Central Serous Chorioretinopathy: Signal to Reduce Corticoid in Renal Transplant Recipients?

OBJECTIVE: The aim of this work was to report the treatment effectiveness of central serous chorioretinopathy (CSCR) in a renal transplant recipient who received conventional therapy with little effect, and then reducing corticoid successively and with a better outcome later. METHODS: We performed a retrospective comparison of best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) of a 57-year-old renal transplant recipient who received conventional therapy and reducing corticoid successively after he was diagnosed as CSCR in the left eye. RESULTS: The BCVA of the left eye stayed at 20/200 after 3 months' conventional therapy, but rapidly improved to 20/25 after reducing corticoid by one-half. At the same time, SD-OCT showed much more obvious absorption of retinal liquid in the left eye from reducing corticoid than from conventional therapy. Despite the reducing of corticoid by one-half, the patient did not show any signs of rejection of the renal transplant. CONCLUSIONS: CSCR may be a sign in renal transplant recipients for reducing corticoid, and reducing corticoid might be a more reliable and safer treatment for such patients.

Characterization of monoclonal antibodies against hepatitis C virus nonstructural protein 3: different antigenic determinants from human B cells.

The nonstructural (NS3) region protein of hepatitis C virus (HCV) possesses major B-cell epitopes that induce antibodies after infection. To elucidate further the characteristics of these B cells and their role in the immune regulation of HCV infection, T9 (portion of NS3 region, amino acids [a.a.] 1188-1493)-specific monoclonal antibodies were derived and mapped for B-cell antigenic determinants with recombinant proteins. A total of 10 T9-specific hybridomas were generated and tested for B-cell antigenic determinants. To analyze the B-cell antigenic determinants, eight recombinant proteins including NS3-e (a.a. 1175-1334), NS3-a' (a.a. 1175-1250), NS3-a (a.a. 1251-1334), NS3-b (a.a. 1323-1412), NS3-c (a.a. 1407-1499), NS3-a/b (a.a. 1251-1412), NS3-bc (a.a. 1323-1499), and NS3-abc (a.a. 1251-1499) encoded by NS3-region internal clones were expressed and tested for immunoblotting. The data suggested IgG hybridomas recognized NS3-a, NS3-a', or NS3-b protein by immunoblotting. By contrast, the NS3-e protein bears the major antigenic determinant recognized by human sera. Half of the hybridomas were found to react with protein NS3-a', which is not a major B-cell antigenic determinant in humans. These data suggested that conformational epitopes in vivo may be important for B-cell recognition.

[Long-term efficacy study of hepatitis B vaccination in newborns--results of 11 years' follow-up].

OBJECTIVE: To evaluate the long-term efficacy of hepatitis B(HB) vaccination in newborns and the need for a booster dose. This research is one of the longest HB vaccine follow-up studies in the world with its subjects came from a program of universal infant HB vaccination. METHODS: Children who were born in 1986 and immunized with hepatitis B vaccine at birth were followed up at least once a year. Serum HBsAg, anti-HBc and anti-HBs were tested. At the 5th year after the first dose the prevalence of hepatitis B infection in the children in other district who were also born in 1986 and remained unvaccinated was surveyed as external controls. Random sampling was applied and the possible bias was analyzed. The trends of the positive rates of serum HBsAg, anti-HBs and anti-HBc in the immunized cohort were studied. With external control, the long-term efficacy of HB vaccination was calculated. RESULTS: The positive rates of HBsAg in the vaccine group from the first to eleventh year were 0.46%-0.98% and were below than those of baseline and external control. HBsAg rates in the cohort at different ages were similar with an average of 0.70%(25/3 578). The long-term efficacy of newborn vaccination was 85.42% (95% confidant interval: 70.11%-100%). CONCLUSIONS: The efficacy of HB vaccine was long-lasting and a booster dose was not necessary at least up to age 11 years.

Long-term efficacy of active postexposure immunization of infants for prevention of hepatitis B virus infection. United States-People's Republic of China Study Group on Hepatitis B.

Perinatal transmission of hepatitis B virus (HBV) contributes to the high prevalence of chronic infection in China and many other countries. In a placebo-controlled trial among 166 infants, the 12-month efficacy of active postexposure prophylaxis to prevent chronic perinatal HBV infection varied by vaccine (range, 45%-89%). In a 5-year follow-up study, 2 additional infants became chronically infected with HBV, and the efficacy of active prophylaxis was estimated to be 38% and 72% for the two vaccines at 5 years. In addition, 80% of immunized infants continued to have protective levels of antibody at the end of 5 years. However, among 27 infants who received passive-active immunoprophylaxis with high-dose hepatitis B immune globulin, only 60% (11/19) had protective antibody levels. These data indicate that active postexposure immunization initiated soon after birth continues to provide protection during early childhood when there is a high risk of chronic HBV infection.