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497 Immune responses in children with otitis media with effusion (OME)
264
497
J ALLEHGV CL,N :MMIJNC; I*,Ul,AAv lsn~
Abstracts
IMMUNE RESPONSES IN CHILDREN WITH OTITIS MEDIA WITH EFFUSION S . T.Siaurdardottir
(OWE).
M.D.. R.Otte M.D., M.CasselbrgDt M.D.. J.Haddad M D c P.Fireman M.D. Pittsburah PA. * . To investigate the role of immune mechanisms in the pathogenesis of OME, serum samples from 75 children with a history of chronic OME were assayed for total and specific Immunoglobulins. Of 42 children (age 3-12 years), 7 (17%) had low (<2SD) IgA; 5 (12%) had low total IgG; 4 (5%) had low IgGl and 7 (17%) had low IgG2. All had normal IgG3, IgG4 and IgM levels. Antibodies (AB) to Pneumococcus (PN) serotypes 3, 6, 14, 18, 19 and 23 were assayed by ELISA. Sixteen (38%) had low average PN AB (~300 ng AB Nitrogen/ml) compared to protective values > 250-300. Eleven children were immunized with 23 valent PN vaccine. Postvaccination sera showed an AB rise of 1.8 20.9 (X fr 1STD) fold. Eight (73%) had ~2 fold rises and AB concentration was ~300 in 7 (63%). Fold rises for each respectively were 1.520.4; serotype, l.lkO.4; 1.951.9; 2.151.6; 1.5kl.l and l.lAO.2. Rises >2 fold were observed in l%, O%, 27%, 45%, 27% and 0% for each serotype, respectively. This compares to a >2 fold increase in 96%, 22%, 38%, 78%, 73% and 44%, respectively, in children with acute OME. (Ped Inf Dis 1986;5:39) Many of these children with chronic OME manifested deficiencies of the humoral immune system, which may have importance in the pathogenesis of chronic OME.
498
IN VIVO
AND IN VITRO
ASS-
OP -
m. Robert E. Esch, Ph.D., Kent J. Weinhold, Ph.D., C. Edward Buckley, III, M.D. Lenoir and Durham. NC. Despite conventional wisdom about the cliniinduced delayed skin cal equivalence of antigen tests and lymphocyte transformation, quantitative studies of relationships between these assessments of cell mediated innnunity are not available. We measured the dose dependence of CASTA(Candida albicans Ikin test antigen) induced transformation ( H-Thymidine incorporation) of Ficoll-Hypaque separated peripheral blood lymphocytes in 18 subjects who were subsequently skin tested with 0.1 ml of l-100 og/ml of antigen. Skin test reaction diameters (flare/erythema and wheal/edema/induration) were measured at 0.25, 6, 24, 48 and 72 hours. The dose dependent in viva and in vitro reactions were evaluated using a hyperbolic tangent model of the sigmoid dose response curve in order to obtain bivariate estimates of responsiveness and Using the in vitro estimates as an sensitivity. independent variable, linear regression revealed that the responsiveness of the subjects’ cultured lymphocytes predicted a very large part of ehe skin test erythema (R2=0.437, p(O.0001) and edema (R'=0.404, p
500
GENETICALLY-DETERMINED T CELL DEFICIENCY: CLINICAL AND LABORATORY PROFILES OF 76 INFANTS. D.L. M.D. M.E. Eslick. M.D.. R.H. Bucklev. M.D, Durham, NC. llnless immune reconstitution can be achieved, death from opportunistic infection is usually the rule for infants with inherited T cell deficiencies. To identify useful diagnostic characteristics, the presenting features of 76 infants referred to this institution from 1968- 1990 were analyzed. 56 were male. 20 female, 71% white. 18.4% black and 10.5% other. All but 9 presented in the first 12 months of life. Linear growth was normal for the majority, bur most male patients were underweight. Physical findings included: thrush, inanition, lack of palpable nodes or visible ronsils and respirator) symptoms (coughing, tachypnea, wheezing). 90% were infected with at least one pathogen. Sites of infectjon were blood (B) 27%. stool (S) 26%. lung (I.) 19%. urine (U) 15%. nasopharynx (N) 6%. skin (SK) 5% and spinal fluid 2%. The most frequent pathogens isolated were S epidermidis (B), rotavirus (S). P. carinii (L). C. albicani (U), parainfluenza virus (N). S. aureus (SK). Other studies revealed lymphopenia, leukopenia. anemia and panhypogammaglobulioemia without specific antibod\ responses. Lymphocyte phenotyping revealed mean per centages for CD3 17, CD4 1 I, and CD8 1 I. Proliferative responsesto mitogens were 415,000cpm in 95% of patients (mean control cpm 140,270). Response to allogeoeic cells in mixed lymphocyte culrure was occasionally present. Knowledge of clinical and laboratory findings may lead 10 early recognition oi primary T cell deficiencies and may be useful in distinguishing infants with human immunodeficiency virus infections.
497
J ALLEHGV CL,N :MMIJNC; I*,Ul,AAv lsn~
Abstracts
IMMUNE RESPONSES IN CHILDREN WITH OTITIS MEDIA WITH EFFUSION S . T.Siaurdardottir
(OWE).
M.D.. R.Otte M.D., M.CasselbrgDt M.D.. J.Haddad M D c P.Fireman M.D. Pittsburah PA. * . To investigate the role of immune mechanisms in the pathogenesis of OME, serum samples from 75 children with a history of chronic OME were assayed for total and specific Immunoglobulins. Of 42 children (age 3-12 years), 7 (17%) had low (<2SD) IgA; 5 (12%) had low total IgG; 4 (5%) had low IgGl and 7 (17%) had low IgG2. All had normal IgG3, IgG4 and IgM levels. Antibodies (AB) to Pneumococcus (PN) serotypes 3, 6, 14, 18, 19 and 23 were assayed by ELISA. Sixteen (38%) had low average PN AB (~300 ng AB Nitrogen/ml) compared to protective values > 250-300. Eleven children were immunized with 23 valent PN vaccine. Postvaccination sera showed an AB rise of 1.8 20.9 (X fr 1STD) fold. Eight (73%) had ~2 fold rises and AB concentration was ~300 in 7 (63%). Fold rises for each respectively were 1.520.4; serotype, l.lkO.4; 1.951.9; 2.151.6; 1.5kl.l and l.lAO.2. Rises >2 fold were observed in l%, O%, 27%, 45%, 27% and 0% for each serotype, respectively. This compares to a >2 fold increase in 96%, 22%, 38%, 78%, 73% and 44%, respectively, in children with acute OME. (Ped Inf Dis 1986;5:39) Many of these children with chronic OME manifested deficiencies of the humoral immune system, which may have importance in the pathogenesis of chronic OME.
498
IN VIVO
AND IN VITRO
ASS-
OP -
m. Robert E. Esch, Ph.D., Kent J. Weinhold, Ph.D., C. Edward Buckley, III, M.D. Lenoir and Durham. NC. Despite conventional wisdom about the cliniinduced delayed skin cal equivalence of antigen tests and lymphocyte transformation, quantitative studies of relationships between these assessments of cell mediated innnunity are not available. We measured the dose dependence of CASTA(Candida albicans Ikin test antigen) induced transformation ( H-Thymidine incorporation) of Ficoll-Hypaque separated peripheral blood lymphocytes in 18 subjects who were subsequently skin tested with 0.1 ml of l-100 og/ml of antigen. Skin test reaction diameters (flare/erythema and wheal/edema/induration) were measured at 0.25, 6, 24, 48 and 72 hours. The dose dependent in viva and in vitro reactions were evaluated using a hyperbolic tangent model of the sigmoid dose response curve in order to obtain bivariate estimates of responsiveness and Using the in vitro estimates as an sensitivity. independent variable, linear regression revealed that the responsiveness of the subjects’ cultured lymphocytes predicted a very large part of ehe skin test erythema (R2=0.437, p(O.0001) and edema (R'=0.404, p
500
GENETICALLY-DETERMINED T CELL DEFICIENCY: CLINICAL AND LABORATORY PROFILES OF 76 INFANTS. D.L. M.D. M.E. Eslick. M.D.. R.H. Bucklev. M.D, Durham, NC. llnless immune reconstitution can be achieved, death from opportunistic infection is usually the rule for infants with inherited T cell deficiencies. To identify useful diagnostic characteristics, the presenting features of 76 infants referred to this institution from 1968- 1990 were analyzed. 56 were male. 20 female, 71% white. 18.4% black and 10.5% other. All but 9 presented in the first 12 months of life. Linear growth was normal for the majority, bur most male patients were underweight. Physical findings included: thrush, inanition, lack of palpable nodes or visible ronsils and respirator) symptoms (coughing, tachypnea, wheezing). 90% were infected with at least one pathogen. Sites of infectjon were blood (B) 27%. stool (S) 26%. lung (I.) 19%. urine (U) 15%. nasopharynx (N) 6%. skin (SK) 5% and spinal fluid 2%. The most frequent pathogens isolated were S epidermidis (B), rotavirus (S). P. carinii (L). C. albicani (U), parainfluenza virus (N). S. aureus (SK). Other studies revealed lymphopenia, leukopenia. anemia and panhypogammaglobulioemia without specific antibod\ responses. Lymphocyte phenotyping revealed mean per centages for CD3 17, CD4 1 I, and CD8 1 I. Proliferative responsesto mitogens were 415,000cpm in 95% of patients (mean control cpm 140,270). Response to allogeoeic cells in mixed lymphocyte culrure was occasionally present. Knowledge of clinical and laboratory findings may lead 10 early recognition oi primary T cell deficiencies and may be useful in distinguishing infants with human immunodeficiency virus infections.