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Background: Healthcare workers may be exposed to a variety of biological hazards. Although many studies have shown that some immunological alterations were related to work stress and sleep disorders, few studies investigated effects of shiftwork on the immunological system., Objectives: The aim of the study was to compare the immune status of a group of nurses on shiftwork with that of nurses working only day shifts., Methods: A total of 138 nurses were evaluated at baseline and after a year of follow-up, via tests for perceived stress, daytime sleepiness, number of lymphocytes and subpopulation of CD3+, CD4+, CD8+-CD57+, CD19+ and CD56+, cytotoxic activity and lympho-prolferative response of NK cells, serum concentrations of IL-1beta, IL-6, INFgamma and TNFalpha., Results and Conclusion: No significant alterations of any of the studied parameters were found both at baseline and after a year of follow-up. The biological hazards for nurses do not seem to be increased by shiftwork.

Objectives: Regulatory T cells (T(REG)) represent a T cell subset able to modulate immune response by suppressing autoreactive T-lymphocytes. The evidence of a reduced number and an impaired function of this cell population in autoimmune/inflammatory chronic diseases led to the hypothesis of its involvement in the pathogenesis of these disorders. Glucocorticoid-induced TNFR-related protein (GITR) is a well known marker of murine T(REG) cells, but little is known in humans. The aim of this study was to investigate the characteristics of T(REG) cells in systemic lupus erythematosus (SLE) and the potential role of GITR as marker of human T(REG)., Methods: Nineteen SLE patients and 15 sex- and age-matched normal controls (NC) were enrolled. CD4(+) T cells were magnetic sorted from peripheral blood by negative selection. Cell phenotype was analyzed through flow-cytometry using primary and secondary antibodies and real time polymerase-chain reaction (PCR) using TaqMan probes., Results: The CD25(high)GITR(high) subset was significantly decreased in SLE patients with respect to NC (0.37±0.21% vs 0.72±0.19%; p<0.05). On the opposite, the CD25⁻GITR(high) cell population was expanded in the peripheral blood of SLE patients (3.5±2.25 vs 0.70±0.32%, p<0.01). Interestingly, FoxP3 at mRNA level was expressed in both CD25⁻GITR(high) and CD25(high)GITR(high) cells, suggesting that both cell subsets have regulatory activity., Conclusions: CD4(+)CD25⁻GITR(high) cells are increased in SLE as compared to NC. The expression of high level of GITR, but not CD25, on FoxP3+ cells appears to point to a regulatory phenotype of this peculiar T cell subset.

Recent studies report that some probiotic strains are able to improve allergic diseases. For this reason, we would verify tolerability and efficacy of a industrial preparation of Lactobacillus paracasei (11,688; Proge Farm, Italy) and Lactobacillus salivarius (11,794; Proge Farm, Italy) and value their "in vitro" immunomodulatory effect. We know that, after birth, there's a persistence of Th2 immune response that predisposes to atopy, whereas commensal bacteria are able to induce a Th1 immune response that counter-balances the original response. The "in vivo" study was set up with the recruitment of 20 atopic pediatric patients treated 30 days with 2 doses of Fiorilac (Sharper, Italy), a preparation of the two strains in the proportion of 1:12. Only one patient referred significant improvements of atopic disease, 19 patients reported a good tolerability to the product and 3 patients had a regularization of intestinal function. Immunological tests showed an increase of Th1 immune response as in CD4+ lymphocytes percentage as of IL-12 and IL-10 cytokines production and a significant increase of natural killer (NK) activity, which predisposes to an active response to viral infections and neoplastic transformations.

Aim: The aim of the study was to compare lymphocytic infiltrations in early spontaneous abortions with those with signs of disruption at the chorio-decidual interface in elective abortions. Determinations were performed on preparations received at the Anatomy-Pathology Services of Ospedale San Paolo, Savona (Italy) in 2005., Methods: Immunohistochemistry studies were performed using antisera CD3, CD4 and CD14 with a DAB detection kit on a Ventana BenchMark automated slide staining system. The material was grouped into three classes: early spontaneous abortions (class 1); elective abortions with signs of disruption at the chorio-decidual interface (class 2); elective abortions without such signs (class 3)., Results: Preparations from classes 1 and 2 shared a similar picture of lymphocytic activation and the presence of macrophagic elements. The test results demonstrated that the proportion of the T cell population increased with the rise in CD8+ lymphocytes in both class 1 and class 2 preparations., Conclusion: The results indicate that T-cell-mediated immune activation may the cause or one of the causes of spontaneous abortion and that the effects of disruption at the chorio-decidual interface observed in elective abortion provide a clue to initial signs of loss of pregnancy. From the discovery of a population without evident signs of active abortion (elective abortion with a disturbed chorio-decidual interface) but with evidence of initial lymphocytic activation compared with that devoid of such signs (elective abortion) one can conjecture that lymphocytic activation is a major factor in the process leading to early spontaneous abortion.

Recently, a new member of the TNF family, BLyS, was identified. This protein, synthesized by myeloid cell lines, specifically interacts with B lymphocytes and increases their life-span. BLyS was studied in the murine models of some autoimmune diseases and it was demonstrated that it has a key role in the B lymphocyte system homeostasis and in the relation between chronic inflammation and autoimmunity. Analysis of BLyS plasma levels in Systemic Lupus Erythematosus, Sjogren's Syndrome and Rheumatoid Arthritis (RA) has shown that BLyS is higher in a group of patients than in the controls. In RA, BLyS correlates with the disease activity, in particular, with the swollen joints count; so, at least part of the chronic rheumatoid synovitis could be the epiphenomenon of the B cells activation driven by monocyte-macrophage population. More studies are necessary to understand the role of BLyS in the interaction between the monocyte and the B lymphocyte in some autoimmune disease and the possible usefulness of this cytokine as a diagnostic or prognostic marker and/or therapeutic target.

Aim: B-cell chronic lymphocytic leukemia (B-CLL) is characterized by homogeneous coexpression of CD19, CD23 and CD5, and poor expression of membrane Ig. The aim of this study was to evaluate, in B-CLL patients and in healthy subjects by flow cytometry, B cell expression of surface molecules involved in cell activation, differentiation, T-B cooperation and apoptosis., Methods: The study population consisted of 29 patients (16 men and 13 women; mean age: 66.5 years) with B-CCL. The control group consisted of 16 sex- and age-matched healthy subjects. The results are reported as percentages and mean fluorescence intensity (MFI) of CD19+ cells coexpressing each analyzed molecule., Results: We found that the lymphocyte activation markers, CD69, CD25 and CD11c, were more expressed in B-CLL patients than controls. CD38 and CD95 expressions were higher on normal B lymphocytes than leukemic B cells. Finally, CD80 and CD86, molecules involved in T-B cooperation, showed an inverse expression between lymphocytes of B-CLL patients and healthy subjects. CD80 was higher on normal than leukemic B cells, while CD86 expression was higher on CLL B cells. Linear regression analysis showed a positive correlation between CD80 and CD95 expression on leukemic B cells; a reverse correlation was observed between CD69 and CD11c., Conclusion: These results suggest that common mechanisms may regulate the simultaneous expression of CD80 and CD95 or the reverse expression of CD69 and CD11c, respectively, in different stages of B cell activation and/or differentiation.

Background: In vascular pathology the endothelial lesions easily reflect on blood cells, inducing a reactive state. In the present study the eventual presence of activation signals in leukocytes and platelets was tested., Methods: Fifty-eight subjects with major vascular pathology and 14 with lower limbs venous insufficiency were studied, together with a control group of 25 normal subjects. Elastase PMN, superoxide ion, leukocytes and subpopulation count, platelet factor 3, clot retraction, heparin in neutralizing activity (HNA plasmatic and intraplatelet), platelet count and volume were tested., Results: As regards leukocytes, it was observed a significative increase of elastase PMN and monocytes number for both the studied pathologies, of superoxide ion and leukocyte number only for major vascular pathology; for platelets, an inhibition of functionality, revealed by clot retraction test for arterious and venous pathologies and by HNA test only for the venous one., Conclusions: As regards the leukocyte activation, elastase PMN is particularly responsive to the endothelial lesion both in arterious and in venous districts, while superoxide ion appears to increase in presence of a marked alteration. The level of monocytes is indicative of an inflammatory condition and of leukocytes of an atherosclerotic inflammatory process. As for platelets, the test clot retraction is specifically sensible to the endothelial abnormality in both the arterious and venous pathologies with addition of an abnormal HNA test only in venous insufficiency. This platelet dysfunction is probably due to endothelial release of vasoactive and heparin amplifying substances.

Six children aged between three and six years, born from undamaged families and free from malformative, chronic, degenerative or metabolic diseases, never treated with chemoantibiotics, were checked for their immune status. They were compared with other six children with the same somatic characteristics, the same health status and the same economical-social condition as the first six ones; but frequently treated with chemoantibiotics (not less than three therapy periods during each year of their life). The comparative study was performed by checking various parameters (lymphocyte blastization; rosette "E"; T3, T4, T8 lymphocytes with T4/T8 ratio; B lymphocytes; NK cells, chemotaxis; phagocytosis; killing; serum immunoglobulins A, G, M; C3; C4) index of immune functions, in uniform conditions. Results were statistically elaborated by means of "t-Student between groups test", "on ordinal ranks test", "t-Student for paired data test" and "Pearson's correlation coefficient" calculation. Significative differences by means of "t-Student between groups test" were recorded for what C3 is concerned, higher in never treated children, for PWM stimulation Blastization, lower in never treated children, for unstimulated blastization, chemotaxis and plasma IgM lower in frequently treated children. By means of "t-Student for paired data test" the above mentioned differences were confirmed and significantly higher values of plasma Immunoglobulin G and B lymphocyte in never treated children were pointed out. The differences between the last children and the controls are much higher than those previously recorded between similar groups 6-12 years old.

Patients with H&N tumours treated with surgery, chemo- and radiotherapy also underwent an immunologic therapy with timopentina to evaluate clinic and immunologic efficacy during a 1-year follow-up. Twenty-five patients were recorded in this study divided at random into two groups. In group A the patients were administered timopentina (50 mg/3 times per week/6 weeks) subcutaneously in 4 o 5 cycles during the year. Group B were not administered timopentina. The immunologic state was assessed through investigation of the following: Evaluation of PBL and their T and B cell subpopulations Phagocytosis and blastigenesis Surface receptor and soluble receptor of IL2 NK activity IL1 production. The immunologic values of the two groups were correlated against a control group of twenty non-neoplastic patients. Our study revealed a better immunologic conditions at the end of follow-up in patients treated with timopentina compared to the other patients.

The immune response to viral infections is a combination of many events: viral antigen presentation to the immune system, proliferation of specific lymphocytes, cytokine intervention. This review describes the virus-cell relationship contributing to the latency state in viral infections (especially in AIDS) and cytokine network, its importance in the pathogenesis of viral diseases and its therapeutic potential.

The aim of the investigation was to directly study the IL 2 receptor (IL 2 R) and its subunits, p55 and p75 chains, either membrane-bound or soluble, on peripheral blood mononuclear cells (PBMC) of patients with solid malignancies and, indirectly, the same patients' PBMC ability to produce IL 2. Fifty-eight cancer patients, 29 men and 29 women, were studied: their mean age was 57.3 years, range 35-79. Twenty-two healthy age-sex-matched subjects served as controls. The tumors were the most common and the most representative among human cancers, i.e. breast, lung, head and neck, digestive tract and liver, prostate and gynecologic cancers: they were generally in advanced stages and in 23 cases metastatic. The PBMC proliferative response to PHA, PHA plus IL 2 and IL 2 was evaluated along with the response to PHA in presence of anti-p55, anti-p75 monoclonal antibodies, or both. Moreover, membrane-bound IL 2 R, p55 and p75 chains, on PHA-stimulated PBMC were detected, along with soluble IL 2 R in the serum and in the culture supernatants. The conclusions suggest that in solid malignancies: the membrane-bound IL 2 R s, both p55 and p75 chains, are expressed normally, there is an high serum level of soluble IL 2 R, there is a normal release of soluble IL 2 R in culture, and there is an indirect evidence of a lack of IL 2 production. Therefore, no primary impairment of IL 2 R was found in solid tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

In this study, we have evaluated certain haematologic and immunologic parameters in two advanced disease patient groups treated with chemotherapy (CMF schedule)+thymostimulin or chemotherapy alone, respectively. Statistical analysis of the data does not reveal any significant difference between the two patient groups. In our opinion, however, the administration of thymic hormone seems to protect the marrow crasis and, as a consequence, to obtain a lower incidence of side effects and respect of chemotherapeutic schedule.

The eventuality that a particular emotional involvement could weigh heavily on a person's psychophysical welfare, assuming a complementary role in the appearance of clinically noticeable pathologies (infections, allergies, neoplasms) has been object of several hypotheses which have been confirmed in researches on animals. Our research, by examining an unavoidable and surely natural situation like that one of the birth of a brother for a first born, a particularly severe for what affectivity is concerned, had the aim to evidence if there were some biological expressions, able to quantitatively settle the eventual immune functions' alterations indicative of a preexistent equilibrium. With this purpose have been examined several biological expressions indicative of immune functions (B lymphocytes, T lymphocytes, NK cells, lymphocyte transformation, chemotaxis, phagocytosis, C3 Complement fraction) in three first-born children with 2 to 3 years of age, whose mothers had in course a second pregnancy, during a period of about 20 months (from III pregnancy month to XIV month of age of the brother). The evolution of these immune functions evidence, during the whole period of observation, a non univocal performance. In the most of the cases was evidenced a variation towards diminution of the biological expression of some functions (lymphocyte transformation, T3 lymphocytes, T4 lymphocytes, T4/T8 rate, "E" Rosettes, chemotaxis and phagocytosis), while in the case of NK cells there were also variations towards augmentation. Particularly important were the variations towards diminution, that biological expressions as lymphocyte transformation and "E" Rosettes undergo. In two children the variations, towards diminution, showed themselves already before the birth of the brother. The variation of the T3 and T4 lymphocytes, of the T4/T8 rate, of chemotaxis and of phagocytosis were more limited. The values of the other examined biological expressions (T8, B7, C3) were in the normal range during the whole period of observation. Our results let us to attribute to emotional events, as in experimented model, the capacity to affect the biological expression that measures some immune functions, by depressing them in most of the cases, so in way to adulterate the immune equilibrium, and by setting the premises to upset the capability of immune defense in the examined persons. Our observations lead us to think that effectively, an event during which an important emotional state is induced, by upsetting the immune equilibrium, could more predispose a child (in this case the first born) to the action of pathogens.

The Authors describe the aetiological mechanisms of periapical diseases. They deal with immunologic reactions in inflammation with particular features on the lymphocytic and macrophagic products and their role in the periapical reactions. Furthermore, they describe the pathogenesis of bone resorption, a common evolution of the chronic periapical disease.

The AA. studied the effects of a polyvalent oral vaccine on the cellular immunity, and on IgA level in animal. They also studied its ability to reactivate the response to the Clostridium tetani toxin in human volunteers. The results show a very good ability of the vaccine as specific and aspecific stimulator.

Some immunological parameters have been examined in eleven children with juvenile rheumatoid arthritis. A quantitative and functional defect in T lymphocytes has been observed associated with defective chemotaxis of neutrophils. High levels of circulating immune-complexes were detected in sera of 5 out 11 patients. 1 patient showed high levels of antinuclear antibodies and positivity for the rheumatoid factor. Immunological pathogenesis of juvenile rheumatoid arthritis is discussed.

The PHA-resposiveness of normal and Hodgkin patient human peripheral blood lymphocytes has been studied before and after incubation with Hodgkin cytotoxic sera. The following conclusions have been reached: (a) Hodgkin cytotoxic serum is capable of decreasing the PHA-responsiveness of normal lymphocytes and of furtherly impairing the already defective PHA-responsiveness of Hodgkin lymphocytes. (b) The impaired PHA-responsiveness can be restored to the original levels by eluting the cytotoxic antibody. Control experiments in which normal and Hodgkin lymphocytes were put in contact with normal and Hodgkin non-cytotoxic serum showed no decrease of PHA-responsiveness. These data are in agreement with the hypothesis that the presence of serum cytotoxin is at least partly responsible for the immuno-incompetence of T-lymphocytes characteristic of Hodgkin's disease.

We have considered the possibility of using commercial Blasto-Kit, with AB pool, for chromosome analysis. Comparative researches have been made between Blasto-Kit-AB and Blasto-Kit in which AB serum was replaced by FCS. Using 0.1 ml of whole blood lymphocyte response to PHA after incorporation of thymidine H3 and the mitotic rate obtained have been evaluated. The Blasto-Kit-AB gives better results if compared with Blasto-Kit-FCS either in lymphocyte response to PHA or in chromosome analysis.

Cellular immunity in two brothers with thyroid carcinoma in a family presenting pathological thyroid changes is investigated. In these brothers a low PHA lymphocyte blast-transformation and an elevated number of surface membrane Ig bearing lymphocytes were observed. These data are discussed in relation to the question of immunological defects which frequently are present in carcinoma patients.

Some recent views on pathophisyology of "myasthenia gravis" are presented. The Authors explain the typical damage of myasthenia gravis, i.e. the progressively reduced muscolar function on the basis of an autoimmune derangement affecting the motor-end plates. The most commonly used types of treatment, both medical (i.e. antiChE, A.C.T.H., steroids and immunodepressant drugs) and surgical (thymectomy) are reviewed. The very important role of Intensive Care for the treatment either of myasthenia gravis "per se" or of possible consequences of some drugs (A.C.T.H. steroids) is also stressed. Finally the Authors present their results about their experience on 36 patients affected by myasthenia gravis and admitted to I.C.U. once (29 patients) or twice or more (7 patients). The Authors describe some practical problems presented by patients during their stay in I.C.U.