[Effect of administration of blood products on the course of tetanus antibody concentration in immuno-incompetent patients]. / Einfluss der Verabreichung von Blutprodukten auf den Verlauf der Tetanus-Antikörperkonzentration bei immuninkompetenten Patienten.

OBJECTIVE: Collecting of data for immunoprophylaxis of tetanus in immunodeficient patients via administration of blood products. DESIGN: Prospective single case studies. SETTING: Clinical therapy in a department of hematology with continuous determination of tetanus antibody concentrations in patients' sera and administered blood products with an enzyme immunoassay. PATIENTS: 3 patients with acute myeloid leukemia (FAB classifications M1, M3, M4). INTERVENTIONS: Regular administration of blood products due to clinical therapy. RESULTS: After administration of about 4,000 IU tetanus antitoxin i.v., serum concentration is increasing by 1 IU/ml. Half life in serum amounts to 7 days. Protection lasts therefore up to 6 weeks. CONCLUSIONS: Immunodeficient patients may receive a medium-term effective protection against tetanus after selection of suitable blood products. This method is interesting also for prophylaxis of postoperative tetanus in immunocompetent patients.

[The status of maternally acquired tetanus immunity in newborn infants]. / Zur Situation der Tetanus-Leihimmunität bei Neugeborenen.

In newborn and their mothers a considerable lack of immunity to tetanus was found. Values of corresponding serum pairs differed in part; some children were unprotected in spite of maternal immunity. Pregnant women without protection should therefore be vaccinated twice before delivery. Over and above this, good hygienic standards in obstetrics must be maintained.

[Studies on the immunity status against tetanus in Rhine-Hesse]. / Untersuchungen zur Immunitätslage gegen Tetanus in Rheinhessen.

Immunity to tetanus in the population of Rhine-Hesse deteriorates with increasing age. A reduction of both the average antibody concentration and the duration of immunity after the last vaccination can be found. The percentage of unprotected people also increases with age. Especially women have a poor protection against tetanus. The immunity to tetanus should therefore be checked in elderly persons and in women irrespective of a possible lesion.

In vivo protective effect of tumour necrosis factor alpha against experimental infection with herpes simplex virus type 1.

C57BL/6 mice, which differ genetically from other strains by their resistance to herpes simplex virus type 1 (HSV-1) infection, were inoculated intraperitoneally with different doses of tumour necrosis factor alpha (TNF-alpha). Mice pretreated with 100 ng, or even 10 ng, of TNF-alpha showed prolonged survival compared to control mice that were infected with 10(7) p.f.u. of HSV-1. Significant protection was observed in mice injected 4 or 8 h prior to or after HSV-1 inoculation, respectively. Protection was also observed when mice which differed at their H-2 locus were treated with TNF-alpha after infection with HSV-1. Interferon could not be detected in the sera of mice at different time points after infection with HSV-1 or injection of TNF-alpha and there was no enhanced interferon titre in mice treated with both TNF-alpha and HSV-I, suggesting some interferon-independent protection. However, mice treated with TNF-alpha showed a marked activation of natural killer (NK) cells compared to untreated control mice or mice that were treated with HSV-1 alone. To test whether enhanced NK cell activity is responsible for TNF-alpha-induced protection, mice were injected with the NK cell-specific antibody anti-asialo Gm-1. In this experimental protocol the survival rate was almost unaffected, indicating that the observed protection was not due to activation of NK cells and that TNF-alpha is involved in the regulation of antiviral mechanisms other than the activation of interferons. Although additional production of interferon induced by TNF-alpha cannot be excluded, an antiviral effect of TNF-alpha on the course of HSV-1 infection may be postulated from our data.

[A screening procedure for determining tetanus antibody concentrations in blood products]. / Screeningverfahren zur Bestimmung von Tetanus-Antikörperkonzentrationen in Blutprodukten.

The application of antibodies to tetanus toxin is necessary for prevention of postoperative tetanus in patients at risk, e.g. in emergency surgery. However, intravenous preparations with sufficiently rapid distribution throughout the body are not available. This could only be achieved via the blood products (whole blood unit, fresh frozen plasma, thrombocyte concentrate) transfused in such cases. For semiquantitative determination of antibody concentration in blood products, an ELISA assay was developed, which can be used as a screening method for selection of sera with high titers. The assay is quick and easy to perform so that large numbers of sera can be tested within a short time.

Differential gene expression of IFN-alpha and tumor necrosis factor-alpha in peripheral blood mononuclear cells from patients with AIDS related complex and AIDS.

Human PBMC from HIV-1-infected individuals produced ex vivo in response to vesicular stomatitis virus only low amounts of IFN-alpha. This impairment was significant as early as Walter Reed (WR) stage 2; at WR stage 4-5, the production was almost zero. At WR stage 2 of infection, IFN-alpha mRNA was exclusively found in association with polyribosomes, indicating that IFN-alpha gene was transcriptionally inactive under the experimental conditions used. A similar decrease of the level of transcripts as a function of the progression of the disease was also observed for the IFN-gamma mRNA. In contrast, TNF-alpha production was strongly enhanced in PBMC from HIV-1-infected individuals after stimulation with LPS compared to the TNF-alpha production of activated PBMC from healthy donors. Almost parallel with the increase of the level of the transcript for TNF-alpha, the level of TNF-beta increases as well. Data are presented which show that the increased TNF-alpha production is due to a longer half-life of TNF-alpha transcripts in PBMC from infected individuals. These results let us suggest that the up-regulation of TNF-alpha gene expression in PBMC from HIV-infected individuals is controlled predominantly on the posttranscriptional level, whereas transcriptional events regulate the level of IFN-alpha transcripts. This assumption is supported by run-on experiments which revealed that the extent of transcription of TNF-alpha gene is almost identical in nuclei from stimulated PBMC of noninfected and HIV-infected donors, whereas the transcription of IFN-alpha gene is strongly suppressed in nuclei from HIV-infected individuals at WR stages 3 and 6.

Lysis of human melanoma cells by autologous cytolytic T cell clones. Identification of human histocompatibility leukocyte antigen A2 as a restriction element for three different antigens.

From the peripheral blood of the melanoma patient (AV), we derived cytolytic T lymphocyte (CTL) clones that lysed the autologous tumor line SK-MEL-29, but not autologous EBV-B cells, K562, and other tumor targets. By immunoselection experiments it was shown that the CTL clones recognized at least three different antigens on the autologous tumor cells. We demonstrate here that these melanoma antigens are presented to the CTL in association with HLA-A2. First, HLA-A2-reactive pregnancy sera as well as an mAb against HLA-A2 inhibited the CTL lysis. Second, immunoselected melanoma subclones that were resistant to lysis by CTL clones against the three antigens described were found to lack expression of HLA-A2. By sensitizing the patient's lymphocytes against an HLA-A2- melanoma clone, we established a new series of CTL clones recognizing autologous AV melanoma cells. However, efficient lysis was only seen when target cells were pretreated with IFN-gamma. The lytic activity of these CTL was selectively inhibited by an mAb against a common HLA-B determinant. These results indicate that in addition to HLA-A2, other class I antigens are involved in the recognition of AV melanoma cells by autologous CTL.

[Side effects of homologous transfusion]. / Nebenwirkungen der homologen Transfusion.

The risk of transmitting infectious agents through homologous blood transfusions can't be completely eliminated. According to our present knowledge, the posttransfusion-hepatitis (PTH) type B has been overestimated till the end of the seventies. Concerning PTH type Non A Non B special serological diagnostic techniques are missing, but nevertheless, there are indications as well that the frequency of this transfusion side-effect is overrated. The occurrence of HIV-transmission through blood-transfusions is right now considered to be 1:10(6) to 1: (3 X 10(6)). Because of continuous improvement of the analysing methods, these results seem to be reasonable and are similar to those we found. To determine the influence of transfusions on the defense mechanism of tumor-patients further investigations are necessary, because the immunosuppressive effect of the individual blood components has to be rated differently.