[Immunodeficiencies and enzyme deficiencies]. / Immunodeficienze e deficit enzimatici.

The first part of the paper outlines the actual situation of the recent investigations on the interpretative problem of the immunological deficits combined with enzymatic deficits. ADA deficit associated with combined immunodeficiency is an autosomal recessive form. Low enzyme levels, which is produced by a structural gene located on chromosome 20, were detected in chronic lymphatic leukemias where ADA decrease is correlated to low levels of T lymphocytes and the prevalence of an atypical B lymphocyte population. Particularly high levels of ADA were detected in acute lymphoblastic leukemias, in transplant rejection, in blastic crisis of chronic myeloid leukemia... NP deficit is associated with a T branch immunodeficiency, with high levels of inosine, guanosine, hypouricemia, hypochromic microcythemia and hematopoietic tissue megaloblastosis. This enzyme, with trimeric structure, whose structural gene is located on chromosome 14, shows a cytoplasmic location, and its maximum activity is to be found in T lymphocytes separated by rosetting. IGPT deficit is to be held responsible for the neurological Lesch-Nyhan syndrome. This deficit is associated with a depression of B lymphocyte function evaluated as response to the mitogens (PWM, Protein A) or as specific immunoglobulins production. At last the Authors report some personal investigations performed on hemolysates and lymphocytes of subjects with impaired immunity, as well as on some children at birth to establish the correlation between ADA and NP behaviour and immunosurveillance. Lastly, the data on the variations of the enzymatic and immunological parameters of subjects with immunodeficiency associated to enzymopenia after red cell transfusion are reported.

[Immunomodulators]. / Immunomodulatori.

A comprehensive picture of the most well-known immunomodulators has been drawn, focussing the attention on their immunopharmacological profile and their prospective clinical use. Besides, the cell targets of the immunologically active agents are also considered. The role of cyclic nucleotides in the mechanisms of immune regulation as well as the importance of the host characteristics in this connection are carefully analyzed. Some general considerations are finally set forth on the usefulness of the immunopharmacology investigation both in defining the action of the agents under study and in suggesting their potential role in the design of new agents for immunotherapy.

[New findings on the immunology of bronco-82]. / Nuove acquisizioni sulla immunologia del bronco-82.

The effect of Bronco-82 treatment, a bacterial polyvalent vaccine, was determined on some of the most significant parameters of the immune response, i.e. PHA-induced blastogenesis, secretory IgA levels, IL 2 receptor expression, human T-cell activation antigen (MLR 3) and gamma-interferon production. The results obtained pointed out a high immunostimulating activity of the vaccine on the parameters considered. Some aspects of the complex immunomodulating effects of Bronco-82 are discussed.

[Changes in several immunological parameters and the presence of anti-HTLV III antibodies in drug addicts]. / Modificazioni di alcuni parametri immunologici e presenza di anticorpi anti-HTLV III in tossicodipendenti.

The immunological picture in a group of heroin addicts and in a methadone treated group was evaluated. Ninety-six per cent shows modifications of the lymphocyte pattern, independently of the type of opium derivative administered. The OKT4/OKT8 ratio considered one of the hallmarks of acquired immunodeficiency, turns out to be reduced in 64.6% of the cases. In these latter the most outstanding defect is made up by the T-helper drop (83.8% of cases), limited to 23.5% in the group with normal OKT4/OKT8 ratio. The most significant variant between the two groups is represented by the positivity of anti-HTLV III test, which switches from 47 to 74.1% in the patients with reduced ratio. Immunoglobulins turn out to be increased in 81.2% of the cases, independently of the opium derivative administered and without significant differences in relation to the OKT4/OKT8 ratio. Therefore two immunological patterns seem to coexist in the population studied, which very likely represents two evolutive moments of the same disorder with an earlier phase of hyperimmune condition from a persistent antigenic stimulation which characterizes the situation at risk. In a later phase, the impact of HTLV III infection causes the deletion of the lymphocyte helper subpopulation which elicits the immunodepressive situation.

Characterization of circulating T-lymphocyte subsets in alcoholic liver disease by monoclonal antibodies: correlation with the absolute lymphocyte count.

Peripheral blood T-lymphocytes from 27 patients with alcoholic liver disease were assessed on the basis of their ability to react with OKT monoclonal antibodies. A significant positive correlation was observed between the absolute numbers of T-lymphocytes and suppressor/cytotoxic T cells and the absolute lymphocyte count. These data suggest that quantitative changes in T-lymphocyte subsets in alcoholic liver disease do not necessarily reflect an imbalance in T immunoregulatory mechanisms.

[Treatment with levamisole in a case of deficiency of the neutrophil granulocyte function associated with an increase in plasma IgA and recurrent dermal abscess infections]. / Trattamento con Levamisolo di un caso di deficit della funzionalità dei granulociti neutrofili associato ad aumento delle IgA plasmatiche e infezioni ascessuali dermiche ricorrenti.

The authors describe a case of recurrent dermal abscess infections resistant to usual antibiotic therapy and demonstrating a failing of the activity of the neutrophils and a remarkable increase of plasmatic IgA. The treatment with Levamisole regularized the laboratory data and, as a result, determined a consequent important improvement of the patient.

[Difference in the behavior of T-lymphocyte populations in heroin and methadone addicts]. / Differenza nel comportamento delle popolazioni T-linfocitarie nei dipendenti da eroina e da metadone.

An assessment of T-lymphocyte populations was performed in two groups of drug addicts by the technique of monoclonal antibodies. Group I was composed of 11 asymptomatic heroin addicts, group II being in heroin withdrawal program from at least six months. Homosexual subjects, partners of patients with AIDS and patients with liver abnormalities or with recent infectious diseases were excluded from the present study. In all the examined subjects the antibody pattern to Toxoplasma gondii, Epstein-Barr virus, Cytomegalovirus was either negative or slightly positive as after old infections. All subjects were HBsAg negative and HBsAb positive. Group I patients showed a significant inversion of OKT4/OKT8 ratio (p less than 0.01), due to a reduction in T helper lymphocytes (p less than 0.05) and an increase in T suppressors (p less than 0.05). Both groups showed a not significantly different proliferative response to Phytohemagglutinin (PHA) and Concanavalin A (Con A), although 8 out of 11 patients of group I exhibited a reduced proliferative response to PHA. Group I patients also showed a reduced proliferative response to Pokeweed mitogen (PWM). These results might suggest an involvement of B-lymphocytes in immunological changes of heroin addicts. In group II patient all the examined variables, OKT4/OKT8 ratio, absolute number as well as percentage of T-lymphocytes subpopulations and proliferative responses to the employed mitogens, resulted in the normal range. These data seem to exclude that methadone, in contrast with heroin, may induce a cell-mediated immunodepression.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunodeficiency in Down's syndrome: low levels of serum thymic factor in trisomic children.

The activity of thymus-dependent serum factor SF was significantly lower in 18 children wit Down's syndrome (DS) than in 14 matched controls. The percentage of circulating T lymphocytes forming E-rosettes was also low in DS. Together with the previous finding of immature of T lymphocytes in peripheral blood, the present data suggest that the basic immune defect of DS is failure in differentiation of peripheral post-thymic precursors to fully immunocompetent T lymphocytes resulting from lack of thymic hormonal factors.

Immunoglobulin levels, T-cell markers, mitogen responsiveness and thymic hormone activity in Turner's syndrome.

Immunoglobulin levels (IgG, IgA, IgM), percentage and number of circulating B and T lymphocytes, mitogen responsiveness (PHA and Con A) and activity of thymus-dependent serum factor (SF) were estimated in 29 patients with Turner's syndrome (TS), ranging in age from 2.2/12 to 18.4/12 yr. IgG and IgM were decreased in 14 and 12, respectively, while IgA was very low in 1, and increased in 7. Peripheral blood B and T lymphocytes, in vitro responsiveness to PHA, and Con A, and SF activity were in the normal range. The present immunological study suggests that TS is often associated with low levels of serum IgG and IgM. The possible mechanism of these derangements, whether genetic or hormonal (low estrogen/androgen ratio), is discussed.

[Use of an immunomodulator (levamisole) in HbsAg positive patients]. / Impiego di un immunomodulatore (levamisolo) in pazienti HBaAg positivi.

The results of some clinical trials performed with levamisole on 12 HBsAg-positive subjects, including 5 patients with aggressive chronic hepatitis, (ACH) 2 patients with persistent chronic hepatitis (PCH) and 5 healthy carriers are reported. Levamisole was administered in 2.5 mg/Kg/day doses for three consecutive days. During treatment prothrombin activity normalized in ACH and PCH as well as transaminases, the latter starting from the 4th week, even though a two-fourfold increase of the starting values was observed in the first weeks of disease. HBsAg, anti-HBs titres and immunocomplexes values did not show any significant variations, but for 1 case, while some immunological parameters (E, EA rosettes) normalized in those cases showing base- values lower than the norm.

Effects of isotretinoin on the neutrophil chemotaxis in cystic acne.

The authors show that the use of Isotretinoin (Ro 4-3740) in cystic acne brings a reduction of chemotactic activity of the neutrophil granulocytes, like another retinoid, Etretinate, in pustular and vulgar psoriasis. This effect of retinoids, with a direct action on the polymorphonuclear leukocytes plays an important role in the recovery of the disease.