Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports.

With the use of the newer antidepressants beyond the traditional tricyclics and monoamine oxidase inhibitors, newer options in headache prophylaxis are provided as well as the potential for undesirable and even potentially life-threatening interactions between medications. In this article, four patient reports of a specific interaction--the serotonin syndrome--are presented. These events resulted from transitioning headache patients from an older antidepressant (phenelzine) to a newer antidepressant (venlafaxine).

Expansion of the gammadelta T cell subset in vivo during bloodstage malaria in B cell-deficient mice.

Mice rendered B cell-deficient either by chronic anti-mu treatment initiated at birth or by gene knockout (JHD and mu-MT mice) suppressed acute Plasmodium chabaudi infections with a time course similar to intact control mice. Moreover, both kinds of B cell-deficient mice showed a 50- to 100-fold increase in splenic gammadelta T cell number after suppression of parasitemia compared with uninfected B cell-deficient controls; the magnitude of this increase resulted in significantly (P< 0.05) greater numbers of splenic gammadelta T cells in the B cell-deficient mice than in infected B cell-intact controls (about 10-fold). In contrast, the number of splenic CD4+ alphabeta T cells was only slightly elevated (< 2-fold) in both kinds of B cell-deficient mice compared with their intact controls. The number of splenic gammadelta T cells following suppression of P. vinckei parasitemia was approximately ninefold greater in JHD mice than in C57BL/6 controls, whereas similar numbers of splenic CD4+ alphabeta T cells were detected. Maximal numbers of gammadelta T cells were in cell-cycle in both JHD and C57BL/6 mice during descending P. chabaudi parasitemia, but the number of gammadelta T cells in cell-cycle was greater in B cell-deficient mice than in intact controls. Interleukin-10 (IL-10), a potent TH1 cell-suppressive molecule, does not appear to down-regulate the gammadelta T cell response during malaria in B cell-intact mice because the magnitude of the gammadelta T cell response was not significantly greater in IL-10 knockout mice compared with heterozygote controls. These findings collectively indicate that a markedly enhanced expansion of the gamma delta T cell population occurs in the absence of B cells, and this expansion occurs predominantly during acute malaria when parasite burdens are similar in B cell-deficient animals and intact controls.

Susceptibility of rheumatoid and nonrheumatoid synovial cells to antibody-dependent cell-mediated cytotoxicity.

Fibroblastic cells derived from rheumatoid (RA) and nonrheumatoid (N-RA) synovial tissue (synovial cells) were used as targets in assays of antibody-dependent cell-mediated cytotoxicity (ADCC). Synovial cells that had been pretreated with human alloantisera were rapidly lysed by normal human blood mononuclear cells. RA and N-RA synovial cells were equally susceptible to ADCC under these assay conditions. Antibody to autologous synovial cells was not detected in sera from 10 patients with RA by this method of assay.