[Particular aspects of rhinitis and rhino-conjunctivitis]. / Aspects particuliers des rhinites et rhino-conjonctivites.

The authors report their experience of 28 years of practice in the opthalmology service of the CHRU at Rennes. The describe certain particular aspects of rhinitis and rhino-conjuctivitis where the danger resides in an extensive risk to the uvula or the bronchi. They insist on the importance of understanding polyvalents in internal medicine (rôle of the seat of gingivodentary "ideas", value of research into indicative markers of protection A2 and B40 in the HLA system. In the region of nutrition, they emphasize the importance of the rôle of zinc, of vitamin C and of magnesium. They base their hopes on study of the local markers of sensitivity, in order to assess the elements of preventative action for an eventual ocular and bronchial extension.

[Rhinoconjunctivitis: importance of a local diagnosis?]. / Rhinoconjonctivites: intérêt d'un diagnostic local?

Diagnosis of allergic rhinoconjunctivitis, particularly in chronic forms, remains sometimes difficult. Systemic tests such as skin or blood tests may be not sufficient to assess local sensitization. Local tests are needed, performed from nasal secretion or tears. Measurement of total IgE in the local secretions of 41 patients suffering from rhinoconjunctivitis show that diagnosis contribution was upgraded from 61 to 88%. Very interestingly, in some cases, local tests were the only argument for allergy.

1,25-dihydroxyvitamin D3 regulates the synthesis of nerve growth factor in primary cultures of glial cells.

The effect of 1,25-dihydroxyvitamin D3 (1,25-(OH)2 D3) on nerve growth factor (NGF) synthesis was investigated in primary cultures of astrocytes prepared from brain of neonatal rats. 1,25-(OH)2 D3 elicited a dose-dependent increase of NGF mRNA with a maximal effect at 10(-7) M, which persisted for at least 48 h. Northern blot analysis revealed an expression of the vitamin D3 receptor (VDR) gene in primary glial cells. Treatment of cells with 1,25-(OH)2 D3 led to an increase in the VDR mRNA levels. Similar results were obtained in C6 glioma cells. Exposure of primary glial cells to 10(-8) M 1,25-(OH)2 D3 caused only a 2-fold increase of the levels of cell-secreted NGF after 3 days of treatment. However, a 5-fold increase was observed three days after a second addition of vitamin D3. Likewise, a pretreatment with lower doses of hormone such as 10(-10) M or 10(-9) M enhanced the responsiveness of the cells to a 24 h treatment with 10(-8) M hormone. It appears, therefore, that the duration of the treatment influences the level of synthesis of NGF, possibly as a consequence of the increase of the VDR gene expression. The specificity of 1,25-(OH)2 D3 is supported by the fact that a concentration of 10(-7) M of an another vitamin D3 metabolite, 24,25-(OH)2 D3, had no effect on NGF synthesis. Several lines of evidence indicate that astrocytes constitute the major cell type responsive to 1,25-(OH)2 D3 in primary cultures of glial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Tear IgE detected by a new method: Stallerdiag-IgE.

A new method for the tear IgE measurement Stallerdiag-IgE is presented. For this assay, the tears are collected on a strip of filter paper introduced into the conjunctival cul-de-sac. Then the IgE are measured by a simple enzymo-immunological assay. Tear IgE were determined in a normal population and in three groups of patients with keratoconjunctivitis. In the normal population, the tear IgE level is 0.37±0.66 kIU/1. The IgE level observed in the patients with vernal keratoconjunctivitis (19.6±21.5 kIU/1) or chronic allergic keratoconjunctivitis (11.1±16.2 kIU/1) is significantly different (p<0.0005) from the IgE level measured in the patients suffering from non-allergic keratoconjunctivitis (3.4±10.4 kIU/1). By comparison with a non-allergic group, the sensitivity is 80%, the specificity is 89% giving an overall efficiency of 83%.

Clinical trial of 26,26,26,27,27,27-hexafluoro-1,25-dihydroxyvitamin D3 in uremic patients on hemodialysis: preliminary report.

A clinical trial was done by the Group, Japan to evaluate the efficacy of 26,27-F6-1,25(OH)2D3 on the calcium and bone metabolism of 43 uremic patients on hemodialysis, 24 men and 19 women with a mean age of 50.9 +/- 2.1 years. The initial dose administered orally was 0.05 micrograms/day for 2 weeks. Then the dose was increased every 2 weeks by 0.05 micrograms each time until the dose of 0.3 micrograms/day was reached or until serum calcium increased. 26,27-F6(OH)2D3 increased serum calcium levels significantly at a mean dose of 0.08 +/- 0.03 micrograms/day and at 0.05 micrograms/day of dose comparison in hemodialyzed patients. It decreased the serum level of PTH significantly at a mean dose of 0.14 +/- 0.06 micrograms/day and at 0.3 micrograms/day by dose comparison. The serum level of bone Gla protein increased significantly at a mean dose of 0.18 +/- 0.07 micrograms/day and at 0.25 micrograms/day by dose comparison in the same patients. These results suggest that 26,27-F6-1,25(OH)2D3 has a higher potency in calcium mobilization than 1,25(OH)2D3 in uremic patients on hemodialysis.

Diagnostic and therapeutic value of testing stimulation of thyroid-stimulating hormone by thyrotropin-releasing hormone in 100 depressed patients.

The thyrotropin-releasing hormone (TRH) test was performed in 100 depressed patients, including 73 patients with a major depressive episode (MDE) according to DSM-III. Thirty-one patients subsequently received an antidepressant with a predominant serotoninergic action (indalpine or citalopram), and 27 patients received a noradrenergic antidepressant (maprotiline). The diagnostic value of the TRH test was not conclusive for any of the subgroups of depressed patients: MDE, MDE with melancholia or MDE in bipolar patients. Similarly, the value of the TRH test in the choice of antidepressant treatment according to the monoaminergic action was not convincing. These results are discussed in the light of the data of the international literature.

Nonspecific immunoglobulin E in aqueous humor: evaluation in uveitis.

The levels of immunoglobulin E (IgE) in aqueous humor (AH) and serum were determined in 74 uveitis patients and 13 control patients with senile cataract. Uveitis patients' levels ranged from less than 0.06 to 460 IU/ml according to the paper radioimmunosorbent test (PRIST; limit of sensitivity, 0.06 IU/ml). Only one control patient had an AH level higher than the sensitivity limit (0.08 IU/ml). Of the five patients with the highest levels in the AH, four had toxocaral retinitis. The ratio of AH/serum to IgE normalized to the albumin concentration was calculated in 25 uveitis patients and was greater than 0.60 in 13 cases, indicating a possible intraocular IgE synthesis.

General toxicity of water-soluble iodinated contrast media. Pathogenic concepts.

Despite many studies, the mechanism of the general accidents induced by the intravascular injection of water-soluble iodinated contrast media remains unclear. Two theories are proposed; until now, they have not been related to each other. Lalli emphasizes the role of a cerebral impact related to stress, which induces a chain of accidents that are perhaps more aggressive when the molecules cross the blood-brain barrier. Lasser has proposed a theory based on the biochemical catastrophies secondary to the damage of the vascular endothelium and the activation of the Hageman's factor XII. A true anaphylaxis has not been proven: specific immunoglobulins are only exceptionally found, and an actual primary activation of the complement system pathway with mediator release is a controversial phenomenon in vivo. The anaphylactoid collapses result from a chemotoxic effect that might be decreased by several kinds of pharmaceutical premedications; none of them are constantly efficient. The new low osmolar molecules have a very low general toxicity, but their use does not guarantee the lack of anaphylactoid reactions.

[In the Argentinian Republic, health education activities for and with the entire community]. / En la República Argentina, las acciones de educación para la salud para y con toda comunidad.

To be efficient, health education must be part of the economic social and cultural development of the target populations and must facilitate the interdisciplinary and multisectorial participation of the community. Argentina with its geographical immensity, heterogeneous cultural and socio-economic conditions, makes it necessary to establish health and educational structures adapted to each particular region. The Argentinian Committee for health education of the populations participates intensively in the training of health teams, volunteers and above all teachers. These represent the best distributed socio-professional category in the country, where they exert a strong influence on children and their family and contribute thus to the promotion of a healthy youth.

[Decrease in transcortin binding activity in depression]. / Diminution de l'activité liante de la transcortine (CBG) dans la dépression.

In a preliminary study, Cortico-Binding Globuline (CBG) has been determined in 10 depressed major inpatients (DSM3) and compared with healthy volunteers. A clear cut fall of binding activity of transcortin is reported in depressed patients associated with an increase of total and free plasmatic cortisol.

Metabolism and binding properties of 24,24-difluoro-25-hydroxyvitamin D3.

To evaluate possible functional roles for 24,25-dihydroxyvitamin D3, 24,24-difluoro-25-hydroxyvitamin D3 has been synthesized and shown to be equally as active as 25-hydroxyvitamin D3 in all known functions of vitamin D. The use of the difluoro compound for this purpose is based on the assumption that the C-F bonds are stable in vivo and that the fluorine atom does not act as hydroxyl in biological systems. No 24,25-dihydroxyvitamin D3 was detected in the serum obtained from vitamin D-deficient rats that had been given 24,24-difluoro-25-hydroxyvitamin D3, while large amounts were found when 25-hydroxyvitamin D3 was given. Incubation of the 24,24-difluoro compound with kidney homogenate prepared from vitamin D-replete chickens failed to produce 24,25-dihydroxyvitamin D3, while the same preparations produced large amounts of 24,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3. Kidney homogenate prepared from vitamin D-deficient chickens produced 24,24-difluoro-1,25-dihydroxyvitamin D3 from 24,24-difluoro-25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3. In binding to the plasma transport protein for vitamin D compounds, 24,24-difluoro-25-hydroxyvitamin D3 is less active than 25-hydroxyvitamin D3 and 24R,25-dihydroxyvitamin D3. In binding to the chick intestinal cytosol receptor, 24,24-difluoro-25-hydroxyvitamin D3 is more active than 25-hydroxyvitamin D3 which is itself more active than 24R,25-dihydroxyvitamin D3. The 24,24-difluoro-1,25-dihydroxyvitamin D3 is equal to 1,25-dihydroxyvitamin D3, and both are 10 times more active than 1,24R,25-trihydroxyvitamin D3 in this system. These results provide strong evidence that the C-24 carbon of 24,24-difluoro-25-hydroxyvitamin D3 cannot be hydroxylated in vivo, and, further, the 24-F substitution acts similar to H and not to OH in discriminating binding systems for vitamin D compounds.

Temperature-dependent inactivation of nucleic acid binding and aggregation of the 1,25-dihydroxyvitamin D3 receptor.

The interaction of the 1 alpha,25-dihydroxyvitamin D3 receptor with immobilized calf thymus DNA has been compared with its sedimentation properties on hypotonic sucrose gradients. Forty to sixty percent of total hormone:receptor complexes formed at 4 degrees C were retained by DNA-cellulose and could be eluted by 0.18 to 0.2 M KCl. In contrast, heating preparations to 25 degrees C rapidly and irreversibly converted receptor to a form which bound hormone and DEAE-cellulose normally, but was unable to associate with DNA. Similarly, the ability of receptor to aggregate to a 6 S species was labile at 25 degrees C. Stabilization of receptor in the DNA binding aggregating form was accomplished using Ca2+, Mg2+, Mn2+, or Na2MoO4 while several protease and phosphatase inhibitors were ineffective. An examination of DNA binding properties of aggregating and nonaggregating receptor forms revealed that only receptor competent to enter into aggregates could bind DNA suggesting that a functional nucleic acid binding site, and, hence, a nucleic acid interaction is necessary for aggregate formation. Consistent with this view, an RNA:receptor interaction appears to be involved in formation of the 6 S complex since removal of RNA by ribonuclease treatment or purification of receptor reduced aggregation, an effect that could be reversed by addition of purified RNA.

Stimulation of rat intestinal protein synthesis by 1,25-dihydroxyvitamin D3.

To study general stimulatory effects of 1,25-dihydroxyvitamin D3 on intestinal protein synthesis, slices of duodenal villi from 1,25-dihydroxyvitamin D3-treated and vitamin D-deficient rats were incubated in vitro for 90 min at the surface of medium containing [3H]leucine. Incorporation of the [3H]leucine into TCA-precipitated protein, which was shown to be linear for 12 h and 90% inhibited by cycloheximide, was increased by 50-60% at 26 h after a single injection of 125 ng of 1,25-dihydroxyvitamin D3 (three experiments, P less than 0.001). The increase, which was not due to circadian rhythm fluctuations of the intestine, was in synchrony with the second Ca2+ transport response observed by Halloran and DeLuca (Arch. Biochem. Biophys. 208, 477-486, 1981). However, no significant difference in [3H]leucine incorporation was observed before or during the initial Ca2+ transport response observed by Halloran and DeLuca, i.e., at 1.0, 3.0, and 6.5 h following an injection of 1,25-dihydroxyvitamin D3. The late onset of the 1,25-dihydroxyvitamin D3-induced increase in total protein synthesis implies that it is an indirect rather than a direct effect of the hormone.