Avaliação de células T regulatórias e pefil de ativação de linfócitos T na ceratoconjuntivite seca associada ao HTLV-1 / Regulatory T cells evaluation and T lymphocyte activation profile in keratoconjunctivitis sicca associated with HTLV-1

O HTLV-1 é o agente etiológico da leucemia /linfoma de células T do adulto (ATLL), da paraparesia espástica tropical/ mielopatia associada ao HTLV-1 (HAM/TSP) e da uveíte. Além destas, a ceratoconjutivite seca (CCS), doença multifatorial da lágrima e da superfície ocular, tem sido descrita com maior frequência em indivíduos infectados pelo HTLV-1. Assim como em outras doenças associadas, a CCS tem sido relacionada a uma elevada carga proviral. As células T regulatórias (Treg) são importantes na manutenção da homeostase do sistema imunológico e um comprometimento da imunorregulação exercido por elas pode contribuir para o ambiente inflamatório observado na CCS. Este estudo objetivou avaliar os linfócitos Treg de pacientes com CCS associada à infecção pelo HTLV-1. Foram realizados ensaios de imunofenotipagem por citometria de fluxo para avaliar a frequência de linfócitos T ativados (HLA-DR+) e de células T CD4+ e CD8+ regulatórios (FOXP3+), bem como a produção de IL-10 e TGF-β por estas células. Foram avaliados 37 pacientes infectados pelo HTLV-1 e assintomáticos para HAM/TSP, sendo 27 com diagnóstico positivo para a manifestação ocular (CCS), 10 com diagnóstico negativo (ASS), além de 17 voluntários não infectados pelo vírus (NI). As frequências de linfócitos T CD4+FOXP3+, CD8+FOXP3+, CD4+HLA-DR+ e CD8+HLA-DR+ foram significativamente maiores nos grupos CCS e ASS, quando comparados aos indivíduos não infectados. Quanto à produção das citocinas imunossupressoras, foi observada uma maior frequência de linfócitos T CD4+FOXP3+ duplo produtores de IL-10 e TGF-β no grupo CCS quando comparado ao grupo ASS. Com relação aos linfócitos CD8+FOXP3+, o grupo CCS apresentou uma maior frequência de células mono produtoras de IL-10 quando comparado ao ASS. Nossos resultados sugerem que a menor frequência de células Treg CD8+ produtoras de TGF-β em indivíduos infectados pelo HTLV-1 com CCS, pode contribuir para a intensificação da ativação celular e fisiopatologia da doença.

HTLV-1 is the causative agent of leukemia/lymphoma adult T-cell (ATLL), tropical spastic paraparesis / myelopathy associated with HTLV-1 (HAM / TSP) and uveitis. In addition, keratoconjunctivitis sicca (KCS), a multifactorial disease of the tear and of the ocular surface, has been more frequently reported in patients infected with HTLV-1. As for other HTLV-1-associated diseases, KCS has been related to a high proviral load. Regulatory T (Treg) cells are important in maintaining the homeostasis of the immune system. An impairment in the immunoregulation function of Treg may contribute to the inflammatory environment observed in the KCS. This study aimed to evaluate the Treg cells of patients with KCS associated with HTLV-1. Frequency of activated T cells (HLA-DR+) and CD4+ and CD8+ Treg cells (FOXP3+), as well as IL-10 and TGF-β production by Treg were quantified using flow cytometry. Thirty-seven HTLV-1 individuals were included (27 asymptomatic for HAM/TSP with positive diagnosis of ocular manifestation (KCS), 10 with negative diagnosis (ASS - asymptomatic). Seventeen non-infected individuals were included as controls (NI). The frequencies of CD4+ FOXP3+ T cells, CD8+FOXP3+, CD4+HLA-DR+ and CD8+HLA-DR+ were significantly higher in KCS and ASS groups when compared to non-infected individuals. As the production of immunosuppressive cytokines, a higher frequency of CD4+ FOXP3+ double producers of IL-10 and TGF-β in the KCS group was observed when compared to group ASS. Regarding the CD8+FOXP3+ lymphocytes, the KCS group had a higher frequency of mono cells producing IL-10 when compared to the ASS. Our results suggest that the lower frequency of Treg cells CD8+ TGF-β-producing in individuals infected with HTLV-1 with KCS, may contribute to the intensification of cellular activation and pathophysiology of the disease.

The effect of aging on micronuclei frequency and proliferation in human peripheral blood lymphocytes.

INTRODUCTION: Increase in the instability of cellular genome with an increasing age is the result of an accumulation of cellular damage and mutations. This instability which might be observed as chromosome damage or chromosome losses can be measured by the micronucleus technique. AIM: The aim of this study was to investigate the effect of aging and oxidative stress induced by non-toxic levels of H2O2 on micronuclei induction and their relationship to cell proliferation in human peripheral blood lymphocytes. MATERIALS AND METHODS: Healthy volunteers with different ages were choosen. Spontaneous and H2O2 induced micronuclei frequencies were measured in peripheral blood lymphocytes of 30 volunteers by the micronucleus method. RESULTS: Spontaneous micronuclei frequencies increased first then started to decrease after 50 years of age. This biphasic response was significantly higher than micronucleus (MN) frequencies induced by H2O2 (P < 0.05), which followed the similar shape of response to increasing ages with lower frequencies. Proliferative capacity of cells either treated with H2O2 or not did not differ with an increasing age giving similar responses. CONCLUSION: These results indicate biphasic character of chromosome damage; first increase and decrease after 50 years with an increasing age. But this change pattern was not correlated with the steady state of proliferation capacity of cells through an increasing age. Decreases in H2O2-induced MN frequencies compared to spontaneous MN frequencies may be inducing an apoptosis by H2O2 treatment leading to underscoring damaged cells.

Evaluation of smoking genotoxicity in Turkish young adults.

BACKGROUND: For the past few decades, it has been widely known in developed countries that tobacco is dangerous, but it is still insufficiently realized how big these dangers really are. AIMS: To determine and evaluate micronuclei (MN) frequencies of young smokers and nonsmokers in three different tissues (peripheric blood lymphoctes, buccal mucosa, and exfoliative urothelial cells) at the same time. MATERIALS AND METHODS: MN assay was performed on buccal mucosa, urothelial cells, and peripheric blood lymphocyte samples obtained from 15 healthy male smokers (>5 pack-years) and 15 healthy male nonsmoker controls who had not been exposed to any known genotoxic agent. STATISTICAL ANALYSIS USED: The statistical differences between smoker and nonsmoker groups were calculated by using student t test. The differences between smoker-group tissues were compared by ANOVA. RESULTS: It was found that MN frequency (mean value ± standard deviation) in oral mucosa cells from smokers and controls were 1.20 ± 0.22% and 0.26 ± 0.10%; in urothelial exfoliative cells, 1.29 ± 0.28% and 0.12 ± 0.08%; in peripheric blood lymphocytes, 1.53 ± 0.23% and 0.38 ± 0.12%, respectively. The mean MN frequencies in buccal mucosa, urothelial exfoliative cells, and peripheric blood lymphocytes were significantly higher in smokers than in those of controls (P<0.05). All tissues were affected from smoking, but the most destructive effect was seen in urothelial cells of smokers (P<0.05). CONCLUSIONS: Our data showed that cigarette smoke is a DNA damage causitive agent on exfoliative buccal mucosa and urothelial cells and peripheric blood lymphocytes of young smokers, but it has most destructive effect on urothelial cells.

A imunomodulação dos linfócitos TCD4+ e TCD8+ induzida pelas células tronco mesenquimais / The immunomodulation of CD4 + and CD8 + T cells induced by mesenchymal stem

O transplante alogênico de medula óssea é usado como adjuvante no tratamento de neoplasias hematopoéticas, outros tumores e em algumas doenças auto-imunes, com o objetivo de restabelecer o sistema hematopoético após quimioterapia e radioterapia. A doença do enxerto contra o hospedeiro (OECH) é uma das complicações mais freqüentes deste procedimento, ocorre em mais da metade dos pacientes que são submetidos a transplante alogênico de medula óssea, e representa uma importante causa de morbidade, mortalidade e baixa qualidade de vida. As células T são as principais responsáveis pelo desenvolvimento da OECH, com o reconhecimento de antígenos estranhos por células T C04 e ativação conjunta de linfócitos T COS resultando em dano tecidual. As CTMs humanas suprimem a proliferação de linfócitos T citotóxicos e também alteram o perfil de citocinas e a maturação das células apresentadoras de antígenos, desempenhando importante função imunomoduladora, podendo, portanto, ser úteis na terapia celular contra a OECH. O objetivo central deste trabalho foi identificar as bases moleculares da imunomodulação dos linfócitos T mediada pelas CTMs. Para isso, as alterações ocasionadas no perfil de expressão gênica de linfócitos TC04 e TCOS mediante estimulo proliferativo, na presença ou ausência de CTMs, foram analisadas pela metodologia de microarray. Ambos, os linfócitos TC04+ e TCOS+ que foram imunomodulados pelas CTMs apresentaram alterações na expressão de componentes das vias do ciclo celular (G1/S) e de vias envolvidas na regulação da resposta imune, como sinalização da via NF-KB e do receptor TCR. Realizamos a validação desse estudo com base na análise de expressão gênica de componentes envolvidos nessas sinalizações, como RelA, ReIB, NF-KB2, IRAK, TNFAIP3 e BTCR (sinalização da via NF-KB); CTLA4 (sinalização TCR); GITR, FOXp3 e IL-10 (regulação da resposta imunológica). Nossos resultados demonstram que as CTMs induzem a imunomodulação dos linfócitos tanto por alterar componentes envolvidos na proliferação celular, como de genes envolvidos na resposta imunológica dessas células.

A new recurring chromosome 13 abnormality in two older patients with de novo acute myeloid leukemia: An Indian experience.

We report here two cases of trisomy 13 in acute myeloid leukemia M1 subtype. short-term unstimulated bone marrow and peripheral blood lymphocyte culture showed 47, XY, +13 in all metaphase plates and trisomy 13 was confirmed with whole chromosome paint probes. Trisomy 13 in AML-M1 is a rare numerical abnormality. This is the first Indian report of sole trisomy 13 in AML-M1. Here, we present two cases of elder male patients, which may constitute a distinct subtype.

Unusual lymphocytosis with systemic lupus erythematosus.

A 15-year-old boy with systemic lupus erythematosus, who on a follow up visit complained of recurrent episodes of fever, easy fatiguability, and seizures. Investigations revealed lymphocytosis (95%), anemia, and a positive PCR for cytomegalovirus (CMV). Electron microscopy of the lymphocytes revealed intranuclear inclusion bodies supporting the diagnosis of CMV infection. The child was treated with ganciclovir and discharged. At discharge the child was afebrile. However, lymphocytosis persisted even after 9 months of discharge. Repeated screening for possible lymphoreticular malignancy was negative. It is likely that lymphocytosis in this child was due to persistence of CMV infection in host cells leading to continued provocation of the host immune system.

Alteraciones cromosómicas en linfocitos de sangre periférica / Chromosomic alterations in peripherical blood lymphocytes

Background: The chromosomic alterations prevalence is about 1 percent at birth; therefore, cytogenetics is an important tool for the Neonatology and Pediatrics Units at all health centers. Objective: Evaluate cytogenetics studies performed at the Pathology Unit in the Hospital of Antofagasta between 1997 and 2006. Method: Evaluation of 534 chromosome analysis results in peripherial blood lymphocytes obtained from patients belonging to the Neonatology and Pediatrics Units from Hospital Regional of Antofagasta. The sample included newborn, infants, pre-scholars and scholars with Down Syndrome, congenital malformations, dysmorphic syndromes and other genetic alterations. An optical microscope and international nomenclature (ISCN) were used; chromosome analysis included 35 or more mitosis per case. Results: 22,50 percent (n = 120) of exams showed chromosome alterations: 76,67 percent of these cases were numerical alterations and 23,33 percent corresponded to structural alterations. Conclusions: In the studied population, the cytogenetics study is an important tool together with clinical aspects, especially regarding genetic counsil.

La prevalencia estimativa de las alteraciones cromosómicas en el nacimiento es de alrededor de 1 por ciento, por esta razón es que la citogenética se ha transformado en una herramienta importante para el equipo de Neonatología y Pediatría de cualquier servicio hospitalario. Objetivo: Evaluar los estudios citogénicos realizados en el servicio de Anatomía Patológica de Hospital de Antofagasta entre los años 1997 y 2006. Paciente y Métodos: Se evaluaron 534 análisis cromosómicos en linfocitos de sangre periférica obtenidos en el Hospital de Antofagasta, de los Servicios de Pediatría y Neonatología. La muestra incluyó a recién nacidos lactantes, preescolares y escolares con síndrome de Down, malformaciones congénitas, síndrome dismórfico, ambigüedad genital, genopatías en estudio y otras. Se usó un microscopio óptico y el análisis cromosómico incluyó un mínimo de 35 mitosis por caso, se utilizó la nomenclatura internacional ISCN. Resultados: Un 22,50 por ciento (n = 120) de los exámenes mostraron alteraciones cromosómicas, de estos casos un 76,67 por ciento fueron alteraciones numéricas y 23,33 por ciento correspondieron a alteraciones estructurales. Conclusión: El estudio citogénico ha resultado de gran importancia como complemento de la clínica, y especialmente en relación al consejo genético, en la población estudiada.

Anticorpos anti-eritrocitários em pacientes com Coombs direto positivo infectados com malária por P. vivax e P. falciparum / Anti-erithrocytes antibodies in patients with positive direct Coombs infected with P. vivax and P. falciparum malaria

Para se determinar a prevalência de anticorpos anti-eritrocitários de grupo sanguíneo foram analizadas 247 amostras de sangue de pacientes com malária vivax e falciparum com teste de Coombs direto positivo atendidos na Fundação de Medicina Tropical Manaus-Amazonas no período entre setembro/99 a março/2000.Realizaram-se os testes laboratoriais de Coombs direto, dosagens de hemoglobina, bilirrubina e eletroforese de proteínas.Das amostras testadas, 13,3 apresentaram Coombs direto positivo, sendo o anticorpo da classe IgG (33,3) o mais freqüente. Dos pacientes com malária vivax e Coombs direto positivo, 17 apresentaram anemia possivelmente devido a hemólise por auto-imunidade com o envolvimento da gamaglobulina IgG.Não foram detectados anticorposcontra antígenos de grupos sanguíneos nem aloanticorpos séricos.Torna-se necessário a realização de outras pesquisas para avaliação da existência de associação entre a positividade do Coombs direto e anemia ou se a mesma interfere ou não com o curso da doença.

Effect of partial parenteral versus enteral nutritional therapy on serum indices in multiple trauma patients

Malnutrition is a common complication in multiple trauma patients because of the metabolic and catabolic increase and negative nitrogen balance. It may deteriorate patients' outcome. Some clinical and paraclinical parameters are used for nutritional assessment. In this study our goal was evaluation of nutritional parameters in enteral and partial parenteral methods for detecting the better method of nutritional support. This prospective study had done during 30 months on 80 multiple trauma patients with 4[th] to 10[th] GCS [Glascow Coma Scale] at the end of the first day of admission. They divided into 2 groups randomly: we used partial parenteral nutrition in the first group [41 patients] and enteral nutrition in the second one [39 patients]. We studied serum total protein, albumin, transferrin and total lymphocyte count during their first two weeks of hospitalization. In the first group, they received more protein and calorie during 14 days. Serum total protein, Albumin and transferrin were more statistically significant in this group [P < 0.05]. In partial parenteral nutrition patients will receive more protein and calorie, and they will have more total serum protein. It seems that parenteral-enteral nutrition prepares better paraclinical nutritional parameters

Use of mannanoligosacharides as an adjuvant treatment for gastrointestinal diseases and this effects on E. coli inactivated in dogs

PURPOSE: To evaluate the effects of mannanoligosacharides on dogs showing gastroenteritis. METHODS: Sixteen dogs, 2-6 month-old, distributed into two groups: T1 - animals with gastroenteritis receiving treatment for the disease + mannanoligosacharides (2 g/animal).; and T2 - animals with gastroenteritis receiving just treatment for the disease. The animals were randomly included in the sample and all of them were submitted to blood and feces collection for coproculture. In the treatment for gastroenteritis antibiotic, antihemetic, vermifuge, vitamins and sorotheraphy were used. The parameters evaluated were the numbers of leucocytes, neutrophils, lymphocytes and the presence of enteropathogenic bacteria in feces. RESULTS: The mannanoligosacharides was effective in eliminating pathogenic E. coli in 85.71 percent of the animals, while in the no-treated group only 25 percent of the animals were negative to E. coli. CONCLUSION: The mannanoligosacharides is effective in the control of pathogenic E. coli and it can be indicated as an adjuvant treatment for gastroenteritis in dogs.

OBJETIVO: Avaliar os efeitos da adição de mananoligossacarídeos fosforilados (MOS) que apresentavam gastroenterite , pacientes de uma Clínica Veterinária. MÉTODOS: foram estudados 16 cães de 2 a 6 meses de idade, de várias raças. Os animais foram distribuídos em 2 grupos, sendo o grupo T1 composto por animais com gastroenterite, que receberam o tratamento para a doença e Mos (2,0 g/animal) e o grupo T2, animais com gastroenterite, que somente receberam o tratamento para a doença sem o MOS. Os animais foram incluídos aleatoriamente na amostra e todos eles foram submetidos à coleta de sangue e de fezes para coprocultura.O tratamento para a gastroenterite constituiu-se de antibiótico,antiemético,vermífugo,vitaminas e soroterapia. No experimento, foram avaliados os leucócitos, neutrófilos, linfócitos e a presença de bactérias enteropatogênicas nas fezes. RESULTADOS: Constatou-se a efetividade do Mos no grupo tratado, quando houve a eliminação da Escherichia coli patogênica em 85,71 por cento dos animais,enquanto que, no grupo sem o Mos, só 25 por cento, não apresentaram o microorganismo. CONCLUSÃO: O Mos é efetivo no controle da E. coli patogênica, sendo indicado como tratamento adjuvante nas gastroenterites.

Dose assessment by quantification of chromosome aberrations and micronuclei in peripheral blood lymphocytes from patients exposed to gamma radiation

Scoring of unstable chromosome aberrations (dicentrics, rings and fragments) and micronuclei in circulating lymphocytes are the most extensively studied biological means for estimating individual exposure to ionizing radiation (IR), which can be used as complementary methods to physical dosimetry or when the latter cannot be performed. In this work, the quantification of the frequencies of chromosome aberrations and micronuclei were carried out based on cytogenetic analyses of peripheral blood samples from 5 patients with cervical uterine cancer following radiotherapy in order to evaluate the absorbed dose as a result of partial-body exposure to 60Co source. Blood samples were collected from each patient in three phases of the treatment: before irradiation, 24 h after receiving 0.08 Gy and 1.8 Gy, respectively. The results presented in this report emphasize biological dosimetry, employing the quantification of chromosome aberrations and micronuclei in lymphocytes from peripheral blood, as an important methodology of dose assessment for either whole or partial-body exposure to IR.

Peripheral blood lymphocytes apoptosis in juvenile idopathic arthritis: relation to disease activity and type of onset

Abnormalities in the mechanisms regulating apoptosis may have a role in the pathogenesis of autoimmune disorders. The aim of this study was to evaluate the incidence of apoptosis of peripheral blood [PB] lymphocytes in children with juvenile idiopathic arthritis [JIA] and correlating it with CD95 [APO-1/Fas] antigen expression and serum levels of sFas and interleukin-15 [IL-15] in different types of onset and activity of the disease. PB lymphocytes apoptotic index [AI], CD95 [APO-1/Fas] antigen expression, serum levels of sFas and IL-15 were detected in 30 cases of JIA and 20 healthy controls. Results were correlated with the type of onset, activity of the disease and acute phase indicators [ESR, CRP]. The mean values of AI, CD95, sFas and IL-15 were higher in children with JIA than in healthy controls. Significant difference was only found for AI especially with systemic type of onset and high activity. Also the levels of IL-15 increased with activity especially in the systemic type. Moreover, AI showed a significant positive correlation with ESR and CRP but not with IL-15, CD95, or sFas. AI of lymphocytes was high in systemic onset JIA and in active disease and correlated with ESR and CRP, but not with IL-15, CD95 expression or serum sFas

Age-related changes in blood lymphocyte subsets of south Indian children.

BACKGROUND: Enumeration of lymphocyte subsets has been widely used for the diagnosis and monitoring of several haematological and immunological disorders. Various studies have demonstrated age, sex and racial differences in lymphocyte subset expression. Reference values are not available for Indian children and there is a need for this information to replace commonly used, but inappropriate, adult lymphocyte subset ranges. METHODS: One hundred thirty-eight healthy children between 3 and 15 years of age, attending a local government school in Chennai, South India were Included in the study. Haemoglobin levels, and total and differential cell counts were determined using an automated counter and lymphocyte subsets were analysed by flowcytometry. RESULTS: The mean (SD) absolute lymphocyte count declined with age from 4338 (1031) at 3 years to reach a plateau of 3096 (914) at 11-13 years (p < 0.05). A significant decline was also observed in the absolute numbers of CD3+, CD4+, CD8+ and CD19+ cells. However, the percentage values of CD3+, CD4+, CD8+, CD16/56+ cells and the CD4/CD8 ratio remained fairly stable across the age range. CONCLUSION: Our data would prove useful in interpreting disease-related changes in lymphocyte subsets in Indian children of different age groups. Age-related decrease in the absolute lymphocyte count as well as numbers of CD4 and CD8 cells was found to occur between the ages of 3 and 11 years. A normogram relating age to CD4 count has been developed.

Genetic damage in operating room personnel exposed to anaesthetic gases

This study was done to examine whether genetic damage could serve to indicate exposure to anesthetics. A group of 40 operating room personnel of different professions [anesthesiologists, surgeons, technicians and nurses] and a control group of 20 subjects were examined for chromosome aberrations and micronuclei frequency in lymphocytes of peripheral chromosome fragments or whole blood. The results revealed an increase in chromosome damage in the exposed group, but concerning the micronuclei frequency, no clastogenic potential could detected after exposure to anesthetic gases

Hydroxychloroquine sulphate inhibits in vitro apoptosis of circulating lymphocytes in patients with systemic lupus erythematosus.

The serological hallmark of systemic lupus erythematosus (SLE) is the presence of antibodies against double-stranded DNA. However, several studies have suggested that it is not DNA itself, but nucleosomes that are the immunogenic particles involved both in the induction of anti-DNA antibodies, and in the pathophysiology of SLE. Meanwhile, It has been demonstrated that there is an accelerated in vitro apoptosis of lymphocytes from patients with SLE. Therefore, one can postulate that the process of apoptosis may provide a source of nuclear antigens to drive the autoantibody response seen in SLE. Our study has demonstrated that hydroxychloroquine exhibits an anti-apoptotic action and this anti-apoptotic effect is dependent on monocyte coexistence. We used both morphology assessment and fluorescent antibody cell sorter (FACS) analysis to measure the apoptotic percentage of lymphocytes from 25 SLE patients in medium alone (control) or with the addition of different concentrations of hydroxychloroquine. Our results have shown that there is a significant decrease in the percentage of apoptosis at the therapeutic concentration (10(-6) M) as compared with the control (p < 0.05). It has been reported that the anti-rheumatic properties of hydroxychloroquine result from its interference with antigen processing in macrophages and other antigen-presenting cells. We propose that this results in decreased stimulation of autoreactive lymphocytes reactive with self-peptides, and consequently diminution of activation-induced cell death (apoptosis) of mature peripheral lymphocytes.

Enfermedad de Kawasaki. Evaluación inmunológica de 26 casos / Kawasaki disease. Immunological evaluation of 26 cases

La enfermedad de Kawasaki (EK) es una vasculitis aguda febril de la infancia, caracterizada por mútiples signos clínicos y bioquímicos de la inflamación con especial compromiso del corazón. La activación de linfocitos y monocitos/macrófagos y sus produtos solubles secretados, citoquinas , juegan un papel central en la patogénesis de la enfermadad. En este estudio realizamos estudios de laboratorio inmunológico en 26 pacientes con EK. En 22 pacientes en etapa aguda medimos niveles séricos de IgG, IgA, IgM, fracciones del complemento C3 y C4 por Nefelometría, sin encontrar un patrón constante y los anticuerpos FAN y ANCA por imunoflorescencia indirecta fueron negativos. En células mononucleares periféricas de 25 pacientes en etapa aguda encontramos porcentajes variables de CD3, CD4, CD8, CD20, CD56 y DR mediante tinción específica y análisis por cimetría de flujo. El porcentaje de CD25 estuvo elevado en 17/25 casos. Los níveles séricos de TNFalfa medidos poe ELISA en 12 pacientes , fueron bajos. Evaluamos citoquinas intracelulares TNAalfa, IL1beta, IL2, e IFNgamaen células mononucleares periféricas en 15 pacientes en etapas agudas, subagudas y de covalecencia, utilizando tinción específica y análisis por cimetría de flujo, sin encontrar un perfil característico. Dos pacientes mostraron porcentajes elevados de TNFalfa e IL1beta en monocitos durante la etapa de covalecencia, ambos presentaron secuelas coronarias. Es necesario realizar investigación adicioal acerca de este hallazgo. En conclusión, la evaluación inmunulógica mostró un perfil heterógeneo y no se encontró ningún factor de laboratorio en la etapa aguda que sea predictivo de compromiso cardivascular.

Nutritional assessment of nephrotic children

Nephrotic children are prone to develop malnutrition and growth retardation. Hence, the importance of nutritional assessment for such patients is clearly evident. The objectives of this study were to predict the most reliable parameters for such assessment, and to calculate the nitrogen balance for such patients. Nutritional status was assessed, in 23 nephrotic children whose ages ranged from 2 to 14 years, using relevant data derived from through clinical examination, appropriate laboratory investigations, as well as some specific calculations. The same assessment was conducted for 30 normal healthy age-matched children serving as a control group. Nephrotic children, compared to the control group, exhibited a statistically significant decrease regarding the height for age z score, the height for age percentile, the mid-arm circumference, the triceps skin fold thickness, the hemoglobin percentage, the red blood cell count, the white blood cell count, the circulating lymphocyte percentage, the serum protein level, the serum albumin level, and the blood urea nitrogen level. On the other hand, nephrotic children, compared to the control group, had a statistically significant increase in the plasma cholesterol level, the 24 hour urinary volume, the 24 hour urinary protein level, the 24 hour urinary urea level, the urinary protein/urinary creatinine ratio, and the creatinine clearance/urinary creatinine ratio. The nitrogen balance was positive in all the control group, while, it was negative in 78.3% [18 out of 23] nephrotic children. The latter correlated negatively with the circulating lymphocyte percentage, and positively with the 24 hour urinary urea level. It was concluded that nephrotic children were very prone to develop malnutrition and negative nitrogen balance. Both the mid-arm circumference, and the triceps skin fold thickness were valuable tools for nutritional assessment of such sick children. Measuring the circulating lymphocyte percentage, and the 24 hour urinary urea level might give a preliminary clue to the presence of a negative nitrogen balance

Relationship between expression of CD45RA and CD45RO antigens on peripheral blood CDS+ lymphocytes and IgE, asIGE level inpatients with atopic diseases

To determine the role of memory/naive T cells in atopic allergy patients we analyzed peripheral blood mononuclear cells before and during the grass pollen season. The study comprised 16 patients with seasonal symptoms of atopic allergy and 10 with perennial symptoms. Flow cytometry was employed to detect the expression of CD3, CD4, CD4CD45RA, CD4CD45RO, CD8, CD16, and CD19 molecules on peripheral blood lymphocytes. Allergic patients showed a decreased proportion of memory [CD4+CD45RO+] T cells compared with healthy subject [p<0.05]. The proportion of naive [CD4+CD45RA+] helper T Cells increased during natural antigen exposure [grass pollen season] in allergic patients with seasonal symptoms. Conclusions: The results show at least two important observations. A potential homing tendency to nasal, bronchial and conjunctival mucosa of memory T cells [CD45RO] in atopic allergy patients may explain their deficiency in peripheral blood. Secondly, the grass pollen season may switch their phenotype from naive into memory T cells causing the increase of CD45RO cells. These events do not occur in non-allergic individuals and may thus constitute new insight into the basic mechanism of atopic allergy

Chronic lymphocytic leukemia- correlation with Rai's and Binet's clinical staging systems

A retrospective study of chronic lymphocytic leukemia patients diagnosed from 1986 to 1990 is presented. A comparison of prognostic indicators with Rai's staging system [1975] AND Binet's staging system [1981] showed that our patients at diagnosis presented with a greater tumour mass, as suggested by a higher percentage of Rai's stage IV and Binet's stage C. Lymphadenopathy [100%], splenomegaly [90%], hepatomegaly [80%], heamoglobin < 11.0 G/dl [70%] and platelet count < 100x109/1 [55%] were more common and more severe in our patients