Use of interferons in atopic (IgE-mediated) diseases.

The purpose of the present study was to evaluate the possible therapeutic effects of interferon alpha and gamma in the management of atopic dermatitis (AD) and hyperimmunoglobulin E syndrome (HIES). A total of three patients with severe AD/HIES were studied. Two patients with AD (patients no. 1 and 2) were treated initially with IFN-gamma (0.05 mg/m2, thrice weekly). Although initial improvement was observed in both patients, due to the incomplete resolution of the disease in patient no. 1 (severity score decreased from 14 to 6), IFN-gamma was replaced by IFN-alpha (3 x 10(6) U/m2, thrice weekly) which offered further improvement (severity score decreased to 3). Patient no. 2 had a recurrence of the disease activity at the fourth week, which did not respond to an increased dose of IFN-gamma (0.1 mg/m2), hence the medication was changed to IFN-alpha (0.5 x 10(6) U/m2, thrice weekly). Following an additional 20 weeks therapy with IFN-alpha, the lesions improved dramatically and reached complete remission (severity score decreased from 12 to 0). A third patient with HIES was treated with IFN-gamma (0.05 mg/m2, thrice weekly), following which the disease severity score improved from 11 to 3 in 20 weeks. This preliminary study supports the therapeutic effect of IFNs in patients with atopic diseases. The sequential or combined usage of IFN-alpha and IFN-gamma may offer additional therapeutic benefit. The data further suggest that non-IgE-related mechanism(s) may also play an important role in this treatment modality.

Studies of safety, infectivity and immunogenicity of a new temperature-sensitive (ts) 51-1 strain of Salmonella typhi as a new live oral typhoid fever vaccine candidate.

This report describes the results of a phase 1 study evaluating the safety, infectivity, and immunogenicity of a new live oral Salmonella typhi temperature-sensitive (ts) 51-1 typhoid fever vaccine in the human. Three normal male subjects aged 23-32 years received three oral doses of S. typhi ts 51-1, each dose containing 10(9) organisms. Prior to and following immunization each subject was carefully monitored by clinical and laboratory parameters over a 2 week period during which serial specimens of blood and stool were analysed for the presence of the organism. Blood specimens were also obtained for the determination of serum antibody and cell-mediated immune responses and stool filtrates were analysed for the development of coproantibody. The results of these studies indicate that: (1) the vaccine is well tolerated with no clinical or laboratory evidence of adverse reactions; (2) ts 51-1 was detected in only one stool specimen from one volunteer; the organism recovered displayed characteristics of the ts 51-1 vaccine strain; and (3) although no significant humoral or cell-mediated lymphocytotoxic immune responses were detected in the blood, coproantibody was detected in stool specimens from all of the three immunized subjects and IgA-armed ADCC activity was detected in two of three subjects. These studies indicate that S. typhi ts 51-1 may be a suitable strain for the development of an improved oral typhoid fever vaccine. Studies are in progress to determine optimal methods of vaccine delivery preparatory to large phase 2 studies of efficacy.

Lack of graft rejection in a renal transplant recipient with AIDS.

A renal transplant recipient developed evidence of human immunodeficiency virus (HIV) infection and severe opportunistic infection 44 months after transplantation. A strikingly reduced dosage of pharmacologic immunosuppression was required to maintain renal graft function. This may be the result of impaired helper T-cell function associated with the acquired immunodeficiency syndrome (AIDS).

Fetal and neonatal immunoincompetence.

This paper discusses the development of the immune system from early gestation throughout postnatal development. The major aspects of immunoregulation and immunocompetence are reviewed. The mechanism(s) of immunologic tolerance, graft rejection reactions, mixed lymphocyte reactions, allogeneic bone marrow transplantation and graft versus host disease are described.

Effects of iontophoretic 5-hydroxytryptamine on the unitary discharge frequency of caudate nucleus neurons in the rat.

Microiontophoretic application of 5-hydroxytryptamine (5-HT) on rat caudate nucleus neurons has both facilitatory and inhibitory effects on the discharge frequency of the neurons; in many cases 5-HT has a two-phase action. An analysis was made of the behaviour of facilitatory and inhibitory responses in time considering the mean firing rate variations during and after 5-HT iontophoretic release. The experimental results were statistically elaborated.

[Observations on the diffusion of hepatitis A and B virus during an epidemic in a Sicilian town with a high rate of infection]. / Osservazioni sulla diffusione di virus epatitici A e B durante una epidemia in un comune Siciliano con alta prevalenza di infezioni.

Epidemiological investigations were carried out during a viral hepatitis outbreak occurring in a Sicilian town of 30,000 inhabitants with poor sanitary standards, with the aim to study the mode of spread of HAV and HBV in conditions of high incidence of infections. HBsAg, anti HBs, anti HAV (RIA), HBeAg, anti HBe and anti HBc were investigated in serum samples from patients, their family contacts and from healthy individuals of different age groups. Morbidity was inferred from case notifications; search of unreported cases among school children, through the study of absenteeism, did not reveal further cases. In all 148 cases, occurred from August 1976 through July 1977 with a peak in January, 44% were under 5 and 93% under 10 years of age. All but 8 of 59 cases in which laboratory data were available were due to HAV. Anti HAV antibodies were highly prevalent in serum samples obtained in February through April 1977: 62% were positive in the 1 to 3 years age group, and more than 90% among school children. Prevalence of HBsAg was age and sex dependent, ranging from 4% to 15%; anti HBs was present in 8% of the children 1-10 years and in 30% or more in age groups 30-41 and over. It is suggested that direct contact between very young children was the main mode of spread of HAV, and inapparent cases the main source of infection, although ambient diffusion through water contamination could not ruled out. HBV was probably propagated mostly by intrafamilial spread with little overt pathology.