Phospholipids in sera of horses with summer eczema: lipid analysis of the autoserum preparation used in therapy.

REASONS FOR PERFORMING STUDY: Equine summer eczema, also known as insect bite hypersensitivity, affects horses recurrently during summer months. The treatment of this allergic pruritus is difficult and therefore there is a need for efficacious treatments. Autoserum therapy, based on the use of autogenous serum that is specifically prepared for oral administration and given when the animal shows clinical signs has been introduced recently. Lipids are thought to be responsible for the effect of this therapy. OBJECTIVES: The main aim of this study was to analyse the phospholipid content of autogenous serum preparations and to further assess whether these preparations have different lipid profiles depending on the clinical status of the horse. The hypothesis is that the major serum phospholipids typical of the horse are present in the autoserum preparation. STUDY DESIGN: Descriptive controlled clinical study. METHODS: Sera were collected from 10 affected and 6 healthy horses, prepared in a similar fashion and the lipids contained in the resulting autoserum preparations were analysed by electrospray ionisation mass spectrometry. RESULTS: The major phospholipid classes detected were phosphatidylcholine, sphingomyelin, phosphatidic acid and traces of lysophosphatidylcholine. Horses with summer eczema had significantly abundant concentrations of phosphatidylcholine (P = 0.042) and sphingomyelin (P = 0.0017) in comparison with healthy horses, while the concentration of phosphatidic acid was significantly higher in healthy horses (P = 0.0075). CONCLUSIONS: The autoserum preparation contains minute amounts of the main serum phospholipids in differing concentrations in healthy horses and horses with an allergic skin disease.

Improvement of the recurrence-free interval using biological adjuvant therapy in uveal melanoma.

This study was an attempt to compensate for an alleged aetiological deficiency in melanoma by the prophylactic oral administration of the essential biological components missing. Nine random patients suffering from high-risk uveal melanoma (T3) were, in this preliminary study, treated secondarily with biological dietary adjuvants after primary standard therapy, enucleation or brachytherapy. Secondary treatment consisted of certain natural amino-acids, trace-element salts, folic acid and a diet containing neurogenic lipid components. It entailed no side-effects, no toxicity and was inexpensive. None of these nine patients has suffered recurrent disease. The mean follow-up time was over 80 months (median 69, range 58-140 months). Local tumour control was 100%. This clinical result is significantly better (p = 0.018) as compared to similar T3 uveal melanoma patients in standard care who did not receive adjuvant dietary remedies after primary treatment. The control patients consisted of similar adjusted T3 cases selected from the Swedish official registries, and T2 patients from Germany. Based on the previous positive clinical results obtained with cutaneous malignant melanoma in bioimmunotherapy this additional positive result supports the notion that biological components administered orally may compensate for the etiological deficiency leading to malignant melanoma.

Suppression of experimental autoimmune uveitis in guinea pigs by ethylenediamine tetra-acetic acid, corticosteroids, and cyclosporin.

In the present study, footpad immunization using purified bovine retinal S-antigen mixed with complete Freund's adjuvant was used to induce experimental autoimmune uveitis (EAU) in guinea-pigs. The EAU-control group, receiving no treatment, was compared with test animals which received topically and systemically administered ethylenediamine tetra-acetic acid (EDTA) or subcutaneous and topical corticosteroid treatment, as well as a test group which received cyclosporin A subcutaneously. The severity of the uveal inflammation was clinically evaluated by slit lamp examination. The phospholipase A2 (PLA2) activity and the protein content of the aqueous humour as well as the myeloperoxidase (MPO) activity in the ciliary body were also determined. Serum antibodies to retinal S-antigen were followed using an immunoassay technique. Topical or subcutaneous EDTA significantly reduced the ocular inflammatory response to S-antigen induced autoimmune uveitis in the guinea-pigs. The best clinical suppression of EAU was obtained in the group treated subcutaneously with EDTA. Steroid treatment also suppressed the inflammatory processes in the eyes but was not as effective as EDTA or cyclosporine A. PLA2 activity in the aqueous humour and the MPO levels measured from iris-ciliary body homogenate were significantly lower in the groups treated subcutaneously with EDTA or cyclosporin A as compared with the untreated EAU-controls. The guinea-pigs treated subcutaneously with EDTA and cyclosporin A showed the lowest antiserum titres to retinal S-antigen. The prevention of PLA2 activity in aqueous humour after EDTA treatment correlated well with the milder inflammatory response in the eye. Based on the present study, it is therefore suggested that EDTA both locally and systematically reduces the S-antigen induced inflammatory response by decreasing the formation of inflammatory mediators derived from the arachidonic acid cascade.

Postoperative active specific immunotherapy with supportive measures in patients suffering from recurrent metastasized melanoma: case reports of six patients.

The clinical results from postoperative active specific immunotherapy using autologous polymerized tumor material in six patients suffering from metastasized melanoma is reported. Correction of an alleged systemic deficiency leading to malignant cell transformation was attempted by administering certain essential trace elements, amino acids, vitamins, and a diet containing lipids, extracted from the mammalian central nervous system, after heating. Vaccinations against influenza were also given as a precaution against certain viral infections sometimes seen to precede melanoma recurrence. The clinical results with this postoperative adjuvant therapy are so encouraging that we suggest that sterile tumor tissue should be saved at operation and treated to produce insoluble particles as an option for postoperative treatment of patients suffering from metastasized melanoma. Prospective randomized studies are indicated.

A randomized double-blind study using CaNa2EDTA, a phospholipase A2 inhibitor, in the management of human acute pancreatitis.

In a randomized double-blind study the effect of CaNa2EDTA, a phospholipase A2 inhibitor, was tested as a treatment for acute pancreatitis. CaNa2EDTA was infused intravenously during the first 2 days after admission to hospital, in addition to normal conservative treatment. CaNa2EDTA decreased the serum phospholipase A2 activity and appeared to promote recovery from the illness. To what extent the inhibition of serum phospholipase activity may prevent the progress of severe haemorrhagic pancreatitis or diminish mortality and morbidity in acute pancreatitis should be investigated in further studies.

Active specific immunotherapy with supportive measures in the treatment of palliatively nephrectomized, renal adenocarcinoma patients. A thirteen-year follow-up study.

The results of a 13-year (1971-1984) follow-up of specific active immunotherapy using polymerized autologous tumor tissue with adjuvants and supportive measures, following palliative nephrectomy in 71 patients suffering from advanced renal adenocarcinoma, are presented. The control patient group comprised 56 patients who received the best possible conservative treatment available. The statistically calculated life expectancy in the immunotherapy group is 44.5 months (SE 5.7) and in the control group 19.0 months (SE 3.3). The difference is statistically highly significant (generalized Wilcoxon [Breslow], t = 14.9, p less than 0.0001). There were no serious side effects from the immunization. The supportive measures entailing the administration of factors involved in cell regulatory functions mediated by the central nervous system, amino acids, trace elements, hormones and vitamins has still to be optimized.

Phospholipase A2 inhibitors and their possible clinical use in the treatment of acute pancreatitis.

A laboratory method was established for measurement of phospholipase A2 activity in buffer and serum. A series of different phospholipase A2 inhibitors was tested. The most effective inhibitors were Ca2+ chelating compounds like EDTA, DTPA, EGTA, and phytic acid. The calcium salt of EDTA also has some inhibitory effect. Serum phospholipase A2 activity in normal healthy control patients was measured. The activity in 27 patients with acute pancreatitis was tested. The activity was abnormally high in five patients. This activity was in vitro inhibited by EDTA and partly by CaNa2EDTA. The clinical picture of these patients did not differ from that of phospholipase-A2-negative patients. Six patients with acute pancreatitis were treated by intravenous infusion of CaNA2EDTA. Two of them had haemorrhagic pancreatitis and two were suspected of having early haemorrhagic pancreatitis. During the CaNa2EDTA infusion serum amylase and phospholipase A2 activities decreased. All patients recovered. No harmful side effects were noticed.