Evaluation of Selected Parameters of the Specific Immune Response against Pseudomonas aeruginosa Strains.

The immune response to Pseudomonas aeruginosa strains could be influenced by differences in antibiotic resistance and virulence. At the present time, it is unclear which type of immune responses enables uncontrolled invasion of opportunistic pathogens. The conditional pathogenicity of Pseudomonas aeruginosa served as an inspiration to begin a study on this bacterium. The aim of this study was to gain insight into selected parameters describing immune responses with regards to the adaptable agents of this pathogen. For the analysis of the specific immune response, the potential of Pseudomonas aeruginosa to stimulate lymphocytes, including Th17 lymphocytes, dendritic cells and other components of the adaptive immune response, was examined. The highest percentage of CD83+CD1a-HLA-DR++ cells was found after stimulation with lysates of strains isolated from the patients with severe systemic infection. We found statistically significant differences in percentages of HLA-DR+ PBMCs and MFI of HLA-DR between groups of Pseudomonas aeruginosa strains isolated from the patients with different clinical courses of infection. Our results suggest that the clinical course and outcomes of Pseudomonas aeruginosa infections are not associated with impairment of the specific immune response.

Interferon alpha as antiviral therapy in chronic active Epstein-Barr virus disease with interstitial pneumonia - case report.

BACKGROUND: Chronic active Epstein-Barr virus (EBV) disease (CAEBV) is defined as a severe, progressive lymphoproliferative disorder associated with active EBV infection persisting longer than 6 months and developing in patients without recognised immunodeficiency. Rarely, interstitial pneumonitis (IP) occurs as a serious complication in CAEBV patients. The standard therapeutic regimen for IP in CAEBV has not yet been defined. Although interferon alpha (IFN-alpha) is known to suppress viral DNA replication by affecting its basal promoter activation process, it is rarely used in CAEBV patients. CASE PRESENTATION: A 22-year-old Caucasian woman, diagnosed with CAEBV 1.5 years earlier, was admitted to the Immunology Clinic due to a 4-week history of productive cough, fever and general weakness. Cultures of blood, urine and sputum were negative, but EBV DNA copies were found in the sputum, whole blood, isolated peripheral blood lymphocytes as well as in the blood plasma. Cytokine assessment in peripheral blood revealed the lack of IFN-alpha synthesis. Disseminated maculate infiltrative areas in both lungs were observed on a computed tomography (CT) chest scan. The patient was not qualified for the allogeneic hematopoietic stem cell transplantation (allo-HSCT) due to the risk of immunosuppression-related complications of infectious IP. Inhaled (1.5 million units 3 times a day) and subcutaneous (6 million units 3 times a week) IFN-alpha was implemented. To the best of our knowledge, this was the first documented use of inhaled IFN-alpha in a patient with CAEBV and concomitant IP. Patient's status has improved, and she was eventually qualified to allo-HSCT with reduced conditioning. Currently, the patient feels well, no EBV was detected and further regression of pulmonary changes was documented. CONCLUSIONS: CAEBV should be considered in patients who present with interstitial lung infiltration and involvement of other organs. Although more promising results have been obtained with allo-HSCT, inhaled IFN-alpha may also be a therapeutic option in patients with CAEBV and a concomitant IP.

Intracellular IL-4 and IFN-γ expression in iNKT cells from patients with chronic lymphocytic leukemia.

Malignant B cells in chronic lymphocytic leukemia serve an essential role in the whole immune response, so their interactions with other immune cells are more complex than observed in solid tumors. The latest study results indicate that the immune dysregulation in chronic lymphocytic leukemia (CLL) also affects a small population of invariant natural killer T cells (iNKT). Using peripheral blood iNKT cells obtained from patients with CLL, the objective of the present study was to assess the intracellular expression of typical cytokines involved in the Th1 (IFN-γ) and Th2 (IL-4) response pathways following stimulation with the iNKT-specific ligand α-galactosylceramide. iNKT cells from patients with CLL exhibited upregulated IL-4 and IFN-γ expression in comparison to those from HVs. No significant association between the ability of iNKT cells to produce IL-4 or IFN-γ and the expression of CD1d on leukemic B lymphocytes or monocytes was identified. However, the function of iNKT cells was compromised in patients with CLL by a strong Th2 bias (high IL-4 and low IFN-γ expression). The ratio of iNKT+IFN-γ+:iNKT+IL-4+ was significantly decreased in the CLL group when compared with HVs, and this decreased further as the disease progressed. This change may result in the promotion of leukemic B lymphocyte survival. Therefore, in the pathogenesis of CLL, Th2 bias may delay the antitumor response that relies on stimulation of the Th1 immune response.

[Molecular basis of HLA class-I deficiency and bare lymphocyte syndrome (BLS)]. / Molekularne podloze niedoboru glównych antygenów zgodnosci tkankowej HLA klasy I i zespól nagich limfocytów.

Molecules of human leukocyte HLA class I antigens play a crucial role in the presentation of endogenic peptides, allowing effector cells of the immune system to control the immune homeostasis of the host. There are rare immunodeficiencies which result in impaired HLA antigen expression on cell membranes and which are called bare lymphocyte syndrome (BLS). These diseases allow us to gain insight into the roles of antigen-processing pathways in HLA class I expression and into the genetic disorders of transcription factors crucial to the expression of HLA class II molecules. Moreover, the clinical pictures of BLS patients provide us with a rare opportunity to study the host's immune responses when one of the most important immune mechanisms is impaired. In this study we present disorders of endogenic antigen-presentation pathways and point out pathways which, at least in part, allow the host to overcome these defects. We also present hypotheses that may explain the clinical findings in BLS patients.

[Comparison of some nutritional parameters in hemodialysis patients over and below 65 years of age]. / Ocena porównawcza wybranych parametrów stanu odzywienia u chorych powyzej oraz ponizej 65 roku iycia, przewlekle hemodializowanych.

UNLABELLED: There is a close relationship between inflammation, malnutrition and atherosclerosis in chronic hemodialysis (HD) patients (pts). This process is closely related to poor clinical outcomes including morbidity and mortality, especially in elderly patients. The aim of this study conducted in HD pts over 65 years old (group A) and in younger pts (group B) was the assessment of some parameters of: nutritional status, inflammation, atherosclerosis and anthropometry. In group A (40 pts), mean age 72,2 +/- 4,7, the time on HD treatment was 37,1 +/- 33,0 months and in group B (83 pts), mean age 48,3 +/- 9,7 years, time on HD treatment was 97,4 +/- 90,1 months. We have measured the serum concentrations (conc.) of some parameters: hemoglobin (Hb), C-reactive protein total (CRP), albumin (alb), cholesterol (t-chol), calcium (Ca), phoshorus (P), intact parathormone (iPTH). The adequacy of HD was measured by Kt/V. We have estimated: body mass index (BMI), interdialytic weight gain (IWG), normalized protein catabolic rate (nPCR) and weekly EPO consumption. Some anthropometric parameters which were studied included: triceps skin fold (TSF), waist circumference (WC), mid-arm muscle circumference (MC). The physical activity was expressed by hand grip test (GT) on the hand without the vascular access. The mean values of Kt/V were similar in both groups (1,2 +/- 0,1 vs 1,2 +/- 0,2). Likewise there were no significant differences in mean levels of CRP (9,7 +/- 9,1 vs 14,1 +/- 12,2 mg/l) and Hb (6,7 +/- 0,7 vs 7,0 +/- 0,9 mmol/l), but weekly EPO consumption was higher in group A (48,1 +/- 35,8 vs 38,6 +/- 29,3 U/kg, p<0,01). We have observed, that in group A the mean serum levels of albumin and t-chol were significantly lower (33,2 +/- 3,1 vs 37,5 +/- 3,9 g/l, p <0,05 and respectively 3,9 +/- 0,7 vs 4,3 +/- 0,9 mmol/l, p<0,05).) and IWG as well (2,1 +/- 1,2 vs 3,3 +/- 1,6 kg; p<0,01). The mean values BMI and nPCR were significantly lower in group A (24,4 +/- 3,2 vs 27,3 +/- 2,5 kg/m2, p<0,01 and respectively: 0,9 +/- 0,1 vs 1,1 +/- 0,2 g/kg/day, p<0,01). Likewise mean values of IWG and MAP were significantly lower in elderly patients (2,1 +/- 1,2 vs 3,3 +/- 1,6 kg; p<0,01 and respectively 91,5 +/- 19 vs 95,5 +/- 13 mm Hg; p<0,01). Mean serum Ca and P conc. were significantly lower in group A (2,1 +/- 0,1 vs 2,3 +/- 0,2 mmol/l, p<0,01 and respectively 1,4 +/- 0,3 vs 1,8 +/- 0,5 mmol/l, p<0,01). Likewise mean iPTH conc. was significantly lower in elderly patients (379,2 +/- 362,3 vs 571,6 +/- 510,9 pg/ml). The mean values of strength of grip were lower in group A (20,5 +/- 11,4 vs 34,7 +/- 13,6 kg, p<0,01). In both groups there were no significant differences between the mean values of TSF (11,2 +/- 3,8 vs 13,4 +/- 6,8 mm), but mean values of WC and as well MC as well were lower in group A (91,0 +/- 8,1 vs 98 +/- 12,4 cm; p<0,05 and respectively 25,5 +/- 3,1 vs 28,9 +/- 3,8 cm; p<0,05). There was a significant negative correlation (cor.) between the age of patient and intradialytic body weight gain (r = -0,4607, p<0,001) and significant positive cor. between: albumin and nPCR (r = 0,433, p<0,01) and albumin and Hb (r = 0,391, p<0,01). There was a significant negative cor. between strength of grip and time of HD treatment (r = -0,350, p<0,05). IN CONCLUSION: The studied elderly hemodialysis patients are more malnourished than younger ones.