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We aimed to determine the immunological effects of low doses of recombinant interleukin-2 (rIL-2) and recombinant interferon-alpha (rIFN-alpha) in patients bearing advanced renal cell carcinoma.Twenty-seven patients received therapeutic cycles consisting of subcutaneous rIL-2 for 5 days per week and intramuscular rIFN-alpha twice weekly, for 4 consecutive weeks. The cycle was repeated indefinitely at regular 4-month intervals, for all patients. rIL-2 (1 x 10(6) IU/m2) was administered every 12 h on days 1 and 2 and once a day on days 3-5 of each week; rIFN-alpha (1.8 x 10(6) IU/m2) was given on days 3 and 5. In the enrolled patients, total and differential white blood cell counts, phenotypic analysis of some lymphocyte subsets, and soluble IL-2 receptor (sIL-2R), were investigated before and after each of the first six cycles of therapy (about 24 months of follow-up).The cycles of immunotherapy induced a significant increase of total lymphocytes (37%, P0.001), eosinophils (222%, P0.001), CD25+ cells (27%, P=0.004), sIL-2R (174%, P0.001) and natural killer (NK) cells (CD3-CD56+) (61%, P0.001); the subset that expresses CD56 with high density (CD56+ bright) expanded more (233%, P0.001) than the subset expressing the same marker with low density (CD56+ dimmer) (15%, P = 0.043). Unlike the previous subsets, the treatment decreased significantly T-lymphocytes with NK cell marker (CD3+ CD56+) (28%, P = 0.011). No significant differences of effectiveness were found among the subsequent treatment cycles, except for CD25+ cells and sIL-2R (P = 0.036 and P = 0.005, respectively): the increase induced by immunotherapy was maximum after the first cycle and decreased progressively thereafter.Long-term repeated cycles of low-dose immunotherapy induced repeated and significant expansion of one of the most important lymphocyte subsets for the non-MHC-restricted immune response to the tumour mass: CD3-CD56+ cells.

In order to study the relationship between the long term renal haemodynamic effects of calcium antagonists and hypertensive renal damage, 8 patients with mild to moderate essential hypertension (6 males and 2 females, aged 19 to 60 years) underwent measurement of 24-hour microalbuminuria (urinary albumin excretion), mean blood pressure, effective renal plasma flow (para-aminohippuric acid clearance) and glomerular filtration rate (inulin clearance) before and after 12 to 16 months’ treatment with amlodipine 10mg once daily. Mean blood pressure fell from 125 ± 7mm Hg at baseline to 101 ± 3mm Hg during treatment with amlodipine (p < 0.001). Effective renal plasma flow did not change (633 ± 51 ml/min · 1.73m2 to 626 ± 46 ml/min · 1.73m2), while renal vascular resistance decreased from 8.5 ± 0.6 dyn · sec · cm−5 to 7.0 ± 0.4 dyn · sec · cm−5 (p = 0.01). Glomerular filtration rate rose significantly (109 ± 7 ml/min · 1.73m2 at baseline to 122 ± 4 ml/min · 1.73m2, p < 0.02 after amlodipine treatment) and urinary albumin excretion decreased from 17.4 ± 4.2 mg/24h to 7.2 ± 1.5 mg/24h (p < 0.05). Our findings show that long term treatment with amlodipine is followed by sustained renal vasodilation, an increase in glomerular filtration rate and, consequently, an increase in filtration fraction. However, despite the long term increase in glomerular filtration, urinary albumin excretion falls substantially. We suggest that long term renal protection afforded by amlodipine may occur independently of its effects on glomerular haemodynamics.

L’escrezione proteica urinaria e stata studiata nelle malattie renali. La quantita escreta di albumina, transferrina, IgG e α2-macroglobuline e lo studio delle relazioni tra albuminuria/transferrinuria, albuminuria/IgG globulinuria e IgG globulinuria/transferrinuria puo differenziare prevalentemente le lesioni tubulari da quelle glomerulari in diverse malattie renali.

From 450 renal biopsy cases, 28 patients were selected in accordance with precise morphological criteria as being affected with membranous glomerulonephritis, and were kept under observation for various periods of time. It was possible to identify some important morphological and clinical correlations and to identify 3 types of fundamental lesions in the basement membrane. The morphological lesions and the morphofunctional relationships were of no value in forecasting the evolution of the nephropathy in individual cases; usually this evolution was slow but progressive, no matter what therapy was applied. The survival index of 75% in the 5th year showed a decline to less than 50% in the 10th year of the disease.