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Purpose: The second wave of coronavirus disease 2019 (COVID?19) pandemic triggered a mucormycosis epidemic in India. Diabetes mellitus and dysregulated immune response were contributors, and rhino?orbital?cerebral mucormycosis (ROCM) was the most common presentation. It is however not known whether bio?chemical parameters at presentation correlate with stage of ROCM or final outcome in terms of vision or mortality. Methods: This retrospective, hospital?based study included all in?patients of mucormycosis with ophthalmic manifestations at presentation admitted during June 1, 2021 to August 31, 2021. It aimed to evaluate the association between severity of infection, serum levels of HbA1c, ferritin, interleukin?6 (IL?6), C?reactive protein (CRP), and D?dimer levels at presentation and outcome. Results: There were altogether 47 eligible cases having a mean age of 48.8 ± 10.9 years with a male:female ratio of 2.6:1; forty?two (89.4%) had pre?existing diabetes, and five (10.6%) had steroid?induced hyperglycemia. The mean HbA1c among diabetics was 9.7 ± 2.1. HbA1c and serum CRP showed an increase over subsequent stages, which was not statistically significant (P = 0.31). IL?6 values for all stages were similar (P = 0.97). Only serum ferritin levels showed a statistically significant increase over stages (P = 0.04). IL?6 was significantly lower (P = 0.03) in patients who survived, whereas CRP levels were significantly lower in patients who had final visual acuity (VA) better than only perception of light (P = 0.03). Conclusion: Uncontrolled diabetes mellitus is a significant association of ROCM. Serum ferritin levels at presentation best correlate with extent of the disease. CRP levels are best to prognosticate cases that will have sufficient VA to carry on activities of daily living, whereas IL?6 levels are best associated with survival
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Tie2 expressing monocytes/macrophages (TEMs) are a subtype of monocytes or macrophages which expressing tyrosine kinase receptor Tie2. They can exist in peripheral blood and tissues of both human and mouse. TEMs can participate in the formation of tumor microenvironment by accelerating tumor angiogenesis, lymphangiogenesis and immunosuppression. At present, TEMs have been found to have potential diagnostic and prognostic guiding significance for a variety of tumors, and they are expected to provide new directions and strategies for tumor therapy. This paper reviews the research progress of TEMs in tumor.
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Idiopathic pulmonary hemosiderosis is conventionally treated withsteroids, prolonged usage of which maybe deleterious anddisease often recurs on tapering. We initiated hydroxy-chloroquine and azathioprine early in treatment along withsteroids in seven children with idiopathic pulmonaryhemosiderosis, and observed that early introduction of secondline immunosuppressants helped in reducing disease flare andsteroid toxicity without serious adverse effects.
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The early mortality of sepsis patients has been largely decreased since the publication of the Surviving Sepsis Campaign guidelines.However, the poor long-term prognosis, high 3-year mortality, impaired mental and physical functions, and tremendous financial burden constitute a new challenge to the treatment of sepsis.Persistent inflammation immuno-suppression catabolism syndrome (PICS) is known to be a definite factor affecting the long-term prognosis of sepsis.This article presents a systematic review of the concept, pathogenesis and treatment strategies of PICS, hoping to provide a new approach to the diagnosis and management of sepsis.
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Objective:In oder to investigate the effect of Chuanmingshen violaceum polysaccharides ( CVP) and Solfated Chua-nmingshen violaceum polysaccharides ( SCVP) on immunosuppression induced by cyclophosphamide ( CY) in mice.Methods: CY were used to induce immunosuppression in mice;Spleen and thymus indexes were used to evaluate the immune organs indexes;the [3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltet-razolium bromide,MTT] method was used to detect the proliferation of spleen lymphocytes of each group;the concentrations of IFN-γand IL-2 were assayed by ELISA kit.Results: SCVP and CVP could resist immunosuppression by promoting lymphocyte proliferation, increasing the contents of IFN-γ and IL-2, promoting immune organs development in immunosuppressive mice induced by CY.Conclusion:SCVP and CVP exhibited the potential to used as immunopotentiator.
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Caso de paciente masculino 41 años, diabético tipo 1, trasplantado renal con tratamiento inmunosupresor, antecedente de carcinoma basocelular y espinocelular in situ tratado quirúrgicamente. Presentó en 2007 lesión nodular hiperpigmentada en pectoral izquierdo, se realizó exéresis con histopatología junio 2008: melanoma Clark III, Breslow 4 mm, ganglio centinela negativo. Clasificado como melanoma pectoral izquierdo Clark III Breslow 4 mm Estadio II (pT4aN0M0). Sintomatología gástrica noviembre 2009 estudios de imagen: hígado con lesiones nodulares múltiples tipo metastásicas, punción con aguja fina de hígado: melanoma metastásico. Reactivación a hígado múltiples metástasis, y metástasis pulmón derecho en diciembre 2009. Recibió tratamiento con temozolamida por ser paciente inmunosuprimido, con riñón único y baja depuración de creatinina, y limitación de quimioterapia con platino, recibió 3 ciclos, con progresión de enfermedad clínica e imaginológica, recibe segunda línea con interferón alfa-2b dosis modificadas, evolucionando tórpidamente, fallece por insuficiencia hepática complicada encefalopatía e insuficiencia renal crónica reagudizada.
Male patient of 41 years, type 1 diabetes, renal transplant immunosuppressive treatment, history of squamous cell carcinoma spleen in situ treated by surgery with free margins, submitted in 2007 hyperpigmented nodular lesion in the left chest, was performed exéresis with histopathology June 2008: melanoma Clark III, Breslow 4mm, sentinel node negative. Left pectoral classified as Clark III melanoma Breslow 4mm Stadium II (pT4aN0M0) May 2008 with multiple liver reactivation metastases, in November 2009 have gastric symptoms with imaging studies reported multiple nodular liver lesions type metastatic liver biopsy of metastatic melanoma and in right lung December 2009, was treated with temozolomide given immunocompromised patient treated with single kidney and low creatinine clearance with limited platinum-based chemotherapy received three cycles, showing progression of clinical disease and imaging, get second line with interferon alfa-2b dose modified, evolving torpidamente and died from liver failure complicated by encephalopathy and exacerbation of chronic renal failure.
Subject(s)
Humans , Male , Adult , Carcinoma, Basal Cell/pathology , Diabetes Mellitus/pathology , Renal Insufficiency, Chronic/mortality , Melanoma/surgery , Melanoma/pathology , Liver Neoplasms/diagnosis , Kidney Transplantation/methods , Cyclosporine/administration & dosage , Immunosuppressive Agents/administration & dosage , UltrasonicsABSTRACT
Mesenchymal stem cells (MSC) are common residents of bone marrow and are defined by their higher self-renewal ability and multilineage differentiation. MSC play an important role in supporting haematopoiesis and therefore are implicated in influencing immune responses. In line with this, MSC have been utilized to treat graft-versus-host disease (GVHD) in order to suppress unwanted T cell proliferation. In this study, we investigated the immune-suppressive effect of bone marrow derived MSC on T cell proliferation at the cell cycle level. MSC were generated from human bone marrow and confirmed by their immune-phenotyping. Resting or PHA stimulated allogeneic peripheral blood mononuclear cells (PBMC) were co- cultured in the presence or absence of MSC. T cell proliferation was accessed by trypan-blue exclusion assay at day three. Consequently cell cycle analysis was carried out to determine the mechanism of antiproliferation. MSC failed to elicit proliferation at resting T cell. However, proliferation of PHA-stimulated T cells was dramatically inhibited in the presence of MSC in a dose dependent manner (p<0.05). Following the inhibitory activity, MSC prevented activated T cells from entering the S phase of cell cycle by arresting them in the G1 phase. Our findings indicate that MSC escape recognition by T cells and inhibit T cell proliferation by cell cycle arrest at G1 phase. This immune-suppressive effect is most probably mediated by cell-to-cell contact and/or secreted soluble factors.
Subject(s)
T-Lymphocytes , Cell Cycle , Stem CellsABSTRACT
To investigate the expression of vaginal Th1 and Th2 cytokines in rats with experimental vaginal candidiasis under different immune conditions, ICR murine vaginal candidiasis model was established and immno-suppressed murine models of vaginal cadidiasis were established in estrogen-treated mice. Non-estrogen-treated mice were used as controls. The mRNA level of Th1(IL-2)/Th2 (IL-4, IL-10, TGF-β1) cytokines in murine vaginal tissues was determined by RT-PCR.The cykotine in local tissues was increased to different extent under normal immune condition. IL-2mRNA was increased during early stage of infection, while IL-10 was increased transiently during late stage of infection. TGF-β1 production was found to be increased persistently. At same time, the expression of IL-2 mRNA was suppressed in immno-suppressed group, and the level of IL-4, IL-10,and TGF-β1 were higher than the normal immunity group to different degree during infection. The high level of IL-2 mRNA during early stage of infection was associated with clearance of mucosal Candidia albicans (C. albicans), and its expression suppressed leading to decreased clearance of mucosal C. albican in immuno-suppression. The over-expression of IL-4 and IL-10 could significantly enhance the susceptibility to C. albicans infection in mice.
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Rapamycin is frequently used as an immunosuppressive agent and also plays an important role in tumor suppression.It combines to FKBP12 and forms a compound to inhibit the serine/threonine protein kinase mammalian target of rapamycin(mTOR),its activation is required for protein synthesis and cell-cycle progression.Rapamycin can block cell cycle at G1 phase and to inhibit cell proliferation.Furthermore rapamycin may inhibit cytokine production and cytokine signaling.Therefore rapamycin is used in the treatment of post-transplantation organ rejection and tumor therapy due to its dual effects of immuno-suppression and tumor inhibition.
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A microsporidian parasite Enterocytozoon bieneusi is the most common microorganism recognized in AIDS patients, and slow scientific progress is attributed to our inability to propagate the parasite. We report upon the development of a system of propagation using the pig biliary system. The parasite spores were continuously detected in the bile samples post onset of spore shedding in the gall bladder, which suggests that this organism maintain persistent infection in the biliary system and that the hepatobiliary tree may represent a reservoir of infection. In conclusion the biliary tree is an adequate niche for the propagation of E. bieneusi. This work has also resulted in the development of a procedure of ultrasound-guided cholecystocentesis for aspirating biles. This is a simple and non-surgical procedure, and creates no signs of clinical complications in the livers and the gall bladders after dozens of separate attempts. Thus, this is a very useful and safe technique for the aspiration of bile from live animals.
Subject(s)
Animals , AIDS-Related Opportunistic Infections/parasitology , Bile/parasitology , Biliary Tract/parasitology , DNA, Protozoan/analysis , Disease Models, Animal , Enterocytozoon/growth & development , Feces/parasitology , Gallbladder/parasitology , Immunosuppression Therapy/veterinary , Microsporidiosis/parasitology , Paracentesis/methods , Polymerase Chain Reaction/veterinary , Specimen Handling/methods , Spores, Protozoan/isolation & purification , SwineABSTRACT
The purpose of the following experiments was to determine the in vivo properties on immunologic specificity and duration of action of anti-dog lymphocyte rabbit serum (ADLRS) prepared against dog lymphocyte. Twenty adult mongrel dogs having average body weight of 10kg. were used in this experiments, being divided into control (10 dogs) and experimental group (10 dogs) for the comparison of the results Experimental group: O.7 cc/kg. of ADLRS was injected into the both gluteal region with intervals of 6 hours, 12 hours, 24 hours, 48 hours and 72 hours. Control group: 10 cc of normal rabbit serum(NRS) was injected into the both gluteal region with same intervals as experimental group. Peripheral blood findings and bone marrow pictures were compared with the results of pre. and post-injection of ADLRS and NRS, and histopathological studies were investigated The following results were obtained. 1. The total REC and WBC counts remained within normal limits; however, the mean decrease percentages of the peripheral lymphocyte in the experimental group were 32.9%, 45.8N, 51.3%, 48.4% and 32.8% respectively. On the other hand, the decrease of the lymphocyte in the control group was quite meager. 2. No significant changes in bone marrow pictures were noted in both groups. 3. Histopathologically, the specific alterations of lymphoid tissues accompanying delayed-type immune depression consisted of an early selective depletion of small lymphocytes from the thymus-dependent areas of spleen follicles, lymph nodes, thymus and other lymphoid tissues. 4. The small lymphocyte depleted-areas were partially replaced by large pyroninophilic cells. 5. Plasmacytoid hyperplasia and germinal center development occurring afterwards, always outside thymus-dependent areas, were also observed in control dogs treated with normal rabbit serum. These results confirmed that the target cell of the ALS is thymus-dependent areas and supported the hypothesis.that two different population of lymphocyte exist within the lymphoid organs. 6. The thymus, which showed only occasionally and cellulartity, seemed to be also affected by ALS in later period. 7. ADLRS prepared by the author reached its peak of action during the period of 24 to 48 assumed that the immunosuppressive response will return to normal possibly in 7~10 days after injection.