#14#
Revisiones-Ciencias
Sociales (todas) *** Reviews-Social Sciences (all)
INMUNOSUPRESIÓN
*** IMMUNOSUPPRESSION
(Conceptos
/ Keywords: Immunosuppression; Immunosuppressive ag.; Transpl. immunol.; GVH;
Antirejection therapy; Lymphocyte depletion; Transpl. conditioning; etc).
Enero /
January 2001 --- Marzo / March 2004
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[1]
TÍTULO / TITLE: - Fulminant hepatic
failure secondary to acetaminophen poisoning: a systematic review and
meta-analysis of prognostic criteria determining the need for liver
transplantation.
REVISTA
/ JOURNAL: - Crit Care Med 2003 Jan;31(1):299-305.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.CCM.0000034674.51554.4C
AUTORES
/ AUTHORS: - Bailey B; Amre DK; Gaudreault P
INSTITUCIÓN
/ INSTITUTION: - Division of Emergency Medicine, Department
of Pediatrics, Hopital Ste-Justine, Universite de Montreal, Quebec, Canada. baileyb@med.umontreal.ca
RESUMEN
/ SUMMARY: - OBJECTIVES: To summarize and compare
different prognostic criteria used to determine need for liver transplantation
in patients with fulminant hepatic failure secondary to acetaminophen
poisoning. DATA SOURCES: Studies published in the literature that investigated
criteria for hepatic transplantation secondary to acetaminophen-induced liver
failure as identified by a preestablished MEDLINE strategy (1966 through
October 2001). STUDY SELECTION: Studies were included if 2 x 2 tables could be
reconstructed and if they did not assume that patients undergoing
transplantation would have eventually died had they not received the
transplant. DATA EXTRACTION: Relevant articles were reviewed by two authors
independently. Discrepancies or disagreements, if any, on the inclusion or
exclusion of studies were resolved by consulting the third author. DATA
SYNTHESIS: King’s criteria (pH < 7.30 or prothrombin time of >100 secs
plus creatinine of >300 micromol/L plus encephalopathy grade of > or =3)
were evaluated in nine studies, pH < 7.30 in four, prothrombin time of
>100 secs in three, prothrombin time of >100 secs plus creatinine of
>300 micromol/L plus encephalopathy grade of > or =3 in three, creatinine
of >300 micromol/L in two, and one each for increase in prothrombin time day
4, factor V of <10%, Acute Physiology and Chronic Health Evaluation (APACHE)
II score of >15, and Gc-globulin of <100 mg/L. King’s criteria were more
sensitive than pH: 69% (95% confidence interval, 63-75) vs. 57% (95% confidence
interval, 44-68). Their specificities were, however, comparable: 92% (95%
confidence interval, 81-97) vs. 89% (95% confidence interval, 62-97). APACHE II
score of >15 had the highest positive likelihood ratio (16.4) and the lowest
negative likelihood ratio (0.19) but was evaluated in only one study. The
accuracy measures of all other criteria were lower than that of King’s criteria
or pH < 7.30. CONCLUSIONS: Presently, available criteria are not very
sensitive and may miss patients requiring transplantation. Future studies
should further evaluate the efficacy of the APACHE II criteria. N. Ref:: 33
----------------------------------------------------
[2]
TÍTULO / TITLE: - Gene therapy progress
and prospects: gene therapy in organ transplantation.
REVISTA
/ JOURNAL: - Gene Ther 2003 Apr;10(8):605-11.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.gt.3302020
AUTORES
/ AUTHORS: - Bagley J; Iacomini J
INSTITUCIÓN
/ INSTITUTION: - Transplantation Biology Research Center,
Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129,
USA.
RESUMEN
/ SUMMARY: - One major complication facing organ
transplant recipients is the requirement for life-long systemic
immunosuppression to prevent rejection, which is associated with an increased
incidence of malignancy and susceptibility to opportunistic infections. Gene
therapy has the potential to eliminate problems associated with
immunosuppression by allowing the production of immunomodulatory proteins in
the donor grafts resulting in local rather than systemic immunosuppression.
Alternatively, gene therapy approaches could eliminate the requirement for
general immunosuppression by allowing the induction of donor-specific
tolerance. Gene therapy interventions may also be able to prevent graft damage
owing to nonimmune-mediated graft loss or injury and prevent chronic rejection.
This review will focus on recent progress in preventing transplant rejection by
gene therapy. N.
Ref:: 47
----------------------------------------------------
[3]
TÍTULO / TITLE: - The influence of
environment and experience on neural grafts.
REVISTA
/ JOURNAL: - Nat Rev Neurosci 2001 Dec;2(12):871-9.
●●
Enlace al texto completo (gratuito o de pago) 1038/35104055
AUTORES
/ AUTHORS: - Dobrossy MD; Dunnett SB
INSTITUCIÓN
/ INSTITUTION: - School of Biosciences, Cardiff University,
Museum Avenue Box 911, Cardiff CF10 3US, Wales, UK. dobrossymd@cardiff.ac.uk N. Ref:: 106
----------------------------------------------------
[4]
TÍTULO / TITLE: - Organ transplantation:
what is the state of the art?
REVISTA
/ JOURNAL: - Ann Surg 2003 Dec;238(6 Suppl):S72-89.
AUTORES
/ AUTHORS: - Collins BH
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of
Transplantation, Duke University Medical Center, Durham, NC 27710, USA. colli005@mc.duke.edu N. Ref:: 130
----------------------------------------------------
[5]
TÍTULO / TITLE: - Dialysis, kidney
transplantation, or pancreas transplantation for patients with diabetes
mellitus and renal failure: a decision analysis of treatment options.
REVISTA
/ JOURNAL: - J Am Soc Nephrol. Acceso gratuito al texto
completo a partir de 1 año de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://www.jasn.org/
●●
Cita: Journal of the American Society of Nephrology: <> 2003
Feb;14(2):500-15.
AUTORES
/ AUTHORS: - Knoll GA; Nichol G
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Department of
Medicine, University of Ottawa, Canada. gknoll@ottawahospital.on.ca
RESUMEN
/ SUMMARY: - Patients with type 1 diabetes mellitus and
end-stage renal disease may remain on dialysis or undergo cadaveric kidney
transplantation, living kidney transplantation, sequential pancreas after
living kidney transplantation, or simultaneous pancreas-kidney transplantation.
It is unclear which of these options is most effective. The objective of this
study was to determine the optimal treatment strategy for type 1 diabetic
patients with renal failure using a decision analytic Markov model. Input data
were obtained from the published medical literature, the United Network for
Organ Sharing registry, and patient interviews. The outcome measures were life
expectancy (in life-years [LY]) and quality-adjusted life expectancy (in
quality-adjusted life-years [QALY]). Living kidney transplantation was
associated with 18.30 LY and 10.29 QALY; pancreas after kidney transplantation,
17.21 LY and 10.00 QALY; simultaneous pancreas-kidney transplantation, 15.74 LY
and 9.09 QALY; cadaveric kidney transplantation, 11.44 LY and 6.53 QALY;
dialysis, 7.82 LY and 4.52 QALY. The results were sensitive to the value of
several key variables. Simultaneous pancreas-kidney transplantation had the
greatest life expectancy and quality-adjusted life expectancy when living
kidney transplantation was excluded from the analysis. These data indicate that
living kidney transplantation is associated with the greatest life expectancy
and quality-adjusted life expectancy for type 1 diabetic patients with renal
failure. Treatment strategies involving pancreas transplantation should be
considered for patients with frequent metabolic complications of diabetes and
for those patients who favor kidney-pancreas transplantation over kidney
transplantation alone. For patients without a living donor, simultaneous
pancreas-kidney transplantation is associated with the greatest life
expectancy.
----------------------------------------------------
[6]
TÍTULO / TITLE: - The future of
antigen-specific immunotherapy of allergy.
REVISTA
/ JOURNAL: - Nat Rev Immunol 2002 Jun;2(6):446-53.
●●
Enlace al texto completo (gratuito o de pago) 1038/nri824
AUTORES
/ AUTHORS: - Valenta R
INSTITUCIÓN
/ INSTITUTION: - Department of Pathophysiology, University
of Vienna Medical School, Vienna General Hospital-AKH, Australia. Rudolf.valenta@akh-wein.ac.at
RESUMEN
/ SUMMARY: - More than 25% of the population in
industrialized countries suffers from immunoglobulin-E-mediated allergies. The
antigen-specific immunotherapy that is in use at present involves the
administration of allergen extracts to patients with the aim to cure allergic
symptoms. However, the risk of therapy-induced side effects limits its broad
application. Recent work indicates that the epitope complexity of natural
allergen extracts can be recreated using recombinant allergens, and
hypoallergenic derivatives of these can be engineered to increase treatment
safety. It is proposed that these modified molecules will improve the current practice
of specific immunotherapy and form a basis for prophylactic vaccination. N. Ref:: 120
----------------------------------------------------
[7]
TÍTULO / TITLE: - Ultraviolet
light-induced regulatory (suppressor) T cells: an approach for promoting
induction of operational allograft tolerance?
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1
Suppl):S29-31.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000112969.24120.64
AUTORES
/ AUTHORS: - Aubin F; Mousson C
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology and EA3181,
University Hospital, Besancon, France. francois.aubin@ufc-chu.univ-fcomte.fr.
RESUMEN
/ SUMMARY: - Ultraviolet (UV) light is known to induce
skin cancers by causing DNA gene mutations and inducing immunosuppression.
Taking advantage of these immunosuppressive capacities, UV light has been used,
with different modalities, as an immunosuppressive therapy in a variety of
diseases including allograft rejection and graft-versus-host disease.
Phototherapy includes UVB irradiation, UVA irradiation, oral psoralen (+)UVA
irradiation (PUVA), photodynamic therapy, and extracorporeal photopheresis,
which consists of infusion of UVA-irradiated autologous leukocytes collected by
apheresis and incubated with 8-methoxypsoralen. According to numerous
experimental models and human data, there is increasing evidence that UVB
irradiation and extracorporeal photopheresis can induce regulatory T cells and
anticlonotypic activity. These therapies induce apoptosis of activated T cells
or of extracorporally treated mononuclear cells, and up-regulate the expression
of costimulary molecules and adhesion molecules on antigen presenting cells.
UVB- or UVA-induced apoptotic cells could secrete immune suppressive cytokines
(interleukin (IL)-4, IL-10). The processing and presentation of apoptotic T
cell antigens from clones of pathogenic T cells by activated antigen presenting
cells might explain the induction of systemic anticlonotypic activity by
photopheresis. This induction of cell-mediated suppressive activity opens up
future prospects with the aim of expanding regulatory T cells and/or
anticlonotypic activity, especially by photopheresis in organ and cell
transplantation. N.
Ref:: 40
----------------------------------------------------
[8]
TÍTULO / TITLE: - Guidelines for
preventing opportunistic infections among hematopoietic stem cell transplant
recipients. Recommendations of CDC, the Infectious Disease Society of America,
and the American Society of Blood and Marrow Transplantation.
REVISTA
/ JOURNAL: - Cytotherapy 2001;3(1):41-54.
●●
Enlace al texto completo (gratuito o de pago) 1080/146532401753156403
----------------------------------------------------
[9]
TÍTULO / TITLE: - The treatment of
glomerular disease—a compromise between the standard and the individual
approach.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2003 Jul;18 Suppl 5:v31-3.
AUTORES
/ AUTHORS: - Kiperova B
INSTITUCIÓN
/ INSTITUTION: - Medical University of Sofia, University
Hospital Alexandrovska, Clinic of Nephrology, Sofia, Bulgaria. bkiperova@yahoo.com
RESUMEN
/ SUMMARY: - Chronic glomerulonephritis (GN) is one of
the leading causes of end-stage renal disease (ESRD). The possibilities for
successful treatment in the earliest stages are still limited.
Immunosuppressive treatment leads to complete or partial remission only in some
patients. Even then, a non-immunological evolution to chronic renal
insufficiency often enters a progressive course. By applying a consistent
strategy for their individual evaluation and management, it is possible to
improve the outcome of patients with GN. The early referral to a nephrologist
and an early histomorphological diagnosis; the precise assessment of the type
of injury, i.e. proliferative or non-proliferative; the indices of activity and
chronicity; and the prognostic indicators are helpful for the therapeutic
approach. The goal of the management of GN has to be to suppress the disease
with minimum side effects of the treatment. Many unanswered questions and
controversies remain concerning the immunosuppressive therapy. A precise
distinction is needed between the problematic assertions and evidence-based
protocols. A common task for the treatment of all types of chronic GN should be
the protection of renal structure and function: control of blood pressure,
action on renal haemodynamics and proteinuria via pharmacological inhibition of
the renin-angiotensin system, control of hyperlipidaemia and limitation of
fibrosis. Some novel and promising pharmacological approaches to extracellular
matrix accumulation and chronic interstitial fibrosis are in progress. N. Ref:: 15
----------------------------------------------------
[10]
TÍTULO / TITLE: - Administration of donor
apoptotic cells: an alternative cell-based therapy to induce tolerance?
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):43S-45S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067951.90241.54
AUTORES
/ AUTHORS: - Kleinclauss F; Perruche S; Cahn JY;
Tiberghien P; Saas P
INSTITUCIÓN
/ INSTITUTION: - INSERM E0119/UPRES EA2284, Etablissement
Francais du Sang Bourgogne Franche-Comte, Universite de Franche-Comte,
Besancon, France.
RESUMEN
/ SUMMARY: - Apoptotic cells are endowed with
immunomodulatory properties. The authors propose infusing apoptotic cells as a
cell-based therapy product to facilitate allogeneic hematopoietic engraftment
after a nonmyeloablative conditioning regimen. Such an approach may be used to
obtain macrochimerism in combined hematopoietic cells and solid organ
transplantation. In this article, the authors describe the mechanisms of
combined hematopoietic and organ allograft transplantation and the potential
difficulties. The authors discuss how intravenous apoptotic cell infusion may
influence the outcome of combined transplantation. This may prove to be an
interesting approach for future development in cell therapy. N. Ref:: 29
----------------------------------------------------
[11]
TÍTULO / TITLE: - Hematopoietic cell
transplantation for inherited metabolic diseases: an overview of outcomes and
practice guidelines.
REVISTA
/ JOURNAL: - Bone Marrow Transplant 2003
Feb;31(4):229-39.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.bmt.1703839
AUTORES
/ AUTHORS: - Peters C; Steward CG
INSTITUCIÓN
/ INSTITUTION: - Department of Pediatrics, University of
Minnesota School of Medicine, Minneapolis, 55455, USA.
RESUMEN
/ SUMMARY: - For the past two decades, hematopoietic
cell transplantation (HCT) has been used as effective therapy for selected
inherited metabolic diseases (IMD) including Hurler (MPS IH) and Maroteaux-Lamy
(MPS VI) syndromes, childhood-onset cerebral X-linked adrenoleukodystrophy
(X-ALD), globoid-cell leukodystrophy (GLD), metachromatic leukodystrophy (MLD),
alpha-mannosidosis, osteopetrosis, and others. Careful pre-HCT evaluation is
critical and coordinated, multidisciplinary follow-up is essential in this
field of transplantation. The primary goals of HCT for these disorders have
been to promote long-term survival with donor-derived engraftment and to
optimize the quality of life. Guidelines for HCT and monitoring are provided; a
brief overview of long-term results is also presented. N. Ref:: 131
----------------------------------------------------
[12]
TÍTULO / TITLE: - Choosing treatment for
proliferative lupus nephritis.
REVISTA
/ JOURNAL: - Arthritis Rheum 2002 Aug;46(8):1981-3.
●●
Enlace al texto completo (gratuito o de pago) 1002/art.10466
AUTORES
/ AUTHORS: - Balow JE
N. Ref:: 31
----------------------------------------------------
[13]
TÍTULO / TITLE: - Mechanisms of tolerance
induction through the transplantation of donor hematopoietic stem cells:
central versus peripheral tolerance.
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):21S-25S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067947.90241.66
AUTORES
/ AUTHORS: - Wekerle T; Blaha P; Koporc Z; Bigenzahn S;
Pusch M; Muehlbacher F
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Vienna General
Hospital, Waehringer Guertel 18, A 1090 Vienna, Austria. thomas.wekerle@akh-wien.ac.at
RESUMEN
/ SUMMARY: - The transplantation of donor hematopoietic
stem cells has been used successfully in numerous experimental settings to
induce donor-specific tolerance. After appropriate host conditioning,
hematopoietic stem-cell transplantation leads to a lasting state of donor
macrochimerism that is associated with a robust form of tolerance. One of the
key factors in the success of this approach is its reliance on intrathymic
clonal deletion to ensure lifelong tolerization of newly developing T cells.
Evidence for ongoing central deletion comes from studies following
superantigen-reactive T cells and from experiments using mice transgenic for an
alloreactive T-cell receptor. In protocols inducing tolerance through
macrochimerism, the preexisting mature T-cell repertoire is controlled by
either globally destroying all T cells before the hematopoietic cell
transplantation or, in more recent models, by tolerizing it through
co-stimulation blockade. The peripheral mechanisms induced by hematopoietic
stem-cell transplantation and co-stimulation blockade include both extrathymic
clonal deletion and the nondeletional mechanisms anergy, suppression, or both.
In addition to these immunologic hurdles, a physiologic engraftment barrier has
to be surmounted for the successful induction of mixed chimerism. This can be
achieved by cytoreductive host treatment or by the infusion of high numbers of
donor hematopoietic cells. A detailed delineation of the mechanisms responsible
for tolerance induction after hematopoietic stem-cell transplantation is
expected to help in the translation of these experimental protocols to clinical
organ transplantation. N.
Ref:: 31
----------------------------------------------------
[14]
TÍTULO / TITLE: - Low recurrence rate of
hepatocellular carcinoma after liver transplantation: better patient selection
or lower immunosuppression?
REVISTA
/ JOURNAL: - Transplantation 2002 Dec 27;74(12):1664-5.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000039802.85634.9C
AUTORES
/ AUTHORS: - Weber M; Kadry Z; Clavien PA N. Ref:: 11
----------------------------------------------------
[15]
TÍTULO / TITLE: - Hereditary
hemochromatosis: perspectives of public health, medical genetics, and primary
care.
REVISTA
/ JOURNAL: - Genet Med 2003 Jan-Feb;5(1):1-8.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.GIM.0000047946.94270.34
AUTORES
/ AUTHORS: - Imperatore G; Pinsky LE; Motulsky A; Reyes
M; Bradley LA; Burke W
INSTITUCIÓN
/ INSTITUTION: - National Canter for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention,
Atlanta, Georgia 30341, USA.
RESUMEN
/ SUMMARY: - Hereditary hemochromatosis (HHC) is a
condition characterized by excess iron in body tissues, resulting in
complications such as cirrhosis, cardiomyopathy, diabetes, and arthritis. These
complications usually manifest during adulthood. Two methods of screening for
the detection of early stage of HHC are available: serum iron measures and
molecular testing to detect mutations in the gene. These phenotypic and
genotypic screening tests are of particular interest because a simple
treatment-periodic phlebotomy-can be used to prevent iron accumulation and
clinical complications. HHC might represent the first adult-onset genetic
disorder for which universal population-based screening would be appropriate.
Therefore, HHC has been proposed as a paradigm for the introduction of adult
genetic diseases into clinical and public health practice. However, universal
screening for HHC has not been recommended because of the uncertainty about the
natural history of the iron overload or HHC and, in particular, uncertainty
about the prevalence of asymptomatic iron overload and the likelihood that it
will progress to clinical complications. If universal screening is not
appropriate based on current data, what other measures might reduce the disease
burden of iron overload? New studies provide more systematic information about
the penetrance of the C282Y mutation and shed further light on the natural
history of the disorder. The authors review these data and consider their
implications for public health, medical genetics, and primary care. N. Ref:: 64
----------------------------------------------------
[16]
TÍTULO / TITLE: - Donor-derived
hematopoietic stem cells in organ transplantation: technical aspects and
hurdles yet to be cleared.
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):55S-57S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067954.60639.9C
AUTORES
/ AUTHORS: - Herve P
INSTITUCIÓN
/ INSTITUTION: - Establissement Francais du Sang Borgogne
Franche-Comte, Besancon, France. patrick.herve@efs.sante.fr
RESUMEN
/ SUMMARY: - The use of hematopoietic stem-cell (HSC)
therapy in organ transplantation is a challenge to promote chimerism with the
aim of enhancing organ tolerance. Several HSC sources are available, including
bone marrow (most of the time), peripheral blood after stem-cell mobilization,
and placental blood. HSC collection techniques from vertebral bodies or iliac
crests require a number of complex manipulations. The best yield of HSC is
obtained from vertebral bodies. HSC harvesting by cytapheresis after cell
mobilization with a cytokine such as granulocyte colony-stimulating factor
should be preferred with a live donor. The number of CD3+ T cells is more than
10-fold higher in peripheral blood than in bone marrow. Cell separation by the
immunoselection technique (positive selection of the CD34+ cell population)
eliminates erythrocytes, granulocytes, and T cells, thus preventing the
possible occurrence of acute graft-versus-host disease. In the future, an
accreditation will be required for HSC collection and processing. In Europe,
the reference tool is the Joint Accreditation Committee of Ishage-Europe or the
Foundation for the Accreditation of Haematopoietic Cell Therapy manual, which
provides standards for every technical step of these procedures. N. Ref:: 26
----------------------------------------------------
[17]
TÍTULO / TITLE: - Ethical considerations
on preimplantation genetic diagnosis for HLA typing to match a future child as
a donor of haematopoietic stem cells to a sibling.
REVISTA
/ JOURNAL: - Hum Reprod 2002 Mar;17(3):534-8.
AUTORES
/ AUTHORS: - Pennings G; Schots R; Liebaers I
INSTITUCIÓN
/ INSTITUTION: - Department of Philosophy, Lok. 5 C 442,
Academic Hospital, Free University Brussels, Pleinlaan 2, B-1050 Brussels,
Belgium. gpenning@vub.ac.be
RESUMEN
/ SUMMARY: - Recently, several requests were made by
couples with an affected child who wanted preimplantation genetic diagnosis
(PGD) to select embryos in the hope of conceiving an HLA identical donor
sibling. This article considers the ethical arguments for and against the
application of PGD for this goal. Only embryos HLA matched with an existing
sibling in need of a compatible donor of haematopoietic stem cells would be
transferred. The main arguments are the instrumentalization of the child, the
best-interests standard, the postnatal test for acceptability and the
experience of the donor child. It is argued that conceiving a child to save a
child is a morally defensible decision on the condition that the operation that
will be performed on the future child is acceptable to perform on an existing
child. The instrumentalization of the donor child does not demonstrate
disrespect for its autonomy or its intrinsic worth. N. Ref:: 29
----------------------------------------------------
[18]
TÍTULO / TITLE: - Donor-derived
hematopoietic cells in organ transplantation: a major step toward allograft
tolerance?
REVISTA
/ JOURNAL: - Transplantation 2003 May 15;75(9
Suppl):3S-7S.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000067943.90241.73
AUTORES
/ AUTHORS: - Rifle G; Mousson C
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology-Intensive
Care-Transplantation, Hopital du Bocage, 2 boulevard de Lattre de Tassigny,
21034 Dijon, France. gerard.rifle@chu-dijon.fr
RESUMEN
/ SUMMARY: - Infusion of donor-derived cells can
improve organ allograft survival in animal models. Under certain conditions, it
can even induce tolerance (i.e., unlimited organ survival without any
maintenance immunosuppressive therapy). Use of nonmyeloablative regimens allows
engraftment of donor-derived bone marrow cells, induction of mixed chimerism,
and tolerance in rodents. High doses of bone marrow cells together with
anti-T-cell antibodies can even result in mixed chimerism without cytoablative
host conditioning. Cultured donor-derived CD34+ cells or donor-derived immature
(or even mature) dendritic cells associated with monoclonal antibodies directed
against co-stimulatory molecules might also induce tolerance. Among the
numerous experimental protocols leading to tolerance of solid organs in animal
models, how can we find our bearings in human transplantation? Numerous
problems have yet to be solved: the type and amount of donor-derived cells
(including stromal cells) to be used, the timing for infusion of donor cells in
keeping with organ transplantation, the route of infusion (should it be
intravenous, into the portal vein?), and the conditioning regimen. The first
clinical trials would appear to indicate that tolerance induction in humans
using donor-derived cells is a relatively safe solution that is both promising
and realistic. N.
Ref:: 42
----------------------------------------------------
[19]
TÍTULO / TITLE: - Cost advantages of oral
drug therapy for managing cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S9-12.
AUTORES
/ AUTHORS: - Somerville KT
INSTITUCIÓN
/ INSTITUTION: - University of Utah Health Sciences Center,
Department of Pharmacy Services, Salt Lake City, UT, USA. troy.somerville@hsc.utah.edu
RESUMEN
/ SUMMARY: - Cost advantages of the oral route of drug
therapy administration over the intravenous route for managing cytomegalovirus
(CMV) disease are described. The overall costs usually are lower for the oral
route of administration than for the intravenous route, although the cost to
the patient depends on insurance coverage. Other advantages of the oral route
include greater safety and convenience, which may improve patient adherence and
quality of life. In patients with acquired immunodeficiency syndrome (AIDS),
the use of oral ganciclovir instead of intravenous ganciclovir to treat the
maintenance phase of CMV retinitis reduced the incidence of neutropenia and sepsis,
outpatient and inpatient resource use, and costs. Oral therapy also improved
patient quality of life. A cost-effectiveness model for liver transplant
recipients found that CMV prophylaxis is warranted for all patients,
ganciclovir is preferred over CMV immune globulin i.v. and oral acyclovir for
prophylaxis, and the oral route of administration is more cost-effective than
the intravenous route for ganciclovir. Valganciclovir, the oral prodrug of
ganciclovir, was not included in this model. Oral maintenance therapy is
usually cost-effective, safer, and more convenient than intravenous therapy in
the management of CMV. N.
Ref:: 8
----------------------------------------------------
[20]
TÍTULO / TITLE: - Graft function and
other risk factors as predictors of cardiovascular disease outcome.
REVISTA
/ JOURNAL: - Transplantation 2001 Sep 27;72(6
Suppl):S16-9.
AUTORES
/ AUTHORS: - Forsythe JL
INSTITUCIÓN
/ INSTITUTION: - Transplant Unit, The Royal Infirmary of
Edinburgh, UK. john.forsythe@luht.scot.nhs.uk
RESUMEN
/ SUMMARY: - The high incidence of cardiovascular
disease after renal transplantation is related to a high prevalence and
accumulation of risk factors before and after transplantation. Hypertension,
posttransplantation diabetes, and hyperlipidemia are well-recognized risk
factors for the development of cardiovascular events after renal
transplantation and are strongly associated with immunosuppressive therapy.
Hyperhomocysteinemia is a potential risk factor for cardiovascular disease in
renal transplant recipients, but although a growing matter of study, a direct
association with immunosuppressive agents is not yet proven. In addition to
treatment intervention, risk management should also involve tailoring the
immunosuppressive regimen to minimize the more indirect cardiovascular risk
factors such as renal dysfunction and acute rejection. N. Ref:: 41
----------------------------------------------------
[21]
TÍTULO / TITLE: - Successful management
of disseminated Nocardia transvalensis infection in a heart transplant
recipient after development of sulfonamide resistance: case report and review.
REVISTA
/ JOURNAL: - J Heart Lung Transplant 2003
Apr;22(4):492-7.
AUTORES
/ AUTHORS: - Lopez FA; Johnson F; Novosad DM; Beaman
BL; Holodniy M
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Louisiana State
University Health Sciences Center, New Orleans, Louisiana, USA.
RESUMEN
/ SUMMARY: - Nocardia transvalensis is a rarely
reported cause of clinically significant disease, and, to our knowledge, has
not been reported previously as a cause of infection in the cardiac transplant
population. We report a case of N transvalensis new taxon-2 pulmonary infection
that disseminated to the brain and skin in a cardiac transplant recipient
despite adequate sulfonamide serum levels. Subsequent isolates were resistant
to sulfonamides, and molecular ribotyping of the primary and subsequent
isolates confirmed that these were the same N transvalensis new taxon-2 strain.
The taxonomic and diagnostic considerations, as well as the clinical
significance of anti-microbial-resistant nocardia, are reviewed and discussed
herein. N. Ref:: 37
----------------------------------------------------
[22]
TÍTULO / TITLE: - Electrostatic potential
on human leukocyte antigen: implications for putative mechanism of chronic
beryllium disease.
REVISTA
/ JOURNAL: - Environ Health Perspect. Acceso gratuito
al texto completo.
●●
Enlace a la Editora de la Revista http://ehpnet1.niehs.nih.gov/docs/montharch.html
●●
Cita: Environmental Health Perspectives: <> 2003 Nov;111(15):1827-34.
AUTORES
/ AUTHORS: - Snyder JA; Weston A; Tinkle SS; Demchuk E
INSTITUCIÓN
/ INSTITUTION: - Health Effects Laboratory Division,
National Institute for Occupational Safety and Health, Centers for Disease
Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505, USA.
RESUMEN
/ SUMMARY: - The pathobiology of chronic beryllium disease
(CBD) involves the major histocompatibility complex class II human leukocyte
antigen (HLA). Although occupational exposure to beryllium is the cause of CBD,
molecular epidemiologic studies suggest that specific (Italic)HLA-DPB1(/Italic)
alleles may be genetic susceptibility factors. We have studied
three-dimensional structural models of HLA-DP proteins encoded by these genes.
The extracellular domains of HLA-DPA1*0103/B1*1701, *1901, *0201, and *0401,
and HLA-DPA1*0201/B1*1701, *1901, *0201, and *0401 were modeled from the X-ray
coordinates of an HLA-DR template. Using these models, the electrostatic
potential at the molecular surface of each HLA-DP was calculated and compared.
These comparisons identify specific characteristics in the vicinity of the
antigen-binding pocket that distinguish the different HLA-DP allotypes.
Differences in electrostatics originate from the shape, specific disposition,
and variation in the negatively charged groups around the pocket. The more
negative the pocket potential, the greater the odds of developing CBD estimated
from reported epidemiologic studies. Adverse impact is caused by charged
substitutions in positions 55, 56,
69, 84, and 85, namely, the exact same loci identified
as genetic markers of CBD susceptibility as well as cobalt-lung hard metal
disease. These findings suggest that certain substitutions may promote an
involuntary cation-binding site within a putatively metal-free peptide-binding
pocket and therefore change the innate specificity of antigen recognition. N. Ref:: 31
----------------------------------------------------
[23]
TÍTULO / TITLE: - Implications of the
advent of homozygous alpha l, 3-galactosyltransferase gene-deficient pigs on
transmission of infectious agents.
REVISTA
/ JOURNAL: - Xenotransplantation 2003 Jul;10(4):287-8.
AUTORES
/ AUTHORS: - Chapman LE; Wilson CA
INSTITUCIÓN
/ INSTITUTION: - National Center for Infectious Diseases,
Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lec3@cdc.gov
N. Ref:: 16
----------------------------------------------------
[24]
TÍTULO / TITLE: - Formulary
considerations for drugs used to prevent cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S17-21.
AUTORES
/ AUTHORS: - Pescovitz MD
INSTITUCIÓN
/ INSTITUTION: - Organ Transplant Program, Indiana
University Medical Center, Indianapolis, IN, USA. mpescov@iupui.edu
RESUMEN
/ SUMMARY: - Four types of therapeutic strategies for
managing cytomegalovirus (CMV) in solid organ transplant recipients, the
mechanisms of action and efficacy of drugs used for prophylaxis, and the
criteria for evaluating drugs for inclusion in a formulary are described.
Universal and selective prophylaxis are simple to implement and effective for
CMV prophylaxis, but they are costly and patient nonadherence and viral
resistance can develop. Preemptive therapy may cause less resistance and cost
less, but it is more complex and associated with a higher incidence of
infection, which may have no effect on secondary effects from CMV infection,
and higher recurrence of disease than prophylactic therapy. Treatment of active
disease may be less costly for the drug than other approaches, but intravenous
access is required and the rates of infection recurrence and mortality are
higher compared with prophylaxis and preemptive therapy. Criteria for deciding
which CMV prophylactic drugs to include in a formulary include efficacy,
safety, convenience, and cost. CMV immune globulin i.v. is costly and exhibits
reduced efficacy when used alone in patients at high risk for CMV disease.
Intravenous ganciclovir is effective, but it is costly because of infusion
costs. Intravenous drug therapies are inconvenient and associated with a risk
of bacterial and fungal infection. Oral acyclovir is safe to use and
inexpensive (since a genetic exists), but it has poor efficacy and is
inconvenient because of the need for four large daily doses. Valacyclovir is
more convenient and with similar safety and probably better efficacy than
acyclovir, but it is more costly. Oral ganciclovir and oral valganciclovir have
similar safety and costs, with greater efficacy than acyclovir. The single
daily dose and lack of resistance to valganciclovir are advantages over oral
ganciclovir, which requires three daily doses and can result in the development
of resistance. N.
Ref:: 20
----------------------------------------------------
[25]
TÍTULO / TITLE: - Costs and consequences
of cytomegalovirus disease.
REVISTA
/ JOURNAL: - Am J Health Syst Pharm 2003 Dec 1;60(23
Suppl 8):S5-8.
AUTORES
/ AUTHORS: - Schnitzler MA
INSTITUCIÓN
/ INSTITUTION: - Washington University, 4547 Clayton
Avenue, Box 8084, St. Louis, MO 63110, USA. schnitz@wueconc.edu
RESUMEN
/ SUMMARY: - The impact of prophylactic oral
ganciclovir therapy on the incidence of cytomegalovirus (CMV) disease, patient
and graft survival, and costs in patients receiving kidney and liver transplants
is described. CMV disease is a common cause of morbidity and mortality in solid
organ transplant recipients unless prophylactic drug therapy is used.
Prophylactic oral ganciclovir therapy reduces the incidence of CMV disease in
kidney and liver transplant recipients. It is more effective for recipients who
are seronegative before the transplant and receive organs from seronegative
(D-/R-) donors than in seronegative recipients of organs from seropositive
(D+/R-) donors. CMV disease remains a problem in the latter. CMV disease
increases the risk of graft failure, which decreases the likelihood of patient
survival. The extent of matching of the DR subregion of the human leukocyte
antigen complex in the donor and recipient may affect graft survival in
patients with CMV disease. Graft failure is costly and should be considered in
economic analyses of CMV prophylaxis regimens because of the potential impact
of prophylaxis on CMV disease. The use of oral ganciclovir for CMV prophylaxis
has reduced the incidence of CMV disease in kidney and liver transplant
recipients. N. Ref:: 10
----------------------------------------------------
[26]
TÍTULO / TITLE: - IMGT databases, web
resources and tools for immunoglobulin and T cell receptor sequence analysis, http://imgt.cines.fr.
REVISTA
/ JOURNAL: - Leukemia 2003 Jan;17(1):260-6.
●●
Enlace al texto completo (gratuito o de pago) 1038/sj.leu.2402637
AUTORES
/ AUTHORS: - Lefranc MP
INSTITUCIÓN
/ INSTITUTION: - Laboratoire d’ImmunoGenetique Moleculaire,
LIGM, Universite Montpellier II, UPR CNRS 1142, Institut de Genetique Humaine,
IGH, Montpellier, France.
RESUMEN
/ SUMMARY: - IMGT, the international ImMunoGeneTics database(®)
(http://imgt.cines.fr), is a high-quality
integrated information system specializing in immunoglobulins (IG), T cell
receptors (TR) and major histocompatibility complex (MHC) of human and other
vertebrates, created in 1989, by LIGM, at the Universite Montpellier II, CNRS,
Montpellier, France. IMGT provides a common access to standardized data which
include nucleotide and protein sequences, oligonucleotide primers, gene maps,
genetic polymorphisms, specificities, 2D and 3D structures. IMGT includes
several databases (IMGT/LIGM-DB, IMGT/3Dstructure-DB, IMGT/HLA-DB), Web
resources (‘IMGT Marie-Paule page’) and interactive tools (IMGT/V-QUEST,
IMGT/JunctionAnalysis). IMGT expertly annotated data and tools described in
this paper are particularly useful for the analysis of the IG and TR
rearrangements in leukemia, lymphoma and myeloma, and in translocations
involving the antigen receptor loci. IMGT is freely available at http://imgt.cines.fr. N. Ref:: 51
----------------------------------------------------
[27]
TÍTULO / TITLE: - Complexities of
CD28/B7: CTLA-4 costimulatory pathways in autoimmunity and transplantation.
REVISTA
/ JOURNAL: - Annu Rev Immunol 2001;19:225-52.
●●
Enlace al texto completo (gratuito o de pago) 1146/annurev.immunol.19.1.225
AUTORES
/ AUTHORS: - Salomon B; Bluestone JA
INSTITUCIÓN
/ INSTITUTION: - The Committee on Immunology, Ben May
Institute for Cancer Research and Department of Pathology, University of
Chicago, Chicago, Illinois 60637, USA.
RESUMEN
/ SUMMARY: - Recent advances in the understanding of T
cell activation have led to new therapeutic approaches in the treatment of immunological
disorders. One attractive target of intervention has been the blockade of T
cell costimulatory pathways, which result in more selective effects on only
those T cells that have encountered specific antigen. In fact, in some
instances, costimulatory pathway antagonists can induce antigen-specific
tolerance that prevents the progression of autoimmune diseases and organ graft
rejection. In this review, we summarize the current understanding of these
complex costimulatory pathways including the individual roles of the CD28,
CTLA-4, B7-1 (CD80), and B7-2 (CD86) molecules. We present evidence that
suggests that multiple mechanisms contribute to CD28/B7-mediated T cell
costimulation in disease settings that include expansion of activated
pathogenic T cells, differentiation of Th1/Th2 cells, and the migration of T
cells into target tissues. Additionally, the negative regulatory role of CTLA-4
in autoimmune diseases and graft rejection supports a dynamic but complex
process of immune regulation that is prominent in the control of
self-reactivity. This is most apparent in regulation of the
CD4(+)CD25(+)CTLA-4(+) immunoregulatory T cells that control multiple
autoimmune diseases. The implications of these complexities and the potential
for use of these therapies in clinical immune intervention are discussed. N. Ref:: 163
----------------------------------------------------
[28]
TÍTULO / TITLE: - Advanced medical
therapy does not render heart transplantation obsolete for ambulatory end-stage
heart failure patients: a debate.
REVISTA
/ JOURNAL: - J Heart Lung Transplant 2001
Jul;20(7):725-8.
AUTORES
/ AUTHORS: - Copeland JG
INSTITUCIÓN
/ INSTITUTION: - University of Arizona Sarver Heart Center,
Tucson, Arizona 85724-5071, USA. jgc@u.arizona.edu N. Ref:: 8
----------------------------------------------------
[29]
TÍTULO / TITLE: - A systematic review of
psychosocial factors affecting survival after bone marrow transplantation.
REVISTA
/ JOURNAL: - Psychosomatics 2003 May-Jun;44(3):181-95.