Impairment of polymorphonuclear functions in hospitalized geriatric patients

Polymorphonuclear (PMN) functions were assessed in 93 non-selected hospitalized patients, 32 active, healthy, elderly controls and 29 young controls. The results confirm the impairment of PMN functions in the aged. However, PMN functions in hospitalized older persons are similar to those in non-institutionalized controls, and underlying diseases and treatment do not seem to aggravate the PMN impairment. Thus, it can be assumed that the frequent and severe infections afflicting the hospitalized aged are due to the alteration of the other host-defense mechanisms.

Polymorphonuclear functions in Hodgkin's disease patients at diagnosis, in remission, and in relapse

Five tests investigating different aspects of the nonspecific defense mechanisms including capillary tube random migration, particle ingestion activity, quantitative and histochemical nitroblue tetrazolium dye reduction by polymorphonuclear neutrophils, and serum lysozyme concentrations were performed in 46 patients with Hodgkin's disease. The anomalies observed in the active stage of the disease consisted of a decreased random migration, a high level of serum lysozyme, and an increased nitroblue tetrazolium reduction by resting phagocytes associated with a decrease in nitroblue tetrazolium reduction by stimulated phagocytes. The particle ingestion activity was normal. The serum lysozyme assay was the only test observed to normalize in the group of patients in remission. Its determination, therefore, offers an additional means of evaluating disease activity.

Malignant external otitis and polymorphonuclear leukocyte migration impairment. Improvement with ascorbic acid

Malignant external otitis (MEO) is a rare disease due to a Pseudomonas infection of the external ear occurring in an elderly patient with uncontrolled diabetes mellitus. Its high mortality raises the question of an alteration of the defense mechanisms of the body. A 58-year-old man was affected with MEO, and after several months of unsuccessful treatment, a study of the function of his polymorphonuclear neutrophil leukocytes (PMNs) revealed a defect of the migration capability. Ascorbic acid (vitamin C) was proved in vitro to be able to improve the results of the migration test. The patient was treated for one month with ascorbic acid and, parallel to the normalization of the chemotaxis test results, the ear lesions healed. The mechanism of such an alteration of the PMN function, implying several factors (the active infection, old age, and diabetes mellitus), is still unclear. Nevertheless, it is certainly important to test the PMN function in patients with MEO and treat them with immunomodulators.

In vitro effect of tobacco smoke components on the functions of normal human polymorphonuclear leukocytes

The function of polymorphonuclear leukocytes (PMNs) has previously been shown to be impaired in smokers in comparison with healthy nonsmokers. Potent inhibition of PMN chemotaxis has been achieved with whole tobacco smoke, the gas phase of smoke, and a water-soluble extract of whole smoke. In the present work several aspects of PMN function were studied after exposure to water-soluble fraction of the particle phase of tobacco smoke collected on glass fiber filters. These tests included capillary tube random migration, chemotaxis under agarose, phagocytosis of yeasts, Nitro Blue Tetrazolium dye reduction, and whole-blood bactericidal activity. The water extract of the particle fraction of smoke had a high content of nicotine when compared with the levels achieved in plasma of smokers and a much lower concentration of aldehydes when compared with the gas phase of smoke. It had no cytotoxic effect and did not affect phagocytosis, oxygen consumption, or bactericidal activity. Nitro Blue Tetrazolium reduction of both resting and stimulated PMNs was significantly decreased only with the most concentrated solution. The tested solutions exerted a dose-related depressive effect on capillary tube random migration, whereas the random migration measured in the agarose chemotaxis test was normal. Nevertheless, the chemotactic response to a caseine solution was significantly decreased. The same tests were performed in the presence of several concentrations of a nicotine solution and the only test to be affected was the capillary tube random migration, and, that only at a very high concentration. The results of this study contribute to the more precise delineation of the extent of the dysfunction of PMNs exposed to tobacco smoke components and indicate that deleterious products are released from the particle phase of the smoke, which deposits all along the respiratory tree.

Phagocytosis in myeloproliferative disorders

The phagocytic function was investigated by means of four tests (capillary tube random migration, phagocytosis of yeast particles, quantitative nitroblue tetrazolium dye reduction and whole-blood bactericidal activity for Staphylococcus aureus) in 57 patients who had myeloproliferative disorders: 24 had chronic granulocytic leukemia, 22 had polycythemia vera, six had myelofibrosis, and five had essential thrombocythemia. This study confirms the previously reported functional anomalies of phagocytosis in all the myeloproliferative disorders and shows that, despite these anomalies, the increased number of phagocytes allows an efficient whole-blood bactericidal activity, essential for the nonspecific host defence mechanisms.

Effect of tobacco smoking on the functions of polymorphonuclear leukocytes

Eight tests investigating the function of circulating polymorphonuclear leukocytes were performed in 68 subjects, half of whom smoked at least 20 cigarettes per day. Comparison of the two groups allowed determination of the in vivo effect of tobacco smoke on the nonspecific defense system of the body. Ingestion ability, oxygen consumption, and bactericidal activity were normal in smokers. Myeloperoxidase and neutrophil alkaline phosphatase activities also were unchanged. The nitroblue tetrazolium reduction and the serum lysozyme levels were slightly increased in smokers. The capillary tube random migration, though, was depressed, and intensive smoking further aggravated this change. It is suggested that tobacco smoke acts directly on one (or several) unidentified target site of polymorphonuclear leukocytes. This impairment, demonstrated in vivo, probably plays a role in the genesis of the bronchopulmonary diseases so frequent in heavy smokers.

[Insufficiency of secretion from the exocrine pancreas in infants (excluding mucoviscidosis) Diagnosis and consequences]

The diagnosis of insufficiency of exocrine pancreatic secretion was made in two infants after demonstration of a marked decrease in the flow rate of enzyme secretions during the duodenal infusion of milk and after the IV injection of C.C.K.-P.Z. The two infants had a normal sweat test. One had pancreatic lipomatosis with neuropaenia, whilst the other had pancreatic deficiency which did not fall into the context of Shwachman's syndrome. This study suggests that the absence of exocrine pancreatic secretion is accompanied by multiple abnormalitites : decreased absorption of fats and vitamin B12 and, it would appear, variations in certain activities of the jejunal mucosa and decreased insulin stimulation from the intestine. Such a situation reflects the complexity of the relations established between the organs participating in the processes of absorption and digestion.