- Differentiating characteristics and evaluating intravenous and subcutaneous immunoglobulin. [Journal Article]
- AJAm J Manag Care 2019; 25(6 Suppl):S98-S104
- Clinicians have a range of options for treating patients with disease states that require the use of immunoglobulin (Ig). Traditionally, intravenous immunoglobulin (IVIG) administration has provided …
Clinicians have a range of options for treating patients with disease states that require the use of immunoglobulin (Ig). Traditionally, intravenous immunoglobulin (IVIG) administration has provided effective therapy for a variety of disease states. More recently, subcutaneous immunoglobulin (SCIG) administration has become available for patients with primary immunodeficiencies and chronic inflammatory demyelinating polyneuropathy (CIDP). Ig is used as replacement therapy in patients with primary or secondary immunodeficiencies and has been shown to reduce morbidity due to bacterial infections associated with antibody deficiency. The mechanism of action for use of Ig in the treatment of autoimmune disorders is complex and partially understood, but immunomodulatory effects have been suggested in CIDP and multifocal motor neuropathy. The available IVIG and SCIG products differ in their pharmaceutical properties (eg, pH, osmolality, IgA content, sodium content, and stabilizer), which can affect safety and tolerability in some patients. The pharmacokinetics of Ig also differ based on the route of administration. With IVIG administration every 3 or 4 weeks, peak concentrations are greater and trough concentrations are lower, which can increase the propensity of systemic adverse effects (AEs) and impact tolerability of therapy. SCIG infusions are typically administered more frequently (ie, biweekly, weekly, and even daily based on patient need), resulting in steady state concentrations with fewer fluctuations in Ig plasma levels. The route of administration plays a major role in the types of AEs seen in patients receiving Ig therapy, with systemic AEs associated with IV administration and local reactions more commonly seen with SC administration. By understanding the differences in IVIG and SCIG products, which are not interchangeable, and the patient characteristics that guide product selection, clinicians and managed care providers can better serve patients with immunodeficiency disorders and other disease states.
- Hormones, Metabolism and the Benefits of Exercise: Plasma Steroids and Cardiorespiratory Fitness Response to Regular Exercise [BOOK]
- BOOKSpringer: Chamcham
- The aim of this report is to evaluate the relationships between baseline levels of adrenal, gonadal and conjugated steroids and baseline cardiorespiratory fitness, as assessed by maximal oxygen uptak…
The aim of this report is to evaluate the relationships between baseline levels of adrenal, gonadal and conjugated steroids and baseline cardiorespiratory fitness, as assessed by maximal oxygen uptake (VO2max), as well as its response to a standardized exercise program. To address this aim we used a subset of the HERITAGE Family Study (N = 448). In men, significant positive associations were found between baseline VO2max/kg weight and plasma levels of androsterone glucuronide (ADTG), dihydrotesterone (DHT), 17 hydroxy progesterone (OHPROG), sex hormone binding globulin (SHBG), and testosterone (TESTO), and negative association with aldosterone (ALDO). In women, only the free androgen index (FAI) was negatively associated with baseline VO2max/kg weight. Neither baseline plasma steroid levels nor SHBG concentrations were associated with the gains in VO2max resulting from exposure to the 20-week aerobic exercise program after adjustment for baseline values, age and ethnicity (white or black). We conclude that baseline plasma steroid levels are only weakly associated with individual differences in cardiorespiratory fitness in the sedentary state in men but not in women, whereas no association could be detected with trainability, as defined by the change in VO2max with the exercise program.
- Protective efficacy using Cape- golden berry against pre-carcinogenic aflatoxins induced in rats. [Journal Article]
- TRToxicol Rep 2019; 6:607-615
- Aflatoxins are harmful compounds that induced carcinogenic impacts on tissues. It could generate oxidative stress causing cells damage. Bioactive substances from natural plants could avoid mycotoxins…
Aflatoxins are harmful compounds that induced carcinogenic impacts on tissues. It could generate oxidative stress causing cells damage. Bioactive substances from natural plants could avoid mycotoxins' bad impacts. Cape-goldenberry (CGB), a source of active substances, was vacuum-dried at 30 °C then milled. Fresh and dried CGB-powder properties were estimated. Animal experiment was designed using six rat-groups to evaluate CBG effect to reduce harmful effect of aflatoxins. Rats treated groups were orally administrated by aflatoxins (AFs) with or without CGB in diets. Blood parameters, liver and kidney functions, serum lipids, and liver histological changes were estimated. The CGB powder showed several time doubles of phenolics, flavonoids, and antioxidants than fresh fruits. Diet supplementation by CGB of AFs-treated rats showed enhancement in final weight, food efficiency, and weight gain compared to AFs treatment only. Also, liver and kidney functions, liver enzymes, iron level, tumors indicator, and serum lipids of AFs- rats. Moreover, total protein, albumin, and globulin reduction by AFs have been improved by CGB presence in diets. Histopathological studies for AFs-rats liver showed dilated blood sinusoids with aggregation of inflammatory, Kupffer cell hyperplasia, degenerated hepatocytes, and apoptotic cells. However, in AFs-rat groups fed CGB in diets, liver hepatocytes appeared to be almost normal similar to the control. Results pointed out that CGB recorded a corrective action for aflatoxin B1 and G1 toxicity. This was recorded for the blood and serum parameters, and liver enzymes. This CGB action avoiding AFs-toxicity was more clearly declared in the liver tissues.
- N-Glycosylation influences human corticosteroid-binding globulin measurements. [Journal Article]
- ECEndocr Connect 2019 Jul 01
- CONCLUSIONS: Plasma CBG measurements are influenced by variations in N-glycosylation. This is important given the increasing number of CDG defects identified recently, and because N-glycosylation abnormalities are common in patients with metabolic and liver diseases.
- The prognostic role of preoperative systemic immune-inflammation index and albumin/globulin ratio in patients with newly diagnosed high-grade glioma. [Journal Article]
- CNClin Neurol Neurosurg 2019 Jun 24; 184:105397
- CONCLUSIONS: In conclusion, this study demonstrated that high SII and low AGR values may serve as promising prognostic markers to identify HGG patients with poor prognosis.
- Successful Outcome in Patients with Fanconi Anemia Undergoing T-Cell Replete Mismatched Related Donor Hematopoietic Cell Transplantation Using Reduced-Dose Cyclophosphamide Post Transplant. [Journal Article]
- BBBiol Blood Marrow Transplant 2019 Jul 12
- Allogeneic Hematopoietic Cell Transplantation (HCT) has been shown to restore normal hematopoiesis in Fanconi anemia (FA) patients with excellent results in matched related donor HCT; outcomes of alt…
Allogeneic Hematopoietic Cell Transplantation (HCT) has been shown to restore normal hematopoiesis in Fanconi anemia (FA) patients with excellent results in matched related donor HCT; outcomes of alternative donor HCT are less favorable. In non-FA patients, several reports documented stable engraftment/low risk of graft-versus-host disease (GVHD) using unmanipulated HLA-mismatched related donors and post HCT cyclophosphamide (PT-CY) for GVHD prophylaxis. In FA patients, data on using this approach are scarce; we therefore launched a study to perform HCT from HLA-mismatched related donors and report here our results on nineteen patients. Conditioning was fludarabine 30mg/m2/day x 5, anti-Thymocyte globulins 5mg/kg/day x 4, total body irradiation (200 cGy). GVHD prophylaxis was cyclosporine and mycophenolate and reduced doses of PT-CY 25 mg/kg on days +3, and +5. Absolute neutrophil count recovery occurred in all patients. Grade III-IV acute GVHD occurred in three patients and chronic GVHD in one. At a median follow-up of 38.3±5.8 months, the five-year probability of overall survival for our patients is 89.2%±7.2%. The regimen was well tolerated; hemorrhagic cystitis occurred in seven patients, and severe mucositis in five. There were two deaths; the primary causes of death were severe GVHD in one patient and leukemia recurrence in the second. We conclude that in FA patients lacking matched related donors, use of mismatched related HCT with low dose PT-CY is a viable option; it is well tolerated with a high rate of engraftment and an acceptable incidence of GVHD.
- [A case of nephrectomy with strong positive HLA antibody undergoing the third renal transplantation]. [Journal Article]
- ZNZhong Nan Da Xue Xue Bao Yi Xue Ban 2019 May 28; 44(5):596-599
- The positive human leukocyte antigen (HLA) antibody present in kidney transplant recipients affects both surgery and rejection, and also affects the long-term survival of the transplanted kidney. Dur…
The positive human leukocyte antigen (HLA) antibody present in kidney transplant recipients affects both surgery and rejection, and also affects the long-term survival of the transplanted kidney. During the third kidney transplant, bilateral axillary fossa and iliac vessel were destroyed. It was very difficult for selection or separation of surgical vessels because the adhesions and scar formation was easy to damage blood vessels and intestinal tubes. A case with strong positive HLA antibody undergoing the third kidney transplant in our hospital was successfully solved the problems, such as less transplant space and vascular scar adhesion. Rituximab, rabbit anti-human thymocyte immunoglobulin, and methylprednisolone treated-antibodies were used in the operation. The immune function test was used to develop individualized treatment after the operation. The postoperative creatinine and urine volume tended to be stable, and the 16-month follow-up renal function was good.
- Extracellular Histones Induced Eryptotic Death in Human Erythrocytes. [Journal Article]
- CPCell Physiol Biochem 2019; 53(1):229-241
- CONCLUSIONS: EHs act as a DAMP agent in the human RBCs that induces eryptosis. The cytotoxic effect is rapid as the hallmarks of eryptosis such as cell shrinkage, surface PS exposure, [Ca2+]i rise, ROS production and caspase-3 activation can be seen 3 h after treatment in a dose-dependent manner. The EHs' cytotoxic effects could be blocked by heparin and the Ab against TLR2.
- Deep learning driven QSAR model for environmental toxicology: Effects of endocrine disrupting chemicals on human health. [Journal Article]
- EPEnviron Pollut 2019 Jul 06; 253:29-38
- Over 80,000 endocrine-disrupting chemicals (EDCs) are considered emerging contaminants (ECs), which are of great concern due to their effects on human health. Quantitative structure-activity relation…
Over 80,000 endocrine-disrupting chemicals (EDCs) are considered emerging contaminants (ECs), which are of great concern due to their effects on human health. Quantitative structure-activity relationship (QSAR) models are a promising alternative to in vitro methods to predict the toxicological effects of chemicals on human health. In this study, we assessed a deep-learning based QSAR (DL-QSAR) model to predict the qualitative and the quantitative effects of EDCs on the human endocrine system, and especially sex-hormone binding globulin (SHBG) and estrogen receptor (ER). Statistical analyses of the qualitative responses indicated that the accuracies of all three DL-QSAR methods were above 90%, and greater than the other statistical and machine learning models, indicating excellent classification performance. The quantitative analyses, as assessed using deep-neural-network-based QSAR (DNN-QSAR), resulted in a coefficient of determination (R2) of 0.80 and predictive square correlation coefficient (Q2) of 0.86, which implied satisfactory goodness of fit and predictive ability. Thus, DNN was able to transform sparse molecular descriptors into higher dimensional spaces, and was superior for assessment qualitative responses. Moreover, DNN-QSAR demonstrated excellent performance in the discipline of computational chemistry by handling multicollinearity and overfitting problems.
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- Bortezomib Eliminates Plasma Cells From a Renal Graft in Plasma Cell-Rich Acute Rejection. [Journal Article]
- TPTransplant Proc 2019 Jul 10
- Plasma cell-rich acute rejection (PCAR) and antibody-mediated rejection (ABMR), for which a standard treatment has not yet been established, are associated with poor graft survival after kidney trans…
Plasma cell-rich acute rejection (PCAR) and antibody-mediated rejection (ABMR), for which a standard treatment has not yet been established, are associated with poor graft survival after kidney transplantation. Here, we report a case series of 3 Japanese patients diagnosed with PCAR accompanied by ABMR. Steroid pulse therapy and rabbit antithymocyte globulin, plasma exchange, intravenous immunoglobulin, and rituximab therapies were sequentially performed in the first case. A graft biopsy after each treatment showed that plasma cell infiltration persisted. Five months after the initiation of rejection therapy, the patient was subjected to bortezomib therapy, which led to the partial elimination of plasma cells from the graft. However, the graft function gradually deteriorated, and hemodialysis treatment was warranted. In the other 2 cases, the patients received the same combination of therapy including bortezomib within a short period. Graft biopsies performed subsequently showed a marked decrease in the number of infiltrated plasma cells, and stabilization of renal graft function was achieved in both cases. Bortezomib, which targets plasma cells, is a potent drug that eliminates infiltrated plasma cells from the graft in PCAR. Thus, in addition to conventional therapy comprising plasma exchange, intravenous immunoglobulin, and rituximab against ABMR, bortezomib may be necessary to administer without any delay to control PCAR.