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Background: Inclusion of new vaccines in vaccination programmes for children would be easier if they could be combined with existing vaccines. Vaccines containing acellular pertussis in the diphtheria/tetanus/pertussis (DTP-a) combination are expected to replace the conventional whole-cell vaccines (DTP-w). We tested the immunogenicity and safety of a combination of DTP-a with the Haemophilus influenzae type b (Hib) conjugate of Hib capsular polysaccharide and tetanus toxid (PRP-T), and inactivated poliovirus vaccine (i.p.v.)., Methods: 120 infants were enrolled and randomised to four groups to receive DTP-a at ages 2, 4, and 6 months. At 4 and 6 months they also received Hib conjugate and i.p.v., either as separate injections or mixed with DTP-a. All injections were given intramuscularly in the anterolateral area of the thigh. Any reactions after each vaccination were noted by the parents. EIA was used to measure titres of diphtheria, tetanus, and pertussis antibodies, RIA for Hib anticapsular antibodies, and microneutralisation assay for poliovirus antibodies from serum samples collected at the ages of 2, 4, 6, and 7 months., Findings: There were 30 infants in each group. Only mild adverse events were reported. There was a tendency towards slightly lower concentrations of filamentous haemagglutinin, tetanus, and poliovirus 1 antibodies when the vaccines were mixed. However, there was a more pronounced difference (p = 4 x 10(-6)) in Hib antibodies between groups receiving Hib capsular polysaccharide mixed with DTP-a (geometric mean concentrations 0.37 microgram/mL and 0.56 microgram/mL) compared with groups receiving the vaccines separately (3.10 micrograms/mL and 3.94 micrograms/mL)., Interpretation: Administration of premixed DTP-a, Hib conjugate, and i.p.v. affect the immune response significantly. The mechanism of this interference is not clear. The immunogenicity of all antigens must be tested before new combinations can be accepted for vaccination programmes for infants.

We carried out a randomized double-bind, placebo-controlled clinical trial on the topical treatment of recurrent mucocutaneous herpes with a strong water solution of Ascoxal, an ascorbic acid-containing pharmaceutical formulation with mucolytic and non-specific antimicrobial activities. The lesion was firmly pressed with a cotton wool pad soaked in drug solution 3 times for 2 min with 30-min intervals on the first day only. Evaluation of the effects was by daily recordings of several different symptoms, including the presence and severity of erythema, induration, papulae or vesicles and scab by both the patient and a trained nurse, and by virus culture. Fourteen episodes with active treatment and 18 with the placebo were analyzed. According to the patients' records, the active treatment resulted in a significantly smaller cumulative number of days with scab (P < 0.01), or with any remaining symptom (P < 0.02) and significantly fewer occasions of worsening of any symptom after the treatment (P < 0.05). According to the nurse's records, the persistence of scabs was significantly shorter in the active treatment group (means 3.4 vs 5.9 days, P = 0.03). Virus culture after the first day of treatment yielded herpes simplex virus significantly less frequently in the active treatment group than in the placebo group (P < 0.01). In conclusion, a brief treatment with this ascorbic acid-containing preparation resulted in statistically significant clinical and antiviral effects, which calls for further and more extensive studies with a more intensive treatment schedule.

Cultured adherent human macrophages and a promonocytic cell line, U 937, were previously shown to produce a Mr 95,000 gelatin-binding protein. The protein has no immunologic cross-reactivity with the well-characterized gelatin-binding protein fibronectin and the Mr 70,000 gelatin-binding protein produced by a variety of mesenchymal or epithelial cell types (T. Vartio et al, J Biol Chem 257:8862, 1982). In the present study the Mr 95,000 protein was found in Triton X-100 extracts of granulocytes purified from human blood buffy coat. The protein, as isolated by gelatin-agarose, was immunologically cross-reactive with the corresponding macrophage protein in immunoblotting assay. When peripheral blood and bone marrow cells were examined for the presence of the Mr 95,000 protein by indirect immunofluorescence, positive staining was detected only in differentiated granulocytes but not to any significant extent in metamyelocytes, myelocytes, promyelocytes, or in normal or leukemic blasts. In granulocytes the protein had a granular cytoplasmic distribution. In freshly prepared monocyte cultures, the Mr 95,000 protein was detected in low amounts in the cytoplasm, while along with differentiation of the cells into macrophages, the immunofluorescence increased in a reticular and vesicular cytoplasmic pattern and in a juxtanuclear cap, probably representing the Golgi complex. In conclusion, the Mr 95,000 gelatin-binding protein was specifically detected in macrophages and granulocytes and may thus serve as a differentiation marker for these phagocytic cells.

Induction of alpha interferon in human monocyte cultures exposed to moderate titres of herpes simplex virus (HSV) is a regular phenomenon, but shows variability in the resulting interferon titres. Thirty recent clinical isolates of HSV (15 type 1 and 15 type 2) were found to be equally effective interferon inducers, irrespective of their origin. Ultraviolet irradiation or thermal inactivation of the virus or blocking of the DNA synthesis by foscarnet did not destroy the capability of the virus to induce interferon. These results show that the interferon response in HSV-exposed human monocytes is relatively independent from the inducing virus strain and does not require replication of HSV.

Three patients with the Lesch-Nyhan syndrome were found to have normal delayed hypersensitivity, peripheral-blood T-lymphocyte counts, lymphocyte responses to P.H.A., and serum IgM, IgA, and IgE levels. However, the percentages of B-lymphocytes, IgG levels, serum-isohaemagglutinin titres, and lymphocyte responses to pokeweed mitogen (P.W.M.) were subnormal. These observations suggest that activity of the salvage pathway of purine synthesis catalysed by hypoxanthine-guanine phosphoribosyl transferase (H.G.P.R.T.) is not required for the responses of T-lymphocytes to mitogenic or antigenic stimulation, but may contribute to the proliferation and function of B lymphocytes. The major role of the de-novo pathway of purine synthesis in human lymphocyte responses to mitogenic or antigenic stimulation is shown by the effects of inhibitors of this pathway, including immunosuppressive agents, and by the effects of congenital deficiency or inhibition of adenosine deaminase.

An outbreak of 9 cases of paralytic poliomyelitis and 1 non-paralytic case occurred in Finland between August, 1984, and January, 1985, after two decades of freedom from the disease attributable to a successful immunisation programme. During the outbreak poliovirus type 3 was isolated from the patients, from about 15% of healthy persons tested, and from sewage water. At least 100 000 persons were estimated to have been infected. With 1.5 million extra doses of inactivated poliovirus vaccine to children under 18 years of age and an oral poliovirus vaccine campaign covering about 95% of the entire population in February-March, 1985, the outbreak was halted in February, 1985. Impaired herd immunity to the epidemic strain of poliovirus type 3, which differed from the type 3 vaccine strains in both immunological and molecular properties, was important in the emergence of this outbreak. The inactivated poliovaccine that had been used in the vaccination programme was relatively weakly immunogenic, especially as regards the type 3 component. Whether continuous antigenic variation of poliovirus type 3 has wider epidemiological implications is not known.

In February, 1985, mass vaccination with live oral poliovirus vaccine (OPV) was started during a poliomyelitis outbreak in Finland. Pregnant women were advised to take the vaccination. Judged as the rate of reported malformations, OPV during early pregnancy had no harmful effects on fetal development.