Oncolytic reovirus enhances rituximab-mediated antibody-dependent cellular cytotoxicity against chronic lymphocytic leukaemia.

The naturally occurring oncolytic virus (OV), reovirus, replicates in cancer cells causing direct cytotoxicity, and can activate innate and adaptive immune responses to facilitate tumour clearance. Reovirus is safe, well tolerated and currently in clinical testing for the treatment of multiple myeloma, in combination with dexamethasone/carfilzomib. Activation of natural killer (NK) cells has been observed after systemic delivery of reovirus to cancer patients; however, the ability of OV to potentiate NK cell-mediated antibody-dependent cellular cytotoxicity (ADCC) is unexplored. This study elucidates the potential of oncolytic reovirus for the treatment of chronic lymphocytic leukaemia (CLL), both as a direct cytotoxic agent and as an immunomodulator. We demonstrate that reovirus: (i) is directly cytotoxic against CLL, which requires replication-competent virus; (ii) phenotypically and functionally activates patient NK cells via a monocyte-derived interferon-α (IFNα)-dependent mechanism; and (iii) enhances ADCC-mediated killing of CLL in combination with anti-CD20 antibodies. Our data provide strong preclinical evidence to support the use of reovirus in combination with anti-CD20 immunotherapy for the treatment of CLL.

[Sporadic persistence of amebic hepatitis]. / Sulla sporadicità persistente dell'epatite amebica.

A case of classical colliquative amoebic hepatitis, documented with aspiration of abundant amoebic pus by means of hepatocentesis and treated with chloroquine and haematin, is reported. This type of amoebiasis is rare nowadays, it is pointed out. Present-day clinico-epidemiological features are outlined: reduction in official cases, reversal of the ratio between colitis and hepatitis (the latter is on the increase), disappearance of acute dysenteric forms, less tendency to colliquative development in cases where the liver is involved, an involvement which is seen most frequently with an atypical chronic-type imprint. Mention is finally made of the reasons behind this cliniqo-epidemiological shift.

[The complement fixation test in leishmaniasis. Comparison between an antigen extracted from leishmania cultures and one extracted from BCG]. / La reazione di fissazione del complemento nella leishmaniosi. Confronto tra un antigene estratto da culture di leishmanie e un antigene estratto da BCG.

A comparison between a BCG antigen and various batches of an antigen extracted at different times from leishmania cultures in the fixation of complement reaction is reported. A better response was obtained with BCG (further confirmation on a larger series is being sought), whereas the leishmania antigens were difficult to prepare and their batch titres were not constant.

[Serum zinc concentration and antibody response to hepatitis B vaccine in hemodialysis patients]. / Concentrazione sierica dello zinco e risposta anticorpale al vaccino anti-epatite B negli emodializzati.

The serum zinc concentration seems unlikely to be an important factor influencing immune response to hepatitis B vaccination in hemodialysis patients, on the basis of the following results: the absence of statistically significant differences in serum zinc concentrations between patients with absence of post-vaccine seroconversion or non protective seroconversion and patients with excellent seroconversion (anti-HBs concentrations over 124.6 mUI/ml); the association of protective antibody responses in 50% of non responders after an additional dose of HBV vaccine, without preliminary corrections of zinc balance.

[Clofibrate hepatitis. A case report]. / Epatite da clofibrato. Descrizione di un caso.

The case of a patient who developed hepatitis during treatment with clofibrate is reported. The first attack of hepatitis, which resolved after the drug was suspended, was followed by another at rechallenge with a similar drug, fenofibrate.

[Correlation between values of alpha-1-fetoprotein and clinical manifestations of cirrhosis in the evaluation of a carcinomatous course of the disease. Preliminary data on case material on elderly patients]. / Correlazione fra valori di alfa-1-fetoproteina e manifestazioni cliniche della cirrosi nella valutazione di una evoluzione carcinomatosa della malattia. Dati preliminari su una casistica di pazienti anziani.

Early diagnosis of PHC development in cirrhosis is sometimes difficult through common tests excluding invasive diagnostic procedures; liver biopsy as a routine periodical control during the course of the disease is not advisable and AFP monitoring as a diagnostic test is preferable. The present study shows the results of a screening for AFP levels in a series of 113 cirrhotic patients aged over 50. 11.5% of them presented increased levels of serum AFP, indicating development of PHC. AFP elevated values resulted in 76.5% of cases associated with a previous HBV infection, and the risk of PHC development resulted sixfold greater in anti-HBc positive male cirrhotic patients. In patients with elevated AFP levels the prevalence of complications of cirrhosis resulted up to tenfold greater than in AFP negative patients.

[Factors predicting the response to alpha-interferon therapy in patients with chronic hepatitis C]. / Fattori predittivi di risposta al trattamento con alfa interferone in pazienti con epatopatia cronica anti-HCV positiva.

Objective of the study was to identify predictive factors of response to treatment with interferon in patients with anti-HCV positive chronic liver disease. 92 anti-HCV positive patients, 51 with chronic hepatitis and 41 with active cirrhosis, were treated for 12 months with recombinant alpha 2a interferon at a starting dose of 6 MU TIW/6 months, followed by 3 MU TIW/6 months. Patients were considered responders (RS) when they presented normal serum ALT values both at the end of treatment and after 6 months of follow-up; relapsers (RC) those with normal ALT values at the end of treatment but with increase during the 6 months of follow-up and non-responders (NR) patients who had no beneficial effect on ALT levels during treatment. 21 patients were RS, 11 RC and 60 cases NR. Univariate analysis of pre-treatment factors showed that response to interferon was associated with absence of cirrhosis and lower gamma-GT levels in RS than in RC. Multiple logistic regression of these variables showed that gamma-GT levels and absence of cirrhosis were the only independent factors associated with response to treatment. In conclusion, in our series of patients, only two factors were confirmed useful in predicting response to interferon treatment and it is concluded that they must always be evaluated before starting treatment with interferon which is not without side effects and may not have beneficial effect.

[Comparison between fixation test with BCG and immunofluorescence in the diagnosis of leishmaniasis]. / Confronto tra reazione di fissazione del complemento con BCG e immunofluorescenza nella diagnostica della leishmaniosi

The complement fixation test with an antigen from commercially lyophilized BCG and the immunofluorescence test were carried out on serum samples from patients with visceral leishmaniasis, oriental sore and tbc. The IFT positivity was obtained only in patients with visceral leishmaniasis. The CFT with BCG showed positive results in 3 on 5 serum samples from patients with visceral leishmaniasis, in 2 with oriental sore, at low titres, and in 5 serum samples from patients with tbc. The AA. confirm the high specificity of the IFT, but suggest that the CFT with BCG can be used as a convenient screening test.

[The complement fixation test with BCG in the diagnosis of leishmaniasis]. / La reazione di fissazione del complemento con BCG nella diagnostica della leishmaniosi

The utility of complement-fixation test with an antigen from commercially lyophilized BCG was investigated in the diagnosis of leishmaniasis. The following results were obtained: Visceral leishmaniasis: 4 positivity on 5 cases; Oriental sore: 3 positivity on 6 cases; Canine leishmaniasis: 6 positivity, at high level, and 2 negativity; Other diseases: 5 positivity, on 17 sera of tbc; No positivity in sera from patients with various diseases, in control and in normal dogs. The results are compared with those quoted in medical literature and discussed. The meaning of the reaction is also briefly discussed, and the hypothesis of the presence of partigens between BCG and leishmania, or presence of autoantibodies is prospected.

Peripheral nerve involvement in chronic liver disease. Clinical and electrophysiological study.

A clinical and electrophysiological study was carried out on 19 selected patients with chronic liver disease. Clinical signs of peripheral nerve involvement were found in 4 patients (21%); while electrophysiological impairment was present in 11 patients (57.8%). These abnormalities were mostly limited to the sensory and motor fibers of the tibialis posterior nerve. Our data confirm the presence of peripheral nerve involvement in chronic liver disease, and that it may be evidenced by careful electrophysiological examination.

Platelet thromboxane production in liver cirrhosis.

To determine whether platelet prostaglandin production in patients with liver cirrhosis was as impaired as platelet aggregation, serum thromboxane production was studied in 52 patients with liver cirrhosis; 12 patients had consumed more than 80 gr of alcohol/day, for more than ten years; 13 patients had also had diabetes mellitus for more than two years. A reduced thromboxane synthesis by platelets of liver disease patients was observed; the parallel decrease of both platelet thromboxane and serum PGE2 formation may also suggest a decrease in arachidonic acid availability for prostaglandin and thromboxane production. A smaller reduction of thromboxane and PGE2 formation in cirrhotics with diabetes mellitus or chronic alcohol intake was also observed.

[Counterimmunoelectrophoresis on cellulose acetate membrane with a commercial lyophilized antigen in diagnosis of human hydatidosis]. / Controimmunoelettroforesi (CIEP) su membrana di acetato di cellulosa, con un antigene liofilizzato del commercio, nella diagnostica della idatidosi umana.

A very simplified method of crossed over electrophoresis (CIEP) was employed with a lyophilized commercially produced antigen (previously submitted to several freezing and thawing) and cellulose acetate membrane, for the diagnosis of human hydatidosis. Results are as follows: active hydatidosis (surgically confirmed): number of sera tested 35; positive 32 (91%). Sera of patients with parasitic and non parasitic illnesses (especially malignancies of liver and lung) did not show any precipitin lines. The pattern of immunoprecipitation is characteristically in the form of an "upper lip" or a thick and undulating "streak". The very thin arcs of precipitation which are occurring in some control sera, are to be considered negative. These results indicate that with regard to the rule of the "three S" (specificity, sensitivity and simplicity) the method appears sufficiently satisfactory.

[Serum monoamine oxidase (MAO) in the differential diagnosis of chronic liver disease. I]. / La monoaminossidasi sierica (MAO) nella diagnostica differenziale delle epatopatie croniche. Nota I.

Aim of this study was to evaluate the diagnostic value of serum MAO activity (sMAO) in chronic liver disease. sMAO has been assayed by benzylamine colorimetric method. No statistically significant differences of sMAO values have been found between controls and acute viral hepatitis or various diseases patients. Differences instead between controls and patients sMAO values (chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis) were statistically significant (p less than 0.005).

HBV infection risk in hospital workers.

Prevalence of HBV infection markers and its association with some risk factors has been studied on hospital staff of the University Polyclinic of Palermo. The results show that male sex, job category (technicians, nurses, cleaners) and age are significantly associated with a higher prevalence of HBV infection markers; length of service and working in departments with a presumably higher exposure to blood did not result as a risk factor of higher prevalence of HBV infection when submitted to multiple regression logistic analysis. It is suggested that results of this study may be affected by the elevated spread of HBV infection in this area, and extra risk associated to hospital exposure is too small to be demonstrated.