Hepatitis-B virus and schistosomiasis infections in childhood proteinuria.

Hepatitis-B surface antigen (HBsAg), circulating anti-schistosomal IgG (CSAb) and circulating specific schistosomal immune complexes (CIC) were detected, using ELISA, in sera of 40 active nephrotic children, 40 active S. mansoni infected cases and 20 apparently normal age-matched controls. The presence of HBsAg cases was significantly higher among nephrotic cases (20%), active S. mansoni cases (17.5%) than controls. Moreover, HBsAg cases were significantly higher in positive CIC S. mansoni cases than negative CIC ones. The mean O.D. readings of CSAb was significantly higher in positive HBsAg nephrotic cases than negatives. At the same time, the anti-schistosomal antibodies were higher in S. mansoni cases with proteinuria than those without. Specific CIC level was significantly higher among nephrotic and schistosomiasis cases than controls. The CIC were significantly higher in schistosomiasis cases with positive HBsAg than those with negative HBsAg and were detected in 80% of cases with proteinuria compared to 37% of cases without proteinuria with a statistically significant difference. On the other hand, CIC level was not influenced, in nephrotic cases, by the presence or absence of HBsAg. It was concluded that the presence of proteinuria was considered as a good monitor of the kidney affection either with schistosomiasis or the nephrotic syndrome or the HBsAg. The detection of CIC can be used as a good monitor too and could be included in methods of early diagnosis and/or following the disease prognosis.

Defective serum chemotactic capacity in rheumatoid arthritis.

Polymorphonuclear leukocytes (PMN) chemotaxis and serum chemoattractant ability were studied in patients with rheumatoid arthritis (RA) employing the agarose plate technique. No statistically significant differences were observed in random migration of unstimulated cells compared to the controls. Moreover, there were no statistically significant differences between the chemotactic migration of control and patient cells in response to a number of non-treated sera. The chemotactic responsiveness of normal PMN cells to treated rheumatoid serum was significantly less than that observed using treated control serum with Escherichia coli lipopolysaccharide. The possible explanation for this abnormality may be due to the presence of chemotactic inhibitors in some RA serum. No correlation was detected between chemoattractant activity of rheumatoid arthritis serum, circulating immune complexes or rheumatoid factor. There were no statistically significant differences in the adhesiveness of RA-PMNs compared to normal PMNs.

Immunologic studies of human schistosomiasis. I. Clinical and immunological findings in acute and chronic schistosomiasis.

Sera and ascitic fluid of 26 patients with acute and chronic schistosomiasis were studied for the presence of circulating immune complexes (CIC's), IgG, IgM, IgA, complement C3 and C4, as well as their correlation with the clinical manifestations of the disease. Serum levels of CIC's and IgG were significantly increased in patients with acute S. mansoni and S. haematobium infections and in patients with chronic schistosomiasis. Serum IgA levels were evaluated in 20% of patients with S. mansoni infection, 67% with S. haematobium infections and in 100% of chronically infected patients. Complement C3 levels were normal in all patients. Ascitic fluid analysis revealed the presence of IgG, IgM, IgA, C3 and C4 and high concentrations of CIC's. A significant positive correlation was demonstrated to occur between serum CIC's and IgG, as well as between the serum and ascitic fluid levels of CIC's of chronic patients. These findings also correlated with the degree and severity of the clinical syndrome.

Immunologic studies of human schistosomiasis. II. Interrelationship of serum and ascitic fluid histamine, IgE and total eosinophils in acute and chronic human schistosomiasis.

Sera and ascitic fluid of 26 patients with acute and chronic schistosomiasis were studied for the determination of histamine levels, IgE and total eosinophil counts and their correlation with the clinical manifestations of the disease. Serum histamine levels were significantly increased in acute and chronically infected patients. Serum IgE levels were markedly increased in all patients with S. mansoni infection and S. haematobium infection and moderately elevated in chronic patients. Eosinophilia was found in 60% of patients with S. mansoni infection and in 83% with S. haematobium infection. Ascitic fluid analysis revealed the presence of IgE and high concentrations of histamine. There was also a significant positive correlation (p less than 0.01) between serum and ascitic fluid histamine levels, as well as to IgE levels. These results support the contention that histamine and other immune system components may play a role in the pathophysiology of different stages of schistosomiasis.

Studies of phagocytic cell function in rheumatoid arthritis. I. Phagocytic and metabolic activities of neutrophils.

The polymorphonuclear cells (PMN's) of 20 patients with rheumatoid arthritis (RA) were analyzed for endocytic ability and metabolic capacity and were compared to those from a healthy control group over short intervals. The results of these studies indicate that the phagocytic activity (PA) and the nitroblue tetrazolium (NBT) dye reduction were significantly decreased in RA patients after 30 minutes of incubation. The rheumatoid patients showed a higher percentage of band cells and hypersegmented nuclei of their peripheral blood PMN's (PB-PMN's). No correlation was found between neutrophil functions and other parameters of the rheumatoid disease activity.

Studies of phagocytic functions in rheumatoid arthritis. II. Effects of serum factors on phagocytic and metabolic activities of neutrophils.

A previous article has shown a diminished phagocytic and intracellular metabolic activity of the polymorphonuclear cells (PMN's) from patients with rheumatoid arthritis (RA). No correlation was found between PMN's functions with either clinical or laboratory expression of disease activity. In the present study the effects of rheumatoid sera on PMN's functions were investigated and the results revealed significant inhibition of phagocytic activity (PA) and nitroblue tetrazolium (NBT) dye reduction capacity of cells from RA as well as from a normal (N) control group. The number of PMN's showing aggregated latex particles on their surfaces was significantly higher in RA patient groups in the presence of rheumatoid sera. PMN's from N and RA groups were lysed in the presence of rheumatoid sera, with more significant destruction of RA-PMN's. No correlation was found between the PMN's function and the amount of circulating immune complexes (CIC's) or rheumatoid factor (RF). Significantly lower concentration of complement (C4) levels and higher IgA mean values were observed in the patient group compared to the standard values. The mechanism(s) underlying the impaired PA and NBT reduction may be due to defective intrinsic cell function as well as the extra cellular effects of blocking or lytic factors present in rheumatoid sera.

Inhibition of polymorphonuclear leukocyte migration by sera of patients with rheumatoid arthritis.

The migration of peripheral polymorphonclear leukocytes (PMN) of patients with rheumatoid arthritis (RA) and normal controls was studied using autologous sera and homologous rheumatoid positive and negative sera. A significant inhibition of cells from RA patients was observed using autologous or homologous rheumatoid sera in contrast to patients' PMN exposed to control sera in which no significant migration inhibition was detected. Negative results were observed when rheumatoid sera were used with PMN from normal controls. No correlation was found between the degree of PMN migration inhibition and the titer of rheumatoid factor. The results of these studies indicate that mononuclear cells in rheumatoid patients have varying degrees of sensitization to certain factor(s) in rheumatoid sera.

Evaluation of lymphocyte populations and their mitogenic activity in relation to serum copper and immunoglobulin levels in rheumatoid arthritis.

Purified mononuclear cells from the peripheral blood and sera from 30 patients with active rheumatoid arthritis (RA) were compared to the control or standard values in respect to the total number of B (EA) and T (E) rosette forming lymphocytes, their responsiveness to phytohemagglutinin (PHA) and pokeweed (PWM) mitogen, and serum immunoglobulins, (C3) complement and copper levels. The RA patients had significantly lower values for EA cells, PWM stimulation index, hemoglobin and hematocrit. Significantly higher values for serum copper and sedimentation rates were found. Relatively higher values for IgG, M, A and C3 were found in RA patients with lower values for E cells.