静脉注射大剂量人体丙种球蛋白对儿童重症病毒性脑炎预后的影响

①目的　探讨静脉注射大剂量人体丙种球蛋白 (IVIG)对儿童重症病毒性脑炎 (SVE)预后的影响。②方法　将 5 6例SVE病儿随机分为常规组 (n =2 2 ,给予抗病毒、降颅压、止惊、冬眠疗法、加压氧和糖皮质激素等常规治疗 )和IVIG组 (n =34,在常规治疗基础上尽量在 7d内给予IVIG ,剂量为每天 4 0 0～ 6 0 0mg/kg体质量 ,共2～ 3d) ,比较两组病儿治疗后的近期和远期预后 ,测定两组治疗前后血浆白细胞介素 6 (IL 6 )、肿瘤坏死因子 α(TNF α)水平并与对照组进行比较。③结果　与常规组比较 ,IVIG组治疗过程中呼吸衰竭、消化道出血、院内感染的发生率和病死率明显降低 (χ2 =6 .5 10～ 13.86 0 ,P <0 .0 5 ,0 .0 1) ;病后遗留脑性瘫痪者明显减少 (χ2 =4 .0 2 7,P <0 .0 5 ) ;病后 3,6 ,12个月IVIG组除瘫痪外 ,癫痫、脑影像学损害、脑电图和脑干听觉诱发电位异常者均明显减少 (χ2 =6 .4 5 1～ 4 5 .5 81,P <0 .0 5 ,0 .0 1) ;病后 6 ,12个月IVIG组的言语智商和总智商较常规组明显高 (t =2 .0 81～ 3.4 13,P <0 .0 5 ,0 .0 1)。IVIG组在病后 3,6个月时血浆IL 6 (15 .1,7.5ng/L)和TNF α(2 0 .4 ,11.8ng/L)水平较对照组 (4.2 ,8.5ng/L)明显升高 (z =- 3.337～ - 3.899,P <0 .0 1) ,但病后 12个月时血浆IL 6和TNF      

Basic principles of immunology (immune response) for hemapheresis practitioners

Advances in medical knowledge and technology have identified the essential elements involved in the human immune system, their relationships and interactions, and offer more advanced concepts in the design, function, and maintenance of immune response. Immune response begins with the earliest progenitor cell and transfers its legacy of protection through white blood cells and the complement system. A basic understanding of immunology is essential to the hemapheresis practitioner as new treatment regimens requiring hemapheresis interventions develop. © 1992 Wiley-Liss, Inc.     

Empfehlungen für die Anwendung der Immunapherese bei der Therapie bullöser Autoimmundermatosen

The etiology of epidermolysis bullosa acquisita (EBA) is unknown. EBA may be associated with other autoim‐mune systemic diseases; it also has been described in connection with different malignant tumors, showing complete remission after successful treatment of the tumor.In such cases, EBA may be regarded as a paraneo‐plastic dermatosis. We detected a highly differentiated neuroendocrine pancreatic cancer in a 78‐year‐old woman with EBA. Even thought her tumor was completely removed and the patient has been disease‐free for over seven years, a complete regression of her autoimmune bullous dermatosis could not be induced. By using intravenous immunoglobulins in combination with mycophenolate mofetil, further blister formation could be ameliorated.     

Influence of impaired T- and B-cell compartments on efficacy of IVIg in dysimmune neuropathies

Autoimmune mechanisms are postulated to play a role in the development and progression of dysimmune neuropathies (DN). We investigated the relation between lymphocyte number and marker expression, and disease activity in 20 patients with DN under intravenous immunoglobulins (IVIg) treatment. B- and T-lymphocyte markers were studied by flow cytometry of the expression of CD5, CD25, CD23 and CD38 markers on B cells and of CD3, CD4 and CD8 markers, respectively. These parameters were compared with those obtained from matched healthy volunteers. The proportions of CD38+ B cells were higher in patients compared with those of controls. Proportions of activated CD4+ and CD8+ T cells were comparable in peripheral blood mononuclear cells of patients and controls, but a significant reduction of the absolute numbers of CD3+, CD4+ and CD8+ cells were observed in DN patients. The percentages of CD25+ memory T cells were instead significantly increased in DN patients. Lastly, T-cell reduction and the CD19/CD38 ratio over total B (CD19+) cells directly correlated with a poor response to IVIg therapy. In DN, whereas T-cell number is reduced, activated T and B cells are increased, thus suggesting an intrinsic defect of the immune response.     

Natural killer cell activity and serum immunoglobulins in epileptic patients

Serum immunoglobulins and the activity of natural killer (NK) cells of 50 epileptic patients (eight with idiopathic generalized epilepsy and 42 with cryptogenic partial epilepsy) and 28 controls have been studied. The values of IgA, IgG and IgM were the same-in patients and controls. The NK activity in controls was linearly related to the effector-to-target ratio, but this linear relationship was not observed in epileptic patients. The cytotoxic activity of NK cells at the lowest effector-to-target ratio was significantly greater in patients than in controls. This increase was observed in each therapy group. Our results seem to confirm a disturbance of the immune system in epileptic patients and suggest that this modification of cellular immunity is not a drug effect but is related to the illness itself.     

Dissociation of hepatitis A virus antigen-anti-HAV antibody complexes by 2-mercaptoethanol and dithiothreitol

Intravenous inoculation of two marmosets and one chimpanzee with hepatitis A virus (HAV) resulted in the replication of virus in liver, excretion of HAV particles in stool, and the appearance of circulating antibodies specific for hepatitis A. The development of an early antibody response in the chimpanzee and in one of the two infected marmosets was shown to interfere with the serologic detection of HAV antigen (HAV Ag) in homogenates of acute phase liver tissue obtained from these animals. Treatment of HAV Ag-positive and IgM anti-HAV-positive liver homogenates with thiol reducing compounds was shown to release HAV Ag from in vitro formed immune complexes. The increased RIA response for HAV Ag in homogenates treated with 2-mercaptoethanol (2-ME) or dithiothreitol (DTT) was further shown not to be due to activation of HAV Ag itself or to a nonspecific effect on the RIA coating antibody, radiolabeled probe, or homogenized liver tissue. IgG and IgM double-antibody sandwich RIAs for HAV Ag were also compared for their ability to detect HAV Ag under reducing and nonreducing conditions. Application of the 2-ME or DTT treatment procedure to the serologic detection of other viral antigens or viruses whose presence in blood, stool, tissue macerate, or other milieu may be masked by specific antibody appears to be feasible.     

Bound immunoglobulins of classes M,A, and G studied in the thymus of patients with myasthenia gravis

Deposits of granular material containing immunoglobulins (Ig) of the M, A, and G classes, were found by direct immunofluorescence in the thymus of patients with myasthenia. Treatment of sections of the thymus of myasthenic patients with unlabeled preparations against individual classes of human Ig inhibits the reaction of the granular material with homologous labeled preparations. Disappearance of fluorescence of the deposits also was observed in sections treated with glycine-HCl buffer, pH 2.8. These results suggest that the granular material consists of immune complexes in which IgM, IgA, and IgG act as antibodies and components of the thymus tissues as the antigen. The presence of bound Ig in the thymus is evidence that in myasthenia an autoimmune process directed against the tissues of this organ is involved.Laboratory of Streptococcal Infections, N. F. Gamaleya Institute of Epidemiology and Microbiology. Professorial Surgical Department, I. M. Sechenov First Moscow Medical Institute. Laboratory of Clinical Pathophysiology, Institute of General and Pathological Physiology, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR M. I. Kuzin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 6, pp. 709–712, June, 1978.     

The effect on immunity of long-term intensive training in elite swimmers

The impact of long-term training on systemic and mucosal immunity was assessed prospectively in a cohort of elite swimmers over a 7-month training season in preparation for national championships. The results indicated significant suppression (P < 0.05) of serum IgA. IgG and IgM and salivary IgA concentration in athletes associated with long-term training at an intensive level. There was also a trend towards lower IgG2 subclass levels in serum in athletes compared with controls (P= 0.07). There were no significant changes in numbers or percentages of B or T cell subsets, but there was a significant fall in natural killer (NK) cell numbers and percentages in athletes over the training season (P < 0.05). After individual training sessions there was a significant decrease in salivary IgA levels for athletes compared with controls (P= 0.02). In athletes there was a downward trend in salivary IgA levels over the 7-month training period in both the pre-exercise (P= 0.06) and post-exercise samples (P= 0.04). There were no significant trends in salivary IgG levels over the study period in either athletes or controls. The only significant change in salivary IgM levels was an increase in detection rate in the pre-competition phase in athletes (P= 0.03). The study suggests that training of elite athletes at an intensive level over both short- and long-time frames suppresses both systemic and mucosal immunity. Protracted immune suppression linked with prolonged training may determine susceptibility to infection, particularly at times of major competitions.     

Analysis of thymic epithelial cell proliferation in vitro by combining bromodeoxyuridine and keratin labeling in an immunofluorescence assay

A simple method of analyzing thymic epithelial cell (TEC) proliferation has been developed by combining bromodeoxyuridine (BrDU) and keratin labeling in an immunofluorescence assay. The first reagent specifically visualizes the cells entering the S phase of the cell cycle, whereas the second immunostaining reveals which of the proliferating BrDU-positive cells actually belong to the epithelial lineage. This method, besides being rapid and free of radioactivity, appears to be reliable in view of the minor variations in the percentages of BrDU+ TEC observed in several distinct experiments. Thus, BrDU/keratin immunolabeling appears to represent a useful tool for the analysis of in vitro TEC proliferation.     

Localization of the Antigen and Antibodies in the Placenta of Immunized Sheep

ABSTRACT: Placentomata of sheep immunized with human serum albumin (HSA) were examined. Both HSA and immunoglobulins were found in the maternal part and maternofetal border of the placenta using FITC labelled antisera on paraffin sections. Radiolabelled HSA was also detected in the fetal blood. The ultrastructure of placentomata revealed immunopathological process.