Search

Les hypotheses phylogenetiques, le contrat narcissique defini par P. Aulagnier, l’instance surmoique eclairent certains aspects des processus de transmission. Mediateur de ces processus au sein de la famille, le surmoi parental structure par les interdits fondamentaux du meurtre et de l’inceste permet la transmission du pouvoir de transmettre. Dans certains cas traumatiques familiaux et/ou collectifs, c’est ce pouvoir qui risque de s’interrompre.

Studies carried out in our laboratory showed that NGF has a primary role in wound healing, induces healing in the skin of farm animals and promotes healing of human pressure ulcers. More recently, it has been demonstrated that NGF has a role in eye physiology and promotes healing of corneal ulcers in humans. In the present study, we evaluated the efficacy of topical NGF treatment in a dog model of eye chronic disease to promote epithelial healing, reduction of corneal scarring, increase sensory innervation and goblet cells density. English Bulldogs who had undergone the surgical removal of the lachrymal gland developed chronic keratoconjunctivitis sicca. One eye of each dog was treated twice daily with 100 ml of NGF ointment for 1 month, while the fellow eye was used as control. Eyes were evaluated at baseline and after 1 month of NGF. NGF treatment significantly recovered epithelial keratopathy, reduced corneal haze, improved corneal sensitivity and strongly increased the tear production as well as the conjunctival goblet cell density. This study shows that topical application of NGF improves ocular surface signs in dogs with dry eye. Overall, our findings suggest a crucial role of NGF in nerve cells/skin cells physiopathology.

The paper of Belda and co-workers describes the interesting finding that swimmers have an increased number of neutrophils in induced sputum. A mixed type of neutrophilic–eosinophilic inflammation has been …

● PURPOSE: To develop and validate a questionnaire that measures health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC). ● DESIGN: Prospective, observational case series. ● METHODS: An initial list of 42 items was developed and administered to 30 children with active VKC (six girls and 24 boys; mean age, nine two years). The 30 most significant items were selected and converted into questions on a three-step scale for validation in 41 children with active VKC (eight girls and 33 boys; mean age, 9.5 2.1 years). Twenty-two children also completed the generic KINDL questionnaire. Clinical signs were evaluated and scored and total sign scores (TSSs) were calculated. Validation was performed by factorial analysis and Pearson correlation. Internal consistency was computed by the Chronbach on the extracted factors. ● RESULTS: Factorial analysis extracted two factors with good internal consistency: symptoms (12 items; 0.89) and daily activities (four items;0.77). Correlations of Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) scores to KINDL scores were in the expected direction. Most patients reported itching (93%), burning (90%), redness (90%), the need to use eye drops (90%), tearing (83%), and photophobia (80%). The children’s greatest concerns were limitations on going to the pool (71%), playing sports (58%), and meeting friends (58%). QUICK symptom scores were correlated significantly to conjunctival hyperemia (P < .001), secretion (P .042), chemosis (P .012), superficial punctate keratopathy (P < .001), and TSS (P .010). ● CONCLUSIONS: The QUICK questionnaire is a new, simple instrument to measure HRQoL in children with severe allergic conjunctivitis. This test is effective for the global evaluation of the impact of VKC on children’s

The authors aimed to define the ocular symptomatology of women with polycystic ovaries and hyperandrogenism.Prospective, observational case series.Of the 62 consecutive patients with an ultrasonographic diagnosis of polycystic ovary (PCO), 16 were identified as having clinical and biochemical signs of hyperandrogenism. All women with a history of ocular symptoms (20/62 total patients [32.3%], 15/16 polycystic ovary syndrome (PCOS) patients [93.7%], and 5/46 PCO patients [10.8%]) underwent a complete eye examination with conjunctival impression cytologic sampling. Clinical measurements of tear function (tear film break-up time [BUT], Schirmer I test) were completed along with analysis of conjunctival goblet cell number, conjunctival immunostaining, and reverse-transcriptase polymerase chain reaction for the mucins MUC1 and MUC5AC. Clinical, histologic, and biochemical data of patients with PCOS were compared statistically with that of patients with PCO and with eight age- and gender-matched healthy controls. Eight of the most severely affected patients received systemic antiandrogen therapy and underwent further ocular evaluation four months after systemic therapy.Women with PCOS had greater conjunctival hyperemia (P.001), dryness (P.001), itching (P.001), mucous discharge (P.001), and contact lens intolerance (P.001) than patients with PCO. Patients with PCOS had a significant reduction of the tear film BUT accompanied by a significant increase in goblet cell number and conjunctival MUC5AC messenger ribonucleic acid expression compared with both PCO patients and healthy subjects.Evaluation of the ocular surface should be considered in patients with PCO or PCOS. Women with PCOS were more likely to have itchy-dry eyes, decreased tear film BUT, and increased goblet cell density.

To the Editor: The expression of receptors for IgE on human eosinophils remains controversial, as reviewed in a recent comprehensive editorial.[1][1] Although human eosinophils from subjects infected by Schistosoma mansoni were recently reported to express different types of receptors for IgE (high

A major allergen of Parietaria officinalis, a species responsible for a large number of respiratory allergies in Mediterranean areas, has been identified and characterized. This allergen (Pol) was found in the fraction which precipitates between 70 and 100% ammonium sulphate saturation. Pol showed a molecular weight of 15,000 daltons as determined by SDS-PAGE and HPLC. The pI of Pol was in the pH region 4-6, IEF showing four major bands. Two major bands were shown by CIE, CRIE and immuno-blotting; major contaminants or aggregates were also revealed by the latter technique and by HPLC. Pol showed an allergic specific activity 2 times higher than the crude extract; moreover it was shown to be a major allergen since it inhibited 29 out of 30 sera from allergic patients sensitive to P. officinalis.

This study was performed to investigate the inflammatory changes occurring in the human conjunctiva at different time periods after allergen provocation. Twenty-three ryegrass-sensitive patients with allergic conjunctivitis (19 with hayfever and four with vernal conjunctivitis) were challenged by topical administration of ryegrass antigen to the eye. Allergen concentrations were increased in increments until an immediate ocular allergic reaction was elicited. Numbers of various inflammatory cells (neutrophils, eosinophils, lymphocytes, and monocytes) found in conjunctival scrapings were quantified and correlated with the clinical profile, total serum IgE, and serum IgE to Rye I antigen. Twenty minutes after some level of antigen topical challenge to the eye, all patients had ocular redness, tearing, and itching. Compared with findings in seven control subjects, significant inflammatory cells were found in the conjunctival scrapings of patients before challenge (p less than 0.05) and 20 minutes (p less than 0.001) and 6 hours (p less than 0.002) after effective challenge. Significant increases in neutrophils of patients occurred after 20 minutes (p less than 0.001), and in eosinophils at 6 hours (p less than 0.005), compared with values of control subjects. When each case was evaluated individually, nine of the 23 patients had highly evident inflammatory changes 6 hours after allergen provocation. The levels of total serum IgE and serum IgE to Rye I antigen of these nine patients did not differ significantly from the other patients in the study. Our data provide the first evidence in humans that significant inflammatory changes in conjunctival scrapings are present long after allergen exposure has ended.

Histamine release and leukotrienes (LTB4 and LTC4) production from circulating basophil have been studied in 13 patients with episodic cluster headache (CH) during the remission phase of symptoms, and in 9 normal subjects. Cell suspensions of basophils were stimulated with scalar dilutions of anti-IgE, f-met-peptide and Ca2+ ionophore A23187. Histamine was measured by an automated fluorimetric method; LTB4 and LTC4 with RIA in individual cases, and with Reverse-Phase HPLC in the two pools obtained from the supernatants of CH patients and controls. Mean values of histamine release in patients with CH were significantly lower when compared to those obtained in control subjects after stimulation with anti-IgE at the three dilutions used. LTC4 mean levels measured in CH patients were significantly lower than those of supernatants from controls after stimulation with 0.05 gamma/ml of A23187. A reduction of LTC4 and LTB4 levels in CH patients was also observed in R-P HPLC, which showed different elution patterns in the two groups. The histamine release in individual cases was related to leukotriene production: LTC4 levels were significantly (p less than .05) higher in "high histamine releasers" than in "low histamine releasers". Our results indicate that CH patients have complex abnormalities of histamine release and of leukotriene production during the painless phase of the disease.

An indirect immunofluorescence technique and an indirect immunoperoxidase technique were used on cryostat sections of human group-O submaxillary salivary gland and rat stomach. Circulating antibodies reacting with mucus antigen(s) were found in sera from 52·7% of patients with active pulmonary tuberculosis and in 21·8% of patients with chronic obstructive lung disease. Among hospital patients with other diseases and healthy controls, mucus antibodies were found in 7·2 and 5·4% respectively. The mucus antibodies were not absorbed by an excess of red blood-cells derived from group AD+healthy subjects of from the rat donor of the stomach, while the fluorescence and the immunoperoxidase reactions were almost ompletely abolished after the absorption of positive sera with human dried bronchial secretion. It is postulated that mucus antibody may be a new and important sero- logical marker of disorders accompanied by mucus ac- cumulation in the lung and possibly other organs and/or by severe changes of the anatomical structures which act as a barrier to the reabsorption of abnormal amounts of mucus.

Experiments are reported for the evaluation of an indirect ELISA using peroxidase conjugate for the detection of IgG antibodies to Dactylis glomerata (DG), a grass pollen antigen frequently responsible for allergic rhinitis and asthma. When optimized, the test proved to be useful in clinical practice for a semiquantitative, cheap and simply-performed determination of IgG antibodies to DG. The advantages and disadvantages of this method, compared with those of elaborate antigen-binding assays, are discussed.

Extensive evidence suggests that mediator release from inflammatory cells plays a role in the pathogenesis of allergic disorders in humans.‘.2 Most studies have focused on the identification of new mediators de novo synthesized by human inflammatory cells; two such examples are AGEPC and leukotrienes.‘” In addition, a number of laboratories are striving to understand the immunologic and biochemical mechanisms underlying the release of chemical media-. tors.6-8 However, few studies have been devoted to clarifying the pathophysiologic mechanisms that control the release of mediators from human inflammatory cells (i.e., the concept of “releasability”). The concept and the study of releasability in humans originated in the laboratory of Lichtenstein and Conroy’ almost a decade ago. They foresaw that, in addition to quantitative immunologic parameters such as IgE and IgG antibody levels, the study of allergic disorders should include the evaluation of cellular releasability. Until then, releasability was defined on an almost philosophic plane because it was impossible to characterize and separate immunologic from releasability parameters. Schleimer et al.’ selected the basophil system, a reliable experimental model of human anaphylaxis, to initiate the study of releasability. For example, they showed that histamine release is not correlated to the absolute quantity of IgE antibody present on human basophils challenged with the appropriate antigen. 9 ” Similarly, the release of histamine in response to anti-IgE is not related to the number of IgE molecules on the basophil surface.” In addition, they demonstrated that significant differences in IgEand non-&E-mediated releasability exist in some allergic conditions.“-” These pioneering studies supported the notion that basophil releasability is a real entity that could be of some relevance in the pathogenesis of inflammatory disorders. Stimulated by the lack of information on the factors that affect basophil releasability, we initiated a series of investigations to identify and characterize factors that physiologically control basophil releasability. We also used the ba