Algunas consideraciones sobre los fenómenos de resistencia a antirretrovíricos en la infección VIH / Some considerations regarding resistance mechanism to antiretrovirals in HIV infection

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[The presence of anti-Chlamydia pneumoniae antibodies in peripheral vascular and neurological disorders]. / Presencia de anticuerpos anti-Chlamydia pneumoniae en procesos vasculares periféricos y neurológicos.

OBJECTIVES: To make a retrospective analysis of the synthesis of antibodies to the MOMPS and LPS antigens of Chlamydia pneumoniae in patients with occlusive disease of the peripheral arteries (ODPA) and multiple sclerosis (MS). PATIENTS AND METHODS: We studied 190 samples of plasma from patients included in the following groups: group 1:66 samples from 66 patients with ODPA; group 2:74 samples from 31 patients with MS (20 remittent-relapsing and 11 secondarily progressive), followed over time; and group 3:50 samples from persons acting as controls. In all cases determinations were made using ELISA, of the IgG anti-MOMP and the IgG and IgA anti-LPS. Comparison of the continuous variables was made using the Mann-Whitney U Test. Discrete variables were analysed using the exact bilateral Fisher Test. The Wilcoxon Test over ranges was used to compare the evolution of antibodies in the patients with MS. RESULTS: The percentage of positive results in groups 1 to 3 for anti-LPS IgG were: 24.6%, 18.9% and 20.8%, respectively, with no differences between patients and controls; nor were there any differences with IgA (29%, 29.7% and 25%, respectively). However differences were seen in the anti-MOMP IgG between patients and controls (group 1:80.3%, group 2:37.8% and group 3: 33.3%). In patients with MS the results of the evolution of the antibodies did not reflect a uniform tendency of the levels of the different antibodies. CONCLUSION: A higher level of IgG anti-MOMP was seen in ODPA and MS, although this did not occur with anti-LPS or IgA.

Presencia de anticuerpos anti-Chlamydia pneumoniaeen procesos vasculares periféricos y neurológicos / The presence of anti-chlamydia pneumonia antibodies in peripheral vascular and neurological disorders

Objetivos. Analizar, retrospectivamente, la síntesis de anticuerpos frente a los antígenos MOMP y LPS de Chlamydia pneumoniae en pacientes con enfermedad oclusiva de las arterias periféricas (EOAP) y esclerosis múltiple (EM). Pacientes y métodos. Se estudiaron 190 muestras de suero procedentes de enfermos que se incluyeron en los siguientes grupos: grupo 1: 66 muestras de otros tantos enfermos con EOAP; grupo 2: 74 muestras de 31 pacientes con EM (20 remitente-recidivante y 11 secundariamente progresiva) seguidos en el tiempo, y grupo 3: 50 muestras de sujetos controles. En todas se determinaron, mediante ELISA, la IgG anti-MOMP y la IgG e IgA anti-LPS. La comparación de las variables continuas se realizó con la prueba U de Mann-Whitney. Las variables discretas se analizaron con la prueba de Fischer bilateral exacta. Para comparar la evolución de los anticuerpos en los enfermos con EM se utilizó la prueba de rangos con signo de Wilcoxon. Resultados. Los porcentajes de positividad, en los grupos 1 a 3, para la IgG anti-LPS fueron: 24,6 por ciento, 18,9 por ciento y 20,8 por ciento, respectivamente, sin que existieran diferencias entre enfermos y controles. Tampoco hubo diferencias para la IgA (29 por ciento, 29,7 por ciento y 25 por ciento, respectivamente). Sí se hallaron diferencias en la IgG anti-MOMP entre enfermos y controles (grupo 1: 80,3 por ciento, grupo 2: 37,8 por ciento y grupo 3: 33,3 por ciento). En los enfermos con EM, los resultados de la evolución de los anticuerpos no reflejaron una tendencia uniforme de las tasas de los diferentes anticuerpos. Conclusión. Se encontró una mayor tasa de IgG anti-MOMP en la EOAP y la EM; sin embargo, esto no ocurrió para la IgG e IgA anti-LPS (AU)

Chlamydia pneumoniae y enfermedad cerebrovascular / Chlamydia pneumoniae and cerebrovascular disease

Introducción. La Chlamydia pneumoniae se ha relacionado con la enfermedad arteriosclerótica extracraneal, tanto por estudios seroepidemiológicos como histológicos. Realizamos un estudio de casos y controles para determinar la seroprevalencia de infección crónica por C. pneumoniae, y la detección de la bacteria en biopsias arteriales. Pacientes y métodos. El grupo de casos estuvo formado por 26 pacientes con estenosis carotídea subsidiaria de tratamiento quirúrgico. Los controles fueron 50 individuos sometidos a cirugía de varices. Se ajustaron los grupos por edad, sexo y tabaquismo. De ambos grupos se obtuvieron muestras serológicas, donde se determinaron anticuerpos IgG frente a MOMP de C. pneumoniae por microinmunofluorescencia y ELISA. Se obtuvo biopsia arterial en los casos de placa de ateroma carotídeo y en los controles de la arteria pudenda externa. Sobre las biopsias se realizó reacción en cadena de polimerasa utilizando los primers: HL-1, HM-1 y HR-1. Se midió el nivel de fibrinógeno como marcador de inflamación crónica. Resultados. La seroprevalencia de infección crónica por C. pneumoniae por microinmunofluorescencia para IgG>1:32 fue: 69,23 por ciento en casos y 24 por ciento en controles (OR: 7,12; IC al 95 por ciento: 2,47-20,48). Por ELISA la seroprevalencia fue: 76,92 en casos y 16 por ciento en controles (OR: 17,5; IC al 95 por ciento: 5,35-57,23). El ADN de C. pneumoniae se detectó en 18 casos (69,23 por ciento) y en 6 controles (12 por ciento) (p< 0,0001, ji al cuadrado). No se pudo establecer correlación entre los resultados serológicos e histológicos. Los niveles de fibrinógeno no mostraron diferencias entre los grupos. Conclusión. Nuestros resultados apoyan la hipótesis sobre la participación de C. pneumoniae en la etiopatogenia de la arteriosclerosis cerebral extracraneal (AU)

[Chlamydia pneumoniae and vascular pathology]. / Chlamydia pneumoniae y patología vascular.

An updating of the microbiological and diagnostic characteristics of Chlamydia pneumoniae is carried out, and a hypothesis formulated for its probable role in the production of the atheromatous plaque. Furthermore, the immunological results obtained from patients with peripheral vascular pathology, pneumonia from C. pneumoniae, or other genital processes from C. trachomatis, and a healthy control group are included. The presence of C. pneumoniae was revealed by PCR techniques in biopsies from patients with vascular pathology in a high percentage, particularly in samples from the carotid artery (74%) or the aortic wall (83%). The true pathogenic power of Chlamydia in vascular processes in questioned.

Antigenic and genetic structure of Borrelia burgdorferi.

Lyme borreliosis is a disease caused by the spirochaetes Borrelia burgdorferi, Borrelia afzelii and Borrelia garinii and it is transmitted by ticks. Most of the proteins (outer surface proteins, flagellar proteins and other uncertain location proteins) have a strong antigenic variability. Osp A protein genetic and serological studies facilitated the differentiation of seven serotypes strongly correlated with the known genospecies. The genetic structure of these spirochaetes included a large linear chromosome, several linear microchromosomes as well as a number of circular plasmids.

[Study of viral replication in HbsAg positive chronic hepatitis]. / Estudio de la replicaciíon vírica en las hepatitis crónicas AgHBs positivo.

Viral replication seric markers (VRSM), (BeHAg, BcHAg, and DNA-VHB) and the hepatic tissue BcHAg of thirty four patients suffering from chronic hepatopathies (6 PCH, 18 ACH, and 10 cirrhosis) were investigated. The greatest incidence of RVSM was observed in PCH. The combined study using all the markers demonstrated a positive correlation: DNA-VHB and BeHAg (p less than 0,001); DNA-VHB and BcHAg (p less than 0,001); BeHAg and BcHAg (p less than 0,001). The same result was obtained when comparing BcHAg (n) with the rest of RVSM: DNA-VHB (p less than 0,001), BeHAg (p less than 0,001) and seric BcHAg (p less than 0,01). Patients with a most intense histologic activity according to the Knodell index, presented a higher ratio of positive nuclei for BcHAg. The conclusion is that there is a good correlation amongst replication markers, specially hepatic BcHAg and DNA-VHB.

[Changes in phagocytosis of aerobic bacteria by neutrophils after exposure to subinhibitory concentrations of aztreonam and ciprofloxacin]. / Modificación de la fagocitosis de bacterias aerobias por los neutrófilos tras la exposición a concentraciones subinhibitorias de aztreonam y ciprofloxacino.

In the present research work we are performing a study on the effect of the antibiotic concentrations low minimal inhibitory concentration of aztreonam and ciprofloxacin on phagocytosis of aerobic bacteria by neutrophils (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa). Both antibiotics induced an increased of phagocytosis by similar mechanisms. In our assay aztreonam and ciprofloxacin would not act directly on granulocyte but they would affect the bacteria increasing the opsonization and phagocytosis.

The risk of infection with hepatitis B virus in relation to length of hospital employment.

A sero-epidemiological study was carried out on a representative sample of employees of the Hospital Clinico 'San Cecilio' in an attempt to quantify the influence of the time spent working in the hospital on the risk of becoming infected by hepatitis B virus. The results show that the rate of infection by HBV is directly proportional to the length of employment in the hospital, with a probability of infection between 0.6% and 1.4% for each working year.

Detection of specific IgG and IgM antibodies in the haemagglutination inhibition test and the enzyme-linked immunoassay for the diagnosis of rubella infection.

A study has been carried out on the sera of 710 women who wished to know their state of rubella immunity using haemagglutination inhibition (HAI) and enzyme-linked immunoassay (ELISA) techniques. The majority of the women presented no symptoms. The ability of HAI to detect low antibody levels (1:8, 1:16) appears to be greater than that of Rubazyme ELISA IgG, employing the recommendations of the manufacturers. The correlation between HAI and IgG values above HAI titres of 1:16 is nearly 100%. In an additional study of 17 primary infections in pregnant women with definite rubella symptoms, the total titre of antibodies was determined by HAI and IgG and specific IgM with ELISA Rubazyme in successive samples. In four cases, IgM was clearly positive and no increase in either HAI or IgG antibodies could be demonstrated over three successive samples taken at an interval of 15 to 20 days. Therefore, we consider it necessary to determine IgM antibodies (evaluating these in the absence of the rheumatoid factor) in every doubtful case occurring in pregnant women, irrespective of whether clinical signs are present or not.

[Immunological profile against the hepatitis B virus in different population groups (author's transl)]. / Determinación del perfil immunológico frente al virus HVB en grupos de población.

To study the immunological profile against the hepatitis B virus 742 sera (107 from the Renal Unit and 635 from other hospital services) were assayed for HBsAg, HBsAc, and HBcAc. The results obtained appear to indicate that the simultaneous determination of the three tests is unnecessary for diagnosis, although it is important for follow-up and prognosis. The isolated measurement of HBsAg is a good diagnostic test, but although it appears early it lasts little, a reason why it should perhaps be complemented with the other tests when considering the time factor. If only one technique is to be made available HBcAc determination seems necessary because it appears simultaneously with the HBsAg and it persists for a long time thereafter. A high degree of positivity of HBsAc and HBcAc was found in dialysis patients, a fact apparent also in the other population groups.