Omalizumab use during pregnancy for CIU: a tertiary care experience.

The treatment of antihistamine and steroid resistant Chronic Idiopathic Urticaria (CIU) during pregnancy poses a challenge due to teratogenicity of immunosuppressants. Omalizumab is a recently FDA approved therapy for CIU and is classified as pregnancy category B. We present an initial series of subjects treated at a tertiary care center for antihistamine and steroid resistant CIU with omalizumab who became pregnant during therapy.

A laser nephelometric method for measuring alternative pathway complement activity of human and murine serum.

A kinetic method for the evaluation of alternative pathway complement activity in man and mice is presented. A laser nephelometer was employed for detection of non-sensitized rabbit erythrocyte lysis based on the observation that the intensity of laser scatter (LS) is proportional to the number of erythrocytes in suspension. During erythrocyte lysis a continuous decline in LS is observed since lytic products do not evoke LS. Utilizing the indirect Coombs test and cross-electrophoresis it was shown that rabbit erythrocyte lysis causes activation of the alternative complement pathway. This method is modified for room temperature, is independent of sample hemoglobin content and, in its micro version, it can be done with 10 microliter of human serum, i.e. 50 microliters of murine serum.

Antibodies against rabbit red blood cells in murine serum and their effect on the activity of complement alternative pathway.

Antibody content against rabbit red blood cells (anti-RaRBC) in murine sera of different strains (Swiss, CBA, C57BL/6, AKR, BALB/c) and activity of complement alternative pathway (AP) were investigated. In contrast to the CBA and C57BL/6, random-bred Swiss strain and inbred BALB/c and AKR strains are good producers of these natural antibodies. There is no correlation between AP activity and anti-RaRBC content. Isolated human anti-RaRBC antibodies, IgM and IgG classes, lead to the enhancement of APhu and APmo activity, contrary to the murine anti-RaRBC which belong solely to IgM class, and do not express this capability.

The effects of submandibularectomy on the thymus and T-cell system of mice.

Functional changes of the T-cell immune system in submandibularectomized (SMx) male mice of CBA/H strain were analyzed three or four weeks after treatment. Thymuses and spleens were weighed and morphologically examined by light microscopy. We tested proliferation rates of thymocytes and splenocytes (stimulated by Con A and PHA) and cytotoxic activity of T lymphocytes in SMx, CBA/H (H-2k) mice by means of the rejection test of allogeneic skin graft (Balb/c, H-2d) and a microcytoxicity to allo-antigens of EL-4 tumor cells (H-2b). Results showed a reduction of the weights of the thymus and spleen. However, there was increased functional capacity of the thymocytes--expressed as increased proliferation rates of the stimulated thymocytes, increased microcytotoxicity to allo-antigens of EL-4 tumor cells in vitro, and a reduction of the survival period of skin allografts in vivo. No morphological changes other than a reduction in both the cortex and medullar of the thymus were observed. The subpopulational changes within the T-cell system because of SMx indicate that the morphological atrophy could be just a consequence of SMx.

Increased frequency of Rh(E) in acute appendicitis.

In 64 children with histopathologically confirmed acute appendicitis, the Rh(E) antigen was found to be more frequent than in corresponding, ethnically and geographically matched controls. The Rh phenotype responsible for the increase of E appeared to be CcD-Ee. The difference was highly significant and supported the hypothesis of a polygenic predisposition to acute appendicitis.

Variability of haptoglobin and alpha 2-macroglobulin in Albino Oxford and Dark Augustin inbred strains of rats before and after trauma.

Increased synthesis of acute-phase proteins (APP) in the liver represents the most prominent aspect of acute phase reaction (APR). Haptoglobin (Hp) and alpha 2-macroglobulin (alpha 2-M) are among the most important APP in rats. In this study AO (Albino Oxford) and DA (Dark Augustin) inbred strains of rats, with different resistance to trauma, were used to compare concentrations of Hp, alpha 2-M, IL-1, IL-6 and TNF, before and after tourniquet trauma. Cytokines IL-1, IL-6 and TNF have an important role in APP gene expression. Our results showed that before trauma, more resistant AO rats had higher concentrations of Hp and alpha 2-M compared to DA rats. The influence of genetic elements of these differences is significant. Tourniquet trauma caused an early increase of IL-1, IL-6 and TNF activities in the serum which preceded the increase in the Hp and alpha 2-M concentrations but differences between strains were not found.

Genetic basis of resistance to trauma in inbred strains of mice.

In this study the resistance to mechanical, thermal, and radiation trauma in four inbred strains of mice (AKR, BALB/c, CBA, and C57Bl/6) was compared with the degree of genetic resemblance, by analyzing the allozyme variabilities of these strains. It was shown that the highest degree of genetic resemblance was among CBA and AKR strains, which correlated with a similar degree of resistance to trauma. On the other hand, BALB/c and C57Bl/6 strains expressed significant differences, both genetically and with respect to the responses to trauma. The hypothesis is introduced that the genetic determination of the resistance to trauma is based on: a) a polygenic control of general physiological homeostasis, with the possibility that b) some specific genes or single loci may contribute more than others to such adaptations of the strains tested.

Inheritance of acute appendicitis: familial aggregation and evidence of polygenic transmission.

We explored familiality as well as the heritability and possible mode(s) of inheritance of acute appendicitis in childhood and early adolescence. Our case-control study showed that a positive family history for reported appendectomy was significantly more frequent in families of 80 consecutive patients eventually proved to have histopathologic acute appendicitis than in families of surgical controls matched for sex, age, and number of siblings. The relative risk was 10.0 (95% confidence limits 4.7-21.4). The pattern of familial aggregation was further supported by the fact that the age-standardized morbidity ratio was four times greater among family members of cases than among controls. We then applied the unified mixed model of segregation analysis, as implemented in the computer program POINTER, to a new set of 100 multigenerational pedigrees of children with histopathologically confirmed acute appendicitis that were broken down into 674 nuclear families. Age-specific morbidity risk and lifetime incidence of acute appendicitis were estimated from relatives of controls matched for age and sex to probands. Complex segregation analysis supported a polygenic or multifactorial model with a total heritability of 56%. There was no evidence to support a major gene, although a rare gene could not be ruled out as the cause of a small proportion of cases. Specific studies to address genetic and environmental factors in this serious disease seem worthwhile; but, for now, a positive family history of appendicitis might join other evidence leading to improved clinical recognition of acute appendicitis.

[Reaction of the injured organism to infection]. / Reakcija povredenog organizma na infekciju.

Authors have examined degree of the immune response to experimentally inoculated agent in the early (6 hours) and late (7 days) phase of the organism response to thermal injury in BALB/c rats divided into two experimental groups and three control groups (only infected, only burnt and intact). Brucella abortus bovis of VA-19 species known as a good immune response stimulator in the host was i.p. inoculated in LD 50 (1 x 10(7) bact/ml). as the infective agent. Thermal injury-scalding was induced after the Art-hurson's method. Obtained results after observed brucella multiplication and spreading in blood, spleen, liver and lymph nodes as well as after determination of the phagocyte activation degree measured by the lumisol-dependent-chemiluminescence technique have pointed out that the general response to also confirm reliability of serologic diagnosis of toxoplasmosis by IgM antibody detecting in disease outbreaks. Acute acquired toxoplasmosis could not be reliably diagnosed on the basis of IgG-ELISA and IgG-IIF test findings. Enzyme immunoassays-ELISA are significantly more sensitive and more specific than IIF ones.

[The importance of using various methods in the determination of serum immune complex levels]. / Znacaj primene razlicitih metoda za odredivanje koncentracije imunih kompleksa u serumu.

Concentration of immune complexes (IC) in the serum of patients with various diseases (glomerulonephritis systemic lupus erythematosus--SLE, rheumatoid arthritis--RA and with positive antibodies to human immunodeficiency virus--HIV+) has been determined using two methods: PEG precipitation and laser nephelometry (NL) of binding to Latex = C1 12q complement components in aqueous media. The presence of antiimmunoglobulin antibodies, that is, rheumatoid factor (RF) and its eventual effect on the precision of measurement of IC using LN C1q method has been determined by LN-Latex RF method. The results have shown that the increased IC values obtained by one method can be within physiological levels if the other method was applied and vice versa. Depending on the group of examinees such negative correlation ranged from 33% to 64%. This is the result of already known limitations of the studied methods and confirms the necessity of simultaneous application of different methods for determination of IC concentration. Regardless of anticomplementary activity of serum rheumatoid factor its presence in the serum has not shown to have any effect on the precision of determination of IC concentration using IC by LN- C1q method.

[Case of implantation of human fetal thymus on the immunological reactivity in patients with Hodgkin's disease]. / Uticaj implantacije humanog fetalnog timusa na immunolosku reaktivnost u bolesnika od Hodgkinove bolesti

Five patients with Hodgkin's disease (IV stage) were implanted with fetal human thymus. Implantation were performed under the fascia of rectus abdominis muscle. Thymuses were obtained from fetuses 4-5 month old in aseptic condition and stored in tissue culture medium 199, before implantation. Immunological studies carried out during 4-6 months, revealed the elevation of the number of the lymphocyte in the peripheral blood, normalization of the number of rosete forming cells (RFC) as well as the response of peripheral blood lymphocytes to phytohaemagglutinin (PHA) stimulation. Two patients had long improvement of immunological responsiveness, but the other 3 only a transitient one during the first month after implantation. The possibility of the immunologic treatment in the early stages of Hodgkin's disease is discussed.

[The quality of preserved blood]. / Kvalitet konzervisane krvi.

The examinations of 30 blood samples each preserved with three Yugoslav different ACD-solutions were performed. The blood samples were stored at 2-6 degrees C and examinations were performed at the day of blood donation and after on the 7th, 14th and 21st day during the storage. Differences in hematocrit (well known dilution effect of the ACD-solutions used) and intensive morphological and chemical changes were found in all blood samples regardless the type of ACD-solution used. It was shown that the permanently increasing number morphologically altered erythrocytes (echinocytes and spherocytes) and the excessive release of hemoglobin and potassium from erythrocytes were occurred during the storage of blood samles. Too, there were noticed significant decrease of pH values enormous accumulation of ammoniac and other metabolic producta.