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Sustained Remission

Lara Valor, Jesús Garrido, Lina Martínez-Estupiñán, Diana Hernández-Flórez, Iustina Janta, Francisco Javier López-Longo, Indalecio Monteagudo, Carlos M González, Esperanza Naredo
To identify features associated with long-term persistent remission in rheumatoid arthritis (RA) patients on tapered biological disease-modifying antirheumatic drugs (bDMARD) (tap-bDMARD) therapy. We carried out a 40-month (m) extension follow-up study of 77 RA patients from a previous 12 m tap-bDMARD study. Disease activity was assessed at baseline and every 3 months. Doppler US investigation of 42 joints for the presence and grade (0-3) of B-mode synovial hypertrophy (SH) and synovial power Doppler signal (i...
June 18, 2018: Rheumatology International
Qing Zhang, Jiacheng Bi, Xiaodong Zheng, Yongyan Chen, Hua Wang, Wenyong Wu, Zhengguang Wang, Qiang Wu, Hui Peng, Haiming Wei, Rui Sun, Zhigang Tian
Checkpoint blockade enhances effector T cell function and has elicited long-term remission in a subset of patients with a broad spectrum of cancers. TIGIT is a checkpoint receptor thought to be involved in mediating T cell exhaustion in tumors; however, the relevance of TIGIT to the dysfunction of natural killer (NK) cells remains poorly understood. Here we found that TIGIT, but not the other checkpoint molecules CTLA-4 and PD-1, was associated with NK cell exhaustion in tumor-bearing mice and patients with colon cancer...
June 18, 2018: Nature Immunology
Dezhi Li, Qian Liu, Zhifang Feng, Qi Zhang, Saran Feng
RATIONALE: Nephrogenic diabetes insipidus (NDI) rarely presents in the initial stage of acute lymphoblastic leukemia (ALL) and relapse due to renal infiltration is also rare. PATIENT CONCERNS: A 19-year-old man presented with weakness, polydipsia, and polyuria for 1 month. DIAGNOSES: NDI was diagnosed with insignificant response to a water deprivation test after stimulation with vasopressin injection. Bone marrow examination combined with immunophenotypic analysis, cerebrospinal cytology, and abdominal ultrasonography confirmed the diagnoses of precursor B cell ALL with renal infiltration...
June 2018: Medicine (Baltimore)
Monica Bocchia, Anna Sicuranza, Elisabetta Abruzzese, Alessandra Iurlo, Santina Sirianni, Antonella Gozzini, Sara Galimberti, Lara Aprile, Bruno Martino, Patrizia Pregno, Federica Sorà, Giulia Alunni, Carmen Fava, Fausto Castagnetti, Luca Puccetti, Massimo Breccia, Daniele Cattaneo, Marzia Defina, Olga Mulas, Claudia Baratè, Giovanni Caocci, Simona Sica, Alessandro Gozzetti, Luigiana Luciano, Monica Crugnola, Mario Annunziata, Mario Tiribelli, Paola Pacelli, Ilaria Ferrigno, Emilio Usala, Nicola Sgherza, Gianantonio Rosti, Alberto Bosi, Donatella Raspadori
Chronic myeloid leukemia (CML) patients in sustained "deep molecular response" may stop TKI treatment without disease recurrence; however, half of them lose molecular response shortly after TKI withdrawing. Well-defined eligibility criteria to predict a safe discontinuation up-front are still missing. Relapse is probably due to residual quiescent TKI-resistant leukemic stem cells (LSCs) supposedly transcriptionally low/silent and not easily detectable by BCR-ABL1 qRT-PCR. Bone marrow Ph+ CML CD34+ /CD38- LSCs were found to specifically co-express CD26 (dipeptidylpeptidase-IV)...
2018: Frontiers in Oncology
Hamidah Alias, Sie Chong D Lau, Ilse Schuitema, Leo M J de Sonneville
Objective: This study aimed to evaluate neuropsychological consequences in survivors of childhood brain tumor. Method: A case-control study was conducted over a period of 4 months in a tertiary referral center in Kuala Lumpur, Malaysia. Fourteen survivors of childhood brain tumor aged 7-18 years, who were off-treatment for at least 1 year and were in remission, and 31 unrelated healthy controls were recruited. The median age at diagnosis was 8.20 years (range: 0.92-12.96 years). The diagnoses of brain tumors were medulloblastoma, germ cell tumor, pineocytoma, pilocystic astrocytoma, suprasellar germinoma, and ependymoma...
2018: Frontiers in Psychology
Abdullah Alkandari, Hutan Ashrafian, Thozhukat Sathyapalan, Peter Sedman, Ara Darzi, Elaine Holmes, Thanos Athanasiou, Stephen L Atkin, Nigel J Gooderham
Background: The global pandemic of obesity and the metabolic syndrome are leading causes of mortality and morbidity. Bariatric surgery leads to sustained weight loss and improves obesity-associated morbidity including remission of type 2 diabetes. MicroRNAs are small, endogenous RNAs that regulate gene expression post-transcriptionally, controlling most of the human transcriptome and contributing to the regulation of systemic metabolism. This preliminary, longitudinal, repeat sampling study, in which subjects acted as their own control, aimed to assess the temporal effect of bariatric surgery on circulating microRNA expression profiles...
2018: BMC Obesity
Ying Wen, Katharine J Bar, Jonathan Z Li
PURPOSE OF REVIEW: Clinical trials with an antiretroviral therapy (ART) interruption remains indispensable for assessing strategies for ART-free HIV remission. This review highlights the lessons learned from ART interruption studies so far, including the risks to the participants and implications for HIV remission. RECENT FINDINGS: Historically, analytic HIV treatment interruption (ATI) studies were commonly designed with a prolonged duration of ART interruption and with viral load set point as the primary outcome...
June 6, 2018: Current Opinion in HIV and AIDS
Mrinal M Patnaik, Ayalew Tefferi
DISEASE OVERVIEW: Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic stem cell disorder with overlapping features of myelodysplastic syndromes and myeloproliferative neoplasms, with an inherent risk for leukemic transformation (∼15%-20% over 3-5 years). DIAGNOSIS: Diagnosis is based on the presence of sustained (>3 months) peripheral blood monocytosis (≥1 × 109 /L; monocytes ≥10%), along with bone marrow dysplasia. Clonal cytogenetic abnormalities occur in ∼ 30% of patients, while >90% have gene mutations...
June 2018: American Journal of Hematology
Dylan E Lee, M Estela Martinez-Escala, Linda M Serrano, Xiaolong A Zhou, Jason B Kaplan, Barbara Pro, Jaehyuk Choi, Joan Guitart
Importance: Hemophagocytic lymphohistiocytosis (HLH) has been reported as a serious complication of cutaneous T-cell lymphoma (CTCL). Despite available diagnostic guidelines, it remains a diagnostic and therapeutic challenge in this patient population. Objectives: To examine the characteristics of CTCL associated with HLH and analyze the presenting signs and symptoms, therapeutic options, and outcome. Design, Setting, and Participants: In this case series, patients diagnosed with CTCL and HLH who were treated at a single institution from January 1, 2014, through December 31, 2017, were studied...
June 6, 2018: JAMA Dermatology
Limor Man, Laura Park, Richard Bodine, Michael Ginsberg, Nikica Zaninovic, Glenn Schattman, Robert E Schwartz, Zev Rosenwaks, Daylon James
Infertility is a frequent side effect of chemotherapy and/or radiotherapy and for some patients, cryopreservation of oocytes or embryos is not an option. As an alternative, an increasing number of these patients are choosing to cryopreserve ovarian tissue for autograft following recovery and remission. Despite improvements in outcomes among patients undergoing auto-transplantation of cryopreserved ovarian tissue, efficient revascularization of grafted tissue remains a major obstacle. To mitigate ischemia and thus improve outcomes in patients undergoing auto-transplantation, we developed a vascular cell-based strategy for accelerating perfusion of ovarian tissue...
May 16, 2018: Journal of Visualized Experiments: JoVE
Konstantinos Tselios, Dafna D Gladman, Zahi Touma, Jiandong Su, Nicole Anderson, Murray B Urowitz
OBJECTIVE: Disease course in systemic lupus erythematosus (SLE) is primarily relapsing-remitting. Long quiescent and chronically active patterns are less frequent. We recently described an atypical "monophasic" course in a small number of patients. The aim of the present study was to assess the prevalence and characteristics of such patients in a defined SLE cohort. METHODS: The inception patients of the University of Toronto Lupus Clinic (enrolled within 18 mos of diagnosis) were investigated...
June 1, 2018: Journal of Rheumatology
Jiang Yue, James F Griffith, Jiankun Xu, Fan Xiao, Lin Shi, Defeng Wang, Priscilla C H Wong, Edmund K Li, Martin Li, Tena K Li, Wah Yan Mak, Tracy Y Zhu, Vivian W Hung, Ling Qin, Lai-Shan Tam
OBJECTIVES: To investigate the efficacy of two tight-control treatment strategies aimed at simplified disease activity score [SDAI] remission (SDAI ≤ 3.3) compared to DAS28 remission (DAS28 < 2.6) on progression of bone erosions in early rheumatoid arthritis (ERA) patients using high-resolution peripheral quantitative computed tomography (HR-pQCT). METHODS: This was an open-label study in which 80 early RA patients were randomized to receive 1-year of tight-control treatment...
May 3, 2018: Seminars in Arthritis and Rheumatism
Sara J Brandt, Maximilian Kleinert, Matthias Tschöp, Timo Müller
Obesity is a world-wide pandemic which can be fatal for the most extremely affected individuals. Lifestyle interventions such as diet and exercise are largely ineffective, and current anti-obesity medications offer little in the way of significant or sustained weight loss. Bariatric surgery is effective, but largely restricted to only a small subset of extremely obese patients. While the hormonal factors mediating sustained weight loss and remission of diabetes by bariatric surgery remain elusive, a new class of polypharmacological drugs shows potential to shrink the gap in efficacy between a surgery and pharmacology...
May 30, 2018: Journal of Endocrinology
Ann-Sofi Sjö, Ulrika Bergsten
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease that is treated with both pharmacological and nonpharmacological methods. The treatment works well for patients who are knowledgeable about their disease and situation. However, this may be different for others as, among other things, it depends on how well informed the patients are in relation to their condition. Available research primarily focuses on patients in remission. One way of supporting and strengthening the group who experience a lack of well-being due to their disease and providing them with increased knowledge about their situation can be to give them access to a nurse-led clinic based on person-centred care...
May 28, 2018: Musculoskeletal Care
Franco Grimaldi, Fabio Vescini, Veronica Tonelli, Cinzia Pistis, Elda Kara, Vincenzo Triggiani, Elio Tonutti, Francesco Curcio, Martina Fabris
BACKGROUND AND OBJECTIVE: BLyS (B-Lymphocyte stimulator) is over-expressed in several tumoral settings, with direct or indirect effects on neoplastic proliferation and possibly representing a therapeutic target. In this study we explored the role of BLyS in a large population of patients with neuroendocrine tumors (NETs). METHODS: The study analyzed the stored sera of 124 consecutive unselected patients with NETs: 36 lung carcinoids (24 typical, 12 atypical), 47 gastroenteric tract and 41 pancreatic (30 non-functioning and 11 functioning: 9 insulinomas, 2 glucagonomas)...
May 28, 2018: Endocrine, Metabolic & Immune Disorders Drug Targets
Kosaku Murakami, Masahiro Sekiguchi, Shintaro Hirata, Takao Fujii, Kiyoshi Matsui, Satoshi Morita, Koichiro Ohmura, Yutaka Kawahito, Norihiro Nishimoto, Tsuneyo Mimori, Hajime Sano
OBJECTIVE: To investigate the effect of abatacept (ABA) on preventing joint destruction in biological disease-modifying anti-rheumatic drug (bDMARD)-naïve rheumatoid arthritis (RA) patients in real-world clinical practice. PATIENTS AND METHODS: RA patients were collected from the ABROAD (ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD) study cohort. They had moderate or high disease activity and were treated with ABA as a first-line bDMARD...
May 29, 2018: Modern Rheumatology
Philippe Carron, Gaëlle Varkas, Thomas Renson, Roos Colman, Dirk Elewaut, Filip Van den Bosch
BACKGROUND: New treatment algorithms using TNF blockers in early stages of spondyloarthritis (SpA) induce high rates of clinical remission or low disease activity. It could be anticipated that such early intervention strategies in peripheral SpA (pSpA) may induce drug-free remission. OBJECTIVE: To evaluate drug-free clinical remission after induction therapy with golimumab (GLM) in patients with active pSpA in a very early stage of the disease. To identify patient characteristics predicting sustained drug-free remission...
May 27, 2018: Arthritis & Rheumatology
L N Jiang, J M Zhao
The histological assessment of liver biopsy in chronic hepatitis C patients after direct-acting antiviral agents(DAAs) treatment plays a key role in evaluation of response to therapy. Liver necro-inflammation gradually subsides in patients who achieved sustained virologic response after DAAs treatment, thus the histological assessment focus on evaluating remission of liver fibrosis and other lesions. However, the evaluation of liver inflammation and fibrosis are usually inconsistent when the histological scoring systems are recommended by the clinical practice guidelines and applied in chronic hepatitis C patients who achieved viral clearance after DAAs therapy...
March 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Seong Ran Jeon, Jocelyn Chai, Christiana Kim, Christine H Lee
PURPOSE OF REVIEW: Fecal microbiota transplantation (FMT) has been investigated as a potential treatment for inflammatory bowel disease (IBD). This review examines current evidence around the efficacy and safety of FMT for patients with IBD. RECENT FINDINGS: Randomized controlled trials (RCTs) and meta-analyses have suggested that FMT may facilitate clinical and endoscopic remission in patients with active ulcerative colitis (UC). Although the evidence for FMT in Crohn's disease (CD) is more limited, positive outcomes have been observed in small cohort studies...
May 26, 2018: Current Infectious Disease Reports
Georgios Zagkotsis, Christina Vourlakou, Aristeidis Paraskevopoulos, Theofanis Apostolou
IgA nephropathy (IgAN) is one of the most common recurrent glomerulonephritis after renal transplantation. Rarely, it is accompanied with the presence of crescents that leads to rapid deterioration of renal function and graft loss. We present a 54-year-old patient with IgAN that received a cadaveric kidney allograft, but developed biopsy proven recurrent IgAN 7 months after renal transplantation. He was treated with intravenous steroids and angiotensin-converting enzyme inhibitor and remission was achieved...
May 25, 2018: CEN Case Reports
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