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Immune reconstitutional syndrome

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https://www.readbyqxmd.com/read/28344059/gastrointestinal-toxicity-systemic-inflammation-and-liver-biochemistry-in-allogeneic-haematological-stem-cell-transplantation
#1
K Jordan, P Pontoppidan, H Uhlving, K Kielsen, D G Burrin, S Weichendorff, I J Christensen, M H Jørgensen, C Heilmann, H Sengeløv, K Müller
INTRODUCTION: Liver toxicity is frequently seen in relation to allogeneic hematopoietic stem cell transplantation (HSCT), but pathogenesis and the risk factors are poorly understood. The purpose of this study was to investigate associations between liver toxicity, gastrointestinal toxicity and levels of immune regulating cytokines during the early post-transplant period. METHODS: We prospectively included 81 children and adults undergoing HSCT after myeloablative conditioning...
March 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28333858/immune-reconstitution-inflammatory-syndrome-causing-progressive-optic-nerve-edema-in-cryptococcal-meningitis
#2
Astrid C Werner, Laurel N Vuong, Thomas R Hedges, Caroline R Baumal
PURPOSE: To report an human immunodeficiency virus-positive patient undergoing therapy for cryptococcal meningitis who developed progressive optic disc edema that was steroid responsive. METHODS: Observational case report. RESULTS: One month after commencing antifungal treatment for cryptococcal meningitis, the patient developed bilateral, progressive, recurrent optic disc edema with subretinal fluid that coincided with initiation of highly active antiretroviral therapy and recovery of CD4 cell counts...
March 22, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28330607/association-between-anti-thymocyte-globulin-exposure-and-survival-outcomes-in-adult-unrelated-haemopoietic-cell-transplantation-a-multicentre-retrospective-pharmacodynamic-cohort-analysis
#3
Rick Admiraal, Stefan Nierkens, Moniek A de Witte, Eefke J Petersen, Ger-Jan Fleurke, Luka Verrest, Svetlana V Belitser, Robbert G M Bredius, Reinier A P Raymakers, Catherijne A J Knibbe, Monique C Minnema, Charlotte van Kesteren, Jurgen Kuball, Jaap J Boelens
BACKGROUND: Anti-thymocyte globulin (ATG) is used to prevent graft-versus-host disease (GvHD) after allogeneic haemopoietic cell transplantation (HCT). However, ATG can also cause delayed immune reconstitution of T cells, negatively affecting survival. We studied the relation between exposure to ATG and clinical outcomes in adult patients with acute leukaemia and myelodysplastic syndrome. METHODS: We did a retrospective, pharmacokinetic-pharmacodynamic analysis of data from patients with acute lymphoid leukaemia, acute myeloid leukaemia, or myelodysplastic syndrome receiving their first T-cell repleted allogeneic peripheral blood stem cell HCT with ATG (thymoglobulin) as part of non-myeloablative conditioning from March 1, 2004, to June 1, 2015...
March 16, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28322482/progressive-multifocal-leukoencephalopathy-associated-with-fumaric-acid-esters-treatment-in-psoriasis-patients
#4
Deepak M W Balak, Enes Hajdarbegovic, Wichor M Bramer, Martino H A Neumann, H Bing Thio
BACKGROUND: Fumaric acid esters (FAEs) are a systemic treatment for psoriasis considered to have a favorable long-term safety profile without an increased risk for immunosuppression. However, progressive multifocal leukoencephalopathy (PML), a rare, opportunistic viral infection of the central nervous system, has been linked anecdotally to FAE treatment. OBJECTIVE: to assess clinical features and outcomes of FAE-associated PML cases. METHODS: Systematic literature search in multiple databases up to February, 25(th) 2016 for reports of PML in psoriasis patients treated with FAEs...
March 21, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28321034/galectin-9-as-a-predictive-marker-for-the-onset-of-immune-related-adverse-effects-associated-with-anti-ccr4-moab-therapy-in-patients-with-adult-t-cell-leukemia
#5
Tareg Omer Mohammed, Haorile Chagan-Yasutan, Yugo Ashino, Wakana Nakayama, Yayoi Takahashi, Taizo Shimomura, Tetsuhiro Fujimoto, Yuko Watanabe, Toshiro Niki, Hitoshi Suzushima, Toshio Hattori
Adult T-cell leukemia/lymphoma (ATL/ATLL) is one of the most malignant lymphomas with poor prognosis. ATL/ATLL cells express CC chemokine receptor 4, and mogamulizumab (anti-CCR4 monoclonal antibody) exhibits strong cytotoxicity for ATL/ATLL cells. We analyzed plasma samples of 6 patients with ATL/ATLL treated with chemotherapy followed by mogamulizumab therapy (mogatherapy) for changes in the levels of biomarkers in relation to immune-related adverse effects. As treatment is often associated with skin eruptions, we investigated the profiles of inflammatory cytokines, including galectin-9 (Gal-9), which becomes increased in various infectious diseases and allergic patients...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28320359/chronic-cough-conundrum-a-case-report-of-a-new-diagnosis-of-hiv-and-pulmonary-kaposi-s-sarcoma
#6
Pamela P Bailey, Marylou M Dryer, John P Piper, Sajjad Ahmad
BACKGROUND: When evaluating a common complaint such as cough, clinicians should rely on a patient's history and physical to guide them, but also not diverge from guidelines in screening and testing lest certain diagnoses be overlooked. CASE PRESENTATION: A 44 year old Hispanic male presented to a pulmonologist's office after failing multiple courses of antibiotics for chronic cough, now six months in duration. He described intermittent scant hemoptysis and an evanescent migratory non-pruritic rash occasionally noted on his trunk or limbs...
March 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28316373/nuclear-factor-of-activated-t-cells-and-cytokines-gene-expression-of-the-t-cells-in-aids-patients-with-immune-reconstitution-inflammatory-syndrome-during-highly-active-antiretroviral-therapy
#7
Jia Sun, Heling Chen, Yirui Xie, Junwei Su, Ying Huang, Lijun Xu, Michael Yin, Qihui Zhou, Biao Zhu
Background. The etiology of immune reconstitution inflammatory syndrome (IRIS) in AIDS patients after the initiation of HAART remains unknown. Several researches indicated that the development of IRIS is associated with the production and variation of cytokines, whose gene expression are closely related to the Ca2(+)/CN-nuclear factor of activated T cells (NFAT) pathway. Methods. We studied the expression of NFAT isoforms and their major target cytokines genes in peripheral blood CD3(+) T cells of subjects through fluorescence quantitative PCR and explored the expression changes of these genes before and after HAART...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28303782/paradoxical-reactions-and-the-immune-reconstitution-inflammatory-syndrome
#8
L W Preston Church, Amit Chopra, Marc A Judson
In HIV-infected individuals, paradoxical reactions after the initiation of antiretroviral therapy (ART) are associated with a variety of underlying infections and have been called the immune reconstitution inflammatory syndrome (IRIS). In cases of IRIS associated with tuberculosis (TB), two distinct patterns of disease are recognized: (i) the progression of subclinical TB to clinical disease after the initiation of ART, referred to as unmasking, and (ii) the progression or appearance of new clinical and/or radiographic disease in patients with previously recognized TB after the initiation of ART, the classic or "paradoxical" TB-IRIS...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28275598/bilateral-ocular-myositis-associated-with-whipple-s-disease
#9
Vivak Parkash, Hardeep Singh Mudhar, Bart E Wagner, Didier Raoult, Ruth Batty, Hubert Lepidi, John Burke, Paul Collini, Thushan de Silva
PURPOSE: To describe the clinical features of a Caucasian female patient with a history of treated gastrointestinal Whipple's disease (WD) who developed new-onset diplopia, with a description of the histopathological features of the extraocular muscle biopsies. METHODS: A previously fit 38-year-old Caucasian female presented with acute-onset diplopia after being on a sustained medication regime for biopsy-proven gastrointestinal WD. A magnetic resonance imaging scan of her orbits with gadolinium revealed diffuse enhancement of the bellies of the extraocular muscles bilaterally, particularly the medial rectus, superior rectus, and superior oblique muscles, consistent with an infiltrative myositis...
January 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/28271555/immune-reconstitution-inflammatory-syndrome-presenting-as-secondary-syphilis-with-polymorphous-erythema-and-knee-arthritis
#10
J Brochard, L Khatchatourian, P Woaye-Hune, C Biron, M Lefebvre, M Denis-Musquer, P Grange, N Dupin, F Raffi
Syphilis and HIV are strongly linked to one another and immune reconstitution inflammatory syndrome (IRIS) after antiretroviral therapy (ART) initiation can complicate matters. A 24-years-old homosexual man was hospitalized for fever, cough and headache. HIV infection had been diagnosed 5 years earlier but he discontinued ART for the last 2 years. This article is protected by copyright. All rights reserved.
March 8, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28261277/gene-therapy-for-primary-immune-deficiencies-a-canadian-perspective
#11
REVIEW
Xiaobai Xu, Chetankumar S Tailor, Eyal Grunebaum
The use of gene therapy (GT) for the treatment of primary immune deficiencies (PID) including severe combined immune deficiency (SCID) has progressed significantly in the recent years. In particular, long-term studies have shown that adenosine deaminase (ADA) gene delivery into ADA-deficient hematopoietic stem cells that are then transplanted into the patients corrects the abnormal function of the ADA enzyme, which leads to immune reconstitution. In contrast, the outcome was disappointing for patients with X-linked SCID, Wiskott-Aldrich syndrome and chronic granulomatous disease who received GT followed by autologous gene corrected transplantations, as many developed hematological malignancies...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28260421/successful-pregnancy-after-natalizumab-associated-progressive-multifocal-leukoencephalopathy-in-a-patient-with-multiple-sclerosis
#12
Kalliopi Pitarokoili, Kerstin Hellwig, Carsten Lukas, Ralf Gold
We report the case of a post-progressive multifocal leukoencephalopathy (PML), multiple sclerosis (MS) patient with an uncomplicated pregnancy and delivery. A 28-year-old woman on natalizumab (total of 49 infusions) was diagnosed with PML due to typical magnetic resonance imaging (MRI) and clinical presentation. John Cunningham virus (JCV) was detected in the cerebrospinal fluid (CSF) during the immune reconstitution inflammatory syndrome (IRIS). Nine months after PML onset, JCV negativity in the CSF was observed...
March 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28259888/hiv-associated-kaposi-s-sarcoma
#13
Christian Hoffmann, Michael Sabranski, Stefan Esser
Kaposi's sarcoma (KS) is still one of the most common malignancies in patients with human immunodeficiency virus (HIV) infection. Large randomized clinical trials have shown a protective effect of combination antiretroviral therapy (cART) against the development of KS, even in patients with a relatively preserved immune system. In patients with sufficient cART, KS has become a rarity. In most patients with HIV-associated KS who initiate cART, the KS lesions stabilize with decreasing HIV plasma viremia and immune reconstitution, or even resolve completely without any specific treatment...
2017: Oncology Research and Treatment
https://www.readbyqxmd.com/read/28250304/pneumocystis-pneumonia-concomitant-with-ectopic-acth-syndrome-caused-by-a-large-cell-neuroendocrine-carcinoma-of-the-thymus
#14
Naohiro Oda, Nobuaki Miyahara, Masahiro Tabata, Daisuke Minami, Kiichiro Ninomiya, Arihiko Kanehiro, Motoshi Komatsubara, Kenichi Inagaki, Mitsune Tanimoto, Katsuyuki Kiura
We herein report the case of a 44-year-old man who was diagnosed with pneumocystis pneumonia (PCP) concomitant with ectopic adrenocorticotropic hormone (ACTH) syndrome, which had been caused by a large cell neuroendocrine carcinoma of the thymus. Chest computed tomography revealed ground-glass opacities in the lungs. PCP was diagnosed by a polymerase chain reaction with bronchoalveolar lavage. The levels of cortisol were slowly corrected with an adrenal enzyme inhibitor, and the exacerbation of PCP was successfully avoided...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28228569/no-evidence-of-beneficial-effects-of-plasmapheresis-in-natalizumab-associated-pml
#15
Doriana Landi, Nicola De Rossi, Sara Zagaglia, Cristina Scarpazza, Luca Prosperini, Maria Albanese, Fabio Buttari, Francesco Mori, Girolama Alessandra Marfia, Maria Pia Sormani, Ruggero Capra, Diego Centonze
OBJECTIVE: To examine retrospectively the effects of plasmapheresis (PLEX) on the survival and clinical outcomes of patients with multiple sclerosis (MS) and natalizumab (NTZ)-associated progressive multifocal leukoencephalopathy (PML). METHODS: The medical literature was searched for the terms natalizumab and progressive multifocal leukoencephalopathy. A total of 193 international and 34 Italian NTZ-PML cases were included. Clinical outcome was determined by comparing the patients' clinical status at PML diagnosis with status after PML resolution...
February 22, 2017: Neurology
https://www.readbyqxmd.com/read/28210571/unmasking-histoplasmosis-immune-reconstitution-inflammatory-syndrome-in-a-patient-recently-started-on-antiretroviral-therapy
#16
Reuben Kiggundu, Henry W Nabeta, Richard Okia, Joshua Rhein, Robert Lukande
Histoplasmosis is the most common endemic mycoses among HIV-infected people. Patients with suppressed cell immunity mainly due to HIV are at increased risk of disseminated disease. Dermatological manifestations of immune reconstitution inflammatory syndrome (IRIS) and cutaneous manifestations of histoplasmosis similar to an IRIS event have been previously described. We report the case of a 43-year-old male who presented with cutaneous disseminated histoplasmosis due to Histoplasma capsulatum var. capsulatum 4 months after the onset of the antiretroviral therapy and some improvement in the immune reconstitution...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28209523/tb-iris-proteomic-analysis-of-in-vitro-pbmc-responses-to-mycobacterium-tuberculosis-and-response-modulation-by-dexamethasone
#17
Liam Bell, Janique M Peyper, Shaun Garnett, Rabecca Tadokera, Robert Wilkinson, Graeme Meintjes, Jonathan M Blackburn
Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) occurs in 8-54% of South African patients undergoing treatment for tuberculosis/human immunodeficiency virus co-infection. Improved TB-IRIS molecular pathogenesis understanding would enhance risk stratification, diagnosis, prognostication, and treatment. We assessed how TB-IRIS status and dexamethasone influence leukocyte proteomic responses to Mycobacterium tuberculosis (Mtb). Patient blood was obtained three weeks post-anti-retroviral therapy initiation...
February 14, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28191773/notch-expanded-murine-hematopoietic-stem-and-progenitor-cells-mitigate-death-from-lethal-radiation-and-convey-immune-tolerance-in-mismatched-recipients
#18
Filippo Milano, Fabiola Merriam, Ian Nicoud, Jianqiang Li, Ted A Gooley, Shelly Heimfeld, Suzan Imren, Colleen Delaney
The hematopoietic syndrome of acute radiation syndrome (h-ARS) is characterized by severe bone marrow aplasia, resulting in a significant risk for bleeding, infections, and death. To date, clinical management of h-ARS is limited to supportive care dictated by the level of radiation exposure, with a high incidence of mortality in those exposed to high radiation doses. The ideal therapeutic agent would be an immediately available, easily distributable single-agent therapy capable of rapid in vivo hematopoietic reconstitution until recovery of autologous hematopoiesis occurs...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28176791/il-36%C3%AE-is-a-crucial-proximal-component-of-protective-type-1-mediated-lung-mucosal-immunity-in-gram-positive-and-negative-bacterial-pneumonia
#19
M A Kovach, B Singer, G Martinez-Colon, M W Newstead, X Zeng, P Mancuso, T A Moore, S L Kunkel, M Peters-Golden, B B Moore, T J Standiford
Interleukin-36γ (IL-36γ) is a member of novel IL-1-like proinflammatory cytokine family that are highly expressed in epithelial tissues and several myeloid-derived cell types. Little is known about the role of the IL-36 family in mucosal immunity, including lung anti-bacterial responses. We used murine models of IL-36γ deficiency to assess the contribution of IL-36γ in the lung during experimental pneumonia. Induction of IL-36γ was observed in the lung in response to Streptococcus pneumoniae (Sp) infection, and mature IL-36γ protein was secreted primarily in microparticles...
February 8, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28163944/immune-reconstitution-inflammatory-syndrome-opening-pandora-s-box
#20
Mariana Meireles, Conceição Souto Moura, Margarida França
One of the purposes of antiretroviral therapy (ART) is to restore the immune system. However, it can sometimes lead to an aberrant inflammatory response and paradoxical clinical worsening known as the immune reconstitution inflammatory syndrome (IRIS). We describe a 23-year-old male, HIV1 infected with a rapid progression phenotype, who started ART with TCD4+ of 53 cells/mm(3) (3,3%) and HIV RNA = 890000 copies/mL (6 log). Four weeks later he was admitted to the intensive care unit with severe sepsis...
2017: Case Reports in Infectious Diseases
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