Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets

OBJECTIVE

This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations.

METHODS

Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC).

RESULTS

Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min.

CONCLUSIONS

The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.

Autologous platelet concentrates for facial rejuvenation

Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient’s blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy.

Acquired pellicle engineering using a combination of organic (sugarcane cystatin) and inorganic (sodium fluoride) components against dental erosion

This study evaluated the combination of a sugarcane cystatin (CaneCPI-5) and sodium fluoride (NaF) in acquired pellicle engineering for the prevention of dental erosion in vitro. 75 human enamel specimens were prepared and divided into 5 treatment groups (n = 15/group): Deionized water (Control); Elmex™ (SnCl2/NaF/AmF); 0.1 mg/ml CaneCPI-5; 500 ppm NaF; and CaneCPI-5+NaF (Combination). The specimens were individually treated (200 μl; 2 min; 37 °C), then incubated in human saliva (200 μl; 1 h, at 37 °C) for acquired pellicle formation. Afterwards, the specimens were submitted to an erosive challenge (1% citric acid, pH 3.6, 10 ml, 2 min, 25 °C). This sequence was conducted 5 times. Percentage of surface microhardness change (%SMC), relative surface reflection intensity (rSRI) and calcium released to the citric acid (CR) were measured and analyzed by One-way ANOVA followed by Tukey's test (p<0.05). In general, all the treatments (SnCl2/NaF/AmF, CaneCPI-5, NaF and Combination) significantly protected the enamel when compared the control group. Regarding %SMC and rSRI, the Combination was the most effective treatment, reducing the %SMC significantly (p<0.01) when compared to all the other treatments, although this difference was not significant in the CR analysis. All treatments demonstrated a protective effect on enamel against dental erosion; however the combination of CaneCPI-5 with NaF showed a greater protection.

Characterization of white spot lesions formed on human enamel under microcosm biofilm for different experimental periods

The initial characteristics of white spot lesion (WSLs), such as the degree of integrated mineral loss (ΔZ), depth and pattern of mineral distribution, have an impact on further demineralization and remineralization. However, these lesion parameters have not been evaluated in WSLs produced from microcosm biofilms.

Protective effect of calcium silicate toothpaste on enamel erosion and abrasion in vitro

Objectives

To compare in vitro the effect of a toothpaste containing fluoride (F), calcium silicate (CaSi) and sodium phosphate salts to conventional toothpaste (NaF) on human enamel specimens submitted to erosive and abrasive challenges.

Methods

48 sound and 48 enamel samples pre-treated with 1% citric acid were divided into 4 groups (n = 12): Group 1- Non-fluoride toothpaste; Group 2- NaF toothpaste (1450 ppmF); Group 3- CaSi toothpaste (1450 ppmF; MFP); Group 4- Erosion only. The samples were subjected to pH cycling (3 cycles/day; 90s; 1% citric acid, pH 3.6) and to abrasion for 7 days. After the 1^st and the last cycle, they were submitted to abrasion (15s, 1.5N load), using a brushing machine, soft toothbrush and toothpaste slurry (1:3; 15ml/sample) and then immersed in the slurry for 45s. Samples were immersed in artificial saliva between the challenges. Enamel loss was evaluated using profilometry on days 3 and 7. Data were analysed by ANOVA and Tukey's test (p < 0.05).

Results

For sound enamel at baseline, mean (±SD) enamel loss (μm) for groups 1-4 on day 3 was 2.15 ± 0.35^a, 1.20 ± 0.22^b, 0.95 ± 0.19^b and 1.98 ± 0.32^a; on day 7 was 3.05 ± 0.40^a, 2.07 ± 0.32^b, 1.36 ± 0.33^c and 3.69 ± 0.27^d respectively. For acid-softened enamel at baseline, enamel loss on day 3 was 3.16 ± 0.19^a, 2.17 ± 0.14^b, 1.70 ± 0.11^c and 3.04 ± 0.19^a; on day 7 was 3.92 ± 0.25^a, 3.07 ± 0.13^b, 2.09 ± 0.15^c and 3.87 ± 0.25^a respectively.

Conclusions

Both F toothpastes led to significantly higher enamel protection from short-term erosion and abrasion in comparison to the non-F toothpaste and erosion only. In the longer term, CaSi toothpaste conferred significantly higher protection than NaF toothpaste.

Clinical significance

The results showed that for the longer term the CaSi toothpaste provided significantly higher protection than the NaF toothpaste, which indicates a good potential of the former to help prevent erosive tooth wear.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Objective

This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices.

Methodology

Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI – Crest Anti-cavity Regular; GII – Crest 3D White; GIII – Colgate Total 12 Clean Mint; GIV – Colgate Optic White; GV – Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn’s tests (p<0.05).

Results

All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)^bc for GI, 1.17 (1.01-1.34)^cd for GII, 1.36 (1.28-1.45)^ab for GIII, 1.08 (1.04-1.14)^d for GIV and 2.28 (2.18-2.39)^a for GV.

Conclusion

When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Dentifrice pH but not consistency may affect fluoride uptake in plaque

OBJECTIVE

Test the ability of acidic fluoridated solutions to enhance fluoride (F) bound on bacteria (1) and the effect of dentifrice consistency on plaque fluid F uptake (2).

METHODS

(1) Streptococcus mutans isolates were grown in BHI medium (37°C/18h). Bacteria were washed either with EDTA or CaCl2 both at 1mM to remove or add calcium, respectively. Pellets were incubated with 12 mM NaF at pH 4.5 or 7 for 1 min and F was quantified in the lysates and supernatants with the electrode, after HMDS-facilitated diffusion. (2) A randomized, double-blind, crossover clinical trial was performed in three phases with nineteen adults (20-35 years) that used one of the dentifrices: commercial toothpaste (1100 ppm F, pH7.0 and conventional viscosity (Sorriso Fresh(®))); experimental liquid dentifrice (ELD) (1100 ppm F, pH7.0 and low viscosity [1.1% carboxymethylcellulose (CMC)]) and ELD (1100 ppm F and high viscosity pH7.0 (2.2% CMC)). F concentration in plaque fluid was analyzed using an inverted F electrode.

RESULTS

(1) Significantly higher F amounts were detected in the lysates of bacteria incubated with NaF solution at pH4.5 compared to the supernatant, which was not seen at pH7.0, being this effect calcium-dependent. (2) Significantly higher F concentrations in plaque fluid were found 1h after toothbrushing compared to 12h, but no significant differences were seen among the toothpastes.

CONCLUSIONS

F at low pH binds more efficiently to S. mutans than at neutral pH and dentifrice viscosity does not interfere in plaque fluid fluoride incorporation.

CLINICAL SIGNIFICANCE

pH of the dentifrice but not consistency may be important to F uptake in plaque.

Total fluoride intake and excretion in children up to 4 years of age living in fluoridated and non-fluoridated areas

Fractional fluoride retention is important during the early years of life when considering the risk of development of dental fluorosis. This study aimed to measure fractional fluoride retention in young children. The objectives were to investigate the relationships between fractional fluoride retention and total daily fluoride intake, age, and body mass index (BMI). Twenty-nine healthy children, up to 4 yr of age, participated; 14 lived in a fluoridated area (0.64 μg ml(-1) of fluoride in drinking water) and 15 lived in a non-fluoridated area (0.04 μg ml(-1) of fluoride in drinking water). The total daily fluoride intake of each child was calculated from the daily dietary fluoride intake and toothpaste ingestion (if fluoride toothpaste was used). Total daily fluoride excretion was measured by collecting voided urine and faeces over a 24-h period, and fractional fluoride retention was calculated by dividing the amount of fluoride retained in the body (total daily fluoride intake minus total daily fluoride excretion) by the total daily fluoride intake. Nine children were excluded from data analysis because of suspected invalid samples. Mean (range) fractional fluoride retention for the remaining 20 children was 0.61 (0.06-0.98). There were no statistically significant correlations between fractional fluoride retention and either age or BMI. However, fractional fluoride retention was correlated with total daily fluoride intake: fractional fluoride retention = 1 - exp (-C × total daily fluoride intake), where C = 28.75 (95% CI = 19.75-37.75). The wide variation in fluoride retention in young children could have important implications when recommendations for fluoride use are being considered.

Effect of NaF and TiF(4) varnish and solution on bovine dentin erosion plus abrasion in vitro

OBJECTIVES

This in vitro study aimed to analyze the effect of TiF(4) compared to NaF varnishes and solutions, to protect against dentin erosion associated with abrasion.

MATERIALS AND METHODS

Bovine dentin specimens were pre-treated with NaF-Duraphat (2.26% F), NaF/CaF(2)-Duofluorid (5.63% F), experimental-NaF (2.45% F), experimental-TiF(4) (2.45% F) and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive pH cycling was performed using a soft drink (pH 2.6) 4 × 90 s/day and the toothbrushing-abrasion 2 × 10 s/day, in vitro for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Dentin tissue loss was measured profilometrically (μm).

RESULTS

ANOVA/Tukey's test showed that all fluoridated varnishes (Duraphat, 7.5 ± 1.1; Duofluorid, 6.8 ± 1.1; NaF, 7.2 ± 1.9; TiF(4), 6.5 ± 1.0) were able to significantly reduce dentin tissue loss (40.7% reduction compared to control) when compared to placebo varnish (11.2 ± 1.3), control (11.8 ± 1.7) and fluoridated (NaF, 9.9 ± 1.8; TiF(4), 10.3 ± 2.1) solutions (p < 0.0001), which in turn did not significantly differ from each other.

CONCLUSION

All fluoridated varnishes, but not the solutions, had a similar performance and a good potential to reduce dentin tissue loss under mild erosive and abrasive conditions in vitro. Risk patients for erosion and abrasion, especially those with exposed dentin, should benefit from this clinical preventive measure. Further research has to confirm this promising result in the clinical situation.

The erosion and abrasion-inhibiting effect of TiF(4) and NaF varnishes and solutions on enamel in vitro

OBJECTIVE. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF(4) compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. METHODS. Enamel specimens were pre-treated with experimental-TiF(4) (2.45% F), experimental-NaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (μm). RESULTS. Kruskal-Wallis/Dunn tests showed that all fluoridated varnishes (TiF(4) -ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF-ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat-ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF-ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF(4) -ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other. CONCLUSION. Based on the results, it can be concluded that the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.

Prevalence of dental fluorosis in Bauru, São Paulo, Brazil

OBJECTIVE

To evaluate the prevalence of dental fluorosis in scholars aging 12 to 15 years old, residents in the city of Bauru, State of São Paulo, Brazil.

METHODS

1318 volunteers were enrolled in this study and examined in 18 public schools of the State of São Paulo. The examinations were performed in the schools' court by three dentists (with a Master's degree in Public Health), after toothbrushing supervised by another dentist. The teeth were dried with cotton pellets and examined under natural light by visual inspection, using an explorer as recommended by the WHO, a plane mirror and a tongue depressor. The Thylstrup-Fejerskov (TF) index was used for rating fluorosis. Intra and inter-examiner reproducibility was calculated and data were submitted to descriptive analysis.

RESULTS

Approximately 36% of the children presented dental fluorosis, of which 28% was diagnosed as TF1 while the remaining received scores between TF2 and TF4.

CONCLUSION

The prevalence of dental fluorosis in Bauru is within the expected range, based on previous studies. Although fluoride is an important resource for caries control, its use must be adequate to the needs of each specific population.

Fluoride ingestion from food items and dentifrice in 2-6-year-old Brazilian children living in a fluoridated area using a semiquantitative food frequency questionnaire

OBJECTIVES

The aim of this study was to evaluate the fluoride intake of 2-6-year-old Brazilian children using a semiquantitative food frequency questionnaire (FFQ) which also estimated fluoride intake from dentifrice.

METHODS

The FFQ was previously validated through application to 78 2-6-year-old Brazilian children and then administered to 379 children residing in an optimally fluoridated community in Brazil (Bauru, State of São Paulo). The FFQ was applied to the parents and used to estimate the food intake of the children. The constituents of the diet were divided into solids, water and other beverages. The fluoride content of the diet items was analyzed with the fluoride electrode. The questionnaire also estimated fluoride intake from dentifrice.

RESULTS

The average (+/-SD) fluoride intake from solids, water, other beverages and dentifrice was 0.008 +/- 0.005; 0.011 +/- 0.004; 0.009 +/- 0.014 and 0.036 +/- 0.028 mg F/kg body weight/day, respectively, totalizing 0.064 +/- 0.035 mg F/kg body weight/day. The dentifrice and the diet contributed with 56.3% and 43.7% of the daily fluoride intake, respectively. Among the children evaluated, 31.2% are estimated to have risk to develop dental fluorosis (intake>0.07 mg F/kg body weight/day).

CONCLUSIONS

The dentifrice was the main source of fluoride intake by the children evaluated. However, the fluoride concentration in food items also significantly contributed to the daily ingestion by 2-6-year-old children. The questionnaire used seems to be a promising alternative to duplicate diet to estimate the fluoride intake at this age range and may have potential to be used in broad epidemiological surveys.

Availability of fluoride from meals given to kindergarten children in Brazil

OBJECTIVES

The aim of this study was to evaluate the amount of fluoride supplied daily in the meals given in 44 public kindergarten schools in Bauru, Brazil. In addition, the fluoride concentration of water supplies and its impact on the amount of fluoride found in the meal samples were also investigated.

METHODS

Meal samples and water were collected during 2 weeks (10 working days) in public kindergarten schools. Samples of meals were homogenized with known volumes of deionized water. Fluoride present in meal samples was analyzed with the ion-specific electrode (Orion 9609), after hexamethyldisilazane-facilitated diffusion. Fluoride in water samples was analyzed with the same electrode, after buffering with TISAB II. All the analyses were made in duplicate.

RESULTS

Fluoride analyzed (mean+/-SD) was 0.50+/-0.20 microg/ml, ranging from nondetectable to 1.42 microg/ml for water samples (n=424) and 0.067+/-0.059 mg, ranging from 0.007 to 0.580 mg for meal samples (n=431). A weak but significant correlation was observed between the amount of fluoride in meals and fluoride concentration in water supplies (r=0.139, P=0.0042).

CONCLUSIONS

Despite the seemingly small role played by school meals in the total daily fluoride intake, they can contribute to the total fluoride intake of children on a chronic basis, when in association with other fluoride products. Additionally, the impact of fluoridated public water supply on the final fluoride concentration of the school meals analyzed may be regarded as low.

Nails as biomarkers of fluoride in children of fluoridated communities

PURPOSE

The objective of this study was to verify the use of nails as biomarkers of chronic fluoride (F) exposure from the diets of children living in communities with negligibly or optimally fluoridated water.

METHODS

Fifteen 2- to 6-year-old children living in Bauru-São Paulo (fluoridated) and 15 lifelong residents of Itápolis-São Paulo (nonfluoridated) participated in the study. Fluoride concentrations in nails and duplicate diet were analyzed with the electrode, following hexamethyldisiloxane (HMDS)-facilitated diffusion. Data were analyzed by student's t-test and linear regression (P < .05).

RESULTS

Mean fluoride concentrations ([microg/g) in fingernails and toenails of Bauru children were 3.56 +/- 1.3 and 2.81 +/- 1.29, respectively, and for Itápolis children 2.29 +/- 1.25 and 1.58 +/- 0.59, respectively. The differences between Bauru and Itápolis children, as well as between fluoride concentrations in fingernails and toenails, were statistically significant. The estimated fluoride intake from the diet was significantly higher for Bauru children (0.55 +/- 0.61 mg) when compared to Itápolis children (0.09 +/- 0.06 mg). A significant positive correlation was found between the mean of fingernail and toenail fluoride concentrations and estimated fluoride intake from the diet (r = 0.57).

CONCLUSIONS

This study's preliminary data suggests that fingernails and toenails may be used as biomarkers of chronic fluoride exposure from the diet. Additional studies are necessary to determine the predictive values, sensitivity, and specificity of this biomarker so that nails are used to differentiate children at the age of dental fluorosis risk and who live in communities with negligibly or optimally fluoridated water.

Programa de agentes comunitários de saúde: a percepção de usuários e trabalhadores da saúde

Valorizar a família e a comunidade em que se insere, além de estimular a sua participação na promoção da saúde e na prevenção das doenças são linhas-eixo da filosofia do PACS (Programa de Agentes Comunitários de Saúde). Este trabalho teve como elemento de estudo as ações desenvolvidas no PACS do Município de Bauru, São Paulo, segundo a percepção dos agentes comunitários de saúde (ACS) e das famílias por eles atendidas. Como ponto de partida para realização deste trabalho, foram entrevistados 22 agentes e 22 representantes de famílias, selecionadas aleatoriamente segundo a microárea de sua residência. Formaram-se dois grupos focais, a partir do PACS ao qual estavam vinculados agentes e usuários. A análise qualitativa das respostas demonstrou correspondência entre a percepção de ACS e comunidade nos dois grupos focais, que, no entanto, diferiram entre si. Foram observadas realidades distintas, norteando a realização de algumas ações programáticas e o enfrentamento das dificuldades locais.

Effect of domestic water filters on water fluoride content and level of the public water supply in Bauru, Brazil

PURPOSE

The purpose of this study was to evaluate the extent to which domestic, activated carbon water filters remove fluoride from water and to analyze the fluoride level of the public water supply in Bauru, province of São Paulo, Brazil.

METHODS

Samples of filtered and nonfiltered tap water were collected from 180 houses in 9 different regions in the city; each served with its own water treatment facility. Fluoride was analyzed with the ion specific electrode (Orion 9609).

RESULTS

Of the filters presented in the 180 houses, only 12 removed fluoride from water, either totally (3) or partially (9). Water fluoride concentrations in 6 regions were within the acceptable range (0.5 to 1.0 ppm). Overfluoridation was observed in 1 area, and underfluoridation was seen in 2 areas.

CONCLUSIONS

Most domestic activated carbon filters did not remove fluoride from water. Children who drank filtered water did not need fluoride supplementation. As has been shown in other studies, the fluoride level in the public water supply in some regions of Bauru was not adequate on the day analyzed.

[Diphteric and tetanic antitoxins seric values in the first year of life, before and after immunization an horizontal survey in Mozambic (author's transl)]

Successive evaluations of diphtheritic (AD) and tetanic antitoxin have been made from birth to twelve months in infants receiving at 3, 4 and 5 months an immunization with antidiphtheritic, antitetanic and absorbed antimeasles vaccine. The decrease of AD of maternal origin is not, contrary to common opinion, regularly exponential. Factors influencing the elimination of AD from maternal origin are discussed. An important decrease is often observed after the first immunizing infection. AD level evolution is independent from that to IgG but there is a correspondence at birth in mother and infant between the highest values of AD and the lowest values of total proteides. The commonly observed existence of AD in mother blood indicates the persistence in Maputo of a strong diphteric endemy, and this justifies the association of the antidiphtheritic vaccination to the antitetanic one. After immunization, high levels of antibodies are always reached for tetanic antitoxin and a little less, regularly, for AD. High levels of AD are more frequent in infants having demonstrated no infectious symptoms. Towards the end of the first year, antibodies levels frequently decrease. From these findings possible ways are discussed for immunizing infants in Africa with antitoxins.

Evolution of serum immunoglobulin levels during the first year of life in Mozambique

The serum levels of IgG, IgA and IgM as well as total proteins were followed from birth to one year of age in a sample of 44 infants. Values for a 'healthy' population are presented. The results of correlation analysis question current views on the independence of the different immunoglobulin classes.

A comparison of the evolution of transmitted IgG immunoglobulin and diphtheria antitoxin titers in the newborn

The evolution of the titers of transmitted IgG and diphtheria antitoxin was studied in 20 neonates during the first 2 months of life (6 serum samples for each). A rapid fall of the passive IgG titer was observed during the first weeks: as a rule the higher the initial titer the greater the fall. After the 15th day the rate of decline slows down. The evolution of the titer of transmitted maternal diphtheria antitoxin depends also on the initial level, and if it is low it can remain more or less constant for a long time. The initial level of passive IgG does not influence the drop in diphtheria antitoxin titre and vice versa. Therefore, the evolution of total IgG and diphtheria antitoxin levels appear not to be interdependent.

[Blood serum levels of immunoglobulins among African children: Seasonal variations and ethnic factors (a study done in Lourenco-Marques among a group of 11-year olds) (author's transl)]

The blood titers of IgG, IgA and IgM and total proteins were determined in October 1971 (dry season) and again in April 1972 (wet season) among girls and boys belonging to 4 ethnic groups: White, Bantu, Indian, Mixed. Parasitic studies were also done. These studies indicate a rise of IgM among the girls and of IgA in both sexes from October 1971 to April 1972. The average IgM titer among the four groups is higher than the one found in the Occident. This is especially notable for the Bantu and the Mixed. The Indian levels exceeded, on the average, the White group's. The average IgG figures are only slightly higher than those found in the literature for Western populations. Genetic influences do not appear to explain the differences found between the ethnic groups. The role of environment is stressed, and parasitic influences are discussed.

Evolution of titre of serum IgG in newborn

The rythm of decline of maternally acquired IgG levels during the neonatal period differs widely from one subject to another. It does not always obey a simple exponential law, and calculations of half-life during the first 2 weeks of life are not very valid up till now. A sudden fall is often observed between the 1st and 4th day, particularly when the initial concentration is high (it represents 25% of the level on an average). The rythm slows down after the fourth or the eighth day. Under normal conditions, the newborn organism rarely synthesizes IgG in quantities that can be measured by ordinary techniques. However, in various pathological conditions an appreciable rise in IgG level may be seen, very probably connected with active formation.