Delayed hypersensitivity. A critical evaluation of five recall antigens in a large reference population

Symreng, Tommy; Groth, O; Norr, Alex; Schildt, B.; Zetterqvist, H.

doi:10.1016/0261-5614(83)90004-3

Cited by 23 publications

(10 citation statements)

References 24 publications

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“…DCH reaction was assessed as an indicator of cellular immunity, as well as a nutritional marker. Extracts from Candida , purified protein derivative and mumps were injected intracutaneously [16]. The size of the largest induration was registered 48–72 h later and expressed as the sum of the longest diameter length and the longest perpendicular length [16].…”

Section: Methodsmentioning

confidence: 99%

Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly

Cederholm

Lindgren

Palmblad

2000

Journal of Internal Medicine

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Abstract. Cederholm T, Lindgren JA Ê , Palmblad J (Centre for Hematology and Inflammatory Research, Huddinge University Hospital and Karolinska Institutet, Stockholm, Sweden). Impaired leukotriene C4 generation in granulocytes from protein-energy malnourished chronically ill elderly. J Intern Med 2000; 247: 715±722.Objective. The dysregulation of the immune and inflammatory systems observed in protein-energy malnutrition (PEM) may be partly due to perturbation of essential fatty acid metabolism. In this study, we assessed the calcium ionophore A23187-induced generation of the arachidonate metabolites leukotriene B4 (LTB4) and leukotriene C4 (LTC4) in isolated granulocyte suspensions. Design. Case±control study. Setting. A university-affiliated acute care hospital in urban Stockholm. Subjects. Fourteen severely malnourished elderly subjects with stable non-malignant disorders (age 74 6 1 years, mean 6 SEM) and 12 healthy agematched controls were examined. Main outcome measures. Leukotrienes were analysed by high-performance liquid chromatography. Body mass index (BMI, kg m 22 ) and delayed cutaneous hypersensitivity (DCH) reaction were determined.Results. BMI was 16.5 6 0.5 and 26.2 6 0.9 kg m 22 (mean 6 SE) in the malnourished group and controls (P , 0.001), respectively. DCH was 8.5 mm (median) in patients and 29.5 mm in controls (P , 0.001). LTC4 generation in granulocytes from PEM patients was half of that of controls (9.1 6 2.0 vs. 17.8 6 5.2 pmol mL 21 , P , 0.05) when cells were stimulated with 0.2 mmol L 21 of A23187, and 13.7 6 2.5 and 27.2 6 7.5 pmol mL 21 , respectively (NS), upon stimulation with 1.0 mmol L 21 of A23187. LTB4 production in PEM patients and controls did not differ at any of the two calcium ionophore concentrations. LTC4 production correlated with BMI (r = 0.41, P , 0.05), but there was no significant correlation between DCH and LTB4 or LTC4 production. Conclusion. Protein-energy malnutrition is accompanied by perturbation of leukotriene synthesis, which may be one factor underlying the dysregulation of inflammatory responses in the depleted patient.

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Section: Methodsmentioning

confidence: 99%

Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly

Cederholm

Lindgren

Palmblad

2000

Journal of Internal Medicine

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“…Delayed hypersensitivity skin testing was performed on admission and at 9 weeks, using three antigens: purified protein derivative, Candida, and mumps. 15 The patients were regarded as reactive if the sum of two perpendicular diameters, read at 48 hours, in at least one of the tests was > 10 mm; they were regarded as anergic if the reaction was < 10 mm. The patients were classified as proteinenergy malnourished if at least three nutritional variables were lower than the following values, including one of each of the anthropometric, serum protein, and skin test measurements.…”

Section: Methodsmentioning

confidence: 99%

Feeding dependence and nutritional status after acute stroke.

Unosson

Bjurulf

et al. 1994

Stroke

103

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Background and PurposeWe assessed the nutritional status of patients with acute stroke and evaluated it in relation to the patients' dependence on assistance with feeding.Methods Fifty patients aged 70 years or older, admitted from their homes, were included. Weight index, triceps skinfold thickness, arm muscle circumference, serum proteins, delayed hypersensitivity, body composition measured by bioelectric impedance, and functional condition were determined on admission and 2 and 9 weeks after admission. Food and fluid consumption were also recorded.Results On admission, four patients were regarded as protein-energy malnourished. Those who required assistance with feeding after admission (n=18, 36%) had lower serum albumin (P<.05), lower body cell mass (P<.01), and were

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“…In the determination of DCH, extracts of Candida (1000 PNU ml-' , Hollister-Stier, Spokane, WA, USA), mumps (40CFUl-', Connaught Laboratories, Swiftwater, PE, USA) and PPD (purified protein derivative of tuberculin, 2TU 0.1 ml-l, Satens Serum Institute, Copenhagen, Denmark) were injected (0.1 ml) intracutaneously in the left upper arm. The size of the largest induration was registered after 48-72 h and expressed as the sum of the longest diameter and the longest perpendicular length [17].…”

Section: Nutritional Assessmentmentioning

confidence: 99%

Low levels of essential fatty acids are related to impaired delayed skin hypersensitivity in malnourished chronically ill elderly people

Cederholm

Berg

Johansson

et al. 1994

Eur J Clin Investigation

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Abstract. Essential fatty acid (FA) deficiency, which may accompany protein-energy malnutrition (PEM), has been associated with impaired inflammatory reactions. We evaluated this relationship by analysing FA profiles and delayed cutaneous hypersensitivity in 20 malnourished elderly non-cancer patients and in 20 agematched control patients. As indicated by serum cholesterol and serum triglycerides, the lipid levels were decreased by about one-third in the subjects with PEM. In comparison with the controls, there was a reduction in the w3 FA (e.g. eicosapentanoate) in total serum lipids (mgl-*) and serum phospholipids ( O h ) of 40% and 47%, respectively. Reductions in serum w6 FA (e.g. linoleate and arachidonate) levels corresponded to the drop in total FA concentrations (30%). The cutaneous hypersensitivity was impaired in 14 of the malnourished patients. The magnitude of the skin reaction was positively correlated (P < 0.05) to the concentrations of eicosapentanoate in serum lipids and serum phospholipids, as well as to the linoleate concentration in total serum lipids. Six of the malnourished patients took part in a nutritional intervention programme for 3 months. In parallel with an improvement in the nutritional status there was a 35% increase (P < 0.05) in the total w3 FA serum concentration.Negative skin tests became positive and the median skin induration enlarged threefold (P < 0.05). Thus, deficiency of w3 FA might be one factor contributing to cutaneous anergy in elderly malnourished patients.

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Delayed hypersensitivity. A critical evaluation of five recall antigens in a large reference population

Cited by 23 publications

References 24 publications

Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly

Impaired leukotriene C4 generation in granulocytes from protein‐energy malnourished chronically ill elderly

Feeding dependence and nutritional status after acute stroke.

Low levels of essential fatty acids are related to impaired delayed skin hypersensitivity in malnourished chronically ill elderly people

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