Teresa Pizzella

Treatment of chronic hepatitis B in children with prednisone followed by alfa-interferon: a controlled randomized study.

The efficacy and safety of sequential treatment with prednisone and interferon was evaluated in a randomized, controlled study on 43 children with biopsy proven HBsAg/HBeAg/hepatitis B virus-DNA positive, anti-delta negative, chronic hepatitis (34 chronic persistent hepatitis, 9 chronic active hepatitis). Patients received either a 1-month course of prednisone (0.6 to 0.3 mg/kg per day) followed by interferon alfa-2a (3 MU/m2, thrice weekly, for 12 months; 22 patients) or no treatment (21 patients). At the end of the study (20 months), clearance of hepatitis B virus-DNA and HBeAg seroconversion were observed in nine (41%) of the patients treated with prednisone and interferon and in two (9.5%) of the untreated controls (p = 0.020). Two of the treated patients who lost HBeAg, also cleared HBsAg. In the treated group, 13 (59%) patients had stable normal levels of alanine aminotransferase on their last examination. The baseline serum level of hepatitis B virus-DNA was an important predictor of response. In fact, HBeAg clearance was observed in 75% of patients with a baseline hepatitis B virus-DNA level lower than 100 pg/ml and in none with a level above 100 pg/ml. We suggest that combined treatment with prednisone followed by alfa-interferon may be safe and effective in inducing a stable clearance of HBeAg and, in some cases, of HBsAg in children with chronic hepatitis B and with a low level of viral replication. For children with high levels of viral replication, this regimen seems to be ineffective.

Sensitive ELISA for IgG and IgM anti-albumin autoantibodies not influenced by HBsAg-associated polyalbumin receptors.

An enzyme immunoassay for the detection of IgG and IgM anti-polymerized albumin autoantibodies (AAA) is described. It was found that polyalbumin receptors on HBsAg particles interfere in the detection of IgG AAA when polymerized human albumin (pHSA), but not polymerized bovine albumin (pBSA), is used as coating antigen. Polyalbumin receptors do not appear to interfere in the detection of IgM AAA, with either pHSA or pBSA as coating antigen. All normal sera showed evidence of AAA, of both IgG and IgM classes. Levels of IgG and IgM AAA in sera from most type A and type B acute hepatitis patients were above the range of normal controls. ELISA detection of AAA distinct from HBsAg reactivity can help in understanding the role of these autoantibodies in HBV infection.

Cytomegalovirus as a co-factor of disease progression in human immunodeficiency virus type 1 infection

SummaryCytomegalovirus has been suggested as a co-factor of disease progression in patients with human immunodeficiency virus type 1 infection. Cytomegalovirus infection is highly prevalent among populations at risk of human immunodeficiency virus 1 infection, and has been associated with both an increased susceptibility to infection and a more rapid course of the disease towards immunodeficiency. Cytomegalovirus can have a direct immunosuppressive effect (through infection of immune cells) and can enhance the replication of human immunodeficiency virus (through the transactivation of the genic immunodeficiency virus expression, the stimulation of cytokine production, and the increase in Fc receptor expression on target cells). The role of cytomegalovirus as a co-factor of the progression towards immunodeficiency in subjects infected with the human immunodeficiency virus type 1 needs to be elucidated with more extensive clinical studies and the application of new molecular biology techniques.

Esterase staining of monocytes in suspensions of Ficoll-Paque isolated mononuclear cells

Abstract Reagents for esterase identification of monocytes on slide preparations are suitable for staining Ficoll-Paque isolated mononuclear cells in suspension. The suspension method is rapid and costless, and permits an accurate evaluation of esterase-positive cell percentages in mixed cell populations.

Effect of prednisone priming followed by alfa-interferon in treatment of children with chronic hepatitis B: an interim analysis of a controlled trial.

A six-month analysis of a controlled trial on the treatment of chronic hepatitis B in children shows that prednisone priming followed by alpha-interferon 2A was effective in 6 of 9 treated patients in reducing HBV replication and disease activity.

Changes inlymphocyte adenosine deaminase(ADA) and purine nucleoside phosphorylase(PNP) levels in lung cancer after radical surgery: 176

Patients with solid tumors have low lymphocyte ADA levels, while operated patients without recurrence show normal levels(1). To elucidate whether ADA levels are restored by the surgical removal of tumor, we determined ADA and PNP activities in peripheral mononuclear cells(PMC),in T-enriched and T-depleted subpopulations from 13 healthy controls and from 6 patients with lung cancer before and 1 month after complete removal of tumor. Lymphocyte subpopulations were prepared by rosetting withSRBC. Before surgery the mean PMC ADA value (17.2±4.8 SD ,mU/107 cells)was significantly lower than the control value(24.8±4.9, P<0.01). ADA levels were lower than controls inbothT (18.1±5.1 vs.20.4±3.9) and non-T cells(24.4±5.1 vs.26.7±4.0) .After surgery ADA levels,compared to pre-surgery values ,were increased in PMC (24.2±2.2,P<0.025)and in T-enriched (25.7±7.9, P<0.05),but decreased in T-depleted subpopulations (19.9±6.7). PNP pre-surgery levels did not differ from control values in PMC, T-enriched or T-depleted subpopulations; after surgery, they showed a trend similar to ADA. In conclusion 1 month after radical surgery ADA levels are apparently restored in unseparated PMC, however an ADA increase is found in T-cells,while low levels persist in non-T cells. 1) Russo M. et al.: Br. J. Cancer 43 (1981), 196-200.

T Cell Activation in Typhoid Fever Detected by Increased Levels of Adenosine Deaminase

The demonstration of an inherited adenosine deaminase (ADA) deficiency in patients with combined immunodeficiency (Giblett et al., 1972) suggests a causal association between lymphocyte ADA levels and immune function. ADA activity is greatly increased in in vitro stimulated lymphocytes (Hovi et al., 1976) and in peripheral mononuclear cells from subjects developing an active immune response (Galanti et al., 1981). Recent data indicate that mechanisms of cell-mediated immunity play the major role in recovery from typhoid fever (Rajagopalan et al., 1982). The aim of this study is to assess the value of lymphocyte ADA assay in detecting T cell activation during typhoid fever.

Lymphocyte Adenosine Deaminase Levels in Active and in Inactive Forms of HBsAg-Positive Chronic Liver Disease

Patients with congenital adenosine deaminase (ADA) deficiency show an impairment of both cell-mediated and humoral immunity (Giblett et al., 1972); exogenous ADA added to lymphocytes from these patients partially restores their in vitro response to mitogens (Polmar et al., 1975). On the other hand, ADA inhibitors in association with deoxynucleosides inhibit lymphocyte proliferation and T suppressor cell activity, while T helper cell function and differentiation of B cells are unaffected (Gelfand et al., 1979).