Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To study the role of T cells in bronchiolitis obliterans organizing pneumonia (BOOP) and chronic eosinophilic pneumonia (CEP) and to examine the influence of differing racial background, T-cell subsets in bronchoalveolar lavage (BAL) fluid (BALF) and in peripheral blood of 8 Japanese patients with idiopathic BOOP and 5 with CEP were compared with those of 15 normal subjects. The BALF pattern in BOOP was characterized by a significantly high number and percentage of lymphocyte and by a low CD4 to CD8 ratio compared with patients with CEP and healthy volunteers. Patients with CEP showed a significantly higher percentage of BALF eosinophils compared with other groups. There was no significant difference in BALF CD4 to CD8 ratio between patients with CEP and volunteers. Two-color analysis of T-cell subsets revealed that CD3+HLA-DR+ cells (activated T cell) in BALF of patients with BOOP and CEP increased significantly compared with volunteers, while BALF CD3+CD25+ cells (interleukin 2 receptor+ T-cell) did not. In addition, BALF CD8+HLA-DR+ cells (activated suppressor/cytotoxic T cell) in patients with BOOP and CD4+HLA-DR+ cells (activated helper T cell) in patients with CEP were significantly higher than levels detected in healthy subjects. The percentage of CD8+CD57+ cells and the number of CD8+CD11b- cells (cytotoxic T cell) in BALF were significantly higher in patients with BOOP compared with patients with CEP and healthy volunteers. There were no significant differences in the expression of peripheral blood T-lymphocyte surface antigens among the groups. These findings indicate that cytotoxic T cells in Japanese patients with idiopathic BOOP and helper T cells in CEP appear in the lungs is consistent with a previous report in Caucasians, supporting the hypothesis that T cells may play an important role in the pathogenesis of these diseases.
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PMID:Increase of activated T-cells in BAL fluid of Japanese patients with bronchiolitis obliterans organizing pneumonia and chronic eosinophilic pneumonia. 760 45

We have assessed the diagnostic value of site-directed bronchoalveolar lavage (BAL) and combined transbronchial biopsy (TBB) in 29 HIV-infected patients with localized pneumonia, in whom a previous BAL was nondiagnostic and in whom improvement did not occur with empiric antibiotic therapy. All patients but three had a CD4 cell count < 100/microliters. A definite diagnosis could be reached in 26 of 29 (90%) individuals, including 24 pathogens. Neither the radiologic pattern nor the type of Pneumocystis carinii (PC) prophylaxis could predict the positivity of either one of these two diagnostic procedures. Site-directed BAL alone allowed a diagnosis in infection in eight (28%) cases. TBB alone led to diagnosis in eight (28%) cases, including three PC and two toxoplasma gondii, undiagnosed by the site-directed BAL. Both techniques were positive and in agreement in 10 (34%) cases. The majority of the diagnosis led to a specific treatment. Therefore, the patients' survival was positively altered by the procedure. In conclusion, the performance of site-directed BAL and combined TBB markedly optimizes the diagnostic yield of each of these procedures performed separately in HIV-infected patients with localized pneumonia.
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PMID:Site-directed bronchoalveolar lavage and transbronchial biopsy in HIV-infected patients with pneumonia. 766 91

The spectrum of TCR usage has been analyzed for virus-specific CD8+ T cells isolated from the regional mediastinal lymph modes and from the lung by bronchoalveolar lavage (BAL) of C57BL/6 (B6) mice with influenza pneumonia. Lymphocytes were recovered during the acute phase of the primary response in mice infected with an H3N2 (A/HKx31) virus, or in immune animals that were secondarily challenged with an H1N1 virus (A/PR8). Cells taken directly from the BAL of infected mice exhibited an increase in the frequency of V beta 8.3+/CD8+ T cells. In addition, 20 to 50% of proliferating CD8+ T cells in the mediastinal lymph nodes and BAL populations stimulated in vitro with A/HKx31 were V beta 8.3 TCR+. These observations indicated that the V beta 8.3+/CD8+ T cells were specifically involved in the inflammatory process during influenza infection. However, in vivo depletion of V beta 8+ T cells in CD4-depleted mice did not adversely affect viral clearance, suggesting that other CD8+ T cells can compensate for the absence of these cells. The spectrum of TCR usage was also analyzed for influenza-specific T cell hybridomas derived from freshly isolated BAL of mice with pneumonia. Many of these T cell hybridomas were V beta 8.3+, although other TCR V beta elements were used. All of the V beta 8.3+ hybridomas recognized the H-2Db-restricted NP epitope, 365-380. Although the V beta 8.3 TCR contain similar TCR D beta and J beta elements, V alpha usage was surprisingly variable. Therefore, recognition of this particular epitope was dominated by the beta-chain of the TCR. We conclude that the murine CD8+ response to influenza A virus infection of B6 mice is limited in terms of the diversity of the responding T cells. However, there is significant plasticity in the CD8+ response, which readily compensates for the absence of the dominant T cell population.
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PMID:Prominent usage of V beta 8.3 T cells in the H-2Db-restricted response to an influenza A virus nucleoprotein epitope. 768 11

In the Ivory Coast, pneumologists examined 188 chest X-rays of patients with pulmonary tuberculosis (TB) treated at the Treichville Antituberculosis Center to compare the principal X-ray characteristics of patients with only TB with those of patients infected with TB and HIV. They did not conduct CD4 counts. 45 TB patients were also infected with HIV for an HIV prevalence rate of 38%. 73.3% of HIV infected TB patients were infected with HIV-1. 4.4% were infected with HIV-2. 22.3% were infected with both HIV-1 and HIV-2. Men predominated in both the TB only group and the TB-HIV group (67.1% and 77.7%, respectively). HIV infected patients were more likely to have thoracic extrapulmonary TB lesions than HIV seronegative patients (57.8% vs. 22%; P 0.05). Thus, 57.8% of co-infected patients had AIDS as defined by the CDC in 1987. Among co-infected patients, lesions on the mediastinal lymph nodes predominated (80.7%). Involvement of the parenchyma, demonstrated by miliary X-rays, was rather common (22.3% vs. 38.3% for HIV negative patients). The X-ray of 84.6% of patients with caseous pneumonia were infected with HIV and TB. These findings parallel those in the literature. They suggest that thoracic manifestations of TB indicate the state of immunodepression.
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PMID:[Aspects of thoracic radiography of patients with tuberculosis and HIV infection in Ivory Coast]. 770 Dec 11

The natural appearance of Pneumocystis carinii in induced sputum samples was studied in 60 HIV-infected patients with severe immunodeficiency and without a history of P. carinii pneumonia (PCP). The patients were prospectively evaluated for occurrence of P. carinii in induced sputum samples, PCP diagnosis and CD4+ cell counts during observation periods of 2 to 31 months. P. carinii was detected in 16 patients all of whom developed clinical PCP. In 5 patients P. carinii was detected 3 weeks to 8 months prior to clinical symptoms. Immunofluorescence using monoclonal antibody 3F6 was more sensitive than toluidine in detecting P. carinii in sputum samples (p < 0.05). In the patients who developed PCP a drop of the mean CD4 count to 40-50 x 10(6)/l was observed 200 days before diagnosis. However, out of 13 patients with CD4 counts of 0-20 x 10(6)/l only 7 developed PCP during 200 days of observation. The results do not support the suggested reactivation of a latent infection present in the vast majority of adults. PCP may instead result from exposure to the organism or presence of an unknown cofactor. We conclude that P. carinii is present in some asymptomatic HIV patients and that the detection of the organism in sputum should be regarded as pathological and prophylaxis or treatment inserted. The risk of transmission of P. carinii to patients with severe immunodeficiency should be seriously considered.
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PMID:Natural history of asymptomatic and symptomatic pneumocystis carinii infection in HIV infected patients. 774 86

Between July and November 1992, in Senegal, health workers took sputum samples from 27 HIV-positive patients (19 men and 8 women) aged 20-66 at the infectious disease service of Fann University Hospital Center in Dakar so researchers could determine the prevalence of Pneumocystis carinii pneumonia among HIV-positive patients and specify the characteristics of P. carinii pneumonia among HIV-positive patients in Dakar. The simple, effective, and low-cost technique used was coloration of the sputum with Toluidine O. 70.3% had HIV-1 infection, 26% had HIV-2 infection, and 3.7% had both HIV-1 and HIV-2 infection. 55.5% had CD4 counts under 200/cu. mm. 40.7% had higher CD4 counts. The CD4 count could not be measured in one patient. Six (22.2%) tested positive for P. carinii. Four of the patients with P. carinii pneumonia were HIV-1 positive. The other two were HIV-2 positive. 83.3% had fever and were becoming thinner. 33.3% had a cough. 16.6% had difficulty breathing. One patient with P. carinii infection was asymptomatic. Two pneumocystis patients had diffuse interstitial infiltration and perihilar infiltration. Another patient also had pulmonary tuberculosis. The CD4 count for 80% of HIV-infected patients who tested positive for P. carinii pneumonia was less than 200/cu. mm.
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PMID:[Preliminary study of pneumocystis carinii pneumonia diagnosed by induced expectoration in HIV positive patients in Dakar]. 775 66

One hundred immunocompromised HIV negative patients with microbiologically positive pneumonia underwent bronchoalveolar lavage (BAL) studies. Thirty cases showed peripheral neutropenia (< 1000 neutrophils/microL), 70 did not. The total cell number in BAL, the differential cell counts, and the lymphocyte subsets (CD4, CD8, CD19, CD57) were measured. Patients with pneumonia and normal or elevated peripheral neutrophils had a significantly increased total number of cells in BAL compared to patients with peripheral neutropenia (3.2 +/- 2 vs 1.3 +/- 0.6 x 10(5) cells/ml2 lavage fluid, p < 0.01). Ninety percent of the BAL differential cell counts obtained in patients exceeding 1000 neutrophils/microL showed a lymphocytic and/or neutrophilic alveolitis, whereas only 54% of patients with peripheral neutropenia displayed abnormal counts (p < 0.01). Yet the typical pattern of neutrophilic alveolitis was found more often for peripheral neutrophil counts over 1000/microL with high significance (p < 0.0001). Abnormal BAL cell patterns for neutropenic patients uniformly showed a lymphocytic alveolitis, only 10% additionally conformed with the pattern of neutrophilic alveolitis. Patients with pneumonia with and without peripheral neutropenia had similar findings in BAL lymphocyte subsets and exhibited a reduced CD4/CD8 ratio compared to controls (p < 0.05). The high susceptibility of severe neutropenic patients to pulmonary, especially fungal infections may be explained by the local lack of neutrophils.
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PMID:Differential cell count and lymphocyte subsets in bronchoalveolar lavage during pneumonia with and without peripheral neutropenia. 777 4

In the Swiss Study "HIV and pregnancy" we observed 153 singleton pregnancies of HIV-positive women. 23 (15%) of those ended with a premature delivery. For drug addicts (n = 100), the incidence of prematurity, 20%, significantly higher than in those free of drugs (n = 53) with 5.6%. The most frequent cause of prematurity was premature labor or rupture of the membranes (n = 13), followed by maternal illness (n = 8) and fetal complications (n = 2). Women with premature delivery tended to have lower CD4 cell counts than those with term delivery (29.4% vs 12.0% with < 200 CD4 cells/microliters). Low CD4 cell counts and drug consumption are two independent but cumulative risks for severe infections. 16 of the 153 women (12 with, 4 without drug consumption) had severe infections during pregnancy; in 4 cases (25%), this led to prematurity. The most common infection was pneumonia (14/16), further one case of pyelonephritis and one of cerebral toxoplasmosis. Two of these 16 infants (12.5%) were HIV-positive. We could not confirm a relationship between prematurity and vertical HIV transmission. Of the HIV-classified children, 3/18 (16.7%) premature infants and 16/74 (21.6%) term infants were infected.
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PMID:[Premature labor in HIV infected women. Swiss "HIV and Pregnancy" Study Group]. 778 79

Immunocompetent C.B-17 mice were immunized against Pneumocystis carinii by several intratracheal inoculations with infective P. carinii. These mice and another group of C.B-17 mice naive to P. carinii were then depleted of CD4+ cells by treatment with both anti-CD4 and anti-Thy1 monoclonal antibodies. Both groups of mice were then challenged with an infective inoculum containing 10(7) P. carinii organisms by intratracheal instillation. The mean log10 counts of P. carinii nuclei in the lungs of the nonimmune mice were 4.98, 5.89, and 6.77 when they were killed at 4, 10, and 19 days, respectively, after challenge. The P. carinii counts in the lungs of the immune mice were significantly lower at each time point and below detectable levels at 10 and 19 days. Analysis of P. carinii DNA by PCR revealed no detectable P. carinii in the lungs of the immunized mice at either 10 or 19 days, whereas all of the nonimmunized mice contained P. carinii DNA at all time points. The sera of immune but not nonimmune mice contained P. carinii-specific immunoglobulin G. These results indicate that immunization of an immunocompetent host against P. carinii can protect against P. carinii pneumonia even after the host is depleted of CD4+ cells. In addition, the results are consistent with the possibility that antibodies were responsible for the observed protection against P. carinii.
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PMID:Active immunity to Pneumocystis carinii reinfection in T-cell-depleted mice. 779 48

We report a case of pneumonitis induced by PL granules. A 45-year-old man took PL granules and other drugs for fever and headache. Because he subsequently developed high grade fever, cough and diarrhea, he was admitted to our hospital. His chest X-ray film revealed multiple patchy shadows in both lung fields. Analysis of bronchoalveolar lavage fluid (BALF) disclosed a high number of cells (total), lymphocytes, and a high CD4/CD8 ratio. Microscopic examination of transbronchial lung biopsy (TBLB) specimens showed infiltration of mononuclear cells and thickening of the alveolar wall. After discontinuation of drugs, his condition (symptoms, laboratory data, and chest X-ray findings) promptly improved. Lymphocyte stimulation tests (LST) for PL granules and acetaminophen were positive and an oral challenge test with PL granules was also positive. Based on these findings, we diagnosed this as a case of pneumonitis and enteritis due to PL granules. To our knowledge, this is the first reported case of pneumonitis due to PL granules.
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PMID:[A case of pneumonitis induced by PL granules]. 785 81


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