Immunogenetic factors in skin cancer

Article Abstract:

Genes of the major histocompatibility complex code form a class of proteins called the human leukocyte antigens, or simply HLA. These proteins play critical roles in the immune response of the body, including the rejection or tolerance of transplanted tissues. These antigens also play key roles in susceptibility to certain diseases, including some forms of cancer. In the September 19, 1991 issue of The New England Journal of Medicine, researchers present results adding to the growing body of evidence implicating different HLA molecules in susceptibility to skin cancer. It is generally believed that some cancers may be recognized and destroyed by the immune system in their earliest stages of development. People with skin cancer are never found to have the HLA-A11 antigen, and it is thought that this antigen somehow favors the recognition and destruction of skin cancer cells. However, the relationship of the HLA antigens to skin cancer is likely to be complex. Exposure to sunlight is an important risk factor for the development of skin cancer, and it is now known that ultraviolet light (UV) in the B range, so-called UVB, is responsible. Ultraviolet B causes mutations in skin cells which can lead to cancer. However, UVB appears to be a double-whammy; it is directly toxic to Langerhans cells, immune cells that live in the skin. In some people, UVB destroys contact hypersensitivity (a particular immune reaction) in the exposed skin. While only about 35 to 40 percent of all people have this ultraviolet sensitivity, virtually all patients with basal-cell or squamous-cell skin cancer are UVB sensitive. This fact suggests that effects correlated with the HLA antigens might not be due to those antigens alone. For example, the genes for tumor necrosis factor (TNF) alpha are within the same region. This factor determines UVB sensitivity in mice and may have the same effect in people. It may be possible that increased susceptibility to skin cancer results from specific genes for TNF alpha. Therefore, exposure to UVB might simultaneously be causing the mutations that lead to cancer and destroying the immune response that might destroy the cancerous cells as they develop. Susceptibility to skin cancer may prove to be the result of independent influences of a number of different factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Ultraviolet radiation, Major histocompatibility complex, Skin cancer, editorial

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Clinical features and prognostic factors in adults with bacterial meningitis

Article Abstract:

A nationwide study is made to determine clinical features and the prognostic factors in adults with community-acquired acute bacterial meningitis. It was found that the mortality associated with bacterial meningitis remains high, and the strongest risk factors for an unfavorable outcome are those that are indicative of systematic compromise, a low level of consciousness, and infection with S. pneumoniae.

Netherlands, Adults, Prognosis, Surveys, Bacterial meningitis

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