Szymaniak L
Katedry i Zakładu Mikrobiologii i Immunologii Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1998;44:45-64.
Pathogenetic mechanisms responsible for efficacy of specific immunotherapy still remain to be fully explained. This concerns both desensitization with classic allergens and very rarely used specific immunotherapy with bacteria. Microbes can play important role as hypersensitivity factor in some allergo-inflammatory processes. Bacterial products may act as basophil histamine liberators through immunological (IgE-mediated) and nonimmunological--particular lectin-sugar way. The aim of study was to verify if histamine release triggered by microbes could be modified (blocked) with specific antibacterial antibodies--taking into consideration both of mechanisms of basophil degranulation. The size of immediate (in healthy persons--Tab. 3, 4) and late as well as delayed (in asthmatic patients--Tab. 8) skin reactivity to examined microorganisms and the degree of basophil histamine release induced with these bacteria were compared. Human basophils were isolated from peripheral blood on Ficoll-Hypaque gradient, next challenged with whole, formalin-killed bacteria and with the same bacteria after incubation with specific and nonspecific sera. To differentiate between IgE-dependent and non-immunological mechanisms of histamine release, the IgE molecules were removed from the surface of the basophils by exposure to pH 3.6 (stripping). In each experiment histamine release induced by anti-IgE antibodies was used as control of stripping (Tab. 5, 9). Levels of histamine from the basophils (without and after stripping) incubated with non-coated and specific antibodies coated bacteria were compared. The results were expressed as a percentage of total histamine content in the sample. Histamine release was assayed spectrofluorometrically by using Shore method in Norn modification. The main investigations concerned the basophils from 12 healthy, non-atopic individuals, who had positive immediate skin reactions with at least 1 from 3 microbial strains: Staphylococcus aureus 9615 (unencapsulated), Staphylococcus aureus Smith (encapsulated) and Escherichia coli. Sera containing specific antibodies for these microorganisms were obtained from immunized rabbits. As negative control served sera collected from animals after immunization. Additionally the basophils of 6 asthmatic (intrinsic asthma) patients treated with autovaccines were examined. All patients demonstrated positive late and delayed skin reactions, 3 of them also immediate, to autologous Neisseria and Moraxella species cultured from upper respiratory tract. The bacteria were used as a component of autovaccine and as a basophils stimulating factor in histamine assay. Microbes were incubated with patients own sera before (unspecific serum) and after treatment (source of "specific" antibodies).
特异性免疫疗法疗效的致病机制仍有待充分解释。这既涉及经典过敏原脱敏,也涉及极少使用的细菌特异性免疫疗法。微生物在某些变应性炎症过程中作为超敏反应因子可发挥重要作用。细菌产物可通过免疫(IgE介导)和非免疫——特别是凝集素-糖的方式,作为嗜碱性粒细胞组胺释放剂。本研究的目的是验证微生物引发的组胺释放是否能用特异性抗菌抗体进行调节(阻断)——同时考虑嗜碱性粒细胞脱颗粒的两种机制。比较了对所检测微生物的即时(在健康人——表3、4)、迟发以及延迟(在哮喘患者——表8)皮肤反应的大小,以及这些细菌诱导的嗜碱性粒细胞组胺释放程度。通过Ficoll-Hypaque梯度从外周血中分离人嗜碱性粒细胞,接着用完整的、经福尔马林灭活的细菌以及与特异性和非特异性血清孵育后的相同细菌进行刺激。为区分组胺释放的IgE依赖性和非免疫机制,通过暴露于pH 3.6(剥离)从嗜碱性粒细胞表面去除IgE分子。在每个实验中,用抗IgE抗体诱导的组胺释放作为剥离的对照(表5、9)。比较了与未包被和特异性抗体包被细菌孵育的嗜碱性粒细胞(未剥离和剥离后)的组胺水平。结果以样品中总组胺含量的百分比表示。采用Norn改良的Shore方法通过荧光分光光度法测定组胺释放。主要研究涉及12名健康、非特应性个体的嗜碱性粒细胞,这些个体对3种微生物菌株中的至少1种有即时皮肤阳性反应:金黄色葡萄球菌9615(无荚膜)、金黄色葡萄球菌Smith(有荚膜)和大肠杆菌。从免疫兔获得含有针对这些微生物的特异性抗体的血清。作为阴性对照的是免疫后从动物采集的血清。此外,还检查了6名接受自身疫苗治疗的哮喘(内源性哮喘)患者的嗜碱性粒细胞。所有患者对从上呼吸道培养的自身奈瑟菌属和莫拉菌属均表现出迟发和延迟皮肤阳性反应,其中3名患者还表现出即时反应。这些细菌用作自身疫苗的成分以及组胺测定中的嗜碱性粒细胞刺激因子。在(非特异性血清)治疗前和治疗后(“特异性”抗体来源)将微生物与患者自身血清孵育。