[Lipophilic yeasts of the genus Malassezia and skin diseases. I. Seborrhoeic dermatitis]. / Lipofilné kvasinky rodu Malassezia a choroby koze. I. Seboroická dermatitída.

Recent technological advances have revived the interest in Malassezia yeasts and their clinical role, which has long been a matter of controversy because of their fastidious nature in vitro and relative difficulty in isolation, cultivation and identification. Lipophilic yeasts of the genus Malassezia form a part of normal microbial flora of healthy human (and animal) skin, but they also have been associated with several dermatological diseases, like seborrhoeic dermatitis and atopic dermatitis. Our understanding of the interactions between Malassezia and the host might provide new opportunities to better control these often chronically relapsing diseases.

[Treatment of juvenile pemphigus vulgaris with intravenous immunoglobulins]. / Liecba juvenilného pemphigus vulgaris intravenóznymi imunoglobulínmi.

Juvenile pemphigus vulgaris (JPV) is a rare autoimmune disease. It is treated by different immunosuppressive drugs, which may have serious side effects. Such problems are most apparent in the therapy of children and adolescents. The use of intravenous immunoglobulins (IVIG) is a safe and effective method and therefore it can replace or at least postpone the initiation of the combined immunosuppressive therapy. The article reports experience with the IVIG therapy of severe JPV in 16-year-old female patient. The double combination of IVIG and prednisone was used. IVIG were administered in a dose of 400 mg/kg/day during three consecutive days with the intervals of 1-2 months. Totally 5 cycles were applied. The therapeutic effect was excellent, it started within few days, but it was only temporary and lasted for 1-2 months. IVIG therapy enabled the dose of prednisone to be reduced from 50 mg/day to 15 mg/day. Following the cessation of IVIG, the double combination therapy of prednisone and azathioprine was initiated, but it was unsuccessful in controlling the disease. Remission of JPV achieved with triple combination of prednisone (25 mg/day), azathioprine (100 mg/day) and dapsone (50 mg/day) was comparable to that of IVIG and prednisone combination. On the basis of their positive experience the authors recommend to use IVIG also for cases of childhood and juvenile pemphigus, in which this therapy can delay the need for administration of immunosuppressive drugs with potential of serious adverse effects.

Impaired responses of peripheral blood mononuclear cells to nickel in patients with nickel-allergic contact dermatitis and concomitant atopic dermatitis.

BACKGROUND: Allergic contact dermatitis (ACD) is pathogenetically dependent on cell-mediated immune responses mediated by type 1 T lymphocytes. Atopic dermatitis (AD), in contrast, occurs as a result of sustained activation of type 2 subsets of T cells. Although atopic patients may become sensitized to various contact allergens, little is known about the influence of atopy on delayed-type hypersensitivity. OBJECTIVES: To investigate the in vitro responses of peripheral blood mononuclear cells (PBMC) to nickel stimulation in groups of atopic and nonatopic patients with patch test-verified nickel ACD. METHODS: Ten nonatopic patients with nickel ACD, 10 patients with nickel ACD and concomitant AD, 10 patients with AD but with no contact allergy, and 10 healthy persons participated in the study. PBMC were cultured in the presence or absence of nickel sulphate, phytohaemagglutinin (PHA) or tetanus toxoid (TT). [(3)H]thymidine incorporation was used to measure the rate of antigen-induced DNA synthesis and enzyme-linked immunosorbent assay was used to measure the production of interleukin (IL)-2 (type 1 cytokine) and IL-5 (type 2 cytokine). RESULTS: Nickel-stimulated PBMC of nickel-allergic patients with AD proliferated significantly less and secreted significantly lower amounts of IL-2 than cells of nonatopic nickel-allergic patients. IL-5 production was also lower in the former group, although the difference was nonsignificant. Moreover, neither the nickel-specific DNA synthesis nor the cytokine production by PBMC of atopic nickel-allergic patients differed significantly from those of healthy control persons and AD patients without contact allergy. Proliferative and secretory responses of PBMC to PHA or TT stimulation differed nonsignificantly between the groups. Nickel-induced IL-2 production correlated well with IL-5 production in nickel-allergic patients regardless of their atopic status. CONCLUSIONS: Our results indicate that PBMC of nickel-allergic patients with concomitant AD are characterized by impaired in vitro proliferative and secretory responses to the contact allergen nickel but not to the mitogen PHA or the recall antigen TT. The type 2 cytokine IL-5 may play a role in the development of ACD.

[Antigens for the ELISA test for serodiagnosis of Helicobacter pylori infection]. / Antigény pre ELISA test na sérodiagnostiku infekcie Helicobacter pylori.

Semipurified urease and outer membranes of Helicobacter pylori were isolated and used as antigens for the construction of new ELISA tests for the serodiagnosis of infections caused by this microorganism. The highest discriminating capacity between infected and not infected subjects was obtained by the test detection of IgG antibodies against the urease antigen which reached a 100% sensitivity, 90% specificity, a 100% negative and 91% positive predictive value. Examination of sera of healthy children and blood donors revealed the possibility of asymptomatic infection and an increase of specific antibody levels with age.

Vaginal leukocyte characteristics in urogenital trichomoniasis.

Morphological and functional characteristics of vaginal exudate leukocytes were examined in 47 patients with urogenital trichomoniasis. Electron microscopic morphology, viability, phagocytosis of Candida albicans blastospores and ability to undergo respiratory burst in the iodonitrotetrazolium reductase test were evaluated in these cells. Vaginal inflammatory leukocytes were almost exclusively polymorphonuclear neutrophils, and their concentration was positively correlated (r = 0.58; p less than 0.001) with the number of trichomonads in the exudate. Median leukocyte viability reached 39% and both phagocytic and tetrazolium reductase activities of these cells were significantly reduced in comparison with those of circulating polymorphonuclear leukocytes. Patients with a clinical picture of severe mucosal inflammation had significantly higher vaginal exudate leukocyte concentrations and viability than those without inflammatory signs. The possible role of vaginal leukocytes in the pathogenesis of urogenital trichomoniasis is discussed.

Characterization of a 25,000-dalton Helicobacter pylori protein, cross-reacting with a Campylobacter jejuni protein.

Extract obtained by ultrasonic disruption of Helicobacter pylori bacteria contained a protein with subunit molecular mass of 25 kD which bound antibodies in sera from patients with H. pylori-associated disease. The protein was purified by gel permeation and elution from SDS-polyacrylamide gel slices, and was used to raise an anti-25-kD protein-specific rabbit serum. Using the antiserum in experiments, the results indicated the following: The protein exists as covalently linked dimers (45 kD) of the 25-kD subunits. Variable numbers of non-covalently linked copies of the dimers make up the native protein. The protein was susceptible to digestion by papain, pronase, and trypsin. Pepsin cleaved off a fragment of approximately 2 kD. A small share of the protein was exposed at the bacterial cell surface, the greatest share being localized internally. The protein was not secreted and it was probably not an integral part of the outer membrane. It was produced in variable quantity by all of 11 H. pylori strains tested and was a major protein in some strains. A cross-reacting protein with subunit size of 25 kD was also produced by Campylobacter jejuni strains, but not by any of a variety of other bacteria. Since both H. pylori and C. jejuni infection occur with a high frequency. the cross-reacting 25-kD protein may interfere unfavourably with the diagnostic specificity of serological tests for infection caused by these bacteria.