Reference values for selected trace elements in serum of term newborns from the urban area of Rome.

Reference values for Al, Cd, Co, Cu, Li, Mn, Mo, Ni, Rb, Se and Zn, and indicative intervals for Sb are proposed in serum from cord blood of 143 term newborns of the urban area of Rome. On the basis of the eligibility criteria adopted, only babies with gestational age > 37 weeks and body weight at the delivery > 2500 g, i.e., "normal" term infants, were included in this study. With the exception of Cd, Li, Ni and Sb, experimental data for each of the other analytes were found to approach a normal distribution. The estimated references values (in ng/ml) were the following: Al, 1. 12-6.79; Cd, 0.10-0.52; Co, 0.20-0.43; Cu, 140-691; Li, 0.31-2.23; Mn, 0.79-3.26; Mo, 0.36-1.56; Ni, 0.20-3.15; Rb, 196-1302; Sb, 0. 10-1.48 (indicative range); Se, 20.2-69.7; and Zn, 318-1405. For several elements, the information available in the relevant literature does not allow adequate comparisons to be performed. This was actually possible only for Cu, Se and Zn. The correlations between the weights at birth (BW), gestational ages (GA) and elemental concentrations were elucidated. As expected, significant positive correlations were found for Cu and Se with GA and BW, respectively. Strong mutual associations were observed for several other elements, but their interpretation is still debatable.

Serum amyloid A protein is elevated in relapsing-remitting multiple sclerosis.

In multiple sclerosis (MS), the signs of inflammation that can be detected in the central nervous system are not mirrored by unequivocal markers of activation of the immune system in the periphery. We performed a serial monitoring of serum amyloid A protein (SAA), a major acute phase reactant, in peripheral blood of patients with relapsing-remitting MS over a 3-month period. Patients were monitored in parallel with gadolinium-enhanced magnetic resonance imaging (Gd-MRI) of the brain. The results show that signs of ongoing peripheral inflammation, reflected by elevations of SAA levels, can be detected in MS patients.

Immunologic follow-up of infants treated with granulocyte transfusion for neonatal sepsis.

The immunologic status and the occurrence of alloimmunization against granulocytes, platelets, lymphocytes, and red cells was evaluated in 33 babies who received granulocyte transfusion because of neonatal sepsis. Nine age-matched babies were examined as control. A first group of 19 infants was examined only once between 6 and 23 months of age. Alloantibodies were searched by the following serologic methods: standard techniques for red cell antibodies; lymphocytotoxicity test; agglutination and immunofluorescence tests on granulocytes and platelets. No antibodies were demonstrated. The immunologic profile was investigated by determining the Ig levels, the percentage of E rosette-forming cells, and the lymphocyte blastic response to phytohemagglutinin and concanavalin A. Granulocyte function was studied by phagocytosis and killing of Candida. No significant differences were observed between treated and control babies. In a second group of 14 infants the occurrence of early immunization within 3 to 9 weeks after the last transfusion was investigated. No evidence of early immunization was found. The present data suggest that following neonatal granulocyte transfusion the risk of adverse immune reactions should be low.

Polymorphonuclear leukocyte transfusion for the treatment of sepsis in the newborn infant.

A therapeutic trial of transfusions with polymorphonuclear leukocyte concentrates was performed in newborn infants with bacterial sepsis proven by blood culture. With each transfusion, 20 ml/kg of a preparation obtained by continuous flow filtration leukapheresis, and containing 0.5 to 1 x 10(9) WBC, with less than 6% lymphocytes, was administered. Twenty newborn infants with sepsis received from 2 to 15 PMN transfusions. Results were compared with findings in 18 newborn infants with sepsis admitted during the trial period, and not treated because of unavailability of the PMN preparation (Group B). Infants with fulminant illness were excluded from both groups. Groups A and B were similar with respect to clinical characteristics and to etiology (in the majority cases a highly antibiotic-resistant Klebsiella). The mortality rate was significantly lower in Group A than in Group B in the whole series (10% vs 72%, P < 0.001), and also in the subgroups with birth weight equal or below 1,500 gm (10% vs 91%, P < 0.001). Major complications and associated conditions (i.e., necrotizing enterocolitis, meningitis, pneumonia, peritonitis, osteoarthritis, disseminated intravascular coagulation) were observed in 12 patients of Group B, and in only three infants of Group A. Untoward effects attributable to PMN transfusions were never observed. PMN transfusion was a highly effective therapeutic tool in our population of infected newborn infants.

A child with atopic features, raised serum IgE, and recurrent infection treated with levamisole.

A 6-year-old girl had a long history of severe eczema, asthma, recurrent otitis media, and staphylococcal infections with disseminated chronic skin abscesses. Immunological studies showed a neutrophil chemotaxis defect, hyperimmunoglobulinaemia E, IgE antibodies against cows' milk proteins, absence of IgM, and absence of staphylococcal haemolysins. Neutrophil phagocytic and bactericidal functions and complement system were normal. In the course of treatment with levamisole (2.5 mg/kg, 3 times a week for one year) a striking clinical improvement occurred: the skin lesions and the staphylococcal abscesses gradually cleared and the girl gained weight. There was also a partial correction of the immune deficiency.

[A simplified micromethod for the measurement of leukocyte candidacidal activity (author's transl)]. / Micrometodo semplificato per la determinazione dell'attivita' candidacida dei leucociti

A technicall simple micromethod for the assessment of leukocyte candidacidal activity is described. It is based on the alterations in Giemsa staining characteristics which Candida albicans cells develop when ingested by glass-adhering phagocytes. This method, which requires small quantities of whole blood and produces reliable results, may be of promising clinical usefulness for detecting primary and secondary phagocyte candidacidal defects in patients with chronic or recurrent localized and systemic candidiasis.

[A simplified micromethod for the measurement of leukocyte chemotaxis (author's transl)]. / Micrometodo semplificato per la determinazione della chemiotassi leucocitaria

A new in vitro micromethod for the assessment of chemotaxis, based on the measurement of glass-adhering phagocyte migration through a cellulose membrane filter in a standard tissue culture chamber, is described. This technically simple method, which requires only small volumes of whole blood and produces reliable results, may be of promising clinical usefulness for the study of the several disease states related to abnormalities of chemotaxis.