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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↗

Peripheral white blood cell alterations in early labor.

The peripheral blood counts of 101 pregnant women in very early labor and 41 nonpregnant controls were compared through automated total and differential blood count techniques. There were profound quantitative changes in the peripheral bloods of the pregnant women. These included, in association with pregnancy, increases in the absolute number (per ml) of total white cell counts (p less than 0.0005), segmented neutrophils (p less than 0.0005), band neutrophils (p less than 0.0005), and monocytes (p less than 0.0005). In contrast, there was a significant decrease in the absolute number (per ml) of peripheral lymphocytes in pregnancy (p less than 0.05) and a significantly larger proportion of bloods from pregnant women had less than 10(6) lymphocytes per ml (p less than 0.0005). The percentage of segmented neutrophils increased significantly during pregnancy (p less than 0.0005) as did band neutrophils (p less than 0.0005). We also noted a significant decrease in the percentages of peripheral lymphocytes (p less than 0.0005). In contrast, there were no significant differences in the percentages of monocytes between pregnant women and nonpregnant controls. The increase in the absolute number of monocytes and the decrease in the absolute number of lymphocytes led to a significant decrease in lymphocyte-monocyte ratio (p less than 0.0005) during pregnancy. It is concluded that the maternal peripheral blood changes in late pregnancy may reflect immune changes required for the immune adaption between fetus and mother-host.

Female↗

Health effects of radiation incidents in the southern Urals.

This article discusses the most important information on health effects in the Urals region (Russia) of residents exposed to radiation from activities of a weapon plutonium separation plant. The population residing on the contaminated territory was exposed to chronic combined irradiation (external gamma-irradiation and internal irradiation due to Sr-90 and Cs-137). The red bone marrow (RBM) was the critical organ affected as a result of radiation events in the Urals. In the early period, after the discharges of radioactive wastes into the river Techa (about 3 M Ci) started, cases of chronic radiation sickness (CRS; 940 cases, in total), postirradiation reactions manifested by changes in blood parameters (e.g., leukopenia, thrombocytopenia, granulocytopenia), nervous system disorders, immunity changes and ostealgic syndrome were registered in a portion of those riverside village residents who had received the highest doses. Increased leukemia and cancer mortality and morbidity rates were noted among this population in later periods. No late effects were observed in residents exposed to an explosion in a radioactive waste depot in September, 1957 when radioactive wastes with about 20 M Ci of activity were released into the environment. Similarly, the offspring of the residents exposed on the Techa also did not display any late effects. The data about the possibilities of long-term (43-45 years after the start of exposure) biological indication of chronic internal exposure are presented. The methods used in the study include in situ fluorescent hybridization, analysis of mutations in the TCR gene of peripheral blood lymphocytes and erythrocyte mutations in the glycophorine A system. No dependence of genomic translocations and mutations in glycophorine A on cumulative exposure dose to RBM was traced.

Adult↗

Specific down-regulation of anti-allergen IgE and IgG antibodies in humans associated with injections of allergen-specific antibody complexes.

Several approaches have recently been put forward describing attempts to suppress the IgE immune response towards allergens, which is thought to be the key event in allergic diseases. In a series of clinical trials we have shown that injections of complexes made up from allergen and specific antibodies are an effective treatment for allergic bronchial asthma and atopic dermatitis. In the work presented here we have examined the humoral immunity changes associated with the use of such complexes in a group of 19 adult patients suffering from atopic dermatitis and hypersensitive to Dermatophagoides pteronyssinus (Dp), and in whom a significant clinical improvement was observed. By comparing serum samples taken prior to and after 4 months of therapy, we show that the administration of immune complexes is associated with: (i) a significant and selective reduction of IgG and IgE antibodies specific for Dp allergens; (ii) a down-regulation that affects only the antibodies present in the complexes; (iii) the induction of corresponding anti-idiotypic antibodies. To our knowledge, this is the first demonstration in humans that an anti-allergen antibody response can be down-regulated in a highly selective manner and that this is accompanied by significant clinical improvement. Moreover, the selective reduction of IgG antibodies could be of value in the treatment of some forms of auto-immune diseases.

Adult↗

Biological markers of host susceptibility to air pollutants in epidemiologic studies on chronic airways obstruction.

Measuring the variations in risk among individuals or populations of environmentally induced chronic airways obstruction is necessary to develop rational policy to reduce the incidence of those diseases in a given population. Before being able to formulate this policy, however, one must know how to detect those individuals who are susceptible to ari pollutants since they are at increased risk of disease. In the paper the authors discussed several monitoring techniques to detect markers of early biological events relevant to host susceptibility and disease progression. The biological markers are based on genetic traits, pulmonary function tests, biochemical and immune changes. The authors discuss merits and demerits of particular approaches in identifying persons prone to chronic airways obstruction. They stress the point that more research is needed on biochemical and immunological markers of lung injury to assess their usefulness in identifying individuals at higher risk.

Air Pollutants↗

HIV-1 immunogen induction of HIV-1-specific delayed-type hypersensitivity: results of a double-blind, adjuvant-controlled, dose-ranging trial.

OBJECTIVE: To investigate the capacity of an HIV-1 immunogen to induce or augment HIV-1-specific delayed-type hypersensitivity (DTH) over a range of doses in asymptomatic HIV-1-seropositive adults. DESIGN: A single center, double-blind, adjuvant-controlled, dose-ranging trial involving 48 HIV-1-seropositive asymptomatic patients. Each dose group consisted of 12 subjects, eight receiving HIV-1 immunogen and four incomplete Freund's adjuvant (IFA). The doses studied were 50, 100, 200, or 400 micrograms (total protein). The HIV-1 immunogen was administered intramuscularly every 4 weeks for 36 weeks, with dosing contingent on the lack of an HIV-1 immunogen DTH response. A maximum of six doses was permitted. METHODS: Immunogenicity was assessed every 4 weeks by DTH skin testing to the inactivated HIV-1 antigen in saline with > 9 mm induration representing a response to immunization. Changes in p24-antibody levels were determined by endpoint titration using an enzyme-linked immunosorbent assay and Western blot. RESULTS: At doses of > or = 100 micrograms, all treated patients demonstrated significant differences in the ability to mount an HIV-1-specific cell-mediated response relative to adjuvant controls. Dose-related response patterns were observed in the period between doses and the occurrence of rises in HIV-1 DTH. Treatment appeared to increase p24-antibody titers as well as reactivities to other HIV-1 antigens as determined by Western blots. The HIV-1 immunogen was well tolerated. CONCLUSIONS: The minimum dose of the HIV-1 immunogen in IFA required to induce HIV-1 DTH relative to the IFA control group was 100 micrograms in this patient population.

Adult↗

[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↗