Immune system parameters in children of Central and Eastern Europe: the CESAR study.

OBJECTIVE: of this paper is to compare observed values of immune parameters obtained in the CESAR study (The Central Europe Study of Air Pollution and Respiratory Health, funded by EC PHARE program) with ranges derived from other large population-based studies. STUDY DESIGN: Data were collected in healthy school children aged 9-11 years, in 6 countries: Bulgaria, the Czech Republic, Hungary, Poland, Romania and the Slovak Republic with the same standard approach in 1996. Random samples of 85 children per country, from 19 communities were selected from children having completed the health questionnaire, in total 495 children were analyzed. Lymphocyte subsets were determined by two-colour flow cytometric immunophenotyping using the lysed whole blood method (Becton-Dickinson). For determination of immunoglobulin concentration in sera nephelometric method (Behring Nephelometer system) was used. RESULTS: Medians, (5th-95th percentiles) of the lymphocyte subsets absolute count (x 10(9)/l) were as follows: CD19+ B cells 0.36 (0.13-0.66), total CD3+ T cells 1.74 (0.98-2.90), CD3+CD4+ helper-inducer T cells 0.95 (0.47-1.78), CD3+CD8+ suppressor/cytotoxic T cells 0.71 (0.38-1.22), CD3-CD16+56+ NK cells 0.36 (0.14-0.78), and for CD3+CD4+/CD3+CD8+ ratio 1.4 (0.8-2.4). Medians, (5th-95th percentiles) of percentages of lymphocyte subpopulations (%) were as follows: CD19+ B 13 (7-22), CD3+ T 70 (59-80), CD3+CD4+ T 38 (27-48), CD3+CD8+ T 28 (20-39), CD3-CD16+56+ NK cells 14 (6-27). Medians, (2.5th-97.5th percentiles) of the total immunoglobulin [g/l] were 11.7 (7.4-18.2) for IgG, 1.2 (0.5-2.5) for IgM, and 1.5 (0.5-3.4) for IgA. Based on the aspects of the size of the CESAR immune biomarker study and on the use of the standardized protocols we recommend to use the reference ranges on lymphocyte subsets and immunoglobulin in Europe as provided by this study.

[Autoimmune mechanisms in the pathogenesis of neurologic paraneoplastic diseases]. / Autoimunitné mechanizmy v patogenéze neurologických paraneoplastických ochorení.

Neurologic paraneoplastic syndromes (NPS) are disorders of the nervous system that are associated with the presence of malignant tumors. They are also known as the remote effects of cancer. There is mounting circumstantial evidence supporting the autoimmune origin of NPS. In NPS patients, paraneoplastic autoantibodies have been identified which react with the same or similar antigenic epitopes in tumor cells and neurons. However, except for the Lambert-Eaton myasthenic syndrome (LEMS) it remains still unproven as to whether the autoantibodies are pathogenic or merely represent an epiphenomenon to the actual disease process, since the antigens identified by the paraneoplastic autoantibodies are primarily intracellular as to their location. Few data are available regarding the role of cell-mediated cytotoxicity and antigen dependent T-cell cytotoxicity. Further studies will be necessary to elucidate the role of autoimmunity in the production of paraneoplastic neurologic disorders. (Tab. 2, Ref. 6.)

[Sympathetic ophthalmia]. / Sympatická oftalmia.

The authors give an account of a case of sympathetic ophthalmia which was successfully managed by reoperation of the injured eye, corticoids and immunosuppressive drugs. Sympathetic ophthalmia developed after perforation of the cornea along with traumatic cataract one month following the accident. It was manifested by irritation of the anterior segment of both eyes and marked exudation into the area of the posterior pole of the sympathizing eye. On the injured eye surgical reconstruction of the anterior segment was performed and concurrently broad spectrum antibiotics and corticoids were administered. On this therapy the anterior segment of both eyes began to improve, while the exudation into the area of the posterior pole of the sympathizing eye proceeded; therefore immunosuppressive therapy was started. The manifestations of sympathetic ophthalmia receded gradually. After an alternative way of corticoid reduction was started, a relapse of sympathetic ophthalmia occurred. The relapse was suppressed by a temporary increase of the dosage. Three months after the development of sympathetic ophthalmia, using the treatment described, the uveal inflammation of both eyes receded. At present, two years after the accident, both eyes are in a satisfactory condition with normal visual acuity--on the injured eye with an aphakic correction.