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After the initial observation that human and animal mononuclear phagocytes can be activated into specific killer cells against larvae of the parasite Schistosoma mansoni by seric IgE antibody from infected patients, a possible interaction of IgE with human alveolar macrophages in asthmatic patients was investigated. In vitro, alveolar macrophages from non-atopic individuals can bind monoclonal IgE molecules, as well as IgE antibody from the serum of patients with respiratory allergy. A subsequent contact with anti-IgE antibody or with the specific allergen induces the extracellular release of a variety of mediators, such as lysosomal enzymes, neutral proteases, or superoxide anion. Due to the presence of allergen-specific IgE antibody on the macrophage surface in situ, the same results were obtained in vitro with freshly purified alveolar macrophages from allergic patients. Disodium cromoglycate, corticosteroids, or beta-adrenergic stimulants are strong inhibitors of this specific exocytosis of physiological mediators. The atopic cells formed rosettes with allergen-coated erythrocytes at 4 degrees C, except after pretreatment with aggregated monoclonal IgE or with the allergen.

The authors undertake a review of the literature so that they can point out present knowledge of the immunological relationship between mother and fetus. The fetus is a true allograft since it carries paternal antigens. Total harmony occurs so that immunisation of the mother against the feto-placental unit is recognised. This immunological reaction must occur to allow smooth development of the fetus with, at the same time, protection of the mother against trophoblastic invasion. Many regulatory mechanisms are summoned up to bring about this immunological response. While the progress in immunological knowledge has enabled us to glimpse this immunological relationship, it seems strongly probable that knowledge of these mechanisms can have applications outside gynaecology and obstetrics and be of equal value in the interpretation of immunological reactions which are found on oncology and parasitology.

In order to study the possible role of alveolar macrophages (AMs) in the development of local immune responses, we compared interleukin-1 (IL-1) production by peripheral blood monocytes and AMs from 17 allergic asthmatics and 32 controls. When stimulated by lipopolysaccharide, alveolar macrophages and blood monocytes from controls released IL-1 (127 +/- 74.6 and 178.8 +/- 120 IL-1 units/ml, respectively) in the same amounts as AMs and blood monocytes from allergic asthmatics (148 +/- 47.5 and 160.5 +/- 78.3 IL-1 units/ml, respectively). After stimulation by anti-IgE or the specific allergen, asthmatic blood monocytes released IL-1-like activity (71.8 +/- 46.4 and 45.4 +/- 25.9 IL-1 units/ml, respectively). In contrast, asthmatic AM supernatants contained no detectable IL-1-like activity after stimulation by allergen or anti-IgE. The same pattern was observed with monocytes and AMs from controls after passive cell sensitization with 20% of IgE-rich serum. In a second step, the effect of supernatants of IgE-dependent stimulated AMs was tested on thymocyte proliferation induced by a purified IL-1, permitting the demonstration of an IL-1 inhibitory factor released by the AMs while these supernatants didn't modify the IL-2-dependent proliferation of a CTL-L line. The use of indomethacin and assessment of PGE2 levels in AM supernatants made it possible to discard the role of prostaglandins in this inhibitory effect. Moreover this activity, which is resistant to heat and trypsin treatment, has a molecular mass between 40 and 50 kD and did not correspond to serum proteases, alpha-1-antiproteinase, and arginase.(ABSTRACT TRUNCATED AT 250 WORDS)

A two-site immunoradiometric assay using a monoclonal antibody (MoAb) against Brugia malayi microfilariae allowed the detection of parasite molecules both in the serum and the urine of patients from Sri Lanka infected with Wuchereria bancrofti. Whereas 50% of patients had no antigen in their serum, all of them excreted detectable amounts of antigen in their urine, the levels being higher in symptomatic than in asymptomatic patients. The poor detection in serum appeared to be related to the presence of circulating immune complexes. It was shown that the isotype of the antibodies complexed with the circulating antigen was IgM in the asymptomatic group, while it was mainly IgG in the symptomatic patients (swelling and lymphoedema or elephantiasis). These results suggest the existence of regulatory immune mechanisms affecting the clinical expression of lymphatic filariasis.

A longitudinal study of patients undergoing rush hyposensitization by honey-bee or yellow jacket venom revealed significant changes of the immunophenotypes until the optimal dose was reached, and a progressive reversion to pre-treatment values in the following months. The activation markers CD23 on B cells and CD25 (IL-2 receptor) on T and B lymphocytes decreased. Although there was little variation of the major CD4 and CD8 lymphocyte populations, CD45R+ cells increased whilst CDw29+ lymphocytes diminished. This inverse variation was associated with a peak of CD4+ CD45R+ cells with concomitant decrease in CD4+ CDw29+ cells showing an inverse effect of the treatment on the reciprocal subsets of CD4 lymphocytes. This indicates a shift in the suppressor/inducer to helper/inducer cell ratio early during rush hyposensitization which may also suggest reversion into a less mature stage of CD4+ cells, associated with the transition from a highly allergen-reactive state to progressive unresponsiveness.

A receptor for the Fc fragment of IgE on human platelets has been recently described, which mediated an IgE-dependent activation in the presence of specific allergen. We investigated the allergen-induced activation of platelets from patients with Hymenoptera hypersensitivity before and after specific rush desensitization. Nineteen patients with a history of anaphylactic reactions were included (15 sensitive to yellow-jacket and four to honey-bee venom), fourteen/nineteen having experienced severe life-threatening systemic reactions and 5/19 large local reactions. All showed positive skin tests and high values of specific IgE. By comparison to the baseline results obtained before desensitization, a significant decrease of platelet activation (76.8% inhibition) after rush desensitization was observed. In the case of two polysensitized patients, after Hymenoptera venom desensitization alone, platelets not only lost their reactivity to venom but also towards the other allergen. This modulation of the IgE-dependent platelet reactivity during desensitization offers therefore a new approach for the study of allergen-induced desensitization.

The study of antibody-dependent cellular cytoxicity mechanisms in human and experimental schistosomiasis has revealed the particular role of immune complexes in triggering phagocytic cell activation. IgE complexes or aggregates were demonstrated to bind to specific receptors on rat macrophages as well as on human or baboon macrophages, leading to the killing of the parasite target. In the eosinophil-dependent cytotoxicity mechanisms, IgE complexes have been shown to exert a regulatory effect on eosinophil activation in vitro and in vivo and on the ability of this cell population to kill parasites. The various observations reported in this review suggest that the characteristics of the Fc receptors, the composition and antigen-antibody ratio of immune complexes might be essential factors in the regulation of the immune response against parasites.

In earlier studies we found that normal rat macrophages, preincubated at 37 degrees C with the serum of syngeneic rats immune to Schistosoma mansoni, strongly adhered to S. mansoni schistosomules whereas no significant adherence was induced with serum from normal rat. Using 51 chromium release assay, it now proved that immune serum-incubated macrophages lysed the schistosomules in 18 h. Absorption experiments and ultracentrifugation of the immune serum showed that immune complexes containing specific IgE antibody against S. mansoni and soluble parasite antigens induced macrophage adherence and cytotoxicity. Using various labeling techniques, the binding of aggregated rat IgE to the macrophage surface at 37 degrees C is evident in conditions where endocytosis is neglible. The binding of immune complexes containing IgE antibody to S. mansoni elicits dramatic ultrastructural changes in the macrophage and an increase of its lysosomal enzymes together with specific lytic activity for the schistosomules. The parallel development of immune serum-induced macrophage adherence or cytotoxicity with the level of circulating IgE antibody to the parasite in correlation with the development of immunity in the rat, suggests that this new mechanism of macrophage activation could play a role in immune effector mechanisms against S. mansoni. Therefore, IgE acts as a humoral mediator of cellular immunity.

Schistosome-derived inhibitory factor (SDIF) previously shown to inhibit lymphocyte proliferation, markedly decreased the primary IgE response of rats immunized with dinitrophenylated ovalbumin (DNP-OVA) when injected either simultaneously or shortly after antigen administration. No effect however was observed when SDIF was injected before the immunization. An inhibition of non-IgE anti-DNP antibodies was also found in SDIF-treated rats although the decrease was lower than with IgE antibody. IgE responses of both low and high IgE responder rats were reduced but a lower dose of SDIF was required in the case of high IgE responder Brown Norway rats. When SDIF was only given at the time of priming, the secondary IgE response was no longer modified. However, the administration of SDIF together with the second injection of the antigen induced marked decrease in the secondary IgE response. The effects of SDIF on primary and secondary IgE responses could be attributed to the inhibitory activity of the parasite-derived factor on lymphocyte proliferation. The observed inhibition of secondary IgE antibody responses confers to SDIF a pharmacological interest in allergic diseases.

Mebendazole was given to four patients with hepatic hydatid disease. In three patients hydatidosis had remained after surgery, and in the fourth it could not be treated surgically. Mebendazole was given orally in maximum doses of 400-600 mg three times a day during courses lasting 21 to 30 days. Ultrasonic echotomography showed a complete regression of the intrahepatic cysts after four to 13 months in all four cases. In three patients the course of treatment had to be repeated. Mebendazole also induced clinical improvement and a progressive lowering of the concentration of specific IgE of Echinococcus granulosus. During treatment circulating blood levels of specific immune complexes of antigen 5 were increased. These observations indicate that mebendazole has a lethal effect on E granulosus cysts in primary hydatid disease in man and that the efficacy of chemotherapy can be assessed with ultrasonography and by measuring changes in the concentration of specific IgE of E granulosus and circulating immune complexes.