Leukocyte CMV antigen levels in renal allograft recipients

Thirty-eight [38] new kidney recipients, and 12 normal controls were included in this study to determine the value of various immunologic parameters in the early monitoring of active CMV infection. CMV antigen and IgG and IgM antibodies were measured weekly in both recipient and control groups. In addition, the level of Soluble Interleukin 2 Receptor [SIL2R] and T cell subsets were measured at monthly intervals. This was correlated to their clinical condition. Eight [8] of the 38 recipients became positive for CMV antigen in peripheral blood leukocytes. This usually preceded the appearance of CMV IgM antibodies by at least one week. On further follow-up, CMV IgM decreased to normal levels in 4 to 6 weeks in 5 recipients. The remaining 3 died from CMV syndrome. In addition, the serum SIL2R level in the recipients before transplantation was significantly higher than in the control group. One month after transplantation, the CMV negative antigen group showed a significant lowering of the SIL2R level, while the CMV positive group showed a significant rise in this level. One month later, SIL2R decreased significantly. Finally, T cell subset determination in the CMV positive group showed a slight lowering of helper T cells and a marked elevation of the suppressor cells compared to the CMV negative group. This was also associated with a significant decrease in the helper/suppressor ratio. CMV antigenaemia is a sensitive and specific marker of CMV infection that significantly precedes the appearance of CMV antibodies. It is of great value in the monitoring of renal transplant recipients who are at high risk of CMV infection

Tuberculin reactivity and the effect of serum antibodies to PPd in tuberculosis

This study included 150 patients complaining of active pulmonary T.B/ and 16 healthy controls. They were subjected to history taking and clinical examination radiological examination and classification according to the national tuberculosis association USA [1961]; sputa were examined for acid fast bacilli; test and haemagglutination technique to detect the circulating anti PPD antibodies. There was a reverse correlation between the level of dermal reactivity to PPD and serum level of anti- PPD antibodies in the patients of the study. Titre of anti PPD- antibodies could differentiate tuberculin negative patients with active disease [high anti PPD antibodies level] from Tuberculin negative healthy controls [absent anti- PPD antibodies]. Thus detection of anti- PPD antibodies may be of diagnostic value in suspected tuberculosis disease with energy or hyporeactivity to PPD. After 2 months of antituberculus therapy, there was a significant increase of the diameter of their tuberculin skin, and concomitant drop in their serum level of anti PPD antibodies of patients especially for those with initial tuberculin negative reactions