Parapemphigus and variants; clinical and immunological aspects

The clinical, histopathological and immunological findings and therapeutic data of 29 patients with different variants of pemphigoid seen by us in the period 1981-1988 are summarized. All 29 patients: disseminated or bullous pemphigoid (20 cases), localized pemphigoid (3 cases), cicatricial pemphigoid (2 cases), juvenile pemphigoid (2 cases), papular pemphigoid (1 case) and pemphigus vegetans (1 case) showed as common denominators subepidermal blister formation and linear deposition of Ig (IgG) and complement in the basement membrane zone. In nearly all the cases with disseminated pemphigoid treatment with immunosuppressive drugs orally was indicated. With particular reference to the age of patients in this subgroup (mean age greater than 70 years) aspects inherent to the treatment are briefly discussed. In contrast to the (relatively) benign course of the disease in localized pemphigoid and in juvenile pemphigoid, cicatricial pemphigoid with mucosal localization appears to be a variant within the spectrum of pemphigoid with severe complications due to tissue retraction and loss of local function.     

Bancroftian filariasis in a Philippine village: clinical, parasitological, immunological, and social aspects.

The distribution and effects of Bancroftian filariasis in 535 inhabitants of a Philippine village were investigated. Clinical, parasitiological, immunological, and socioeconomic assessments were made. A history of acute lymphatic inflammation and the presence of inguinal lymphadenopathy were common. Lymphatic obstructive disease, defined as leg edema, hydrocele, or an epididymal cyst, was more common in men than women and increased progressively with age. The prevalence and intensity of microfilaremia rose with age in males, whereas the prevalence but not the intensity of infection increased with age in females. The prevalence of immunological responsiveness, as assessed by skin reactivity to microfilarial antigen and serum antibodies to adult filarial worms, increased with age in both males and females. There was no relationship between either microfilaremia or obstructive disease and the ability to work or have children, but both were more common in heads of households with the lowest socioeconomic scores. Epidemiological factors which may have contributed to these findings are discussed. (author's modified)     

Influence of alcohol consumption on immunological status: a review

The aim of this review is to present and discuss the effect of different levels of alcohol consumption on the immune system. Not only the amount consumed but also the type of alcoholic beverage have to be taken into account in order to determine the consequences on activity, number, distribution, balance, interaction and response of immunocompetent cells. The association between alcohol exposure and the risk of developing an alcohol-related disease is multifactorial. In fact, age, gender, smoking habits, dietary intake and exercise are involved among other factors. The evaluation of the host cellular and humoral immune responses has shown that alcohol may induce some benefits when consumption is moderate. Moreover, those alcoholic beverages that contain antioxidants, such as red wine, could be protectors against immune cell damage. According to the literature consulted, the daily consumption of 10-12 g and 20-24 g of alcohol for women and men, respectively, is considered to be a moderate intake; the type of beverage has been established not to be important when defining moderation. Particular attention is often focused on the U- or J-shaped curve which also suggests that light to moderate drinking produces a protective effect. Such an inverse relationship indicates a reduction of risk for both light and moderate consumers and a higher risk not only for hard drinkers, but also for non-consumers.     

Indirect calorimetry--a review of recent clinical applications

There has been a resurgence of interest in the information provided by indirect calorimetry. In the past calorimetry was considered a research technique, but technological advances have made it applicable in many clinical situations. Recent clinical applications of this technique have been examined in this review.     

The HLA system and immunological defence against cancer: a review.

In nonmalignant disease, there have been two mechanisms implicated in the association of HLA antigens with disease. In ankylosing spondylitis, evidence is accumulating for cross tolerance between a bacterial antigen and the HLA-B27 antigen; while in the autoimmune diseases, the involvement of an abnormal immune response gene, associated with A1/B8 haplotype, is strongly suspected. The same haplotype has also been associated with recovery from hepatitis B infection and survival of patients with Hodgkin's disease and acute myeloid leukaemia. At present, there are no techniques to study directly immune response genes in man and so these observations are still strictly academic. However, with increasing interest in the use of immunotherapy in cancer and the demonstration in mice that the major histocompatibility system may be the site of action of soluble mediators of immune memory, understanding the mechanisms of action of the HLA associated resistance factors may enable a more rational approach to immunotherapy in man.     

Hypomagnesemia. A review of pathophysiological, clinical and therapeutical aspects

The aim of this paper is to discuss, on the basis of an extensive literature review, the role of magnesium (Mg) in health and disease. Mg is an essential cation playing a crucial role in many enzyme systems. Quantitative Mg body stores are regulated by metabolic and hormonal effects on gastrointestinal absorption and renal excretion. Mg is a smooth muscle relaxant, dilates coronary arteries and peripheral vessels, exerts antiarrhythmic effects, may have a permissive effect on catecholamine actions and can play a role in various thrombogenic conditions. Today, hypomagnesemia has become a recognized medical occurrence which may be associated with many different diseases, either genetic or acquired. Mg deficiency is one of the most frequent electrolyte abnormalities in clinical practice, but it is probably the most underdiagnosed one. Clinical manifestations of hypomagnesemia may begin insidiously or dramatically sudden. A large part of the population (especially aged subjects) may have an inadequate Mg intake and a chronic latent Mg deficiency. Routine inclusion of serum Mg analysis in the electrolyte panel represents a continued need to recognize hypomagnesemia and to treat Mg-depleted patients. New clinical studies on Mg deficiency are necessary to ascertain the usefulness and cost-effectiveness of Mg replacement therapy.     

Alcohol and women: clinical aspects

Alcohol-related pathologies lead to most serious expressions, both at clinical and social level. The diffused social acceptance of consumption and abuse behavior and the lack of alcohol education for professionals (physicians, psychologists, social workers etc.) make difficult to put in the right frame this issue. Just a multidimensional approach can make the problem understandable. The history of alcohol consumption during the time gives us an exhaustive picture of the negative consequences of alcohol consumption. Alcohol consumption during pregnancy is a problem still underestimated and represents a serious risk for the health of the newborns: children alcohol-exposed in uterus are at risk to develop many pathologies and even the fetal-alcohol syndrome (FAS) that leads to facial anomalies, growth deficiencies and neurological damages. Therefore interventions coping with this kind of issues are needed in order to enhance people's health.     

Melatonin: physiological and pathophysiological aspects and possible applications

The number of indications for the medical use of melatonin is slowly increasing. Melatonin is produced by the pineal gland and is a key signal in the circadian rhythm of the body. Melatonin plays an obvious role in the pathophysiology and treatment of sleep disorders and jetlag. Recent research has also demonstrated its favourable effect on blood-pressure regulation. By analogy, melatonin may play a role in a variety of other circadian processes. However, research into the precise effects is still insufficient.