#05#
Revisiones-Clínica-Diagnóstico
*** Reviews-Clinical-Diagnostics
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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Only articles written in Spanish and/or English are included.
[1]
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.
----------------------------------------------------
[2]
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
----------------------------------------------------
[3]
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
----------------------------------------------------
[4]
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
----------------------------------------------------
[5]
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
----------------------------------------------------
[6]
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
----------------------------------------------------
[7]
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
----------------------------------------------------
[8]
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.
----------------------------------------------------
[9]
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
----------------------------------------------------
[10]
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
----------------------------------------------------
[11]
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
----------------------------------------------------
[12]
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
----------------------------------------------------
[13]
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
----------------------------------------------------
[14]
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.
----------------------------------------------------
[15]
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
----------------------------------------------------
[16]
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
----------------------------------------------------
[17]
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
----------------------------------------------------
[18]
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
----------------------------------------------------
[19]
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
----------------------------------------------------
[20]
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
----------------------------------------------------
[21]
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.
----------------------------------------------------
[22]
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.
----------------------------------------------------
[23]
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
----------------------------------------------------
[24]
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
----------------------------------------------------
[25]
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
----------------------------------------------------
[26]
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
----------------------------------------------------
[27]
TÍTULO / TITLE: - Cytokine-based
immunointervention in the treatment of autoimmune diseases.
REVISTA
/ JOURNAL: - Clin Exp Immunol 2003 May;132(2):185-92.
AUTORES
/ AUTHORS: - Adorini L
INSTITUCIÓN
/ INSTITUTION: - BioXell, Via Olgettina 58, 20132 Milan,
Italy. luciano.adorini@bioxell.com N. Ref:: 99
----------------------------------------------------
[28]
TÍTULO / TITLE: - Protocol core needle
biopsy and histologic Chronic Allograft Damage Index (CADI) as surrogate end
point for long-term graft survival in multicenter studies.
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):773-9.
AUTORES
/ AUTHORS: - Yilmaz S; Tomlanovich S; Mathew T;
Taskinen E; Paavonen T; Navarro M; Ramos E; Hooftman L; Hayry P
INSTITUCIÓN
/ INSTITUTION: - Data Analysis Center, Division of
Transplantation, Department of Surgery, University of Calgary, Alberta, Canada.
RESUMEN
/ SUMMARY: - This study is an investigation of whether
a protocol biopsy may be used as surrogate to late graft survival in
multicenter renal transplantation trials. During two mycophenolate mofetil
trials, 621 representative protocol biopsies were obtained at baseline, 1 yr,
and 3 yr. The samples were coded and evaluated blindly by two pathologists, and
Chronic Allograft Damage Index (CADI) score was constructed. At 1 yr, only 20%
of patients had elevated (>l.5 mg/100 ml) serum creatinine, whereas 60% of
the biopsies demonstrated an elevated (>2.0) CADI score. The mean CADI score
at baseline, 1.3 +/- 1.1, increased to 3.3 +/- 1.8 at 1 yr and to 4.1 +/- 2.2
at 3 yr. The patients at 1 yr were divided into three groups, those with CADI
<2, between 2 and 3.9, and >4.0, the first two groups having normal (1.4 +/-
0.3 and 1.5 +/- 0.6 mg/dl) and the third group pathologic (1.9 +/- 0.8 mg/dl)
serum creatinine. At 3 yr, there were no lost grafts in the low CADI group, six
lost grafts (4.6%) in the in the elevated CADI group, and 17 lost grafts
(16.7%) in the high CADI group (P < 0.001). One-year histologic CADI score
predicts graft survival even when the graft function is still normal. This
observation makes it possible to use CADI as a surrogate end point in
prevention trials and to identify the patients at risk for intervention trials.
----------------------------------------------------
[29]
TÍTULO / TITLE: - Pulmonary infiltrates
in the non-HIV-infected immunocompromised patient: etiologies, diagnostic
strategies, and outcomes.
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: <> 2004 Jan;125(1):260-71.
AUTORES
/ AUTHORS: - Shorr AF; Susla GM; O’Grady NP
INSTITUCIÓN
/ INSTITUTION: - Pulmonary and Critical Care Medicine
Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. afshorr@dnamail.com
RESUMEN
/ SUMMARY: - Pulmonary complications remain a major
cause of both morbidity and mortality in immunocompromised patients. When such
individuals present with radiographic infiltrates, the clinician faces a
diagnostic challenge. The differential diagnosis in this setting is broad and
includes both infectious and noninfectious processes. Rarely are the
radiographic findings classic for one disease, and most potential etiologies
have overlapping clinical and radiographic appearances. In recent years,
several themes have emerged in the literature on this topic. First, an
aggressive approach to identifying a specific etiology is necessary; as a
corollary, diagnostic delay increases the risk for mortality. Second, the
evaluation of these infiltrates nearly always entails bronchoscopy.
Bronchoscopy allows identification of some etiologies with certainty, and often
allows for the exclusion of infectious agents even if the procedure is
otherwise unrevealing. Third, early use of CT scanning regularly demonstrates
lesions missed by plain radiography. Despite these advances, initial
therapeutic interventions include the use of broad-spectrum antibiotics and
other anti-infectives in order to ensure that the patients is receiving
appropriate therapy. With the results of invasive testing, these treatments are
then narrowed. Frustratingly, outcomes for immunocompromised patients with
infiltrates remain poor. N.
Ref:: 58
----------------------------------------------------
[30]
TÍTULO / TITLE: - Postmenopausal
tubo-ovarian abscess due to Pseudomonas aeruginosa in a renal transplant
patient: a case report and review of the literature.
REVISTA
/ JOURNAL: - Transplantation 2001 Oct 15;72(7):1241-4.
AUTORES
/ AUTHORS: - El Khoury J; Stikkelbroeck MM; Goodman A;
Rubin RH; Cosimi AB; Fishman JA
INSTITUCIÓN
/ INSTITUTION: - Infectious Disease Division, GRJ 504,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
RESUMEN
/ SUMMARY: - BACKGROUND: Pseudomonas aeruginosa is an
uncommon cause of infection in the female genital tract. We report a case of
postmenopausal tubo-ovarian abscess (TOA) due to P. aeruginosa in a renal
transplant recipient. The presentation included mild abdominal symptoms with
rapid progression of peritonitis and surgical abscess drainage. This is the
first such case in an organ transplant recipient described in the English literature.
METHODS AND RESULTS: Published reports of 1040 cases of TOA were reviewed. The
most common features were a history of sexually transmitted disease or pelvic
inflammatory disease, and symptoms including abdominal pain and fever.
Escherichia coli, Bacteroides spp., and Klebsiella pneumoniae were the most
frequently encountered pathogens. Neisseria gonorrhoeae and Chlamydia
trachomatis, which are frequently isolated from cervical cultures, are
uncommonly isolated from tubo-ovarian abscesses. Forty percent of patients were
treated with antibiotics alone, 18.8% with abdominal surgery, and 32% with
surgery and antimicrobial therapy. CONCLUSION: This report illustrates the
muted presentation and atypical microbiology of gynecologic infection in an
organ transplant recipient. N.
Ref:: 59
----------------------------------------------------
[31]
- Castellano -
TÍTULO / TITLE:Terapia individualizada con
azatioprina o 6-mercaptopurina mediante monitorizacion de la actividad de la
tiopurina metiltransferasa (TPMT). Individualized therapy with azathioprine or
6-mercaptopurine by monitoring thiopurine methyl-transferase (TPMT) activity.
REVISTA
/ JOURNAL: - Rev Clin Esp. 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: Revista Clínica Española: <> 2002 Oct;202(10):555-62.
AUTORES
/ AUTHORS: - Gisbert JP; Gomollon F; Mate J; Pajares JM
INSTITUCIÓN
/ INSTITUTION: - Servicio de Aparato Digestivo. Hospital
Universitario de La Princesa. Madrid. España. gisbert@meditex.es N. Ref:: 83
----------------------------------------------------
[32]
TÍTULO / TITLE: - HLA class II tetramers:
tools for direct analysis of antigen-specific CD4+ T cells.
REVISTA
/ JOURNAL: - Arthritis Rheum 2002 Jan;46(1):5-12.
AUTORES
/ AUTHORS: - Nepom GT; Buckner JH; Novak EJ;
Reichstetter S; Reijonen H; Gebe J; Wang R; Swanson E; Kwok WW
INSTITUCIÓN
/ INSTITUTION: - Virginia Mason Research Center and
University of Washington School of Medicine, Seattle 98101-2795, USA. nepom@vmresearch.org
RESUMEN
/ SUMMARY: - Immunotherapies for human autoimmune and
immune-mediated diseases are proliferating rapidly, and with these changes
comes the opportunity to monitor patients for immune responses to therapy based
on early surrogate markers for clinical responses. Class II tetramers have the
potential to serve as these sorts of markers for immune monitoring, and thereby
assist with patient management, therapy selection, and improved outcomes.
However, important issues of TCR avidity require resolution, because much is
still unknown regarding location, quantitation, and characterization of the
human T cell response. Opportunities for application of tetramer technologies
in the near future will enable both clinical progress and the development of
new insights into human CD4+ T cell biology in vivo. N. Ref:: 39
----------------------------------------------------
[33]
TÍTULO / TITLE: - Post-transplant
Burkitt’s leukemia or lymphoma. Study of five cases treated with specific
intensive therapy (PETHEMA ALL-3/97 trial).
REVISTA
/ JOURNAL: - Leuk Lymphoma 2003 Sep;44(9):1541-3.
AUTORES
/ AUTHORS: - Xicoy B; Ribera JM; Esteve J; Brunet S;
Sanz MA; Fernandez-Abellan P; Feliu E
INSTITUCIÓN
/ INSTITUTION: - Services of Hematology, Hospital
Universitari Germans Trias i Pujol, Badalona, España.
RESUMEN
/ SUMMARY: - Burkitt’s lymphoma (BL) and Burkitt-like
acute lymphoblastic leukemia (ALL) are uncommon lymphoproliferative disorders
after solid organ or stem cell transplantation. Although their prognosis is
considered to be poor, there are scarce data on the clinical characteristics and
the response to specific therapies. We report the main clinical characteristics
and the results of a specific intensive chemotherapy in 5 adult patients with
postransplant BL/ALL3 included in the PETHEMA ALL3/97 protocol. Two patients
died in induction, another died in consolidation phase and the remaining 2
patients are in continuous complete remission 6 and 18 months from the
diagnosis. N. Ref:: 6
----------------------------------------------------
[34]
TÍTULO / TITLE: - Introduction to the
Immunocompromised Host Society consensus conference on epidemiology,
prevention, diagnosis, and management of infections in solid-organ transplant
patients.
REVISTA
/ JOURNAL: - Clin Infect Dis 2001 Jul 1;33 Suppl
1:S1-4.
AUTORES
/ AUTHORS: - Rubin RH; Schaffner A; Speich R
INSTITUCIÓN
/ INSTITUTION: - Center for Experimental Pharmacology and
Therapeutics, Harvard-MIT Division of Health Sciences and Technology,
Cambridge, MA 02142-1308, USA. rhrubin@mit.edu
RESUMEN
/ SUMMARY: - Infectious complications are still a
significant cause of morbidity and death in solid-organ transplant patients,
with significant infection being found in up to two-thirds of these
individuals. The risk of infection in the organ transplant patient,
particularly of opportunistic infection, is largely determined by 3 factors:
the net state of immunosuppression, the epidemiologic exposures the patient
encounters, and the consequences of the invasive procedures to which the
patient is subjected. The most important principles of patient treatment are
prevention, early diagnosis, and specific therapy. This issue is designed as a
position paper by a group of experts on epidemiology, prevention, diagnosis,
and management of infections in solid-organ transplant patients. We feel that
our efforts may serve as an important first step in the development of
guidelines in this area. N.
Ref:: 25
----------------------------------------------------
[35]
TÍTULO / TITLE: - Low recurrence rate of
hepatocellular carcinoma after liver transplantation: better patient selection
or lower immunosuppression?
REVISTA
/ JOURNAL: - Transplantation 2002 Dec 27;74(12):1664-5.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000039802.85634.9C
AUTORES
/ AUTHORS: - Weber M; Kadry Z; Clavien PA N. Ref:: 11
----------------------------------------------------
[36]
TÍTULO / TITLE: - Cyclosporin trough
levels: is monitoring necessary during short-term treatment in psoriasis? A
systematic review and clinical data on trough levels.
REVISTA
/ JOURNAL: - Br J Dermatol 2002 Jul;147(1):122-9.
AUTORES
/ AUTHORS: - Heydendael VM; Spuls PI; Ten Berge IJ;
Opmeer BC; Bos JD; de Rie MA
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Academic
Medical Center, University of Amsterdam, PO Box 22660, the Netherlands.
RESUMEN
/ SUMMARY: - BACKGROUND: Cyclosporin is an effective
treatment for severe plaque psoriasis. Unfortunately, its use may be limited by
time- and dose-related nephrotoxicity. Serum trough levels may be useful for
monitoring the risk of nephrotoxicity. OBJECTIVES: To determine whether monitoring
of trough levels is necessary in psoriasis patients undergoing short-term
treatment with cyclosporin. METHODS: A computerized and manual literature
search identified studies on adults with plaque-type psoriasis treated with
cyclosporin < or = 5 mg kg-1 daily, in which trough levels were measured in
whole blood. Number of patients, treatment duration, formulation and dosage,
renal function tests and trough levels were extracted. The association between
renal function and trough levels was investigated. Additionally, in a
randomized controlled trial on cyclosporin vs. methotrexate in moderate to
severe psoriasis, cyclosporin trough levels were measured frequently in 20
patients during 12 weeks of treatment. The Pearson correlation coefficient
between serum creatinine and cyclosporin trough levels was calculated. RESULTS:
Fifty-six articles were found concerning cyclosporin trough level measurements
in psoriasis patients, of which eight were analysed. Many studies were excluded
due to inappropriate cyclosporin dosages used. As data were heterogeneous and
lacked various key parameters, a correlation study and a meta-analysis could
not be performed. Instead, a quantitative description of the literature was
given. No high mean trough levels or elevations of serum creatinine were
described. In our clinical study, all the mean trough levels in 17 patients
treated with cyclosporin 3 mg kg-1 daily were within the therapeutic range
(< 200 ng mL-1). Elevated trough levels were found in two of three patients
treated with cyclosporin 3-5 mg kg-1 daily. No signs of renal dysfunction were
seen. CONCLUSIONS: The literature does not provide a definitive answer on
whether monitoring cyclosporin trough levels in patients with psoriasis should
be standard practice. Our own data show no need for cyclosporin trough level
monitoring during short-term treatment with cyclosporin 3 mg kg-1 daily.
However, when cyclosporin doses are > 3 mg kg-1 daily, monitoring may be
indicated. N. Ref:: 32
----------------------------------------------------
[37]
TÍTULO / TITLE: - Interfacing dendritic
and natural killer cells: a tool for targeted tolerance induction?
REVISTA
/ JOURNAL: - Transplantation 2003 Dec
27;76(12):1657-61.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000106804.22930.CB
AUTORES
/ AUTHORS: - Homann D; von Herrath MG
INSTITUCIÓN
/ INSTITUTION: - Barbara Davis Center for Childhood
Diabetes, University of Colorado Health Sciences Center, Denver, CO, USA. N. Ref:: 68
----------------------------------------------------
[38]
TÍTULO / TITLE: - Subcutaneous
panniculitic T-cell lymphoma in children: response to combination therapy with
cyclosporine and chemotherapy.
REVISTA
/ JOURNAL: - J Am Acad Dermatol 2004 Feb;50(2
Suppl):S18-22.
●●
Enlace al texto completo (gratuito o de pago) 1016/S0190
AUTORES
/ AUTHORS: - Shani-Adir A; Lucky AW; Prendiville J;
Murphy S; Passo M; Huang FS; Paller AS
INSTITUCIÓN
/ INSTITUTION: - Division of Dermatology, Children’s
Memorial Hospital, 2300 Children’s Plaza, Chicago, IL 60614, USA.
RESUMEN
/ SUMMARY: - We describe 2 adolescent boys with facial
swelling and/or subcutaneous nodules and fever. Extensive evaluation, including
several biopsy specimens, led to a diagnosis of subcutaneous panniculitic
T-cell lymphoma, an entity rarely seen in children. Both patients were treated
with oral cyclosporine in an effort to suppress the cytokine release from
T-cells that has been thought to induce the hemophagocytic syndrome. The
patients responded dramatically to cyclosporine treatment with defervescence of
the fever and reduction in number and size of the subcutaneous nodules.
Subsequent therapy with multidrug chemotherapy achieved complete remission in
the first patient. This report suggests the value of cyclosporine as a
first-line agent coupled with chemotherapy in the treatment of patients with
subcutaneous panniculitic T-cell lymphoma. A clinicopathologic review of 8
described pediatric cases of subcutaneous panniculitic T-cell lymphoma is also
presented. N. Ref:: 15
----------------------------------------------------
[39]
TÍTULO / TITLE: - The current status of
T-cell depleted allogeneic stem-cell transplants in adult patients with AML.
REVISTA
/ JOURNAL: - Cytotherapy 2001;3(3):175-88.
●●
Enlace al texto completo (gratuito o de pago) 1080/146532401753174007
AUTORES
/ AUTHORS: - Bunjes D
INSTITUCIÓN
/ INSTITUTION: - Stem Cell Transplantation Programme,
Department of Haematology/Oncology, Ulm University Hospital, FRG. N. Ref:: 186
----------------------------------------------------
[40]
TÍTULO / TITLE: - Shared epitopes and
rheumatoid arthritis: disease associations in Greece and meta-analysis of
Mediterranean European populations.
REVISTA
/ JOURNAL: - Semin Arthritis Rheum 2002
Jun;31(6):361-70.
AUTORES
/ AUTHORS: - Ioannidis JP; Tarassi K; Papadopoulos IA;
Voulgari PV; Boki KA; Papasteriades CA; Drosos AA
INSTITUCIÓN
/ INSTITUTION: - Clinical and Molecular Epidemiology Unit,
Department of Hygiene and Epidemiology and the Division of Rheumatology,
University of Ioannina School of Medicine, Ioannina, Greece.
RESUMEN
/ SUMMARY: - OBJECTIVES: To assess the strength of the
associations between HLA shared epitopes (SE) and rheumatoid arthritis (RA)
susceptibility, articular disease severity, and extra-articular features in
Mediterranean European populations. METHODS: One hundred and seventy-four Greek
RA patients and 103 controls were evaluated. Data were then included in a meta-analysis
of 9 studies of Mediterranean European populations (959 RA patients and 1,405
controls). RESULTS: In our study population, SE alleles were significantly more
common in RA patients than in controls (odds ratio [OR], 2.5; 95% confidence
interval [CI], 1.4-4.3). Larsen radiologic score was predicted by SE and
disease duration. SE did not increase the risk of any extra-articular
manifestation. The meta-analysis showed a pooled OR of 3.7 (95% CI, 2.6-5.2)
for susceptibility to RA conferred by SE (OR, 3.4 v 3.9 in Greek v non-Greek
populations). CONCLUSIONS: SE determine articular destruction without
increasing the risk of extra-articular manifestations. The immunogenetic
associations of RA susceptibility are consistent, but their strength may depend
on the SE prevalence in different ethnic groups.
----------------------------------------------------
[41]
TÍTULO / TITLE: - Patient management by
Neoral C(2) monitoring: an international consensus statement.
REVISTA
/ JOURNAL: - Transplantation 2002 May 15;73(9
Suppl):S12-8.
AUTORES
/ AUTHORS: - Levy G; Thervet E; Lake J; Uchida K
INSTITUCIÓN
/ INSTITUTION: - Multiorgan Transplant Program, Toronto
General Hospital, 621 University Avenue, 10NU-116, Toronto, Ontario M5G 2C4,
Canada. N. Ref:: 36
----------------------------------------------------
[42]
TÍTULO / TITLE: - Nosocomial pneumonia in
immunosuppressed patients.
REVISTA
/ JOURNAL: - Infect Dis Clin North Am 2003
Dec;17(4):785-800.
AUTORES
/ AUTHORS: - Agusti C; Rano A; Sibila O; Torres A
INSTITUCIÓN
/ INSTITUTION: - Servei de Pneumologia, Institut Clinic de
Pneumologia i Cirurgia Toracica, Hospital Clinic, Institut d’Investigacions
Biomediques August Pi i Seunyer, Universitat de Barcelona, Villarroel 170,
08036 Barcelona, España. cagusti@medicina.ub.es
RESUMEN
/ SUMMARY: - Nosocomial pneumonia represents a serious
challenge for clinicians caring for IC patients. Although there have been
advances in prophylactic, preemptive, and therapeutic measures, the
implications of an inadequate empirical treatment for survival require a prompt
and active attitude. A great diversity of diagnostic and laboratory procedures
is currently available. In each case, the clinician must determine the tests
that should be performed based on different variables. The proper use of
noninvasive and bronchoscopic procedures substantially increases the diagnostic
yield causing changes in the empirical treatment in most patients. The authors
believe that fiberoptic bronchoscopy must be done early when the pulmonary
infiltrates are identified if there is not a rapid (48 hours) and clear
response to empiric treatment. This approach allows the establishment of a more
specific treatment when the possibilities of full recovery are still high. The
potential benefit of treatment modifications for survival in IC patients who
require MV and undergo bronchoscopy is most probably minimal, because of the
severity and irreversibility of the underlying pulmonary process. It is hoped
that the application of molecular tools in diagnosis and the advances in
preventive strategies and therapeutic agents will improve the survival of NP in
a population of IC patients that is expected to grow over the next years. N. Ref:: 108
----------------------------------------------------
[43]
TÍTULO / TITLE: - Immunocompromised Host
Society Consensus Conference on Epidemiology, Prevention, Diagnosis, and
Management of Infections in Solid-Organ Transplant Patients. Davos,
Switzerland, 23 June 1998, fully updated summer 2000.
REVISTA
/ JOURNAL: - Clin Infect Dis 2001 Jul 1;33 Suppl
1:S1-65. N. Ref:: 0
----------------------------------------------------
[44]
TÍTULO / TITLE: - Genetic predisposition
to infectious pathogens: a review of less familiar variants.
REVISTA
/ JOURNAL: - Pediatr Infect Dis J 2003
May;22(5):457-61.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.inf.0000068205.82627.55
AUTORES
/ AUTHORS: - Somech R; Amariglio N; Spirer Z; Rechavi G
INSTITUCIÓN
/ INSTITUTION: - Pediatric Hemato-Oncology, Chaim Sheba
Medical Center, Tel Hashomer, Israel.
RESUMEN
/ SUMMARY: - The susceptibility and clinical
manifestations of infectious diseases in human populations are influenced by a
variety of factors, among them host genetics. Obvious examples for the effect
of host genetics on predisposition to unique infections are the primary
immunodeficiency diseases. Minor gene variants that influence the host immune
system are much more common. The iceberg model can be used to illustrate the
epidemiology of immunodeficiency states. Accordingly only a few individuals
have known and severe recognized primary immunodeficiencies, whereas many more
patients have mild immunodeficiencies that may remain undiagnosed and are
predisposed to a unique infectious disease. We review some of the less common
variants that influence the host defense and predispose to certain infectious
agents or change their outcome. N.
Ref:: 43
----------------------------------------------------
[45]
TÍTULO / TITLE: - HFE gene and hereditary
hemochromatosis: a HuGE review. Human Genome Epidemiology.
REVISTA
/ JOURNAL: - Am J Epidemiol 2001 Aug 1;154(3):193-206.
AUTORES
/ AUTHORS: - Hanson EH; Imperatore G; Burke W
INSTITUCIÓN
/ INSTITUTION: - United States Air Force School of Aerospace
Medicine, Brooks Air Force Base, San Antonio, TX, USA. erichansonmdmph@yahoo.com
RESUMEN
/ SUMMARY: - Hereditary hemochromatosis (HHC) is an
autosomal recessive disorder of iron metabolism characterized by increased iron
absorption and deposition in the liver, pancreas, heart, joints, and pituitary
gland. Without treatment, death may occur from cirrhosis, primary liver cancer,
diabetes, or cardiomyopathy. In 1996, HFE, the gene for HHC, was mapped on the
short arm of chromosome 6 (6p21.3). Two of the 37 allelic variants of HFE
described to date (C282Y and H63D) are significantly correlated with HHC.
Homozygosity for the C282Y mutation was found in 52-100% of previous studies on
clinically diagnosed probands. In this review, 5% of HHC probands were found to
be compound heterozygotes (C282Y/H63D), and 1.5% were homozygous for the H63D
mutation; 3.6% were C282Y heterozygotes, and 5.2% were H63D heterozygotes. In
7% of cases, C282Y and H63D mutations were not present. In the general
population, the frequency of the C282Y/C282Y genotype is 0.4%. C282Y
heterozygosity ranges from 9.2% in Europeans to nil in Asian, Indian
subcontinent, African/Middle Eastern, and Australasian populations. The H63D
carrier frequency is 22% in European populations. Accurate data on the
penetrance of the different HFE genotypes are not available. Extrapolating from
limited clinical observations in screening studies, an estimated 40--70% of
persons with the C282Y homozygous genotype will develop clinical evidence of
iron overload. A smaller proportion will die from complications of iron
overload. To date, population screening for HHC is not recommended because of
uncertainties about optimal screening strategies, optimal care for susceptible
persons, laboratory standardization, and the potential for stigmatization or
discrimination. N.
Ref:: 103
----------------------------------------------------
[46]
TÍTULO / TITLE: - Ethical considerations
on preimplantation genetic diagnosis for HLA typing to match a future child as
a donor of haematopoietic stem cells to a sibling.
REVISTA
/ JOURNAL: - Hum Reprod 2002 Mar;17(3):534-8.
AUTORES
/ AUTHORS: - Pennings G; Schots R; Liebaers I
INSTITUCIÓN
/ INSTITUTION: - Department of Philosophy, Lok. 5 C 442,
Academic Hospital, Free University Brussels, Pleinlaan 2, B-1050 Brussels,
Belgium. gpenning@vub.ac.be
RESUMEN
/ SUMMARY: - Recently, several requests were made by
couples with an affected child who wanted preimplantation genetic diagnosis
(PGD) to select embryos in the hope of conceiving an HLA identical donor
sibling. This article considers the ethical arguments for and against the
application of PGD for this goal. Only embryos HLA matched with an existing
sibling in need of a compatible donor of haematopoietic stem cells would be
transferred. The main arguments are the instrumentalization of the child, the
best-interests standard, the postnatal test for acceptability and the
experience of the donor child. It is argued that conceiving a child to save a
child is a morally defensible decision on the condition that the operation that
will be performed on the future child is acceptable to perform on an existing
child. The instrumentalization of the donor child does not demonstrate
disrespect for its autonomy or its intrinsic worth. N. Ref:: 29
----------------------------------------------------
[47]
TÍTULO / TITLE: - Host and viral genetics
and risk of cervical cancer: a review.
REVISTA
/ JOURNAL: - Virus Res 2002 Nov;89(2):229-40.
AUTORES
/ AUTHORS: - Hildesheim A; Wang SS
INSTITUCIÓN
/ INSTITUTION: - Division of Cancer Epidemiology and
Genetics, National Cancer Institute, 6120 Executive Blvd, Room 7062, EPS/MSC#
7234, Rockville, MD 20852, USA. hildesha@exchange.nih.gov
RESUMEN
/ SUMMARY: - Infection with human papillomaviruses
(HPV) is known to play a central role in the development of cervical cancer.
Both host and viral genetic factors have been postulated to be important
determinants of risk of HPV progression to neoplasia among infected
individuals. In this report, we review epidemiological studies that have
evaluated the role in cervical cancer pathogenesis of genetic variation in
human leukocyte antigen (HLA) genes and in the HPV genome itself. A protective
effect of HLA Class II DRB1*13/DBQ1*0603 alleles is the most consistent HLA
finding in the published literature. A consistent association between HPV16
non-European variants and risk of disease is also evident from published work.
These findings are discussed. Gaps in our understanding and future research
needs are also discussed. N.
Ref:: 90
----------------------------------------------------
[48]
TÍTULO / TITLE: - Cost advantages of oral
drug therapy for managing cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S9-12.
AUTORES
/ AUTHORS: - Somerville KT
INSTITUCIÓN
/ INSTITUTION: - University of Utah Health Sciences Center,
Department of Pharmacy Services, Salt Lake City, UT, USA. troy.somerville@hsc.utah.edu
RESUMEN
/ SUMMARY: - Cost advantages of the oral route of drug
therapy administration over the intravenous route for managing cytomegalovirus
(CMV) disease are described. The overall costs usually are lower for the oral
route of administration than for the intravenous route, although the cost to
the patient depends on insurance coverage. Other advantages of the oral route
include greater safety and convenience, which may improve patient adherence and
quality of life. In patients with acquired immunodeficiency syndrome (AIDS),
the use of oral ganciclovir instead of intravenous ganciclovir to treat the
maintenance phase of CMV retinitis reduced the incidence of neutropenia and
sepsis, outpatient and inpatient resource use, and costs. Oral therapy also
improved patient quality of life. A cost-effectiveness model for liver
transplant recipients found that CMV prophylaxis is warranted for all patients,
ganciclovir is preferred over CMV immune globulin i.v. and oral acyclovir for
prophylaxis, and the oral route of administration is more cost-effective than
the intravenous route for ganciclovir. Valganciclovir, the oral prodrug of
ganciclovir, was not included in this model. Oral maintenance therapy is
usually cost-effective, safer, and more convenient than intravenous therapy in
the management of CMV. N.
Ref:: 8
----------------------------------------------------
[49]
TÍTULO / TITLE: - Immunoablation followed
or not by hematopoietic stem cells as an intense therapy for severe autoimmune
diseases. New perspectives, new problems.
REVISTA
/ JOURNAL: - Haematologica. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://db.doyma.es/
●●
Cita: Haematologica: <> 2001 Apr;86(4):337-45.
AUTORES
/ AUTHORS: - Marmont AM N. Ref:: 127
----------------------------------------------------
[50]
TÍTULO / TITLE: - Acremonium strictum
pulmonary infection in a leukemic patient successfully treated with
posaconazole after failure of amphotericin B.
REVISTA
/ JOURNAL: - Eur J Clin Microbiol Infect Dis 2002
Nov;21(11):814-7. Epub 2002 Oct 31.
●●
Enlace al texto completo (gratuito o de pago) 1007/s10096-002-0828-8
AUTORES
/ AUTHORS: - Herbrecht R; Letscher-Bru V; Fohrer C;
Campos F; Natarajan-Ame S; Zamfir A; Waller J
INSTITUCIÓN
/ INSTITUTION: - Departement d’Hematologie et d’Oncologie,
Hopital de Hautepierre, Avenue Moliere, 67098 Strasbourg, France. raoul.herbrecht@chru-strasbourg.fr
RESUMEN
/ SUMMARY: - A severely neutropenic patient with
chronic lymphocytic leukemia developed a diffuse bilateral pulmonary infection
while receiving a therapeutic daily dosage of intravenous amphotericin B for
Candida glabrata esophagitis. Computed tomography of the chest showed numerous
lung nodules, ground glass areas and a pleural effusion. Biopsy of one nodule
demonstrated hyaline septate hyphae. Multiple sputum cultures grew Acremonium
strictum. Increasing the dose of amphotericin B and the addition of
itraconazole did not resolve the infection. Change of treatment to posaconazole
given orally at 200 mg four times/d resulted in progressive improvement leading
finally to cure after 24 weeks of therapy. Treatment with posaconazole was
clinically and biologically well tolerated.
N. Ref:: 15
----------------------------------------------------
[51]
- Castellano -
TÍTULO / TITLE:Inmunoterapia sublingual en ninos.
Comite de Inmunoterapia de la Sociedad Española de Inmunologia Clinica y
Alergologia Pediatrica (SEICAP). Sublingual immunotherapy in children.
Immunotherapy Committee of the Spanish Society for Clinical Immunology and
Pediatric Allergology.
REVISTA
/ JOURNAL: - Allergol Immunopathol (Madr) 2003
Jul-Aug;31(4):244-9.
AUTORES
/ AUTHORS: - Lleonart R; Munoz F; Eseverri JL;
Martinez-Canabate A; Tabar AI; Pedemonte C
INSTITUCIÓN
/ INSTITUTION: - Comite de Inmunoterapia de la Sociedad
Española de Inmunologia Clinica y Alergologia Pediatrica (SEICAP), Barcelona,
España.
RESUMEN
/ SUMMARY: - Sublingual immunotherapy is currently
attracting growing interest because of its ease of administration and,
according to previous studies, its infrequent and mild adverse effects.
However, at least in children, the efficacy of this therapy has not been
completely demonstrated. In addition, the mechanisms of action remain to be
elucidated since few studies have been published and the results have been
contradictory and sometimes inconclusive. For this reason, we performed a
literature review through the MEDLINE database, selecting double-blind studies
carried out in children. Only 10 studies meeting these requirements were
retrieved. All the studies were performed by European researchers and nine were
published in European journals. Efficacy was evaluated by clinical parameters
and by reduction in medication use. The results on efficacy are not
homogeneous, although most support the utility of this route of administration.
Moreover, reports of allergens other than those used in these studies dust
mites and grass pollens are lacking. In conclusion, further studies evaluating
the efficacy of this therapy in children are required. Among the general
population, if the efficacy of sublingual immunotherapy in the treatment of
sensitization to hymenoptera venoms were demonstrated, as has been the case
with subcutaneous immunotherapy, the utility of this route of administration
would be definitively confirmed. Finally, sublingual immunotherapy could be
used in children who have shown systemic reactions to subcutaneous
immunotherapy or who refuse to undergo injections. N. Ref:: 25
----------------------------------------------------
[52]
TÍTULO / TITLE: - Deleterious clinical
effects of transfusion-associated immunomodulation: fact or fiction?
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):1180-95.
AUTORES
/ AUTHORS: - Vamvakas EC; Blajchman MA
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, New York
University Medical Center, New York, NY 10016, USA. stephen.vamvakas@med.nyu.edu N. Ref:: 114
----------------------------------------------------
[53]
TÍTULO / TITLE: - Hepatitis B core
antibody-positive grafts: recipient’s risk.
REVISTA
/ JOURNAL: - Transplantation 2003 Feb 15;75(3
Suppl):S49-53.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000047006.96782.64
AUTORES
/ AUTHORS: - de Villa VH; Chen YS; Chen CL
INSTITUCIÓN
/ INSTITUTION: - Liver Transplant Program, Department of
Surgery, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical
Center, Kaohsiung, Taiwan.
RESUMEN
/ SUMMARY: - The transmission of hepatitis B virus
infection through hepatitis B core antibody (anti-HBc)-positive liver grafts in
hepatitis B surface antigen (HBsAg)-negative recipients has been established.
The mandatory use of immunosuppression in transplant patients favors
reactivation of latent virus that may be present in grafts from HBsAg-negative
anti-HBc-positive donors. With the persistent organ donor scarcity, the use of
these grafts cannot be avoided, especially in urgent cases and in areas where
the prevalence of the hepatitis B virus is high, as in Asia. The recognition of
posttransplant de novo hepatitis B from core antibody-positive liver donors
has, therefore, led to modifications in graft allocation policies and the
introduction of strategies for prophylaxis. The risk of developing this type of
new-onset hepatitis B virus infection in liver transplant recipients and the
various approaches to minimize this risk are reviewed. The peculiar
implications of using core antibody-positive grafts in the context of living
donor liver transplantation in Asia are discussed. N. Ref:: 30
----------------------------------------------------
[54]
TÍTULO / TITLE: - Inflammatory
myopathies: clinical, diagnostic and therapeutic aspects.
REVISTA
/ JOURNAL: - Muscle Nerve 2003 Apr;27(4):407-25.
●●
Enlace al texto completo (gratuito o de pago) 1002/mus.10313
AUTORES
/ AUTHORS: - Mastaglia FL; Garlepp MJ; Phillips BA;
Zilko PJ
INSTITUCIÓN
/ INSTITUTION: - Centre for Neuromuscular and Neurological
Disorders, University of Western Australia, Queen Elizabeth II Medical Centre,
Nedlands, Australia. flmast@cyllene.uwa.edu.au
RESUMEN
/ SUMMARY: - The three major forms of immune-mediated
inflammatory myopathy are dermatomyositis (DM), polymyositis (PM), and
inclusion-body myositis (IBM). They each have distinctive clinical and
histopathologic features that allow the clinician to reach a specific diagnosis
in most cases. Magnetic resonance imaging is sometimes helpful, particularly if
the diagnosis of IBM is suspected but has not been formally evaluated.
Myositis-specific antibodies are not helpful diagnostically but may be of
prognostic value; most antibodies have low sensitivity. Muscle biopsy is mandatory
to confirm the diagnosis of an inflammatory myopathy and to allow unusual
varieties such as eosinophilic, granulomatous, and parasitic myositis, and
macrophagic myofasciitis, to be recognized. The treatment of the inflammatory
myopathies remains largely empirical and relies upon the use of
corticosteroids, immunosuppressive agents, and intravenous immunoglobulin, all
of which have nonselective effects on the immune system. Further controlled
clinical trials are required to evaluate the relative efficacy of the available
therapeutic modalities particularly in combinations, and of newer
immunosuppressive agents (mycophenolate mofetil and tacrolimus) and
cytokine-based therapies for the treatment of resistant cases of DM, PM, and
IBM. Improved understanding of the molecular mechanisms of muscle injury in the
inflammatory myopathies should lead to the development of more specific forms
of immunotherapy for these conditions. N.
Ref:: 256
----------------------------------------------------
[55]
TÍTULO / TITLE: - Pulmonary infiltrates
in immunosuppressed patients: analysis of a diagnostic protocol.
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: <> 2002 Jun;40(6):2134-40.
AUTORES
/ AUTHORS: - Danes C; Gonzalez-Martin J; Pumarola T;
Rano A; Benito N; Torres A; Moreno A; Rovira M; Puig de la Bellacasa J
INSTITUCIÓN
/ INSTITUTION: - Servei de Microbiologia, Institut Clinic
d’Infeccions i Immunologia, Institut d’Investigacions Biomediques Agusti Pi i
Sunyer, Hospital Clinic de Barcelona, Barcelona, España.
RESUMEN
/ SUMMARY: - A diagnostic protocol was started to study
the etiology of pulmonary infiltrates in immunosuppressed patients. The
diagnostic yields of the different techniques were analyzed, with special
emphasis on the importance of the sample quality and the role of rapid
techniques in the diagnostic strategy. In total, 241 patients with newly
developed pulmonary infiltrates within a period of 19 months were included.
Noninvasive or invasive evaluation was performed according to the
characteristics of the infiltrates. Diagnosis was achieved in 202 patients
(84%); 173 patients (72%) had pneumonia, and specific etiologic agents were
found in 114 (66%). Bronchoaspirate and bronchoalveolar lavage showed the
highest yields, either on global analysis (23 of 35 specimens [66%] and 70 of
134 specimens [52%], respectively) or on analysis of each type of pneumonia. A
tendency toward better results with optimal-quality samples was observed, and a
statistically significant difference was found in sputum bacterial culture. Rapid
diagnostic tests yielded results in 71 of 114 (62.2%) diagnoses of etiological
pneumonia.
----------------------------------------------------
[56]
TÍTULO / TITLE: - Current treatment
strategies in ANCA-positive renal vasculitis-lessons from European randomized
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 Jul;18 Suppl 5:v2-4.
AUTORES
/ AUTHORS: - Tesar V; Rihova Z; Jancova E; Rysava R;
Merta M
INSTITUCIÓN
/ INSTITUTION: - First Medical Department, First Medical
Faculty, Charles University, Prague, Czech Republic. tesar@beba.cesnet.cz
RESUMEN
/ SUMMARY: - Antineutrophil cytoplasmic antibody
(ANCA)-positive renal vasculitis is the most common cause of rapidly
progressive (crescentic) glomerulonephritis. Its life-threatening natural
course may be modified substantially by current treatment modalities. The
European Vasculitis Study Group (EUVAS) developed a subclassification of
ANCA-positive vasculitides based on the disease severity at presentation, and
have organized (so far) two waves of clinical trials. The first wave of
randomized clinical trials had the aim of optimizing the existing therapeutic
regimens; the second wave concentrated on testing some newer therapeutic
approaches. Here, the design and available results of the first wave and the
design of some second wave trials are reviewed briefly. The potential of the
new targeted approaches (e.g. anti-tumour necrosis factor therapy) is also
briefly mentioned. N.
Ref:: 9
----------------------------------------------------
[57]
TÍTULO / TITLE: - How should the
immunosuppressive regimen be managed in patients with established chronic
allograft failure?
REVISTA
/ JOURNAL: - Kidney Int Suppl 2002 May;(80):68-72.
AUTORES
/ AUTHORS: - Danovitch GM
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, UCLA School of
Medicine, USA. gdanovitch@mednet.ucla.edu N. Ref:: 25
----------------------------------------------------
[58]
TÍTULO / TITLE: - Electrostatic potential
on human leukocyte antigen: implications for putative mechanism of chronic
beryllium disease.
REVISTA
/ JOURNAL: - Environ Health Perspect. Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://ehpnet1.niehs.nih.gov/docs/montharch.html
●●
Cita: Environmental Health Perspectives: <> 2003 Nov;111(15):1827-34.
AUTORES
/ AUTHORS: - Snyder JA; Weston A; Tinkle SS; Demchuk E
INSTITUCIÓN
/ INSTITUTION: - Health Effects Laboratory Division,
National Institute for Occupational Safety and Health, Centers for Disease
Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505, USA.
RESUMEN
/ SUMMARY: - The pathobiology of chronic beryllium
disease (CBD) involves the major histocompatibility complex class II human
leukocyte antigen (HLA). Although occupational exposure to beryllium is the
cause of CBD, molecular epidemiologic studies suggest that specific
(Italic)HLA-DPB1(/Italic) alleles may be genetic susceptibility factors. We
have studied three-dimensional structural models of HLA-DP proteins encoded by
these genes. The extracellular domains of HLA-DPA1*0103/B1*1701, *1901, *0201,
and *0401, and HLA-DPA1*0201/B1*1701, *1901, *0201, and *0401 were modeled from
the X-ray coordinates of an HLA-DR template. Using these models, the
electrostatic potential at the molecular surface of each HLA-DP was calculated
and compared. These comparisons identify specific characteristics in the
vicinity of the antigen-binding pocket that distinguish the different HLA-DP
allotypes. Differences in electrostatics originate from the shape, specific
disposition, and variation in the negatively charged groups around the pocket.
The more negative the pocket potential, the greater the odds of developing CBD
estimated from reported epidemiologic studies. Adverse impact is caused by
charged substitutions in positions
55, 56, 69,
84, and 85, namely, the exact
same loci identified as genetic markers of CBD susceptibility as well as
cobalt-lung hard metal disease. These findings suggest that certain
substitutions may promote an involuntary cation-binding site within a
putatively metal-free peptide-binding pocket and therefore change the innate
specificity of antigen recognition. N.
Ref:: 31
----------------------------------------------------
[59]
TÍTULO / TITLE: - Formulary
considerations for drugs used to prevent cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S17-21.
AUTORES
/ AUTHORS: - Pescovitz MD
INSTITUCIÓN
/ INSTITUTION: - Organ Transplant Program, Indiana
University Medical Center, Indianapolis, IN, USA. mpescov@iupui.edu
RESUMEN
/ SUMMARY: - Four types of therapeutic strategies for
managing cytomegalovirus (CMV) in solid organ transplant recipients, the
mechanisms of action and efficacy of drugs used for prophylaxis, and the
criteria for evaluating drugs for inclusion in a formulary are described.
Universal and selective prophylaxis are simple to implement and effective for
CMV prophylaxis, but they are costly and patient nonadherence and viral
resistance can develop. Preemptive therapy may cause less resistance and cost
less, but it is more complex and associated with a higher incidence of
infection, which may have no effect on secondary effects from CMV infection,
and higher recurrence of disease than prophylactic therapy. Treatment of active
disease may be less costly for the drug than other approaches, but intravenous
access is required and the rates of infection recurrence and mortality are
higher compared with prophylaxis and preemptive therapy. Criteria for deciding
which CMV prophylactic drugs to include in a formulary include efficacy,
safety, convenience, and cost. CMV immune globulin i.v. is costly and exhibits
reduced efficacy when used alone in patients at high risk for CMV disease.
Intravenous ganciclovir is effective, but it is costly because of infusion
costs. Intravenous drug therapies are inconvenient and associated with a risk
of bacterial and fungal infection. Oral acyclovir is safe to use and
inexpensive (since a genetic exists), but it has poor efficacy and is
inconvenient because of the need for four large daily doses. Valacyclovir is
more convenient and with similar safety and probably better efficacy than
acyclovir, but it is more costly. Oral ganciclovir and oral valganciclovir have
similar safety and costs, with greater efficacy than acyclovir. The single
daily dose and lack of resistance to valganciclovir are advantages over oral
ganciclovir, which requires three daily doses and can result in the development
of resistance. N.
Ref:: 20
----------------------------------------------------
[60]
TÍTULO / TITLE: - Costs and consequences
of cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S5-8.
AUTORES
/ AUTHORS: - Schnitzler MA
INSTITUCIÓN
/ INSTITUTION: - Washington University, 4547 Clayton
Avenue, Box 8084, St. Louis, MO 63110, USA. schnitz@wueconc.edu
RESUMEN
/ SUMMARY: - The impact of prophylactic oral
ganciclovir therapy on the incidence of cytomegalovirus (CMV) disease, patient
and graft survival, and costs in patients receiving kidney and liver
transplants is described. CMV disease is a common cause of morbidity and
mortality in solid organ transplant recipients unless prophylactic drug therapy
is used. Prophylactic oral ganciclovir therapy reduces the incidence of CMV
disease in kidney and liver transplant recipients. It is more effective for
recipients who are seronegative before the transplant and receive organs from
seronegative (D-/R-) donors than in seronegative recipients of organs from
seropositive (D+/R-) donors. CMV disease remains a problem in the latter. CMV
disease increases the risk of graft failure, which decreases the likelihood of
patient survival. The extent of matching of the DR subregion of the human
leukocyte antigen complex in the donor and recipient may affect graft survival
in patients with CMV disease. Graft failure is costly and should be considered
in economic analyses of CMV prophylaxis regimens because of the potential
impact of prophylaxis on CMV disease. The use of oral ganciclovir for CMV
prophylaxis has reduced the incidence of CMV disease in kidney and liver
transplant recipients. N.
Ref:: 10
----------------------------------------------------
[61]
TÍTULO / TITLE: - Present results and
perspectives of allogeneic non-myeloablative hematopoietic stem cell
transplantation for treatment of human solid tumors.
REVISTA
/ JOURNAL: - Ann Oncol 2003 Aug;14(8):1177-84.
AUTORES
/ AUTHORS: - Renga M; Pedrazzoli P; Siena S
INSTITUCIÓN
/ INSTITUTION: - Divisione Oncologia Medica Falck,
Dipartimento di Oncologia ed Ematologia, Ospedale Niguarda Ca’ Granda, Milan,
Italy. oncologia@ospedaleniguarda.it
RESUMEN
/ SUMMARY: - Several clinical observations have
confirmed that a donor immune-mediated anti-malignancy effect, called
graft-versus-leukemia or graft-versus-tumor, occurs following allogeneic
hematopoietic stem cell transplantation. While the potential antitumor effect
mediated by donor lymphocytes has been established in many hematological
malignancies, its efficacy in inducing clinically meaningful responses in solid
tumors has been largely unexplored despite evidence of its potential benefit in
experimental animal models. Only in recent years has the investigational
application of non-myeloablative stem cell transplantation in patients with
refractory non-hematological cancers proved that a graft-versus-tumor effect
can be generated in patients with metastatic renal cell cancer and possibly
with other solid tumors. In the present article we review the biological basis,
development and early clinical results of this novel immunotherapeutic approach
for solid tumors. N.
Ref:: 64
----------------------------------------------------
[62]
TÍTULO / TITLE: - Analysis of HLA
expression in human tumor tissues.
REVISTA
/ JOURNAL: - Cancer Immunol Immunother 2003
Jan;52(1):1-9. Epub 2002 Dec 10.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00262-002-0332-0
AUTORES
/ AUTHORS: - Cabrera T; Lopez-Nevot MA; Gaforio JJ;
Ruiz-Cabello F; Garrido F
INSTITUCIÓN
/ INSTITUTION: - Departamento de Analisis Clinicos,
Hospital Universitario Virgen de las Nieves, Avd. Fuerzas Armadas 2, 18014
Granada, España.
RESUMEN
/ SUMMARY: - Cancer cells can be detected and destroyed
by cytotoxic T lymphocytes in many experimental tumor systems, and—as has been
well-documented—in some human tumors. In humans however, most diagnosed tumors
are not eliminated by T cells but grow steadily, invading and metastasizing
until the host is destroyed. Evidence is accumulating that progressive tumor
growth occurs not because the immune system is defective or deteriorated, but
because the cancer cell is capable of developing a variety of strategies to
escape immune recognition. In addition, cancer cells acquire new biological
properties to generate invasive capacity in order to migrate and colonize new
tissues. Major histocompatibility complex (MHC) antigens are molecules that are
specialized in communicating with the T cell receptor and natural killer (NK)
cell ligands. With the former, they use the interaction with peptides derived
from processed cellular and exogenous proteins to monitor self and non-self
status. With the latter, they determine the degree of activation and killing
capacity of NK cells by interacting with NK receptors. Any change in the MHC
profile of tumor cells (including classical and nonclassical MHC molecules) may
therefore have a profound influence on the immune recognition and immune
rejection of cancer cells. We have reviewed the data from our laboratory and
other groups, and have presented a standardized procedure for analyzing the MHC
profile of human tumors with special emphasis on the quality and laboratory use
of the material obtained from microdissected tumor samples. Appropriate tissue
processing is of particular relevance, since it is not possible to obtain tumor
cell lines from most patients. Oncologists require rapid information on the MHC
profile of the tumor if gene therapy is envisaged to restore normal MHC class I
gene expression. N.
Ref:: 39
----------------------------------------------------
[63]
TÍTULO / TITLE: - Chronic
graft-versus-host disease: clinical manifestation and therapy.
REVISTA
/ JOURNAL: - Bone Marrow Transplant 2001
Jul;28(2):121-9.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj/bmt/1703111
AUTORES
/ AUTHORS: - Ratanatharathorn V; Ayash L; Lazarus HM;
Fu J; Uberti JP
INSTITUCIÓN
/ INSTITUTION: - Blood and Marrow Stem Cell Transplantation
Program at University of Michigan Medical Center, Ann Arbor, MI, USA.
RESUMEN
/ SUMMARY: - Chronic graft-versus-host disease (GVHD)
is a major cause of morbidity and mortality in long-term survivors of
allogeneic stem cell transplantation. The immunopathogenesis of chronic GVHD
is, in part, TH-2 mediated, resulting in a syndrome of immunodeficiency and an
autoimmune disorder. The most important risk factor for chronic GVHD is prior
history of acute GVHD and strategies that prevent acute GVHD also decrease the
risk of chronic GVHD. Other important risk factors are the use of a non-T
cell-depleted graft, and older age of donor and recipient. Whether recipients
of peripheral blood stem cells are at increased risk of chronic GVHD remains
unsettled. There are no known pharmacologic agents which can specifically
prevent development of chronic GVHD. Agents which have efficacy in the
treatment of autoimmune disorders have been utilized as therapy for established
chronic GVHD and are associated with response rates of 20% to 80%. Most
responses are confined to skin, soft tissue, oral mucosa and occasionally
liver. Bronchiolitis obliterans responds infrequently to therapy and is
associated with a dismal prognosis. Newer, promising therapeutic strategies
under investigation include thalidomide, photopheresis therapy, anti-tumor
necrosis factor and B cell depletion with anti-CD20 monoclonal antibody. N. Ref:: 126
----------------------------------------------------
[64]
TÍTULO / TITLE: - Neutropenia is not
required for clinical remission during azathioprine therapy in inflammatory
bowel disease.
REVISTA
/ JOURNAL: - Eur J Gastroenterol Hepatol 2001
Sep;13(9):1053-5.
AUTORES
/ AUTHORS: - Persley KM; Present DH
INSTITUCIÓN
/ INSTITUTION: - Mount Sinai Medical Center, 12 East 86th
Street, New York, NY 10029, USA.
RESUMEN
/ SUMMARY: - Inflammatory bowel disease is an
idiopathic chronic inflammatory process of the gastrointestinal tract. The
aetiology remains unknown but probably involves a combination of genetic susceptibility,
environmental triggers and abnormal immune regulation. Immunomodulators are
effective in treating inflammatory bowel disease. Azathioprine and
6-mercaptopurine (6MP) are the most frequently used immunomodulator agents.
These agents are probably underused by many clinicians because of concerns
about myelosuppression, pancreatitis, allergic reactions and hepatotoxicity,
which can occur in a fraction of patients taking these drugs. Therefore,
clinicians have sought ways to optimize therapeutic response and limit toxic
side effects. Neutropenia, although uncommon, can occur in patients taking
azathioprine or 6MP. The question of neutropenia effecting clinical response
has been raised as a possible indicator of therapeutic response. In the study
from Campbell and Ghosh [7] in this issue of the European Journal of
Gastroenterology and Hepatology, no difference in relapse rates was noted
between neutropenic and non-neutropenic patients. In fact, severe
life-threatening neutropenia was seen in four patients. N. Ref:: 11
----------------------------------------------------
[65]
TÍTULO / TITLE: - Steroid-resistant
kidney transplant rejection: diagnosis and treatment.
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: <> 2001 Feb;12 Suppl
17:S48-52.
AUTORES
/ AUTHORS: - Bock HA
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Kantonsspital,
Aarau, Switzerland. bock@ksa.ch
RESUMEN
/ SUMMARY: - Decreases in transplant function may be
attributable to a variety of conditions, including prerenal and postrenal
failure, cyclosporin A (CsA) toxicity, polyoma nephritis, recurrent
glomerulonephritis, and rejection. The diagnosis of rejection should therefore
be made on the basis of a transplant biopsy of adequate size, before the
initiation of any therapy. Pulse steroid treatment (three to five 0.25- to
1.0-g pulses of methylprednisolone, administered intravenously) is the usual
first-line therapy and has a 60 to 70% success rate, although orally
administered prednisone (0.25 g) may be just as efficacious. Even if reverted,
any rejection should trigger an at least temporary increase in basal
immunosuppression, consisting of an increase in CsA or tacrolimus target
levels, the addition of steroids or an increase in their dosage, the addition
of mycophenolate mofetil, or a switch from CsA to tacrolimus. The addition of
rapamycin or its RAD derivative may fulfill the same purpose. Steroid
resistance should not be assumed before the fifth day of pulse steroid
treatment, although histologic features of vascular rejection may indicate the
need for more aggressive treatment earlier. Steroid-resistant rejection is
traditionally treated with poly- or monoclonal antilymphocytic antibodies, with
success rates of 60 to 70%. Their potential benefit must be carefully balanced against
the risks of infection and lymphoma. More recently, mycophenolate mofetil has
been successfully used to treat steroid-resistant rejection, but only of the
interstitial (cellular) type. Switching from CsA to tacrolimus for treating
recurrent or antibody-resistant rejection is successful in approximately 60% of
cases. Plasmapheresis and intravenously administered Ig have been used in some
desperate cases, with surprising success. Because none of the available drugs
has a significantly better profile of therapeutic versus adverse effects, the
possible benefits of continued rejection therapy must be continuously balanced
with the potential for serious, sometimes fatal, side effects. N. Ref:: 35
----------------------------------------------------
[66]
TÍTULO / TITLE: - Evidence-based
recommendations for immunosuppression in IgA nephropathy: handle with caution.
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 Feb;18(2):241-5.
AUTORES
/ AUTHORS: - Floege J
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology and Immunology,
University of Aachen, Pauwelsstrasse 30, D-52057 Aachen, Germany. juergen.floege@post.rwth-aachen.de N. Ref:: 27
----------------------------------------------------
[67]
TÍTULO / TITLE: - Vitamin D as
immunomodulatory therapy for kidney transplantation.
REVISTA
/ JOURNAL: - Transplantation 2002 Oct 27;74(8):1204-6.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000031949.70610.BB
AUTORES
/ AUTHORS: - Becker BN; Hullett DA; O’Herrin JK; Malin
G; Sollinger HW; DeLuca H
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, B-3063 UW
Nephrology, University of Wisconsin, 2500 Overlook Terrace, Madison, WI 53705,
USA. bnb@medicine.wisc.edu
RESUMEN
/ SUMMARY: - Vitamin D (1alpha,25-dihydroxyvitamin D(3)
[1alpha,25-(OH)(2)D(3)]) has been studied in the past for its immunosuppressive
properties, and, in that context, it may also have potential utility as an
immunomodulatory agent for transplantation. A number of studies have
demonstrated that 1alpha,25-(OH)(2)D(3) or its analogs regulate immune cell
proliferation, differentiation, and responsiveness. A burgeoning number of
studies have also explored using 1alpha,25-(OH)(2)D(3) and its analogs directly
as therapy in animal models of kidney transplantation with success in
prolonging allograft function and preventing acute rejection. Some of these in
vivo effects may well be caused by alterations in immune cell function, but it
is also possible that exogenous 1alpha,25-(OH)(2)D(3) and its analogs are altering
the intragraft milieu as well, specifically through changes in the TGF-beta
signaling cascade. Such provocative data and the availability of newer
1alpha,25-(OH)(2)D(3) analogs that may limit side effects (e.g. hypercalcemia)
have created interest in examining this secosteroid clinically in kidney
transplantation. N.
Ref:: 34
----------------------------------------------------
[68]
TÍTULO / TITLE: - Posttransplantation
lymphoproliferative disorders.
REVISTA
/ JOURNAL: - Arch Intern Med 2003 Sep 22;163(17):1997-2004.
●●
Enlace al texto completo (gratuito o de pago) 1001/archinte.163.17.1997
AUTORES
/ AUTHORS: - Andreone P; Gramenzi A; Lorenzini S;
Biselli M; Cursaro C; Pileri S; Bernardi M
INSTITUCIÓN
/ INSTITUTION: - Dipartimento di Medicina Interna,
CardioAngiologia ed Epatologia, Policlinico S Orsola-Malpighi, Bologna, Italy. andreone@med.unibo.it
RESUMEN
/ SUMMARY: - Posttransplantation lymphoproliferative
disorders include a wide spectrum of diseases ranging from
hyperplastic-appearing lesions to frank non-Hodgkin lymphoma. More than 90% of
these disorders are Epstein-Barr virus-associated lesions of B-cell origin that
arise in the setting of pharmacologic immunosuppression after transplantation.
With the increased use of organ transplantation and intensive
immunosuppression, posttransplantation lymphoproliferative disorders are
becoming more common. The prognosis is often poor, with most patients dying
despite receiving treatment. The aim of this review is to report the most
recent knowledge about the clinical features, diagnosis, prophylaxis, and
treatment of posttransplantation lymphoproliferative disorders, which can be
useful to physicians and health assistants dealing with these life-threatening,
posttransplantation clinical entities in clinical practice. N. Ref:: 76
----------------------------------------------------
[69]
TÍTULO / TITLE: - Monitoring the patient
off immunosuppression. Conceptual framework for a proposed tolerance assay
study in liver transplant recipients.
REVISTA
/ JOURNAL: - Transplantation 2001 Oct 27;72(8
Suppl):S13-22.
AUTORES
/ AUTHORS: - Thomson AW; Mazariegos GV; Reyes J;
Donnenberg VS; Donnenberg AD; Bentlejewski C; Zahorchak AF; O’Connell PJ; Fung
JJ; Jankowska-Gan E; Burlingham WJ; Heeger PS; Zeevi A
INSTITUCIÓN
/ INSTITUTION: - Thomas E. Starzl Transplantation
Institute, Department of Surgery, University of Pittsburgh and Children’s
Hospital of Pittsburgh, Pennsylvania 15213, USA. thomsonaw@msx.upmc.edu
RESUMEN
/ SUMMARY: - The mission of the recently established
Immune Tolerance Network includes the development of protocols for the
induction of transplant tolerance in organ allograft recipients and the
development of assays that correlate with and may be predictive of the tolerant
state. The state of clinical organ transplant tolerance seems to already exist
in a small minority of conventionally immunosuppressed liver and, more rarely,
kidney transplant patients. Immunosuppressive drug therapy has been withdrawn
from these patients for a variety of reasons, including protocolized weaning
for a uniquely large group of liver patients at the University of Pittsburgh.
In this study, we propose to evaluate the validity of a variety of in vitro
immunologic and molecular biologic tests that may correlate with, and be
predictive of, the state of organ transplant tolerance in stable liver patients
off immunosuppression. Only peripheral blood will be available for the
execution of these tests. Both adult and pediatric liver graft recipients will
be studied, in comparison to appropriate controls. We shall examine circulating
dendritic cell (DC) subsets [precursor (p) DC1 and p DC2] including cells of
donor origin, and assess both the frequency and function of donor-reactive T
cells by ELISPOT and by trans-vivo delayed-type hypersensitivity analysis in a
surrogate murine model. Cytokine gene polymorphism and alloantibody titers will
also be investigated. It is anticipated that the results obtained may provide
physicians with a tolerance assay “profile” that may determine those patients
from whom immunosuppressive therapy may be safely withdrawn. N. Ref:: 114
----------------------------------------------------
[70]
TÍTULO / TITLE: - Pharmacokinetic,
pharmacodynamic, and outcome investigations as the basis for mycophenolic acid
therapeutic drug monitoring in renal and heart transplant patients.
REVISTA
/ JOURNAL: - Clin Biochem 2001 Feb;34(1):17-22.
AUTORES
/ AUTHORS: - Shaw LM; Korecka M; DeNofrio D; Brayman KL
INSTITUCIÓN
/ INSTITUTION: - Departments of Pathology & Laboratory
Medicine and Surgery, University of Pennsylvania Medical Center, Philadelphia,
PA, USA. shawlmj@mail.med.upenn.edu
RESUMEN
/ SUMMARY: - Mycophenolate mofetil is widely used in
combination with either cyclosporine or tacrolimus for rejection prophylaxis in
renal and heart transplant patients. Although not monitored routinely nearly to
the degree that other agents such as cyclosporine or tacrolimus, there is an
expanding body of experimental evidence for the utility of monitoring
mycophenolic acid, the primary active metabolite of mycophenolate mofetil,
plasma concentration as an index of risk for the development of acute
rejection. The following are important experimentally-based reasons for
recommending the incorporation of target therapeutic concentration monitoring
of mycophenolic acid: (1) the MPA dose-interval
area-under-the-concentration-time curve, and less precisely, MPA predose
concentrations predict the risk for development of acute rejection; (2) the
strong correlation between mycophenolic acid plasma concentrations and
expression of important cell surface activation antigens, whole blood
pharmacodynamic assays of lymphocyte proliferation and median graft rejection
scores in a heart transplant animal model; (3) the greater than 10-fold
interindividual variation of MPA area under the concentration time curve values
in heart and renal transplant patients receiving a fixed dose of the parent
drug; (4) drug-drug interactions involving other immunosuppressives are such
that when switching from one to another (eg, from cyclosporine to tacrolimus or
vice-versa) substantial changes in MPA concentrations can occur in patients
receiving a fixed dose of the parent drug; (5) significant effects of liver and
kidney diseases on the steady-state total and free mycophenolic acid area under
the concentration time curve values; (6) the need to closely monitor
mycophenolic acid when a major change in immunosuppression is planned such as
steroid withdrawal. Current investigations are focused on determination of the
most optimal sampling time and for mycophenolic acid target therapeutic
concentration monitoring. Further investigations are needed to evaluate the
pharmacologic activity of the newly described acyl glucuronide metabolite of
mycophenolic acid which has been shown to inhibit, in vitro, inosine monophosphate
dehydrogenase. N.
Ref:: 37
----------------------------------------------------
[71]
TÍTULO / TITLE: - Genetic polymorphisms
influencing therapy and susceptibility to rejection in organ allograft
recipients.
REVISTA
/ JOURNAL: - BioDrugs 2002;16(1):11-7.
AUTORES
/ AUTHORS: - Poli F; Piccolo G; Scalamogna M
INSTITUCIÓN
/ INSTITUTION: - Centro Trasfusionale e di Immunologia dei
Trapianti, Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.
RESUMEN
/ SUMMARY: - Solid organ transplantation during the
past 30 years has developed from an experimental procedure into routine
clinical practice. The current repertoire of immunosuppressive agents has made
a major contribution to transplant survival; however, problems in different
areas still need to be overcome. Several gene polymorphisms are supposed to
influence immunosuppressive therapy and susceptibility to rejection. Therefore,
a priority of transplant biologists is to estimate individual patient risk and
to characterise the genetic profile of patients in need of a transplant in
order to optimise the use of a scarce resource such as organs from cadaver
donors, and to avoid serious drug-induced adverse effects. Polymorphisms in
genes encoding tumour necrosis factor-alpha (TNFalpha), interleukin (IL)-6,
IL-10, interferon-gamma (IFNgamma), transforming growth factor-beta (TGFbeta)
and thiopurine S-methyltransferase (TPMT) can have significant effects on an
individual’s risk of rejection, as well as their ability to tolerate
immunosuppressive therapy. Genotyping of known polymorphisms in these genes may
in the future contribute to our ability to individualise immunosuppressive
therapy in organ transplant recipients.
N. Ref:: 72
----------------------------------------------------
[72]
TÍTULO / TITLE: - Electrospray mass
spectrometry for the identification of MHC class I-associated peptides
expressed on cancer cells.
REVISTA
/ JOURNAL: - J Immunol Methods 2002 Apr
1;262(1-2):5-19.
AUTORES
/ AUTHORS: - Bonner PL; Lill JR; Hill S; Creaser CS;
Rees RC
INSTITUCIÓN
/ INSTITUTION: - Department of Life Sciences, The
Nottingham Trent University, Clifton Lane, NG11 8NS, UK. philip.bonner@ntu.ac.uk
RESUMEN
/ SUMMARY: - Electrospray ionisation (ESI) mass
spectrometry (MS) has been used extensively for the detection of peptides
presented by major histocompatibility complex (MHC) molecules. This review
focuses on the optimisation of electrospray mass spectrometry and the use of
tandem mass spectrometry to sequence MHC class I peptides. We review the
isolation of MHC class I peptides from the surface of cells with particular
reference to tumour cells. In addition, we also discuss the advantages and
disadvantages of the methods available to concentrate and fractionate the
peptides prior to analysis by electrospray mass spectrometry. N. Ref:: 108
----------------------------------------------------
[73]
TÍTULO / TITLE: - Prognostic use of human
leukocyte antigen genotyping for rheumatoid arthritis susceptibility, disease
course, and clinical stratification.
REVISTA
/ JOURNAL: - Rheum Dis Clin North Am 2002
Feb;28(1):17-37.
AUTORES
/ AUTHORS: - Wassmuth R; Wagner U
INSTITUCIÓN
/ INSTITUTION: - Institute for Transplantation Diagnostics
and Cell Therapeutics, Duesseldorf University Medical Center, University of
Duesseldorf, Duesseldorf, Germany. ralf.wassmuth@web.de
RESUMEN
/ SUMMARY: - HLA markers of the class II region are
important for determination of the predisposition to RA, clinical
manifestations, and rate of progression of joint destruction in this autoimmune
disease. Furthermore, evidence emerges indicating that HLA markers also have an
impact on treatment outcome in RA. Currently, several immunopathogenetic models
of HLA-dependent influences in RA are under debate. These models insufficiently
explain the graded influence of HLA-DR and HLA-DQ on manifestation and joint
destruction, however. Currently, there is not enough evidence to unequivocally
identify a primary susceptibility locus or to pinpoint the HLA-dependent
mechanism in RA. Overall, the influence of HLA class II markers on disease
susceptibility is rather restricted, and, in turn, their utility in
establishing the diagnosis of RA is of limited use. Although relative risks are
higher for the association of particular genotypes with extra-articular forms
of RA, HLA genotyping may not contribute to prognostication in individual
patients but may aid in disease stratification. In contrast, HLA genotyping in
early RA, particularly when combined with the determination of RFs and
determination of the presence of bony erosions, is of value to identify
patients at risk for poor outcome. In turn, these patients may benefit from
early aggressive therapy, and HLA genotyping should be useful to aid in risk
stratification in patients and thus helpful for the choice of treatment.
Lastly, disease and risk stratification based on HLA markers along with the
elucidation of HLA-dependent mechanisms may facilitate the development of
specific immunotherapy modalities. N.
Ref:: 98
----------------------------------------------------
[74]
TÍTULO / TITLE: - Solitary embolic
cutaneous aspergillosis in the immunocompromised patient with acute myelogenous
leukemia - a propos another case caused by Aspergillus flavus.
REVISTA
/ JOURNAL: - Int J Dermatol 2003 Dec;42(12):946-50.
AUTORES
/ AUTHORS: - Krunic AL; Medenica M; Busbey S
INSTITUCIÓN
/ INSTITUTION: - Section of Dermatology, University of
Chicago Hospitals, Chicago, IL, USA. N.
Ref:: 27
----------------------------------------------------
[75]
TÍTULO / TITLE: - Clinical validation
studies of Neoral C(2) monitoring: a review.
REVISTA
/ JOURNAL: - Transplantation 2002 May 15;73(9
Suppl):S3-11.
AUTORES
/ AUTHORS: - Nashan B; Cole E; Levy G; Thervet E
INSTITUCIÓN
/ INSTITUTION: - Klinik fur Viszeral und
Transplantationschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str.
1, D-30625 Hannover, Germany. N.
Ref:: 34
----------------------------------------------------
[76]
TÍTULO / TITLE: - Primary lymphoma of the
esophagus in a chronically immunosuppressed patient with hepatitis C infection:
case report and review of the literature.
REVISTA
/ JOURNAL: - Am J Med Sci 2001 Mar;321(3):203-5.
AUTORES
/ AUTHORS: - Golioto M; McGrath K
INSTITUCIÓN
/ INSTITUTION: - Division of Gastroenterology, Duke
University Medical Center, Durham, North Carolina, USA. golio001@mc.duke.edu
RESUMEN
/ SUMMARY: - Adenocarcinoma and squamous cell carcinoma
account for the vast majority of esophageal malignancies. Other malignancies
that can involve the esophagus include melanoma, sarcoma, and lymphoma.
Gastrointestinal involvement with lymphoma has a variable incidence, as
reported in the literature. However, primary involvement, as defined by Dawson,
is extremely rare. Lymphoma has been linked to immunosuppressive conditions
(such as AIDS), medications, and transplantation. We present what we believe to
be the first case of primary esophageal lymphoma in a patient on long-term
immunosuppression with azathioprine who was also infected with the hepatitis C
virus (HCV). HCV has been postulated to have a relationship with B cell
lymphomas. N. Ref:: 20
----------------------------------------------------
[77]
TÍTULO / TITLE: - Should HIV-positive
recipients undergo heart transplantation?
REVISTA
/ JOURNAL: - J Thorac Cardiovasc Surg 2003
Nov;126(5):1639-40.
●●
Enlace al texto completo (gratuito o de pago) 1016/S0022
AUTORES
/ AUTHORS: - Bisleri G; Morgan JA; Deng MC; Mancini DM;
Oz MC
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of
Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia
University, New York, NY 10032, USA. N.
Ref:: 6
----------------------------------------------------
[78]
TÍTULO / TITLE: - Editorial on “Diagnosis
and treatment of arterial steal syndromes in liver transplantation recipients”.
REVISTA
/ JOURNAL: - Liver Transpl 2003 Jun;9(6):603-4.
●●
Enlace al texto completo (gratuito o de pago) 1053/jlts.2003.50127
AUTORES
/ AUTHORS: - Farges O; Belghiti J N. Ref:: 8
----------------------------------------------------
[79]
TÍTULO / TITLE: - IgG-Fc receptors and
the clinical relevance of their polymorphisms.
REVISTA
/ JOURNAL: - Wien Klin Wochenschr 2001 Oct
30;113(20-21):825-31.
AUTORES
/ AUTHORS: - de Haas M
INSTITUCIÓN
/ INSTITUTION: - Division Central Laboratory, Blood
Transfusion Service, Laboratory of Clinical and Experimental Immunology,
Central Laboratory, Blood Transfusion Service, Laboratory of Clinical and
Experimental Immunology, University of Amsterdam, The Netherlands.
RESUMEN
/ SUMMARY: - Receptors for the Fc part of IgG form the
bridge between immune complexes, antibodies and blood cells. Besides
phagocytes, such as granulocytes and monocytes, also lymphocytes and platelets
express members of the large family of IgG-Fc receptors or Fc gamma Rs. Three
main classes of leukocyte Fc gamma Rs can be distinguished: Fc gamma RI, Fc
gamma RII and Fc gamma RIII. Depending on the type of intracellular domain of
the leukocyte Fc gamma Rs, interaction of a cell with an antibody-sensitized
particle will induce either an activating signal (leading to phagocytosis,
degranulation or toxic oxygen formation) or, in case of Fc gamma RIIb, an
inhibiting signal. The inhibiting role of Fc gamma RIIb has long been thought
to be only important for B-cell responses, however, recently it has been
indicated that Fc gamma RIIb may have a much broader role in immune response,
also regulating responses of phagocytes. In general, leukocyte Fc gamma Rs have
high affinity for IgG1 and IgG3 subclasses. However, the affinity for the
various IgG subclasses is influenced by receptor polymorphisms encoded by
single nucleotide polymorphisms of the Fc gamma RIIa and Fc gamma RIIIa and Fc
gamma RIIIb encoding genes. Because these subtle Fc gamma R changes determine
the level of clearance of immune complexes, associations between Fc gamma R
isoforms and disease risks have been investigated and also indicated as
discussed in this review. Next to the leukocyte Fc gamma Rs, an IgG transport
receptor, FcRn (neonatal Fc receptor) has been described. This receptor seems to
be important for placental IgG transport and for IgG plasma level homeostasis.
FcRn is expressed by endothelial cells and hepatocytes and functions in these
cells as a receptor rescuing IgG from destruction, thereby increasing IgG half
life. Also blood cells express FcRn and the exact role of FcRn in these cells
is still to determined. Thus, although a lot is known, questions on the exact
pattern of expression of the IgG receptors and their role in immune response
still remain. N.
Ref:: 49
----------------------------------------------------
[80]
TÍTULO / TITLE: - Antibody-associated
polyneuropathy syndromes: principles and treatment.
REVISTA
/ JOURNAL: - Semin Neurol 2003 Jun;23(2):181-90.
●●
Enlace al texto completo (gratuito o de pago) 1055/s-2003-41131
AUTORES
/ AUTHORS: - Kornberg AJ; Pestronk A
INSTITUCIÓN
/ INSTITUTION: - Department of Neurology, Royal Children’s
Hospital, Parkville, Victoria, Australia.
RESUMEN
/ SUMMARY: - Treatment of immune-mediated neuropathies
first requires an accurate diagnosis. The diagnosis is often based on clinical,
electrophysiological, and immunological features of the syndrome. The selection
of appropriate therapies is then based on the spectrum of response of a
syndrome to medications and an assessment of possible side effects. In
neuropathies with associated serum immunoglobulin M autoantibodies, such as
anti-myelin-associated glycoprotein and motor syndromes, the choices of therapy
are often limited to cytotoxic agents and, in some cases, intravenous
immunoglobulin. In neuropathies with immunoglobulin G antibodies in both serum
and cerebrospinal fluid, such as sensory neuronopathies associated with anti-Hu
antibodies, there is no well-documented response to any immunotherapy. The
general principles regarding therapy of immune neuropathies will be discussed
with a focus on diagnosis and treatment options of the demyelinating and
immunoglobulin M antibody-associated neuropathies. N. Ref:: 73
----------------------------------------------------
[81]
TÍTULO / TITLE: - Rush Hymenoptera venom
immunotherapy: a safe and practical protocol for high-risk patients.
REVISTA
/ JOURNAL: - J Allergy Clin Immunol 2002
Dec;110(6):928-33.
AUTORES
/ AUTHORS: - Sturm G; Kranke B; Rudolph C; Aberer W
INSTITUCIÓN
/ INSTITUTION: - Department of Environmental Dermatology
and Allergy, University of Graz, Graz, Austria.
RESUMEN
/ SUMMARY: - BACKGROUND: Hymenoptera venom
immunotherapy in allergic patients is a well-established treatment modality for
the prevention of systemic anaphylactic reactions caused by insect stings. A
variety of therapy regimens exists, from conventional to rush and ultrarush
modalities that operate on continuous or intermittent schedules. OBJECTIVE: The
aim of this study was to report the 8-year experience with our rush venom
immunotherapy regimen in predominantly high-risk patients and to compare data
on safety and convenience with the results of 26 studies published from 1978 to
2001. METHODS: One hundred one patients allergic to bee, yellow jacket, or
hornet venom were treated with rush Hymenoptera venom immunotherapy. Diagnosis
and selection of patients for venom immunotherapy were carried out according to
the recommendations of the European Academy of Allergology and Clinical
Immunology. We used a 4-day regimen, and the incidence and nature of systemic
reactions (SRs) were documented. Fifty-two patients were treated with honeybee
venom, and 49 were treated with yellow jacket venom. RESULTS: One hundred (99%)
patients reached the maintenance dose. We observed 8 injection-related SRs
(0.47% of all injections given) in 7 (6.9%) patients. The number of SRs was
higher in patients treated with bee venom extract (12%) compared with in
patients receiving yellow jacket venom extract (2%). There was no significant
difference in the risk of SRs between female and male patients. The incidence
of SRs was considerably lower than the average of 17.8% reported in the
literature. CONCLUSION: With a rush immunotherapy regimen over a time period of
8 years in predominantly high-risk patients, the incidence of SRs was low,
despite the high number of patients with bee venom allergy, who are more likely
to have side effects. Epinephrine as rescue medication was never necessary, and
the regimen proved to be safe and convenient for both the patients and the
medical staff.
----------------------------------------------------
[82]
TÍTULO / TITLE: - Capillary C4d
deposition as a marker of humoral immunity in renal allograft rejection.
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
Sep;13(9):2420-3.
AUTORES
/ AUTHORS: - Watschinger B; Pascual M N. Ref:: 38
----------------------------------------------------
[83]
TÍTULO / TITLE: - Treatment of
nonmelanoma skin cancer in organ transplant recipients: review of responses to
a survey.
REVISTA
/ JOURNAL: - J Am Acad Dermatol 2003 Sep;49(3):413-6.
AUTORES
/ AUTHORS: - Clayton AS; Stasko T
INSTITUCIÓN
/ INSTITUTION: - Division of Dermatology, Mohs Micrographic
Surgery Clinic, Vanderbilt University Medical Center, Nashville, Tennessee,
USA.
RESUMEN
/ SUMMARY: - There are approximately 100,000 US organ
transplant recipients, many with nonmelanoma skin cancers. To better understand
how clinicians treat them, we e-mailed a survey to the International
Transplant-Skin Cancer Collaborative and the Association of Academic
Dermatologic Surgeons. Twenty-five physicians responded. The majority use
topical 5-fluorouracil, cryosurgery, electrodesiccation and curettage, and
surgery. We review when these modalities are used. N. Ref:: 18
----------------------------------------------------
[84]
TÍTULO / TITLE: - European best practice
guidelines for renal transplantation. Section IV: Long-term management of the
transplant recipient. IV.2.1 Differential diagnosis of chronic graft
dysfunction.
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 4:4-8.
RESUMEN
/ SUMMARY: - GUIDELINES: A. Any significant
deterioration in graft function should be investigated using the appropriate
diagnostic tools and, if possible, therapeutic interventions should be
initiated. The usual causes of a decline in glomerular filtration rate after
the first year include transplant-specific causes such as chronic allograft
nephropathy, acute rejection episodes, chronic calcineurin inhibitor
nephrotoxicity, transplant renal artery stenosis and ureteric obstruction, as
well as immunodeficiency-related causes and non-transplant-related causes, such
as recurrent or de novo renal diseases and bacterial infections. B. Any new
onset and persistent proteinuria of >0.5 g/24 h should be investigated and
therapeutic interventions should be initiated. The usual causes include chronic
allograft nephropathy and transplant glomerulopathy, and recurrent or de novo
glomerulonephritis.
----------------------------------------------------
[85]
TÍTULO / TITLE: - Definitions of
cytomegalovirus infection and disease in transplant recipients.
REVISTA
/ JOURNAL: - Clin Infect Dis 2002 Apr 15;34(8):1094-7.
Epub 2002 Mar 11.
AUTORES
/ AUTHORS: - Ljungman P; Griffiths P; Paya C
INSTITUCIÓN
/ INSTITUTION: - Department of Hematology, Huddinge
University Hospital, Karolinska Institutet, SE-14186 Stockholm, Sweden. Per.Ljungman@medhs.ki.se
RESUMEN
/ SUMMARY: - Cytomegalovirus (CMV) infection and
disease are important causes of morbidity and mortality among transplant
recipients. For the purpose of developing consistent reporting of CMV in
clinical trials, definitions of CMV infection and disease were developed and
published. This study seeks to update the definitions of CMV on the basis of
recent developments in diagnostic techniques, as well as to add to these
definitions the concept of indirect effects caused by CMV. N. Ref:: 19
----------------------------------------------------
[86]
TÍTULO / TITLE: - Treatment responses of
childhood aplastic anaemia with chromosomal aberrations at diagnosis.
REVISTA
/ JOURNAL: - Br J Haematol 2002 Jul;118(1):313-9.
AUTORES
/ AUTHORS: - Ohga S; Ohara A; Hibi S; Kojima S; Bessho
F; Tsuchiya S; Ohshima Y; Yoshida N; Kashii Y; Nishimura S; Kawakami K;
Nishikawa K; Tsukimoto I
INSTITUCIÓN
/ INSTITUTION: - Aplastic Anaemia Committee of the Japanese
Society of Paediatric Haematology, Tokyo, Japan. ohgas@pediatr.med.kyushu-u.ac.jp
RESUMEN
/ SUMMARY: - The clinical outcome of childhood aplastic
anaemia (AA) with aberrant cytogenetic clones at diagnosis was surveyed. Among
198 children with newly diagnosed AA registered with the AA Committee of the
Japanese Society of Paediatric Hematology between 1994 and 1998, cytogenetic
studies of bone marrow (BM) cells were completed in 159 patients. Apart from
one Robertsonian translocation, seven patients (4.4%) showed clonal chromosomal
abnormalities in hypoplastic BM without myelodysplastic features. The patients
included six girls and one boy with a median age of 11 years (range 5-14
years). Six patients had del(6), del(5), del(13), del(20), or -7, and one
showed add(9). Four patients responded to the first immunosuppressive therapy
(IST: cyclosporin A plus anti-thymocyte globulin) and one obtained a
spontaneous remission. Cytogenetic abnormalities remained in two patients with
an IST response. On the other hand, two patients showed no IST response. One
did not respond to repeat IST and died of acute graft-versus-host disease after
an unrelated-BM transplant. Another obtained a complete response after a
successful BM transplant. No haematological findings at diagnosis predicted the
treatment response. No significant morphological changes developed during the
course of the illness. A literature review revealed that half of 24 AA patients
with chromosomal abnormalities responded to the first IST, and that +6 was the
sole predictable marker for IST unresponsiveness. These results suggest that
IST can be applied as the initial therapy for AA with cytogenetic abnormalities
in the absence of completely matched donors.
N. Ref:: 32
----------------------------------------------------
[87]
TÍTULO / TITLE: - The extent and analysis
of cytokine and cytokine receptor gene polymorphism.
REVISTA
/ JOURNAL: - Transpl Immunol 2002 Aug;10(2-3):143-6.
AUTORES
/ AUTHORS: - Keen LJ
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology and Microbiology,
University of Bristol, UK. l.j.keen@bristol.ac.uk
RESUMEN
/ SUMMARY: - Cytokines play an important role in the
regulation of normal immune function. In recent years cytokines and their
receptors have been shown to be highly polymorphic. Polymorphisms in these
genes have been associated with a number of immune diseases as well as organ
transplant complications. The current disease association data is confusing and
often contradictory. Whilst single locus analyses are the predominant form of
cytokine polymorphism analysis, the use of polymorphic haplotypes is becoming
increasingly common. This may help to give a clearer picture of the association
of cytokine polymorphism with immune disfunction. N. Ref:: 23
----------------------------------------------------
[88]
TÍTULO / TITLE: - The impact of
cytomegalovirus infections and acute rejection episodes on the development of
vascular changes in 6-month protocol biopsy specimens of cadaveric kidney
allograft recipients.
REVISTA
/ JOURNAL: - Transplantation 2003 Jun
15;75(11):1858-64.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000064709.20841.E1
AUTORES
/ AUTHORS: - Helantera I; Koskinen P; Tornroth T;
Loginov R; Gronhagen-Riska C; Lautenschlager I
INSTITUCIÓN
/ INSTITUTION: - Department of Virology, Helsinki
University Central Hospital and University of Helsinki, Helsinki, Finland.
RESUMEN
/ SUMMARY: - BACKGROUND: The role of cytomegalovirus
(CMV) in chronic kidney allograft rejection remains controversial. The purpose
of this study was to examine the impact of CMV infection on histopathologic
changes in 6-month protocol biopsy specimens of kidney allografts. METHODS:
Altogether, 52 renal allograft recipients were studied. CMV infection was diagnosed
by CMV antigenemia test, viral cultures from blood and urine, or both. CMV was
demonstrated in the biopsy specimens by antigen detection and hybridization in
situ. Acute rejections were diagnosed by biopsy histology, and biopsy specimens
were graded according to the Banff ‘97 classification. RESULTS: CMV infection
was diagnosed in 41 patients. The 11 patients in whom CMV infection was not
detected were used as controls. Acute rejection was diagnosed in 22 of 41 CMV
patients and in 6 of 11 control patients. CMV was demonstrated in the biopsy
specimens of 19 of 41 CMV patients. CMV was not associated with increased
glomerular, tubular, or interstitial changes. However, the arteriosclerotic
changes in small arterioles were significantly increased in the subgroup of
patients where CMV was demonstrated in the graft as compared with controls
(P<0.01). Analysis of the impact of acute rejection on arteriolar thickening
showed that only a positive history of both acute rejection and CMV found in
the graft was associated with significantly increased vascular changes compared
with CMV-free recipients (P<0.05). CONCLUSIONS: Neither CMV nor acute
rejection alone was associated with increased vascular or other histopathologic
changes in 6-month protocol biopsy specimens of kidney allografts, but a
previous history of both acute rejection and the presence of CMV in the graft
was associated with increased vascular changes.
----------------------------------------------------
[89]
TÍTULO / TITLE: - Transplant
capillaropathy and transplant glomerulopathy: ultrastructural markers of
chronic renal allograft rejection.
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 Apr;18(4):655-60.
AUTORES
/ AUTHORS: - Ivanyi B
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, University of
Szeged, Szeged, Hungary. ivanyi@patho.szote.u-szeged.hu N. Ref:: 21
----------------------------------------------------
[90]
TÍTULO / TITLE: - Adenovirus
pyelonephritis in a pediatric renal transplant patient.
REVISTA
/ JOURNAL: - Pediatr Nephrol 2003 May;18(5):457-61.
Epub 2003 Mar 18.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00467-003-1080-x
AUTORES
/ AUTHORS: - Kim SS; Hicks J; Goldstein SL
INSTITUCIÓN
/ INSTITUTION: - Baylor College of Medicine, Texas, USA.
RESUMEN
/ SUMMARY: - Gross hematuria, graft pain, and rising
serum creatinine are classic signs of acute rejection, obstruction, or
bacterial pyelonephritis for patients with renal transplants. This presentation
often prompts percutaneous renal allograft biopsy. If subsequent evaluation
fails to show evidence of acute rejection, obstruction, or bacterial infection,
viral etiologies should be considered. We report a 14-year-old Hispanic female
with a living-related renal transplant who had gross hematuria, graft
tenderness, and increased serum creatinine, but did not have evidence of acute
rejection, obstruction, or bacterial pyelonephritis. To our knowledge, this is
the first report of adenovirus pyelonephritis in a transplanted kidney of a
pediatric patient, with isolation of adenovirus in the urine and in the
allograft using immunocytochemical techniques.
N. Ref:: 26
----------------------------------------------------
[91]
TÍTULO / TITLE: - “Least incompatible”
units for transfusion in autoimmune hemolytic anemia: should we eliminate this
meaningless term? A commentary for clinicians and transfusion medicine
professionals.
REVISTA
/ JOURNAL: - Transfusion 2003 Nov;43(11):1503-7.
AUTORES
/ AUTHORS: - Petz LD
N. Ref:: 22
----------------------------------------------------
[92]
TÍTULO / TITLE: - Genetic epidemiology of
rheumatoid arthritis.
REVISTA
/ JOURNAL: - Tissue Antigens 2002 Dec;60(6):465-73.
AUTORES
/ AUTHORS: - Harney S; Wordsworth BP
INSTITUCIÓN
/ INSTITUTION: - Oxford University Institute of
Musculosketal Science, Botnar Center, Nuffield Othopaedic Center, Oxford, UK.
RESUMEN
/ SUMMARY: - Building on the spectacular success of
molecular genetics in defining the biological basis of many rare single gene
disorders over the past decade, epidemiologists have turned their attention to
unravelling the complex genetic mysteries of common disorders, such as
rheumatoid arthritis (RA). As a prelude to any such endeavour it is obviously
important to establish that there is a significant genetic component to the
disease. The classical approaches of twin and other family recurrence risk
studies, coupled with prevalence studies in different ethnic and migrant
populations, have been used to estimate the environmental and genetic
contributions to RA. However, developing a consensus on these estimates has
proved difficult, thereby providing an early warning to the unwary investigator
that the road to gene discovery in RA is likely to be a rough ride. N. Ref:: 61
----------------------------------------------------
[93]
TÍTULO / TITLE: - International
Federation of Clinical Chemistry/International Association of Therapeutic Drug
Monitoring and Clinical Toxicology working group on immunosuppressive drug
monitoring.
REVISTA
/ JOURNAL: - Ther Drug Monit 2002 Feb;24(1):59-67.
AUTORES
/ AUTHORS: - Holt DW; Armstrong VW; Griesmacher A;
Morris RG; Napoli KL; Shaw LM
INSTITUCIÓN
/ INSTITUTION: - Analytical Unit, St George’s Hospital
Medical School, London, UK. d.holt@sghms.ac.uk
RESUMEN
/ SUMMARY: - Issues surrounding the measurement and
interpretation of immunosuppressive drug concentrations have been summarized in
a number of consensus documents. The Scientific Division of the International
Federation of Clinical Chemistry has formed a working group in collaboration
with the International Association of Therapeutic Drug Monitoring and Clinical
Toxicology. This paper sets out the goals of the working group in light of the
developments that have occurred in the field of immunosuppressive drug
monitoring since the publication of the last consensus documents.
----------------------------------------------------
[94]
TÍTULO / TITLE: - Light microscopic and
electron microscopic diagnosis of gastrointestinal opportunistic infections in
HIV-positive patients.
REVISTA
/ JOURNAL: - Pathology 2002 Feb;34(1):21-35.
AUTORES
/ AUTHORS: - Field AS
INSTITUCIÓN
/ INSTITUTION: - Department of Anatomical Pathology, St
Vincent’s Hospital, Darlinghurst, NSW, Australia. afield@stvincents.com.au
RESUMEN
/ SUMMARY: - The surgical pathologist is expected to
recognise gastrointestinal opportunistic infections in biopsies from
HIV-positive patients, and patients immunocompromised iatrogenically by cancer
therapy, steroid treatment and transplantation immunosuppression regimes. This
review article presents the diagnostic features in gastrointestinal biopsies of
microsporidia, cyclospora, isospora, cryptosporidia, mycobacteria, adenovirus,
enteropathogenic bacteria, cryptococcus and leishmania. All of these infections
have been diagnosed at our hospital in Sydney, Australia, since the AIDS
epidemic began. A protocol for the examination and assessment of these
gastrointestinal biopsies is presented and discussed. N. Ref:: 89
----------------------------------------------------
[95]
TÍTULO / TITLE: - Genetic engineering of
allergens: future therapeutic products.
REVISTA
/ JOURNAL: - Int Arch Allergy Immunol 2002
Jul;128(3):171-8.
AUTORES
/ AUTHORS: - Ferreira F; Wallner M; Breiteneder H;
Hartl A; Thalhamer J; Ebner C
INSTITUCIÓN
/ INSTITUTION: - Institute of Genetics, University of
Salzburg, Salzburg, Austria. fatima.ferreira@mh.sbg.ac.at
RESUMEN
/ SUMMARY: - Genetic engineering of allergens for
specific immunotherapy should aim at the production of modified molecules with
reduced IgE-binding epitopes (hypoallergens), while preserving structural
motifs necessary for T cell recognition (T cell epitopes) and for induction of
IgG antibodies reactive with the natural allergen (blocking antibodies). Common
approaches for engineering of hypoallergens usually require knowledge of T and
B cell epitopes and involve changing specific base pairs (mutated gene),
introduction of a new piece of DNA into the existing DNA molecule (chimeric or
hybrid gene), and deletions (truncated gene or fragments). DNA family shuffling
has the advantage that it does not require a priori knowledge of structural and
functional properties for efficient generation of hypoallergens. The
combination of the hypoallergen concept with the Th1-inducing genetic
immunization approach might be an attractive alternative for protein-based
immunotherapy. N.
Ref:: 66
----------------------------------------------------
[96]
TÍTULO / TITLE: - Clinical importance of
confirming or excluding the diagnosis of chronic graft-versus-host disease.
REVISTA
/ JOURNAL: - Bone Marrow Transplant 2001
Dec;28(11):1047-51.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj/bmt/1703278
AUTORES
/ AUTHORS: - Jacobsohn DA; Montross S; Anders V;
Vogelsang GB
INSTITUCIÓN
/ INSTITUTION: - Department of Oncology and Pediatrics,
Hematologic Malignancies, The Johns Hopkins University School of Medicine,
Baltimore, MD, USA.
RESUMEN
/ SUMMARY: - Chronic graft-versus-host disease (cGVHD)
is a major complication of allogeneic hematopoietic cell transplantation. The
presentation of this disease is varied, and it requires histological
confirmation for diagnosis. In addition, cGVHD can often mimic other diseases,
and vice versa. We have conducted a retrospective analysis of 123 patients
referred to the GVHD clinic at the Johns Hopkins Oncology Center from 1994 to
1998 with a diagnosis of active cGVHD. Of these, nine patients (7%) had no
evidence of cGVHD, and 25 patients (20%) had inactive cGVHD. Many of these
patients were found to have other processes accounting for their ongoing
symptoms. We conclude that since the therapy for this disease has significant
toxicities and since what appears to represent cGVHD may actually be another
disease, correct diagnosis of cGVHD or exclusion of this diagnosis is
essential. N. Ref:: 22
----------------------------------------------------
[97]
TÍTULO / TITLE: - Induction
immunosuppression for patients who underwent transplantation for cirrhosis
caused by hepatitis C? The answer is no!
REVISTA
/ JOURNAL: - Liver Transpl 2002 Oct;8(10 Suppl
1):S47-9.
●●
Enlace al texto completo (gratuito o de pago) 1053/jlts.2002.35853
AUTORES
/ AUTHORS: - Burroughs AK
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, The Liver
Transplantation and Hepatobiliary Unit, The Royal Free Hospital, London, UK. andrew.burroughs@talk21.com N. Ref:: 32
----------------------------------------------------
[98]
TÍTULO / TITLE: - Epstein-Barr
virus-associated pulmonary leiomyosarcoma arising twenty-nine years after renal
transplantation.
REVISTA
/ JOURNAL: - J Thorac Cardiovasc Surg 2003
Sep;126(3):877-9.
AUTORES
/ AUTHORS: - Ferri L; Fraser R; Gaboury L; Mulder D
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, McGill University
Health Centre, Montreal General Hospital, Room D10.168, 1650 Cedar Avenue,
Montreal, Quebec H3G 1A4, Canada. lferri@po-box.mcgill.ca N. Ref:: 5
----------------------------------------------------
[99]
TÍTULO / TITLE: - How concerned should we
be about missing antibodies to low incidence antigens?
REVISTA
/ JOURNAL: - Transfusion 2003 Jul;43(7):844-7.
AUTORES
/ AUTHORS: - Garratty G N. Ref:: 26
----------------------------------------------------
[100]
TÍTULO / TITLE: - Chimerism and minimal
residual disease monitoring after reduced intensity conditioning (RIC)
allogeneic transplantation.
REVISTA
/ JOURNAL: - Leukemia 2002 Aug;16(8):1423-31.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.leu.2402550
AUTORES
/ AUTHORS: - Perez-Simon JA; Caballero D; Diez-Campelo
M; Lopez-Perez R; Mateos G; Canizo C; Vazquez L; Vidriales B; Mateos MV;
Gonzalez M; San Miguel JF
INSTITUCIÓN
/ INSTITUTION: - Servicio de Hematologia, Hospital Clinico
Universitario de Salamanca, Salamanca, España.
RESUMEN
/ SUMMARY: - Since graft-versus-leukemia (GVL) is the
main weapon for disease eradication after reduced intensity conditioning (RIC)
allogeneic SCT, the availability of sensitive and specific techniques to
monitor changes in tumor load after transplant are especially helpful. These
minimal residual disease techniques would allow an early intervention in the
event of low tumor burden, for which immunotherapy is highly effective. Some
authors have found an association between persistence of MRD, mixed chimerism
and risk of relapse. Nevertheless, data from the literature remain
contradictory and further correlations should be established, especially in RIC
transplants. In this study we have analyzed the impact of MRD and chimerism
monitoring on the outcome of 34 patients undergoing RIC allogeneic SCT who were
considered poor candidates for conventional transplantation due to advanced age
or other concurrent medical conditions. At day +100 25 (75%) patients reached
complete remission (CR), there were five (15%) partial responses and three
patients progressed. Incidence of grade 2-4 aGVHD and extensive cGVHD were 35%
and 58%, respectively. Sixteen percent of patients developing aGVHD relapsed as
compared to 47% in those without aGVHD (P = 0.03) and also 10% of patients
developing cGVHD relapsed as compared to 50% relapses in those without cGHVD (P
= 0.03). Four patients (12%) died due to early (n = 1) and late (n = 3)
transplant-related mortality. After a median follow-up of 15 months, 24 out of
the 34 patients remain alive. Projected overall survival and disease-free
survival at 3 years are 68% and 63%, respectively. Early chimerism analysis showed
67% of patients with complete chimerism (CC) in bone marrow (BM), 86% in
peripheral blood (PB), 89% in granulocytes and 68% in T lymphocytes. On day
+100, these figures were 68%, 79%, 90% and 73%, respectively, and on day +180
there were 83% patients with CC in BM, 100% in PB, 100% in granulocytes and
100% in T lymphocytes. We observed a trend to a higher incidence of relapse in
patients with mixed chimerism (MC) as compared to patients with CC. MRD
monitoring by flow cytometry and/or RT-PCR analysis was performed in 23
patients. MRD assessment on days +21 to +56 after transplant allowed
identification of patients at risk of relapse. In this sense, seven out of 12
patients (58.3%) who had positive MRD on days +21 to +56 relapsed as compared
to none out of 11 patients who had negative MRD (P = 0.002). Of the seven
patients with criteria to monitor MRD who relapsed after transplant, all but
one remained MRD positive until relapse. By contrast, 10 patients remained MRD
negative and all of them are in continuous CR. In nine additional patients,
persistence of MRD or mixed chimerism was observed after transplant and
withdrawal of cyclosporin with or without DLI was performed. Only two out of
these nine patients relapsed. MRD clearance was preceded by CC and GVHD. In
conclusion, in our study we found that RIC allogeneic transplantation can be
used in patients considered poor candidates for conventional transplantation
due to advanced age or other concurrent medical conditions with both low
toxicity and low transplant-related mortality. Simultaneous studies of both
chimerism and MRD are a useful tool in order to predict risk of relapse in
patients undergoing RIC transplants and so can be helpful for individualizing
treatment strategies after transplant. N.
Ref:: 47
----------------------------------------------------
[101]
TÍTULO / TITLE: - Eosinophilic
infiltrates in a pulmonary allograft: a case and review of the literature.
REVISTA
/ JOURNAL: - J Heart Lung Transplant 2001
Jun;20(6):692-5.
AUTORES
/ AUTHORS: - Mogayzel PJ Jr; Yang SC; Wise BV;
Colombani PM
INSTITUCIÓN
/ INSTITUTION: - Eudowood Division of Pediatric Respiratory
Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. mogayzel@mail.jhmi.edu
RESUMEN
/ SUMMARY: - An unusual case of peribronchial
eosinophilic infiltrates associated with peripheral blood eosinophilia in a
lung transplant patient is described. The role that eosinophils play in lung
allograft rejection is reviewed. Tissue eosinophils have been associated with
acute pulmonary allograft rejection. Although, eosinophils in bronchoalveolar
lavage fluid (BAL) have been observed in allograft rejection, this relationship
is less well defined. The role of eosinophils in the pathophysiology of
allograft rejection is unclear. N.
Ref:: 27
----------------------------------------------------
[102]
TÍTULO / TITLE: - Challenges in staining
T cells using HLA class II tetramers.
REVISTA
/ JOURNAL: - Clin Immunol 2003 Jan;106(1):23-8.
AUTORES
/ AUTHORS: - Kwok WW
INSTITUCIÓN
/ INSTITUTION: - Benaroya Research Institute at Virginia
Mason, 1201 Ninth Avenue, Seattle, WA 98101, USA. bkwok@vmresearch.org N. Ref:: 15
----------------------------------------------------
[103]
TÍTULO / TITLE: - Controlling the
incidence of infection and malignancy by modifying immunosuppression.
REVISTA
/ JOURNAL: - Transplantation 2001 Dec 27;72(12
Suppl):S89-93.
AUTORES
/ AUTHORS: - Soulillou JP; Giral M
RESUMEN
/ SUMMARY: - Long-term outcomes in renal
transplantation have improved over the years but are still a matter of concern.
Because patients typically require lifelong immunosuppression, the risks of
cancer and infection associated with immunosuppressive agents continue to
demand attention. Physicians strive endlessly to find the right balance between
the level of immunosuppression required to prevent rejection and the level that
will minimize dose-dependent side effects. Data presented in this paper suggest
that some renal transplant recipients might have more than necessary
immunosuppression during maintenance therapy and that reducing the
immunosuppressant dose can decrease cancer incidence, without worsening
long-term patient or allograft survival. Additionally, data were examined
suggesting that immunosuppressive agents might be associated with different
risks for cancer, specifically, the potential advantage of reduced cancer risk
for sirolimus and sirolimus derivatives in comparison with standard immunosuppressive
agents. Although promising, these preliminary results are from preclinical
studies, and further study is warranted.
N. Ref:: 42
----------------------------------------------------
[104]
TÍTULO / TITLE: - Guidelines for the
diagnosis and management of acquired aplastic anaemia.
REVISTA
/ JOURNAL: - Br J Haematol 2003 Dec;123(5):782-801.
AUTORES
/ AUTHORS: - Marsh JC; Ball SE; Darbyshire P;
Gordon-Smith EC; Keidan AJ; Martin A; McCann SR; Mercieca J; Oscier D; Roques
AW; Yin JA
INSTITUCIÓN
/ INSTITUTION: - St. George’s Hospital Medical School,
London, UK. janice@bshhya.demon.co.uk
----------------------------------------------------
[105]
TÍTULO / TITLE: - Effective prophylactic
protocol in delayed hypersensitivity to contrast media: report of a case
involving lymphocyte transformation studies with different compounds.
REVISTA
/ JOURNAL: - Radiology. Acceso gratuito al texto
completo a partir de los 2 años de la publicación; - http://radiology.rsnajnls.org/
●●
Cita: Radiology: <> 2002 Nov;225(2):466-70.
AUTORES
/ AUTHORS: - Romano A; Artesani MC; Andriolo M; Viola
M; Pettinato R; Vecchioli-Scaldazza A
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine and
Geriatrics, Universita’ Cattolica del Sacro Cuore, Allergy Unit, Complesso
Integrato Columbus, Via G. Moscati 31, 00168 Rome, Italy. columbus.allerg@linet.it
RESUMEN
/ SUMMARY: - A patient with maculopapular reactions to
iopamidol needed to undergo angiography for a cerebral arteriovenous
malformation. In vivo and in vitro tests were performed with ionic and nonionic
contrast media, including iopamidol and iobitridol. All results were positive,
demonstrating delayed hypersensitivity. The patient received
6-alpha-methylprednisolone and cyclosporine 1 week before and 2 weeks after
four angiograms were obtained with the use of iobitridol, which was well
tolerated.
----------------------------------------------------
[106]
TÍTULO / TITLE: - A retrospective review
of sirolimus (Rapamune) therapy in orthotopic liver transplant recipients
diagnosed with chronic rejection.
REVISTA
/ JOURNAL: - Liver Transpl 2003 May;9(5):477-83.
●●
Enlace al texto completo (gratuito o de pago) 1053/jlts.2003.50119
AUTORES
/ AUTHORS: - Neff GW; Montalbano M; Slapak-Green G;
Berney T; Bejarano PA; Joshi A; Icardi M; Nery J; Seigo N; Levi D; Weppler D;
Pappas P; Ruiz J; Schiff ER; Tzakis AG
INSTITUCIÓN
/ INSTITUTION: - University of Miami, Department of
Medicine, Miami, FL 33136, USA. gneff@med.miami.edu
RESUMEN
/ SUMMARY: - Treatment options are limited for
orthotopic liver transplant (OLT) recipients suffering from chronic rejection
(CR). We performed a retrospective review of OLT recipients diagnosed with CR
and treated with sirolimus. The medical records of all OLT recipients treated
with sirolimus between October, 1998 and October, 2000 were retrospectively
reviewed. The diagnosis of CR was made by both clinical and histologic
criteria: bile duct to hepatic artery ratio less than 0.7, histologic activity
index, hepatic arterial wall thickening, and chronic elevation of liver
chemistries. Two groups were defined in regard to sirolimus response: sirolimus
responders (SR) and sirolimus nonresponders (SNR). Response to treatment was
granted only when patients were found to have resolution of abnormal liver
transaminases and an improvement in hepatic artery to bile duct ratio. Serum
collections for liver chemistries were collected on days 1, 30, 60, and 90.
Liver biopsies were reviewed in blinded fashion from day 1 and at least 180
days on therapy by double-blinded pathologists. Sirolimus-related complications
were recorded and include drug toxicity, anemia with and without treatment,
hospitalizations, infections, immunosuppression complications, lipid profile
disorders, edema, muscle aches, and gastrointestinal complaints. Twenty-one
patients were diagnosed with CR. The SR group included 13 of 21, and 8 of 21
were in the SNR group. Anemia was diagnosed in 12 of 21 patients: SR, 7 of 13;
SNR, 5 of 8; with 5 patients requiring red blood cell transfusions (2 SR, 3
SNR). Recombinant erythropoietin was started in 5 of 21 patients. Sirolimus
serum levels were found to be greater than 20 ng/dL in 12 patients. Sirolimus
was discontinued in 9 patients,
----------------------------------------------------
[107]
TÍTULO / TITLE: - The role of cytokine
polymorphisms in rejection after solid organ transplantation.
REVISTA
/ JOURNAL: - Genes Immun 2001 Oct;2(6):297-303.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj/gene/6363795
AUTORES
/ AUTHORS: - Marshall SE; Welsh KI
INSTITUCIÓN
/ INSTITUTION: - Oxford Transplant Centre, Churchill
Hospital, Oxford OX3 7LJ, UK.
RESUMEN
/ SUMMARY: - The importance of cytokines to the immune
response is irrefutable. Their role in the biology of solid organ
transplantation per se is also assured. Thus it is likely that subtle
differences in cytokine composition, particularly at the initiation of an
immune response, may have a major effect on the outcome of that response. This
may be particularly relevant in solid organ transplantation, where it is
possible that genetic polymorphisms which influence cytokine production may
determine the outcome of a transplant. Indeed, it has been suggested that
immunosuppression may be individualised on the basis of recipient or donor
genotype. However, much of the early data regarding the importance of specific
cytokine polymorphisms has not been reproduced, and the significance of this
field remains controversial. Nonetheless, with the experience gained from
earlier studies, some clear patterns for future studies are emerging. N. Ref:: 46
----------------------------------------------------
[108]
TÍTULO / TITLE: - What is the role of
genetic testing in diagnosis of haemochromatosis?
REVISTA
/ JOURNAL: - Ann Clin Biochem 2001 Jan;38(Pt 1):3-19.
AUTORES
/ AUTHORS: - Worwood M
INSTITUCIÓN
/ INSTITUTION: - Department of Haematology, University of
Wales College of Medicine, Cardiff, UK. worwood@cardiff.ac.uk N. Ref:: 116
----------------------------------------------------
[109]
TÍTULO / TITLE: - Community-acquired
pneumonia in immunocompromised patients. Opportunistic infections to consider
in differential diagnosis.
REVISTA
/ JOURNAL: - Postgrad Med. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.postgradmed.com/journal.htm
●●
Cita: Postgraduate Medicine: <> 2003 Jan;113(1):65-6, 69-70, 73-4 passim.
AUTORES
/ AUTHORS: - Cebular S; Lee S; Tolaney P; Lutwick L
INSTITUCIÓN
/ INSTITUTION: - State University of New York-Downstate
Medical Center, Brooklyn, USA.
RESUMEN
/ SUMMARY: - Immunocompromised persons are at increased
risk for a large group of infections that are either uncommon or much less
severe in the immunocompetent host. These opportunistic infections broaden the
diagnostic considerations in differential diagnosis of community-acquired
pneumonia in patients with immunodeficiencies. This article highlighted
epidemiologic factors, clinical presentations, and treatment options for four
selected opportunistic infections that represent varied classes of pathogens:
nematodes (S stercoralis), mycoses (C neoformans), bacteria (P aeruginosa in
patients with HIV infection), and viruses (measles virus). N. Ref:: 23
----------------------------------------------------
[110]
TÍTULO / TITLE: - A ten-year-old boy with
a pulmonary nodule secondary to Cryptococcus neoformans: case report and review
of the literature.
REVISTA
/ JOURNAL: - Pediatr Infect Dis J 2003
Dec;22(12):1089-93.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.inf.0000101916.33855.06
AUTORES
/ AUTHORS: - Sweeney DA; Caserta MT; Korones DN;
Casadevall A; Goldman DL
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Albert Einstein
College of Medicine, Bronx, NY 10461, USA.
RESUMEN
/ SUMMARY: - Pulmonary cryptococcosis is an uncommonly
recognized disease of childhood. Among immunocompetent and non-HIV-infected
individuals, pulmonary cryptococcosis may be asymptomatic or present with
chronic, nondescript symptomatology. In this report we describe a 10-year-old
with malignant fibrous histiocytoma of bone and a pulmonary nodule secondary to
Cryptococcus neoformans. We use this case as a background to review the
pediatric literature regarding pulmonary cryptococcosis and to discuss the
utility of immunohistochemistry for diagnosis of this clinical entity. N. Ref:: 34
----------------------------------------------------
[111]
TÍTULO / TITLE: - Do we have a new early
marker of chronic transplant dysfunction now?
REVISTA
/ JOURNAL: - Cardiovasc Res 2002 Jun;54(3):492-4.
AUTORES
/ AUTHORS: - Briest W
N. Ref:: 30
----------------------------------------------------
[112]
TÍTULO / TITLE: - Vibrio cholerae
bacteremia in a neutropenic patient with non-small-cell lung carcinoma.
REVISTA
/ JOURNAL: - Eur J Clin Microbiol Infect Dis 2002
Sep;21(9):676-8. Epub 2002 Sep 3.
●●
Enlace al texto completo (gratuito o de pago) 1007/s10096-002-0794-1
AUTORES
/ AUTHORS: - Berghmans T; Crokaert F; Sculier JP
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Institut
Jules Bordet, Rue Heger-Bordet 1, 1000 Brussels, Belgium. thierry.berghmans@bordet.be
RESUMEN
/ SUMMARY: - Vibrio cholerae was isolated from the
blood cultures of a neutropenic patient treated with chemotherapy for
non-small-cell lung cancer. Attempts to isolate Vibrio spp. from a rectal swab
and stool were unsuccessful. Piperacillin/tazobactam treatment resulted in
eradication of the microorganism from the patient’s blood. Although Vibrio spp.
have occasionally been the source of infection in immunocompromised patients,
this report describes the first case of non-0:1 Vibrio cholerae bacteremia in a
neutropenic patient with a solid tumour.
N. Ref:: 16
----------------------------------------------------
[113]
TÍTULO / TITLE: - Antigen-specific
immunotherapy for autoimmune disease: fighting fire with fire?
REVISTA
/ JOURNAL: - Immunology 2001 Dec;104(4):361-6.
AUTORES
/ AUTHORS: - Peakman M; Dayan CM
INSTITUCIÓN
/ INSTITUTION: - Department of Immunology, Guy’s, King’s
and St Thomas’ School of Medicine, Rayne Institute, 123 Coldharbour Lane,
London SE5 9NU, UK. mark.peakman@kcl.ac.uk N. Ref:: 60
----------------------------------------------------
[114]
TÍTULO / TITLE: - Bilateral Aspergillus
endophthalmitis in a patient with chronic lymphocytic leukaemia.
REVISTA
/ JOURNAL: - Br J Ophthalmol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://bjo.bmjjournals.com/
●●
Cita: British Journal of Ophthalmology: <> 2003 Nov;87(11):1429-30.
AUTORES
/ AUTHORS: - Machado Od Ode O; Goncalves R; Fernandes
EM; Campos WR; Orefice F; Curi AL N.
Ref:: 9
----------------------------------------------------
[115]
TÍTULO / TITLE: - Protocol core needle
biopsy and histologic Chronic Allograft Damage Index (CADI) as surrogate end
point for long-term graft survival in multicenter studies.
REVISTA
/ JOURNAL: - J Urol 2003 Sep;170(3):1055-6.
AUTORES
/ AUTHORS: - Goldfarb DA
----------------------------------------------------
[116]
TÍTULO / TITLE: - Regulation of tumour
immunity by CD25+ T cells.
REVISTA
/ JOURNAL: - Immunology 2002 Sep;107(1):5-9.
AUTORES
/ AUTHORS: - Gallimore A; Sakaguchi S
INSTITUCIÓN
/ INSTITUTION: - Medical Biochemistry, University of Wales
College of Medicine, Cardiff, UK. gallimoream@cardiff.ac.uk N. Ref:: 42
----------------------------------------------------
[117]
TÍTULO / TITLE: - Cytomegalovirus in
“immunocompetent”, critically ill, intensive care patients.
REVISTA
/ JOURNAL: - Crit Care Med 2001 Mar;29(3):681-2.
AUTORES
/ AUTHORS: - Marik PE; Weinmann A N. Ref:: 28
----------------------------------------------------
[118]
TÍTULO / TITLE: - Persistent remission
after immunosuppressive therapy of hairy cell leukemia mimicking aplastic
anemia: two case reports.
REVISTA
/ JOURNAL: - Int J Hematol 2003 May;77(4):391-4.
AUTORES
/ AUTHORS: - Sugimori C; Kaito K; Nakao S
INSTITUCIÓN
/ INSTITUTION: - Cellular Transplantation Biology, Kanazawa
University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
RESUMEN
/ SUMMARY: - Some patients with hairy cell leukemia
(HCL) manifest pancytopenia and bone marrow hypoplasia without an apparent
increase in atypical cells, so their disease resembles severe aplastic anemia
at onset. We treated 2 HCL patients, who were initially diagnosed with aplastic
anemia, with antithymocyte globulin (ATG) in combination with cyclosporine or
antilymphocyte globulin (ALG). Both patients obtained partial remission in
response to the immunosuppressive therapy and did not need transfusion
treatment for more than 3 years. Sustained improvement of hematopoiesis in such
B-cell malignancies after ATG/ ALG therapy suggests that the mechanisms
underlying successful immunosuppressive therapy for aplastic anemia may involve
B-cell suppression, inhibiting hematopoietic stem cells. N. Ref:: 18
----------------------------------------------------
[119]
TÍTULO / TITLE: - Therapeutic targets in
allergic eye disease.
REVISTA
/ JOURNAL: - Allergy Asthma Proc 2001
Jan-Feb;22(1):25-8.
AUTORES
/ AUTHORS: - Bielory L
INSTITUCIÓN
/ INSTITUTION: - Immuno-Ophthalmology Service, UMDNJ-New Jersey
Medical School, 90 Bergen Street, DOC Suite 4700, Newark, NJ 07103-2499, USA.
RESUMEN
/ SUMMARY: - The objective of this article is to
provide an overview of the present state of treatment of ocular allergy.
Immuno-ophthalmology arose in the portion of this past century when
investigators uncovered the uniqueness of the lens proteins and that it could
induce an immunological response otherwise know as phacoanaphylaxis. Further
studies have shown many similarities between the eye and other organ systems,
but one of the most profound problems was the spring “catarrh” that involved
the eyes and nose, i.e., rhinoconjunctivitis. Treatment over the past 10 years
has expanded with the better understanding of the allergic response at the
conjunctival surface. Allergen immunotherapy remains a cornerstone of
treatment. In fact, the very first report of the use of immunotherapy in 1911
“measured the patient’s resistance during experiments .. of pollen extracts to
excite a conjunctival reaction” (Noon L, and Cantar BO, Lancet 1572-1573,
1911). N. Ref:: 13
----------------------------------------------------
[120]
TÍTULO / TITLE: - Aspirin desensitization
in patients with AERD.
REVISTA
/ JOURNAL: - Clin Rev Allergy Immunol 2003
Apr;24(2):159-68.
AUTORES
/ AUTHORS: - Stevenson DD
INSTITUCIÓN
/ INSTITUTION: - Division of Allergy, Asthma, and
Immunology, Scripps Clinic and the Scripps Research Institute, La Jolla, CA
92037, USA.
RESUMEN
/ SUMMARY: - All patients with aspirin exacerbated
respiratory disease (AERD) can be desensitized to ASA. After achieving this
state, patients can then take ASA daily without adverse effect. ASA
desensitization can be maintained indefinitely as long as the patient takes ASA
each day. Crossdesensitization with older NSAIDs also occurs. After ASA
desensitization, patients can take daily ASA in order to treat their underlying
respiratory disease. In AERD patients treated with ASA 650 BID for at least a
year, 115/172 (67%) improved in their clinical courses while decreasing
systemic and topical corticosteroids. Sixteen failed to improve, 24 stopped ASA
because of intractable side effects (gastritis or hives) and 17 patients
discontinued ASA treatment in the first year of study for unrelated reasons.
Therefore, treatment with daily ASA is a significant therapeutic option for
patients afflicted with AERD. It should be used for AERD patients who do not
respond to topical corticosteroids and leukotriene modifier drugs. Those who
respond to systemic steroids or have intractable or recurrent nasal polyps are
particularly well-suited for this therapeutic intervention. N. Ref:: 17
----------------------------------------------------
[121]
TÍTULO / TITLE: - Safety and efficacy of
an imported fire ant rush immunotherapy protocol with and without prophylactic
treatment.
REVISTA
/ JOURNAL: - J Allergy Clin Immunol 2002
Mar;109(3):556-62.
AUTORES
/ AUTHORS: - Tankersley MS; Walker RL; Butler WK; Hagan
LL; Napoli DC; Freeman TM
INSTITUCIÓN
/ INSTITUTION: - Allergy and Immunology Department, Wilford
Hall Medical Center, Lackland Air Force Base, TX, USA.
RESUMEN
/ SUMMARY: - BACKGROUND: Hypersensitivity to the sting
of the imported fire ant (IFA) is a growing and significant cause of morbidity
and mortality in the United States. Conventional immunotherapy with IFA whole
body extract (WBE) has been shown to be effective; however, rush immunotherapy
(RIT) with IFA WBE has not been studied. OBJECTIVE: In this study, we evaluated
the safety and efficacy of RIT with IFA WBE and sought to determine whether
prophylactic pretreatment with antihistamines and steroids reduces the systemic
reaction rate associated with RIT. METHODS: Patients with IFA hypersensitivity
were randomized to placebo or twice-daily terfenadine 60 mg, ranitidine 150 mg,
and prednisone 30 mg initiated 2 days before RIT in a double-blinded study. The
2-day RIT protocol consisted of hourly injections to achieve a final dose of
0.3 mL 1:100 wt/vol. Patients returned on day 8 to receive 2 hourly injections
of 0.25 mL 1:100 wt/vol (total, 0.5 mL) and again on day 15 for a single
injection of 0.5 mL 1:100 wt/vol. Efficacy of the protocol was determined on
day 22, a pair of IFA sting challenges being performed 2 hours apart. RESULTS:
Fifty-nine patients were enrolled into the study; a total of 58 patients (age
range, 18 to 49 years) initiated the 2-day RIT. Only 3 patients (5.2%)
experienced a mild systemic reaction during the protocol. Among those
experiencing a systemic reaction with RIT, there was no statistical difference
between the 2 premedication groups (3.6% active and 6.7% placebo; P =.87).
Sting challenges were performed on 56 patients for a total of 112+ stings; only
1 mild systemic reaction occurred (efficacy, 98.2%). CONCLUSION: RIT with IFA
WBE for IFA hypersensitivity is both safe and efficacious; the rate of mild
systemic reactions is low. Premedication is not necessary, inasmuch as
prophylactic pretreatment with antihistamines and steroids did not reduce the
systemic reaction rate associated with RIT.
----------------------------------------------------
[122]
TÍTULO / TITLE: - HLA studies in
psoriatic arthritis: current situation and future needs.
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 Jan;30(1):4-6.
AUTORES
/ AUTHORS: - Gladman DD; Farewell VT N. Ref:: 17
----------------------------------------------------
[123]
TÍTULO / TITLE: - Gastrointestinal
infectious disease complications following transplantation and their
differentiation from immunosuppressant-induced gastrointestinal toxicities.
REVISTA
/ JOURNAL: - Clin Transplant 2001;15 Suppl 4:11-22.
AUTORES
/ AUTHORS: - Rubin RH
INSTITUCIÓN
/ INSTITUTION: - Massachusetts General Hospital, Boston
02114, USA. rhrubin@partners.org
RESUMEN
/ SUMMARY: - It is often very difficult to distinguish
between infection-related and immunosuppression-related gastrointestinal (GI)
complications after transplantation. The risk of infection itself is determined
by the patient’s net state of immunosuppression as well as the presence of
anatomic or technical abnormalities and the patient’s epidemiological exposures.
Of the anatomic abnormalities, diverticulitis is a particular problem in
transplant patients, with a high rate of perforation and abscess formation. The
causes of infectious disease syndromes are very different immediately after,
early after, and late after transplantation. Infection during the first month
may result from a pre-existing infection in the donor or recipient, or from the
surgical wound, endotracheal tube, vascular access or drainage. During 1-6
months after transplantation, viruses attack and, with sustained
immunosuppression, make opportunistic infections possible. Beyond 6 months
after transplantation, the 80% of patients with good result from the transplant
are at risk primarily for community-acquired microbes, including such enteric pathogens
as Salmonella. Of the remaining patients, 10% have chronic viral infections and
the 10% who have poor allograft function are at greatest risk for opportunistic
infection. This time line is helpful in determining whether a GI complication
is likely to be related to infection rather than a specific effect of an
immunosuppressant drug. Fever, inflammatory cells in the stool, abnormalities
on endoscopy or computed tomography and leukocytosis can be useful in the
diagnosis but are inconsistent markers for an infectious cause. N. Ref:: 11
----------------------------------------------------
[124]
TÍTULO / TITLE: - The testicular-derived
Sertoli cell: cellular immunoscience to enable transplantation.
REVISTA
/ JOURNAL: - Cell Transplant 2003;12(4):335-49.
AUTORES
/ AUTHORS: - Emerich DF; Hemendinger R; Halberstadt CR
INSTITUCIÓN
/ INSTITUTION: - Sertoli Technologies, Inc, Cranston RI
02921, USA. ED3FJM@aol.com
RESUMEN
/ SUMMARY: - There is a renewed enthusiasm for the
potential of cellular transplantation as a therapy for numerous clinical
disorders. The revived interest is largely due to the unprecedented success of
the “Edmonton protocol,” which produced a 100% cure rate for type I diabetics
following the transplantation of human islet allografts together with a
modified immunosuppressive regimen. While these data provide a clear and
unequivocal demonstration that transplantation is a viable treatment strategy,
the shortage of suitable donor tissue together with the debilitating
consequences of lifelong immunosuppression necessitate a concerted effort to
develop novel means to enable transplantation on a widespread basis. This
review outlines the use of Sertoli cells to provide local immunoprotection to
cografted discordant cells, including those from xenogeneic sources. Sertoli
cells are normally found in the testes where one of their functions is to
provide local immunologic protection to developing germ cells. Isolated Sertoli
cells 1) engraft and self-protect when transplanted into allogeneic and
xenogeneic environments, 2) protect cografted allogeneic and xenogeneic cells
from immune destruction, 3) protect islet grafts to reverse diabetes in animal
models, 4) enable survival and function of cografted foreign dopaminergic
neurons in rodent models of Parkinson’s disease (PD), and 5) promote
regeneration of damaged striatal dopaminergic circuitry in those same PD
models. These benefits are discussed in the context of several potential
underlying biological mechanisms. While the majority of work to date has
focused on Sertoli cells to facilitate transplantation for diabetes and PD, the
generalized ability of these unique cells to potently suppress the local immune
environment opens additional clinical possibilities. N. Ref:: 134
----------------------------------------------------
[125]
TÍTULO / TITLE: - Management of
cytomegalovirus infection and disease after solid-organ transplantation.
REVISTA
/ JOURNAL: - Clin Infect Dis 2001 Jul 1;33 Suppl
1:S32-7.
AUTORES
/ AUTHORS: - van der Bij W; Speich R
INSTITUCIÓN
/ INSTITUTION: - Department of Clinical Immunology,
University Hospital, Groningen, The Netherlands. w.van.der.bij@int.azg.nl
RESUMEN
/ SUMMARY: - Cytomegalovirus (CMV) continues to be a
cause of substantial morbidity and death after solid-organ transplantation.
There are 3 major consequences of CMV infection: CMV disease, including a wide
range of clinical illnesses; superinfection with opportunistic pathogens; and
injury to the transplanted organ, possibly enhancing chronic rejection. This
article discusses the considerable progress that has been made in elucidating
risk factors for CMV disease, in the rapid detection of CMV in clinical
specimens, and in the use of antiviral chemotherapy and immunoglobulin to
prevent and treat CMV disease after solid-organ transplantation. N. Ref:: 42
----------------------------------------------------
[126]
- Castellano -
TÍTULO / TITLE:Aplicaciones de la biologia molecular
en el trasplante renal. Applications of molecular biology to renal transplant.
REVISTA
/ JOURNAL: - Nefrologia. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/
●●
Cita: Nefrologia: <> 2003;23(1):15-26.
AUTORES
/ AUTHORS: - Lario S; Bescos M; Campistol JM
INSTITUCIÓN
/ INSTITUTION: - Unidad de Trasplante Renal, Hospital
Clinic, de Barcelona Villarroel, 170 08036 Barcelona. jmcampis@medicina.ub.es N. Ref:: 35
----------------------------------------------------
[127]
TÍTULO / TITLE: - Histopathological study
of intrahepatic islets transplanted in the nonhuman primate model using edmonton
protocol immunosuppression.
REVISTA
/ JOURNAL: - J Clin Endocrinol Metab. Acceso gratuito
al texto completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://jcem.endojournals.org/
●●
Cita: J. of Clin Endocrinol & Metab: <> 2002 Dec;87(12):5424-9.
AUTORES
/ AUTHORS: - Hirshberg B; Mog S; Patterson N; Leconte
J; Harlan DM
INSTITUCIÓN
/ INSTITUTION: - Transplantation and Autoimmunity Branch,
National Institute of Diabetes and Digestive and Kidney Diseases, National
Institutes of Health, Bethesda, Maryland 20892, USA.
RESUMEN
/ SUMMARY: - While islet cell transplantation is a
promising way to restore insulin independence to patients with type I diabetes
mellitus, a detailed histological analysis of the transplanted, intraportal
islets has not yet been reported. Rhesus macaques underwent total
pancreatectomy, then had allogeneic isolated islets infused into their portal
vein, followed by daclizumab, tacrolimus, and sirolimus to prevent islet
rejection. Islets were evenly distributed among the liver lobes. Liver sections
from a primate given allogeneic islets 5 d earlier did not display any islet
capillary formation, whereas intrahepatic islets transplanted 30 and 90 d
before euthanasia showed an abundant capillary supply. Localized hepatocellular
glycogenosis was observed surrounding the islets in a primate with functioning
islets 7 months post transplant. Liver sections from a primate that rejected
islets transplanted 2 months prior displayed only islet remnants with prominent
local lymphohistiocytic inflammation and an occasional capillary. We conclude
that islets develop an abundant vascular supply within 30 d following
transplant and because capillaries persist even following rejection, that the
vascular cells are likely from the recipient. While transplanted islets were
not vascularized early post transplant, the primates remained insulin
independent. The long-term consequence of islets in the liver, marked by the
glycogenosis, remains unknown and warrants further study.
----------------------------------------------------
[128]
TÍTULO / TITLE: - Resolution of oral non-Hodgkin’s
lymphoma by reduction of immunosuppressive therapy in a renal allograft
recipient: a case report and review of the literature.
REVISTA
/ JOURNAL: - Oral Surg Oral Med Oral Pathol Oral Radiol
Endod 2002 Dec;94(6):697-701.
●●
Enlace al texto completo (gratuito o de pago) 1067/moe.2002.126889
AUTORES
/ AUTHORS: - Keogh PV; Fisher V; Flint SR
INSTITUCIÓN
/ INSTITUTION: - Department of Oral Surgery, Oral Medicine
and Oral Pathology, Dublin Dental School and Hospital, Trinity College,
Ireland. pakeogh@dental.tcd.ie
RESUMEN
/ SUMMARY: - A case of oral non-Hodgkin’s lymphoma
arising in a patient with insulin-dependent diabetes who had undergone renal
allograft transplantation is described. The resolution of the disease was
achieved by a reduction in her immunosuppressive therapy. The differential
diagnosis is discussed, and the management of posttransplantation lymphoproliferative
disorders is reviewed. N.
Ref:: 40
----------------------------------------------------
[129]
TÍTULO / TITLE: - The cellular basis of
post-burn immunosuppression: macrophages and mediators.
REVISTA
/ JOURNAL: - Int J Mol Med. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://virology.med.uoc.gr/IJMM/ijmm.htm
●●
Cita: International J. of Molecular Medicine: <> 2002 Sep;10(3):239-43.
AUTORES
/ AUTHORS: - Schwacha MG; Chaudry IH
INSTITUCIÓN
/ INSTITUTION: - Center for Surgical Research, University
of Alabama at Birmingham, 35294-0019, USA. martin.schwacha@ccc.uab.edu
RESUMEN
/ SUMMARY: - Major thermal injury induces the activation
of an inflammatory cascade that contributes to the development of subsequent
immunosuppression, increased susceptibility to sepsis and multiple organ
failure. The productive capacity of macrophages for inflammatory mediators,
(i.e., nitric oxide, prostaglandins, TNF-alpha, IL-6 etc.), is profoundly
increased post-burn, thereby implicating macrophages in the development of the
post-burn immunosuppression. This review will focus on recent findings with
regards to the role of macrophages in the development of post-burn
immunosuppression with particular emphasis on the role of nitric oxide and
prostaglandins. N.
Ref:: 54
----------------------------------------------------
[130]
TÍTULO / TITLE: - Ambulatory blood
pressure 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: <> 2001;16 Suppl 1:110-3.
AUTORES
/ AUTHORS: - Fernandez-Vega F; Tejada F; Baltar J;
Laures A; Gomez E; Alvarez J
INSTITUCIÓN
/ INSTITUTION: - Servicio de Nefrologia 1, Hospital Central
de Asturias, C/Celestino Villamil s/n, 33006 Oviedo, España.
RESUMEN
/ SUMMARY: - Renal transplantation has been a usual
medical practice in developed countries for several decades. A large number of
studies report the excellent results obtained with such a practice. The
survival of the graft, although able to be improved, is excellent and gives a
great deal of hope to patients with renal insufficiency. The high level of
investigation into immunosuppressor drugs offers, almost continuously, more
efficient and better tolerated products. Paradoxically, the usual problems of
patients with a renal transplant are not immunological but cardiovascular.
Elevated serum cholesterol levels, obesity, diabetes and other cardiovascular
risk factors (CVRFs) are usual in these patients, arterial hypertension (AHT)
being the most frequent. Nephrologists are increasingly using ambulatory blood
pressure monitoring (ABPM) on a daily basis. In the last 10 years, we have
obtained highly valuable and interesting results with this technique which have
allowed us to study and understand with greater precision the relationship of
AHT to the kidney. Here we analyse and review the most relevant aspects of ABPM
in the different stages of kidney disease, with special emphasis on renal
transplantation. N.
Ref:: 40
----------------------------------------------------
[131]
TÍTULO / TITLE: - Spectrum of Aspergillus
infection in lung transplant recipients: case series and review of the
literature.
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: <> 2001 Jan;119(1):169-75.
AUTORES
/ AUTHORS: - Mehrad B; Paciocco G; Martinez FJ; Ojo TC;
Iannettoni MD; Lynch JP 3rd
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, University of
Michigan Medical School, Ann Arbor, MI, USA.
RESUMEN
/ SUMMARY: - STUDY OBJECTIVES: (1) To define the
incidence and natural history of Aspergillus colonization and infection in lung
transplant recipients, and (2) to assess the impact of prophylaxis,
surveillance, and therapy on the incidence and outcome of the disease. DESIGN:
Retrospective review of 133 consecutive single or bilateral lung
transplantations performed at a single institution, and review of the published
literature. RESULTS: Airway colonization, isolated tracheobronchitis, and
invasive pneumonia due to Aspergillus species occurred in 29%, 5%, and 8% of
our series, and in 26%, 4%, and 5% of the pooled published data (all series, including
ours), respectively. Greater than 50% of all diagnoses were made in the first 6
months after transplantation in both our series and the published literature.
Incidence of progression from airway colonization to invasive disease was 1 in
38 in our series and 3 of 97 (3%) in the pooled published data. In patients
with isolated tracheobronchitis, all 6 patients in our series and 41 of 50
patients (82%) in all published series, including ours, responded to antifungal
therapy and/or surgical debridement. Among patients with invasive pneumonia or
disseminated disease, however, 5 of 10 patients in our series and 26 of 64
patients (41%) in the pooled series survived their infection. CONCLUSIONS: The
role of antifungal therapy in Aspergillus airway colonization in lung
transplant recipients is unclear. Data support a strategy of scheduled
screening bronchoscopy followed by aggressive treatment for isolated
Aspergillus tracheobronchitis in lung transplant recipients. N. Ref:: 50
----------------------------------------------------
[132]
TÍTULO / TITLE: - The cytology of
HIV-induced immunosuppression. Changing pattern of disease in the era of highly
active antiretroviral therapy.
REVISTA
/ JOURNAL: - Cytopathology 2001 Oct;12(5):281-96.
AUTORES
/ AUTHORS: - Kocjan G; Miller R
INSTITUCIÓN
/ INSTITUTION: - Department of Histopathology, Royal Free
and University College Medical School, University College London, UK. N. Ref:: 89
----------------------------------------------------
[133]
- Castellano -
TÍTULO / TITLE:Inmunoterapia en el asma.
Immunotherapy in asthma.
REVISTA
/ JOURNAL: - Rev Clin Esp. 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: Revista Clínica Española: <> 2003 Oct;203(10):479-81.
AUTORES
/ AUTHORS: - Sainz Gutierrez JC; de Miguel Diez J;
Sanchez Mateos JF; Alvarez-Sala Walther JL
INSTITUCIÓN
/ INSTITUTION: - Servicio de Alergologia, Hospital General
Universitario Gregorio Maranon, Madrid.
N. Ref:: 23
----------------------------------------------------
[134]
TÍTULO / TITLE: - Adoptive T cell
therapy—immune monitoring and MHC multimers.
REVISTA
/ JOURNAL: - Clin Immunol 2003 Jan;106(1):5-9.
AUTORES
/ AUTHORS: - Yee C
INSTITUCIÓN
/ INSTITUTION: - Fred Hutchinson Cancer Research Center,
Seattle, WA 98109, USA. N.
Ref:: 23
----------------------------------------------------
[135]
TÍTULO / TITLE: - Gene therapy in
transplantation.
REVISTA
/ JOURNAL: - Transpl Immunol 2002 May;9(2-4):301-14.
AUTORES
/ AUTHORS: - Chen D; Sung R; Bromberg JS
INSTITUCIÓN
/ INSTITUTION: - Carl C. Icahn Institute for Gene Therapy
and Molecular Medicine and the Recanati/Miller Transplantation Institute, Mount
Sinai School of Medicine, New York, NY 10029-6574, USA.
RESUMEN
/ SUMMARY: - Gene transfer and gene therapy represent a
relatively new field that has grown and expanded enormously in the last 5-10
years. The application of gene transfer and gene medicines to transplantation
is currently in its infancy. Consideration for gene medicines in
transplantation requires delivery of vectors, either to the graft or to the
immune system. Delivery of vectors to the graft provides a choice of potential
immunologic targets including: costimulatory signals; inhibitory cytokines;
adhesion molecules; and molecules relating to apoptosis. In addition,
non-immunologic targets, that increase graft protective mechanisms by reducing
ischemic and immunologic damage, represent significant targets for gene
transfer. Delivery of vectors to the immune system includes potential targets
to modify the immune system, and results in tolerance. Other considerations for
gene therapy include the development of additional technologies, such as gene
conversion or transgenesis coupled with xenotransplantation, which may provide
genetically modified organs. Another important aspect of gene transfer relates
to regulation of the transgene expression. A variety of issues concerning
innate immunity, adaptive immunity, response to vector components, response to
transgene products, and entry of vectors into the antigen presentation and
processing pathway require further investigation and refinement of approaches.
Lastly, regulatable promoters and the understanding of their interaction with
individual cells, tissues and organs, and their interaction with innate and
adaptive immunity, are of paramount importance to improving the efficacy and
utility of gene transfer. There is no doubt that there is much exciting basic
and translational science to be accomplished in the next decade in order to
solve these potential barriers and advance gene medicines into the clinical
realm in transplantation. N.
Ref:: 159
----------------------------------------------------
[136]
TÍTULO / TITLE: - Heart failure as an
inflammatory condition: potential role for androgens as immune modulators.
REVISTA
/ JOURNAL: - Eur J Heart Fail 2002 Dec;4(6):673-80.
AUTORES
/ AUTHORS: - Pugh PJ; Jones RD; Jones TH; Channer KS
INSTITUCIÓN
/ INSTITUTION: - Department of Cardiology, Royal
Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
RESUMEN
/ SUMMARY: - Heart failure has traditionally been
considered a disease of the myocardium, with symptoms arising from altered
haemodynamics. However, it is now recognised that, in addition to marked
neuroendocrine disturbance, there is perturbation of cytokine expression in
patients with heart failure, resulting in an inflammatory imbalance. This not
only influences symptoms, but also plays a central role in the underlying
pathophysiological processes of heart failure, leading to disease progression
and poorer prognosis. Recognition of the influence of cytokines, in particular
tumour necrosis factor, has opened a new avenue for potential therapies for
heart failure. Current approaches involve immunomodulation, aimed at
suppressing tumour necrosis factor. We suggest that androgens may potentially
offer a superior therapeutic strategy by their well-recognised non-specific
immunosuppressive and anti-inflammatory effects. Studies of cell lines, human
mononuclear cells and animals in vivo have demonstrated the ‘anti-cytokine’
actions of androgens, and we have found a similar action in whole blood from
patients with heart failure. These effects, along with the anabolic action of
these agents, make androgens an attractive potential option for treatment of
patients with heart failure. N.
Ref:: 92
----------------------------------------------------
[137]
TÍTULO / TITLE: - Therapeutic drug
monitoring of immunosuppressant drugs in clinical practice.
REVISTA
/ JOURNAL: - Clin Ther 2002 Mar;24(3):330-50;
discussion 329.
AUTORES
/ AUTHORS: - Kahan BD; Keown P; Levy GA; Johnston A
INSTITUCIÓN
/ INSTITUTION: - Division of Immunology and Organ
Transplantation, University of Texas Health Science Center at Houston Medical
School, 77030, USA. Barry.D.Kahan@uth.tmc.edu
RESUMEN
/ SUMMARY: - BACKGROUND: Therapeutic drug monitoring
(TDM) is essential to maintain the efficacy of many immunosuppressant drugs
while minimizing their toxicity. TDM has become more refined with the
development of new monitoring techniques and more specific assays. OBJECTIVE:
This article summarizes current data on TDM of the following immunosuppressant
drugs used in organ transplantation: cyclosporine, tacrolimus, sirolimus,
everolimus, and mycophenolate mofetil. METHODS: Published data were identified
by a MEDLINE search of the English-language literature through March 2001 using
the terms therapeutic drug monitoring, cyclosporine, tacrolimus, sirolimus,
everolimus, and mycophenolate mofetil. Relevant conference abstracts were also
included. RESULTS: TDM of cyclosporine has been well studied, and recent
findings indicate that monitoring of drug levels 2 hours after dosing is a more
sensitive predictor of outcome than trough (C0) monitoring. C0 levels are being
used more widely in TDM of tacrolimus; however, the relationship between C0 and
area under the curve has varied widely in clinical trials, with correlations
ranging from 0.11 to 0.92. The use of TDM of sirolimus, everolimus, and
mycophenolate mofetil is evolving rapidly. CONCLUSIONS: TDM of
immunosuppressant drugs that have a narrow therapeutic index is an increasingly
useful tool for minimizing drug toxicity while maximizing prevention of graft
loss and organ rejection. N.
Ref:: 85
----------------------------------------------------
[138]
TÍTULO / TITLE: - HLA associations with
nasopharyngeal carcinoma in Southern Chinese: a meta-analysis.
REVISTA
/ JOURNAL: - Clin Otolaryngol 2002 Feb;27(1):61-7.
AUTORES
/ AUTHORS: - Goldsmith DB; West TM; Morton R
INSTITUCIÓN
/ INSTITUTION: - Department of Otolaryngology, Green Lane
Hospital, Auckland, New Zealand.
RESUMEN
/ SUMMARY: - The literature relating to human leucocyte
antigens (HLA) and nasopharyngeal carcinoma (NPC) identifies conflicting ranges
of possible allelic associations. We aimed to clarify this by conducting a
systematic review to identify and quantify associations present across all of
the available studies. A literature search was performed and, subsequently, a
meta-analysis was performed on 13 published studies using both fixed-effects
and random-effects models when appropriate. Evidence for positive associations
between NPC and the HLA alleles A2, B14 and B46 (P = 1.57 x 10-5, 1.13 x 10-3
and 6.38 x 10-5 respectively) were found, and negative associations were
identified for the alleles A11, B13 and B22 (P = 5.42 x 10-3, 0.017 and 0.009).
Whereas an association between HLA-B13 or B22 and NPC has not been noted
previously, the results for HLA-A2, A11, B14 and B46 are in accordance with
published studies. There is evidence that specific allele subtypes or combinations
of alleles may carry particular risk for NPC.
----------------------------------------------------
[139]
TÍTULO / TITLE: - Capnocytophaga
gingivalis bacteremia detected only on quantitative blood cultures in a child
with leukemia.
REVISTA
/ JOURNAL: - Pediatr Infect Dis J 2003 Feb;22(2):202-4.
AUTORES
/ AUTHORS: - Mantadakis E; Danilatou V; Christidou A;
Stiakaki E; Kalmanti M
INSTITUCIÓN
/ INSTITUTION: - Pediatric Hematology/Oncology Clinic,
University Hospital of Heraklion, Crete, Greece.
RESUMEN
/ SUMMARY: - Capnocytophaga species are inhabitants of
the normal mouth flora. We describe the case of a 6-year-old-girl with leukemia
and poor oral hygiene who developed bacteremia caused by Capnocytophaga
gingivalis. The organism was detected only on quantitative blood cultures. N. Ref:: 16
----------------------------------------------------
[140]
TÍTULO / TITLE: - Autoimmune bullous
dermatoses in the elderly: diagnosis and management.
REVISTA
/ JOURNAL: - Drugs Aging 2003;20(9):663-81.
AUTORES
/ AUTHORS: - Mutasim DF
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, University of
Cincinnati, College of Medicine, Cincinnati, Ohio, USA. diya.mutasim@uc.edu
RESUMEN
/ SUMMARY: - Elderly individuals are susceptible to
autoimmune bullous dermatoses (in particular, pemphigoid, epidermolysis bullosa
acquisita and paraneoplastic pemphigus). Bullous dermatoses are associated with
high morbidity and mortality. Bullous dermatoses result from autoimmune
responses to one or more components of the basement membrane or desmosomes.
Pemphigoid results from autoimmunity to hemidesmosomal proteins present in the
basement membrane of stratified squamous epithelia. Patients present with tense
blisters in flexural areas of the skin. Mild or moderate bullous pemphigoid may
be treated with potent topical corticosteroids while extensive disease usually
requires systemic corticosteroids or systemic immunosuppressive agents such as
azathioprine. Mucosal pemphigoid affects one or more mucous membranes that are
lined by stratified squamous epithelia. The two most commonly involved sites
are the eye and the oral cavity. Lesions frequently result in scar formation,
which may cause blindness. Patients with severe disease or ocular involvement
require aggressive therapy with corticosteroids and cyclophosphamide.
Epidermolysis bullosa acquisita results from autoimmunity to type VII collagen
in the anchoring fibrils of the basement membrane area. Lesions may either
arise on an inflammatory base or be non-inflammatory and result primarily from
trauma. The inflammatory type of the disease is more responsive to therapy than
the non-inflammatory type. Treatment options include corticosteroids, dapsone,
cyclosporin, plasmapheresis and immunoglobulin G. Paraneoplastic pemphigus
results from autoimmunity to multiple antigens within the desmosomes. The
disorder is associated with neoplasms, especially leukaemia and lymphoma.
Patients present with severe stomatitis and polymorphous skin eruption. The
mucosal and cutaneous involvement may respond to successful treatment of the
underlying neoplasm or may require immunosuppressive therapy. N. Ref:: 122
----------------------------------------------------
[141]
TÍTULO / TITLE: - Mycophenolate mofetil
for solid organ transplantation: does the evidence support the need for
clinical pharmacokinetic monitoring?
REVISTA
/ JOURNAL: - Ther Drug Monit 2003 Apr;25(2):137-57.
AUTORES
/ AUTHORS: - Cox VC; Ensom MH
INSTITUCIÓN
/ INSTITUTION: - Faculty of Pharmaceutical Sciences,
University of British Columbia, Vancouver, British Columbia, Canada.
RESUMEN
/ SUMMARY: - The need for clinical pharmacokinetic
monitoring (CPM) of the immunosuppressant mycophenolate mofetil (MMF) has been
debated. Using a previously developed algorithm, the authors reviewed the
evidence to support or refute the utility of CPM of MMF. First, MMF has proven
efficacy for prevention of organ rejection in renal and cardiac transplant
populations. In addition, the pharmacologically active form of MMF,
mycophenolic acid (MPA), can be measured readily in plasma, and relationships
between the incidence of rejection and MPA predose concentrations and MPA area
under the curve (AUC) have been reported. A lower limit of the therapeutic range
(MPA predose concentrations >1.55 microg/mL, as measured by enzyme
multiplied immunoassay technique [EMIT], or MPA AUC >30 or 40 microg. h/mL,
as measured by high-performance liquid chromatography [HPLC]) has been
suggested to prevent rejection in renal allograft patients. Similarly, in
cardiac transplant patients, decreased incidences of organ rejection have been
reported in patients with MPA concentrations >2 or 3 microg/mL (using EMIT)
and total AUC values >42.8 microg. h/mL (using HPLC). However, the
relationship between pharmacokinetic parameters and adverse events in renal and
cardiac transplant patients remains unclear. Due to the nature of antirejection
therapy, the pharmacologic response of MMF is not readily assessable, and
therapy is life-long. MPA pharmacokinetics exhibit large inter- and
intrapatient variability and may be altered in specific patient populations due
to changes in protein binding, concomitant disease states, or interactions with
concurrent immunosuppressants. Therefore, on the basis of current evidence, CPM
can provide more information regarding efficacy of MMF than clinical judgment
alone in select patient populations. However, further randomized, prospective
trials are required to clarify unresolved issues. Specifically, an upper limit
of the therapeutic range, above which the risk of side effects is increased,
needs to be elucidated for MMF therapy. Other future directions for research
include determining a practical limited sampling strategy for MPA AUC;
clarifying the relationship between free MPA concentrations, efficacy, and
toxicity; and defining the pharmacodynamic relationship between activity of
inosine monophosphate dehydrogenase (the enzyme inhibited by MPA) and risk of
rejection or adverse effects. N.
Ref:: 97
----------------------------------------------------
[142]
TÍTULO / TITLE: - Bronchiolitis
obliterans syndrome: utility of the new guidelines in single lung transplant
recipients.
REVISTA
/ JOURNAL: - J Heart Lung Transplant 2003
Apr;22(4):427-32.
AUTORES
/ AUTHORS: - Nathan SD; Barnett SD; Wohlrab J; Burton N
INSTITUCIÓN
/ INSTITUTION: - Inova Transplant Center, Inova Fairfax
Hospital, Falls Church, Virginia 22042, USA. steven.nathan@inova.com
RESUMEN
/ SUMMARY: - BACKGROUND: Bronchiolitis obliterans
syndrome is defined by a >20% decrease from baseline in the forced
expiratory volume in 1 second (FEV(1)). Recently, a consensus panel under the
auspices of the International Society for Heart and Lung Transplantation
proposed a new stage, designated “potential BOS” or BOS 0-p. This study sought
to validate retrospectively this new stage in a cohort of single-lung
transplant recipients. METHODS: A retrospective analysis of serial pulmonary
function tests in 43 single-lung transplant recipients was performed. Baseline
FEV(1) and midflow rate (FEF(25-75%)) were determined and compared with the
most recent set of pulmonary function tests in clinically stable patients.
RESULTS: The sensitivity of the FEF(25-75%) at <or=75% of baseline for
subsequently detecting BOS Stage 1 was 80%, with a specificity of 82.6%. For
the patients with idiopathic pulmonary fibrosis, the sensitivity was 62.5% and
the specificity was 100.0%, whereas in the patients with chronic obstructive lung
disease, the sensitivity was 91.7% and the specificity was 69.2%. Different
cutoff points for the FEF(25-75%) also were tested and are shown in receiver
operator curves. Likelihood ratios for the different cutoff points also were
calculated. Five of 9 (55.6%) patients qualified for BOS 0-p using the FEV(1)
parameter (FEV(1) of 81-90% of baseline) alone. CONCLUSION: The FEF(25-75%)
seems to be a useful criterion for predicting BOS development in single-lung
transplant recipients. The FEF(25-75%) might best be used with likelihood
ratios for different values rather than for 1 defined cutoff point of or=75% of
baseline. The value of the second criterion that constitutes BOS 0-p (FEV(1),
81-90%of baseline) remains uncertain.
----------------------------------------------------
[143]
TÍTULO / TITLE: - Mycophenolic acid
pharmacodynamics and pharmacokinetics provide a basis for rational monitoring
strategies.
REVISTA
/ JOURNAL: - Am J Transplant 2003 May;3(5):534-42.
AUTORES
/ AUTHORS: - Shaw LM; Korecka M; Venkataramanan R;
Goldberg L; Bloom R; Brayman KL
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology & Laboratory
Medicine, School of Pharmacy, University of Pittsburgh, PA 15261, USA. shawlmj@mail.med.upenn.edu N. Ref:: 57
----------------------------------------------------
[144]
TÍTULO / TITLE: - Immune reconstitution
following hematopoietic stem-cell transplantation.
REVISTA
/ JOURNAL: - Cytotherapy 2001;3(3):211-20.
●●
Enlace al texto completo (gratuito o de pago) 1080/146532401753174043
AUTORES
/ AUTHORS: - Novitzky N; Davison GM
INSTITUCIÓN
/ INSTITUTION: - The University of Cape Town Leukaemia
Centre and the Department of Haematology, Groote Schuur Hospital, Cape Town,
South Africa.
RESUMEN
/ SUMMARY: - BACKGROUND: Reconstitution of the immune
system following allogeneic stem-cell transplantation is a complex process that
requires successful engraftment of the hematopoietic stem cell, as well as
adequate thymic function. As the majority of patients have reduced thymic
function due to age, hormonal changes, as well as the damage caused by
conditioning and GvHD, immune recovery is often delayed and incomplete.
Following graft infusion there is rapid proliferation of natural killer (NK)
cells that appear to proceed directly from the hematopoietic stem cell. B-cell
function is dependent on specific maturation development in the BM
micro-environment, as well as CD4 help. The CD8 population expands rapidly due
to proliferation of many memory cells that react against Class I Ags, as well
as viral molecules. Expansion of T-helper cells originates mainly from the
memory pool that is present in the bone marrow graft. Naive cells require competent
thymus hence the CD4 cell counts may be subnormal with clinical
immunodeficiency. Controversy remains as to the capacity of the thymus to
recover and thus extra thymic proliferation of T cells have been postulated.
However these cells appear to have a limited capacity to expand and a fixed
repertoire. DISCUSSION: Donor lymphocyte infusions may contribute a competent
CD4 population that can cause GvHD, but have limitations in the capacity to
respond to new antigens. Future research needs to be concentrated on improving
the capacity of the thymus to reconstitute a functional naive population. N. Ref:: 78
----------------------------------------------------
[145]
TÍTULO / TITLE: - B19 virus infection in
renal transplant recipients.
REVISTA
/ JOURNAL: - J Clin Virol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.elsevier.com/gej-ng/29/46/32/show/Products/VIRUSINT/index.htt
●●
Cita: J Clinical Virology: <> 2003 Apr;26(3):361-8.
AUTORES
/ AUTHORS: - Cavallo R; Merlino C; Re D; Bollero C;
Bergallo M; Lembo D; Musso T; Leonardi G; Segoloni GP; Ponzi AN
INSTITUCIÓN
/ INSTITUTION: - Virology Unit, Department of Public Health
and Microbiology, University of Turin, Via Santena 9, 10126, Turin, Italy. rossana.cavallo@unito.it
RESUMEN
/ SUMMARY: - BACKGROUND: B19 virus infection with
persistent anaemia has been reported in organ transplant recipients. Detection
of B19 virus DNA in serum is the best direct marker of active infection.
OBJECTIVE: The present study evaluated the incidence and clinical role of
active B19 virus infection in renal transplant recipients presenting with
anaemia. STUDY DESIGN: Forty-eight such recipients were investigated by nested
PCR on serum samples. The controls were 21 recipients without anaemia. Active
HCMV infection was also investigated as a marker of high immunosuppression.
RESULTS AND CONCLUSIONS: In 11/48 (23%) patients B19 virus DNA was demonstrated
in serum versus only 1/21 (5%) of the controls. Ten of these 11 patients had
already been seropositive at transplantation and active infection occurred in
eight of them during the first 3 months after transplantation. The remaining
patient experienced a primary infection 9 months after transplantation. Eight
(73%) of these 11 patients displayed a concomitant HCMV infection and four
(36%) showed increasing serum creatinine levels but none developed glomerulopathy;
3/11 (27%) recovered spontaneously from anaemia whereas 8/11 (73%) needed
therapy. In conclusion, the relatively high occurrence (23%) of B19 virus
infection in patients presenting with anaemia, suggests that it should be
considered in the differential diagnosis of persistent anaemia in renal
transplant recipients. Presence of the viral DNA should be assessed early from
transplantation and the viral load should be monitored to follow persistent
infection and better understand the relation between active infection and
occurrence of anaemia, and to assess the efficacy of IVIG therapy and/or
immunosuppression reduction in clearing the virus. N. Ref:: 56
----------------------------------------------------
[146]
- Castellano -
TÍTULO / TITLE:Nuevos tratamientos
inmunodepresores de induccion en el trasplante renal. New induction
immunosuppression treatments in kidney transplantation.
REVISTA
/ JOURNAL: - Med Clin (Barc). 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: Medicina Clínica: <> 2001 Jun 30;117(4):147-57.
AUTORES
/ AUTHORS: - Pascual J; Ortuno J
INSTITUCIÓN
/ INSTITUTION: - Servicio de Nefrologia. Universidad de
Alcala. Hospital Ramon y Cajal. Madrid. jpascual@hrc.insalud.es N. Ref:: 94
----------------------------------------------------
[147]
TÍTULO / TITLE: - Therapeutic monitoring
of mycophenolate mofetil in organ transplant recipients: is it necessary?
REVISTA
/ JOURNAL: - Clin Pharmacokinet 2002;41(5):319-27.
AUTORES
/ AUTHORS: - Mourad M; Wallemacq P; Konig J; de Frahan
EH; Eddour DC; De Meyer M; Malaise J; Squifflet JP
INSTITUCIÓN
/ INSTITUTION: - Department of Kidney and Pancreas
Transplantation, University Hospital Saint Luc, Universite Catholique de
Louvain, Brussels, Belgium. Michel.Mourad@chir.ucl.ac.be
RESUMEN
/ SUMMARY: - Adequate immunosuppression minimising the
risk of organ rejection with acceptable tolerability of the used drugs is a
crucial step in organ transplantation. The primary goal is to maintain a
consistent time-dependent target concentration by tailoring individual dosage leading
to the best efficacy and tolerability combination. The use of therapeutic drug
monitoring (TDM) to optimise immunosuppressive therapy is routinely employed
for maintenance drugs such as cyclosporin and tacrolimus. The question whether
therapeutic monitoring of mycophenolic acid (MPA) in organ transplant
recipients treated with mycophenolate mofetil is necessary is not definitely
answered. The correlation of mycophenolic acid pharmacokinetic parameters with
efficacy and toxicity makes the therapeutic monitoring of this drug promising.
However, further studies are mandatory to draw the best guidelines in order to
achieve higher levels of evidence that MPA-TDM may improve patient
outcome. N. Ref:: 63
----------------------------------------------------
[148]
TÍTULO / TITLE: - Sunlight,
immunosuppression and skin cancer: role of histamine and mast cells.
REVISTA
/ JOURNAL: - Clin Exp Pharmacol Physiol 2001
Jan-Feb;28(1-2):1-8.
AUTORES
/ AUTHORS: - Hart PH; Grimbaldeston MA; Finlay-Jones JJ
INSTITUCIÓN
/ INSTITUTION: - Department of Microbiology and Infectious
Diseases, School of Medicine, Flinders University, Adelaide, South Australia,
Australia. prue.hart@flinders.edu.au
RESUMEN
/ SUMMARY: - 1. The development into tumours of skin
cells transformed by ultraviolet (UV) B radiation of wavelengths 290-320 nm is
enhanced by the ability of UVB to suppress an immune response that would
otherwise destroy them. Ultraviolet B-induced immunomodulation may be by
multiple mechanisms, but generally manifests in an antigen-presenting cell
defect and an altered cytokine environment in the draining lymph nodes. 2.
Immune responses to microbial or self-antigens may be dysfunctional by similar
mechanisms following UVB exposure. 3. Earliest-acting intermediates in the
initiation of UVB-induced immunosuppression are the UVB absorbers
(photoreceptors) of the skin, notably DNA resulting in immunoregulatory
cytokine production, and trans-urocanic acid (UCA), which, upon isomerization
to its cis isomer, signals downstream immunosuppressive events. 4. In mice,
dermal mast cells are critical to UVB-induced systemic immunomodulation. In
mice, there is a functional link as well as a linear relationship between the
prevalence of histamine-staining dermal mast cells and the log of the dose of
UVB required for 50% immunosuppression. Studies with histamine receptor
antagonists support histamine as the main’ product of mast cells involved.
Histamine acts in large part via a prostanoid-dependent pathway. 5.
Approximately 50% of humans and greater than 90% of patients with non-melanoma
skin cancer are UVB susceptible for suppression of a contact hypersensitivity
response. Neither cytokine polymorphisms nor UVB-induced levels of cis-UCA in irradiated
skin have been linked to UVB susceptibility. Patients with basal cell
carcinomas (BCC) have an increased dermal mast cell prevalence in
non-sun-exposed buttock skin. We propose that mast cells function in humans, as
in mice, by initiating immunosuppression and, thereby, allowing a permissive
environment for BCC development. N.
Ref:: 71
----------------------------------------------------
[149]
TÍTULO / TITLE: - Cicatricial pemphigoid
in the upper aerodigestive tract: diagnosis and management in severe laryngeal
stenosis.
REVISTA
/ JOURNAL: - Ann Otol Rhinol Laryngol 2003
Mar;112(3):271-5.
AUTORES
/ AUTHORS: - Boedeker CC; Termeer CC; Staats R; Ridder
GJ
INSTITUCIÓN
/ INSTITUTION: - Department of Otorhinolaryngology-Head and
Neck Surgery, Albert-Ludwigs-University, Freiburg, Germany.
RESUMEN
/ SUMMARY: - Pemphigoid is a group of rare, acquired,
autoimmune subepithelial blistering diseases. The condition has been
subclassified into bullous pemphigoid and cicatricial pemphigoid (CP).
Diagnosis is based on clinical presentation, evidence of subepithelialvesicles
or bullae on routine histologic analysis, and direct and indirect
immunofluorescence studies. Cicatricial pemphigoid is characterized by linear
deposition of immunoreactants, principally IgG and complement factor 3, along
epithelial basement membranes. Cicatricial pemphigoid usually leads to mucosal
scarring. We present a case of severe CP that led to laryngeal and subglottic
stenosis and involvement of both eyes and the oral, nasal, and nasopharyngeal
mucosae. Treatment with dapsone, corticosteroids, azathioprine sodium,
cyclosporine A, cyclophosphamide, methotrexate sodium, and mycophenolate
mofetil between 1997 and 2001 only resulted in temporary disease control. The
patient has been treated with leflunomide for the past 8 months, and there have
been no relapses. Treatment of CP with leflunomide has not been described in
the literature until now. N.
Ref:: 25
----------------------------------------------------
[150]
TÍTULO / TITLE: - Is immunosuppression
justified for nonuremic diabetic patients to keep them insulin independent?
(The argument for).
REVISTA
/ JOURNAL: - Transplant Proc 2002 Aug;34(5):1927-8.
AUTORES
/ AUTHORS: - Sutherland DE
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, University of
Minnesota, 420 Delaware Street SE, Mail Code 280, Minneapolis, MN 55455,
USA. N. Ref:: 14
----------------------------------------------------
[151]
TÍTULO / TITLE: - Atopic diseases of
childhood.
REVISTA
/ JOURNAL: - Curr Opin Pediatr 2003 Oct;15(5):495-511.
AUTORES
/ AUTHORS: - Stone KD
INSTITUCIÓN
/ INSTITUTION: - Children’s Hospital Boston, Department of
Pediatrics, Harvard Medical School, Massachusetts, USA. kelly.stone@tch.harvard.edu
RESUMEN
/ SUMMARY: - PURPOSE OF REVIEW: The incidence of atopic
diseases, including atopic dermatitis, allergic rhinitis, and asthma, has
increased in developed countries over the past several decades. These diseases
comprise a large component of general pediatric practice. This review will
highlight some of the recent advances in understanding the pathogenesis and
natural history of these diseases, as well as the current approaches to the
treatment of children with atopic diseases. RECENT FINDINGS: Recent studies
have identified multiple risk factors for the development and progression of
atopic diseases. As a result, much research is focused on identifying therapies
that can be initiated at a young age to prevent disease progression. New treatment
options have become available in recent years, such as topical immunomodulators
for atopic dermatitis, leukotriene antagonists for seasonal allergic rhinitis,
and alpha-immunoglobulin E therapy for asthma. The importance of viewing
allergic rhinitis and asthma as disorders of a single airway has been
emphasized. Finally, an update on the national asthma guidelines was recently
released in an effort to promote optimal asthma care. SUMMARY: This review
summarizes many of the recent advances in the diagnosis and treatment of atopic
diseases in children. Although not intended to be a comprehensive review of
this broad field, it provides a framework for appreciating the complexity of
these diseases and for effectively managing them. N. Ref:: 180
----------------------------------------------------
[152]
TÍTULO / TITLE: - Molecular diagnosis of
an Enterocytozoon bieneusi human genotype C infection in a moderately
immunosuppressed human immunodeficiency virus seronegative liver-transplant
recipient with severe chronic diarrhea.
REVISTA
/ JOURNAL: - J Clin Microbiol. Acceso gratuito al texto
completo a partir de los 6 meses de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://jcm.asm.org/
●●
Cita: J. Clinical Microbiology: <> 2001 Jun;39(6):2371-2.
AUTORES
/ AUTHORS: - Sing A; Tybus K; Heesemann J; Mathis
A N. Ref:: 5
----------------------------------------------------
[153]
TÍTULO / TITLE: - Oral and sublingual
immunotherapy in paediatric patients.
REVISTA
/ JOURNAL: - Curr Opin Allergy Clin Immunol 2003
Apr;3(2):139-45.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.all.0000064778.71837.e2
AUTORES
/ AUTHORS: - Passalacqua G; Baena-Cagnani CE; Berardi
M; Canonica GW
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine,
University of Genoa, Italy.
RESUMEN
/ SUMMARY: - PURPOSE OF REVIEW: Sublingual
immunotherapy is becoming a routine treatment for respiratory allergy in
several countries and it has been validated in international documents. This
article will review the available literature on oral and sublingual
immunotherapy, discussing the possible use of sublingual immunotherapy in
paediatric patients. RECENT FINDINGS: As oral immunotherapy was found to be
poorly effective in clinical trials, its use has been discontinued. In
contrast, several controlled studies have shown the efficacy of sublingual
immunotherapy in children with allergic asthma and rhinitis, and a
postmarketing survey has confirmed its safety. Moreover, new data on the
long-lasting efficacy of this treatment and on the absence of local
immunological effects have recently been published. SUMMARY: The clinical
efficacy and the optimal safety profile of sublingual immunotherapy make it a
good candidate for treating respiratory allergy in children. Some aspects, such
as the dose-response relationship and preventive effect, will be a research
challenge for future developments and better definition of indications in
children. N. Ref:: 65
----------------------------------------------------
[154]
TÍTULO / TITLE: - Gastrointestinal
complications of transplant immunosuppression.
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
Jan;13(1):277-87.
AUTORES
/ AUTHORS: - Helderman JH; Goral S
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Division of
Nephrology, and the Vanderbilt Transplant Center, Vanderbilt University Medical
Center, Nashville, Tennessee 37232, USA.
N. Ref:: 88
----------------------------------------------------
[155]
TÍTULO / TITLE: - Molecular basis of HLA
polymorphism: implications in clinical transplantation.
REVISTA
/ JOURNAL: - Transpl Immunol 2002 May;9(2-4):173-80.
AUTORES
/ AUTHORS: - Tiercy JM
INSTITUCIÓN
/ INSTITUTION: - Division of Immunology & Allergology,
University Hospital of Geneva, Switzerland. jean-marie.tiercy@hcuge.ch
RESUMEN
/ SUMMARY: - Polymorphism of the human leukocyte
antigens (HLA) represents a major barrier to organ and hematopoietic stem cell
(HSC) transplantation. The cloning and sequencing of HLA class I and II genes
has not only provided a clear picture of the molecular basis of allelic
polymorphism, but also allowed the development of a variety of PCR-based DNA
typing techniques. Such methods are now progressively replacing serological
typing for assessing donor/recipient HLA compatibility in clinical transplantation.
The 100 serological HLA-A,B,Cw,DR,DQ,DP specificities now comprise more than
1300 alleles defined at the DNA sequence level. Most of the serotypes are
subdivided into numerous allelic subtypes in worldwide populations (up to 50
alleles in some cases), although a limited number of alleles are detected in a
given population group. In organ transplantation application of HLA molecular
typing allowed to improve typing quality, leading to a more precise matching
assessment with better clinical results. Knowledge of the molecular basis of
class I gene polymorphisms also led to the development of new matching
algorithms such as HLA-Matchmaker, based on immunogenic amino acid triplets
localized on antibody-accessible external domains of class I antigens. The most
impressive impact of novel DNA typing methods concerns matching for allogeneic
HSC transplantation because subtle serologically silent sequence differences
between allelic subtypes are efficiently recognized by alloreactive T-cells
with potentially serious consequences for graft outcome. High resolution HLA
class I and II matching has contributed to improve patients survival after
unrelated HSC transplantation, although the relative importance of individual
loci remains to be elucidated. Donor matching criteria should take into account
parameters such as the time frame allowed by the patient’s disease and the
probability to identify a well matched donor based on the patient’s HLA
phenotype. N. Ref:: 61
----------------------------------------------------
[156]
TÍTULO / TITLE: - Eradication of
parvovirus B19 infection after renal transplantation requires reduction of
immunosuppression and high-dose immunoglobulin therapy.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002 Oct;17(10):1840-2.
AUTORES
/ AUTHORS: - Liefeldt L; Buhl M; Schweickert B;
Engelmann E; Sezer O; Laschinski P; Preuschof L; Neumayer HH
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Charite,
Humboldt-University Berlin, Germany. lutz.liefeldt@charite.de N. Ref:: 17
----------------------------------------------------
[157]
TÍTULO / TITLE: - Recent advances in
immunosuppressive therapy for renal transplantation.
REVISTA
/ JOURNAL: - Semin Dial 2001 May-Jun;14(3):218-22.
AUTORES
/ AUTHORS: - Peddi VR; First MR
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology and Hypertension,
Department of Internal Medicine, University of Cincinnati College of Medicine,
Cincinnati, Ohio 45267-0585, USA. ram.peddi@uc.edu
RESUMEN
/ SUMMARY: - Recent advances in immunosuppression have
focused on more effective, safer, and targeted therapies that have resulted in
improved short- and intermediate-term renal allograft survival. During the past
decade there has been a marked decrease in acute rejection rates following
renal transplantation because of the use of newer immunosuppressive agents.
Recent data indicate that the average yearly reduction in the relative hazard
of graft failure beyond 1 year was 4.2% for all recipients (0.4% for those
recipients who had an acute rejection episode and 6.3% for those who did not
have an acute rejection). Despite these improvements the currently available
immunosuppressive agents are associated with significant cardiovascular risk
factors, an increased risk of infection, and the development of malignancies in
the long term. Predictive parameters of donor-specific hyporesponsiveness are
needed so as to allow identification of patients in whom immunosuppressive
therapy can be safely reduced. Immunosuppressive agents that have recently been
approved for use in the United States and those that are in clinical and
preclinical studies are discussed. N.
Ref:: 27
----------------------------------------------------
[158]
TÍTULO / TITLE: - Preimplantation renal
biopsy: structure does predict function.
REVISTA
/ JOURNAL: - Transplantation 2003 Feb 15;75(3):264-6.
AUTORES
/ AUTHORS: - D’Agati VD; Cohen DJ
INSTITUCIÓN
/ INSTITUTION: - Columbia University College of Physicians
and Surgeons, New York, NY, USA. N.
Ref:: 11
----------------------------------------------------
[159]
TÍTULO / TITLE: - Recommendations for the
implementation of Neoral C(2) monitoring in clinical practice.
REVISTA
/ JOURNAL: - Transplantation 2002 May 15;73(9
Suppl):S19-22.
AUTORES
/ AUTHORS: - Cole E; Midtvedt K; Johnston A; Pattison
J; O’Grady C
INSTITUCIÓN
/ INSTITUTION: - University of Toronto, Toronto General
Hospital, 621 University Ave., Toronto, Ontario M5G 2C4, Canada.
----------------------------------------------------
[160]
TÍTULO / TITLE: - Epstein-Barr
virus-associated extranodal NK/T-cell lymphoma, nasal type of the hypopharynx,
in a renal allograft recipient: case report and review of literature.
REVISTA
/ JOURNAL: - Hum Pathol 2001 Nov;32(11):1264-8.
AUTORES
/ AUTHORS: - Stadlmann S; Fend F; Moser P; Obrist P;
Greil R; Dirnhofer S
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, University of
Innsbruck, Innsbruck, Austria.
RESUMEN
/ SUMMARY: - Posttransplant lymphoproliferative
disorders (PTLPDs) are predominantly B-cell lymphoproliferations, whereas a
T-cell origin is rarely observed. In contrast to B-cell PTLPD, T-cell PTLPDs
show an inconsistent association with Epstein-Barr virus (EBV). Until now, only
13 cases of EBV-associated T-cell PTLPDs have been reported. We describe a case
of an EBV-associated T-cell PTLPD in a renal allograft recipient 2 years after
transplantation. Histologic examination showed medium- to large-sized lymphoid
cells with an angiocentric growth pattern and necrosis. The atypical cells
showed a CD2+, CD3epsilon+, CD7+, CD43+, CD45R0+, CD56+, and CD4-, CD5-, CD8-
betaF1- phenotype with expression of the latent membrane protein (LMP)-1 of
EBV. In addition, EBV-specific RNAs (EBER ½) were identified by in situ
hybridization. Molecular analysis of the T-cell receptor (TCR) gamma chain by
polymerase chain reaction (PCR) showed a polyclonal pattern. The morphologic,
immunohistochemical, and molecular findings were consistent with a diagnosis of
an EBV-associated extranodal natural killer (NK)/T-cell non-Hodgkin lymphoma
(NHL) of nasal type. To our knowledge, this is the first reported case of this
rare entity in the posttransplant setting.
N. Ref:: 18
----------------------------------------------------
[161]
TÍTULO / TITLE: - Gene polymorphisms and
transplantation.
REVISTA
/ JOURNAL: - Curr Opin Immunol 2001 Oct;13(5):572-6.
AUTORES
/ AUTHORS: - Akalin E; Murphy B
INSTITUCIÓN
/ INSTITUTION: - Renal Division, Mount Sinai School of
Medicine, 1 Gustave L Levy Place, Box 1243, New York, NY 10029, USA.
RESUMEN
/ SUMMARY: - The influence of gene polymorphisms in key
immunoregulatory molecules on the clinical course post-transplant has become an
area of active research, since it offers a possible explanation for the
heterogeneity in outcomes between individuals. Several groups have now
investigated the association of polymorphisms in molecules—including cytokines,
cytokine receptors, adhesion molecules and costimulatory molecules—that
participate in the immune response to an allograft. Several interesting
observations have been made that would suggest that genetic variability
influencing allograft survival reaches beyond that of the MHC molecules. N. Ref:: 35
----------------------------------------------------
[162]
TÍTULO / TITLE: - Induction of tolerance
in autoimmune diseases by hematopoietic stem cell transplantation: getting
closer to a cure?
REVISTA
/ JOURNAL: - Int J Hematol 2002 Aug;76 Suppl 1:226-47.
AUTORES
/ AUTHORS: - Burt RK; Slavin S; Burns WH; Marmont AM
INSTITUCIÓN
/ INSTITUTION: - Northwestern University Medical Center,
Division of Immune Therapy and Autoimmune Disease, Chicago, IL, USA.
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
----------------------------------------------------
[163]
TÍTULO / TITLE: - Molecular genetics of
the HLA complex.
REVISTA
/ JOURNAL: - Wien Klin Wochenschr 2001 Oct
30;113(20-21):814-24.
AUTORES
/ AUTHORS: - Fischer GF; Mayr WR
INSTITUCIÓN
/ INSTITUTION: - Klinische Abteilung fur
Blutgruppenserologie, Universitat Wien, Vienna, Austria. gottfried.fischer@akh-wien.ac.at
RESUMEN
/ SUMMARY: - The Human Leukocyte Antigen (HLA) system
can be defined as a set of glycoproteins which take up peptides intracellulary
and become ligands for immune receptors once they are expressed on the cell
membrane. Functional HLA molecules are trimers consisting of a heavy chain and
a light chain which bind a peptide. The production of HLA molecules in the
endoplasmic reticulum, their assembly and their trafficking to the cell
membrane have been studied in great detail. A salient feature of HLA molecules
is their polymorphism which is essentially a tremendous amount of variation in
the amino acid sequence of mainly the heavy chain between different HLA types.
Polymorphic chains of HLA molecules are encoded in the human major
histocompatibility complex (MHC) on the short arm of chromosome 6. A map of the
nucleotide sequence of the human MHC has been established. The polymorphism of
HLA molecules, i.e. the HLA type, is intimately associated with the nature of
the peptides bound. In principle, HLA molecules can bind a variety of different
peptides. However, peptides with distinct biochemical features are
preferentially bound according to the HLA-type. HLA-typing is applied
clinically in transplantation and disease association. Recently, recombinant
HLA molecules have been used as a tool to define the T cell receptor
repertoire. N. Ref:: 59
----------------------------------------------------
[164]
TÍTULO / TITLE: - Psychological stress
and antibody response to immunization: a critical review of the human
literature.
REVISTA
/ JOURNAL: - Psychosom 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.psychosomaticmedicine.org/
●●
Cita: Psychosomatic Medicine: <> 2001 Jan-Feb;63(1):7-18.
AUTORES
/ AUTHORS: - Cohen S; Miller GE; Rabin BS
INSTITUCIÓN
/ INSTITUTION: - Department of Psychology, Carnegie Mellon
University, Pittsburgh, PA 15213, USA. scohen@andrew.cmu.edu
RESUMEN
/ SUMMARY: - OBJECTIVE: The objective of this review
was to evaluate the evidence for the hypothesis that psychological stress
influences antibody response to immunization in humans. METHODS: A critical
review of the literature was conducted. RESULTS: The evidence supports an
association between psychological stress and suppression of humoral immune
(antibody) response to immunization. This association is convincing in the case
of secondary immune response but weak for primary response. The lack of
consistent evidence for a relation with primary response may be attributed to a
failure to consider the critical points when stress needs to be elevated in the
course of the production of antibody. Lower secondary antibody responses were
found among patients with chronically high levels of stress (severe enduring
problems or high levels of trait negative affect). These responses were found
most consistently among older adults. Lower secondary responses were also found
for those reporting acute stress or negative affect, but only in studies of
secretory immunoglobulin A antibody in which psychological and antibody
measures were linked very closely in time. Health practices did not mediate
relations between stress and antibody responses; however, there were
indications that elevated cortisol levels among stressed patients could play a
role. Evidence also suggests the possible influences of dispositional
stress-reactivity and low positive affect in the inhibition of antibody
production. CONCLUSIONS: The literature supports a relationship between
psychological stress and antibody responses to immunizations. The data are
convincing in the case of secondary response but weak for primary response.
More attention to the kinetics of stress and antibody response and their
interrelations is needed in future research.
N. Ref:: 51
----------------------------------------------------
[165]
TÍTULO / TITLE: - A case of oral
localized histoplasmosis in an immunocompetent patient.
REVISTA
/ JOURNAL: - Eur J Clin Microbiol Infect Dis 2001
Oct;20(10):753-5.
AUTORES
/ AUTHORS: - Mignogna MD; Fedele S; Lo Russo L; Ruoppo
E; Lo Muzio L
INSTITUCIÓN
/ INSTITUTION: - Department of Odontostomatological and
Maxillofacial Sciences, University of Naples Federico II, School of Dentistry,
Italy. mdmig@tin.it N. Ref:: 25
----------------------------------------------------
[166]
- Castellano -
TÍTULO / TITLE:Inmunosupresion y trasplante
hepatico en pacientes infectados por el VHC. Inmunosuppression and liver
transplantation in patients with hepatitis C virus infection.
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: <> 2002 Apr;25(4):276-9.
AUTORES
/ AUTHORS: - Berenguer M
INSTITUCIÓN
/ INSTITUTION: - Servicio de Medicina Digestiva, Hospital
Universitario La Fe, Valencia, España. mbhaym@teleline.es N. Ref:: 24
----------------------------------------------------
[167]
TÍTULO / TITLE: - Clinical epidemiology:
diagnostic and prognostic tests.
REVISTA
/ JOURNAL: - Curr Opin Rheumatol 2003 Mar;15(2):104-9.
AUTORES
/ AUTHORS: - Ward MM
INSTITUCIÓN
/ INSTITUTION: - Intramural Research Program, National
Institute of Musculoskeletal and Skin Diseases, National Institutes of Health,
Bethesda, Maryland, USA. wardm1@mail.nih.gov
RESUMEN
/ SUMMARY: - Recent studies of diagnostic and
prognostic tests have commonly examined serological tests and new imaging
techniques. Antifilaggrin antibodies have been found to be highly specific for
the diagnosis of rheumatoid arthritis (RA), but uncertainty remains about the
sensitivity of this test, particularly in early RA. Magnetic resonance imaging
and ultrasound continue to be explored as methods to detect synovitis and
erosions in RA. Several recent studies have confirmed the association between
the human leukocyte antigen DRB1 shared epitope and worse radiographic outcomes
in patients with RA. Interlaboratory variation in detecting autoantibodies
remains a concern, as does overuse of tests for antineutrophil cytoplasmic
autoantibodies. N.
Ref:: 53
----------------------------------------------------
[168]
TÍTULO / TITLE: - Role of chiral
chromatography in therapeutic drug monitoring and in clinical and forensic
toxicology.
REVISTA
/ JOURNAL: - Ther Drug Monit 2002 Apr;24(2):290-6.
AUTORES
/ AUTHORS: - Williams ML; Wainer IW
INSTITUCIÓN
/ INSTITUTION: - Department of Oncology, Leicester
University, Leicester, United Kingdom.
RESUMEN
/ SUMMARY: - Advances in chiral chromatographic
separations have given pharmacologists and toxicologists the tools to examine
unexpected clinical results involving chiral drugs. The ability to unravel
complex phenomena associated with drug transport and drug metabolism is presented
in this manuscript. The relation between the chirality of the drug mefloquine
and the intracellular concentrations of the drug cyclosporine is illustrated by
examining the effect of the enantiomers of mefloquine on the transport activity
of P-glycoprotein (Pgp). These studies were conducted using a liquid
chromatographic column containing immobilized Pgp. The results demonstrated
that (+)-mefloquine competitively displaced the Pgp substrate cyclosporine
whereas (-)-mefloquine had no effect on cyclosporine-Pgp binding. The data
suggest that cyclosporine cellular and CNS concentrations can be increased
through the concomitant administration of (+)-mefloquine. The use of chirality
in clinical and forensic situations is also illustrated by the metabolism of the
enantiomers of ketamine (KET). The plasma concentrations of (+)-KET and (-)-KET
and the norketamine metabolites (+)-NK and (-)-NK were measured in rat plasma
using enantioselective gas chromatography. The separations were accomplished
using a gas chromatography chiral stationary phase based on beta-cyclodextrin.
The pharmacokinetic profiles of (+)-, (-)-KET and (+)-, (-)-NK were determined
in control and protein-calorie malnourished (PCM) rats to determine the effect
of PCM on ketamine metabolism and clearance. The results indicate that PCM
produced a significant and stereoselective decrease in KET and NK metabolism.
The data suggest that the effects of environmental factors (smoking, alcohol
use, diet) and drug interactions (coadministered agents) can be measured using
the changes in stereochemical metabolic and pharmacokinetic patterns of KET and
similar drugs. N.
Ref:: 33
----------------------------------------------------
[169]
TÍTULO / TITLE: - The treatment of
chronic inflammatory demyelinating polyradiculoneuropathy.
REVISTA
/ JOURNAL: - Semin Neurol 2003 Jun;23(2):169-80.
●●
Enlace al texto completo (gratuito o de pago) 1055/s-2003-41130
AUTORES
/ AUTHORS: - Kissel JT
INSTITUCIÓN
/ INSTITUTION: - Department of Neurology, Division of
Neuromuscular Disease, The Ohio State University, 1654 Upham Drive, Columbus,
OH 43210-1250, USA.
RESUMEN
/ SUMMARY: - Chronic inflammatory demyelinating
polyradiculoneuropathy is an inflammatory disorder of nerve that usually
presents with slowly progressive weakness and sensory loss and areflexia. It is
among the most treatable of the peripheral nerve disorders, and several
modalities have been shown to be effective in prospective, randomized
controlled trials. Although most patients show a gratifying early response to
treatment, in many cases the patients relapse. The cumulative effects of the
neuropathic impairments, along with side effects from long-term
immunosuppressive treatment, combine to produce significant long-term morbidity
and loss of function. This review will cover the epidemiology, clinical
features, laboratory findings, and pathogenesis of chronic inflammatory
demyelinating polyradiculoneuropathy; the current status of the treatment of
this disorder will be reviewed, highlighting those therapies shown to be
effective in randomized controlled trials.
N. Ref:: 108
----------------------------------------------------
[170]
TÍTULO / TITLE: - Protocol core needle
biopsy and histological chronic allograft damage index as surrogate endpoint
for Long-Term graft survival.
REVISTA
/ JOURNAL: - Transplant Proc 2004 Jan-Feb;36(1):89-91.
●●
Enlace al texto completo (gratuito o de pago) 1016/j.transproceed.2003.11.006
AUTORES
/ AUTHORS: - Hayry P; Paavonen T; Taskinen E;
Tomlanovich E; Mathew T; Navarro M; Ramos E; Hooftman L; Vamvakopoulos J; Aavik
E; Yilmaz S
INSTITUCIÓN
/ INSTITUTION: - University of Helsinki Hospital, Helsinki,
Finland. pekka.hayry@helsinki.fi
RESUMEN
/ SUMMARY: - Following encouraging results from several
single-center studies showing that early histological manifestations of chronic
rejection are seen in the graft before a decline in transplant function, we
tested this concept in a multicenter study and investigated whether protocol
needle biopsy may be used as a surrogate to late graft survival in multicenter
renal transplantation trials. During two mycophenolate mofetil trials, 621
representative protocol biopsies were obtained at baseline, 1 year, and 3
years. The samples were coded and evaluated blindly by two pathologists and a
Chronic Allograft Damage Index (CADI) score was constructed. At 1 year only 20%
of patients had elevated (>1.5 mg/100 mL) serum creatinine, whereas 60% of
the biopsies demonstrated an elevated (>2.0) CADI score. The mean CADI score
at baseline, 1.3 +/- 1.1, increased to 3.3 +/- 1.8 at 1 year and to 4.1 +/- 2.2
at 3 years. The patients at 1 year were divided into 3 groups, those with CADI
<2, between 2 and 3.9, and >4.0, the first two groups having normal (1.4
+/- 0.3 and 1.5 +/- 0.6 mg/dL) and the third group pathological (1.9 +/- 0.8
mg/dL) levels of serum creatinine. At 3 years there were no lost grafts in the
“low” CADI group, six lost grafts (4.6%) in the “elevated” CADI group, and 17
lost grafts (16.7%) in the “high” CADI group (P <.001). One-year
histological CADI score predicts graft survival even when the graft function is
still normal. This observation makes it possible to use CADI as a surrogate
endpoint in prevention trials and to identify the patients at risk for intervention
trials.
----------------------------------------------------
[171]
TÍTULO / TITLE: - Diffusion-weighted MR
imaging of posterior reversible leukoencephalopathy syndrome: a pictorial
essay.
REVISTA
/ JOURNAL: - Clin Imaging 2003 Sep-Oct;27(5):307-15.
AUTORES
/ AUTHORS: - Kinoshita T; Moritani T; Shrier DA;
Hiwatashi A; Wang HZ; Numaguchi Y; Westesson PL
INSTITUCIÓN
/ INSTITUTION: - Department of Radiology, Division of
Radiology, University of Rochester Medical Center, 601 Elmwood Avenue Box 648,
Rochester, NY 14642, USA. kino@grape.med.tottori-u.ac.jp
RESUMEN
/ SUMMARY: - Posterior reversible leukoencephalopathy
syndrome is characterized by reversible white matter lesions. However, ischemic
injury with irreversible damage may occur. This pictorial essay illustrates MR
features associated with posterior reversible leukoencephalopathy syndrome. We
will emphasize the role of diffusion-weighted imaging for the discrimination of
irreversible ischemic injury from reversible vasogenic edema. N. Ref:: 9
----------------------------------------------------
[172]
TÍTULO / TITLE: - Monitoring of cellular
resistance to cancer chemotherapy.
REVISTA
/ JOURNAL: - Hematol Oncol Clin North Am 2002 Apr;16(2):357-72,
vi.
AUTORES
/ AUTHORS: - Krishan A; Arya P
INSTITUCIÓN
/ INSTITUTION: - Radiation Oncology Department, University
of Miami Medical School, Division of Experimental Therapeutics (R-71), P.O. Box
01690, Miami, FL 33101, USA. akrishan@med.miami.edu
RESUMEN
/ SUMMARY: - Cellular resistance to a broad spectrum of
natural products used as antitumor drugs is believed to be a major cause for
the failure of chemotherapy. Flow cytometry has been used for monitoring the
expression of drug resistance markers, determining accumulation of fluorescent
drugs, and for screening of drugs that enhance chemosensitivity by blocking
efflux and enhancing drug retention. This article reviews recent developments
in our understanding of the multiple drug resistance phenotype and the use of
flow cytometry for the study of drug efflux and its modulation in human tumor
cells. N. Ref:: 77
----------------------------------------------------
[173]
TÍTULO / TITLE: - Epidemic pathogenic
selection: an explanation for hereditary hemochromatosis?
REVISTA
/ JOURNAL: - Med Hypotheses 2002 Sep;59(3):325-9.
AUTORES
/ AUTHORS: - Moalem S; Percy ME; Kruck TP; Gelbart RR
INSTITUCIÓN
/ INSTITUTION: - Department of Physiology, University of
Toronto, Neurogenetics Laboratory, Surrey Place Centre, Toronto, Canada. sharon.moalem@utoronto.ca
RESUMEN
/ SUMMARY: - Hereditary hemochromatosis (HH) is a
disorder associated with progressive iron overload and deposition in multiple
organs. It is the most common inherited single gene disorder in people of
Northern and Western European descent. About 80% of individuals of European
descent with HH are homozygous for a cysteine-to-tyrosine substitution (C282Y)
in the gene now called HFE. The function of HFE protein, a major
histocompatibility class I-like transmembrane protein, has not been fully
elucidated. Three consequences of the C282Y mutation are lack of expression of
HFE on the cellular surface, a lowered iron level in macrophages, and an
increased rate of clearance of iron from the intestinal lumen. These changes
could confer protection against certain pathogens early in life before iron
overload occurs. Furthermore, the C282Y mutation might have been selected for
during the European plagues caused by Yersinia spp. and other pathogens because
of the conferred resistance to infection, i.e., by epidemic pathogenic
selection. N. Ref:: 37
----------------------------------------------------
[174]
TÍTULO / TITLE: - The CD52 antigen and
development of the CAMPATH antibodies.
REVISTA
/ JOURNAL: - Cytotherapy 2001;3(3):137-43.
●●
Enlace al texto completo (gratuito o de pago) 1080/146532401753174098
AUTORES
/ AUTHORS: - Hale G
INSTITUCIÓN
/ INSTITUTION: - Sir William Dunn School of Pathology,
University of Oxford, Oxford, UK. N.
Ref:: 51
----------------------------------------------------
[175]
TÍTULO / TITLE: - Inheritable variable
sizes of DNA stretches in the human MHC: conserved extended haplotypes and
their fragments or blocks.
REVISTA
/ JOURNAL: - Tissue Antigens 2003 Jul;62(1):1-20.
AUTORES
/ AUTHORS: - Yunis EJ; Larsen CE; Fernandez-Vina M;
Awdeh ZL; Romero T; Hansen JA; Alper CA
INSTITUCIÓN
/ INSTITUTION: - Department of Cancer Immunology and AIDS,
Dana-Farber Cancer Institute, Boston, MA 02115, USA. Edmond_Yunis@dfci.harvard.edu
RESUMEN
/ SUMMARY: - The difference in sizes of conserved
stretches of DNA sequence within the major histocompatibility complex (MHC) in
human individuals constitutes an underappreciated genetic diversity that has
many practical implications. We developed a model to describe the variable
sizes of stretches of conserved DNA in the MHC using the known frequencies of
four different kinds of small (< 0.2 Mb) blocks of relatively conserved DNA
sequence: HLA-Cw/B; TNF; complotype; and HLA-DR/DQ. Each of these small blocks
is composed of two or more alleles of closely linked loci inherited as one
genetic unit. We updated the concept of the conserved extended haplotype (CEH)
using HLA allele identification and TNF microsatellites to show that specific
combinations of the four blocks form single genetic units (>/= 1.5 Mb) with
a total haplotype frequency in the Caucasian population of 0.30. Some CEHs
extend to the HLA-A and -DPB1 loci forming fixed genetic units of up to at
least 3.2 Mb of DNA. Finally, intermediate fragments of CEHs also exist, which
are, nevertheless, larger than any of the four small blocks. This complexity of
genetic fixity at various levels should be taken into account in studies of
genetic disease association, immune response control, and human diversity. This
knowledge could also be used for matching CEHs and their fragments for patients
undergoing allotransplantation. N.
Ref:: 93
----------------------------------------------------
[176]
TÍTULO / TITLE: - Kidney transplantation:
graft monitoring and immunosuppression.
REVISTA
/ JOURNAL: - World J Surg 2002 Feb;26(2):185-93. Epub
2001 Dec 17.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00268-001-0206-1
AUTORES
/ AUTHORS: - Fisher JS; Woodle ES; Thistlethwaite JR Jr
INSTITUCIÓN
/ INSTITUTION: - Section of Transplantation, Department of
Surgery, University of Tennessee, Room A-202, Memphis,Tennessee 38103, USA.
RESUMEN
/ SUMMARY: - Renal transplantation has become the
preferred means of treating end-stage renal disease. Episodes of allograft
rejection have become the exception rather than the rule. The development of
real-time ultrasound-guided allograft biopsy and adoption of the Banff criteria
for histologic evaluation permit safe,accurate monitoring of graft histology.
New immunosuppressive agents have drastically reduced the number of episodes of
both primary and refractory rejection. Novel biologic agents in the form of
monoclonal antibodies and soluble receptor hybrid molecules may serve to reduce
the required doses of toxic chemical immunosuppressants and provide more
specific immune suppression directed at those elements of the immune system
involved in rejection of a given allograft. Development of assays to identify
patients who demonstrate donor antigen-specific hyporeactivity is now feasible.
Hopefully, these assays will serve as a guide for the reduction and possible
removal of immunosuppressive agents from stable renal allograft
recipients. N. Ref:: 81
----------------------------------------------------
[177]
TÍTULO / TITLE: - Cutaneous infection
caused by Ulocladium chartarum in a heart transplant recipient: case report and
review.
REVISTA
/ JOURNAL: - Acta Derm Venereol 2003;83(3):218-21.
AUTORES
/ AUTHORS: - Duran MT; Del Pozo J; Yebra MT; Crespo MG;
Paniagua MJ; Cabezon MA; Guarro J
INSTITUCIÓN
/ INSTITUTION: - Department of Microbiology, Complexo
Hospitalario Universitario Juan Canalejo, A Coruna, España. tduran@canalejo.org
RESUMEN
/ SUMMARY: - A cutaneous mycoses caused by Ulocladium
chartarum in a heart transplant recipient is reported. The infection cleared
after complete surgical excision and 6 months of oral itraconazole therapy. In
vitro activity of amphotericin B, fluconazole, itraconazole, voriconazole,
ravuconazole and terbinafine against the clinical isolate is shown. N. Ref:: 10
----------------------------------------------------
[178]
TÍTULO / TITLE: - Tailoring
immunosuppressive therapy based on donor and recipient risk factors.
REVISTA
/ JOURNAL: - Transplant Proc 2001 May;33(3):2207-11.
AUTORES
/ AUTHORS: - First MR
INSTITUCIÓN
/ INSTITUTION: - University of Cincinnati Medical Center,
Cincinnati, Ohio 45267-0585, USA. N.
Ref:: 35
----------------------------------------------------
[179]
TÍTULO / TITLE: - Fatal Aspergillus
fumigatus Myositis in an immunocompetent patient.
REVISTA
/ JOURNAL: - Eur J Clin Microbiol Infect Dis 2001
Nov;20(11):810-3.
AUTORES
/ AUTHORS: - Javier RM; Sibilia J; Lugger AS;
Natarajan-Ame S; Kuntz JL; Herbrecht R
INSTITUCIÓN
/ INSTITUTION: - Service de Rhumatologie, Hjpital de
Hautepierre, Strasbourg, France.
RESUMEN
/ SUMMARY: - A 69-year old farmer developed Aspergillus
myositis in the right psoas and paravertebral muscles extending to the
retroperitoneum and the fifth lumbar vertebra. The infection appeared after two
local instillations of steroid for back pain. Although the patient was not
immunocompromised, surgical drainage and antifungal therapy failed to cure him;
he died of a bacterial pulmonary superinfection while cultures of the abscess
drainage fluid grew Aspergillus. The likely portal of entry in this patient was
direct inoculation during infiltration of the steroid; the steroid probably
caused a local impairment in host defenses. Only six cases of Aspergillus
myositis have been reported previously. All of them occurred in severely
immunosuppressed patients and the outcome was fatal in all cases. N. Ref:: 15
----------------------------------------------------
[180]
TÍTULO / TITLE: - Tolerance through bone
marrow transplantation with costimulation blockade.
REVISTA
/ JOURNAL: - Transpl Immunol 2002 May;9(2-4):125-33.
AUTORES
/ AUTHORS: - Wekerle T; Blaha P; Langer F; Schmid M;
Muehlbacher F
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Vienna General
Hospital, Austria. thomas.wekerle@akh-wien.ac.at
RESUMEN
/ SUMMARY: - The routine induction of tolerance in
organ transplant recipients remains an unattained goal. The creation of a state
of mixed chimerism through allogeneic bone marrow transplantation leads to
robust donor-specific tolerance in several experimental models and this
approach has several features making it attractive for clinical development.
One of its major drawbacks, however, has been the toxicity of the required host
conditioning. The use of costimulation blocking reagents (anti-CD 154
monoclonal antibodies and the fusion protein CTLA4Ig) has led to much less
toxic models of mixed chimerism in which global T cell depletion of the host is
no longer necessary and which has even allowed the elimination of all
cytoreductive treatment when combined with the injection of very high doses of
bone marrow cells. In this overview we will briefly discuss general features of
tolerance induction through bone marrow transplantation, will then describe
recent models using costimulation blockade to induce mixed chimerism and will
review the mechanisms of tolerance found with these regimens. Finally we will
attempt to identify issues related to the clinical introduction of bone marrow
transplantation with costimulation blockade which remain unresolved. N. Ref:: 84
----------------------------------------------------
[181]
TÍTULO / TITLE: - Maintenance
immunosuppression in the renal transplant recipient: an overview.
REVISTA
/ JOURNAL: - Am J Kidney Dis 2001 Dec;38(6 Suppl
6):S25-35.
AUTORES
/ AUTHORS: - Gaston RS
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, University of
Alabama at Birmingham, Birmingham, AL 35294, USA. rgaston@nrtc.uab.edu
RESUMEN
/ SUMMARY: - Managing maintenance immunosuppressive
regimens after kidney transplantation is often challenging and confusing,
requiring careful attention to efficacy, dosing, adverse effects, and costs of
multiple medications. Most protocols combine a primary immunosuppressant
(cyclosporine or tacrolimus) with one or two adjunctive agents (azathioprine,
mycophenolate mofetil, sirolimus, corticosteroids). Avoiding drug-drug
interactions is a major part of effective immunosuppressant management, and
special situations (eg, pregnancy, intravenous dosing, caring for minority
patients) can prove especially daunting. This review summarizes available data
regarding current practices in maintenance immunosuppression, emphasizing
issues that arise in day-to-day management of renal transplant recipients. N. Ref:: 69
----------------------------------------------------
[182]
TÍTULO / TITLE: - Minimization of
immunosuppression in kidney transplantation. The need for immune monitoring.
REVISTA
/ JOURNAL: - Transplantation 2001 Oct 27;72(8
Suppl):S32-5.
AUTORES
/ AUTHORS: - Hricik DE; Heeger PS
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Case Western
Reserve University, Cleveland, Ohio, USA. deh5@po.cwru.edu N. Ref:: 16
----------------------------------------------------
[183]
TÍTULO / TITLE: - Recombinant allergens
for immunotherapy.
REVISTA
/ JOURNAL: - Allergy Asthma Proc 2002
Jan-Feb;23(1):5-8.
AUTORES
/ AUTHORS: - Chapman MD; Smith AM; Vailes LD; Pomes A
INSTITUCIÓN
/ INSTITUTION: - Asthma and Allergic Diseases Center,
Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
RESUMEN
/ SUMMARY: - Many of the problems associated with using
natural allergenic products for allergy diagnosis and treatment can be overcome
using genetically engineered recombinant allergens. Over the past 10 years, the
most important allergens from mites, pollens, animal dander, insects, and foods
have been cloned, sequenced, and expressed. Allergens have diverse biological
functions (they may be enzymes, enzyme inhibitors, lipocalins, or structural
proteins). High-level expression systems have been developed to produce
recombinant allergens in bacteria, yeast, or insect cells. Recombinant allergens
show comparable immunoglobulin E (IgE) antibody binding to natural allergens
and show excellent reactivity on skin testing and in in vitro diagnostic tests.
Recombinant allergens will enable innovative new strategies for allergen
immunotherapy to be developed. These include peptide-based vaccines, engineered
hypoallergens with reduced reactivity for IgE antibodies, nucleotide-conjugated
vaccines that promote Th1 responses, and the possibility of developing
prophylactic allergen vaccines. N.
Ref:: 31
----------------------------------------------------
[184]
TÍTULO / TITLE: - Cross-match protocols
for femoral neck fractures—finding one that can work.
REVISTA
/ JOURNAL: - Ann R Coll Surg Engl 2004 Jan;86(1):11-4.
●●
Enlace al texto completo (gratuito o de pago) 1308/003588404772614614
AUTORES
/ AUTHORS: - Khan AM; Mushtaq N; Giannakas K; Sochart
DH; Andrews JG
INSTITUCIÓN
/ INSTITUTION: - Department of Orthopaedic Surgery, Hope
Hospital, Salford, UK. akhtar.khan2@ntlworld.com
RESUMEN
/ SUMMARY: - BACKGROUND: Cross-match practice for
patients with femoral neck fractures continues to cause concern due to a
failure of compliance to the existing protocols. To address this issue, a
number of studies were conducted over a 3-year period. METHODS: First, the
existing cross-match practice for patients admitted with femoral neck fractures
was reviewed to demonstrate the deficiencies within the system. Second, the
opinion of anaesthetic and orthopaedic trainees was assessed regarding blood
requirements for different femoral neck fractures following surgery and the
justification of their perceptions. RESULTS: A summation of the studies is
reported which demonstrates the reasons for the poor compliance to previous
protocols. CONCLUSIONS: A simple and effective protocol is provided that has
helped reduce pre-operative cross-matching of femoral neck fractures from 71%
to 16.7% when assessed 2 years after its introduction.
----------------------------------------------------
[185]
TÍTULO / TITLE: - Recurrent septicemia
due to Campylobacter fetus and Campylobacter lari in an immunocompetent
patient.
REVISTA
/ JOURNAL: - Infection 2002 Jun;30(3):171-4.
AUTORES
/ AUTHORS: - Krause R; Ramschak-Schwarzer S; Gorkiewicz
G; Schnedl WJ; Feierl G; Wenisch C; Reisinger EC
INSTITUCIÓN
/ INSTITUTION: - Dept. of Internal Medicine, Karl-Franzens
University School of Medicine, Graz, Austria. robert.krause@kfunigraz.ac.at
RESUMEN
/ SUMMARY: - We describe a severe and recurrent
septicemia due to Campylobacter in a 75-year-old immunocompetent patient. Two
Campylobacter strains were detected in several blood cultures. Campylobacter
fetus and Campylobacter lari were identified with PCR tests based on
species-specific nucleotide sequences for the 16S rRNA gene. N. Ref:: 30
----------------------------------------------------
[186]
TÍTULO / TITLE: - Extramedullary
plasmacytoma in cardiac transplant recipients.
REVISTA
/ JOURNAL: - J Am Acad Dermatol 2003 Nov;49(5
Suppl):S255-8.
●●
Enlace al texto completo (gratuito o de pago) 1016/S0190
AUTORES
/ AUTHORS: - Pacheco TR; Hinther L; Fitzpatrick J
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, University of
Colorado Health Sciences Center, Denver 80262, USA.
RESUMEN
/ SUMMARY: - Extramedullary plasmacytomas are an
immunoproliferative, monoclonal disease of B-cell lineage and are classified as
non-Hodgkin’s lymphomas. Cutaneous extramedullary plasmacytomas are rare. We
report 2 cases of transplantation-associated cutaneous extramedullary
plasmacytomas in a setting of chronic immunosuppression. N. Ref:: 13
----------------------------------------------------
[187]
TÍTULO / TITLE: - The role of
immunosuppression in recurrence of hepatitis C.
REVISTA
/ JOURNAL: - Liver Transpl 2003 Nov;9(11):S63-6.
●●
Enlace al texto completo (gratuito o de pago) 1053/jlts.2003.50264
AUTORES
/ AUTHORS: - Lake JR
INSTITUCIÓN
/ INSTITUTION: - Gastroenterology Division, University of
Minnesota, Minneapolis, MN 55455, USA. lakex009@tc.umn.du
RESUMEN
/ SUMMARY: - 1. Recurrent hepatitis C is an increasing
problem posttransplantation. 2. It is difficult to determine histologically if
alloimmunity, i.e., rejection, is also plays a role in posttransplantation
hepatitis C. 3. Change in the degree of immunosuppression, rather than the
absolute amount of immunosuppression, is bad for HCV-infected recipients. 4.
Corticosteroid boluses are bad for HCV-infected recipients. N. Ref:: 20
----------------------------------------------------
[188]
TÍTULO / TITLE: - Mechanisms of
transplant tolerance induction using costimulatory blockade.
REVISTA
/ JOURNAL: - Curr Opin Immunol 2002 Oct;14(5):592-600.
AUTORES
/ AUTHORS: - Wekerle T; Kurtz J; Bigenzahn S; Takeuchi
Y; Sykes M
INSTITUCIÓN
/ INSTITUTION: - The Division of Transplantation,
Department of Surgery, Vienna General Hospital, University of Vienna, Waehringer
Guertel 18, A 1090 Vienna, Austria. Thomas.Wekerle@akh-wien.ac.at
RESUMEN
/ SUMMARY: - The potential use of
costimulation-blocking reagents to induce transplantation tolerance has
recently created considerable excitement. Recent evidence has begun to
delineate the mechanisms by which these powerful effects occur. It has become
increasingly clear, firstly, that T cell costimulation is mediated by a
delicate network of signaling pathways and, secondly, that interference with
these systems can lead to numerous different tolerance mechanisms, including
immune regulation, anergy and deletion.
N. Ref:: 90
----------------------------------------------------
[189]
TÍTULO / TITLE: - Inhibition of human
T-cell responses by allergen peptides.
REVISTA
/ JOURNAL: - Immunology 2001 Dec;104(4):377-82.
AUTORES
/ AUTHORS: - Larche M
INSTITUCIÓN
/ INSTITUTION: - Imperial College School of Medicine,
National Heart & Lung Institute, Dovehouse Street, London SW3 6LY, UK. m.larche@ic.ac.uk N. Ref:: 34
----------------------------------------------------
[190]
TÍTULO / TITLE: - Lymphedema: an
immunologically vulnerable site for development of neoplasms.
REVISTA
/ JOURNAL: - J Am Acad Dermatol 2002 Jul;47(1):124-7.
AUTORES
/ AUTHORS: - Ruocco V; Schwartz RA; Ruocco E
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, 2nd
University of Naples, Naples, Italy.
RESUMEN
/ SUMMARY: - Lymphedema is the result of accumulation
of protein-rich interstitial fluid (lymph stasis) caused by a failure of lymph
drainage in the face of a normal capillary filtration. Whether the origin is
congenital or acquired from infection, radiation, trauma, or surgery, chronic
lymph stasis impairs local immune surveillance by disrupting trafficking of the
immunocompetent cells in the lymphedematous district and stimulates vicarious
angiogenesis by promoting development of a collateral lymphatic and hematic
network in the lymphedematous district. When the local mechanisms of immune
surveillance begin to fail, the lymphedematous region becomes an
immunologically vulnerable area, predisposed to malignancy, chiefly vascular
tumors such as Stewart-Treves syndrome and Kaposi’s sarcoma, because of the continual
angiogenic stimulus. N.
Ref:: 54
----------------------------------------------------
[191]
TÍTULO / TITLE: - Advances in the
management of psoriasis: monoclonal antibody therapies.
REVISTA
/ JOURNAL: - Int J Dermatol 2002 Dec;41(12):827-35.
AUTORES
/ AUTHORS: - Mehrabi D; DiCarlo JB; Soon SL; McCall CO
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Emory
University School of Medicine, Atlanta, GA 30322, USA.
RESUMEN
/ SUMMARY: - Psoriasis is a common skin disorder
characterized by erythematous, scaling plaques. Until recently, therapies for
this disease have been aimed at reducing keratinocyte proliferation. We have
learned that psoriasis is not primarily a disorder of keratinocyte
hyperproliferation, but is an inflammatory disease. This knowledge, especially
our current understanding of the role of activated T cells in psoriasis, has
led to new therapeutic options and new areas of research. Immunosuppressive
agents such as cyclosporine have proven very useful in the treatment of psoriasis,
but their use is limited by toxicity. Monoclonal antibodies directed against
key components of the inflammatory process have been studied in an attempt to
produce safer, more selective immunosuppressive agents. This review summarizes
much of the available literature describing the use of monoclonal antibodies in
the treatment of psoriasis. N.
Ref:: 59
----------------------------------------------------
[192]
TÍTULO / TITLE: - Immunologic treatment
of allergic diseases.
REVISTA
/ JOURNAL: - Curr Opin Allergy Clin Immunol 2001
Dec;1(6):541-3.
AUTORES
/ AUTHORS: - Broide D; Malling HJ N. Ref:: 20
----------------------------------------------------
[193]
TÍTULO / TITLE: - Allergen immunotherapy:
a practice parameter. American Academy of Allergy, Asthma and Immunology.
American College of Allergy, Asthma and Immunology.
REVISTA
/ JOURNAL: - Ann Allergy Asthma Immunol 2003 Jan;90(1
Suppl 1):1-40.
----------------------------------------------------
[194]
TÍTULO / TITLE: - Laboratory assays for
predicting the severity of haemolytic disease of the fetus and newborn.
REVISTA
/ JOURNAL: - Transpl Immunol 2002 Aug;10(2-3):191-8.
AUTORES
/ AUTHORS: - Hadley AG
INSTITUCIÓN
/ INSTITUTION: - National Blood Service, Bristol, UK. andrew.hadley@nbs.nhs.uk
RESUMEN
/ SUMMARY: - Haemolytic disease of the fetus and
newborn (HDFN) is characterised by the presence of IgG antibodies in the
maternal circulation which cause haemolysis in the fetus by crossing the placenta
and sensitising red cells for destruction by macrophages in the fetal spleen.
Serological, quantitative and cellular assays have all been developed to
predict the severity of HDFN. These assays measure and/or characterise
alloantibodies in the maternal circulation. Quantitative assays which
accurately measure antibody levels correlate with disease severity better than
serological assays which are inherently less precise. Nevertheless, high
antibody levels are found in some cases of mild HFDN and relatively low
antibody levels are found in some severe cases. This suggests that disease
severity is influenced by factors in addition to antibody concentration. These
factors remain to be fully elucidated but may include: the subclass and
glycosylation of maternal antibodies; the structure, site density, maturational
development and tissue distribution of blood group antigens; the efficiency of
IgG transport to the fetus; the functional maturity of the fetal spleen;
polymorphisms which affect Fc receptor function; and the presence of
HLA-related inhibitory antibodies. Cellular assays which are sensitive to
factors affecting antibody function have, therefore, been developed in an
attempt to improve the prediction of disease severity. Although these assays are
cumbersome, there are now sufficient data to suggest that some cellular assays
provide clinically useful information to complement serological and
quantitative assays. N.
Ref:: 68
----------------------------------------------------
[195]
TÍTULO / TITLE: - Immunogenetics of
longevity. Is major histocompatibility complex polymorphism relevant to the
control of human longevity? A review of literature data.
REVISTA
/ JOURNAL: - Mech Ageing Dev 2001 Apr 30;122(5):445-62.
AUTORES
/ AUTHORS: - Caruso C; Candore G; Romano GC; Lio D;
Bonafe M; Valensin S; Franceschi C
INSTITUCIÓN
/ INSTITUTION: - Dipartimento di Biopatologia e Metodologie
Biomediche, Universita di Palermo, Corso Tukory 211, 90134 Palermo, Italy. marcoc@unipa.it
RESUMEN
/ SUMMARY: - Literature data suggest that human
longevity may be directly correlated with optimal functioning of the immune
system. Therefore, it is likely that one of the genetic determinants of
longevity resides in those polymorphisms for the immune system genes that
regulate immune responses. Accordingly, studies performed on mice have
suggested that the Major Histocompatibility Complex (MHC), known to control a
variety of immune functions, is associated with the life span of the strains.
In the last 25 years, a fair number of cross-sectional studies that searched
for the role of HLA (the human MHC) genes on human longevity by comparing HLA
antigen frequencies between groups of young and elderly persons have been
published, but conflicting findings have been obtained. In fact, the same HLA
antigens are increased in some studies, decreased in others and unchanged in
others. On the whole, that could lead us to hypothesize that the observed
age-related differences in the frequency of HLA antigens are due to bias. In
our opinion, this hypothesis is real for most studies owing to major
methodological problems. However, some studies that do not meet these biases
have shown an association between longevity and some HLA-DR alleles or
HLA-B8,DR3 haplotype, known to be involved in the antigen non-specific control
of immune response. Thus, HLA studies in man may be interpreted to support
suggestions derived from the studies on congenic mice on MHC effects on
longevity. However, in mice the association may be by way of susceptibility to
lymphomas whereas, in human beings, the effect on longevity is likely, via
infectious disease susceptibility. Longevity is associated with positive or
negative selection of alleles (or haplotypes) that respectively confer
resistance or susceptibility to disease(s), via peptide presentation or via
antigen non-specific control of the immune response. N. Ref:: 94
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[196]
TÍTULO / TITLE: - Opioid-induced
immunosuppression: is it centrally mediated or peripherally mediated?
REVISTA
/ JOURNAL: - Biochem Pharmacol 2003 Jun
1;65(11):1761-6.
AUTORES
/ AUTHORS: - Wei G; Moss J; Yuan CS
INSTITUCIÓN
/ INSTITUTION: - Department of Anesthesia & Critical
Care, The University of Chicago, 5841 S. Maryland Avenue, MC 4028, Chicago, IL
60637, USA.
RESUMEN
/ SUMMARY: - Opioid compounds are commonly used pain
medications. However, their administration is associated with a number of
side-effects. Among them, opioid-induced immunosuppression is a significant
medical problem, which is evidenced by a strong association between the use of
opioids and exacerbated infections, including AIDS. Research data have
demonstrated the effects of opioids to be suppressive on phagocytic, natural
killer (NK), B and T cells. However, these immunosuppressive effects may be
mediated by mechanisms different from those for antinociceptive actions. This
article reviews possible central and peripheral mechanisms of opioid-induced
immunosuppression. To the extent that peripherally mediated immunosuppressive
effects play a significant role in opioid-induced immunosuppression, novel
peripheral opioid antagonists may have a therapeutic role in attenuating
opioid-induced immunosuppression without affecting analgesia. N. Ref:: 72
----------------------------------------------------
[197]
TÍTULO / TITLE: - The case against
protocol kidney biopsies.
REVISTA
/ JOURNAL: - Transplant Proc 2002 Aug;34(5):1716-8.
AUTORES
/ AUTHORS: - Ponticelli C; Banfi G
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, IRCCS Ospedale
Maggiore di Milano, Via Commenda 15, 20122 Milan, Italy. ponticelli@policlinico.mi.it N. Ref:: 30
----------------------------------------------------
[198]
TÍTULO / TITLE: - Tissue typing in
support of unrelated hematopoietic cell transplantation.
REVISTA
/ JOURNAL: - Tissue Antigens 2003 Jan;61(1):1-11.
AUTORES
/ AUTHORS: - Petersdorf EW; Anasetti C; Martin PJ;
Hansen JA
INSTITUCIÓN
/ INSTITUTION: - Division of Clinical Research, Fred
Hutchinson Cancer Research Ctr, Division of Clinical Research, and Department
of Medicine, University of Washington, Seattle 98109-1024, USA. epetersd@fhcrc.org
RESUMEN
/ SUMMARY: - The success of unrelated hematopoietic
cell transplantation (HCT) for the treatment of hematologic malignancies has
closely paralleled development of robust typing methods for comprehensive and
precise donor-recipient matching. The application of molecular methods in
clinical research has led to a more complete understanding of the immunogenetic
barriers involving host-vs-graft (HVG) and graft-vs-host (GVH) reactions. Along
with the development of less toxic transplant regimens, advances in the prevention
and treatment of graft-vs-host disease (GVHD) and in the supportive care of the
transplant recipient, improved HLA matching of potential unrelated donors has
led to clinical results that begin to compare favorably with that of
HLA-identical sibling transplants. N.
Ref:: 77
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[199]
TÍTULO / TITLE: - In vivo studies of
monoclonal anti-D and the mechanism of immune suppression.
REVISTA
/ JOURNAL: - Transfus Clin Biol 2002 Jan;9(1):9-14.
AUTORES
/ AUTHORS: - Kumpel BM
INSTITUCIÓN
/ INSTITUTION: - International Blood Group Reference
Laboratory, Bristol Institute of Transfusion Sciences, Southmead Road, Bristol
BS10 5ND, UK. belinda.kumpel@nbs.nhs.uk
RESUMEN
/ SUMMARY: - Administration of anti-D immunoglobulin to
D- women after delivery of a D+ infant has dramatically reduced the number of
immunised women and cases of haemolytic disease of the fetus and newborn. The
use of monoclonal anti-D might alleviate some of the pressures on maintaining
adequate supplies of plasma sourced anti-D. Two human monoclonal antibodies,
BRAD-3 (IgG1) and BRAD-5 (IgG3), with proven activity in in vitro functional
(immunological) assays with cells bearing IgG Fc receptors (Fc gamma R) were
selected for clinical studies. They were prepared by purification of IgG
secreted by culture of the Epstein-Barr virus-transformed B cell lines in
hollow fibre bioreactors. The clearance of D+ red cells injected into D-
subjects was accelerated by prior injection of the monoclonal antibodies, both
individually and blended (3:1, BRAD-5: BRAD-3). The subjects were protected
from Rh D immunisation. A large multicentre study evaluated the BRAD-3/5 blend
for its ability to prevent Rh D immunisation in 95 D- subjects given 400
micrograms i.m. 24 hours after injection of 5 ml D+ red cells. Challenge
injections of D+ red cells alone were given 24 and 36 weeks later, and blood
samples were taken every 4 weeks from the subjects throughout the study for
detection of anti-D responses. There was one definite and one possible failure
of protection; in one subject the plasma anti-D level rose from week 12
onwards, and in another individual rapid seroconversion was observed at week
28. Considering the relatively large dose of red cells and the number of
subjects studied, it was concluded that the failure rate was much lower than in
routine Rh D prophylaxis. The responder rate was 13% by week 36 and 24% by week
48. The low percentage of responders and the modest levels of endogenous anti-D
produced suggested that administration of monoclonal anti-D had induced
long-term specific suppression of anti-D responses in these subjects. The most
likely mechanism of action was considered to be inhibition of B cells resulting
from co-crosslinking antigen receptors with inhibitory Fc gamma R when the B
cells contacted red cells that had bound passive anti-D. N. Ref:: 45
----------------------------------------------------
[200]
TÍTULO / TITLE: - Recognition and management
of hereditary hemochromatosis.
REVISTA
/ JOURNAL: - Am Fam Physician. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aafp.org/afp.xml
●●
Cita: American Family Physician: <> 2002 Mar 1;65(5):853-60.
AUTORES
/ AUTHORS: - Brandhagen DJ; Fairbanks VF; Baldus W
INSTITUCIÓN
/ INSTITUTION: - Mayo Medical School, Rochester, Minnesota,
USA. brandhagen.david@mayo.edu
RESUMEN
/ SUMMARY: - Hereditary hemochromatosis is the most
common inherited single-gene disorder in people of northern European descent.
It is characterized by increased intestinal absorption of iron, with deposition
of the iron in multiple organs. Previously, the classic description was
combined diabetes mellitus, cutaneous hyperpigmentation and cirrhosis.
Increasingly, however, hereditary hemochromatosis is being diagnosed at an
earlier, less symptomatic stage. The diagnosis is based on a combination of
clinical, laboratory and pathologic findings, including elevated serum
transferrin saturation. Life expectancy is usually normal if phlebotomy is
initiated before the development of cirrhosis or diabetes mellitus. Hereditary
hemochromatosis is associated with mutations in the HFE gene. Between 60 and 93
percent of patients with the disorder are homozygous for a mutation designated
C282Y. The HFE gene test is useful in confirming the diagnosis of hereditary
hemochromatosis, screening adult family members of patients with HFE mutations
and resolving ambiguities concerning iron overload. N. Ref:: 34
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