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Immune reconstitution inflammatory syndrome

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https://www.readbyqxmd.com/read/29321933/acute-progression-of-aspergillosis-in-a-patient-with-lung-cancer-receiving-nivolumab
#1
Naohiro Uchida, Kohei Fujita, Koichi Nakatani, Tadashi Mio
A 65-year-old man with chronic progressive pulmonary aspergillosis (CPPA) was admitted for the treatment of lung adenocarcinoma while receiving an immune checkpoint inhibitor, nivolumab. The tumour responded well to the therapy, but the cavity of CPPA became large in contrast to the tumour after 20 courses of therapy. He was diagnosed as having exacerbation of CPPA and successfully and concurrently treated with an antifungal agent and nivolumab. Since there was absence of obvious immunosuppression and the presence of a drastic effect on tumour remission during nivolumab therapy, this phenomenon suggested that the trigger of CPPA progression was dependent not on immunosuppression but on a hyperreaction to microorganisms, which was similar to the immune reconstitution inflammatory syndrome caused by nivolumab...
February 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29319289/an-adalimumab-induced-late-onset-immune-reconstitution-inflammatory-syndrome-treated-with-adalimumab
#2
Marco Confalonieri, Nicola DI Meo, Giovanni Damiani, Chiara Torregiani, Roberto Trevisan, Metka Kodric, Giusto Trevisan
No abstract text is available yet for this article.
February 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29301795/recurrent-cytomegalovirus-colitis-a-rare-case-of-immune-reconstitution-inflammatory-syndrome
#3
Joseph Alukal, Mohammed Asif, Rachana Mundada, William B McNamee
Cytomegalovirus (CMV) colitis usually occurs in patients with advanced immunosuppression when the CD4 count is <50 cells/μL. We reported a case of recurrent CMV colitis in a patient with HIV who presented with profuse lower gastrointestinal bleed. This was a case of immune reconstitution inflammatory syndrome (IRIS) manifesting as CMV colitis and has been reported only once in the literature previously. This patient had a CD4 count of 157 cells/μL and undetectable viral load after being on antiretroviral therapy (ART) for 5 months, which was consistent with IRIS...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29278532/risks-of-cardiovascular-or-central-nervous-system-adverse-events-and-immune-reconstitution-inflammatory-syndrome-for-dolutegravir-versus-other-antiretrovirals-meta-analysis-of-randomized-trials
#4
Andrew M Hill, Nikkita Mitchell, Sophie Hughes, Anton L Pozniak
PURPOSE OF REVIEW: Results from nonrandomized cohort studies suggest higher risks of CNS adverse events for dolutegravir, versus other ARVs. There have been two case reports of myocarditis on dolutegravir. Integrase inhibitors have been associated with IRIS in two cohort studies. Meta-analysis of randomized trials can be used to cross-check potential safety signals. This systematic review of drug safety used an EMBASE and MEDLINE search combined with serious adverse event (SAE) reports on the website www...
December 22, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/29241731/efficacy-of-lentiviral-mediated-gene-therapy-in-an-omenn-syndrome-rag2-mouse-model-is-not-hindered-by-inflammation-and-immune-dysregulation
#5
Valentina Capo, Maria Carmina Castiello, Elena Fontana, Sara Penna, Marita Bosticardo, Elena Draghici, Luigi P Poliani, Lucia Sergi Sergi, Rosita Rigoni, Barbara Cassani, Monica Zanussi, Paola Carrera, Paolo Uva, Kerry Dobbs, Nicolò Sacchetti, Luigi D Notarangelo, Niek P van Til, Gerard Wagemaker, Anna Villa
BACKGROUND: Omenn syndrome (OS) is a rare severe combined immunodeficiency associated with autoimmunity, caused by defects of the lymphoid-specific V(D)J recombination. Most patients carry hypomorphic mutations in recombination activating genes (RAG) 1 or 2. Hematopoietic stem cell (HSC) transplantation is the standard treatment, however gene therapy (GT) may represent a valid alternative, especially for patients lacking a matched donor. OBJECTIVE: To determine the efficacy of lentiviral vector (LV) mediated GT in the murine model of OS (Rag2R229Q/R229Q) in correcting immunodeficiency and autoimmunity...
December 11, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29229308/lymphocyte-dominant-encephalitis-and-meningitis-in-simian-immunodeficiency-virus-infected-macaques-receiving-antiretroviral-therapy
#6
Lisa M Mangus, Sarah E Beck, Suzanne E Queen, Samuel A Brill, Erin N Shirk, Kelly A Metcalf Pate, Dillon C Muth, Robert J Adams, Lucio Gama, Janice E Clements, Joseph L Mankowski
A retrospective neuropathologic review of 30 SIV-infected pigtailed macaques receiving combination antiretroviral therapy (cART) was conducted. Seventeen animals with lymphocyte-dominant inflammation in the brain and/or meninges that clearly was morphologically distinct from prototypic SIV encephalitis and human immunodeficiency virus encephalitis were identified. Central nervous system (CNS) infiltrates in cART-treated macaques primarily comprised CD20+ B cells and CD3+ T cells with fewer CD68+ macrophages...
January 2018: American Journal of Pathology
https://www.readbyqxmd.com/read/29197074/bullous-pemphigoid-complicated-by-cytomegalovirus-disease-as-a-manifestation-of-immune-reconstitution-inflammatory-syndrome-retrospective-analyses-of-our-institutional-cases-and-literature-review
#7
Yoko M Narita, Chiho Horie, Kazuhisa Hirahara, Yoko Kano, Tetsuo Shiohara, Yoshiko Mizukawa
BACKGROUND: Cytomegalovirus (CMV) disease induced by reactivation of latent CMV is a fatal viral infection that may develop in a setting of therapy with immunosuppressive agents. There is a clear need to clarify any clinical features and markers of CMV disease. OBJECTIVE: We investigated which clinical markers usually available in a clinical setting can predict CMV disease occurring in bullous pemphigoid (BP) patients receiving corticosteroids. METHOD: We described a BP patient with CMV disease complicated by gastrointestinal hemorrhage and liver dysfunction...
December 2, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/29194105/immune-reconstitution-inflammatory-syndrome-in-a-case-of-nonspecific-orbital-inflammation
#8
Alexandra Manta, Shoaib Ugradar, Fabiola Murta, Daniel Ezra, Ian Cormack
The immune reconstitution inflammatory syndrome is an exaggerated abnormal immune response, typically seen in HIV-positive patients following restoration of a normal CD4 count as a result of initiation of antiretroviral therapy. It has been described in relation to either occult opportunistic infections or to a paradoxical relapse of a previously successfully treated infection with negative microbiological cultures. The authors report the case of a 60-year-old HIV-positive African male who presented with 2 episodes of orbital inflammation that occurred in conjunction with improvements of CD4 count following Highly Active Antiretroviral Therapy...
November 15, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29187293/immune-reconstitution-inflammatory-syndrome-in-hiv-infected-patients-with-pneumocystis-jirovecii-pneumonia
#9
Luisa Roade Tato, Joaquín Burgos Cibrian, Adrià Curran Fábregas, Jordi Navarro Mercadé, Rein Willekens, María Teresa Martín Gómez, Esteban Ribera Pascuet, Vicenç Falcó Ferrer
INTRODUCTION: The incidence of immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients after an episode of Pneumocystis jirovecii pneumonia (PJP) seems to be lower than with other opportunistic infections. We conducted an observational study in order to determine the incidence, clinical characteristics and outcome of patients diagnosed with PJP-related IRIS. METHODS: We conducted an observational study of HIV patients diagnosed with PJP-related IRIS from January 2000 to November 2015...
November 26, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29173177/integrase-strand-transfer-inhibitors-and-the-emergence-of-immune-reconstitution-inflammatory-syndrome-iris
#10
Mina Psichogiou, Dimitrios Basoulis, Maria Tsikala-Vafea, Stefanos Vlachos, Christos J Kapelios, Georgios L Daikos
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a major concern when starting highly active anti-retroviral therapy (HAART) in new patients and especially late presenters. This study attempts to identify risk factors for IRIS and investigate whether certain treatment regimens increase the probability of IRIS for patients at risk. METHODS: Retrospective single-centre study of HIV patients treated with HAART. RESULTS: A total of 417 patients were included...
November 22, 2017: Current HIV Research
https://www.readbyqxmd.com/read/29162707/cd4-t-cells-orchestrate-lethal-immune-pathology-despite-fungal-clearance-during-cryptococcus-neoformans-meningoencephalitis
#11
Lori M Neal, Enze Xing, Jintao Xu, Jessica L Kolbe, John J Osterholzer, Benjamin M Segal, Peter R Williamson, Michal A Olszewski
Cryptococcus neoformans is a major fungal pathogen that disseminates to the central nervous system (CNS) to cause fatal meningoencephalitis, but little is known about immune responses within this immune-privileged site. CD4(+) T cells have demonstrated roles in anticryptococcal defenses, but increasing evidence suggests that they may contribute to clinical deterioration and pathology in both HIV-positive (HIV+) and non-HIV patients who develop immune reconstitution inflammatory syndrome (IRIS) and post-infectious inflammatory response syndrome (PIIRS), respectively...
November 21, 2017: MBio
https://www.readbyqxmd.com/read/29154044/modulating-host-immune-responses-to-fight-invasive-fungal-infections
#12
REVIEW
James E Scriven, Mark W Tenforde, Stuart M Levitz, Joseph N Jarvis
Modulation of host immunity in invasive fungal infection is an appealing but as yet mostly elusive treatment strategy. Animal studies in invasive candidiasis and aspergillosis have demonstrated beneficial effects of colony stimulating factors, interferon-gamma and monoclonal antibodies. More recent studies transfusing leukocytes pre-loaded with lipophilic anti-fungal drugs, or modulated T-cells, along with novel vaccination strategies show great promise. The translation of immune therapies into clinical studies has been limited to date but this is changing and the results of new Candida vaccine trials are eagerly awaited...
December 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/29150377/urgent-versus-post-stabilisation-antiretroviral-treatment-in-hospitalised-hiv-infected-children-in-kenya-push-a-randomised-controlled-trial
#13
Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: Urgent antiretroviral therapy (ART) among hospitalised HIV-infected children might accelerate recovery or worsen outcomes associated with immune reconstitution. We aimed to compare urgent versus post-stabilisation ART among hospitalised HIV-infected children in Kenya. METHODS: In this unmasked randomised controlled trial, we randomly assigned (1:1) HIV-infected, ART-naive children aged 0-12 years who were eligible for treatment to receive ART within 48 h (urgent group) or in 7-14 days (post-stabilisation group) at four hospitals in Kenya (two in Nairobi and two in western Kenya)...
January 2018: Lancet HIV
https://www.readbyqxmd.com/read/29142146/inflammatory-natalizumab-associated-pml-baseline-characteristics-lesion-evolution-and-relation-with-pml-iris
#14
Mike P Wattjes, Martijn T Wijburg, Jeroen van Eijk, Stephan Frequin, Bernard M J Uitdehaag, Frederik Barkhof, Clemens Warnke, Joep Killestein
BACKGROUND AND OBJECTIVE: Natalizumab-associated progressive multifocal leukoencephalopathy (NTZ-PML) patients may show imaging signs suggestive of inflammation at diagnosis ('inflammatory PML'), reminiscent of PML-immune reconstitution inflammatory syndrome (PML-IRIS). We investigated the imaging characteristics of inflammatory NTZ-PML lesions and PML-IRIS to determine differentiating and overlapping features. METHODS: We scored the presence, localisation and pattern of imaging characteristics of inflammation on brain MRI scans of inflammatory NTZ-PML patients...
November 15, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29135655/neutrophil-activation-and-enhanced-release-of-granule-products-in-hiv-tb-immune-reconstitution-inflammatory-syndrome
#15
Justine K Nakiwala, Naomi F Walker, Collin R Diedrich, William Worodria, Graeme Meintjes, Robert J Wilkinson, Harriet Mayanja-Kizza, Robert Colebunders, Luc Kestens, Katalin A Wilkinson, David M Lowe
BACKGROUND: Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) remains incompletely understood. Neutrophils are implicated in tuberculosis pathology but detailed investigations in TB-IRIS are lacking. We sought to further explore the biology of TB-IRIS and in particular the role of neutrophils. SETTING: Two observational, prospective cohort studies in HIV/TB co-infected patients starting antiretroviral therapy, one to analyze gene expression and subsequently one to explore neutrophil biology...
November 6, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29075540/immune-reconstitution-inflammatory-syndrome-and-cytomegalovirus-pneumonia-case-report-highlights-and-missing-links-in-classification-criteria-and-standardized-treatment
#16
Stefania Petarra-Del Río, Adrian Rodriguez-Hernandez, Luis Anguiano-Landa, Georgina Aguilar-Portillo, Isidro Zavala-Trujillo, Arnulfo Hernan Nava-Zavala, Maria G Zavala-Cerna
BACKGROUND: Cytomegalovirus (CMV) pulmonary involvement is rarely associated with IRIS; therefore, limited information is available. CASE PRESENTATION: Here, we describe the case of a 43-year-old HIV-infected male who developed an unusual case of IRIS after cytomegalovirus (CMV) pneumonia. Clinically there was a progressive and paradoxical worsening of respiratory distress, despite being treated for CMV after initiation with antiretroviral therapy. Chest X-ray revealed disseminated infiltrates in both lungs; chest CT-scan showed generalized lung involvement and mediastinal adenopathy...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29055444/progressive-multifocal-leukoencephalopathy-immune-reconstitution-inflammatory-syndrome-pml-iris-in-liver-transplant-recipient
#17
J Avsenik, A Horvat Ledinek, K Šurlan Popovič
65-year-old liver transplant recipient presented with progressive neurologic dysfunction. CSF analysis revealed high JC virus load and MRI findings suggested the diagnosis of progressive multifocal leukoencephalopathy (PML). Cidofovir and mirtazapine were initiated and patient's regular immunosuppressants were reduced. Subsequently patient developed left sided hemiplegia, drowsiness and severe neglect syndrome. MRI revealed enlargement of PML lesions with contrast enhancement and worsening of oedema, consistent with immune reconstitution inflammatory syndrome (IRIS)...
October 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29048509/plasma-but-not-cerebrospinal-fluid-interleukin-7-and-interleukin-5-levels-pre-antiretroviral-therapy-commencement-predict-cryptococcosis-associated-immune-reconstitution-inflammatory-syndrome
#18
Ngomu Akeem Akilimali, Christina C Chang, Daniel M Muema, Tarylee Reddy, Mahomed-Yunus S Moosa, Sharon R Lewin, Martyn A French, Thumbi Ndung'u
Background: Patients with human immunodeficiency virus/AIDS-associated cryptococcal meningitis (CM) frequently experience clinical deterioration, known as cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS), upon initiation of antiretroviral therapy (ART). The immunological mechanisms underlying C-IRIS are incompletely defined and no reliable predictive biomarkers exist. We investigated whether plasma or cerebrospinal fluid (CSF) levels of cytokines and chemokines predicted C-IRIS and are potential predictive biomarkers...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29046115/bone-and-the-immune-system
#19
M Neale Weitzmann
Osteoporosis increases fracture risk, a cause of crippling morbidity and mortality. The immunoskeletal interface (ISI) is a centralization of cell and cytokine effectors shared between skeletal and immune systems. Consequently, the immune system mediates powerful effects on bone turnover. Physiologically, B cells secrete osteoprotegerin (OPG), a potent anti-osteoclastogenic factor that preserves bone mass. However, activated T cells and B cells secrete pro-osteoclastogenic factors including receptor activator of Nuclear factor-kappaB (NF-kB) ligand (RANKL), Interleukin (IL)-17A, and tumor necrosis factor (TNF)-α promoting bone loss in inflammatory states such as rheumatoid arthritis...
October 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/29044307/immune-reconstitution-inflammatory-syndrome-as-a-cause-of-autoimmune-hepatitis-and-acute-liver-failure
#20
Edison Moraes Rodrigues, Rogério Fernandes, Ruth Susin, Bárbara Fior
Acute liver failure is a rare syndrome with high mortality and is often diagnosed late. Intensivist physicians play fundamental roles in the diagnostic suspicion and the management of the multiple-organic dysfunctions characteristic of this entity. Immune reconstitution inflammatory syndrome is an entity that is characterized by the paradoxical worsening of the patient's previous condition, after the initiation of antiretrovirals, triggered against either pathogens present in the host or autoantigens. Autoimmune hepatitis has recently been described as one of these autoimmune manifestations...
July 2017: Revista Brasileira de Terapia Intensiva
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