ABSTRACT
BACKGROUND: Ocular pemphigoid is a chronic autoimmune disease that leads to vision lost. In its etiology participate autoantibodies against the connective tissue of the conjunctiva of different isotypes (IgM, IgG and IgA) as well as the complement system (C3). Lymphocytes of the CD4 + and CD8 + phenotypes and monocytes were detected in the infiltrates of the biopsies of the conjunctiva. MATERIAL AND METHODS: We treated and studied 82 patients who had several topical and systemic treatments during years to alleviate this condition but whose side effects limited their usefulness. We started the administration of cyclosporin-A (Cy-A) 100 mg/day per os and diminishing gradually the intake of steroids. The relief of ocular pain and headache were the first symptoms that changed the patients' quality of life. Ophtalmological controls revealed improvement of the lesions of the conjunctiva and cornea and subsequent biopsies showed a marked decrease in the cellular infiltrates and in antibody deposits. CONCLUSIONS: Thus, Cy-A is an useful treatment for ocular chronic autoimmune pemphigoid and eventually azathioprine (50 mg/day) can cheaply replace it although its well-known toxicity.
Subject(s)
Autoimmune Diseases/drug therapy , Conjunctivitis/drug therapy , Corneal Ulcer/drug therapy , Cyclosporine/therapeutic use , Immunosuppressive Agents/therapeutic use , Pemphigoid, Bullous/drug therapy , Adult , Aged , Autoimmune Diseases/immunology , Azathioprine/economics , Azathioprine/therapeutic use , Conjunctivitis/etiology , Conjunctivitis/immunology , Corneal Ulcer/etiology , Corneal Ulcer/immunology , Cyclosporine/economics , Cytokines/immunology , Drug Costs , Female , Humans , Immunosuppressive Agents/economics , Male , Middle Aged , Pemphigoid, Bullous/immunology , Retrospective Studies , T-Lymphocyte Subsets/drug effects , T-Lymphocyte Subsets/immunology , Treatment OutcomeABSTRACT
A bat feces extract was able to induce the synthesis of specific IgG in rabbits and IgE in atopics. These findings were corroborated by skin tests, RAST and RAST-inhibition. Nowadays, data concerning the experimental induction of hypersensitivity pneumonitis using a glycoprotein of bat feces are presented. This antigen was aerosolized for inhalation by adult guinea pigs for 12 weeks to detect specific serum IgM, IgG and IgE antibodies as well as sensitized T-CD4 cells. Histopathological studies of the lungs showed interstitial infiltrates of macrophages and lymphocytes, cellular bronchiolitis and single non-necrotizing granulomas from the seventh to the ninth weeks. From the tenth week to the end of the experiment the lesions of the lungs progressively worsened. The results from this animal model suggest that the chronic contact with the bat feces'antigen can induce other inflammatory lung reactions than those IgE dependant.
Subject(s)
Alveolitis, Extrinsic Allergic/etiology , Chiroptera/immunology , Feces , Aerosols , Allergens/isolation & purification , Allergens/toxicity , Alveolitis, Extrinsic Allergic/immunology , Alveolitis, Extrinsic Allergic/pathology , Animals , Argentina , Environmental Exposure , Feces/chemistry , Glycoproteins/isolation & purification , Glycoproteins/toxicity , Granuloma/etiology , Granuloma/immunology , Granuloma/pathology , Guinea Pigs , Housing , Immunity, Cellular , Immunoglobulin E/immunology , Immunoglobulin G/immunologyABSTRACT
Three groups of HIV-positive men and a control group of healthy subjects were evaluated simultaneously by delayed-type skin tests with recall antigens detection of CD4 cell counts in peripheral blood and the IgE serum levels. Delayed-type skin test reactivity and CD4 cell counts in peripheral blood decreased while IgE serum levels increased as immune imbalance progressed with the worsening of HIV infection (p = 0.003 between controls and HIV-positive patients). The existence of atopy did not significantly influence IgE serum levels in the groups of HIV-positive patients (p < 0.2). Candidin appeared as a useful antigen in the delayed-type skin tests considering that it was the only antigen that remained positive with low values of CD4 cell counts (< or = 250/mm3). The detection of serum IgE levels as well as the performance of delayed-type skin tests with recall antigens are useful tools to evaluate immunological status whereas the number of CD4 in peripheral blood is critical for determining the initiation of antiretroviral therapy.
