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3.
J Infect Dis ; 165(5): 873-8, 1992 May.
Artículo en Inglés | MEDLINE | ID: mdl-1569336

RESUMEN

Murine monoclonal antibodies to lipopolysaccharides (LPS) from rough J5 mutant of Escherichia coli O111:B4 protected D-galactosamine-treated mice against lethal effects of LPS and provided protection in an experimental infection model with live E. coli. Three previously prepared anti-LPS antibodies were evaluated for ability to inhibit LPS-induced tumor necrosis factor (TNF) secretion. In vivo, TNF production was induced in mice treated with D-galactosamine and challenged with LPS. Two antibodies (D6B3 and D6B4) decreased serum TNF levels and prevented lethal effects of LPS. Nonprotective anti-LPS antibody (D9A2) and an unrelated antibody to neomycin did not reduce circulating TNF levels after LPS challenge. Pretreatment of mice with D6B3 and D6B4 protected mice from infection with E. coli and prevented serum TNF increases induced by E. coli infection. In nonprotected animals, high levels of TNF were detected in serum 3-6 h after infection; animals died within 24 h. In vitro, addition of protective antibodies to macrophage cultures at initiation of LPS stimulation inhibited TNF production. Nonprotective antibody D9A2 failed to block LPS-induced TNF production.


Asunto(s)
Anticuerpos Monoclonales/inmunología , Infecciones por Escherichia coli/inmunología , Lipopolisacáridos/inmunología , Factor de Necrosis Tumoral alfa/biosíntesis , Animales , Femenino , Galactosamina/farmacología , Lipopolisacáridos/toxicidad , Ratones , Factor de Necrosis Tumoral alfa/inmunología
4.
Carbohydr Res ; 217: 117-25, 1991 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-1797395

RESUMEN

The structure of the O-specific polysaccharide of Klebsiella pneumoniae O1K2 lipopolysaccharide was investigated by use of methylation, periodate oxidation, partial hydrolysis, and 1H- and 13C-n.m.r. spectroscopy. It was shown to consist of a linear chain composed of two disaccharide repeating units, [----3)-alpha-D-Galp-(1----3)-beta-D-Galp-(1----] and [----3)-alpha-D-Galp-(1----3)-beta-D-Galf-(1----].


Asunto(s)
Lipopolisacáridos/química , Secuencia de Carbohidratos , Klebsiella pneumoniae/química , Espectroscopía de Resonancia Magnética , Datos de Secuencia Molecular , Estructura Molecular
5.
AIDS ; 5(7): 865-70, 1991 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-1892592

RESUMEN

Trichosanthin was purified from fresh Chinese root tubers of Trichosanthes kirilowii and evaluated for anti-HIV activity. Trichosanthin inhibited syncytium formation between infected H9 cells and uninfected Sup-T1 cells from 0.5 to 4 micrograms/ml. Trichosanthin also inhibited HIV replication in H9 and CEM-SS cells at 1 microgram/ml, but was toxic for MT-4 cells (HTLV-I-positive), at doses greater than 0.25 microgram/ml. This new purification procedure confirms the anti-HIV activity of trichosanthin on some cell lines in different biological assays.


Asunto(s)
Antivirales/farmacología , Medicamentos Herbarios Chinos/farmacología , Tricosantina/farmacología , Aminoácidos/análisis , Antivirales/química , Antivirales/aislamiento & purificación , Línea Celular/efectos de los fármacos , Cromatografía en Gel , Cromatografía Líquida de Alta Presión , Medicamentos Herbarios Chinos/química , Medicamentos Herbarios Chinos/aislamiento & purificación , Electroforesis en Gel de Poliacrilamida , Células Gigantes/citología , Células Gigantes/efectos de los fármacos , VIH-1/fisiología , Humanos , Linfocitos T/citología , Timidina/metabolismo , Tricosantina/química , Tricosantina/aislamiento & purificación , Replicación Viral/efectos de los fármacos
6.
Infect Immun ; 58(9): 2828-33, 1990 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-1696932

RESUMEN

To prepare monoclonal antibodies (MAbs) directed against the core-lipid A fractions of smooth lipopoly-saccharide (LPS) from Klebsiella pneumoniae O1:K2, we immunized BALB/c mice with the LPS-associated proteins plus LPS. This preparation exposed the core-lipid A moiety, which is normally hidden in the micellar structure of classical LPS preparations. Among 10 MAbs selected for their reactivity with LPS-associated proteins plus LPS from K. pneumoniae O1:K2, 6 (3A3, 3C2, 3C4, 7D2, 11C3, and 12B6) were directed against the core fraction and 2 (6C5 and 10A5) were directed against the lipid A fraction. Only one (2A4) recognized the O antigen, and one (6D5) had an undefined specificity. When injected before challenge with K. pneumoniae O1:K2 LPS in galactosamine-sensitized mice, five of the MAbs (3C4, 6D5, 7D2, 11C3, and 12B6) provided protection in this model of lethal endotoxemia. MAb 7D2 was also protective in an experimental infection with capsulated K. pneumoniae O1:K2.


Asunto(s)
Anticuerpos Monoclonales/inmunología , Proteínas Bacterianas/sangre , Endotoxinas/sangre , Infecciones por Klebsiella/inmunología , Klebsiella pneumoniae/inmunología , Lípido A/sangre , Lipopolisacáridos/sangre , Animales , Especificidad de Anticuerpos , Antígenos Bacterianos/inmunología , Reacciones Cruzadas , Epítopos/inmunología , Escherichia coli/inmunología , Femenino , Ratones , Ratones Endogámicos BALB C , Antígenos O
7.
Int J Immunopharmacol ; 12(5): 491-6, 1990.
Artículo en Inglés | MEDLINE | ID: mdl-2210912

RESUMEN

RU 41740, a glyco-protein extract of Klebsiellae pneumoniae 01 K2 strain, is known to have immunomodulator activities. It acts on macrophages as well as on B and T-cells, and enhances their cytokine production, particularly interleukin 1 (IL-1). The fact that cytokines have an effect on hemopoiesis led us to suspect an effect of RU 41740 on hemopoietic reconstitution. In this study, a model of autologous reconstitution of a hemopoietic system after sublethal irradiation in mice was used. C57 BL/6 mice were treated orally with RU 41740 (10 mg/kg/day) before or after irradiation (6.5 Gy). LPS of Klebsiella pneumoniae was used as a positive control. The hemopoietic reconstitution occurred more rapidly in treated animals especially when RU 41740 was given before irradiation.


Asunto(s)
Proteínas Bacterianas/farmacología , Hematopoyesis/efectos de los fármacos , Traumatismos Experimentales por Radiación/prevención & control , Animales , Proteínas Bacterianas/uso terapéutico , Médula Ósea/efectos de la radiación , Células de la Médula Ósea , Hematopoyesis/efectos de la radiación , Células Madre Hematopoyéticas/efectos de los fármacos , Células Madre Hematopoyéticas/efectos de la radiación , Klebsiella pneumoniae , Lipopolisacáridos/farmacología , Masculino , Ratones , Ratones Endogámicos , Bazo/citología , Bazo/efectos de la radiación , Células Madre/efectos de la radiación , Factores de Tiempo
9.
J Infect Dis ; 159(4): 641-7, 1989 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-2647860

RESUMEN

Murine monoclonal antibodies that bind outer membrane antigens of the J5 mutant of Escherichia coli O111:B4 were derived from spleen cells of BALB/c mice immunized with killed whole cells and boosted with lipopolysaccharide (LPS) and LPS-associated proteins. Seven hybridomas were selected for their reactivity against the J5 LPS; they cross-reacted with O111, O55, O127, and O128 E. coli LPS. One (B7B3) also reacted with the Serratia marcescens LPS and Klebsiella pneumoniae lipid A. A protective effect was obtained with D6B4 antibody in a lethal endotoxemia model induced by LPS from O111, O127, and O128 E. coli serotypes in D-galactosamine-sensitized mice. D6B4 and D6B3 antibodies protected mice infected with E. coli O111:B4, when administered before infection. The D6B4 antibody was also protective when administered after infection. The antibodies D6B3 and D4B5 were protective in heterologous infection induced by E. coli O2:K1.


Asunto(s)
Anticuerpos Antibacterianos/inmunología , Anticuerpos Monoclonales/inmunología , Infecciones por Escherichia coli/prevención & control , Escherichia coli/inmunología , Sepsis/prevención & control , Animales , Anticuerpos Monoclonales/uso terapéutico , Especificidad de Anticuerpos , Reacciones Cruzadas , Ensayo de Inmunoadsorción Enzimática , Infecciones por Escherichia coli/inmunología , Femenino , Hibridomas , Lipopolisacáridos/inmunología , Ratones , Sepsis/inmunología
10.
Res Immunol ; 140(2): 159-72, 1989 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-2662280

RESUMEN

RU-41740, a glycoprotein complex extracted from Klebsiella pneumoniae, is an immunomodulating agent which acts on B cells and macrophages. It has been shown that RU-41740 is composed mainly of two macromolecular fractions, F1, having an LPS-related structure, and P1, with a proteoglycan structure. In the present paper, the effects of these molecules on B cells and on IL-1 and tumour necrosis factor (TNF), production by macrophages were compared. Data reveal that both fractions were mitogenic for murine B cells and induced IL-1 and TNF production by macrophages. The LPS-like fraction (F1) was sensitive to polymyxin B and was unable to activate macrophages and spleen cells from LPS non-responder mice. The P1 fraction was mitogenic for B cells and induced the production of IL-1 and TNF activities by macrophages from LPS non-responder C3H/HeJ mice. The cytotoxic activity was due to TNF alpha, since treatment with anti-TNF alpha antiserum abrogated the lytic activity of supernatants from stimulated macrophages. The differences observed between P1 and F1 fractions in terms of sensitivity to polymyxin B and activity towards C3H/HeJ spleen cells and macrophages suggest that the two structurally distinct molecules isolated from RU-41740 could act at different sites on immunocompetent cells.


Asunto(s)
Adyuvantes Inmunológicos , Proteínas Bacterianas/farmacología , Animales , Proteínas Bacterianas/inmunología , Proteínas Bacterianas/aislamiento & purificación , Femenino , Glicoproteínas/inmunología , Glicoproteínas/farmacología , Técnicas In Vitro , Interleucina-1/biosíntesis , Klebsiella pneumoniae/inmunología , Lipopolisacáridos/inmunología , Lipopolisacáridos/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Masculino , Ratones , Ratones Endogámicos , Mitógenos , Polimixina B/farmacología , Bazo/efectos de los fármacos , Bazo/inmunología , Factor de Necrosis Tumoral alfa/biosíntesis
11.
Int J Immunopharmacol ; 10(7): 851-4, 1988.
Artículo en Inglés | MEDLINE | ID: mdl-3266199

RESUMEN

We have tested the effect of a Klebsiella pneumoniae extract, RU 41740, and its lipopolysaccharidic fraction (LPS-LAP) on the in vitro activation of human B-cells. Two models have been used: the polyclonal activation induced by pokeweed mitogen and the specific antibody production to mannan, a polysaccharide extracted from the cell wall of Candida albicans. We have shown that RU 41740, and especially its lipopolysaccharidic fraction, significantly increases the production of immunoglobulins and specific antibodies. This effect is mediated by T-lymphocytes, since preincubation of isolated T-cells, but not of non-T-cells, resulted in the same effect. Together with the known enhancing effect of LPS-LAP on T-cell proliferation, these data strongly suggest that LPS-LAP increases the production of B-cell-activating lymphokines by T-cells.


Asunto(s)
Linfocitos B/inmunología , Proteínas Bacterianas/farmacología , Activación de Linfocitos , Adyuvantes Inmunológicos , Células Productoras de Anticuerpos/inmunología , Humanos , Técnicas In Vitro , Lipopolisacáridos/farmacología , Mananos/inmunología , Mitógenos de Phytolacca americana/farmacología , Linfocitos T/inmunología
12.
J Chromatogr ; 396: 281-6, 1987 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-3305533

RESUMEN

An high-performance liquid chromatography technique was applied to purify the lipopolysaccharide fraction from a lysate of Klebsiella pneumoniae O1 K2 (NCTC 5055). The separation of the lipopolysaccharide fraction from the proteins was carried out with a reversed-phase column. By this method the lipopolysaccharide fraction was obtained in a pure state, devoid of proteins but possessing the same biological properties as the lipopolysaccharide fraction prepared by the classical phenol-water technique.


Asunto(s)
Klebsiella pneumoniae/análisis , Lipopolisacáridos/aislamiento & purificación , Proteínas Bacterianas/análisis , Carbohidratos/análisis , Cromatografía Líquida de Alta Presión , Ácidos Grasos/análisis , Espectrofotometría Ultravioleta
13.
Antimicrob Agents Chemother ; 31(6): 920-4, 1987 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-3619424

RESUMEN

Aerosol treatment with RU 41821, a glycoprotein extract from Klebsiella pneumoniae, was tested in mice for its effect on the kinetics of the induction of bronchoalveolar cells (i.e., alveolar macrophages, monocytes, lymphocytes, and polymorphonuclear leukocytes). RU 41821 led to an increase in the total number of bronchoalveolar cells. The largest increase was observed for polymorphonuclear leukocytes, and more moderate increases occurred in the numbers of alveolar macrophages, monocytes, and lymphocytes. The alveolar macrophages recruited in response to RU 41821 were activated, as indicated by luminol-dependent chemiluminescence in response to stimulation by opsonized zymosan. The effects of five RU 41821 aerosol treatments and those of a single treatment were further examined in vivo by aerosol infection of mice inoculated with a mouse-pathogenic influenza virus. The maximum protective effect was obtained after five once-a-day treatments and was correlated with the largest increase in the total number of bronchoalveolar cells.


Asunto(s)
Antivirales/farmacología , Proteínas Bacterianas/farmacología , Bronquios/citología , Virus de la Influenza A/efectos de los fármacos , Macrófagos/efectos de los fármacos , Alveolos Pulmonares/citología , Aerosoles , Animales , Bronquios/efectos de los fármacos , Femenino , Cinética , Mediciones Luminiscentes , Ratones , Infecciones por Orthomyxoviridae/microbiología , Infecciones por Orthomyxoviridae/prevención & control , Alveolos Pulmonares/efectos de los fármacos
14.
Ann Inst Pasteur Immunol ; 138(3): 425-36, 1987.
Artículo en Inglés | MEDLINE | ID: mdl-3307833

RESUMEN

RU-41740, a purified glycoprotein extract from Klebsiella pneumoniae, (which is an efficient non-specific immune activator in a broad spectrum of in vitro and in vivo reactions) was administered either orally or parenterally in the mouse. It enhanced the resistance of mice to candidiasis, both in terms of survival rate and a decrease in viable yeast cell recovery in kidneys. The drug administered at 0.1 mg or 1 mg/kg augmented 4-fold the mean survival time (MST) of animals infected with 1 to 2 X 10(6) Candida albicans, both by the intraperitoneal and the intravenous route. The effect of the orally administered drug was less striking but nonetheless present. At 10 mg/kg, the MST of infected animals increased about 2-fold. In vitro, in the presence or absence of zymosan, the drug at 10 or 100 micrograms/ml was able to stimulate the phagocytic process of elicited mouse peritoneal cells (65% polymorphonuclear cells, 35% macrophages) and human peripheral blood cells (95% polymorphonuclear cells, 5% monocytes) in terms of activated oxygen species production. The involvement of polymorphonuclear cells in the mechanisms of natural resistance to C. albicans infection led us to discuss the role of these cells as targets for the drug.


Asunto(s)
Candidiasis/prevención & control , Fagocitosis/efectos de los fármacos , Animales , Candidiasis/sangre , Candidiasis/inmunología , Femenino , Cinética , Klebsiella pneumoniae , Recuento de Leucocitos , Ratones , Neutrófilos
15.
Int J Immunopharmacol ; 9(7): 775-81, 1987.
Artículo en Inglés | MEDLINE | ID: mdl-2828252

RESUMEN

RU 41740, an immunomodulating compound extracted from Klebsiella pneumoniae, was previously shown to enhance mice resistance to bacterial and viral lung infections. To explore lung defense mechanisms, we studied the influence of RU 41740 aerosol treatment on the bronchoalveolar cell populations. Five successive daily RU 41740 aerosol treatments induced a large accumulation of leukocytes in the lungs 4h after the last treatment. Polymorphonuclear leukocytes predominated. The numbers of lymphocytes and monocytes rose significantly. A single RU 41740 aerosol treatment significantly raised the number of polymorphonuclears only. A luminol-dependent chemiluminescence assay was used to test the effect of RU 41740 on the opsonized zymosan induced response of alveolar macrophages. In vitro, addition of RU 41740 enhanced this chemiluminescence. After a single RU 41740 aerosol treatment of mice, the chemiluminescence of purified alveolar macrophages from these mice increased significantly. The protective effect of five daily RU 41740 aerosol treatments against influenza virus infection was believed to be due to the great intensity of the cellular response and the polymorphonuclear influx. The alveolar macrophage activation observed might also explain the enhanced resistance of mice to influenza virus infection.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Proteínas Bacterianas/farmacología , Pulmón/efectos de los fármacos , Infecciones por Orthomyxoviridae/prevención & control , Adyuvantes Inmunológicos/administración & dosificación , Aerosoles , Animales , Proteínas Bacterianas/administración & dosificación , Líquido del Lavado Bronquioalveolar/citología , Líquido del Lavado Bronquioalveolar/inmunología , Recuento de Células , Femenino , Mediciones Luminiscentes , Pulmón/inmunología , Macrófagos/efectos de los fármacos , Ratones , Ratones Endogámicos , Neutrófilos/efectos de los fármacos , Infecciones por Orthomyxoviridae/inmunología
16.
Int J Immunopharmacol ; 7(4): 525-31, 1985.
Artículo en Inglés | MEDLINE | ID: mdl-2412973

RESUMEN

RU. 41 740, a glycoprotein extract from Klebsiella pneumoniae O1K2 strain was tested for its ability to enhance resistance of mice against influenza virus infection. Local (aerosol) and systemic (IP) routes of RU. 41 740 administration were compared for their effectiveness in protecting mice. When RU. 41 740 was administered prophylactically (10 mg/kg) via aerosol route (5 consecutive days before challenge), significant protection (P less than 0.0001) was conferred against lethal aerosol inoculation of influenza virus. Treated mice exhibited a reduced mortality, a decreased lung-to-body weight ratio and lower intrapulmonary virus titers. The main glycoprotein soluble fraction (RU. 41 821) was as active as the total glycoprotein extract (P less than 0.0001). Whereas the local (aerosol) route of administration was effective, the systemic (intraperitoneal) route of administration did not confer significant protection against an aerosol inoculum of virus. This finding suggests the important role of local immunity. The levels of interferon in the lavage fluids of immunized and infected mice suggest that interferon is not the main protective mechanism. The enhanced protection observed could be related to an augmented humoral or cell-mediated response within the lung.


Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Proteínas Bacterianas , Glicoproteínas/administración & dosificación , Klebsiella pneumoniae/inmunología , Infecciones por Orthomyxoviridae/inmunología , Administración Intranasal , Animales , Peso Corporal/efectos de los fármacos , Femenino , Inmunidad Innata/efectos de los fármacos , Interferones/análisis , Pulmón/efectos de los fármacos , Pulmón/microbiología , Ratones , Tamaño de los Órganos/efectos de los fármacos , Infecciones por Orthomyxoviridae/microbiología , Infecciones por Orthomyxoviridae/terapia , Factores de Tiempo
17.
Int J Tissue React ; 7(2): 117-22, 1985.
Artículo en Inglés | MEDLINE | ID: mdl-3861595

RESUMEN

Studies were performed to investigate the effects of several agents known to modulate wound healing on prostaglandin production by mouse embryo fibroblasts and adult thymic phagocytic cells in culture. Dexamethasone (10(-6)M) induced in both cell types a significant inhibition of the production of PGE2 and 6 keto PGF1 alpha, and a moderate inhibition of PGF2 alpha. Using an antiglucocorticoid compound, RU 38486, we were able to demonstrate that the inhibition of PG secretion represents a classical receptor-mediated effect of the steroid. In contrast, LPS and RU 41740 (5 micrograms/ml) induced a significant stimulation of PGE2 and 6-keto-PGF1 alpha secretion in the two types of cells. These results suggest that agents which modulate in different ways the process of tissue repair have opposite effects on PG production by cells involved in inflammatory and/or immunological reactions.


Asunto(s)
Proteínas Bacterianas , Dexametasona/farmacología , Glicoproteínas/farmacología , Fagocitos/metabolismo , Prostaglandinas/biosíntesis , Tromboxano B2/biosíntesis , Tromboxanos/biosíntesis , 6-Cetoprostaglandina F1 alfa/biosíntesis , Adyuvantes Inmunológicos/farmacología , Animales , Células Cultivadas , Dinoprost , Dinoprostona , Antagonismo de Drogas , Embrión de Mamíferos , Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Ratones , Fagocitos/efectos de los fármacos , Prostaglandinas E/biosíntesis , Prostaglandinas F/biosíntesis , Timo/citología
18.
Ann Immunol (Paris) ; 135D(1): 59-69, 1984.
Artículo en Inglés | MEDLINE | ID: mdl-6385817

RESUMEN

RU-41740, a glycoprotein extract from Klebsiella pneumoniae K2O1 strain, is an immunomodulating compound which has been shown to reduce infectious episodes in immunodeficient patients. Data from preliminary experimental designs suggested that RU-41740 could affect several target cells, such as T cells, B cells and macrophages. In the present report, we show that RU-41740 is a selective B-lymphocyte activator. It induces blast transformation in Nude mouse spleen cell cultures and in B-cell-enriched fractions obtained from normal mice. It does not activate T lymphocytes to proliferate. Activation of mouse B lymphocytes by RU-41740 is not affected by removal of adherent cells. RU-41740 also activates immunoglobulin secretion by murine B lymphocytes. Incubating spleen cells from C3H/HeJ mice with RU-41740 results in cell proliferation and activation of antibody-forming cells. This suggests that B-cell activation is not due to LPS contamination. Other experiments show that RU-41740 can also trigger mouse macrophages to produce interleukin-1 activity. Indeed, supernatants from peritoneal adherent cells incubated in the presence of RU-41740 can stimulate blastogenesis in thymocytes from C3H/HeJ mice. Thus, B-cell activation and IL-1 production by macrophages could constitute two additive mechanisms involved in immunomodulation induced by RU-41740.


Asunto(s)
Linfocitos B/efectos de los fármacos , Proteínas Bacterianas , Glicoproteínas/inmunología , Interleucina-1/biosíntesis , Klebsiella pneumoniae/análisis , Macrófagos/metabolismo , Animales , Glicoproteínas/farmacología , Activación de Linfocitos/efectos de los fármacos , Macrófagos/efectos de los fármacos , Ratones , Ratones Endogámicos C3H , Ratones Endogámicos DBA , Ratones Desnudos , Mitosis/efectos de los fármacos , Linfocitos T/efectos de los fármacos
19.
Cancer Immunol Immunother ; 14(1): 59-60, 1982.
Artículo en Inglés | MEDLINE | ID: mdl-6925461

RESUMEN

C 1821 is a purified glycoprotein extract of Klebsiella pneumoniae serotype 2 with immunomodulating properties in animals (in vivo and in vitro) and in humans (in vitro). The compound is devoid of any apparent toxicity when given orally. The aim of the present work was to evaluate the effects of a short term oral administration of C 1821 on delayed cutaneous hypersensitivity to recall antigens in untreated cancer patients (mostly lymphomas). Consecutive patients were alternately allocated to receive C 1821 or placebo for 14 days. C 1821 restored and significantly (P less than 0.02) enhanced skin reactions, as shown using the Multitest system.


Asunto(s)
Glicoproteínas/administración & dosificación , Hipersensibilidad Tardía/inmunología , Neoplasias/inmunología , Administración Oral , Adulto , Anciano , Femenino , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/inmunología , Humanos , Linfoma/tratamiento farmacológico , Linfoma/inmunología , Masculino , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Pruebas Cutáneas
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