Association of γδ T cells with disease severity and mortality in septic patients.

Gamma-delta T cells are the most abundant of all epithelial-resident lymphocytes and are considered a first line of defense against pathogens in the mucosa. Our objective was to confirm the reduction in γδ T cell subsets and its relationship with mortality in patients with sepsis. We studied 135 patients with sepsis attended in the emergency department and intensive care unit of two hospitals and compared them with a similar control group of healthy subjects. The αß and γδ T cell subsets were determined via flow cytometry according to the stage of the sepsis and its relationship with mortality. All the lymphocyte subsets were reduced with respect to the corresponding subsets in the control group. All the γδ T cell populations decreased significantly as the septic picture worsened. Furthermore, γδ T cells showed decreases at days 2, 3, and 4 from the start of sepsis. Twenty-six patients with sepsis died (19.3%). The γδ T cells, specifically, the CD3(+) CD56(+) γδ T cells, were significantly reduced in those septic patients who died. Our results indicate that, during sepsis, γδ T cells show the largest decrease and this reduction becomes more intense when the septic process becomes more severe. Mortality was associated with a significant decrease in γδ T cells.

Differential effect of appendectomy and tonsillectomy on anti-Kudoa sp. antibodies in patients with MALTectomy.

We found an association between tonsillectomized patients and subsequent appendicitis. We also observed that MALTectomy significantly decreased secretory IgA levels in serum of patients, being this decrease more pronounced when both operations (tonsillectomy and appendectomy) had been performed. The elevated humoral responses detected previously by us in BALB/c mice immunized with Kudoa sp. pseudocyst extracts and the high IgG1 and IgE levels induced by the oral administration of Kudoa sp. pseudocysts to BALB/c mice showed the possible immunopathological effects in man from the ingestion of Kudoa sp. infected fish. We use the ELISA method to investigate the possible relationship between MALTectomy (tonsillectomy and appendectomy) and specific antibody levels to Kudoa sp. Both anti-Kudoa sp. specific antibody levels and the number of patients that recognized Kudoa sp. antigens were greater in tonsillectomy patients when compared to the control and the other studied groups (appendectomized and appendectomized+tonsillectomies patients). Tonsillectomy was associated to a switch in the class of immunoglobulins involved in these responses and these responses may be abrogated by appendectomy. Tonsils and appendix may respond in different ways to Kudoa sp. antigens and these different reactions may be involved in some immunopathological reactions.

Anisakis simplex and Kudoa sp.: evaluation of specific antibodies in appendectomized patients.

High prevalence and intensity of infection with anisakid larvae has been reported in commercially important fish in Spain. Likewise, Kudoa-infected fish have lately been detected in both fresh and frozen fish. In the present study the possible relation between appendectomy and specific antibodies to these fish parasites was investigated. One hundred and sixty patients were enrolled in this study. They were divided into two groups of eighty patients each and matched for sex and age: Group 1 (appendectomized) and Group 2 (control group). Total immunoglobulins (Ig's), IgG, IgM, IgA and IgE against Anisakis simplex or Kudoa sp. antigens were analysed by ELISA. The mean values of the specific antibodies were lower in the appendectomy group, although significant differences were not observed in the case of IgG, IgA and IgE anti-A. simplex and IgE anti-Kudoa sp. In summary, appendectomy significantly decreased serum specific immunoglobulin levels against these food borne parasite antigens. This decrease was detectable from three months to three years post-appendectomy. It is necessary to study the influence of the surgical removal of other important parts of the GALT on these anti-parasite humoral immune responses.

[Prevalence of sensitization to Blomia in Gran Canaria]. / Prevalencia de sensibilizaciones a Blomia en Gran Canaria.

In the present study we assessed the prevalence of sensitizations to Blomia in our environment. Perennial climatological conditions in the Canarian Islands facilitates the habitat to mites. The Blomia is found in tropical and subtropical homes of Europe, USA and Asia like the Dermatophagoides. We have designed a transversal and prospective study on 100 patients who consulted our Unit for the first time. A Prick-test for the common allergens, including Blomia Kulagini, and in vitro determination of total and specific IgE to Dermatophagoides Pteronyssinus and Farinae, was performed in those patients showing the same or higher levels than class 3 CAP System RAST-Fesa against Blomia Tropicalis. Results achieved in our environment and our patients are the following: 1. Prevalence of sensitizations to BK in patients who consult for the first time is 50%. 2. The specific IgE immunologic response to BK is 56% (45 patients). 3. Scarce correlation in the papule areas and specific IgE levels between BT and DTP (p = 0.22020); BT and DFA (p = 0.09063). Table VI. Fig. I and II. 4. These results and previous studies of allergenization suggest poor crossed reactivity between Blomia and Dermatophagoides. 5. We think that Blomia is a new etilogic agent of the allergic respiratory disorders in our environment and therefore it should be included in the standard set of allergens from a diagnostic and therapeutical point of view. We keep studying its identification and count in dust samples from our homes, as well as the crossed reactivity, by RAST inhibition, with other acari.