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https://www.readbyqxmd.com/read/29227329/a-systematic-review-and-meta-analysis-of-second-line-immunosuppressants-for-autoimmune-hepatitis-treatment
#1
Michele De Lemos-Bonotto, Cristiane Valle-Tovo, Ane M Costabeber, Angelo A Mattos, André L F Azeredo-da-Silva
INTRODUCTION: The gold-standard treatment for autoimmune hepatitis (AIH) is a prednisone/azathioprine combination. However, subgroups of patients may be unresponsive to this treatment. The aim of this study is to evaluate the efficacy of second-line immunosuppressive therapies for AIH through a systematic review and meta-analysis in adult patients. PATIENTS AND METHODS: The systematic review was registered at the PROSPERO platform under number 42015019831. Databases MEDLINE (PubMed), Lilacs, Cochrane, and Scielo were searched...
December 8, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29226141/evaluation-of-immunosuppressive-therapy-use-for-tracheal-transplantation-with-trachea-mimetic-bellows-scaffolds-in-a-rabbit-model
#2
Jae Yeon Lee, Jeong Hun Park, Soo Jin Son, Mina Han, Gonhyung Kim, Seong Soo Kang, Seok Hwa Choi, Dong-Woo Cho
The objective of this study was to evaluate the use of immunosuppressive therapy with high-dose cyclosporine, high-dose azathioprine, and a combination of low-dose cyclosporine and azathioprine after tracheal reconstruction by using a trachea-mimetic graft of polycaprolactone (PCL) bellows-type scaffold in a rabbit model. Twenty-four healthy New Zealand white rabbits were used in the study. All underwent circumferential tracheal replacement using tissue-engineered tracheal graft, prepared from PCL bellows scaffold reinforced with silicone ring, collagen hydrogel, and human turbinate mesenchymal stromal cell (hTMSC) sheets...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29225988/effective-administration-of-rituximab-in-anti-mda5-antibody-positive-dermatomyositis-with-rapidly-progressive-interstitial-lung-disease-and-refractory-cutaneous-involvement-a-case-report-and-literature-review
#3
Yuka Ogawa, Dai Kishida, Yasuhiro Shimojima, Koichi Hayashi, Yoshiki Sekijima
We describe the case of a 48-year-old man with dermatomyositis (DM) who demonstrated rapidly progressive interstitial lung disease (RP-ILD) and refractory cutaneous involvement together with high levels of anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5-Ab). Even after combination immunosuppressive therapy including a corticosteroid, cyclosporine A, and intravenous cyclophosphamide, his respiratory insufficiency and cutaneous involvement progressively worsened. However, the administration of rituximab (RTX) resulted in clinical remission as well as a visible reduction in anti-MDA5-Ab levels, suggesting that RTX could be a useful remedy in cases refractory to conventional immunosuppressive agents, especially those of RP-ILD related to anti-MDA5-Ab-positive DM...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29225777/evaluation-of-electrochemiluminescence-immunoassays-for-immunosuppressive-drugs-on-the-roche-cobas-e411-analyzer
#4
Angela W S Fung, Michael J Knauer, Ivan M Blasutig, David A Colantonio, Vathany Kulasingam
Background:  Therapeutic drug monitoring of immunosuppressant drugs are used to monitor drug efficacy and toxicity and to prevent organ transplantation rejection. This study evaluates the analytical performance of semi-automated electrochemiluminescence immunoassays (ECLIA) for cyclosporine (CSA), tacrolimus (TAC) and sirolimus (SRL) on the Roche cobas e 411 analyzer at a major transplant hospital to identify method suitability and limitations. Methods: Residual whole blood samples from patients undergoing immunosuppressant therapy were used for evaluation...
2017: F1000Research
https://www.readbyqxmd.com/read/29225251/successful-treatment-of-syndrome-of-inappropriate-antidiuretic-hormone-secretion-associated-with-neuro-sweet-disease-in-myelodysplastic-syndrome
#5
Satoko Oka, Kazuo Ono, Masaharu Nohgawa
Sweet disease may occur in several organs, and central nervous system involvement, known as Neuro-Sweet disease (NSD), is rare. The clinical features of NSD include recurrent encephalomeningitis accompanied by fever and erythematous plaques; systemic corticosteroid therapy is highly effective. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an important electrolyte abnormality because it can be life-threatening. We describe the first case of SIADH and NSD associated with low-risk myelodysplastic syndrome that was successfully treated with corticosteroids and cyclosporine...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29225189/luteolin-attenuates-airway-inflammation-by-inducing-the-transition-of-cd4-cd25-to-cd4-cd25-regulatory-t-cells
#6
Seung-Hyung Kim, Evelyn Saba, Bok-Kyu Kim, Won-Kyung Yang, Yang-Chun Park, Han Jae Shin, Chang Kyun Han, Young Cheol Lee, Man Hee Rhee
Regulatory T cells (Th2) play an important role in autoimmunity and have been shown to exert anti-inflammatory effects in allergic asthma. Mouse model of airway inflammation was used to examine the suppressive activity of luteolin-induced CD4+CD25+ regulatory T cells (Tregs) in vivo. In this study, BALB/c mice were sensitized with ovalbumin antigen (OVA) by aerosol challenge. Then, various biological processes were examined, including airway eosinophilia; mucus hypersecretion; elevation of OVA-specific IgE, expression of Th2 cytokines and chemokine levels; expression of eotaxin 2 and CCR3; and airway hyper responsiveness (AHR)...
December 7, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29224938/subclinical-atherosclerosis-in-pediatric-liver-transplant-recipients-carotid-and-aorta-intima-media-thickness-and-their-predictors
#7
Emily R Perito, Andrew Phelps, Tabitha Vase, Vickie A Feldstein, Robert H Lustig, Philip Rosenthal
OBJECTIVE: To investigate prevalence and predictors of cardiovascular risk in pediatric liver transplant recipients using noninvasive markers of subclinical atherosclerosis: carotid intima-media thickness (cIMT) and aorta intima-media thickness (aIMT). STUDY DESIGN: Cross-sectional study of 88 pediatric liver transplant recipients. The cIMT and aIMT were measured by ultrasound imaging using standardized protocol. RESULTS: Participants were 15...
December 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29224682/calcineurin-inhibitors-in-systemic-lupus-erythematosus
#8
REVIEW
Chi Chiu Mok
The calcineurin inhibitors (CNIs) belong to a group of immunosuppressive agents that block T-cell activation through the suppression of the calcium/calcimodulin-dependent phosphatase calcineurin. Agents such as cyclosporine A (CSA) and tacrolimus (TAC) have long been used in patients with systemic lupus erythematosus (SLE). TAC is preferred to CSA in SLE because of the lower frequency of cosmetic, hypertensive and dyslipidemic adverse effects. Recent randomised controlled trials have demonstrated noninferiority of TAC to mycophenolate mofetil (MMF) or cyclophosphamide (CYC) for induction therapy of lupus nephritis...
June 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29223733/mitochondrial-pore-opening-and-loss-of-ca2-exchanger-nclx-levels-occur-after-frataxin-depletion
#9
R Purroy, E Britti, F Delaspre, J Tamarit, J Ros
Frataxin-deficient neonatal rat cardiomyocytes and dorsal root ganglia neurons have been used as cell models of Friedreich ataxia. In previous work we show that frataxin depletion resulted in mitochondrial swelling and lipid droplet accumulation in cardiomyocytes, and compromised DRG neurons survival. Now, we show that these cells display reduced levels of the mitochondrial calcium transporter NCLX that can be restored by calcium-chelating agents and by external addition of frataxin fused to TAT peptide. Also, the transcription factor NFAT3, involved in cardiac hypertrophy and apoptosis, becomes activated by dephosphorylation in both cardiomyocytes and DRG neurons...
December 6, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29223393/mersalyl-prevents-the-tl-induced-permeability-transition-pore-opening-in-the-inner-membrane-of-ca2-loaded-rat-liver-mitochondria
#10
Sergey M Korotkov, Svetlana A Konovalova, Vladimir P Nesterov, Irina V Brailovskaya
It was earlier shown that the calcium load of rat liver mitochondria in medium containing TlNO3 and KNO3 resulted in the Tl+-induced mitochondrial permeability transition pore (MPTP) opening in the inner membrane. This opening was accompanied by an increase in swelling and membrane potential dissipation and a decrease in state 3, state 4, and 2,4-dinitrophenol-uncoupled respiration. This respiratory decrease was markedly leveled by mersalyl (MSL), the phosphate symporter (PiC) inhibitor which poorly stimulated the calcium-induced swelling, but further increased the potential dissipation...
December 6, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29222397/indoxyl-sulfate-upregulates-liver-p-glycoprotein-expression-and-activity-through-aryl-hydrocarbon-receptor-signaling
#11
Tacy Santana Machado, Stéphane Poitevin, Pascale Paul, Nathalie McKay, Noémie Jourde-Chiche, Tristan Legris, Annick Mouly-Bandini, Françoise Dignat-George, Philippe Brunet, Rosalinde Masereeuw, Stéphane Burtey, Claire Cerini
In patients with CKD, not only renal but also, nonrenal clearance of drugs is altered. Uremic toxins could modify the expression and/or activity of drug transporters in the liver. We tested whether the uremic toxin indoxyl sulfate (IS), an endogenous ligand of the transcription factor aryl hydrocarbon receptor, could change the expression of the following liver transporters involved in drug clearance: SLC10A1, SLC22A1, SLC22A7, SLC47A1, SLCO1B1, SLCO1B3, SLCO2B1, ABCB1, ABCB11, ABCC2, ABCC3, ABCC4, ABCC6, and ABCG2 We showed that IS increases the expression and activity of the efflux transporter P-glycoprotein (P-gp) encoded by ABCB1 in human hepatoma cells (HepG2) without modifying the expression of the other transporters...
December 8, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29219791/effects-of-the-vitamin-d-analog-2amd-in-cyclosporine-induced-nephrotoxicity-dose-response-and-antifibrotic-activity
#12
Bianca Tomasini-Johansson, Cori O'Brien, Alexandra Larson-Osborne, Inger Toraason, Debra Hullett, Lori Plum, Hector DeLuca, Hans Sollinger
OBJECTIVES: In this study, we aimed to ascertain the efficacy and determine the dose effects of a new analog of vitamin D, 2α-methyl-19-nor-(20S)-1α,25-dihydroxyvitamin D3 (2AMD), in decreasing fibrosis and improving renal function in a rat model of kidney disease. MATERIALS AND METHODS: Using the cyclosporine model of chronic kidney disease, we tested 4 dose regimens (2.5, 5, 10, and 20 ng/kg) of 2AMD by subcutaneous administration. The 2AMD analog was compared with another analog, 2-methylene-19-nor-(20S)-1α,25-dihydroxyvitamin D3 (2MD), given at 5 ng/kg...
December 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29218495/systemic-epstein-barr-virus-positive-t-cell-lymphoproliferative-disorders-of-childhood-with-fulminant-leukocytosis-and-tumor-lysis-a-case-report-with-autopsy-findings
#13
Sachie Wada, Takayuki Suzuki, Koichi Kitazume, Akira Fujita, Seiichiro Shimizu
Systemic Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disorders (T-LPD) of childhood is an extremely rare disease characterized by an aggressive clinical course and very poor prognosis. We report an adolescent male with systemic EBV-positive T-LPD of childhood after primary EBV infection, resulting in a fatal clinical course within 9 days, along with autopsy findings. A 19-year-old male without an immunocompromised status presented with an acute onset of high fever, and was hospitalized for persistent fever, vomiting and diarrhea on the 5th day from onset...
December 7, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29217890/nontubercular-mycobacterial-infection-in-a-renal-allograft-recipient
#14
U Anandh, K Jayanna
A 71-year-old male, a renal allograft recipient, presented to us with a history of fever and right palm swelling. He had a history of fever 7 years back when he was treated with antitubercular treatment (ATT). Three years back, he was diagnosed to have gout and he was started on allopurinol. He developed severe bone marrow toxicity and allopurinol was changed to febuxostat. On admission, routine investigations did not reveal any focus of infection. The fluid aspirate from the palm revealed acid-fast bacilli (AFB)...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29217782/rational-management-approach-to-pure-red-cell-aplasia
#15
Suresh Kumar Balasubramanian, Meena Sadaps, Swapna Thota, Mai Aly, Bartlomiej P Przychodzen, Cassandra M Hirsch, Valeria Visconte, Tomas Radivoyevitch, Jaroslaw P Maciejewski
Pure red cell aplasia is an orphan disease without rationally established standard therapies. Most cases are idiopathic; a subset is antibody-mediated. There is overlap between idiopathic cases and those with T-large granular lymphocytic leukemia, hypogammaglobulinemia, and low-grade lymphomas. In all these, the pathogenetic mechanisms may involve autoreactive cytotoxic responses. We selected 62 uniformly diagnosed pure red cell aplasia patients and analyzed their pathophysiologic features and responsiveness to rationally applied first-line and salvage therapies to propose diagnostic and therapeutic algorithms that may help guide management of prospective patients...
December 7, 2017: Haematologica
https://www.readbyqxmd.com/read/29215459/complete-b-cell-deficiency-reduces-allograft-inflammation-and-intragraft-macrophages-a-rat-kidney-transplant-model
#16
Sarah E Panzer, Nancy A Wilson, Bret M Verhoven, Ding Xiang, C Dustin Rubinstein, Robert R Redfield, Weixiong Zhong, Shannon R Reese
BACKGROUND: Increasingly it is being appreciated that B cells have broad roles beyond the humoral response, and are able to contribute to and regulate inflammation. The specific role of B cells in the pathogenesis of early allograft inflammation remains unclear. METHODS: To address this question, we generated B cell deficient Lewis rats via CRISPR technology. In a full mismatch transplant model, kidneys from Brown Norway donors were transplanted into B cell deficient Lewis recipients (B) or wild type Lewis recipients...
December 5, 2017: Transplantation
https://www.readbyqxmd.com/read/29214791/a-case-of-schnitzler-s-syndrome-without-monoclonal-gammopathy-associated-chronic-urticaria-treated-with-anakinra
#17
Min Joo Ahn, Ji Eun Yu, Jiung Jeong, Da Woon Sim, Young Il Koh
Chronic urticaria may often be associated with interleukin (IL)-1-mediated autoinflammatory disease, which should be suspected if systemic inflammation signs are present. Here, we report a case of Schnitzler's syndrome without monoclonal gammopathy treated successfully with the IL-1 receptor antagonist anakinra. A 69-year-old man suffered from a pruritic urticarial rash for 12 years. It became aggravated episodically and was accompanied by high fever, arthralgia, leukocytosis, and an elevated C-reactive protein and erythrocyte sedimentation rate...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29214751/multi-center-performance-evaluations-of-tacrolimus-and-cyclosporine-electrochemiluminescence-immunoassays-in-the-asia-pacific-region
#18
Xuzhen Qin, Jianzhong Rui, Yong Xia, Hong Mu, Sang Hoon Song, Raja Elina Raja Aziddin, Gabrielle Miles, Yuli Sun, Sail Chun
BACKGROUND: The immunosuppressant drugs (ISDs), tacrolimus and cyclosporine, are vital for solid organ transplant patients to prevent rejection. However, toxicity is a concern, and absorption is highly variable across patients; therefore, ISD levels need to be precisely monitored. In the Asia-Pacific (APAC) region, tacrolimus and cyclosporine concentrations are typically measured using immunoassays. The objective of this study was to assess the analytical performance of Roche Elecsystacrolimus and cyclosporinee electrochemiluminescence immunoassays (ECLIAs)...
March 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29211658/letermovir-prophylaxis-for-cytomegalovirus-in-hematopoietic-cell-transplantation
#19
Francisco M Marty, Per Ljungman, Roy F Chemaly, Johan Maertens, Sanjeet S Dadwal, Rafael F Duarte, Shariq Haider, Andrew J Ullmann, Yuta Katayama, Janice Brown, Kathleen M Mullane, Michael Boeckh, Emily A Blumberg, Hermann Einsele, David R Snydman, Yoshinobu Kanda, Mark J DiNubile, Valerie L Teal, Hong Wan, Yoshihiko Murata, Nicholas A Kartsonis, Randi Y Leavitt, Cyrus Badshah
Background Cytomegalovirus (CMV) infection remains a common complication after allogeneic hematopoietic-cell transplantation. Letermovir is an antiviral drug that inhibits the CMV-terminase complex. Methods In this phase 3, double-blind trial, we randomly assigned CMV-seropositive transplant recipients, 18 years of age or older, in a 2:1 ratio to receive letermovir or placebo, administered orally or intravenously, through week 14 after transplantation; randomization was stratified according to trial site and CMV disease risk...
December 6, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29210087/methotrexate-use-in-allergic-contact-dermatitis-a-retrospective-study
#20
Ashaki Patel, Erin Burns, Nicole M Burkemper
BACKGROUND: Methotrexate, a folate antimetabolite, is used to treat atopic dermatitis and psoriasis. Although methotrexate's therapeutic efficacy has been noted in the literature, there are few data on the efficacy of methotrexate treatment for allergic contact dermatitis. OBJECTIVE: To evaluate the efficacy and tolerability of methotrexate in treating allergic contact dermatitis at a single institution, and also to assess methotrexate efficacy in patients with chronic, unavoidable allergen exposure...
December 6, 2017: Contact Dermatitis
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