#02#
Revisiones-Clínica
(todas) *** Reviews-Clinical (all)
INMUNOSUPRESIÓN
*** IMMUNOSUPPRESSION
(Conceptos
/ Keywords: Immunosuppression; Immunosuppressive ag.; Transpl. immunol.; GVH;
Antirejection therapy; Lymphocyte depletion; Transpl. conditioning; etc).
Enero /
January 2001 --- Marzo / March 2004
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documento sólo contiene artículos escritos en Castellano y/o Inglés.
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Only articles written in Spanish and/or English are included.
[1]
TÍTULO / TITLE: - Hepcidin: a putative
iron-regulatory hormone relevant to hereditary hemochromatosis and the anemia
of chronic disease.
REVISTA
/ JOURNAL: - Proc Natl Acad Sci U S A. Acceso gratuito
al texto completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.pnas.org/
●●
Cita: Proc Natl Acad Sci USA (PNAS): <> 2001 Jul 17;98(15):8160-2.
●●
Enlace al texto completo (gratuito o de pago) 1073/pnas.161296298
AUTORES
/ AUTHORS: - Fleming RE; Sly WS
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, Saint Louis
University School of Medicine, St. Louis, MO 63014, USA. N. Ref:: 30
----------------------------------------------------
[2]
TÍTULO / TITLE: - Beta lactam monotherapy
versus beta lactam-aminoglycoside combination therapy for sepsis in
immunocompetent patients: systematic review and meta-analysis of randomised
trials.
REVISTA
/ JOURNAL: - British Medical J (BMJ). Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://bmj.com/search.dtl
●●
Cita: British Medical J. (BMJ): <> 2004 Mar 20;328(7441):668. Epub 2004
Mar 2.
●●
Enlace al texto completo (gratuito o de pago) 1136/bmj.38028.520995.63
AUTORES
/ AUTHORS: - Paul M; Benuri-Silbiger I; Soares-Weiser
K; Leibovici L
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine E and Infectious
Diseases Unit, Rabin Medical Centre, Beilinson Campus, Petah-Tikva 49100,
Israel. mica@zahav.net.il
RESUMEN
/ SUMMARY: - OBJECTIVE: To compare beta lactam
monotherapy with beta lactam-aminoglycoside combination therapy for severe
infections. DATA SOURCES: Medline, Embase, Lilacs, Cochrane Library, and
conference proceedings, to 2003; references of included studies; contact with
all authors. No restrictions, such as language, year of publication, or publication
status. STUDY SELECTION: All randomised trials of beta lactam monotherapy
compared with beta lactam-aminoglycoside combination therapy for patients
without neutropenia who fulfilled criteria for sepsis. DATA SELECTION: Two
reviewers independently applied selection criteria, performed quality
assessment, and extracted the data. The primary outcome assessed was all cause
fatality by intention to treat. Relative risks were pooled with the random
effect model (relative risk < 1 favours monotherapy). RESULTS: 64 trials
with 7586 patients were included. There was no difference in all cause fatality
(relative risk 0.90, 95% confidence interval 0.77 to 1.06). 12 studies compared
the same beta lactam (1.02, 0.76 to 1.38), and 31 studies compared different
beta lactams (0.85, 0.69 to 1.05). Clinical failure was more common with
combination treatment overall (0.87, 0.78 to 0.97) and among studies comparing
different beta lactams (0.76, 0.68 to 0.86). There was no advantage to
combination therapy among patients with Gram negative infections (1835
patients) or Pseudomonas aeruginosa infections (426 patients). There was no
difference in the rate of development of resistance. Nephrotoxicity was
significantly more common with combination therapy (0.36, 0.28 to 0.47). Heterogeneity
was not significant for these comparisons. CONCLUSIONS: In the treatment of
sepsis the addition of an aminoglycoside to beta lactams should be discouraged.
Fatality remains unchanged, while the risk for adverse events is increased. N. Ref:: 26
----------------------------------------------------
[3]
TÍTULO / TITLE: - Immunopathogenesis and
immunotherapy in AIDS virus infections.
REVISTA
/ JOURNAL: - Nat Med 2003 Jul;9(7):861-6.
●●
Enlace al texto completo (gratuito o de pago) 1038/nm0703-861
AUTORES
/ AUTHORS: - Letvin NL; Walker BD
INSTITUCIÓN
/ INSTITUTION: - Division of Viral Pathogenesis, Beth
Israel Deaconess Medical Center, Massachusetts General Hospital, Harvard
Medical School, Boston, Massachusetts 02114, USA.
RESUMEN
/ SUMMARY: - The heterogeneity of HIV and the different
human leukocyte antigen (HLA) backgrounds of infected individuals have posed
challenges to understanding the pathogenesis of HIV infection. But continuing
advances in our knowledge of the role of immune responses in controlling HIV
viremia should help to define goals for immune-based therapies and vaccine
strategies against AIDS. N.
Ref:: 106
----------------------------------------------------
[4]
TÍTULO / TITLE: - Integration of growth
factor and nutrient signaling: implications for cancer biology.
REVISTA
/ JOURNAL: - Mol Cell 2003 Aug;12(2):271-80.
AUTORES
/ AUTHORS: - Shamji AF; Nghiem P; Schreiber SL
INSTITUCIÓN
/ INSTITUTION: - Harvard Biophysics Program, Harvard
University, 12 Oxford Street, Cambridge, MA 02138, USA.
RESUMEN
/ SUMMARY: - Signaling networks that promote cell
growth are frequently dysregulated in cancer. One regulatory network, which
converges on effectors such as 4EBP1 and S6K1, leads to growth by promoting
protein synthesis. Here, we discuss how this network is regulated by both
extracellular signals, such as growth factors, and intracellular signals, such
as nutrients. We discuss how mutations amplifying either type of signal can
lead to tumor formation. In particular, we focus on the recent discovery that a
tumor suppressor complex whose function is lost in tuberous sclerosis patients
regulates the nutrient signal carried by the critical signaling protein TOR to
the effectors 4EBP1 and S6K1. Finally, we describe how the small molecule
rapamycin, which inhibits TOR and thereby the activation of these effectors,
could be useful to treat tumors that have become dependent upon this pathway
for growth. N. Ref:: 80
----------------------------------------------------
[5]
TÍTULO / TITLE: - Defying death—HIV
mutation to evade cytotoxic T lymphocytes.
REVISTA
/ JOURNAL: - N Engl J Med. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://content.nejm.org/
●●
Cita: New England J Medicine (NEJM): <> 2002 Oct 10;347(15):1203-4.
●●
Enlace al texto completo (gratuito o de pago) 1056/NEJMcibr022067
AUTORES
/ AUTHORS: - Lieberman J
INSTITUCIÓN
/ INSTITUTION: - Center for Blood Research, Boston, MA
02115, USA. N. Ref:: 5
----------------------------------------------------
[6]
TÍTULO / TITLE: - Dendritic cells:
emerging pharmacological targets of immunosuppressive drugs.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2004 Jan;4(1):24-34.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri1256
AUTORES
/ AUTHORS: - Hackstein H; Thomson AW
INSTITUCIÓN
/ INSTITUTION: - Institute for Clinical Immunology and
Transfusion Medicine, Justus-Liebig University Giessen, Langhansstr. 7, D-35392
Giessen, Germany. holger.hackstein@immunologie.med.uni-giessen.de
RESUMEN
/ SUMMARY: - Immunosuppressive drugs have
revolutionized organ transplantation and improved the therapeutic management of
autoimmune diseases. The development of immunosuppressive drugs and
understanding of their action traditionally has been focused on lymphocytes,
but recent evidence indicates that these agents interfere with immune responses
at the earliest stage, targeting key functions of dendritic cells (DCs). Here,
we review our present understanding of how classical and new immunosuppressive
agents interfere with DC development and function. This knowledge might provide
a rational basis for the selection of immunosuppressive drugs in different
clinical settings and for the generation of tolerogenic DCs in the
laboratory. N. Ref:: 116
----------------------------------------------------
[7]
TÍTULO / TITLE: - Impact of shared
epitope genotype and ethnicity on erosive disease: a meta-analysis of 3,240
rheumatoid arthritis patients.
REVISTA
/ JOURNAL: - Arthritis Rheum 2004 Feb;50(2):400-12.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.20006
AUTORES
/ AUTHORS: - Gorman JD; Lum RF; Chen JJ; Suarez-Almazor
ME; Thomson G; Criswell LA
INSTITUCIÓN
/ INSTITUTION: - University of California, San Francisco,
CA 94143-0500, USA. lac@itsa.ucsf.edu
RESUMEN
/ SUMMARY: - OBJECTIVE: The strongest known genetic
association in rheumatoid arthritis (RA) is with HLA-DRB1 alleles that share a
similar amino acid sequence, termed the shared epitope (SE). Although many studies
have examined the association of the SE with disease severity, the results have
been inconsistent, which may reflect the relatively small sample sizes or
ethnic differences. The aim of this study was to assess the association of
HLA-DRB1 SE alleles and genotype with the development of bony erosions in RA by
meta-analysis. METHODS: We identified English-language articles published
between January 1, 1987 and June 1, 1999 through Medline, EMBase, and manual
searches of 6 relevant journals. Included were studies in which molecular
typing of HLA-DRB1 alleles was performed and in which the presence or absence
of bony erosions was reported. Data were extracted from the studies, and
erosions were coded as present or absent. Authors were contacted for missing information
and data on individual patients. RESULTS: A total of 29 studies and 3,240
patients were available for analysis. The summary odds ratios (ORs), when all
patients were evaluated as a single group, demonstrated a significant
association of the presence of the SE (2 or 1 versus 0 SE alleles) with
erosions (OR 2.0; 95% confidence interval [95% CI] 1.8-2.2), although
significant heterogeneity was present (P = 0.002). Subgroup analyses
demonstrated the important influence of ethnic background. For example, no
association of the SE with erosions was demonstrated in Greeks (OR 0.8 [95% CI
0.2-1.5]). In contrast, there was a striking dose-dependent relationship in
southern European Caucasians and Asians, with ORs as high as 6.2 and 5.4,
respectively, in patients with 2 SE alleles. Although our ability to assess the
relationship between SE genotype and erosions was limited, particular
importance of the DRB1*0401 SE allele was suggested in an analysis restricted
to northern European Caucasians. CONCLUSION: The SE is associated with the
development of erosive disease in many ethnic groups; however, striking
exceptions exist. These variations may be due to allele differences between
populations, such as the frequency of DRB1*0401 among different ethnic groups.
Further study to better understand the genetic and environmental differences
between these populations may provide insight into mechanisms that influence
the clinical expression of RA.
----------------------------------------------------
[8]
TÍTULO / TITLE: - Routes to transplant
tolerance versus rejection; the role of cytokines.
REVISTA
/ JOURNAL: - Immunity 2004 Feb;20(2):121-31.
AUTORES
/ AUTHORS: - Walsh PT; Strom TB; Turka LA
INSTITUCIÓN
/ INSTITUTION: - University of Pennsylvania, 700 Clinical
Research Building, 415 Curie Boulevard, Philadelphia, PA 19104, USA.
RESUMEN
/ SUMMARY: - The alloimmune response can be divided
into specific junctures where critical decisions between tolerance and immunity
are made which define the outcome of the transplant. At these “decision nodes”
various cytokines direct alloresponsive T cells to develop either a
proinflammatory response aimed at graft destruction or an immunoregulatory
response facilitating graft acceptance. This review will focus on the role of
these cytokines in influencing the progression of an alloimmune response
leading ultimately to either allograft survival or rejection. N. Ref:: 97
----------------------------------------------------
[9]
TÍTULO / TITLE: - Microchimerism: an
investigative frontier in autoimmunity and transplantation.
REVISTA
/ JOURNAL: - JAMA. Acceso gratuito al texto completo.
●●
Enlace a la Editora de la Revista http://jama.ama-assn.org/search.dtl
●●
Cita: JAMA: <> 2004 Mar 3;291(9):1127-31.
●●
Enlace al texto completo (gratuito o de pago) 1001/jama.291.9.1127
AUTORES
/ AUTHORS: - Adams KM; Nelson JL
INSTITUCIÓN
/ INSTITUTION: - Program in Human Immunogenetics, Clinical
Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
98109-1024, USA.
RESUMEN
/ SUMMARY: - Recent studies indicate cells transfer
between fetus and mother during pregnancy and can persist in both decades
later. The presence within one individual of a small population of cells from
another genetically distinct individual is referred to as microchimerism.
Naturally acquired microchimerism has recently been investigated in autoimmune
diseases, including scleroderma, thyroiditis, primary biliary cirrhosis,
Sjogren syndrome, systemic lupus, dermatomyositis, and neonatal lupus. Iatrogenic
chimerism has been investigated in transplantation and following blood
transfusion. Considering findings of naturally acquired microchimerism along
with iatrogenic microchimerism suggests microchimerism can have detrimental
and/or beneficial effects in both settings. Recent identification of
tissue-specific microchimerism either from naturally acquired or iatrogenic
microchimerism (eg, cardiac myocytes) raises the possibility that
microchimerism can be a target of autoimmunity or alternatively contribute to
tissue repair. Advances in this new frontier of research with varied and
numerous implications for human health are summarized. N. Ref:: 26
----------------------------------------------------
[10]
TÍTULO / TITLE: - The allogeneic response
and tumor immunity.
REVISTA
/ JOURNAL: - Nat Med 2001 Jun;7(6):649-52.
●●
Enlace al texto completo (gratuito o de pago) 1038/89008
AUTORES
/ AUTHORS: - Fabre JW
INSTITUCIÓN
/ INSTITUTION: - Department of Clinical Sciences, Institute
of Liver Studies Guy’s, King’s and St Thomas’ School of Medicine, London, UK. john.fabre@kcl.ac.uk
RESUMEN
/ SUMMARY: - The strong allogeneic response to donor
MHC molecules in transplantation and the weak response to tumor antigens
represent two important and divergent but potentially interactive immune
responses. A patient’s response to allogeneic MHC molecules might promote an
effective T-cell response to self MHC-restricted tumor peptides and the
possibilities for this are discussed here. These allogeneic responses might
successfully be harnessed to promote the immune eradication of metastatic
cancer. N. Ref:: 45
----------------------------------------------------
[11]
TÍTULO / TITLE: - A review of activity
indices and efficacy endpoints for clinical trials of medical therapy in adults
with Crohn’s disease.
REVISTA
/ JOURNAL: - Gastroenterology 2002 Feb;122(2):512-30.
AUTORES
/ AUTHORS: - Sandborn WJ; Feagan BG; Hanauer SB; Lochs
H; Lofberg R; Modigliani R; Present DH; Rutgeerts P; Scholmerich J; Stange EF;
Sutherland LR
INSTITUCIÓN
/ INSTITUTION: - The Clinical Trials Task Force of the
International Organization of Inflammatory Bowel Disease. sandborn.william@mayo.edu N. Ref:: 115
----------------------------------------------------
[12]
TÍTULO / TITLE: - Skin cancers after
organ transplantation.
REVISTA
/ JOURNAL: - N Engl J Med. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://content.nejm.org/
●●
Cita: New England J Medicine (NEJM): <> 2003 Apr 24;348(17):1681-91.
●●
Enlace al texto completo (gratuito o de pago) 1056/NEJMra022137
AUTORES
/ AUTHORS: - Euvrard S; Kanitakis J; Claudy A
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Edouard Herriot
Hospital, Lyons, France. sylvie.euvrard@numericable.fr N. Ref:: 100
----------------------------------------------------
[13]
TÍTULO / TITLE: - Haematopoietic cell
transplantation as immunotherapy.
REVISTA
/ JOURNAL: - Nature 2001 May 17;411(6835):385-9.
●●
Enlace al texto completo (gratuito o de pago) 1038/35077251
AUTORES
/ AUTHORS: - Appelbaum FR
INSTITUCIÓN
/ INSTITUTION: - Clinical Research Division, Fred
Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-310, PO Box
19024, Seattle, Washington 98109-1024, USA.
RESUMEN
/ SUMMARY: - The graft-versus-tumour effect seen after
allogeneic (genetically different) haematopoietic cell transplantation for
human malignancies represents the clearest example of the power of the human
immune system to eradicate cancer. Recent advances in our understanding of the
immunobiology of stem-cell engraftment, tolerance and tumour eradication are
allowing clinicians to better harness this powerful effect. N. Ref:: 60
----------------------------------------------------
[14]
TÍTULO / TITLE: - Lack of association of
the HLA-DRB1 shared epitope with rheumatoid nodules: an individual patient data
meta-analysis of 3,272 Caucasian patients with rheumatoid arthritis.
REVISTA
/ JOURNAL: - Arthritis Rheum 2004 Mar;50(3):753-62.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.20119
AUTORES
/ AUTHORS: - Gorman JD; David-Vaudey E; Pai M; Lum RF;
Criswell LA
INSTITUCIÓN
/ INSTITUTION: - University of California, San Francisco,
and School of Public Health, University of California, Berkeley.
RESUMEN
/ SUMMARY: - OBJECTIVE: The objective of this
individual patient data (IPD) meta-analysis was to examine the relationship of
rheumatoid nodules to the HLA-DRB1 shared epitope (SE) and to individual SE
genotypes. METHODS: English-language studies that enrolled adult non-Hispanic
Caucasian patients with rheumatoid arthritis (RA) were identified by searches
of Medline and Embase, and by manual searches of medical journals. All authors
were contacted for IPD. Meta-analysis was performed to assess the association
of SE presence, dose, and genotype with rheumatoid nodules. Meta-analyses
adjusted for disease duration and cumulative meta-analyses were also performed
to assess the influence of RA duration and year of study publication on the
results. RESULTS: A total of 24 studies and 3,272 patients were available for
analysis. IPD were obtained for 22 of the studies. There was a nonsignificant
association between the presence of the SE (i.e., 1 or 2 alleles versus 0
alleles) and rheumatoid nodules (summary odds ratio [OR] 1.3, 95% confidence
interval [95% CI] 0.97-1.6). Analysis by SE genotype, however, demonstrated a
weak relationship with inheritance of a single DRB1*0401 SE allele (OR 1.4, 95%
CI 1.1-1.8). No other genotypes achieved statistical significance in the
adjusted or unadjusted analyses. CONCLUSION: The presence of the HLA-DRB1 SE
does not appear to significantly increase the risk of rheumatoid nodules among
Caucasian patients with RA. Analysis by DRB1 SE genotype was uninformative,
suggesting only a potential (and at most modest) role of the DRB1*0401 SE
allele. Results from this IPD meta-analysis implicate other genetic,
stochastic, and/or environmental factors in the susceptibility to rheumatoid
nodules.
----------------------------------------------------
[15]
TÍTULO / TITLE: - Chronic graft-vs-host
disease.
REVISTA
/ JOURNAL: - JAMA. Acceso gratuito al texto completo.
●●
Enlace a la Editora de la Revista http://jama.ama-assn.org/search.dtl
●●
Cita: JAMA: <> 2003 Nov 19;290(19):2599-603.
●●
Enlace al texto completo (gratuito o de pago) 1001/jama.290.19.2599
AUTORES
/ AUTHORS: - Bhushan V; Collins RH Jr
INSTITUCIÓN
/ INSTITUTION: - Hematopoietic Cell Transplantation
Program, Department of Internal Medicine, University of Texas Southwestern
Medical Center, Dallas 75390-8852, USA.
N. Ref:: 26
----------------------------------------------------
[16]
TÍTULO / TITLE: - Interferon-gamma
reduces interleukin-4- and interleukin-13-augmented transforming growth
factor-beta2 production in human bronchial epithelial cells by targeting Smads.
REVISTA
/ JOURNAL: - Chest. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.chestjournal.org/
●●
Cita: Chest: <> 2003 Mar;123(3 Suppl):372S-3S.
AUTORES
/ AUTHORS: - Wen FQ; Liu XD; Terasaki Y; Fang QH;
Kobayashi T; Abe S; Rennard SI
INSTITUCIÓN
/ INSTITUTION: - Pulmonary and Critical Care Medicine
Section, University of Nebraska Medical Center, Omaha, NE 68198-5125, USA. N. Ref:: 0
----------------------------------------------------
[17]
TÍTULO / TITLE: - When the lymphocyte
loses its clothes.
REVISTA
/ JOURNAL: - Immunity 2003 Apr;18(4):453-7.
AUTORES
/ AUTHORS: - Nekrep N; Fontes JD; Geyer M; Peterlin BM
INSTITUCIÓN
/ INSTITUTION: - Institute of Biochemistry, Medical Faculty
of the University of Ljubljana, Slovenia.
RESUMEN
/ SUMMARY: - The type II bare lymphocyte syndrome (BLS)
or major histocompatibility complex class II (MHCII) deficiency is a severe
combined immunodeficiency (SCID) that is characterized by the absence of
constitutive and inducible expression of MHCII determinants on immune cells.
Four complementation groups of BLS have been defined, and they result from
mutations in DNA-bound activators and the coactivator for MHCII transcription.
Recently, all complementation groups of BLS patients have been accounted for.
Studies of the syndrome and specific mutations reveal important lessons for the
genetics of the immune response. N.
Ref:: 35
----------------------------------------------------
[18]
TÍTULO / TITLE: - Ex vivo selection of
recipient-type alloantigen-specific CD4(+)CD25(+) immunoregulatory T cells for
the control of graft-versus-host disease after allogeneic hematopoietic
stem-cell transplantation.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S32-4.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106470.07410.CA
AUTORES
/ AUTHORS: - Trenado A; Fisson S; Braunberger E;
Klatzmann D; Salomon BL; Cohen JL
INSTITUCIÓN
/ INSTITUTION: - Biologie et Therapeutique des Pathologies
Immunitaires, Hopital Pitie-Salpetriere, Paris, France.
RESUMEN
/ SUMMARY: - Allogeneic hematopoietic stem-cell
transplantation (HSCT) is the treatment of choice for many malignant and
nonmalignant hematologic disorders. Donor T cells present in the hematopoietic
stem-cell transplant improve engraftment and immune reconstitution and
contribute to the graft-versus-leukemia effect, but are also responsible for
the life-threatening graft-versus-host disease (GVHD). CD4(+)CD25(+)
immunoregulatory T cells, which play a pivotal role in preventing
organ-specific diseases, can also modulate GVHD if administered in equal
numbers of T cells at the time of grafting. In this article, the authors
describe a procedure of ex vivo selection and expansion of regulatory T cells
specific for recipient-type alloantigens. These expanded regulatory T cells
controlled GVHD. Their therapeutic use in HSCT should allow specific
suppression of the activation of donor alloreactive T cells involved in GVHD
while preserving the beneficial effects of other T cells. N. Ref:: 27
----------------------------------------------------
[19]
TÍTULO / TITLE: - Hemochromatosis gene
modifies course of hepatitis C viral infection.
REVISTA
/ JOURNAL: - Gastroenterology 2003 May;124(5):1509-23.
AUTORES
/ AUTHORS: - Pietrangelo A
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Centre
for Hemochromatosis and Metabolic Liver Diseases, University of Modena and
Reggio Emilia, Modeno, Italy. antonello@unimore.it N. Ref:: 161
----------------------------------------------------
[20]
- Castellano -
TÍTULO / TITLE:La ruta de senalizacion
CA++/calcineurina/NFAT en activacion endotelial y angiogenesis: efectos de la
ciclosporina A. CA++/ calcineurin/NFAT signaling in endothelial activation and
angiogenesis: effects od cyclosporin A .
REVISTA
/ JOURNAL: - Nefrologia. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/
●●
Cita: Nefrologia: <> 2003;23 Suppl 3:44-8.
AUTORES
/ AUTHORS: - Quesada AJ; Redondo JM
INSTITUCIÓN
/ INSTITUTION: - Centro de Biologia Molecular Severo Ochoa,
Consejo Superior de Investigaciones Cientificas, Universidad Autonoma de Madrid
y Centro Nacional de Investigaciones Cardiovasculares (CNIC), Sinesio Delgado, 4
28049 Cantoblanco, Madrid. jmredondo@cbm.uam.es N. Ref:: 31
----------------------------------------------------
[21]
TÍTULO / TITLE: - Regulating the immune
response to transplants. a role for CD4+ regulatory cells?
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):399-406.
AUTORES
/ AUTHORS: - Waldmann H; Cobbold S
INSTITUCIÓN
/ INSTITUTION: - Sir William Dunn School of Pathology,
University of Oxford, South Parks Road, Oxford OX1 3RE, United Kingdom. herman.waldmann@path.ox.ac.uk N. Ref:: 50
----------------------------------------------------
[22]
TÍTULO / TITLE: - Dendritic cells in
transplantation—friend or foe?
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):357-68.
AUTORES
/ AUTHORS: - Lechler R; Ng WF; Steinman RM
INSTITUCIÓN
/ INSTITUTION: - Department of Immunology, Division of
Medicine, Hammersmith Hospital, Imperial College School of Medicine, Du Cane
Road, London W12 ONN, United Kingdom. r.lechler@ic.ac.uk N. Ref:: 80
----------------------------------------------------
[23]
TÍTULO / TITLE: - Clinical practice
guidelines for managing dyslipidemias in kidney transplant patients: a report
from the Managing Dyslipidemias in Chronic Kidney Disease Work Group of the
National Kidney Foundation Kidney Disease Outcomes Quality Initiative.
REVISTA
/ JOURNAL: - Am J Transplant 2004;4 Suppl 7:13-53.
●●
Enlace al texto completo (gratuito o de pago) 1111/j.1600-6135.2004.0355.x
AUTORES
/ AUTHORS: - Kasiske B; Cosio FG; Beto J; Bolton K;
Chavers BM; Grimm R Jr; Levin A; Masri B; Parekh R; Wanner C; Wheeler DC;
Wilson PW
RESUMEN
/ SUMMARY: - The incidence of cardiovascular disease
(CVD) is very high in patients with chronic kidney (CKD) disease and in kidney
transplant recipients. Indeed, available evidence for these patients suggests
that the 10-year cumulative risk of coronary heart disease is at least 20%, or
roughly equivalent to the risk seen in patients with previous CVD. Recently,
the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative
(K/DOQI) published guidelines for the diagnosis and treatment of dyslipidemias
in patients with CKD, including transplant patients. It was the conclusion of
this Work Group that the National Cholesterol Education Program Guidelines are
generally applicable to patients with CKD, but that there are significant
differences in the approach and treatment of dyslipidemias in patients with CKD
compared with the general population. In the present document we present the
guidelines generated by this workgroup as they apply to kidney transplant
recipients. Evidence from the general population indicates that treatment of
dyslipidemias reduces CVD, and evidence in kidney transplant patients suggests
that judicious treatment can be safe and effective in improving dyslipidemias.
Dyslipidemias are very common in CKD and in transplant patients. However, until
recently there have been no adequately powered, randomized, controlled trials
examining the effects of dyslipidemia treatment on CVD in patients with CKD.
Since completion of the K/DOQI guidelines on dyslipidemia in CKD, the results
of the Assessment of Lescol in Renal Transplantation (ALERT) Study have been
presented and published. Based on information from randomized trials conducted
in the general population and the single study conducted in kidney transplant
patients, these guidelines, which are a modified version of the K/DOQI
dyslipidemia guidelines, were developed to aid clinicians in the management of
dyslipidemias in kidney transplant patients. These guidelines are divided into
four sections. The first section (Introduction) provides the rationale for the
guidelines, and describes the target population, scope, intended users, and
methods. The second section presents guidelines on the assessment of
dyslipidemias (guidelines 1-3), while the third section offers guidelines for
the treatment of dyslipidemias (guidelines 4-5). The key guideline statements
are supported mainly by data from studies in the general population, but there
is an urgent need for additional studies in CKD and in transplant patients.
Therefore, the last section outlines recommendations for research.
----------------------------------------------------
[24]
TÍTULO / TITLE: - Disease modifying
therapies in multiple sclerosis: report of the Therapeutics and Technology
Assessment Subcommittee of the American Academy of Neurology and the MS Council
for Clinical Practice Guidelines.
REVISTA
/ JOURNAL: - Neurology 2002 Jan 22;58(2):169-78.
AUTORES
/ AUTHORS: - Goodin DS; Frohman EM; Garmany GP Jr;
Halper J; Likosky WH; Lublin FD; Silberberg DH; Stuart WH; van den Noort S
----------------------------------------------------
[25]
TÍTULO / TITLE: - Nystatin prophylaxis
and treatment in severely immunodepressed patients.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2002;(4):CD002033.
AUTORES
/ AUTHORS: - Gotzsche PC; Johansen HK
INSTITUCIÓN
/ INSTITUTION: - The Nordic Cochrane Centre,
Rigshospitalet, Dept. 7112, Blegdamsvej 9, Copenhagen O, Denmark, 2100. p.c.gotzsche@cochrane.dk
RESUMEN
/ SUMMARY: - BACKGROUND: Nystatin is sometimes used
prophylactically in patients with severe immunodeficiency or in the treatment
of fungal infection in such patients, although the effect seems to be
equivocal. OBJECTIVES: To study whether nystatin decreases morbidity and
mortality when given prophylactically or therapeutically to patients with
severe immunodeficiency. SEARCH STRATEGY: MEDLINE and The Cochrane Library
using a comprehensive search strategy, date of last search November 2001.
Contacted industry and scanned reference lists. SELECTION CRITERIA: Randomised
trials comparing nystatin with placebo, an untreated control group, fluconazole
or amphotericin B. DATA COLLECTION AND ANALYSIS: Data on mortality, invasive
fungal infection and colonisation were extracted by both authors independently.
A random effects model was used unless p>0.10 for the test of heterogeneity.
MAIN RESULTS: We included 12 trials (1,464 patients). The drugs were given
prophylactically in ten trials and as treatment in two. Seven trials were in
acute leukaemia, two in cancer, one in liver transplant patients, one in
critically ill surgical and trauma patients, and one in AIDS patients. Nystatin
had been compared with placebo in three trials and with fluconazole in nine;
the dose varied from 1.5 MIE to 72 MIE daily. The effect of nystatin was
similar to that of placebo on fungal colonisation (relative risk 0.85, 95%
confidence interval 0.65 to 1.13). There was no statistically significant
difference between fluconazole and nystatin on mortality (relative risk 0.76,
0.49 to 1.18) whereas fluconazole was more effective in preventing invasive
fungal infection (relative risk 0.37, 0.15 to 0.91) and colonisation (relative
risk 0.49, 0.34 to 0.70). The results were very similar if the three studies
which were not performed in cancer patients were excluded. REVIEWER’S
CONCLUSIONS: Nystatin cannot be recommended for prophylaxis or treatment of
Candida infections in immunodepressed patients. N. Ref:: 22
----------------------------------------------------
[26]
TÍTULO / TITLE: - Immune tolerance after
long-term enzyme-replacement therapy among patients who have
mucopolysaccharidosis I.
REVISTA
/ JOURNAL: - Lancet 2003 May 10;361(9369):1608-13.
AUTORES
/ AUTHORS: - Kakavanos R; Turner CT; Hopwood JJ; Kakkis
ED; Brooks DA
INSTITUCIÓN
/ INSTITUTION: - Lysosomal Diseases Research Unit,
Department of Chemical Pathology, Women’s and Children’s Hospital, North
Adelaide, South Australia, Australia
RESUMEN
/ SUMMARY: - BACKGROUND: Enzyme-replacement therapy has
been assessed as a treatment for patients who have mucopolysaccharidosis I
(alpha-L-iduronidase deficiency). We aimed to investigate the humoral immune
response to recombinant human alpha-L-iduronidase among these patients.
METHODS: We characterised the antibody titres and specific linear sequence
epitope reactivity of serum antibodies to alpha-L-iduronidase for ten patients
with mucopolysaccharidosis I, at the start of treatment and after 6, 12, 26,
52, and 104 weeks. We compared the values for patients’ samples with those for
samples from normal human controls. FINDINGS: Before enzyme-replacement
therapy, all patients had low serum antibody titres to recombinant human
alpha-L-iduronidase that were within the control range. Five of the ten
patients produced higher-than-normal titres of antibody to the replacement
protein during the treatment course (serum antibody titres 130000-500000 and
high-affinity epitope reactivity). However, by week 26, antibody reactivity was
reduced, and by week 104 all patients had low antibody titres and only low-affinity
epitope reactivity. Patients who had mucopolysaccharidosis I with antibody
titres within the normal range at 6-12 weeks did not subsequently develop
immune responses. INTERPRETATION: After 2 years of treatment, patients who
initially had an immune reaction developed immune tolerance to
alpha-L-iduronidase. This finding has positive implications for long-term
enzyme-replacement therapy in patients who have mucopolysaccharidosis I. N. Ref:: 32
----------------------------------------------------
[27]
TÍTULO / TITLE: - Interleukin-2 receptor
monoclonal antibodies in renal transplantation: meta-analysis of randomised
trials.
REVISTA
/ JOURNAL: - British Medical J (BMJ). Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://bmj.com/search.dtl
●●
Cita: British Medical J. (BMJ): <> 2003 Apr 12;326(7393):789.
●●
Enlace al texto completo (gratuito o de pago) 1136/bmj.326.7393.789
AUTORES
/ AUTHORS: - Adu D; Cockwell P; Ives NJ; Shaw J;
Wheatley K
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Queen Elizabeth
Hospital, Birmingham, B15 2TH. dwomoa.adu@uhb.nhs.uk
RESUMEN
/ SUMMARY: - OBJECTIVE: To study the effect of
interleukin-2 receptor monoclonal antibodies on acute rejection episodes, graft
loss, deaths, and rate of infection and malignancy in patients with renal
transplants. DESIGN: Meta-analysis of published data. DATA SOURCES: Medline,
Embase, and Cochrane library for years 1996-2003 plus search of medical
editors’ trial amnesty and contact with manufacturers of the antibodies.
SELECTION OF STUDIES: Randomised controlled trials comparing interleukin-2
receptor antibodies with placebo or no additional treatment in patients with
renal transplants receiving ciclosporin based immunosuppression. RESULTS: Eight
randomised controlled trials involving 1871 patients met the selection criteria
(although only 1858 patients were analysed). Interleukin-2 receptor antibodies
significantly reduced the risk of acute rejection (odds ratio 0.51, 95%
confidence interval 0.42 to 0.63). There were no significant differences in the
rate of graft loss (0.78, 0.58 to 1.04), mortality (0.75, 0.46 to 1.23),
overall incidence of infections (0.97, 0.77 to 1.24), incidence of
cytomegalovirus infections (0.81, 0.62 to 1.04), or risk of malignancies at one
year (0.82, 0.39 to 1.70). The different antibodies had a similar sized effect
on acute rejection (test for heterogeneity P=0.7): anti-Tac (0.37, 0.16 to
0.89), BT563 (0.37, 0.1 to 1.38), basiliximab (0.56, 0.44 to 0.72), and
daclizumab (0.46, 0.32 to 0.67). The reduction in acute rejections was similar
for all ciclosporin based immunosuppression regimens (test for heterogeneity
P=1.0). CONCLUSIONS: Adding interleukin-2 receptor antibodies to ciclosporin
based immunosuppression reduces episodes of acute rejection at six months by
49%. There is no evidence of an increased risk of infective complications.
Longer follow up studies are needed to confirm whether interleukin-2 receptor
antibodies improve long term graft and patient survival.
----------------------------------------------------
[28]
TÍTULO / TITLE: - Regulatory T cells in
transplantation tolerance.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2003 Mar;3(3):199-210.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri1027
AUTORES
/ AUTHORS: - Wood KJ; Sakaguchi S
INSTITUCIÓN
/ INSTITUTION: - Nuffield Department of Surgery, University
of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK. kathryn.wood@nds.ox.ac.uk
RESUMEN
/ SUMMARY: - The identification and characterization of
regulatory T (T(Reg)) cells that can control immune responsiveness to alloantigens
have opened up exciting opportunities for new therapies in transplantation.
After exposure to alloantigens in vivo, alloantigen-specific immunoregulatory
activity is enriched in a population of CD4+ T cells that express high levels
of CD25. In vivo, common mechanisms seem to underpin the activity of CD4+CD25+
T(Reg) cells in both naive and manipulated hosts. However, the origin,
allorecognition properties and molecular basis for the suppressive activity of
CD4+CD25+ T(Reg) cells, as well as their relationship to other populations of
regulatory cells that exist after transplantation, remain a matter of
debate. N. Ref:: 138
----------------------------------------------------
[29]
TÍTULO / TITLE: - Interleukin 2 receptor
antagonists for renal transplant recipients: a meta-analysis of randomized
trials.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):166-76.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000109643.32659.C4
AUTORES
/ AUTHORS: - Webster AC; Playford EG; Higgins G;
Chapman JR; Craig JC
INSTITUCIÓN
/ INSTITUTION: - Cochrane Renal Group, Centre for Kidney
Research, Children’s Hospital at Westmead, Westmead, NSW, Australia.
RESUMEN
/ SUMMARY: - BACKGROUND: Interleukin 2 receptor
antagonists (IL-2Ra) are increasingly used to treat renal transplant
recipients. This study aims to systematically identify and summarize the
effects of using IL-2Ra as induction immunosuppression, as an addition to standard
therapy, or as an alternative to other antibody therapy. METHODS: Databases,
reference lists, and abstracts of conference proceedings were searched
extensively to identify relevant randomized controlled trials in all languages.
Data were synthesized using the random effects model. Results are expressed as
relative risk (RR), with 95% confidence intervals (CI). RESULTS: A total of 117
reports from 38 trials involving 4,893 participants were included. When IL-2Ra
were compared with placebo (17 trials; 2,786 patients), graft loss was not
significantly different at 1 year (14 trials: RR 0.84; CI 0.64-1.10) or 3 years
(4 trials: RR 1.08; CI 0.71-1.64). Acute rejection was significantly reduced at
6 months (12 trials: RR 0.66; CI 0.59-0.74) and at 1 year (10 trials: RR 0.67;
CI 0.60-0.75). At 1 year, cytomegalovirus infection (7 trials: RR 0.82; CI
0.65-1.03) and malignancy (9 trials: RR 0.67; CI 0.33-1.36) were not
significantly different. When IL-2Ra were compared with other antibody therapy,
no significant differences in treatment effects were demonstrated, but IL-2Ra
had significantly fewer side effects. CONCLUSIONS: Given a 40% risk of
rejection, seven patients would need treatment with IL-2Ra in addition to
standard therapy, to prevent one patient from undergoing rejection, with no
definite improvement in graft or patient survival. There is no apparent
difference between basiliximab and daclizumab.
----------------------------------------------------
[30]
TÍTULO / TITLE: - Tolerance and
autoimmunity.
REVISTA
/ JOURNAL: - N Engl J Med. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://content.nejm.org/
●●
Cita: New England J Medicine (NEJM): <> 2001 Mar 1;344(9):655-64.
AUTORES
/ AUTHORS: - Kamradt T; Mitchison NA
INSTITUCIÓN
/ INSTITUTION: - Deutsches Rheumaforschungszentrum Berlin
and Universitatsklinikum Charite, Medizinische Klinik mit Schwerpunkt
Rheumatologie and Klinische Immunologie, Germany. kamradt@drfz.de N. Ref:: 151
----------------------------------------------------
[31]
TÍTULO / TITLE: - Progress in the
treatment of rheumatoid arthritis.
REVISTA
/ JOURNAL: - JAMA. Acceso gratuito al texto completo.
●●
Enlace a la Editora de la Revista http://jama.ama-assn.org/search.dtl
●●
Cita: JAMA: <> 2001 Dec 12;286(22):2787-90.
AUTORES
/ AUTHORS: - Pisetsky DS; St Clair EW
INSTITUCIÓN
/ INSTITUTION: - Division of Rheumatology, Allergy, and
Clinical Immunology, Duke University Medical Center, 1516 Durham Veterans
Affairs Medical Center, Box 151G, Durham, NC 27710, USA. dpiset@acpub.duke.edu N. Ref:: 27
----------------------------------------------------
[32]
TÍTULO / TITLE: - Organ-specific
autoimmune disease: a deficiency of tolerogenic stimulation.
REVISTA
/ JOURNAL: - J Exp Med. Acceso gratuito al texto
completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jem.org/
●●
Cita: J. Exp Med: <> 2001 Sep 3;194(5):F31-6.
AUTORES
/ AUTHORS: - Lesage S; Goodnow CC
INSTITUCIÓN
/ INSTITUTION: - Australian Cancer Research Foundation
Genetics Lab, Medical Genome Centre, John Curtin School of Medical Research,
Canberra, ACT 2601, Australia. N.
Ref:: 35
----------------------------------------------------
[33]
TÍTULO / TITLE: - Genetic interaction of
CTLA-4 with HLA-DR15 in multiple sclerosis patients.
REVISTA
/ JOURNAL: - Ann Neurol 2003 Jul;54(1):119-22.
●●
Enlace al texto completo (gratuito o de pago) 1002/ana.10617
AUTORES
/ AUTHORS: - Alizadeh M; Babron MC; Birebent B; Matsuda
F; Quelvennec E; Liblau R; Cournu-Rebeix I; Momigliano-Richiardi P; Sequeiros
J; Yaouanq J; Genin E; Vasilescu A; Bougerie H; Trojano M; Martins Silva B;
Maciel P; Clerget-Darpoux F; Clanet M; Edan G; Fontaine B; Semana G
INSTITUCIÓN
/ INSTITUTION: - Laboratoire Universitaire d’Immunologie
(UPRES EA 1257, IFR 97) and Etablissement Francais du Sang Bretagne, Faculte de
Medecine, Rennes, France.
RESUMEN
/ SUMMARY: - Multiple sclerosis is a chronic
inflammatory disease of the central nervous system with a genetic component.
Until now, the more consistent association with the disease is found with the
major histocompatibility complex, especially HLA-DRB1*1501-DQB1*0602 haplotype.
In this report, we demonstrate the interaction of Cytotoxic T
Lymphocyte-associated antigen 4 (CTLA-4 [CD152]) gene with DRB1*15 haplotype in
multiple sclerosis genetic susceptibility. Our data were obtained from two
European independent family-based studies including 610 multiple sclerosis
family trios. Ann Neurol 2003;54:119-122
N. Ref:: 20
----------------------------------------------------
[34]
TÍTULO / TITLE: - Novel therapeutic
molecular targets for prostate cancer: the mTOR signaling pathway and epidermal
growth factor receptor.
REVISTA
/ JOURNAL: - J Urol 2004 Feb;171(2 Pt 2):S41-3;
discussion S44.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.ju.0000108100.53239.b7
AUTORES
/ AUTHORS: - Tolcher AW
INSTITUCIÓN
/ INSTITUTION: - Director Clinical Research, Institute for
Drug Development Cancer Therapy and Research Center, San Antonio, Texas, USA.
RESUMEN
/ SUMMARY: - PURPOSE: The scientific rationale and
existing evidence for the use of novel molecular targets in the chemoprevention
of cancer are reviewed, with special attention to prostate cancer. MATERIALS
AND METHODS: A search for relevant literature on basic science and clinical
trials was conducted using PubMed/MEDLINE. RESULTS: The emergence of
molecularly targeted therapies for advanced malignancies creates an important
opportunity to examine these agents for the chemoprevention of prostate cancer.
Two critical targets in the proliferation and malignant transformation of
normal cells, the PI3/Akt signal transduction pathway and the epidermal growth
factor receptor, are currently the focus of several novel investigational
therapies that are in late stage phase II and phase III studies. CONCLUSIONS:
Research to date supports consideration of these novel molecular targets as
future agents in the chemoprevention of prostate cancer. N. Ref:: 28
----------------------------------------------------
[35]
TÍTULO / TITLE: - Strategies to improve
long-term outcomes after renal transplantation.
REVISTA
/ JOURNAL: - N Engl J Med. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://content.nejm.org/
●●
Cita: New England J Medicine (NEJM): <> 2002 Feb 21;346(8):580-90.
●●
Enlace al texto completo (gratuito o de pago) 1056/NEJMra011295
AUTORES
/ AUTHORS: - Pascual M; Theruvath T; Kawai T;
Tolkoff-Rubin N; Cosimi AB
INSTITUCIÓN
/ INSTITUTION: - Renal Unit, Department of Medicine,
Massachusetts General Hospital, Boston, MA 02114, USA. mpascual@partners.org N. Ref:: 99
----------------------------------------------------
[36]
TÍTULO / TITLE: - Tolerogenic dendritic
cells induced by vitamin D receptor ligands enhance regulatory T cells
inhibiting allograft rejection and autoimmune diseases.
REVISTA
/ JOURNAL: - J Cell Biochem 2003 Feb 1;88(2):227-33.
●●
Enlace al texto completo (gratuito o de pago) 1002/jcb.10340
AUTORES
/ AUTHORS: - Adorini L; Penna G; Giarratana N;
Uskokovic M
INSTITUCIÓN
/ INSTITUTION: - BioXell, SpA, 20132 Milano, Italy. luciano.adorini@bioxell.com
RESUMEN
/ SUMMARY: - Dendritic cells (DCs) not only induce but
also modulate T cell activation. 1,25-dihydroxyvitamin D(3) [1,25(OH)(2)D(3)]
induces DCs with a tolerogenic phenotype, characterized by decreased expression
of CD40, CD80, and CD86 costimulatory molecules, low IL-12 and enhanced IL-10
secretion. We have found that a short treatment with 1,25(OH)(2)D(3) induces
tolerance to fully mismatched mouse islet allografts that is stable to
challenge with donor-type spleen cells and allows acceptance of donor-type
vascularized heart grafts. This effect is enhanced by co-administration of
mycophenolate mofetil (MMF), a selective inhibitor of T and B cell
proliferation that has also effects similar to 1,25(OH)(2)D(3) on DCs. Graft
acceptance is associated with an increased percentage of CD4(+)CD25(+)
regulatory cells in the spleen and in the draining lymph node that can protect
100% of syngeneic recipients from islet allograft rejection. CD4(+)CD25(+)
cells, able to inhibit the T cell response to a pancreatic autoantigen and to
significantly delay disease transfer by pathogenic CD4(+)CD25(-) cells, are
also induced by treatment of adult nonobese diabetic (NOD) mice with
1,25-dihydroxy-16,23Z-diene-26,27-hexafluoro-19-nor vitamin D(3) (BXL-698).
This treatment arrests progression of insulitis and Th1 cell infiltration, and
inhibits diabetes development at non-hypercalcemic doses. The enhancement of
CD4(+)CD25(+) regulatory T cells, able to mediate transplantation tolerance and
to arrest type 1 diabetes development by a short oral treatment with VDR
ligands, suggests possible clinical applications of this approach. N. Ref:: 41
----------------------------------------------------
[37]
TÍTULO / TITLE: - T cell death and
transplantation tolerance.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):407-16.
AUTORES
/ AUTHORS: - Li XC; Strom TB; Turka LA; Wells AD
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. N. Ref:: 50
----------------------------------------------------
[38]
TÍTULO / TITLE: - Pathways for
self-tolerance and the treatment of autoimmune diseases.
REVISTA
/ JOURNAL: - Lancet 2001 Jun 30;357(9274):2115-21.
AUTORES
/ AUTHORS: - Goodnow CC
INSTITUCIÓN
/ INSTITUTION: - Australian Cancer Research Foundation,
Genetics Laboratory, Medical Genome Centre, John Curtin School of Medical
Research, Australian National University, Canberra, Australia.
RESUMEN
/ SUMMARY: - Antigen delivers both immunogenic and
tolerogenic signals to lymphocytes. The outcome of antigen exposure represents
a complex integration of the timing of antigen binding with signals from many
other immunogenic and tolerogenic costimulatory pathways. A road map of these
signalling pathways is only beginning to be charted, revealing the mechansim of
action and limitations of current immunotherapeutic agents and the points of
attack for new agents. Ciclosporin and tacrolimus interfere with tolerogenic
signals from antigen in addition to blocking immunogenic signals, thus
preventing active establishment of tolerance. Corticosteroids inhibit a key
immunogenic pathway, NFkappaB, and more specific inhibitors of this pathway may
allow tolerance to be actively established while immune responses are blocked.
New experimental therapies aim to mimic tolerogenic antigen signals by chronically
stimulating antigen receptors with antigen or antibodies to the receptor, or
aim to block costimulatory pathways involving CD40 ligand, B7, or interleukin
2. Obtaining the desired response with these strategies is unpredictable
because many of these signals have both tolerogenic and immunogenic roles. The
cause of autoimune diseases has been determined for several rare monogenic
disorders, revealing inherited deficiencies in tolerogenic costimulatory
pathways such as FAS. Common autoimmune disorders may have a biochemically
related pathogenesis. N.
Ref:: 52
----------------------------------------------------
[39]
TÍTULO / TITLE: - A randomized long-term
trial of tacrolimus/sirolimus versus tacrolimus/mycophenolate mofetil versus
cyclosporine (NEORAL)/sirolimus in renal transplantation. II. Survival,
function, and protocol compliance at 1 year.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):252-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000101495.22734.07
AUTORES
/ AUTHORS: - Ciancio G; Burke GW; Gaynor JJ; Mattiazzi
A; Roth D; Kupin W; Nicolas M; Ruiz P; Rosen A; Miller J
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of
Transplantation, University of Miami School of Medicine, Miami, FL 33101, USA. gciancio@med.miami.edu
RESUMEN
/ SUMMARY: - BACKGROUND: In an attempt to reduce
chronic calcineurin inhibitor induced allograft nephropathy in first cadaver
and human leukocyte antigen non-identical living-donor renal transplantation,
sirolimus (Siro) or mycophenolate mofetil (MMF) was tested as adjunctive
therapy, with planned dose reductions of tacrolimus (Tacro) over the first year
postoperatively. Adjunctive Siro therapy with a similar dose reduction
algorithm for Neoral (Neo) was included for comparison. METHODS: The detailed
dose reduction plan (Tacro and Siro, group A; Tacro and MMF, group B; Neo and
Siro, group C) is described in our companion report in this issue of
Transplantation. The present report documents function, patient and graft
survival, protocol compliance, and adverse events. RESULTS: As mentioned (in
companion report), group demographics were similar. The present study shows no
significant differences in 1-year patient and graft survival but does show a
trend that points to more difficulties in group C by way of a rising slope of
serum creatinine concentration (P=0.02) and decreasing creatinine clearance
(P=0.04). There were more patients who discontinued the protocol plan in group
C. Thus far, no posttransplant lymphomas have appeared, and infectious
complications have not differed among the groups. However, a greater percentage
of patients in group C were placed on antihyperlipidemia therapy, with an
(unexpected) trend toward a higher incidence of posttransplant diabetes
mellitus in this group. Group A required fewer, and group B the fewest,
antihyperlipidemia therapeutic interventions (P<0.00001). CONCLUSIONS: This
1-year interim analysis of a long-term, prospective, randomized
renal-transplant study indicates that decreasing maintenance dosage of Tacro
with adjunctive Siro or MMF appears to point to improved long-term function,
with reasonably few adverse events.
----------------------------------------------------
[40]
TÍTULO / TITLE: - ACC/AHA Guidelines for
the Evaluation and Management of Chronic Heart Failure in the Adult: Executive
Summary A Report of the American College of Cardiology/American Heart
Association Task Force on Practice Guidelines (Committee to Revise the 1995
Guidelines for the Evaluation and Management of Heart Failure): Developed in
Collaboration With the International Society for Heart and Lung
Transplantation; Endorsed by the Heart Failure Society of America.
REVISTA
/ JOURNAL: - Circulation. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://circ.ahajournals.org/
●●
Cita: Circulation: <> 2001 Dec 11;104(24):2996-3007.
AUTORES
/ AUTHORS: - Hunt SA; Baker DW; Chin MH; Cinquegrani
MP; Feldmanmd AM; Francis GS; Ganiats TG; Goldstein S; Gregoratos G; Jessup ML;
Noble RJ; Packer M; Silver MA; Stevenson LW; Gibbons RJ; Antman EM; Alpert JS;
Faxon DP; Fuster V; Gregoratos G; Jacobs AK; Hiratzka LF; Russell RO; Smith SC
Jr
----------------------------------------------------
[41]
TÍTULO / TITLE: - Early outcome after
sirolimus-eluting stent implantation in patients with acute coronary syndromes:
insights from the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology
Hospital (RESEARCH) registry.
REVISTA
/ JOURNAL: - J Am Coll Cardiol 2003 Jun
4;41(11):2093-9.
AUTORES
/ AUTHORS: - Lemos PA; Lee CH; Degertekin M; Saia F;
Tanabe K; Arampatzis CA; Hoye A; van Duuren M; Sianos G; Smits PC; de Feyter P;
van der Giessen WJ; van Domburg RT; Serruys PW
INSTITUCIÓN
/ INSTITUTION: - Department of Cardiology, Thoraxcenter,
Erasmus Medical Center, Dr Molewaterplein 40, NL-3015 GD Rotterdam, the
Netherlands.
RESUMEN
/ SUMMARY: - OBJECTIVES: This study evaluated the early
outcomes of patients with acute coronary syndromes (ACS) treated with
sirolimus-eluting stents (SES). BACKGROUND: The safety of SES implantation in
patients with a high risk for early thrombotic complications is currently
unknown. METHODS: Sirolimus-eluting stents have been utilized as the device of
choice for all percutaneous procedures in our institution, as part of the
Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH)
registry. After four months of enrollment, 198 patients with ACS had been
treated exclusively with SES (64% of those treated in the period) and were
compared with a control group composed of 301 consecutive patients treated with
bare stents in the same time period immediately before this study. The
incidence of major adverse cardiac events (MACE) during the first month was
evaluated (death, nonfatal myocardial infarction [MI], or re-intervention).
RESULTS: Compared with control patients, patients treated with SES had more
primary angioplasty (95% vs. 77%; p < 0.01), more bifurcation stenting (13%
vs. 5%; p < 0.01), less previous MI (28% vs. 45%; p < 0.01), and less
glycoprotein IIb/IIIa inhibitor utilization (27% vs. 42%; p < 0.01). The
30-day MACE rate was similar between both groups (SES 6.1% vs. control patients
6.6%; p = 0.8), with most complications occurring during the first week. Stent
thrombosis occurred in 0.5% of SES patients and in 1.7% of control patients (p
= 0.4). In multivariate analysis, SES utilization did not influence the
incidence of MACE (odds ratio 1.0 [95% confidence interval: 0.4 to 2.2]; p =
0.97). CONCLUSIONS: Sirolimus-eluting stent implantation for patients with ACS
is safe, with early outcomes comparable with bare metal stents. N. Ref:: 25
----------------------------------------------------
[42]
TÍTULO / TITLE: - Depletion of host
reactive T cells by photodynamic cell purging and prevention of graft versus
host disease.
REVISTA
/ JOURNAL: - Leuk Lymphoma 2003 Nov;44(11):1871-9.
AUTORES
/ AUTHORS: - Goggins TF; Chao N
INSTITUCIÓN
/ INSTITUTION: - Hematology-Oncology, Duke University
Medical Center, 2400 Pratt Street, Ste. 1100, Durham, NC 27710, USA. goggi002@mc.duke.edu
RESUMEN
/ SUMMARY: - Graft versus Host Disease (GVHD) is the
principal cause of morbidity and mortality in patients undergoing allogeneic
stem cell transplant. T cell depletion has been recognized as a method of
reducing the incidence of GVHD in allogeneic transplants. Until recently, most
T cell depletion methods were non-selective in reducing lymphocytes. Rhodamine
purging is one method, which selectively reduces alloreactive T cells
preventing GVHD. We review here the methods of non-selective and selective T
cell depletion, particularly the newer method of photodynamic purging utilizing
rhodamine. N. Ref:: 129
----------------------------------------------------
[43]
- Castellano -
TÍTULO / TITLE:Guia de consenso sobre tuberculosis
y tratamiento de la enfermedad inflamatoria intestinal con infliximab.
Consensus guideline on tuberculosis and treatment of inflammatory bowel disease
with infliximab. Spanish Working Group on Crohn Disease and Ulcerative Colitis.
REVISTA
/ JOURNAL: - Gastroenterol Hepatol. Acceso gratuito al
texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://db.doyma.es/
●●
Cita: Gastroenterología & Hepatología: <> 2003 Jan;26(1):29-33.
AUTORES
/ AUTHORS: - Obrador A; Lopez San Roman A; Munoz P;
Fortun J; Gassull MA
INSTITUCIÓN
/ INSTITUTION: - Servicio de Digestivo. Hospital Son
Dureta. Palma de Mallorca. España. N.
Ref:: 19
----------------------------------------------------
[44]
TÍTULO / TITLE: - Acute and chronic
graft-versus-host disease after allogeneic peripheral-blood stem-cell and bone
marrow transplantation: a meta-analysis.
REVISTA
/ JOURNAL: - J Clin Oncol 2001 Aug 15;19(16):3685-91.
AUTORES
/ AUTHORS: - Cutler C; Giri S; Jeyapalan S; Paniagua D;
Viswanathan A; Antin JH
INSTITUCIÓN
/ INSTITUTION: - Division of Hematologic Oncology,
Dana-Farber Cancer Institute, and Harvard School of Public Health, Boston, MA
02115, USA. corey_cutler@dfci.harvard.edu
RESUMEN
/ SUMMARY: - PURPOSE: Controversy exists as to whether
the incidence of graft-versus-host disease (GVHD) is increased after
peripheral-blood stem-cell transplantation (PBSCT) when compared with bone
marrow transplantation (BMT). We performed a meta-analysis of all trials
comparing the incidence of acute and chronic GVHD after PBSCT and BMT reported
as of June, 2000. Secondary analyses examined relapse rates after the two
procedures. METHODS: An extensive MEDLINE search of the literature was
undertaken. Primary authors were contacted for clarification and completion of
missing information. A review of cited references was also undertaken. Sixteen
studies (five randomized controlled trials and 11 cohort studies) were included
in this analysis. Data was extracted by two pairs of reviewers and analyzed for
the outcomes of interest. Meta-analyses, regression analyses, and assessments
of publication bias were performed. RESULTS: Using a random effects model, the
pooled relative risk (RR) for acute GVHD after PBSCT was 1.16 (95% confidence
interval [CI], 1.04 to 1.28; P=.006) when compared with traditional BMT. The
pooled RR for chronic GVHD after PBSCT was 1.53 (95% CI, 1.25 to 1.88; P
<.001) when compared with BMT. The RR of developing clinically extensive
chronic GVHD was 1.66 (95% CI, 1.35 to 2.05; P <.001). The excess risk of
chronic GVHD was explained by differences in the T-cell dose delivered with the
graft in a meta-regression model that did not reach statistical significance.
There was a trend towards a decrease in the rate of relapse after PBSCT (RR =
0.81; 95% CI, 0.62 to 1.05). CONCLUSION: Both acute and chronic GVHD are more
common after PBSCT than BMT, and this may be associated with lower rates of
malignant relapse. The magnitude of the transfused T-cell load may explain the
differences in chronic GVHD risk.
----------------------------------------------------
[45]
TÍTULO / TITLE: - Chemokines, chemokine
receptors, and allograft rejection.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):377-86.
AUTORES
/ AUTHORS: - Nelson PJ; Krensky AM
INSTITUCIÓN
/ INSTITUTION: - Medizinishe Poliklinik, Klinikum
Innenstadt, Ludwig-Maximilians-University, Schillerstrasse 42, 80336, Munich,
Germany. nelson@medpoli.med.uni-muenchen.de N. Ref:: 40
----------------------------------------------------
[46]
TÍTULO / TITLE: - The target of rapamycin
(TOR) proteins.
REVISTA
/ JOURNAL: - Proc Natl Acad Sci U S A. Acceso gratuito
al texto completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.pnas.org/
●●
Cita: Proc Natl Acad Sci USA (PNAS): <> 2001 Jun 19;98(13):7037-44.
●●
Enlace al texto completo (gratuito o de pago) 1073/pnas.121145898
AUTORES
/ AUTHORS: - Raught B; Gingras AC; Sonenberg N
INSTITUCIÓN
/ INSTITUTION: - Department of Biochemistry and McGill
Cancer Centre, McGill University, 3655 Promenade Sir-William-Osler, Montreal,
QC H3G 1Y6 Canada.
RESUMEN
/ SUMMARY: - Rapamycin potently inhibits downstream
signaling from the target of rapamycin (TOR) proteins. These evolutionarily
conserved protein kinases coordinate the balance between protein synthesis and
protein degradation in response to nutrient quality and quantity. The TOR
proteins regulate (i) the initiation and elongation phases of translation, (ii)
ribosome biosynthesis, (iii) amino acid import, (iv) the transcription of
numerous enzymes involved in multiple metabolic pathways, and (v) autophagy.
Intriguingly, recent studies have also suggested that TOR signaling plays a
critical role in brain development, learning, and memory formation. N. Ref:: 132
----------------------------------------------------
[47]
TÍTULO / TITLE: - Coeliac disease:
dissecting a complex inflammatory disorder.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2002 Sep;2(9):647-55.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri885
AUTORES
/ AUTHORS: - Sollid LM
INSTITUCIÓN
/ INSTITUTION: - Institute of Immunology, Rikshospitalet,
University of Oslo, 0027 Oslo, Norway. l.m.sollid@labmed.uio.no
RESUMEN
/ SUMMARY: - The disease mechanisms of complex
inflammatory disorders are difficult to define because of extensive
interactions between genetic and environmental factors. Coeliac disease is a
typical complex inflammatory disorder, but this disease is unusual in that
crucial genetic and environmental factors have been identified. This knowledge
has allowed functional studies of the predisposing HLA molecules, the
identification of antigenic epitopes and detailed studies of disease-relevant T
cells in coeliac disease. This dissection of the pathogenic mechanisms of
coeliac disease has uncovered principles that are relevant to other chronic
inflammatory diseases. N.
Ref:: 101
----------------------------------------------------
[48]
TÍTULO / TITLE: - Alpha E: no more
rejection?
REVISTA
/ JOURNAL: - J Exp Med. Acceso gratuito al texto
completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jem.org/
●●
Cita: J. Exp Med: <> 2002 Oct 7;196(7):873-5.
AUTORES
/ AUTHORS: - Kilshaw PJ; Higgins JM
INSTITUCIÓN
/ INSTITUTION: - The Babraham Institute, Cambridge, CB2
4AT, United Kingdom. peter.kilshaw@bbsrc.ac.uk N. Ref:: 25
----------------------------------------------------
[49]
TÍTULO / TITLE: - HLA DNA typing and
transplantation.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):347-56.
AUTORES
/ AUTHORS: - Erlich HA; Opelz G; Hansen J
INSTITUCIÓN
/ INSTITUTION: - Roche Molecular Systems, Alameda, CA
94501, USA. henry.erlich@roche.com N. Ref:: 26
----------------------------------------------------
[50]
TÍTULO / TITLE: - Innate immune responses
to transplants: a significant variable with cadaver donors.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):369-76.
AUTORES
/ AUTHORS: - Baldwin WM 3rd; Larsen CP;
Fairchild RL
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, Johns Hopkins
Medical Institutes, Baltimore, MD 21205, USA. wbaldwin@jhmi.edu N. Ref:: 70
----------------------------------------------------
[51]
TÍTULO / TITLE: - Mixed chimerism and
transplant tolerance.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):417-24.
AUTORES
/ AUTHORS: - Sykes M
INSTITUCIÓN
/ INSTITUTION: - Bone Marrow Transplantation Section,
Transplantation Biology Research Center, Massachusetts General Hospital/Harvard
Medical School, Boston, MA 02129, USA. N.
Ref:: 80
----------------------------------------------------
[52]
TÍTULO / TITLE: - Chronic rejection.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):387-97.
AUTORES
/ AUTHORS: - Libby P; Pober JS
INSTITUCIÓN
/ INSTITUTION: - Division of Cardiovascular Medicine,
Brigham and Women’s Hospital, Boston, MA 02115, USA. plibby@rics.bwh.harvard.edu N. Ref:: 60
----------------------------------------------------
[53]
TÍTULO / TITLE: - Rapamycin plays a new
role as differentiator of vascular smooth muscle phenotype. focus on “The
mTOR/p70 S6K1 pathway regulates vascular smooth muscle differentiation”.
REVISTA
/ JOURNAL: - Am J Physiol Cell Physiol. Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://ajpcell.physiology.org/contents-by-date.0.shtml
●●
Cita: Am J Physiol Cell Physiol: <> 2004 Mar;286(3):C480-1.
●●
Enlace al texto completo (gratuito o de pago) 1152/ajpcell.00526.2003
AUTORES
/ AUTHORS: - Lucchesi PA N. Ref:: 12
----------------------------------------------------
[54]
TÍTULO / TITLE: - Treatment and outcome
of invasive bladder cancer in patients after renal transplantation.
REVISTA
/ JOURNAL: - J Urol 2004 Mar;171(3):1085-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.ju.0000110612.42382.0a
AUTORES
/ AUTHORS: - Master VA; Meng MV; Grossfeld GD; Koppie
TM; Hirose R; Carroll PR
INSTITUCIÓN
/ INSTITUTION: - Departments of Urology and Surgery,
University of California, San Francisco, California 94143, USA. vmaster@urol.ucsf.edu
RESUMEN
/ SUMMARY: - PURPOSE: Optimal management and clinical
outcome of bladder cancer in renal transplant recipients are not well-defined.
We analyzed single institution treatment strategies and outcomes of these
patients. MATERIALS AND METHODS: We retrospectively reviewed the University of
California, San Francisco transplant database which contains information on
6,288 renal transplants performed between 1964 and 2002. The United Network for
Organ Sharing database and Israel Penn International Transplant Tumor Registry
were also queried to characterize the global nature of bladder cancer in renal
transplant recipients. RESULTS: The United Network for Organ Sharing database
(1986 to 2001) contained information on 31 patients who were found to have
bladder cancer (0.024% prevalence) and the Israel Penn International Transplant
Tumor Registry (1967 to 2001) contained information on 135 patients
representing 0.84% of all reported malignancies. We identified 7 renal
transplant recipients with bladder cancer at our institution. Invasive
transitional cell carcinoma developed in 5 patients at a median of 2.8 years
after transplant. Three patients underwent uncomplicated radical cystectomy and
preservation of the renal allograft. Overall survival at 48 months was 60%.
CONCLUSIONS: Bladder cancer after renal transplantation is not common. For
patients who present with invasive disease, traditional extirpative surgery should
be considered. Moreover, the allograft is rarely the source of transitional
cell carcinoma and can be preserved. In our experience the cancer and urinary
outcomes compare favorably with nontransplant patient outcomes after treatment. N. Ref:: 21
----------------------------------------------------
[55]
TÍTULO / TITLE: - CD3-specific
antibody-induced active tolerance: from bench to bedside.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2003 Feb;3(2):123-32.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri1000
AUTORES
/ AUTHORS: - Chatenoud L
INSTITUCIÓN
/ INSTITUTION: - Centre de l’Association Claude Bernard sur
les Maladies Autoimmunes and Hopital Necker Enfants Malades IRNEM, 161 Rue de
Sevres, 75015 Paris, France. chatenoud@necker.fr
RESUMEN
/ SUMMARY: - Although they were used initially as
non-specific immunosuppressants in transplantation, CD3-specific monoclonal
antibodies have elicited renewed interest owing to their capacity to induce
immune tolerance. In mouse models of autoimmune diabetes, CD3-specific
antibodies induce stable disease remission by restoring tolerance to pancreatic
beta-cells. This phenomenon was extended recently to the clinic—preservation of
beta-cell function in recently diagnosed patients with diabetes was achieved by
short-term administration of a CD3-specific antibody. CD3-specific antibodies
arrest ongoing disease by rapidly clearing pathogenic T cells from the target.
Subsequently, they promote long-term T-cell-mediated active tolerance. Recent
data indicate that transforming growth factor-beta-dependent CD4+CD25+
regulatory T cells might have a central role in this effect. N. Ref:: 117
----------------------------------------------------
[56]
TÍTULO / TITLE: - Effects of MHC class I
on HIV/SIV disease in primates.
REVISTA
/ JOURNAL: - AIDS 2002;16 Suppl 4:S105-14.
AUTORES
/ AUTHORS: - Carrington M; Bontrop RE
INSTITUCIÓN
/ INSTITUTION: - Basic Research Program, SAIC Frederick,
National Cancer Institute, Frederick, MD 21702, USA. carringt@ncifcrf.gov
RESUMEN
/ SUMMARY: - Data indicate that resistance to HIV-1
disease involves an array of contrasting HLA genotypic effects that are subtle,
but significant, particularly when these genetic effects are considered as a
whole. Numerous reports attributing a role for HLA genotype in AIDS outcomes
have been reported, and a few of these have been affirmed in multiple studies.
Functional studies of immune cell recognition have provided clues to the
underlying mechanisms behind some of the strongest HLA associations, suggesting
the means by which relative resistance or susceptibility to the virus may
occur. SIV infection in non-human primates has served as an invaluable model
for understanding AIDS pathogenesis (in rhesus monkeys) and viral resistance
(in chimpanzee). The effect of rhesus MHC class I molecules on the evolution of
SIV has been convincingly described [19], and a recent study in humans has
suggested that selection pressure conferred by HLA molecules is responsible for
specific genetic variation in HIV-1 [114]. HIV-1 may eventually have
conspicuous evolutionary effects on HLA and other AIDS restriction genes, a
prolonged process that could have occurred in chimpanzee [92].To prevent such
an outcome, it will be necessary to approach the disease from many
perspectives, andapply comprehensively the knowledge gained to the successful
control of the virus. N.
Ref:: 114
----------------------------------------------------
[57]
TÍTULO / TITLE: - IL-6: a magic potion
for liver transplantation?
REVISTA
/ JOURNAL: - Gastroenterology 2003 Jul;125(1):256-9.
AUTORES
/ AUTHORS: - Selzner M; Graf R; Clavien PA N. Ref:: 42
----------------------------------------------------
[58]
TÍTULO / TITLE: - Neuroimmunophilins:
novel neuroprotective and neuroregenerative targets.
REVISTA
/ JOURNAL: - Ann Neurol 2001 Jul;50(1):6-16.
AUTORES
/ AUTHORS: - Guo X; Dillman JF 3rd; Dawson
VL; Dawson TM
INSTITUCIÓN
/ INSTITUTION: - Department of Neurology, The Johns Hopkins
University School of Medicine, Baltimore, MD 21287, USA.
RESUMEN
/ SUMMARY: - Cyclosporin A (CsA) and FK506 (tacrolimus)
are immunosuppresants that are widely used in organ transplantation. CsA is an
11-member cyclic peptide, whereas FK506 is a macrolide antibiotic. Recently,
these powerful and useful compounds have become of great interest to
neuroscientists for their unique neuroprotective and neuroregenerative effects.
These drugs and nonimmunosuppressive analogs protect neurons from the effects
of glutamate excitotoxicity, focal ischemia, and
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopaminergic cell
death. They also stimulate functional recovery of neurons in a variety of
neurologic injury paradigms. These drugs exert their effects via immunophilins,
the protein receptors for these agents. The immunophilin ligands show
particular promise as a novel class of neuroprotective and neuroregenerative
agents that have the potential to treat a variety of neurologic disorders. N. Ref:: 102
----------------------------------------------------
[59]
TÍTULO / TITLE: - Patient and graft
survival following liver transplantation for hepatitis C: much ado about
something.
REVISTA
/ JOURNAL: - Gastroenterology 2002 Apr;122(4):1162-5.
AUTORES
/ AUTHORS: - Charlton M N. Ref:: 20
----------------------------------------------------
[60]
TÍTULO / TITLE: - The immunological
barrier to xenotransplantation.
REVISTA
/ JOURNAL: - Immunity 2001 Apr;14(4):437-46.
AUTORES
/ AUTHORS: - Cascalho M; Platt JL
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Mayo Clinic,
Rochester, MN 55905, USA. N.
Ref:: 55
----------------------------------------------------
[61]
TÍTULO / TITLE: - Fulminant hepatic
failure secondary to acetaminophen poisoning: a systematic review and
meta-analysis of prognostic criteria determining the need for liver
transplantation.
REVISTA
/ JOURNAL: - Crit Care Med 2003 Jan;31(1):299-305.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.CCM.0000034674.51554.4C
AUTORES
/ AUTHORS: - Bailey B; Amre DK; Gaudreault P
INSTITUCIÓN
/ INSTITUTION: - Division of Emergency Medicine, Department
of Pediatrics, Hopital Ste-Justine, Universite de Montreal, Quebec, Canada. baileyb@med.umontreal.ca
RESUMEN
/ SUMMARY: - OBJECTIVES: To summarize and compare
different prognostic criteria used to determine need for liver transplantation
in patients with fulminant hepatic failure secondary to acetaminophen
poisoning. DATA SOURCES: Studies published in the literature that investigated
criteria for hepatic transplantation secondary to acetaminophen-induced liver
failure as identified by a preestablished MEDLINE strategy (1966 through
October 2001). STUDY SELECTION: Studies were included if 2 x 2 tables could be
reconstructed and if they did not assume that patients undergoing transplantation
would have eventually died had they not received the transplant. DATA
EXTRACTION: Relevant articles were reviewed by two authors independently.
Discrepancies or disagreements, if any, on the inclusion or exclusion of
studies were resolved by consulting the third author. DATA SYNTHESIS: King’s
criteria (pH < 7.30 or prothrombin time of >100 secs plus creatinine of
>300 micromol/L plus encephalopathy grade of > or =3) were evaluated in
nine studies, pH < 7.30 in four, prothrombin time of >100 secs in three,
prothrombin time of >100 secs plus creatinine of >300 micromol/L plus
encephalopathy grade of > or =3 in three, creatinine of >300 micromol/L
in two, and one each for increase in prothrombin time day 4, factor V of
<10%, Acute Physiology and Chronic Health Evaluation (APACHE) II score of
>15, and Gc-globulin of <100 mg/L. King’s criteria were more sensitive
than pH: 69% (95% confidence interval, 63-75) vs. 57% (95% confidence interval,
44-68). Their specificities were, however, comparable: 92% (95% confidence
interval, 81-97) vs. 89% (95% confidence interval, 62-97). APACHE II score of
>15 had the highest positive likelihood ratio (16.4) and the lowest negative
likelihood ratio (0.19) but was evaluated in only one study. The accuracy
measures of all other criteria were lower than that of King’s criteria or pH
< 7.30. CONCLUSIONS: Presently, available criteria are not very sensitive
and may miss patients requiring transplantation. Future studies should further
evaluate the efficacy of the APACHE II criteria. N. Ref:: 33
----------------------------------------------------
[62]
TÍTULO / TITLE: - Gene therapy progress
and prospects: gene therapy in organ transplantation.
REVISTA
/ JOURNAL: - Gene Ther 2003 Apr;10(8):605-11.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.gt.3302020
AUTORES
/ AUTHORS: - Bagley J; Iacomini J
INSTITUCIÓN
/ INSTITUTION: - Transplantation Biology Research Center,
Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129,
USA.
RESUMEN
/ SUMMARY: - One major complication facing organ
transplant recipients is the requirement for life-long systemic
immunosuppression to prevent rejection, which is associated with an increased
incidence of malignancy and susceptibility to opportunistic infections. Gene
therapy has the potential to eliminate problems associated with
immunosuppression by allowing the production of immunomodulatory proteins in
the donor grafts resulting in local rather than systemic immunosuppression.
Alternatively, gene therapy approaches could eliminate the requirement for
general immunosuppression by allowing the induction of donor-specific
tolerance. Gene therapy interventions may also be able to prevent graft damage
owing to nonimmune-mediated graft loss or injury and prevent chronic rejection.
This review will focus on recent progress in preventing transplant rejection by
gene therapy. N.
Ref:: 47
----------------------------------------------------
[63]
TÍTULO / TITLE: - Suppression of
graft-versus-host disease by naturally occurring regulatory T cells.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S9-S11.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106475.38978.11
AUTORES
/ AUTHORS: - Zeng D; Lan F; Hoffmann P; Strober S
INSTITUCIÓN
/ INSTITUTION: - Division of Rheumatology and Immunology,
Department of Medicine, Stanford University School of Medicine, Stanford, CA
94305, USA.
RESUMEN
/ SUMMARY: - Studies of graft-versus-host disease after
allogeneic bone marrow transplantation have shown that there are subsets of
freshly isolated donor T cells that induce the disease and subsets that suppress
the disease. The balance of subsets in the graft determines disease severity.
The authors’ work on the nature of the regulatory-suppressor T cells and their
mechanisms of action is summarized in this article. N. Ref:: 24
----------------------------------------------------
[64]
TÍTULO / TITLE: - Leflunomide for the
treatment of rheumatoid arthritis: a systematic review and metaanalysis.
REVISTA
/ JOURNAL: - J Rheumatol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jrheum.com/archive.html
●●
Cita: J of Rheumatology: <> 2003 Jun;30(6):1182-90.
AUTORES
/ AUTHORS: - Osiri M; Shea B; Robinson V;
Suarez-Almazor M; Strand V; Tugwell P; Wells G
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Faculty of
Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
RESUMEN
/ SUMMARY: - OBJECTIVE: To systematically review the
evidence from clinical trials on the efficacy and toxicity of leflunomide for
the treatment of active rheumatoid arthritis (RA). METHODS: We searched
Medline, Embase, Current Contents, and the Cochrane Controlled Trial Register
for human randomized controlled trials (RCT) and controlled clinical trials up
to December 2001. We also hand-searched reference lists and conference
proceedings and consulted content experts. Relative benefit (RB), and weighted
mean differences or standardized mean differences with their 95% confidence
interval (95% CI) were calculated. RESULTS: Six RCT totaling 2044 patients with
RA were included in this review. Using specific criteria, all trials were
considered of high methodological quality. Leflunomide improved the ACR20
response rate roughly 2 times over placebo both at 6 months (RB = 1.93, 95% CI
1.51, 2.47) and at 12 months (RB = 1.99, 95% CI 1.42, 2.77). Other clinical
outcomes of disease activity and function and radiological scores were also
significantly better for leflunomide patients than those taking placebo. No
significant differences for most of the outcomes were observed between
leflunomide and sulfasalazine (SSZ) or methotrexate (MTX). Adverse events were
more common in the leflunomide group, but withdrawal rates were fewer than for
placebo. Overall, withdrawal rates and adverse events in the leflunomide group
were not different from SSZ or MTX. CONCLUSION: Leflunomide improves all
clinical outcomes and delays radiographic progression at 6 and 12 months of RA
treatment compared to placebo. Its efficacy and adverse events at 2 years of
treatment are comparable to SSZ and MTX. Longterm efficacy and toxicity remain
to be established.
----------------------------------------------------
[65]
TÍTULO / TITLE: - The HFE Cys282Tyr
mutation as a necessary but not sufficient cause of clinical hereditary
hemochromatosis.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2003 May 1;101(9):3347-50.
●●
Enlace al texto completo (gratuito o de pago) 1182/blood-2002-06-1747
AUTORES
/ AUTHORS: - Beutler E
INSTITUCIÓN
/ INSTITUTION: - Department of Molecular and Experimental
Medicine, Scripps Research Institute, La Jolla, CA 92037, USA. beutler@scripps.edu N. Ref:: 47
----------------------------------------------------
[66]
TÍTULO / TITLE: - Molecular aspects of
iron absorption and HFE expression.
REVISTA
/ JOURNAL: - Gastroenterology 2001 Dec;121(6):1489-96.
AUTORES
/ AUTHORS: - Parkkila S; Niemela O; Britton RS; Fleming
RE; Waheed A; Bacon BR; Sly WS
INSTITUCIÓN
/ INSTITUTION: - Department of Anatomy and Cell Biology,
University of Oulu, Oulu, Finland.
RESUMEN
/ SUMMARY: - Hereditary hemochromatosis, a disease of
iron overload, occurs in about 1 in 200-400 Caucasians. The gene mutated in
this disorder is termed HFE. The product of this gene, HFE protein, is
homologous to major histocompatibility complex class I proteins, but HFE does
not present peptides to T cells. Based on recent structural, biochemical, and
cell biological studies, transferrin receptor (TfR) is a ligand for HFE. This
association directly links HFE protein to the TfR-mediated regulation of iron
homeostasis. Although evidence is accumulating that binding of HFE to TfR is
critical for the effects of HFE, the final pieces in the HFE puzzle have not
been established. This review focuses on recent advances in HFE research and
presents a hypothetical model of HFE function.
N. Ref:: 69
----------------------------------------------------
[67]
TÍTULO / TITLE: - Interventions for
mucous membrane pemphigoid and epidermolysis bullosa acquisita.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(1):CD004056.
AUTORES
/ AUTHORS: - Kirtschig G; Murrell D; Wojnarowska F;
Khumalo N
INSTITUCIÓN
/ INSTITUTION: - Dermatology, Vrije Universiteit Medisch
Centrum, PO Box 7057, Amsterdam, Netherlands, 1007 MB. G.Kirtschig@vumc.nl
RESUMEN
/ SUMMARY: - BACKGROUND: Mucous membrane pemphigoid and
epidermolysis bullosa acquisita are acquired autoimmune blistering diseases of
the skin. Although they are rare, both can result in scarring of mucous
membranes, which may lead to blindness and life threatening respiratory
complications. OBJECTIVES: To assess the effects of treatments for mucous
membrane pemphigoid and epidermolysis bullosa acquisita. SEARCH STRATEGY:
Randomised Controlled Trials (RCTs) of patients with MMP or EBA were identified
from MEDLINE and EMBASE from their inception to March 2000. The Cochrane Skin
Group Specialised Register and the Cochrane Controlled Trials Register (CCTR)
were last examined in February 2002. The bibliographies from identified studies
were searched. The author who has conducted clinical trials in the field was
contacted to identify unpublished trials. SELECTION CRITERIA: RCTs involving
participants of any ages, and with a diagnosis confirmed by immunofluorescence.
Where no RCTs were located, studies with other designs were considered. DATA
COLLECTION AND ANALYSIS: Data were extracted from all included studies using a
defined electronic data extraction protocol. Two reviewers evaluated the
studies in terms of the inclusion criteria. The data from identified RCTs was
extracted independently by three reviewers and subsequently checked for
discrepancies. Any disagreements were resolved by discussion with each other
and the fourth reviewer. Meta-analysis was not appropriate due to a lack of
data. MAIN RESULTS: We found two small RCTs of MMP, both conducted in patients
with severe eye involvement. The same author conducted both trials. In the
first trial cyclophosphamide was superior to prednisone after six months of
treatment; all 12 patients responded well to cyclophosphamide versus a good
response in only five of 12 patients treated with prednisone (relative risk
2.40, 95% confidence interval 1.23 to 4.69). In the second trial all 20
patients treated with cyclophosphamide responded well to it after three months
of treatment, but only 14 of 20 patients responded to the treatment with
dapsone (relative risk 1.4, 95% confidence interval 1.07 to 1.90). We were not
able to identify a RCT of therapeutic interventions in EBA. Thirty reports of
uncontrolled studies of treatment for MMP involving five or more patients and
11 reports of treatment for EBA involving two or more patients were found, but
were difficult to interpret. REVIEWER’S CONCLUSIONS: There is limited evidence
(from two small trials) that severe ocular mucous membrane pemphigoid responds
best to treatment with cyclophosphamide combined with corticosteroids, and that
mild to moderate disease in most patients seems effectively suppressed by
treatment with dapsone. It is difficult to make any treatment recommendations
for EBA in the absence of reliable evidence sources. N. Ref:: 59
----------------------------------------------------
[68]
TÍTULO / TITLE: - Tolerance and cancer:
mechanisms of tumor evasion and strategies for breaking tolerance.
REVISTA
/ JOURNAL: - J Clin Oncol 2004 Mar 15;22(6):1136-51.
●●
Enlace al texto completo (gratuito o de pago) 1200/JCO.2004.10.041
AUTORES
/ AUTHORS: - Mapara MY; Sykes M
INSTITUCIÓN
/ INSTITUTION: - Department of Hematology and Oncology,
University Medical Center Charite, Campus Virchow Klinikum, Humboldt University
Berlin, Germany.
RESUMEN
/ SUMMARY: - The development of malignant disease might
be seen as a failure of immune surveillance. However, not all tumors are
naturally immunogenic, and even among those that are immunogenic, the
uncontrolled rapid growth of a tumor may sometimes out-run a robust immune
response. Nevertheless, recent evidence suggests that mechanisms of tolerance
that normally exist to prevent autoimmune disease may also preclude the
development of an adequate antitumor response and that tumors themselves have
the ability to thwart the development of effective immune responses against
their antigens. A major challenge has been to develop approaches to breaking
this tolerance in tumor-bearing hosts, and recent advances in our understanding
of antigen presentation and tolerance have led to some promising strategies. An
alternative approach is to use T cells from nontumor-bearing, allogeneic hosts
in the form of lymphocyte infusions, with or without hematopoietic cell
transplantation. Immunotherapy may occur in this setting via the response of
nontolerant, tumor antigen-specific T cells from nontumor-bearing hosts or via
the powerful destructive effect of an alloresponse directed against antigens
shared by malignant cells in the recipient. Approaches to exploiting this
beneficial effect without the deleterious consequence of graft-versus-host
disease in allogeneic hematopoietic cell recipients are discussed. N. Ref:: 100
----------------------------------------------------
[69]
TÍTULO / TITLE: - Routes to allograft
survival.
REVISTA
/ JOURNAL: - J Clin Invest. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jci.org/
●●
Cita: J Clinical Investigation: <> 2001 Apr;107(7):797-8.
AUTORES
/ AUTHORS: - Bromberg JS; Murphy B
INSTITUCIÓN
/ INSTITUTION: - Recanati/Miller Transplant Institute,
Mount Sinai School of Medicine, New York, New York 10029, USA. jon.bromberg@mountsinai.org N. Ref:: 21
----------------------------------------------------
[70]
TÍTULO / TITLE: - Cytolytic pathways in
haematopoietic stem-cell transplantation.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2002 Apr;2(4):273-81.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri775
AUTORES
/ AUTHORS: - van den Brink MR; Burakoff SJ
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Memorial
Sloan-Kettering Cancer Center, New York, New York 10021, USA. vandenbm@mskcc.org
RESUMEN
/ SUMMARY: - The remarkable activity of donor T cells
against malignant cells in the context of an allogeneic haematopoietic
stem-cell transplantation (HSCT) is arguably, at present, the most potent
clinical immunotherapy for cancer. However, alloreactive donor T cells are also
important effector cells in the development of graft-versus-host disease
(GVHD), which is a potentially lethal complication for recipients of an
allogeneic HSCT. Therefore, the separation of the GVHD and graft-versus-tumour
(GVT) activity of donor T cells has become a topic of great interest for many
investigators. Recent studies have shown that donor T cells make differential
use of their cytolytic pathways in mediating GVHD and GVT effects. Therefore,
the selective blockade or enhancement of cytolytic pathways provides an
intriguing therapeutic opportunity to separate the desired GVT effect from the
potentially devastating GVHD. N.
Ref:: 96
----------------------------------------------------
[71]
TÍTULO / TITLE: - Failure to yield: drug
resistance in inflammatory bowel disease.
REVISTA
/ JOURNAL: - Gastroenterology 2002 Apr;122(4):1165-7.
AUTORES
/ AUTHORS: - Tremaine WJ N. Ref:: 18
----------------------------------------------------
[72]
TÍTULO / TITLE: - Preliminary guidelines
for diagnosing and treating tuberculosis in patients with rheumatoid arthritis
in immunosuppressive trials or being treated with biological agents.
REVISTA
/ JOURNAL: - Ann Rheum Dis 2002 Nov;61 Suppl 2:ii62-3.
AUTORES
/ AUTHORS: - Furst DE; Cush J; Kaufmann S; Siegel J;
Kurth R
INSTITUCIÓN
/ INSTITUTION: - UCLA Medical School, Los Angeles, USA
Presbyterian Hospital, Dallas, USA.
----------------------------------------------------
[73]
TÍTULO / TITLE: - Cyclophosphamide for
multiple sclerosis.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2002;(4):CD002819.
AUTORES
/ AUTHORS: - La Mantia L; Milanese C; Mascoli N;
Incorvaia B; D’Amico R; Weinstock-Guttman B
INSTITUCIÓN
/ INSTITUTION: - MS Group, Istituto Nazionale Neurologico
C. Besta, Via Celoria, 11, MIlano, Italy, 20133. msgroup@istituto-besta.it
RESUMEN
/ SUMMARY: - BACKGROUND: Multiple sclerosis is a
presumed cell-mediated autoimmune disease of the central nervous system.
Cyclophosphamide (CFX) is a cytotoxic and immunosuppressive agent, used in
systemic autoimmune diseases. Controversial results have been reported on its
efficacy in MS. We conducted a systematic review of all relevant trials,
evaluating the CFX efficacy in patients with progressive MS. OBJECTIVES: The
main objectives were to determine whether CFX slows the disease progression.
SEARCH STRATEGY: Electronic databases (including MEDLINE, EMBASE, Cochrane
Controlled Trials Register) were systematically searched. References list of
retrieved studies and conference abstracts on the main meetings on Multiple
Sclerosis were handsearched. SELECTION CRITERIA: Randomised controlled trials
(RCTs) evaluating the clinical effect of CFX treatment in patients affected by
clinically definite progressive MS. CFX had to be administered alone or in
combination with ACTH or steroids. The comparison group had to be placebo or no
treatment or the same co intervention (ACTH or steroids) The main outcome
criteria were : progression of disability (defined as an increase of 0.5 point
in Kurtzke Extended Disability Status Scale (EDSS) for patients with baseline
EDSS > or = 6 and 1 for EDSS < or = 5.5), differences of disability
between treatment-control groups and the number of patients with side effects.
DATA COLLECTION AND ANALYSIS: The identified references were reviewed by two
reviewers who independently decided the eligibility of the study, extracted and
summarized data and assessed the trial’s quality. The statistical analysis was
performed using the Cochrane RevMan software and analyzed using Cochrane
MetaView. MAIN RESULTS: Of the 326 identified references, 80 were selected for
full review, only four RCTs were selected for the final analysis. Intensive
immunosuppression with CFX (alone or associated with ACTH or prednisone) in
patients with progressive MS compared to placebo or no-treatment (152
participants) did not prevent the long -term (12-18-24 months) risk to
evolution to a next step of EDSS. However, the mean change in disability (final
disability subtracted from the baseline) significantly favoured the treated
group at 12 (effect size - 0.21; C. I. - 0.24, - 0.17) and 18 months (- 0.19;
C. I. - 0.24, - 0.14). We were not able to verify the efficacy of other
schedules. Five patients died; sepsis and amenorrhea frequently occurred in
treated patients (descriptive analysis). REVIEWER’S CONCLUSIONS: Only limited
objectives were reached. This review shows a role of CFX in the treatment of
progressive MS, but less toxic schedules must be considered, before its use in
the clinical practice. N.
Ref:: 62
----------------------------------------------------
[74]
TÍTULO / TITLE: - Genetically modified
immunocompetent cells in HIV infection.
REVISTA
/ JOURNAL: - Gene Ther 2001 Nov;8(21):1593-600.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.gt.3301569
AUTORES
/ AUTHORS: - Palu G; Li Pira G; Gennari F; Fenoglio D;
Parolin C; Manca F
INSTITUCIÓN
/ INSTITUTION: - Department of Histology, Microbiology and
Medical Biotechnologies, University of Padua, Italy.
RESUMEN
/ SUMMARY: - Even in the era of highly active
antiretroviral therapy (HAART), gene therapy (GT) can remain a promising
approach for suppressing HIV infection, especially if complemented with other
forms of pharmacological and immunological intervention. A large number of
vectors and targets have been studied. Here we discuss the potential of
genetically treated, antigen-specific immunocompetent cells for adoptive
autologous immunotherapy of HIV infection. Cellular therapies with
gene-modified CD8 and CD4 lymphocytes are aimed at reconstituting the
antigen-specific repertoires that may be deranged as a consequence of HIV
infection. Even if complete eradication of HIV from the reservoirs cannot be
achieved, reconstitution of cellular immunity specific for opportunistic
pathogens and for HIV itself is a desirable option to control progression of
HIV infection and AIDS pathogenesis better.
N. Ref:: 103
----------------------------------------------------
[75]
TÍTULO / TITLE: - Gorillas with
spondyloarthropathies express an MHC class I molecule with only limited
sequence similarity to HLA-B27 that binds peptides with arginine at P2.
REVISTA
/ JOURNAL: - J Immunol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jimmunol.org/
●●
Cita: J. of Immunology: <> 2001 Mar 1;166(5):3334-44.
AUTORES
/ AUTHORS: - Urvater JA; Hickman H; Dzuris JL;
Prilliman K; Allen TM; Schwartz KJ; Lorentzen D; Shufflebotham C; Collins EJ;
Neiffer DL; Raphael B; Hildebrand W; Sette A; Watkins DI
INSTITUCIÓN
/ INSTITUTION: - Wisconsin Regional Primate Research
Center, University of Wisconsin, Madison, WI 53715, USA.
RESUMEN
/ SUMMARY: - The human MHC class I gene, HLA-B27, is a
strong risk factor for susceptibility to a group of disorders termed
spondyloarthropathies (SpAs). HLA-B27-transgenic rodents develop SpAs,
implicating HLA-B27 in the etiology of these disorders. Several nonhuman
primates, including gorillas, develop signs of SpAs indistinguishable from
clinical signs of humans with SpAs. To determine whether SpAs in gorillas have
a similar HLA-B27-related etiology, we analyzed the MHC class I molecules
expressed in four affected gorillas. Gogo-B01, isolated from three of the
animals, has only limited similarity to HLA-B27 at the end of the alpha1
domain. It differs by several residues in the B pocket, including differences
at positions 45 and 67. However, the molecular model of Gogo-B*0101 is consistent
with a requirement for positively charged residues at the second amino acid of
peptides bound by the MHC class I molecule. Indeed, the peptide binding motif
and sequence of individual ligands eluted from Gogo-B*0101 demonstrate that,
like HLA-B27, this gorilla MHC class I molecule binds peptides with arginine at
the second amino acid position of peptides bound by the MHC class I molecule.
Furthermore, live cell binding assays show that Gogo-B*0101 can bind HLA-B27
ligands. Therefore, although most gorillas that develop SpAs express an MHC
class I molecule with striking differences to HLA-B27, this molecule binds
peptides similar to those bound by HLA-B27.
N. Ref:: 61
----------------------------------------------------
[76]
TÍTULO / TITLE: - Clinical consequences
of iron overload in hemochromatosis homozygotes.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2003 May 1;101(9):3351-3; discussion 3354-8.
●●
Enlace al texto completo (gratuito o de pago) 1182/blood-2002-11-3453
AUTORES
/ AUTHORS: - Ajioka RS; Kushner JP
INSTITUCIÓN
/ INSTITUTION: - Division of Hematology, Department of
Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
84132, USA. N. Ref:: 58
----------------------------------------------------
[77]
TÍTULO / TITLE: - Insulin/IGF and target
of rapamycin signaling: a TOR de force in growth control.
REVISTA
/ JOURNAL: - Trends Cell Biol 2003 Feb;13(2):79-85.
AUTORES
/ AUTHORS: - Oldham S; Hafen E
INSTITUCIÓN
/ INSTITUTION: - The Burnham Institute, La Jolla, CA 92037,
USA.
RESUMEN
/ SUMMARY: - ‘They come in all sizes.’ Apart from its
origin and use in the clothing industry, this saying reflects the fact that the
size of organisms spans an enormous range. Whether destined to be large or
small, species grow in an organized fashion to reach their final specified
size. For growth to proceed, food must be metabolized to liberate energy in the
form of adenosine triphosphate (ATP) and protein building blocks in the form of
amino acids. One major orchestrator of this complex growth process in diverse
metazoan species is the insulin/insulin-like growth factor (IGF) system. This
review summarizes current studies primarily from Drosophila regarding the
function of the insulin/IGF system in the control of growth. N. Ref:: 75
----------------------------------------------------
[78]
TÍTULO / TITLE: - Review article: medical
treatment of moderate to severe Crohn’s disease.
REVISTA
/ JOURNAL: - Aliment Pharmacol Ther 2003 Jun;17 Suppl
2:23-30.
AUTORES
/ AUTHORS: - Scribano M; Prantera C
INSTITUCIÓN
/ INSTITUTION: - Division of Gastroenterology, Azienda
Ospedaliera S.Camillo-Forlanini, Rome, Italy.
RESUMEN
/ SUMMARY: - The treatment for patients with Crohn’s
disease of moderate to severe activity includes traditional drugs, such as
corticosteroids, the primary therapy for these forms of disease, able to induce
the remission of symptoms in a high percentage of patients. Because of the side-effects
produced by systemic steroids, a new glucocorticoid derivative, budesonide,
which acts locally in the mucosa, has recently been introduced with positive
results. On the assumption that intestinal bacteria play a role in the causing
Crohn’s disease symptoms, antibiotics are often used in the treatment of active
phases, as an alternative to or in association with steroids. The most widely
employed antibiotics are metronidazole and ciprofloxacin. Immunosuppressors,
such as azathioprine and 6-mercaptopurine, are useful for the treatment of
chronic active disease and for maintaining remission, but they have only a
marginal role in the therapy of an acute flare-up of Crohn’s disease.
Methotrexate acts more rapidly and its use in patients with active disease
resistant to standard therapy is of interest. The discovery of biological
agents represents a new era in the management of patients. To date, infliximab
is the more extensively studied biological therapy in the treatment of Crohn’s
disease and clinical studies have demonstrated its efficacy in inducing
remission of refractory disease. N.
Ref:: 59
----------------------------------------------------
[79]
TÍTULO / TITLE: - Sarcoidosis.
REVISTA
/ JOURNAL: - Lancet 2003 Mar 29;361(9363):1111-8.
AUTORES
/ AUTHORS: - Baughman RP; Lower EE; du Bois RM
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine,
University of Cincinnati, Cincinnati Medical Center, Cincinnati, OH 45267-0565,
USA. bob.baughman@uc.edu
RESUMEN
/ SUMMARY: - There have been several new insights into
the cause and treatment of sarcoidosis. Studies of genetic variation have shown
that specific genetic polymorphisms are associated with increased risk of
disease or affect disease presentation. These polymorphisms include variation
of MHC and cytokines such as tumour necrosis factor (TNF). Not all
investigators have come to the same conclusion, suggesting an interaction of
various factors, including the patient’s ethnic origin. Treatment of sarcoidosis
varies considerably. Patients with symptomatic disease for more than 2-5 years
have been of particular interest. Corticosteroids remain the standard of care
in such cases, but immunosuppressive drugs have proved steroid-sparing in many
patients. New agents, including pentoxifylline, thalidomide, and infliximab
have proved useful in selected cases. The effectiveness of these agents seems
to lie in their ability to block TNF, especially in the treatment of chronic
disease. N. Ref:: 117
----------------------------------------------------
[80]
TÍTULO / TITLE: - The influence of
environment and experience on neural grafts.
REVISTA
/ JOURNAL: - Nat Rev Neurosci 2001 Dec;2(12):871-9.
●●
Enlace al texto completo (gratuito o de pago) 1038/35104055
AUTORES
/ AUTHORS: - Dobrossy MD; Dunnett SB
INSTITUCIÓN
/ INSTITUTION: - School of Biosciences, Cardiff University,
Museum Avenue Box 911, Cardiff CF10 3US, Wales, UK. dobrossymd@cardiff.ac.uk N. Ref:: 106
----------------------------------------------------
[81]
TÍTULO / TITLE: - The tolerant recipient:
looking great in someone else’s genes.
REVISTA
/ JOURNAL: - J Clin Invest. Acceso gratuito al texto completo.
●●
Enlace a la Editora de la Revista http://www.jci.org/
●●
Cita: J Clinical Investigation: <> 2001 Jan;107(1):33-4.
AUTORES
/ AUTHORS: - Rosengard BR; Turka LA
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, University of
Pennsylvania, Philadelphia, Pennsylvania, USA.
N. Ref:: 18
----------------------------------------------------
[82]
TÍTULO / TITLE: - Diagnosis and therapy
of coronary artery disease in renal failure, end-stage renal disease, and renal
transplant populations.
REVISTA
/ JOURNAL: - Am J Med Sci 2003 Apr;325(4):214-27.
AUTORES
/ AUTHORS: - Logar CM; Herzog CA; Beddhu S
INSTITUCIÓN
/ INSTITUTION: - Renal Section, Salt Lake VA Healthcare
System, Department of Medicine, University of Utah School of Medicine, Salt
Lake City, USA.
RESUMEN
/ SUMMARY: - Even though cardiovascular disease is the
leading cause of death in patients with CRF and end-stage renal disease (ESRD),
ill-conceived notions have led to therapeutic nihilism as the predominant
strategy in the management of cardiovascular disease in these populations. The
recent data clearly support the application of proven interventions in the
general population, such as angiotensin-converting enzyme inhibitors and
statins to patients with CRF and ESRD. The advances in coronary stents and
intracoronary irradiation have decreased the restenosis rates in renal failure
patients. Coronary artery bypass with internal mammary graft might be the
procedure of choice for coronary revascularization in these patients. The role
of screening for asymptomatic coronary disease is established as a
pretransplant procedure, but it is unclear whether this will be applicable to
all patients with ESRD. Future studies need to focus on unraveling the mechanisms
by which uremia leads to increased cardiovascular events to design optimal
therapies targeted toward these mechanisms and improve cardiovascular
outcomes. N. Ref:: 125
----------------------------------------------------
[83]
TÍTULO / TITLE: - Glucocorticoids and
invasive fungal infections.
REVISTA
/ JOURNAL: - Lancet 2003 Nov 29;362(9398):1828-38.
AUTORES
/ AUTHORS: - Lionakis MS; Kontoyiannis DP
INSTITUCIÓN
/ INSTITUTION: - Department of Infectious Diseases,
Infection Control and Employee Health, University of Texas MD Anderson Cancer
Center, Houston, TX 77030, USA.
RESUMEN
/ SUMMARY: - Since the 1990s, opportunistic fungal
infections have emerged as a substantial cause of morbidity and mortality in
profoundly immunocompromised patients. Hypercortisolaemic patients, both those
with endogenous Cushing’s syndrome and, much more frequently, those receiving
exogenous glucocorticoid therapy, are especially at risk of such infections.
This vulnerability is attributed to the complex dysregulation of immunity
caused by glucocorticoids. We critically review the spectrum and presentation
of invasive fungal infections that arise in the setting of hypercortisolism,
and the ways in which glucocorticoids contribute to their pathogenesis. A
better knowledge of the interplay between glucocorticoid-induced
immunosuppression and invasive fungal infections should assist in earlier
recognition and treatment of such infections. Efforts to decrease the intensity
of glucocorticoid therapy should help to improve outcomes of opportunistic
fungal infections. N.
Ref:: 135
----------------------------------------------------
[84]
TÍTULO / TITLE: - Hemophagocytic syndrome
in renal transplant recipients: report of 17 cases and review of literature.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 27;77(2):238-43.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000107285.86939.37
AUTORES
/ AUTHORS: - Karras A; Thervet E; Legendre C
INSTITUCIÓN
/ INSTITUTION: - Service de Nephrologie et Transplantation
Renale, Hopital Saint-Louis, Paris, France.
RESUMEN
/ SUMMARY: - BACKGROUND: Hemophagocytic syndrome (HPS)
combines febrile hepatosplenomegaly, pancytopenia, hypofibrinemia, and liver
dysfunction. It is defined by bone marrow and organ infiltration by activated,
nonmalignant macrophages phagocytizing blood cells. HPS is often caused by an
infectious or neoplastic disease and has rarely been described in renal
transplant recipients. METHODS: We retrospectively analyzed 17 cases of HPS after
cadaveric renal transplantation (13 men and 4 women, age 41+/-8 years). The
median time between transplantation and hemophagocytosis was 52 days. Eleven
patients (64%) had received antilymphocyte globulins during the 3 months before
presentation. RESULTS: Fever was present in all patients, and
hepatosplenomegaly was present in 9 of 17 patients. Other nonspecific clinical
findings included abdominal, neurologic, and respiratory symptoms. Laboratory
tests showed anemia (hemoglobin 6.1+/-1.3 g/dL), thrombocytopenia
(34,000+/-32,000/mm3), and leukopenia (1,700+/-1,400/mm3). Elevated liver
enzymes were present in 12 of 17 patients, and cholestasis was present in 10 of
17 patients. Elevated triglycerides and ferritin were noted in 75% and 86% of
cases, respectively. HPS was related to viral infection in nine patients
(cytomegalovirus, Epstein-Barr virus, human herpesvirus 6, and human
herpesvirus 8), bacterial infection in three patients (tuberculosis and
Bartonella henselae), and other infections in two patients (toxoplasmosis and
Pneumocystis carinii pneumoniae). Posttransplant lymphoproliferative disease
was present in two patients. Despite large-spectrum anti-infectious treatment
and dramatic tapering of immunosuppression, death occurred in eight patients (47%).
Graft nephrectomy was performed in four of the nine surviving patients.
CONCLUSIONS: We report here the largest series of HPS after renal
transplantation. This rare disease is usually secondary to herpes viridae
infections, mostly cytomegalovirus and Epstein-Barr virus in severely
immunocompromised patients. Despite aggressive treatment, the prognosis remains
poor. N. Ref:: 22
----------------------------------------------------
[85]
TÍTULO / TITLE: - Methotrexate for
induction of remission in refractory Crohn’s disease.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(1):CD003459.
AUTORES
/ AUTHORS: - Alfadhli AA; McDonald JW; Feagan BG
INSTITUCIÓN
/ INSTITUTION: - Medicine, 5-OF 12 LHSC - UC, 339
Windermere Road, London, Ontario, Canada, N6A 5A5.
RESUMEN
/ SUMMARY: - BACKGROUND: Although corticosteroids are
effective for induction of remission of Crohn’s disease, approximately 20% of
patients who respond relapse when steroids are withdrawn and become steroid
dependent (Binder 1985). Furthermore, corticosteroids exhibit significant
adverse effects. The success of methotrexate as a treatment for rheumatoid
arthritis led to its evaluation in patients with refractory Crohn’s disease.
Methotrexate has been studied for induction of remission of refractory Crohn’s
disease and has become the principal alternative to azathioprine/6MP therapy.
The evidence for its effectiveness has not been subjected to a systematic
review. OBJECTIVES: To conduct a systematic review of the evidence for
effectiveness of methotrexate for induction of remission in patients with
active Crohn’s disease in the presence and absence of concomitant steroid
therapy. SEARCH STRATEGY: A computer-assisted search of MEDLINE and EMBASE for
relevant studies published in English, French, Spanish, Italian and German
between 1966 and June 2002. Manual searches of reference lists from potentially
relevant papers were performed to identify additional studies. The Cochrane
Controlled Trials Register and the IBD Review Group Specialized Trials Register
were also searched. SELECTION CRITERIA: Randomized controlled trials involving
patients of age > 17 years with refractory Crohn’s disease defined by
conventional clinical, radiological and endoscopic criteria, which was
categorized as being active (Crohn’s disease activity index >150). DATA
COLLECTION AND ANALYSIS: Outcome measures: The outcome measure was the rate of
induction of remission and complete withdrawal from steroids in the treatment
and control groups after 16 weeks of treatment. A secondary outcome was
induction of remission with reduction in steroid dose of at least 50%.
Selection of trials: The results of the searches above were reviewed
independently by two observers and relevant studies selected according to the
predefined selection criteria. Any disagreement among reviewers was resolved by
consensus. The same two reviewers assessed the methodological quality of each
trial (details of randomization method, including whether intention-to-treat
analysis was possible from the published data, number of patients lost to
follow-up, and if a blinded outcome assessment was used). A standard data
extraction form was used. Appropriateness of combining results: Trials were
first reviewed to assess the clinical comparability of trial protocols and
study populations. MAIN RESULTS: Three randomized placebo-controlled trials
were identified. The three studies differed with respect to participants,
intervention, and outcomes to the extent that it was considered to be
inappropriate to combine the data statistically. Two studies which employed low
doses of methotrexate orally showed no statistically significant difference
between methotrexate and placebo treated patients, and one which employed a
higher dose intramuscularly showed substantial benefit (number needed to treat,
NNT=5). Adverse effects were more common with high dose intramuscular
methotrexate therapy than with placebo. REVIEWER’S CONCLUSIONS: There is
evidence from a single large randomized trial on which to recommend the use of
methotrexate 25 mg intramuscularly weekly for induction of remission and
complete withdrawal from steroids in patients with refractory Crohn’s disease.
Although adverse effects are more common than with placebo, they were not
severe. There is no evidence on which to base a recommendation for use of lower
dose oral methotrexate. N.
Ref:: 21
----------------------------------------------------
[86]
TÍTULO / TITLE: - Drug-eluting stents in
vascular intervention.
REVISTA
/ JOURNAL: - Lancet 2003 Jan 18;361(9353):247-9.
AUTORES
/ AUTHORS: - Fattori R; Piva T
INSTITUCIÓN
/ INSTITUTION: - Department of Radiology, Cardiovascular
Unit, University Hospital S Orsola, 40138, Bologna, Italy. ross@med.unibo.it
RESUMEN
/ SUMMARY: - CONTEXT: Restenosis is the most important
long-term limitation of stent implantation for coronary artery disease,
occurring in 15-60% of patients. In-stent restenosis, a refractory coronary
lesion resulting from neointimal hyperplasia, challenges both vascular
biologist and interventional cardiologist. Various drugs and devices have been
used tried to overcome restenosis but are not particularly successful. Over
1500000 percutaneous coronary interventions are done annually. Restenosis is
not only important clinically but also for its impact on health-care costs.
STARTING POINT: Growth and migration of vascular smooth-muscle cells result in
neointimal proliferation after vascular injury and are the key mechanism of
in-stent restenosis. The rationale of the most recent approaches to restenosis
(eg, brachytherapy and immunosuppressive agents) arises from the similarity
between tumour-cell growth and the benign tissue proliferation which
characterises intimal hyperplasia. Several immunosuppressants have been tested for
their potential to inhibit restenosis, with the novel strategy of administering
the drug via a coated stent platform. Local drug delivery achieves higher
tissue concentrations of drug without systemic effects, at a precise site and
time. The first multicentre trial with stents coated with sirolimus was by
Marie-Claude Morice and colleagues (N Engl J Med 2002; 346: 1773-80). In a
trial of 238 patients, restenosis of 50% or more at 6 months was 0% and 27%
with sirolimus or normal stents (p<0.001), respectively, after percutaneous
revascularisation. Muzaffer Degertekin and colleagues (Circulation 2002; 106:
1610-13) present data on 2-year follow-up of 15 patients who had been implanted
with the sirolimus stent in another study, and confirm persistent inhibition of
restenosis and an absence of unexpected adverse events. WHERE NEXT? Local
application of antiproliferative agents is a promising technique and research
is developing. Other agents with potential benefits (eg, statins, local
gene-therapy, adenovirus-mediated arterial gene-transfer, L-arginine,
abciximab, angiopeptin, recombinant pegylated hirudin, and hiloprost) as well
as improvements in polymer technology (biodegradable smart polymers, coatings
for multiple-drug release) are under evaluation. The clinical impact of the
elimination of restenosis may influence the approach to coronary artery
disease, the future of cardiac surgery, and health-care economics in
cardiology. N. Ref:: 22
----------------------------------------------------
[87]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.6.1. Cancer risk after renal transplantation.
Post-transplant lymphoproliferative disease (PTLD): prevention and treatment.
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;17 Suppl 4:31-3, 35-6.
RESUMEN
/ SUMMARY: - GUIDELINES: A. In the first year after
organ transplantation, recipients are at the greatest risk of developing
lymphoproliferative diseases (PTLDs), which are induced most often by
Epstein-Barr virus (EBV) infection, and patients should therefore be screened
prior to or at the time of transplantation for EBV antibodies. B. In the rare
cases (<5%) where the recipient is EBV seronegative, he or she has a 95%
likelihood of receiving an organ from an EBV-seropositive donor, which
translates into a high risk of primary EBV infection with seroconversion soon
after transplantation. In such cases, the recipient should receive a
prophylactic antiviral treatment with acyclovir, valacyclovir or ganciclovir,
starting at the time of transplant and lasting for at least 3 months. The
specific recommendations given for CMV prophylaxis could be applicable in this
situation. C. The treatment of PTLD should be based on accurate pathology with
extensive cell markers and phenotyping. The treatment modalities are as
follows. Reduction of basal immunosuppression in all cases (either maintain
only steroids, or decrease by at least 50% the anti-calcineurin drugs and stop
other immunosuppressive drugs). In the case of EBV-positive B-cell lymphoma,
antiviral treatment with acyclovir, valacyclovir or ganciclovir may be initiated
for at least 1 month or according to the blood level of EBV replication when
available. In the case of rare lymphomas from the mucosal-associated lymphoid
tissue (MALT) with positive Helicobacter pylori, full eradication of H. pylori
should be carried out with a validated protocol. Subsequent H. pylori
prophylaxis should be implemented to avoid relapse. In the case of
CD20-positive lymphomas, treatment with rituximab, a chimeric monoclonal
antibody directed against CD20, should be carried out with one i.v. injection
per week for 4 weeks. In the case of diffuse lymphomas or improper response to
previous treatment, CHOP chemotherapy should be used alone or in combination
with rituximab. The CHOP regimen is cyclophosphamide, doxorubicine, vincristine
and prednisone. Complete cessation of immunosuppression with or without graft
nephrectomy should also be considered.
----------------------------------------------------
[88]
TÍTULO / TITLE: - Immunomodulatory agents
for idiopathic pulmonary fibrosis.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(3):CD003134.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003134
AUTORES
/ AUTHORS: - Davies HR; Richeldi L; Walters EH
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, The Queen Elizabeth
Hospital, Woodville Rd, Woodville, South Australia, Australia.
RESUMEN
/ SUMMARY: - BACKGROUND: Idiopathic Pulmonary Fibrosis
(IPF) or Usual Interstitial Pneumonia (UIP) is a form of chronic fibrosing
interstitial pneumonia of unknown aetiology, with progressively deteriorating
respiratory function and ultimately death from respiratory failure. Most
treatments are intended to suppress inflammation but none has been proven to
alter this process. The most widespread approach uses oral corticosteroids;
others use immunosuppressive, immunomodulatory or anti-fibrotic agents, alone
or with corticosteroids. A Cochrane review of corticosteroids in IPF has found
no evidence that they are of benefit. OBJECTIVES: To determine the effect of
non-corticosteroid immunosuppressive, anti-fibrotic and immunomodulatory agents
in the treatment of IPF(UIP). SEARCH STRATEGY: We searched the Cochrane Central
Register of Controlled Trials (CENTRAL - The Cochrane Library, Issue 2 2003),
MEDLINE (January 1966 to April 2003), EMBASE (January 1985 to April 2003) and
with additional handsearching. SELECTION CRITERIA: RCTs/CCTs utilising
non-corticosteroid immunosuppressive, anti-fibrotic or immunomodulatory agents
versus either placebo or corticosteroids alone in adult patients with
histological evidence of IPF(UIP) or with a diagnosis consistent with published
American Thoracic Society guidelines were included. DATA COLLECTION AND
ANALYSIS: We retrieved abstracts of identified articles and reviewed those
possibly fulfilling inclusion criteria and included or excluded. Two reviewers
assessed the studies for inclusion in the review. Where doubt existed a third
reviewer re-assessed the article and consensus was obtained. Methodological
quality was assessed using the Jadad scale and the Cochrane assessment of
allocation of concealment. MAIN RESULTS: 59 studies were identified. Quality
was generally poor. Only three RCT/CCTs were suitable for meta-analysis, two
lesser quality RCTs were included in discussion only, 52 studies were excluded
and two ongoing trials were identified.Each high quality trial used a different
agent (azathioprine, colchicine, interferon-gamma 1b) and meaningful
comparisons are not possible. Azathioprine and Interferon were studied as
additional therapy, whilst colchicine was compared with oral corticosteroids.
Only interferon was shown to produce any significant improvement in pulmonary
function and arterial oxygenation. There may be a small (but undefined) long
term survival advantage for azathioprine.One of the lower quality studies
showed a marginal benefit for cyclophosphamide and prednisone over prednisone
alone; the other showed no benefit for azathioprine and prednisone over
prednisone alone. There are no high quality studies utilising cyclophosphamide.
REVIEWER’S CONCLUSIONS: There is little good quality information regarding the
efficacy of non-corticosteroid agents in IPF(UIP). The older agents have
generally not been well evaluated. A number of new agents require further
evaluation. Currently there is little to justify the routine use of any
non-corticosteroid agent in the management of IPF(UIP). N. Ref:: 130
----------------------------------------------------
[89]
TÍTULO / TITLE: - Individuality: the
barrier to optimal immunosuppression.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2003 Oct;3(10):831-8.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri1204
AUTORES
/ AUTHORS: - Kahan BD
INSTITUCIÓN
/ INSTITUTION: - Division of Immunology and Organ
Transplantation, Department of Surgery, University of Texas Medical School at
Houston, Suite 6.240, 6431 Fannin, Houston, Texas 77030, USA. Barry.D.Kahan@uth.tmc.edu.
RESUMEN
/ SUMMARY: - Immunosuppressive therapy aims to protect
transplanted organs from host responses. Individuals have unique repertoires of
responses to foreign antigens and toxic reactions to immunosuppressants; the
former determining the type or intensity of rejection reactions and the latter
influencing the severity of iatrogenic effects. Because existing agents target
molecules that are widely distributed in tissues, new strategies must
selectively block lymphoid cells only, disrupt alloresponses but not innate
immune responses, interact synergistically with other agents, facilitate the
homeostatic process that naturally leads to graft acceptance and ideally only
interrupt donor-specific responses. Approaches presently under investigation
aim to alter cell trafficking, or selectively deviate the maturation of
antigen-presenting cells or inhibit lymphocyte-activation cascades - events
that are crucial to rejection responses.
N. Ref:: 92
----------------------------------------------------
[90]
TÍTULO / TITLE: - Cell survival and
clinical outcome following intrastriatal transplantation in Parkinson disease.
REVISTA
/ JOURNAL: - J Neuropathol Exp Neurol 2001
Aug;60(8):741-52.
AUTORES
/ AUTHORS: - Hagell P; Brundin P
INSTITUCIÓN
/ INSTITUTION: - Department of Clinical Neuroscience,
University Hospital, Lund University, Sweden.
RESUMEN
/ SUMMARY: - Intrastriatal transplantation of embryonic
dopaminergic neurons is currently explored as a restorative cell therapy for
Parkinson disease (PD). Clinical results have varied, probably due to
differences in transplantation methodology and patient selection. In this
review, we assess clinical trials and autopsy findings in grafted PD patients
and suggest that a minimum number of surviving dopaminergic neurons is required
for a favorable outcome. Restoration of [18F]-fluorodopa uptake in the putamen
to about 50% of the normal mean seems necessary for moderate to marked clinical
benefit to occur. Some studies indicate that this may require mesencephalic
tissue from 3-5 human embryos implanted into each hemisphere. The volume,
density and pattern of fiber outgrowth and reinnervation, as well as functional
integration and dopamine release. are postulated as additional important
factors for an optimal clinical outcome. For neural transplantation to become a
feasible therapeutic alternative in PD, graft survival must be increased and
the need for multiple donors of human embryonic tissue substantially decreased
or alternate sources of donor tissue developed. Donor cells derived from
alternative sources should demonstrate features comparable to those associated
with successful implantation of human embryonic tissue before clinical trials
are considered. N.
Ref:: 62
----------------------------------------------------
[91]
TÍTULO / TITLE: - Regulatory (suppressor)
T cells in peripheral allograft tolerance and graft-versus-host reaction.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S5.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000107184.18562.FC
AUTORES
/ AUTHORS: - Rifle G; Herve P
INSTITUCIÓN
/ INSTITUTION: - UPRES EA563, Faculte de Medecine,
Universite de Bourgogne and Department of Nephrology-Intensive
Care-Transplantation, Hopital du Bocage, Dijon, France. gerard.rifle@chu-dijon.fr.
RESUMEN
/ SUMMARY: - Among the mechanisms capable of inducing
peripheral tolerance, regulatory (suppressor) T cells (Treg) probably play a
key role in the control of both reactivity to self-antigens and alloimmune
response. Augmentation or manipulation of Treg could improve organ allograft
survival or control graft-versus-host disease, thus resulting in operational
tolerance. The role of this immunomanipulation as one method of inducing
tolerance has yet to be clearly defined.
N. Ref:: 14
----------------------------------------------------
[92]
TÍTULO / TITLE: - The complementary roles
of deletion and regulation in transplantation tolerance.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2003 Feb;3(2):147-58.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri1002
AUTORES
/ AUTHORS: - Lechler RI; Garden OA; Turka LA
INSTITUCIÓN
/ INSTITUTION: - Department of Immunology, Division of
Medicine, Imperial College of Science, Technology and Medicine, Hammersmith
Campus, Commonwealth Building, Du Cane Road, London W12 0NN, UK. r.lechler@ic.ac.uk
RESUMEN
/ SUMMARY: - Neonatal tolerance of alloantigens was
described in mice nearly half a century ago, but unfortunately, the translation
of these early findings into the clinical arena proved to be much more
challenging than was first anticipated. However, the past decade has seen
considerable progress in our understanding of the mechanisms that contribute to
transplantation tolerance in experimental models. This review outlines our
current understanding of the mechanisms of allograft tolerance, emphasizing the
complementary roles of deletion and regulation of alloreactive T cells. N. Ref:: 145
----------------------------------------------------
[93]
TÍTULO / TITLE: - “Rebooting” the immune
system with cyclophosphamide: taking risks for a “cure”?
REVISTA
/ JOURNAL: - Ann Neurol 2003 Jan;53(1):7-9.
●●
Enlace al texto completo (gratuito o de pago) 1002/ana.10449
AUTORES
/ AUTHORS: - Lewis RA; Lisak RP N. Ref:: 11
----------------------------------------------------
[94]
TÍTULO / TITLE: - Organ transplantation:
what is the state of the art?
REVISTA
/ JOURNAL: - Ann Surg 2003 Dec;238(6 Suppl):S72-89.
AUTORES
/ AUTHORS: - Collins BH
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of
Transplantation, Duke University Medical Center, Durham, NC 27710, USA. colli005@mc.duke.edu N. Ref:: 130
----------------------------------------------------
[95]
TÍTULO / TITLE: - Nystatin prophylaxis
and treatment in severely immunodepressed patients.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2002;(2):CD002033.
AUTORES
/ AUTHORS: - Gotzsche PC; Johansen HK
INSTITUCIÓN
/ INSTITUTION: - The Nordic Cochrane Centre,
Rigshospitalet, Dept. 7112, Blegdamsvej 9, Copenhagen O, Denmark, 2100. p.c.gotzsche@cochrane.dk
RESUMEN
/ SUMMARY: - BACKGROUND: Nystatin is sometimes used
prophylactically in patients with severe immunodeficiency or in the treatment
of fungal infection in such patients, although the effect seems to be
equivocal. OBJECTIVES: To study whether nystatin decreases morbidity and
mortality when given prophylactically or therapeutically to patients with
severe immunodeficiency. SEARCH STRATEGY: MEDLINE and The Cochrane Library
using a comprehensive search strategy, date of last search November 2001.
Contacted industry and scanned reference lists. SELECTION CRITERIA: Randomised
trials comparing nystatin with placebo, an untreated control group, fluconazole
or amphotericin B. DATA COLLECTION AND ANALYSIS: Data on mortality, invasive
fungal infection and colonisation were extracted by both authors independently.
The outcomes were weighted by the inverse variance. A random effects model was
used unless p>0.10 for the test of heterogeneity. MAIN RESULTS: We included
12 trials (1,464 patients). The drugs were given prophylactically in ten trials
and as treatment in two. Seven trials were in acute leukaemia, two in cancer,
one in liver transplant patients, one in critically ill surgical and trauma
patients, and one in AIDS patients. Nystatin had been compared with placebo in
three trials and with fluconazole in nine; the dose varied from 1.5 MIE to 72
MIE daily. The effect of nystatin was similar to that of placebo on fungal
colonisation (relative risk 0.85, 95% confidence interval 0.65 to 1.13). There
was no statistically significant difference between fluconazole and nystatin on
mortality (relative risk 0.76, 0.49 to 1.18) whereas fluconazole was more
effective in preventing invasive fungal infection (relative risk 0.37, 0.15 to
0.91) and colonisation (relative risk 0.49, 0.34 to 0.70). The results were
very similar if the three studies which were not performed in cancer patients
were excluded. REVIEWER’S CONCLUSIONS: Nystatin cannot be recommended for prophylaxis
or treatment of Candida infections in immunodepressed patients. N. Ref:: 21
----------------------------------------------------
[96]
TÍTULO / TITLE: - Nephrotic syndrome in
childhood.
REVISTA
/ JOURNAL: - Lancet 2003 Aug 23;362(9384):629-39.
AUTORES
/ AUTHORS: - Eddy AA; Symons JM
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, University of
Washington, Children’s Hospital and Regional Medical Center, Seattle, WA 98105,
USA. allison.eddy@seattlechildrens.org
RESUMEN
/ SUMMARY: - Childhood nephrotic syndromes are most
commonly caused by one of two idiopathic diseases: minimal-change nephrotic
syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS). A third distinct
type, membranous nephropathy, is rare in children. Other causes of isolated
nephrotic syndrome can be subdivided into two major categories: rare genetic
disorders, and secondary diseases associated with drugs, infections, or
neoplasia. The cause of idiopathic nephrotic syndrome remains unknown, but
evidence suggests it may be a primary T-cell disorder that leads to glomerular
podocyte dysfunction. Genetic studies in children with familial nephrotic
syndrome have identified mutations in genes that encode important podocyte
proteins. Patients with idiopathic nephrotic syndrome are initially treated
with corticosteroids. Steroid-responsiveness is of greater prognostic use than
renal histology. Several second-line drugs, including alkylating agents,
ciclosporin, and levamisole, may be effective for complicated and
steroid-unresponsive MCNS and FSGS patients. Nephrotic syndrome is associated
with several medical complications, the most severe and potentially fatal being
bacterial infections and thromboembolism. Idiopathic nephrotic syndrome is a
chronic relapsing disease for most steroid-responsive patients, whereas most
children with refractory FSGS ultimately develop end-stage renal disease.
Research is being done to further elucidate the disorder’s molecular
pathogenesis, identify new prognostic indicators, and to develop better
approaches to treatment. N.
Ref:: 140
----------------------------------------------------
[97]
TÍTULO / TITLE: - Effect of dexamethasone
on beta2-adrenergic desensitization in airway smooth muscle: role of the ARG19
polymorphism.
REVISTA
/ JOURNAL: - Chest. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.chestjournal.org/
●●
Cita: Chest: <> 2003 Mar;123(3 Suppl):368S-9S.
AUTORES
/ AUTHORS: - Moore PE; Calder MM; Silverman ES;
Panettieri RA Jr; Shore SA
INSTITUCIÓN
/ INSTITUTION: - Departments of Pediatrics and Pharmacology
(Dr. Moore and Mr. Calder), Vanderbilt University School of Medicine,
Nashville, TN 37232-2586, USA. N.
Ref:: 1
----------------------------------------------------
[98]
TÍTULO / TITLE: - Dialysis, kidney
transplantation, or pancreas transplantation for patients with diabetes
mellitus and renal failure: a decision analysis of treatment options.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Feb;14(2):500-15.
AUTORES
/ AUTHORS: - Knoll GA; Nichol G
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Department of
Medicine, University of Ottawa, Canada. gknoll@ottawahospital.on.ca
RESUMEN
/ SUMMARY: - Patients with type 1 diabetes mellitus and
end-stage renal disease may remain on dialysis or undergo cadaveric kidney
transplantation, living kidney transplantation, sequential pancreas after
living kidney transplantation, or simultaneous pancreas-kidney transplantation.
It is unclear which of these options is most effective. The objective of this
study was to determine the optimal treatment strategy for type 1 diabetic
patients with renal failure using a decision analytic Markov model. Input data
were obtained from the published medical literature, the United Network for
Organ Sharing registry, and patient interviews. The outcome measures were life
expectancy (in life-years [LY]) and quality-adjusted life expectancy (in
quality-adjusted life-years [QALY]). Living kidney transplantation was
associated with 18.30 LY and 10.29 QALY; pancreas after kidney transplantation,
17.21 LY and 10.00 QALY; simultaneous pancreas-kidney transplantation, 15.74 LY
and 9.09 QALY; cadaveric kidney transplantation, 11.44 LY and 6.53 QALY;
dialysis, 7.82 LY and 4.52 QALY. The results were sensitive to the value of
several key variables. Simultaneous pancreas-kidney transplantation had the
greatest life expectancy and quality-adjusted life expectancy when living
kidney transplantation was excluded from the analysis. These data indicate that
living kidney transplantation is associated with the greatest life expectancy
and quality-adjusted life expectancy for type 1 diabetic patients with renal
failure. Treatment strategies involving pancreas transplantation should be
considered for patients with frequent metabolic complications of diabetes and
for those patients who favor kidney-pancreas transplantation over kidney
transplantation alone. For patients without a living donor, simultaneous
pancreas-kidney transplantation is associated with the greatest life expectancy.
----------------------------------------------------
[99]
TÍTULO / TITLE: - Challenges to achieving
clinical transplantation tolerance.
REVISTA
/ JOURNAL: - J Clin Invest. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jci.org/
●●
Cita: J Clinical Investigation: <> 2001 Oct;108(7):943-8.
AUTORES
/ AUTHORS: - Salama AD; Remuzzi G; Harmon WE; Sayegh MH
INSTITUCIÓN
/ INSTITUTION: - Laboratory of Immunogenetics and
Transplantation, Renal Division, Brigham and Women’s Hospital, Boston,
Massachusetts 02115, USA. N.
Ref:: 50
----------------------------------------------------
[100]
TÍTULO / TITLE: - Overcoming restenosis
with sirolimus: from alphabet soup to clinical reality.
REVISTA
/ JOURNAL: - Lancet 2002 Feb 16;359(9306):619-22.
AUTORES
/ AUTHORS: - Poon M; Badimon JJ; Fuster V
INSTITUCIÓN
/ INSTITUTION: - Mount Sinai School of Medicine, 1 Gustav L
Levy Place, Box 1030, New York, NY 10029, USA.
N. Ref:: 34
----------------------------------------------------
[101]
TÍTULO / TITLE: - Antiadhesion molecule
therapy in inflammatory bowel disease.
REVISTA
/ JOURNAL: - Inflamm Bowel Dis 2002 Jul;8(4):291-300.
AUTORES
/ AUTHORS: - van Assche G; Rutgeerts P
INSTITUCIÓN
/ INSTITUTION: - Division of Gastroenterology, University
Hospital Leuven, Belgium. gert.vanassche@uz.kuleuven.ac.be
RESUMEN
/ SUMMARY: - Adhesion molecules regulate the influx of
leukocytes in normal and inflamed gut. Some of these molecules such as MadCAM-1
are specific for the gastrointestinal endothelium, but in inflammatory bowel
diseases most of the adhesion factors are up-regulated. Adhesion molecules also
are involved in local lymphocyte stimulation and antigen presentation within
the intestinal mucosa. Recently, therapeutic compounds directed against
trafficking of lymphocytes toward the gut mucosa have been designed, and are
being developed as a novel class of drugs in the treatment of Crohn’s disease
(CD) and ulcerative colitis. This review deals with the immunological aspects
of leukocyte trafficking focused on gut homing of T cells. Secondly, the
changes in adhesion molecules and T-cell trafficking during intestinal
inflammation are discussed. Finally, we review the clinical data that have been
gathered in trials of biological therapies directed against adhesion molecules.
Both antiintercellular adhesion molecule-1 (ICAM-1) and anti-alpha4 integrin
strategies are being developed. Trials with the anti-ICAM-1 antisense
oligonucleotide, ISIS-2302, in steroid-refractory CD have provided conflicting
efficacy data. The anti-alpha4 integrin antibodies natalizumab (Antegren) and
LDP-02 are in phase III and phase II trials, respectively. In the near future,
these novel biological agents may prove valuable therapeutic tools in the
management of refractory IBD. N.
Ref:: 56
----------------------------------------------------
[102]
TÍTULO / TITLE: - New agents in acute
myeloid leukemia and other myeloid disorders.
REVISTA
/ JOURNAL: - Cancer 2004 Feb 1;100(3):441-54.
●●
Enlace al texto completo (gratuito o de pago) 1002/cncr.11935
AUTORES
/ AUTHORS: - Ravandi F; Kantarjian H; Giles F; Cortes J
INSTITUCIÓN
/ INSTITUTION: - Department of Leukemia, The University of
Texas M D Anderson Cancer Center, Houston, Texas 77030, USA. fravandi@mdanderson.org
RESUMEN
/ SUMMARY: - Over the past several decades, improvements
in chemotherapeutic agents and supportive care have resulted in significant
progress in treating patients with acute myeloid leukemia (AML). More recently,
advances in understanding the biology of AML have resulted in the
identification of new therapeutic targets. The success of all-trans-retinoic
acid in acute promyelocytic leukemia and of imatinib mesylate in chronic
myeloid leukemia have demonstrated that targeted therapy may be more effective
and less toxic when well defined targets are available. At the same time,
understanding mechanisms of drug resistance and means to overcome them has led
to modification of some of the existing cytotoxic agents. Rational design and
conduct of clinical trials is necessary to ensure that the full potential of these
new agents is realized. N.
Ref:: 140
----------------------------------------------------
[103]
TÍTULO / TITLE: - Effects of glatiramer
acetate on relapse rate and accumulated disability in multiple sclerosis:
meta-analysis of three double-blind, randomized, placebo-controlled clinical
trials.
REVISTA
/ JOURNAL: - Mult Scler 2003 Aug;9(4):349-55.
AUTORES
/ AUTHORS: - Boneschi FM; Rovaris M; Johnson KP; Miller
A; Wolinsky JS; Ladkani D; Shifroni G; Comi G; Filippi M
INSTITUCIÓN
/ INSTITUTION: - Department of Neuroscience, Scientific
Institute, University H San Raffaele, Milan, Italy.
RESUMEN
/ SUMMARY: - Three randomized, double-blind,
placebo-controlled trials have shown that glatiramer acetate (GA) is effective
in reducing relapse rate in patients with relapsing-remitting (RR) multiple
sclerosis (MS). Using raw data pooled from 540 patients, we performed a
meta-analysis of these three trials, to investigate whether the extent of GA
efficacy varies according to disease-related variables at study entry. Three
regression models were developed to assess the efficacy of GA on the annualized
relapse rate (primary outcome measure), on the total number of on-trial
relapses and on the time to first relapse. We also explored the efficacy of GA
on accumulated disability and the potential role of baseline clinical variables
as predictors of relapse-rate variables and treatment efficacy. The mean
adjusted annualized relapse rate on study was 1.14 in the pooled
placebo-treated subjects and 0.82 in the pooled GA group (P = 0.004),
indicating an average reduction in annualized relapse rate of 28%. About a one
third reduction of the total number of on-trial relapses was also observed in
patients receiving GA (P < 0.0001), who had a median time to the first relapse
of 322 days versus a median time to the first relapse of 219 days seen in those
receiving placebo (P = 0.01). A beneficial effect on accumulated disability was
also found (risk ratio of 0.6; 95%; CI = 0.4-0.9; P = 0.02). The drug
assignment (P = 0.004), baseline EDSS score (P = 0.02) and number of relapses
during the two years prior to study entry (P = 0.002) were significant
predictors of on-trial annualized relapse rate. No other demographic or
clinical variable at baseline significantly influenced the treatment effect.
This meta-analysis reaffirms the effectiveness of GA in reducing relapse rate
and disability accumulation in RRMS, at a magnitude comparable to that of other
available immunomodulating treatments. It also suggests that GA efficacy is not
significantly influenced by the patients’ clinical characteristics at the time
of treatment initiation.
----------------------------------------------------
[104]
TÍTULO / TITLE: - HLA complex genes in
type 1 diabetes and other autoimmune diseases. Which genes are involved?
REVISTA
/ JOURNAL: - Trends Genet 2001 Feb;17(2):93-100.
AUTORES
/ AUTHORS: - Undlien DE; Lie BA; Thorsby E
INSTITUCIÓN
/ INSTITUTION: - Institute of Immunology, The National
Hospital and University of Oslo, N-0027, Oslo, Norway. d.e.undlien@rh.uio.no
RESUMEN
/ SUMMARY: - The predisposition to develop a majority
of autoimmune diseases is associated with specific genes within the human
leukocyte antigen (HLA) complex. However, it is frequently difficult to
determine which of the many genes of the HLA complex are directly involved in
the disease process. The main reasons for these difficulties are the complexity
of associations where several HLA complex genes might be involved, and the strong
linkage disequilibrium that exists between the genes in this complex. The
latter phenomenon leads to secondary disease associations, or what has been
called ‘hitchhiking polymorphisms’. Here, we give an overview of the complexity
of HLA associations in autoimmune disease, focusing on type 1 diabetes and
trying to answer the question: how many and which HLA genes are directly
involved? N. Ref:: 40
----------------------------------------------------
[105]
TÍTULO / TITLE: - Thalidomide treatment
for refractory Crohn’s disease: a review of the history, pharmacological
mechanisms and clinical literature.
REVISTA
/ JOURNAL: - Ann Med 2001 Nov;33(8):516-25.
AUTORES
/ AUTHORS: - Ginsburg PM; Dassopoulos T; Ehrenpreis ED
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology, University
of Chicago Hospitals, IL 60637, USA.
RESUMEN
/ SUMMARY: - Several recent case reports and clinical
trials have demonstrated that thalidomide is emerging as an efficacious
alternative in the treatment of selected patients with refractory Crohn’s
disease. The effects of thalidomide are at least partly mediated by
down-regulation of tumour necrosis factor (TNF)-alpha, a potent proinflammatory
cytokine. However, thalidomide is also known to inhibit angiogenesis, and it
has several other well-described immunomodulatory properties. Clinical studies
have confirmed that previously refractory Crohn’s disease patients respond to
thalidomide, and many enter clinical remission. Efficacy usually occurs within
4 weeks. Thalidomide also has steroid-sparing properties, and it is
particularly useful in treating oral and fistulous complications of Crohn’s
disease. Although it is usually tolerable, careful monitoring is recommended to
prevent toxicities, such as birth defects and peripheral neuropathy. This
review provides a detailed summary of the literature to date on the use of
thalidomide treatment for Crohn’s disease. Special attention is directed
towards its history, mechanisms, and proposed role. The recent development of
thalidomide analogues is also discussed briefly. N. Ref:: 116
----------------------------------------------------
[106]
TÍTULO / TITLE: - High-dose immune
suppression and autologous hematopoietic stem cell transplantation in
refractory Crohn disease.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2003 Mar 1;101(5):2064-6. Epub 2002 Oct 10.
●●
Enlace al texto completo (gratuito o de pago) 1182/blood-2002-07-2122
AUTORES
/ AUTHORS: - Burt RK; Traynor A; Oyama Y; Craig R
INSTITUCIÓN
/ INSTITUTION: - Division of Immunotherapy, Northwestern
University Medical School, Chicago, IL 60611, USA. rburt@nwu.edu
RESUMEN
/ SUMMARY: - Two patients with severe Crohn disease,
defined by a Crohn Disease Activity Index (CDAI) higher than 250 despite
anti-tumor necrosis factor alpha (TNF-alpha), were treated by intense immune
suppression and autologous hematopoietic stem cell transplantation (HSCT). Stem
cells were mobilized from the peripheral blood using cyclophosphamide (2.0
g/m2) and granulocyte colony-stimulating factor (G-CSF; 5 micro g/kg/d),
enriched ex vivo by CD34+ selection, and reinfused after immune conditioning
with cyclophosphamide (200 mg/kg) and equine anti-thymocyte globulin (ATG; 90
mg/kg). Patients have remained in remission (CDAI < 100) for 1 year since
HSCT. We conclude that further HSCT studies for severe Crohn disease appear
warranted. N. Ref:: 13
----------------------------------------------------
[107]
TÍTULO / TITLE: - Immunosuppressive and
cytotoxic therapy for pulmonary sarcoidosis.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(3):CD003536.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003536
AUTORES
/ AUTHORS: - Paramothayan S; Lasserson T; Walters EH
INSTITUCIÓN
/ INSTITUTION: - Respiratory Medicine, Kingston Hospital
NHS Trust, Galsworthy Rd, Kingston Upon Thames, Surrey, UK, KT2 7QB.
RESUMEN
/ SUMMARY: - BACKGROUND: Immunosuppressive and
cytotoxic agents have been used as both an alternative to oral corticosteroids,
and as a means of maintaining a low dose of steroids in the treatment of
pulmonary sarcoidosis. OBJECTIVES: To determine the efficacy of
immunosuppressive and cytotoxic agents in the treatment of pulmonary
sarcoidosis. SEARCH STRATEGY: The Cochrane Airways Group trials register was
searched for possible randomised trials. Bibliographies were searched for other
potentially relevant trials. Searches were current as of February 2001.
SELECTION CRITERIA: Randomised controlled trials comparing an immunosuppressive
or cytotoxic therapy with a control in patients with pulmonary sarcoidosis were
included in the review. DATA COLLECTION AND ANALYSIS: Two reviewers
independently extracted data for entry in to the Review Manager statistical
package (MetaView 4.1). Pharmaceutical companies and study investigators were
contacted for unpublished trials. MAIN RESULTS: Four studies were included in
the review. Trials comparing methotrexate, chloroquine and cyclosporin A were
identified. No data could be combined for a meta-analysis. Data on lung
function, chest x-ray scores and dyspnoea were largely inconclusive. Adverse
effects were associated with methotrexate, cyclosporin A and chloroquine. In
one small study, methotrexate was associated with a steroid sparing effect
after 12 months of therapy, but no difference was observed at 6 months.
REVIEWER’S CONCLUSIONS: The current body of evidence supporting the use of
immunosuppressive agents and cytotoxic therapies is limited. Side-effects
associated with some of the therapies were severe. N. Ref:: 46
----------------------------------------------------
[108]
TÍTULO / TITLE: - Fatal Scopulariopsis
brevicaulis infection in a paediatric stem-cell transplant patient treated with
voriconazole and caspofungin and a review of Scopulariopsis infections in
immunocompromised patients.
REVISTA
/ JOURNAL: - J Infect 2004 Jan;48(1):112-6.
AUTORES
/ AUTHORS: - Steinbach WJ; Schell WA; Miller JL;
Perfect JR; Martin PL
INSTITUCIÓN
/ INSTITUTION: - Division of Pediatric Infectious Diseases,
Department of Pediatrics, Duke University Medical Center, Box 3499, Durham, NC,
USA. stein022@mc.duke.edu N. Ref:: 33
----------------------------------------------------
[109]
TÍTULO / TITLE: - Treatment of chronic
granulomatous disease with myeloablative conditioning and an unmodified
hemopoietic allograft: a survey of the European experience, 1985-2000.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2002 Dec 15;100(13):4344-50. Epub 2002 Aug 8.
●●
Enlace al texto completo (gratuito o de pago) 1182/blood-2002-02-0583
AUTORES
/ AUTHORS: - Seger RA; Gungor T; Belohradsky BH;
Blanche S; Bordigoni P; Di Bartolomeo P; Flood T; Landais P; Muller S; Ozsahin
H; Passwell JH; Porta F; Slavin S; Wulffraat N; Zintl F; Nagler A; Cant A;
Fischer A
INSTITUCIÓN
/ INSTITUTION: - European Group for Blood and Marrow
Transplantation (EBMT) and the European Society for Immunodeficiencies (ESID),
Division of Immunology/Hematology, University Children’s Hospital, Zurich,
Switzerland. reinhard.seger@kispi.unizh.ch
RESUMEN
/ SUMMARY: - Treatment of chronic granulomatous disease
(CGD) with myeloablative bone marrow transplantation is considered risky. This
study investigated complications and survival according to different risk
factors present at transplantation. The outcomes of 27 transplantations for
CGD, from 1985 to 2000, reported to the European Bone Marrow Transplant
Registry for primary immunodeficiencies were assessed. Most transplant
recipients were children (n = 25), received a myeloablative busulphan-based
regimen (n = 23), and had unmodified marrow allografts (n = 23) from human
leukocyte antigen (HLA)-identical sibling donors (n = 25). After myeloablative
conditioning, all patients fully engrafted with donor cells; after
myelosuppressive regimens, 2 of 4 patients fully engrafted. Severe (grade 3 or
4) graft-versus-host disease (GVHD) disease developed in 4 patients: 3 of 9
with pre-existing overt infection, 1 of 2 with acute inflammatory disease.
Exacerbation of infection during aplasia was observed in 3 patients;
inflammatory flare at the infection site during neutrophil engraftment in 2:
all 5 patients belonged to the subgroup of 9 with pre-existing infection.
Overall survival was 23 of 27, with 22 of 23 cured of CGD (median follow-up, 2
years). Survival was especially good in patients without infection at the
moment of transplantation (18 of 18). Pre-existing infections and inflammatory
lesions have cleared in all survivors (except in one with autologous
reconstitution). Myeloablative conditioning followed by transplantation of
unmodified hemopoietic stem cells, if performed at the first signs of a severe
course of the disease, is a valid therapeutic option for children with CGD
having an HLA-identical donor. N.
Ref:: 30
----------------------------------------------------
[110]
TÍTULO / TITLE: - The transplantation of
hematopoietic stem cells after non-myeloablative conditioning: a cellular
therapeutic approach to hematologic and genetic diseases.
REVISTA
/ JOURNAL: - Immunol Res 2003;28(1):13-24.
AUTORES
/ AUTHORS: - Maris M; Storb R
INSTITUCIÓN
/ INSTITUTION: - Fred Hutchinson Cancer Research Center,
and University of Washington, Seattle, WA, USA. mmaris@fhcrc.org
RESUMEN
/ SUMMARY: - Originally, allogeneic hematopoietic stem
cell transplantation (HSCT) was viewed as a form of rescue from the marrow
lethal effects of high doses of chemo-radiotherapy used to both eradicate malignancy
and to provide sufficient immunosuppression to ensure allogeneic engraftment.
Clear evidence of a therapeutic graft-versus-tumor (GVT) effect mediated by
allogeneic effector cells (T cells) has prompted the exploration of HSCT
regimens that rely solely upon host immunosuppression (non-myeloablative) to
facilitate allogeneic donor engraftment. The engrafted donor effector cells are
then used to accomplish the task of eradicating host malignant cells. The
non-myeloblative regimen developed in Seattle uses 2 Gy total body irradiation
(TBI) before transplant followed by postgrafting cyclosporine (CSP) and
mycophenolate mofetil (MMF). This regimen resulted in initial mixed donor-host
chimerism in all patients with hematologic malignancies and genetic disorders
who received HLA-matched sibling allografts. The 17% incidence of graft
rejection was reduced to 3% with the addition of fludarabine, 30 mg/m2/day on d
-4, -3, and -2. The non-myeloablative combination of fludarabine/TBI has also
been successful at achieving high engraftment rates in recipients of 10 of 10
HLA antigen matched unrelated donor HSCTs in patients with hematologic
malignancies. By reducing acute toxicities relative to conventional HSCT, most
patients have received their pre- and post-HSCT therapy almost exclusively as
outpatients. Acute and chronic GVHD occur after non-myeloablative HSCT, but the
incidence and severity appear less compared to conventional HSCT. As in
conventional transplants, immune dysregulation from GVHD and its treatment and
delayed reconstitution of immune function continue to present risks to patients
who have otherwise undergone successful non-myeloablative HSCT. Cellular
therapeutic effects have been observed after non-myeloablative HSCT such as
correction of inherited genetic disorders, and eradication of hematologic
malignant diseases and renal cell carcinoma via GVT responses. N. Ref:: 52
----------------------------------------------------
[111]
TÍTULO / TITLE: - Immunosuppressive
agents in childhood nephrotic syndrome: a meta-analysis of randomized
controlled trials.
REVISTA
/ JOURNAL: - Kidney Int 2001 May;59(5):1919-27.
AUTORES
/ AUTHORS: - Durkan AM; Hodson EM; Willis NS; Craig JC
INSTITUCIÓN
/ INSTITUTION: - Centre for Kidney Research, The Children’s
Hospital at Westmead, New South Wales, Australia.
RESUMEN
/ SUMMARY: - BACKGROUND: Many children with
steroid-sensitive nephrotic syndrome (SSNS) relapse frequently and receive
immunosuppressive agents. In this systematic review of randomized controlled trials
(RCTs), the benefits and harms of these immunosuppressive agents are evaluated.
METHODS: RCTs with outcome data at six months or more that evaluated
noncorticosteroid agents in relapsing SSNS were included. A summary relative
risk for relapse at 6 to 12 months was calculated using a random effects model.
RESULTS: Seventeen trials involving 631 children were identified.
Cyclophosphamide [3 trials; relative risk (RR) 0.44, 95% confidence interval
(CI), 0.26 to 0.73] and chlorambucil (2 trials; RR 0.13, 95% CI, 0.03 to 0.57)
significantly reduced the relapse risk at 6 to 12 months compared with
prednisone alone. In the single chlorambucil versus cyclophosphamide trial,
there was no observed difference in relapse risk at two years (RR 1.31, 95% CI,
0.80 to 2.13). Cyclosporine was as effective as cyclophosphamide (1 trial; RR
1.07, 95% CI, 0.48 to 2.35) and chlorambucil (1 trial; RR 0.82, 95% CI, 0.44 to
1.53), but the effect was not sustained when cyclosporine was ceased. During
treatment, levamisole (3 trials; RR 0.60, 95% CI, 0.45 to 0.79) was more
effective than steroids alone, but the effect was not sustained. CONCLUSIONS:
Cyclophosphamide, chorambucil, cyclosporine, and levamisole reduce the risk of
relapse in children with relapsing SSNS compared with prednisone alone.
Clinically important differences in efficacy among these agents are possible,
and further comparative trials are still needed. Meanwhile, the choice between
these agents depends on physician and patient preferences related to therapy
duration and complication type and frequency.
----------------------------------------------------
[112]
TÍTULO / TITLE: - Sublingual
immunotherapy for allergic rhinitis.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(2):CD002893.
AUTORES
/ AUTHORS: - Wilson DR; Torres LI; Durham SR
INSTITUCIÓN
/ INSTITUTION: - Upper Respiratory Medicine, Imperial
College School of Medicine at the National Heart & Lung Institute,
Dovehouse Street, London, UK, SW3 6LR. duncw 99@yahoo.co.uk
RESUMEN
/ SUMMARY: - BACKGROUND: Allergic rhinitis is a common
condition which, at its most severe, can significantly impair quality of life
despite optimal treatment with antihistamines and topical nasal
corticosteroids. Allergen injection immunotherapy significantly reduces
symptoms and medication requirements in allergic rhinitis but its use is
limited by the possibility of severe systemic reactions. There has therefore
been considerable interest in alternative routes for delivery of allergen
immunotherapy, particularly the sublingual route. OBJECTIVES: To evaluate the
efficacy of sublingual immunotherapy (SLIT), compared with placebo, for
reductions in symptoms and medication requirements. SEARCH STRATEGY: The
Cochrane Controlled Trials Register, MEDLINE (1966-2002), EMBASE (1974-2002)
and Scisearch were searched, up to September 2002, using the terms (Rhin* OR
hay fever) AND (immunotherap* OR desensiti*ation) AND (sublingual). SELECTION
CRITERIA: All studies identified by the searches were assessed by the reviewers
to identify randomised controlled trials involving participants with symptoms
of allergic rhinitis and proven allergen sensitivity, treated with SLIT or
corresponding placebo. DATA COLLECTION AND ANALYSIS: Data from identified studies
were abstracted onto a standard extraction sheet and subsequently entered into
RevMan 4.1. Analysis was performed by the method of Standardised Mean
Differences (SMD) using a random effects model. P values <0.05 were
considered statistically significant. Subgroup analyses were performed
according to the type of allergen administered, the age of participants and the
duration of treatment. MAIN RESULTS: Twenty two trials involving 979 patients
were included. There were 6 trials of SLIT for House Dust Mite allergy, 5 for
Grass Pollen, 5 for Parietaria, 2 for Olive and one each for, Ragweed, Cat,
Tree and Cupressus. Four studies enrolled exclusively children. Seventeen
studies administered the allergen by sublingual drops subsequently swallowed, 3
by drops subsequently spat out and 2 by sublingual tablets. Eight studies
involved treatment for less than 6 months, 10 studies for 6-12 months and 4
studies for greater than 12 months. All included studies were double-blind
placebo-controlled trials of parallel group design. Concealment of treatment
allocation was considered adequate in all studies and the use of identical
placebo preparations was almost universal. There was significant heterogeneity,
most likely due to widely differing scoring systems between studies, for most
comparisons. Overall there was a significant reduction in both symptoms (SMD
-0.34, 95% confidence interval -0.69 to -0.15; p=0.002) and medication
requirements (SMD -0.43 [-0.63, -0.23]; p=0.00003) following immunotherapy.
Subgroup analyses failed to identify a disproportionate benefit of treatment
according to the allergen administered. There was no significant reduction in
symptoms and medication scores in those studies involving only children but
total numbers of participants were small, casting doubt on the validity of the
conclusion. Increasing duration of treatment does not clearly increase
efficacy. The total dose of allergen administered may be important but
insufficient data were available to analyse this factor. REVIEWER’S CONCLUSIONS:
SLIT is a safe treatment which significantly reduces symptoms and medication
requirements in allergic rhinitis. The size of this benefit compared to that of
other available therapies, particularly injection immunotherapy, is not clear,
having been assessed directly in very few studies. Further research is required
concentrating on optimising allergen dosage and patient selection. N. Ref:: 41
----------------------------------------------------
[113]
TÍTULO / TITLE: - “Stepping-up” from
methotrexate: a systematic review of randomised placebo controlled trials in
patients with rheumatoid arthritis with an incomplete response to methotrexate.
REVISTA
/ JOURNAL: - Ann Rheum Dis 2001 Nov;60 Suppl 3:iii51-4.
AUTORES
/ AUTHORS: - Hochberg MC; Tracy JK; Flores RH
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, University of
Maryland School of Medicine, Baltimore 21201, USA. N. Ref:: 20
----------------------------------------------------
[114]
TÍTULO / TITLE: - Allogeneic
transplantation of hematopoietic stem cells after nonmyeloablative conditioning
for Hodgkin’s disease: indications and results.
REVISTA
/ JOURNAL: - Semin Oncol 2004 Feb;31(1):27-32.
AUTORES
/ AUTHORS: - Schmitz N; Sureda A; Robinson S
INSTITUCIÓN
/ INSTITUTION: - Department of Hematology, AK St. Georg,
Hamburg, Germany.
RESUMEN
/ SUMMARY: - A number of treatment options are
available for patients with relapsed Hodgkin’s disease (HD). Radiotherapy,
salvage chemotherapy, high-dose therapy (HDT) followed by autologous
transplantation, and classical or nonmyeloablative conditioning followed by
allogeneic transplantation can all be effective in patients with relapsed HD.
Patients with early relapse after modern first-line chemotherapy, as well as
patients with primary progressive disease, will be candidates for innovative
approaches including nonmyelablative stem cell transplant (NST). Although
initial results with NST look promising, more time and structured study of both
HD and NST will be necessary to ultimately define the role of NST in this
disease. N. Ref:: 37
----------------------------------------------------
[115]
TÍTULO / TITLE: - Drug immunosuppression
therapy for adult heart transplantation. Part 2: clinical applications and
results.
REVISTA
/ JOURNAL: - Ann Thorac Surg 2004 Jan;77(1):363-71.
AUTORES
/ AUTHORS: - Mueller XM
INSTITUCIÓN
/ INSTITUTION: - Department of Cardiovascular Surgery,
Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada. xavier.mueller@usherbrooke.ca
RESUMEN
/ SUMMARY: - This review describes the clinical
application of classical immunosuppressive drugs as well as that of more recent
drugs. All current immunosuppressive drugs target T-cell activation, and
cytokine production and clonal expansion, or both. Immunosuppressive protocols
can be broadly divided into induction therapy, maintenance immunosuppression,
and treatment of acute rejection episodes.
N. Ref:: 82
----------------------------------------------------
[116]
TÍTULO / TITLE: - Syngeneic hematopoietic
stem-cell transplantation for non-Hodgkin’s lymphoma: a comparison with
allogeneic and autologous transplantation—The Lymphoma Working Committee of the
International Bone Marrow Transplant Registry and the European Group for Blood
and Marrow Transplantation.
REVISTA
/ JOURNAL: - J Clin Oncol 2003 Oct 15;21(20):3744-53.
Epub 2003 Sep 8.
●●
Enlace al texto completo (gratuito o de pago) 1200/JCO.2003.08.054
AUTORES
/ AUTHORS: - Bierman PJ; Sweetenham JW; Loberiza FR Jr;
Taghipour G; Lazarus HM; Rizzo JD; Schmitz N; van Besien K; Vose JM; Horowitz
M; Goldstone A
INSTITUCIÓN
/ INSTITUTION: - University of Nebraska Medical Center,
Omaha, NE 68198-7680, USA. pjbierman@unmc.edu
RESUMEN
/ SUMMARY: - PURPOSE: To compare results of syngeneic,
allogeneic, and autologous hematopoietic stem-cell transplantation for
non-Hodgkin’s lymphoma (NHL). PATIENTS AND METHODS: The databases of the
International Bone Marrow Transplant Registry (IBMTR) and the European Group
for Blood and Marrow Transplantation were used to identify 89 NHL patients who
received syngeneic transplants. These patients were compared with NHL patients
identified from the IBMTR and the Autologous Blood and Marrow Transplant
Registry who received allogeneic (T-cell depleted and T-cell replete) and
autologous (purged and unpurged) transplants. RESULTS: No significant
differences in relapse rates were observed when results of allogeneic
transplantation were compared with syngeneic transplantation for any histology.
T-cell depletion of allografts was not associated with a higher relapse risk,
but was associated with improved overall survival for patients with low-grade and
intermediate-grade histology. Patients who received unpurged autografts for
low-grade NHL had a five-fold (P =.008) greater risk of relapse than recipients
of syngeneic transplants, and recipients of unpurged autografts had a two-fold
(P =.0009) greater relapse risk than patients who received purged autografts.
Among low-grade NHL patients, the use of purging was associated with
significantly better disease-free survival (P =.003) and overall survival (P
=.04) when compared with patients who received unpurged autografts. CONCLUSION:
These analyses failed to find evidence of a graft-versus-lymphoma effect, but
do provide indirect evidence to support the hypothesis that tumor contamination
may contribute to lymphoma relapse, and that purging may be beneficial for
patients undergoing autologous hematopoietic stem-cell transplantation for
low-grade NHL.
----------------------------------------------------
[117]
TÍTULO / TITLE: - Review article: the
treatment of inflammatory bowel disease with 6-mercaptopurine or azathioprine.
REVISTA
/ JOURNAL: - Aliment Pharmacol Ther 2001
Nov;15(11):1699-708.
AUTORES
/ AUTHORS: - Nielsen OH; Vainer B; Rask-Madsen J
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology C, Herlev
Hospital, University of Copenhagen, Denmark. ohn@dadlnet.dk
RESUMEN
/ SUMMARY: - The thioguanine derivative, azathioprine,
is a prodrug of 6-mercaptopurine that is further metabolized by various enzymes
present in the liver and gut. Azathioprine and 6-mercaptopurine have been used
in the treatment of inflammatory bowel disease, i.e. ulcerative colitis and
Crohn’s disease, for more than 30 years. However, widespread use of
azathioprine or 6-mercaptopurine in inflammatory bowel disease is of more
recent origin, the primary reason being a long-standing debate on the efficacy
of these agents in inflammatory bowel disease. Both drugs are slow acting,
which is why clinical efficacy cannot be expected until several weeks or even
months of treatment have elapsed. Consequently, azathioprine and
6-mercaptopurine have no place as monotherapy in the treatment of acute
relapsing inflammatory bowel disease. Today, azathioprine and 6-mercaptopurine
are the most commonly used immunomodulatory drugs in the treatment of inflammatory
bowel disease. Their clinical effects are probably identical, although their
exact mode of action is still unknown. The mode of action of azathioprine is
thought to be multifactorial, including conversion to 6-mercaptopurine (which
acts as a purine antimetabolite), possible blockade of thiol groups by
alkylation, inhibition of several pathways in nucleic acid biosynthesis
(preventing proliferation of cells involved in the determination and
amplification of the immune response) and damage to DNA through the
incorporation of thiopurine analogues. However, 6-thioguanine nucleotides may
accumulate in toxic doses in myeloid precursor cells, resulting in
life-threatening myelosuppression. Azathioprine and 6-mercaptopurine are
further known to alter lymphocyte function, reduce the number of lamina propria
plasma cells and affect natural killer cell function. The purpose of this
comprehensive review is to suggest guidelines for the application of
azathioprine and 6-mercaptopurine in the treatment of inflammatory bowel
disease. N. Ref:: 74
----------------------------------------------------
[118]
TÍTULO / TITLE: - Current directions in
hemochromatosis research: towards an understanding of the role of iron overload
and the HFE gene mutations in the development of clinical disease.
REVISTA
/ JOURNAL: - Nutr Rev 2003 Jan;61(1):38-42.
AUTORES
/ AUTHORS: - Neff LM
INSTITUCIÓN
/ INSTITUTION: - Jean Mayer USDA Human Nutrition Research
Center on Aging, Tufts University, New England Medical Center, Boston, MA, USA.
RESUMEN
/ SUMMARY: - Since the discovery of a candidate gene
(HFE) thought to be involved in the development of hereditary hemochromatosis,
there has been much interest in the potential use of genetic testing as a
screening tool for the disease in the general population. However, a recent
study suggests that less than 1% of subjects who are homozygous for the gene
mutations will go on to develop the full-blown disease of hereditary
hemochromatosis, historically termed “bronzed diabetes.” The study also
suggests that homozygotes have no higher risk of mortality or of any clinically
significant morbidity than normal control subjects. This conclusion contradicts
earlier findings that linked iron overload and HFE mutations to a number of
devastating diseases, including cardiovascular disease, diabetes, and
cancer. N. Ref:: 15
----------------------------------------------------
[119]
TÍTULO / TITLE: - B cell-ablative therapy
for the treatment of autoimmune diseases.
REVISTA
/ JOURNAL: - Arthritis Rheum 2002 Aug;46(8):1984-5.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.10476
AUTORES
/ AUTHORS: - Patel DD
N. Ref:: 18
----------------------------------------------------
[120]
TÍTULO / TITLE: - Endothelial expression
of MHC class II molecules in autoimmune disease.
REVISTA
/ JOURNAL: - Curr Pharm Des 2004;10(2):129-43.
AUTORES
/ AUTHORS: - Turesson C
INSTITUCIÓN
/ INSTITUTION: - Department of Rheumatology, Malmo
University Hospital, Malmo, Sweden. turesson.carl@mayo.edu
RESUMEN
/ SUMMARY: - Major histocompatibility complex (MHC)
class II molecules are up-regulated on endothelial cells in human allografts,
and are thought to be involved in graft rejection. The MHC class II subtypes
HLA-DR, DQ and DP regulate T cell dependent immune responses, and aberrant
expression could be important in autoimmunity. Increased endothelial MHC class
II expression has been demonstrated in several autoimmune diseases, including
myocarditis with dilated cardiomyopathy, rheumatoid arthritis (RA) and systemic
lupus erythematosus (SLE). Recent data suggest that there is an association
between endothelial expression of MHC class II molecules and diffuse
endothelial dysfunction, which may be part of the explanation of the increased
risk of cardiovascular disease in patients with RA, SLE and other chronic
inflammatory conditions. MHC class II transcription is in part genetically
determined. Cytokine induced up-regulation of MHC class II molecules can be
inhibited in vitro by antioxidants and different drugs, such as cyclosporin and
statins. Research on the development of new treatments for systemic autoimmune
diseases and cardiovascular disease should include evaluation of effects on
endothelial activation, including MHC class II expression. This review also
discusses the genetic basis of MHC class II expression and its implications for
understanding MHC genotype associations with autoimmune diseases. Recent
studies of interactions between endothelial cells and T cells are reviewed.
Such interactions could be of major importance in the pathogenesis of
autoimmune and vascular diseases. N.
Ref:: 217
----------------------------------------------------
[121]
TÍTULO / TITLE: - Valacyclovir provides
optimum acyclovir exposure for prevention of cytomegalovirus and related
outcomes after organ transplantation.
REVISTA
/ JOURNAL: - J Infect Dis. Acceso gratuito al texto
completo a partir de los 2 años de la publicación; - http://www.journals.uchicago.edu/
●●
Cita: J. of Infectious Diseases: <> 2002 Oct 15;186 Suppl 1:S110-5.
AUTORES
/ AUTHORS: - Fiddian P; Sabin CA; Griffiths PD
INSTITUCIÓN
/ INSTITUTION: - Royal Free and University College Medical
School (Royal Free Campus), London NW3 2PF, United Kingdom. paul.fiddian@which.net
RESUMEN
/ SUMMARY: - A meta-analysis of 12 randomized trials
(1574 patients) examined herpesvirus and related outcomes following organ
transplantation over a range of acyclovir exposures (including valacyclovir).
Overall, cytomegalovirus (CMV) infection (odds ratio [OR], 0.44; 95% confidence
interval [CI], 0.34-0.57; P<.001), CMV disease (OR, 0.41; 95% CI, 0.31-0.54;
P<.001), death (OR, 0.60; 95% CI, 0.40-0.90; P=.01), opportunistic infection
(OR, 0.70; 95% CI, 0.53-0.91; P=.009), acute graft rejection (OR, 0.67; 95% CI,
0.52-0.86; P<.001), herpes simplex virus disease (OR, 0.17; 95% CI,
0.12-0.24; P<.001), and varicella-zoster virus disease (OR, 0.06; 95% CI,
0.01-0.25; P<.001) were significantly reduced. Increased acyclovir exposure
influenced more end points: Maximum efficacy resulted from valacyclovir (8
g/day). Increasing acyclovir exposure to that achieved with valacyclovir
extends benefits of prophylaxis to include impact on graft rejection and
opportunistic infections.
----------------------------------------------------
[122]
TÍTULO / TITLE: - Intestinal
transplantation for gut failure.
REVISTA
/ JOURNAL: - Gastroenterology 2003 May;124(6):1615-28.
AUTORES
/ AUTHORS: - Fishbein TM; Gondolesi GE; Kaufman SS
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Mount Sinai School
of Medicine, New York, New York 10029, USA. Thomas.Fishbein@MSNYUhealth.org N. Ref:: 95
----------------------------------------------------
[123]
TÍTULO / TITLE: - Dendritic cells
transduced with viral interleukin 10 or Fas ligand: no evidence for induction
of allotolerance in vivo.
REVISTA
/ JOURNAL: - Transplantation 2002 Jan 15;73(1 Suppl):S27-30.
AUTORES
/ AUTHORS: - Buonocore S; Van Meirvenne S; Demoor FX;
Paulart F; Thielemans K; Goldman M; Flamand V
INSTITUCIÓN
/ INSTITUTION: - 2 Laboratory of Physiology, Medical School
of Vrije Universiteit Brussel.
RESUMEN
/ SUMMARY: - Dendritic cells (DC) are the most potent
presenters of alloantigens and therefore are responsible for the induction of
allograft rejection. Genetic modifications of DC allowing the expression of a
tolerogenic molecule may render them immunosuppressive. We transduced bone
marrow-derived DC with recombinant MFG retrovirus encoding either viral
interleukin (vIL)-10 or Fas ligand (FasL) to induce transplantation tolerance.
Up to 10 ng/ml of bioactive vIL-10 was produced by DC after transfer of the
corresponding gene. Although the inhibitory properties of vIL-10-transduced DC
were revealed in vitro in a mixed lymphocyte culture, no clear down-regulation
of the allogeneic response was observed in vivo after single or multiple
injections of those DC overexpressing vIL-10. When we transduced wild-type bone
marrow-derived DC with recombinant MFG retrovirus encoding murine FasL, cells
quickly died, probably because of suicidal or fratricidal Fas-dependent death.
Indeed, only DC from Fas-deficient lpr mice survived to FasL gene transfer.
Those FasL-transduced lpr DC exhibited a strong cytotoxic activity against
Fas-positive targets in vitro. DC overexpressing FasL did not behave as
immunosuppressive DC in vivo. The subcutaneous injection of FasL+ lpr DC in MHC
class II-disparate mice hyperactivated the allospecific proliferation of T
cells in the draining lymph nodes compared with mice treated with
control-transduced DC. These results argue against the development of FasL+ DC
or vIL-10-secreting DC as immunosuppressive tools in vivo. The alternative
pathways of T-cell activation triggered by these genetically modified DC need
to be investigated. N.
Ref:: 20
----------------------------------------------------
[124]
TÍTULO / TITLE: - Induction of tolerance
in autoimmune diseases by hematopoietic stem cell transplantation: getting
closer to a cure?
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2002 Feb 1;99(3):768-84.
AUTORES
/ AUTHORS: - Burt RK; Slavin S; Burns WH; Marmont AM
INSTITUCIÓN
/ INSTITUTION: - Division of Immune Therapy and Autoimmune
Disease, Northwestern University Medical Center, 320 E. Superior, Searle Bldg.
Rm 3-489, Chicago, IL 60611, USA. rburt@nwu.edu
RESUMEN
/ SUMMARY: - Hematopoietic stem cells (HSCs) are the
earliest cells of the immune system, giving rise to B and T lymphocytes,
monocytes, tissue macrophages, and dendritic cells. In animal models, adoptive
transfer of HSCs, depending on circumstances, may cause, prevent, or cure
autoimmune diseases. Clinical trials have reported early remission of otherwise
refractory autoimmune disorders after either autologous or allogeneic
hematopoietic stem cell transplantation (HSCT). By percentage of
transplantations performed, autoimmune diseases are the most rapidly expanding
indication for stem cell transplantation. Although numerous editorials or
commentaries have been previously published, no prior review has focused on the
immunology of transplantation tolerance or development of phase 3 autoimmune
HSCT trials. Results from current trials suggest that mobilization of HSCs,
conditioning regimen, eligibility and exclusion criteria, toxicity, outcome,
source of stem cells, and posttransplantation follow-up need to be disease
specific. HSCT-induced remission of an autoimmune disease allows for a
prospective analysis of events involved in immune tolerance not available in
cross-sectional studies. N.
Ref:: 358
----------------------------------------------------
[125]
TÍTULO / TITLE: - Treatment of idiopathic
nephrosis by immunophillin modulation.
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: <> 2003 Aug;18 Suppl
6:vi79-86.
AUTORES
/ AUTHORS: - Meyrier A
INSTITUCIÓN
/ INSTITUTION: - Service de Nephrologie, Hopital Europeen
Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France. alain.meyrier@brs.ap-hop-paris.fr
RESUMEN
/ SUMMARY: - Until 1985, glucocorticoids and cytotoxic
drugs were the only treatments available for idiopathic nephrotic syndrome
(nephrosis), that is, minimal change disease (MCD) and focal segmental
glomerulosclerosis (FSGS). Trials of cyclosporine (CsA) treatment of nephrosis,
the rationale of which was based on pathophysiologic considerations, have shown
that this immunophillin modulator is effective in inducing and maintaining
remission in patients suffering from idiopathic nephrotic syndrome. It appears
that the best results, in the order of 80% remission rate, are obtained in
steroid-sensitive cases, essentially MCD, and that in steroid-resistant FSGS
the drug obtains remission in no more than 20% of the cases. Addition of
glucocorticoids increases the success rate to approximately 30% of cases. Renal
toxicity is proportional to previous impairment of renal function, primary
renal disease (FSGS vs MCD) dosage >5.5 mg/kg/day and duration of treatment.
The better bioavailability of the new formulation of CsA (Neoral), implies that
the former dosage recommendations be reconsidered for distinctly lower figures.
Repeat renal biopsy after 1 year of continuous CsA treatment is advisable, as
stable serum creatinine levels may be falsely reassuring. CsA dependency is the
rule during the first year of treatment. However, in some 25% of cases stable
remission may be maintained after slow tapering off following 3-4 years of
treatment. Other immunophillin modulators have been tried in the treatment of
idiopathic nephrotic syndrome. Despite few preliminary reports indicating some
success of tacrolimus the effects of this drug do not seem convincingly
superior to CsA in terms of remission rate, toxicity and dependency. Rapamycin
has not been tried in the treatment of nephrosis. Anecdotal cases of de novo
FSGS induced by rapamycin in transplanted patients might indicate that this
drug is in fact contraindicated in the treatment of nephrosis. N. Ref:: 36
----------------------------------------------------
[126]
TÍTULO / TITLE: - In vitro generation of
IL-10-producing regulatory CD4+ T cells is induced by immunosuppressive drugs
and inhibited by Th1- and Th2-inducing cytokines.
REVISTA
/ JOURNAL: - Immunol Lett 2003 Jan 22;85(2):135-9.
AUTORES
/ AUTHORS: - O’Garra A; Barrat FJ
INSTITUCIÓN
/ INSTITUTION: - Division of Immunoregulation, The National
Institute for Medical Research (NIMR), The Ridgeway, Mill Hill, NW7 1AA,
London, UK. N. Ref:: 40
----------------------------------------------------
[127]
TÍTULO / TITLE: - Penicillin-resistant
Streptococcus pneumoniae septic shock and meningitis complicating chronic graft
versus host disease: a case report and review of the literature.
REVISTA
/ JOURNAL: - Am J Med 2002 Aug 1;113(2):152-5.
AUTORES
/ AUTHORS: - Haddad PA; Repka TL; Weisdorf DJ
INSTITUCIÓN
/ INSTITUTION: - Division of Hematology, Oncology and
Transplantation, Department of Medicine, University of Minnesota, Minneapolis,
USA. N. Ref:: 34
----------------------------------------------------
[128]
TÍTULO / TITLE: - Treating human
autoimmune disease by depleting B cells.
REVISTA
/ JOURNAL: - Ann Rheum Dis 2002 Oct;61(10):863-6.
AUTORES
/ AUTHORS: - Looney RJ
INSTITUCIÓN
/ INSTITUTION: - University of Rochester, Rochester, New
York 14642, USA. John_looney@URMC.Rochester.edu N. Ref:: 40
----------------------------------------------------
[129]
TÍTULO / TITLE: - Pretransplant blood
transfusions revisited: a role for CD(4+) regulatory T cells?
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S26-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106469.12073.01
AUTORES
/ AUTHORS: - Roelen D; Brand A; Claas FH
INSTITUCIÓN
/ INSTITUTION: - Department of Immunohematology and
Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands. d.l.roelen@lumc.nl.
RESUMEN
/ SUMMARY: - Pretransplant blood transfusions have been
shown to improve organ allograft survival. However, the immunologic mechanism
leading to this beneficial effect of blood transfusions is still unknown. The
observation that transfusions sharing at least one HLA-DR antigen (human
leukocyte antigen) with the recipient are more effective than HLA-mismatched
transfusions has led to the hypothesis that CD(4+) regulatory T cells are induced
that recognize allopeptides of the blood transfusion donor in the context of
the self-HLA-DR molecule on the donor cells. In vitro studies showed that
CD(4+) T cells recognizing an allopeptide in the context of self-HLA-DR are
indeed able to decrease the alloimmune response of autologous T cells by
affecting the activated T cells directly or indirectly by their modulatory
effect on dendritic cells. The first studies in a patient with a
well-functioning kidney graft after receiving an HLA-DR-matched pretransplant
blood transfusion showed that the low organ donor-specific cytotoxic
T-lymphocyte response after transplantation was indeed attributable to the
activity of regulatory CD(4+) T cells. N.
Ref:: 24
----------------------------------------------------
[130]
TÍTULO / TITLE: - Low dose methotrexate
in inflammatory bowel disease: current status and future directions.
REVISTA
/ JOURNAL: - Am J Gastroenterol 2003 Mar;98(3):530-7.
AUTORES
/ AUTHORS: - Schroder O; Stein J
INSTITUCIÓN
/ INSTITUTION: - Second Department of Internal Medicine,
Division of Gastroenterology, Johann Wolfgang Goethe-University,
Frankfurt/Main, Germany.
RESUMEN
/ SUMMARY: - Despite many recent advances, some notable
limitations exist in the medical management of patients with inflammatory bowel
disease. Glucocorticoids suppress active inflammation very effectively, but
their long term use is associated with high rates of relapse and unacceptable
toxicity. 6-Mercaptopurine and its prodrug azathioprine are effective in
inducing and maintaining remission; however, a significant number of patients
are resistant or intolerant to thiopurines. Low dose methotrexate, an
anti-inflammatory drug, is a well established medication for rheumatoid
arthritis and psoriasis. After an initial report in 1989, several clinical
trials and analyses of clinical notes have examined the role of methotrexate in
patients with ulcerative colitis and Crohn’s disease. This review was conducted
to summarize the current knowledge about the underlying basic anti-inflammatory
mechanisms of methotrexate as well as the pharmacology and toxicology of this
drug with particular emphasis on inflammatory bowel disease. It also critically
evaluates all existing trials not only in the induction of remission but also
in maintenance therapy. We conclude that low dose methotrexate is an effective
and safe treatment in glucocorticoid-dependent and thiopurine intolerant
patients with Crohn’s disease but not ulcerative colitis. It remains to be seen
whether low dose methotrexate may also be useful in long term maintenance
therapy in patients with inflammatory bowel disease. N. Ref:: 60
----------------------------------------------------
[131]
TÍTULO / TITLE: - The future of
antigen-specific immunotherapy of allergy.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2002 Jun;2(6):446-53.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri824
AUTORES
/ AUTHORS: - Valenta R
INSTITUCIÓN
/ INSTITUTION: - Department of Pathophysiology, University
of Vienna Medical School, Vienna General Hospital-AKH, Australia. Rudolf.valenta@akh-wein.ac.at
RESUMEN
/ SUMMARY: - More than 25% of the population in
industrialized countries suffers from immunoglobulin-E-mediated allergies. The
antigen-specific immunotherapy that is in use at present involves the
administration of allergen extracts to patients with the aim to cure allergic
symptoms. However, the risk of therapy-induced side effects limits its broad
application. Recent work indicates that the epitope complexity of natural
allergen extracts can be recreated using recombinant allergens, and
hypoallergenic derivatives of these can be engineered to increase treatment
safety. It is proposed that these modified molecules will improve the current
practice of specific immunotherapy and form a basis for prophylactic
vaccination. N.
Ref:: 120
----------------------------------------------------
[132]
TÍTULO / TITLE: - Indoleamine
2,3-dioxygenase-expressing antigen-presenting cells and peripheral T-cell
tolerance: another piece to the atopic puzzle?
REVISTA
/ JOURNAL: - J Allergy Clin Immunol 2003
Nov;112(5):854-60.
●●
Enlace al texto completo (gratuito o de pago) 1016/S0091
AUTORES
/ AUTHORS: - von Bubnoff D; Hanau D; Wenzel J; Takikawa
O; Hall B; Koch S; Bieber T
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology,
Friedrich-Wilhelms University, Bonn, Germany.
RESUMEN
/ SUMMARY: - There is growing evidence that dendritic
cells, the major antigen-presenting cells and T-cell activators, have a broad
effect on peripheral T-cell tolerance and regulation of immunity. Very
recently, a new feature of regulatory antigen-presenting cells was observed. Certain
dendritic cells, monocytes, and macrophages express the enzyme indoleamine
2,3-dioxygenase, and thus because of enhanced degradation of the essential
amino acid tryptophan, they modulate T-cell activity in specific local tissue
environments. In this review we discuss the various and apparently disparate
effects of indoleamine 2,3-dioxygenase induction in cells of the immune system.
We place current knowledge about this mechanism in the context of atopy. We
introduce the hypothesis that tryptophan degradation might add to the ability
to control and downregulate allergen-specific T-cell responses in atopic
individuals. N.
Ref:: 44
----------------------------------------------------
[133]
TÍTULO / TITLE: - How I treat chronic
graft-versus-host disease.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2001 Mar 1;97(5):1196-201.
AUTORES
/ AUTHORS: - Vogelsang GB
INSTITUCIÓN
/ INSTITUTION: - Oncology Center, Johns Hopkins University
School of Medicine, Baltimore, MD 21231-1000, USA. vogelge@jhmi.edu
RESUMEN
/ SUMMARY: - Allogeneic stem cell transplantation (SCT)
is now a commonplace procedure. Clinicians who care for patients with
hematologic malignancies and aplastic anemia are almost certain to follow up
patients after SCT. This review is intended to help clinicians observe patients
for probably the most important late complication of SCT, chronic
graft-versus-host disease (GVHD). It reviews the pathophysiology, risk factors,
clinical manifestations, evaluation, treatment, and supportive care of chronic
GVHD. N. Ref:: 34
----------------------------------------------------
[134]
TÍTULO / TITLE: - Dendritic cells and the
mode of action of anticalcineurinic drugs: an integrating hypothesis.
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: <> 2003 Mar;18(3):467-8;
discussion 469-70.
AUTORES
/ AUTHORS: - Fierro A; Mora JR; Bono MR; Morales J;
Buckel E; Sauma D; Rosemblatt M
INSTITUCIÓN
/ INSTITUTION: - Clinica las Condes, Transplantation Unit,
Santiago, Chile. afierro@vtr.net N. Ref:: 16
----------------------------------------------------
[135]
TÍTULO / TITLE: - Scedosporium
prolificans osteomyelitis in an immunocompetent child treated with voriconazole
and caspofungin, as well as locally applied polyhexamethylene biguanide.
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: <> 2003 Aug;41(8):3981-5.
AUTORES
/ AUTHORS: - Steinbach WJ; Schell WA; Miller JL;
Perfect JR
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, Duke University,
Durham, North Carolina 27710, USA. stein022@mc.duke.edu
RESUMEN
/ SUMMARY: - Scedosporium species are increasingly
isolated from immunocompromised and immunocompetent patients. Unfortunately,
Scedosporium infections are generally resistant to amphotericin B, and
Scedosporium prolificans strains are particularly resistant to the antifungal
agents now in use. We report here on an immunocompetent child with S.
prolificans-associated osteomyelitis successfully treated with debridement,
local irrigation with polyhexamethylene biguanide, and the systemic
administration of voriconazole and caspofungin despite poor in vitro activity
of voriconazole alone against the isolate. We also review the treatments and
outcomes of 28 reported cases of osteomyelitis or septic arthritis caused by
Scedosporium species in immunocompetent patients. N. Ref:: 62
----------------------------------------------------
[136]
TÍTULO / TITLE: - Therapeutic management
of extrahepatic manifestations in patients with chronic hepatitis C virus
infection.
REVISTA
/ JOURNAL: - Rheumatology (Oxford). Acceso gratuito al
texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://rheumatology.oupjournals.org/
●●
Cita: Rheumatology (Oxford): <> 2003 Jul;42(7):818-28. Epub 2003 Apr 16.
●●
Enlace al texto completo (gratuito o de pago) 1093/rheumatology/keg299
AUTORES
/ AUTHORS: - Ramos-Casals M; Trejo O; Garcia-Carrasco
M; Font J
INSTITUCIÓN
/ INSTITUTION: - Department of Autoimmune Diseases,
Clinical Institutes of Infection and Immunology, Insitut d’Investigacions
Biomediques August Pi i Sunyer, Hospital Clinic, Department of Medicine, School
of Medicine, University of Barcelona, España. mramos@clinic.ub.es N. Ref:: 123
----------------------------------------------------
[137]
TÍTULO / TITLE: - Manipulation of
dendritic cells for tolerance induction in transplantation and autoimmune
disease.
REVISTA
/ JOURNAL: - Transplantation 2002 Jan 15;73(1
Suppl):S19-22.
AUTORES
/ AUTHORS: - Lu L; Thomson AW
INSTITUCIÓN
/ INSTITUTION: - Thomas E. Starzl Transplantation
Institute, Department of Surgery, University of Pittsburgh Medical Center,
Pittsburgh, Pennsylvania 15213, USA. Lul@msx.upmc.edu
RESUMEN
/ SUMMARY: - Dendritic cells (DC) constitute a complex
system of uniquely well-equipped antigen-presenting cells that initiate and
regulate immune responses. Extensive recent studies have improved our
understanding of DC development, differentiation, activation, and function. DC
exist as distinct subsets that differ in their lineage affiliation, surface
molecule expression, and biological function. These factors seem to determine
the T-cell polarizing signals and type of T cell response-T helper 1, T helper
2, or T regulatory- induced by DC (1). Evidence has accumulated that DC play an
important role in both central and peripheral tolerance via various mechanisms,
including induction of T-cell anergy, immune deviation, T regulatory cell
activity, and promotion of activated T-cell apoptosis. Although many of the
details of the molecular basis of DC tolerogenicity have yet to be elucidated,
emerging information suggests that costimulatory molecule deficiency,
expression of death-inducing ligands (in particular Fas [CD95] ligand),
microenvironmental factors (in particular anti-inflammatory/immunosuppressive
cytokines), and inhibition of gene transcription regulatory proteins (e.g.,
nuclear factor-kappaB) can impart tolerogenic potential to DC (2). Manipulation
of DC by control of their maturation and differentiation, or genetic
engineering of these cells to express immunosuppressive molecules, offers
potential for therapy of allograft rejection and autoimmune disease. In this
brief overview, we outline principles and methods for generation of
“tolerogenic” DC and outcomes that have been reported in experimental models.
Space constraints limit literature citations.
N. Ref:: 18
----------------------------------------------------
[138]
TÍTULO / TITLE: - Risk for myopathy with
statin therapy in high-risk patients.
REVISTA
/ JOURNAL: - Arch Intern Med 2003 Mar 10;163(5):553-64.
AUTORES
/ AUTHORS: - Ballantyne CM; Corsini A; Davidson MH;
Holdaas H; Jacobson TA; Leitersdorf E; Marz W; Reckless JP; Stein EA
INSTITUCIÓN
/ INSTITUTION: - Center for Cardiovascular Disease
Prevention, Baylor College of Medicine, 6565 Fannin, Mail Station A601, Suite
A656, Houston, TX 77030, USA. cmb@bcm.tmc.edu
RESUMEN
/ SUMMARY: - Emerging data suggest that the
3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins)
offer important benefits for the large population of individuals at high risk
for coronary heart disease. This population encompasses a sizable portion of
individuals who are also at high risk for drug-drug interactions due to their
need for multiple medications. In general, statins are associated with a very
small risk for myopathy (which may progress to fatal or nonfatal
rhabdomyolysis); however, the potential for drug-drug interactions is known to
increase this risk in specific high-risk groups. The incidence of myopathy
associated with statin therapy is dose related and is increased when statins
are used in combination with agents that share common metabolic pathways. Of
particular concern is the potential for interactions with other lipid-lowering
agents such as fibrates and niacin (nicotinic acid), which may be used in
patients with mixed lipidemia, and with immunosuppressive agents, such as
cyclosporine, which are commonly used in patients after transplantation.
Clinicians should be alert to the potential for drug-drug interactions to
minimize the risk of myopathy during long-term statin therapy in patients at
high risk for coronary heart disease. N.
Ref:: 128
----------------------------------------------------
[139]
TÍTULO / TITLE: - Renal transplantation:
can we reduce calcineurin inhibitor/stop steroids? Evidence based on protocol
biopsy findings.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Mar;14(3):755-66.
AUTORES
/ AUTHORS: - Gotti E; Perico N; Perna A; Gaspari F;
Cattaneo D; Caruso R; Ferrari S; Stucchi N; Marchetti G; Abbate M; Remuzzi G
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine and
Transplantation, Ospedali Riuniti di Bergamo, Mario Negri Institute for
Pharmacological Research, Italy.
RESUMEN
/ SUMMARY: - How to combine antirejection drugs and
which is the optimal dose of steroids and calcineurin inhibitors beyond the
first year after kidney transplantation to maintain adequate immunosuppression
without major side effects are far from clear. Kidney transplant patients on
steroid, cyclosporine (CsA), and azathioprine were randomized to per-protocol
biopsy (n = 30) or no-biopsy (n = 29) 1 to 2 yr posttransplant. Steroid or CsA
were discontinued or reduced on the basis of biopsy to establish effects on
drug-related complications, acute rejection, and graft function over 3 yr of
follow-up. Serum creatinine, GFR (plasma clearance of iohexol), RPF (renal
clearance of p-aminohippurate), CsA pharmacokinetics, and adverse events were
monitored yearly. At the end, patients underwent a second biopsy. Per-protocol
biopsy histology revealed no lesions (n = 5, steroid withdrawal), CsA
nephropathy (n = 13, CsA discontinuation/reduction), or chronic rejection (n =
12, standard therapy). Reducing the drug regimen led to overall fewer side
effects related to immunosuppression as compared with standard therapy or
no-biopsy. Steroids were safely stopped with no acute rejection or graft loss.
Complete CsA discontinuation was associated with acute rejection in the first
four patients. Lowering CsA to low target CsA trough (30 to 70 ng/ml) never led
to acute rejection or major renal function deterioration. Biopsy patients on
conventional regimen had no acute rejection, one graft loss, no significant
change in GFR, and significant RPF decline. No-biopsy controls: no acute
rejection, one graft loss, significant decline of GFR and RPF. By serial biopsy
analysis, severe lesions did not develop in patients with steroid
discontinuation in contrast to patients on standard therapy over follow-up. CsA
reduction did not adversely affect histology. Per-protocol biopsy more than 1
yr after kidney transplantation is a safe procedure to guide change of drug
regimen and to lower the risk of major side effects.
----------------------------------------------------
[140]
TÍTULO / TITLE: - Clinical protocol.
Purging of autologous stem cell sources with bcl-x(s) adenovirus for women
undergoing high-dose chemotherapy for stage IV breast carcinoma.
REVISTA
/ JOURNAL: - Hum Gene Ther 2001 Nov 1;12(16):2023-5.
AUTORES
/ AUTHORS: - Ayash LJ; Clarke M; Adams P; Ferrara J;
Ratanatharathorn V; Reynolds C; Roessler B; Silver S; Strawderman M; Uberti J;
Wicha M
RESUMEN
/ SUMMARY: - High-dose chemotherapy (HDCT) and
autologous bone marrow transplantation (BMT) is frequently used to treat
patients with metastatic cancer including breast cancer and neuroblastoma.
However, the bone marrow of such patients is often contaminated with tumor
cells. Recently, we have found that a recombinant adenovirus vector that
contains a bcl-x, minigene (a dominant negative inhibitor of the bcl-2 family),
called the bcl-x(s) adenovirus, is lethal to cancer cells derived from
epithelial tissues, but not to normal human hematopoietic cells. To determine
the mechanism, by which this virus spares normal hematopoietic cells, we
isolated normal mouse hematopoietic stem cells and infected them with an
adenovirus that contains a beta-galactosidase minigene. Such cells do not
express beta-galactosidase, indicating that hematopoietic stem cells do not express
transgene encoded by adenovirus vectors based upon the RSV-AD5 vector system.
When breast cancer cells mixed with hematopoietic cells were infected with the
bcl-x(s) adenovirus, cancer cells were selectively killed by the suicide
adenoviruses. Hematopoietic cells exposed to the suicide vectors were able to
reconstitute the bone marrow of mice exposed to lethal doses of y-irradiation.
These studies suggest that adenovirus suicide vectors may provide a simple and
effective method to selectively eliminate cancer cells derived from epithelial
tissue that contaminate bone marrow to be used for autologous BMT. We therefore
propose to initiate a phase I clinical trial to test the safety of this virus
in women with breast cancer undergoing high does chemotherapy and autologous
BMT.
----------------------------------------------------
[141]
TÍTULO / TITLE: - Drug immunosuppression
therapy for adult heart transplantation. Part 1: immune response to allograft
and mechanism of action of immunosuppressants.
REVISTA
/ JOURNAL: - Ann Thorac Surg 2004 Jan;77(1):354-62.
AUTORES
/ AUTHORS: - Mueller XM
INSTITUCIÓN
/ INSTITUTION: - Department of Cardiovascular Surgery,
Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada. xavier.mueller@usherbrooke.ca
RESUMEN
/ SUMMARY: - In the early days of transplantation,
immunosuppression therapy was rather broad and nonspecific, mainly using
high-dose corticosteroids and azathioprine. Thereafter we progressively
narrowed the target of immunosuppressive strategy starting with polyclonal
antibodies. The introduction of cyclosporine, OKT3, and tacrolimus further
narrowed the target on the T-cell pathways. More recently mycophenolate mofetil
progressively took the place of azathioprine with its higher lymphocyte
specificity and sirolimus and interleukin-2 receptor antibodies were
introduced. In this field in constant movement the aim is to find a drug or a
regimen that provides optimal immunosuppression therapy with minimal side
effects, in other words to find the right balance between overimmunosuppression
and underimmunosuppression therapy. This review is divided into two parts. The
first part will provide a basic understanding of the immunologic response to allograft
and explain how conventional and recently introduced immunosuppressive agents
work. The second part will describe the clinical application of
immunosuppressive drugs to provide practical information for those in charge of
heart transplant recipients. N.
Ref:: 68
----------------------------------------------------
[142]
TÍTULO / TITLE: - Longstanding
obliterative panarteritis in Kawasaki disease: lack of cyclosporin A effect.
REVISTA
/ JOURNAL: - Pediatrics 2003 Oct;112(4):986-92.
AUTORES
/ AUTHORS: - Kuijpers TW; Biezeveld M; Achterhuis A;
Kuipers I; Lam J; Hack CE; Becker AE; van der Wal AC
INSTITUCIÓN
/ INSTITUTION: - Emma Children’s Hospital, Academic Medical
Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. t.w.kuijpers@amc.uva.nl
RESUMEN
/ SUMMARY: - Kawasaki disease is a childhood vasculitis
of medium-sized vessels, affecting the coronary arteries in particular. We have
treated a therapy-resistant child who met all diagnostic criteria for Kawasaki
disease. After the boy was given intravenous immunoglobulins and salicylates,
as well as several courses of pulsed methylprednisolone, disease recurred and
coronary artery lesions became progressively detectable. Cyclosporin A was started
and seemed clinically effective. In contrast to the positive effect on
inflammatory parameters, ie, C-reactive protein and white blood cell counts, a
novel plasma marker for cytotoxicity (granzyme B) remained elevated. Coronary
disease progressed to fatal obstruction and myocardial infarction.
Echocardiography, electrocardiograms, and myocardial creatine phosphokinase did
not predict impending death. At autopsy an obliterative panarteritis was
observed resulting from massive fibrointimal proliferation, affecting the aorta
and several large and medium-sized arteries. Immunophenotypic analysis of the
inflammatory infiltrates in arteries revealed mainly granzyme-positive
cytotoxic T cells and macrophages in the intima and media, as well as nodular
aggregates of T cells, B cells, and plasma cells in the adventitia of affected
arteries. These findings further endorse the role of specific cellular and
humoral immunity in Kawasaki disease. Unremitting coronary arteritis and
excessive smooth muscle hyperplasia resulted in coronary occlusion despite the
use of cyclosporin A. N.
Ref:: 37
----------------------------------------------------
[143]
TÍTULO / TITLE: - Rationale for trials of
long-term mycophenolate mofetil therapy for primary biliary cirrhosis.
REVISTA
/ JOURNAL: - Hepatology 2002 Feb;35(2):258-62.
●●
Enlace al texto completo (gratuito o de pago) 1053/jhep.2002.31607
AUTORES
/ AUTHORS: - Jones EA
INSTITUCIÓN
/ INSTITUTION: - Department of Gastrointestinal and Liver
Diseases, Academic Medical Center, Amsterdam, The Netherlands. E.A.Jones@amc.uva.nl N. Ref:: 51
----------------------------------------------------
[144]
TÍTULO / TITLE: - The history and future
of T-cell depletion as graft-versus-host disease prophylaxis for allogeneic
hematopoietic stem cell transplantation.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2001 Dec 1;98(12):3192-204.
AUTORES
/ AUTHORS: - Ho VT; Soiffer RJ
INSTITUCIÓN
/ INSTITUTION: - Department of Adult Oncology, Dana-Farber
Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston,
MA, USA. N. Ref:: 244
----------------------------------------------------
[145]
TÍTULO / TITLE: - Ultraviolet
light-induced regulatory (suppressor) T cells: an approach for promoting
induction of operational allograft tolerance?
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S29-31.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000112969.24120.64
AUTORES
/ AUTHORS: - Aubin F; Mousson C
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology and EA3181,
University Hospital, Besancon, France. francois.aubin@ufc-chu.univ-fcomte.fr.
RESUMEN
/ SUMMARY: - Ultraviolet (UV) light is known to induce
skin cancers by causing DNA gene mutations and inducing immunosuppression.
Taking advantage of these immunosuppressive capacities, UV light has been used,
with different modalities, as an immunosuppressive therapy in a variety of
diseases including allograft rejection and graft-versus-host disease. Phototherapy
includes UVB irradiation, UVA irradiation, oral psoralen (+)UVA irradiation
(PUVA), photodynamic therapy, and extracorporeal photopheresis, which consists
of infusion of UVA-irradiated autologous leukocytes collected by apheresis and
incubated with 8-methoxypsoralen. According to numerous experimental models and
human data, there is increasing evidence that UVB irradiation and
extracorporeal photopheresis can induce regulatory T cells and anticlonotypic
activity. These therapies induce apoptosis of activated T cells or of
extracorporally treated mononuclear cells, and up-regulate the expression of
costimulary molecules and adhesion molecules on antigen presenting cells. UVB-
or UVA-induced apoptotic cells could secrete immune suppressive cytokines (interleukin
(IL)-4, IL-10). The processing and presentation of apoptotic T cell antigens
from clones of pathogenic T cells by activated antigen presenting cells might
explain the induction of systemic anticlonotypic activity by photopheresis.
This induction of cell-mediated suppressive activity opens up future prospects
with the aim of expanding regulatory T cells and/or anticlonotypic activity,
especially by photopheresis in organ and cell transplantation. N. Ref:: 40
----------------------------------------------------
[146]
TÍTULO / TITLE: - Mammalian target of
rapamycin inhibition as therapy for hematologic malignancies.
REVISTA
/ JOURNAL: - Cancer 2004 Feb 15;100(4):657-66.
●●
Enlace al texto completo (gratuito o de pago) 1002/cncr.20026
AUTORES
/ AUTHORS: - Panwalkar A; Verstovsek S; Giles FJ
INSTITUCIÓN
/ INSTITUTION: - Section of Developmental Therapeutics,
Department of Leukemia, University of Texas M. D. Anderson Cancer Center,
Houston, Texas, USA.
RESUMEN
/ SUMMARY: - The mammalian target of rapamycin (mTOR)
is a downstream effector of the phosphatidylinositol 3-kinase (PI3K)/Akt
(protein kinase B) signaling pathway, which mediates cell survival and
proliferation. mTOR regulates essential signal-transduction pathways, is
involved in the coupling of growth stimuli with cell cycle progression, and
initiates mRNA translation in response to favorable nutrient environments. mTOR
is involved in regulating many aspects of cell growth, including membrane
traffic, protein degradation, protein kinase C signaling, ribosome biogenesis,
and transcription. Because mTOR activates both the 40S ribosomal protein S6
kinase (p70s6k) and the eukaryotic initiation factor 4E-binding protein 1, its
inhibitors cause G1-phase cell cycle arrest. Inhibitors of mTOR also prevent
cyclin dependent kinase (CDK) activation, inhibit retinoblastoma protein
phosphorylation, and accelerate the turnover of cyclin D1, leading to a
deficiency of active CDK4/cyclin D1 complexes, all of which may help cause
G1-phase arrest. It is known that the phosphatase and tensin homologue tumor
suppressor gene (PTEN) plays a major role in embryonic development, cell migration,
and apoptosis. Malignancies with PTEN mutations, which are associated with
constitutive activation of the PI3K/Akt pathway, are relatively resistant to
apoptosis and may be particularly sensitive to mTOR inhibitors. Rapamycin
analogs with relatively favorable pharmaceutical properties, including CCI-779,
RAD001, and AP23573, are under investigation in patients with hematologic
malignancies. N.
Ref:: 116
----------------------------------------------------
[147]
TÍTULO / TITLE: - Cholesteryl ester
transfer protein facilitates the movement of water-insoluble drugs between
lipoproteins: a novel biological function for a well-characterized lipid
transfer protein.
REVISTA
/ JOURNAL: - Biochem Pharmacol 2002 Dec
15;64(12):1669-75.
AUTORES
/ AUTHORS: - Kwong M; Wasan KM
INSTITUCIÓN
/ INSTITUTION: - Division of Pharmaceutics and
Biopharmaceutics, Faculty of Pharmaceutical Sciences, The University of British
Columbia, 2146 East Mall Avenue, Vancouver, BC, Canada V6T 1Z3.
RESUMEN
/ SUMMARY: - This review article addresses the recently
discovered finding that cholesteryl ester transfer protein (CETP) can
facilitate the transfer of water-insoluble drugs between different lipoprotein
subclasses. This protein, which is often referred to as lipid transfer protein
I (LTP I), is involved in the lipid regulation of lipoproteins. It is
responsible for the facilitated transfer of core lipoprotein lipids,
cholesteryl ester and triglycerides, and approximately one-third of the coat
lipoprotein lipid, phosphatidylcholine, between different plasma lipoproteins.
The human body appears to recognize exogenous water-insoluble drugs as
lipid-like particles, which suggests that these compounds may interact with
lipoproteins just like endogenous plasma lipids, and thus their transfer
between lipoproteins may be facilitated by plasma CETP. Patients with a variety
of diseases (i.e. diabetes, cancer, AIDS) often exhibit hypo- and/or
hypercholesterolemia and triglyceridemia, commonly referred to as
dyslipidemias, which result in changes in their plasma lipoprotein-lipid
composition and concentration. The interaction of water-insoluble drugs with
these dyslipidemic lipoproteins may be responsible for the differences seen in
the pharmacokinetics and pharmacodynamics of the drug within different diseased
patient populations. It is possible that these differences may be linked to the
ability of CETP to transfer these compounds from one lipoprotein to another.
This review examines the current understanding of the relationship between CETP
activity and the lipoprotein distribution of a number of compounds (e.g.
amphotericin B and cyclosporine A). It further suggests that additional
research will expand our understanding of the role of CETP to explain other
functions in lipophilic drug distribution and metabolism. N. Ref:: 45
----------------------------------------------------
[148]
TÍTULO / TITLE: - Heme oxygenase in liver
transplantation: heme catabolism and metabolites in the search of function.
REVISTA
/ JOURNAL: - Hepatology 2003 Aug;38(2):286-8.
●●
Enlace al texto completo (gratuito o de pago) 1053/jhep.2003.50360
AUTORES
/ AUTHORS: - Bauer M
N. Ref:: 31
----------------------------------------------------
[149]
TÍTULO / TITLE: - Advances in
transplantation tolerance.
REVISTA
/ JOURNAL: - Lancet 2001 Jun 16;357(9272):1959-63.
AUTORES
/ AUTHORS: - Yu X; Carpenter P; Anasetti C
INSTITUCIÓN
/ INSTITUTION: - Human Immunogenetics Program, Fred
Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
RESUMEN
/ SUMMARY: - Immunosuppressive drugs developed in the
past two decades have improved the short-term survival of organ allografts, but
tolerance has not been achieved and almost all transplant recipients continue
to require drugs throughout life. Graft rejection arises from the cognate
interaction of T cells with antigen-presenting cells, the recognition of
alloantigen through the T-cell receptor, and the delivery of accessory
stimulation signals. Once activated by the specific antigen, replicating T
cells die if they are re-exposed to the same antigen. Since depletion of
antigen-activated T cells is one critical mechanism of transplantation
tolerance, drugs such as ciclosporin that interfere with activation-induced
T-cell death could inhibit tolerance, whereas drugs such as mycophenolate
mofetil, that induce the death of activated T cells, could facilitate
tolerance. Other tolerance mechanisms depend on inactivation rather than
elimination of allograft reactive T cells. When antigen recognition occurs
without costimulation through the CD28 and CD154 accessory receptors, or in
absence of cell division, T cells become unresponsive. Thus, inhibitors of CD28
and CD154, and inhibition of T-cell division by rapamycin promotes
transplantation tolerance. N.
Ref:: 54
----------------------------------------------------
[150]
TÍTULO / TITLE: - Rational use of new and
existing disease-modifying agents in rheumatoid arthritis.
REVISTA
/ JOURNAL: - Ann Intern Med. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.annals.org/
●●
Cita: Annals of Internal Medicine: <> 2001 Apr 17;134(8):695-706.
AUTORES
/ AUTHORS: - Kremer JM
INSTITUCIÓN
/ INSTITUTION: - The Center for Rheumatology, Albany, New
York, USA. jkremer@rheum-docs.com
RESUMEN
/ SUMMARY: - Because of radiographic evidence of
progressive bone loss and the inability to eliminate synovial proliferation
with methotrexate, it became apparent that therapy for rheumatoid arthritis
needed further advancement. Methotrexate is not a remission-inducing drug and
may have dose-limiting toxicity. In the past 2 years, three new
disease-modifying antirheumatic drugs (DMARDs) have been approved: leflunomide,
etanercept, and infliximab. Each of these agents has demonstrated efficacy
compared with placebo in randomized, controlled studies. Because methotrexate
had a dominant therapeutic role, the new drugs were also studied in combination
with it. Other established DMARDs, such as sulfasalazine and
hydroxychloroquine, have also demonstrated efficacy when used together with
methotrexate. The results of these combination studies clearly demonstrate that
clinical responses can be meaningfully improved when new and existing DMARDs
are added to methotrexate. Although toxicity remains a serious concern when
powerful immune modulators and antimetabolites are used in combination,
relatively few serious adverse events have been reported during 2-year treatment
periods. It has also become apparent that combinations of new DMARDs and
methotrexate virtually halt radiographic progression over 2 years. The new
agents are expensive, but annual costs must be weighed against the personal and
societal expense of joint arthroplasty, hospitalizations, disability, and
diminished quality of life that accompanies poorly controlled rheumatoid
arthritis. The ultimate value of combination DMARD therapy with methotrexate
will be determined by long-term data on safety, efficacy, and effects on
radiographic deterioration of bone. Additional long-term observational data on
the incidence of joint arthroplasty and disability will help to place the issue
of societal costs in a better perspective. This will allow the value of aggressive
treatment to be established with certainty.
N. Ref:: 87
----------------------------------------------------
[151]
TÍTULO / TITLE: - Immunisations in
solid-organ transplant recipients.
REVISTA
/ JOURNAL: - Lancet 2002 Mar 16;359(9310):957-65.
AUTORES
/ AUTHORS: - Stark K; Gunther M; Schonfeld C; Tullius
SG; Bienzle U
INSTITUCIÓN
/ INSTITUTION: - Institute of Tropical Medicine, Charite,
Humboldt University, Berlin, Germany. starkk@rki.de
RESUMEN
/ SUMMARY: - Solid-organ transplant recipients are at
increased risk of various infectious diseases, some of which are vaccine
preventable mmunisations are among the most efficient interventions available.
Solid-organ tranplant recipients would greatly benefit from effective
immunisations, provided the recommendations are based on a careful risk-benefit
analysis in which the effectiveness of the vaccine is weighed against possible
adverse reactions, including graft rejection. In this review, we summarise the
data from studies on relevant immunisations in solid-organ transplant
recipients. The major issues are the immunogenicity and safety of
immunisations, the factors associated with poor immune response, and
recommendations for immunisation schemes.
N. Ref:: 94
----------------------------------------------------
[152]
TÍTULO / TITLE: - Xenotransplantation and
other means of organ replacement.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2001 Nov;1(2):154-60.
●●
Enlace al texto completo (gratuito o de pago) 1038/35100578
AUTORES
/ AUTHORS: - Cascalho M; Platt JL
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery and Immunology, Mayo
Clinic, Rochester, Minnesota 55905, USA.
RESUMEN
/ SUMMARY: - Exciting new technologies, such as
cellular transplantation, organogenesis and xenotransplantation, are thought to
be promising approaches for the treatment of human disease. The feasibility of
applying these technologies, however, might be limited by biological and
immunological hurdles. Here, we consider whether, and how, xenotransplantation
and various other technologies might be applied in future efforts to replace or
supplement the function of human organs and tissues. N. Ref:: 73
----------------------------------------------------
[153]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.6.3. Cancer risk after renal transplantation. Solid
organ cancers: prevention and treatment.
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;17 Suppl 4:32, 34-6.
RESUMEN
/ SUMMARY: - GUIDELINES: J. All renal transplant
recipients should have regular ultrasonography of their native kidneys (when
applicable) for screening of renal cell carcinomas, which are observed at much
higher incidence in both dialysed and transplant patients. K. Guidelines
published for screening and prevention of solid organ cancers in the general
population should be strictly applied to transplant recipients, who are in
general at higher cancer risk, but would benefit equally or even greater. L.
All male renal transplant recipients aged 50 and over should have a yearly
prostate specific antigen (PSA) test prior to a regular digital rectal
examination. M. All female renal transplant recipients should have a yearly
cervical (PAP) smear together with regular pelvic examination and regular
mammography, according to national recommendations where available. N. All
renal transplant recipients should undergo a faecal occult-blood testing as a
screening for colorectal cancer and other (pre-malignant) lesions, according to
national recommendations where available. O. In all these conditions, it is
recommended to reduce immunosuppression whenever possible.
----------------------------------------------------
[154]
TÍTULO / TITLE: - Clinical development of
mammalian target of rapamycin inhibitors.
REVISTA
/ JOURNAL: - Hematol Oncol Clin North Am 2002
Oct;16(5):1101-14.
AUTORES
/ AUTHORS: - Dancey JE
INSTITUCIÓN
/ INSTITUTION: - Cancer Treatment Evaluation Program,
Division of Cancer Treatment and Diagnosis, Investigational Drug
Branch/CTEP/DCTD/NCI, 6130 Executive Boulevard, EPN 7131, Rockville, MD 20854,
USA. danceyj@ctep.nci.nih.gov
RESUMEN
/ SUMMARY: - Rapamycin and CCI-779 have significant in
vitro and in vivo anti-proliferative activity against a broad range of human
tumor cell lines, justifying the clinical evaluation of this class of agent in
cancer patients. Preliminary results from phase I studies of CCI-779 suggest
that the agent is well tolerated and has anti-tumor activity. The challenge to
investigators is to efficiently determine what role this class of agent will
play in the treatment of cancer patients.
N. Ref:: 69
----------------------------------------------------
[155]
TÍTULO / TITLE: - Review article: medical
treatment of mild to moderately active Crohn’s disease.
REVISTA
/ JOURNAL: - Aliment Pharmacol Ther 2003 Jun;17 Suppl
2:18-22.
AUTORES
/ AUTHORS: - Lofberg R
INSTITUCIÓN
/ INSTITUTION: - Karolinska Institutet, IBD-unit at HMQ
Sophia Hospital, Stockholm, Sweden. ibd@sophiahemmet.se
RESUMEN
/ SUMMARY: - Crohn’s disease is a chronic, debilitating
subset of inflammatory bowel diseases, which may affect any part of the
gastrointestinal tract. The most common sites of inflammation are the terminal
ileum and/or the colon. Fistulous disease is present in up to 20% of patients,
particularly in those having rectal involvement. The aetiology of Crohn’s
disease still remains obscure, therefore medical therapy is directed towards
symptomatic relief in active disease and relapse prevention in the long-term
setting. Contemporary Crohn’s disease management comprises individual treatment
depending mainly on Crohn’s disease localization in the gastrointestinal tract
and the disease severity. The mainstay of current medical treatment for mild to
moderately active stages of Crohn’s disease includes aminosalicylates,
antibiotics, glucococorticosteroids and immunomodulators. Biologics such as
anti TNF-compounds and anti-integrins are being introduced. N. Ref:: 21
----------------------------------------------------
[156]
TÍTULO / TITLE: - Severe Ehrlichia
chaffeensis infection in a lung transplant recipient: a review of ehrlichiosis
in the immunocompromised patient.
REVISTA
/ JOURNAL: - Emerg Infect Dis. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.cdc.gov/
●●
Cita: Emerging Infectious Diseases: <> 2002 Mar;8(3):320-3.
AUTORES
/ AUTHORS: - Safdar N; Love RB; Maki DG
INSTITUCIÓN
/ INSTITUTION: - Section of Infectious Diseases, University
of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792, USA.
RESUMEN
/ SUMMARY: - We describe a case of human ehrlichiosis
in a lung transplant recipient and review published reports on ehrlichiosis in
immunocompromised patients. Despite early therapy with doxycycline, our patient
had unusually severe illness with features of thrombotic thrombocytopenic
purpura. Of 23 reported cases of ehrlichiosis in immunocompromised patients,
organ failure occurred in all patients and 6 (25%) died. N. Ref:: 32
----------------------------------------------------
[157]
TÍTULO / TITLE: - Survival after
HLA-identical allogeneic peripheral blood stem cell and bone marrow
transplantation for hematologic malignancies: meta-analysis of randomized
controlled trials.
REVISTA
/ JOURNAL: - Bone Marrow Transplant 2003
Aug;32(3):293-8.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.bmt.1704112
AUTORES
/ AUTHORS: - Horan JT; Liesveld JL; Fernandez ID; Lyman
GH; Phillips GL; Lerner NB; Fisher SG
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, University of
Rochester School of Medicine and Dentistry, Rochester, NY, USA.
RESUMEN
/ SUMMARY: - The impact of peripheral blood stem cell
transplantation (PBSCT) on survival relative to bone marrow transplantation
(BMT) remains poorly defined. Several randomized controlled trials (RCTs)
comparing HLA-matched related PBSC- and BMT for patients with hematologic
malignancies have been published, yielding differing results. We conducted a
meta-analysis of published RCTs to more precisely estimate the effect of PBSCT
on survival. Seven trials that assessed survival were identified and included
in our analysis. Using a fixed effects model, and combining the results of all
seven trials, the summary odds ratio for mortality after PBSCT was 0.81 (95%
CI, 0.62-1.05) when compared to BMT. Subgroup analysis revealed no association
between the median PBSCT 34+ cell dose and relative risk for morality after
PBSCT. However, there was an association between the proportion of patients
enrolled with advanced-stage disease and the summary odds ratio for mortality.
The pooled estimate was 0.64 for studies where patients with
intermediate/advanced disease comprised at least 25% of enrollment, and was
1.07 for the studies enrolling a smaller proportion. This finding substantiates
results from previously published studies that have demonstrated a survival
advantage with PBSCT limited to patients with advanced disease.
----------------------------------------------------
[158]
TÍTULO / TITLE: - One-year survival in
patients with acute myocardial infarction and a saphenous vein graft culprit
treated with primary angioplasty.
REVISTA
/ JOURNAL: - Am J Cardiol 2003 May 15;91(10):1250-4.
AUTORES
/ AUTHORS: - Nguyen TT; O’Neill WW; Grines CL; Stone
GW; Brodie BR; Cox DA; Grines LL; Boura JA; Dixon SR
INSTITUCIÓN
/ INSTITUTION: - William Beaumont Hospital, Royal Oak,
Michigan 48073, USA.
----------------------------------------------------
[159]
TÍTULO / TITLE: - Regulatory T cells in
kidney transplant recipients: active players but to what extent?
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Jun;14(6):1706-8.
AUTORES
/ AUTHORS: - Zhai Y; Kupiec-Weglinski JW N. Ref:: 20
----------------------------------------------------
[160]
TÍTULO / TITLE: - The bare lymphocyte syndrome
and the regulation of MHC expression.
REVISTA
/ JOURNAL: - Annu Rev Immunol 2001;19:331-73.
●●
Enlace al texto completo (gratuito o de pago) 1146/annurev.immunol.19.1.331
AUTORES
/ AUTHORS: - Reith W; Mach B
INSTITUCIÓN
/ INSTITUTION: - Jeantet Laboratory of Molecular Genetics,
Department of Genetics and Microbiology, University of Geneva Medical School, 1
rue Michel-Servet, Geneva 4, 1211 Switzerland. Walter.Reith@medecine.unige.ch
RESUMEN
/ SUMMARY: - The bare lymphocyte syndrome (BLS) is a
hereditary immunodeficiency resulting from the absence of major
histocompatibility complex class II (MHCII) expression. Considering the central
role of MHCII molecules in the development and activation of CD4(+) T cells, it
is not surprising that the immune system of the patients is severely impaired.
BLS is the prototype of a “disease of gene regulation.” The affected genes
encode RFXANK, RFX5, RFXAP, and CIITA, four regulatory factors that are highly
specific and essential for MHCII genes. The first three are subunits of RFX, a
trimeric complex that binds to all MHCII promoters. CIITA is a non-DNA-binding
coactivator that functions as the master control factor for MHCII expression.
The study of RFX and CIITA has made major contributions to our comprehension of
the molecular mechanisms controlling MHCII genes and has made this system into
a textbook model for the regulation of gene expression. N. Ref:: 183
----------------------------------------------------
[161]
TÍTULO / TITLE: - Prediction of an
HLA-DR-binding peptide derived from Wilms’ tumour 1 protein and demonstration
of in vitro immunogenicity of WT1(124-138)-pulsed dendritic cells generated
according to an optimised protocol.
REVISTA
/ JOURNAL: - Cancer Immunol Immunother 2002
Jul;51(5):271-81. Epub 2002 Apr 26.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00262-002-0278-2
AUTORES
/ AUTHORS: - Knights AJ; Zaniou A; Rees RC; Pawelec G;
Muller L
INSTITUCIÓN
/ INSTITUTION: - University of Tubingen, Section for
Transplantation Immunology and Immunohaematology, Second Department of Internal
Medicine, Zentrum fur Medizinische Forschung ZMF, Waldhornlestrasse 22, 72072
Tubingen, Germany.
RESUMEN
/ SUMMARY: - The Wilms’ tumour 1 (WT1) protein is
over-expressed in several types of cancer including leukaemias and might
therefore constitute a novel target for immunotherapy. Recently, human
leucocyte antigen (HLA) class I-binding WT1 peptides have been identified and
shown to stimulate CD8(+) T cells in vitro. For maximal CD8 cell efficacy,
CD4(+) helper T cells responding to major histocompatibility complex (MHC) class
II-binding epitopes are required. Here, we report that scanning the WT1 protein
sequence using an evidence-based predictive computer algorithm (SYFPEITHI)
yielded a peptide WT1(124-138) predicted to bind the HLA-DRB1*0401 molecule
with high affinity. Moreover, synthetic WT1(124-138)-peptide-pulsed dendritic
cells (DC), generated according to a protocol optimised in the present study,
sensitised T cells in vitro to proliferate and secrete interferon-gamma
(IFN-gamma) when rechallenged with specific peptide-pulsed DC, but not with
peripheral blood mononuclear cells (PBMC). These results suggest that the WT1
protein may yield epitopes immunogenic to CD4 as well as CD8 T cells, and
therefore constitute a novel potential target for specific immunotherapy.
----------------------------------------------------
[162]
TÍTULO / TITLE: - Medical therapy for
Crohn’s disease: the state of the art.
REVISTA
/ JOURNAL: - Surg Clin North Am 2001 Feb;81(1):71-101,
viii.
AUTORES
/ AUTHORS: - Stein RB; Lichtenstein GR
INSTITUCIÓN
/ INSTITUTION: - University of Pennsylvania School of
Medicine, and Department of Medicine, Presbyterian Medical Center,
Philadelphia, USA.
RESUMEN
/ SUMMARY: - Various medications are used to control
the symptoms of Crohn’s disease. This article reviews the traditional medical
therapies of Crohn’s disease, including aminosalicylates and corticosteroids,
and the broad armamentarium of immune modulators and biologic agents that are
becoming increasingly important in the management of Crohn’s disease. N. Ref:: 164
----------------------------------------------------
[163]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.5.1. Cardiovascular risks. Cardiovascular disease
after renal transplantation.
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;17 Suppl 4:24-5.
RESUMEN
/ SUMMARY: - GUIDELINES: A. Post-transplant
cardiovascular disease is very common, an important cause of morbidity and the
first cause of mortality in renal transplant recipients. Therefore, detection
and early treatment of post-transplant cardiovascular disease are mandatory. B.
Specific risk factors for developing post-transplant cardiovascular disease
include pre-transplant cardiovascular disease, arterial hypertension, uraemia
(graft dysfunction), hyperlipidaemia, diabetes mellitus, smoking and
immunosuppressive treatment. These factors should be targeted for intervention.
C. Pre-transplant cardiovascular disease is a major risk factor for post-transplant
cardiovascular disease. Therefore, prior to transplantation, it is mandatory to
detect and treat symptomatic coronary artery disease, heart failure due to
valvular failure or cardiomyopathy, and pericardial constriction. This policy
should also be followed in asymptomatic diabetic patients.
----------------------------------------------------
[164]
TÍTULO / TITLE: - Guidelines for
preventing opportunistic infections among hematopoietic stem cell transplant
recipients. Recommendations of CDC, the Infectious Disease Society of America,
and the American Society of Blood and Marrow Transplantation.
REVISTA
/ JOURNAL: - Cytotherapy 2001;3(1):41-54.
●●
Enlace al texto completo (gratuito o de pago) 1080/146532401753156403
----------------------------------------------------
[165]
TÍTULO / TITLE: - Interleukin 2 receptor
antagonists for kidney transplant recipients.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2004;1:CD003897.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003897.pub2
AUTORES
/ AUTHORS: - Webster A; Playford E; Higgins G; Chapman
J; Craig J
INSTITUCIÓN
/ INSTITUTION: - Centre for Kidney Research, The Children’s
Hospital at Westmead, Locked Bag 4001, Westmead, NSW, AUSTRALIA, 2145.
RESUMEN
/ SUMMARY: - BACKGROUND: Interleukin 2 receptor
antagonists (IL2Ra) are used as induction therapy for prophylaxis against acute
rejection in kidney transplant recipients. Use of IL2Ra has increased steadily,
with 38% of new kidney transplant recipients in the United States, and 23% in
Australasia receiving IL2Ra in 2002. OBJECTIVES: This study aims to
systematically identify and summarise the effects of using an IL2Ra, as an
addition to standard therapy, or as an alternative to other antibody therapy.
SEARCH STRATEGY: The Cochrane Renal Group’s specialised register (June 2003),
the Cochrane Controlled Trials Register (in The Cochrane Library issue 3,
2002), MEDLINE (1966-November 2002) and EMBASE (1980-November 2002). Reference
lists and abstracts of conference proceedings and scientific meetings were
hand-searched from 1998-2003. Trial groups, authors of included reports and
drug manufacturers were contacted. SELECTION CRITERIA: Randomised controlled
trials (RCTs) in all languages comparing IL2Ra to placebo, no treatment, other
IL2Ra or other antibody therapy. DATA COLLECTION AND ANALYSIS: Data was
extracted and quality assessed independently by two reviewers, with differences
resolved by discussion. Dichotomous outcomes are reported as relative risk (RR)
with 95% confidence intervals (CI). MAIN RESULTS: One hundred and seventeen
reports from 38 trials involving 4893 participants were included. Where IL2Ra
were compared with placebo (17 trials; 2786 patients), graft loss was not
significantly different at one (RR 0.83, 95% CI 0.66 to 1.04) or three years
(RR 0.88, 95% CI 0.64 to 1.22). Acute rejection (AR) was significantly reduced
at six months (RR 0.66, 95% CI 0.59 to 0.74) and at one year (RR 0.67, 95% CI
0.60 to 0.75). At one year, cytomegalovirus (CMV) infection (RR 0.82, 95% CI
0.65 to 1.03) and malignancy (RR 0.67, 95% CI 0.33 to 1.36) were not
significantly different. Where IL2Ra were compared with other antibody therapy
no significant differences in treatment effects were demonstrated, but adverse
effects strongly favoured IL2Ra. REVIEWER’S CONCLUSIONS: Given a 40% risk of
rejection, seven patients would need treatment with IL2Ra to prevent one
patient having rejection, with no definite improvement in graft or patient
survival. There is no apparent difference between basiliximab and daclizumab.
IL2Ra are as effective as other antibody therapies and with significantly fewer
side effects
----------------------------------------------------
[166]
TÍTULO / TITLE: - Calcium channel
blockers for preventing acute tubular necrosis in kidney transplant recipients.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2004;1:CD003421.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003421.pub2
AUTORES
/ AUTHORS: - Shilliday I; Sherif M
INSTITUCIÓN
/ INSTITUTION: - Renal Unit, Monklands Hospital, Monkscourt
Avenue, Airdrie, UK, ML6 0JS.
RESUMEN
/ SUMMARY: - BACKGROUND: The incidence of delayed graft
function in cadaveric grafts has increased over the last few years due in part
to the large demand for cadaveric kidneys necessitating the use of kidneys from
marginal donors. Calcium channel blockers have the potential to reduce the
incidence of post-transplant acute tubular necrosis (ATN) if given in the
peri-operative period. However, there is controversy surrounding their use in
this situation with no consensus as to their efficacy. OBJECTIVES: To evaluate
the benefits and harms of using calcium channel blockers in the peri-transplant
period in patients at risk of ATN following cadaveric kidney transplantation.
SEARCH STRATEGY: We searched the Cochrane Renal Group’s specialised register,
the Cochrane Central Register of Controlled Trials (CENTRAL, in The Cochrane
Library issue 2, 2003) MEDLINE (1966 to January 2003) and EMBASE (1980 -
January 2003). The Trials Search Coordinator was contacted to develop the
search strategy. SELECTION CRITERIA: Randomised controlled trials comparing
calcium channel blockers given in the peri-transplant period with controls were
included. Quasi-randomised trials were excluded. DATA COLLECTION AND ANALYSIS:
Data was extracted and quality assessed independently by two reviewers, with
differences resolved by discussion. Dichotomous outcomes are reported as
relative risk (RR) and measurements on continuous scales are reported as
weighted mean differences (WMD) with 95% confidence intervals (CI). MAIN
RESULTS: Nine trials were suitable for inclusion. Treatment with calcium
channel blockers in the peri-transplant period was associated with a
significant decrease in the incidence of post transplant ATN (RR 0.57, 95%CI
0.40 to 0.82) and delayed graft function (RR 0.44, 95% CI 0.28 to 0.69). There
was no difference between control and treatment groups in graft loss,
mortality, requirement for haemodialysis. There was insufficent information to
comment on adverse events. REVIEWER’S CONCLUSIONS: These results suggest that
calcium channel blockers given in the peri-operative period may reduce the
incidence of ATN post-transplantation. The result should be treated with
caution due to the heterogeneity of the trials which made comparison of studies
and pooling of data difficult.
----------------------------------------------------
[167]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.6.2. Cancer risk after renal transplantation. Skin
cancers: prevention and treatment.
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;17 Suppl 4:31-6.
RESUMEN
/ SUMMARY: - GUIDELINES: D. Due to the high prevalence
of skin cancers after organ transplantation, it is highly recommended to inform
patients about self-awareness. E. Primary prevention should include the
avoidance of sun exposure, use of protective clothing and use of an effective
sunscreen (protection factor >15) for unclothed body parts (head, neck,
hands and arms) in order to prevent the occurrence of squamous-cell carcinoma.
This is the most frequent skin tumour in transplant recipients, and its
preferential location is the head. F. Recipients with pre-malignant skin
lesions (warts, epidermodysplasia verruciformis or actinic keratoses) should be
referred early to a dermatologist for active treatment and close follow-up. G.
All skin cancers should be completely removed by a dermatologist with
appropriate techniques, such as electro-desiccation with curettage, cryotherapy
or surgical excision. H. Secondary prevention for recipients should include
close follow-up by a dermatologist (at least every 6 months), the use of
topical retinoids to control actinic keratoses and to diminish squamous-cell
carcinoma recurrence, and reduction of immunosuppression whenever possible. I.
In recipients with multiple and/or recurrent skin cancers, the use of systemic
retinoids, such as low-dose acitretin, could be recommended for months/years,
if well tolerated, in addition to further reduction in immunosuppression
whenever possible.
----------------------------------------------------
[168]
TÍTULO / TITLE: - Treatment of nephrotic
syndrome in children and controlled trials.
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: <> 2003 Aug;18 Suppl 6:vi75-8.
AUTORES
/ AUTHORS: - Filler G
INSTITUCIÓN
/ INSTITUTION: - Department of Paediatrics, Division of
Nephrology, Children’s Hospital of Eastern Ontario, University of Ottawa,
Canada. filler@cheo.on.ca
RESUMEN
/ SUMMARY: - AIM: To determine the sequential therapy
of childhood nephrotic syndrome (NS) with presumed minimal change nephropathy
using the evidence from clinical trials. METHODS: Meta-analysis of 22
randomized controlled trials was performed, using frequency of relapse and side
effects of therapeutic regimes. RESULTS: A meta-analysis of seven trials
comparing duration of therapy for initial onset showed that duration of at
least 3 months significantly reduced the risk of relapse at 12-24 months (relative
risk 0.73; 95% confidence interval 0.60-0.89) without an increase in adverse
events. Five trials were performed for steroid treatment of relapse.
Deflazacort reduced relapses during therapy, but is not generally available. No
difference was observed when comparing single and divided dosing of prednisone.
Frequency of relapses could not be influenced by duration of relapse therapy.
Alternate day therapy was more effective than intermittent use of prednisone.
Two studies out of five on cyclophosphamide or chlorambucil showed consistently
that alkylating agents should be used before cyclosporine as alternative
therapy to steroids. CONCLUSIONS: Children with initial onset of NS should be
treated with prednisone at a dose of 60 mg/m(2)/day for 6 weeks, followed by a
dose of 40 mg/m(2)/48 h for at least another 6 weeks. If steroid toxicity for
treatment of relapsing NS requires alternative treatment, cyclophosphamide (2
mg/kg/day for at least 8 weeks) remains the drug of choice with a curative
potential. If children still relapse after alkylating agents, levamisole may
serve as an alternative only for frequent relapsing NS, whereas
steroid-dependent NS should be treated with cyclosporine.
----------------------------------------------------
[169]
TÍTULO / TITLE: - Non-corticosteroid
treatment for nephrotic syndrome in children.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2001;(4):CD002290.
AUTORES
/ AUTHORS: - Durkan A; Hodson E; Willis N; Craig J
INSTITUCIÓN
/ INSTITUTION: - Centre for Kidney Research, The Children’s
Hospital at Westmead, Locked Bag 4001, Westmead, NSW, Australia, 2145. ElisaH@chw.edu.au
RESUMEN
/ SUMMARY: - BACKGROUND: Eighty to ninety per cent
children with steroid sensitive nephrotic syndrome (SSNS) have one or more
relapses. About half of these children relapse frequently and are at risk of
the adverse effects of corticosteroids. Non-corticosteroid immunosuppressive
agents are used to prolong periods of remission in children, who relapse frequently.
However these non-corticosteroid agents also have significant potential adverse
effects. Currently there is no consensus as to the most appropriate second line
agent in children who are steroid sensitive, but who continue to relapse. In
this systematic review of randomised controlled trials (RCTs), the benefits and
harms of these immunosuppressive agents are evaluated. OBJECTIVES: To evaluate
the benefits and harms of non-corticosteroid immunosuppressive agents in
relapsing SSNS in children. SEARCH STRATEGY: Published and unpublished
randomised controlled trials were identified from the Cochrane Controlled
Trials Register, MEDLINE, EMBASE, reference lists of articles, abstracts from
proceedings and contact with known investigators in the area. SELECTION
CRITERIA: Randomised or quasi-randomised trials were included if they were
carried out in children (aged three months to 18 years) with relapsing SSNS, if
they compared non-corticosteroid agents with placebo, prednisone or no
treatment, different doses and/ or durations of the same non-corticosteroid
agent, different non-corticosteroid agents and if they had outcome data at six
months or more. DATA COLLECTION AND ANALYSIS: Two reviewers independently
reviewed all eligible studies for inclusion, assessed study quality and
extracted data. The principle outcome measure was the number of children with
and without relapse after six and 12 to 24 months. Secondary outcomes sought
were the mean time to next relapse, the mean number of relapses per year and
adverse events. A random effects model was used to estimate summary effect
measures after testing for heterogeneity. Examination of possible between-study
differences due to study quality, different interventions and different
populations was attempted by subgroup analysis. MAIN RESULTS: Eighteen trials
involving 828 children were identified. Cyclophosphamide (three trials;
relative risk (RR) 0.44; 95% confidence intervals (95% CI) 0.26 to 0.73) and
chlorambucil (two trials; RR 0.13; 95% CI 0.03 to 0.57) significantly reduced
the relapse risk at six to twelve months compared with prednisone alone. In the
single chlorambucil versus cyclophosphamide trial, there was no observed
difference in relapse risk at two years (RR 1.31; 95% CI 0.80 to 2.13).
Cyclosporin was as effective as cyclophosphamide (one trial, RR 1.07; 95% CI
0.48 to 2.35) and chlorambucil (one trial, RR 0.82; 95% CI 0.44 to 1.53) but
the effect was not sustained when cyclosporin was ceased. During treatment
levamisole (three trials, RR 0.60; 95% CI 0.45 to 0.79) was more effective than
steroids alone but the effect was not sustained. Mizoribine (one trial) and
azathioprine (two trials) were no more effective than placebo or prednisone
alone in maintaining remission. REVIEWER’S CONCLUSIONS: Eight weeks courses of
cyclophosphamide or chorambucil and prolonged courses of cyclosporin and
levamisole reduce the risk of relapse in children with relapsing SSNS compared
with corticosteroids alone. Clinically important differences in efficacy among
these agents are possible and further comparative trials are still needed.
Meanwhile choice between these agents depends on physician and patient
preferences related to therapy duration and the type and frequency of
complications. N.
Ref:: 49
----------------------------------------------------
[170]
TÍTULO / TITLE: - Cytotoxic drugs and
interferons for chronic inflammatory demyelinating polyradiculoneuropathy.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(1):CD003280.
AUTORES
/ AUTHORS: - Hughes RA; Swan AV; van Doorn PA
INSTITUCIÓN
/ INSTITUTION: - Department of Neuroimmunology, Guy’s,
King’s and St Thomas’ School of Medicine, 2nd Floor Hodgkin
Building, Guy’s Hospital, London, UK, SE1 1UL. richard.a.hughes@kcl.ac.uk
RESUMEN
/ SUMMARY: - BACKGROUND: Chronic inflammatory
demyelinating polyradiculoneuropathy is a disease causing progressive or
relapsing and remitting weakness and numbness. It is probably due to an
autoimmune inflammatory process. Immunosuppressive or immunomodulatory drugs
would be expected to be beneficial. OBJECTIVES: We aimed to review
systematically the evidence from randomised trials concerning cytotoxic drugs
and interferons for chronic inflammatory demyelinating polyradiculoneuropathy. SEARCH
STRATEGY: We searched the Cochrane Neuromuscular Disease Group trials register
(searched December 2001), MEDLINE (searched January 1977 to December 2001),
EMBASE (January 1980 to December 2001), CINAHL (searched January 1982 to
December 2001) and LILACS (searched January 1982 to December 2001). We
contacted the authors of the trials identified and other disease experts
seeking other published and unpublished trials. SELECTION CRITERIA: We sought
randomised and quasi-randomised trials of all immunosuppressive agents such as
azathioprine, cyclophosphamide, methotrexate, cyclosporin A, mycophenolate
mofetil, and rituximab and all immunomodulatory agents such as alpha interferon
and beta interferon in participants fulfilling standard diagnostic criteria for
chronic inflammatory demyelinating polyradiculoneuropathy. DATA COLLECTION AND
ANALYSIS: Two of us independently selected the trials which met our criteria,
judged their methodological quality and extracted the data onto specially
designed forms. We wanted to measure the change in disability after one year as
our primary outcome measure. MAIN RESULTS: We found one parallel group open
trial of azathioprine for nine months involving 27 participants and another of
interferon beta involving 10 participants in a double blind crossover trial
with each treatment period lasting 12 weeks. Neither trial provided our primary
outcome measure and neither showed a significant beneficial effect on any of
the outcome measures selected by the authors or ourselves in the protocol for
this review. REVIEWER’S CONCLUSIONS: The evidence is inadequate to decide
whether azathioprine, interferon beta or any other immunosuppressive drug or
interferon is beneficial in chronic inflammatory demyelinating
polyradiculoneuropathy. N.
Ref:: 66
----------------------------------------------------
[171]
TÍTULO / TITLE: - Interventions for
bullous pemphigoid.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(3):CD002292.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD002292
AUTORES
/ AUTHORS: - Khumalo N; Kirtschig G; Middleton P;
Hollis S; Wojnarowska F; Murrell D
INSTITUCIÓN
/ INSTITUTION: - Dermatology Department, Groote Schuur
Hospital, Cape Town, South Africa, Anzio Road, Observatory, Cape Town, Western
Cape, South Africa.
RESUMEN
/ SUMMARY: - BACKGROUND: Bullous pemphigoid is the most
common autoimmune bullous disease in the West. Oral steroids are considered the
standard treatment. OBJECTIVES: To assess the effects of treatments for bullous
pemphigoid. SEARCH STRATEGY: We searched the Skin Group Specialised Register,
the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE to March
2003 and bibliographies from identified studies. SELECTION CRITERIA: Randomised
controlled trials of treatments for patients with immunofluorescence confirmed
bullous pemphigoid. DATA COLLECTION AND ANALYSIS: Two reviewers evaluated the
studies in terms of the inclusion criteria, five extracted data independently;
disagreements were resolved by discussion. Statistical pooling of the data was
inappropriate because of heterogeneity of treatments. MAIN RESULTS: We found
seven randomised controlled trials with a total of 634 patients. All studies
involved different comparisons, none included a placebo group.Different doses,
different formulations of corticosteroids and the addition of azathioprine
failed to show significant differences in measures of disease control. However,
patients who took azathioprine were able to almost halve the amount of
prednisone required for disease control. Plasma exchange plus prednisone
achieved significantly better disease control than prednisone alone; this
favourable effect was not apparent in another study. The latter study also
compared plasma exchange or azathioprine plus prednisone, but failed to show
significant differences for disease control or mortality, although total
adverse events at six months almost reached statistical significance in favour
of plasma exchange plus prednisone. Comparing tetracycline plus nicotinamide
with prednisolone, no significant difference for disease response was shown. A
very potent topical corticosteroid was compared to oral prednisone in patients
with moderate and extensive disease. In patients with extensive disease, the
topical steroid group showed significantly better survival and disease control,
and less severe complications, while no significant differences for these
outcomes were seen in patients with moderate disease.Most of the reported
deaths were in patients taking high doses of oral corticosteroids. REVIEWER’S
CONCLUSIONS: Very potent topical steroids are effective and safe treatments for
bullous pemphigoid; their use in extensive disease may be limited by side
effects and practical factors.Starting doses of prednisolone greater than 0.75
mg/kg/day do not seem to give additional benefit, lower doses may be adequate
for disease control; this could reduce the incidence and severity of adverse
reactions.The effectiveness of the addition of plasma exchange or azathioprine
to corticosteroids has not been established.Combination treatment with
tetracycline and nicotinamide may be useful; this needs further validation. N. Ref:: 38
----------------------------------------------------
[172]
TÍTULO / TITLE: - Imiquimod 5% cream for
the treatment of cutaneous lesions in immunocompromised patients.
REVISTA
/ JOURNAL: - Acta Derm Venereol Suppl (Stockh) 2003
Sep;(214):23-7.
AUTORES
/ AUTHORS: - Johnson R; Stockfleth E
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Massachusetts
General Hospital, 55 Fruit Street, Bartlett Hall, Boston, MA 02114, USA. RAJOHNSON@PARTNERS.ORG N. Ref:: 43
----------------------------------------------------
[173]
TÍTULO / TITLE: - Induction of immune
tolerance by dendritic cells: implications for preventative and therapeutic
immunotherapy of autoimmune disease.
REVISTA
/ JOURNAL: - Immunol Cell Biol 2002 Dec;80(6):509-19.
AUTORES
/ AUTHORS: - Thompson AG; Thomas R
INSTITUCIÓN
/ INSTITUTION: - Centre for Immunology and Cancer Research,
Princess Alexandra Hospital, University of Queensland, Brisbane, Australia.
RESUMEN
/ SUMMARY: - Dendritic cells (DC) have a key role in
controlling the immune response, by determining the outcome of antigen
presentation to T cells. Through costimulatory molecules and other factors, DC
are involved in the maintenance of peripheral tolerance through modulation of
the immune response. This modulation occurs both constitutively, and in
inflammation, in order to prevent autoimmunity and to control established
immune responses. Dendritic cell control of immune responses may be mediated
through cytokine or cell-contact dependent mechanisms. The molecular and
cellular basis of these controls is being understood at an increasingly more
complex level. This understanding is reaching a level at which DC-based
therapies for the induction of immune regulation in autoimmunity can be tested
in vivo. This review outlines the current state of knowledge of DC in immune
tolerance, and proposes how DC might control both T cell responses, and
themselves, to prevent autoimmunity and maintain peripheral tolerance. N. Ref:: 135
----------------------------------------------------
[174]
TÍTULO / TITLE: - Thalidomide: a review
of approved and investigational uses.
REVISTA
/ JOURNAL: - Clin Ther 2003 Feb;25(2):342-95.
AUTORES
/ AUTHORS: - Matthews SJ; McCoy C
INSTITUCIÓN
/ INSTITUTION: - Department of Pharmacy Practice, School of
Pharmacy, Bouve College of Health Sciences, Northeastern University, Boston,
Massachusetts 02115, USA. s.matthews@neu.edu
RESUMEN
/ SUMMARY: - BACKGROUND: Thalidomide is best known as a
major teratogen that caused birth defects in up to 12,000 children in the
1960s. More recently, this agent has been approved by the US Food and Drug
Administration for the treatment of erythema nodosum leprosum (ENL) through a
restricted-use program. Its immunomodulatory, anti-inflammatory, and
antiangiogenic properties are currently under study in a number of clinical
conditions. OBJECTIVE: This article reviews the pharmacology of thalidomide;
its approved and off-label uses in dermatologic, oncologic, and
gastrointestinal conditions; and adverse events associated with its use.
METHODS: Relevant articles were identified through searches of MEDLINE
(1966-June 2002), International Pharmaceutical Abstracts (1970-June 2002), and
EMBASE (1990-June 2002). Search terms included but were not limited to
thalidomide, pharmacokinetics, pharmacology, therapeutic use, and
teratogenicity, as well as terms for specific disease states and adverse
events. Further publications were identified from the reference lists of the
reviewed articles. Abstracts of recent symposia were obtained from the American
Society of Clinical Oncology Web site. RESULTS: Thalidomide is thought to exert
its therapeutic effect through the modulation of cytokines, particularly tumor
necrosis factor-alpha. In addition to its approved indication for ENL,
thalidomide has been studied in various other conditions, including
graft-versus-host disease, discoid lupus erythematosus, sarcoidosis,
relapsed/refractory multiple myeloma, Waldenstrom’s macroglobulinemia,
myelodysplastic syndromes, acute myeloid leukemia, myelofibrosis with myeloid
metaplasia, renal cell carcinoma, malignant gliomas, prostate cancer, Kaposi’s
sarcoma, colorectal carcinoma, oral aphthous ulcers, Behcet’s disease, Crohn’s
disease, and HIV/AIDS-associated wasting. Adverse events most frequently
associated with its use include somnolence, constipation, rash, peripheral
neuropathy, and thromboembolism. CONCLUSIONS: Use of thalidomide is limited by
toxicity, limited efficacy data, and restricted access. Evidence of its
efficacy in conditions other than ENL awaits the results of controlled clinical
trials. N. Ref:: 222
----------------------------------------------------
[175]
TÍTULO / TITLE: - Pumping iron: the
strange partnership of the hemochromatosis protein, a class I MHC homolog, with
the transferrin receptor.
REVISTA
/ JOURNAL: - Traffic 2001 Mar;2(3):167-74.
AUTORES
/ AUTHORS: - Enns CA
INSTITUCIÓN
/ INSTITUTION: - Department of Cell and Developmental
Biology, L-215, Oregon Health Sciences University, Portland, OR 97201, USA. ennsca@ohsu.edu
RESUMEN
/ SUMMARY: - People suffering from hereditary
hemochromatosis (HH) can not regulate the uptake of iron properly and gradually
accumulate iron in their body over their lifetime. The protein involved in HH,
HFE, has been recently identified as a class I major histocompatibility complex
(MHC) homolog. The wild-type HFE associates and co-traffics with the
transferrin receptor (TfR). The mutation responsible for 83% of HH (C260Y)
results in the failure of HFE to form a critical disulfide bond, bind beta2
microglobulin, bind TfR, and traffic to the cell surface. In non-polarized
cells, the partnership of HFE and TfR results in decreased iron uptake into
cells. The mechanism whereby a class I MHC homolog modifies the function of a
membrane receptor and how this dynamic complex of molecules regulates iron
transport across intestinal epithelial cells is the subject of this review. N. Ref:: 66
----------------------------------------------------
[176]
TÍTULO / TITLE: - Plasticity of
hematopoietic stem cells: enough to induce tolerance and repair tissue?
REVISTA
/ JOURNAL: - Arthritis Rheum 2002 Apr;46(4):855-8.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.10201 [pii]
AUTORES
/ AUTHORS: - Burt RK; Traynor AE; Oyama Y; Barr WG N. Ref:: 28
----------------------------------------------------
[177]
TÍTULO / TITLE: - Effects of immunosuppressive
drugs on dendritic cells and tolerance induction.
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):37S-42S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067950.90241.1D
AUTORES
/ AUTHORS: - Lagaraine C; Lebranchu Y
INSTITUCIÓN
/ INSTITUTION: - EA 3249, Cellules hematopoietiques,
hemostase et greffe, Laboratoire d’immunologie, Faculte de medecine, Tours,
France.
RESUMEN
/ SUMMARY: - Dendritic cells, the most effective
antigen-presenting cells for priming naive T cells and initiating immune
responses, are also able to induce tolerance. This balance between immunity and
tolerance depends on the functional stage of dendritic cells (DC). Activation
of naive T cells by immature DC can induce tolerance. It is therefore of
interest to summarize the effects of immunosuppressive agents on DC maturation
and functions. In contrast to glucocorticosteroids, mycophenolate mofetil, and
vitamin D(3) analogs, calcineurin inhibitors do not seem to inhibit DC
maturation in in vitro culture systems. However, these molecules all appear to
interfere with DC functions. N.
Ref:: 44
----------------------------------------------------
[178]
TÍTULO / TITLE: - Nutritional
pharmacology in surgical patients.
REVISTA
/ JOURNAL: - Am J Surg 2002 Apr;183(4):349-52.
AUTORES
/ AUTHORS: - Alexander JW
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, University of
Cincinnati College of Medicine, 231 Albert B. Sabin Way, Cincinnati, Ohio
45267-2558, USA. jwesley.alexander@uc.edu
RESUMEN
/ SUMMARY: - The use of pharmaconutrition for
supportive care of surgical patients is now well established, but the field is
still in its infancy. Complex pharmaconutrient formulas containing arginine,
glutamine, and n-3 fatty acids have been proven to shorten hospital stay,
decrease the incidence of infection, and reduce hospital costs in selected
groups of patients. The effects are greatest in those patients with severe
trauma including burn injury, those undergoing major surgical procedures,
especially when malnourished, and those who are critically ill ICU patients
including patients with existing infection. The complex interaction of
pharmaconutrients and other pharmacologic agents are just now beginning to be
investigated. N.
Ref:: 22
----------------------------------------------------
[179]
TÍTULO / TITLE: - IL-10 and its related
cytokines for treatment of inflammatory bowel disease.
REVISTA
/ JOURNAL: - World J Gastroenterol. Acceso gratuito al
texto completo.
●●
Enlace a la Editora de la Revista http://www.wjgnet.com/1007-9327/wj.htm
●●
Cita: World Journal of Gastroenterology: <> 2004 Mar 1;10(5):620-5.
AUTORES
/ AUTHORS: - Li MC; He SH
INSTITUCIÓN
/ INSTITUTION: - Allergy and Inflammation Research Institute,
Shantou University Medical College, 22 Xin Ling Road, Shantou 515041, Guangdong
Province, China.
RESUMEN
/ SUMMARY: - Inflammatory bowel diseases (IBDs),
including Crohn’s disease and ulcerative colitis are chronic inflammatory
disorders of gastrointestinal tract. Although the etiology is incompletely
understood, initiation and aggravation of the inflammatory process seem to be
due to a massive local mucosal immune response. Interleukin-10 (IL-10) is a
regulatory cytokine which inhibits both antigen presentation and subsequent
pro-inflammatory cytokine release, and it is proposed as a potent
anti-inflammatory biological therapy in chronic IBD. Many methods of IL-10 as a
treatment for IBD have been published. The new strategies of IL-10 treatment,
including recombinant IL-10, the use of genetically modified bacteria, gelatine
microsphere containing IL-10, adenoviral vectors encoding IL-10 and combining
regulatory T cells are discussed in this review. The advantages and
disadvantages of these IL-10 therapies are summarized. Although most results of
recombinant IL-10 therapies are disappointing in clinical testing because of
lacking efficacy or side effects, therapeutic strategies utilizing gene therapy
may enhance mucosal delivery and increase therapeutic response. Novel
IL-10-related cytokines, including IL-19, IL-20, IL-22, IL-24, IL-26, IL-28 and
IL-29, are involved in regulation of inflammatory and immune responses. The use
of IL-10 and IL-10-related cytokines will provide new insights into cell-based and
gene-based treatment against IBD in near future. N. Ref:: 54
----------------------------------------------------
[180]
TÍTULO / TITLE: - The treatment of
glomerular disease—a compromise between the standard and the individual
approach.
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: <> 2003 Jul;18 Suppl 5:v31-3.
AUTORES
/ AUTHORS: - Kiperova B
INSTITUCIÓN
/ INSTITUTION: - Medical University of Sofia, University
Hospital Alexandrovska, Clinic of Nephrology, Sofia, Bulgaria. bkiperova@yahoo.com
RESUMEN
/ SUMMARY: - Chronic glomerulonephritis (GN) is one of
the leading causes of end-stage renal disease (ESRD). The possibilities for
successful treatment in the earliest stages are still limited.
Immunosuppressive treatment leads to complete or partial remission only in some
patients. Even then, a non-immunological evolution to chronic renal
insufficiency often enters a progressive course. By applying a consistent
strategy for their individual evaluation and management, it is possible to
improve the outcome of patients with GN. The early referral to a nephrologist
and an early histomorphological diagnosis; the precise assessment of the type
of injury, i.e. proliferative or non-proliferative; the indices of activity and
chronicity; and the prognostic indicators are helpful for the therapeutic
approach. The goal of the management of GN has to be to suppress the disease
with minimum side effects of the treatment. Many unanswered questions and
controversies remain concerning the immunosuppressive therapy. A precise
distinction is needed between the problematic assertions and evidence-based
protocols. A common task for the treatment of all types of chronic GN should be
the protection of renal structure and function: control of blood pressure,
action on renal haemodynamics and proteinuria via pharmacological inhibition of
the renin-angiotensin system, control of hyperlipidaemia and limitation of
fibrosis. Some novel and promising pharmacological approaches to extracellular
matrix accumulation and chronic interstitial fibrosis are in progress. N. Ref:: 15
----------------------------------------------------
[181]
TÍTULO / TITLE: - Administration of donor
apoptotic cells: an alternative cell-based therapy to induce tolerance?
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):43S-45S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067951.90241.54
AUTORES
/ AUTHORS: - Kleinclauss F; Perruche S; Cahn JY;
Tiberghien P; Saas P
INSTITUCIÓN
/ INSTITUTION: - INSERM E0119/UPRES EA2284, Etablissement
Francais du Sang Bourgogne Franche-Comte, Universite de Franche-Comte,
Besancon, France.
RESUMEN
/ SUMMARY: - Apoptotic cells are endowed with
immunomodulatory properties. The authors propose infusing apoptotic cells as a
cell-based therapy product to facilitate allogeneic hematopoietic engraftment
after a nonmyeloablative conditioning regimen. Such an approach may be used to
obtain macrochimerism in combined hematopoietic cells and solid organ
transplantation. In this article, the authors describe the mechanisms of
combined hematopoietic and organ allograft transplantation and the potential
difficulties. The authors discuss how intravenous apoptotic cell infusion may
influence the outcome of combined transplantation. This may prove to be an
interesting approach for future development in cell therapy. N. Ref:: 29
----------------------------------------------------
[182]
TÍTULO / TITLE: - Potential role of major
histocompatibility complex class II peptides in regulatory tolerance to
vascularized grafts.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S35-7.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106472.91343.8D
AUTORES
/ AUTHORS: - LeGuern C
INSTITUCIÓN
/ INSTITUTION: - Transplantation Biology Research Center,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA. leguern@helix.mgh.harvard.edu
RESUMEN
/ SUMMARY: - The inactivation of persisting T
lymphocytes reactive to self- and non-self-antigens is a major arm of
operational immune tolerance in mammals. Silencing of such T cells proceeds
mostly by means of suppression, a process that is mediated by regulatory T-cell
subsets and especially by CD4(+)CD(25high) regulatory T cells (Treg). Although
Treg activation and ensuing suppressive activity appear to be major
histocompatibility complex class II dependent, the fine specificity of Treg
T-cell receptors has not yet been elucidated. Recent data from the author’s
laboratory on a class II gene therapy induction of tolerance to allogeneic
kidney grafts suggest that class II peptides are involved as generic signals
for Treg activation. A brief compilation of results that would support this
hypothesis is discussed in the present article. N. Ref:: 31
----------------------------------------------------
[183]
TÍTULO / TITLE: - Immunosuppression and
xenotransplantation of cells for cardiac repair.
REVISTA
/ JOURNAL: - Ann Thorac Surg 2004 Feb;77(2):737-44.
●●
Enlace al texto completo (gratuito o de pago) 1016/j.athoracsur.2003.08.036
AUTORES
/ AUTHORS: - Xiao YF; Min JY; Morgan JP
INSTITUCIÓN
/ INSTITUTION: - Stem Cell Research Laboratory, The Charles
A. Dana Research Institute, Department of Medicine, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, Massachusetts, USA. yxiao@bidmc.harvard.edu
RESUMEN
/ SUMMARY: - The death of highly vulnerable
cardiomyocytes during ischemia leads to cardiac dysfunction, including heart
failure. Due to limited proliferation of adult mammalian cardiomyocytes, the
dead myocardium is replaced by noncontractile fibrotic tissue. Introducing exogenous
cells to participate in the regeneration of infarcted myocardium has thus been
proposed as a novel therapeutic approach. In view of the availability of
various xenogeneic cells and fewer ethical and political concerns that surround
human embryonic stem cells and fetal cardiomyocytes, cellular
xenotransplantation may be a potential alternative approach for cardiac repair
in humans. However, one of the most daunting challenges of xenotransplantation
is immunorejection. This article summarizes the progress in cellular
xenotransplantation for cardiac repair in experimental settings and the current
understanding of possible immune responses following the engraftment of
xenogeneic cells. The public attitude towards xenotransplantation is reportedly
more favorable to receiving cells or tissues than a whole organ, but many
scientific obstacles need to be overcome before the utilization of xenogeneic
cells for cardiac repair in patients with heart disease becomes applicable to
clinical practice. N.
Ref:: 82
----------------------------------------------------
[184]
TÍTULO / TITLE: - Natural killer cell
receptors: new biology and insights into the graft-versus-leukemia effect.
REVISTA
/ JOURNAL: - Blood. Acceso gratuito al texto completo a
partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.bloodjournal.org/
●●
Cita: Blood: <> 2002 Sep 15;100(6):1935-47.
●●
Enlace al texto completo (gratuito o de pago) 1182/blood-2002-02-0350
AUTORES
/ AUTHORS: - Farag SS; Fehniger TA; Ruggeri L; Velardi
A; Caligiuri MA
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Division
of Hematology/Oncology, The Ohio State University, A433A Starling Loving Hall,
320 W Tenth Avenue, Columbus, OH 43210, USA. farag-1@medctr.osu.edu
RESUMEN
/ SUMMARY: - Natural killer (NK) cells have held great
promise for the immunotherapy of cancer for more than 3 decades. However, to
date only modest clinical success has been achieved manipulating the NK cell
compartment in patients with malignant disease. Progress in the field of NK
cell receptors has revolutionized our concept of how NK cells selectively
recognize and lyse tumor and virally infected cells while sparing normal cells.
Major families of cell surface receptors that inhibit and activate NK cells to
lyse target cells have been characterized, including killer cell
immunoglobulinlike receptors (KIRs), C-type lectins, and natural cytotoxicity
receptors (NCRs). Further, identification of NK receptor ligands and their
expression on normal and transformed cells completes the information needed to
begin development of rational clinical approaches to manipulating receptor/ligand
interactions for clinical benefit. Indeed, clinical data suggest that mismatch
of NK receptors and ligands during allogeneic bone marrow transplantation may
be used to prevent leukemia relapse. Here, we review how NK cell receptors
control natural cytotoxicity and novel approaches to manipulating NK
receptor-ligand interactions for the potential benefit of patients with
cancer. N. Ref:: 134
----------------------------------------------------
[185]
TÍTULO / TITLE: - Donor chimerism and stem
cell function in a murine congenic transplantation model after low-dose
radiation conditioning: effects of a retroviral-mediated gene transfer protocol
and implications for gene therapy.
REVISTA
/ JOURNAL: - Exp Hematol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.medicinedirect.com/journal
●●
Cita: Experimental Hematology: <> 2002 Nov;30(11):1324-32.
AUTORES
/ AUTHORS: - Goebel WS; Yoder MC; Pech NK; Dinauer MC
INSTITUCIÓN
/ INSTITUTION: - Herman B. Wells Center for Pediatric
Research and Department of Pediatrics, Hematology/Oncology, James Whitcomb
Riley Hospital for Children, Indiana University School of Medicine,
Indianapolis, IN, USA.
RESUMEN
/ SUMMARY: - OBJECTIVE: We investigated low-dose
radiation conditioning for the transplantation of retrovirus-transduced cells
in a C57Bl6/J murine model. MATERIALS AND METHODS: The effect of low-dose
radiation on stem cell function was investigated using a competitive
repopulation assay. Stem cell function of marrow cells that underwent a
retroviral-mediated gene transfer (RMGT) protocol was examined by this assay,
and donor chimerism of these cells when transplanted into 160-cGy conditioned
syngeneic hosts was compared to fresh marrow. RESULTS: Irradiation with 300 or
160 cGy substantially decreased stem cell function as measured by competitive
repopulation. Animals conditioned with 160 cGy and transplanted with 20 x 10(6)
fresh marrow cells permitted donor cell engraftment of 53.6% +/- 11.4% 6 months
after transplant compared to 100% donor cell engraftment after 1100 cGy
irradiation. Lymphoid and myeloid engraftment did not significantly differ from
total engraftment in submyeloablated hosts. When transplanted into lethally
irradiated hosts, the competitive repopulating activity of marrow treated with
a single dose of 5-fluorouracil followed by ex vivo culture according to a
standard RMGT protocol was equal to 5-fluorouracil-only treated marrow.
However, cells treated with 5-fluorouracil or 5-fluorouracil plus ex vivo
culture for RMGT repopulated less well than fresh marrow cells in 160 cGy
conditioned hosts. CONCLUSIONS: Low-dose irradiation decreases host stem cell
function, allowing engraftment of both fresh and RMGT protocol-treated marrow,
although the engraftment of 5-fluorouracil-treated cells was reduced at least
two-fold, and 5-fluorouracil plus RMGT protocol-treated cells at least
three-fold, compared to fresh marrow. Modification of current RMGT protocols may
be important for optimizing engraftment under these conditions.
----------------------------------------------------
[186]
TÍTULO / TITLE: - Gastroduodenal Crohn’s
disease: medical management.
REVISTA
/ JOURNAL: - Inflamm Bowel Dis 2003 Mar;9(2):127-8;
discussion 131.
AUTORES
/ AUTHORS: - Tremaine WJ
INSTITUCIÓN
/ INSTITUTION: - Division of Gastroenterology and
Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. tremaine.william@mayo.edu N. Ref:: 9
----------------------------------------------------
[187]
TÍTULO / TITLE: - Mycophenolate mofetil
versus azathioprine therapy is associated with a significant protection against
long-term renal allograft function deterioration.
REVISTA
/ JOURNAL: - Transplantation 2003 Apr 27;75(8):1341-6.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000062833.14843.4B
AUTORES
/ AUTHORS: - Meier-Kriesche HU; Steffen BJ; Hochberg
AM; Gordon RD; Liebman MN; Morris JA; Kaplan B
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine,
University of Florida College of Medicine, Gainesville, FL 32610-0224, USA. meierhu@medicine.ufl.edu.
RESUMEN
/ SUMMARY: - BACKGROUND: To evaluate the association of
long-term continuous mycophenolate mofetil (MMF) versus azathioprine (AZA)
therapy and renal allograft function, as measured by the slope of reciprocal
creatinine, we analyzed 49,666 primary renal allograft recipients reported to the
United States Renal Data System between October 31, 1988 and June 30, 1998.
METHODS: The primary study endpoint was defined as a greater than 20% decrease
below a 6-month baseline of 1/serum creatinine (SCr) (slope of reciprocal
creatinine) at or beyond 1 year after transplantation. A secondary endpoint was
defined as reaching an SCr value greater than 1.6 mg/dL. Univariate
Kaplan-Meier analysis and multivariate Cox proportional hazard models were used
to investigate the risk of reaching the study endpoints. Multivariate analyses
were corrected for potential confounding covariates. RESULTS: According to the
Cox proportional hazard model, 12-month continued therapy of MMF versus AZA was
associated with a protective effect against declining renal function, as
measured by the slope of reciprocal creatinine (relative risk [RR]=0.84,
confidence interval 0.78-0.91, P<0.001). For 24-month continued therapy of
MMF versus AZA, MMF was associated with a further decreased risk for a decline
in renal function (RR=0.66, confidence interval=0.57-0.77, P<0.001).
Furthermore, MMF was associated with a protective effect against reaching the
SCr threshold of 1.6 mg/dL (RR=0.80, P<0.001) beyond 12 months
posttransplantation. CONCLUSIONS: Continuous use of MMF versus AZA was associated
with a protective effect against declining renal function beyond 1 year after
transplantation. Further study is needed to confirm that continued MMF therapy
is protective against long-term deterioration in renal function.
----------------------------------------------------
[188]
TÍTULO / TITLE: - HLA in coeliac disease:
unravelling the complex genetics of a complex disorder.
REVISTA
/ JOURNAL: - Tissue Antigens 2003 Feb;61(2):105-17.
AUTORES
/ AUTHORS: - Louka AS; Sollid LM
INSTITUCIÓN
/ INSTITUTION: - Institute of Immunology, Rikshospitalet,
University of Oslo, Norway.
RESUMEN
/ SUMMARY: - Coeliac disease (gluten sensitive
enteropathy) is a common, polygenic and multifactorial disorder that serves as
a pioneering model for the study of inflammatory disease. A major environmental
factor is known (ingested gluten from wheat), and there is unprecedented
genetic and functional evidence pinpointing HLA-DQA1*05-DQB1*02 ( DQ2) and
DQA1*03-DQB1*0302 ( DQ8) in disease predisposition. We discuss the current
state of play in coeliac disease genetics, focussing particularly on the HLA
complex. Emerging evidence suggests that additional HLA risk loci exert weak
effects, independent of DQA1*05-DQB1*02, on the B8-DR3-DQ2 haplotype. There is
also good evidence from linkage studies of disease gene(s) on chromosome 5q. We
discuss the role and implications of linkage disequilibrium and haplotype
blocks in complex disease gene mapping. We briefly address findings from
studies of animal models for chronic inflammatory disease, and consider roles
for both common genes associated with multiple inflammatory diseases, and genes
unique to coeliac disease. The coeliac genetics research community has
established a sound foundation for the identification of additional disease
genes in the not-too-distant future. Functional studies will play a critical
role, and coeliac disease has a promising future in this respect. Coeliac
disease continues to function as a model disorder, facilitating the development
and implementation of complex disease gene mapping strategies. N. Ref:: 59
----------------------------------------------------
[189]
TÍTULO / TITLE: - Evaluation of
thalidomide for treatment or prevention of chronic graft-versus-host disease.
REVISTA
/ JOURNAL: - Leuk Lymphoma 2003 Jul;44(7):1141-6.
AUTORES
/ AUTHORS: - Flowers ME; Martin PJ
INSTITUCIÓN
/ INSTITUTION: - Division of Clinical Research, Fred
Hutchinson Cancer Research Center, 1100 Fairview Avenue N., DS-290, PO Box
19024, Seattle, WA 98109-1024, USA. mflowers@fhcrc.org
RESUMEN
/ SUMMARY: - During the past 5 years, better
understanding of immunomodulatory and anti-angiogenesis properties of
thalidomide has increased interest in the use of this agent for a wider variety
of clinical applications. This article reviews the clinical evaluation of
thalidomide for treatment or prevention of chronic
graft-versus-host-disease. N.
Ref:: 38
----------------------------------------------------
[190]
TÍTULO / TITLE: - Dry eye as a major
complication associated with chronic graft-versus-host disease after
hematopoietic stem cell transplantation.
REVISTA
/ JOURNAL: - Cornea 2003 Oct;22(7 Suppl):S19-27.
AUTORES
/ AUTHORS: - Ogawa Y; Kuwana M
INSTITUCIÓN
/ INSTITUTION: - Institute for Advanced Medical Research,
and Department of Ophthalmology, Keio University School of Medicine, Tokyo,
Japan. yoko@sc.itc.keio.ac.jp
RESUMEN
/ SUMMARY: - PURPOSE: To review the condition of dry
eye associated with chronic graft-versus-host disease (GVHD). METHODS: The
immunopathogenic processes and therapeutic options for lacrimal gland chronic
GVHD are discussed. RESULTS: Dry eye is the most frequent ocular complication
after hematopoietic stem cell transplantation. The condition typically occurs
around 6 months post-operation and is recognized as a complication of chronic
GVHD. Lacrimal gland specimens from patients with dry eye show prominent
fibrosis and an increase in CD34+ stromal fibroblasts in the glandular
interstitium in addition to infiltration of T cells into the periductal areas.
In periductal areas, CD4+ and CD8+ T cells colocalize with stromal fibroblasts
that express the full component of surface molecules necessary for antigen
presentation. These findings strongly suggest that periductal fibroblasts are
involved in fibrogenic and immune processes by interacting with T cells in the
lacrimal gland of patients with chronic GVHD, resulting in rapidly progressive
dry eye. Current therapies for dry eye related to chronic GVHD include tear
supplements and nonspecific immunosuppressants. CONCLUSION: We report a
significant role for stromal fibroblasts in the pathogenic processes of dry eye
related to chronic GVHD. Although several supportive therapies can reduce the
symptoms, specific therapies that suppress fibrotic and immune processes in the
lacrimal glands are necessary to control dry eye associated with chronic
GVHD. N. Ref:: 49
----------------------------------------------------
[191]
TÍTULO / TITLE: - HLA-DPB1 and chronic
beryllium disease: a HuGE review.
REVISTA
/ JOURNAL: - Am J Epidemiol 2003 Mar 1;157(5):388-98.
AUTORES
/ AUTHORS: - McCanlies EC; Kreiss K; Andrew M; Weston A
INSTITUCIÓN
/ INSTITUTION: - Biostatistics and Epidemiology Branch,
Health Effects Laboratory Division, National Institute for Occupational Safety
and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505,
USA. eim4@cdc.gov
RESUMEN
/ SUMMARY: - The human leukocyte antigen (HLA) complex
is a series of genes located on chromosome 6 that are important in normal
immune function. Susceptibility to chronic beryllium disease, a granulomatous
lung disease that appears in workers exposed to beryllium, is modified by
genetic variants of the HLA-DP subregion. Evaluation of HLA-DPB1 sequence
motifs in current and former beryllium workers implicated a glutamic acid
residue at position 69 (HLA-DPB1(Glu69)) in chronic beryllium disease. This
finding has since been extended to specific HLA-DPB1(Glu69) alleles. Specific
job tasks have also been implicated in degree of risk, and in this paper the
authors explore gene-environment interaction. The utility of this genetic
information for prospective, current, and former beryllium workers must be
weighed against the potential for employment and insurance discrimination.
Continued research in the beryllium-exposed population will be important for
improving personal risk assessment and identifying high-risk genes associated
with disease progression. N.
Ref:: 79
----------------------------------------------------
[192]
TÍTULO / TITLE: - Donor-specific
tolerance in fully major histocompatibility major histocompatibility
complex-mismatched limb allograft transplants under an anti-alphabeta T-cell
receptor monoclonal antibody and cyclosporine A protocol.
REVISTA
/ JOURNAL: - Transplantation 2003 Dec 27;76(12):1662-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000105343.49626.6F
AUTORES
/ AUTHORS: - Siemionow MZ; Izycki DM; Zielinski M
INSTITUCIÓN
/ INSTITUTION: - Department of Plastic Surgery, Cleveland
Clinic Foundation, A60, 9500 Euclid Avenue, Cleveland, OH 44195, USA. siemiom@ccf.org
RESUMEN
/ SUMMARY: - BACKGROUND: Recent studies have
demonstrated that treatment with alphabeta-T-cell receptor (TCR) monoclonal
antibody and cyclosporine A (CsA) can extend survival in composite tissue
allografts (CTA). The purpose of this study was to induce tolerance in fully
major histocompatibility complex (MHC)-mismatched rat limb allografts under 7
days of a combined alphabeta-TCR-CsA protocol. METHODS: The authors performed
30 hind-limb allotransplantations across the MHC barrier between Brown Norway
donors (BN; RT1n) and Lewis recipients (LEW; RT1l). Isograft and allograft
controls received no treatment. The experimental groups received monotherapy of
alphabeta-TCR and CsA or a combination of alphabeta-TCR and CsA for 7 days
only. Donor-specific tolerance and immunocompetence were determined by standard
skin grafting in vivo and mixed lymphocyte reaction (MLR) in vitro. The
efficacy of immunosuppressive therapy and the level of donor-specific chimerism
were determined by flow cytometry. RESULTS: Long-term survival (>350 days)
was achieved in allograft recipients (n=6) under the 7-day protocol of combined
alphabeta-TCR-CsA. Donor-specific tolerance and immunocompetence of long-term
chimeras were confirmed by acceptance of skin grafts from the donors and
rejection of the third-party alloantigens (AxC Irish). At day 120, MLR
demonstrated unresponsiveness to the host and donor antigens but strong
reactivity against third-party alloantigens. Flow cytometry confirmed the high efficacy
of immunosuppressive treatment and the development of donor-specific chimerism
(7.6% of CD4+-RT1n+ cells, 1.3% of CD8+-RT1n+ cells, and 16.5% of CD45RA+-RT1n+
cells) in the periphery of tolerated recipients. CONCLUSIONS: Combined therapy
of alphabeta-TCR-CsA for 7 days resulted in tolerance induction in fully
MHC-mismatched rat hind-limb allografts. Tolerance was directly associated with
stable, donor-specific chimerism.
----------------------------------------------------
[193]
TÍTULO / TITLE: - Perioperative
single-dose glucocorticoid administration: pathophysiologic effects and
clinical implications.
REVISTA
/ JOURNAL: - J Am Coll Surg 2002 Nov;195(5):694-712.
AUTORES
/ AUTHORS: - Holte K; Kehlet H
INSTITUCIÓN
/ INSTITUTION: - Department of Surgical Gastroenterology,
Hvidovre University Hospital, Denmark. N.
Ref:: 138
----------------------------------------------------
[194]
TÍTULO / TITLE: - Immunomodulatory
effects of statins: mechanisms and potential impact on arteriosclerosis.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2002
Jun;13(6):1673-81.
AUTORES
/ AUTHORS: - Palinski W; Tsimikas S
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine 0682, University of
California San Diego, La Jolla, California 92093-0682, USA. wpalinski@ucsd.edu
RESUMEN
/ SUMMARY: - Clinical trials with statins have
demonstrated a marked reduction of cardiovascular mortality. However, it
remains controversial whether these clinical benefits stem from powerful
cholesterol-lowering effects of statins or whether they are due in part to
their cholesterol-independent effects on vascular function, plaque growth,
plaque rupture, or thrombosis. The identification of several mechanisms through
which statins decrease the recruitment of monocytes and T cells into the
arterial wall and inhibit T cell activation and proliferation in vitro have
prompted speculations that immunomodulatory effects of statins may be
beneficial in recipients of organ transplants. Hypercholesterolemia is frequent
in these patients, and delayed-type hypersensitivity reactions in the arterial
walls of the graft may be compounded by chronic inflammation associated with
conventional atherogenesis. To assess the potential clinical relevance of
immunomodulatory effects of statins, the role of the immune system in
atherogenesis and the effects of statins in vitro in experimental models and in
clinical trials will be reviewed. It is concluded that despite solid in vitro
evidence, clinical evidence for an independent immunosuppressive effect of
statins in organ transplant patients is presently insufficient; however,
further investigation of their in vivo occurrence and clinical relevance is
warranted. N. Ref:: 106
----------------------------------------------------
[195]
TÍTULO / TITLE: - Low-dosage methotrexate
for treatment and maintenance of remission in patients with inflammatory bowel
disease.
REVISTA
/ JOURNAL: - Pharmacotherapy 2002 May;22(5):613-20.
AUTORES
/ AUTHORS: - Vandell AG; DiPiro JT
INSTITUCIÓN
/ INSTITUTION: - University of Georgia College of Pharmacy,
Athens, USA.
RESUMEN
/ SUMMARY: - A literature search was conducted to examine
the safety and effectiveness of low-dosage methotrexate for treatment and
maintenance of remission in patients with inflammatory bowel disease. Nine
published articles indicated that for patients with Crohn’s disease, oral or
intramuscular methotrexate 20-25 mg/week is safe and effective to induce
remission, followed by a lower dosage to maintain remission. In addition,
methotrexate allows for corticosteroid dosage reduction. Therapy may be
continued until the disease flares or adverse events occur. Evidence is
insufficient to support methotrexate as treatment for ulcerative colitis. N. Ref:: 20
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[196]
TÍTULO / TITLE: - Intravenous ribavirin
treatment for severe adenovirus disease in immunocompromised children.
REVISTA
/ JOURNAL: - Pediatrics 2002 Jul;110(1 Pt 1):e9.
AUTORES
/ AUTHORS: - Gavin PJ; Katz BZ
INSTITUCIÓN
/ INSTITUTION: - Division of Infectious Diseases,
Department of Pediatrics, Children’s Memorial Hospital and Northwestern
University Medical School, Chicago, Illinois 60614, USA. pgavin@childrensmemorial.org
RESUMEN
/ SUMMARY: - BACKGROUND: Adenovirus is an important
cause of morbidity and mortality in the immunocompromised host. The incidence
of severe adenovirus disease in pediatrics is increasing in association with
growing numbers of immunocompromised children, where case fatality rates as
high as 50% to 80% have been reported. There are no approved antiviral agents
with proven efficacy for the treatment of severe adenovirus disease, nor are
there any prospective randomized, controlled trials of potentially useful
anti-adenovirus therapies. Apparent clinical success in the treatment of severe
adenovirus disease is limited to a few case reports and small series.
Experience is greatest with intravenous ribavirin and cidofovir. Ribavirin, a
guanosine analogue, has broad antiviral activity against both RNA and DNA
viruses, including documented activity against adenovirus in vitro. Ribavirin
is licensed in aerosol form for the treatment of respiratory syncytial virus
infection, and orally in combination with interferon to treat hepatitis C.
Intravenous ribavirin is the treatment of choice for infection with hemorrhagic
fever viruses. The most common adverse effect of intravenous ribavirin is
reversible mild anemia. The use of cidofovir in severe adenovirus infection has
been limited by adverse effects, the most significant of which is
nephrotoxicity. OBJECTIVE: We report our experience with intravenous ribavirin
therapy for severe adenovirus disease in a series of immunocompromised children
and review the literature. DESIGN/METHODS: We retrospectively reviewed the
medical records of 5 children treated with intravenous ribavirin for documented
severe adenovirus disease. Two patients developed adenovirus hemorrhagic
cystitis after cardiac and bone marrow transplants, respectively. The bone
marrow transplant patient also received intravenous cidofovir for progressive
disseminated disease. An additional 3 children developed adenovirus pneumonia;
2 were neonates, 1 of whom had partial DiGeorge syndrome. The remaining infant
had recently undergone a cardiac transplant. Intravenous ribavirin was
administered on a compassionate-use protocol. RESULTS: Complete clinical
recovery followed later by viral clearance was observed in 2 children: the
cardiac transplant recipient with adenovirus hemorrhagic cystitis and the
immunocompetent neonate with adenovirus pneumonia. The remaining 3 children
died of adenovirus disease. Intravenous ribavirin therapy was well tolerated.
Use of cidofovir in 1 child was associated with progressive renal failure and
neutropenia. DISCUSSION: Our series of patients is representative of the
spectrum of immunocompromised children at greatest risk for severe adenovirus
disease, namely solid-organ and bone marrow transplant recipients, neonates,
and children with immunodeficiency. Although intravenous ribavirin was not
effective for all children with severe adenovirus disease in this series or in
the literature, therapy is unlikely to be of benefit if begun late in the
course of the infection. Early identification, eg by polymerase chain reaction
of those patients at risk of disseminated adenovirus disease may permit earlier
antiviral treatment and better evaluation of therapeutic response. CONCLUSIONS:
Two of 5 children with severe adenovirus disease treated with intravenous
ribavirin recovered. The availability of newer rapid diagnostic techniques,
such as polymerase chain reaction, may make earlier, more effective treatment
of adenovirus infection possible. Given the seriousness and increasing
prevalence of adenovirus disease in certain hosts, especially children, a
large, multicenter clinical trial of potentially useful anti-adenoviral
therapies, such as intravenous ribavirin, is clearly required to demonstrate
the most effective and least toxic therapy.
N. Ref:: 45
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[197]
TÍTULO / TITLE: - Immunosuppressive
agents for treating IgA nephropathy.
REVISTA
/ JOURNAL: - Cochrane Database Syst Rev
2003;(4):CD003965.
●●
Enlace al texto completo (gratuito o de pago) 1002/14651858.CD003965
AUTORES
/ AUTHORS: - Samuels JA; Strippoli GF; Craig JC; Schena
FP; Molony DA
INSTITUCIÓN
/ INSTITUTION: - Nephrology / Pediatric Nephrology,
UT-Houston Health Science Center, 6431 Fannin Street, MSB 4-148, Houston, TX
77030, USA. Joshua.A.Samuels@uth.tmc.edu
RESUMEN
/ SUMMARY: - BACKGROUND: IgA nephropathy (IgAN) is a
world-wide disease and the cause of end-stage renal failure (ESRF) in 15 to 20%
of patients within 10 years and in 30 to 40% of individuals within 20 years
from the apparent onset of disease. No specific treatment has yet been
established but many approaches have been investigated. OBJECTIVES: To assess
the benefits and harms of immunosuppressive treatment for IgAN. SEARCH
STRATEGY: We searched The Cochrane Renal Group’s specialized register (May
2003), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane
Library, Issue 3, 2002) MEDLINE (1966 - September 2002), EMBASE (1988 -
September 2002) and handsearched reference lists of retrieved articles and
conference proceedings. SELECTION CRITERIA: Randomized controlled trials (RCTs)
and quasi-RCTs comparing treatment of IgAN with immunosuppressive agents
against placebo, no treatment, other immunosuppressive or non-immunosuppressive
agents. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed
trial quality and extracted data. Statistical analyses were performed using the
random effects model and the results expressed as relative risk (RR) for
dichotomous outcomes and weighted mean difference (WMD) for continuous
outcomes, with 95% confidence intervals (CI). MAIN RESULTS: Thirteen eligible
RCTs involving 623 patients were identified. All identified RCTs had a placebo,
no treatment or warfarin/dipyridamole control group. Seven trials used
steroids, three used alkylating agents/cyclosporin and three used combinations
of steroids and alkylating agents/cyclosporin. No trial directly compared
steroids versus alkylating agents/cyclosporin. Quality was sub-optimal.
Steroids were associated with a lower risk of progression to ESRF (RR 0.44, 95%
CI 0.25 to 0.80) and lower urinary protein excretion (WMD -0.49 g/24h, 95% CI
-0.72 to -0.12). Urinary protein excretion was lower for patients treated with
alkylating agents/cyclosporin compared to placebo/no treatment (WMD -0.94
g/24h, 95% CI -1.43 to -0.46). There was no significant reduction of urinary
protein excretion with combination treatment of steroids and alkylating agents
compared with placebo/no treatment. REVIEWER’S CONCLUSIONS: The optimal
management of IgAN remains uncertain. The RCTs identified were small, of
sub-optimal methodological quality and tended to only report favorable and
surrogate outcomes without a thorough reporting of treatment harms. All
outcomes favor the use of immunosuppressive interventions, with steroids
appearing to be the most promising. Further study, in the form of RCTs, is
necessary to ascertain which patients would benefit from these interventions,
whether they are the ones with early signs of renal dysfunction or those with
more advanced renal impairment. N.
Ref:: 47
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[198]
TÍTULO / TITLE: - The genetics of
autoimmune endocrine disease.
REVISTA
/ JOURNAL: - Clin Endocrinol (Oxf) 2003 Jul;59(1):1-11.
AUTORES
/ AUTHORS: - Tait KF; Gough SC
INSTITUCIÓN
/ INSTITUTION: - Division of Medical Sciences, University
of Birmingham, Edgbaston and Birmingham Heartlands Hospital, Bordesley Green
East, Birmingham, UK.
RESUMEN
/ SUMMARY: - The common autoimmune endocrinopathies
result from an interaction between environmental factors and genetic
predisposition. Several chromosomal gene regions have been shown to contribute
to more than one disease, supporting the clinical observation that the
autoimmune endocrine diseases cluster within individuals and families. Genetic
studies have implicated the major histocompatability complex (MHC)-human
leucocyte antigen (HLA) genes on chromosome 6p21, although this chromosomal
region does not explain all of the genetic contribution to the various disorders.
Non-MHC-HLA genes, including disease-specific loci, are beginning to be
identified and the publication of the draft sequence of the human genome will
undoubtedly expediate future discoveries. Combined with the establishment of
large cohorts of subjects with disease and the development of technology
capable of performing high-throughput genotyping, genetic studies are likely to
impact on the future treatment and prevention of the common autoimmune
endocrine diseases. N.
Ref:: 107
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[199]
TÍTULO / TITLE: - Liposomal amphotericin
B in the treatment of visceral leishmaniasis in immunocompetent patients.
REVISTA
/ JOURNAL: - Fundam Clin Pharmacol 2003
Apr;17(2):183-8.
AUTORES
/ AUTHORS: - Minodier P; Retornaz K; Horelt A; Garnier
JM
INSTITUCIÓN
/ INSTITUTION: - Pediatric Emergency Unit, CHU Nord, Chemin
des Bourrelly, 13915 Marseille Cedex 20, France. philippe.minodier@ap-hm.fr
RESUMEN
/ SUMMARY: - The leishmaniases are protozoan diseases
caused by Leishmania parasites. The first-line treatment of its visceral forms
is pentavalent antimony (meglumine antimoniate or sodium stibogluconate), but
toxicity is frequent with this drug. Moreover antimony unresponsiveness is
increasing in Leishmania infantum and L. donovani foci, both in immunocompetent
and in immunosuppressed patients. Amphotericin B is a polyene macrolide
antibiotic that binds to sterols in cell membranes. It is the most active
antileishmanial agent in use. Its infusion-related and renal toxicity may be
reduced by lipid-based delivery. Liposomal amphotericin B (AmBisome); Gilead
Science, Paris, France) seems to be less toxic than other amphotericin B lipid
formulations (Amphocil); Liposome Technology Inc., Menlo Park, CA, USA,
Amphotec); Ben Venue Laboratories Inc., Bedford, OH, USA). Optimal drug
regimens of AmBisome) vary from one geographical area to another. In the
Mediterranean Basin, a total dose of 18 mg/kg (3 mg/kg on days 1-5 and 3 mg/kg
on day 10) could be used as first-line treatment of visceral leishmaniasis in
immunocompetent patients. In immunocompromised patients, especially those
co-infected with HIV, relapses are frequent with AmBisome), as with other
drugs. N. Ref:: 55
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[200]
TÍTULO / TITLE: - Vascular disease in
mixed connective tissue disease (MCTD).
REVISTA
/ JOURNAL: - Intern Med 2001 Dec;40(12):1176.
AUTORES
/ AUTHORS: - Kondo H
N. Ref:: 13
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