Chronic hepatitis B surface antigen (HBsAg) / cells enhanced the whereas it persisted in others, is unclear. In addition, HBsAg blastogenic response in group 3 but did not rewhether the carrier children who cleared the HBsAg without verse the unresponsiveness in group 1 and group 2 subdetectable anti-HBs may benefit from hepatitis B immunizajects. The addition of interleukin (IL)-2 in culture retion is also unknown. versed unresponsiveness in all cases except one case inTo study the immune unresponsiveness to HBsAg at the group 1. Compared with before vaccination, PBMC from genetic and cellular levels in carrier children who cleared group 2 subjects produced significantly less interferon serum HBsAg but failed to develop anti-HBs, we vaccinated gamma (IFN-g) and more IL-4 in response to HBsAg after those subjects with recombinant hepatitis B vaccine and vaccination, a cytokine response not observed in group aimed to determine (1) whether anti-HBs production could 1 subjects. HLA typing indicated that 3 of 10 patients in be elicited or enhanced, (2) whether HBsAg-specific T cells group 1 (30%) and 1 of 5 patients in group 2 (20%) had could be activated in vivo, and (3) whether suppression or HLA-DRw14-DRw52, a marker previously linked to low defect of antigen presentation is involved in the unresponanti-HBs response to hepatitis B vaccine in Taiwan. We siveness. Because analysis of cytokine produced by peripheral conclude that the underlying causes of poor anti-HBs blood mononuclear cells (PBMC) in response to HBsAg may response in group 1 subjects are multifactorial, includaid in the understanding of the mechanisms underlying the ing specific failure of antigen presentation or T-cell actiimmune response to HBsAg, we examined the cytokine provation, or the lack of T helper (Th)2 cell-like response duction of the immune response to HBsAg in our subjects to HBsAg. HLA-DRw14-DRw52 does not confer absolute to determine whether the cytokine pattern is related to the nonresponsiveness to HBsAg. These patients are not unresponsiveness. By HLA typing, we attempted to show benefited by hepatitis B immunization. (HEPATOLOGY whether HLA phenotype can predict a poor anti-HBs re-1996;24:1355-1360.) sponse in carriers who cleared serum HBsAg. PATIENTS AND METHODS Patients.A total of 415 HBV carrier children from the Department of Pediatrics, National Taiwan University Hospital, were checked for serum HBV markers and had conventional liver profiles every 6 we studied their immune response to HBsAg. There were 10 boys feron gamma; S/N, sample cpm per negative control mean cpm; Th, T helper cell. From the
Nasopharyngeal carcinoma is difficult to diagnose in its early stages. It also has frequent recurrences and/or distant metnstases after radiotherapy. Extensive clinical, serological and biochemical studies were done during 1980‐1982 on 351 patients to aid in the diagnosis of the disease, especially with recurrence or metastasis. Seropositive rates of the antibody titers against viral capsid antigens (VCA) and early antigens (EA) of Epstein‐Barr virus (EBV) in IgG and IgA classes were 41.7%‐100%. They ranked, in order of frequency: anti‐VCA/IgA, anti‐VCA/IgG, anti‐EA/IgG, and anti‐EA/IgA. Mean total serum IgG and IgA levels were moderately increased in all patients. Serum GOT, GPT, alkaline phosphatase, laclnte dehydrogenase and mucoprotein were elevated either alone or in combination in a few patients before treatment, in many patients with recurrence or metastases, and in all patients with liver metastasis.
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