Long-term monitoring of the immune reactivity of stainless steel welders.

The immune reactivity of stainless steel welders (n = 22-53) was evaluated in a three year's study. The results (phagocytic activity, cellular and humoral immunity) were statistically compared with those in control group of non-exposed persons from the same plant (n = 14-23) and with long-term laboratory reference values (LRV) (n = 14-311). In welders several changes were found when compared to the LRV: in humoral response there were higher prealbumin, lysozyme, circulating immune complexes and lower IgG. In phagocytic tests there were lower ingestion, bactericidal activity and higher metabolic activity of peripheral mononuclear leucocytes. In cellular immunity the marked lymphocytosis, higher counts of T-lymphocytes, CD4+ and CD8+ lymphocytes were noticed. After lowering the concentrations of metals in the working area there were trends to normal values in some parameters [relative numbers of T-lymphocytes, relative number of CD4+ lymphocytes, phagocytic activity, metabolic activity of leucocytes (INT index), IgA, complement C3, transferrin]. The extent and the length of the exposure to welding fumes, smoking and changed conditions at working place were followed as well.

Immunological monitoring of dry-cleaning shop workers--exposure to tetrachloroethylene.

A panel of immunological parameters has been examined in a group of dry-cleaning workers (n = 21) and in a control group of administrators (n = 16) from the same plant. The results were also compared to long-term laboratory reference values (LRV) (n = 14-311). External exposure to tetrachloroethylene (PER) was represented by TWA (8 h) values in the range 11-752 mg PER/m3. Biological monitoring showed an amount from 9 to 344 mg PER/m3 in exhaled air by the end of workshift. 1. The exposed dry-cleaning workers compared to the controls from the plant had statistically significant changes in metabolic activity of phagocytes, alpha 2-macroglobulin, C3 and C4 complement component, salivary secretory IgA, and blastic transformation test. Most of the values were within the range of normal values. 2. The exposed dry-cleaning workers had several abnormal immune parameters compared to the long-term laboratory values (LRV) especially in the alpha 2-macroglobulin, C3 and percentage of T-lymphocytes. Most of the changes, even those that were statistically significant, were still within the range of normal values, but they might be classified as trends or shifts away from normal (spontaneous blastic transformation, absolute number of phagocyting cells, coeruloplasmin, circulating immunocomplexes, serum lysozyme). 3. The non-exposed controls from the same plant showed both quantitative and qualitative differences when compared to the LRV. Changes were seen in IgG, C4, CSI and in increased spontaneous metabolic activity of leucocytes, total leucocyte count, absolute number of phagocyting cells, alpha 2-macroglobulin, prealbumin, C4, circulating immunocomplexes and serum lysozyme. 4. The distribution analysis of all results detected a large number of abnormal values in both groups, more in the at-risk group. 5. As inhalation was the main route of PER exposure it was concluded that the changes might represent aspects of the response of the respiratory immune system, mainly of the alveolar macrophages. Additional postinfection effects could not be excluded in both studied groups. Individual differences in immune reactivity as well as individual range of exposure should be taken into consideration.

[Environmental monitoring and biological monitoring of young people exposed to nonoccupational levels of formaldehyde, toluene and other hydrocarbons]. / Monitorování prostredí a biologické monitorování mladistvých, neprofesionálne exponovaných nízkým koncentracím formaldehydu, toluenu a jiných uhlovodíkû.

During the period of 1983-1985, in two of apprentice schools of P. town the health disorders were investigated in the total of 82 apprentices 15-18 years old from the environment with elevated concentrations of formaldehyde and toluene. The study was contrasted with a control total of 42 apprentices. Cytogenetical examination has been performed, and selected immunological parameters in both blood serum and saliva have been assessed with red and white blood cells counts including differential formula of white blood cells. In addition, the atmospheric toxicity of formaldehyde and vapours of organic solvents (toluene, xylene, varnish naphtha) was measured. A single biological exposure test has been performed for the detection toluene. Statistically significant were differences in occurrence of cell chromosomal aberrations between the group of long term formaldehyde and toluene exposure (averagely 3.53% ABB) and controls (2.21% ABB) as obtained in 1983 and 1984, and so were differences between the long term-to-toluene exposed group (3.30% ABB) and the above mentioned control group as obtained in 1984. No similar results were stated between the long term-to-formaldehyde exposed (3.07% ABB) and control (2.55% ABB) groups in 1985. The main evidence consisted in finding the genotoxical/clastogenic effect of observed agents associated with mainly chromosomal abnormalities of chromatide type. It outflowed from the determination of selected serum proteins (Ig and acute phase proteins) and salivary lysozyme that the group under the combined influence of formaldehyde and toluene showed significantly lower IgG and higher alpha-1-antitrypsin (A1AT). The group at risk of toluene was characteristical in elevated concentrations of alpha-2-macroglobulin (A2M) and A1AT. Most pronounced changes in first year had been revealed through the evaluation of the influence of the duration at risk (significant decrease in IgA and prealbumin, and the increase in A2M and A1AT). The infectious disease as experienced 2 month prior the collection resulted in a significant decrease of IgM, A2M and A1AT in risky groups in individuals with infection in anamnesis. Salivary lysozyme concentration of apprentice environmentally exposed to formaldehyde in the noon showed the decrease, whereas its increase occurred in controls with the difference on 5% significancy level. Blood count assessements showed no significant differences between the investigated values as well as any were assessed between the incidence of health disorders of apprentices and their correspondance to the given group.

[Anticardiolipin antibodies in diffuse connective tissue diseases with IgG, IgM and IgA isotypes]. / Antikardiolipinové protilátky u difúzních nemocí pojiva v izotypech IgG, IgM a IgA.

Anticardiolipin (aCL) antibodies were assessed in isotypes IgG, IgM and IgA by the enzyme immunochemical technique in serum of 86 subjects with diffuse connective tissue affections and in 75 subjects of three control groups (syphilis, syndrome of common variable immunodeficiency and blood donors). In systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and syphilis the mean values of the three isotypes of aCL antibodies were significantly higher than in blood donors (p = 0.05 to 0.001); in diffuse scleroderma and primary polymyositis/dermatomyositis in isotype IgG (p = 0.01-0.001). Positive findings of aCL antibodies (isolated or in combinations of Ig isotypes (were found most frequently in SLE (34.4%), RA (33.3%) and syphilis (66.6%); sera of blood donors were positive in 8.7%. Venous thrombosis was recorded in the case-records of 28% patients with SLE but only in 5.4% of those with RA. Spontaneous abortion terminated 8/66 pregnancies in 28 women with SLE. In one female patient with SLE the aCL syndrome was detected. On account of frequent positivity of aCL antibodies in syphilis, the authors consider it essential to rule out the coincidence of this disease. Examination of aCL-IgA antibodies extends the detection of positive cases (isolated or in combinations of Ig) in SLE and RA.

[Use of in vitro methods in the immunotoxicologic evaluation of drugs]. / Pouzití metod in vitro pro imunotoxikologické hodnocení léciv.

The present paper proposes a model of in vitro tests examining the effect of drugs on the immunity system. The tests include the proliferation response of T cells (blastic transformation test of murine spleen cells and human peripheral mononuclear cells after stimulation by phytohaemagglutinin) and the antibody response (primary antibody response of murine spleen cells in the tissue culture after stimulation with sheep erythrocytes--demonstration of plaque-forming cells, formation of immunoglobulins by human peripheral mononuclear cells in the tissue culture after stimulation with pokeweed-mitogen--demonstration of immunoglobulins by ELISA test). Cytostatic agents derived from platinum were selected as the model group of drugs: cisplatin, oxoplatin and carboplatin in the concentrations ranging from 10(-4) to 10(-9) mol/l. In all tests IC50, i.e., the concentration of the drug producing 50% inhibition of response, was compared. The present authors have demonstrated that murine spleen nuclear cells are more sensitive to platinum cytostatics than human peripheral mononuclear cells; smaller concentrations of drugs are sufficient for 50% inhibition of immunity response of murine cells. Platinum cytostatics influence more the proliferative response of T cells than the antibody response. Platinum cytostatics act more on the cells in the stage of proliferation, or differentiation, i.e., after antigenic and mitogenic stimulation, than on the cells in a relative rest.

Immunological aspects of diagnosis of celiac sprue in children.

Serum anti-gluten (AGA) and anti-reticulin (ARA) antibodies were examined in children suffering from celiac sprue (CS); cellular hypersensitivity to gluten was tested and secretion of immunoglobulins and anti-gluten antibodies into the culture medium after 24-hour in vitro cultivation of jejunal mucosal biopsies was investigated with the aim to assess significance of these methods for CS diagnosis. Indirect immunofluorescence was used in ARA determination, ELISA method for AGA determination, cellular hypersensitivity was examined using the test of leucocyte migration inhibition (LMIT) with gluten. ARA were detected in 69% of children with untreated CS and in 28% of CS children who were on a gluten-free diet. ARA specificity was 100%. Statistically significant higher titres of IgG AGA and IgA AGA were proved in children with untreated CS as compared with the control group. IgA AGA were detected significantly more frequently than IgG AGA. No relationship between positive AGA and the degree of alteration of the jejunal mucosa was found. IgG AGA sensitivity in CS children with pathological findings on the jejunal mucosa was 52%, specificity being 95%. IgA AGA sensitivity was 82% with specificity 90%. After a parallel application of IgA AGA and ARA, sensitivity of the tests rose up to 95.5%, specificity being 90%. Examinations of ARA and AGA have a significant importance for laboratory tests used for screening children with pathological findings on the jejunal mucosa and for indication to jejunal biopsies. The above tests do not replace jejunal biopsy in CS diagnosis. They can be applied in monitoring children with CS during gluten challenge and in checking how the gluten-free diet is observed. Significantly higher stimulation of leucocyte migration in gluten environment was proved in children suffering from CS as compared with the control group. Stimulation of migration is supposed to indicate cellular hypersensitivity to the antigen used in CS children. After a 24-hour culturing of jejunal mucosal biopsies, significantly elevated concentrations of IgA immunoglobulin and IgG, IgA and IgM AGA were found in the culture medium as compared with those obtained from cultured jejunal mucosal biopsies of control group children. The test of leucocyte migration inhibition and in vitro culturing of jejunal mucosa are quite complex and exacting methods when used in routine practice. Their significance lies in the fact they enable us to study in vitro immunological reactions in children suffering from celiac sprue.