Does calprotectin represent a regulatory factor in host defense or a drug target in inflammatory disease?

Calprotectin, a protein composed by two subunits of 8 and 14 kD respectively, is released by neutrophils in the biological fluids under inflammatory states. For instance, detection of calprotectin in faeces represents a diagnostic tool in the case of inflammatory bowel disease. Quite interestingly, calprotectin is increased in the stool of healthy newborns from day three up to day thirty and, physiologically, this increase may be interpreted as a defense mechanism against yeast and fungi. Therapeutic attempts at inhibiting the deleterious effect of calprotectin have been experimentally made by using lycoricinidol. This natural compound is able to hamper the calprotectin-induced apoptosis on the one hand. On the other hand, the same compound plays a prophylactic role in the course of experimental arthritis in rats.

Calprotectin levels in meconium.

AIM: To evaluate the effect of gender, gestational age, birthweight, mode of delivery, 5'-Apgar score and maternal conditions on calprotectin concentrations in meconium. METHODS: Calprotectin was measured in 131 neonates, in the first passed meconium. RESULTS: Calprotectin levels (mean +/- SD) resulted in 145.2 +/- 78.5 mg kg(-1) meconium, significantly correlated with birthweight (r = -0.333; p < 0.001), gestational age (r = -0.206; p = 0.018) and 5'-Apgar score (r = -0.243, p = 0.035). The estimated regression model was: calprotectin levels (mg kg(-1)) = 269.58-41.54 weight (kg): r = 0.383, p < 0.001. No differences were found in relation to gender, mode of delivery and maternal conditions. CONCLUSION: Calprotectin is already present in the first passed meconium, with higher levels in preterm and low birthweight neonates, as well as in neonates with some degree of perinatal asphyxia, as indicated by the negative correlation with 5'-Apgar score. These findings are probably secondary to both the immaturity of the intestinal mucosa and its hypoxic-ischaemic damage.

Antibodies to Chlamydia pneumoniae in healthy children from Bari, south Italy.

Specific IgG and IgM antibodies to Chlamydia pneumoniae were evaluated by microimmunofluorescence test in a group of healthy subjects (age 0-18 years). Antibody titers (IgG) > or = 1:16 were found in 9.7% of the age group 0-1 years, in 5.3% of the group of 2-3 years and rose to 19% in children of the group 4-6 years. The seroprevalence was 11% and 17.1% in the group 7-12 years and 13-15 years, respectively. In the last group of 16-18 years the seroprevalence was 9.1%. The overall seroprevalence was 11.8% and C. pneumoniae infection is acquired before school age. In addition, in our pediatric patients it seems that C. pneumoniae does not play an important pathogenic role, being responsible for only 1.6% of the acute lower respiratory infections. The factors that may account for these findings are discussed.

[Atopic manifestations, growth and nutritional data in newborns at high risk for allergy fed serum protein hydrolysate: 2-year follow-up]. / Manifestazioni atopiche, accrescimento e dati nutrizionali in neonati ad alto rischio per atopia allattati con idrolisato di sieroproteine: due anni di follow-up.

Authors have studied, in high risk for atopy newborns, with a follow-up of two years, the effect of feeding whey hydrolysate, evaluating the incidence of atopic manifestations, the growth pattern and different biochemical nutritional parameters, comparing the results to those observed in breast fed newborns. No significative differences have been shown suggesting that whey protein hydrolysate could be a good alternative to breast milk, when this is not available.

Thromboembolic risk in children with nephrotic syndrome.

The in vivo activation of the hemostatic system was evaluated in 14 children (4-13 years old) with nephrotic syndrome at different stages of the disease. The blood platelet count, beta-thromboglobulin (beta-TG), platelet factor 4 (PF4), fibrinogen, the coagulation inhibitors antithrombin III and protein C (ATIII:Ag and PC:Ag), and D-dimers were determined. Platelet number was significantly higher at the onset of the disease than in the next stages (p less than 0.05). beta-TG, PF4 and fibrinogen were significantly increased as compared with controls at the onset (p less than 0.001) and decreased progressively during the course of the disease without reaching the control values. Blood coagulation inhibitors behaved differently; PC was higher in patients than in controls at all stages (p less than 0.05) whereas ATIII values were significantly decreased at the onset (p less than 0.05), but increased during the course the disease (p less than 0.01). No changes were observed in the D-dimer plasma levels. These data suggest that the thrombotic risk in nephrotic syndrome is particularly evident at the onset of the disease, and appears to be due mainly to changes in platelet number and function, and to increased fibrinogen levels rather than to alterations of plasma anticoagulant factors.

[The clinico-immunological evaluation of a bivalent vaccine against measles and rubella]. / Valutazione clinico-immunologica di un vaccino bivalente contro morbillo e rosolia.

Prevention of measles and rubella can be obtained by a single administration of bivalent vaccine which can be added to the trivalent vaccine already practice in the USA since 1970 and in the Scandinavian Countries since 1982. We evaluated the immunological response and the clinical reactions to a bivalent vaccine against measles and rubella by the study of a control group including 29 children (17 females and 12 males) aged from a minimum of 15 months to a maximum of 9 years and 4 months. All the children who resulted not to be immune to the 2 viruses by serologic tests showed a rise in the antibody titer with 100% seroconversion, whereas in those proving to be already immune to one of the 2 viruses, a persistent antibody titer or an increase was revealed in all except one. Neither general nor local clinical reactions were observed except for two children who showed feverish measles-like reactions 8 days after the vaccine administration. These results suggest that this bivalent vaccine is highly effective, without negative effects. Furthermore associated with trivalent vaccines, it offers larger immunization opportunity mainly in children who have already been affected by mumps.

[Evaluation of the effectiveness of gastro-protected proteoferrin in the therapy of sideropenic anemia in childhood]. / Valutazione dell'efficacia della proteoferrina gastroprotetta nella terapia dell'anemia sideropenica in età pediatrica.

The clinical efficacy and tolerability of gastroprotected ferritin were assessed in children affected by iron deficiency and/or sideropenic anemia. Forty-seven children with iron-deficiency and/or sideropenic anemia were included in the study and were treated with gastroprotected ferritin at a dose of 4-5 mg/kg/day per os for 4 months. Only 33 children correctly completed the entire treatment cycle, achieving a marked improvement of blood parameters (increased Hb, accompanied by higher levels of sideremia and in particular ferritin, with a contemporary decrease in erythrocytic protoporphyrin and transferrinemia) and clinical symptoms, especially pallor, anorexia, debility, somnolence, hyperactivity, disturbed sleep and excessive sweating. Of the remaining 14 children, 9 failed to present for the planned control after the 4 months of therapy, 3 abandoned therapy due to difficulties of assumption and 2 because of intolerance phenomena, such as nausea and diarrhoea. In conclusion, gastroprotected proteoferrin is efficacious and well tolerated in the treatment of iron deficiency in children.

[Clinico-immunologic evaluation of a trivalent vaccine against measles, rubella and mumps]. / Valutazione clinico-immunologica di un vaccino trivalente contro morbillo, rosolia e parotite.

Prevention of measles, mumps and rubella can be obtained by a single administration of a trivalent vaccine as it has already been practiced in the U.S.A. since 1970 in the Scandinavian Countries since 1982. The immunological response and the clinical reactions to a new trivalent vaccine (Triviraten-Berna) against measles, mumps, and rubella has been studied in a control group including 41 children (20 females and 21 males) aged from a minimum of 16 months to a maximum of 7 years and 4 months. All the children who resulted not to be immune to the 3 viruses by serologic tests showed a rise in the antibody titer with 100% seroconversion, whereas in those resulting to be already immune to one of the 3 viruses, a persistent antibody titer or an increase was revealed. Neither general nor local clinical reactions were observed. These results suggest that this trivalent vaccine is highly effective, without negative effects and helpful for a mass prevention of such viral diseases.

[Plasma profile of free amino acids in children with chronic renal insufficiency undergoing hemodialysis therapy]. / Studio del profilo plasmatico degli aminoacidi liberi in bambini con insufficienza renale cronica in terapia emodialitica.

Some Authors found changes in plasma aminoacids concentration in patients with chronic renal failure treated with conservative therapy or with dialysis. Particularly they observed a reduction in the concentration of essential aminoacids (EAA) and an increase of the non essential (NEAA), with increase in their ratio. In our study we analyzed the plasma aminoacids pools in 12 children with chronic renal failure treated with hemodialysis. We have measured the plasma aminoacids concentrations before and after hemodialysis to evaluate their variations and their role in the pathogenesis of some symptoms of uremia. A decreased concentration of EAA and an increased concentration of NEAA, before hemodialysis, were observed. These findings were not modified by this therapy, but turned out to be related to protein intake.

[Observations on the immunological pathogenesis of the Schoenlein-Henoch disease. Diagnostic and therapeutic notes on 32 cases (author's transl)]. / Osservazioni sulla patogenesi immunologica della malattia di Schoenlein-Henoc. Considerazioni diagnostico - terapeutiche su 32 casi.

Diagnostic and therapeutic observations on 32 children affected by the Schoenlein Henoch disease are reported providing a contribution to the knowledge of the immunological pathogenetic mechanism of the disease. Platelets, fibrinogen, immunoglobulins, complement, immunocomplexes and fibrin degradation product in serum- and sometimes in urine- have been determined. Some data, as the increase of immunoglobulin A and fibrin degradation product, are typical of the involvement of an immunological mechanism. On the basis of these results, anticoagulant and anti-platelet aggregation drugs have been administered in combination with antiallergic and vascular protective drugs. In this manner, the coagulation mechanism, which is responsible for the enteric and renal intravascular alteration, is influenced.