Characterization of a cytotoxic CD57+ T cell subset from patients with pulmonary tuberculosis.

We investigated the proportion, phenotype, and cytotoxicity of CD8+CD57+ and CD57- T cells in peripheral blood from 20 tuberculosis (TB)-patients and 20 healthy tuberculin skin test-positive donors. Our results showed an increase in CD8+CD57+ T cells from TB-patients as compared with those from age-matched healthy donors (p<0.0001). CD8+CD57+ T cells from TB-patients expressed CD69, perforin, granzyme-A, and a CD28-CD62L-CD161- phenotype without recognition for the alpha-galactosylceramide-CD1d complex. This cell subset also expressed TNF-alpha and IFN-gamma, under phorbol-myristate-acetate/ionomycin stimulation. Interestingly, the cytotoxicity against autologous monocytes was higher in CD57- cells from TB-patients and donors than their CD57+ counterparts, in the presence of Mycobacterium tuberculosis H37Rv culture filtrate. However, only CD8+CD57+ T cells from TB-patients exhibited spontaneous cytotoxicity against monocytes in the absence of antigen. Our results suggest that CD8+CD57+ T cells are a subset of effector cells that could be helpful to evaluate the cell-mediated immune response to M. tuberculosis.

[Coproantibodies in intestinal amebiasis]. / Coproanticuerpos en amibiasis intestinal.

E. histolytica tissue invasion induces IgG and IgM and probably IgA serum antibody formation of different types in the intestinal mucosa. 21 children with intestinal invasive amebiasis were studied. Samples were taken from peripheral blood and stools during diagnostic studies and three weeks later. Contraimmunoelectrophoretic antibody determinations and indirect hemagglutination tests IH were made in an attempt to demonstrate its true nature. During the acute phase (first sample), results showed antibodies against amoeba in stools by CIE in 57 per cent and by IH in 80 per cent; in serum, results were 38 and 76 per cent respectively. In the second sample and three weeks after diagnosis was established a decrease in the number of patients with coproantibodies against amoeba was observed and the number of patients with serum antibodies increased. We are also providing evidence that supports the IgG and IgA nature of coproantibodies against amoeba. These results suggest the presence of a local immunological reaction in invasive amebiasis.

[Dermatomyositis in pediatrics]. / Dermatomiositis en pediatría.

The study included 19 children with dermatomyositis. All showed frequently atypical cutaneous disords which in most cases were the initial manifestation. In every case there was some clinical evidence of proximal myopathy. Arthralgias were frequently found and sinusal tachycardia was present in 10 cases. The correct diagnosis was made from the beginning only in 6 cases. Systemic lupus erythematosus was the main cause of confusion. The differential diagnosis between these two entities cannot be made only by the presence or not of nephropathy, even if this disease was evident in 42% of patients with dermatomyositis. The most useful laboratory tests for the diagnosis and management were CPK, aldose and serum TGO. Electromyography was abnormal in every case where it was practiced. Muscular biopsy was valuable in 15 of the 19 patients. All were treated with prednisone and in most cases with good results.

[Humoral immune response in hepatic and intestinal amebiasis in children]. / Respuesta inmune humoral en la amibiasis intestinal y hepática del niño

The various classes of immunoglobulins with antibody function against E. histolytica were studied in 8 children with amebic liver abscess and in 7 with acute intestinal amebiasis. The predominant fraction was IgG in 7 patients from the first group and in 1 from the second; this suggests a secondary type humoral immune response which implies a previous experience with E. histolytica antigens. A definitive predominance of IgM was shown in a patient with amebic liver abscess, the same as in primary humoral immune response. Humoral antibodies did not develop in the remaining 6 patients with acute intestinal amebiasis. The disparateness of the humoral immune response found in these cases make it difficult to speculate on the role of immunoglobulins in the pathogenesis or in immunologic protection in amebiasis. Possibly, the most important is the participation of cellular immunity.

[Leukemia of plasma cells]. / Leucemia de celulas plasmáticas

A case of plasma cell leukemia is reported, together with a review of the literature, including a summary of the signs, symptoms and laboratory findings usually present. The relationship of this leukemic state to ordinary multiple myeloma is discussed.

[Rosette-forming peripheral lymphocytes, in children with measles]. / Linfocitos periféricos formadores de rosetas, en niños con sarampión

During measles infection in human beings, depression of cellular immunity appears. The authors studied several groups of children with measles complaining of various degrees of malnutrition in terms of rosette forming lymphocytes in peripheral blood; marked reduction of T lymphocytes were seen in all of the groups during the acute stage of the disease, that persisted up to two weeks after the exanthematous stage. When comparison was established of eutrophic and 1st degree malnourished children with those affected with 3rd degree malnutrition, differences were found in the recovery of the number of rosett-E forming cells.

Identification of lectin isoforms in juvenile freshwater prawns Macrobrachium rosenbergii (DeMan, 1879).

From the serum of juvenile freshwater prawns, we isolated by affinity chromatography on glutaraldehyde-fixed rat erythrocytes stroma, immobilized in Sephadex G-25, a sialic acid specific lectin of 9.6 kDa per subunit. Comparative analysis against adult organisms purified lectin, by chromatofocusing, showed that the lectin from juvenile specimens is composed by four main isoforms with a pI of 4.2, 4.6, 5.1, and 5.6, whereas the lectin from adults is eluted at pH 4.2. The amino acid composition of the lectin obtained from adult and juvenile stages suggest identity, but the compositions are not identical since a higher content of carbohydrates was found in the lectin from younger organisms. The freshwater prawn lectin showed specificity toward N-acetylated amino sugar residues such as GlcNAc, GalNAc, Neu5Ac and Neu5,9Ac; but in juvenile organisms the lectin showed three times less hemagglutinating activity than the lectin from adults. Both lectins agglutinated rat, rabbit and chicken erythrocytes, indicating that Neu5,9Ac in specific O-glycosydically linked glycans seems to be relevant for the interaction of M. rosenbergii lectins with their specific cellular receptor. Our results suggest that the physicochemical characteristics of the lectin from the freshwater prawn are regulated through maturation.

[Study of the immune system in relatives of children with dermatomyositis]. / Estudio del sistema inmune en familiares de niños con dermatomiositis.

In view of the fact that relatives of patient with other connective tissue diseases may show immunologic abnormalities, we investigated cellular (PPD, SK-SD, candidine and diphteria-tetanous toxoid cutaneous tests) and humoral (IgG, IgM, IgA. CH50, C3, rheumatoid factor and ANA) immune responses in first degrees relatives (parents and siblings) of children with dermatomyositis. Of the 53 subjects tested, 19 had high values of one or two immunoglobulines; however, the mean Ig value was not different from that of the general population (p greater than 0.1), CH50, C3, rheumatoid factor and ANA were normal or negative. Cutaneous tests made on 46 subjects did not reveal abnormalities. Therefore our conclusion is that first degree relatives of children with dermatomyositis have not significant immunologic abnormalities.

Usefulness of concentrated CSF hemagglutination technique for the diagnosis of cerebral cysticercosis.

Determinations were made in concentrated CSF immunoglobulins in two groups of patients with different neurological problems and in patients with surgically confirmed diagnosis of CNS cysticercosis. Antibody vs. cysticercus antigen determinations were also made in concentrated CNS by means of indirect hemagglutination as a procedure to establish CNS cysticercosis. Positive results were obtained in 68 per cent of surgically confirmed cysticercosis. This procedure seems to be more sensitive for CNS cysticercosis diagnosis.

[Cause of arthritis in childhood. Relation to age, sex and affected joints]. / Causas de artritis en la infancia. Relación con la edad, sexo y articulaciones afectadas.

In a retrospective study (1963--1976) out of 514 children with the general diagnosis of arthritis, the diagnoses most frequently established were; pyogenic arthritis (45.9%), rheumatic fever (18.7%) and juvenile rheumatoid arthritis (17%). Less frequent were tuberculous arthritis (5.8%), systemic lupus erythematosus (3.9%), hemophilic hemarthrosis (2.1%), and other connective tissue diseases (1.5%). Age of onset was significantly lower in patients with pyogenic arthritis. Pyogenic, tuberculous and hemophilic arthritis in most cases were characterized by large joint monoarthritis. Acute polyarthritis was common in rheumatic fever. Chronic polyarthritis was a frequent feature in the other cases. It is concluded that age of onset, number and site of affected joints, as well as evolution time may be useful in the diagnosis.

PMN cell phagocytic function in malnourished patients with zinc uptake.

Zinc effects on phagocytic activity depend upon its serum concentration. According to certain experimental findings, a decrease in zinc serum concentration is parallel to a deficiency in host defense mechanisms and thus we were interested in studying the effect of zinc sulphate in the phagocytic function of polymorphonuclear cells of 15 zinc deficient patients with III degree malnourishment. In all patients, zinc serum determinations were made before and after zinc intake and chemotaxis, phagocytosis and NBT reduction tests were made at 7, 14 and 30 days. Results are compared with an eight patient group with similar clinical and nutritional characteristics observing an improvement in PMN cell phagocytic activity in patients with zinc uptake (p < 0.001). No differences were observed in a chemotaxic phagocytosis and NBT reduction tests in regard to the time during which patients did not receive zinc uptake.

[Comparative effect of terbutaline and adrenaline in the treatment of bronchial asthma]. / Efecto comparativo entre el sulfato de terbutalina y la adrenalina en el tratamiento del asma bronquial infantil.

The bronchodilating effect of terbutaline and of adrenaline were compared in 15 patients with ages from 6 to 17 years, having a clinical and functional diagnosis of bronchial asthma, but without signs of infection. The results showed an evident bronchodilating effect, similar in both drugs, with minimal cardiovascular effects following administration of terbutaline (p < 0.005).

[Familial neoplasms and childhood dermatomyositis]. / Neoplasia familiar y dermatomiositis infantil.

Familial frequency of malignant neoplasms from 20 children with dermatomyositis was investigated and compared with 225 controls. Eight patients with dermatomyositis (40 per cent) had nine family members with a malignant tumour; this frequency is significantly higher than those found in the controls with juvenile rheumatoid arthritis (P less than 0.01), neoplasms (P less than 0.01), and a variety of diseases (P less than 0.05). This finding and the known association of neoplasm-dermatomyositis might suggest an hereditary predisposing factor, possibly a subtle inmune deficiency, common for tumours and dermatomyositis.

[Skin response to phytohemagglutinin in patients with typhoid fever, bronchial asthma and Hodgkin's disease]. / Respuesta cutánea a fitohemaglutinina en pacientes con fiebre tifoidea, asma bronquial y enfermedad de Hodgkin.

The skin response to phytohemagglutinin was investigated as an index of cellular immunity in group of 50 children made up of 11 with thypoid fever, 13 with bronchial asthma type I, 15 with Hodgkin's disease and 11 controls. A mild but statistically significant (p less than 0.005) depression was found in the skin response of patients with typhoid fever and moderate in patients with Hodgkin's disease. In patients with bronchial asthma, it was similar to control cases; thus, in the future, finer parameters are considered necessary in these cases to investigate cellular immunity.

Indirect hemagglutination with PPD in cerebrospinal fluid for the tuberculous meningoencephalitis.

Reliability of indirect hemagglutination test was evaluated with PPD in CSF for the diagnosis and prognosis of tuberculous meningoencephalitis. The test was positive 100 percent in 22 patients with this disease and negative in 53 patients from the control group (p = 0.001) with viral or pyogenic infection in the CNS. No correlation was observed between antibody titers and the prognosis of the disease. Modifications of the original technique are described.

[Concentration and activity of alpha-1-antitrypsin in neonatal hepatitis]. / Concentración y actividad de alfa-1-antitripsina en hepatitis neonatal.

The concentration and activity of alpha 1-antitrypsin were studied in 20 children with the diagnosis of neonatal hepatitis. The concentration of alpha 1-AT was found normal or high in all of the patients (3.6 +/- 0.12 mg/ml). No case was found with PiZZ homozygote type alpha 1-AT deficiency. The activity of alpha l-AT was found decreased in 90% of the patients with neonatal hepatitis (control: 0.86 +/- 0.18 mg. trypsin inhibited by ml. of serum; neonatal hepatitis: 0.49 +/- 0.07 mg/ml.). The possibility that this may correspond to a disorder characteristic of neonatal hepatitis is mentioned.

[Thrombocytosis in juvenile rheumatoid arthritis]. / Trombocitosis en artritis reumatoide juvenil.

To find out the possible relationship between thrombocytosis and JRA, 2 to 11 platelet counts (every 1 to 6 months) were performed in each of 26 patients with active JRA, and were compared with figures for hemoglobin, WBC, sedimentation rate and articular index. Thrombocytosis was found in 88% of the cases. There was positive correlation, with statistical significance, among thrombocytosis, anemia, and sedimentation rate. Significant relationship was also found among thrombocytosis, the presence of articular inflammation and leukocytosis. There was no parallelism between platelets types of the disease. We conclude that in active JRA, thrombocytosis is a frequent finding in relation with anemia and the inflammatory activity of the disease.

[Meta-analysis: an alternative method in clinical research]. / Meta-análisis: un método alternativo de investigación clínica.

Meta-analysis is a research method which allows for the grouping of results from different studies relating to the same topic. Its main objective is to increase the precision surrounding the original research problem and provide a possibility to answer to different questions. This method has been developed in the areas of physics and the social sciences and has been widely accepted within the medical field. Its main use in medicine is in relation to the evaluation of therapeutic measures, yet its application has extended to the evaluation of diagnostic tests, etiological and prognostic factors. In spite of its development, there are still persisting problems in research difficult to solve because of the heterogeneity of the grouped studies, the identification of the size of the relevant effect and of the application of the results in clinical practice. The growing use of this research method within the medical field calls for its comprehension, as well as the recognition of its advantages and limitations in order for its users to be capable of judging the validity of individual meta-analysis.

Effect of diphenylhydantoin in serum and secretory IgA concentrations.

Diphenylhydantoin (DFH) treatment for epileptic patients has shown adverse effects such as malignant lymphadenopathy, systemic lupus erithematosus, periarteritis nodosa and recently immunological alterations such as a decreased lymphocytic response to fitohemaglutinin and serum IgA concentration, therefore we thought DFH effect on secretory IgA would be an important finding. This phenomenon might imply a defect in resistance local mechanisms for infection. Two groups of patients were studied: a) 25 children with an established diagnosis of epilepsy, "grand mal" type, that received anticonvulsive treatment with DFH for six months and b) 25 children with a diagnosis of infectious meningoencephalitis that required DFH to control convulsive crisis. Patients with a history of recurrent infections, lymphadenopathies, hepatosplenomegaly, drug allergy, collagenopathies and immunodeficiency were ruled out from this study. In all patients T and B lymphocytes, serum IgA, saliva and duodenal fluid and IgA determinations were made. Results show IgA concentration decrease in saliva and duodenal fluid of epileptic and meningoencephalitic patients (p less than 0.05), as well as lymphocyte T depression in epileptic and non epileptic patients treated with DFH (p less than 0.001).

[T and B lymphocytes in the peripheral blood of the in-utero malnourished new born infant]. / Linfocitos T y B en sangre periférica del recién nacido desnutrido in utero

The per centum distribution of T and B lymphocytes was determined in 30 full term newborns showing adequate development for their gestational age and in 42 full term newborns showing in utero malnutrition. A significant decrease (p less than 0.001) of both lymphocytic subpopulations was found in the in utero malnutrition group. The possibility of a decreased efficiency of the immune response in this group of patients is discussed.