HIV-positive men differ in immunologic but not catecholamine response to an acute psychological stressor

Acute psychological stress in humans induces sudden alterations in catecholamine plasma levels and in the distribution of peripheral blood lymphocytes. The purpose of this study was to investigate whether infection with the human immunodeficiency virus (HIV) had an impact on the psychoneuroimmunologic axis. Twelve asymptomatic HIV-positive homo- or bisexual men (CD4 cell counts>400/mm3) and 13 healthy HIV-negative control subjects were exposed to an acute psychological stressor consisting of a 30 min semi-structured stress interview using emotion- and client-centered conversation techniques surrounded by two relaxation periods. Changes in neuroendocrine and immunological, as well as cardiovascular parameters, were intermittently monitored. Under the influence of the stressor plasma norepinephrine (NE) levels increased significantly in HIV-positive patients (+30.6%; p<0.05) and in HIV-negative individuals (+17.5%; n.s.). These changes were paralleled by significant increases in blood pressure and heart rate. Plasma cortisol decreased continuously from initially high levels during the entire experimental setting in both groups, compatible with an adaption reaction. Concomitantly, WBC and neutrophilic granulocytes increased significantly in HIV-negative subjects, while they were blunted in HIV-positive patients. Interestingly, NK cell increases were significantly higher during the stress experiment in HIV-positive patients than in HIV-negative controls. CD4+ and B cell counts remained unaffected by the stressor. These results suggest that catecholamine secretion induced by an acute psychological stressor is preserved in HIV-infected patients with the responsiveness of WBC and neutrophilic granulocytes being diminished, while NK cells showed an increased response.     

Acquired immune deficiency syndrome-related hyperkeratotic Kaposi's sarcoma with severe lymphoedema: report of five cases

Kaposi's sarcoma (KS) is the most frequent neoplasm in acquired immune deficiency syndrome (AIDS) patients. Whereas typical cases present as erythematous, plaque or nodular lesions, hyperkeratotic variants of AIDS-associated KS are rare. We describe five patients with AIDS-associated KS with hyperkeratosis and lymphoedema as prominent features. We also speculate on its pathogenesis.     

1141644472Surface Enhanced Laser Desorption and Ionization (SELDI) mass spectrometry for investigation of human embryo conditioned IVF culture medium

Background:  Fetal programming is the notion that adverse environmental conditions in utero can cause short term survival adaptations that may have long-term consequences, such as chronic disease in subsequent lifetime. Recently, some authors reported that the increase of allergy prevalence in childhood may be linked with fetal immune development. In this regard, literature survey inspired to study the influence of two conjugated linoleic acid (CLA)-isomers (c9,t11 and t10,c12) on parameters of the immune system in pregnancy.
Methods:  Lymphocytes from allergic and non-allergic mothers, cord blood of their newborns, and the decidual layer of term placentae were isolated and cultured for 2 days and supplemented or not with relevant allergens, c9,t11 CLA, t10,c12 CLA or linoleic acid, respectively. Expression of CD69 (activation marker) and CD71 (transferrin receptor; proliferation marker) on B and T lymphocytes and T helper cell type 1 (Th1) and Th2 cytokines in culture supernatant were analyzed.
Results:  Both CLA isomers led to an increase of the IFN-γ/IL-10 ratio in supernatants of peripheral maternal and cord blood cells from allergic patients and non-allergic-control. CLA supplementation decreased IL-10 secretion of peripheral maternal and decidual lymphocytes and the portion of CD71⁺ maternal B cells. Linoleic acid induced a similar effect.
Conclusion:  An immunological effect of CLA on maternal and fetal lymphocyte responses could be demonstrated. It would be expected that further investigations could reveal differences in effects of CLA and linoleic acid.     

How realistic is cutaneous gene therapy?

Recent progress with innovative, experimental gene therapy approaches in animals, and recent improvements in our understanding and manipulation of stem cells, gene expression and gene delivery systems, have raised plenty of hopes in essentially all branches of clinical medicine that hitherto untreatable or poorly manageable diseases will soon become amenable to treatment. Few other organ systems have received such enthusiastic reviews in recent years as to the chances and prospects of gene therapy as the skin, with its excellent accessibility and its pools of--seemingly--readily manipulated epithelial stem cells (cf. Cotsarelis et al., Exp Dermatol 1999: 8: 80-88). However, as in other sectors of clinical medicine, the actual implementation of general gene therapy strategies in clinical practice has been faced with a range of serious difficulties (cf. Smith, Lancet 1999: 354 (suppl 1): 1-4; Lattime & Gerson (eds.), Gene Therapy of Cancer, Academic Press, San Diego, 1999). Thus, it is critically important to carefully distinguish unfounded hype from justified hope in this embryonal area of dermatologic therapy, to discuss in detail what can be realistically expected from cutaneous gene therapy approaches in the next few years, and importantly, what kind of promises should not be made to our patients at this time.     

Topische Immunmodulation in der Dermatologie

Zusammenfassung Immunmodulatoren umfassen sowohl immunstimulatorische als auch immunsuppressive Medikamente. Das Konzept der Immuntherapie ist bereits seit mehr als 100 Jahren bekannt, jedoch wurden die grundlegenden Mechanismen erst in der jüngsten Vergangenheit aufgeklärt und verstanden. Die zur topischen Immuntherapie verwendeten obligaten Kontaktsensibilisatoren, wie z. B. Diphencypron (DCP) oder Dinitrochlorobenzol (DNCB), wirken gegen virale und vermutlich auch autoimmune Erkrankungen. Neuere Agenzien wie die Toll-like-Rezeptor-Agonisten Imiquimod und Resiquimod können zur Therapie viraler Infektionen und Hautkrebs bei immunkompetenten und immunsupprimierten Patienten eingesetzt werden. Die kürzlich entdeckten immunstimulatorischen CpG-Sequenzen sind aufgrund ihrer Adjuvanseigenschaften evtl. geeignet, die Effizienz konventioneller Vakzinierungen gegen Krebs, Atopie oder Allergien zu erhöhen. Bei den Immunsuppressoren werden topisch wirksames Tacrolimus und Pimecrolimus mit großem Erfolg zur Behandlung chronisch-entzündlicher Hauterkrankungen bei Kindern und Erwachsenen eingesetzt. Durch Einführung dieser neuen Medikamentenklassen hat das Post-Kortisonzeitalter der Dermatologie begonnen. Die vorhandenen und weitere Toll-like-Rezeptor-Agonisten und Calcineurin-Antagonisten werden in Ergänzung zu Kortikosteroiden die spezifische dermatologische Therapie verbessern helfen. Die topische Immuntherapie mit immunstimulatorischen und immunsuppressiven Agenzien birgt großes Potenzial für eine effektive und patientenfreundliche Behandlung verschiedener infektiöser, maligner und entzündlicher Hauterkrankungen. Langzeituntersuchungen werden die Verträglichkeit und das Sicherheitsprofil dieser Substanzen erkennen lassen.

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