Prognostic value of a novel circulating serum 90K antigen in breast cancer.

Monoclonal antibody SP-2 to the tumour-associated antigen 90K was generated by immunisation with conditioned medium of human breast cancer cells. We investigated whether circulating levels of 90K can influence the prognosis of patients with breast cancer. Serum samples were obtained from 425 patients with histologically proven breast cancer with no clinical evidence of disease after surgery (NED) and in 310 patients with metastatic disease. Serum 90K was determined by a new immunoradiometric assay (IRMA). Antigen levels in NED patients were elevated in 18.5% of cases, mean levels being higher than in healthy controls (P = 0.001). Among 375 evaluable patients, the 75-month overall survival for 90K-negative (< or = 11 U ml-1) and 90K-positive (> 11 U ml-1) patients was 78% and 53% respectively (P = 0.004). The prognostic value of 90K appeared to be limited to patients with node-positive disease. Number of metastatic axillary lymph nodes and level of 90K antigen were the only independent variables for predicting overall survival. Patients with metastatic breast cancer had elevated 90K in 51.3% of cases. High 90K levels were significantly associated with the presence of metastases to liver, shorter disease-free interval and younger age. We conclude that an elevated 90K antigen level in serum is a predictor of poor prognosis in breast cancer

Patterns of lacrimal dysfunction in primary biliary cirrhosis.

The lacrimal function has been evaluated in 23 patients suffering from primary biliary cirrhosis by rose bengal test, the Schirmer test 1, and the tear breakup time. Ocular dryness was present in 78% of cases studied. No difference was found with respect to the length or severity of the hepatic involvement between patients with and without lacrimal dysfunction, but in patients with signs of hypolacrimation the changes in the lacrimal tests increased with the duration and histological progression of liver disease

Cyclosporin-A in the treatment of atopic dermatitis: effects on the immune system and clinical efficiency

In order to evaluate the effect of Cyclosporin-A (CyA) at doses of 5 mg/kg per day in atopic dermatitis we studied clinical effects, immunoglobulin production, lymphocytes subset, immunphenotype and local cytokine production in seven patients before and after 3 months CyA therapy. Clinically CyA was very effective in eliminating pruritus, erythema and vescicles with no significant adverse side effects. Using flow cytometric analysis we demonstrated that CyA treatment restored an overexpression of circulating CD25-positive cells. Similar results have been recorded with HLA-DR expression. CyA normalized the number of CD29 cells which were reduced in the blood of patients before starting treatment. Furthermore, after treatment, several cytokines (IL-2, IL-1α and IL-1β) had diasappeared from the epidermis. © 1994

Cyclosporin-A in the treatment of atopic dermatitis: effects on the immune system and clinical efficiency

In order to evaluate the effect of Cyclosporin-A (CyA) at doses of 5 mg/kg per day in atopic dermatitis we studied clinical effects, immunoglobulin production, lymphocytes subset, immunphenotype and local cytokine production in seven patients before and after 3 months CyA therapy. Clinically CyA was very effective in eliminating pruritus, erythema and vescicles with no significant adverse side effects. Using flow cytometric analysis we demonstrated that CyA treatment restored an overexpression of circulating CD25-positive cells. Similar results have been recorded with HLA-DR expression. CyA normalized the number of CD29 cells which were reduced in the blood of patients before starting treatment. Furthermore, after treatment, several cytokines (IL-2, IL-1α and IL-1β) had diasappeared from the epidermis. © 1994

TH2 cytokines profile in severe adult atopic dermatitis [PROFILO DI CITOCHINE A TIPO TH2 IN CORSO DI DERMATITE ATOPICA GRAVE DELL'ADULTO]

Atopic dermatitis is a disorder in which both type I and type IV reactions are involved. The disease is characterized by eczematous lesions and an aspecific infiltrate, often rich in eosinophils. Inflammatory infiltrate is constituted of T cells of the TH1 subset, but many authors showed that the TH2 subtype is important in the early phase of the disease. On the basis of our and of other group studies we investigated, at a molecular level, the mRNA expression of IL-4, IL-5, IL-2 and IFN-γ, in order to define the immunological pattern of the inflammatory infiltrate. IL-2 and IFN-γ are important mediators of delayed immunity, whereas IL-4 and IL-5 are involved especially in early immunity mechanisms, but can also participate in type IV reaction. Interleukin-4 and IL-5 are both produced by the T helper-2 lymphocyte subset. On the other hand the TH1 subset produces IL-2 and IFN-γ. IL-4 and IL-5 have many functions that could be summarized in eosinophils chemoattraction and maturation, and support to immunoglobulin-E production. IL-4 and IFN-γ have opposite functions on IgE production and are counter regulatory each other. 11 patients affected by atopic dermatitis and 5 normal patients have been biopsied. Biopsies and blood samples were taken within 48 hours from the appearance of new lesions and snap frozen in liquid nitrogen. Messenger RNA was extracted from biopsies, reverse transcribed and amplified. β-actin was used as a semiquantitative control. All patients showed a TH2-like cytokine pattern with IL-4 and IL-5 expression in both blood and skin samples. Two patients, biopsied several days later than the others, showed a reduction of IL-4 and IL-5 with an increased production of IL-2 and IFN-γ. We suggest that after an early immune reactions supported by a TH2-like cytokine secrection, there is a switching in the cytokine pattern to a TH1-like cytokine pattern