ABSTRACT
Thirty cystic echinococcosis (CE) patients in Uruguay with severe bone or secondary disseminated echinococcosis were immunologically assessed using cellular (lymphocyte transformation assay, LTA) and humoral (specific antibody and subclass responses, circulating antigen and circulating immune-complexes) immunological assays during the course of chemotherapy (albendazole and/or praziquantel). CE patients were divided into 4 groups, according to clinical treatment and outcome: (I) surgery and chemotherapy, (II) chemotherapy with outcome unchanged, (III) chemotherapy with outcome improved, and (IV) chemotherapy considered cured. Increased circulating antigen was of prognostic value in some severe CE cases where levels remained high and/or increased. The lymphoproliferative response in vitro to Echinococcus granulosus antigen was statistically greater in all patient groups compared to normal individuals but at lower levels in improved or cured CE patients. Levels of non-specific LTA response were significantly lower than controls for all groups during albendazole treatment (P < 0.001) but returned to normal levels in cured patients, a result consistent with parasite-induced suppression of cellular responses. This study suggests that, at least in severe osseous and secondary CE, immunosurveillance by specific antibodies, especially total specific immunoglobulin, was overall of more practical use than antigen-specific in-vitro lymphocyte transformation assays.
Subject(s)
Antibodies, Helminth/blood , Echinococcosis/immunology , Immunoglobulin G/analysis , Adult , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Antigen-Antibody Complex/blood , Antigens, Helminth/blood , Biomarkers/blood , Bone Diseases/immunology , Bone Diseases/parasitology , Bone Diseases/therapy , Case-Control Studies , Combined Modality Therapy , Drug Therapy, Combination , Echinococcosis/drug therapy , Echinococcosis/surgery , Female , Humans , Lymphocyte Activation , Male , Praziquantel/therapeutic use , Treatment Outcome , UruguayABSTRACT
Eighteen adult white male patients with cutaneous sporotrichosis were treated with itraconazole following different daily dose schemes. Cure was obtained in all cases after periods of 15-75 days (median 44 days) with total doses between 3.1 and 14.8 g (median 8.4 g). No serious side effects were observed and no relapses occurred in the follow-up period of between 1 and 26 months (median 14.7). These results show that itraconazole represents a safe and effective drug for the treatment of sporotrichosis. Comparison with other studies leads us to consider a daily dose of 200 mg as the most appropriate. A concomitant warming of the affected limbs should be recommended.
Subject(s)
Antifungal Agents/therapeutic use , Ketoconazole/analogs & derivatives , Sporotrichosis/drug therapy , Adult , Aged , Humans , Itraconazole , Ketoconazole/therapeutic use , Male , Middle AgedABSTRACT
Synovial lymphocyte responses to viral antigens were measured in repeated tests over periods of up to 3 years in 4 patients with rheumatoid arthritis, one of whom was rheumatoid factor positive. Consistent responses to adenovirus, mumps and cytomegalovirus were demonstrated. Responses of peripheral blood lymphocytes were almost always much less than synovial lymphocyte responses. Synovial lymphocyte phytohemagglutinin responses were greatly reduced and usually less than synovial lymphocyte antigen responses.
