Senih Fikrig

Failure of Pneumococcal Vaccine in Children with Sickle-Cell Disease

POLYVALENT pneumococcal vaccines have recently been used in infants,1 children2 and adults.3 They are safe, immunogenic and protective against pneumococcal disease in normal adults.3 However, all p...

HOMOGRAFT IMMUNITY IN PREGNANCY: LACK OF HARM TO THE FETUS FROM SENSITIZATION OF THE MOTHER*

The usual concept of homograft immunity suggests that the mammalian placenta should be rejected by the mother as an incompatible homograft. Half of the genetic makeup of the fetus and hence presumably of the fetal portion of the placenta is derived from the father. This should afford sufficient tissue incompatibility to induce immunity in the mother and rejection of the placenta. The placenta survives in most mammals far longer, however, than would be expected of a homograft; the duration of gestation extends from 12>

Nitroblue tetrazoliumdye test and differential diagnosis of meningitis

days in the opossum to 22 months in the elephant. All but the shortest of these extend beyond the usual time of homograft survival. The intimacy of the association between fetal and maternal tissue varies widely in different species. In some, such as the horse, it is never anatomically close; an intact epithelial surface of the placenta lies in apposition to an intact uterine epithelium, although the approximation of maternal and fetal blood vessels may be closer than this arrangement would imply. In other species certain of the intervening tissue layers disappear, until in the hemochorial placenta of the rabbit, rodents, and primates, tissue of fetal origin lies in direct contact with maternal blood. The hemochorial placenta offers an unusual opportunity for exposure of the mother to cells of fetal origin. In man large numbers of trophoblast cells are shed from the exposed trophoblast directly into the maternal circulation? With this degree of exposure of the mother to fetal tissue it would seem that there must be some special provision for the avoidance of the homograft reaction. Various explanations for placental survival have been ~f fered .~ Broadly these propose either that maternal immunity fails to develop or that it develops but fails to harm the fetus. We wished to determine whether an observable immunity in the mother against her fetuses was compatible with a normal pregnancy. Previous investigator^^*^ have shown that sensitization induced in the mother against the father did not prevent apparently normal pregnancies. In these studies the mother was presumably sensitized to those transplantation antigens of the fetus derived from the father, but the normal genetic relationship of mother to fetus was maintained. We wished to investigate the problem under more stringent conditions, in which there was no genetic relationship between offspring and the pregnant mother and in which the latter was sensitized against both maternal and paternal tissue. Using the technique of ova transplantation, we believe we have shown in rabbits that homograft sensitivity existing between mother and genetically unrelated offspring throughout pregnancy is consistent with a successful pregnancy of normal duration and the subsequent delivery and rearing of normal young.

Familial moniliasis, defective delayed hypersensitivity, and adrenocorticotropic hormone deficiency

Summary The NBT test has been found to be highly useful in the differentiation of bacterial from viral and tuberculous meningitis. The test is of limited value in association with inappropriately treated bacterial meningitis and is not dependable in patients with sickle cell anemia and pneumococcal meningitis.

Persistence of Protective Pneumococcal Antibody following Vaccination in Patients with the Nephrotic Syndrome

Five siblings, 2 normal and 3 with moniliasis, cutaneous anergy, and limited pituitary adrenocorticotropin reserve, were studied. The affected siblings failed to manifest delayed hypersensitivity. Endocrine studies showed that the affected siblings had almost no increase in urinary excretion of 17-ketogenic steroids after adrenocorticotropin infusion, and a significantly lower increase in 17-ketogenic steroid excretion during a metyrapone test as compared to control subjects. One sibling had hypoparathyroidism.

Subpopulations of Human T Lymphocytes

We have determined the level of persisting pneumococcal antibody in a group of nephrotic children vaccinated by us 5 years ago. Of the 19 vaccinated children, 2 have died and 1 has moved away. Sera from the remaining 16 patients were examined by radioimmunoassay to determine the antibody response to 11 of the 14 types contained in the polyvalent pneumococcal vaccine. The lowest protective level of geometric mean titre (GMT) of antibody in our laboratory is 300 ng antibody nitrogen per millilitre. 56% (9/16) of the patients showed adequate GMT 5 years after vaccination. All 9 patients had minimal change nephrotic syndrome. 44% (7/16) of the children had a GMT less than 300 ng antibody nitrogen per millilitre. 3 of these patients had focal sclerosis, 3 had membranoproliferative glomerulonephritis, and 1 patient had IgM nephropathy. Of these 7 patients, 1 with the lowest GMT (23 ng antibody nitrogen per millilitre) developed pneumococcal peritonitis. During this same period, in 20 other unvaccinated nephrotic patients followed continuously from 1976 to 1981, 7 cases of pneumococcal peritonitis occurred (p less than 0.05). Additionally, 1 unvaccinated child died of pneumococcal sepsis. Our study indicates that patients with minimal change nephrotic syndrome continue to maintain adequate amounts of antibody, but those with disease other than minimal change nephrotic syndrome are unable to maintain an adequate level of antibody.

THE SURVIVAL TIME OF SKIN HOMOGRAFTS EXCHANGED BETWEEN MOTHER AND OFFSPRING IN RABBITS.

Peripheral blood from children with bronchial asthma was examined for the proportions of T cells, T cells with receptors for IgM (T μ ) or IgG (T γ ), and locomotion

Autologous Mixed Lymphocyte Reaction in Man.: VII. Autologous Mixed Lymphocyte Reaction in Patients with Bronchial Asthma, Allergic Rhinitis and Atopic Dermatitis

Prolonged survival of grafts from offspring to mother has been reported in man and in the rat. We have studied this phenomenon in rabbits using the technique of ova transplantation which permits separation of genetic and environmental factors in pregnancy. Neither factor significantly altered the survival of grafts from offspring to mother in this species. Possible explanations of the phenomenon observed in man and the rat are discussed.

In vivo effects of pokeweed mitogen on mouse spleen cells.

The proliferative response of T lymphocyte cultured with autologous non‐T lymphocyte is known as the autologous mixed lymphocyte reaction (AMLR). In AMLR. Both helper and suppressor functions are generated. In this investigation we have examined I cell proliferative responses in AMLR in 12 patients with bronchia asthma 10 patients with allergic rhinitis, and 10 patients with atopic dermatitis and compared that with simultaneously with bronchial asthma is significantly higher than that of health normals. However, AMRL response in patients with allergic rhinitis or atopic dermatitis is comparable to controls. Mechanisms for increased AMLR in patients with bronchial asthma are discussed.

1016 SPECTRUM OF HTLV-III INFECTION IN CHILDREN

Summary The intravenous injection of PWM to mice produced in vivo changes in the spleen similar to those produced by intravenous injection of PHA. These changes were a marked increase in the weight of the spleen, along with an increase in the number of nucleated cells, lymphoblasts, and mitotic figures. In addition, PWM also produced a marked increase in the total number of plasma cells. However, these cells did not appear in the peripheral blood, and the effect of PWM on it was limited to a transient leukopenia. The technical assistance of Mrs. Barbara Kartzinel is gratefully acknowledged.