Allergic encephalitis

The genes of the inducible and the constitutively expressed forms of NOS have been cloned and expressed. The expression of inducible NOS in the brain tissue of animals with experimentally induced neurological disorders (boma disease virus and rabies virus in rats), herpes simplex virus (mice) and experimental allergic encephalitis (in rats) suggests that NO produced by induced NOS may be a toxic fector in the pathogenesis of neurological diseases (Koprowski et /., 1993). 

Anti-CD40L, in experimental models, also inhibits graft-versus-host disease (149) and experimental allergic encephalitis (150) and may find use also in the human counterparts of those models. 

Th3 lymphocytes are mainly found in mucous membranes, they release TGFp and cytokines IL 4 and IL 10. They are sometimes referred to as CD4+ CD25-since they do not demonstrate CD25 expression. They can be obtained after oral administration of myelin to mice. Their presence has been observed in mesenterial lymph nodes. Th3 lymphocytes may inhibit the development of allergic encephalitis in mice, if they are administered peritoneally. Administering anti-TGFp monoclonal antibodies to mice reversed the immunosuppression effect (Chen et al., 1994). 

The effect of berbamine on experimental allergic encephalitis (EAG) was investigated in Lewis rats. Amelioration of the acute-phase of EAE was only minimal, but the incidence of relapsing EAE was reduced by 65% for berbamine at a non-toxic treatment dosage of 60 mg/kg via gavage on alternate days. These results suggest that berbamine, and perhaps other bisbenzylisoquinoline alkaloids, may have a potential role in the therapy of progressive multiple sclerosis [189]. 

The effect of tetrandrine on experimental allergic encephalitis (EAE) was investigated in Lewis rats. Amelioration of the acute-phase of EAE was only minimal, but the incidence of... 

Experimental allergic encephalitis (EAE) obtained by injection of myelin basic protein (MBP)... 

It has been well established that a number of chemokines including, KC, IP-10, MIP-1 a, RANTES, MARC (murine MCP-3), and TCA-3 (murine 1-309) are upregulated during the course of murine experimental allergic encephalitis (EAE) a mouse model of multiple sclerosis (MS) (25). Glabinski et al. have also demonstrated that the chemokines... 

There are many problems involved in mounting a competent rabies trial in humans. For example, as will be mentioned later, poly(ICLC) is a potent immune adjuvant with some antigens. There was concern that the use of poly(ICLC) might increase the incidence of allergic encephalitis in patients receiving a vaccine made from suckling mouse brain. However, in tests in rats, this was found not to be the case. 

Most cells of the immune system are ordinarily kept apart from those of the nervous system by means of the blood-brain barrier. However, allergic encephalomyelitis, in which T cells attack the myelin sheath of brain neurons, can easily be induced in mice.506 A similar autoimmune process is thought to be involved in human multiple sclerosis (see Chapter 30, pp. 1769, 1808, and Fig. 30-9).507,508 High levels of circulating IgM are found in some demyelinating diseases of peripheral neurons.508 In Rasmussen s encephalitis, which causes brain inflammation and epilepsy, serum antibodies attack a glutamate receptor subunit GluR3.509... 

EAE experimental allergic/autoimmune encephalitis is an animal model for demyelinating diseases, such as multiple sclerosis. It is induced by injection of myelin basic protein or whole CNS tissue together with adjuvants. 

In loiasis both adult and microfilariae are susceptible to diethylcarbamazine. However, encephalitis is a major risk in patients with heavy infestation (SEDA-17, 356) (7), and ivermectin should be preferred. Severe allergic reactions can need treatment with antihistamines and glucocorticoids. The risk of encephalitis has led to the recommendation that prophylactic use of diethylcarbamazine against Loa loa should only be contemplated when the chance of infection is considerable. 

The Advisory Committee on Immunization Practices (ACIP) has recommended that vaccinees should be observed for 30 minutes after immunization and that medications to treat anaphylaxis should be available (12) [http //www.cdc.gov/mmwr/PDF/rr/rr4201.pdf]. A personal history of allergic disorders should be considered when weighing the risks and benefits of the vaccine for an individual. Japanese encephahtis vaccine should not be given to persons who had a previous adverse reaction after receiving Japanese encephalitis vaccine or a previous hypersensitivity reaction to other vaccines of neural origin. 

In Japan, children who had immediate-type allergic reactions to Japanese encephalitis vaccine had antigelatin IgE in their sera. However, the immunological mechanism of non-immediate-type allergic reactions that consist of cutaneous signs developing several hours or more after Japanese encephalitis immunization is not yet clear. Serum samples taken from 28 children who had non-immediate-type allergic skin reactions have been compared with serum samples taken from 10 children who had immediate-type reactions (13). All the children who... 

Table 1 Allergic reactions after Japanese encephalitis immunization...

An association between reactions to Japanese encephalitis vaccine and a history of urticaria or allergic rhinitis has been identified (14). 

Data on adverse events reported to a passive provincial surveillance system have been evaluated after the mass immunization with a polysaccharide meningococcal vaccine of 1 198 751 people aged 6 months to 20 years in Quebec. A total of 118 reports of severe adverse events were selected. The most frequent were allergic reactions (9.2 per 100 000 doses), followed by few neurological reactions (0.5 per 100 000 doses) and very few anaphylactic reactions (0.1 per 100 000 doses). There were no reports of long-lasting sequelae or of encephalopathy, encephalitis, or meningitis (15). 

Serious allergic reactions were reported in 18 patients after the use of a Japanese encephalitis vaccine containing thiomersal (51). Reactions in 15 patients were thought to be related to the product 13 had urticaria affecting the whole body, one had erythema multiforme, and one had a rash. Fourteen reactions arose after the second... 

The safety and efficacy of a fixed combination of pyrimethamine 25 mg + sulfadoxine 500 mg, supplemented with folinic acid 15 mg, both twice a week, as primary prophylaxis of Pneumocystis pneumonia and Toxoplasma encephalitis has been evaluated in 106 patients infected with HIV in a single-arm, open, prospective study (17). There were allergic reactions in 18 patients and permanent withdrawal was required in seven. One patient who took continued prophylaxis despite progressive hypersensitivity reactions developed a serious adverse reaction (Stevens-Johnson syndrome). 

Positive patch tests to phenolphthalein have been reported in some eczematous lesions (Bernstein 1931 Wise and Sulzberger 1933). False positive patch tests, reflecting epidermal hysteresis, have also been demonstrated after phenolphthalein administration (Shelley et al. 1972). Wyatt et al. (1972) found that serum taken during exacerbations produced a local inflammation when injected intradermally. Possible cross-reaction with erythrosin which is used as a food and drug colorant has been reported (Wile 1936). Other rare allergic manifestations after phenolphthalein administration are urticaria, Stevens-Johnson syndrome, lupus erythe-matosus-like eruptions, and encephalitis (Lindemayr 1959 Kendall 1954). 

---