Summary
Groups of patients with dendritic ulcers, persistent stromal disease, together with a group of controls were investigated for humoral and cell mediated immune responses in order to find whether correlation exists between disease severity and these in vitro tests. Kinetic studies of cell mediated immune responses were also carried out in a small group of patients. Using a whole blood test of lymphocyte transformation to HSV antigen, there was some evidence of a depression of specific response in patients with stromal disease. Primary herpetic keratitis was associated with a considerable positive response in lymphocyte transformation and in the production of macrophage migration inhibition factor. Recurrent disease was associated with elevation of specific lymphocyte transformation during active disease, which fell to a normal resting level during convalescence. Although there was a tendency towards increased frequency in HL-A 1 in patients with dendritic ulcers which was not apparent in stromal disease, this trend did not reach statistical significance. Since lymphocyte transformation using specific virus antigen was the only in vitro correlate of clinical severity, it is concluded that it can be recommended as a useful test to determine patients at risk of developing the more serious forms of keratitis.
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Zusammenfassung
Wir untersuchten die zelluläre und humorale Immunantwort bei Patienten mit Keratitis dendritica, persistierendem Stromaherpes und bei Kontrollpersonen, um herauszufinden, ob sich zwischen diesen immunologischen in-vitro-Testen und dem Krankheitsbild eine Korrelation herstellen läßt. Bei einzelnen Patienten wurden auch Verlaufskorrelationen versucht. Im Lymphozytentransformations-Test mit HSV-Antigen zeigte sich bei Verwendung von Vollblut ein Hinweis, daß bei Patienten mit Stromaherpes die spezifische Immunantwort auf Herpesantigene verringert sein könnte. Eine primäre Herpeskeratitis hingegen war mit einer erheblich gesteigerten Reaktion im Transformationstest und im Makrophagen-Migrations-Hemmungstest verbunden. Bei wiederholten Infektionen waren die Reaktionen im Transformationstest während der akuten Erkrankungsphase erhöht und sanken im Verlauf der Heilung auf normales Niveau ab.
Patienten mit Keratitis wiesen etwas häufiger das HLA-Al auf. Dies war aber nicht statistisch signifikant.
Der Lymphozytentransformationstest war der einzige in-vitro-Test, der sich mit dem klinischen Schweregrad korrelieren ließ. Er wird von uns deshalb als nützlicher Test dafür empfohlen, ob bei Herpes-Patienten die Gefahr besteht, daß sie eine der schwereren Keratitisformen entwickeln.
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© 1981 J.F. Bergmann Verlag, München
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Easty, D.L., Carter, C., Funk, A., Entwhistle, C. (1981). Factors Influencing the Spread of Herpes Simplex Virus Into the Corneal Stroma. In: Sundmacher, R. (eds) Herpetische Augenerkrankungen. Internationales Symposion der Deutschen Ophthalmologischen Gesellschaft vom 12. bis 14. April 1980 in Freiburg. J.F. Bergmann-Verlag. https://doi.org/10.1007/978-3-642-80499-1_20
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DOI: https://doi.org/10.1007/978-3-642-80499-1_20
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