Myalgia Epidemica und Poliomyelitis

Ohne Zusammenfassung     

Response to immunization against polio after allogeneic marrow transplantation.

Long-term immunity to poliovirus and immunization response to inactivated poliovirus vaccine (IPV) were studied in 55 patients who underwent allogeneic bone marrow transplantation (BMT). Antibodies were determined by neutralization assays. Patients were studied before, at 12 months after BMT and at 12 months after immunization with IPV. Thirty-seven patients were seropositive to all poliovirus types at 12 months after BMT. At least a four-fold decrease in antibody level was recorded between BMT and 12 months later in 55%, 41%, and in 45% of the patients to poliovirus types 1, 2, and 3, respectively. Nineteen patients were immunized with one dose of trivalent IPV. Eight patients (42%), seven patients (36%), and four patients (21%) responded with at least a four-fold antibody titer increase to poliovirus type 1, 2, and 3, respectively. Twenty-nine patients were primarily immunized with three IPV doses. The response rates were 52%, 48% and 48% to poliovirus types 1, 2, and 3, respectively. The immunization responses were similar in patients who did or did not have chronic GVHD. Reimmunization of allogeneic BMT recipients against poliovirus is necessary and a three dose schedule is needed to obtain an adequate immunization response.     

Assessment of class-specific antibodies against denatured DNA in patients with systemic lupus erythematosus

In this retrospective study 103 serum samples from 16 females with systemic lupus erythematosus (SLE), obtained during a mean follow-up time of 2 years, were investigated for the presence of anti-denatured [single-stranded (ss)] DNA antibodies of the IgG, IgM, and IgA classes. The anti-ssDNA antibodies were determined by an enzyme-linked immunosorbent assay (ELISA), and the results were expressed in three ways: as units derived from a single serum dilution and as two parameters,E andA, calculated from the dose-response curve,E being an estimate of the effective amount of antibodies andA a function of the reaction constant between the antigen and the antibody. The simultaneous occurrence of anti-ssDNA antibodies of all three immunoglobulin classes was seen most often in the patients with the shortest duration of the disease. Clinically active disease was found to correlate with high reaction constants of the IgA anti-ssDNA antibodies. There was also an association between the IgA anti-ssDNA antibody levels and the presence of nephritis. Great fluctuations in the amounts of effective antibodies of the IgG class were seen in seven patients, in six of whom changes in the disease activity also were seen. Changes in the disease activity were unaccompanied by fluctuations in the IgG anti-ssDNA levels in four patients; two of these patients were positive for antibodies against extractable nuclear antigens. We conclude that it is of value to express the results of the anti-ssDNA ELISA as a function of the dose-response curve when monitoring patients with SLE and that immunoglobulin class-specific determinations of anti-ssDNA antibodies may provide information about the disease activity in many patients with SLE.     

Which donor should be chosen for hematopoietic stem cell transplantation among unrelated HLA-A, -B, and -DRB1 genomically identical volunteers?

The aim of this study was to identify significant prognostic factors by using unrelated genomically HLA-A, -B and -DRB1-identical donors. Such data could help to choose the best donor. We studied 136 consecutive patients with hematologic malignancies and a median age of 32 years (range, 0-55 years) who received hematopoietic stem cell transplantation. Bone marrow grafts were given to 83 and peripheral blood stem cells to 53 patients. The cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 30% and of chronic GVHD was 54%. At 5 years, the overall transplant-related mortality (TRM) was 34%, and patient survival was 50%. In Cox multivariate analysis, 32 potential risk factors were analyzed. Monoclonal antibody OKT-3 during conditioning was correlated with grade II to IV acute GVHD, chronic GVHD, and TRM. HLA-DP mismatch was associated with poor TRM and poor survival. Cytomegalovirus-seropositive patients with a seronegative donor had a decreased leukemia-free survival. Five-year TRM was 14% with no risk factor, 38% with 1 risk factor, and 87% with 2 risk factors. The 5-year survival was 72%, 48%, and 30% with 0, 1, and 2 risk factors, respectively. We concluded that unrelated hematopoietic stem cell transplantation may be improved if an optimal donor and immunosuppression are chosen.     

Anastomotic rupture at the site of polytetrafluoroethylene (PTFE) and distal vein cuff of femoropopliteal bypass. Two case reports

Two female patients, 63 and 78 years of age, underwent femoropopliteal bypass with polytetrafluoroethylene (PTFE) graft and distal vein cuff. They developed graft occlusion due to false aneurysm at the site of vein cuff during one and eight weeks after surgery, respectively. Improper suture technique or weak vein wall might lead to suture disruption leading to false aneurysm as presented in this article.     

Paths taken towards NK cell–mediated immunotherapy of human cancer—a personal reflection

The discovery that NK cells are able to specifically recognize cells lacking the expression of self‐MHC class I molecules provided the first insight into NK cell recognition of tumour cells. It started a flourishing field of NK cell research aimed at exploring the molecular nature of NK cell receptors involved in tumour cell recognition. While much of the important early work was conducted in murine experimental model systems, studies of human NK cells rapidly followed. Over the years, human NK cell research has swiftly progressed, aided by new detailed molecular information on human NK cell development, differentiation, molecular specificity, tissue heterogeneity and functional capacity. NK cells have also been studied in many different diseases aside from cancer, including viral diseases, autoimmunity, allergy and primary immunodeficiencies. These fields of research have all, indirectly or directly, provided further insights into NK cell‐mediated recognition of target cells and paved the way for the development of NK cell‐based immunotherapies for human cancer. Excitingly, NK cell‐based immunotherapy now opens up for novel strategies aimed towards treating malignant diseases, either alone or in combination with other drugs. Reviewed here are some personal reflections of select contributions leading up to the current state‐of‐the‐art in the field, with a particular emphasis on contributions from our own laboratory. This review is part of a series of articles on immunology in Scandinavia, published in conjunction with the 50th anniversary of the Scandinavian Society for Immunology.