Circulating immune complexes in tuberculosis — an indicator of activity

Circulating immune complexes (CIC) were assayed in 100 cases of tuberculosis and 30 age matched control children. The estimation was done by PEG assay before the commencement of antitubercular therapy. CIC were present in only 3.3% of the control children as compared to 68% of children with tuberculosis. The presence of CIC was observed to vary with the type of tuberculosis. The percentage positivity was highest (100%) in children with miliary tuberculosis. Subsequent estimation of CIC done after one and three months of antitubercular therapy showed a marked decrease in the percentage of positive cases (6.1 and zero percent respectively).     

IgA肾病和紫瘢性肾炎循环免疫复合物IgA检测的研究

目的 探讨小儿IgA肾病（IgAN）、过敏性紫瘢肾炎（HSPN）检测血甭循环免疫复合物IgA（IgA－IC）的临床意义。方法 应用胶固素酶联免疫吸附试验（ELISA）对IgAN、HSPN及其他泌尿系统疾病198例检测血清IgA－IC，观察IgA-IC与IgAN病理的关系。结果 IgAN、HSPN组检测IgA－IC与正常对照组比较无显著性差异，各组之间比较也无显著差异。结论 IgAN有HSPN患儿检测IgA－IC与正常对照组及他肾脏疾病组比较无显著差异，IgA－IC对IgAN及HSPN无诊断价值。IgA－IC升高与IgAN的病理分级无关。     

Levels of SP-A-anti-SP-A immune complexes in neonatal respiratory distress syndrome correlate with subsequent development of bronchopulmonary dysplasia

As part of a double-blind, randomized, placebo-controlled study of human surfactant therapy for neonatal respiratory distress syndrome (NRDS), we measured circulating immune complexes between surfactant protein-A and anti-surfactant protein-A antibodies (SAS). Plasma from almost all infants contained detectable immune complexes. Immune complex levels in surfactant-treated infants were comparable with those of placebo-treated controls. Despite the relatively small sample size, maximum SAS immune complex values between 2 and 4 weeks after birth correlated significantly with subsequent development of BPD. Levels of these immune complexes correlated with eventual BPD independently of, and more strongly than, gestational age and birth weight. Thus, plasma SAS immune complex measurements may be useful in analyzing the course and outcome of NRDS, in particular the likelihood of subsequent development of BPD. This assay may also help to identify infants at risk for BPD and to target preventative therapy to them.     

Circulating immune complexes and insulin antibodies in obesity in children

Clinical and laboratory studies of circulating immune complexes (CIC) and insulin antibodies were carried out in 110 children aged 7 to 14 years. Of these, 90 patients suffered from obesity and 20 were normal. The data obtained indicate that obese children had a high content of CIC and insulin antibodies. The high content of CIC and appearance of pathogenic CIC in obese children may attest to a possibility of the development of autoimmune processes. Insulin resistance seen in obese children is likely to be connected with appearance of insulin antibodies.     

Participation of immune complexes in adenovirus infection

To determine the participation of immune complexes during adenovirus infection, we evaluated serum and necropsy specimens of patients with confirmed adenovirus infection of the lower respiratory tract. In lung and kidney from seven dead patients, immunofluorescence revealed the presence of hexon, immunoglobulins and complement. These patients had clinical manifestations of kidney dysfunction. In dead patients (3/3 in whom serum was available) neither anti-adenovirus antibodies nor adenovirus-specific immune complexes could be found in the final stage of the infection. However, two of these patients had anti-adenovirus antibodies and immune complexes in samples obtained early in the infection. Most patients (16/19) who survived the infection had circulating anti-adenovirus antibodies. Half also had immune complexes specific for adenovirus in some moment of the illness. This suggests that immune complexes arise during respiratory infection by adenovirus, probably contributing to its clinical picture.     

Circulating immune complexes in cystic fibrosis and their correlation to clinical parameters

Circulating immune complexes (CIC) have been found to be elevated in individuals with cystic fibrosis (CF). Previous investigators, using a variety of assays, have reported high levels of CIC in as many as 86% of these patients. Our study followed the progress of 25 patients with CF over a period of 10 months to determine which, if any, clinical parameters correlated with the occurrence and/or concentration of CIC. Immune complex determinations were performed using a coprecipitation method with equine rheumatoid-complement complex. One hundred percent of the CF patients had CIC elevated above normal levels, however, levels of CIC did not correlate with the severity of an individual's acute exacerbation. Clinical parameters including pulmonary function tests, vital signs, total serum IgG levels, and other laboratory studies, were obtained on each individual and analyzed with respect to their relationship to CIC. Only four of 38 parameters examined had p less than 0.05. Factors that showed significant correlation to elevated CIC's in the highly elevated portion of our CIC population were poor NIH score, increased patient age, low peak expiratory flow rate, and elevated total serum IgG. These clinical values are associated more with the measurement of chronic disease. These data suggest that CICs cannot be used as an indication of short-term prognosis or as a monitor to follow the course of acute severe lung infections in the CF patient. Of interest was the observation that all patients who died during the course of the investigation had CIC levels greater than 80 micrograms/ml.     

Circulating soluble immune complexes containing pseudomonas antigens in cystic fibrosis.

In order to investigate whether circulating immune complexes containing Pseudomonas aeruginosa antigens mediate pulmonary damage in cystic fibrosis, we studied lung function, serum immune complex levels, and immunoglobulin concentrations in relationship to chronic pseudomonas colonisation in 69 affected children. Sixteen of the children with cystic fibrosis had increased levels of immune complexes which contained pseudomonas antigens. There was no significant relationship between lung function corrected for the effect of chronic pseudomonas colonisation and the presence of such complexes or increased levels of complexes detected by Cl1 binding or raised serum immunoglobulin concentrations. Our results suggest that these abnormalities in cystic fibrosis are secondary effects of chronic infection and they do not provide evidence for immune complex mediated lung damage in this disease.     

Circulating immune complexes and neutrophil function in low-birth-weight newborn infants in the early neonatal period

Peripheral blood neutrophil function and the content of circulating immune complexes in funic blood were examined in 35 premature neonates with low body weight, 27 neonates with grade I prematurity and in 24 normal full-term neonates (a control group) by days 1-2 and days 7-8 of life. The positive time-course of changes in the neutrophil capacity for completed phagocytosis and in the content of circulating immune complexes was disclosed in full-term neonates with low body weight at birth. The same parameters showed a negative time-course of changes in premature neonates.     

急性特发性血小板减少性紫癜患儿免疫功能变化及其临床意义

目的检测特发性血小板减少性紫癜(ITP)患儿的免疫功能并探讨ITP的发病机制。方法抗血小板抗体(PAIgG)测定采用放射免疫法,IgA、IgG、IgM测定采用WL-快速免疫消浊比浊法,T淋巴细胞亚群测定采用APAAP法,血清IL-2、sIL-2R和IL-6测定采用ELISA法。结果 ITP患儿的IL-2、IL-6,IgA、IgM、CD8及IL-2R表达均明显升高(P<0.01),CD4+、CD4+/CD8+细胞均明显减少(P<0.01)。结论细胞免疫及体液免疫异常共同参与ITP致病机制,调节淋巴细胞亚群平衡有助于寻找ITP治疗的新途径。     

急性淋巴细胞白血病患儿反复解脲寡源杆菌感染1例报道并文献复习

目的提高对白血病患儿化疗中并发罕见细菌感染诊断及治疗的认识。方法报道1例急性淋巴细胞白血病患儿化疗中先后发生解脲寡源杆菌败血症和颅内感染的诊治经过并文献复习。结果诊断为急性淋巴细胞白血病(L1型,BⅢ型,标危),化疗中相隔数月发生同一细菌(解脲寡源杆菌)3次感染,前两次为败血症,第三次为颅内感染并脑积水,随着自身免疫力的恢复,并联合抗感染及手术治疗治愈出院。相关文献示解脲寡源杆菌感染主要发生于全身或局部免疫功能低下的患者,全身系统性感染罕见,随着自身免疫力的提高,疾病似有自限性。结论不明原因长期发热的病例应警惕条件致病菌导致的特殊部位感染;治疗除了以体外药敏试验为依据,自身免疫功能的恢复也是感染控制的重要因素。     

儿童免疫性血小板减少症的研究进展

特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)是儿童时期最常见的获得性出血性疾病,因其发病机制与免疫相关,又称免疫性血小板减少症.近年来ITP在诊断和治疗方面取得了许多进展,特别是对诊断时的分期、症状的评分、治疗的适应证及预后等方面达成了一些共识,该文就儿童ITP近年来在病因和流行病学、症状及评分、诊断及分期、辅助检查、治疗的适应证及预后等方面的进展作一综述.