Interleukin-10 and interferon-gamma patterns during tuberculosis treatment: possible association with recurrence.

Interleukin (IL) 10 and interferon-gamma (IFN-) levels in induced sputum supernatants of 21 tuberculosis (TB) patients at diagnosis and during chemotherapy were correlated to recurrence rates. IL-10 decreased until day 60 of treatment (T60), and between T60 and T180 it increased again in 7 cases (Pattern 1) and further decreased in 14 cases (Pattern 2). Follow-up of 69 months was performed in 20/21 cases; 6 had recurrence of TB, of which 5/7 (71%) had Pattern 1 and 1/13 (7.7%) Pattern 2 (OR 30.0, 95%CI 2.19411.3, P 0.0072). This was not observed for IFN-. High IL-10 levels at the end of treatment may function as a risk factor for TB recurrence.

Low expression of antigen-presenting and costimulatory molecules by lung cells from tuberculosis patients

Costimulatory and antigen-presenting molecules are essential to the initiation of T cell immunity to mycobacteria. The present study analyzed by immunocytochemistry, using monoclonal antibodies and alkaline phosphatase-anti-alkaline phosphatase method, the frequency of costimulatory (CD86, CD40, CD40L, CD28, and CD152) and antigen-presenting (MHC class II and CD1) molecules expression on human lung cells recovered by sputum induction from tuberculosis (TB) patients (N = 22) and non-TB controls (N = 17). TB cases showed a statistically significant lower percentage of HLA-DR+ cells than control subjects (21.9 ± 4.2 vs 50.0 ± 7.2 percent, P < 0.001), even though similar proportions of TB cases (18/22) and control subjects (16/17, P = 0.36) had HLA-DR-positive-stained cells. In addition, fewer TB cases (10/22) compared to control subjects (16/17) possessed CD86-expressing cells (P = 0.04; OR: 0.05; 95 percentCI = 0.00-0.51), and TB cases expressed a lower percentage of CD86+ cells (P = 0.04). Moreover, TB patients with clinically limited disease (£1 lobe) on chest X-ray exhibited a lower percentage of CD86-bearing cells compared to patients with more extensive lung disease (>1 lobe) (P = 0.02). The lower expression by lung cells from TB patients of HLA-DR and CD86, molecules involved in antigen presentation and activation of T cells, may minimize T cell recognition of Mycobacterium tuberculosis, fostering an immune dysfunctional state and active TB.

Low expression of antigen-presenting and costimulatory molecules by lung cells from tuberculosis patients.

Costimulatory and antigen-presenting molecules are essential to the initiation of T cell immunity to mycobacteria. The present study analyzed by immunocytochemistry, using monoclonal antibodies and alkaline phosphatase-anti-alkaline phosphatase method, the frequency of costimulatory (CD86, CD40, CD40L, CD28, and CD152) and antigen-presenting (MHC class II and CD1) molecules expression on human lung cells recovered by sputum induction from tuberculosis (TB) patients (N = 22) and non-TB controls (N = 17). TB cases showed a statistically significant lower percentage of HLA-DR+ cells than control subjects (21.9 +/- 4.2 vs 50.0 +/- 7.2%, P < 0.001), even though similar proportions of TB cases (18/22) and control subjects (16/17, P = 0.36) had HLA-DR-positive-stained cells. In addition, fewer TB cases (10/22) compared to control subjects (16/17) possessed CD86-expressing cells (P = 0.04; OR: 0.05; 95%CI = 0.00-0.51), and TB cases expressed a lower percentage of CD86+ cells (P = 0.04). Moreover, TB patients with clinically limited disease ( pound1 lobe) on chest X-ray exhibited a lower percentage of CD86-bearing cells compared to patients with more extensive lung disease (>1 lobe) (P = 0.02). The lower expression by lung cells from TB patients of HLA-DR and CD86, molecules involved in antigen presentation and activation of T cells, may minimize T cell recognition of Mycobacterium tuberculosis, fostering an immune dysfunctional state and active TB.

Mechanism of enterovirus involvement in epidemic neuropathy: hypothesis regarding pathophysiology.

During the epidemic of optic and peripheral neuropathy which occurred in Cuba in 1992-1993, viruses antigenically related to the Coxsackie viruses were isolated from cerebrospinal fluid of patients. Concurrently with the virologic studies, epidemiologic, toxicologic, nutritional, immunologic, and histopathologic investigations were also carried out. Although it was demonstrated that the illness was associated with toxic and nutritional risk factors, it has not been possible to identify a specific etiology for the symptoms observed. Taking into consideration the results obtained in all of the various investigations, we have formulated an integral, multifactorial hypothesis which attempts to explain a pathophysiologic mechanism by which the viruses isolated could participate in the pathogenesis of the illness. We propose that the viral agents produce a persistent infection, and the possibility that they may act as mediator of an autoimmune pathogenic process.

Antibodies to poliomyelitis virus in cord blood of neonates born to from mothers in contact or not in contact with the wild virus.

Neutralizing antibodies to polioviruses in cord blood of neonates born from 64 mothers under age 20 and in 53 mothers aged 30 years and over were investigated in order to know and compare the transfer to newborns of antibodies to polioviruses produced by live oral vaccine mainly and those antibodies induced by natural contact with wild poliovirus strains. Total immunity for the two groups was higher than 80% for the three types of polioviruses, with only virus 3 showing an immunity below 80% (77.4%) in mothers aged 30 years and over. Average geometric titers though relatively low may be considered satisfactory. However, there is a statistically significant difference in titers to poliovirus type 2 (24.9) in mothers over age 30 years as compared to those found in mothers below age 20 years (10.8), for which we have found no explanation. It is not deemed necessary for the time being to take special prophylactic measures with these children given the occurrent epidemiologic status quo.

Epidemiological surveillance and control of poliomyelitis in the Republic of Cuba.

Organization and performance of Poliomyelitis Epidemiological Surveillance and control in Cuba are described. Since the first vaccination campaign the average of vaccinated population is of 90% and over. Annual and cyclic epidemic peaks disappeared after oral polio vaccination. During 20 years only 7 sporadic cases were diagnosed; the last one in 1979. Surveillance of disease and immunity of infant population was carried out by clinical examination, isolation techniques for Polio and other enteroviruses and by testing neutralizing antibodies in 0-4 years of age population samples from 1963 to 1979. Satisfactory high antibody levels have been maintained up to date after using different combinations of Polio viruses in vaccines and by having regulated the dose intervals. Subsequent virologic investigation in children under age 3, from nurseries of several provincial capitals, leads us to think that there is no Poliovirus circulation in the country. Behavior of the disease and the laboratory finding indicators reveal very successful results in Poliomyelitis elimination programmes.