L-ficolin in children with recurrent respiratory infections

The lectin pathway of complement activation is used by a collectin, mannan-binding lectin (MBL), and two ficolins, L-ficolin and H-ficolin, to opsonize microorganisms for phagocytosis. We published evidence recently that MBL insufficiency is associated with recurrent respiratory infections in childhood. We have now measured serum L-ficolin in 313 respiratory infection patients and 74 healthy control children. L-ficolin concentrations below the lower limit of the control group were found in 6% of the patients (P <0.02) and were associated most strongly with children having co-existing atopic disorders (11%; P=0.002). We suggest that L-ficolin may have a role in protection from microorganisms complicating allergic disease.     

Immunorestoration in children with recurrent respiratory infections treated with isoprinosine

In 27 children, 4-8 years old, with recurrent respiratory infections of the upper and lower respiratory tracts Isoprinosine (ISO) tablets were administered for 7-10 days at daily doses of 50-100 mg/kg. Clinical signs of acute respiratory disease, including temperature abnormalities and subjective complaints, subsided in a short time and the children showed no symptoms for periods ranging from several weeks to several months following the therapy. The children were selected for immunotherapy with ISO on the basis of their low levels of E-rosette forming cells in peripheral blood. Several immune function parameters assessed immediately after treatment with ISO and compared with those obtained before illness and ISO administration. Low levels of T-lymphocytes returned to normal after ISO therapy, B-lymphocyte relative and absolute numbers, however, were not affected by the treatment. Nor were any changes due to ISO found in immunoglobulins, complement components, beta 2-microglobulin and C-reactive protein. Moreover, ISO had no stimulative effect on spontaneous tetrazolium reductase activity of granulocytes but it showed a slight inhibition of their phagocytosis-associated metabolic activity.     

T lymphocytes in children with allergic respiratory disease.

The role of T lymphocytes in atopic disease is of considerable importance because animal studies indicate that cells of this lymphoid series may influence reaginic antibody response. T lymphocyte subpopulations were studied in a group of 76 children with allergic respiratory disease. There was no statistical difference between atopic children with asthma and those with allergic rhinitis as compared with an age-matched control population of 20 non-atopic children in terms of levels of active T lymphocytes or total T lymphocytes. The results of this study do not support the concept of a T cell immunodeficiency in children with allergic respiratory disease.     

Mannan-binding lectin insufficiency in children with recurrent infections of the respiratory system

Blood samples were collected over a 4-year period from 335 children (aged 1-16 years) suffering from recurrent respiratory infections and 78 controls. The patients were subdivided into four groups: I, children with no immune system defects detected (n = 101); II, children with allergies (n = 94); III, children with humoral response defects (n = 93); and IV, children with disturbances of cellular immunity (n = 66). Nineteen patients had both humoral and cellular abnormalities. All patients and controls were investigated to determine the exon 1 and promoter region variants of the mbl-2 gene. MBL serum concentrations were also determined in samples from 291 patients and 75 controls. The proportion of O (B, D or C) alleles was significantly higher in the patient group compared to controls, and this association was strongest for subgroup III. The promoter LX variant frequency was also commoner in the patients as a whole, and significantly so in subgroups II and IV. Genotypes markedly influenced MBL concentrations in all groups, and correlated with ability to activate the lectin pathway of complement activation. The strongest and most significant inverse correlations between serum MBL and respiratory disease were found in patient group III and in 17 patients with multiple humoral and/or cellular abnormalities. Among nine patients with unexpectedly low LP activity in view of their MBL concentrations, one person was found to be MASP-2 deficient. Our results indicate that mannan-binding lectin insufficiency, with or without a coexisting immune defect, is associated with the occurrence of recurrent respiratory infections in childhood, and this relationship is particularly strong and statistically significant in children with concomitant impairments of humoral immunity.     

Immunostimulation in recurrent respiratory tract infections therapy in children

Selected immunologic parameters and effectivity of immunotherapy was evaluated in 117 children (12-month-10-year-1-old) suffering from recurrent respiratory tract infections. All the children displayed a profound depression of T lymphocytes number, which resemble the situation seen in AIDS patients. An increase of serum IgM concentration was also noted. Immunotherapy included treatment with the following preparations: TFX and Levamisol which stimulate T cell functions, Broncho-Vaxom which stimulates specific antibody production and a complex herb preparation PADMA showing undefined general stimulatory activity. Separate group of children was subjected to climatotherapy in Czerniawa Sanatorium and received no immunostimulants. All methods of treatment employed had beneficial effect. The highest percentage of positive results was obtained in children receiving TFX and Levamisol. In all groups under study, an elevation of T cells percentage was observed. This was especially evident in Levamisol treated patients. There was no correlation, however, between T cells number and clinical improvement.     

C4A deficiency in children and adolescents with recurrent respiratory infections

Increased susceptibility to recurrent viral and bacterial respiratory infections in children and young adults is not well understood. To evaluate the role of complement factor C4 in the defense against respiratory infections, we studied complement factor C4 allotypes C4A and C4B and copy numbers of C4A and C4B genes in 84 children and young adults with recurrent acute otitis media, sinusitis, or pneumonia and in 74 healthy controls. The occurrence of C4A gene deficiency was significantly higher in patients compared with controls (26% vs 14%, p = 0.048). Girls predominated in the group of patients with C4A deficiency (73% girls and 27% boys, p = 0.004). The lectin pathway of complement was more often functionally impaired in patients with C4A deficiency than in patients with no C4A deficiency (41% vs 13%, p = 0.033). Classical and alternative pathways were normal in individuals with C4 null alleles. C4A deficiency is 1 of the minor defects of the innate immunity that may predispose children and young adults to recurrent respiratory infections. C4 gene testing should be added to the list of investigations when the cause for recurrent acute otitis media, maxillary sinusitis, or pneumonia in children and young adults is sought.     

Immunoglobulin levels and function in pre-school children with recurrent respiratory infections.

Thirty pre-school children with recurrent respiratory infections had a higher age adjusted mean serum IgG level than their siblings or a reference group. One index child had persistently low serum IgA, but mean serum IgA and IgM levels for the index children were normal. All of the 23 index children and 17 siblings studied had a four-fold or greater rise in virus neutralizing antibody titre. There was no correlation between serum immunoglobulin levels and frequency of infections. There was, however, a significant inverse correlation between salivary IgA levels when healthy and the number of infections experienced by each child in the study year. Salivary IgA levels rose considerably during acute infections.     

Role of T-cell subsets in bacterial infections.

Classic functional partitioning of T-cell subsets is being questioned: in many bacterial and protozoan infections, CD8 T cells play a role in protection; two types of CD4 T helper cells have been characterized, one protective, the other exacerbating disease; finally, gamma delta T cells have been implicated in the host response to certain bacteria. Moreover, evidence is accumulating that, in addition to T-cell helper functions, cytolytic T-cell functions participate in antibacterial immunity.     

Vitamin D deficiency in children with recurrent respiratory infections,with or without immunoglobulin deficiency

Purpose

The objective of this study was to evaluate thevitamin D concentration in patients with recurrent respiratory infections with or without immunoglobulin G, A or M (IgG, IgA, IgM) deficiency, and to find a correlation between the vitamin D concentration and the response to hepatitis B vaccination.

儿童传染性单核细胞增多症T细胞亚群的变化及其干预方法探讨

目的 探讨儿童传染性单核细胞增多症(IM)T细胞亚群的变化及免疫干预的有效性.方法 入选的48例患儿分为2组,治疗组患儿28例,用丙种球蛋白(IVIG)治疗,IVIG 400 mg/(kg·d),连用5 d;或IVIG 1g/(kg·d),连用2 d.对照组患儿20例,予更昔洛韦(GCV)5～10 mg/(kg·d)连用5 d.并予对症支持治疗.选择20例正常儿童作为健康对照.结果 健康儿童CD4(%)、CD8(%)及CD4/CD8比值分别为(34.12±3.53)%、(26.22±4.43)%及(1.41±0.3);IVIG组分别为(24.2±4.3)%、(36.4±6.8)%及(0.72±0.12);GCV组(23.7±5.1)%、(37.3±7.8)%及(0.67±0.13),健康对照组与两组IM患儿比较,差异有统计学意义(P<0.05);与治疗前比较,IVIG组患儿治疗后CD4(%)升高、CD8(%)下降及CD4/CD8比值升高(P<0.05);而GCV组患儿治疗前后上述指标无显著性变化(P>0.05);IVIG治疗组患儿临床症状及体征较GCV治疗组消失快(P<0.05),IVIG组患儿治疗有效率88.7%,GCV组患儿治疗有效率59.2%(χ2=3.97,P<0.05);IVIG组患儿平均住院日为(9.2±4.3)d,较GCV组(13.8±5.1)d明显缩短(t=-4.24,P<0.05);结论IM患儿除了病毒感染导致的直接影响外,存在明显的免疫功能紊乱;IVIG免疫干预治疗优于单纯抗病毒治疗.     

The effect of vitamin E treatment on the incidence of OKT+4 lymphocytes in the peripheral blood of children with chronic respiratory tract infections

Children with respiratory tract infections treated for 6 weeks with vitamin E improved their clinical status and normalized the proportion of OKT+4 T lymphocytes and the ratio of OKT+4 to OKT+8 cells in their peripheral blood.     

Optimal assessment of the ability of children with recurrent respiratory tract infections to produce anti-polysaccharide antibodies

Specific anti-polysaccharide antibody deficiency (SPAD) is an immune disorder. Diagnostic criteria have not yet been defined clearly. One hundred and seventy-six children evaluated for recurrent respiratory tract infections were analysed retrospectively. For each subject, specific anti-pneumococcal antibodies had been measured with two enzyme-linked immunosorbent assays (ELISAs), one overall assay (OA) using the 23-valent pneumococcal polysaccharide vaccine (23-PPSV) as detecting antigen and the other purified pneumococcal polysaccharide serotypes (serotype-specific assay, SSA) (serotypes 14, 19F and 23F). Antibody levels were measured before (n = 176) and after (n = 93) immunization with the 23-PPSV. Before immunization, low titres were found for 138 of 176 patients (78%) with OA, compared to 20 of 176 patients (11%) with the SSA. We found a significant correlation between OA and SSA results. After immunization, 88% (71 of 81) of the patients considered as responders in the OA test were also responders in the SSA; 93% (71 of 76) of the patients classified as responders according to the SSA were also responders in the OA. SPAD was diagnosed in 8% (seven of 93) of patients on the basis of the absence of response in both tests. Thus, we propose to use OA as a screening test for SPAD before 23-PPSV immunization. After immunization, SSA should be used only in case of a low response in OA. Only the absence of or a very low antibody response detected by both tests should be used as a diagnostic criterion for SPAD.     

Atypical bronchial cilia in children with recurrent respiratory tract infections. A comparative ultrastructural study

Ultrastructurally atypical bronchial cilia are studied and semiquantitatively analysed in 24 children suffering from recurrent respiratory tract infections with or without bronchiectasis. In patients with Kartagener's syndrome normal-looking and shortened dynein arms are present at some axonemal microtubular doublets. This finding suggests that the polymerization or assemblage of dynein molecules on microtubules only is defective but not totally lacking. Bilateral, local and partial absence of dynein arms is demonstrated in some of the patients with acquired unilateral bronchiectases. These patients also reveal anomalies of the "9 + 2" microtubular axonemal pattern. It is suggested that these abnormalities of the tubulin-dynein system are local and acquired defects that may impair bronchial mucociliary clearance. None of the patients with pneumonia and asthma or with cystic fibrosis studied show any anomalies of the dynein arms. However aberrant axonemal microtubular patterns and other ciliopathies such as naked axonemes and megacilia are present at times in these patients. We postulate that these atypical cilia are secondary acquired abnormalities. Only some patients with bacterial or viral pneumonia demonstrate a partial lack of dynein arms in bronchial cilia. Other ciliopathies such as megacilia, naked and intracytoplasmic axonemes and apical blebs are more frequent and more common in these patients. We suppose they manifest a secondary and rather aspecific pathogenic influence upon the bronchial ciliary substructure.     

Two subsets of rat T lymphocytes defined with monoclonal antibodies

A new monoclonal mouse antibody that recognizes a subset of rat peripheral T cells has been prepared by immunizing mice with rat thymocyte glycoprotein. This antibody, designated MRC OX 8, labels all peripheral T cells that are unlabeled by the previously described W3/25 monoclonal antibody. No peripheral T cells were found that bound both antibodies, but, in contrast, 90% of thymocytes were doubly labeled. Thoracic duct lymphocytes of congenitally athymic nude rats were not labeled by either antibody, but the spleens of such animals contained both W3/25⁺ cells and MRC OX 8⁺ cells. These splenocyte subpopulations did not overlap. Using the fluorescence-activated cell sorter to isolate cells binding MRC OX 8 antibody, the phenotype of T cells mediating various T cell functions was established. Combining the present results with those published previously, it is shown that the cells providing help for antibody responses and those mediating graft-vs. -host reactions are phenotypically W3/25⁺ MRC OX 8^?. On the other hand, parental T cells that suppress antibody formation in F₁ hosts were identified as W3/25^? MRC OX 8⁺. The relationship between the rat T cell subsets defined by these antibodies and those in the mouse identified by the Ly series of alloantibodies is discussed and a comparison made between the rat W3/25⁺ subset and a recently identified human T cell subset.     

Prophylactic management of children at risk for recurrent upper respiratory infections: the Preventia I Study

BACKGROUND: Given the morbidity and mortality of asthma and the recent dramatic increase in its prevalence, pharmacologic prophylaxis of this disease in children at risk would represent a major medical advance. OBJECTIVES: The Preventia I Study was designed to evaluate the efficacy and long-term safety of loratadine in reducing the number of respiratory infections in children at 24 months. A secondary objective was to investigate the benefit of loratadine treatment in preventing the onset of respiratory exacerbations. METHODS: Preventia I was a randomized placebo-controlled study involving 22 countries worldwide. The children were 12-30 months of age at enrollment and had experienced at least five episodes of ENT infections, and no more than two episodes of wheezing during the previous 12 months. Phase I was a 12-month double-blind period during which the children were treated with loratadine 5 mg/day (2.5 mg/day for children相似文献   

Immunoregulatory effect of T cell subsets on PWM-induced IgG synthesis by blood lymphocytes in lung cancer.

The mechanism of pokeweed mitogen (PWM) dependent decreased IgG production by blood lymphocytes from lung cancer patients was studied in comparison to control patients and blood donors. It has been shown that the depletion of monocytes has some influence on IgG synthesis but is not a decisive factor. Also, quantitative alterations in the CD4 and CD8 lymphocyte subsets do not significantly influence the PWM stimulation index for IgG synthesis. The assessment of T lymphocyte suppressor activity in lung cancer patients was performed by means of a co-culture with blood mononuclear cells, while helper activity was evaluated through co-culture with donor B lymphocytes. It has been found that lung cancer patient T lymphocytes have no increased suppressor activity, however, especially in the CD4 subset, display the decrease of helper function for B lymphocytes in PWM-induced IgG synthesis. The weakened helper function of CD4 lymphocytes may explain the suppression of specific antibody synthesis do novo which is evident in patients with lung cancer.     

The role of body temperature on respiratory rate in children with acute respiratory infections

BackgroundThe World Health Organization (WHO) recommends the use of tachypnea as a proxy to the diagnosis of pneumonia.ObjectiveThe purpose of this study was to examine the relationship between body temperature alterations and respiratory rate (RR) difference (RRD) in children with acute respiratory infections(ARI).MethodsThis cross-sectional study included 297 children with age 2–60 months who presented with cough and fever at the pediatric emergency and outpatient clinics in the Department of Pediatrics, Baskent University Hospital, from January 2016 through June 2018. Each parent completed a structured questionnaire to collect background data. Weight and height were taken. Body temperature, respiratory rate, presence of the chest indrawing, rales, wheezing and laryngeal stridor were also recorded. RRD was defined as the differences in RR at admission and after 3 days of treatment.ResultsBoth respiratory rate and RRD were moderately correlated with body temperature (r=0.71, p<0.001 and r=0.65, p<0.001; respectively). For every 1°C increase in temperature, RRD increased by 5.7/minutes in overall, 7.2/minute in the patients under 12 months of age, 6.4/minute in the female. The relationship between body temperature and RRD wasn''t statistically significant in patients with rhonchi, chest indrawing, and low oxygen saturation.ConclusionRespiratory rate should be evaluated according to the degree of body temperature in children with ARI. However, the interaction between body temperature and respiratory rate could not be observed in cases with rhonchi and severe pneumonia.