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Immunosuppressive Treatment

Chuanyin Sun, Guanhua Xu, Jin Lin
BACKGROUND: It can be difficult to distinguish between IgG4-related lymphadenopathy and multicentric Castleman's disease (MCD) because these conditions cannot be differentially diagnosed using immunohistochemical staining alone. In this study, we analyzed the clinical features of IgG4-related lymphadenopathy and MCD patients. METHODS: We retrospectively analyzed 27 patients with MCD, including 20 with plasma cell-type (PC-type) and 7 with hyaline vascular (HV) features (mixed-type)...
October 1, 2018: Clinical Laboratory
Menglin Fan, Yanan Li, Chunhua Yao, Xiufeng Liu, Xuming Liu, Jihua Liu
Imbalance of Treg/Th17 and chronic synovitis characterized by the recruitment and infiltration of inflammatory cells are the typical features of rheumatoid arthritis (RA). IL-6 promotes the differentiation and function of Th17 cells, which contributes to the imbalance of Treg/Th17 and aggravates lymphocytic infiltration in joints. DC32, a dihydroartemisinin derivative, was found to have anti-inflammatory and immunosuppressive activities in previous study. The aim of this study is to evaluate the effects and mechanisms of DC32 in immunodeficiency and inflammatory infiltration of RA...
October 15, 2018: International Immunopharmacology
Nhora Silva, Natalia Calvache, Elizabeth Arrieta, Juan Carlos Bravo, Camilo Salazar, Joaquín Rosales, Francisco Jaramillo, Juan Guillermo Restrepo
The small lymphocytic lymphoma is a mature B cell neoplasm with a broad spectrum of clinical presentations. Opportunistic infections that are not related to the treatment, even in advanced stages, have a low incidence rate. There are few case reports in the medical literature of patients who have not received immunosuppressive therapy and present with small lymphocytic lymphoma associated with disseminated histoplasmosis at diagnosis. A female 82-year-old patient was admitted due to an intermittent dry cough, asthenia, and adynamia that had persisted for one month...
September 1, 2018: Biomédica: Revista del Instituto Nacional de Salud
Yuko Iwabuchi, Yoei Miyabe, Shiho Makabe, Marie Nakano, Shun Manabe, Kazunori Karasawa, Takahito Moriyama, Kosaku Nitta
Rituximab has been approved in Japan for the treatment of intractable nephrotic syndrome, but in cases of childhood-onset disease only; its efficacy and safety in adult-onset disease has yet to be established. This study was undertaken to evaluate the efficacy of rituximab and adverse effects in patients with adult-onset minimal change nephrotic syndrome (MCNS).The study involved 32 childhood-onset cases (mean age at onset: 8.6 years) and 19 adult-onset cases (mean age at onset: 30.6 years) of frequently relapsing steroid-dependent MCNS, all of whom received intravenous rituximab drip infusion (375 mg/m body surface area per dose) at 4 time points at 6-month intervals...
October 2018: Medicine (Baltimore)
Vaishnavi Pochineni, Helbert Rondon-Berrios
Kidney transplantation is the current treatment of choice for patients with end-stage renal disease. Innovations in transplantation and immunosuppression regimens have greatly improved the renal allograft survival. Based on recently published data from the Scientific Registry of Transplant recipients, prevalence of kidney transplants is steadily rising in the United States. Over 210,000 kidney transplant recipients were alive with a functioning graft in mid-2016, which is nearly twice as many as in 2005. While successful renal transplantation corrects most of the electrolyte and mineral abnormalities seen in advanced renal failure, the abnormalities seen in the post-transplant period are surprisingly different from those seen in chronic kidney disease...
2018: Frontiers in Medicine
Sophie Chauvet, Lubka T Roumenina, Pierre Aucouturier, Maria-Chiara Marinozzi, Marie-Agnès Dragon-Durey, Alexandre Karras, Yahsou Delmas, Moglie Le Quintrec, Dominique Guerrot, Noémie Jourde-Chiche, David Ribes, Pierre Ronco, Frank Bridoux, Véronique Fremeaux-Bacchi
C3 glomerulopathy (C3G) results from acquired or genetic abnormalities in the complement alternative pathway (AP). C3G with monoclonal immunoglobulin (MIg-C3G) was recently included in the spectrum of "monoclonal gammopathy of renal significance." However, mechanisms of complement dysregulation in MIg-C3G are not described and the pathogenic effect of the monoclonal immunoglobulin is not understood. The purpose of this study was to investigate the mechanisms of complement dysregulation in a cohort of 41 patients with MIg-C3G...
2018: Frontiers in Immunology
Mi Deng, Xun Gui, Jaehyup Kim, Li Xie, Weina Chen, Zunling Li, Licai He, Yuanzhi Chen, Heyu Chen, Weiguang Luo, Zhigang Lu, Jingjing Xie, Hywyn Churchill, Yixiang Xu, Zhan Zhou, Guojin Wu, Chenyi Yu, Samuel John, Kouyuki Hirayasu, Nam Nguyen, Xiaoye Liu, Fangfang Huang, Leike Li, Hui Deng, Haidong Tang, Ali H Sadek, Lingbo Zhang, Tao Huang, Yizhou Zou, Benjamin Chen, Hong Zhu, Hisashi Arase, Ningshao Xia, Youxing Jiang, Robert Collins, M James You, Jade Homsi, Nisha Unni, Cheryl Lewis, Guo-Qiang Chen, Yang-Xin Fu, X Charlene Liao, Zhiqiang An, Junke Zheng, Ningyan Zhang, Cheng Cheng Zhang
Immune checkpoint blockade therapy has been successful in treating some types of cancer but has not shown clinical benefits for treating leukaemia1 . This result suggests that leukaemia uses unique mechanisms to evade this therapy. Certain immune inhibitory receptors that are expressed by normal immune cells are also present on leukaemia cells. Whether these receptors can initiate immune-related primary signalling in tumour cells remains unknown. Here we use mouse models and human cells to show that LILRB4, an immunoreceptor tyrosine-based inhibition motif-containing receptor and a marker of monocytic leukaemia, supports tumour cell infiltration into tissues and suppresses T cell activity via a signalling pathway that involves APOE, LILRB4, SHP-2, uPAR and ARG1 in acute myeloid leukaemia (AML) cells...
October 17, 2018: Nature
Gan Wee Leng, Ruslinda Mustafar, Lydia Kamaruzaman, Rozita Mohd, Rizna Abdul Cader, Kong Wei Yen, Pau Kiew Bing
Managing primary or even secondary glomerulonephritis remains a challenge to many nephrologists. In primary focal segmental glomerulosclerosis (FSGS) with heavy proteinuria, renin aldosterone system blockade and high dose of oral prednisolone is the mainstay of treatment. Other immunosuppressive medications like Cyclophosphamide, Cyclosporine A and Mycophenolate Mofetil (MMF) are warranted if a complete remission is not achieved.  We illustrate a case of 21 year old gentleman with primary FSGS that was difficult to achieve remission despite on high dose steroid and oral Cyclophosphamide...
July 2018: Acta Medica Indonesiana
Pauline Rivière, Andreas Münch, Pierre Michetti, Nilesh Chande, Gert de Hertogh, Patrick Schoeters, Marc Ferrante, Séverine Vermeire, Gert Van Assche
Background: Evidence for second line therapy in patients with microscopic colitis (MC) failing budesonide is scarce, although anti-tumor necrosing factors (anti-TNFs), methotrexate and azathioprine have been reported to be effective in small cohort studies. Vedolizumab, a monoclonal antibody targeting α4β7-integrin, prevents homing of T-cells to the gut. We evaluated clinical remission with vedolizumab in budesonide-refractory MC patients. Methods: We solicited gastroenterologists in Europe and Canada for cases of MC treated with vedolizumab...
October 17, 2018: Journal of Crohn's & Colitis
Anquan Peng, Xinming Yang, Weijing Wu, Zian Xiao, Dinghua Xie, Shenglei Ge
BACKGROUND AND OBJECTIVE: It has been recognized that anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides may lead to hypertrophic pachymeningitis (HP) or intractable otitis media (OM). To our knowledge, few cases of coexistent ANCA-related HP and OM have been described previously. To increase awareness of this disease, we reviewed the literature describing patients with HP and intractable OM in a population with AAV to guide clinical decision making for otolaryngologists...
October 17, 2018: European Archives of Oto-rhino-laryngology
Thomas Daix, Estelle Guérin, Elsa Tavernier, Jean-Philippe Marsaud, Adélaïde Hacan, François Gauthier, Alessandro Piccardo, Philippe Vignon, Jean Feuillard, Bruno François
BACKGROUND: Similarly, to sepsis, cardiac surgery with cardiopulmonary bypass (CPB) induces major changes in leukocyte subsets. Immature granulocytes (IGs) increase both in sepsis and after open-heart surgery. Secondary infections are a major complication of cardiac surgery with CPB. We hypothesized that the assessment of leukocyte subsets with multicolor flow cytometry (FCM) could help the front-line clinician to better identify patients at high risk of infectious complications in this clinical setting...
October 16, 2018: Cytometry. Part B, Clinical Cytometry
L Bause
The introduction of biologics has led to a great improvement in the treatment options for inflammatory rheumatic diseases. Nevertheless, surgical interventions are still necessary in many patients but a change in surgical indications could be observed. The previously predominant synovectomy of inflamed rheumatic joints is now reduced to a few so-called rebellious joints with persistent inflammation. Joint-preservation and tenoplasty are standard surgical procedures requiring a specific approach including potential complications...
October 16, 2018: Der Orthopäde
Kohei Ishibashi, Yoshinobu Eishi, Nobuhiro Tahara, Masanori Asakura, Naka Sakamoto, Kazufumi Nakamura, Yoichi Takaya, Tomohisa Nakamura, Yoshikazu Yazaki, Tetsuo Yamaguchi, Koko Asakura, Toshihisa Anzai, Teruo Noguchi, Satoshi Yasuda, Fumio Terasaki, Toshimitsu Hamasaki, Kengo Kusano
Background: Cardiac sarcoidosis (CS) is a noncaseating granulomatous disease of unknown etiology. Lifelong immunosuppressive therapy, most frequently using corticosteroids, is a standard therapy to control hypersensitivity of immune reactions and prevent inflammation. However, it sometimes causes various systemic adverse effects and requires dose escalation. Thus, additional therapy may be required for the treatment of this disease. Recently, Propionibacterium acnes ( P. acnes ) was reported as one of the etiologic agents of CS, indicating that antibacterial drugs (ABD) may be effective for the treatment of CS...
October 2018: Journal of Arrhythmia
Viswanath Gunda, Benjamin Gigliotti, Dorothy Ndishabandi, Tameem Ashry, Michael McCarthy, Zhiheng Zhou, Salma Amin, Gordon J Freeman, Alessandro Alessandrini, Sareh Parangi
BACKGROUND: Patients with anaplastic thyroid cancer (ATC) have an extremely poor prognosis despite aggressive multimodal therapy. ATC has a high prevalence of BRAFV600E mutations and is associated with an immunosuppressive microenvironment; we previously demonstrated that the combination of BRAF inhibitor and checkpoint inhibitor immunotherapy synergistically reduce tumour volume in an immunocompetent mouse model of orthotopic ATC. METHODS: We again utilised our mouse model of ATC to assess the combination of BRAFV600E inhibitor PLX4720 and anti-PD-L1 or anti-PD-1 antibody on survival, and performed immune cell profiling of lymphoid and myeloid-lineage cells during maximal treatment response and tumour regrowth...
October 17, 2018: British Journal of Cancer
Benjamin Kukull, Rupali S Avasare, Kelly D Smith, Donald C Houghton, Megan L Troxell, Nicole K Andeen
Collapsing glomerulopathy has been described in settings of viral infections, drug, genetic, ischemic, renal transplant, and idiopathic conditions. It has a worse prognosis than other morphologic variants of focal segmental glomerulosclerosis, and may be treated with aggressive immunosuppression. In this study, we sought to characterize the clinical and morphologic findings in older adults with collapsing glomerulopathy. Renal biopsies and associated clinical data from patients aged 65 or older with a diagnosis of collapsing glomerulopathy were retrospectively reviewed at 3 academic institutions...
October 16, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Joana Coutinho, Joaquim de Sa, Filipe Castro Teixeira, Catarina Reis Santos, Raquel Sa Chorão, Rui Alves Filipe, Ernesto Fernandes Rocha
BACKGROUND: Birt-Hogg-Dubé (BHD) Syndrome is a rare genodermatosis caused by a mutation on folliculin gene, with a strong link to renal cancer. To date few patients with such condition have reached dialysis stage, as nephron-sparing surgery is usually possible at the time of diagnosis. To our best knowledge no patient with BHD syndrome has been submitted to renal transplantation. CASE PRESENTATION: We report the case of a woman diagnosed with multifocal bilateral renal cell carcinoma that underwent bilateral radical nephrectomy and was started on a regular hemodialysis program at the age of 29...
October 16, 2018: BMC Nephrology
Cinzia Fionda, Helena Stabile, Rosa Molfetta, Alessandra Soriani, Giovanni Bernardini, Alessandra Zingoni, Angela Gismondi, Rossella Paolini, Marco Cippitelli, Angela Santoni
Natural Killer cells (NK) are innate effector cells with a critical role in immunosurveillance against different kinds of cancer cells, including Multiple Myeloma (MM). However, the number and/or function of these lymphocytes are strongly reduced during MM progression and in advanced clinical stages. A better understanding of the mechanisms controlling both MM and NK cell biology have greatly contributed to develop novel and combined therapeutic strategies in the treatment of this incurable hematologic malignancy...
October 10, 2018: Cancer Treatment Reviews
Armin Bender, Caroline Fix, Verena Eubel, Rüdiger Eming, Robert Pollmann, Thomas Schmidt, Michael Hertl
BACKGROUND: Erosive oral lichen planus (OLP) is, at times, extremely difficult to treat and has a major impact on patients' quality of life. There are only limited therapeutic options, such as topical and systemic glucocorticoids, retinoids, and immunosuppressants with considerable side effects and limited efficacy upon chronic use. OBJECTIVES: In the present individualised clinical trial, we assessed the efficacy of adjuvant intravenous immunoglobulins (IVIG; 2 g/kg/monthly cycle) in addition to the oral retinoid, acitretin, in three patients with refractory OLP over a period of two to six months...
October 15, 2018: European Journal of Dermatology: EJD
Premal H Thaker, Nicholas Borys, Jason Fewell, Khursheed Anwer
GEN-1 is a gene-based immunotherapy, comprising a human IL-12 gene expression plasmid and a synthetic plasmid delivery system, delivered intraperitoneally (ip.) to produce local and persistent levels of a pleiotropic immunocytokine, IL-12, at the tumor site in patients with advanced ovarian cancer. The goal of local and persistent IL-12 delivery is to remodel the highly immunosuppressive tumor microenvironment to favor immune stimulation while avoiding serious systemic toxicities, a major limitation of recombinant IL-12 therapy...
October 16, 2018: Future Oncology
Yoshiya Tanaka
The immune system and bone metabolism influence each other. An imbalance in the immune system, resulting in inflammatory stimuli may induce an imbalance in bone turnover via induction of osteoclast differentiation and inhibition of osteoblast differentiation, leading to various pathological conditions including osteoporosis. T-cell subsets, helper T (Th)1 and Th17, which activate the immune system, induce osteoclasts, whereas regulatory T (Treg) cells, responsible for immunosuppression, inhibit osteoclastic differentiation...
October 15, 2018: Journal of Bone and Mineral Metabolism
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