Prevalence of polyoma BK virus infection among living-donor renal transplant recipients.

BACKGROUND: Polyomavirus nephropathy (PVN) mainly caused by BK polyomavirus (BKPyV) remains the most common productive viral infection of the kidney in immunosuppressed patients. The diagnosis of PVN is based on the detection of BK viruria and BK viremia in conjunction with histological findings in the graft biopsy. METHODS: Our study was aimed to estimate the prevalence of productive BKPyV infection among renal transplant patients within the first year post-transplant and identify those at risk of developing PVN. Our cross-sectional study was conducted on 134 kidney transplant patients. Evidence of BKPyV replication was assessed by viral quantification of blood and urine samples of studied patients using a quantitative real-time polymerase chain reaction (Q-PCR)PCR), detection of decoy cells in urine cytology smears, histological examination of graft biopsies from Q-PCR BKPyV-positive patients, and immunohistochemical staining by simian virus 40 (SV40) antibody. RESULTS: Significant BKPyV infection was prevalent in 8% (n = 11) of our patients, with a peak of BKPyV infection about 8 months post transplant. BKPyV viral load by Q-PCR assay in these patients varied from 1350 to 20,000,000 (1.35 × 10(3) to 2 × 10(7) ) copies/mL for urine samples and 935 to 18,920 (9.35 × 10(2) to 1.89 × 10(4) ) copies/mL for blood samples. All the 11 patients were positive for decoy cells but only 3 developed PVN based on histology and positive SV40 staining. BKPyV infection was more prevalent in older patients. All patients responded to reduction in their immunosuppressive regimens, apart from 2 patients who required replacement of calcineurin inhibitors-based regimen with mammalian target of ramapycin inhibitors with an overall good response. CONCLUSION: Protocol screening programs based on detection of viral replication by viruria, viremia, and decoy cells in urine are necessary to shed light on patients with high virus replication and hence increased risk of developing PVN, and to allow early diagnosis and intervention.

Serum and synovial cartilage oligomeric matrix protein levels in early and established rheumatoid arthritis.

OBJECTIVE: To assess cartilage oligomeric matrix protein (COMP) levels in serum and synovial fluid in patients with early and established rheumatoid arthritis (RA), and to correlate the levels with clinical, laboratory and radiological characteristics. PATIENTS AND METHODS: The study included 24 female RA patients. Full medical history was taken, thorough clinical examination and laboratory investigations performed, and body mass index (BMI) recorded. Radiological damage was assessed according to the modified Larsen score. Disease activity score 28 (DAS28) was calculated. The control group comprised 30 age- and gender-matched healthy subjects. Serum and synovial COMP levels were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Mean patient age was 44.04 ± 10.5 years. Of the 24 patients, 12 had early RA and 12 had established disease with joint destruction; 5 of each group had knee effusion. Serum COMP was significantly higher in patients (19.54 ± 5.47 µg/ml) compared to controls (5.93 ± 1.95 µg/ml; p < 0.001) and was also significantly higher in patients with established disease (23.9 ± 3.1 µg/ml) compared to those in early stages (15.1 ± 3.2 µg/ml; p < 0.001). Synovial COMP was also significantly increased in established compared to early-stage RA (31.2 ± 9.8 µg/ml vs. 51.6 ± 10.4 µg/ml; p = 0.013). Serum and synovial COMP significantly correlated with age, disease duration, BMI, DAS28 and modified Larsen score. On performing regression analysis in RA patients, only BMI could predict the serum level of COMP (p = 0.02). CONCLUSION: COMP is a promising biomarker for disease activity in RA, making it a potential therapeutic target. The obvious correlation with the BMI throws light on the importance of weight control not only in osteoarthritis (OA), but also in RA.

Mesenchymal stem cell transfusion for desensitization of positive lymphocyte cross-match before kidney transplantation: outcome of 3 cases.

OBJECTIVES: Donor specific antibodies (DSA) and a positive cross-match are contraindications for kidney transplantation. Trials of allograft transplantation across the HLA barrier have employed desensitization strategies, including the use of plasmapheresis, intravenous immunoglobulins, anti-B-cell monoclonal antibodies and splenectomy, associated with high-intensity immunosuppressive regimens. Our case 1 report suffered from repeatedly positive lymphocyte cross match after 1st renal transplantation. Graft nephrectomy could not correct the state of sensitization. Splenectomy was done in a trial to get rid of the antibody producing clone. Furthermore plasmapheresis with low dose IVIG could not as well revert the state of sensitization for the patient. MATERIAL AND METHODS: About 50 millions donor specific MSCs were injected to the patient. RESULTS: MSCs transfusion proved to be the only procedure which could achieve successful desensitization before performing the second transplantation owing to their immunosuppressive properties. CONCLUSION: This case indicates that DS-MSCs is a potential option for anti-HLA desensitization. In cases 2 and 3 IV DS-MSCs transfusion was selected from the start as a successful line of treatment for pre renal transplantation desensitization to save other unnecessary lines of treatment that were tried in case 1.

Rapid detection of IgM and IgG antibodies to herpesviridae virus.

In this study, the immunoconcepts EA indirect enzyme antibody technique (colorzyme) was used not only for detection of IgG antibodies but also for quantitative detection of IgM antibodies to Herpes Simplex virus (HSV), Cytomegalovirus (CMV) and Epstein Barr Virus (EBV) to diagnose recent iactivei infection. Reference reactive and negative antisera and randomly collected human sera were tested by complement fixation test (CFT) against HSV antigens and tested also by immunofluorescent (IF) and colorzyme Immunoconcepts EA tests. All sera that were negative to HSV, CMV and EBV antibodies by CFT were negative by IF and colorzyme EA tests. All antibody positive sera and reference positive antisera were also positive by IF and colorzyme EA tests with slight variation in antibody titres between CFT and colorzyme test results. Human sera which were negative or IgM positive to HSV, CMV and EBV by ELISA as well as negative and positive reference sera from different diagnostic kits were retested by IF and colorzyme EA for IgM antiviral reactivity results were concordance by the three rests. All incubations in colorzyme test were at room temperature and only an ordinary microscope used in IF test or plate washers and readers needed for ELISA test. The colorzyme immunoconcepts is a simple, rapid and sensitive for viral diagnosis and can be used in any private laboratory.

Helicobacter pylori among Egyptian patients with chronic liver diseases. A comparative study.

The prevalence of Helicobacter pylori in Egyptian patients with different stages of liver diseases was compared to those with normal liver status. Eighty patients subjected to upper gastrointestinal endoscopy were enrolled. They were divided according to their liver status into two groups; the first patients with liver cirrhosis and the second who had no liver affection. Gall bladder diseases were excluded by abdominal ultrasound examinations. Endoscopic antral mucosal biopsies were used for H. pylori screening by both culture and urease test, and for histopathological examinations. Both groups were matched as regards age, sex, and socioeconomic conditions. Culture was positive in 42.2% and 40.7% of patients in both groups respectively (P > 0.05). Urease test showed positive results in 58% and 76.6% in both groups respectively (P > 0.05). Helicobacter pylori prevalence showed no significant differences between both studied groups as regards age, sex, or type of gastric lesions. Furthermore, liver status in patients with chronic liver diseases does not play a role in distribution of infection. The study shows the high prevalence of H. pylori among Egyptians and the absence of a relation between H. pylori and chronic liver diseases.

Lymphocyte homing in mice: lack of significant alteration when H-2 antigen expression is moderately modified.

The part played by MHC antigens on lymphocyte homing has been investigated by inducing modifications of their expression on lymphoid cells. A significant, though moderate, enhancement of H-2 antigen expression has been observed following in vitro treatment of lymphocytes with alpha-IFN. A decrease has been obtained after in vivo treatment of mice with chloramphenicol. These rather moderate alterations of H-2 density (ca. 20-30%, as determined by cytofluorometry) did not induced changes of lymphocyte capacity to home into the different lymphoid organs.