IgG-autoantibodies against oxidized low-density lipoprotein in ischemic stroke onset

In the arterial wall oxidized Low Density Lipoprotein is a pro-inflammatory chemotactic factor for macrophages and immunoreactive cells. The association between oxidized low density lipoprotein (oxLDL) and stroke is suspected, but not established. The plasma oxLDL level in patients with ischemic stroke would be increased and could serve as a marker of ischemic stroke. Serum oxLDL concentrations were determined in 267 ischemic stroke patients (mean age of 72.6.6 +/- 8.6 years) and in 125 age matched controls. Anti-oxLDL antibodies were measured by ELISA. It was investigated the relationship between the serum titers of anti-oxLDL and ischemic stroke onset (within 24 hours) as compared to healthy control subjects. Thirty-one percent (82/267) of the patients tested had higher anti-oxLDL levels than controls. Mean anti-oxLDL titer was 544.6 +/- 48.2 mU/mL vs 416.2 +/- 31.4 mU/mL respectively, statistically significantly higher than those of controls (p < 0.001). The high concentrations of IgG anti-oxLDL contribute to a cascade of events characterized as immunoinflammatory reactions of ischemic stroke. It is probable that humoral immunity plays a significant role in the very initial stages of ischemic stroke. We can deduce that immune response to oxLDL is of variable importance, regarding pathophysiologic process in the ischemic stroke.

Evaluation of granulocyte elastase as a sensitive diagnostic parameter of inflammation in first ischemic stroke

Several traditional vascular risk factors are associated with proinflammatory alterations, including leukocyte activation, and predispose cerebral vasculature to thrombogenesis on inflammatory stimulation. PMN elastase derived from the activated neutrophils might play an important role in injury. This study tries to elucidate the involvement of activated polymorphonuclear neutrophil proteolytic activity in the pathophysiology of ischemic stroke. Levels of PMN elastase/alpha 1-proteinase inhibitor complex (PMN-E/alpha1-PI) were measured in 145 patients (mean age 72.4+/-6.3) with first ischemic stroke from the onset day (day 0) to 7 days after onset (day 7) and 260 control subjects drawn matched for age, sex. Quantitative estimation of the plasma levels of the PMN-E/alpha1-PI complex was carried out with a highly sensitive enzyme-linked immunoassay (ELISA). Plasma PMN elastase levels were statistically significantly higher on 7 day patients (384.7+/-31.4 microg/L vs 216.5+/-26.8 microg/L on day 0; p<0.01) than in those without ischemic stroke (67.4+/-5.2 microg/L). Plasma PMN elastase may be a well-characterised and sensitive inflammation marker, and it is associated with endothelial dysfunction. PMN elastase can be used as a measure for the activity of granulocytes during an inflammatory response. Furthermore it may be possible to treat such disorders with proteinase inhibitors.

Anticardiolipin antibodies, recurrent stroke and vascular events: a prospective study on 210 patients

The presence of anticadiolipin antibodies (aCL) has been associated with vascular occlusive events. However, the role of aCL in predicting ischemic events, particularly ischemic stroke, is controversial. In order to determine if aCL is either associated with thrombotic disease or with an increased risk of recurrent stroke or thrombotic events, we performed a prospective study on a cohort of Romanian patients with stroke that were tested for aCL. We studied the prevalence of cardiovascular risk factors in the two subgroups (aCL positive or aCL negative) considering the age of patients and the medical evolution in the first 12 months after the index stroke. Globally, neither the antecedents of thrombotic events or abortions, nor the clinical or biological profile or the recurrence of vascular events showed any significant difference between the group with or without aCL. Only in two patients the criteria for antiphospholipid syndrome were fulfilled. In 37% of cases, there was a variability of aCL positive titers at 8 weeks after the index event. This raised the necessity to isolate a subpopulation with higher risk of ischemia in the presence of aCL, and the need of more specific subtypes of antiphospholipid antibodies as a marker of thrombophilia.

High prevalence of anticardiolipin antibodies in patients with asymptomatic hepatitis C virus infection associated acute ischemic stroke

Anticardiolipin antibody (aCL) is considered to be one of the contributory factors in the development of acute ischemic stroke. Chronic hepatitis C virus infection (HCV) and the antiphospholipid syndrome are two conditions that have increased the risk of stroke. The purpose of this study was to investigate the prevalence of anticardiolipin antibodies in patients with asymptomatic chronic hepatitis C virus infection-related acute ischemic stroke. Fifty eight patients (39 women, 19 men), mean age 62 years (range 46-77 years) with acute ischemic stroke and asymptomatic chronic hepatitis C virus infection were studied; all were positive for anti-HCV antibodies. A control group of 36 patients (20 women, 16 men), mean age 58 years (range 44-75 years) with ischemic stroke without HCV were also tested. Both anti-HCV antibodies and IgG aCL antibodies were measured by enzyme-linked immunosorbent assay (ELISA). The significantly higher levels of IgG aCL antibodies were detected in serum samples of 27/58 (46%) patients with acute ischemic stroke and asymptomatic chronic hepatitis C virus infection. The control group had much lower levels of IgG aCL antibodies in 2/36 (5%) patients. This study clearly shows a high prevalence of IgG aCL antibodies in the serum of patients with acute ischemic stroke and HCV. Mean levels of serum IgG aCL antibodies were significantly higher among the HCV patients with acute ischemic stroke than the patients with acute ischemic stroke without HCV (94.8+/-7.6 GPL U/mL as compared to 27.2+/-3.2 GPL U/mL), p<0.001. We showed that a number of chronic hepatitis C virus infection-related ischemic strokes is associated with the presence of anticardiolipin antibodies, a condition predisposing to coagulopathy. These results suggest that anticardiolipin antibodies associated with HCV may be an important marker for acute ischemic stroke. The higher prevalence and titre of IgG aCL antibodies in patients with HCV suggests that these humoral factors might be involved in the pathogenesis of ischemic stroke.

Cerebral ischemic attack secondary to hepatitis C virus infection

Hepatitis virus C (HCV) is worldwide a health problem, which may lead to serious complications. The aim of this study was to correlate the onset of the cerebral ischemic attack accompanied by mixed cryoglobulinemia, with the chronic hepatitis C virus infection. These studies were carried out in 12 patients with serologic/virusologic confirmed chronic HCV infection associated with ischemic stroke. Ischemic stroke occurred in equal proportion in women and men. The patients did not know of HCV infection diagnosis at that moment. All patients had type II mixed monoclonal cryoglobulinemia, hypergammaglobulinemia with polyclonal IgG and monoclonal IgM, blood hyperviscosity, high level of cryocrit, positive rheumatoid factor, normal levels of serum transaminases, negative serum hepatitis B surface antigen (HBs Ag), negative anti HBc antibodies, positive HCV antibodies, positive serum RNA HCV, decreased serum C3 and C4 levels, antinuclear antibodies-false positive. Immunological tests for autoantibodies, namely, anti-Sm antibody, anti-RNP antibody, anti-SS-A and -B antibodies, and anti-Scl antibody were not detectable due to high level serum cryoglobulin. Cryoglobulin was washed several times with an isotonic chloride solution for purification, then subject to immunological analyses. The purified cryoglobulin contained monoclonal IgM-kappa, polyclonal IgG. Cryoglobulinemia is a risk factor for ischemic stroke, as it causes arterial thrombosis.

Study of anti-striational and anti-thyroid antibodies in patients with myasthenia gravis

The study was carried out in 74 patients out of whom 46 with generalized myasthenia gravis and 28 with the ocular form of disease--all in acute state, ranging in Osserman's severity scale between I-IV; the age at onset of disease varied between 18-79 years. It showed anti-striational antibodies in 31% of the patients and anti-thyroid antibodies in 40%, as compared with 41 controls. Likewise it was observed that the presence of anti-striational antibodies with significant high values was associated with the presence of thymomas in 16 generalized myasthenia gravis patients and in 3 ocular myasthenia gravis patients (p < 0.001). Anti-thyroid antibodies were more frequently observed in ocular myasthenia gravis (23 cases) as compared to generalized myasthenia gravis (7 cases) with significant high levels (p < 0.001). The results obtained showed that the study of anti-striational antibodies can be of great utility in the diagnosis of thymoma, and that the study of anti-thyroid antibodies can be of great utility to sustain the clinical diagnosis of ocular myasthenia gravis. The presence of anti-striational and of anti-thyroid antibodies showed a basic alteration of immunoregulatory mechanisms of maintaining immune tolerance in myasthenia gravis patients.

Clinical relevance of antikeratin antibodies in rheumatoid arthritis and symmetric polyarthritis associated with hepatitis C infection

Chronic hepatitis C virus (HCV) has been linked to extrahepatic autoimmune phenomena. In addition a variety of autoantibodies were found in patients with HCV. This study was performed to assesss the clinical relevance of antikeratin antibodies in rheumatoid arthritis (RA) and in patients with symmetric polyarthritis associated with hepatitis C infection. Serum antikeratin antibodies were evaluated in 3 different groups of patients; all were rheumatoid factor (RF) seropositive: Group 1: 31 patients with HCV associated symmetric polyarthralgia or arthritis. Group 2: 28 patients with RA (modified ACR criteria for probable RA). Group 3: 16 patients with autoimmune disorders other than RA. Seventeen healthy individuals matched for age and sex served as controls. In our study, 75 patients who were rheumatoid factor positive (measured by ELISA, the cutoff was established to 20 U/mL) were tested for antikeratin antibodies using an indirect immunofluorescence technique with 1:10 serum dilution. Antikeratin antibodies were detected in 18/28 (64%) patients with true RA and only 3/31 (9%) patients with HCV-related arthritis (p < 0.0001). Antikeratin antibodies were observed in 3/16 (18%) patients of group 3 (p < 0.05). Antikeratin antibodies were not found in the sera of the healthy controls.

Lipid peroxidation and catalase in diabetes mellitus with and without ischemic stroke

Production of reactive oxygen species (ROS) increased in diabetic patients and oxidative damage may contribute to the development of diabetic complications. Malondialdehyde is known as marker of the oxidative damage. Catalase is one of antioxidative factors involved in elimination of ROS In this study, the plasma level of lipid peroxides and plasma catalase activity in 315 patients with diabetes mellitus were assayed. We also included 114 non-diabetic healthy controls whose age, sex were matched to the diabetic patients. The plasma levels of lipid peroxides (LPO) were determined by spectrophotometric method modified by Satoh and Yagi. Lipid peroxidation was estimated by the plasma level of malondialdehyde (MDA). In controls mean value of plasma lipid peroxides was 1.329 +/- 0.118 nmol/ml. In diabetic patients with ischemic stroke MDA level was 2.919 +/- 0.182 nmol/l; p<0.001, and in patients without ischemic stroke the MDA level was 2.329 +/- 0.149 nmol/l; p<0.05; between diabetic patients with ischemic stroke and patients without ischemic stroke p<0.01. The high level of lipid peroxides might induce a self-maintained chronic process which, in time, might lead to the aggravation of the macro- and microangiopathy in diabetes. The plasma levels of catalase were determined by Goth's spectrophotometric method. In 114 healthy persons the mean value of plasma catalase (CAT) activity was 115.3 +/- 14.5 MU/l with less plasma catalase for females (108.7 +/- 12.4 MU/l) than for males (118.9 +/- 16.6 MU/l). Mean value of plasma CAT was (102.4 +/- 12.7 MU/l in patients with ischemic stroke, p<0.001 and 116.3 +/- 18.7 MU/l in patients without ischemic stroke, p<0.05); between diabetic patients with ischemic stroke and patients without ischemic stroke p<0.01. Our results revealed a decrease in plasma CAT activity in patients with diabetes mellitus and ischemic stroke as compared to patients with diabetes mellitus without ischemic stroke. We can conclude that in diabetic patients the decrease in plasma CAT activity is the consequence of oxidative modifications. These results suggest that diabetic patients have significantly increased oxidative damage.

Sex pheromone of the vine mealybug, Planococcus ficus in Israel: occurrence of a second component in a mass-reared population

Two pheromonal components were detected in airborne collections from the vine mealybug Planococcus ficus (Signoret) (Hemiptera: Pseudococcidae) mass-reared on potato sprouts. The compounds were identified as (S)-lavandulyl senecioate (I) and (S)-lavandulyl isovalerate (II) by GC and GC-MS by comparison with synthetic standards. Chiral GC analysis on a cyclodextrin column established their chirality. Compound I was identified recently as the sex pheromone of P. ficus in California. The attraction of vine mealybug males to both components I and II was demonstrated in a Petri dish bioassay and in a flight assay in the rearing chamber. Indoors, both compounds displayed a similar level of attractiveness to the mass-reared males. However, trials in a vineyard indicated that feral males were attracted only to compound I. Reanalysis of the airborne pheromone indicated that laboratory first generation daughters of females that were collected in the vineyard produce only (S)-lavandulyl senecioate (I). The relative amount of (S)-lavandulyl isovalerate (II) increased gradually in each subsequent generation of P. ficus reared on potatoes. These findings indicate that feral P. ficus mealybugs produce and respond only to (S)-lavandulyl senecioate (I), whereas mealybugs that were reared in the laboratory on potato sprouts produce and respond to both (S)-lavandulyl senecioate (I) and (S)-lavandulyl isovalerate (II).

Investigation of TNF-alpha, IL-6, IL-8 and of procalcitonin in patients with neurologic complications in sepsis

Some mediators of inflammation are associated with sepsis, involving nervous system. Proinflammatory cytokines, TNF-alpha, IL-6, and IL-8, and procalcitonin (PCT), proinflammatory protein, were investigated in patients with neurologic complications in sepsis. TNF-alpha, IL-6, IL-8, and PCT were prospectively investigated in 62 patients with neurologic complications in sepsis. TNF-alpha and IL-6 were studied both in serum as in the CSF, IL-8 and PCT were studied only in serum. TNF-alpha, IL-6, and IL-8 were studied by ELISA (R & D Systems), and the PCT by immunoluminometric assay (BRAHMS). Mean value of TNF-alpha in serum was 578+/-214 pg/ml, and in CSF was 458+/-167 pg/ml (p<0.01). Mean value of IL-6 in serum was 749+/-213 pg/ml, and in CSF was 617.5+/-182 pg/ml (p<0.01). Mean value of IL-8 in serum was 332+/-196 pg/ml (p<0.01). Mean value of PCT in serum was 80+/-16 ng/ml (p<0.01). The investigated parameters do not permit the identifying of cases with neurologic complications. The increased correlation coefficient between cytokines in serum and in CSF suggests the damage of the blood-brain barrier. The raise of PCT in serum, induced by TNF-alpha and IL-6, is an argument of the severity of sepsis.

Study of anti-cardiolipin and anti-beta2-glycoprotein I antibodies in patients with ischemic stroke

The study of IgG and IgM anti-cardiolipin antibodies (IgG/IgM aCL) is now well accepted and is routinely used in the risk assessment of various conditions associated with thrombosis. The aim of the study was to define whether the investigation of aCL is sufficient by itself to evaluate a risk of ischemic stroke. Frequency of aCL and anti-beta2-glycoprotein I (beta2-GPI) antibodies was prospectively investigated in 96 patients with ischemic stroke and in 119 controls by ELISA. In ischemic stroke patients IgG aCL were found in 36%, the IgM-aCL were found in 58%, the IgG-IgM-aCL were found in 43%. The levels of both antibodies were higher in patients with ischemic stroke than in controls (p < 0.01). In controls, IgM-aCL were positive in 2% and IgG-aCL antibodies were negative. IgG-beta-GPI Abs were found in ischemic patients in 19% and IgM-beta2-GPI Abs in 37%. The IgG-IgM-anti-beta2-GPI Abs were found in 24% patients. They were negative in controls. There was a correlation between levels of aCL and anti-beta2-GPI Abs for both isotypes (r = 0.728) but not between IgG- and IgM-beta2-GPI Abs. IgG-aCL test was more sensitive for ischemic stroke than the IgG-beta2-GPI Abs test (71.4%, respectively 65.7%) but less specific (66.8%, respectively 88.6%). The sensitivity of anti-beta2-GPI Abs for ischemic stroke was increased when both isotypes were tested. These results showed that aCL and anti-beta2-GPI Abs could be pathogenetically important for ischemic stroke and that anti-beta2-GPI Abs testing might contribute to a better evaluation of ischemic stroke.

IgG anti-cardiolipin antibodies-markers of inflammation in diabetic patients with ischemic stroke

Some researchers investigated the role of anticardiolipin antibodies in the pathogenesis of the ischemic stroke. The objective of the study was to evaluate the relationship between the prevalence of the IgG anti-cardiolipin antibodies (IgG aCL) and ischemic stroke in patients with diabetes mellitus. IgG aCL were prospectively investigated in 87 diabetic patients with ischemic stroke (mean age 78.5 years) and in 68 diabetic patients without ischemic stroke (mean age 72.8 years). IgG aCL were determined by ELISA. Twenty-three out of 87 diabetic patients without ischemic stroke had IgG aCL and 25 out of 68 diabetic patients without stroke had IgG aCL. The IgG aCL titer did not differ significantly between patients with ischemic stroke and those without stroke (p>0.05). Our data showed that IgG aCL are not a risk factor for ischemic stroke in diabetic patients. Both patients with diabetes and those with diabetes and ischemic stroke had serum IgG aCL. IgG aCL indicate inflammatory conditions in these pathologies.

Study of some markers of inflammation in atherothrombotic pathogenesis of acute ischemic stroke

Recent researches focused on the study of the role of the inflammation in the atherothrombotic pathogenesis of the acute cerebral ischemia. The aim of the study was to identify some acute phase proteins with possible role in the pathogenesis of the ischemic stroke. Some acute phase proteins were prospectively investigated by standard methods in sera of 78 patients with ischemic stroke in the first admission day. There were two groups according to neurological deficit one month after the ischemic stroke: good outcome and poor outcome. In the second group mean value of C-reactive protein (CRP) was 0.122 +/- 0.06 g/l (p < 0.01), mean value of C3 was 2.61 +/- 0.36 g/l (p < 0.01), mean value of C4 was 0.73 +/- 0.07 g/l (p < 0.05), mean value of alpha 1-antitrypsin (AAT) was 4.9 +/- 0.46 g/l (p < 0.01), mean value of alpha 1-antichymotrypsin (ACT) was 0.33 +/- 0.04 g/l (p < 0.01), mean value of alpha 1-acid glycoprotein (AGA) was 1.12 +/- 0.15 g/l, (p < 0.05), mean value of fibrinogen was 2.6 +/- 0.22 g/l (p < 0.01), mean value of haptoglobin was 2.8 +/- 0.33 g/l, (p < 0.05), mean value of transferrin was 2.8 +/- 0.26 g/l (p < 0.05), mean value of ferritin was 238 +/- 22.42 microg/l (p < 0.001), mean value of fibronectin was 2.14 +/- 0.17 g/l (p < 0.05), mean value of ceruloplasmin was 1.23 +/- 0.24 g/l (p < 0.01). High significant values of ferritine and significant values of CRP, C3, AAT, ACT and fibrinogen were observed in patients with poor outcome. The presented data suggest that the studied markers are useful to appreciate the role of the inflammatory reaction in the atherothrombotic pathogenesis of the ischemic stroke.

Silicosis related changes in serum copper

To ascertain the diagnostic and prognostic value of serum copper in silicosis, this trace element was determined in 68 patients (all males), aged varied between 20 and 60 years (mean age 44 +/- 2.3 years). The same determination was carried out in a control group of 35 healthy subjects. The patients were distributed into three subgroups according to the evolutive stage of disease. The mean value of serum copper increased gradually from stage to stage reaching in stage III the highest copper mean value (p < 0.01). Serum copper concentrations also increased with the severity of the disease. These changes suggest that copper is directly responsible for the lung changes in silicosis and can be used as an indicator of the severity of the inflammatory reaction.

Considerations on the changes of certain immunologic cells in silicosis

Cell-mediated immunity was estimated in a group of 68 patients divided into three subgroups according to the evolutive stage of disease. It was demonstrated that in silicosis there is a disturbance of immunity. The detection of E rosettes and of activated rosettes was carried out according to the classical method. The mean percentage of total T lymphocytes was found lower in silicosis (62 +/- 2% statistically significant for p < 0.05), compared to the control group (66 +/- 4.6%). The study revealed a decrease of T helper lymphocytes, an increase of T suppressor/cytotoxic lymphocytes and a decrease of the T helper/T suppressor ratio (1.96 +/- 0.13) in silicosis as compared to the control group (2.83 +/- 0.31). The presence of these changes in silicotic patients suggested the participation of cell-mediated immunity in the pathogenesis of disease, the cell mediated immunity being directly responsible for the evolution of silicosis.

Study of islet cell antibodies as predictive marker of type 1 diabetes

The aim of this study was to evidence whether islet cell antibodies (ICAs) (by a standard indirect immunofluorescent technique) could be used to identify subjects at risk for type-1 diabetes. In the present prospective diabetes family study, 23 of 2642 first-degree relatives of patients with type-1 diabetes have developed the disease. The antibody status of these 23 samples was compared with that from 23 carefully matched control. At a mean of 26 years before the onset of diabetes, ICAs were found in 16 patients at the titer 1:60 (versus O control subjects, p < 0.001). The authors consider that ICAs may be interpreted as an immunological change in the islets of first-degree relatives of patients with type-1 diabetes.

Peripheral leukocytes activation in aortic aneurysmal disease

The pathogenesis of aneurysmal disease involves factors acting over time. A sustained chronic inflammatory reaction is observed in association with initiations, maintenance, rapid growth and rupture of aortic aneurysms. This study was designed to identify the possible pathogenic role of the inflammatory cells in the outcome of aneurysmal disease, testing the activation state of peripheral lymphocytes and neutrophils. Circulating activated lymphocytes and repeated peaks of neutrophils activation in sequential follow-up is associated with larger aneurysms, mural thrombosis, tendency to aneurysm extension and rupture.

Value of the lymphoblastic transformation in patients with silicosis

The authors verify whether in silicosis the accumulation of silicon dioxide (SiO2) particles in the lung can induce changes of the activated T lymphocytes in the peripheral blood. The lymphoblastic transformation of lymphocytes stimulated with phytohemagglutinin (PHA), concanavalin A (Con A), Mycobacterium tuberculosis (Mt) and purified protein derivative (PPD) was studied using the classical methods. It was observed that in patients exposed to SiO2 lymphocyte reactivity to the above stimulants decreases. Significant differences between patients and controls were observed only in the response to PHA (p < 0.001).

Considerations on the changes of certain immunologic parameters in occupational allergic bronchial asthma due to textile fibers

The changes of some immunologic parameters such as IgG, IgA and IgM, the C3 complement, the circulating immune complexes and alpha 1--antitrypsin were investigated in 75 patients with occupational allergic bronchial asthma to textile fibers as compared with 50 apparently healthy controls with no occupational exposure to textile fibers. It was observed that IgG and IgA decreased significantly while IgM increased. Likewise C3 decreased in all patients with occupational allergic bronchial asthma (OABA) as compared with the controls an CIC increased significantly. The determinations carried out demonstrated a parallelism of action in the immune response.

[Antilipemic therapy in dyslipidemias in obese non-insulin-dependent diabetics (ONIDDM)]

There are multiple lipids anomalies on diabetes. IDDM has, because of insulin lack, raised levels of triglycerides and afferent lipoproteins. NIDDM, especially the obese one, directly linked with insulin-resistance and hyperinsulinemia, has different and complex anomalies. There is a specific type named "B phenotype" with high cardiovascular risk: raised LDL chol charged with TG and low level of HDL chol. Our study on 58 cases with NIDDM obese concluded that only 28% had high TG levels but 71.8% had low levels of HDL chol. We administered fibrates, therapeutical doses, 3 months. We made lipidograms from the beginning and after one and three months. So we proved the good effect of fibrates on lipids: rise of HDL chol., moderate effect on LDL chol. for reduced cardio-vascular risk. There were good results on glucose tolerability (improving 65.8%, p < 0.01).

Relationship between serum total sialic acid and C-reactive protein in silicosis

Serum total sialic acid and C-reactive protein (CRP) were studied in 68 patients with silicosis divided into 3 groups according to the evolutive stage of disease. The results were compared with the data obtained in a control group of 35 healthy subjects. The changes in serum total sialic acid levels were in parallel with those of CRP in silicosis. Patients in stage III had the highest mean values of serum total sialic acid (p < 0.01) and of CRP (p < 0.001). Linear regression analysis revealed a close positive correlation between serum total sialic acid and CRP levels in silicosis (r = 0.86, p < 0.01).

Antineutrophil cytoplasm antibodies in patients with silicosis

The presence of antineutrophil cytoplasm antibodies (ANCA) was followed up in silicosis with or without renal involvement. From the 68 patients with silicosis, 5 presented renal involvement. Of these 3 showed the presence of pANCA. The other 63 patients without renal involvement presented cANCA only in 2 cases. The control group showed no presence of ANCA. The incidence of ANCA in silicosis with renal involvement was discussed in view of an eventual elucidation of the pathogenesis of this disease, which was frequently associated with autoimmunity diseases.

[The clinico-epidemiological premises for antioxidant prevention and treatment in chronic myocardial infarct]

The improvement of therapeutic and recoverable proceeding to chronic myocardial infarction (IMC) imposes a complex epidemiological estimation of the global cardiovascular risk, of their clinical and biological status. The retrospective evaluation of the risk factors (RF) by epidemiological methods, in 38 hospitalized prevalence of both constitutional and behavioral factors, and the quantification of the risk state, according to graph Euro 194, has pointed on the fact that 50% of IMC cases have presented a global risk of 10-20%. That justified the application of a preventive conduct in order to continually neutralize the associates FR. The biochemical determinations have allowed to frame the dyslipidemic patients, according to the ARCOL classification in the classes D (29.2%), E (25.0%) and B (20.8%) with direct implication in the adopted therapy. The colorimetric dozing with thyo-barbituric acid of the malonly dialdehyde (MAD) each is a product of the lipidic peroxidation, as well as the interpreting or correlation of the registered values with an evolutive clinic stage, and with the existence of some existing diseases (diabetes, chronic hepatitis etc.) along with signification of other dismethabolical parameters (cholesterol, triglycerides, LDLc, apoB) have confirmed the necessity of a complex therapy, including an antioxidative treatment, having the role to directly inhibit or exclude the free radicals resulted after the oxidative stress of the infarct.

Changes of some parameters of humoral and cellular immunity in allergy to pollen

The study of some parameters of humoral and cellular immunity in 45 pollinosis patients and 18 healthy controls, showed a deficit of humoral immunity reflected in a decrease of the IgA and IgG mean values and an increase of the IgM mean values (coefficient of correlation (r): r IgA/IgG = 0.912; r IgM/IgG = -0.316). As regards the cellular immunity the study revealed both a numeric and a functional decrease of the T lymphocytes r Th/Ts = -0.877, showing a deficit of cellular-mediated immunity.

Study of lung antibodies in patients with silicosis

The presence of lung antibodies was determined in a group of 68 patients with silicosis in various stages of evolution and in a control group of 35 healthy subjects, by the standard indirect immunofluorescent technique with fluorescent conjugate anti human gammaglobulin and monospecific fluorescent conjugates anti human IgG, IgA and IgM. In the group of patients investigated, lung antibodies were detected by means of fluorescent conjugate anti human gammaglobulin, in 47 cases of the 68 examined. As regards the investigations using monospecific fluorescent conjugates it was observed that all the 47 patients presented lung antibodies of the IgG class, 32 presented lung antibodies of the IgA class and 15 presented lung antibodies of the IgM class. The presence of lung antibodies in silicotic patients suggests the participation of acquired humoral immunity in the pathogeny of disease without, however, being directly responsible for the evolution of disease. The association of silicosis with various other autoimmune diseases pleads for the existence of an immune component in the evolution of this pneumoconiosis.

[Pell-Nicol, a medicinal toothpaste]

A medicinal toothpaste based on an atomized extract obtained out of sulfurous mud of Nicolina Iassy (a natural organic-mineral complex) has been formulated and physico-chemically characterized. The optimal formula has been chosen corresponding to following parameters: aspect, colour, taste, smell; weight/tube (65 g +/- 5%); Dentine Abrasion Value (D. A. V.) = 30; pH = 6.95-7.42; foaming capability of foam, in minutes = 0.40-0.60; residue on the sieve (g% = 0.09); heavy metals content; abrasive substances; g% = 32-37 at least; sodium chloride g% = 0.30 at least; firmness time = 30 sec. Also it have been effectuated rheological measurements and dynamic viscosity. The medicinal toothpaste Pell-Nicole presents a plastic behaviour with thixotropic character, which confers a good stability in time, an adequate firmness and comparable properties with others marketed products. The therapeutical effects have been tested, such as the antimicrobial and anti-inflammatory actions. The medicinal dentifrice toothpaste Pell-Nicole is recommended for gum affections, superficial chronic inflammatory forms, deep paradontopathies, as well as for a proper dental hygiene.

The role of certain immunologic parameters in silicosis

The paper presents some possibilities of estimating the immunologic aggression in silicosis in a group of 68 patients divided into three subgroups according to the evolutive stage of disease. The results were compared with the data obtained in a control group of 35 clinically healthy subjects not subjected to respiratory noxae. Parameters such as the immunogram (IgG, IgA IgM, IgD), the C3 complement, the circulating immune complexes (CIC) and the C reactive protein (CRP) were investigated using classical immunochemical methods. It was observed that the immunoglobulin titer presented a polyclonal increase. The mean values of C3 complement decreased in stages I and II of disease. The CIC level presented high mean values unrelated to the stage of the disease. The incidence of CRP was found high in stage III. It was demonstrated that there is no significant correlation between the humoral immunologic abnormalities and the radiologic changes or the depression of the pulmonary functional test. These changes suggest that the humoral immunologic abnormalities are not directly responsible for the lung changes in silicosis and cannot be used as a predictive indicator of the severity of the disease or of its progress. The data obtained showed a hyperreactivity of the humoral mediated immunity over the whole course of the disease thus supporting the assumption of an immunopathogenic mechanism in this disease.

Demonstration of the neutrophil granulocyte functional capacity in silicosis, using the NBT test

The functional capacity of neutrophils was studied using the NBT test in 68 patients with silicosis in various evolutive stages, comparatively with a group of 35 controls. The NBT test showed an initial increase of nonspecific cellular reactivity which decreased as the disease evolved. The results in the control group showed 9 +/- 5% NBT positive neutrophils. The highest proportion of NBT positive neutrophils (17.6 +/- 2.3, p < or = 0.05) was found in stage I of the disease and then decreased gradually with the evolution of the disease. The proportion of NBT positive neutrophils may be considered as a biochemical marker of neutrophil functionality.

The zinc-immunodeficiency relationship in old patients

The influence of oral zinc sulphate therapy on the humoral immunity was investigated by dosages of serum immunoglobulins (Ig) and of plasma zinc levels in 12 patients with a mean age of 70 years, in comparison with other 11 patients treated with placebo and with a control group of 50 apparently healthy subjects. The results of this double-blind study demonstrated the zinc effect on the immunoregulation, as the Ig levels, and particularly those of the IgG class, initially high, were lowered in a statistically significant proportion. It is assumed that further clinical trials with various zinc concentrations could bring more information on this trace element participation in the humoral immunoregulation.

Changes of serum complement and of circulating immune complexes in patients with multiple sclerosis

The changes of total hemolytic complement (CH50), of C3 and C1q components and of the circulating immune complexes (CIC) were studied in a group of 112 patients with multiple sclerosis (MS) and in 50 controls. The attack was taken as a basis of observation. It was observed that in MS attacks CH50, C3 and C1q were decreased owing to the activation of the complement in the classical way. The CH50 values were found well enough correlated with C3 and C1q (r = 0.535) and respectively r = 0.497) and clearly correlated with the CIC values (r = 0.907). A sharp decrease of CH50 increases the probability of the appearance of an attack with slow remission and the probability of an attack with slow remission is the greater, the greater the increase of CIC values. Low CH50, C3 and C1q values correlated with high CIC values may be considered markers of severity in MS.

The variations of the serum IgD and of the circulant immune complexes in diabetic patients

The levels of serum IgD and of the circulating immune complexes (CIC) were determined in 168 diabetic patients, of whom 78 with type 1, 59 with type 2 and 31 with the so-called "intermediary" type of the disease, in comparison with 124 non-diabetic subjects for IgD and 100 for CIC. The results revealed very low IgD titres (less than 1 mg%, considered undetectable) in almost 3/4 of the cases; values over 1 mg% were recorded mostly in the cases of type 1, followed by those of "intermediary" and of type 2 diabetes. The mean CIC values of 67.13 +/- 36.53 optic density units (O.D.U.) were significantly higher than in the non-diabetic controls. Certain differences with respect to age, diabetes type, duration of the disease and of the insulin therapy were also recorded. The data are interpreted with caution, further investigations being necessary to the assertion of definite conclusions.

Changes of circulating immune complexes in the serum and CSF of patients with multiple sclerosis

The level of circulating immune complexes (CIC) was studied before and after treatment in a group of 86 patients with multiple sclerosis (MS) (36 males and 50 females) ranging in age between 20 and 30 years and in 32 controls. CIC determinations were performed both in the serum and in the CSF, using the method of precipitation in polyethylene glycol (PEG). In 61.62% of the patients the mean serum CIC values (82.44 ODU; p = 0.01) exceeded those found in the controls (60.1 ODU) while the CSF mean CIC values (21.63 ODU; p = 0.05) exceeded those in the controls in 59.30% of the patients (12.8 ODU). The prevalence of patients with CIC values exceeding the control values presented variations according to the clinical stage of disease. Thus in the acute stage 83.33% of the patients presented the highest mean serum CIC values (110.5 ODU; p = 0.05) and 100% of the patients presented the highest mean CSF CIC values (27.9 ODU). After treatment it was observed that the prevalence of patients with high CIC values decreased. In conclusion it was observed that there is a correlation between the prevalence of patients with increased CIC values in the serum and CSF, and the clinical stage and treatment administered. This observation suggests that CIC determinations both in the serum and in the CSF may constitute an immunologic marker in MS.

Synthesis of 19-nor-aldosterone, 18-hydroxy-19-nor-corticosterone and 18,19-dihydroxycorticosterone in the human aldosterone-producing adenoma

The recently synthesized 18-C-steroid derivative, 19-nor-aldosterone(19-nor- aldo) and 18-hydroxy-19-nor-corticosterone(18-OH-19-nor-corticosterone) possess mineralocoroticoid and hypertensinogenic activity. They and an additional newly synthesized steriod, 18,19-dihydroxycorticosterone[18,19(OH)2-corticosterone], may play a role in the etiology and pathogenesis of disorders thought to be caused by steroids with mineralocorticoid and hypertensionogenic properties. In this study we provide evidence that 19-nor-aldo, 18-OH-19-nor-corticosterone and 18,19(OH)2-corticosterone are produced in vitro by aldosterone-producing adrenal adenomas and adenomas and adenoma of Cushing's syndrome. "silent" adrenal adenomas and the adjacent adrenal tissue. Measurable amounts of these steroids were found in the incubation fluids of adrenal tissues using specific RIAs performed after a sequence of HPLC systems. The rates of production of the three steroids were high in the aldosterone-producing adrenal adenomas and in adrenal hyperplasia compared with in either Cushing's adenoma or "silent" adenoma.

Synthesis of 4,19-disubstituted derivatives of DOC. Radioreceptor assay of some corticosteroid derivatives in human mononuclear leukocytes

Several new 4,19-substituted steroids and previously synthesized corticosteroids were assayed for affinity to type 1 receptors in human mononuclear leukocytes. 11 beta,19-epoxy-4,21-dihydroxypregn-4-ene-3,20-dione (2) was hydrogenated with Pd-C to yield a mixture of all four dihydro derivatives 5, accompanied by 4,21-diacetoxy-11 beta,19-epoxy-3-hydroxypregnan-20-one (6) and 21-acetoxy-11 beta,19-epoxy-4-hydroxypregnane-3,20-dione (7). With hot acetic + p-toluenesulfonic acid 5 underwent rearrangement to 21-acetoxy-11 beta,19-epoxypregn-5-ene-4,20-dione (8) Pd-C hydrogenation of 3,21-diacetoxy-5 beta,19-cyclopregna-2,9(11)-diene-4,20-dione (10) gave 3,21-diacetoxy-5 beta,19-cyclopregn-5-ene-4,20-dione (11) and the 9,11-dihydro derivative of the latter. Treatment of 10 with warm HCl furnished 19-chloro-4,21-dihydroxypregna-4,9(11)-diene-3,20-dione (13). Pd-C hydrogenation of its diacetate 14 afforded the 4,5-dihydro derivative 18, 19-chloro-21-acetoxypregn-9(11)-en-20-one (15), its 4-acetoxy derivative 16 and the 3,4-diacetoxy derivative 17. When tested in a radioreceptor assay in human mononuclear leukocytes the synthesized compounds showed only low relative binding affinities (RBA) to type 1 receptor, the highest being 0.72% for 13 (aldosterone = 100%). For comparison, other RBA in this system were: 19-noraldosterone, 20%; 18-deoxyaldosterone, 5.8%; 18-deoxy-19-noraldosterone, 4.7%; 18,21-anhydroaldosterone, 0.37%; 17-isoaldosterone, 7.6% and apoaldosterone, 4.3%

Bound amino acids in uremic sera: search for peptidic middle molecules by preparative polyacrylamide gel electrophoresis and high performance liquid chromatography

The samples of normal and uremic sera were ultrafiltered, separated on SEP-PAK C18 cartridges and subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The serum material extracted from the slab gel was purified from SDS and further fractionated by reverse-phase high performance liquid chromatography (HPLC). The obtained fractions were examined by amino acid analysis and mass spectrometry. An increased number of moderately polar fractions containing bound amino acids was found in sera of uremic patients on hemodialysis. Two most prominent uremic fractions corresponded to N-benzoylglycine (hippuric acid) (fraction I, k' = 9,4) and phenylacetylglutamine (fraction II, k' = 9,7). Increased amounts of bound glutamine, glycine, serine, leucine, asparagine, alanine, valine, phenylalanine were found in other moderately polar uremic fractions. These fractions (k' range from 12.1 to 13.2) contained no free amino acids, nor any other known small uremic serum compounds; they were considered as peptide 'middle molecules' (MM) of a molecular mass smaller than 1700.

The IgD-zinc relationship in patients with allergic bronchial asthma

In recent years, evidence was brought of the zinc ion (Zn++) interference in the mechanism of certain processes occurring at molecular level, i.e., the protein synthesis, the activity of some enzymatic complexes, the regulation of transmembranal transport or the processes of immune regulation. The present paper investigates the variations of the immunoglobulin classes in patients with bronchial asthma, particularly the relationship between IgD levels and those of the zinc ion in the blood serum.

[Immunologic research in pediatrics]

The child, in his ontogenesis, repeats the phylogenetic evolution of the immune processes. The immunologic maturation gradually appears, the process having a definite duration. The immunologic maturation seems to be parallel to the maturation of other physiological processes. The immune system of the child is different from that of the adult, and the development features of his immune reactivity will give a specific evolution to his morbid manifestations.

18,21-Anhydroaldosterone and derivatives

18,21-Anhydroaldosterone 8, 18,21-anhydro-19-noraldosterone 9, and 3 alpha, 5 beta-tetrahydro-18,21-anhydro-19-noraldosterone 13, which may be present in acid-processed urine, were prepared by cleaving their 20-ketal derivatives 2, 3, and 12 with hot mineral acid. Compounds 8 and 9 were also made by direct dehydration of aldosterone 5 and 19-noraldosterone 10 in good yield. The reverse ring opening of 8 to 5 could be carried out in moderate yield with an acetic acid-acetic anhydride-perchloric acid mixture, while an analogous ring opening of 9 gave only a poor yield of 10.

[Clinical observations of treatment with Lyorodin-depot (Jenapharm)]

According to the indications of fluphenazin decanoate in the long-term treatment in schizophrenia the authors analyse the findings of a simple blind study of Lyorodin-depot on a sample of 20 inpatients. The drug was administered at intervals of 21 days for 18 weeks under clinical surveillance. The method consisted of patients' follow-up on an itemized card, psychological checkups and para-clinical investigations. The analysis of clinical findings reveals the amelioration of symptoms at the parameters accounted for, the favourable evolution low incidence of the side effects that confirms its clinical efficiency and tolerance.

Accumulation of alpha-Tocopherol in Senescing Organs as Related to Chlorophyll Degradation

alpha-Tocopherol (alpha-T) has been identified, using gas chromatography-mass spectroscopy and (1)H- and (13)C-nuclear magnetic resonance, in senescing leaves of Melia azedarach L. The content of alpha-T increased concomitantly with the breakdown of chlorophyll in senescing Vinca and Melia leaves. An increase in alpha-T was found also in detached Melia leaves, senescing in either light or darkness and in senescing, ethylene-treated orange leaves and fruit. The possibility that phytol, which is released from chlorophyll by chlorophyllase is utilized for the biosynthesis of alpha-T is discussed. Senescing leaves of the low chlorophyllase plants, parsley and tobacco, did not contain alpha-T in measureable amounts.

[Research on phagocytosis]

A problem of particular importance, but also particularly difficult, is the investigation of the phagocytic system, considering its implication in various aspects of pathology. This has determined the authors to present the major modalities for the investigation of phagocytosis. They recommend as a diagnostic method for garnulocytopathies (including a series of metabolic abnormalities. Of the leucocytes with implications for the bactericidal capacity), a testing of leucocyte bactericidal capacity. The test with nitroblue tetrazolium is also recommended, for the screening and differential diagnosis of fever conditions of infectious origin and other etiologies.

[The drawing of blood for performing routine and complementary immunological studies in medical practice]

Here is shown that drawing blood for immunological tests represents an important stage that must be reached according to medical indications, in order to avoid errors, taking into account the large range of these tests. All along the report it is discussed the dividing of the immunological tests needed into usual ones, with a value of basis screening, and complementary tests, with a value of advanced screening and their detailing. With regards to the immunopathological substratum, it is always necessary that the immunological tests should be performed by medical staff specialized in this domain.