[The role of atopic background in the genesis of allergic manifestations in intestinal parasitoses]. / Rolul terenului atopic în geneza manifestarilor alergice din parazitozele intestinale.

The previous literature and personal observations showed the predominant role of the atopic background in the appearance of the allergic manifestation in the parasitic infestation and especially in giardiasis. The lot investigated was made of 52 patients with allergic manifestations, also infested with Giardia intestinalis or with Ascaris lumbricoides. The hereditary collateral and personal allergic antecedents and the clearly deficient histaminopexy (1/20) were present in 1/2 of the patients. Summation of the various parameters of atopic background shows its presence in about 2/3 of the patients investigated. Association of the clinical involvement of trophallergens was present in 1/2 of the patients. The results show that the allergic manifestation in the intestinal parasitoses have a multifactorial determination. The atopic background is predominant in their development. These manifestations are often a result of alimentary allergy due to the absorption of alimentary antigens through the enteral mucous membrane affected by the parasite.

Contributions to the study of gastric carcinogenesis.

Investigations were carried out on duodeno- and jejunogastric reflux, gastric juice acidity, microbial population and the concentration of nitrites in 199 subjects. In gastric cancer patients or those with gastric ulcer, chronic atrophic gastritis, stomach resection or more seldom with removal of the gallbladder, a significant increase over normal values of the pH, duodenogastric reflux, microbial flora contamination (especially intestinal) and nitrite concentration was found. In smokers the salivary nitrite concentration was greater than in non-smokers and in direct relationship to gastric concentrations. The parallelism of these alterations suggests a causative relation between them and their presence in diseases or conditions of notorious increased incidence in gastric cancer highlights the direction to be followed in the primary prophylaxis of this disease.

A prospective study of postacute viral hepatitis: the role of HBsAg.

Twenty-two patients with HBsAg positive acute viral hepatitis have been followed-up for two years after the acute episode. Besides the usual clinical, pathological and biological examinations, the following tests were carried out: serum HBsAg: circulating T and B lymphocytes: serum IgG, IgA, IgM: leukocyte migration test to HBsAg; serum complement: autoantibodies, rheumatoid factors, cryoglobulins, alpha-fetoprotein. Serum HBsAg persistence was correlated with some features of the acute episode: protracted clinical form: recurrences or relapses; splenomegaly; decrease of circulating T-lymphocytes; presence of lymphocyte sensibilization to HBsAg. Among the seven serum HBsAg carriers, three developed a chronic hepatitis. The state of healthy chronic HBsAg carrier was associated with high levels of serum IgA (over 300 IU/ml). A chronic hepatitis has been also diagnosed in four out of the 15 patients who cleared their serum HBsAg. The presence, on the one hand, of a chronic hepatitis among the patients who cleared their HBsAg and, on the other hand, its absence in some of the HBsAg carriers suggest that HBsAg persistence is not a sine qua non condition for the development of the chronic liver disease. The onset of autoimmune phenomena due to the disturbance of immunologic homeostasis and perhaps other genetic or environmental factors seemingly allow the perpetuation of a hepatic damage.

Circulating immune complexes in chronic hepatitis as related to the presence of HBsAg.

The relationship between the presence of circulating immune complexes (CIC) and of HBsAg in the serum of patients with chronic liver diseases was studied in a group of 78 patients of whom: 16 with chronic persistent hepatitis (CPH), 39 with chronic active hepatitis (CAH) and 23 with liver cirrhosis (LC). The results showed a clear relationship between the incidence of CIC and the presence of HBsAg in the patients with persistent or active chronic hepatitis but not in those with liver cirrhosis. The presence of HBsAg was detected in the composition of CIC in only part of the cases (10/25 patients). This low incidence suggests that in chronic hepatitis other antigens can also participate in the formation of CIC.

Some aspects of cellular and humoral immunity in bronchial asthma and allergic rhinitis.

Blood lymphocyte subpopulations were investigated in 50 patients with allergic diseases (38 with allergic rhinitis and 12 with allergic bronchial asthma). The total T lymphocyte (Tt) count (E rosette test), the active T lymphocyte (Ta) count (active E rosette test) and the B lymphocyte count (EAC rosette test) were determined and the results were correlated with: 1) lymphocyte sensitization in vitro to different allergens and to PPD; 2) circulating immune complexes; 3) serum histaminopexic capacity. In allergic rhinites a decrease of Tt and B lymphocytes and an increase of Ta lymphocytes was observed. In allergic bronchial asthma the Tt lymphocyte were found reduced. Lymphocyte reactivity to PPD in vitro was present in 100% of the cases and in vitro lymphocyte sensitivity to several allergens was observed in most of the cases. The histaminopexic capacity was absent or low in 75% of the patients with allergic rhinitis and in 66.6% of the patients with allergic bronchial asthma. The involvement of cellular mediated immunity in allergic diseases is discussed.

Active rosette-forming lymphocytes in chronic hepatitis.

Lymphocyte subpopulations (total T lymphocytes, active T lymphocytes, late T lymphocytes, B lymphocytes), leukocyte migration inhibition test, serum HBsAg, serum immunoglobulins (IgG, IgA, IgM) were determined in 15 chronic active hepatitis patients and 35 chronic persistent hepatitis patients (diagnosed clinically, biochemically and histologically) and 10 healthy subjects who had acute B viral hepatitis three years ago. A decreased number of total T lymphocytes has been found in HBsAg-seropositive chronic hepatitis. An increase of relative and absolute number of active T lymphocytes was noticed in HBsAg-seronegative healthy persons with a past history of acute viral hepatitis B.

Effect of silymarin on experimental liver lesions.

The effect of Silymarin (Legalon) upon liver lesions was investigated using four experimental models: In acute galactosamine-hepatitis, Silymarin administration achieved protection of the liver structure (electron-microscopy included), liver cell glycogen, RNA and enzymatic activity, Galactosamine-depressed gluconeogenesis in the isolated perfused rat liver was significantly preserved by Silymarin treatment. In lead and cadmium poisoning the structural damage and histochemical and histoenzymatic changes were partly but significantly prevented. The complex noxious effects of Imuran overdoses were favourably influenced by Silymarin, without diminishing the cytostatic-immunosuppressive action of Imuran.

Immune complexes in chronic hepatitis.

Rheumatoid factors were present in 33.2%, crioglobulins in 47.6%, and anticomplementary assay in 34.2% of cases with chronic active hepatitis. No statistically significant loss of total complement was observed, but its components especially C1 and C3, exhibited lowered titers in 48.6% and respectively 45.7% of 160 cases. The origin, significance and pathogenicity of these factors are discussed in connection with the presence and possible role of the immunologic complexes to the development of chronic liver injury.