Production of interleukin-1 by peripheral blood monocytes in children with respiratory diseases

Overall 111 healthy children aged 3 to 7 years, 71 children with ARVI and those aged 2 to 14 years with ARVI complicated by bronchitis and pneumonia were examined. The level and rate of IL-1 production by peripheral blood monocytes in response to lipopolysaccharide (LPS) were determined. It has been established that 98.7% of the healthy children responded to LPS by marked production of IL-1. In 3 children, there was po synthesis of IL-1, in 26.1% of the healthy children, peripheral blood monocytes produced IL-1 without addition of LPS. In children with respiratory bacterial infections, there was a significant increase of IL-1 production as compared to the control. IL-1 production in ARVI was lowered.     

Hypercalciuria in children with febrile convulsions

BACKGROUND: The purpose of the present study was to investigate whether idiopathic hypercalciuria may be implicated in the pathogenesis of febrile convulsions. METHODS: We studied 38 children (22 boys) with febrile convulsions (mean (+/- SD) age 3.25 +/- 1.09 years) and 45 healthy children (28 boys) of similar age who served as controls. Twenty-four hour urine calcium and phosphate, as well as serum calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (PTH) concentrations were determined. RESULTS: Hypercalciuria (urine Ca >4.0 mg/kg bodyweight per 24 h) was found in nine children with febrile convulsions (23.7%) and in three controls (6.7%). Hypercalciuric children excreted significantly more phosphate in their urine (37.0 +/- 11.6 mg/kg bodyweight per 24 h) than normocalciuric children (18.7 +/- 8.7 mg/kg bodyweight per 24 h) and controls (20.2 +/- 7.6 mg/kg bodyweight per 24 h). They also had higher serum intact PTH concentrations (49.87 +/- 15.36 pg/mL) than normocalciuric (35.39 +/- 15.67 pg/mL) and control children (28.21 +/- 14.00 pg/mL). According to the calcium-loading test, eight of nine children with hypercalciuria had the renal type of the disorder. Furthermore, hypercalciuric children had significantly more convulsive episodes (2.77 +/- 1.98) than normocalciuric children (1.86 +/- 1.24). CONCLUSIONS: Our results suggest that renal hypercalciuria may be implicated in the pathogenesis of febrile convulsions.     

Hyponatraemia in children with febrile convulsions.

In a study of 23 children admitted to hospital with a febrile convulsion, mild hyponatraemia was found on 8 occasions. In 6 of these cases there was evidence of inappropriate secretion of antidiuretic hormone. The hyponatraemia is unlikely to be the cause of the convulsion, but probably predisposes the child to a subsequent convulsion during the same febrile illness.     

Spontaneous and inducible interleukin 1 production from peripheral blood monocytes in bacterial and viral infections in children

Peripheral blood monocytes from children with severe bacterial infection showed a high level of spontaneous (unstimulated) production of interleukin 1 (IL-1). In viral respiratory or gastrointestinal infections there usually was little or no spontaneous IL-1 production from monocytes, and the values did not differ from those of children with no infections or inflammatory disease. Lipopolysaccharide-induced IL-1 production from monocytes was slightly but not significantly greater in bacterial infections than in viral infections and controls. Tuberculin (purified protein derivative)-induced IL-1 production from monocytes of patients with viral infections was significantly less than in bacterial infections and also slightly less than in controls. These results indicate that systemic bacterial infections activate spontaneous release of IL-1 from monocytes whereas uncomplicated viral infections usually do not. Tuberculin-inducible IL-1 activity of monocytes appears decreased in viral infections; this might be associated with suppressed cell-mediated immunity in such infections.     

Incidence of febrile convulsions in children with congenital hypothyroidism

Brain excitability has been inconsistently reported to be increased both in hypo- and hyperthyroidism, but there have been few studies on the effects of thyroid hormones on brain excitability in children. With this in mind, we investigated the incidence of febrile convulsions (FCs) among patients with congenital hypothyroidism, who have been taking L - thyroxine since the age of 1 month. The incidence of FCs among congenital hypothyroid patients was 1.6% (1/63) which was significantly low ( p < 0:05) compared with that of normal control children who visited our hospitals as outpatients (28/341, 8.2%) and that of others (322/3301, 9.8%) investigated 33 years ago in the same area. The incidence of FC among siblings of the 63 patients (7/74, 9.5%) was not statistically different from the controls. At least 8 of the 126 parents (6.4%) had experienced FC, however, only one child was affected in the 8 families. In conclusion, it seems likely that patients with congenital hypothyroidism on regular L -T4 replacement are less prone to experience FC. More studies on the incidence of convulsive disorders in children with thyroid diseases are needed to clarify the effects of thyroid hormones on brain excitability.     

Prevalence of recent immunisation in children with febrile convulsions

AIM: To determine the prevalence of recent immunisation amongst children under 7 years of age presenting for febrile convulsions. METHODS: This is a retrospective study of all children under the age of seven presenting with febrile convulsions to a tertiary referral hospital in Sydney. A total of 78 cases occurred in the period January 2011 to July 2012 and were included in the study. Data was extracted from medical records to provide a retrospective review of the convulsions. RESULTS: Of the 78 total cases, there were five medical records which contained information on whether or not immunisation had been administered in the preceding 48 h to presentation to the emergency department. Of these five patients only one patient (1.28% of the study population) was confirmed to have received a vaccination with Infanrix, Prevnar and Rotavirus. The majority of cases reported a current infection as a likely precipitant to the febrile convulsion. CONCLUSION: This study found a very low prevalence of recent immunisation amongst children with febrile convulsions presenting to an emergency department at a tertiary referral hospital in Sydney. This finding, however, may have been distorted by underreporting of vaccination history.     

热性惊厥患儿肾功能及尿微量蛋白的变化

热性惊厥是儿童期惊厥发作的最常见类型,在5岁前儿童中的发生率大约为2%~5%[1],一般预后良好。然而,惊厥发作时存在一个短暂的缺氧过程,这种缺氧过程是否会造成患儿肾功能的一过性改变,目前未见相关报道,本研究对此进行探讨。1资料与方法1.1研究对象本研究对象分为3组:热性惊厥     

Dermatophagoides-induced interleukin-10 production by peripheral blood lymphocytes from patients with asthma in remission

Interleukin (IL)-10 is a cytokine that regulates inflammatory responses. We studied the role of IL-10 in the development of tolerance to Dermatophagoides farinae in asthma patients in remission, since asthma improves in most children during adolescence. The spontaneous production of IL-10 by cultured peripheral blood mononuclear cells (PBMC) was higher in patients with active asthma than in normal subjects. IL-10 production decreased when 1 microg/ml D. farinae was added to cultures, but increased again in a dose-dependent manner when higher concentrations of D. farinae were added. In patients with remission of asthma, IL-10 production was lower than in patients with active asthma. However, production of IL-10 showed a reciprocal increase in the presence of 1 microg/ml D. farinae, and decreased again at 10 and 50 microg/ml D. farinae. Such alterations were not observed in normal subjects. Cell lines established from patients asthma in remission showed higher IL-10 production when compared with that by cell lines from normal subjects or patients with active asthma when the cells were stimulated by D. farinae at 1 or 10 microg/ml. Neutralization of IL-10 led to revival of the D. farinae-specific proliferative response of PBMC from patients in remission, which was otherwise decreased. The increase of IL-10 production stimulated by D. farinae was inhibited by addition of an anti-IL-10 antibody. In contrast, antigen-induced interferon (IFN)-gamma production, which was increased by D. farinae stimulation when patients were in remission, did not increase after treatment with anti-IL-10, although spontaneous IFN-gamma production increased to the level seen after D. farinae stimulation. The reduced IL-4 production by cells from patients in remission after stimulation with D. farinae antigen, which was significantly higher in active patients, was not reversed by neutralization of IL-10. The D. farinae-induced IL-10/IL-4 production ratio, but not the IL-10/IL-5 production ratio, may be a significant indicator for evaluation of whether a patient has been in remission. In conclusion, D. farinae-specific anergy of T cells is likely to be induced by increased levels of IL-10 and IFN-gamma that are initially produced by specific T cells after exposure to relevant mite allergen in patients in remission.     

Parental age and birth order effects in children with febrile convulsions

This is a study of the parental age and birth order of 100 Chinese children with febrile convulsions compared with 100 controls. The birth order of children with febrile convulsions (1.6±0.8) was found to be lower than that of the controls (2.1±1.0), a difference significant at P<0.001, whereas there was no significant difference for both paternal and maternal age. Using multiple regression analysis, it was found that the birth order effect was significant at P<0.0001. This finding suggests that perinatal factors may play a role in the pathogenesis of febrile convulsions.     

Lactic dehydrogenase isoenzyme in cerebrospinal fluid of children with febrile convulsions

Aim: To study the lactic dehydrogenase isoenzyme values in children with simple and complex febrile convulsions. Methods: Cerebrospinal fluid samples were collected from 115 children, 57 with simple febrile convulsions, 27 with complex febrile convulsions and 31 with no neurological or intracranial pathology (controls). Lactic dehydrogenase activity and isoenzyme levels were measured on a Hitachi analyser. Results: Mean total lactic dehydrogenase activity was similar in the three groups. In the control group, lactic dehydrogenase-1 was the main fraction, followed by lactic dehydrogenase-2 and lactic dehydrogenase-3; only small percentages of lactic dehydrogenase-4 and lactic dehydrogenase-5 were detected. In the febrile convulsion group, the lactic dehydrogenase-1 fraction percentage was lower and lactic dehydrogenase-2, lactic dehydrogenase-3 percentages were higher than those in the control group; and the differences were statistically significant between the control and study groups (p 3 0.01). Values of lactic dehydrogenase-4 and lactic dehydrogenase-5 were similar in all three groups.

Conclusion: This is the first report on the lactic dehydrogenase isoenzyme pattern in the cerebrospinal fluid of patients with simple and complex febrile convulsions. The important finding that focal and general febrile convulsions are not associated with cell damage and changes in aerobic and anaerobic metabolism as lactic dehydrogenase remained unchanged. Analysis of cerebrospinal fluid lactic dehydrogenase isoenzyme levels can assist clinicians in differentiating febrile convulsions from clinical situations that might mimic them.     

Serum and cerebrospinal fluid zinc levels in children with febrile convulsions

The mechanisms underlying febrile convulsions (FC), which have multiple etiological factors, are not yet clear. The aim of the present study was to determine whether there were any changes in serum and cerebrospinal fluid (CSF) zinc (Zn) levels in children with febrile convulsion during seizures. A total of 102 children were included in the study, with four groups formed as follows: group A, 40 children with FC (aged 9 months to 5 years); group B, 20 children having fever without convulsion (aged 6 months to 5 years); group C, 20 children with afebrile convulsion (aged 6 months to 6 years) and group D, 22 healthy children (aged 5 months to 6 years). Serum and CSF zinc levels for groups A, B and C and serum Zn levels only for group D were measured. The serum Zn levels of 17 children in group A were again measured during healthy periods. Serum Zn levels of groups A, B, C and D had a mean of 0.70 ± 0.10 mg/dL, 1.07 ± 0.08 mg/dL, 1.26 ± 0.32 mg/dL and 1.17 ± 0.21 mg/dL, respectively, and the values of group A were lower than those of the other three groups (P < 0.001). In group B, serum Zn levels were also lower than those of groups C and D (P < 0.05). The CSF Zn levels of groups A, B and C were found to have a mean of 0.07 ± 0.02 mg/L, 0.12 ± 0.02 mg/L and 0.14 ± 0.04 mg/L, respectively. In group A, the CSF Zn levels were lower than those of groups B and C (P < 0.001), and in group B they were lower than those of group C (P < 0.05). For the 17 patients in group A, serum Zn levels during healthy periods (0.87 ±0.10 mg/dL) were found to be higher than the values shortly after seizures, but lower than those of groups B, C and D (P < 0.001). We could not observe any relationship between zinc levels of the serum and CSF and the degree and duration of the fever. These findings suggest that serum and CSF Zn levels decreased during infectious diseases, and that this decrease was more significant in patients with FC.     

Prophylactic treatment with valproic acid or diazepam in children with febrile convulsions

The purpose of this study was to limit prophylactic treatment of children with febrile convulsions to patients who have the highest risk of recurrence. Two hundred and thirty-one children with a first febrile seizure were divided into high- and low-risk groups according to estimated risk of recurrence. All high-risk children were offered treatment with valproic acid. If this was declined they were offered treatment with diazepam instead. Low-risk children were untreated. Valproic acid and diazepam were found to be equally effective in reducing the risk of recurrence of febrile convulsions. By selecting for prophylactic treatment according to estimated risk of recurrence it is possible to reduce the rate of recurrence of febrile seizures in children at high-risk (60%) to the same level as that of untreated low-risk children (23%). Only about half of all children with febrile convulsions need treatment and follow-up according to these criteria.     

Calcium, magnesium, and glucose levels in blood and CSF of children with febrile convulsions.

Levels of calcium, magnesium, and glucose were measured in the blood and cerebrospinal fluid (CSF) of children with febrile convulsions. Calcium and magnesium levels were within the normal range and the blood: CSF ratios were similar to those of normal subjects. Hyperglycaemia was a frequent finding and was reflected in raised CSF glucose levels. Blood glucose levels were only transiently raised and none of the children had diabetes mellitus.     

Polymorphisms for interleukin 1 beta exon 5 and interleukin 1 receptor antagonist in Taiwanese children with febrile convulsions

OBJECTIVE: To investigate whether interleukin 1 beta (IL-1 beta) exon 5 and IL-1 receptor antagonist (IL-1Ra) gene polymorphisms can be used as markers of susceptibility to febrile convulsions in children. METHODS: Children were divided into 2 groups: those with febrile convulsions (group 1; n = 51) and normal control subjects (group 2; n = 83). Polymorphisms for IL-1 beta exon 5 and IL-1Ra gene polymorphisms were detected by polymerase chain reaction. Genotypes and allelic frequencies for IL-1 beta exon 5 and IL-1Ra gene polymorphisms in both groups were compared. RESULTS: Genotype and allele frequencies for IL-1 beta exon 5 in both groups were not significantly different. Proportions of E1 homozygotes and E1/E2 heterozygotes for IL-1 beta exon 5 were 50 (98.1%) and 1 (1.9%), respectively, in group 1 and 82 (98.8%) and 1 (1.2%), respectively, in group 2. Frequencies of alleles E1 and E2 for IL-1 beta exon 5 were 101 (99.0%) and 1 (1.0%), respectively, in group 1 and 165 (99.4%) and 1 (0.6%), respectively, in group 2. Genotype proportions and allele frequencies for IL-1Ra between groups were significantly different. Proportions of genotypes I/I and I/II for IL-1Ra were 49 (96.1%) and 2 (3.9%) in group 1 and 69 (83.1%) and 14 (16.9%) in group 2. Frequencies of alleles I and II for IL-1Ra were 100 (98.0%) and 2 (2.0%) in group 1 and 152 (91.6%) and 14 (8.4%) in group 2. CONCLUSIONS: The IL-1Ra allele I is associated with a higher susceptibility to febrile convulsion, which may become a useful marker for predicting the development of febrile convulsions. The IL-1 beta exon 5 gene polymorphisms are not a useful marker for predicting the susceptibility to febrile convulsions.     

紫癜性肾炎患儿外周血单个核细胞白细胞介素-13的变化

目的　探讨白细胞介素１３（ＩＬ－ １３） 在紫癜性肾炎（ＨＳＰＮ） 的变化。方法　应用逆转录－ 多聚酶链反应（ＲＴ－ＰＣＲ） 及双抗体夹心ＥＬＩＳＡ 法,分别检测了３０ 例健康儿童和２０ 例ＨＳＰＮ 患儿活动期和恢复期外周血单个核细胞（ＰＢＭＣ） 在植物血凝素（ＰＨＡ） 刺激下ＩＬ－ １３ ｍＲＮＡ和蛋白水平的变化。结果　①ＨＳＰＮ 活动期ＰＢＭＣ中ＩＬ－１３ ｍＲＮＡ 和蛋白水平均显著高于正常对照组（０ ．４８ ±０ ．１１ ｖｓ０．３６±０．１６ 和４７ ．８９ ±１１ ．６７ ｐｇ／ｍｌｖｓ３５．２２±４．４２ ｐｇ／ｍｌ, Ｐ均＜ ０．０１） ,恢复期与正常对照组相比无显著差异（０．３８±０．１２ ｖｓ０．３６±０ ．１６ 和３５ ．９４ ±５．６０ ｐｇ／ｍｌｖｓ ３５ ．２２±４ ．４２ ｐｇ／ｍｌ,Ｐ均＞ ０．０５）;②临床上表现为蛋白尿型、肾病综合征型及急性肾炎综合征型者,活动期ＰＢＭＣ中ＩＬ－ １３ ｍＲＮＡ和蛋白水平均显著高于正常对照组,而表现为单纯血尿型者与正常对照组相比无显著差异。结论　ＨＳＰＮ 患儿活动期ＩＬ－ １３ 表达异常,且与临床类型有一定的相关关系。     

白细胞介素10受体1在食物过敏儿童外周血T淋巴细胞中的表达

目的　研究白细胞介素10受体1（IL-10R1）在食物过敏儿童外周血T淋巴细胞的表达及其临床意义。方法　选择2017-07-01至2017-12-31在北京大学第三医院儿科食物过敏门诊诊断为食物过敏的50例患儿作为食物过敏组,选择同期在北京大学第三医院儿童健康发展中心行健康体检的25名儿童作为对照组。采用流式细胞技术检测IL-10R1在两组儿童外周血CD4+T及CD8+T淋巴细胞表达阳性率及平均荧光强度值（MFI）。同时比较IL-10R1在过敏原特异性IgE阳性与阴性食物过敏患儿外周血CD4+T及CD8+T淋巴细胞表达阳性率及MFI。根据食物过敏患儿症状、体征严重程度进行赋值评分,分析食物过敏患儿IL-10R1在外周血CD4+T及CD8+T淋巴细胞表达阳性率与食物过敏症状、体征评分有无相关性。结果　IL-10R1在食物过敏组患儿外周血CD4+T及 CD8+T淋巴细胞表达阳性率和MFI均低于对照组,IL-10R1在食物过敏组CD4+T淋巴细胞表达阳性率和MFI中位数分别为40.23、 12.18; 在对照组CD4+T淋巴细胞表达阳性率和MFI中位数分别为45.32、 17.69（Z值分别为-2.506、 -5.457;P值分别为0.012、 0.000）。IL-10R1在食物过敏组CD8+T淋巴细胞表达阳性率和MFI中位数分别为34.50、 12.47;对照组CD8+T淋巴细胞IL-10R1表达阳性率和MFI中位数分别为39.46、 17.28（Z值分别为-4.035、 -5.226; P值分别为0.000、 0.000）。IL-10R1在过敏原特异性IgE阳性与阴性患儿外周血CD4+T及CD8+T淋巴细胞表达阳性率及MFI没有差异。食物过敏患儿IL-10R1在外周血CD4+T及CD8+T淋巴细胞表达阳性率与食物过敏症状、体征评分无相关性。结论　IL-10R1在外周血CD4+T淋巴细胞和CD8+T淋巴细胞表面表达减少可能与食物过敏发病有关;IL-10R1在外周血CD4+T淋巴细胞和CD8+T淋巴细胞表面表达在IgE和非IgE介导的食物过敏发病过程中均起作用;IL-10R1在外周血CD4+T淋巴细胞和CD8+T淋巴细胞表面表达可能与食物过敏发病严重程度无关。     

Increased Interleukin-1 (IL-1) Production from LPS-Stimulated Peripheral Blood Monocytes in Children with Febrile Convulsions

ABSTRACT. Peripheral blood mononuclear cells (MNC) from 27 children with a febrile convulsion were tested for production of interleukin-1 (IL-1) in culture. MNC stimulated with lipopolysaccharide (LPS) showed a significantly increased production of IL-1 when compared to MNC from children without convulsions but with bacterial infections ( p < 0.001), viral infections ( p < 0.005) or no infection ( p < 0.005). Children who had experienced a febrile convulsion were retested several months later; this time the IL-1 production from LPS-stimulated MNC was not different from controls. These results demonstrate that MNC at the time of febrile convulsions have increased sensitivity to LPS and possibly to other IL-1 inducers; the resulting enhanced IL-1 response from sensitized MNC may have a role in the pathogenesis of febrile convulsions.