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Retinal cotton-wool-like spots: a marker for AIDS?

The prognostic value of ocular manifestations and its correlation with immune changes in HIV-infected subjects was studied longitudinally with an average follow-up of one year (3-22 months). The most common ocular manifestations were retinal cotton-wool-like spots, observed in 58.8% of AIDS patients and in 76.9% of those with ocular involvement. Two of three ARC cases with cotton-wool-like spots developed Pneumocystis carinii pneumonia a few weeks after ophthalmoscopic examination. A close correlation between ocular changes and decrease of CD4+ lymphocytes was observed. In our opinion, these ocular manifestations are as useful as opportunistic infections or AIDS-related neoplasias in the natural history of HIV infection.

AIDS-Related Complex↗

[Evaluation of the immunological effectiveness of the planned vaccinal prophylaxis of diphtheria and tetanus in Sverdlovsk and Sverdlovsk Province].

The level and intensity of antitoxic immunity to diphtheria and tetanus in children and adolescents were determined. The presence of tetanus antitoxin in titers exceeding the protective level in 96.3-98.5% of the examined children and adolescents is indicative of a high actual coverage by immunization. Protective titers against diphtheria were lower. There was no essential difference in the levels of protection in children immunized according to the vaccination schedule and in those immunized with some deviations from this schedule. A considerable part of newborns and children aged 3 months had antibodies to diphtheria and tetanus antitoxins. After the third booster immunization changes in antidiphtheria immunity characteristics occurred only in 2.5% of the vaccines and no changes in antitetanus immunity characteristics were observed.

Adolescent↗

[LAV infections and the acquired immunodeficiency syndrome in infants].

The clinical and immunologic abnormalities of 7 infants with Lymphadenopathy Associated Virus (LAV) infection are reported. Indicative immune changes, positive anti-LAV serologic test and/or virus isolation led to the diagnosis. In a case with a particularly severe form of the disease, whose mother died from AIDS, serologic tests and virus isolation were negative. Beside a case associated with blood transfusion, the familial and ethnic context helped the diagnosis. Clinical and biochemical features were close to those in adult AIDS, including hepatosplenomegaly, polyadenopathy, a decreased absolute number of OKT4(+) lymphocytes and hypergammaglobulinemia. The importance of cellular and sometimes also humoral immune deficiency was highly variable. For 4 patients, the severity of the immune deficiency allowed the diagnosis of AIDS. Occurrence of such an infection in the first months of life suggests a fetomaternal viral transmission; however, a postnatal contamination cannot be ruled out. Long-term prognosis is difficult to assess. It depends, among other factors, on the importance of the immune deficiency.

Acquired Immunodeficiency Syndrome↗

[The role of IgM in paratyphoid immunity].

The authors analyze the results of studies on the effect produced by the immunization of calves with paratyphoid vaccine on the production of agglutinins, changes in the blood serum immunoglobulin levels, and the specificity of IgM to Salmonella dublin and Salmonella typhimurium antigens. The highest level of agglutinins to paratyphoid antigens in the blood sera of the immunized calves was registered on days 14-21 after immunization, changes in the levels of different immunoglobulin classes being insignificant. The agglutination test and the enzyme immunoassay have revealed that antibodies to S. dublin anb S. typhimurium antigens belong to IgM.

Agglutination Tests↗

[Cellular immunity using skin tests in children with malignant diseases at the time of diagnosis and after therapy].

Patients with cancer often have disturbances of cellular immunity. Changes of cellular immunity are frequently associated with tumor progression or an increased risk of a relapse. Cellular immunity is studied with an in vivo test system using 7 different recall antigens. We studied the cutaneous reaction of 80 children with various malignant diseases at time of diagnosis, at the end of the chemotherapy or prior to a relapse of the disease using the multitest Merieux. Before starting treatment patients with systemic diseases showed only a little response to the recall antigens. Patients with solid tumors had normal responses. No prognostic meaning of the multitest results were seen, if it was done before starting the treatment. At time of a relapse, these patients mostly had negative skin reactions using the multitest. It has to be studied if these results show a new systemic disease or if they are expression of an ongoing disturbance of cellular immunity of these patients.

Antigens, Neoplasm↗

Retinal cotton-wool-like spots: a marker for AIDS?

The prognostic value of ocular manifestations and their correlation with immune changes in HIV-infected subjects (75 PGL, 23 ARC, and 17 AIDS) have been longitudinally studied with an average follow-up of one year (3 to 22 months). The most common ocular manifestations were retinal cotton-wool-like spots, observed in 58.8% of AIDS patients and in 76.9% of those with ocular involvement. Two of three ARC patients who showed cotton-wool-like spots developed PCP a few weeks after ophthalmoscopic examination. A close correlation between ocular changes and decrease of CD4+ lymphocytes was observed. In our opinion, these ocular manifestations are as useful an indicator as opportunistic infections or AIDS-related neoplasias in the prognosis of HIV infection.

AIDS-Related Complex↗

Variations in humoral and cellular immunologic changes in relation to the evolutive stage of chronic active liver disease.

The humoral immune changes (of Ig, CIC, C3) and the cellular ones (T lymphocytes with the T1, T2, Ta subpopulations and B lymphocytes) have been followed up for a mean period of 36 months in 22 patients with chronic active liver disease (CALD), of whom 11 with chronic active hepatitis and 11 with active liver cirrhosis. Thirteen of these patients received long term corticotherapy and 9 only a hepatotropic treatment. A comparison of the mean values of the immune parameters investigated in the active and in the remission stages has revealed an improvement of the immune disorders in the remission stages, both at humoral and cellular levels, more evident in the patients treated by corticotherapy.

Adult↗

Influence of pregnancy, birth and abortion on the evolution of systemic lupus erythematosus.

The effect of pregnancy, birth and abortion on systemic lupus erythematosus (SLE) was studied in 225 patients with or without a history of pregnancy and abortion. It was observed that pregnancy, birth and abortion aggravate the evolution of disease in patients with active SLE. The tissue autoantibodies studies presented a low titer in patients in whom pregnancy had occurred in the course of disease. Antimeasles antibodies presented a high titer in patients with a history of gestation. These data suggest that gestation induces immune changes which aggravate SLE.

Abortion, Spontaneous↗

Immune pathology in polyarticular osteoarthritis.

Although osteoarthritis (OA) generally is considered a disorder of mechanical origin, the common occurrence of chronic mononuclear cell infiltrates in the synovium in conjunction with immunofluorescent evidence for immune-reactant products in cartilage of surgical case specimens (knees, hips, and peripheral joints) has suggested the local involvement of immune processes in the arthritis. Further, the findings of polyarthropathy in the majority of these cases have indicated the propensity for a systemic disorder. Wide variations were noted in both synovial and cartilage immune changes, quite different to those found in rheumatoid arthritis, along with the frequent asymptomatology of the many joints involved. These features, with and without other causative factors, suggest that immune reactions of local and/or systemic origin occur at times in a population at risk for joint degradation.

Cartilage, Articular↗

[Malaria plasmodia in the mouse. Parasitization of mature and immature erythrocytes by Plasmodium berghei, Plasmodium yoelii and Plasmodium chabaudi (author's transl)].

Plasmodium berghei parasites (strain K173) in mice with developing immunity changed to a variant type with increased resistance against antibodies and enhanced invasion of mature erythrocytes; on passages in normal mice this variant type retransformed to the normal type (Kretschmar 1964). On detailed study, parasites of the variant type showed a markedly decreased predilection for polychromatophilic erythrocytes, leading to slowed multiplication during prepatency, increased invasion of mature erythrocytes and rapidly fatal course of the infection. Avoidance of parasitized immature erythrocytes remained unaltered in the variant type. In presence of antibodies many parasites invaded mature erythrocytes even in blood with high concentrations of immature erythrocytes. --Plasmodium yoelii (strain 17X) showed very high predilection for polychromatophilic erythrocytes, only slight lowering of immature erythrocyte concentration and low parasitization of mature erythrocytes. Parasites with altered preference for polychromatophilic erythrocytes were not observed in animals with parasitemia relapsing after spontaneous disappearance of the primary parasitemia or after injection of antiserum. It is suggested that in a variant of Plasmodium yoelii with high invasion of mature erythrocytes (Yoeli et al. 1975), the decisive virulence factor might be a lowered predilection for polychromatophilic erythrocytes. Avoidance of parasitized immature erythrocytes is less marked in Plasmodium yoelii than in Plasmodium berghei. In presence of antibodies more parasites invade mature erythrocytes. --Plasmodium chabaudi showed an appreciable preference for invasion of immature erythrocytes. Moreover, significantly more multiply parasitized mature and immature erythrocytes were found than would have been produced by random invasion of erythrocytes.

Animals↗

Non-Hodgkin's lymphoma in pregnancy. Three cases and review of the literature.

The features of non-Hodgkin's lymphoma occurring in pregnancy were studied in three cases and reviewed in the 21 additional cases reported in the medical literature of the past 50 years. The inception and course of neoplasia in general appears to be affected by the hormonal and immune changes of pregnancy. Lymphomas occurring during this period are of high-grade malignancy and have a tendency to involve the organs most stimulated in pregnancy; breast, ovary, and uterus. The cell types are indicative of early stages of differentiation, and mediastinal location is more common. Despite the usually late diagnosis and the aggressive disease, the pregnancy can continue to term ending in the natural delivery of unaffected babies who remain healthy thereafter. The course of lymphoma, however, almost invariably accelerates post partum, particularly during lactation, resulting in the rapid deterioration and death of the mother. Results better than expected have been recently obtained with combination chemotherapy.

Adult↗

Aging immunocytes and immunity. Characteristics and significance.

With aging, many aspects of immune function change. Despite the greater complexity of problems and increased numbers of variables that attend research involving aged individuals, certain fundamental alterations in immune reactivity appear associated with aging. These alterations have important biologic implications. The immune changes in "healthy" octogenarians can have significant clinical effects when these individuals suffer stress or disease.

Adult↗

[Immune response in splenectomized children to anti-pneumococcal vaccination].

The antibody response following anti-pneumococcal immunization with a 14-valent vaccine was studied in 54 children, aged 2 to 18 years after splenectomy. Splenectomy had been performed for traumatic, hematologic or immunologic reasons. Antibody titration with respect to 12 serotypes was performed by radioimmunoassay immediately before and one month after immunization. Changes in responses were studied according to the indication for splenectomy and to the vaccine serotype. The main conclusions of this study are the excellent tolerance of immunization, the lack of significant difference between the average responses according to the indications for splenectomy, the obtainment of a titer probably protective for 80% of the patient studied and the confirmation of the low immunogenic character of serotype 6A. These results suggest that anti-pneumococcal prophylaxis by immunization can be highly recommended before splenectomy but it can also be performed after surgery.

Adolescent↗

[Cellular immunity in patients with diabetes mellitus complicated by diabetic retinopathies].

A total of 200 patients with diabetes mellitus were examined for T and B immunity systems. The T and B lymphocytes were counted, the response of T lymphocytes to PHA and their sensitivity to thymosine and theophylline were determined. The data obtained attest to inhibition of the T immunity system in patients with diabetes mellitus regardless of the ophthalmoscopic appearance of the eye fundus, with this inhibition being most remarkable in subjects without vascular lesions of the retina. Patients with proliferating diabetic retinopathy manifested activation of the B cell component of immunity. Changes in the content and function of T lymphocytes were followed by inhibition of the hormonal activity of the thymus and accumulation in the blood of the theophylline-sensitive T cell population. It is suggested that quantitative and qualitative deficiencies of cellular immunity give rise to the development of immune complex pathology resulting in the formation and progression of diabetic retinopathies.

Adolescent↗

Blast lymphocyte transformation (LTT), rosette (E-RFC) and leukocyte migration inhibition (MIF) tests in persons exposed to the action of lead during work. Report II.

80 persons from a city environment, aged 22 to 62, were examined (Cfr. Report I). Spontaneous blast T lymphocyte transformation was found to depend on lead concentration in the blood; the transformation was intensified as Pb 2+ ion concentration in the lymphocyte culture increased within the range of 10(-5) mg/ml. The process was of positive correlation and was statistically significant. PHA-induced blast lymphocyte transformation was found inversely proportional to serum Pb2+ ion concentration, the negative correlation of the two parameters was worked out. Thus, it was proved that mitogenic effects of the action of lead and PHA were of no additive nature, the actions of the two agents opposed each other, probably a competition for the place of specific binding to the cell membrane receptors took place. The process may be helpful in accounting for immunity changes in bodies exposed to the action of lead.

Adult↗

[Cellular and humoral immunity in asymptomatic carriers of the hepatitis B virus].

Eighty-eight asymptomatic HBsAg carriers were examined for cellular and humoral immunity and markers of virus B hepatitis in liver tissue and blood serum. The following results were obtained: HBsAg and HBcAg in liver tissue were found in 10 and 19 out of the 24 examinees, respectively, HBeAg and anti-Hbe in blood serum in 2 and 20 out of the 25 examinees, respectively. No alterations were recorded on the part of humoral immunity. Changes in cellular immunity manifested themselves by reduction in the number of T lymphocytes, and decreased response to PHA. Sensitization to HBsAg led to the purification of hepatitis B virus whereas the presence of simultaneous sensitization to liver-specific lipoprotein contributed to development of graver patterns of liver injury. The role of the immune system and hepatitis B virus itself in the pathogenesis of liver injury in asymptomatic HBsAg carriers is discussed.

Adolescent↗

[Alteration of the natural humoral immunity in experimental diphtheritic infection induced by different doses of the agent].

The authors carried out a complex study of natural humoral immunity factors in rabbits experimentally infected with various doses of diphtheria bacillus (500, 200, 100, 50 and 1 million, 10 000 and 1000 microorganisms). Natural protection factors--the complement, properdin, and lysozyme proved to undergo similar dynamic changes with each infection dose. The extent and direction of the changes depended on the infection dose. No significant natural immunity changes were caused by a low dose. A dose of 10 000 microbes caused stimulation of properdin and lysozyme activity. Dose of 1, 5, and 50 million suppressed the activity of all the components, the most pronounced with the later dose. Changes occurring with the doses of 200 and 100 million microbes were phasic in character.

Animals↗