ABSTRACT
This systematic review investigates the immunosuppressive environment in HBV-associated hepatocellular carcinoma (HCC), characterized by dysfunctional and exhausted HBV-specific T cells alongside an increased infiltration of HBV-specific CD4+ T cells, particularly regulatory T cells (Tregs). Heightened expression of checkpoint inhibitors, notably PD-1, is linked with disease progression and recurrence, indicating its potential as both a prognostic indicator and a target for immunotherapy. Nevertheless, using PD-1 inhibitors has shown limited effectiveness. In a future perspective, understanding the intricate interplay between innate and adaptive immune responses holds promise for pinpointing predictive biomarkers and crafting novel treatment approaches for HBV-associated HCC.
Subject(s)
Adaptive Immunity , Carcinoma, Hepatocellular , Hepatitis B virus , Liver Neoplasms , Carcinoma, Hepatocellular/immunology , Carcinoma, Hepatocellular/virology , Humans , Liver Neoplasms/immunology , Liver Neoplasms/virology , Hepatitis B virus/immunology , T-Lymphocytes, Regulatory/immunology , Programmed Cell Death 1 Receptor/immunology , Immune Checkpoint Inhibitors/therapeutic use , Immune Checkpoint Inhibitors/pharmacology , Hepatitis B/immunology , Hepatitis B/virology , Hepatitis B/complications , Hepatitis B, Chronic/immunology , Hepatitis B, Chronic/virology , Hepatitis B, Chronic/complications , CD4-Positive T-Lymphocytes/immunology , T-Lymphocytes/immunology , ImmunotherapyABSTRACT
Haemophilus influenzae is an uncommon uropathogen with fastidious growth requirements, which must be taken into consideration in the diagnostic process. We present a rare case of urosepsis with H. influenzae in a young patient with nefrocalcinosis.
Subject(s)
Bacteremia , Haemophilus Infections , Sepsis , Urinary Tract Infections , Humans , Haemophilus Infections/complications , Haemophilus Infections/diagnosis , Haemophilus Infections/drug therapy , Haemophilus influenzae , Bacteremia/complications , Bacteremia/diagnosis , Bacteremia/drug therapy , Sepsis/diagnosis , Urinary Tract Infections/complications , Urinary Tract Infections/diagnosisABSTRACT
OBJECTIVE: We investigated the prevalence of micronutrient deficiencies and associated patient and disease-related risk factors in patients with chronic pancreatitis (CP). METHODS: We enrolled 115 consecutive CP outpatients. Micro-nutritional assessments included plasma levels of fat-soluble vitamins (A, D and E) and trace elements (magnesium and zinc). Bioelectrical impedance and muscle function tests were used to characterize the macro-nutritional status (sarcopenia and phase angle). Prevalence of micro-nutritional deficiencies was estimated and associated with a number of patient and disease characteristics including presence of exocrine pancreatic insufficiency (EPI) and diabetes mellitus. In an additional analysis, we explored the association between micronutrient levels and macro-nutritional status. RESULTS: The mean age of patients was 57.9 ± 13.0 years, 71% were men and 50% had an alcoholic aetiology. Vitamin D deficiency (22%) was the most common micronutrient deficit followed by zinc deficiency (20%) and magnesium deficiency (17%). Vitamin A deficiency (10%) and vitamin E deficiency (7%) were only seen in patients with EPI (P ≤ 0.03), while the presence of trace element deficits was associated with plasma albumin levels (P ≤ 0.006). Plasma zinc levels were decreased in sarcopenic patients (P < 0.001) and positively correlated to phase angle (coefficient 0.28; P < 0.001). CONCLUSION: Various micronutrient deficits were observed in CP outpatients, and associated risk factors were diverse and distinct for the individual nutrients. Taken together, our findings highlight the complexity of micronutrient assessment in patients with CP and emphasise the importance of simultaneous evaluation of plasma protein levels, inflammatory activity and macro-nutritional status.
