[Allergic contact dermatitis to nickel: modification of receptor expression on peripheral lymphocytes of women after oral provocation tests (preliminary data)]. / Dermatite allergica da contatto a nichel: modificazioni delle espressioni recettoriali dei linfociti periferici in donne dopo test di provocazione per via orale (dati preliminari)

Blood lymphocyte subset evaluation was performed before after oral challenge with 10 mg of Ni, in 9 healthy women and in 15 allergic to Ni. Following challenge, 7 allergic showed a flare up of eczema and/or urticaria. In the controls, CD4+ lymphocytes were modified 24 hours after Ni challenge: CD4+/CD44RO- "virgin" cells were reduced while CD4+/CD45RO+ "memory" cells increased. The allergic women, not sensitive to oral Ni, showed an increase of B lymphocytes after the test. On the contrary, the oral Ni reacting patients presented a reduction of monocytes 4 hours after Ni ingestion and marked reduction (ranging from 20 to 50%) of T and B lymphocytes after 24 hours. These significant T and B lymphocytes changes suggest a migration of the cells in peripheral tissues, likely skin and GUT mucosa.

Intravenous immunoglobulins suppress the recurrences of genital herpes simplex virus: a clinical and immunological study.

Effective treatment is not currently available for suppressing the recurrence of genital herpes simplex virus (HSV) infections. Since intravenous immunoglobulins (IVIG) proved useful against HSV in experimental models, we treated patients with very high frequency of HSV genital recurrences (more than 15 episodes per year) with IVIG (400 mg/Kg every fourth week). The control group was treated with intermittent oral acyclovir (800 mg twice a day for one week every month). Both groups were treated for six months and, then, patients were followed-up to further six months. Both IVIG and acyclovir were effective in reducing the frequency of HSV genital recurrences as compared to base-line. However, patients treated with IVIG had a more striking reduction in the frequency of recurrences as well as both a shorter mean duration and a minor severity of the lesions as compared to acyclovir-treated patients. Furthermore, we found a trend indicating IVIG as more effective in reducing the viral load. Since in IVIG-recipients we found a strong increase of peripheral blood lymphocytes with natural killer (NK) surface phenotype, we suggest that the clinical effectiveness of IVIG treatment is probably mediated via the expansion of NK cell populations. Our study indicates that the treatment with IVIG is an effective and safe tool for suppressing the recurrences of genital HSV infections.

[Immuno-histopathologic changes in the gastrointestinal mucosa in patients with nickel contact allergy]. / Modificazioni immuno-istopatologiche della mucosa gastro-intestinale in pazienti con allergia da contatto al Nichel.

The study concerns the histological and immunohistochemical findings of the gastrointestinal mucosa of 20 patients (group A) suffering from contact allergic dermatitis (CAD) to Ni, with symptom recrudescence due to food ingested Ni. Results were compared with those observed in 20 patients suffering from CAD to Ni (group B), without sensitivity to food ingested Ni, and in 20 normal subjects (controls). The sensitivity to food ingested Ni, as suggested by history, was demonstrated by placebo-controlled oral-Ni challenge. The biopsies for histological and immunohistochemical study were performed during endoscopy and obtained from the antrum and from the duodenal mucosa. In the biopsies obtained from 16 of group A patients there was evidence of inflammatory infiltrate of lymphocytes and plasma cells with oedema and vasodilation in the lamina propria. Slight flattening of the villi and enlongation of the crypts were concomitant. These findings were light in the 4 patients of group A and in 11 of group B and instead were absent in the remaining group B patients and in the controls. Immunohistochemically, lymphocytes in the lamina propria were prevalently CD20 + (B cells) and CD4 + (Th cells), some were CD45RO + (memory) and finally few CD8 + (Tc/s cells). CD45RO + cells was found in cluster in patients of group A and in 4 of group B, whereas in the others were isolated. Since some studies have shown that immunological pattern of skin reaction to Ni is characterized by increased CD45RO + cells, it may be hypothesized that in patients suffering from CAD to Ni, the sensitivity to food-ingested Ni may be induced by a type IV immunological reaction in the gut.

Cyclical immunotherapy in patients with psoriasis.

Psoriasis, a chronic and unpredictable dermatosis, is a constant therapeutical challenge to dermatologists. However, new knowledge in immunodermatology has stimulated interest in and encourage the use of new molecules, especially cyclosporin A (CyA). Thanks to certain characteristics, this molecule is capable of modulating and blocking the intense network of cytochine that seems to cause this dermatosis. The first clinical experiments have demonstrated that low dosages (3-5/kg die) can achieve rapid and effective remissions. The Italian experience gathered from numerous centres has been assessed to better understand and manage the use of CyA, especially as regards to tolerance and reliability. There is proven remission in 77% of the cases of plaque psoriasis. The duration of remission, as well as the paucity of side effects, has brought to the concept of cyclical therapy with CyA. The advantages of this mode of therapy are: the possibility of determining the most effective dosage; quantification of the dermatosis-free period; opportunity to personalize treatment and decide its duration; early intervention, should the dermatosis recur; exclusion of side effects and better control over those remaining.