Extracorporeal photopheresis increases neutrophilic myeloid-derived suppressor cells in patients with GvHD.

Extracorporeal photopheresis (ECP) is beneficial in patients with T-cell-mediated disorders, including GvHD, but the underlying immunological mechanisms are incompletely understood. Myeloid-derived suppressor cells (MDSCs) are innate immune cells characterized by their capacity to suppress T-cell proliferation. We quantified MDSCs by flow cytometry in peripheral blood from patients after BMT with GvHD before and after ECP treatment, patients after BMT but without GvHD and age-matched healthy controls. MDSC functionality was analyzed using T-cell proliferation, cytokine release and arginase activity. GvHD patients showed increased baseline percentages of neutrophilic MDSCs (PMN-MDSCs) compared with healthy controls and patients after BMT without GvHD. ECP treatment in GvHD patients rapidly increased circulating percentages of PMN-MDSCs. Functionally, PMN-MDSCs efficiently dampened Th1 and Th17 responses and were paralleled by an increase of cellular and extracellular arginase activity. Following ECP longitudinally over 16 weeks, two GvHD responder subgroups were identified, with group one continuously increasing PMN-MDSCs and group two with stable or decreasing PMN-MDSCs over time. This study demonstrates for the first time that ECP increases T-cell-dampening PMN-MDSCs in GvHD patients, a finding that should be confirmed in larger series of GvHD patients.

Gardnerella vaginalis is associated with other sexually transmittable microorganisms in the male urethra.

In a prospective study, urethral swabs were taken from 544 men presented to an STD clinic, 118 with and 426 without urethritis, and examined by microscope and/or culture for G. vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum, Mycoplasma hominis, Candida species and Trichomonas vaginalis. G. vaginalis was isolated from 4.2% of the males with urethritis and from 6.3% of those without urethritis. Using loglinear analysis, the following associations were significant (p less than 0.05): three-way: G. vaginalis, U. urealyticum, C. trachomatis; two-way: G. vaginalis, U. urealyticum and G. vaginalis, M. hominis and U. urealyticum, M. hominis. It is concluded that G. vaginalis is associated with genital mycoplasmas not only in the female, but also in the male urogenital tract.

Sexually transmittable organisms in the urethra of males with and without urethritis.

In 589 males, 169 with and 420 without urethritis, urethral swabs were taken and assessed semiquantitatively for the sexually transmittable infectious agents Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and Candida species. The organisms were isolated in patients with and without urethritis as follows: N. gonorrhoeae with urethritis 19.5%, without 0.0%; C. trachomatis with urethritis 16.0%, without 2.9%; U. urealyticum (high cfu-counts) with urethritis 27.2%, without 11.7%; M. hominis (high cfu) with 4.7%, without 2.9%. Combined infections were more frequent in males with urethritis (20.8%) than in those without (5.4%). None of the investigated pathogenic microorganisms could be demonstrated in 37.9% of males with and in 71.2% of males without urethritis. Using loglinear analysis, a significant coincidence of infections with N. gonorrhoeae and U. urealyticum and of infections with U. urealyticum and M. hominis was found. It is concluded that an asymptomatic infection of the male urethra with sexually transmittable organisms is to be expected in partner's control examinations and in patients presenting for other STD like venereal warts or genital herpes. Therefore in these men, even if they are asymptomatic, a comprehensive microbiological examination is strongly recommended.

[Condylomata acuminata-associated STD infections of the urethra of the male. A comparative epidemiologic study]. / Condylomata-acuminata-assoziierte STD-Infektionen der Urethra des Mannes. Eine vergleichende epidemiologische Studie.

Urethral swabs from 322 men without urethritis, 73 of whom had venereal warts (condylomata acuminata, CA) and 249 who had none, were investigated between 1981 and 1984 by microscope and culture for the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Trichomonas vaginalis, Garderella vaginalis, B streptococci, aerobic pathogenic bacteria and Candida species. The isolation frequencies in patients with and without CA were as follows: N. gonorrhoea: with CA 0%, without 0.4%; C. trachomatis: with CA 6%, without 4.4%; U. urealyticum in high CFU: with CA 15%, without 17.7%; Mycoplasma spp. in high CFU: with CA 6%, without 4%; T. vaginalis: with CA 0%, without 0.4%; G. vaginalis: with CA 4%, without 5%; B streptococci: with CA 4%, without 6%; Candida spp. only in low CFU: with CA 3%, without 2.4%.--The results indicate that as far as the isolation frequencies of sexually transmittable pathogens in the urethra are concerned, there are no significant differences between patients with CA and asymptomatic patients presenting to an STD department. However, N. gonorrhoeae was significantly less frequently isolated and C. trachomatis and U. urealyticum significantly more frequently isolated in our patients than has been reported in previous studies.

Transmission rate of Ureaplasma urealyticum, Mycoplasma spp., Gardnerella vaginalis, B-streptococci, Candida spp. and Chlamydia trachomatis from the mother to the newborn.

In a preliminary study of the transmission rate of Ureaplasma urealyticum, Mycoplasma species, Gardnerella vaginalis, B-Streptococci, Candida species and Chlamydia trachomatis from the mother to the newborn, swabs were taken from 45 parturients and their neonates and cultured by suitable methods. Out of 30 parturients with a positive culture, 8 harboured more than one microorganism investigated. U. urealyticum was found in 11 newborn and all of them had a positive mother. Candida spp. were found in 4 newborn, but 3 of these had a negative mother. G. vaginalis was detected in only 1 infant and the mother was negative. C. trachomatis was not isolated from any mother but was present in 2 newborn infants. Thus only U. urealyticum showed clear evidence of transmission from mother to baby.

[Detection of Gardnerella vaginalis in the pathogen spectrum of sexually transmissible diseases in vulvovaginitis]. / Nachweis von Gardnerella vaginalis im Erregerspektrum sexuell übertragbarer Krankheiten bei Vulvovaginitis.

Gardnerella vaginalis, a sexually transmittable organism, is regarded as the indicator of the so-called "non-specific vaginitis". The isolation rate of G. vaginalis from 72 women attending our out-patient department during one year because of urogenital complaints was higher in pretreated than in untreated patients. In genital swabs taken from untreated patients, G. vaginalis could be isolated only in 17%, whereas this was observed in 38% of the specimens from women pretreated with various antimicrobial agents. In 9% of the women without vaginal discharge G. vaginalis was isolated. In specimens obtained from 53% of the women positive for G. vaginalis further organisms such as Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, Ureaplasma urealyticum, Mycoplasma spp. and B-Streptococci could be isolated. Asymptomatic infections with Neisseria gonorrhoeae (1) and C. trachomatis (4) were also observed. The present study clearly demonstrates that a broad microbiological examination is essential for specific therapy in vaginitis. Even if unspecific vaginitis is diagnosed by the presence of clue-cells, increased vaginal pH and fishy odour, a combined infection by further sexually transmittable organisms, especially N. gonorrhoeae, is to be excluded.

[Incidence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Streptococci of the Lancefield group B and Candida species in newborn infants during the first week of life]. / Nachweishäufigkeit von Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Streptokokken der Lancefield-Gruppe B und Candida species bei Neugeborenen während der ersten Lebenswoche.

In a total of 200 children born at Würzburg University Gynecological Clinic, culture and in some cases microscopic investigations were performed in the first week of life to identify chlamydia trachomatis, ureaplasma urealyticum, mycoplasma species, Lancefield group B streptococci and candida species. Chlamydia trachomatis was isolated in one symptom-free neonate, while ureaplasma urealyticum was found in 31 (15%) of the infants. Statistically, premature rupture was significantly more frequent (29%) in the ureaplasma-urealyticum-positive group than among the ureaplasma-urealyticum-negative infants (11%) (p less than 0.05). Mycoplasma species was detected in one newborn, Lancefield group B in 3 (1.5%). In 7 of the infants (3.5%) Candida species was isolated.

[Chlamydia trachomatis in the urogenital tract of pregnant women]. / Chlamydia trachomatis im Urogenitaltrakt bei Schwangeren.

In two hundred and thirty three prenatal patients from the Prenatal Clinic of the University of Würzburg cervical, vaginal and urethral swabs were taken for microscopic examination and culture for Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Trichomonas vaginalis (T. vaginalis), Beta-hemolytic streptococci, Candida species, Ureaplasma urealyticum (U. urealyticum), Mycoplasma species and facultatively pathogenic and apathogenic aerobic bacteria. In ten cases (4%) C. trachomatis was found. In six cases hemolytic streptococci group B were detected. Fifty two cases showed a Candida species. Seventy nine cases presented U. urealyticum. One case showed a Mycoplasma species and one case showed Trichomonas vaginalis. Striking was the significantly increased rate of premature rupture of the membranes in the group with U. urealyticum compared to the group without U. urealyticum.

[Immunity against poliomyelitis in the German Federal Republic (author's transl)]. / Untersuchungen zur Immunitätslage gegen Poliomyelitis in Deutschland.

The immunity of the populations of several countries of the GFR against poliovirus 1, 2 and 3 was investigated in 11 laboratories. Sera of 4707 persons aged 0 to 30 years were assessed for neutralising antibodies (serum dilution 1:4) against the 3 types of poliovirus. 34.5% of the 4707 investigated sera had no neutralising antibodies at least against one type of the poliovirus, 4.7% showed no antibodies against all 3 types of the virus. Especially children aged 0 to 4 years were protected incompletely against the 3 types of poliovirus. In comparison with similar investigations of 1969 and 1972 no decisive change of immunity of the population of the GFR against poliomyelitis has occurred.

[Generalized herpes simplex]. / Generalisierter Herpes simplex.

This report is about a 58-year-old female patient with generalized herpes simplex virus exanthema. The virus was detected not only in the skin eruptions but also in rinsing liquid from the throat. Its typical feature revealed it to be herpes simplex virus Type I. On the basis of similar cases which have been described in literature, we point out that it is necessary to carry out virological and serological tests in cases of uncertain vesico-pustular or erythema exsudativum multiforme like exanthemas. These exanthemas must be separated from the postherpetic erythema exsudativum multiforme because of the identified virus.

[Echovirus 30 epidemic (author's transl)]. / Echovirus-30-Epidemie.

Echovirus 30 was the cause of abacterial meningitis and pharyngitis in 22 cases in the Ludwigshafen on Rhine area in summer 1976 and in a further 26 cases in various regions of the German Federal Republic. In 11 children echotype-30-virus could be isolated from the CSF. In 47 children the diagnosis was established by a rise of neutralising antibodies. Positive virus isolation from the CSF was only possible during the first two days of the illness using rhabdomyosarcoma cell tissue cultures. These were particularly sensitive to the echovirus 30 subtype found.

RD cells in the laboratory diagnosis of enteroviruses.

It is shown that, in addition to the already known replication of Coxsackie A viruses, 16 out of 18 different types of ECHO viruses tested as well as all three types of polioviruses can also be grown in RD cells with the development of a pronounced CPE. One of the exceptions, ECHO virus type 16, can be propagated in either HEL or HFDK cells and the other, ECHO virus type 22, in Vero cells. These four permanent or semi-permanent cell cultures thus prove very useful for the isolation of most of the diagnostically important enteroviruses as well as for their serological identification by neutralization in a micro-titer system described in this paper.

The use of RD cells in the isolation of Echo type 30 virus from patients with aseptic meningitis.

Between early July and August 1976, 60 cases of aseptic meningitis and pharyngitis in children from various parts of West Germany were reported to this institute. Successful virus isolation from spinal fluid in 12 out of 36 cases was greatly facilitated by the use of RD cell tissue cultures, whereas isolation attempts in HEL, Vero, and HFDK cells were unsuccessful. In all cases, the isolated virus was identified as ECHO type 30. Neutralization studies with sera of 48 remaining cases also using RD cells clearly indicated that the epidemic outbreak was caused by ECHO type 30 virus.