ESAT-6 and Rv2626c decreased during therapy, while antibody levels to the 38 kDa antigen and LAM increased during therapy; FdxA antibody levels did not vary with treatment. Neither severity of presentation nor chest X-ray patterns affected levels of these antibodies before treatment. In contrast, after the 8-month therapeutic course, patients who presented with moderate/severe disease had higher levels of anti-ESAT-6, anti-FdxA, and anti-38kDa antibodies than those of patients with mild disease onset. Patients with bilateral lung lesions had significantly higher anti-38kDa and anti-LAM levels, both at diagnosis and after 8-month treatment, than patients with lesions involving only one lung. Antibodies to alanine dehydrogenase and malate synthetase measured at initiation of treatment were higher in tuberculosis patients who subsequently failed therapy than in those who were cured. The main conclusions of the study are: a) plasma levels of antibodies to a number of M. tuberculosis represent serological correlates of active disease; b) these correlates are affected in an antigen-specific fashion by anti-tuberculosis treatment; c) particular serological markers may be predictive of treatment outcome.

Adolescent↗

PubMedDate not supplied

Acute external capsuloligamentous lesions of the knee.

The authors discuss 18 cases of acute capsuloligamentous lesions of the external compartment of the knee submitted to surgical treatment. The results obtained by separately studying the progression of the various types of anatomical lesions revealed a relationship between the entity of the lesion and the results. Positive results were as follows: 100% in isolated lesions of the EC, 70% in lesions of the EC and ACL, 40% in lesions of the EC + ACL + PCL. In grade I distorsion trauma surgery is not indicated; in grade II lesions treatment is based on an objective examination in narcosis, and surgery should be performed when dynamic tests are positive; in grade III lesions surgery is always indicated. An objective examination in narcosis (rarely arthroscopy) is thus of essential importance to therapeutic indications.

Acute Disease↗

PubMedDate not supplied

Role of interleukins in induction and regulation of human IgE.

The studies on human IgE synthesis here summarized provide further insight into the cellular and molecular mechanisms involved in IgE regulation, as well as in the alterations responsible for IgE disregulation in some pathological conditions. They have clearly demonstrated that IL-4 is the essential factor for the induction of human IgE synthesis, since no substantial IgE production in vitro could be obtained in the absence of this lymphokine. Another T cell-derived lymphokine, IFN gamma, negatively regulates the IgE synthesis induced by IL-4. These two lymphokines can be produced by different T helper cells, as shown in mice, but they can also be the product of the same T cell clones. In such a case, the possibility that a given clone provides helper function for IgE seems to be dependent on the balance between the amounts of the two lymphokines produced. The IgE helper activity of rIL-4 appeared to be dependent on the presence in culture of appropriate concentrations of T lymphocytes, suggesting that T-B cell contact or other interleukins, such as IL-2 and IL-6, are needed in IL-4-dependent IgE synthesis. Finally, alterations of one or more of these regulatory mechanisms may play a crucial role in the pathogenesis of diseases characterized by a hyperproduction of IgE.

Animals↗

PubMedDate not supplied

New insights into the mechanisms which regulate IgE synthesis in man.

The studies summarized here provide further insight into the cellular and molecular mechanisms involved in the regulation of human IgE synthesis. They clearly demonstrate that IL-4 is the essential factor for induction of human IgE synthesis, since no substantial in vitro IgE production can be obtained in the absence of this lymphokine. Another T cell-derived lymphokine, IFN-gamma, negatively regulates the IgE synthesis induced by IL-4. These two lymphokines can be produced by different T helper cells, but they can also represent the product of the same T cell clone (TCC). In this case, the possibility that a given TCC provides helper function for IgE seems to be dependent upon the balance between the amounts of the two lymphokines produced. Additional cellular and/or molecular signals are involved in IL-4-dependent IgE synthesis. First of all, a direct T-B interaction is required to precede the activity of IL-4. This interaction does not necessarily consist of cognate interaction between T and B cells, as occurs for IgE synthesis induced by alloreactive TCC. In the presence of exogenous IL-4 virtually all CD4+, and even a number of CD8+, TCC can provide the signaling required by B cells to synthesize IgE. An interaction between some adhesion molecule, more expressed on activated than resting T cells, and its receptor on B cells is sufficient to prepare resting B cells to synthesize IgE in response to IL-4. Furthermore, T cells also contribute to IL-4-dependent IgE synthesis by releasing IL-2.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMedDate not supplied