Antigen- and receptor-driven regulatory mechanisms. III. Induction of delayed type hypersensitivity to azobenzenearsonate with anti-cross- reactive idiotypic antibodies

Delayed-type hypersensitivity (DTH) to p-azobenzenearsonate (ABA) can be induced in A/J mice with intravenous injection of minute amounts of anti-cross-reactive idiotypic (CRI) antibodies, providing that the animals have been pretreated 2 d earlier with low doses of cyclophosphamide (50 mg/kg). However intravenous injection of the F(ab')2 fragments of the anti-CRI antibodies or subcutaneous administration with anti-CRI antibodies induces comparable immunity in both cyclophosphamide-pretreated and normal nontreated animals. Furthermore adoptive transfer experiments indicate that lymph node cells taken from animals sensitized with anti-CRI 4 d earlier can adoptively transfer immunity to naive recipients. Transfer of immunity is mediated by a population of thymus-dependent (T) cells, which express idiotypic structures on their surface. Treatment of effector cells with either anti-theta serum or anti-idiotypic antibodies plus complement completely abrogated their ability to transfer immunity. In addition idiotype-bearing suppressor T cells induced with ABA-coupled spleen cells inhibit the development of ABA-specific DTH induced with anti-CRI antibodies. Genetic analysis revealed that the ability of anti-CRI antibodies to induce ABA-specific DTH was linked to Igh-1 heavy-chain allotype. Anti-idiotypic antibodies to the major CRI associated with anti-ABA antibodies in A/J mice failed to induce significant immunity in BALB/c mice (H-2d, Igh-1a). Nevertheless, they were able to induce significant immunity in C.AL20 mice (H-2d, Igh-1d) which possess a heavy-chain allotype similar to that of A/J mice.     

Acute hypersensitivity reactions to chemotherapy

OBJECTIVES: To provide a review of the immune system response involved in acute hypersensitivity reactions (HSRs) and anaphylactic reactions to chemotherapy. DATA SOURCES: Professional experience, published articles, and book chapters. CONCLUSIONS: Acute HSRs from chemotherapy administration can be a rare to moderate occurrence, depending on the chemotherapy agents involved. It is of vital importance for nurses caring for patients receiving chemotherapy to take steps to prevent HSRs when possible and/or to minimize the potentially fatal effects of those reactions. IMPLICATIONS FOR NURSING PRACTICE: Nurses caring for patients receiving chemotherapy should understand the risk of HSRs as well as the pathophysiology involved to ensure utilization of preventive measures when appropriate and early recognition and intervention in the event of an acute HSR.     

Myocarditis related to drug hypersensitivity

Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to a drug allergy. The clinical manifestations may be nonspecific, and the diagnosis is seldom suspected or established during life. We report a case that demonstrates both typical and atypical features of this disease and review the clinicopathologic correlations. This case illustrates the potential occurrence of both electrical conduction block and ventricular tachyarrhythmias, either of which may account for the mechanism of sudden death in these patients. When cardiac symptoms or electrocardiographic abnormalities (or both) occur in a setting consistent with drug allergy, hypersensitivity myocarditis should be considered. Treatment consists of discontinuation of use of the drug responsible for the reaction and, possibly, administration of corticosteroids and immunosuppressive therapy.     

Immunotherapy of hypersensitivity to hymenoptera venom

Insect sting allergy is a common condition with a risk of life-threatening anaphylaxis. After a severe reaction, the fear of being restung can significantly reduce quality of life. Venom immunotherapy (VIT) is a highly effective treatment of the underlying type I-sensitisation. This review addresses the mechanisms of immune modulation by VIT and outlines current clinical application. Although highly effective in the majority of patients, VIT fails in a few individuals. It can also cause systemic allergic side effects, restricting its application to physicians trained in the treatment of anaphylaxis. This review discusses several new strategies to overcome these problems, which are presently a promising focus of research. These include the use of new adjuvants, of recombinant and genetically engineered venom allergens, as well as vaccination with peptides.     

Severe hypersensitivity reactions to allopurinol.

The frequency of severe reactions to allopurinol has probably been underestimated. A retrospective study encompassing a five-year period has yielded 20 patients with severe hypersensitivity reactions to allopurinol. Patients with preexisting renal impairment or who were receiving concomitant thiazide diuretics appeared to be especially predisposed. Cutaneous reaction patterns included maculopapular eruptions, exfoliative dermatitis, and toxic epidermal necrolysis. eosinophilia was uncommon. Forty percent of the patients developed hepatic involvement and 45% had renal involvement. Hepatic and renal changes usually were reversible and were not unique to any one cutaneous reaction pattern. Three patients with renal involvement required prolonged administration of systemic steroids. Complications included sepsis, decubitus ulcers, and thromboembolism. Two patients required hyperalimentation. Sequelae included dry eyes, pigmentary disturbances, and keloids. Three patients died as a result of their reaction. It is concluded that allopurinol should be used only in select patients, and the dosage should be modified if renal disease exists.     

Immunotherapy of hypersensitivity to hymenoptera venom

Insect sting allergy is a common condition with a risk of life-threatening anaphylaxis. After a severe reaction, the fear of being restung can significantly reduce quality of life. Venom immunotherapy (VIT) is a highly effective treatment of the underlying type I-sensitisation. This review addresses the mechanisms of immune modulation by VIT and outlines current clinical application. Although highly effective in the majority of patients, VIT fails in a few individuals. It can also cause systemic allergic side effects, restricting its application to physicians trained in the treatment of anaphylaxis. This review discusses several new strategies to overcome these problems, which are presently a promising focus of research. These include the use of new adjuvants, of recombinant and genetically engineered venom allergens, as well as vaccination with peptides.     

A new way to improve the light-fastness of azo reactive dyes through the introduction of benzene sulfonamide derivatives into the triazine ring

Herein, a new kind of hetero-bifunctional reactive dyes with high light-fastness was designed and synthesized by introducing benzene sulfonamide and its derivatives into the triazine ring. Benzene sulfonamide or its derivatives and 2-amino-5-naphthol-7-sulfonic acid (J-acid) were condensed with cyanuric chloride to synthesize coupling components, which were then coupled with the diazo salt of 4-(β-sulfatoethylsulfonyl)aniline. The dyes were characterized by IR spectroscopy and MS. The color fastness test proved that the light-fastness of the dyes could be improved by 1 grade via the introduction of benzene sulfonamide derivatives into the triazine ring when compared with the case of the control dyes. Fluorescence spectra demonstrated that after the introduction of benzene sulfonamide derivatives, the dye molecule could return to the ground state from the excited state and emit fluorescence; in addition, the introduced benzene sulfonamide derivatives helped to deteriorate the adverse effect of UV light on the dye. Moreover, the dyeing results showed that the dyes containing the sulfonamide groups had equal dyeing properties when compared with that of the control dyes.

Herein, a new kind of hetero-bifunctional reactive dyes with high light-fastness was designed and synthesized by introducing benzene sulfonamide and its derivatives into the triazine ring.     

Polyamine deficient diet to relieve pain hypersensitivity

There is a compelling body of evidence that N-methyl-d-aspartate receptors (NMDA-R) play a critical role in the development and maintenance of pain hypersensitivity. However, long-term treatments with NMDA-R antagonists are limited by unacceptable side effects. Since polyamines modulate the functioning of NMDA-R and mainly originate from normal dietary intake and bacterial metabolism in the gut, we developed a nutritional therapy based on dietary polyamine deficiency. Here, we reported that a polyamine deficient diet (PD diet) for 7 days prevented the enhancement of tyrosine phosphorylation of the spinal NR2B subunit-containing NMDA-R associated with inflammation in rats. Based on these data, we studied the ability of PD diet to prevent long-lasting pain hypersensitivity associated with tissue injury on one hind paw by evaluating long-lasting changes in both mechanical nociceptive threshold and weight bearing. A PD diet strongly reduced long-lasting hyperalgesia induced by inflammation or incision, especially in fentanyl-treated rats. Moreover a PD diet also prevented the exaggerated hyperalgesia induced by a second inflammation performed 7 days after the first one. A PD diet also opposed paradoxical hyperalgesia induced by non-nociceptive environmental stress in rats with pain and opioid experiences. A PD diet reversed pain hypersensitivity associated with monoarthritis or neuropathy and restored the analgesic effect of morphine. Since PD diet was devoid of any noticeable side effects, this nutritional therapy could be part of an effective and safe strategy for pre-emptive analgesia and for reducing the transition from acute to chronic pain and its outcomes in various pain syndromes.     

原发性高血压患者肱动脉内皮功能与C反应蛋白高敏性的关系

目的:研究原发性高血压患者肱动脉内皮功能与高敏C反应蛋白(high-sensitivityC-reactiveprotein,hsCRP)的关系。方法:选择104例原发性高血压患者,男54例,女50例。应用B超声对所有病例肱动脉进行扫查,检测在静息、反应性充血时对肱动脉内径进行检测。用免疫学方法测定血液中hcCRP的浓度。结果:加压充血后,肱动脉管径平均扩增率(Flow-MD)高血压组犤(7.06±1.02)%犦低于对照组犤(16.50±1.09)%犦(P<0.01);Flow-MD与hsCRP呈负相关(r=-0.693,P<0.001)。结论:高血压患者血液中hsCRP浓度增高与动脉内皮细胞功能受损关系密切。     

冠心病患者血尿酸及超敏C-反应蛋白检测及分析

[目的]探讨冠心病患者血尿酸（UA）及超敏C-反应蛋白（HS—CRP）检测的临床应用价值。[方法]对134例冠心病患者（试验组）和128名健康体检者（对照组）分别进行UA及HS—CRP的检测,并对结果进行比较分析。[结果]冠心病患者UA及HS—CRP水平均高于健康对照组,两者比较差异有统计学意义（P〈0．01）。[结论]冠心病患者UA及HS—CRP水平明显升高,联合检测UA及HS—CRP对冠心病的诊断、治疗和判断预后有重要的临床意义。     

Risk factor analysis of hypersensitivity reactions to abacavir

BACKGROUND: A hypersensitivity reaction to abacavir has been known to occur in approximately 4% of patients treated with the drug. OBJECTIVE: The goal of this study was to determine risk factors associated with the development of hypersensitivity reactions to abacavir. METHODS: We constructed an analysis population from all protocols conducted by GlaxoSmithKline that involved at least 24 weeks of abacavir exposure with a quality-assured or validated clinical database by June 30, 2000. Demographic, clinical, and laboratory characteristics of patients who developed a hypersensitivity reaction to abacavir were compared with those of patients who did not. Univariate and multivariate logistic regression models were fit to understand the predictive ability of each potential risk factor. Odds ratios (ORs) and 95% Wald CIs were computed. RESULTS: A total of 5332 patients exposed to abacavir were included in this analysis; 197 cases of hypersensitivity reaction were reported (3.7%). In univariate models, several associations were noted, but most subgroups produced rates within the expected range of 3% to 6%. The multivariate model using all demographic data available (Model 1) indicated that the risk of hypersensitivity reaction among black patients (3% hypersensitivity reaction) was lower (OR = 0.59; 95% CI, 0.38-0.91) compared with other ethnic groups. In addition, a lower rate of hypersensitivity reaction was observed in patients who received previous therapy for HIV-1 infection with other antiretroviral agents (3% hypersensitivity reaction) compared with those receiving therapy for the first time (OR = 0.58; 95% CI, 0.44-0.78). CONCLUSIONS: The only characteristics identified as prognostic factors for hypersensitivity reaction to abacavir were antiretroviral treatment status (ie, treatment experience) and black race, each resulting in a lower rate compared with the expected incidence.