EDA-containing fibronectin levels in the cerebrospinal fluid of children with meningitis.

Fibronectin containing an alternatively spliced extra domain A (EDA-FN) participates in diverse biological cell functions, being also directly or indirectly engaged during an inflammatory response to brain injury and/or neuron regeneration. We analyzed FN and EDA-FN isoform levels by ELISA in 85 cerebrospinal fluid samples and 67 plasma samples obtained from children suffering from bacterial or viral meningitis and non-meningitis peripheral inflammation. We have found that the cerebrospinal level of EDA-FN was significantly lower in the bacterial meningitis group than in the viral- and non-meningitis groups. In the patients' plasma, EDA-FN was almost undetectable. The determination of fibronectin containing the EDA segment might be considered as an additional diagnostic marker of bacterial meningitis in children.

Human plasma and cerebrospinal fibronectins differ in the accessibility of the epitopes on the N-terminal domains.

Three monoclonal antibodies specific to the central cell-binding and the C- and N-terminal domains of fibronectin (FN) were used to test antigenic epitope accessibility on human plasma and cerebrospinal fibronectins. In the plasma group, the mean N-terminal FN domain immunoreactivity was about one fourth that of the cell-binding and C-terminal domains, whereas in cerebrospinal fluid they were nearly equal. In the presence of 0.5-6 M urea N-terminal domain immunoreactivity in the plasma increased 3-6-fold, but it decreased 0.7-3-fold in the cerebrospinal fluid. Analysis of fibronectin domain immunoreactivities of the cell-binding and N-terminal domains by a panel of specific monoclonal antibodies may reveal N-terminal fibronectin domain accessibility for reaction with biological partner ligand(s) and/or processes in which FN could be implicated. Such determinations may have important clinical implications.

[The treatment of HCV infection with interferon alpha and ribavirin in a child with diabetes I type]. / Przebieg leczenia rebetronem dziecka z przewleklym zapaleniem watroby wywolanym hcv i z cukrzyca typu I.

UNLABELLED: HCV is a leading cause of chronic hepatitis in worldwide and diabetes is thought to be a risk factor of HCV infection. Interferon treatment may induce the autoimmune reactions. We report a case of 10 year old girl with diabetes since 4 th year of life and HCV infection since 9 year of life, treated with alpha-interferon and ribavirin for 12 months. Interferon was administered in doses of 3 MU 3 times a week, ribavirin 200 mg 3 times daily. Liver function (ALT, AST, GGT, prothrombin) and morphology was monitored every 6 weeks. Autoantibodies (ANA, ASMA, AMA, ATG, TPO) were tested before the treatment, after 6 and 12 months of the treatment. We have observed the adverse reactions typical for interferon and ribavirin treatment, such as: loss of appetite, muscle and joint pains, hair loss, emotional lability, concentration disturbance, irritability, somnolence and mental depression, which subsided after the end of the treatment. The transitional ALT, AST elevation in 6th month of the treatment was observed. During the therapy hypothyreosis was diagnosed in the 7th month, and thyroid autoantibodies (ATG and TPO) appeared in the 12th month. ANA antibodies were present before therapy and its titer increased after 6 month of treatment. During the therapy pneumonia, thrombocytopaenia and anaemia were observed in 6th month. CONCLUSIONS: diabetes is not contraindication to interferon and ribavirin treatment. Interferon treatment in the patients with genetic predisposition to thyroid gland diseases and in the patients with present autoantibodies ought to be applied with special caution.

A longitudinal study of the efficacy of interferon therapy in children with chronic hepatitis B.

BACKGROUND: Interferon alpha (IFN) is the most effective drug in the treatment of chronic hepatitis B. This article presents the results of IFN therapy and 28-month follow-up. MATERIAL/METHODS: 193 Caucasian children (130 boys and 63 girls) aged 1.5-17 years were treated with IFN for 20 weeks (3.0 MIU 3 times a week). They were examined at baseline (period 0), after 6 weeks (period 1), 12 weeks (period 2), 20 weeks (period 3), 6 months (period 4), 12 months (period 5), 18 months (period 6), and 24 months (period 7). RESULTS: HBcAg elimination drom period 3 was: 29.6%, 35.2%, 45.4%, 58.3%, in period 7 63.9% (significantly higher in girls). Significant positive correlations were found in several periods between IFN/m2 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence and negatie correlations between IFN/m2 and ALT activity. ALT activity significantly decreased in girls between periods 0-3, in boys between 0-3 and 4-6. Significant positive correlations between ALT-0 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence was seen in several periods, more frequently in girls. IFN transiently decreased Hb, leukocytes, and thrombocytes, especially in boys. No relationship was found between IFN therapy and bilirubin, protein, albumin and gammaglobulin concentrations. The prothrombin index increased after 6 months of IFN therapy in girls. CONCLUSIONS: The efficacy of IFN therapy is clearer with longer observation, especially in girls. A relationship was found between IFN dose and HBeAg/HbeAb and HBsAg/HBsAb seroconversion. IFN had a transient negative effect on the peripheral blood picture.