Immunologic Response to Tetanus Toxoid Inoculation in Patients with Hepatic Cirrhosis

Cherrick, Gilbert R.; Pothier, Lillian; Dufour, Jean‐François; Sherlock, Sheila

doi:10.1056/nejm195908132610707

Cited by 40 publications

(6 citation statements)

References 7 publications

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“…The overall antibody response to polyvalent pneumococcal vaccine was as good in patients with alcoholic liver cirrhosis as in healthy controls or patients with COPD. The results agree with two previous studies (16,17) using tetanus toxoid but differ from the study by Havens et al (18) who reported a three times stronger antibody production in response to a challenge with diphtheria toxoid in patients with chronic hepatic disease as compared to healthy individuals. Since, as a consequence of the underlying disease process, serum antibody levels may decline at different rates, it is important to know the time course of antibody concentration.…”

Section: Discussionsupporting

confidence: 84%

Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

et al. 1984

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Patients with cirrhosis have an increased risk of dying from pneumococcal pneumonia. Their immunological response to pneumococcal vaccination is not known. We compared the antibody response to challenge with a 14-valent purified pneumococcal polysaccharide vaccine in 15 patients with biopsy-proven alcoholic liver cirrhosis, 10 healthy volunteers and 10 patients with chronic obstructive pulmonary disease. Preimmunization levels for Danish type 1 pneumococcal polysaccharide were lower among cirrhotics than patients with chronic obstructive pulmonary disease. Four and 12 weeks after immunization, no significant differences were found in antibody concentrations between the three groups. We conclude that patients with alcoholic cirrhosis can produce an adequate antibody response to pneumococcal polysaccharide antigen.

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Section: Discussionsupporting

confidence: 84%

Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

et al. 1984

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“…It is difficult to assess the significance of our experiment as far as it concerns the pathogenesis of increased antibody and y-globulin levels in liver cirrhosis. A number of observations points to failure of hepatic filter in this disease as proposed by BJ0RNEBOE [2] : augmented levels of antibodies against gut-derived antigens have been noticed [3, 10, 161, while some authors [1,5,141 have demonstrated a normal reactivity to parenterally administered antigens. THOMAS et al…”

Section: ~~mentioning

confidence: 99%

Influence of Orally Administered Antibiotics on anti-T Agglutinin of Normal Subjects and of Cirrhotic Patients

Boccardi¹,

Attinà²,

Girelli³

1974

Vox Sanguinis

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Anti-T agglutinin was studied in normal healthy subjects and in cirrhotic patients before and after oral administration of antibiotics depressing intestinal microbial flora. After antibiotic treatment anti-T levels were significantly reduced. These observations show that bacterial antigens of intestinal origin are likely to be responsible for anti-T production and that there must be common determinants between them and T antigen of red blood cells. It is not sure whether the previously reported increase of anti-T levels in liver cirrhosis is in favour of the hypothesis that hypergammaglobulinaemia in this condition is due to failure of diseased liver to trap gut-derived antigens.

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“…Attesting to this clinically is the frequent association of splenomegaly and diffuse hyper-h,-globulinemia in such disorders as alcoholic cirrhosis in which a primary immune mechanism is not believed to exist. Although there is conflicting evidence as to whether these patients produce excessive amounts of antibody (79,80) it may be necessary to employ an appropriate intravenous particulate antigen to elicit differences, as was true in comparisons between normal and splenectomized individuals (81,82).…”

Section: Proliferative Activity Of the Normal Rat Spleen Special Feamentioning

confidence: 99%

Proliferative Response of the Spleen and Liver to Hemolysis

Jandl

Files

Barnett

et al. 1965

The Journal of Experimental Medicine

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Combined chemical and autoradiographic studies in rats injected with tritiated thymidine indicate that acute red cell sequestration stimulates reticuloendothelial (RE) proliferation. In the spleen DNA synthesis is most markedly stimulated in the marginal zone which is also the initial site of red cell sequestration. This proliferative response involves several division steps and eventuates in a colonization of the red pulp with increased numbers of all cell lines native to the spleen. In both spleen and liver there occurs also a generalized stimulation of division in the macrophages and littoral cells which involves only 1 or 2 division steps. Chronic compensated hemolytic anemia achieved in rats by injections of phenylhydrazine caused functional overactivity of the RE system, including increased sequestering function and hypergammaglobulinemia. This splenic hyperplasia did not entirely regress after cessation of the injections. In man the splenomegaly of a chronic non-immunological hemolytic anemia, hereditary spherocytosis, was found to involve a marked (average: 8-fold) hyperplasia of all spleen cellular elements. Neither the acute nor chronic proliferative reaction appears to arise from immunological or "toxic" stimuli and the findings support the view that the size of the RE system is a function of its particulate "work load." It is suggested that the cytoproliferative aspects of immune responses may depend upon non-specific, usually particulate stimulation. After prolonged stimulation, hyperplasia of the RES may become partly irreversible.

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Immunologic Response to Tetanus Toxoid Inoculation in Patients with Hepatic Cirrhosis

Cited by 40 publications

References 7 publications

Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

Influence of Orally Administered Antibiotics on anti-T Agglutinin of Normal Subjects and of Cirrhotic Patients

Proliferative Response of the Spleen and Liver to Hemolysis

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