#13#
Revisiones-Ciencias
Básicas-Microorganismos *** Reviews-Basic Sciences-Microorganisms
AGENTES
INMUNOSUPRESORES *** IMMUNOSUPPRESSIVE COMPOUNDS
(Conceptos
/ Keywords: Immunosuppressive comp; Muromonab-cd3; Sirolimus; Tacrolimus;
Cyclosporine; Mycophenolic acid; Antilymphocyte serum; Immunosuppressive comp.
used in oncology, etc).
Enero /
January 2001 --- Marzo / March 2004
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[1]
TÍTULO / TITLE: - The fission yeast TOR
proteins and the rapamycin response: an unexpected tale.
REVISTA
/ JOURNAL: - Curr Top Microbiol Immunol 2004;279:85-95.
AUTORES
/ AUTHORS: - Weisman R
INSTITUCIÓN
/ INSTITUTION: - Department of Molecular Microbiology and
Biotechnology, Faculty of Life Sciences, Tel-Aviv University, 69978 Tel-Aviv,
Israel. ronitt@post.tau.ac.il
RESUMEN
/ SUMMARY: - The TOR proteins are known as key
regulators of cell growth in response to nutritional and mitogenic signals and
as targets for the immunosuppressive and anti-cancerous drug rapamycin. The
fission yeast Schizosaccharomyces pombe has two TOR homologues, tor1+ and
tor2+. Despite their structural similarity, these genes have distinct
functions: tor1+ is required under starvation, extreme temperatures, and
osmotic or oxidative stress conditions, whereas tor2+ is required under normal
growth conditions. Surprisingly, rapamycin does not seem to inhibit the S.
pombe TOR-related functions. Rapamycin specifically inhibits sexual development
in S. pombe, and this seems to stem from direct inhibition of the S. pombe
FKBP12 homologue. Why S. pombe cells are resistant to rapamycin during the
growth phase is as yet unclear and awaits further analysis of the TOR-dependent
signaling pathways. N.
Ref:: 27
----------------------------------------------------
[2]
TÍTULO / TITLE: - Hepatitis C virus
infection and vasculitis: implications of antiviral and immunosuppressive
therapies.
REVISTA
/ JOURNAL: - Arthritis Rheum 2002 Mar;46(3):585-97.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.10107 [pii
●●
Enlace al texto completo (gratuito o de pago) 1002/art.10107
AUTORES
/ AUTHORS: - Vassilopoulos D; Calabrese LH
INSTITUCIÓN
/ INSTITUTION: - Hippokration General Hospital, Athens
University, Athens, Greece. N.
Ref:: 92
----------------------------------------------------
[3]
TÍTULO / TITLE: - Neonatal toxic shock
syndrome-like exanthematous disease (NTED).
REVISTA
/ JOURNAL: - Pediatr Int 2003 Apr;45(2):233-7.
AUTORES
/ AUTHORS: - Takahashi N
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, Jichi Medical
School, Tochigi-ken, Tokyo Women’s Medical University, Tokyo, Japan. naoto-t@jichi.ac.jp
RESUMEN
/ SUMMARY: - The author and colleagues recently
discovered an emerging neonatal infectious disease: neonatal toxic shock
syndrome-like exanthematous disease (NTED), which is induced by the
superantigen toxic shock syndrome toxin-1 (TSST-1), produced by
methicillin-resistant Staphylococcus aureus (MRSA). The massively expanded
Vbeta2+ T cells were rapidly deleted in the peripheral blood of patients with
NTED. A marked depletion of Vbeta2+ T cells was also observed in the peripheral
blood before the expansion of these T cells. Anergy is specifically induced in
the TSST-1 reactive T cells of patients with NTED. Rapid recovery from NTED
without complications is expected to be related to the induction of immunologic
tolerance in neonatal patients. Anti-TSST-1 IgG antibody of maternal origin was
found to play a protective role in preventing the development of NTED. The
number of hospitals that have experience caring for patients with NTED has
increased threefold in the past 5 years. Most MRSA isolates from neonatal
intensive care units in Japan were found to be a single clone of coagulase type
II and to possess TSST-1 and staphylococcal enterotoxin C genes. The timing and
increased incidence of NTED suggest the emergence of a new MRSA clone. By
recognizing that TSST-1 can induce NTED, healthcare providers may give
increased attention to this disease in neonatal wards. N. Ref:: 43
----------------------------------------------------
[4]
- Castellano -
TÍTULO / TITLE:La enfermedad linfoproliferativa
difusa postrasplante renal y su relacion con el virus Epstein-Barr. Experiencia
de un centro. Diffuse lymphoproliferative disease after renal transplantation
and its relation with Epstein-Barr virus. Experience at one center.
REVISTA
/ JOURNAL: - Nefrologia. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/
●●
Cita: Nefrologia: <> 2002;22(5):463-9.
AUTORES
/ AUTHORS: - Franco A; Jimenez L; Aranda I; Alvarez L;
Gonzalez M; Rocamora N; Olivares J
INSTITUCIÓN
/ INSTITUTION: - Servicio de Nefrologia Hospital General
Alicante Maestro Alonso, 109 03010 Alicante. franco_ant@gva.es
RESUMEN
/ SUMMARY: - Post-transplant lymphoproliferative disorders
(PTLD) are a group of heterogeneous lymphoid proliferations in chronic
immunosuppressed recipients which appear to be related to Epstein Barr Virus
(EBV). Receptor EBV seronegativity, use of antilymphocyte antibodies and CMV
disease have been identified as risk factors that may tigger development of
PTLD. We have studied the incidence of PTLD and its relationship with EBV in
588 adult renal transplant recipients who were transplanted in our hospital
from 1988 to 2001. We have also evaluated the diagnostic and therapeutic
methods used, the risk factors and outcome of the patients who developed PTLD.
We identified 8 recipients (4 males and 4 females), range from 18 to 67 years
(mean age 45.6 years) with a median time between grafting and PTLD of 4.1 years
(0.1-7 years), who developed PTLD (1.3%). Only 1 patient received OKT3 and had
CMV disease, two of them (25%) had been treated with hight doses of
prednisolone, another was EBV seronegative, but the rest of them (50%) had no
risk factors. Two patients were diagnosed at autopsy, the diagnosis of 5 was
based on the histology of biopsy and the last one by CT scans of chest-abdomen
and cytology. The presence of EBV in the lymphoproliferative cells was assessed
in 5 out of the 7 studied patients (71.4%). The outcome of our recipients was
poor. Five out of 8 patients died shortly after diagnosis as a direct
consecuence of PTLD and another of an infectious complication of the treatment
(75%). The 2 patients alive started dialysis and 1 of them died 2 years later of
a non-related cause. In conclusion, PTLD is a relatively frequent disease with
a poor prognosis in renal transplant patients. It seems to have a close
relationship with EBV and can develop in the absence of the classical risk
factors. N. Ref:: 18
----------------------------------------------------
[5]
TÍTULO / TITLE: - Potential role of
immune modulation in the effective long-term control of HIV-1 infection.
REVISTA
/ JOURNAL: - J Biol Regul Homeost Agents 2002
Jan-Mar;16(1):83-90.
AUTORES
/ AUTHORS: - Rizzardi GP; Lazzarin A; Pantaleo G
INSTITUCIÓN
/ INSTITUTION: - MOLMED, Milan, Italy. paolo.rizzardi@molmed.it
RESUMEN
/ SUMMARY: - Recent advances in HIV-1 pathogenesis, and
in defining virological and immunological responses to highly active
antiretroviral therapy (HAART), along with the identification of the numerous
drawbacks of HAART, have clearly demonstrated that the eradication of the virus
is not a feasible therapeutic goal, and that there is an urgent need to develop
other approaches to fight HIV-1 infection. Novel therapeutic approaches of
immune modulation have recently been evaluated in pilot clinical trials. First,
treating primary HIV-1 infection with cyclosporin A (CsA) coupled with HAART to
target massive immune activation extends the benefits achieved with HAART
during primary HIV-1 infection and might contribute to the establishment of a
more favourable immunological set-point affecting the ultimate pattern and rate
of disease progression. Second, treating chronic HIV-1 infection in patients
with long-term suppression of virus replication induced by HAART, with the
addition of mycophenolate mofetil (MMF) reduces the pool of activated CD4+ T
lymphocytes able to support productive HIV-1 infection, and might have an
indirect impact on the pool of resting, latently infected CD4+ T cells,
contributing to its depletion in vivo. The important question is clearly
whether these results will have an impact on the clinical management of
patients with HIV-1 infection, determining the precise therapeutic function of
drugs like CsA and MMF, thus investigating the effects of these drugs on
residual viral replication and the decay of the latent reservoir, on long-term
immunological benefit, and, ultimately, on clinical benefit. N. Ref:: 95
----------------------------------------------------
[6]
TÍTULO / TITLE: - Treatment of
gammaherpesvirus-related neoplastic disorders in the immunosuppressed host.
REVISTA
/ JOURNAL: - Semin Hematol 2003 Apr;40(2):163-71.
●●
Enlace al texto completo (gratuito o de pago) 1053/shem.2003.50016
AUTORES
/ AUTHORS: - Little RF; Yarchoan R
INSTITUCIÓN
/ INSTITUTION: - HIV and AIDS Malignancy Branch, Center for
Cancer Research, National Cancer Institute, National Institutes of Health,
Bethesda, MD 20892, USA.
RESUMEN
/ SUMMARY: - Neoplastic disease is a frequent
complication in patients with acquired immunodeficiency disease (AIDS) and
other immunodeficiencies. Many such neoplasms are caused by either Epstein-Barr
virus (EBV) or Kaposi’s sarcoma-associated herpes virus (KSHV). The treatment
of such patients can be challenging. At the same time, the viral origin of
these tumors offers targets to develop pathogenesis-based therapies. Standard
therapies for these diseases involve such approaches as treating the underlying
immunodeficiency, cytotoxic chemotherapy, and immunologic antitumor therapy.
Novel therapy approaches include specific immune therapy and anti-angiogenesis approaches,
now under development. N.
Ref:: 105
----------------------------------------------------
[7]
TÍTULO / TITLE: - B19 virus infection in
renal transplant recipients.
REVISTA
/ JOURNAL: - J Clin Virol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.elsevier.com/gej-ng/29/46/32/show/Products/VIRUSINT/index.htt
●●
Cita: J Clinical Virology: <> 2003 Apr;26(3):361-8.
AUTORES
/ AUTHORS: - Cavallo R; Merlino C; Re D; Bollero C;
Bergallo M; Lembo D; Musso T; Leonardi G; Segoloni GP; Ponzi AN
INSTITUCIÓN
/ INSTITUTION: - Virology Unit, Department of Public Health
and Microbiology, University of Turin, Via Santena 9, 10126, Turin, Italy. rossana.cavallo@unito.it
RESUMEN
/ SUMMARY: - BACKGROUND: B19 virus infection with
persistent anaemia has been reported in organ transplant recipients. Detection
of B19 virus DNA in serum is the best direct marker of active infection.
OBJECTIVE: The present study evaluated the incidence and clinical role of
active B19 virus infection in renal transplant recipients presenting with
anaemia. STUDY DESIGN: Forty-eight such recipients were investigated by nested
PCR on serum samples. The controls were 21 recipients without anaemia. Active
HCMV infection was also investigated as a marker of high immunosuppression.
RESULTS AND CONCLUSIONS: In 11/48 (23%) patients B19 virus DNA was demonstrated
in serum versus only 1/21 (5%) of the controls. Ten of these 11 patients had
already been seropositive at transplantation and active infection occurred in
eight of them during the first 3 months after transplantation. The remaining
patient experienced a primary infection 9 months after transplantation. Eight
(73%) of these 11 patients displayed a concomitant HCMV infection and four
(36%) showed increasing serum creatinine levels but none developed
glomerulopathy; 3/11 (27%) recovered spontaneously from anaemia whereas 8/11
(73%) needed therapy. In conclusion, the relatively high occurrence (23%) of
B19 virus infection in patients presenting with anaemia, suggests that it
should be considered in the differential diagnosis of persistent anaemia in
renal transplant recipients. Presence of the viral DNA should be assessed early
from transplantation and the viral load should be monitored to follow
persistent infection and better understand the relation between active
infection and occurrence of anaemia, and to assess the efficacy of IVIG therapy
and/or immunosuppression reduction in clearing the virus. N. Ref:: 56
----------------------------------------------------
[8]
TÍTULO / TITLE: - Molecular diagnosis of
an Enterocytozoon bieneusi human genotype C infection in a moderately
immunosuppressed human immunodeficiency virus seronegative liver-transplant
recipient with severe chronic diarrhea.
REVISTA
/ JOURNAL: - J Clin Microbiol. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://jcm.asm.org/
●●
Cita: J. Clinical Microbiology: <> 2001 Jun;39(6):2371-2.
AUTORES
/ AUTHORS: - Sing A; Tybus K; Heesemann J; Mathis
A N. Ref:: 5
----------------------------------------------------
[9]
TÍTULO / TITLE: - Eradication of
parvovirus B19 infection after renal transplantation requires reduction of
immunosuppression and high-dose immunoglobulin therapy.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002 Oct;17(10):1840-2.
AUTORES
/ AUTHORS: - Liefeldt L; Buhl M; Schweickert B;
Engelmann E; Sezer O; Laschinski P; Preuschof L; Neumayer HH
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Charite,
Humboldt-University Berlin, Germany. lutz.liefeldt@charite.de N. Ref:: 17
----------------------------------------------------
[10]
TÍTULO / TITLE: - Retroviral oncogenes
and TOR.
REVISTA
/ JOURNAL: - Curr Top Microbiol Immunol
2004;279:321-38.
AUTORES
/ AUTHORS: - Aoki M; Vogt PK
INSTITUCIÓN
/ INSTITUTION: - Department of Molecular and Experimental
Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road,
BCC-239, La Jolla, CA 92037, USA.
RESUMEN
/ SUMMARY: - Retroviruses have recruited the catalytic
subunit of PI 3-kinase and its downstream target, Akt, as oncogenes. These viruses
cause tumors in animals and induce oncogenic transformation in cell culture.
The oncogenicity of these viruses is specifically inhibited by rapamycin;
retroviruses carrying other oncogenes are insensitive to this macrolide
antibiotic. Rapamycin is an inhibitor of the TOR (target of rapamycin) kinase
whose downstream targets include p70 S6 kinase and the negative regulator of
translation initiation 4E-BP. Emerging evidence suggests that the TOR signals
transmitted to the translational machinery are essential for oncogenic
transformation by the PI 3-kinase pathway.
N. Ref:: 93
----------------------------------------------------
[11]
TÍTULO / TITLE: - Reactivation of
replication of hepatitis B and C viruses after immunosuppressive therapy: an
unresolved issue.
REVISTA
/ JOURNAL: - Lancet Oncol 2002 Jun;3(6):333-40.
AUTORES
/ AUTHORS: - Vento S; Cainelli F; Longhi MS
INSTITUCIÓN
/ INSTITUTION: - Section of Infectious Diseases, Department
of Pathology, University of Verona, Borgo Trento Hospital, Verona, Italy. ventosandro@yahoo.it
RESUMEN
/ SUMMARY: - The liver is susceptible to the toxic
effects of many cytotoxic or immunosuppressive treatments. However, in carriers
of hepatitis B virus (HBV) and, less frequently, of hepatitis C virus, liver
damage due to reactivation of viral replication can occur after withdrawal of
immunosuppressive drugs. These reactivations, which are associated with
fulminant forms of hepatitis in up to 25% of cases, are observed both in
symptom-free chronic carriers of hepatitis B surface antigen and in patients
who have chronic hepatitis B or C and concurrent haematological tumours or
solid neoplasms or who have received transplants. HBV-related complications may
cause delays or modifications of therapy, and the chance of cure is reduced. In
this review, we analyse clinical, biochemical, and serological issues in
reactivation of viral replication and examine the role of immune reactions in
the pathogenesis and the possible toxicity of immunosuppressive drugs. We
emphasise the importance of identifying predictive markers of a clinically
relevant reactivation, review difficulties in drug prevention and treatment,
indicate studies that are needed to address the key clinical issues, and give
practical recommendations to practising physicians and oncologists. N. Ref:: 60
----------------------------------------------------
[12]
TÍTULO / TITLE: - Hepatitis B virus (HBV)
reactivation after cytotoxic or immunosuppressive therapy—pathogenesis and
management.
REVISTA
/ JOURNAL: - Rev Med Virol 2001 Sep-Oct;11(5):287-99.
●●
Enlace al texto completo (gratuito o de pago) 1002/rmv.322 [pii]
AUTORES
/ AUTHORS: - Xunrong L; Yan AW; Liang R; Lau GK
INSTITUCIÓN
/ INSTITUTION: - University Department of Medicine, Queen
Mary Hospital, 102 Pokfulum Road, Hong Kong SAR, China.
RESUMEN
/ SUMMARY: - In an endemic area for chronic hepatitis B
infection, reactivation of this virus is a serious cause of morbidity and
mortality in patients undergoing cytotoxic or immunosuppressive therapy.
Careful prospective serological testing has shown that hepatitis B virus
reactivation is a two-staged process. The initial stage occurs during intense
cytotoxic or immunosuppressive therapy and is characterised by enhanced viral
replication, as reflected by increases in the serum levels of hepatitis B virus
DNA, hepatitis B e antigen, hepatitis B virus DNA polymerase and infection of
naive hepatocytes with hepatitis B virus. The second stage is related to
restoration of immune function following withdrawal of cytotoxic or
immunosuppressive therapy, which causes rapid immune-mediated destruction of
infected hepatocytes. Clinically, this can lead to hepatitis, hepatic failure
and even death. The occurrence and severity of hepatitis B virus reactivation after
various cytotoxic or immunosuppressive therapy is unpredictable and treatment
has been disappointing, largely due to the late administration of therapy.
Recently, pre-emptive treatment of chronic hepatitis B patients undergoing
cytotoxic or immunosuppressive therapy, with potent nucleoside analogues has
shown some promising results. Further controlled studies are needed to define
the incidence and risk factors of hepatitis B reactivation so that pre-emptive
treatment with nucleoside analogues could be administered to those patients at
high risk of disease. N.
Ref:: 93
----------------------------------------------------
[13]
TÍTULO / TITLE: - Teaching old drugs new
tricks: reincarnating immunosuppressants as antifungal drugs.
REVISTA
/ JOURNAL: - Curr Opin Investig Drugs 2003
Feb;4(2):192-9.
AUTORES
/ AUTHORS: - Blankenship JR; Steinbach WJ; Perfect JR;
Heitman J
INSTITUCIÓN
/ INSTITUTION: - Department of Molecular Genetics and
Microbiology, Duke University Medical Center, Research Drive, Durham, NC 27710,
USA.
RESUMEN
/ SUMMARY: - Invasive fungal infections are rising
worldwide as the number of immunocompromised patients increases. Unfortunately,
our armamentarium of antifungal drugs is limited. Although current therapies
are effective in treating some of the most prevalent infections, the
development of novel treatments is vital because of emerging drug-resistant
strains and species and because of the toxicity of certain current therapies.
The immunosuppressive drugs CsA (cyclosporin A), FK-506 (tacrolimus) and
rapamycin (sirolimus) exert potent antifungal effects against a variety of
pathogenic fungi. These compounds are all currently in clinical use as
immunosuppressive therapy to treat and prevent rejection of transplanted
organs. Rapamycin is also in clinical trials as an antiproliferative agent for
chemotherapy and invasive cardiology. Recent studies reveal a potent fungicidal
synergism between azoles and the calcineurin inhibitors CsA and FK-506, and
animal studies demonstrate that the CsA-fluconazole synergistic combination has
therapeutic benefit. Less immunosuppressive analogs have been identified with
potential to enhance current therapies, or as monotherapy without deleterious
effects on the immune system. In summary, these highly successful
pharmaceutical agents may find an even broader clinical application in
combating infectious diseases. N.
Ref:: 74
----------------------------------------------------
[14]
TÍTULO / TITLE: - Alternariosis after
liver transplantation.
REVISTA
/ JOURNAL: - Transplantation 2001 Dec 15;72(11):1840-3.
AUTORES
/ AUTHORS: - Benito N; Moreno A; Puig J; Rimola A
INSTITUCIÓN
/ INSTITUTION: - Institut Clinic d’ Infeccions i
Inmunologia, IDIBAPS, Hospital Clinic, Universitat de Barcelona, España. nbenito@clinic.ub.es
RESUMEN
/ SUMMARY: - Alternaria is a saprophytic fungus that is
increasingly recognized as a human pathogen, particularly in immunocompromised
hosts, including solid-organ transplant recipients. Although combined surgical
and medical treatment seem to be useful in the management of this infection, an
optimal antifungal therapy remains to be defined. Only four cases of
alternariosis after orthotopic liver transplantation have been reported. We
describe an additional case and review the literature on infections due to
Alternaria in organ transplant recipients, with special emphasis on
treatment. N. Ref:: 20
----------------------------------------------------
[15]
TÍTULO / TITLE: - Subcutaneous infection
with Mycobacterium fortuitum after allogeneic bone marrow transplantation.
REVISTA
/ JOURNAL: - Bone Marrow Transplant 2001
Oct;28(7):709-11.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj/bmt/1703211
AUTORES
/ AUTHORS: - Okano A; Shimazaki C; Ochiai N; Hatsuse M;
Takahashi R; Ashihara E; Inaba T; Fujita N; Noda Y; Nakagawa M
INSTITUCIÓN
/ INSTITUTION: - Second Department of Medicine, Kyoto
Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kami-gyoku,
Kyoto, 602-8566, Japan.
RESUMEN
/ SUMMARY: - Reports of cases of mycobacterial
infections after SCT are rare. We report a 30-year-old female with a cutaneous
infection of Mycobacterium fortuitum 30 months after allogeneic bone marrow
transplantation for acute lymphoblastic leukemia. The patient was successfully
treated with surgical debridement followed by oral minocycline and
clarithromycin. Mycobacterial infections should be considered in SCT patients
with undiagnosed refractory chronic cutaneous infection, and surgical
debridement is useful for the diagnosis and treatment of such infections. N. Ref:: 7
----------------------------------------------------
[16]
TÍTULO / TITLE: - Polyomavirus BK
nephropathy: a (re-)emerging complication in renal transplantation.
REVISTA
/ JOURNAL: - Am J Transplant 2002 Jan;2(1):25-30.
AUTORES
/ AUTHORS: - Hirsch HH
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine,
University of Basel, Switzerland. hans.hirsch@unibas.ch
RESUMEN
/ SUMMARY: - Persisting polyomavirus replication is now
widely recognized as a (re-)emerging cause of renal allograft dysfunction. Up
to 5% of renal allograft recipients can be affected about 40weeks (range 6-150)
post-transplantation. Progression to irreversible failure of the allograft has
been observed in up to 45% of all cases. The BK virus strain is involved in the
majority of the cases. Risk factors may include treatment of rejection episodes
and increasing viral replication under potent immunosuppressive drugs such as
tacrolimus, sirolimus or mycophenolate. The diagnosis requires the histological
demonstration of nuclear polyomavirus inclusions in affected tubular epithelial
cells. Interstitial inflammatory infiltrates and fibrosis become more prominent
in the persisting disease and may be difficult to distinguish from (coexisting)
rejection. Detection of polyomavirus-inclusion bearing cells (‘decoy cells’) in
the urine and quantification of BK virus DNA in the plasma have been proposed
as surrogate markers for polyomavirus replication and allograft disease,
respectively. Antiviral treatment is not yet established; however, reports of
treatment with cidofovir are encouraging. Current management aims at the judicious
modification and/or reduction of immunosuppression which, in view of preceding
or concurrent rejection, is not without risk.
N. Ref:: 51
----------------------------------------------------
[17]
TÍTULO / TITLE: - Chromomycosis due to
Exophiala jeanselmei in a renal transplant recipient.
REVISTA
/ JOURNAL: - Eur J Dermatol 2003 May-Jun;13(3):305-7.
AUTORES
/ AUTHORS: - Pena-Penabad C; Duran MT; Yebra MT;
Rodriguez-Lozano J; Vieira V; Fonseca E
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Complejo
Hospitalario Juan Canalejo, Servicio de Dermatologia, Xubias de Arriba, 84,
15006. a Coruna, España.
RESUMEN
/ SUMMARY: - Chromomycosis is a rare mycotic infection
that is more frequent in tropical and subtropical regions. Dematiaceous fungi are
the causal agents of this mycosis. Several cases of chromomycosis in organ
transplant recipients have been reported. We present a case of chromomycosis by
Exophiala jeanselmei in a Spanish male who had received a renal transplant
several months previously, and was receiving treatment with tacrolimus,
prednisone and mycophenolate mofetil. Very few cases of chromomycosis due to
Exophiala have been reported, and this is, to our knowledge, the first European
case. N. Ref:: 16
----------------------------------------------------
[18]
TÍTULO / TITLE: - A case of persistent
anemia in a renal transplant recipient: association with parvovirus B19
infection.
REVISTA
/ JOURNAL: - Scand J Infect Dis 2002;34(1):71-5.
AUTORES
/ AUTHORS: - Choi SH; Chang SP; Won JC; Lee JS; Chi HS;
Yang WS; Park SK
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Ulsan
University College of Medicine, Seoul, South Korea.
RESUMEN
/ SUMMARY: - We report an unexplained anemia that
persisted for 4 months in a renal transplant patient who was receiving
immunosuppression therapy that included prednisolone, tacrolimus and
azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and
occasional giant pronormoblasts with intranuclear inclusions, characteristic of
a parvovirus B19 infection. Both the serum and bone marrow cells were positive
by parvovirus B19 DNA PCR. The anemia resolved 6 weeks after the administration
of intravenous immunoglobulin (IVIG). Four months later, anemia redeveloped and
IVIG was infused again. Hemoglobin levels were, however, still subnormal after
1 month of treatment and tacrolimus was then switched to cyclosporin A,
resulting in a clear improvement. A parvovirus B19 infection should be included
in the differential diagnosis of renal transplant recipients who present with
anemia associated with a low reticulocyte count. Tacrolimus may possibly impair
the clearance of a parvovirus B19 infection.
N. Ref:: 21
----------------------------------------------------
[19]
TÍTULO / TITLE: - The Epstein-Barr virus
and post-transplant lymphoproliferative disease: interplay of
immunosuppression, EBV, and the immune system in disease pathogenesis.
REVISTA
/ JOURNAL: - Transpl Infect Dis 2001 Jun;3(2):60-9.
AUTORES
/ AUTHORS: - Tanner JE; Alfieri C
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, Children’s
Hospital of Eastern Ontario, University of Ottawa Medical School, Ottawa,
Ontario, Canada.
RESUMEN
/ SUMMARY: - Transplant patients are at particular risk
for developing post-transplant lymphoproliferative disease (PTLD) following
administration of immunosuppressive therapy. In many cases the PTLD lesions
express Epstein-Barr virus (EBV) latent and lytic genes as well as elevated
levels of host cytokines. An outline of the potential contributions of EBV,
host cytokines and T cells, and the immunosuppressive cyclosporine A,
tacrolimus, and anti-CD3 antibody in the mechanism and pathogenesis of this
disease is presented and discussed. N.
Ref:: 145
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[20]
TÍTULO / TITLE: - Mycobacterial
infections in organ transplant recipients.
REVISTA
/ JOURNAL: - Semin Respir Infect 2002 Dec;17(4):274-83.
●●
Enlace al texto completo (gratuito o de pago) 1053/srin.2002.36445
AUTORES
/ AUTHORS: - John GT; Shankar V
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Christian
Medical College Hospital, Vellore, India. george@cmvellore.ac.in
RESUMEN
/ SUMMARY: - Tuberculosis has a major adverse impact on
solid organ transplant recipients; this article attempts to define this fact.
The prevalence of posttransplant tuberculosis is increasing globally and
currently is 13.7% at our center. The transplant surgery divides the continuum
of pretransplant tuberculosis and posttransplant tuberculosis;
immunosuppression accounts for a greater severity of the latter. Cyclosporin
and tacrolimus are associated with an earlier onset of tuberculosis when
compared with prednisolone and azathioprine immunosuppression. Disseminated
disease is more common in nonrenal transplants. The risk for developing
posttransplant tuberculosis in renal transplant recipients increased 2.25 times
independently with cytomegalovirus (CMV) and twice with chronic liver disease;
OKT3 treatment enhances the risk 1.8-fold. Tuberculosis occurring after 2 years
of transplantation, diabetes mellitus, posttransplant diabetes mellitus,
chronic liver disease, CMV, and deep mycoses each independently confer a risk,
1.5-times or higher, for death. Disseminated disease entails a 2-fold risk.
Treatment with or without rifampicin is possible; the former is associated with
a higher risk for allograft rejection. Isoniazid prophylaxis is recommended for
high-risk patients with apparent clinical efficacy. However, in endemic areas,
attendant liver disease makes it a difficult goal. N. Ref:: 35
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[21]
TÍTULO / TITLE: - Immunosuppressive
effects of beta-herpesviruses.
REVISTA
/ JOURNAL: - Herpes 2003 May;10(1):12-6.
AUTORES
/ AUTHORS: - Boeckh M; Nichols WG
INSTITUCIÓN
/ INSTITUTION: - Fred Hutchinson Cancer Research Center,
University of Washington, Seattle, WA, USA. mboeckh@fhcrc.org
RESUMEN
/ SUMMARY: - Immunomodulatory effects of human
beta-herpesviruses have been reported in vitro and in vivo. Clinical studies suggest
that beta-herpesvirus infection may increase the risk for other infections, the
severity of infection, or the tempo of disease progression. An increased
incidence of bacterial and fungal infections, and graft rejection, have been
reported in association with cytomegalovirus (CMV), and human herpesviruses
type 6 and type 7 infections have been implicated as risk factors for CMV
infection and graft rejection. Beta-herpesviruses may also interact with HIV-1
and hepatitis C. To prove a causal relationship between beta-herpesviruses and
specific clinical outcomes, randomized trials, with selective suppression of
the virus, are required. Such trials have been performed for CMV and showed a
reduction in bacterial and fungal infections as well as rejection in selected
solid organ transplant recipients. More trials are needed to evaluate whether
the effects seen in observational studies are truly related. N. Ref:: 61
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