ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00261.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Infections are one of the major causes for visits to paediatricians. Most children recover without sequelae, untreated or if treated properly, and develop specific immunity towards the challenging microorganisms (mostly viruses). There is a small proportion of children however, with unusual frequent, severe, chronic, recurrent or opportunistic infections in whom an underlying immunodeficiency must be suspected. Based on current knowledge about the major types of congenital immunodeficiencies this review suggests a diagnostic approach to these children. Early evaluation will allow early identification of affected children and, subsequently, lead to proper treatment before devastating infections cause irreversible organ damage.

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00262.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Recent studies from several laboratories suggest that the rate of postnatal maturation of T‐cell function(s) associated within vitroactivation may be slower in children at high genetic risk for atopy (HR), compared to their normal (low risk; LR) counterparts. The present study compared thein vitroactivity of the function‐associated surface molecules CD2, CD3 and CD28 in panels of 27 HR and 13 LR infants, with a reference panel of 10 adults, employing assay systems involving T‐cell stimulation with MoAbs against these molecules. The response maxima induced by saturating levels of the MoAbs were equivalent in all 3 groups, but T‐cells from the HR infants required 10–50 fold higher levels of anti‐CD3 stimulation to attain their maximum response, relative to adults (p = 0.02); T‐cells from LR infants were also less responsive to anti‐CD3 than adults, but these differences were smaller and did not attain statistical significance. It is suggested that these differences are attributable to varying proportions of competent T‐memory cells (which respond to low levels of anti‐CD3) in PBL from these populations, the postnatal accumulation of which proceeds slow

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00263.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The study below comprises prospective analysis of patterns of allergen‐specific T‐cell reactivity in a cohort of 23 children bled at'regular intervals from 6–10 weeks to 2 years of age, together with cross sectional studies on panels of cord and adult blood samples. The results indicate reciprocal patterns of responses to dietary and inhalant allergens, the former being frequent in infancy but rare in adults, whereas the latter are preserved and expand between infancy and adulthood. These findings are consistent with a recently proposed model for the development of immunity to environmental allergens which involves allergen‐driven T‐cell “selection” during early life leading to deletion of food allergen‐specific T‐cells via the induction of specific anergy, with concomitant selection and ultimately expansion of mutually exclusive TH‐1‐like or TH‐2‐like reactivity to inhalant allergens via Im

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00264.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The ability of IVIG to increase platelet counts in patients with idiopathic thrombocytopenic purpura suggests its potential usefulness in other disease states characterized by low platelet counts. This possibility was evaluated in nine patients with the Wiskott‐Aldrich syndrome (WAS) who received IVIG, at a dose of 400 mg/kg every 4 weeks. The mean platelet count prior to institution of IVIG was 32,000/cumm (range 2,400 to 98,000). Following administration of IVIG, the platelet count ranged between 5,000 and 85,000/cumm. There were no immediate increases in platelet counts after IVIG infusion in any patient who had serial platelet counts. During treatment, patients were not given any routine platelet transfusions for low platelet counts. However, while on IVIG, two patients showed a good response to platelet transfusion prior to surgical procedures. In conclusion, chronic IVIG therapy does not appear to affect platelet counts in patients with the Wiskott‐Aldrich syndr

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00265.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Peanuts are the most common cause of fatal and near‐fatal food‐induced anaphylaxis. The immune basis for susceptibility to peanut allergy is poorly understood. The current study examined the possibility that patients with peanut allergy, as compared to normals, use different T cell receptor variable beta regions (Vβ) in the recognition of peanuts. The results demonstrate that stimulation of T cells from patients with peanut allergy results in the selective expansion of Vβ2+T

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00266.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Lectins recognize carbohydrate moities of glycoproteins and glycolipids, and can elicit several biological effects, including cell agglutination, cell activation and mitogenesis. According to the gluten‐lectin theory, celiac lesions represent a response to a toxic lectin, putatively wheat germ agglutinin (WGA). In this study we compared the serum antibody levels IgA, IgG and IgM to WGA and to gliadin in children under investigation for celiac disease (CD), as compared to reference children. We found that the levels of IgA and IgG to WGA as well as gliadin were significantly higher in celiac children on a gluten‐containing diet, compared to children on gluten‐free diet and reference children. These findings lend support to the concept that WGA is a biologically significant component of gluten. Since WGA can mimic the effects of epidermal growth factor (EGF) at the cellular level, we hypothezise that the crypt hyperplasia seen in celiac children could be due to a mitogenic response induced b

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00267.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The aim of this study was to evaluate if continuous treatment with budesonide or salmeterol influences the bronchodilator response to terbutaline in children with asthma; 23 children, aged 7 to 16 years (mean = 11 years), with mild asthma were treated with inhaled budesonide 100 μg b.i.d. and placebo for three weeks in a randomized, double blind crossover study. These treatments were followed by treatment with inhaled salmeterol 50 μg b.i.d. for 3 weeks. On the last day of each period a cumulative dose‐response experiment with terbutaline in the doses 50, 100, 250 and 500 μg (cumulative dose 900 μg) was performed. Lung function was measured before and 20 min after each terbutaline inhalation. Baseline pulmonary functions after budesonide treatment were significantly higher than the baseline measured after the two other treatments (p<0.05). After budesonide treatment, the dose‐response curve was shifted vertically upwards but otherwise parallel to the dose‐response curve after placebo. The increase from baseline after the first cumulative dose of terbutaline was significantly lower after salmeterol treatment than after the two other treatments (p<0.01). Maximal lung functions after 900 μg terbutaline also differed significantly between the three dose‐response days; budesonide being significantly higher and salmeterol significantly lower than placebo (p = 0.02 and p<0.001, respectively). It is concluded that budesonide treatment does not enhance the brochodilator response to terbutaline. Further studies are needed to assess if long‐term continuous salmeterol treatment reduces the response

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00268.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

To study the time‐course of eosinophil cationic protein (ECP) and eosinophil protein X (EPX) during bronchial allergen provocation, we investigated 32 asthmatic children sensitive to house‐dust mites as well as 6 non‐atopic young adult controls. In all subjects, allergen challenges were performed with house dust mite extracts ofDermatophagoides pteronys‐sinusorDermatophagoides farinae.Blood samples were taken at regular intervals during the 24‐h observation period. The individual time‐courses of ECP and EPX revealed different characteristic groups of patterns: (1) an isolated early serum peak of both mediators during or within the first 60 min after provocation (2) an early plus a late peak (3) an isolated late peak 12 h after provocation (4) an isolated late peak 24 h after provocation, and (5) no significant variation during the 24‐h observation period. The early peak could be due to short‐term changes in eosinophil activation, while late peaks may reflect eosinophil proliferation, recruitment, subsequent priming and enhancing of the propensity to release their proteins. ECP and EPX showed a corresponding parallel time‐course in nearly all challenges, with EPX‐concentration exceeding that of ECP. There was no correlation between ECP/EPX serum concentrations and clinical parameters such as lung function data. From our results we conclude that the striking groups of time‐courses of ECP/EPX serum concentration indicate different uniform patterns of eosinophil activation during allergen challenge ‐ but do not predict clinical outcome of provocation. The role of the eosinophil in early asthmatic reactions remains to be establi

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00269.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Pgp‐1 expression was studied as a marker of memory/activation on systemic and mucosal T cells of BALB/c and C57BL/6 mice after infection with respiratory syncytial virus (RSV), using two‐color dual fluorescence flow cytometry employing anti‐L3T4 (CD4), anti‐Ly2 (CD8), and anti‐Pgp‐1 (CD44) monoclonal antibodies. Pgp‐1 was expressed in relatively low densities on T cells of C57BL/6 mice, allowing differentiation of a dual population of Pgp‐110and Pgp‐1hiT cells after antigenic stimulationin vivo.On the contrary, T cells of BALB/c mice were uniformely Pgp‐1hi, making this mouse strain less suitable for studies with this marker. In blood and spleen consistently more CD8+than CD4+T cells were Pgp‐1hi, while in BAL more CD4+than CD8+T cells were Pgp‐1hiAfter primary but not after secondary infection, CD4+Pgp‐1hiT cells increased significantly in the blood and spleen. After secondary infection both CD4+Pgp‐1hiand CD8+Pgp‐1hiT cells increased in the BAL. It is hypothesized that after primary infection systemic RSV‐specific T cells acquire an activation/memory phenotype as characterized by an enhanced expression of Pgp‐1, resulting in a faster and stronger influx of these cells in th

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1995.tb00270.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY