Corneal transplantation and concomitant SARS-CoV-2 infection: a case report / Transplante de córnea e infecção concomitante por SARS-CoV-2: relato de caso

ABSTRACT This report was aimed at presenting a case of neurotrophic keratitis and concomitant SARS-CoV-2 infection in a patient who has recently undergone a corneal DALK transplant. One month after corneal transplantation with adequate corneal epithelialization, the patient presented neurotrophic keratitis with a torpid course of the corneal transplant coinciding with a SARS-CoV-2 infection, with an excessive host immune response. In addition, the patient presented a re-positivization of nasopharyngeal polymerase chain reaction of SARS-CoV-2 with past disease after starting treatment with autologous serum eye drops. The implications at the ophthalmological level of SARS-CoV-2 infection may be clarified as the time the illness progresses and we learn more about how it acts. In this case, the disparity of signs and symptoms, the antecedent of corneal surgery, and the possibility of a herpetic infection as a cause of the primary leukoma suggested neurotrophic keratitis. Nonetheless, the involvement of systemic SARS-CoV-2 infection in the process, triggering an excessive host immune response at the corneal level with an increase in inflammatory cytokines must be taken into account. No relationship was found between treatment with autologous serum and re-positivization of nasopharyngeal polymerase chain reaction, presenting the patient a favorable response to treatment.

RESUMO O objetivo deste relato foi apresentar um caso de ceratite neurotrófica e infecção concomitante por SARS-CoV-2 em paciente submetido recentemente a transplante de córnea DALK. Um mês após o transplante de córnea com adequada epitelização da córnea, o paciente apresentou ceratite neurotrófica com curso tórpido do transplante de córnea, coincidindo com infecção por SARS-CoV-2, com resposta imune excessiva do hospedeiro. Além disso, o paciente apresentou repositivização da reação em cadeia da polimerase nasofaríngeo de SARS-CoV-2, com doença pregressa após iniciar tratamento com colírio de soro autólogo. As implicações a nível oftalmológico da infecção por SARS-CoV-2, podem ser esclarecidas à medida que a doença progride e aprendemos mais sobre sua forma de atuação. Neste caso, a disparidade de sinais e sintomas, o antecedente de cirurgia de córnea e a possibilidade de infecção herpética como causa do leucoma primário sugeriram ceratite neurotrófica. No entanto, deve-se levar em consideração o envolvimento da infecção sistêmica por SARS-CoV-2 no processo, desencadeando uma resposta imune excessiva do hospedeiro no nível da córnea, com aumento de citocinas inflamatórias. Não foi encontrada relação entre o tratamento com soro autólogo e a repositivização da reação em cadeia da polimerase nasofaríngea, apresentando ao paciente uma resposta favorável ao tratamento.

Erythrocyte native immune adhering function (ENIAF) in patients with hematopoietic and lymphoid neoplasms and its effect on NK Cell killing activity / 中国实验血液学杂志

The objective of this study was to investigate the change of native immune adhering function (ENIAF) in self-plasma of patients with hematologic and lymphoid neoplasms and its effect on the killing activity of NK cells. The whole blood was anticoagulated with citric acid. 5 microl precipitated red blood cells and 500 microl plasma of patients or controls were directly mixed with 750 microl quantitative K562 cells at 37 degrees C for 30 minutes. One K562 cell attached by one or more erythrocytes was counted as one rosette, the ratio of rosettes was calculated. Using K562 cells as target cells, the killing activity of NK cells isolated from normal persons was detected by MTT assay, the change of the killing activity was observed after adding RBCs. The results indicated that the ratio of rosettes formed by RBCs of 21 normal controls and K562 cells was 15.3% +/- 6.4%, and the ratio of rosettes formed by RBCs of 24 patients and K562 cells was 7.6% +/- 7.0%. The ability of ENIAF in patients with hematologic and lymphoid neoplasms was significantly lower than that in healthy individuals (t = 3.61, p < 0.001). The killing rate of NK cells in peripheral blood of normal individuals was 67% - 71% without adding RBCs, and it increased by 14.7% +/- 5.2% after adding RBCs of normal controls but decreased by 4.3% +/- 7.6% with RBCs of patients. It is concluded that the ENIAF of RBCs in patients with hematopoietic and lymphoid neoplasms decreases, accompanying the reduction of the killing activity of NK cells to K562 cells, so to detect change of ENIAF may be helpful for the assessment of the immunological function of patients with hematopoietic and lymphoid neoplasms.

Expresión antigénica ABH y carácter secretor en pacientes con lesiones orales precancerosas y cancerosas / Secretor status and ABH antigens expression in patients with oral lesion

Los antígenos ABH, productos de la interacción de dos sistemas genéticos Hh y ABO, están sujetos a leyes de herencia y pueden estar localizados no sólo en los eritrocitos sino también en la mayoría de las células humanas. El objetivo del este trabajo fue investigar la relación entre el carácter secretor de pacientes con lesiones orales pre-malignas y malignas y la expresión antigénica ABH en cortes histológicos de dichas lesiones. Se trabajó con muestras incluídas en tacos de parafina de pacientes con lesiones orales. Los pacientes fueron clasificados en 2 grupos a) lesiones pre-malignas y malignas y b) lesiones benignas. Se investigaron los antígenos ABH por la técnica de inmunoadherencia específica modificada. Se utilizó la adherencia al tejido vascular como control positivo y al tejido adiposo como control negativo. Los resultados fueron semicuantificados desde adherencia fuertemente positiva a negativa. El carácter secretor fue determinado por la técnica de inhibición de la hemaglutinación. En 21 de las 34 muestras se observó una débil expresión antigénica en áreas atípicas, y deleción total en las áreas histológicamente afectadas por neoplasia. En 8 muestras hubo pérdida total de los antígenos ABH tanto en áreas normales como patológicas, estos pacientes presentaron un mayor grado de malignidad y metástasis que aquellos que conservaron la antigenicidad. Los pacientes con lesiones orales pre-malignas y malignas presentaron un incremento del carácter no secretor (52,3 por ciento) respecto de la población control (19,5 por ciento) y de aquellos pacientes con lesiones orales benignas (15.4 por ciento). Se observó una importante asociación entre pacientes no secretores y deleción de los antigenos ABH en muestras de lesiones orales. Además, hemos encontrado, en el grupo no secretor, una mayor malignidad de las lesiones orales como así también una mayor presentación de displasia epitelial. El estudio del carácter secretor en los pacientes con lesiones orales...

Effect of shenmai injection on immunologic function in patients with dilated cardiomyopathy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Shenmai Injection (SMI) on immunologic function in patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>Fifty-six patients were divided into two groups, the control group treated with conventional western medicine, and the SMI group treated with conventional western medicine plus SMI. The indices including red blood cell (RBC) C3b receptor rosette (RBC-C3bRR) and immune complex rosette (RBC-ICR), T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were determined before and after treatment.</p><p><b>RESULTS</b>The level of RBC-C3bRR, CD4, CD8 and CD3 in patients with DCM were significantly decreased (P <0 .01, P < 0.05), RBC-ICR and CD4/CD8 were significantly increased than those in the normal control group (P < 0.01); While the level of RBC-C3bRR, CD4, CD8 and CD3 in the SMI group after treatment were significantly higher, and the level of RBC-ICR and CD4/CD8 were significantly lower (P < 0.01, P < 0.05) than those in the control group.</p><p><b>CONCLUSION</b>The RBC immune adherence and cellular immune function are lower in patients with DCM, and SMI has the effect in regulating immune function in patients with DCM.</p>

Inmuno-hemo-reología: análisis termodinámico de la aglutinación eritrocitaria inmunológica / Immuno-hemo-reology: Thermodynamic analysis of immunological agglutination of erythrocites

La aglutinación inmunológica es la consecuencia de la reacción Ag-Ac que adhiere eritrocitos adyacentes. Los anticuerpos se fijan a los sitios antigénicos distribuidos sobre la superficie de la membrana eritrocitaria, actuando como anclajes moleculares para unir células adyacentes y formas aglutinadas. Una pequeña cantidad de energía es disipada durante la reacción. Si se suministra una cantidad de trabajo mecánico equivalente a la energía disipada, los aglutinatos pueden ser disociados. El trabajo mecánico es realizado por tensiones de corte generadas en un viscosímetro de tipo Couette. Se propone una nueva técnica que utiliza la retrodifusión de un haz láser para analizar la cinética de disociación de aglutinatos eritrocitarios inmunológicos, producida por cizallamiento de los aglutinatos en suspensión. La intensidad del láser, retrodifundida, aumenta en la medida que los aglutinatos son disociados por corte. El registro de la intensidad retrodifundida suministra una curva de disociación que es ajustada por una ecuación exponencial. Los parámetros que caracterizan esta ecuación muestran una buena correlación con la potencia de la aglutinación. La integración numérica de las curvas de disociación conduce a la obtención de un parámetro ED que estima la energía intercambiada en el proceso de disociación y, en consecuencia, la constante de afinidad.

Urinary IgG antibody capture particles adherence test for detecting HIV antibodies: a preliminary report.

It is known that antibodies to HIV are secreted in urine and saliva. IgG antibody capture particle adherence test (GACPAT) has been shown to provide accurate results for antibodies in urine. The aim of the study was to study the sensitivity and specificity of this test in our settings. 114 urine samples were collected from both HIV positive and HIV negative patients and were analysed using GACPAT. The test has a sensitivity of 92.3% and specificity of 100%. We feel that this test has a definite role in our country especially for surveillance purposes.

Partículas lipoproteicas: concepto, aislamiento e implicancias clínicas / Lipoprotein particles: concept, isolation and clinical significance

La utilización de la cromatografía de afinidad con concanavalina A o de cromatografía de inmunoafinidad con anticuerpos anti apoB permite obtener dos grupos de lipoproteínas: las que contienen apoA y las que contienen apoB. El subfraccionamiento por cromatografía de inmunoafinidad secuencial de las partículas lipoproteicas que contienen apoA permite obtener a su vez tres mayores partículas lipoproteicas: LP-A-I, LP-A-I:A-II y LP-A-II. El subfraccionamiento a través de inmunoprecipitación secuencial o cromatografía de inmunoafinidad secuencial de las partículas lipoproteicas que contienen apoB permite obtener cinco mayores grupos de partículas: LP-B, LP-B:C, LP-B:E, LP-B:C:E y LP-A-II:B. La diferencia entre normo e hiperlipoproteinémicos sería el resultado de cambios cuantitativos (y no cualitativos) de las partículas lipoproteicas. En hipercolesterolémicos se destaca un aumento de LP-B en tanto que en hipertrigliceridémicos aumentan la LP-B-C y LP-B:C:E. Las drogas hipolipemiantes, independientemente de su mecanismo de acción, afectan en diferentes sentidos las concentraciones de las partículas lipoproteicas que contienen apoA y apoB. Bajas concentraciones de LP-A-I y elevadas de LP-B:C y LP-B:C:E se asocian con riesgo aterogénico

Immunological activities of monoclonal IgG1 antibody against Trypanosoma gambiense.

The present paper deals with the immune reaction between a monoclonal IgG1 antibody and Trypanosoma gambiense. The aggregation of trypanosomes, immune adherence to macrophages and protection against infection are associated with the antibody. IgG1-mediated clumping of trypanosomes is readily dissociated by the addition of complement. Dissociation of the clumped trypanosomes in the equivalence area released approximately fifty percent of previously bound surface antigens. These antigens were capable of binding again to new IgG1 antibody. Complement deposition rendered bivalent IgG1 antibody in the immune complex functionally univalent. Such an event in the presence of complement is of great advantage to the infected host in killing pathogens in vivo, as it allows more antibodies to attach to surface antigens and subsequently to initiate complement activity.

Seroepidemiological study of herpes viruses in Nepal.

The antibody positive rates among Nepalese, in a community, to herpes simplex virus (HSV), varicella-zoster virus (VZV) and cytomegalovirus (CMV) were studied. Immune adherence hemagglutination test (for VZV) and complement fixation test (for HSV and CMV) were used to measure the antibodies. An 80% positive rate of anti-HSV antibodies was found in early childhood (1-4 years) that further increased with age (96.1% positive in greater than 15 years age). Only 25% of children 1-4 years old showed antibodies to VZV but the number of positives increased rapidly with age (82.9% in greater than 15 years age). Antibody against CMV was positive in all the subjects studied.

Reactividad del receptor eritrocitario CR1 en pacientes con lupus eritematoso sistémico / Erythrocyte CR1 receptor reactivity in patients with systemic lupus erythematosus

Se estudia la reactividad del receptor CR1 eritrocitario, por su capacidad de inmunoadherencia-hemoaglutinación (IAH) frente a distintas concentraciones de gamaglobulina humana agregada en presencia de suero fresco de cobayo como fuente de complemento, en glóbulos rojos de 80 voluntarios sanos y 42 pacientes con lupus eritematoso sistémico. Por este método se detecta reactividad del receptor CR1 en un 87,5% de la población sana versus un 35,7% de la población lúpica. Ambas poblaciones presentan una distribución trimodal de los títulos de IAHA. El 72,5% de la población sana se distribuye en el grupo de reactividad intermedia y 64,3% de la población lúpica en el de reactividad baja, en concordancia con otros autores que describen tres grupos fenotípicos. No se encuentra correlación entre la expresión defectuosa del CR1 y los parámetros convencionales de actividad. Este receptor eritrocitario comprometido en el procesamiento de inmunocomplejos, que constituye el 95% del CR1 circulante, es un factor más que contribuye a la fisiopatología de la enfermedad cuando su reactividad es defectuosa

Simplification of immune adherence hemagglutination test for detection of rabies antibodies in human serum

A Reaçäo de Hemaglutinaçäo por Imunoaderência foi padronizada de maneira simplificada, para detecçäo de anticorpos rábicos em soros humanos. Esta reaçäo mostrou grande reprodutibilidade, maior que a apresentada pela clássica prova de soroneutralizaçäo em camundongos (SN). Ambas as provas mostraram alto grau de correlaçäo, ou seja, altos títulos em uma reaçäo correspondeu a altos títulos na outra; o mesmo ocorreu em relaçäo aos títulos baixos. A reaçäo de Hemaglutinaçäo por Imunoaderência, além de ser de execuçäo extremamente simples e rápida, tem custo bem menor se comparada a provas como a soroneutralizaçäo ou a imunofluorescência indireta. Pode, portanto, ser de grande utilidade em laboratórios com poucos recursos ou mesmo ser utilizada como uma prova de triagem para a titulaçäo de anticorpos rábicos

immune adherence hemagglutination: a new microimmunoassay for the serodiagnosis of visceral leishmaniasis

This report describes immune adherence hemagglutination as a new micro-immunoassay for the serodiagnosis of Leishmania donovani infection. Comparison of the results of immune adherence hemagglutination with those of indirect immunofluorescence assay, showed a close agreement between the two procedures. Sera from fifteen patients with confirmed parasitological evidence [positive splenic aspirate] of visceral leishmaniasis, as well as, fifteen sera from control children under 10 years of age and four normal adults were included in the study. Titers ranging from 128 to 2048 were obtained with immune adherence hemagglutination in patients and negative titers in the control children. The test appeared to be more discriminating with respect to the antigenic burden of the spleen and more sensitive than immunofluorescence assay. Compared with other conventional and sensitive laboratory tests for the serodiagnosis of leishmaniasis, the minimum requirement, rapidity, simplicity and local availability of reagents render the immune adherence hemagglutination a practical immunoassay for measuring specific antibody in those geographic locations where laboratory facilities are limited

Propuesta de caracterización y tipificación de proteínas monoclonales aplicable al laboratorio clínico / Proposal of characterization and typification of monoclonal proteins applicable to clinical laboratory

En el presente trabajo se incorporan y ordenan procedimientos para obtener la mayor información posible a nivel laboratorio clínico en la indagación de proteínas "M" y la definición de su clase (cadenas pesadas) y tipo (cadenas livianas). Se propone una secuencia de las siguientes técnicas: electroforesis, inmunoelectroforesis, inmunofijación, inmunodifusión radial cuantitativa, tratamientos despolimerizantes e inmunosustracción. La inmunosustracción, descripta por W. A. White y col., consiste en la remoción de la inmunoglobulina en estudio mediante un antisuero específico en presencia de polietilenglicol, separación del inmunocomplejo precipitado y posterior evaluación del sobrenadante mediante inmunofijación; se identifica la cadena liviana que pertenece a la inmunoblobulina sustraída por su ausencia al fijar con el antisuero correspondiente. Es particularmente útil cuando se desea establecer la correspondencia liviana/pesada en presencia de bandas homogéneas múltiples, identificar bandas menores enmascaradas en un fondo policlonal y excluir la presencia coincidente de cadenas livianas libres. Se aconseja incorporar el tratamiento despolimerizante con 2-mercaptoetanol previamente a la cuantificación de IgM por inmunodifusión radial ya que la comparación previa entre controles tratados y no tratados reveló una diferencia muy significativa cuando se analizó mediante contraste de diferencias entre pares homólogos (n = 12, test t = 37,2 p <0,01)

Susceptibility to varicella-zoster virus in Thai children and young adults.

During 1982-1983, susceptibility to varicella-zoster virus (VZV) in 224 Thai subjects at high risk for varicella infection was studied. The immune adherence hemagglutination (IAHA) and VZ skin test were carried out to determine VZV immunity in immunocompromised children and young adults. The history of varicella and herpes zoster from each subject was recorded. The mean +/- SD age in children and young adults were 7.3 +/- 2.8 and 19.6 +/- 1.2. Negative IAHA test was found in 74.2% of 62 children and 35.2% of 162 young adults. The increase in immune individuals was demonstrated with advancing age. Response to VZ skin test showed positive results in 79 of 162 (48.8%) young adults. The seronegativity was related to the negative VZ skin test (p less than 0.001, X2 test). Regardless of antibody detection or VZ skin test, 47 of 162 (29%) young adults were susceptible. According to the positive history of varicella and of herpes zoster obtained from 95 young adults, 80% had developed varicella during 1 to 10 years of age and 8.8% had positive history of herpes zoster. The findings suggest that the IAHA and VZ skin test should be used together for assessing VZ immunity. Varicella vaccination is highly recommended for susceptible persons who may develop severe illness.

Fatores de virulência em amostras de Escherichia coli enteropatogênicas para suínos isoladas no Brasil / Virulence factors present in strains of porcine enteropathogenic Escherichia coli isolated in Brazil

Trezentas e vinte e três amostras de Escherichia coli, isoladas de suínos com diarréia em Porto Alegre, RS, pertencentes aos sorogrupos 08, 09, 010, 035, 045, 064, 0108, 0115, 0119, 0138, 0139, 0141, 0147, 0149 e 0157, considerados enteropatogênicos para suínos, foram examinadas quanto à presença de fatores de virulência. A enterotoxina termolábil (LT) foi detectada através do teste de imunohemólise passiva em 56 amostras (17,3%), principalmente nos sorogrupos 08 e 0149, que totalizaram 52 amostras (92.85%) das 56 LT+. Amostras pertencentes aos sorogrupos 035, 0141 e 0157 também produziram LT, ao passo que as amostras pertencentes aos demais sorogrupos näo produziram estA enterotoxina. A enterotoxina termoestável, detectável pelo teste do camundongo recém-nascido, (STa), foi encontrada em 33 (10,2%) amostras pertencentes aos sorogrupos 09, 064, 0138, 0141 e 0149. Entre as 122 amostras STa-, examinadas para a detecçäo de enterotoxina termoestável, pelo teste de alça ligada de leitäo de 6 semanas, (STb), 31 (25,4%) foram positivas e pertenceram aos sorogrupos 035, 064, 0108, 0115, 0119, 0139, 0149 e 0157. Ao que se sabe, é a primeira vez que se relata no Brasil a produçäo de STb por amostras de E. coli de origem suína. Quanto às provas de microhemaglutinaçäo manose-resistente com hemácias de cobaia e cavalo, para a detecçäo dos antígenos K88 e K99, respectivamente, observou-se uma frequência maior de positividade entre as amostras LT+. A presença do antígeno 987P, também relatado pela primeira vez em nosso país, foi detectado sorologicamente em 12 (8,75%) das 137 amostras examinadas

Detection of varicella-zoster antibody by immune adherence hemagglutination test.

The immune adherence hemagglutination (IAHA) is a more sensitive and specific test for evaluation of humoral immunity to varicella-zoster virus (VZV) than a conventional complement fixation (CF) test. The equipment, reagents, procedure used in the IAHA are basically the same as those employed in the CF test. After VZ vaccination, seroconversions detected by IAHA test were significantly greater than those by CF test (P less than 0.01, chi 2 test). Moreover, the IAHA titers were higher about 4 times (G.M. 30.9 vs 8.2) and persisted longer than CF titers. Although the IAHA antigen is not a commercial product, the IAHA is sensitive and suitable assay for VZ antibody determination in routine serological laboratory.