RESUMO
Heparinised blood samples were obtained from 20 patients with chronic plaque psoriasis and from 13 age-matched healthy controls. After preliminary titration, mononuclear cells separated over Ficoll-Tryoson were cultured for 5 days with 10 microg ml(-1) of 15 mycobacterial preparations, or with pokeweed mitogen and concanavalin A. Stimulation indices were determined for each reagent and means were determined for patients and controls. Results for patients showed a striking reduction of responsiveness to mycobacteria, apparently due to loss of responses to group i, common mycobacterial antigens, and no differences in responses to mitogens. These observations relate psoriasis to certain other diseases, notably mycobacterial infections, rheumatoid arthritis, Chagas' disease and human immunodeficiency virus infection. The observations may be relevant to the aetiology of psoriasis, and to potential immunotherapy for the disease.
Assuntos
Antígenos de Bactérias/imunologia , Ativação Linfocitária , Mycobacterium/imunologia , Psoríase/imunologia , Linfócitos T/imunologia , Adulto , Células Cultivadas , Concanavalina A/imunologia , Feminino , Humanos , Masculino , Análise por Pareamento , Mitógenos de Phytolacca americana/imunologia , Psoríase/sangueRESUMO
A placebo-controlled study of immunotherapy with Mycobacterium vaccae for chronic plaque psoriasis showed improvement in the psoriasis area severity index in 19 of 21 immunotherapy recipients (P<0.005). Minor improvement, not reaching statistical significance for the group, occurred in nine of 14 placebo recipients. There were losses to follow-up and the placebo used, tetanus toxoid, was not ideal. Clinical improvement after immunotherapy persisted for 6 months and another injection of the immunotherapeutic given to a few volunteers from either group resulted in benefits lasting a year. Lymphoproliferative tests were carried out at each clinic visit, and on 50 matched controls. Starting with reduced responses to mycobacterial antigens and concanavalin A, both treatment groups showed a fall after 3 months, and diverged at 6 months with M. vaccae recipients rising to values similar to those of healthy controls, whereas placebo recipients continued to fall. Conclusions reached were that immunotherapy with M. vaccae gave long-lasting clinical benefit to most patients, with minimal side effects. This accompanied a return towards normal cellular immune responsiveness to mycobacterial antigens, which did not follow the use of the placebo.
Assuntos
Antígenos de Bactérias/imunologia , Proteínas de Bactérias , Imunoterapia Ativa , Mycobacterium/imunologia , Psoríase/terapia , Adulto , Anticorpos Antibacterianos/sangue , Células Cultivadas , Chaperonina 60 , Chaperoninas/imunologia , Concanavalina A/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Ativação Linfocitária/imunologia , Mycobacterium avium/imunologia , Mycobacterium tuberculosis/imunologia , Psoríase/imunologia , Índice de Gravidade de DoençaRESUMO
This paper reports a study performed on 10 lepromatous leprosy outpatients and on the same number of age- and sex-matched contacts. All of the lepromatous patients were hypocalcemic, but plasma levels of ionized calcium and the acid-base status were normal. The average daily food intake assessed through a questionnaire revealed adequate nutrition of patients and controls. Plasma proteins and 1,25-dihydroxyvitamin D3 and intestinal absorption of calcium were discarded as the causes of the hypocalcemia. In vitro experiments designed to investigate the effect of hydrogen ion concentration on the equilibrium between calcium ion and proteins revealed that, at normal pH values, plasma proteins from lepromatous leprosy patients bind a smaller fraction of total plasma calcium than those from controls. This phenomenon produces a normal concentration of ionized calcium that determines a normal parathyroid status as indicated by the normal urinary excretion of hydroxyproline and plasma concentrations of alkaline phosphatase (total and bone isoenzyme) and tartrate-resistant acid phosphatase.
Assuntos
Proteínas Sanguíneas/metabolismo , Cálcio/metabolismo , Hipocalcemia/etiologia , Hanseníase Virchowiana/complicações , Absorção , Fosfatase Ácida/sangue , Fosfatase Alcalina/sangue , Calcifediol/sangue , Cálcio/sangue , Cálcio da Dieta/administração & dosagem , Cálcio da Dieta/farmacocinética , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Ingestão de Alimentos , Feminino , Humanos , Concentração de Íons de Hidrogênio , Hidroxiprolina/urina , Hanseníase Virchowiana/sangue , Hanseníase Virchowiana/metabolismo , Masculino , Pessoa de Meia-Idade , Ligação Proteica , Albumina Sérica/análise , Albumina Sérica/metabolismoRESUMO
Se comunica un caso de reticulohistiocitosis multicéntrica en una mujer que inició su enfermedad con astenia y manifestaciones articulares, instalando luego lesiones en piel cuya biopsia estableció el diagnóstico. Los análisis de laboratorio fueron normales incluyendo perfil lipídico, función tiroidea e inmunológico. Ante el fracaso del tratamiento con aspirina y otros antiinflamatorios se instituyó corticoideoterapia a dosis inmunosupresoras, con rápida y excelente respuesta. Dado que no existen alteraciones inmunológicas demostradas en la R.H.M., los autores proponen que los corticoides podrían haber actuado por su efecto antiinflamatorio y sugieren usar en nuevos casos dosis menores (antiinflamatorias) de corticoides (AU)
Assuntos
Pessoa de Meia-Idade , Humanos , Feminino , Aspirina/uso terapêutico , Corticosteroides/uso terapêutico , Doenças Linfáticas/tratamento farmacológicoRESUMO
Se comunica un caso de reticulohistiocitosis multicéntrica en una mujer que inició su enfermedad con astenia y manifestaciones articulares, instalando luego lesiones en piel cuya biopsia estableció el diagnóstico. Los análisis de laboratorio fueron normales incluyendo perfil lipídico, función tiroidea e inmunológico. Ante el fracaso del tratamiento con aspirina y otros antiinflamatorios se instituyó corticoideoterapia a dosis inmunosupresoras, con rápida y excelente respuesta. Dado que no existen alteraciones inmunológicas demostradas en la R.H.M., los autores proponen que los corticoides podrían haber actuado por su efecto antiinflamatorio y sugieren usar en nuevos casos dosis menores (antiinflamatorias) de corticoides