Anergy testing in patients with head and neck cancer.

Patients with head and neck cancer were found to be deficient in were not clear [correction] Possible explanations include a change in T-lymphocyte numbers, particularly the helper/suppressor T-cell ratio, with the cause of this change still unknown. Tumor immunosuppressing factors and cancer-induced immunosuppression are proposed to be such causes. The deficiency of T cells resulted in an impaired cell-mediated immune response (CMIR), which lowered the host resistance, such facilitating the tumor to spread. As the CMIR can be evaluated by delayed hypersensitivity skin testing (= anergy screen), the objective of this study was to compare the CMIR function of patients with head and neck cancer to a non-cancer control group using this anergy screen. The study group consisted of 20 patients (17 males, 3 females, age range 10-76 years) with head and neck cancer, which were anti-HIV negative and had not received any therapy yet. The control group consisted of another 20 persons (17 males, 3 females, age range 21-72 years) without any cancer and who were also anti-HIV negative. Exclusion criteria were (1) eczema or skin disease in the area to be tested, (2) having received oral prednisolone within the last week and (3) an anti-HIV positive immune status. The antigens used in this study consisted of PPD (5 IU), tetanus toxoid (TT) (0.8 LF/ml and 1.6 LF/ml, Candida albicans (20 PNU/ ml and 200 PNU/ml), mumps-measles-rubella (MMR) vaccine (1:10 v/v and 1:5 v/v). The test was done by intradermal injection of 0.1 ml of each antigen. The anergy screen was considered positive when the test resulted in an erythema or induration larger than 5 mm at 72 hours after the injection. Complete anergy was diagnosed when there was no skin reaction at all, partial anergy when only 1 antigen tested positive and no anergy when there were positive skin reactions to two or more antigens. In the study group, 9 (45%) patients were diagnosed with complete anergy, 11 (55%) with partial anergy and none with no anergy, while in the control group, none were complete anergic, 3 (15%) were partially anergic and 17 (85%) had no anergy. There was a statistically significant difference (p < 0.01) between these two groups. In conclusion, patients with head and neck cancer seemed to have an impaired CMIR, with at least the partial anergy being statistical significantly different compared to the non-cancer group.

Anergy and chemokine receptors.

The human immunodeficiency virus (HIV) induces a spectrum of immune abnormalities in the host by binding to CD4 molecules and chemokine receptors. Anergy, apoptosis, and immune activation are among the diverse immunological changes observed in the host. Chemokines, being the natural ligands for the chemokine receptors, block the entry of a retroviral strain, which exhibits tropism for the given receptor. This opens new therapeutic strategies and intervention possibilities for treating HIV infected individuals.

Nutrients as modulators of anergy in acquired immune deficiency syndrome.

Malnutrition induces a spectrum of immune abnormalities including a state of anergy in the host. This state is due to a decrease in CD4 + helper cells, diminished cytotoxic cell activity and reduction in production of lymphokines required for signal transduction. Human immunodeficiency virus (HIV), the retrovirus known to cause acquired immune deficiency syndrome (AIDS), leads to a state of anergy by causing similar immunological changes. Micronutrient abnormalities, concomitant infections and genetic factors, etc., are some of the compounding co-factors which further contribute to the deterioration of the immune functions in AIDS patients. Reversal of these immune abnormalities would improve the quality of life of HIV-infected individuals.

Correlaçäo entre a infecçäo pelo HIV, anergia cutânea e alteraçöes oculares observadas entre pacientes com sorologia positiva para o HIV ou de risco para a infecçäo: parte II / Correlation of HIV infection, anergy and ocular manifestations observed in patients with or at risk of HIV infection: part II

Uma série de 203 pacientes ambulatoriais com sorologia positiva para o HIV ou de risco para a infecçäo foram examinados para determinar a frequência das manifestaçöes oftalmológicas e correlacioná-las com a imunodeficiência. O estado imunológico foi pesquisado através de testes cutâneos utilizando os antígenos: PPD, candidina, tricofitina e estreptoquinase. Observou-se que existe uma forte associaçäo entre a infecçäo pelo HIV, a energia cutânea e as alteraçöes oculares. O paciente infectado e anérgico apresenta um risco 22 vezes maior de desenvolver alteraçöes oculares (p=0)