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Revisiones-Ciencias Básicas-Microorganismos *** Reviews-Basic Sciences-Microorganisms

 

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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Enlace / Link

 

[1]

TÍTULO / TITLE:  - Immunopathogenesis and immunotherapy in AIDS virus infections.

REVISTA / JOURNAL:  - Nat Med 2003 Jul;9(7):861-6.

      ●● Enlace al texto completo (gratuito o de pago) 1038/nm0703-861

AUTORES / AUTHORS:  - Letvin NL; Walker BD

INSTITUCIÓN / INSTITUTION:  - Division of Viral Pathogenesis, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.

RESUMEN / SUMMARY:  - The heterogeneity of HIV and the different human leukocyte antigen (HLA) backgrounds of infected individuals have posed challenges to understanding the pathogenesis of HIV infection. But continuing advances in our knowledge of the role of immune responses in controlling HIV viremia should help to define goals for immune-based therapies and vaccine strategies against AIDS.  N. Ref:: 106

 

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[2]

TÍTULO / TITLE:  - Defying death—HIV mutation to evade cytotoxic T lymphocytes.

REVISTA / JOURNAL:  - N Engl J Med. Acceso gratuito al texto completo a partir de los 6 meses de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://content.nejm.org/ 

      ●● Cita: New England J Medicine (NEJM): <> 2002 Oct 10;347(15):1203-4.

      ●● Enlace al texto completo (gratuito o de pago) 1056/NEJMcibr022067

AUTORES / AUTHORS:  - Lieberman J

INSTITUCIÓN / INSTITUTION:  - Center for Blood Research, Boston, MA 02115, USA.  N. Ref:: 5

 

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[3]

TÍTULO / TITLE:  - Effects of MHC class I on HIV/SIV disease in primates.

REVISTA / JOURNAL:  - AIDS 2002;16 Suppl 4:S105-14.

AUTORES / AUTHORS:  - Carrington M; Bontrop RE

INSTITUCIÓN / INSTITUTION:  - Basic Research Program, SAIC Frederick, National Cancer Institute, Frederick, MD 21702, USA. carringt@ncifcrf.gov

RESUMEN / SUMMARY:  - Data indicate that resistance to HIV-1 disease involves an array of contrasting HLA genotypic effects that are subtle, but significant, particularly when these genetic effects are considered as a whole. Numerous reports attributing a role for HLA genotype in AIDS outcomes have been reported, and a few of these have been affirmed in multiple studies. Functional studies of immune cell recognition have provided clues to the underlying mechanisms behind some of the strongest HLA associations, suggesting the means by which relative resistance or susceptibility to the virus may occur. SIV infection in non-human primates has served as an invaluable model for understanding AIDS pathogenesis (in rhesus monkeys) and viral resistance (in chimpanzee). The effect of rhesus MHC class I molecules on the evolution of SIV has been convincingly described [19], and a recent study in humans has suggested that selection pressure conferred by HLA molecules is responsible for specific genetic variation in HIV-1 [114]. HIV-1 may eventually have conspicuous evolutionary effects on HLA and other AIDS restriction genes, a prolonged process that could have occurred in chimpanzee [92].To prevent such an outcome, it will be necessary to approach the disease from many perspectives, andapply comprehensively the knowledge gained to the successful control of the virus.  N. Ref:: 114

 

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[4]

TÍTULO / TITLE:  - Virus evasion of MHC class I molecule presentation.

REVISTA / JOURNAL:  - J Immunol. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://www.jimmunol.org/ 

      ●● Cita: J. of Immunology: <> 2003 Nov 1;171(9):4473-8.

AUTORES / AUTHORS:  - Petersen JL; Morris CR; Solheim JC

INSTITUCIÓN / INSTITUTION:  - Eppley Institute for Research in Cancer and Allied Diseases, Omaha, NE 68198-6805, USA.  N. Ref:: 97

 

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[5]

TÍTULO / TITLE:  - Fatal Scopulariopsis brevicaulis infection in a paediatric stem-cell transplant patient treated with voriconazole and caspofungin and a review of Scopulariopsis infections in immunocompromised patients.

REVISTA / JOURNAL:  - J Infect 2004 Jan;48(1):112-6.

AUTORES / AUTHORS:  - Steinbach WJ; Schell WA; Miller JL; Perfect JR; Martin PL

INSTITUCIÓN / INSTITUTION:  - Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Box 3499, Durham, NC, USA. stein022@mc.duke.edu  N. Ref:: 33

 

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[6]

TÍTULO / TITLE:  - Dendritic cells transduced with viral interleukin 10 or Fas ligand: no evidence for induction of allotolerance in vivo.

REVISTA / JOURNAL:  - Transplantation 2002 Jan 15;73(1 Suppl):S27-30.

AUTORES / AUTHORS:  - Buonocore S; Van Meirvenne S; Demoor FX; Paulart F; Thielemans K; Goldman M; Flamand V

INSTITUCIÓN / INSTITUTION:  - 2 Laboratory of Physiology, Medical School of Vrije Universiteit Brussel.

RESUMEN / SUMMARY:  - Dendritic cells (DC) are the most potent presenters of alloantigens and therefore are responsible for the induction of allograft rejection. Genetic modifications of DC allowing the expression of a tolerogenic molecule may render them immunosuppressive. We transduced bone marrow-derived DC with recombinant MFG retrovirus encoding either viral interleukin (vIL)-10 or Fas ligand (FasL) to induce transplantation tolerance. Up to 10 ng/ml of bioactive vIL-10 was produced by DC after transfer of the corresponding gene. Although the inhibitory properties of vIL-10-transduced DC were revealed in vitro in a mixed lymphocyte culture, no clear down-regulation of the allogeneic response was observed in vivo after single or multiple injections of those DC overexpressing vIL-10. When we transduced wild-type bone marrow-derived DC with recombinant MFG retrovirus encoding murine FasL, cells quickly died, probably because of suicidal or fratricidal Fas-dependent death. Indeed, only DC from Fas-deficient lpr mice survived to FasL gene transfer. Those FasL-transduced lpr DC exhibited a strong cytotoxic activity against Fas-positive targets in vitro. DC overexpressing FasL did not behave as immunosuppressive DC in vivo. The subcutaneous injection of FasL+ lpr DC in MHC class II-disparate mice hyperactivated the allospecific proliferation of T cells in the draining lymph nodes compared with mice treated with control-transduced DC. These results argue against the development of FasL+ DC or vIL-10-secreting DC as immunosuppressive tools in vivo. The alternative pathways of T-cell activation triggered by these genetically modified DC need to be investigated.  N. Ref:: 20

 

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[7]

TÍTULO / TITLE:  - Penicillin-resistant Streptococcus pneumoniae septic shock and meningitis complicating chronic graft versus host disease: a case report and review of the literature.

REVISTA / JOURNAL:  - Am J Med 2002 Aug 1;113(2):152-5.

AUTORES / AUTHORS:  - Haddad PA; Repka TL; Weisdorf DJ

INSTITUCIÓN / INSTITUTION:  - Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, USA.  N. Ref:: 34

 

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[8]

TÍTULO / TITLE:  - Cross-presentation in viral immunity and self-tolerance.

REVISTA / JOURNAL:  - Nat Rev Immunol 2001 Nov;1(2):126-34.

      ●● Enlace al texto completo (gratuito o de pago) 1038/35100512

AUTORES / AUTHORS:  - Heath WR; Carbone FR

INSTITUCIÓN / INSTITUTION:  - Immunology Division, The Walter and Eliza Hall Institute, Melbourne Hospital, Parkville, Victoria, Australia. heath@wehi.edu.au

RESUMEN / SUMMARY:  - T lymphocytes recognize peptide antigens presented by class I and class II molecules encoded by the major histocompatibility complex (MHC). Classical antigen-presentation studies showed that MHC class I molecules present peptides derived from proteins synthesized within the cell, whereas MHC class II molecules present exogenous proteins captured from the environment. Emerging evidence indicates, however, that dendritic cells have a specialized capacity to process exogenous antigens into the MHC class I pathway. This function, known as cross-presentation, provides the immune system with an important mechanism for generating immunity to viruses and tolerance to self.  N. Ref:: 83

 

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[9]

TÍTULO / TITLE:  - Scedosporium prolificans osteomyelitis in an immunocompetent child treated with voriconazole and caspofungin, as well as locally applied polyhexamethylene biguanide.

REVISTA / JOURNAL:  - J Clin Microbiol. Acceso gratuito al texto completo a partir de los 6 meses de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://jcm.asm.org/ 

      ●● Cita: J. Clinical Microbiology: <> 2003 Aug;41(8):3981-5.

AUTORES / AUTHORS:  - Steinbach WJ; Schell WA; Miller JL; Perfect JR

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, Duke University, Durham, North Carolina 27710, USA. stein022@mc.duke.edu

RESUMEN / SUMMARY:  - Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to amphotericin B, and Scedosporium prolificans strains are particularly resistant to the antifungal agents now in use. We report here on an immunocompetent child with S. prolificans-associated osteomyelitis successfully treated with debridement, local irrigation with polyhexamethylene biguanide, and the systemic administration of voriconazole and caspofungin despite poor in vitro activity of voriconazole alone against the isolate. We also review the treatments and outcomes of 28 reported cases of osteomyelitis or septic arthritis caused by Scedosporium species in immunocompetent patients.  N. Ref:: 62

 

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[10]

TÍTULO / TITLE:  - Therapeutic management of extrahepatic manifestations in patients with chronic hepatitis C virus infection.

REVISTA / JOURNAL:  - Rheumatology (Oxford). Acceso gratuito al texto completo a partir de los 2 años de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://rheumatology.oupjournals.org/ 

      ●● Cita: Rheumatology (Oxford): <> 2003 Jul;42(7):818-28. Epub 2003 Apr 16.

      ●● Enlace al texto completo (gratuito o de pago) 1093/rheumatology/keg299

AUTORES / AUTHORS:  - Ramos-Casals M; Trejo O; Garcia-Carrasco M; Font J

INSTITUCIÓN / INSTITUTION:  - Department of Autoimmune Diseases, Clinical Institutes of Infection and Immunology, Insitut d’Investigacions Biomediques August Pi i Sunyer, Hospital Clinic, Department of Medicine, School of Medicine, University of Barcelona, España. mramos@clinic.ub.es  N. Ref:: 123

 

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[11]

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.

 

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[12]

TÍTULO / TITLE:  - Regulation of gene expression in lymphocytes and antigen-presenting cells by measles virus: consequences for immunomodulation.

REVISTA / JOURNAL:  - J Mol Med 2002 Feb;80(2):73-85. Epub 2001 Nov 15.

      ●● Enlace al texto completo (gratuito o de pago) 1007/s00109-001-0299-x

AUTORES / AUTHORS:  - Schneider-Schaulies S; Bieback K; Avota E; Klagge I; ter Meulen V

INSTITUCIÓN / INSTITUTION:  - Institute for Virology and Immunobiology, University of Wurzburg, Versbacher Strasse 7, 97078 Wurzburg, Germany. s-s-s@vim.uni-wuerzburg.de

RESUMEN / SUMMARY:  - Acute measles, a well known disease usually contracted during early childhood, is still the major cause of vaccine-preventable infant deaths worldwide. There are about 40 million cases of acute measles per year, with more than one million cases of infant death as a consequence of measles. These are mainly due to opportunistic infections which develop on the basis of a generalized suppression of the cellular immunity in the course and after the acute disease. Lymphopenia, a general proliferative unresponsiveness of T cells ex vivo and cytokine imbalance, are considered as major hallmarks of measles virus (MV) induced immunosuppression. These findings are compatible with modulation of T cell responses by viral interference with professional antigen-presenting cells such as dendritic cells or direct effects on T cells by suppression of survival or proliferation signals. In vitro, MV interaction causes a variety of effects on dendritic cells, including maturation and loss of their allostimulatory functions. Whether there is an additional impact on the quality of T cell responses is unknown as yet. It is clear, however, that surface interaction of lymphocytes with the MV glycoprotein complex is necessary and sufficient to induce a state of proliferative unresponsiveness in T cells. This surface contact mediated signal essentially interferes with the propagation of the interleukin 2 receptor signal by blocking the activation of the protein kinase B, also called Akt kinase, both in vitro and after experimental infection.  N. Ref:: 122

 

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[13]

TÍTULO / TITLE:  - Severe Ehrlichia chaffeensis infection in a lung transplant recipient: a review of ehrlichiosis in the immunocompromised patient.

REVISTA / JOURNAL:  - Emerg Infect Dis. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.cdc.gov/ 

      ●● Cita: Emerging Infectious Diseases: <> 2002 Mar;8(3):320-3.

AUTORES / AUTHORS:  - Safdar N; Love RB; Maki DG

INSTITUCIÓN / INSTITUTION:  - Section of Infectious Diseases, University of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792, USA.

RESUMEN / SUMMARY:  - We describe a case of human ehrlichiosis in a lung transplant recipient and review published reports on ehrlichiosis in immunocompromised patients. Despite early therapy with doxycycline, our patient had unusually severe illness with features of thrombotic thrombocytopenic purpura. Of 23 reported cases of ehrlichiosis in immunocompromised patients, organ failure occurred in all patients and 6 (25%) died.  N. Ref:: 32

 

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[14]

TÍTULO / TITLE:  - Subcutaneous black fungus (phaeohyphomycosis) infection in renal transplant recipients:three cases.

REVISTA / JOURNAL:  - Transplantation 2004 Jan 15;77(1):140-2.

      ●● Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000107287.70512.E7

AUTORES / AUTHORS:  - Yehia M; Thomas M; Pilmore H; Van Der Merwe W; Dittmer I

INSTITUCIÓN / INSTITUTION:  - Auckland Renal Transplant Group, Auckland Hospital, Auckland, New Zealand. mahay@adhb.govt.nz

RESUMEN / SUMMARY:  - We describe three cases of subcutaneous phaeohyphomycosis developing in the lower limbs of renal transplant recipients shortly after transplantation. Each case presented with dark-colored nodules that subsequently ulcerated. Histopathologic examination revealed dematiaceous fungal hyphae with a surrounding granulomatous reaction. The fungi were subsequently identified as Alternaria alternatum in two cases and Phialophora richardsiae in one case. In one case, the lesions resolved during a prolonged (6-month) course of itraconazole without the requirement for surgical excision. In the other two cases, combined medical and surgical treatment resulted in cure. A review of the literature on phaeohyphomycosis is presented.  N. Ref:: 11

 

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[15]

TÍTULO / TITLE:  - Vascular thrombosis and acute cytomegalovirus infection in immunocompetent patients: report of 2 cases and literature review.

REVISTA / JOURNAL:  - Clin Infect Dis 2003 Jun 1;36(11):E134-9. Epub 2003 May 19.

AUTORES / AUTHORS:  - Abgueguen P; Delbos V; Chennebault JM; Payan C; Pichard E

INSTITUCIÓN / INSTITUTION:  - Department of Infectious Diseases, Centre Hospitalo-Universitaire, Angers, France. piabgueguen@chu-angers.fr

RESUMEN / SUMMARY:  - Acute cytomegalovirus (CMV) infection in immunocompetent patients is common worldwide, with seroprevalence rates of 40%-100%, depending on the country, socioeconomic conditions, and the patient’s age. Infection is most often asymptomatic, but acute cytomegalovirus infection is occasionally revealed by prolonged fever, cervical lymphadenitis, and arthralgia, and it is more rarely revealed by pneumonia, myocarditis, pericarditis, colitis, and hemolytic anemia. Here, we report 2 cases of acute CMV infection in nonimmunocompromised adults that were complicated by venous thrombosis with pulmonary embolism. We also review previously reported cases of vascular thrombosis and discuss the propensity of CMV to induce vascular damage with associated thrombosis.  N. Ref:: 55

 

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[16]

TÍTULO / TITLE:  - The fission yeast TOR proteins and the rapamycin response: an unexpected tale.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:85-95.

AUTORES / AUTHORS:  - Weisman R

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Microbiology and Biotechnology, Faculty of Life Sciences, Tel-Aviv University, 69978 Tel-Aviv, Israel. ronitt@post.tau.ac.il

RESUMEN / SUMMARY:  - The TOR proteins are known as key regulators of cell growth in response to nutritional and mitogenic signals and as targets for the immunosuppressive and anti-cancerous drug rapamycin. The fission yeast Schizosaccharomyces pombe has two TOR homologues, tor1+ and tor2+. Despite their structural similarity, these genes have distinct functions: tor1+ is required under starvation, extreme temperatures, and osmotic or oxidative stress conditions, whereas tor2+ is required under normal growth conditions. Surprisingly, rapamycin does not seem to inhibit the S. pombe TOR-related functions. Rapamycin specifically inhibits sexual development in S. pombe, and this seems to stem from direct inhibition of the S. pombe FKBP12 homologue. Why S. pombe cells are resistant to rapamycin during the growth phase is as yet unclear and awaits further analysis of the TOR-dependent signaling pathways.  N. Ref:: 27

 

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[17]

TÍTULO / TITLE:  - Efficacy of pneumococcal polysaccharide vaccine in immunocompetent adults: a meta-analysis of randomized trials.

REVISTA / JOURNAL:  - Vaccine 2001 Sep 14;19(32):4780-90.

AUTORES / AUTHORS:  - Cornu C; Yzebe D; Leophonte P; Gaillat J; Boissel JP; Cucherat M

INSTITUCIÓN / INSTITUTION:  - Service of Clinical Pharmacology, EA643, Lyon University Hospital, Faculte de Medicine RTH Laennec, BP 8071, 69376, Cedex 08, Lyon, France. catherine.cornu@upcl.univ-lyon1.fr

RESUMEN / SUMMARY:  - The use of pneumococcal polysaccharide vaccine (PPV) is low in some countries, maybe because of doubts regarding its efficacy. This meta-analysis aims at combining evidence from randomized trials of PPV assessing its efficacy in preventing Streptococcus pneumoniae related diseases in immunocompetent adults. In the fourteen trials totalling 48,837 patients retrieved, PPV prevents definite pneumococcal pneumonia by 71%, presumptive pneumococcal pneumonia by 40%, and mortality due to pneumonia by 32%, but not all-cause pneumonia or death. No preventive effect was seen in the subgroup of patients aged 55 years or more, possibly due to a lack of statistical power.

 

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[18]

TÍTULO / TITLE:  - Disseminated ochroconis gallopavum infection in a renal transplant recipient: the first reported case and a review of the literature.

REVISTA / JOURNAL:  - Clin Nephrol 2003 Dec;60(6):415-23.

AUTORES / AUTHORS:  - Wang TK; Chiu W; Chim S; Chan TM; Wong SS; Ho PL

INSTITUCIÓN / INSTITUTION:  - Centre of Infection, Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China.

RESUMEN / SUMMARY:  - Ochroconis gallopavum is a potentially fatal dematiaceous fungus causing opportunistic infections in immunocompromised hosts. We report the first case of disseminated O. gallopavum infection in a 13-year-old renal transplant recipient, which involved the brain, lung and spleen. He was treated with amphotericin B, itraconazole and voriconazole, a new antifungal agent first used to treat such an infection. Besides antifungal treatment, all immunosuppressive agents were stopped and automated peritoneal dialysis was resumed. The initial infection was under control with both clinical and radiological improvements after treatment. However, the patient later acquired Acremonium spp. peritonitis; he failed to respond to high-dose amphotericin B, and finally succumbed. A total of 13 reported O. gallopavum human infections, including the one described here, are reviewed. The most common site of involvement is the brain and the crude mortality rate is up to 46%. As the disease is potentially lethal in immunocompromised hosts, empirical antifungal coverage should be considered in post-renal transplant recipients with suspected brain abscess. Early biopsy of lesion for histopathological and microbiological diagnosis would be essential in managing such cases.  N. Ref:: 23

 

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[19]

TÍTULO / TITLE:  - The HCMV gene products US2 and US11 target MHC class I molecules for degradation in the cytosol.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2002;269:37-55.

AUTORES / AUTHORS:  - van der Wal FJ; Kikkert M; Wiertz E

INSTITUCIÓN / INSTITUTION:  - Department of Medical Microbiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

RESUMEN / SUMMARY:  - Over millions of years of coevolution with their hosts, viruses have developed highly effective strategies to elude the host immune system. The degradation of major histocompatibility complex (MHC) class I heavy chains by human cytomegalovirus (HCMV) is an example of this. Two HCMV proteins, US2 and US11, target newly synthesized MHC class I heavy chains for destruction via a pathway that involves ubiquitin-dependent retrograde transport, or “dislocation”, of the heavy chains from the ER to the cytosol, where the proteins are degraded by proteasomes. In this review, US2- and US11-mediated degradation of MHC class I heavy chains is discussed in relation to data concerning the degradation of other ER luminal proteins. A new, unified model for translocon-facilitated dislocation and degradation of MHC class I heavy chains is presented.  N. Ref:: 115

 

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[20]

TÍTULO / TITLE:  - Beta-herpesvirus challenges in the transplant recipient.

REVISTA / JOURNAL:  - J Infect Dis. Acceso gratuito al texto completo a partir de los 2 años de la publicación;  - http://www.journals.uchicago.edu/ 

      ●● Cita: J. of Infectious Diseases: <> 2002 Oct 15;186 Suppl 1:S99-S109.

AUTORES / AUTHORS:  - Ljungman P

INSTITUCIÓN / INSTITUTION:  - Karolinska Institutet, SE-14186 Stockholm, Sweden. per.ljungman@medhs.ki.se

RESUMEN / SUMMARY:  - Cytomegalovirus (CMV) has major consequences after allogeneic stem cell and solid organ transplantation. CMV may cause significant morbidity and mortality, and monitoring to detect reactivation to reduce disease or management of end organ disease is associated with increased resource utilization. Two other members of the beta-herpesvirus family, human herpesvirus (HHV) type 6 and HHV-7, are increasingly recognized as important pathogens in transplant recipients, either by direct infection (e.g., encephalitis, hepatitis, or pneumonitis) or via interaction with CMV. In addition to direct effects of CMV infection, such indirect effects as an increased risk for bacterial and fungal infections or impaired graft acceptance and function are important research topics. Diagnosis and treatment of CMV infection is currently more advanced than for HHV-6 and HHV-7.  N. Ref:: 109

 

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[21]

TÍTULO / TITLE:  - Cellular engineering of HSV-tk transduced, expanded T lymphocytes for graft-versus-host disease management.

REVISTA / JOURNAL:  - Acta Haematol 2003;110(2-3):121-31.

      ●● Enlace al texto completo (gratuito o de pago) 1159/000072461

AUTORES / AUTHORS:  - Burger SR; Kadidlo DM; Basso L; Bostrom N; Orchard PJ

INSTITUCIÓN / INSTITUTION:  - Advanced Cell and Gene Therapy, Chapel Hill, NC 27516, USA. sburger@ac-gt.com

RESUMEN / SUMMARY:  - Engineering donor T lymphocytes with inducible ‘suicide genes’, such as herpes simplex virus thymidine kinase, has potential to improve safety and efficacy in allogeneic transplantation by facilitating management of graft-versus-host disease. Elective administration of a relatively nontoxic pro-drug would induce in vivo negative selection of engineered lymphocytes specifically, sparing other donor hematopoietic cells. The engineered cells must retain immunologic function, and undergo negative selection in response to clinically attainable plasma concentrations of pro-drug. The cell engineering process itself, typically involving activation, transduction, ex vivo expansion, and selection, must produce clinically useful numbers of genetically modified cells at high purity. We discuss development of a cellular engineering manufacturing process that yields transduced, expanded T lymphocytes meeting these requirements.  N. Ref:: 37

 

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[22]

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

 

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[23]

TÍTULO / TITLE:  - Successful management of disseminated Nocardia transvalensis infection in a heart transplant recipient after development of sulfonamide resistance: case report and review.

REVISTA / JOURNAL:  - J Heart Lung Transplant 2003 Apr;22(4):492-7.

AUTORES / AUTHORS:  - Lopez FA; Johnson F; Novosad DM; Beaman BL; Holodniy M

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.

RESUMEN / SUMMARY:  - Nocardia transvalensis is a rarely reported cause of clinically significant disease, and, to our knowledge, has not been reported previously as a cause of infection in the cardiac transplant population. We report a case of N transvalensis new taxon-2 pulmonary infection that disseminated to the brain and skin in a cardiac transplant recipient despite adequate sulfonamide serum levels. Subsequent isolates were resistant to sulfonamides, and molecular ribotyping of the primary and subsequent isolates confirmed that these were the same N transvalensis new taxon-2 strain. The taxonomic and diagnostic considerations, as well as the clinical significance of anti-microbial-resistant nocardia, are reviewed and discussed herein.  N. Ref:: 37

 

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[24]

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

 

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[25]

TÍTULO / TITLE:  - Prevention of cytomegalovirus disease in recipients of solid-organ transplants.

REVISTA / JOURNAL:  - Clin Infect Dis 2001 Feb 15;32(4):596-603. Epub 2001 Feb 6.

AUTORES / AUTHORS:  - Paya CV

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases and Transplant Center, Mayo Clinic, Rochester, MN 55905. USA. paya@mayo.edu

RESUMEN / SUMMARY:  - The introduction and combination of more-potent immunosuppressive regimens, and the increased transplantation of organs into more severely ill patients, have again placed cytomegalovirus (CMV) disease in the spotlight of posttransplantation complications. Both direct and associated complications related to CMV need to be considered in understanding the pathogenesis of CMV infection after solid-organ transplantation. New diagnostic methods with higher sensitivity for the detection of CMV and the ability to quantify CMV indicate that low levels of CMV replication are present in many patients who don’t have clinical symptoms ascribed to CMV infection. How these low levels of CMV replication impact the outcome of the transplanted graft remains unknown. In addition, there needs to be further study regarding whether only patients at high risk for developing CMV disease or, also, those with clinically asymptomatic levels of CMV replication should be the target of effective preventive regimens. This review summarizes our current knowledge of the pathogenesis of CMV infection after solid-organ transplantation, and it outlines different effective preventive regimens and approaches.  N. Ref:: 47

 

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[26]

TÍTULO / TITLE:  - Common community respiratory viruses in patients with cancer: more than just “common colds”.

REVISTA / JOURNAL:  - Cancer 2003 May 15;97(10):2576-87.

      ●● Enlace al texto completo (gratuito o de pago) 1002/cncr.11353

AUTORES / AUTHORS:  - Hicks KL; Chemaly RF; Kontoyiannis DP

INSTITUCIÓN / INSTITUTION:  - Department of Bone Marrow Transplantation, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

RESUMEN / SUMMARY:  - Community respiratory viruses long have been recognized as primary respiratory pathogens among infants and young children. More recently, it has become clear that these viruses cause a considerable disease burden throughout life. The consequences of repeated infections are most evident in elderly and immunocompromised persons. Even in otherwise healthy persons, reinfections often require medical attention but generally are undiagnosed and unrecognized. These reinfections may spread from healthy persons to those at highest risk. Control requires a multifaceted approach combining vaccination, chemoprophylaxis, and aggressive early antiviral treatment of high-risk individuals, as well as education of all populations affected by these viruses.  N. Ref:: 90

 

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[27]

TÍTULO / TITLE:  - Immune control of HIV: the obstacles of HLA and viral diversity.

REVISTA / JOURNAL:  - Nat Immunol 2001 Jun;2(6):473-5.

      ●● Enlace al texto completo (gratuito o de pago) 1038/88656

AUTORES / AUTHORS:  - Walker BD; Korber BT

INSTITUCIÓN / INSTITUTION:  - Partners AIDS Research Center, Massachusetts General Hospital and Division of AIDS, Harvard Medical School, Boston, MA 02114, USA. bwalker@helix.mgh.harvard.edu  N. Ref:: 27

 

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[28]

TÍTULO / TITLE:  - Cutaneous lymphoma associated with Epstein-Barr virus infection in 2 patients treated with methotrexate.

REVISTA / JOURNAL:  - Mayo Clin Proc. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.mayo.edu/proceedings/ 

      ●● Cita: Mayo Clinic Proceedings: <> 2001 Aug;76(8):845-8.

AUTORES / AUTHORS:  - Tournadre A; D’Incan M; Dubost JJ; Franck F; Dechelotte P; Souteyrand P; Soubrier M

INSTITUCIÓN / INSTITUTION:  - Department of Rheumatology, Hjpital Gabriel Montpied, Clermont-Ferrand, France.

RESUMEN / SUMMARY:  - Whether patients with rheumatoid arthritis (RA) have an increased risk of developing non-Hodgkin lymphoma is controversial, and opinions differ on the possible role of methotrexate in the occurrence of lymphomas in patients with RA. We report 1 T-cell lymphoma and 1 B-cell lymphoma restricted to the skin associated with Epstein-Barr virus infection that healed completely and spontaneously after discontinuation of methotrexate in a man with RA and a woman with dermatomyositis. Cutaneous infiltrating cells were infected by a replicative form of Epstein-Barr virus. After discontinuation of methotrexate, the cutaneous lesions disappeared completely in 15 days without recurrence. Discontinuation of methotrexate is necessary in patients with RA or dermatomyositis who have a lymphoproliferative disorder, and a follow-up period of several weeks should be observed before specific therapy is initiated.  N. Ref:: 18

 

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[29]

TÍTULO / TITLE:  - Hepatitis C virus infection and vasculitis: implications of antiviral and immunosuppressive therapies.

REVISTA / JOURNAL:  - Arthritis Rheum 2002 Mar;46(3):585-97.

      ●● Enlace al texto completo (gratuito o de pago) 1002/art.10107 [pii

      ●● Enlace al texto completo (gratuito o de pago) 1002/art.10107

AUTORES / AUTHORS:  - Vassilopoulos D; Calabrese LH

INSTITUCIÓN / INSTITUTION:  - Hippokration General Hospital, Athens University, Athens, Greece.  N. Ref:: 92

 

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[30]

TÍTULO / TITLE:  - Retroviral proteins that target the major histocompatibility complex class I.

REVISTA / JOURNAL:  - Virus Res 2002 Sep;88(1-2):119-27.

AUTORES / AUTHORS:  - Johnson JM; Franchini G

INSTITUCIÓN / INSTITUTION:  - National Cancer Institute, Basic Research Laboratory, 41/D804, Bethesda, MD 20892-5055, USA. johnsonjm@helix.nih.gov

RESUMEN / SUMMARY:  - The human T-cell leukemia virus type 1 (HTLV-1) and human immunodeficiency virus type 1 (HIV-1) retroviruses are two evolutionary distinct human pathogens. HTLV-1 is the etiologic agent of two diverse diseases: adult T-cell leukemia/lymphoma, as well as the neurologic disorder tropical spastic paraparesis/HTLV-1-associated myelopathy. HTLV-1 is the only retrovirus known to be the etiologic agent of human cancer. HTLV-2, the other known oncovirus, is not apparently associated with human cancer. While HTLV-1 transforms T-cells in vitro, HIV kills CD4+ T-cells and is the etiological agent of human acquired immunodeficiency syndrome, characterized by a progressive loss of CD4+ cells, weakening of the immune system, and susceptibility to opportunistic infections and cancer. HTLV-1 and HIV-1 both cause lifelong infections, which suggests that they have evolved mechanism(s) to evade detection by the host’s immune response; particularly to evade cytotoxic T-lymphocytes, which play a major role in cellular immunity against viruses and will be the focus of this review.  N. Ref:: 80

 

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[31]

TÍTULO / TITLE:  - Neonatal toxic shock syndrome-like exanthematous disease (NTED).

REVISTA / JOURNAL:  - Pediatr Int 2003 Apr;45(2):233-7.

AUTORES / AUTHORS:  - Takahashi N

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, Jichi Medical School, Tochigi-ken, Tokyo Women’s Medical University, Tokyo, Japan. naoto-t@jichi.ac.jp

RESUMEN / SUMMARY:  - The author and colleagues recently discovered an emerging neonatal infectious disease: neonatal toxic shock syndrome-like exanthematous disease (NTED), which is induced by the superantigen toxic shock syndrome toxin-1 (TSST-1), produced by methicillin-resistant Staphylococcus aureus (MRSA). The massively expanded Vbeta2+ T cells were rapidly deleted in the peripheral blood of patients with NTED. A marked depletion of Vbeta2+ T cells was also observed in the peripheral blood before the expansion of these T cells. Anergy is specifically induced in the TSST-1 reactive T cells of patients with NTED. Rapid recovery from NTED without complications is expected to be related to the induction of immunologic tolerance in neonatal patients. Anti-TSST-1 IgG antibody of maternal origin was found to play a protective role in preventing the development of NTED. The number of hospitals that have experience caring for patients with NTED has increased threefold in the past 5 years. Most MRSA isolates from neonatal intensive care units in Japan were found to be a single clone of coagulase type II and to possess TSST-1 and staphylococcal enterotoxin C genes. The timing and increased incidence of NTED suggest the emergence of a new MRSA clone. By recognizing that TSST-1 can induce NTED, healthcare providers may give increased attention to this disease in neonatal wards.  N. Ref:: 43

 

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[32]

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

 

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[33]

TÍTULO / TITLE:  - Viral warts in organ transplant recipients: new aspects in therapy.

REVISTA / JOURNAL:  - Br J Dermatol 2003 Nov;149 Suppl 66:20-4.

AUTORES / AUTHORS:  - Schmook T; Nindl I; Ulrich C; Meyer T; Sterry W; Stockfleth E

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, University Hospital Charite, Schumannstrasse 20-21, D-10117 Berlin, Germany.

RESUMEN / SUMMARY:  - The long-term success of organ transplantation depends on the prevention of allograft rejection and improvement in quality of life for the patients. This has been achieved through better immunosuppressive regimens with lower dosages and a new generation of immunosuppressive drugs. However, these immunosuppressive agents not only impair the patient’s reactivity to the graft, but also to infectious organisms, thereby making them more susceptible to opportunistic pathogens. Because of this, organ transplant recipients are predisposed to epithelial malignancies and infections. The majority of transplant recipients will develop warts induced by human papillomavirus (HPV). Some of these viral warts may present with atypical histological features and may progress into squamous cell carcinomas. The risk for cutaneous cancers after transplantation is much higher than in the immunocompetent population. Current therapies for HPV-associated skin tumours mainly depend on the destruction of affected skin areas. These treatment modalities are of limited efficacy and are usually painful for the patients. A promising novel therapeutic agent is imiquimod, an immune response modifier. Clinical efficacy of imiquimod has been observed for different skin lesions, including viral warts in both immunocompetent and immunosuppressed patients.  N. Ref:: 35

 

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[34]

TÍTULO / TITLE:  - West Nile encephalitis in 2 hematopoietic stem cell transplant recipients: case series and literature review.

REVISTA / JOURNAL:  - Clin Infect Dis 2003 Oct 15;37(8):1044-9. Epub 2003 Sep 18.

AUTORES / AUTHORS:  - Hong DS; Jacobson KL; Raad II; de Lima M; Anderlini P; Fuller GN; Ippoliti C; Cool RM; Leeds NE; Narvios A; Han XY; Padula A; Champlin RE; Hosing C

INSTITUCIÓN / INSTITUTION:  - Department of Blood and Marrow Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.

RESUMEN / SUMMARY:  - Most human cases of West Nile virus infection are acquired via bites from an infected mosquito. In some cases, infection may also be transmitted by infected blood products or transplanted organs. There have been recent publications suggesting that chemotherapy and immunosuppression may increase a person’s risks of developing central nervous system disease if the person is infected with the West Nile virus. Because patients undergoing hematopoietic stem cell transplantation not only are immunocompromised, but also receive multiple blood products, they are at a particularly high risk for acquiring symptomatic disease if exposed to the West Nile Virus. We describe here 2 patients who underwent hematopoietic transplantation at our institution and subsequently developed fatal West Nile virus infections.  N. Ref:: 24

 

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[35]

- Castellano -

TÍTULO / TITLE:La enfermedad linfoproliferativa difusa postrasplante renal y su relacion con el virus Epstein-Barr. Experiencia de un centro. Diffuse lymphoproliferative disease after renal transplantation and its relation with Epstein-Barr virus. Experience at one center.

REVISTA / JOURNAL:  - Nefrologia. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/ 

      ●● Cita: Nefrologia: <> 2002;22(5):463-9.

AUTORES / AUTHORS:  - Franco A; Jimenez L; Aranda I; Alvarez L; Gonzalez M; Rocamora N; Olivares J

INSTITUCIÓN / INSTITUTION:  - Servicio de Nefrologia Hospital General Alicante Maestro Alonso, 109 03010 Alicante. franco_ant@gva.es

RESUMEN / SUMMARY:  - Post-transplant lymphoproliferative disorders (PTLD) are a group of heterogeneous lymphoid proliferations in chronic immunosuppressed recipients which appear to be related to Epstein Barr Virus (EBV). Receptor EBV seronegativity, use of antilymphocyte antibodies and CMV disease have been identified as risk factors that may tigger development of PTLD. We have studied the incidence of PTLD and its relationship with EBV in 588 adult renal transplant recipients who were transplanted in our hospital from 1988 to 2001. We have also evaluated the diagnostic and therapeutic methods used, the risk factors and outcome of the patients who developed PTLD. We identified 8 recipients (4 males and 4 females), range from 18 to 67 years (mean age 45.6 years) with a median time between grafting and PTLD of 4.1 years (0.1-7 years), who developed PTLD (1.3%). Only 1 patient received OKT3 and had CMV disease, two of them (25%) had been treated with hight doses of prednisolone, another was EBV seronegative, but the rest of them (50%) had no risk factors. Two patients were diagnosed at autopsy, the diagnosis of 5 was based on the histology of biopsy and the last one by CT scans of chest-abdomen and cytology. The presence of EBV in the lymphoproliferative cells was assessed in 5 out of the 7 studied patients (71.4%). The outcome of our recipients was poor. Five out of 8 patients died shortly after diagnosis as a direct consecuence of PTLD and another of an infectious complication of the treatment (75%). The 2 patients alive started dialysis and 1 of them died 2 years later of a non-related cause. In conclusion, PTLD is a relatively frequent disease with a poor prognosis in renal transplant patients. It seems to have a close relationship with EBV and can develop in the absence of the classical risk factors.  N. Ref:: 18

 

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[36]

TÍTULO / TITLE:  - Impaired gut function as risk factor for invasive candidiasis in neutropenic patients.

REVISTA / JOURNAL:  - Br J Haematol 2002 May;117(2):259-64.

AUTORES / AUTHORS:  - Blijlevens NM; Donnelly JP; de Pauw BE

INSTITUCIÓN / INSTITUTION:  - Department of Haematology, University Medical Centre, St. Radboud Nijmegen, NL-6500 HB Nijmegen, the Netherlands. N.Blijlevens@hemat.azn.nl  N. Ref:: 53

 

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[37]

TÍTULO / TITLE:  - Chronic relapsing salmonella osteomyelitis in an immunocompetent patient: case report and literature review.

REVISTA / JOURNAL:  - J Infect 2002 Jan;44(1):44-7.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jinf.2001.0925

AUTORES / AUTHORS:  - Banky JP; Ostergaard L; Spelman D

INSTITUCIÓN / INSTITUTION:  - Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.

RESUMEN / SUMMARY:  - We present the first case of Salmonella virchow causing a relapsing bone infection at the same site 12 years apart in an otherwise healthy patient. Chronic relapsing osteomyelitis caused by a zoonotic salmonella may become increasingly important in view of the increased incidence of zoonotic salmonella infections. Based on this case, we recommend 3 months of therapy with a quinolone when treating a chronic relapsing zoonotic salmonella osteomyelitis.  N. Ref:: 25

 

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[38]

TÍTULO / TITLE:  - Human herpesvirus 6 meningoencephalitis successfully treated with ganciclovir in a patient who underwent allogeneic bone marrow transplantation from an HLA-identical sibling.

REVISTA / JOURNAL:  - Int J Hematol 2002 May;75(4):421-5.

AUTORES / AUTHORS:  - Yoshida H; Matsunaga K; Ueda T; Yasumi M; Ishikawa J; Tomiyama Y; Matsuzawa Y

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Suita, Japan. hyoshida@imed2.med.osaka-u.ac.jp

RESUMEN / SUMMARY:  - Human herpesvirus 6 (HHV-6) has recently been recognized as an important pathogen in immunocompromised hosts, such as patients who have undergone allogeneic bone marrow transplantation (allo-BMT). Here we report a case of HHV-6 meningoencephalitis in a patient who underwent allo-BMT from an HLA-identical sibling. The patient suffered from headache, high fever, tremor, and disorientation on day 35 after allo-BMT. Findings at magnetic resonance imaging, electroencephalography, and routine cerebrospinal fluid (CSF) examination suggested the presence of viral meningoencephalitis. We diagnosed HHV-6 meningoencephalitis by means of polymerase chain reaction (PCR) analysis of a CSF specimen. Successful treatment was achieved with ganciclovir. Because HHV-6 encephalitis has a potentially fatal and fulminant course, it is necessary that HHV-6 encephalitis be recognized as one of the central nervous system complications that can follow allo-BMT. PCR analysis for HHV-6 in the CSF specimen is necessary for appropriate diagnosis and treatment.  N. Ref:: 18

 

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[39]

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

 

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[40]

TÍTULO / TITLE:  - Epidemiology of Candida species infections in critically ill non-immunosuppressed patients.

REVISTA / JOURNAL:  - Lancet Infect Dis 2003 Nov;3(11):685-702.

AUTORES / AUTHORS:  - Eggimann P; Garbino J; Pittet D

INSTITUCIÓN / INSTITUTION:  - Medical Clinic II, the Medical Intensive Care Unit and the Infection Control Programme, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland.

RESUMEN / SUMMARY:  - A substantial proportion of patients become colonised with Candida spp during hospital stay, but only few subsequently develop severe infection. Clinical signs of severe infection manifest early but lack specificity until late in the course of the disease, thus representing a particular challenge for diagnosis. Mostly nosocomial, invasive candidiasis occurs in only 1-8% of patients admitted to hospitals, but in around 10% of patients housed in intensive care units where it can represent up to 15% of all nosocomial infections. We review the epidemiology of invasive candidiasis in non-immunocompromised, critically ill patients with special emphasis on disease trends over time, pathophysiology, diagnostic approach, risk factors, and impact. Recent epidemiological data suggesting that the emergence of non-albicans candida strains with reduced susceptibility to azoles, previously linked to the use of new antifungals for empiric and prophylactic therapy in immunocompromised patients, may not have occurred in the critically ill. Management of invasive candidiasis in these patients will be addressed in the December issue of The Lancet Infectious Diseases.  N. Ref:: 177

 

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[41]

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.

 

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[42]

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

 

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[43]

- Castellano -

TÍTULO / TITLE:Virus del herpes humano tipo 6 y tipo 7 en receptores de trasplantes. Human herpesvirus type 6 and type 7 in transplant recipients.

REVISTA / JOURNAL:  - Enferm Infecc Microbiol Clin. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://db.doyma.es/ 

      ●● Cita: Enfermedades Infecciosas y Microbiologia Clinica: <> 2003 Oct;21(8):424-32.

AUTORES / AUTHORS:  - Benito N; Moreno A; Pumarola T; Marcos MA

INSTITUCIÓN / INSTITUTION:  - Servicio de Infecciones. Institut Clinic d’Infeccions i Inmunologia. Hospital Clinic Universitari-IDIBAPS. Barcelona. España. nbenito@clinic.ub.es

RESUMEN / SUMMARY:  - Recent years have witnessed a growing interest in the role of human herpesvirus (HHV) type 6 and type 7 as emerging pathogens or copathogens in transplant recipients. Both HHV-6 and HHV-7 belong to the beta-herpesvirus family and are closely related to another member of the family, cytomegalovirus. After the primary infection, these viruses remain latent in the human host and can reactivate after transplantation. Various clinical processes such as fever, rash, pneumonitis, encephalitis, hepatitis, and myelosuppression have been described in association with herpesvirus. Moreover, a growing body of evidence suggests that the major impact of HHV-6 and HHV-7 reactivation in transplantation is related to indirect effects, such as their association with cytomegalovirus disease, increased opportunistic infections, and graft dysfunction and rejection. The pathogenesis of HHV-6 and HHV-7 during the post-transplantation period, the methods used for their diagnosis, and the evaluation of antiviral drugs and strategies for their prevention and treatment are now the subject of extensive research.  N. Ref:: 104

 

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[44]

TÍTULO / TITLE:  - The immunocompromised host: immune alterations in splenectomized patients and clinical implications.

REVISTA / JOURNAL:  - Curr Pharm Des 2003;9(24):1918-23.

AUTORES / AUTHORS:  - Jirillo E; Mastronardi ML; Altamura M; Munno I; Miniello S; Urgesi G; Amati L

INSTITUCIÓN / INSTITUTION:  - Immunology, University of Bari, Italy. jirillo@midim.uniba.it

RESUMEN / SUMMARY:  - The spleen plays a paramount role in the host protection against invading microorganisms. In support of the above concept, in splenectomized patients there is increasing evidence of overwhelming postsplenectomy infections (OPSI). OPSI are caused by Streptococcus pneumoniae in about 80% of cases, but also Gram-negative bacteria are implicated in a certain number of cases. Therapeutically, penicillin and pneumococcal vaccines represent valid therapeutic approaches in Gram-positive OPSI. However, the effectiveness of polyvalent polysaccharide pneumococcal vaccines is still debated and, thus, other therapeutic strategies should be validated for combating OPSI. According to our personal data, a deficit of phagocytic activities and of T helper (h)-1 cells is very frequent in splenectomized patients. In sera, we found reduced levels of both Interferon-gamma and Interleukin (IL)-4. These data are in accordance with the recent observation on the protective role of T cells against S. pneumoniae. In fact, patients deficient in IL-12 develop severe pneumococcal infections and undergo apoptosis of Th(1) cells.  N. Ref:: 60

 

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[45]

TÍTULO / TITLE:  - NKG2D ligands: unconventional MHC class I-like molecules exploited by viruses and cancer.

REVISTA / JOURNAL:  - Tissue Antigens 2003 May;61(5):335-43.

AUTORES / AUTHORS:  - Cerwenka A; Lanier LL

INSTITUCIÓN / INSTITUTION:  - German Cancer Center DKFZ/0080 IM Neuenheimerfeld D-69120 Heidelberg 280 Germany. a.cerwenka@dkfz-heidelberg.de

RESUMEN / SUMMARY:  - Our best teachers in revealing the importance of immune pathways are viruses and cancers that have subverted the most prominent pathways to escape from immune recognition. Viruses and cancer impair antigen presentation by classical MHC class I to escape adaptive immunity. The activating receptor NKG2D and its MHC class I-like ligands are other recently defined innate and adaptive immune pathways exploited by viruses and cancer. This review discusses recent advances in the understanding of how NKG2D, expressed on innate immune cells including natural killer cells, gammadelta+ T cells and macrophages, and adaptive immune cells such as CD8+ T cells, recognize stress-induced, MHC class I-like, self-ligands. Moreover, we describe how viruses and cancer have developed strategies to evade this recognition pathway.  N. Ref:: 55

 

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[46]

TÍTULO / TITLE:  - Mycobacterium celatum pulmonary infection in the immunocompetent: case report and review.

REVISTA / JOURNAL:  - Emerg Infect Dis. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.cdc.gov/ 

      ●● Cita: Emerging Infectious Diseases: <> 2003 Mar;9(3):399-402.

AUTORES / AUTHORS:  - Piersimoni C; Zitti PG; Nista D; Bornigia S

INSTITUCIÓN / INSTITUTION:  - Department of Clinical Microbiology, Umberto I-Torrette Hospital, Ancona, Italy. piersim@tin.it

RESUMEN / SUMMARY:  - Mycobacterium celatum has been shown to cause disease in immunocompromised patients. We report a case of serious pulmonary infection caused by M. celatum in an apparently immunocompetent patient and review the characteristics of two other reported cases. Clinical and radiologic symptoms and signs included cough, malaise, and weight loss associated with cavitary lesions and pulmonary infiltrates. Although M. celatum is easy to detect in clinical specimens by liquid and solid media, it may be misidentified as a member of the M. tuberculosis complex or as M. xenopi. M. celatum pulmonary infection appears to respond to antimycobacterial chemotherapy, particularly with clarithromycin.  N. Ref:: 23

 

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[47]

TÍTULO / TITLE:  - Pseudallescheria boydii (Anamorph Scedosporium apiospermum). Infection in solid organ transplant recipients in a tertiary medical center and review of the literature.

REVISTA / JOURNAL:  - Medicine (Baltimore) 2002 Sep;81(5):333-48.

AUTORES / AUTHORS:  - Castiglioni B; Sutton DA; Rinaldi MG; Fung J; Kusne S

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, Pennsylvania 15213, USA.

RESUMEN / SUMMARY:  - (Sca) is a ubiquitous filamentous fungus capable of causing invasive disease. We reviewed our electronic microbiology records and the English-language literature. Between 1976 and December 1999 we identified 23 solid organ transplant recipients with Sca infection, 7 of which occurred between December 1987 and December 1999 at our institution. Overall incidence was 1 per 1,000 patients, with a trend of higher incidence in patients receiving lung transplants compared with other transplant organs (p = 0.06). The 23 patients included liver (4), kidney (8), heart (8), lung (2), and heart/lung (1) recipients. Male to female ratio was 19:4, and the mean age was 46 +/- 12 (SD) years. Fungal infection was diagnosed at a median of 4 months (range, 0.4-156 mo) after transplant. The clinical presentation included disseminated disease ( 8), skin lesions (3), lung disease (5), endophthalmitis (1), meningitis (1), brain abscess with or without extension to eye (3), fungal mycotic aneurysm (1), and sinusitis (1). Seven (30%) patients had intravascular infection, and 11 (48%) patients had central nervous system involvement. Antifungal therapy was accompanied by surgical debridement in 9 cases. Three additional patients were found to have airway colonization only and received itraconazole prophylaxis, without evidence of disease. Of 22 patients with known outcome, 16 (72.7%) died. Five of 6 patients who survived had localized infections: skin lesions (n = 3), sinus fungus ball (n = 1), and solitary lung nodule (n = 1). All patients with disseminated disease and 10 of 11 patients with central nervous system disease died. An exception was 1 patient with a brain abscess, successfully treated with voriconazole and surgical drainage. Sca infection is rare but is associated with high mortality. Early diagnosis by culture is important because Sca is resistant to amphotericin B, routinely used in the empiric therapy of invasive fungal infections. Treatment with the combination of an antifungal and surgery may have a better outcome. Voriconazole promises to be an effective antifungal agent. Cultures positive for Sca should not be ignored, and long-term antifungal prophylaxis in candidates and transplant recipients should be considered.  N. Ref:: 70

 

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[48]

TÍTULO / TITLE:  - Management of Aspergillus osteomyelitis: report of failure of liposomal amphotericin B and response to voriconazole in an immunocompetent host and literature review.

REVISTA / JOURNAL:  - Eur J Clin Microbiol Infect Dis 2003 May;22(5):277-83. Epub 2003 May 7.

      ●● Enlace al texto completo (gratuito o de pago) 1007/s10096-003-0909-3

AUTORES / AUTHORS:  - Stratov I; Korman TM; Johnson PD

INSTITUCIÓN / INSTITUTION:  - Department of Microbiology and Immunology, The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia. i.stratov@pgrad.unimelb.edu.au

RESUMEN / SUMMARY:  - Presented here is a case of Aspergillus osteomyelitis in an immunocompetent patient that progressed despite surgery and prolonged treatment with liposomal amphotericin B; the report is followed by a review of the literature. The review of this case and 41 similar cases found an overall cure rate of 69%. The importance of surgery when amphotericin B is used as first-line therapy is indicated by a 14% cure rate when amphotericin B is used alone compared to 75% when combined with surgery. When therapy is failing or surgery is contraindicated, dose escalation using a lipid formulation was not effective. On review, the addition of another agent, in particular 5-fluorocytosine, appears to be more beneficial. The patient reported here responded rapidly to voriconazole, a promising new antifungal agent for Aspergillus infections.  N. Ref:: 47

 

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[49]

TÍTULO / TITLE:  - Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients.

REVISTA / JOURNAL:  - Clin Microbiol Rev. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://cmr.asm.org/ 

      ●● Cita: Clinical Microbiology Reviews: <> 2002 Jan;15(1):145-54.

AUTORES / AUTHORS:  - Hunter PR; Nichols G

INSTITUCIÓN / INSTITUTION:  - School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom. paul.hunter@uea.ac.uk

RESUMEN / SUMMARY:  - Cryptosporidium spp. are a major cause of diarrheal disease in both immunocompetent and immunodeficient individuals. They also cause waterborne disease in both the United States and United Kingdom. Studies on the mechanisms of immunity to cryptosporidiosis indicate the importance of the T-cell response. The spectrum and severity of disease in immunocompromised individuals with cryptosporidiosis reflect this importance since the most severe disease is seen in individuals with defects in the T-cell response. The most commonly studied group is that of patients with AIDS. These patients suffer from more severe and prolonged gastrointestinal disease that can be fatal; in addition, body systems other than the gastrointestinal tract may be affected. The widespread use of antiretroviral therapy does appear to be having a beneficial effect on recovery from cryptosporidiosis and on the frequency of infection in human immunodeficiency virus-positive patients. Other diseases that are associated with increased risk of severe cryptosporidiosis, such as primary immunodeficiencies, most notably severe combined immunodeficiency syndrome, are also predominantly associated with T-cell defects. Of the remaining groups, children with acute leukemia seem to be most at risk from cryptosporidiosis. There is less evidence of severe complications in patients with other malignant diseases or in those receiving immunosuppressive chemotherapy.  N. Ref:: 132

 

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[50]

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

 

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[51]

TÍTULO / TITLE:  - Potential role of immune modulation in the effective long-term control of HIV-1 infection.

REVISTA / JOURNAL:  - J Biol Regul Homeost Agents 2002 Jan-Mar;16(1):83-90.

AUTORES / AUTHORS:  - Rizzardi GP; Lazzarin A; Pantaleo G

INSTITUCIÓN / INSTITUTION:  - MOLMED, Milan, Italy. paolo.rizzardi@molmed.it

RESUMEN / SUMMARY:  - Recent advances in HIV-1 pathogenesis, and in defining virological and immunological responses to highly active antiretroviral therapy (HAART), along with the identification of the numerous drawbacks of HAART, have clearly demonstrated that the eradication of the virus is not a feasible therapeutic goal, and that there is an urgent need to develop other approaches to fight HIV-1 infection. Novel therapeutic approaches of immune modulation have recently been evaluated in pilot clinical trials. First, treating primary HIV-1 infection with cyclosporin A (CsA) coupled with HAART to target massive immune activation extends the benefits achieved with HAART during primary HIV-1 infection and might contribute to the establishment of a more favourable immunological set-point affecting the ultimate pattern and rate of disease progression. Second, treating chronic HIV-1 infection in patients with long-term suppression of virus replication induced by HAART, with the addition of mycophenolate mofetil (MMF) reduces the pool of activated CD4+ T lymphocytes able to support productive HIV-1 infection, and might have an indirect impact on the pool of resting, latently infected CD4+ T cells, contributing to its depletion in vivo. The important question is clearly whether these results will have an impact on the clinical management of patients with HIV-1 infection, determining the precise therapeutic function of drugs like CsA and MMF, thus investigating the effects of these drugs on residual viral replication and the decay of the latent reservoir, on long-term immunological benefit, and, ultimately, on clinical benefit.  N. Ref:: 95

 

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[52]

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

 

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[53]

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

 

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[54]

TÍTULO / TITLE:  - Delayed renal allograft dysfunction and cystitis associated with human polyomavirus (BK) infection in a renal transplant recipient: a case report and review of literature.

REVISTA / JOURNAL:  - Clin Nephrol 2003 Dec;60(6):405-14.

AUTORES / AUTHORS:  - Gupta M; Miller F; Nord EP; Wadhwa NK

INSTITUCIÓN / INSTITUTION:  - Division of Nephrology, Department of Medicine, School of Medicine, State University of New York at Stony Brook, New York 11794, USA.

RESUMEN / SUMMARY:  - Human polyomavirus type BK (BKV) associated nephritis (BKVAN) has recently emerged as an important cause of renal allograft dysfunction and failure. Early recognition of this entity as a cause of allograft dysfunction is extremely important since misdiagnosis can accelerate graft loss. We report a case of BKVAN that presented with symptoms related to cystitis, and review the risk factors, the diagnostic tools and the approach to treatment of BK virus associated allograft nephropathy.  N. Ref:: 32

 

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[55]

TÍTULO / TITLE:  - Interactions between major histocompatibility complex class II surface expression and HIV: implications for pathogenesis.

REVISTA / JOURNAL:  - Eur J Clin Invest 2001 Nov;31(11):984-91.

AUTORES / AUTHORS:  - Kamp W; Breij EC; Nottet HS; Berk MB

INSTITUCIÓN / INSTITUTION:  - Fight for Life Foundation, Amsterdam, the Netherlands.

RESUMEN / SUMMARY:  - Although it has been almost 20 years since the first cases of acquired immunodeficiency syndrome (AIDS) were documented, the pathogenesis is still not completely understood. Interactions between major histocompatibility complex (MHC) Class I and human immunodeficiency virus (HIV), resulting in down-regulation of MHC-I surface expression, have been reported to contribute to pathogenesis by suppressing the host’s immune response. Interactions between MHC Class II and HIV have also been described, but it is unclear how these contribute to the pathogenesis. MHC-II surface expression on HIV-infected monocytes and monocytic cell lines has been described to be increased as well as decreased when compared to uninfected control monocytes. HIV-specific mechanisms appear to down-regulate MHC-II expression on blood monocytes during HIV-1 infection, whereas host mechanisms up-regulate MHC-II expression in response to infection of blood monocytes as well as brain macrophages. A balance between these two may determine MHC-II expression levels in individual patients. Altogether, HIV seems to be able to benefit from both low and high levels of MHC-II surface expression. The first results in reduced immune surveillance of the host, allowing the virus to replicate faster; the second increases infectivity of the virus as a result of higher MHC-II density on macrophages and virion particles.  N. Ref:: 68

 

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[56]

TÍTULO / TITLE:  - Treatment of gammaherpesvirus-related neoplastic disorders in the immunosuppressed host.

REVISTA / JOURNAL:  - Semin Hematol 2003 Apr;40(2):163-71.

      ●● Enlace al texto completo (gratuito o de pago) 1053/shem.2003.50016

AUTORES / AUTHORS:  - Little RF; Yarchoan R

INSTITUCIÓN / INSTITUTION:  - HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.

RESUMEN / SUMMARY:  - Neoplastic disease is a frequent complication in patients with acquired immunodeficiency disease (AIDS) and other immunodeficiencies. Many such neoplasms are caused by either Epstein-Barr virus (EBV) or Kaposi’s sarcoma-associated herpes virus (KSHV). The treatment of such patients can be challenging. At the same time, the viral origin of these tumors offers targets to develop pathogenesis-based therapies. Standard therapies for these diseases involve such approaches as treating the underlying immunodeficiency, cytotoxic chemotherapy, and immunologic antitumor therapy. Novel therapy approaches include specific immune therapy and anti-angiogenesis approaches, now under development.  N. Ref:: 105

 

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[57]

TÍTULO / TITLE:  - Some aspects of protozoan infections in immunocompromised patients- a review.

REVISTA / JOURNAL:  - Mem Inst Oswaldo Cruz. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://www.scielo.br/ 

      ●● Cita: Memorias do Instituto Oswaldo Cruz: <> 2002 Jun;97(4):443-57.

AUTORES / AUTHORS:  - Ferreira MS; Borges AS

INSTITUCIÓN / INSTITUTION:  - Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, 38400-027, Brasil. mferreira@nanet.com.br

RESUMEN / SUMMARY:  - Protozoa are among the most important pathogens that can cause infections in immunocompromised hosts. These microorganisms particularly infect individuals with impaired cellular immunity, such as those with hematological neoplasias, renal or heart transplant patients, patients using high doses of corticosteroids, and patients with acquired immunodeficiency syndrome. The protozoa that most frequently cause disease in immunocompromised patients are Toxoplasma gondii, Trypanosoma cruzi, different Leishmania species, and Cryptosporidium parvum; the first two species cause severe acute meningoencephalitis and acute myocarditis, Leishmania sp. causes mucocutaneous or visceral disease, and Cryptosporidium can lead to chronic diarrhea with hepatobiliary involvement. Various serological, parasitological, histological and molecular methods for the diagnosis of these infections are currently available and early institution of specific therapy for each of these organisms is a basic measure to reduce the morbidity and mortality associated with these infections.  N. Ref:: 163

 

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[58]

TÍTULO / TITLE:  - Immune therapy for EBV infections after hemopoietic stem-cell transplant.

REVISTA / JOURNAL:  - Cytotherapy 2002;4(5):433-4.

      ●● Enlace al texto completo (gratuito o de pago) 1080/146532402320776071

AUTORES / AUTHORS:  - Heslop HE; Bollard CM; Gottschalk S; Kuehnle I; Huls MH; Gee AP; Brenner MK; Rooney CM

INSTITUCIÓN / INSTITUTION:  - Center for Cell and Gene Therapy, Baylor College of Medicine, Houston TX 77030, USA.  N. Ref:: 12

 

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[59]

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

 

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[60]

TÍTULO / TITLE:  - Cytomegalovirus and transcriptional down-regulation of major histocompatibility complex class II expression.

REVISTA / JOURNAL:  - Semin Immunol 2001 Feb;13(1):11-8.

      ●● Enlace al texto completo (gratuito o de pago) 1006/smim.2001.0291

AUTORES / AUTHORS:  - Miller DM; Cebulla CM; Rahill BM; Sedmak DD

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, The Ohio State University College of Medicine and Public Health, Columbus, OH 43210, USA.

RESUMEN / SUMMARY:  - CD4(+)T lymphocytes are a significant component of the afferent and efferent arms of adaptive immunity and are critical for controlling viral infections. CD4(+)T lymphocytes secrete cytokines that augment CD8(+)T lymphocyte and B lymphocyte responses and directly inhibit viral replication. The interface between the CD4(+)T lymphocyte and virus is the major histocompatibility complex (MHC) class II molecule. Cytomegalovirus, a beta-herpesvirus, has evolved mechanisms for inhibiting MHC class II expression and thus escaping CD4(+)T lymphocyte immunosurveillance. Herein, we review cytomegalovirus-mediated down-regulation of inducible and constitutive MHC class II expression, while focusing on lesions that occur at the level of MHC class II transcription.  N. Ref:: 83

 

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[61]

TÍTULO / TITLE:  - Strongyloides stercoralis in the Immunocompromised Population.

REVISTA / JOURNAL:  - Clin Microbiol Rev. Acceso gratuito al texto completo a partir de 1 año de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://cmr.asm.org/ 

      ●● Cita: Clinical Microbiology Reviews: <> 2004 Jan;17(1):208-17.

AUTORES / AUTHORS:  - Keiser PB; Nutman TB

INSTITUCIÓN / INSTITUTION:  - Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.

RESUMEN / SUMMARY:  - Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk.  N. Ref:: 136

 

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[62]

TÍTULO / TITLE:  - Disseminated acanthamebiasis in a renal transplant recipient with osteomyelitis and cutaneous lesions: case report and literature review.

REVISTA / JOURNAL:  - Clin Infect Dis 2002 Sep 1;35(5):e43-9. Epub 2002 Aug 2.

AUTORES / AUTHORS:  - Steinberg JP; Galindo RL; Kraus ES; Ghanem KG

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21209, USA.

RESUMEN / SUMMARY:  - Disseminated acanthamebiasis is a rare disease that occurs predominantly in patients with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome but also in immunosuppressed transplant recipients. Few reports have focused on non-HIV-infected patients, in whom the disease is more likely to go unsuspected and undiagnosed before death. We describe a renal transplant recipient with Acanthamoeba infection and review the literature. The patient presented with osteomyelitis and widespread cutaneous lesions. No causative organism was identified before death, despite multiple biopsies with detailed histological analysis and culture. Disseminated Acanthamoeba infection was diagnosed after death, when cysts were observed in histological examination of sections of skin from autopsy, and trophozoites were found in retrospectively reviewed skin biopsy and surgical bone specimens. In any immunosuppressed patient, skin and/or bone lesions that fail to show improvement with broad-spectrum antibiotic therapy should raise the suspicion for disseminated acanthamebiasis. Early recognition and treatment may improve clinical outcomes.  N. Ref:: 32

 

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[63]

TÍTULO / TITLE:  - Management of Epstein-Barr virus-induced post-transplant lymphoproliferative disease in recipients of solid organ transplantation.

REVISTA / JOURNAL:  - Am J Transplant 2001 Jul;1(2):103-8.

AUTORES / AUTHORS:  - Green M

INSTITUCIÓN / INSTITUTION:  - University of Pittsburgh School of Medicine, Division of Allergy, Immunology and Infectious Diseases, Children’s Hospital of Pittsburgh, PA 15213, USA. greenm@chplink.chp.edu

RESUMEN / SUMMARY:  - The optimal management of Epstein-Barr virus (EBV)-induced post-transplant lymphoproliferative diseases (PTLD) remains controversial. While withdrawal or reduction of immunosuppression is widely accepted as the strategy for the treatment of EBV/PTLD, the role of additional therapeutic interventions remains less clear. Newer strategies, including anti-B-cell monoclonal antibodies and adoptive immunotherapy offer the promise of impaired efficacy and outcome against EBV disease, but lack data demonstrating how and when to use these approaches. The current review provides an overview of potential strategies and presents guidelines for the management of EBV/PTLD in solid-organ transplant recipients.  N. Ref:: 20

 

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[64]

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

 

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[65]

TÍTULO / TITLE:  - Scedosporium apiospermum pneumonia and sternal wound infection in a heart transplant recipient.

REVISTA / JOURNAL:  - Transplantation 2002 Dec 15;74(11):1645-7.

      ●● Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000038746.35254.A4

AUTORES / AUTHORS:  - Talbot TR; Hatcher J; Davis SF; Pierson RN 3rd; Barton R; Dummer S

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.

RESUMEN / SUMMARY:  - BACKGROUND: The most common fungi that cause invasive infection in transplant recipients are the spp, spp, and the endemic fungi such as and. Recently, however, other fungal pathogens have emerged as important causes of invasive disease in these immunocompromised individuals, including the dematiaceous fungi, such as and the spp, species of and, and the hyalohyphomycoses, such as (Pseudallescheria boydii) (1). METHODS: We present a single patient case report and literature review. RESULTS: We illustrate the first reported case of a postoperative sternal wound infection and pneumonia caused by in a heart transplant recipient and review the significant clinical, microbiologic, and therapeutic aspects of infection with this important opportunistic pathogen. CONCLUSIONS: Postsurgical wound infection should be added to the growing list of infections in the transplant population caused by.  N. Ref:: 10

 

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[66]

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

 

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[67]

TÍTULO / TITLE:  - Impaired regulation of HLA-DR expression in human immunodeficiency virus-infected monocytes.

REVISTA / JOURNAL:  - Clin Diagn Lab Immunol. Acceso gratuito al texto completo a partir de los 6 meses de la fecha de publicación.

      ●● Enlace a la Editora de la Revista http://cdli.asm.org/contents-by-date.0.shtml 

      ●● Cita: Clin Diagn Lab Immunol: <> 2002 Jul;9(4):739-46.

AUTORES / AUTHORS:  - Shao L; Sperber K

INSTITUCIÓN / INSTITUTION:  - Division of Clinical Immunology, Mount Sinai School of Medicine, New York, New York 10029, USA.  N. Ref:: 89

 

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[68]

TÍTULO / TITLE:  - Inhibition of the MHC class II antigen presentation pathway by human cytomegalovirus.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2002;269:101-15.

AUTORES / AUTHORS:  - Johnson DC; Hegde NR

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97201, USA.

RESUMEN / SUMMARY:  - Human cytomegalovirus (HCMV) causes serious disease in immunocompromised individuals. Normally, anti-HCMV immune response controls virus replication following reactivation from latency. However, HCMV, like other large herpesviruses, encodes immune evasion proteins that allow the virus to replicate, for a time or in specific tissues, and produce viral progeny in the face of robust host immunity. HCMV glycoproteins US2, US3, US6 and US11 all inhibit different stages of the MHC class I antigen presentation pathway and can reduce recognition by CD8+ T lymphocytes. Here, we discuss two novel inhibitors of the MHC class II antigen presentation pathway, HCMV glycoproteins US2 and US3. Both US2 and US3 can inhibit presentation of exogenous protein antigens to CD4+ T lymphocytes in in vitro assays. US2 causes degradation of MHC class II molecules: HLA-DR-alpha and HLA-DM-alpha, as well as class I heavy chain (HC), but does not affect DR-beta or DM-beta chains. Mutant forms of US2 have been constructed that can bind to DR-alpha and class I HC but do not cause their degradation, separating the binding step from other processes that precede degradation. We also found evidence that US2-induced degradation of class I and II proteins involves a cellular component, other than Sec61, that is limiting in quantity. Unlike US2, US3 binds newly synthesized class II alpha/beta complexes, reducing the association with the invariant chain (Ii) and causing mislocalization of class II complexes in cells. US3 expression reduces accumulation of class II complexes in peptide-loading compartments and loading of peptides. Since US2 and US3 are expressed solely within HCMV-infected cells, it appears that these viral proteins have evolved to inhibit presentation of endogenous, intracellular viral antigens to anti-HCMV CD4+ T cells. This is different from how the MHC class II pathway is normally viewed, as a pathway for presentation of exogenous, extracellular proteins. The existence of these proteins indicates the importance of class II-mediated presentation of endogenous antigens in signalling virus infection to CD4+ T cells.  N. Ref:: 57

 

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[69]

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

 

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[70]

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

 

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[71]

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

 

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[72]

TÍTULO / TITLE:  - Evasion of the immune system by adenoviruses.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;273:3-28.

AUTORES / AUTHORS:  - Blair GE; Blair-Zajdel ME

INSTITUCIÓN / INSTITUTION:  - School of Biochemistry and Molecular Biology, University of Leeds, Leeds, LS2 9JT, UK. g.e.blair@leeds.ac.uk

RESUMEN / SUMMARY:  - Human adenoviruses (Ads) have the ability to transform primary cells, and certain Ads, the subgenus A adenoviruses such as Ad12, induce tumours in immunocompetent rodents. The oncogenic phenotype of the subgenus A adenoviruses is determined by the viral E1A oncogene. In order to generate tumours, Ad12-transformed cells must evade the cellular immune system of the host. Ad12 E1A gene products mediate transcriptional repression of several genes in the major histocompatibility complex (MHC) involved in antigen processing and presentation, resulting in evasion of cytotoxic T lymphocyte (CTL) killing of transformed cells. In this review, the molecular mechanisms of E1A-mediated transcriptional repression of MHC gene expression are described. In addition, evasion of natural killer (NK) cell killing by Ad-transformed cells is also considered.  N. Ref:: 110

 

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[73]

TÍTULO / TITLE:  - A survival game of hide and seek: cytomegaloviruses and MHC class I antigen presentation pathways.

REVISTA / JOURNAL:  - Viral Immunol 2003;16(3):231-42.

      ●● Enlace al texto completo (gratuito o de pago) 1089/088282403322396064

AUTORES / AUTHORS:  - Basta S; Bennink JR

INSTITUCIÓN / INSTITUTION:  - Laboratory of Viral Diseases, NIAID, NIH, Bethesda, Maryland 20892-0440, USA.

RESUMEN / SUMMARY:  - Cytomegaloviruses (CMV) are members of the ubiquitous family of herpesviruses, which escape immunological clearance and persist throughout life in the infected host. Cytomegaloviruses have developed numerous strategies that permit them to co-exist with their host even as an anti-virus immune response endangers their long-term survival. A considerable number of these strategies are aimed at MHC class I presentation of viral proteins to CD8+ T cells (TCD8+ ). Although the gamut of CMV immune evasion will be briefly examined, the primary focus of this review is on the host ability to counteract the strategies developed by CMV to inhibit antigen processing and presentation. A primary mechanism used by the immune system is the recognition of very early virus proteins including recognition of the immunomodulatory proteins themselves. We further speculate that cross-presentation of antigen is an adaptive immune response to the inhibition of direct presentation. Other mechanisms, such as the evolution of pAPC subsets, may also allow the immune system to adapt to a variety of different infectious pathogens while preventing cytopathic infection of all pAPCs.  N. Ref:: 85

 

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[74]

TÍTULO / TITLE:  - Human herpesvirus 6: relevance of infection in the immunocompromised host.

REVISTA / JOURNAL:  - Br J Haematol 2003 Feb;120(3):384-95.

AUTORES / AUTHORS:  - Clark DA; Griffiths PD

INSTITUCIÓN / INSTITUTION:  - Department of Virology, Royal Free and University College Medical School of UCL, Royal Free Campus, London, UK. d.clark@rfc.ucl.ac.uk  N. Ref:: 123

 

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[75]

TÍTULO / TITLE:  - Prevention of fungal infections in the immunocompromised host.

REVISTA / JOURNAL:  - Curr Opin Investig Drugs 2003 Aug;4(8):974-90.

AUTORES / AUTHORS:  - Mahfouz T; Anaissie E

INSTITUCIÓN / INSTITUTION:  - Myeloma Institute for Research and Treatment, Arkansas Cancer Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. mahfouztahsine@uams.edu

RESUMEN / SUMMARY:  - The incidence and severity of invasive fungal infections have significantly increased among immunocompromised hosts leading to excessive morbidity and mortality. Several preventative antifungal strategies (prophylaxis, empirical and pre-emptive) have been developed to improve the outcome of these infections. Although effective, these strategies are associated with toxicity, high cost and potential emergence of resistance. An alternative strategy, in the attempt to optimize the use of antifungal agents in preventing fungal infections, is a risk-adjusted approach based on the risk for, and severity of, infection in a given patient. This strategy has the potential to provide patients likely to suffer severe fungal infection the benefits of antifungal agents while avoiding the negative aspects (toxicity, cost and risk of resistance) in patients at low risk for these infections. In this review we focus on this strategy in cancer patients but it may also be applied to other immunocompromised hosts.  N. Ref:: 143

 

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[76]

TÍTULO / TITLE:  - Retroviral oncogenes and TOR.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;279:321-38.

AUTORES / AUTHORS:  - Aoki M; Vogt PK

INSTITUCIÓN / INSTITUTION:  - Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, BCC-239, La Jolla, CA 92037, USA.

RESUMEN / SUMMARY:  - Retroviruses have recruited the catalytic subunit of PI 3-kinase and its downstream target, Akt, as oncogenes. These viruses cause tumors in animals and induce oncogenic transformation in cell culture. The oncogenicity of these viruses is specifically inhibited by rapamycin; retroviruses carrying other oncogenes are insensitive to this macrolide antibiotic. Rapamycin is an inhibitor of the TOR (target of rapamycin) kinase whose downstream targets include p70 S6 kinase and the negative regulator of translation initiation 4E-BP. Emerging evidence suggests that the TOR signals transmitted to the translational machinery are essential for oncogenic transformation by the PI 3-kinase pathway.  N. Ref:: 93

 

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[77]

TÍTULO / TITLE:  - MHC class I up-regulation by flaviviruses: Immune interaction with unknown advantage to host or pathogen.

REVISTA / JOURNAL:  - Immunol Cell Biol 2003 Jun;81(3):217-23.

AUTORES / AUTHORS:  - Lobigs M; Mullbacher A; Regner M

INSTITUCIÓN / INSTITUTION:  - Division of Immunology and Genetics, John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia. Mario.Lobigs@anu.edu.au

RESUMEN / SUMMARY:  - In contrast to many other viruses that escape from cytotoxic T cell recognition by down-regulating major histocompatibility complex class I-restricted antigen presentation, flavivirus infection of mammalian cells up-regulates cell surface expression of major histocompatibility complex class I molecules. Two putative mechanisms for flavivirus-induced major histocompatibility complex class I up-regulation, one via activation of the transcription factor NF-kappaB, the second by augmentation of peptide import into the lumen of the endoplasmic reticulum, are reviewed, and the biological effect of the flavivirus-mediated phenomenon on target cell recognition by natural killer and cytotoxic T cells is addressed. Finally, we speculate on the physiological role of flavivirus-mediated modulation of major histocompatibility complex class I antigen presentation in the context of the biology of flavivirus transmission between the vertebrate host and arthropod vector and suggest that it may represent a strategy for immune evasion from the natural killer cell response or, alternatively, that up-regulation of major histocompatibility complex class I is a by-product of flavivirus replication without significance for virus growth.  N. Ref:: 75

 

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[78]

TÍTULO / TITLE:  - Human cytomegalovirus inhibition of major histocompatibility complex transcription and interferon signal transduction.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2002;269:153-70.

AUTORES / AUTHORS:  - Miller DM; Cebulla CM; Sedmak DD

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, Ohio State University College of Medicine, 1645 Neil Avenue, Room 129, Columbus, OH 43210, USA.

RESUMEN / SUMMARY:  - Pathogens have evolved diverse mechanisms for escaping host innate and adaptive immunity. Viruses that maintain a persistent infection are particularly effective at disabling key arms of the host immune response. For example, the herpesviruses establish a persistent infection in human and animal hosts, in part through critical immunoevasive strategies. Cytomegalovirus, a beta-herpesvirus, impairs major histocompatibility complex (MHC) class I and class II antigen presentation by decreasing MHC expression on the surface of the infected cell, thus enabling infected cells to escape CD8+ and CD4+ T lymphocyte immunosurveillance. Moreover, cytomegalovirus blocks the interferon signal transduction pathway, thereby limiting the direct and indirect antiviral effects of the interferons. In this review, we focus on an emerging paradigm in which the effectiveness of viruses, particularly human cytomegalovirus, to escape antiviral immune responses is significantly enhanced by their ability to inhibit MHC transcription and interferon (IFN)-stimulated (JAK/STAT) signal transduction.  N. Ref:: 93

 

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[79]

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

 

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[80]

TÍTULO / TITLE:  - Current and future approaches to antimycotic treatment in the era of resistant fungi and immunocompromised hosts.

REVISTA / JOURNAL:  - Int J Antimicrob Agents 2001 Feb;17(2):81-91.

AUTORES / AUTHORS:  - Bastert J; Schaller M; Korting HC; Evans EG

INSTITUCIÓN / INSTITUTION:  - Klinik und Poliklinik fur Dermatologie und Allergologie der Ludwig-Maximilians-Universitat Munchen, Frauenlobstr. 9-11, 80337, Munchen, Germany.

RESUMEN / SUMMARY:  - Due to the ever-increasing number of immunocompromised patients, both localised and life-threatening systemic fungal infections are on the increase. Conventional treatment is of limited help, not in the least due to a less optimum benefit-to-risk ratio. Moreover, emerging pathogens with reduced antimicrobial susceptibility and the development of resistance in Candida albicans form a new challenge. Fortunately, conventional antimycotics have been improved and entirely new ones are on the horizon as well as alternative approaches such as immunoreconstitution.  N. Ref:: 101

 

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[81]

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

 

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[82]

TÍTULO / TITLE:  - TAP-independent antigen presentation on MHC class I molecules: lessons from Epstein-Barr virus.

REVISTA / JOURNAL:  - Microbes Infect 2003 Apr;5(4):291-9.

AUTORES / AUTHORS:  - Lautscham G; Rickinson A; Blake N

INSTITUCIÓN / INSTITUTION:  - Max Delbrueck Centrum for Molecular Medicine, 13125 Berlin, Germany.

RESUMEN / SUMMARY:  - For recognition by CD8(+) lymphocytes, peptides derived from cytosolically processed antigen need to access MHC class I molecules en route to the target cell surface. This normally requires peptide transport into the endoplasmic reticulum via the transporter associated with antigen presentation (TAP) complex. However, as recent work with Epstein-Barr virus illustrates, TAP-independent presentation pathways also exist and are growing in number.  N. Ref:: 50

 

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[83]

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

 

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[84]

TÍTULO / TITLE:  - Reactivation of replication of hepatitis B and C viruses after immunosuppressive therapy: an unresolved issue.

REVISTA / JOURNAL:  - Lancet Oncol 2002 Jun;3(6):333-40.

AUTORES / AUTHORS:  - Vento S; Cainelli F; Longhi MS

INSTITUCIÓN / INSTITUTION:  - Section of Infectious Diseases, Department of Pathology, University of Verona, Borgo Trento Hospital, Verona, Italy. ventosandro@yahoo.it

RESUMEN / SUMMARY:  - The liver is susceptible to the toxic effects of many cytotoxic or immunosuppressive treatments. However, in carriers of hepatitis B virus (HBV) and, less frequently, of hepatitis C virus, liver damage due to reactivation of viral replication can occur after withdrawal of immunosuppressive drugs. These reactivations, which are associated with fulminant forms of hepatitis in up to 25% of cases, are observed both in symptom-free chronic carriers of hepatitis B surface antigen and in patients who have chronic hepatitis B or C and concurrent haematological tumours or solid neoplasms or who have received transplants. HBV-related complications may cause delays or modifications of therapy, and the chance of cure is reduced. In this review, we analyse clinical, biochemical, and serological issues in reactivation of viral replication and examine the role of immune reactions in the pathogenesis and the possible toxicity of immunosuppressive drugs. We emphasise the importance of identifying predictive markers of a clinically relevant reactivation, review difficulties in drug prevention and treatment, indicate studies that are needed to address the key clinical issues, and give practical recommendations to practising physicians and oncologists.  N. Ref:: 60

 

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[85]

TÍTULO / TITLE:  - Hepatitis B virus (HBV) reactivation after cytotoxic or immunosuppressive therapy—pathogenesis and management.

REVISTA / JOURNAL:  - Rev Med Virol 2001 Sep-Oct;11(5):287-99.

      ●● Enlace al texto completo (gratuito o de pago) 1002/rmv.322 [pii]

AUTORES / AUTHORS:  - Xunrong L; Yan AW; Liang R; Lau GK

INSTITUCIÓN / INSTITUTION:  - University Department of Medicine, Queen Mary Hospital, 102 Pokfulum Road, Hong Kong SAR, China.

RESUMEN / SUMMARY:  - In an endemic area for chronic hepatitis B infection, reactivation of this virus is a serious cause of morbidity and mortality in patients undergoing cytotoxic or immunosuppressive therapy. Careful prospective serological testing has shown that hepatitis B virus reactivation is a two-staged process. The initial stage occurs during intense cytotoxic or immunosuppressive therapy and is characterised by enhanced viral replication, as reflected by increases in the serum levels of hepatitis B virus DNA, hepatitis B e antigen, hepatitis B virus DNA polymerase and infection of naive hepatocytes with hepatitis B virus. The second stage is related to restoration of immune function following withdrawal of cytotoxic or immunosuppressive therapy, which causes rapid immune-mediated destruction of infected hepatocytes. Clinically, this can lead to hepatitis, hepatic failure and even death. The occurrence and severity of hepatitis B virus reactivation after various cytotoxic or immunosuppressive therapy is unpredictable and treatment has been disappointing, largely due to the late administration of therapy. Recently, pre-emptive treatment of chronic hepatitis B patients undergoing cytotoxic or immunosuppressive therapy, with potent nucleoside analogues has shown some promising results. Further controlled studies are needed to define the incidence and risk factors of hepatitis B reactivation so that pre-emptive treatment with nucleoside analogues could be administered to those patients at high risk of disease.  N. Ref:: 93

 

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[86]

TÍTULO / TITLE:  - Human cytomegalovirus and natural killer-mediated surveillance of HLA class I expression: a paradigm of host-pathogen adaptation.

REVISTA / JOURNAL:  - Immunol Rev 2001 Jun;181:193-202.

AUTORES / AUTHORS:  - Lopez-Botet M; Llano M; Ortega M

INSTITUCIÓN / INSTITUTION:  - Universitat Pompeu Fabra, CEXS, Barcelona, España. miguel.lopez-botet@cexs.upf.es

RESUMEN / SUMMARY:  - Among various strategies to evade the host immune response, some viruses like human cytomegalovirus (HCMV) interfere with surface MHC class I expression and antigen presentation to T lymphocytes. The ability of natural killer (NK) cells to detect MHC class I molecules through inhibitory receptors can be envisaged as an adaptation of the immune system for responding to such pathological alterations. To fulfil that role, rodents use members of the Ly49 C-type lectin superfamily, whereas primates employ killer immunoglobulin-like receptors and the immunoglobulin-like transcript 2/leucocyte immunoglobulin-like receptor-1 receptor. CD94/NKG2 lectin-like heterodimers represent the most conserved receptor system for MHC class I molecules; by interacting with human HLA-E or murine Qa-1b, CD94/NKG2A inhibitory receptors broadly probe the biosynthesis pathway of other class I molecules. Reciprocally, HCMV has developed mechanisms to evade the NK response while modulating HLA class Ia expression. The ability of HCMV to maintain surface levels of HLA-E and to express an HLA class I surrogate (UL18) are herein discussed in the context of the interplay with human NKR systems.  N. Ref:: 102

 

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[87]

TÍTULO / TITLE:  - The impact of human herpesvirus-6 and -7 infection on the outcome of liver transplantation.

REVISTA / JOURNAL:  - Liver Transpl 2002 Aug;8(8):651-8.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jlts.2002.34966

AUTORES / AUTHORS:  - Razonable RR; Paya CV

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.

RESUMEN / SUMMARY:  - Human herpesvirus (HHV)-6 and -7 are novel members of the beta-herpesvirus family that maintain latency in the human host after primary infection. Reactivation from latency and/or increased degree of viral replication occurs during periods of immune dysfunction. The clinical effect of HHV-6 and HHV-7 reactivation in recipients of liver transplants is now being recognized. Clinical illnesses such as fever, rash, pneumonitis, encephalitis, hepatitis, and myelosuppression have been described in a number of anecdotal reports. Moreover, a growing body of evidence suggests that the more important effect of HHV-6 and HHV-7 reactivation on the outcomes of liver transplantation may be mediated indirectly by their interactions with the other beta-herpesvirus-cytomegalovirus (CMV). Coinfection among these three beta-herpesviruses in clinical syndromes that were classically ascribed to be solely caused by CMV has been shown and has raised substantial interest in the potential role of HHV-6 and HHV-7 as copathogens in the direct and indirect illnesses caused by CMV. This article reviews the current scientific data on the role and the magnitude of impact of HHV-6 and HHV-7 infection on the outcomes of liver transplantation.  N. Ref:: 66

 

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[88]

TÍTULO / TITLE:  - The involvement of class Ib molecules in the host response to infection with Salmonella and its relevance to autoimmunity.

REVISTA / JOURNAL:  - Microbes Infect 2001 Nov-Dec;3(14-15):1249-59.

AUTORES / AUTHORS:  - Soloski MJ; Metcalf ES

INSTITUCIÓN / INSTITUTION:  - Division of Rheumatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA. mski@jhmi.edu

RESUMEN / SUMMARY:  - Class I molecules with limited polymorphism have been implicated in the host response to infectious agents. Following infection with Salmonella typhimurium, mice develop a CD8+ CTL response that specifically recognizes bacteria infected cells. An immunodominant component of the CTL response recognizes a peptide epitope derived from the Salmonella GroEL molecule that is presented by the non-polymorphic MHC class Ib molecule Qa-1. T cells recognizing the bacterial peptide also cross-recognize a homologous peptide from the mammalian hsp60 molecule. Since Qa-1 has a functional equivalent in humans, this observation may be relevant not only to the host response involved in clearing infection but also in understanding the link between infection with Gram-negative pathogens and autoimmune disease.  N. Ref:: 120

 

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[89]

TÍTULO / TITLE:  - Viral infections and their impact on chronic renal allograft dysfunction.

REVISTA / JOURNAL:  - Transplantation 2001 Jun 15;71(11 Suppl):SS24-30.

AUTORES / AUTHORS:  - Soderberg-Naucler C; Emery VC

INSTITUCIÓN / INSTITUTION:  - Karolinska Institute, Huddinge, Sweden.

RESUMEN / SUMMARY:  - Viral infections, particularly those involving HCMV, are an important complication of renal transplantation. Transplantation protocols and treatment regimens that increase HCMV infection and disease may promote the development of CRAD and impair long-term renal allograft survival. Investigators are beginning to illuminate the mechanisms by which HCMV infection may cause chronic rejection in general and transplant vascular sclerosis in particular. Migration and proliferation of SMCs within the intimal layer of blood vessels is an important component of transplant vascular sclerosis, and HCMV appears to facilitate both of these processes. Current management strategies for HCMV focus on prevention, either using a focal preemptive therapeutic approach or by administering antiviral therapies to all or at-risk patients.  N. Ref:: 74

 

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[90]

TÍTULO / TITLE:  - E1A-based determinants of oncogenicity in human adenovirus groups A and C.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2004;273:245-88.

AUTORES / AUTHORS:  - Williams JF; Zhang Y; Williams MA; Hou S; Kushner D; Ricciardi RP

INSTITUCIÓN / INSTITUTION:  - Department of Biological Sciences, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, PA 15213, USA. jfw1@andrew.cmu.edu

RESUMEN / SUMMARY:  - A broad spectrum of genetic and molecular investigations carried out with group C, Ad2 and Ad5, and with group A, Ad12, have shown that early region1 (E1) gene products are sufficient for complete transformation of rodent cells in vitro by these viruses. During the past quarter century, the processes by which E1A proteins, in cooperation with E1B proteins, perturb the cell cycle and induce the transformed phenotype, have become well defined. Somewhat less understood is the basis for the differential oncogenicity of these two groups of viruses, and the processes by which the E1A proteins of Ad12 induce a tumorigenic phenotype in transformants resulting from infection of cells in vivo and in vitro. In this chapter we review previous findings and present new evidence which demonstrates that Ad12 E1A possesses two or more independent functions enabling it to induce tumors. One of these functions lies in its capacity to repress transcription of MHC class I genes, allowing the tumor cells to avoid lysis by cytotoxic T lymphocytes. We have shown that class I repression is mediated through increased binding of repressor COUP-TF and decreased binding of NF-kB to the class I enhancer. In addition to mediating immune escape, E1A also determines the susceptibility of transformants to Natural Killer (NK) cell lysis, and in this case, also, Ad12 transformants are not susceptible. By using Ad12 mutants containing chimeric E1A Ad12-Ad5 genes, point mutations, or a specific deletion, we have shown that the unique spacer region of Ad12 E1A is an oncogenic determinant, but is not required for transformation in vitro. Given that the E1A regions responsible for class I repression are first exon encoded, we have examined a set of cell lines transformed by these altered viruses, and have found that while they display greatly reduced tumorigenicity, they maintain a wildtype capacity to repress class I transcription. Whether the spacer contributes to NK evasion remains unresolved. Lastly, we discuss the properties of the Ad2/Ad5 E1A C-terminal negative modulator of tumorigenicity, and examine the effects on transformation, tumor induction and transformant tumorigenicity, when the Ad5 negative modulator is placed by chimeric construction in Ad12 E1A.  N. Ref:: 104

 

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[91]

TÍTULO / TITLE:  - The influence of HLA genotype on AIDS.

REVISTA / JOURNAL:  - Annu Rev Med 2003;54:535-51. Epub 2001 Dec 3.

      ●● Enlace al texto completo (gratuito o de pago) 1146/annurev.med.54.101601.152346

AUTORES / AUTHORS:  - Carrington M; O’Brien SJ

INSTITUCIÓN / INSTITUTION:  - Basic Research Program, SAIC-Frederick, Inc, National Cancer Institute, Frederick, Maryland 21702, USA. carringt@ncifcrf.gov

RESUMEN / SUMMARY:  - Genetic resistance to infectious diseases is likely to involve a complex array of immune-response and other genes with variants that impose subtle but significant consequences on gene expression or protein function. We have gained considerable insight into the genetic determinants of HIV-1 disease, and the HLA class I genes appear to be highly influential in this regard. Numerous reports have identified a role for HLA genotype in AIDS outcomes, implicating many HLA alleles in various aspects of HIV disease. Here we review the HLA associations with progression to AIDS that have been consistently affirmed and discuss the underlying mechanisms behind some of these associations based on functional studies of immune cell recognition.  N. Ref:: 97

 

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[92]

TÍTULO / TITLE:  - Plasmodium vivax malaria complicated by hemophagocytic syndrome in an immunocompetent serviceman.

REVISTA / JOURNAL:  - Am J Hematol 2003 Oct;74(2):127-30.

      ●● Enlace al texto completo (gratuito o de pago) 1002/ajh.10390

AUTORES / AUTHORS:  - Park TS; Oh SH; Choi JC; Kim HH; Chang CL; Son HC; Lee EY

INSTITUCIÓN / INSTITUTION:  - Department of Laboratory Medicine, College of Medicine, Pusan National University, Busan, Korea.

RESUMEN / SUMMARY:  - We describe a 23-year-old retired military officer who was immunocompetent but diagnosed with hemophagocytic syndrome (HPS) by Plasmodium vivax infection. Initially, the patient was suspected to have toxic hepatitis related to heavy drinking. But abnormal hematologic findings required a further bone marrow examination and the diagnosis of HPS was made. Antimalarial chemotherapy then brought complete remission. Plasmodium falciparum, a species causing more severe malarial infection, was listed as one of the major causes of HPS. However, P. vivax was not mentioned, and only one case was reported in the literature. In this study, we suggest that P. vivax malaria should be included in the differential diagnosis of HPS, even in an immunocompetent person.  N. Ref:: 9

 

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[93]

TÍTULO / TITLE:  - Human monocytic ehrlichiosis: an emerging pathogen in transplantation.

REVISTA / JOURNAL:  - Transplantation 2001 Jun 15;71(11):1678-80.

AUTORES / AUTHORS:  - Tan HP; Stephen Dumler J; Maley WR; Klein AS; Burdick JF; Fred Poordad F; Thuluvath PJ; Markowitz JS

INSTITUCIÓN / INSTITUTION:  - Department of Surgery, Johns Hopkins Hospital, Harvey 611, 600 N Wolfe Street, Baltimore, MD 21287-8611, USA.

RESUMEN / SUMMARY:  - BACKGROUND: The spectrum of disease caused by Ehrlichia spp. ranges from asymptomatic to fatal. Awareness and early diagnosis of the infection is paramount because appropriate therapy leads to rapid defervescence and cure. If left untreated, particularly in immunosuppressed patients, ehrlichioses may result in multi-system organ failure and death. METHODS: We report the second case of human monocytic ehrlichiosis (HME) in a liver transplant recipient, and review the literature. RESULTS: The patient presented with fever and headache, had negative cultures, and despite broad-spectrum antimicrobial coverage appeared progressively septic. After eliciting a history of tick exposure we treated the patient empirically with doxycycline. The diagnosis of HME was confirmed by 1) polymerase chain reaction (PCR) for Ehrlichia chaffeensis, 2) acute and convalescent serum titers, and 3) in vitro cultivation of E chaffeensis from peripheral blood. CONCLUSION: Although human ehrlichioses are relatively uncommon, they are emerging as clinically significant arthropod-borne infections. Although epidemiological exposure is responsible for infection, immunosuppression makes patients more likely to succumb to disease. A high index of suspicion and early treatment results in a favorable outcome.  N. Ref:: 13

 

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[94]

TÍTULO / TITLE:  - Characteristics of poliovirus strains from long-term excretors with primary immunodeficiencies.

REVISTA / JOURNAL:  - Dev Biol (Basel) 2001;105:75-80.

AUTORES / AUTHORS:  - Minor P

INSTITUCIÓN / INSTITUTION:  - National Institute for Biological Standards and Control, Potters Bar, UK.

RESUMEN / SUMMARY:  - Individuals who are deficient in humoral immunity are particularly at risk from infection with enteroviruses, and poliovirus in particular, where antibodies are the main source of protection from disease. Long-term excretion of vaccine strains of poliovirus has been documented for many years and instances of paralytic poliomyelitis in hypogammaglobulinaemic patients who were subsequently found to have been excreting virus for prolonged periods have been reported in the U.S.A., Germany and Japan. The identification of a healthy immunodeficient patient in the U.K. who has probably been excreting type 2 poliovirus for 15 years will be described, with the characteristics of the virus and the results of attempts at treatment so far. Such individuals pose a significant risk to the eradication programme unless they can be identified and treated.  N. Ref:: 12

 

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[95]

TÍTULO / TITLE:  - Role of bacteria and HLA-B27 in the pathogenesis of reactive arthritis.

REVISTA / JOURNAL:  - Rheum Dis Clin North Am 2003 Feb;29(1):21-36, v-vi.

AUTORES / AUTHORS:  - Yu D; Kuipers JG

INSTITUCIÓN / INSTITUTION:  - Division of Rheumatology, University of California at Los Angeles, 35-40 Rehab Center, 1000 Veterans Avenue, Los Angeles, CA 90095, USA. dtyyu@ucla.edu

RESUMEN / SUMMARY:  - Strictly speaking, “reactive arthritis” is a conventional term with no study-verified definition. This review will focus on the type of arthritis that is induced by the following species: Chlamydia, Shigella, Salmonella, Yersinia, and Campylobacter. The types of arthritis caused by these pathogens share a clinical pattern that is common in the spondyloarthropathies, especially undifferentiated spondyloarthropathy and Reiter’s syndrome. All these diseases, including ankylosing spondylitis, must also share major pathogenetic pathways.  N. Ref:: 41

 

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[96]

TÍTULO / TITLE:  - Bacillus sphaericus bacteraemia in children with cancer: case reports and literature review.

REVISTA / JOURNAL:  - J Hosp Infect 2001 Jun;48(2):142-5.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jhin.2001.0995

AUTORES / AUTHORS:  - Castagnola E; Fioredda F; Barretta MA; Pescetto L; Garaventa A; Lanino E; Micalizzi C; Giacchino R; Dini G

INSTITUCIÓN / INSTITUTION:  - Infectious Diseases Unit, G. Gaslini Children’s HospitaL, Genoa, Italy. eliocastagnola@ospedale-gaslini.ge.it

RESUMEN / SUMMARY:  - In the period 1989-1999, Bacillus sphaericus was demonstrated to cause 12 out of 469 (2%) episodes of bacteraemia in children with cancer or receiving bone marrow transplant at G. Gaslini Children’s Hospital, Genoa, Italy. Neutropenia was present in five episodes, six episodes, (all without neutropenia) were related to the presence of a central venous catheter, and one episode occurred in a patient with intestinal graft vs. host disease and gut colonization. All patients survived. Ciprofloxacin was the only drug active against all the isolated strains.Bacillus sphaericus represents a new cause of infection in the immunocompromised host, with low aggressiveness, but a peculiar pattern of antibiotic susceptibility.  N. Ref:: 10

 

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[97]

TÍTULO / TITLE:  - Teaching old drugs new tricks: reincarnating immunosuppressants as antifungal drugs.

REVISTA / JOURNAL:  - Curr Opin Investig Drugs 2003 Feb;4(2):192-9.

AUTORES / AUTHORS:  - Blankenship JR; Steinbach WJ; Perfect JR; Heitman J

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Genetics and Microbiology, Duke University Medical Center, Research Drive, Durham, NC 27710, USA.

RESUMEN / SUMMARY:  - Invasive fungal infections are rising worldwide as the number of immunocompromised patients increases. Unfortunately, our armamentarium of antifungal drugs is limited. Although current therapies are effective in treating some of the most prevalent infections, the development of novel treatments is vital because of emerging drug-resistant strains and species and because of the toxicity of certain current therapies. The immunosuppressive drugs CsA (cyclosporin A), FK-506 (tacrolimus) and rapamycin (sirolimus) exert potent antifungal effects against a variety of pathogenic fungi. These compounds are all currently in clinical use as immunosuppressive therapy to treat and prevent rejection of transplanted organs. Rapamycin is also in clinical trials as an antiproliferative agent for chemotherapy and invasive cardiology. Recent studies reveal a potent fungicidal synergism between azoles and the calcineurin inhibitors CsA and FK-506, and animal studies demonstrate that the CsA-fluconazole synergistic combination has therapeutic benefit. Less immunosuppressive analogs have been identified with potential to enhance current therapies, or as monotherapy without deleterious effects on the immune system. In summary, these highly successful pharmaceutical agents may find an even broader clinical application in combating infectious diseases.  N. Ref:: 74

 

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[98]

TÍTULO / TITLE:  - Alternariosis after liver transplantation.

REVISTA / JOURNAL:  - Transplantation 2001 Dec 15;72(11):1840-3.

AUTORES / AUTHORS:  - Benito N; Moreno A; Puig J; Rimola A

INSTITUCIÓN / INSTITUTION:  - Institut Clinic d’ Infeccions i Inmunologia, IDIBAPS, Hospital Clinic, Universitat de Barcelona, España. nbenito@clinic.ub.es

RESUMEN / SUMMARY:  - Alternaria is a saprophytic fungus that is increasingly recognized as a human pathogen, particularly in immunocompromised hosts, including solid-organ transplant recipients. Although combined surgical and medical treatment seem to be useful in the management of this infection, an optimal antifungal therapy remains to be defined. Only four cases of alternariosis after orthotopic liver transplantation have been reported. We describe an additional case and review the literature on infections due to Alternaria in organ transplant recipients, with special emphasis on treatment.  N. Ref:: 20

 

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[99]

TÍTULO / TITLE:  - Vibrio alginolyticus as the cause of pleural empyema and bacteremia in an immunocompromised patient.

REVISTA / JOURNAL:  - Eur J Clin Microbiol Infect Dis 2002 May;21(5):401-3. Epub 2002 May 14.

      ●● Enlace al texto completo (gratuito o de pago) 1007/s10096-002-0726-0

AUTORES / AUTHORS:  - Chien JY; Shih JT; Hsueh PR; Yang PC; Luh KT

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.  N. Ref:: 16

 

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[100]

TÍTULO / TITLE:  - Subcutaneous infection with Mycobacterium fortuitum after allogeneic bone marrow transplantation.

REVISTA / JOURNAL:  - Bone Marrow Transplant 2001 Oct;28(7):709-11.

      ●● Enlace al texto completo (gratuito o de pago) 1038/sj/bmt/1703211

AUTORES / AUTHORS:  - Okano A; Shimazaki C; Ochiai N; Hatsuse M; Takahashi R; Ashihara E; Inaba T; Fujita N; Noda Y; Nakagawa M

INSTITUCIÓN / INSTITUTION:  - Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kami-gyoku, Kyoto, 602-8566, Japan.

RESUMEN / SUMMARY:  - Reports of cases of mycobacterial infections after SCT are rare. We report a 30-year-old female with a cutaneous infection of Mycobacterium fortuitum 30 months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. The patient was successfully treated with surgical debridement followed by oral minocycline and clarithromycin. Mycobacterial infections should be considered in SCT patients with undiagnosed refractory chronic cutaneous infection, and surgical debridement is useful for the diagnosis and treatment of such infections.  N. Ref:: 7

 

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[101]

TÍTULO / TITLE:  - Kaposi’s sarcoma: aetiopathogenesis, histology and clinical features.

REVISTA / JOURNAL:  - J Eur Acad Dermatol Venereol 2003 Mar;17(2):138-54.

AUTORES / AUTHORS:  - Buonaguro FM; Tomesello ML; Buonaguro L; Satriano RA; Ruocco E; Castello G; Ruocco V

INSTITUCIÓN / INSTITUTION:  - Department of Experimental Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione Pascale, 80131 Naples, Italy.

RESUMEN / SUMMARY:  - Kaposi’s sarcoma (KS) represents today one of the most common skin cancers in transplanted Mediterranean subjects and, since the epidemic of human immunodeficiency virus/acquired immune deficiency syndrome, in young unmarried single men. The disease has been associated with the recent identified human herpesvirus (HHV)-8 or KS herpesvirus and its incidence in the general population shows a north to south gradient that parallels the HHV-8 increasing prevalence from Nordic countries to sub-Saharan regions. The identification of the aetiopathogenetic mechanisms (viral agents and immunodeficiency) involved in the pathogenesis of KS, are relevant for identifying susceptible subjects (HHV-8 seropositive subjects), monitoring the immune levels in iatrogenic immune suppressed patients, and developing new therapeutic approaches based on antiviral and immune modulators. Learning objective: This article should enable the reader: (i) to learn about the clinical and molecular aspects of KS in order to have a multidisciplinary approach to a tumour that shows unique features; (ii) to consider the role of viral agents and immunity; and (iii) to recognize properties of an opportunistic neoplasm. The identification of the HHV-8 role in KS pathogenesis should establish a relevant tool in the clinical management of KS patients.  N. Ref:: 182

 

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[102]

TÍTULO / TITLE:  - Development of acquired immunity to Salmonella.

REVISTA / JOURNAL:  - J Med Microbiol. Acceso gratuito al texto completo.

      ●● Enlace a la Editora de la Revista http://jmm.sgmjournals.org/ 

      ●● Cita: Journal of Medical Microbiology: <> 2003 Jun;52(Pt 6):453-9.

AUTORES / AUTHORS:  - Mastroeni P; Menager N

INSTITUCIÓN / INSTITUTION:  - Bacterial Infection Group, Centre for Veterinary Science, Department of Clinical Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK. pm274@cam.ac.uk

RESUMEN / SUMMARY:  - Salmonella enterica serovar Typhi (S. typhi) causes human typhoid fever, a serious and widespread disease in developing countries. Other Salmonella serovars are associated with food-borne infections. The recent emergence of multi-drug-resistant Salmonella strains highlights the need for better preventive measures, including vaccination. The available vaccines against Salmonella infection do not confer optimal protection. The design of new Salmonella vaccines must be based on the identification of suitable virulence genes and on knowledge of the immunological mechanisms of resistance to the disease. Control and clearance of a vaccine strain rely on the phagocyte oxidative burst, reactive nitrogen intermediates, inflammatory cytokines and CD4(+) TCR-alphabeta(+) T cells and are controlled by genes including NRAMP1 and MHC class II. Vaccine-induced resistance to reinfection requires the presence of Th1-type immunological memory and anti-Salmonella antibodies. The interaction between T and B cells is essential for the development of resistance following vaccination. The identification of immunodeficiencies that render individuals more susceptible to salmonellosis must be taken into consideration when designing and testing live attenuated Salmonella vaccines. An ideal live Salmonella vaccine should therefore be safe, regardless of the immunological status of the vaccinee, but still immunogenic.  N. Ref:: 107

 

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[103]

TÍTULO / TITLE:  - Identification of HLA-B27-restricted peptides in reactive arthritis and other spondyloarthropathies: computer algorithms and fluorescent activated cell sorting analysis as tools for hunting of HLA-B27-restricted chlamydial and autologous crossreactive peptides involved in reactive arthritis and ankylosing spondylitis.

REVISTA / JOURNAL:  - Rheum Dis Clin North Am 2003 Aug;29(3):595-611.

AUTORES / AUTHORS:  - Kuon W; Sieper J

INSTITUCIÓN / INSTITUTION:  - Section of Rheumatology, FU-Klinikum Benjamin Franklin, Berlin Hindenburgdamm 30, 12200 Berlin, Germany. kuon@medizin.fu-berlin.de

RESUMEN / SUMMARY:  - The illustrated clinical and experimental results demonstrate the strong relationship between the MHC class I antigen HLA-B27 and synovial CD8+ T cells with specificity for bacterial and possible self-antigen in SpA. These new aspects obtained in recent experimental and clinical studies might also provide clues to the pathomechanisms of joint inflammation in SpA. In particular, the newly developed techniques will be of great relevance in the near future. New and more precise bioalgorithms reflecting new insights in the biology and biochemistry of proteins as recently presented [98, 99] can be helpful (e.g., a program with an improved prediction of the features of immunoproteasomes). Intracellular and secreted cytokine staining by FACScan allows examination of a great number of cells expressing certain antigens in response to certain stimuli. The analysis of T-cell responses with tetramer/peptide complexes can be useful to screen tissue sections for TCR, recognizing foreign or self-derived epitopes on those complexes loaded with selected (e.g., bacterial) peptides. Identification of arthritogenic peptides and a further understanding of the immunology of the pathomechanisms in SpA might open ways to design new peptide vaccines to prevent inflammation, autoimmunity, and other diseases by early intervention [100].  N. Ref:: 100

 

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[104]

TÍTULO / TITLE:  - Monitoring xenotransplant recipients for infection by PERV.

REVISTA / JOURNAL:  - Clin Biochem 2001 Feb;34(1):23-7.

AUTORES / AUTHORS:  - Herring C; Cunningham DA; Whittam AJ; Fernandez-Suarez XM; Langford GA

INSTITUCIÓN / INSTITUTION:  - Porcine Endogenous Retrovirus Research Group, Imutran Ltd (A Novartis Pharma AG Co), PO Box 399, CB2 2YP, Cambridge, UK. Chris.herring@pharma.novartis.com

RESUMEN / SUMMARY:  - OBJECTIVES: Concerns have been raised over the possibility of transmission of porcine endogenous retrovirus (PERV) to porcine xenograft recipients. METHODS: To help assess this risk, diagnostic assays capable of detection of an active, latent or cleared PERV infection, and the presence of pig cell microchimerism have been developed by a number of groups. Retrospective studies of patients exposed to living pig tissues have been performed using these assays to look for evidence of cross species transmission. RESULTS: To date no evidence of PERV infection has been found in studies of humans exposed to pig tissues, despite evidence of long lived microchimerism. CONCLUSIONS: These data suggest that PERV infection has not occurred in a clinical setting. However, as infection has been seen in a small animal model further investigation of the risk from PERV is warranted.  N. Ref:: 24

 

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[105]

TÍTULO / TITLE:  - Cardiac infections in the immunosuppressed patient.

REVISTA / JOURNAL:  - Infect Dis Clin North Am 2001 Jun;15(2):613-38, xi.

AUTORES / AUTHORS:  - Brusch JL

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Infectious Disease Service, Cambridge Hospital, Massachusetts, USA.

RESUMEN / SUMMARY:  - This article presents the various manifestations of cardiac infections found in the immunosuppressed host. Emphasis is placed on the correlation between specific impairments of host defenses and the occurrence of certain types of pathogens. The effect of immunosuppression on the clinical manifestations of these infections is discussed. Finally, appropriate diagnostic modalities are presented for the major types of infections.  N. Ref:: 181

 

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[106]

TÍTULO / TITLE:  - Infectious etiology of bronchiolitis obliterans: the respiratory viruses connection - myth or reality?

REVISTA / JOURNAL:  - Am J Transplant 2003 Mar;3(3):245-9.

AUTORES / AUTHORS:  - Vilchez RA; Dauber J; Kusne S

INSTITUCIÓN / INSTITUTION:  - Departments ofaMedicine and Surgery, University of Pittsburgh Medical Center and Thomas E. Starzl Transplantation Institute, Pittsburgh, PA, USA.

RESUMEN / SUMMARY:  - A variety of viruses, such as the influenza viruses A and B, the human respiratory syncytial virus, the parainfluenza viruses, and the adenoviruses, cause seasonal respiratory tract infections in young children and adults. Also, studies indicate that these viruses are an important group of pathogens in pediatric and adult lung transplant recipients. More importantly, accumulating data on these infections among lung transplant patients suggest that these illnesses may have immediate and long-term implications for the function of the transplanted lung, including the development of bronchiolitis obliterans. This is important because patient survival and allograft function in lung transplantation remain limited by the development of bronchiolitis obliterans. Models of lung transplantation indicate that respiratory viral infections cause acute and chronic airway damage after transplantation. The mechanism leading to allograft damage by respiratory viruses may be related to the production of alloreactive cytokines such as interleukin (IL)-1, tumor necrosis factor, IL-6 and IL-8 during viral replication. Current clinical data are suggestive of a possible role for respiratory viruses in the development of bronchiolitis obliterans, but further control studies are required to evaluate the significance of respiratory virus infections as a causal factor in the development of bronchiolitis obliterans in lung transplantation.  N. Ref:: 48

 

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[107]

TÍTULO / TITLE:  - Development of immunocompetence: role of micronutrients and microorganisms.

REVISTA / JOURNAL:  - Nutr Rev 2002 May;60(5 Pt 2):S68-72.

AUTORES / AUTHORS:  - Cunningham-Rundles S; Ahrn S; Abuav-Nussbaum R; Dnistrian A

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, Cornell University Weill Medical College, NY, NY, USA.

RESUMEN / SUMMARY:  - Normal maturation of immune response at birth is both supported and stimulated by the gastrointestinal microenvironment, which provides both nutrients and antigenic microbial exposure to the developing child. Micronutrients, trace elements, and vitamins are present in the local environment and have important regulatory effects on adaptive immune cell function through effects on type of cytokine response. Congenital HIV infection is critically affected by both nutrient imbalance and alteration in gastrointestinal microflora, which may impair growth and development as well as immune response. Studies described here indicate that micronutrient deficiency is common in congenital HIV exposure even where infection has not occurred and that gastrointestinal recolonization may exert a restorative effect on both immune response and growth in children with HIV infection.  N. Ref:: 46

 

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[108]

TÍTULO / TITLE:  - Bacillus cereus bacteremia and meningitis in immunocompromised children.

REVISTA / JOURNAL:  - Clin Infect Dis 2001 May 15;32(10):1456-62. Epub 2001 Apr 20.

AUTORES / AUTHORS:  - Gaur AH; Patrick CC; McCullers JA; Flynn PM; Pearson TA; Razzouk BI; Thompson SJ; Shenep JL

INSTITUCIÓN / INSTITUTION:  - Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA.

RESUMEN / SUMMARY:  - Two cases of Bacillus cereus meningitis in immunocompromised children at our hospital within a 2-month period prompted us to review B. cereus—related invasive disease. We identified 12 patients with B. cereus isolated in blood cultures from September 1988 through August 2000 at our institution. Three of these patients also had B. cereus isolated from CSF specimens; 1 additional patient had possible CNS involvement (33%, group A), whereas 8 patients had no evidence of CNS involvement (67%, group B). Patients in group A were more likely to have neutropenia at the onset of sepsis and were more likely to have an unfavorable outcome. They were also more likely to have received intrathecal chemotherapy in the week before the onset of their illness. Two patients from group A died. One survived with severe sequelae. The fourth patient had mild sequelae at follow-up. No sequelae or deaths occurred among patients in group B. In patients with unfavorable outcomes, the interval from the time of recognition of illness to irreversible damage or death was short, which demonstrates a need for increased awareness, early diagnosis, and more-effective therapy, particularly that which addresses B. cereus toxins.  N. Ref:: 6

 

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[109]

TÍTULO / TITLE:  - Diagnosis and management of posttransplant lymphoproliferative disorder in solid-organ transplant recipients.

REVISTA / JOURNAL:  - Clin Infect Dis 2001 Jul 1;33 Suppl 1:S38-46.

AUTORES / AUTHORS:  - Preiksaitis JK; Keay S

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. jkp@bugs.uah.ualberta.ca

RESUMEN / SUMMARY:  - The Epstein-Barr virus (EBV) has a pivotal pathophysiologic role in the development of most lymphoproliferative disorders that occur after solid-organ transplantation. The term “EBV-associated posttransplant lymphoproliferative disorder” (PTLD) includes all clinical syndromes of EBV-associated lymphoproliferation, ranging from uncomplicated posttransplant infectious mononucleosis to true malignancies that contain clonal chromosomal abnormalities. PTLDs are historically associated with a high mortality rate in patients who have a monoclonal form of the disorder. Recently described approaches to pathology, diagnosis, treatment, and preventive strategies of PTLD, however, have the potential to improve outcome.  N. Ref:: 104

 

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[110]

TÍTULO / TITLE:  - Association between nasal methicillin-resistant Staphylococcus aureus carriage and infection in liver transplant recipients.

REVISTA / JOURNAL:  - Liver Transpl 2001 Aug;7(8):752-4.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jlts.2001.0070752

AUTORES / AUTHORS:  - Patel R

INSTITUCIÓN / INSTITUTION:  - Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.  N. Ref:: 18

 

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[111]

TÍTULO / TITLE:  - Polyomavirus BK nephropathy: a (re-)emerging complication in renal transplantation.

REVISTA / JOURNAL:  - Am J Transplant 2002 Jan;2(1):25-30.

AUTORES / AUTHORS:  - Hirsch HH

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, University of Basel, Switzerland. hans.hirsch@unibas.ch

RESUMEN / SUMMARY:  - Persisting polyomavirus replication is now widely recognized as a (re-)emerging cause of renal allograft dysfunction. Up to 5% of renal allograft recipients can be affected about 40weeks (range 6-150) post-transplantation. Progression to irreversible failure of the allograft has been observed in up to 45% of all cases. The BK virus strain is involved in the majority of the cases. Risk factors may include treatment of rejection episodes and increasing viral replication under potent immunosuppressive drugs such as tacrolimus, sirolimus or mycophenolate. The diagnosis requires the histological demonstration of nuclear polyomavirus inclusions in affected tubular epithelial cells. Interstitial inflammatory infiltrates and fibrosis become more prominent in the persisting disease and may be difficult to distinguish from (coexisting) rejection. Detection of polyomavirus-inclusion bearing cells (‘decoy cells’) in the urine and quantification of BK virus DNA in the plasma have been proposed as surrogate markers for polyomavirus replication and allograft disease, respectively. Antiviral treatment is not yet established; however, reports of treatment with cidofovir are encouraging. Current management aims at the judicious modification and/or reduction of immunosuppression which, in view of preceding or concurrent rejection, is not without risk.  N. Ref:: 51

 

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[112]

TÍTULO / TITLE:  - Human herpesviruses 6 and 7 in solid organ transplant recipients.

REVISTA / JOURNAL:  - Clin Infect Dis 2001 May 1;32(9):1357-60. Epub 2001 Apr 10.

AUTORES / AUTHORS:  - Emery VC

INSTITUCIÓN / INSTITUTION:  - Royal Free and University College Medical School, Hampstead, London, United Kingdom. v.emery@rfc.ucl.ac.uk

RESUMEN / SUMMARY:  - The impact of cytomegalovirus, a member of the beta-herpesvirus subgroup of the Herpesviridae, on patients who have undergone transplantation cannot be overstated. However, in the last 15 years, 2 additional members of the human beta-herpesvirus family have been discovered: human herpesviruses 6 and 7 (HHV-6 and HHV-7). The impact of HHV-6 and HHV-7 is assessed, as is the well-being of transplant recipients. Also discussed is whether the data on the pathological consequences of infection warrant routine screening for these viruses in solid organ transplant recipients.  N. Ref:: 30

 

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[113]

TÍTULO / TITLE:  - Comparative pathogenesis of HBV and HCV.

REVISTA / JOURNAL:  - Virus Res 2002 Jan 30;82(1-2):19-23.

AUTORES / AUTHORS:  - Missale G; Penna A; Boni C; Malpeli M; Zerbini A; Pilli M; Urbani S; Ferrari C

INSTITUCIÓN / INSTITUTION:  - Divisione di Malattie Infettive, Azienda Ospedaliera di Parma, Italy. missale@tin.it  N. Ref:: 22

 

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[114]

TÍTULO / TITLE:  - Rhodococcus equi infections in immunocompetent hosts: case report and review.

REVISTA / JOURNAL:  - Clin Infect Dis 2001 Feb 1;32(3):E39-46. Epub 2001 Jan 24.

AUTORES / AUTHORS:  - Kedlaya I; Ing MB; Wong SS

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA. IKedlaya@yahoo.com

RESUMEN / SUMMARY:  - Rhodococcus equi is an unusual cause of infection in humans. Infection in immunocompetent patients is extremely rare-only 19 cases in immunocompetent hosts have been reported. Localized infections represent nearly 50% of reported cases. Pulmonary infections account for only 42% of infections in immunocompetent hosts, compared with 84% of infections in immunocompromised hosts. The mortality rate among immunocompetent patients is approximately 11%, compared with rates of 50%-55% among human immunodeficiency virus (HIV)-infected patients and 20%-25% among non-HIV-infected immunocompromised patients. Treatment of infections in immunocompetent hosts depends on the site of infection. Serious infections need to be treated with combinations of parenteral antibiotics, followed by combinations of oral antibiotics. Surgical treatment is necessary for certain types of local infections. We report a pulmonary infection due to R. equi in an immunocompetent patient, and we review all reported cases of R. equi infection in immunocompetent hosts.  N. Ref:: 30

 

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[115]

TÍTULO / TITLE:  - Chromomycosis due to Exophiala jeanselmei in a renal transplant recipient.

REVISTA / JOURNAL:  - Eur J Dermatol 2003 May-Jun;13(3):305-7.

AUTORES / AUTHORS:  - Pena-Penabad C; Duran MT; Yebra MT; Rodriguez-Lozano J; Vieira V; Fonseca E

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Complejo Hospitalario Juan Canalejo, Servicio de Dermatologia, Xubias de Arriba, 84, 15006. a Coruna, España.

RESUMEN / SUMMARY:  - Chromomycosis is a rare mycotic infection that is more frequent in tropical and subtropical regions. Dematiaceous fungi are the causal agents of this mycosis. Several cases of chromomycosis in organ transplant recipients have been reported. We present a case of chromomycosis by Exophiala jeanselmei in a Spanish male who had received a renal transplant several months previously, and was receiving treatment with tacrolimus, prednisone and mycophenolate mofetil. Very few cases of chromomycosis due to Exophiala have been reported, and this is, to our knowledge, the first European case.  N. Ref:: 16

 

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[116]

TÍTULO / TITLE:  - Cancer processes in immunodeficient populations: an introduction.

REVISTA / JOURNAL:  - Eur J Cancer 2001 Jul;37(10):1202-8.

AUTORES / AUTHORS:  - Boshoff C; Weiss R

INSTITUCIÓN / INSTITUTION:  - Wolfson Institute for Biomedical Research, Cruciform Building, University College London, WC1E 6BT, London, UK. c.boshoff@ucl.ac.uk  N. Ref:: 41

 

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[117]

TÍTULO / TITLE:  - Rhino-orbitocerebral mucormycosis attributable to Apophysomyces elegans in an immunocompetent individual: case report and review of the literature.

REVISTA / JOURNAL:  - J Trauma 2001 Feb;50(2):353-7.

AUTORES / AUTHORS:  - Garcia-Covarrubias L; Bartlett R; Barratt DM; Wassermann RJ

INSTITUCIÓN / INSTITUTION:  - Department of Hyperbaric Medicine, University of South Carolina-Palmetto Richland Memorial Hospital, 2 Richland Medical Park, Suite 300, Columbia, SC 29203, USA.  N. Ref:: 33

 

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[118]

TÍTULO / TITLE:  - Pseudomonas pericarditis in an immunocompetent newborn: unusual presentation with review of the literature.

REVISTA / JOURNAL:  - J Infect 2002 Jan;44(1):49-51.

      ●● Enlace al texto completo (gratuito o de pago) 1053/jinf.2001.0894

AUTORES / AUTHORS:  - El Hassan N; Dbaibo G; Diab K; Musallam S; Haidar R; Obeid M; Bitar F

INSTITUCIÓN / INSTITUTION:  - Department of Paediatrics, American University of Beirut, Medical Center, Lebanon.

RESUMEN / SUMMARY:  - Acute purulent pericarditis is a rare entity in the neonatal age group. The most common isolated organisms are Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae. Other organisms, like Pseudomonas aeruginosa, have been seldom implicated with only one case of Pseudomonas pericarditis reported in the neonatal period. The prognosis is often considered very poor in this age group. This article describes Pseudomonas pericarditis in a 1-week-old immunocompetent female newborn who was successfully managed with combined medical and surgical therapy.  N. Ref:: 7

 

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[119]

TÍTULO / TITLE:  - The paradox of survival results after heart transplantation for cardiomyopathy caused by Trypanosoma cruzi. First Guidelines Group for Heart Transplantation of the Brazilian Society of Cardiology.

REVISTA / JOURNAL:  - Ann Thorac Surg 2001 Jun;71(6):1833-8.

AUTORES / AUTHORS:  - Bocchi EA; Fiorelli A

INSTITUCIÓN / INSTITUTION:  - Brazilian Society of Cardiology, Sao Paulo. dcledimar@incor.usp.br

RESUMEN / SUMMARY:  - BACKGROUND: Donor supply limits heart transplantation (HT) and relative priority should be given to cases with greater chances of success. The objectives of this multicenter study were (1) to determine the survival rate after heart transplantation for patients with Chagas’ heart disease (ChHD) in comparison with other causes; and (2) to identify the causes of death specifically due to reactivation of the Trypanosoma cruzi infection. METHODS: We studied 720 patients who had undergone orthotopic heart transplantation and were followed in 16 heart transplantation centers. The etiology was idiopathic dilated cardiomyopathy in 407 patients, ischemic cardiomyopathy in 196 patients, and ChHD in 117 patients. RESULTS: Follow-up was 2.87 +/- 3.05 years (from 1 month to 13.85 years). Survival of ischemic recipients at 1, 4, 8, and 12 years was 59%, 44%, 34%, and 22%, respectively; for idiopathic dilated cardiomyopathy it was 69%, 57%, 40%, and 32%; and for ChHD it was 71%, 57%, 55%, and 46% (p < 0.027). In ischemic recipients the most frequent causes of death were infection (15.3%), acute graft failure (13.3%), and graft coronary artery disease/sudden death (7.7%). In idiopathic dilated cardiomyopathy the causes were infection (11.1%), rejection (9.6%), and acute graft failure (9.1%). In ChHD the causes were infection (10.3%), rejection (10.3%), and neoplasm (4.3%). In ChHD, reactivation of the cruzi infection was the cause of death in 2 patients. CONCLUSIONS: The survival results after heart transplantation are paradoxical according to the usually high expected death rates for Chagas’ disease. Heart transplantation for ChHD should be regarded as a valuable treatment option.

 

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[120]

TÍTULO / TITLE:  - Subversion of the innate immune response by micro-organisms.

REVISTA / JOURNAL:  - Ann Rheum Dis 2002 Nov;61 Suppl 2:ii8-12.

AUTORES / AUTHORS:  - Fernie-King B; Seilly DJ; Davies A; Lachmann PJ

INSTITUCIÓN / INSTITUTION:  - Microbial Immunology Group, Centre for Veterinary Science, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK.  N. Ref:: 12

 

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[121]

TÍTULO / TITLE:  - Hijacking and exploitation of IL-10 by intracellular pathogens.

REVISTA / JOURNAL:  - Trends Microbiol 2001 Feb;9(2):86-92.

AUTORES / AUTHORS:  - Redpath S; Ghazal P; Gascoigne NR

INSTITUCIÓN / INSTITUTION:  - Dept of Immunology, The Scripps Research Institute, La Jolla, CA 92037, USA.

RESUMEN / SUMMARY:  - Macrophages play a central role in infections, as a target for pathogens and in activation of the immune system. Interleukin-10 (IL-10), a cytokine produced by macrophages, is a potent immunosuppressive factor. Some intracellular pathogens specifically target macrophages for infection and use IL-10 to dampen the host immune response and stall their elimination from the host. Certain viruses induce production of cellular IL-10 by macrophages, whereas other viruses encode their own viral IL-10 homologs. Additionally, specific bacteria, including several Mycobacteria spp. and Listeria monocytogenes, can survive and replicate in macrophages while inducing cellular IL-10, highlighting a potential role for IL-10 of macrophage origin in the immunosuppressive etiology of these pathogens. Thus, the exploitation of IL-10 appears to be a common mechanism of immunosuppression by a diverse group of intracellular pathogens that can infect macrophages.  N. Ref:: 51

 

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[122]

TÍTULO / TITLE:  - Bilateral microsporidial keratoconjunctivitis in an immunocompetent non-contact lens wearer.

REVISTA / JOURNAL:  - Cornea 2003 May;22(4):374-6.

AUTORES / AUTHORS:  - Lewis NL; Francis IC; Hawkins GS; Coroneo MT

INSTITUCIÓN / INSTITUTION:  - Department of Opthalmology, The Prince of Wales Hospital, University of New South Wales, Randwick, Sydney. nonilewis@infolearn.com.au

RESUMEN / SUMMARY:  - PURPOSE: To describe an immunocompetent male with bilateral microsporidial keratoconjunctivitis who responded to treatment with albendazole, propamidine, and fumagillin. METHODS: Corneal and conjunctival epithelial scrapings from a man with bilateral keratoconjunctivitis previously treated with topical corticosteroids were evaluated by Gram stain and by fluorescence microscopy. RESULTS: Gram stain and fluorescence microscopy of corneal epithelial scraping revealed organisms characteristic of microsporidia. Results of human immunodeficiency virus antibody testing were reported as nonreactive. Symptoms of ocular discomfort and clinical signs of keratoconjunctivitis resolved after five weeks of treatment that included systemic albendazole and topical propamidine isethionate 0.1% and fumagillin bicyclohexylammonium salt. A follow-up conjunctival scraping failed to detect any residual organisms 2 weeks after cessation of all treatment. CONCLUSION: Microsporidial ocular infection occurred in an immunocompetent non-contact lens wearer. Microsporidial keratoconjunctivitis should be considered in any individual with atypical multifocal diffuse epithelial keratitis, regardless of immune status or recent history of contact lens wear.  N. Ref:: 29

 

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[123]

TÍTULO / TITLE:  - Cryptococcosis in organ transplant recipients: an overview.

REVISTA / JOURNAL:  - Am J Transplant 2002 Aug;2(7):575-80.

AUTORES / AUTHORS:  - Vilchez RA; Fung J; Kusne S

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, University of Pittsburgh Medical Center, and Thomas E. Starzl Transplantation Institute, PA 15213, USA.

RESUMEN / SUMMARY:  - Cryptococcosis is the third most common invasive fungal infection in organ transplant recipients after candidiasis and aspergillosis. Reports indicate that cryptococcosis usually presents as symptomatic disease, and despite therapy the mortality remains high. In addition, some data suggest that there might be differences in the incidence and clinical manifestations of cryptococcosis, depending on the specific transplant organ. The incidence of cryptococcosis in our transplant center is significantly higher in heart transplant recipients than in other transplant groups (p=0.0001). Although the primary risk factor contributing to cryptococcosis in organ transplant recipients is probably the immunosuppressive therapy used to prevent allograft rejection, environmental factors may also play a role. This is indicated by studies that demonstrate differences in the rate of cryptococcosis according to geographic region. Moreover, data point out differences in the isolation of the fungus from soil samples with higher concentrations of Cryptococcus in areas frequented by birds or contaminated by bird droppings. Therefore, it is prudent to recommend that organ transplant recipients avoid birds or areas contaminated with bird droppings. The current review provides an overview of the changes in the incidence, clinical manifestations, and management of cryptococcosis in organ transplant recipients.  N. Ref:: 45

 

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[124]

TÍTULO / TITLE:  - Olecranon bursitis due to Candida parapsilosis in an immunocompetent adult.

REVISTA / JOURNAL:  - Ann Rheum Dis 2002 Mar;61(3):279-81.

AUTORES / AUTHORS:  - Jimenez-Palop M; Corteguera M; Ibanez R; Serrano-Heranz R  N. Ref:: 12

 

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[125]

TÍTULO / TITLE:  - Implications of Salmonella-induced nitric oxide (NO) for host defense and vaccines: NO, an antimicrobial, antitumor, immunosuppressive and immunoregulatory molecule.

REVISTA / JOURNAL:  - Microbes Infect 2001 Nov-Dec;3(14-15):1223-31.

AUTORES / AUTHORS:  - Eisenstein TK

INSTITUCIÓN / INSTITUTION:  - Department of Microbiology and Immunology, and Center for Substance Abuse Research, 3400 North Broad Street, Temple University School of Medicine, Philadelphia, PA 19140, USA. tke@astro.temple.edu

RESUMEN / SUMMARY:  - Attenuated Salmonella induce immunosuppressive, microbicidal and tumoricidal macrophages in mice. All three effects are mediated by activated macrophages producing nitric oxide (NO). NO is induced by the innate immune response pathway involving IL-12, NK cells and IFN-gamma in response to infection. NO has beneficial and detrimental effects on the host.  N. Ref:: 73

 

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[126]

TÍTULO / TITLE:  - Xenotransplantation and pig endogenous retroviruses.

REVISTA / JOURNAL:  - Rev Med Virol 2003 Sep-Oct;13(5):311-29.

      ●● Enlace al texto completo (gratuito o de pago) 1002/rmv.404

AUTORES / AUTHORS:  - Magre S; Takeuchi Y; Bartosch B

INSTITUCIÓN / INSTITUTION:  - Wohl Virion Centre, The Windeyer Institute of Medical Sciences, University College London, 46 Cleveland Street, London W1T 4JF, UK.

RESUMEN / SUMMARY:  - Xenotransplantation, in particular transplantation of pig cells, tissues and organs into human patients, may alleviate the current shortage of suitable allografts available for human transplantation. This overview addresses the physiological, immunological and virological factors considered with regard to xenotransplantation. Among the issues reviewed are the merits of using pigs as xenograft source species, the compatibility of pig and human organ physiology and the immunological hindrances with regard to the various types of rejection and attempts at abrogating rejection. Advances in the prevention of pig organ rejection by creating genetically modified pigs that are more suited to the human microenvironment are also discussed. Finally, with regard to virology, possible zoonotic infections emanating from pigs are reviewed, with special emphasis on the pig endogenous retrovirus (PERV). An in depth account of PERV studies, comprising their discovery as well as recent knowledge of the virus, is given. To date, all retrospective studies on patients with pig xenografts have shown no evidence of PERV transmission, however, many factors make us interpret these results with caution. Although the lack of PERV infection in xenograft recipients up to now is encouraging, more basic research and controlled animal studies that mimic the pig to human xenotransplantation setting more closely are required for safety assessment.  N. Ref:: 194

 

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[127]

TÍTULO / TITLE:  - Immune evasion mechanisms of varicella-zoster virus.

REVISTA / JOURNAL:  - Arch Virol Suppl 2001;(17):99-107.

AUTORES / AUTHORS:  - Abendroth A; Arvin A

INSTITUCIÓN / INSTITUTION:  - Stanford University School of Medicine, California 94305, USA.

RESUMEN / SUMMARY:  - Varicella-zoster virus can to modulate the expression of class I and class II major histocompatibility (MHC) molecules. MHC class I expression is downregulated in VZV-infected T cells as well as in fibroblasts. VZV-infected cells do not respond to exposure to interferon-gamma (IFN-gamma) by upregulation of MHC class II expression. However, MHC class II expression is induced when cells are treated with IFN-gamma before VZV infection. These effects on MHC class I and class II expression can be expected to interfere transiently with adaptive immune responses of the host, mediated by CD4 and CD8 T cells, ensuring that the virus has sufficient opportunity for transmission to susceptible contracts.  N. Ref:: 43

 

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[128]

TÍTULO / TITLE:  - Epstein-Barr virus-associated smooth muscle tumour: a distinctive mesenchymal tumour of immunocompromised individuals.

REVISTA / JOURNAL:  - Pathology 2002 Jun;34(3):245-9.

      ●● Enlace al texto completo (gratuito o de pago) 1080/00313020220131309

AUTORES / AUTHORS:  - Cheuk W; Li PC; Chan JK

INSTITUCIÓN / INSTITUTION:  - Department of Pathology and Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong. cheuk_wah@hotmail.com

RESUMEN / SUMMARY:  - immunosuppressed patients are predisposed to the development of smooth muscle tumours which show near consistent association with Epstein-Barr virus (EBV). This report describes a 37-year-old patient with acquired immunodeficiency syndrome who initially presented with two masses in the liver. Image-guided core biopsy revealed a spindle cell tumour with histological and immunological features of smooth muscle neoplasm which was shown by in situ hybridisation for EBV early RNAs to be EBV-associated. The literature on this uncommon entity is critically reviewed and the differential diagnosis is also discussed.  N. Ref:: 43

 

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[129]

TÍTULO / TITLE:  - Fatal myocardial aspergillosis in an immunosuppressed child.

REVISTA / JOURNAL:  - J Pediatr Hematol Oncol 2001 Oct;23(7):456-9.

AUTORES / AUTHORS:  - Ozsahin H; Wacker P; Brundler MA; Starobinski M; Helg C; Pastore Y; Miralbell R; Hanquinet S; Gervaix A; Chapuis B; Humbert J

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, University Cantonal Hospitals of Geneva, Switzerland. ayse.h.ozsahin@hcuge.ch

RESUMEN / SUMMARY:  - A girl with resistant acute myeloid leukemia (AML) had a stem cell transplantation. Preceding transplantation, she had recurrent pneumonitis. No causative agent was identified. Despite several antibiotics including high-dose liposomal amphotericin-B, pulmonary infection progressed. Aspergillosis, always considered, could not be documented. She died from cardiac arrest on the second day after transplantation, with no forewarning of previous heart disease. Pericardial and myocardial aspergillosis was an autopsy finding. Pericardial and myocardial aspergillosis, rare manifestations of systemic aspergillosis, should be considered in any immunocompromised patient with long-lasting pulmonary infection, even in the absence of specific cardiac findings.  N. Ref:: 10

 

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[130]

TÍTULO / TITLE:  - Function of CMV-encoded MHC class I homologues.

REVISTA / JOURNAL:  - Curr Top Microbiol Immunol 2002;269:131-51.

AUTORES / AUTHORS:  - Farrell HE; Davis-Poynter NJ; Andrews DM; Degli-Esposti MA

INSTITUCIÓN / INSTITUTION:  - Animal Health Trust, Virology Section, Kentford, Newmarket, Suffolk CB8 7UU, UK.

RESUMEN / SUMMARY:  - Homologues of MHC class I proteins have been identified in the genomes of human, murine and rat cytomegaloviruses (CMVs). Given the pivotal role of the MHC class I protein in cellular immunity, it has been postulated that the viral homologues subvert the normal antiviral immune response of the host, thus promoting virus replication and dissemination in an otherwise hostile environment. This review focuses on recent studies of the CMV MHC class I homologues at the molecular, cellular and whole animal level and presents current hypotheses for their roles in the CMV life cycle.  N. Ref:: 90

 

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[131]

TÍTULO / TITLE:  - Transduction of MHC-class I negative allogeneic cell line to improve the efficacy of anti-tumor vaccination.

REVISTA / JOURNAL:  - J Biol Regul Homeost Agents 2002 Jul-Sep;16(3):236-40.

AUTORES / AUTHORS:  - Curti A; Colombo MP; Baccarani M; Lemoli RM

INSTITUCIÓN / INSTITUTION:  - Institute of Hematology and Clinical Oncology “Seragnoli”, University of Bologna, Bologna, Italy. acurti@alnia.unibo.it  N. Ref:: 27

 

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[132]

TÍTULO / TITLE:  - Repression of MHC determinants in HIV infection.

REVISTA / JOURNAL:  - Microbes Infect 2001 May;3(6):467-73.

AUTORES / AUTHORS:  - Kanazawa S; Matija Peterlin B

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Howard Hughes Medical Institute, University of California, San Francisco, California 94143-0703, USA.

RESUMEN / SUMMARY:  - HIV infects CD4(+) macrophages and lymphocytes. Before the development of AIDS, HIV weakens the immune system in part by blocking antigen processing and presentation via major histocompatibility complex (MHC) molecules. In this report, we discuss how HIV escapes the immune surveillance by MHC II molecules.  N. Ref:: 72

 

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[133]

TÍTULO / TITLE:  - Infectious and immune factors in the pathogenesis of neurodevelopmental disorders: epidemiology, hypotheses, and animal models.

REVISTA / JOURNAL:  - Ment Retard Dev Disabil Res Rev 2001;7(3):200-10.

      ●● Enlace al texto completo (gratuito o de pago) 1002/mrdd.1028 [pii]

AUTORES / AUTHORS:  - Hornig M; Lipkin WI

INSTITUCIÓN / INSTITUTION:  - Emerging Diseases Laboratory, Gillespie Neuroscience Research Facility, University of California, Irvine, California 92697-4292, USA. mhornig@uci.edu

RESUMEN / SUMMARY:  - Both genetic and environmental factors contribute to the pathogenesis of a wide variety of neurodevelopmental disorders, including autism, mental retardation, and schizophrenia. Some heritable disorders approach 100% penetrance; nonetheless, even in these disorders, subtle aspects of clinical disease expression may be influenced by the environment. In other disorders with genetic influences, exogenous factors, and the timepoint(s) during nervous system development at which they are introduced, modulate expression of disease. Elucidation of the mechanisms guiding this intricate interplay between host response genes, environmental agents, and the neurodevelopmental context within which these interactions occur, is necessary to understand the continuum of clinical outcomes. This chapter will review the evidence that infectious and immune factors may contribute to the pathogenesis of neurodevelopmental disorders, describe an animal model of neurodevelopmental disorders based upon viral infection, identify processes by which neural circuitry may be compromised, and outline areas for future research.  N. Ref:: 155

 

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[134]

TÍTULO / TITLE:  - Immune downregulation leads to upregulation of an antiviral response: a lesson from the hepatitis B virus.

REVISTA / JOURNAL:  - Microbes Infect 2002 Nov;4(13):1317-26.

AUTORES / AUTHORS:  - Ilan Y

INSTITUCIÓN / INSTITUTION:  - Liver Unit, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel. ilan@hadassah.org.il

RESUMEN / SUMMARY:  - Induction of tolerance towards antigens that drive susceptibility or pathology may be considered a new mode of treatment for several infections. Hepatitis B virus is a non-cytopathic virus, and oral immune regulation was shown to be effective in modulation of the immune-mediated liver injury.  N. Ref:: 67

 

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[135]

TÍTULO / TITLE:  - Selection of and evasion from cytotoxic T cell responses in the central nervous system.

REVISTA / JOURNAL:  - Adv Virus Res 2001;56:219-42.

AUTORES / AUTHORS:  - Perlman S; Wu GF

INSTITUCIÓN / INSTITUTION:  - Departments of Pediatrics and Microbiology, University of Iowa, Iowa City, Iowa 52242, USA.  N. Ref:: 104

 

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[136]

TÍTULO / TITLE:  - Gastrointestinal infections in the immunocompromised host.

REVISTA / JOURNAL:  - Infect Dis Clin North Am 2001 Jun;15(2):639-70, xi.

AUTORES / AUTHORS:  - Baden LR; Maguire JH

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA. lbaden@partners.org

RESUMEN / SUMMARY:  - Gastrointestinal disease is a significant cause of morbidity and mortality in the immunocompromised patient. This article focuses on the infectious gastrointestinal complications associated with the treatment of malignant disease and with solid organ transplantation but not HIV. Gastrointestinal defenses and the various mechanisms by which they are impaired are reviewed. The major pathogens and malignancies of this patient population and an approach to their diagnosis, treatment, and prevention are discussed.  N. Ref:: 150

 

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[137]

TÍTULO / TITLE:  - Dermatologic infections in the immunocompromised (non-HIV) host.

REVISTA / JOURNAL:  - Infect Dis Clin North Am 2001 Jun;15(2):671-702, xi.

AUTORES / AUTHORS:  - Lopez FA; Sanders CV

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Louisiana State University School of Medicine, New Orleans, Louisiana, USA. alopez1@lsuhsc.edu

RESUMEN / SUMMARY:  - The immunocompromised host’s susceptibility to infections often present a difficult diagnostic challenge to the physician. A working knowledge of the host immune defenses and microbiologic complications that can occur when these functions are compromised provides a more focused framework for further evaluation and management. Infections in these patients are often morbid and life-threatening, creating an urgent need for prompt diagnosis. The skin may manifest the first clue(s) of a serious underlying infection. Appropriate workup and diagnosis of cutaneous lesions provide an expeditious, noninvasive, and potentially life-saving approach to the immunocompromised host with a dermatologic infection.  N. Ref:: 143

 

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[138]

TÍTULO / TITLE:  - Innate immunity in host-microbial interactions: beyond B27 in the spondyloarthropathies.

REVISTA / JOURNAL:  - Curr Opin Rheumatol 2002 Jul;14(4):373-82.

AUTORES / AUTHORS:  - Pacheco-Tena C; Zhang X; Stone M; Burgos-Vargas R; Inman RD

INSTITUCIÓN / INSTITUTION:  - Arthritis Center of Excellence, Toronto Western Hospital, Toronto, Ontario, Canada. pacheco@medscape.com

RESUMEN / SUMMARY:  - The spondyloarthropathies are diseases influenced by genetic predisposition and, to a varying extent, infectious triggers. A causal role for bacterial infections is most clear for reactive arthritis. Recent insights into arthritogenic components of bacteria may set the stage for a better understanding of disease pathogenesis, the role of heat shock proteins in antigen processing and immune activation, and the adjuvant effect of CpG-DNA. Recent developments in the area of innate immunity broaden current concepts of genetically defined factors in host-pathogen interactions. In particular, the biology of toll-like receptors as important elements in the innate immune response to pathogens is being defined. These factors in innate immunity may have important implications for sequelae of infections, such as reactive arthritis.  N. Ref:: 113

 

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[139]

TÍTULO / TITLE:  - Association of human leukocyte antigen with outcomes of infectious diseases: the streptococcal experience.

REVISTA / JOURNAL:  - Scand J Infect Dis 2003;35(9):665-9.

AUTORES / AUTHORS:  - Kotb M; Norrby-Teglund A; McGeer A; Green K; Low DE

INSTITUCIÓN / INSTITUTION:  - Veterans Affairs Medical Center, Research Service, Memphis, Tennessee 38163, USA. mkotb@utmem.edu

RESUMEN / SUMMARY:  - The role of host genetic factors in determining susceptibility to infections has become more evident. Certain individuals appear to be predisposed to certain infections, whereas others are protected. By studying the immune response and the genetic makeup of susceptible and resistant individuals a better understanding of the disease process can be achieved. Infections caused by group A streptococci offer an excellent model to study host-pathogen interactions and how the host genetic variation can influence the infection outcome. These studies showed that the same clone of these bacteria can cause severe or non-severe invasive disease. This difference was largely related to the human leukocyte antigen class 11 type of the patient. Certain class II haplotypes present the streptococcal superantigens in a way that results in responses, whereas others present the same superantigens in a way that elicits very potent inflammatory responses that can lead to organ failure and shock. These findings underscore the role of host genetic factors in determining the outcome of serious infections and warrants further investigations into how the same or different genetic factors affect susceptibility to other emerging and re-emerging pathogens.  N. Ref:: 29

 

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[140]

TÍTULO / TITLE:  - Thalidomide-based treatment for HIV-associated multiple myeloma: a case report.

REVISTA / JOURNAL:  - AIDS Read 2003 Aug;13(8):383-9.

AUTORES / AUTHORS:  - Aboulafia DM

INSTITUCIÓN / INSTITUTION:  - Division of Hematology, University of Washington, Seattle, Washington, USA.

RESUMEN / SUMMARY:  - The spectrum of hematologic and immunologic abnormalities induced by HIV infection is broad. Although the incidence of HIV-associated B-cell neoplasms has increased, relatively few cases of multiple myeloma have been reported, and even fewer cases have detailed treatment outcome. The case of an HIV-infected man in whom multiple myeloma was diagnosed following progressive anemia and fatigue is described. The patient began treatment consisting of thalidomide, dexamethasone, and clarithromycin, which led to a rapid and dramatic antitumor response. He experienced modest regimen-related toxicities while retaining a normal CD4+ T-lymphocyte count and a nondetectable HIV viral load. The immunologic and antitumor effects of thalidomide in the context of multiple myeloma and HIV infection are also briefly reviewed. Given thalidomide’s relatively favorable side-effect profile and purported immunologic benefit, further studies of this drug in the treatment of HIV-associated multiple myeloma should be pursued.  N. Ref:: 50

 

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[141]

TÍTULO / TITLE:  - Constrictive pericarditis caused by candida glabrata in an immunocompetent patient: case report and review of literature.

REVISTA / JOURNAL:  - Scand J Infect Dis 2002;34(8):615-9.

AUTORES / AUTHORS:  - Neughebauer B; Alvarez V; Harb T; Keefer M

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, University of Rochester Medical Center, New York 14642, USA.

RESUMEN / SUMMARY:  - Candida pericarditis is a rare disease described mostly in patients with recent cardiothoracic surgery or debilitating chronic diseases and is generally considered to be associated with high mortality. To our knowledge, we report the first case of Candida pericarditis in a healthy host who had not undergone thoracic surgery and the first documented case and cure of pericarditis caused by C. glabrata. The most probable underlying factor in the development of this pericarditis was the abdominal surgery the patient underwent to correct a gastrogastric fistula, without an intraabdominal leak, which developed 10 y after surgical gastric stapling for weight reduction. The literature on Candida pericarditis is reviewed. If Candida pericarditis is diagnosed early and treated with a combined medical and surgical approach, the prognosis today is much more favorable than that previously reported.  N. Ref:: 25

 

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[142]

TÍTULO / TITLE:  - Use of cytomegalovirus immune globulin and ganciclovir for the prevention of cytomegalovirus disease in lung transplantation.

REVISTA / JOURNAL:  - Transpl Infect Dis 2001;3 Suppl 2:49-56.

AUTORES / AUTHORS:  - Zamora MR

INSTITUCIÓN / INSTITUTION:  - Division of Pulmonary Sciences and Critical Care Medicine, Lung Transplant Program, University of Colorado Health Sciences Center, Denver 80262, USA. marty.zamora@uchsc.edu

RESUMEN / SUMMARY:  - Cytomegalovirus (CMV) infection and disease continue to be significant causes of morbidity and mortality in lung transplant recipients. The potential benefits of CMV prophylaxis extend beyond prevention of the immediate CMV infection to potentially preventing CMV-associated complications, including superinfection due to Aspergillus bacteria, and other opportunistic infections, and bronchiolitis obliterans syndrome (BOS). Longer courses of prophylactic intravenous (IV) ganciclovir, sequential IV/oral therapy, addition of intravenous CMV immune globulin (CMV-IGIV), surveillance tests, and investigation of the role of hypogammaglobulinemia are a few of the strategies and issues being evaluated to improve CMV prophylaxis and, consequently, graft and patient survival.  N. Ref:: 26

 

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[143]

TÍTULO / TITLE:  - Adeno-associated virus (AAV) as a vehicle for therapeutic gene delivery: improvements in vector design and viral production enhance potential to prolong graft survival in pancreatic islet cell transplantation for the reversal of type 1 diabetes.

REVISTA / JOURNAL:  - Curr Mol Med 2001 May;1(2):245-58.

AUTORES / AUTHORS:  - Kapturczak MH; Flotte T; Atkinson MA

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, University of Florida, Gainesville 32610, USA.

RESUMEN / SUMMARY:  - Most viral gene delivery syslems utilized to date have demonstrated significant limitations in practicality and safety due to the level and duration of recombinant transgene expression as well as their induction of host immunogenicity to vector proteins. Recombinant adeno-associated virus (rAAV) vectors appear to offer a vehicle for safe, long-term therapeutic gene transfer; factors afforded through the propensity of rAAV to establish long-term latency without deleterious effects on the host cell and the relative non-immunogenicity of the virus or viral expressed transgenes. The principal historical limitation of this vector system, efficiency of rAAV-mediated transduction, has recently observed a dramatic increase as the titer, purity, and production capacity of rAAV preparations have improved. In terms of systems that could benefit from such improvements, rAAV gene therapy to enhance solid organ transplantation would appear an obvious choice with islet transplantation forming a promising candidate due to the ability to perform viral transductions ex vivo. Currently, islet transplantation can be used to treat type 1 diabetes yet persisting alloimmune and autoimmune responses represent major obstacles to the clinical success for this procedure. The delivery of transgenes capable of interfering with antigenic recognition and/or cell death [e.g., Fas ligand (FasL), Bcl-2, Bcl-XL] as well as imparting tolerance/immunoregulation [e.g., interleukin(IL)-4, IL-10, transforming growth factor (TGF)-beta], or cytoprotection [e.g., heme oxygenase-1 (HO-1), catalase, manganese superoxide dismutase (MnSOD)] may prevent recurrent type 1 diabetes in islet transplantation and offer a promising form of immunotherapy. Research investigations utilizing such systems may also provide information vital to understanding the immunoregulatory mechanisms critical to the development of both alloimmune and autoimmune islet cell rejection mechanisms and recurrent type 1 diabetes.  N. Ref:: 164

 

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[144]

TÍTULO / TITLE:  - Successful treatment of Staphylococcus aureus bacterial endocarditis in a renal transplant recipient.

REVISTA / JOURNAL:  - Transpl Infect Dis 2003 Sep;5(3):144-6.

AUTORES / AUTHORS:  - D’Cunha PT; Davenport DS; Fisher KA

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan 48202, USA. pdcunha1@hfhs.org

RESUMEN / SUMMARY:  - We report the successful treatment of Staphylococcus aureus endocarditis in a renal transplant recipient with preservation of his renal allograft. A 44-year-old man presented to the emergency room with sudden onset of fevers and rigors 7 weeks after renal transplantation. Infective endocarditis was diagnosed by Duke’s Criteria (Durack et al. New criteria for the diagnosis of infective endocarditis. Am J Med 1994: 96: 200-209) with multiple positive blood cultures for S. aureus and a mitral valve vegetation on transesophageal echocardiogram. He was treated with intravenous antibiotics for 6 weeks with continuation of his immunosuppression. He has remained clinically stable for over 5 years. Although the treatment of S. aureus endocarditis in immunosuppressed transplant patients has traditionally resulted in loss of their allograft, prompt diagnosis and appropriate antibiotics with continued immunosuppressive therapy resulted in a successful outcome and allograft preservation in this case.  N. Ref:: 14

 

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[145]

TÍTULO / TITLE:  - Current management strategies for the prevention and treatment of cytomegalovirus infection in pediatric transplant recipients.

REVISTA / JOURNAL:  - Paediatr Drugs 2002;4(5):279-90.

AUTORES / AUTHORS:  - Bueno J; Ramil C; Green M

INSTITUCIÓN / INSTITUTION:  - Pediatric Transplantation Unit, Juan Canalejo Hospital, A Coruna, España. jbueno@canalejo.org

RESUMEN / SUMMARY:  - Cytomegalovirus (CMV) is a significant cause of morbidity and mortality following transplantation, especially in the pediatric population, who remain at high risk of primary infection. The availability of effective antiviral therapy has led to dramatic improvements in the outcome of CMV infection in patients undergoing transplantation. In recent years, three major strategies have been developed for the prevention of CMV disease in this population: reduction of risk of viral acquisition or reactivation by management of risk factors; prophylaxis of all ‘at-risk’ patients using prophylactic strategies for a defined period of time, initiated at or near the time of transplant; and pre-emptive treatment with ganciclovir of selected ‘at-risk’ patients, guided by either laboratory markers indicative of subclinical infection or the presence of specific risk factors. In general, well designed comparative studies of one or more antiviral agents for the prevention of CMV have not been carried out. While ganciclovir appears to be more effective than aciclovir, its tolerability profile is less optimal. The use of foscarnet avoids myelosuppresions, but is associated with significant nephrotoxicity. Its use should be reserved for patients unable to tolerate ganciclovir or with ganciclovir-resistant CMV disease. Similar to foscarnet, the high frequency of nephrotoxicity associated with the use of cidofovir limits its use to clinical scenarios suggestive of ganciclovir resistance. Newer options, such as valaciclovir and valganciclovir, are currently under investigation and preliminary experience has been promising. Finally, passive immunoprophylaxis has been shown to prevent CMV disease after solid organ transplantation, but its use in bone marrow transplantation is controversial. Essentially, pre-emptive strategies have relied on the quantitation in the peripheral blood of CMV phosphoprotein pp65 antigen and/or the polymerase chain reaction assay. Strict guidelines for the use of those assays as a guide to pre-emptive therapy have not been standardized. Prospective trials comparing pre-emptive therapy using either intravenous or oral ganciclovir, and now oral valganciclovir or valaciclovir, are necessary to determine the relative cost effectiveness and efficacy of these alternative strategies. Finally, it remains controversial as to whether prophylaxis or pre-emptive therapy is the optimal strategy for preventing CMV disease. While a growing body of literature describes these approaches in adult transplant recipients, published experience in children has been much more limited.  N. Ref:: 122

 

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[146]

TÍTULO / TITLE:  - Cytomegalovirus. A common virus causing serious disease.

REVISTA / JOURNAL:  - Aust Fam Physician 2003 Oct;32(10):789-93.

AUTORES / AUTHORS:  - Rawlinson W; Scott G

INSTITUCIÓN / INSTITUTION:  - South Eastern Sydney Area Health Service, Prince of Wales Hospital, Sydney Children’s Hospital, Royal Hospital for Women, Faculties of Medicine and Science, University of New South Wales. w.rawlinson@unsw.edu.au

RESUMEN / SUMMARY:  - BACKGROUND: Human cytomegalovirus (CMV) is a herpes virus that causes severe illness and death in people whose immune systems are compromised, including organ and bone marrow transplant recipients, HIV infected people, those on immunosuppressive drugs and newborns infected during pregnancy. OBJECTIVE: This article aims to present a clear guide to diagnosis and treatment of CMV in at risk patients in the community. DISCUSSION: Cytomegalovirus is a common infection in the community, but diagnosis is often seen as difficult. The use of careful clinical assessment tests and a clear diagnostic algorithm can provide appropriate diagnosis in most immunocompromised patients, pregnant women and newborns with CMV. Treatment strategies and available antivirals are improving, complementing the advances made with diagnostic techniques and algorithms.  N. Ref:: 27

 

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[147]

TÍTULO / TITLE:  - A case of persistent anemia in a renal transplant recipient: association with parvovirus B19 infection.

REVISTA / JOURNAL:  - Scand J Infect Dis 2002;34(1):71-5.

AUTORES / AUTHORS:  - Choi SH; Chang SP; Won JC; Lee JS; Chi HS; Yang WS; Park SK

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, Ulsan University College of Medicine, Seoul, South Korea.

RESUMEN / SUMMARY:  - We report an unexplained anemia that persisted for 4 months in a renal transplant patient who was receiving immunosuppression therapy that included prednisolone, tacrolimus and azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and occasional giant pronormoblasts with intranuclear inclusions, characteristic of a parvovirus B19 infection. Both the serum and bone marrow cells were positive by parvovirus B19 DNA PCR. The anemia resolved 6 weeks after the administration of intravenous immunoglobulin (IVIG). Four months later, anemia redeveloped and IVIG was infused again. Hemoglobin levels were, however, still subnormal after 1 month of treatment and tacrolimus was then switched to cyclosporin A, resulting in a clear improvement. A parvovirus B19 infection should be included in the differential diagnosis of renal transplant recipients who present with anemia associated with a low reticulocyte count. Tacrolimus may possibly impair the clearance of a parvovirus B19 infection.  N. Ref:: 21

 

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[148]

TÍTULO / TITLE:  - Rhodococcus equi brain abscess in an immunocompetent patient.

REVISTA / JOURNAL:  - Scand J Infect Dis 2002;34(4):300-2.

AUTORES / AUTHORS:  - Corne P; Rajeebally I; Jonquet O

INSTITUCIÓN / INSTITUTION:  - Department of Intensive Care Medicine, Gui de Chauliac Hospital, Montpellier, France.

RESUMEN / SUMMARY:  - Rhodococcus equi brain abscesses usually occur in immunocompromised patients with prolonged and refractory pulmonary infections. Herein we report a case of R. equi brain abscess in a 67-y-old man without immunodepression. Our patient recovered after neurosurgical resection and prolonged antimicrobial therapy with vancomycin and trimethoprim-sulfamethoxazole.  N. Ref:: 10

 

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[149]

TÍTULO / TITLE:  - The Epstein-Barr virus and post-transplant lymphoproliferative disease: interplay of immunosuppression, EBV, and the immune system in disease pathogenesis.

REVISTA / JOURNAL:  - Transpl Infect Dis 2001 Jun;3(2):60-9.

AUTORES / AUTHORS:  - Tanner JE; Alfieri C

INSTITUCIÓN / INSTITUTION:  - Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa Medical School, Ottawa, Ontario, Canada.

RESUMEN / SUMMARY:  - Transplant patients are at particular risk for developing post-transplant lymphoproliferative disease (PTLD) following administration of immunosuppressive therapy. In many cases the PTLD lesions express Epstein-Barr virus (EBV) latent and lytic genes as well as elevated levels of host cytokines. An outline of the potential contributions of EBV, host cytokines and T cells, and the immunosuppressive cyclosporine A, tacrolimus, and anti-CD3 antibody in the mechanism and pathogenesis of this disease is presented and discussed.  N. Ref:: 145

 

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[150]

TÍTULO / TITLE:  - Rising incidence of hepatocellular carcinoma: the role of hepatitis B and C; the impact on transplantation and outcomes.

REVISTA / JOURNAL:  - Clin Liver Dis 2003 Aug;7(3):683-714.

AUTORES / AUTHORS:  - Kaplan DE; Reddy KR

INSTITUCIÓN / INSTITUTION:  - Division of Gastroenterology and Hepatology, University of Pennsylvania School of Medicine, 3 Raydin, 3400 Spruce Street, Philadelphia, PA 19104, USA.

RESUMEN / SUMMARY:  - Hepatocellular carcinoma caused by hepatitis B and hepatitis C are global scourges but are likely to peak in incidence in the next 2 decades and then decline. Universal vaccination has been effective in stemming the incidence of chronic hepatitis B and early-onset HCC in regions of high endemicity where implemented, but preventive measures in HCV are not yet available. After the attrition of older affected generations, the incidence of HCC will likely decline rapidly. While no vaccine is currently available for hepatitis C, cases are projected to peak and decline because of a marked reduction in transmission as a result of behavioral modification and safeguarding of blood supplies. Until these epidemiologic projections come to pass, management of hepatocellular carcinoma will continue to become a progressively more frequently encountered clinical challenge. Therapy for chronic hepatitis may ameliorate but will not eliminate the development of tumors. The demand for orthotopic liver transplantation will continue to climb, and palliative therapies for non-resectable cases will require studies aimed at optimization of benefit. LDLT may remain an option for high-risk patients affording tumor-free survival for some otherwise terminal patients.  N. Ref:: 331

 

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[151]

TÍTULO / TITLE:  - Impact of HAART on HIV-linked malignancies.

REVISTA / JOURNAL:  - AIDS Read 2003 May;13(5):202, 205.

AUTORES / AUTHORS:  - Laurence J  N. Ref:: 13

 

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[152]

TÍTULO / TITLE:  - Rhodococcus equi infection in transplant recipients: a case of mistaken identity and review of the literature.

REVISTA / JOURNAL:  - Transpl Infect Dis 2002 Mar;4(1):52-6.

AUTORES / AUTHORS:  - Perez MG; Vassilev T; Kemmerly SA

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, Section on Infectious Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121,USA.

RESUMEN / SUMMARY:  - The incidence of Rhodococcus equi infection in solid-organ transplant recipients continues to rise throughout the world. Unfortunately, this opportunistic pathogen is still underestimated and potentially disregarded by physicians and microbiology laboratories due to its morphology on Gram staining. Pulmonary involvement is the most common finding in the immunocompromised host. We report a case of a 63-year-old heart-transplant recipient who presented with increasing fatigue and nonproductive cough for 3 weeks. After full evaluation, a lung abscess was demonstrated by thoracic computerized tomography (CT). Blood and sputum cultures were remarkable for heavy “diphtheroids.” Although the Gram-stain result was initially interpreted as a contaminant, a clinical suspicion for Rhodococcus assisted in further investigation. Broncheoalveolar lavage and CT-guided biopsy of the lung abscess revealed heavy growth of diphtheroids. However, further evaluation by a reference laboratory demonstrated mycolic acid staining consistent with R. equi. Surgical drainage and prolonged antibiotic therapy resulted in complete remission of the pneumonia and abscess. This represents the fourth reported case of R. equi infection in a heart transplant recipient. It is imperative that all physicians and laboratory staff consider R. equi when an immunocompromised patient has any type of pneumonia, especially with abscess formation.  N. Ref:: 20

 

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[153]

TÍTULO / TITLE:  - Immunosuppression in hepatitis B virus and hepatitis C virus transplants: special considerations.

REVISTA / JOURNAL:  - Clin Liver Dis 2003 Aug;7(3):667-81.

AUTORES / AUTHORS:  - Samuel D; Kimmoun E

INSTITUCIÓN / INSTITUTION:  - Centre Hepato-Biliaire, Hopital Paul Brousse, Universite Paris Sud, 12-14 Avenue Paul Vaillant Couturier, 94800 Villejuif, France UPRES 3541. didier.samuel@pbr.ap-hop-paris.fr

RESUMEN / SUMMARY:  - The management of the immunosuppression treatment must take account its consequences on viral replication. Such treatment operates on the emerging balance between the recurrence of the virus on the graft and the immune response of the host. Randomized and prospective trials are currently ongoing with the purpose of determining the opportunity and relevance of each immunosuppressive agent in the treatment. In HBV patients, good control of HBV reinfection by prophylactic strategies using HBIG, lamivudine, or both have decreased the impact of immunosuppression on HBV recurrence. In contrast, HCV recurrence is now a major problem. The mechanisms of viral recurrence need to be deepened thus requiring new studies. The absence of in vitro and in vivo systems to study HCV reinfection is a lack in the comprehension of the relation between HCV and immunosuppression. It will allow adapting the effectiveness of the immunosuppression treatment. The treatment’s primary target is to avoid graft rejection, and its secondary objective is to limit the risk of viral recurrence.  N. Ref:: 88

 

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[154]

TÍTULO / TITLE:  - Myroides odoratus cellulitis and bacteremia: case report and review.

REVISTA / JOURNAL:  - Scand J Infect Dis 2001;33(12):932-4.

AUTORES / AUTHORS:  - Green BT; Green K; Nolan PE

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, University of South Alabama, Mobile, USA.

RESUMEN / SUMMARY:  - A case of Myroides odoratus cellulitis with bacteremia in an apparently immunocompetent man is presented. Although common in soil and water, this agent is a rare clinical isolate and is often not considered pathogenic. The virulence of M. odoratus may be greater than is currently believed and it should be considered in bacteremias from cutaneous sources in immunocompetent patients.  N. Ref:: 7

 

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[155]

TÍTULO / TITLE:  - Cat scratch disease and acute rejection after pediatric renal transplantation.

REVISTA / JOURNAL:  - Pediatr Transplant 2002 Aug;6(4):327-31.

AUTORES / AUTHORS:  - Dharnidharka VR; Richard GA; Neiberger RE; Fennell RS 3rd

INSTITUCIÓN / INSTITUTION:  - The Division of Pediatric Nephrology, Shands Children’s Hospital and University of Florida College of Medicine, Gainesville, Florida 32610, USA. vikasmd@ufl.edu

RESUMEN / SUMMARY:  - Cat scratch disease (CSD) can lead to unexplained fever, generalized lymphadenopathy and organomegaly in immunocompetent individuals. CSD has rarely been reported in immunocompromised transplant recipients, where its clinical features would mimic the more common post-transplant lymphoproliferative disease (PTLD). We report three cases of CSD seen recently in children who had received prior kidney transplants. The three children were between 7 and 9 yr old, and had received kidney transplants 2-4 yr prior, with stable renal function. In each case, there was unexplained fever with either lymphadenopathy or organomegaly. The diagnosis of CSD was suggested by a history of new cats being introduced into each household and confirmed in all cases by the serological presence of a significant titer (> 1 : 64) of IgM antibodies to Bartonella henselae. Tests for other bacterial infections, cytomegalovirus and Epstein-Barr virus infections were negative. All the patients showed a clinical improvement with anti-microbial therapy. In patients A and B, the CSD was associated with an acute rejection episode shortly after diagnosis. The rejection episodes were reversed by intravenous steroid pulse therapy. Only four cases of CSD have been previously reported following solid organ transplantation. Acute rejection following CSD has not been previously reported. CSD should be included in the differential diagnosis of fever in the post-transplant setting, especially where PTLD is suspected.  N. Ref:: 12

 

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[156]

TÍTULO / TITLE:  - Hepatitis B immune globulin preparations and use in liver transplantation.

REVISTA / JOURNAL:  - Clin Liver Dis 2003 Aug;7(3):537-50.

AUTORES / AUTHORS:  - Terrault NA; Vyas G

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, University of California, 513 Parnassus Avenue, Room S 537, San Francisco, CA 94143-0538, USA. noraht@itsa.ucsf.edu

RESUMEN / SUMMARY:  - Hepatitis B immune globulin remains a central component of prophylaxis in HBV-infected patients undergoing liver transplantation. HBIG monotherapy given at a high dosage and indefinitely can prevent recurrence in 65% to 80% of patients. Because treatment failures occur and combination therapy using HBIG plus a nucleoside analog is more uniformly effective, the current standard of care is combination HBIG plus a nucleoside analog. These combination protocols have reduced the rate of virologic breakthrough to 10% or less. Several questions remain. The optimal dose and duration of HBIG use is unclear. Moreover, the development of resistance to lamivudine (and other nucleoside analogs) before transplantation increases the risk for virologic breakthrough post-transplantation. For patients with pre-transplant evidence of active HBV replication caused by the presence of nucleoside analog resistance, HBIG may be the main or only form of prophylaxis. For these patients, HBIG doses sufficient to maintain anti-HBs titers comparable to the days of HBIG monotherapy seem warranted. New HBIG formulations have made anti-HBs therapy more safe and tolerable to patients but the cost of the drug remains significant. The cost factor is particularly important in developing countries or countries with more limited resources for management of liver transplant recipients. Thus, there remains a need to develop and test new forms of anti-HBs therapy, so that effective but less expensive forms of immunoprophylaxis can be made available.  N. Ref:: 44

 

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[157]

TÍTULO / TITLE:  - An enduring association? Microfilariae and immunosuppression [correction of immunosupression] in lymphatic filariasis.

REVISTA / JOURNAL:  - Trends Parasitol 2003 Dec;19(12):565-70.

AUTORES / AUTHORS:  - O’Connor RA; Jenson JS; Osborne J; Devaney E

INSTITUCIÓN / INSTITUTION:  - Trudeau Institute, 100 Algonquin Avenue, Saranac Lake, NY 12983, USA.  N. Ref:: 55

 

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[158]

TÍTULO / TITLE:  - Antiviral resistance in cytomegalovirus: an emerging problem in organ transplant recipients.

REVISTA / JOURNAL:  - Semin Respir Infect 2002 Dec;17(4):265-73.

      ●● Enlace al texto completo (gratuito o de pago) 1053/srin.2002.36447

AUTORES / AUTHORS:  - Limaye AP

INSTITUCIÓN / INSTITUTION:  - Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA 98195, USA. limaye@u.washington.edu

RESUMEN / SUMMARY:  - In the era of more aggressive immunosuppressive regimens and antiviral prophylaxis, ganciclovir-resistant cytomegalovirus (CMV) has been recognized as an important clinical problem in organ transplant recipients. Among the various solid-organ transplant (SOT) recipients, lung transplant recipients appear to be disproportionately affected. Ganciclovir-resistant CMV appears to be a relatively late posttransplant complication and is seen predominantly among CMV-seronegative recipients of organs from seropositive donors, particularly in the setting of potent immunosuppression and prolonged exposure to ganciclovir (especially oral ganciclovir). Limitations in current diagnostic methods mandate a high clinical index of suspicion. In high-risk patients in whom ganciclovir resistance is clinically suspected, while awaiting laboratory confirmation of resistance, empiric addition of intravenous foscarnet, often combined with reduction in immunosuppression and CMV hyperimmune globulin, are commonly used. Better diagnostic tools and newer, less toxic, antiviral agents with different mechanisms of action are urgently needed to decrease the morbidity associated with this complication in organ transplant recipients.  N. Ref:: 39

 

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[159]

TÍTULO / TITLE:  - Cutaneous manifestations of systemic cryptococcosis in immunosupressed patients.

REVISTA / JOURNAL:  - J Med 2001;32(5-6):259-66.

AUTORES / AUTHORS:  - Thomas I; Schwartz RA

INSTITUCIÓN / INSTITUTION:  - Dermatology, UMDNJ New Jersey Medical School, Newark 07103-2714, USA.

RESUMEN / SUMMARY:  - Since its discovery 100 years ago, the encapsulated yeast Cryptococcus neoformans has been implicated in systemic infections of many immunocompromised patients and has been a leading cause of morbidity and mortality in AIDS patients. Clinical symptoms are often initially subtle or lacking. Cutaneous involvement often carries a dismal prognosis as it is usually a sign of dissemination. However, lesions may develop before any systemic or constitutional symptomatology, and despite their non specific appearance, are easily accessible for scrapings, biopsies and cultures. A high index of suspicion is of utmost importance in high risk individuals to avoid delaying the diagnosis and treatment.  N. Ref:: 30

 

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[160]

TÍTULO / TITLE:  - Viral inhibition of MHC class II antigen presentation.

REVISTA / JOURNAL:  - Trends Immunol 2003 May;24(5):278-85.

AUTORES / AUTHORS:  - Hegde NR; Chevalier MS; Johnson DC

INSTITUCIÓN / INSTITUTION:  - Department of Molecular Microbiology and Immunology, 3181 SW Sam Jackson Park Road, Oregon Health and Science University, Portland, OR 97239-3098, USA.  N. Ref:: 59

 

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[161]

TÍTULO / TITLE:  - Phaeohyphomycosis of the central nervous system in immunocompetent hosts: report of a case and review of the literature.

REVISTA / JOURNAL:  - Int J Infect Dis 2003 Dec;7(4):282-6.

AUTORES / AUTHORS:  - Filizzola MJ; Martinez F; Rauf SJ

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, The University of Texas Medical Branch (UTMB), Galveston, Texas, USA. filizzola@aol.com

RESUMEN / SUMMARY:  - Background: Phaeohyphomycosis refers to infections caused by phaeoid fungi that can have an aggressive course in normal hosts. Involvement of the central nervous system may occur with a generally poor outcome. Clinical report and literature review: We report a case of Bipolaris sp. brain abscess in an immunologically competent host. We also review all previous cases of cerebral phaeohyphomycosis in normal hosts reported in the literature to date. Conclusions: Central nervous system phaeohyphomycosis remains an unusual disease; however, its incidence has been increasing in recent years. The prognosis of this condition is still poor, despite medical and surgical interventions. Aggressive diagnostic approaches and careful interpretation of cultures might modify the natural history of this disease.  N. Ref:: 17

 

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[162]

TÍTULO / TITLE:  - The role of bronchoalveolar lavage in the immunocompromised host.

REVISTA / JOURNAL:  - Semin Respir Infect 2003 Jun;18(2):87-94.

AUTORES / AUTHORS:  - Feller-Kopman D; Ernst A

INSTITUCIÓN / INSTITUTION:  - Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

RESUMEN / SUMMARY:  - Bronchoscopy with bronchoalveolar lavage (BAL) is a frequently performed, minimally invasive endoscopic examination in patients with unclear infiltrates or pulmonary infections. It can be performed safely in patients with compromised immune systems of different etiologies. This article summarizes the experience with and efficacy of BAL in different disease states in this clinical circumstance. Because human immunodeficiency virus (HIV)-related diseases and acquired immune deficiency syndrome (AIDS) patients show different characteristics when compared with patients with other reasons for immunosuppression, they are discussed separately. Clinical algorithms are presented.  N. Ref:: 47

 

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[163]

TÍTULO / TITLE:  - Human papillomavirus infection and skin cancer risk in organ transplant recipients.

REVISTA / JOURNAL:  - J Investig Dermatol Symp Proc 2001 Dec;6(3):207-11.

AUTORES / AUTHORS:  - Bouwes Bavinck JN; Feltkamp M; Struijk L; ter Schegget J

INSTITUCIÓN / INSTITUTION:  - Department of Dermatology, Leiden University Medical Center, The Netherlands. J.N.BouwesBavinck@Lumc.nl

RESUMEN / SUMMARY:  - Warts and squamous cell carcinomas are important cutaneous complications in organ transplant recipients. The role of infection with human papillomaviruses (HPV) in the development of cutaneous squamous cell carcinoma is still unclear. An extremely diverse group of HPV types, mainly consisting of epidermodysplasia-verruciformis (EV)-associated HPV types, can be detected in benign, premalignant, and malignant skin lesions of organ transplant recipients. Frequently, there are multiple HPV types present in single skin biopsies. Typically, the prevalence of viral warts rises steadily after transplantation and a strong association exists between the number of HPV-induced warts and the development of skin cancer. The interval between the transplantation to the development of warts is clearly shorter than the interval from transplantation to the diagnosis of the first skin cancer. A comparison of transplant recipients with and without skin cancer, however, showed an equally high prevalence of EV-HPV DNA in keratotic skin lesions in both groups of patients and the detection rate and spectrum of HPV infection in hyperkeratotic papillomas, actinic keratoses, and squamous cell carcinomas was also similar. HPV DNA can frequently be detected in patients with hyperproliferative disorders like psoriasis and antibodies against HPV in patients with regenerating skin (e.g., after extensive second degree burns). Latent infection with EV-HPV seems to be widespread. The hair follicle region might be the reservoir of EV-HPV. The E6 protein from a range of cutaneous HPV types effectively inhibits apoptosis in response to UV-light induced damage. It is therefore conceivable that individuals who are infected by EV-HPV are at an increased risk of developing actinic keratoses and squamous cell carcinomas, possibly by chronically preventing UV-light induced apoptosis.  N. Ref:: 73

 

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[164]

TÍTULO / TITLE:  - Management of hepatitis B and C in renal failure and renal transplant recipients.

REVISTA / JOURNAL:  - Trop Gastroenterol 2002 Apr-Jun;23(2):49-53.

AUTORES / AUTHORS:  - Amarapurkar D; Das HS

INSTITUCIÓN / INSTITUTION:  - Department of Gastroenterology and Hepatology, Bombay Hospital And Medical Research Center, Mumbai. deepakn@bom3.vsnl.net.in  N. Ref:: 79

 

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[165]

TÍTULO / TITLE:  - Chapter 6: Immunosuppression and co-infection with HIV.

REVISTA / JOURNAL:  - J Natl Cancer Inst Monogr 2003;(31):41-6.

AUTORES / AUTHORS:  - Palefsky JM; Holly EA

INSTITUCIÓN / INSTITUTION:  - University of California-San Francisco, 505 Parnassus Ave., Rm. M1203, Box 0126, San Francisco, CA 94143, USA. joelp@medicine.ucsf.edu

RESUMEN / SUMMARY:  - Individuals with immunosuppression caused by HIV infection or organ transplantation are at increased risk of human papillomavirus (HPV)-associated anogenital cancers compared with age-matched healthy individuals. The exact role of immunosuppression in conferring increased risk is not known. Although it is unknown which stages of progression from dysplasia to cancer are most affected by immunosuppression, current data suggest that immunosuppression is most strongly associated with the early stages of dysplasia, and that progression to cancer per se is not associated with immunosuppression. Studies to determine this relationship in detail are hampered by the paucity of precise biomarkers of cell-mediated immune response to HPV. This chapter will address these and other issues to provide a better understanding of the biology of HPV infection among immunocompromised individuals. Questions remain about the biology of HPV infection among immunocompromised HIV-negative individuals (e.g., transplant patients) compared with those who are HIV-positive; the impact of highly active antiretroviral therapy on the natural history of anogenital dysplasia and cancer among those who are HIV-positive, and whether the biology of specific HPV types is the same in HIV-positive as in HIV-negative individuals. Understanding HPV infection in those who are immunocompromised offers the potential to better understand its pathobiology in the putatively immunocompetent host.  N. Ref:: 42

 

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[166]

TÍTULO / TITLE:  - Natural history of hepatitis C and outcomes following liver transplantation.

REVISTA / JOURNAL:  - Clin Liver Dis 2003 Aug;7(3):585-602.

AUTORES / AUTHORS:  - Charlton M

INSTITUCIÓN / INSTITUTION:  - Department of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Transplant Center CH-10, 200 First St. S.W., Rochester, MN 55905, USA. charlton.michael@mayo.edu

RESUMEN / SUMMARY:  - Hepatitis C-associated liver failure is the most common indication for liver transplantation and the infection recurs nearly universally following transplantation. Histologic evidence of recurrence is apparent in approximately 50% of HCV-infected recipients in the first postoperative year. Approximately 10% of HCV-infected recipients will die or lose their allograft secondary to hepatitis C-associated allograft failure in the medium term. HCV-infected recipients who undergo retransplantation experience 5-year patient and graft survival rates that are similar to recipients undergoing retransplantation who are not HCV-infected. While the choice of calcineurin inhibitor or the use of azathioprine have not been clearly shown to affect histologic recurrence of hepatitis C or the frequency of rejection in HCV-infected recipients, cumulative exposure to corticosteroids is associated with increased mortality, higher levels of HCV viremia, and more severe histologic recurrence. In contrast to non-HCV-infected recipients, treatment for acute cellular rejection is associated with attenuated patient survival among recipients with hepatitis C. The development of steroid-resistant rejection is associated with a greater than 5-fold increased risk of mortality in HCV-infected liver transplant recipients. In lieu of large studies in a posttransplant population, therapy with pegylated IFN (+/- ribavirin) should be considered in recipients with histologically apparent recurrence of hepatitis C before total bilirubin exceeds 3 mg/dl. The role of hepatitis C immunoglobulin and new immunosuppression agents in the management of posttransplant hepatitis C infection is still evolving.  N. Ref:: 85

 

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[167]

TÍTULO / TITLE:  - Respiratory virus infections in the immunocompromised host.

REVISTA / JOURNAL:  - Paediatr Respir Rev 2003 Sep;4(3):193-204.

AUTORES / AUTHORS:  - Soldatou A; Davies EG

INSTITUCIÓN / INSTITUTION:  - Department of Immunology, Great Ormond Street Hospital, WC1 N 3JH, London, UK.

RESUMEN / SUMMARY:  - The number of immunocompromised children in the population is increasing for a variety of reasons. Common respiratory viruses acquired in the community or in the hospital setting include the ortho- and paramyxoviruses and may cause severe lower respiratory tract disease in these children. Measles is again becoming a threat. Particularly in transplant patients, Herpes group viruses and adenoviruses, often part of a reactivation illness, can cause potentially life-threatening disease. The use of rapid molecular diagnostic techniques and an increasing array of antiviral therapies can help ensure a good outcome in many cases, although controlled clinical trial data are often lacking. Immunotherapeutic strategies using specific antibodies or cytotoxic T cells are being developed and are likely to have an increasing role in prophylaxis and pre-emptive therapy in the future. The development and introduction of vaccines against common respiratory diseases will help reduce the risks faced by these susceptible children.  N. Ref:: 62

 

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[168]

TÍTULO / TITLE:  - Eikenella corrodens: an unusual cause of severe parapneumonic infection and empyema in immunocompetent patients.

REVISTA / JOURNAL:  - J Natl Med Assoc 2001 Jun;93(6):224-9.

AUTORES / AUTHORS:  - Hoyler SL; Antony S

INSTITUCIÓN / INSTITUTION:  - University of Texas at Austin College of Pharmacy, Texas Oncology Physicians Associates, El Paso 79915, USA.

RESUMEN / SUMMARY:  - Over the past 25 years, Eikenella corrodens has increasingly been recognized for its pathogenic potential. Previously identified as an organism most likely to cause opportunistic infection in the immunocompromised host, Eikenella more recently has been implicated in a number of clinical infections in non-immunocompromised patients. We report a case of community-acquired pneumonia, caused by Eikenella, in a patient with diabetes mellitus and a past history of testicular cancer. A review of the literature was conducted in order to review other cases of pulmonary infection with Eikenella, in immunocompetent adults. The condition was diagnosed in 15 patients, occurring most often in men with a mean age of 50. Patients most often presented with fever, cough and pleuritic chest pain. Complications often involved parapneumonic effusion, empyema, and necrotic parenchymal disease. Mortality rates appear to be low. Eikenella is most often susceptible to ampicillin and has variable susceptibility to aminoglycosides. The addition of clindamycin in non-immunocompromised patients with Eikenella infection, co-infected with other pathogens, also appears to be useful. Surgical intervention plays an important role in the recovery of these patients.  N. Ref:: 15

 

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[169]

TÍTULO / TITLE:  - Primary cutaneous cryptococcosis due to Cryptococcus neoformans var. gattii serotype B, in an immunocompetent patient.

REVISTA / JOURNAL:  - Rev Inst Med Trop Sao Paulo 2002 Jul-Aug;44(4):225-8.

AUTORES / AUTHORS:  - Lacaz Cda S; Heins-Vaccari EM; Hernandez-Arriagada GL; Martins EL; Prearo CA; Corim SM; Martins Mdos A

INSTITUCIÓN / INSTITUTION:  - Laboratorio de Micologia Medica, Instituto de Medicina Tropical de Sao Paulo, Sao Paulo, Brazil.

RESUMEN / SUMMARY:  - The authors report a male patient, a seller with no detected immunosuppression, with an extensive ulcerated skin lesion localized on the left forearm, caused by Cryptococcus neoformans var. gattii serotype B. Oral treatment with fluconazole was successful. A review of the literature showed the rarity of this localization in HIV-negative patients. In contrast, skin lesions frequently occurs in HIV-positive patients, with Cryptococcus neoformans var. neoformans serotype A predominating as the etiological agent. In this paper, the pathogenicity of C. neoformans to skin lesions in patients immunocompromised or not, is discussed, showing the efficacy of fluconazole for the treatment of these processes.  N. Ref:: 26

 

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[170]

TÍTULO / TITLE:  - Role of cytomegalovirus in cardiac allograft vasculopathy.

REVISTA / JOURNAL:  - Transpl Infect Dis 2001;3 Suppl 2:44-8.

AUTORES / AUTHORS:  - Weill D

INSTITUCIÓN / INSTITUTION:  - University of Alabama at Birmingham, USA. dweill@uab.edu

RESUMEN / SUMMARY:  - Cardiac allograft vasculopathy is the most common cause of death and retransplantation following heart transplantation, and about 10% of patients per year have evidence of accelerated vascular disease; 50% at 5 years. Cytomegalovirus (CMV) infection has been associated with accelerated cardiac vasculopathy and decreased 5-year survival. Prophylactic therapy using ganciclovir has reduced the incidence of CMV disease, but not in the group at highest risk, namely the seronegative recipient of an allograft from a seropositive donor (D+/R-). Combination prophylaxis consisting of CMV hyperimmune globulin (CMV-IGIV) plus ganciclovir is associated with decreased intimal thickening, reduced coronary artery disease and obliterative bronchiolitis, and improved survival.  N. Ref:: 22

 

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[171]

TÍTULO / TITLE:  - Efficacy of desensitization via the sublingual route in mite allergy.

REVISTA / JOURNAL:  - Chem Immunol Allergy 2003;82:62-76.

AUTORES / AUTHORS:  - Guez S

INSTITUCIÓN / INSTITUTION:  - Unite des Maladies Allergiques, Hopital Pellegrin-Tripode, Bordeaux, France. stephane.guez@chu-bordeaux.fr

RESUMEN / SUMMARY:  - Desensitization via the sublingual route when treating mite allergy is a new technique in immunotherapy that has aroused the interest of an increasing number of allergists. Assessing its effectiveness is difficult because of the multiplicity of the criteria used by the various published studies to determine what constitutes an improvement. But a critical analysis of the results obtained in the various methodologically rigorous studies suggests that treatment is effective when compared to a placebo. It remains, however, necessary to determine whether or not the sublingual route is superior to the subcutaneous route; its ease of use and harmlessness should not be the only criteria when deciding upon a treatment that above all else should be curative.  N. Ref:: 16

 

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[172]

TÍTULO / TITLE:  - Natural history of hepatitis B and outcomes after liver transplantation.

REVISTA / JOURNAL:  - Clin Liver Dis 2003 Aug;7(3):521-36.

AUTORES / AUTHORS:  - Huang MA; Lok AS

INSTITUCIÓN / INSTITUTION:  - Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, 3912 Taubman Center, Ann Arbor, MI 48109, USA.

RESUMEN / SUMMARY:  - HBV infection is the single most common cause of cirrhosis globally although the prevalence rate is influenced by geographic region. The natural course of HBV infection and the clinical outcome is dependent on the interplay between host, virus, and environmental factors. Understanding the natural history of HBV infection is important in determining treatment strategies. OLT is the ultimate cure for patients with HBV-related liver failure or HCC. The use of HBIG and new antiviral agents has resulted in significant decrease in HBV re-infection rate and survival of patients transplanted for hepatitis B in recent years is comparable to that of patients transplanted for other liver disease.  N. Ref:: 82

 

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[173]

TÍTULO / TITLE:  - Cytomegalovirus-associated acute transverse myelitis in immunocompetent adults.

REVISTA / JOURNAL:  - Clin Microbiol Infect 2003 Dec;9(12):1187-90.

AUTORES / AUTHORS:  - Fux CA; Pfister S; Nohl F; Zimmerli S

INSTITUCIÓN / INSTITUTION:  - Institute for Infectious Diseases, University of Bern, Switzerland.

RESUMEN / SUMMARY:  - We report a case of transverse myelitis as a complication of acute cytomegalovirus (CMV) infection in immunocompetent patients; and review the literature on the entity. Primary CMV infection was documented by CMV antigenemia and high serum titers of CMV IgM and IgG antibodies. Cerebrospinal fluid (CSF) pleocytosis indicated central nervous system inflammation; CSF polymerase chain reaction (PCR) for CMV, however, was negative. The results of magnetic resonance imaging of the myelon were normal. Although CMV-associated transverse myelitis has been well described in HIV-positive individuals, but is very rare in immunocompetent individuals. It remains unclear whether the neuronal damage is immune mediated or due to a cytotoxic effect of viral infection. The outcome is mainly favorable.  N. Ref:: 25

 

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[174]

TÍTULO / TITLE:  - Rhodotorula species fungemia: a threat to the immunocompromised host.

REVISTA / JOURNAL:  - Clin Lab 2003;49(1-2):49-55.

AUTORES / AUTHORS:  - Anatoliotaki M; Mantadakis E; Galanakis E; Samonis G

INSTITUCIÓN / INSTITUTION:  - The University of Crete, Division of Medicine, Heraklion, Crete, Greece.

RESUMEN / SUMMARY:  - Members of the genus Rhodotorula, family Cryptococcaceae, are common airborne fungi showing remarkable ubiquity. In the recent past they were considered nonvirulent saprophytes. However, during the last two decades they have emerged as opportunistic pathogens in immunocompromised patients. A review of the English literature covering the period 1960-2001 disclosed 47 reported cases of Rhodotorula spp fungemia. The great majority of these infections has been reported after 1990, were catheter-related, and diagnosed in patients with cancer. The treatment of Rhodotorula fungemia remains controversial. Resolution of coexistent neutropenia is essential for recovery. Removal of the central venous catheter is usually sufficient and treatment with systenic antifungals may not be required. If catheter removal is undesirable or impossible or when the infection persists, treatment with amphotericin B is the treatment of choice. Rhodotorula is a fungus with a low virulence and fatality rate. Hence, most patients with Rhodotorula fungemia reported in the literature survived with or without administration of antifungal agents.  N. Ref:: 23

 

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[175]

TÍTULO / TITLE:  - MHC restriction in allergic bronchopulmonary aspergillosis.

REVISTA / JOURNAL:  - Front Biosci 2003 Jan 1;8:s140-8.

AUTORES / AUTHORS:  - Chauhan B; Hutcheson PS; Slavin RG; Bellone CJ

INSTITUCIÓN / INSTITUTION:  - Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. chauhamb@slu.edu

RESUMEN / SUMMARY:  - Allergic bronchopulmonary aspergillosis (ABPA) is a rare complication in patients with asthma but more common in patients with cystic fibrosis. In the presence of the fungus Aspergillus fumigatus (Af) in the lower respiratory tract, patients mount a heightened IgG and IgE humoral response specific for Af antigens. Studies on ABPA have suggested a pathogenic role for antigen specific CD4+ Th2 like T lymphocytes producing increased levels of IL-4 and IL-5. MHC class II genes coding for highly polymorphic HLA molecules have been shown to be the likely candidates for controlling immune responses to common allergens. However there has been a lack of information on the pathophysiological role of HLA genes in the development of ABPA. This review describes an association between HLA- class II alleles and the specific responses to Af antigen (Asp f 1) in ABPA. These studies focused on MHC restriction and distribution of HLA- class II alleles in two groups of unrelated North American Caucasian patients with cystic fibrosis and/or asthma. One group consisted of patients with a confirmed diagnosis of ABPA and a second group of patients with Af sensitivity but no ABPA. HLA association studies revealed that the predisposition to develop ABPA is associated with HLA-DR2 and DR5, and possibly DR4 or DR7. A strong association of HLA-DR antigens with ABPA reflects that HLA-DR molecules may present disease-causing peptides. On the other hand a significant association of HLA-DQ2 with Af sensitive nonABPA indicates the involvement of HLA-DQ molecules in protection. A combination of these genetic factors determines the outcome of ABPA in patients with cystic fibrosis and asthma.  N. Ref:: 67

 

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[176]

TÍTULO / TITLE:  - Mycobacterial infections in organ transplant recipients.

REVISTA / JOURNAL:  - Semin Respir Infect 2002 Dec;17(4):274-83.

      ●● Enlace al texto completo (gratuito o de pago) 1053/srin.2002.36445

AUTORES / AUTHORS:  - John GT; Shankar V

INSTITUCIÓN / INSTITUTION:  - Department of Nephrology, Christian Medical College Hospital, Vellore, India. george@cmvellore.ac.in

RESUMEN / SUMMARY:  - Tuberculosis has a major adverse impact on solid organ transplant recipients; this article attempts to define this fact. The prevalence of posttransplant tuberculosis is increasing globally and currently is 13.7% at our center. The transplant surgery divides the continuum of pretransplant tuberculosis and posttransplant tuberculosis; immunosuppression accounts for a greater severity of the latter. Cyclosporin and tacrolimus are associated with an earlier onset of tuberculosis when compared with prednisolone and azathioprine immunosuppression. Disseminated disease is more common in nonrenal transplants. The risk for developing posttransplant tuberculosis in renal transplant recipients increased 2.25 times independently with cytomegalovirus (CMV) and twice with chronic liver disease; OKT3 treatment enhances the risk 1.8-fold. Tuberculosis occurring after 2 years of transplantation, diabetes mellitus, posttransplant diabetes mellitus, chronic liver disease, CMV, and deep mycoses each independently confer a risk, 1.5-times or higher, for death. Disseminated disease entails a 2-fold risk. Treatment with or without rifampicin is possible; the former is associated with a higher risk for allograft rejection. Isoniazid prophylaxis is recommended for high-risk patients with apparent clinical efficacy. However, in endemic areas, attendant liver disease makes it a difficult goal.  N. Ref:: 35

 

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[177]

TÍTULO / TITLE:  - Human herpesvirus type 8 infections among solid organ transplant recipients.

REVISTA / JOURNAL:  - Pediatr Transplant 2002 Jun;6(3):187-92.

AUTORES / AUTHORS:  - Allen UD

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Canada. Upton.allen@sickkids.on.ca

RESUMEN / SUMMARY:  - Human herpes virus 8 (HHV-8) is known to be associated with Kaposi’s sarcoma (KS), primary effusion lymphoma (PEL) and a form of Castleman’s disease. Recently, it has also been shown to be associated with acute bone marrow failure in transplant patients. While, the full spectrum of clinical manifestations due to HHV-8 is yet to be defined in transplant recipients, it is known to cause post-transplant KS as a result of primary as well as secondary infection. This review will discuss the possible role of HHV-8 as a cause of disease in solid organ transplant recipients by focussing on important issues, including the biology of the virus, epidemiology, clinical manifestations, laboratory diagnosis and treatment, followed by a discussion of issues of relevance to the pediatric transplant recipient.  N. Ref:: 56

 

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[178]

TÍTULO / TITLE:  - Immunosuppressive effects of beta-herpesviruses.

REVISTA / JOURNAL:  - Herpes 2003 May;10(1):12-6.

AUTORES / AUTHORS:  - Boeckh M; Nichols WG

INSTITUCIÓN / INSTITUTION:  - Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA. mboeckh@fhcrc.org

RESUMEN / SUMMARY:  - Immunomodulatory effects of human beta-herpesviruses have been reported in vitro and in vivo. Clinical studies suggest that beta-herpesvirus infection may increase the risk for other infections, the severity of infection, or the tempo of disease progression. An increased incidence of bacterial and fungal infections, and graft rejection, have been reported in association with cytomegalovirus (CMV), and human herpesviruses type 6 and type 7 infections have been implicated as risk factors for CMV infection and graft rejection. Beta-herpesviruses may also interact with HIV-1 and hepatitis C. To prove a causal relationship between beta-herpesviruses and specific clinical outcomes, randomized trials, with selective suppression of the virus, are required. Such trials have been performed for CMV and showed a reduction in bacterial and fungal infections as well as rejection in selected solid organ transplant recipients. More trials are needed to evaluate whether the effects seen in observational studies are truly related.  N. Ref:: 61

 

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[179]

TÍTULO / TITLE:  - Resistance and susceptibility in human onchocerciasis—beyond Th1 vs. Th2.

REVISTA / JOURNAL:  - Trends Parasitol 2002 Jan;18(1):25-31.

AUTORES / AUTHORS:  - Hoerauf A; Brattig N

INSTITUCIÓN / INSTITUTION:  - Bernhard Nocht Institute of Tropical Medicine, Bernhard-Nocht-Strasse 74, 20359, Hamburg, Germany. hoerauf@bni.uni-hamburg.de

RESUMEN / SUMMARY:  - As research progress has led to programs for the elimination of onchocerciasis as a public health problem, research must now be intensified to protect elimination efforts. A profound understanding of the immunology in the human-parasite relationship is required for predicting the impacts of an altered immune response in a population post-microfilaricide treatment, and for the development of a vaccine against onchocerciasis, a highly desirable tool to guarantee sustained elimination success. This article summarizes the recent advancements in understanding the human immune mechanisms against onchocerciasis, and focuses on the new concept of T-cell suppressor responses as a major counterbalance mechanism for effector responses driven by T helper 1 and T helper 2 cells against the filarial worms.  N. Ref:: 71

 

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[180]

TÍTULO / TITLE:  - BK virus infection in renal transplant recipients.

REVISTA / JOURNAL:  - Pediatr Transplant 2001 Dec;5(6):398-405.

AUTORES / AUTHORS:  - Lin PL; Vats AN; Green M

INSTITUCIÓN / INSTITUTION:  - Departments of Pediatrics and Surgery, Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania 15213-2583, USA.

RESUMEN / SUMMARY:  - BK virus (BKV) is increasingly being recognized as an important pathogen among renal transplant recipients. To date, only limited information is known about BKV infections in this population; definitive data regarding the epidemiology, diagnosis, treatment, and outcome of BKV infection are lacking. Therefore, further investigations are needed. This article reviews our current understanding of BKV infections among renal transplant patients.  N. Ref:: 43

 

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[181]

TÍTULO / TITLE:  - Immunotherapy of human papillomavirus-associated malignancies and the challenges posed by T-cell tolerance.

REVISTA / JOURNAL:  - Front Biosci 2002 Apr 1;7:d853-71.

AUTORES / AUTHORS:  - Wilcox RA; Chen L

INSTITUCIÓN / INSTITUTION:  - Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA.

RESUMEN / SUMMARY:  - Human papillomaviruses are associated with a broad range of carcinomas, including cervical cancer. Although the delivery of immunogenic tumor-associated antigens represents a promising approach in the treatment of these malignancies, the imposition of T cell tolerance poses a significant challenge in this endeavor. The purpose of this review is to discuss T cell tolerance and the role of T cell costimulation in the immunotherapy of HPV-associated malignancies.  N. Ref:: 266

 

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[182]

TÍTULO / TITLE:  - Infections in the transplant recipient.

REVISTA / JOURNAL:  - Med Health R I 2002 Apr;85(4):125-7.

AUTORES / AUTHORS:  - Fischer SA

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, Brown Medical School, Providence, RI, USA. Sfischer@Lifespan.org  N. Ref:: 22

 

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[183]

TÍTULO / TITLE:  - Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients.

REVISTA / JOURNAL:  - Korean J Radiol 2002 Jul-Sep;3(3):145-57.

AUTORES / AUTHORS:  - Koh WJ; Kwon OJ; Lee KS

INSTITUCIÓN / INSTITUTION:  - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

RESUMEN / SUMMARY:  - Nontuberculous mycobacterial (NTM) infections are an increasingly recognized cause of chronic lung disease in immunocompetent adults, and the M. avium complex, M. kansasii, and a rapidly growing mycobacteria such as M. abscessus, M. fortuitum, and M. chelonae account for most of the pathogens involved. Because the clinical features of NTM disease are not distinguishable from those of tuberculosis, and NTM are ubiquitous in the environment, diagnosis requires that the bacilli are isolated and identified. NTM diseases have been difficult to treat, though since the introduction of new macrolides, the outcome for patients with some NTM diseases has improved significantly. For correct diagnosis and the successful treatment of NTM pulmonary disease, a knowledge of the full spectrum of clinical and radiological findings is important.  N. Ref:: 52

 

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[184]

TÍTULO / TITLE:  - Human herpesvirus 6 (HHV6) infection.

REVISTA / JOURNAL:  - Indian J Pediatr 2004 Jan;71(1):89-96.

AUTORES / AUTHORS:  - Abdel-Haq NM; Asmar BI

INSTITUCIÓN / INSTITUTION:  - Division of Infectious Diseases, Children’s Hospital of Michigan, Detroit Medical Center, Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan 48201, USA. nabdel@dmc.org

RESUMEN / SUMMARY:  - Human herpes virus-6 was first reported in 1986 and is the sixth member of the herpes virus family. HHV-6 consists of two closely related variants HHV-6A and HHV-6B. The majority of infections occur in healthy infants with most infections caused by HHV-6B. The virus preferentially infects CD4+T-lymphocytes and the surface marker CD46 acts as a co-receptor. Infection is followed by persistence and latency in different cells and organs including monocytes/macrophages, salivary glands, the brain and the kidneys. In this article we will discuss the clinical manifestations of HHV-6 infection in healthy children and the syndromes associated with HHV-6 reactivation in immunocompromised patients. Evidence of association between HHV-6 infection and different clinical entities such as multiple sclerosis, malignancy, infectious momononucleosis, drug hypersensitivity syndromes and skin eruptions is discussed. Published data on the use and efficacy of antiviral agents in complicated infections and infections in immunocompromised patients is presented.  N. Ref:: 96

 

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[185]

TÍTULO / TITLE:  - The influence of diabetes mellitus on postoperative infections.

REVISTA / JOURNAL:  - Crit Care Nurs Clin North Am 2003 Mar;15(1):125-35.

AUTORES / AUTHORS:  - Aragon D; Ring CA; Covelli M

INSTITUCIÓN / INSTITUTION:  - Orlando Regional Healthcare System, 5428 Conway Oaks Court, Orlando, FL 32812, USA. daleena@orhs.org

RESUMEN / SUMMARY:  - Clinicians and researchers are linking elevated glucose levels with potential infectious outcomes. Physiologic processes to fight foreign agents are potentially impaired during periods of hyperglycemia. Some of these responses, such as immune function and the inflammatory response, are impaired when they are needed most, such as during the recovery from surgical procedures. Investigators have demonstrated the importance of control of serum glucose postoperatively. Outcomes are improved when tighter glycemic control is practiced. The current literature challenges practitioners to become more cognizant of serum glucose in surgical patients and patients who are critically ill, implementing protocols to gain tighter control of serum glucose in any patient may be appropriate. Further investigation of glycemic control in surgical and other populations will reinforce research findings in this area. Studies should be performed on surgical patients who are particularly vulnerable to DM, glycemic alterations, and postoperative infections, such as patients undergoing peripheral vascular surgery. Further investigations are also needed on the role of hyperglycemia and outcomes in nondiabetic individuals, and on the similarities or differences in glycemic control in types 1 and 2 DM. To increase the generalizability of the study findings, definitions used across studies, such as the type of diabetes, should be standardized. When these studies determine optimal glycemic control practices in a variety of patient populations, clinicians will be able to determine the best practice guidelines to optimize patient care and limit adverse infectious outcomes.  N. Ref:: 36

 

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[186]

TÍTULO / TITLE:  - Polyoma virus in renal transplant recipients.

REVISTA / JOURNAL:  - Nephrol Nurs J 2002 Jun;29(3):247-50; quiz 251-2.

AUTORES / AUTHORS:  - Weiskittel PD

INSTITUCIÓN / INSTITUTION:  - University Hospital, Cincinnati, OH, USA.

RESUMEN / SUMMARY:  - Infection and rejection have been the most critical complications following renal transplantation. Rejection rates have decreased recently with the advent of new and more powerful immunosuppressive agents. However, infection continues to be a serious complication. The use of broad-spectrum antibiotics and the development of antiviral agents have provided effective tools to combat the infectious processes traditionally seen in renal transplant recipients. Recently, a new viral illness has been identified in this population. Polyoma virus infection has been identified as the cause of allograft dysfunction and graft loss. This paper reviews the current prevalence and outcome of renal transplant patients infected with polyoma virus.  N. Ref:: 16

 

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