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immunosuppression minimization

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https://www.readbyqxmd.com/read/29350178/use-of-rifabutin-to-treat-tuberculosis-in-a-cardiac-transplant-recipient-a-case-report%C3%A2
#1
Maya Takayoshi, Kyoichi Wada, Yuka Terada, Sachi Matsuda, Kazuki Nakagita, Akira Oita, Mitsutaka Takada, Aki Shionoiri, Haruki Sunami, Seiko Nakajima, Kensuke Kuroda, Takuma Sato, Osamu Seguchi, Masanobu Yanase, Norihide Fukushima
OBJECTIVE: Tuberculosis is an important concern following organ transplantation. Unfortunately, several antituberculosis drugs interact with immunosuppressants. This report describes our experience with rifabutin (RBT) in the treatment of acute tuberculosis in a cardiac transplant recipient. CASE: A 61-year-old cardiac transplant recipient developed tuberculosis meningitis during treatment of miliary tuberculosis. RBT was given for 27 days concomitantly with cyclosporine (CsA)...
January 19, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29342289/recent-advances-in-kidney-transplantation-a-viewpoint-from-the-descartes-advisory-board
#2
Daniel Abramowicz, Rainer Oberbauer, Uwe Heemann, Ondrej Viklicky, Licia Peruzzi, Christophe Mariat, Marta Crespo, Klemens Budde, Gabriel C Oniscu
Transplantation medicine is a rapidly evolving field. Keeping afloat of the published literature to offer the best clinical care to our patients is a daunting task. As part of its educational mission, the Descartes advisory board identified seven topics in kidney transplantation where there has been substantial progresses over the last years: kidney allocation within Eurotransplant; kidney exchange strategies; kidney machine perfusion strategies; the changing landscape of anti-human leukocyte antigen (HLA) antibodies; the new immunosuppressive drugs in the pipeline; strategies for immunosuppression minimization; and the continuous enigma of focal segmental glomerular sclerosis recurrence after transplantation...
January 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29335633/long-term-survival-among-patients-who-are-disease-free-at-1-year-post-allogeneic-hematopoietic-cell-transplantation-a-single-center-analysis-of-389-consecutive-patients
#3
Melhem M Solh, Asad Bashey, Scott R Solomon, Lawrence E Morris, Xu Zhang, Stacey Brown, H Kent Holland
Allogeneic hematopoietic cell transplantation (HCT) is associated with significant morbidity and mortality especially in the first year after HCT. In this study, we examine the long-term outcomes of patients who survived at least one year post HCT without evidence of relapse. We analyzed the records for 389 consecutive patients receiving an allogeneic transplant from 2005 to 2016 from a MRD, MUD, or haploidentical donor, who were alive and disease free at one year post-transplant. Patient characteristics and outcome parameters were extracted from our institutional database where they had been prospectively entered...
January 15, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29305519/antigen-specific-antitumor-responses-induced-by-ox40-agonist-are-enhanced-by-ido-inhibitor-indoximod
#4
Zuzana Berrong, Mikayel Mkrtichyan, Shamim Ahmad, Mason Webb, Eslam Mohamed, Grigori Okoev, Adelaida Matevosyan, Rajeev Shrimali, Rasha Abu Eid, Scott Hammond, John E Janik, Samir N Khleif
Although an immune response to tumors may be generated using vaccines, so far, this approach has only shown minimal clinical success. This is attributed to the tendency of cancer to escape immune surveillance via multiple immune suppressive mechanisms. Successful cancer immunotherapy requires targeting these inhibitory mechanisms along with enhancement of antigen-specific immune responses to promote sustained tumor-specific immunity. Here we evaluated the effect of indoximod, an inhibitor of the immunosuppressive indoleamine-(2,3)-dioxygenase (IDO) pathway, on antitumor efficacy of anti-OX40 agonist in the context of vaccine in the IDO- TC-1 tumor model...
January 5, 2018: Cancer Immunology Research
https://www.readbyqxmd.com/read/29304271/blau-jabs-syndrome-in-a-tertiary-ophthalmologic-center
#5
Heloisa Nascimento, Jacqueline M Sousa, Délia González Fernández, Gustavo H A Salomão, Elcio H Sato, Cristina Muccioli, Rubens Belfort
In a prospective case series of patients with Blau-Jabs syndrome (BJS) conducted in the Ophthalmology Department/Federal University of Sao Paulo, seven patients with clinical and ophthalmologic manifestations of the disease and a positive genetic test result for the presence of a mutation in the CARD15/NOD2 gene were followed for a minimal period of 1 year. All patients had uveitis, five had nummular corneal subepithelial opacities, and four had multifocal choroiditis. Oral prednisolone was administered to all patients; inflammation was controlled in six patients with at least one immunosuppressive drug...
January 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/29301941/the-role-of-micrornas-in-glucocorticoid-action-literature-review
#6
Sally A Clayton, Simon W Jones, Mariola Kurowska-Stolarska, Andrew R Clark
Glucocorticoids (GCs) are steroids with profound anti-inflammatory and immunomodulatory activities. Synthetic GCs are widely used for managing chronic inflammatory and autoimmune conditions, as immunosuppressants in transplantation, and as antitumor agents in certain hematological cancers. However, prolonged GC exposure can cause adverse effects. A detailed understanding of GCs' mechanisms of action may enable harnessing of their desirable actions while minimizing harmful effects. Here, we review the impact on GC biology of microRNAs, small noncoding RNAs that posttranscriptionally regulate gene expression...
January 4, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29288697/mesenchymal-stromal-cells-for-tolerance-induction-in-organ-transplantation
#7
REVIEW
Federica Casiraghi, Norberto Perico, Giuseppe Remuzzi
The primary challenge in organ transplantation continues to be the need to suppress the host immune system long-term to ensure prolonged allograft survival. Long-term non-specific immunosuppression can, however, result in life-threatening complications. Thus, efforts have been pursued to explore novel strategies that would allow minimization of maintenance immunosuppression, eventually leading to transplant tolerance. In this scenario, bone marrow-derived mesenchymal stromal cells (MSC), given their given unique immunomodulatory properties to skew the balance between regulatory and memory T cells, have emerged as potential candidates for cell-based therapy to promote immune tolerance...
December 27, 2017: Human Immunology
https://www.readbyqxmd.com/read/29285724/management-of-itch-in-atopic-dermatitis
#8
REVIEW
Janelle Pavlis, Gil Yosipovitch
Atopic dermatitis (AD) is the most common itchy dermatosis that affects millions of children and adults worldwide. Chronic itch in this condition has significant impact on measures of quality of life, such as sleep. Treating itch in AD has been challenging for decades, but new drugs have emerged in the last year with significant anti-pruritic effect. The optimal treatment regimen for atopic itch addresses barrier dysfunction, inflammation, neural hypersensitivity, and the itch-scratch cycle. Topical moisturizers remain the foundation of treatment and should be used by all patients with AD-associated pruritus...
December 28, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/29277665/tacrolimus-an-updated-review-on-delivering-strategies-for-multifarious-diseases
#9
REVIEW
Divya Dheer, Jyoti, Prem N Gupta, Ravi Shankar
From the current trends, tacrolimus (TAC) has become an important therapeutic option for the optimal individualization of immunosuppressive therapy especially in case of transplant recipients. TAC is used most frequently in comparison to other immunosuppressants because it offers better safety profile with increased long-term survival in patients especially in children and adolescents. This drug has developed an immense interest in the research field owing to its potential pharmacological scope but due to its poor water solubility, need of concomitant steroids and higher incidences of nephrotoxicity, there comes a need for future research to minimize such limitations and decipher maximum use of the drug...
December 22, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29276997/cancer-immunotherapy-in-a-neglected-population-the-current-use-and-future-of-t-cell-mediated-checkpoint-inhibitors-in-organ-transplant-patients
#10
REVIEW
Young Kwang Chae, Carlos Galvez, Jonathan F Anker, Wade T Iams, Manali Bhave
Although the indications for immune checkpoint inhibitors continue to grow, organ transplant recipients with advanced malignancies have been largely excluded from clinical trials testing the safety and efficacy of these therapies given their need for chronic immunosuppression and the risk of allograft rejection. With the rapid growth of transplant medicine and the increased risk of malignancy associated with chronic immunosuppression, it is critical that we systematically analyze the available data describing immune checkpoint blockade in the organ transplant population...
December 8, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29243390/aquaporin-4-blockade-improves-survival-of-murine-heart-allografts-subjected-to-prolonged-cold-ischemia
#11
Katayoun Ayasoufi, Naoki Kohei, Michael Nicosia, Ran Fan, George W Farr, Paul R McGuirk, Marc F Pelletier, Robert L Fairchild, Anna Valujskikh
Prolonged cold ischemia storage (CIS) is a leading risk factor for poor transplant outcome. Existing strategies strive to minimize IRI in transplanted organs, yet there is a need for novel approaches to improve outcomes of marginal allografts and expand the pool of donor organs suitable for transplantation. Aquaporins (AQPs) are a family of water channels that facilitate homeostasis, tissue injury and inflammation. We tested whether inhibition of AQP4 improves the survival of fully MHC-mismatched murine cardiac allografts subjected to 8 h CIS...
December 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29228820/associations-between-depressive-symptomatology-and-neurocognitive-impairment-in-hiv-aids
#12
Sarah Tymchuk, Daniela Gomez, Noshin Koenig, M John Gill, Esther Fujiwara, Christopher Power
OBJECTIVE: Mood disorders and neurocognitive impairments are debilitating conditions among patients with HIV/AIDS. How these comorbidities interact and their relationships to systemic factors remain uncertain. Herein, we investigated factors contributing to depressive symptomatology (DS) in a prospective cohort of patients with HIV/AIDS in active care that included neuropsychological assessment. METHODS: Among patients with HIV/AIDS receiving combination antiretroviral therapy (cART) and ongoing clinical assessments including measures of sleep, health-related quality of life (HQoL), neuropsychological testing, and mood evaluation (Patient Health Questionnaire-9 [PHQ-9]) were performed...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#13
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29216911/dynamic-expression-of-cytokine-and-transcription-factor-genes-during-experimental-fasciola-gigantica-infection-in-buffaloes
#14
Wei Shi, Zhi-Yong Wei, Hany M Elsheikha, Fu-Kai Zhang, Zhao-An Sheng, Ke-Jing Lu, Dong-Ying Wang, Wei-Yi Huang, Xing-Quan Zhu
BACKGROUND: Determining the mechanisms involved in the immune-pathogenesis of the tropical liver fluke, Fasciola gigantica, is crucial to the development of any effective therapeutic intervention. Here, we examined the differential gene expression of cytokines and transcription factors in the liver of F. gigantica-infected buffaloes, over the course of infection. METHODS: Water buffaloes (swamp type) were infected orally with 500 F. gigantica encysted metacercariae...
December 8, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/29212162/rituximab-treatment-in-adults-with-refractory-minimal-change-disease-or-focal-segmental-glomerulosclerosis
#15
Hong Ren, Li Lin, Pingyan Shen, Xiao Li, Jingyuan Xie, Xiaoxia Pan, Wen Zhang, Nan Chen
Rituximab (RTX) may benefit patients with glomerular disease who suffer from focal segmental glomerular sclerosis (FSGS) or minimal change disease (MCD). Here, we have described our experience treating 6 FSGS and 9 MCD patients with steroid-dependent/refractory nephrotic syndrome (NS) with RTX. Patients received RTX (375 mg/m2) intravenously on days 1, 8, 23, and 29. During a median follow-up of 8 months (range, 3-36 months) after RTX administration, all patients achieved complete or partial remission. Relapses decreased by approximately 30-fold compared with the year preceding RTX treatment, and an 89...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29209569/resistance-to-her2-targeted-anti-cancer-drugs-is-associated-with-immune-evasion-in-cancer-cells-and-their-derived-extracellular-vesicles
#16
Vanesa G Martinez, Sadhbh O'Neill, Josephine Salimu, Susan Breslin, Aled Clayton, John Crown, Lorraine O'Driscoll
Neuromedin U (NmU) -a neuropeptide belonging to the neuromedin family- plays a substantial role in HER2-positive breast cancer, correlating with increased aggressiveness, resistance to HER2-targeted therapies and overall significantly poorer outcome for patients. However, the mechanism through which it exerts these effects remains unclear. To elucidate this, initially we used HER2-positive breast cancer cells stably over-expressing NmU. These cells and their released extracellular vesicles (EVs) had increased amounts of the immunosuppressive cytokine TGFβ1 and the lymphocyte activation inhibitor PD-L1...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/29208469/an-elastomeric-polymer-matrix-peuu-tac-delivers-bioactive-tacrolimus-transdurally-to-the-cns-in-rat
#17
Yolandi van der Merwe, Anne E Faust, Ian Conner, Xinzhu Gu, Firuz Feturi, Wenchen Zhao, Bianca Leonard, Souvik Roy, Vijay S Gorantla, Raman Venkataramanan, Kia M Washington, William R Wagner, Michael B Steketee
Central nervous system (CNS) neurons fail to regrow injured axons, often resulting in permanently lost neurologic function. Tacrolimus is an FDA-approved immunosuppressive drug with known neuroprotective and neuroregenerative properties in the CNS. However, tacrolimus is typically administered systemically and blood levels required to effectively treat CNS injuries can lead to lethal, off-target organ toxicity. Thus, delivering tacrolimus locally to CNS tissues may provide therapeutic control over tacrolimus levels in CNS tissues while minimizing off-target toxicity...
November 24, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29194735/paradoxic-eczema-in-infants-after-heart-transplantation
#18
Stephanie R Jackson Cullison, Elaine C Siegfried
New-onset psoriasis in patients receiving tumor necrosis factor inhibitors is well recognized in children and adults. We describe three children who underwent cardiac transplantation and developed an analogous form of paradoxic eczema occurring 2-48 months after starting systemic tacrolimus, a drug widely used topically to treat eczema. Anecdotal reports and our experience suggest that tacrolimus taper with alternative systemic antirejection immunosuppressant may lead to skin clearance. Pending additional insight, treatment should include optimizing skin barrier function, minimizing microbial and allergic triggers, and coordinating care to choose the best-tolerated systemic immunosuppressant regimen at the lowest effective dose...
December 1, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29183812/muli-bamboo-melocanna-baccifera-leaves-ethanolic-extract-a-non-toxic-phyto-prophylactic-against-low-ph-stress-and-saprolegniasis-in-labeo-rohita-fingerlings
#19
Md Idrish Raja Khan, Ratan Kumar Saha, Himadri Saha
Bamboo (Melocanna baccifera) plant plays a significant role in traditional Asian medicine and it can be used as an alternative to various chemo-therapeutics or prophylactic agents used in aquaculture. In the present study, the first experiment was done for the preparation of extracts from bamboo leaves by using 90% alcohol as a solvent. In the 2nd experiment, toxicity study was carried on Labeo rohita fingerlings (average length of 10.3 ± 1.5 cm and weight 18.5 ± 1.5 g) using BLAL (Bamboo Leaf Alcoholic) extract and it did not show any mortalities in fish even at the dose of 20 g kg-1 body weight, which can be regarded as virtually non-toxic with minimal effect...
November 25, 2017: Fish & Shellfish Immunology
https://www.readbyqxmd.com/read/29159010/multiple-myeloma-presenting-as-acute-renal-failure-in-the-absence-of-other-characteristic-features
#20
Zachary N Gastelum, Diana M Biggs, Aaron Scott
This case report describes a 54-year-old, asymptomatic man who presented with hyperkalemia on routine lab testing who was later found to have acute renal failure, unresponsive to fluid resuscitation, with minimal improvement after hemodialysis. After a comprehensive evaluation ruled out common causes of acute renal failure, the patient underwent testing with a bone survey, urine protein electrophoresis (UPEP), serum protein electrophoresis (SPEP), and immunoelectrophoresis for suspected plasma cell dyscrasia and received plasmapheresis for hyperviscosity syndrome and nephrotoxicity, which resulted in improved renal function...
September 20, 2017: Curēus
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