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Recently, hydrocortisone (HC) has been shown significantly to enhance interleukin-4 (IL-4)-induced in vitro IgE synthesis. For investigation of possible effects of synthetic corticosteroids hut also of effects of other important human hormones, peripheral blood mononuclear cells (PBMC) were incubated with IL-4 and various concentrations of the hormones IgE secreted in the supernatant was determined after a 14-d culture period. Like HC, all synthetic corticosteroids potentiated IgE secretion A minor effect was noted for the mineralocorticoid aldosterone. No modulating effect on IL-4-induced IgE formation was observed for adrenocorticotropic hormone (ACTH), somatotropin (STH), thyroid-stimulating hormone (TSH), triiodothyronine, thyroxine, epinephrine, noradrenaline, insulin, and glucagon. [ABSTRACT FROM AUTHOR]

In five patients with vasculitis, hypereosinophiha, and elevated serum IgE levels a diagnosis of Churg­Strauss syndrome was established. To identify a possible role of IgE in pathogenic mechanisms leading to the vasculitis, we performed a sequential precipitation of the patients' sera with different concentrations of polyethylene glycol (PEG) 6000, Using a radio immunosorbent test, we tested the precipitates obtained for IgE, Considerable amounts of IgE were traced in the serum precipitates of all patients, especially after the second precipitation step (4.0% PEG). In contrast, no IgE-containing precipitates were detectable in sera from patients with different allergic diseases and high IgE serum levels. Together with an increase in C3d serum levels and the failure to demonstrate C1q-binding material in patients' sera, these data suggest the involvement of IgE-containing immune complexes in the pathogenesis of Churg­Strauss vasculitis, activating the complement via the alternate pathway. [ABSTRACT FROM AUTHOR]

To improve the in vitro diagnosis of mould allergy 22 children suffering from allergic asthma caused by Alternaria tenius and/or Cladosporium herbarum as proven by bronchial provocation test were investigated. Partially purified, standardized mould preparations were used in radioallergosorbent test (RAST) with conventional and new update mould discs, mould-induced histamine release and immunoblotting. Updated RAST discs were found to be superior to the old-type discs for the detection of Alternaria but not Cladosporium sensitivity. In all patients except one, specific IgE-antibodies to the respective mould were demonstrated by immunoblotting. Mould-induced histamine release failed to prove sensitization in only two patients. No differences were found comparing histamine release from whole blood with release from isolated cells. The results demonstrate a high sensitivity of in vitro tests when purified and standardized extracts are used. [ABSTRACT FROM AUTHOR]

In the sera of patients with acute bacterial infections specific autoantibodies (sIAPa) of the immunoglobulin class G (IgG) were found which bind to intestinal alkaline phosphatase (IAP) through the Fab portion. This was demonstrated using immunoaffinity (IA) isolation of sIAPa from patients' sera (particularly bacterial meningitis and ventriculitis) digestion with pepsin, purification of F(ab′)2 fragments on protein A and subsequently binding on IAP coupled to CNBr (cyanogen bromide)-activated Sepharose. Immunoblots using specific anti-Fc and anti-Fab antibodies showed that the bulk of F(ab′)2 fragments had bound. Additionally, binding of native IAP to the F(ab′)2 fragments was observed after separation of F(ab′)2 fragments using isoelectric focusing (IEF), blotting onto nitrocellulose and incubation with IAP. Moreover, we have demonstrated the occurrence of natural anti-IAP autoantibodies (nIAPa) which were isolated from sera of healthy individuals using IA chromatography. Investigation of isotype distribution revealed that IgG but not IgM or IgA were predominant even among nIAPa. The nIAPa fraction exhibited lower binding efficiencies on IEF blots than the sIAPa fraction, however, in contrast to sIAPa, cross-reactions with other autoantigens were observed for nIAPa. NIAPa and sIAPa did not show subclass restriction. As revealed by IEF the spectrotypes of sIAPa were found to be patient-specific, poly- to oligoclonal and stable during longer periods. [ABSTRACT FROM AUTHOR]

To improve the in vitro diagnosis of mould allergy 22 children suffering from allergic asthma caused by Alternaria tenius and/or Cladosporium herbarum as proven by bronchial provocation test were investigated. Partially purified, standardized mould preparations were used in radioallergosorbent test (RAST) with conventional and new update mould discs, mould-induced histamine release and immunoblotting. Updated RAST discs were found to be superior to the old-type discs for the detection of Alternaria but not Cladosporium sensitivity. In all patients except one, specific IgE-antibodies to the respective mould were demonstrated by immunoblotting. Mould-induced histamine release failed to prove sensitization in only two patients. No differences were found comparing histamine release from whole blood with release from isolated cells. The results demonstrate a high sensitivity of in vitro tests when purified and standardized extracts are used.

Eleven patients with rheumatoid arthritis that had been refractory to conventional drug therapy were treated with total lymphoid irradiation (TLI). Followup continued for 6 months in 9 patients, 12 months in 6 patients, and 24 months in 3 patients. At 6 and 12 months post-TLI, a significant improvement in clinical disease activity was demonstrated. Side effects noted during TLI included fatigue, nausea, diarrhea, and vomiting. One patient died of cardiorespiratory arrest, 2 patients died of kidney failure secondary to generalized amyloidosis, and 1 patient died of septic shock secondary to a multilocular septic arthritis. One patient experienced 2 episodes of septic arthritis; 2 patients manifested delayed wound healing. Immunologic assessments showed consistent lymphopenia in all patients. T lymphocyte subsets decreased after TLI, and showed a transient increase at 6 months post-TLI. The suppressed mitogen responsiveness, which was noted 2 months after irradiation, was found to increase almost to the pre-TLI levels at 12 months. The observed increase in morbidity and mortality after TLI is evidence that discourages the use of this therapeutic technique, at least in its present form.