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Molecular Pathogenesis and Treatment Perspectives for Hypereosinophilia and Hypereosinophilic Syndromes. Int J Mol Sci 2021; 22:ijms22020486. [PMID: 33418988 PMCID: PMC7825323 DOI: 10.3390/ijms22020486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/25/2022] Open
Abstract
Hypereosinophilia (HE) is a heterogeneous condition with a persistent elevated eosinophil count of >350/mm3, which is reported in various (inflammatory, allergic, infectious, or neoplastic) diseases with distinct pathophysiological pathways. HE may be associated with tissue or organ damage and, in this case, the disorder is classified as hypereosinophilic syndrome (HES). Different studies have allowed for the discovery of two major pathogenetic variants known as myeloid or lymphocytic HES. With the advent of molecular genetic analyses, such as T-cell receptor gene rearrangement assays and Next Generation Sequencing, it is possible to better characterize these syndromes and establish which patients will benefit from pharmacological targeted therapy. In this review, we highlight the molecular alterations that are involved in the pathogenesis of eosinophil disorders and revise possible therapeutic approaches, either implemented in clinical practice or currently under investigation in clinical trials.
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Hasan A, Nafie K, El-Sayed S, Nasr M, Abdulmohaymen A, Baheeg M, Abbadi O. Enterobius vermicularis in appendectomy specimens; Clinicopathological assessment: Cross sectional study. Ann Med Surg (Lond) 2020; 60:168-172. [PMID: 33149902 PMCID: PMC7599363 DOI: 10.1016/j.amsu.2020.10.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/25/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute appendicitis. METHOD ology: All the routinely examined appendectomy specimens received in the pathology laboratory of a referral hospital over a three year period of time were reviewed for the existence of E. v. These cases were evaluated for clinico-laboratory characterization. RESULTS Out of 1150 appendectomies for clinical acute appendicitis picture, 31 (2.7%) cases revealed E. v infestation. The age ranged from 6 to 42 years old but more than 80% of the E. v infected cases were children. Twenty four cases (77.4%) did not show any other appendiceal pathology, six cases showed lymphoid hyperplasia and only one case showed concomitant histological acute inflammatory process. CONCLUSION E. v infestation is an incidental finding during histopathology examination of appendectomy specimens for patients with clinical diagnosis of acute appendicitis, however there is no relation between the existence of E. v and occurrence of acute appendicitis which is the main indication for appendectomy, so further studies are recommended to reach out earlier diagnosis to eliminate the unnecessary surgical intervention. Also surgeons should consider E. v as a differential diagnosis when removing a normal looking appendix to take the necessary precautions for minimizing any chance of contamination and sending all the normal looking appendectomy specimens for histopathology examination.
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Affiliation(s)
- Abdulkarim Hasan
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
| | - Khalid Nafie
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
| | - Samar El-Sayed
- Department of Parasitology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mohamed Nasr
- Department of Histology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ayman Abdulmohaymen
- Department of Surgical Oncology Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Baheeg
- Department of Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Osama Abbadi
- Department of Biochemistry, Faculty of Medicine, Omdurman Islamic University, Sudan
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The immunoglobulin G antibody response to malaria merozoite antigens in asymptomatic children co-infected with malaria and intestinal parasites. PLoS One 2020; 15:e0242012. [PMID: 33170876 PMCID: PMC7654760 DOI: 10.1371/journal.pone.0242012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023] Open
Abstract
Background Co-infection with malaria and intestinal parasites is common in children in Africa and may affect their immune response to a malaria parasite infection. Prior studies suggest that co-infections may lead to increased susceptibility to malaria infection and disease severity; however, other studies have shown the reverse. Knowledge on how co-morbidities specifically affect the immune response to malaria antigens is limited. Therefore, this study sought to determine the prevalence of co-infection of malaria and intestinal parasites and its association with antibody levels to malaria merozoite antigens. Methods A cross sectional study was carried out in two villages with high transmission of malaria in Cameroon (Ngali II and Mfou) where mass drug administration (MDA) had been administered at ~6-month intervals (generally with albendazole or mebendazole). Children aged 1–15 years were enrolled after obtaining parental consent. A malaria rapid diagnostic test was used on site. Four (4) ml of peripheral blood was collected from each participant to determine Plasmodium falciparum infections by microscopy, haemoglobin levels and serology. Fresh stool samples were collected and examined by wet mount, Kato-Katz method and modified Ritchie concentration techniques. A Multiplex Analyte Platform assay was used to measure antibody levels. Results A total of 320 children were enrolled. The prevalence of malaria by blood smear was 76.3% (244/320) and prevalence of malaria and intestinal parasites was 16.9% (54/320). Malaria prevalence was highest in young children; whereas, intestinal parasites (IP+) were not present until after 3 years of age. All children positive for malaria had antibodies to MSP142, MSP2, MSP3 and EBA175. No difference in antibody levels in children with malaria-co infections compared to malaria alone were found, except for antibody levels to EBA-175 were higher in children co-infected with intestinal protozoa (p = 0.018), especially those with Entamoeba histolytica infections (p = 0.0026). Conclusion Antibody levels to EBA175 were significantly higher in children co-infected with malaria and E. histolytica compared to children infected with malaria alone. It is important to further investigate why and how the presence of these protozoans might modulate the immune response to malaria antigens.
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Andreev D, Liu M, Kachler K, Llerins Perez M, Kirchner P, Kölle J, Gießl A, Rauber S, Song R, Aust O, Grüneboom A, Kleyer A, Cañete JD, Ekici A, Ramming A, Finotto S, Schett G, Bozec A. Regulatory eosinophils induce the resolution of experimental arthritis and appear in remission state of human rheumatoid arthritis. Ann Rheum Dis 2020; 80:451-468. [PMID: 33148700 DOI: 10.1136/annrheumdis-2020-218902] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Eosinophils possess pro-inflammatory functions in asthma. However, our recent studies have suggested that innate lymphoid cells type 2 (ILC2s) and eosinophils have proresolving properties in rheumatoid arthritis (RA). Nothing is known yet about the mechanisms determining the double-edged role of eosinophils. Therefore, we investigated whether asthma, a paradigm eosinophilic disease, can elicit resolution of chronic arthritis. METHODS Ovalbumin-triggered eosinophilic asthma was combined with K/BxN serum-induced arthritis, where lung and synovial eosinophil subsets were compared by single-cell RNA sequencing (scRNA-seq). To investigate the involvement of the ILC2-interleukin-5 (IL-5) axis, hydrodynamic injection (HDI) of IL-25 and IL-33 plasmids, IL-5 reporter mice and anti-IL-5 antibody treatment were used. In patients with RA, the presence of distinct eosinophil subsets was examined in peripheral blood and synovial tissue. Disease activity of patients with RA with concomitant asthma was monitored before and after mepolizumab (anti-IL-5 antibody) therapy. RESULTS The induction of eosinophilic asthma caused resolution of murine arthritis and joint tissue protection. ScRNA-seq revealed a specific subset of regulatory eosinophils (rEos) in the joints, distinct from inflammatory eosinophils in the lungs. Mechanistically, synovial rEos expanded on systemic upregulation of IL-5 released by lung ILC2s. Eosinophil depletion abolished the beneficial effect of asthma on arthritis. rEos were consistently present in the synovium of patients with RA in remission, but not in active stage. Remarkably, in patients with RA with concomitant asthma, mepolizumab treatment induced relapse of arthritis. CONCLUSION These findings point to a hitherto undiscovered proresolving signature in an eosinophil subset that stimulates arthritis resolution.
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Affiliation(s)
- Darja Andreev
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Mengdan Liu
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Katerina Kachler
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Mireia Llerins Perez
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Philipp Kirchner
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Julia Kölle
- Department of Molecular Pneumology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Gießl
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Rauber
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Rui Song
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Oliver Aust
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anika Grüneboom
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Juan D Cañete
- Departamento de Reumatología, Hospital Clínic de Barcelona e IDIBAPS, Barcelona, Spain
| | - Arif Ekici
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Ramming
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Susetta Finotto
- Department of Molecular Pneumology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Aline Bozec
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
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Pan L, Liao B, Guo CL, Liu JX, Wang H, Long XB, Liu Z. Inflammatory features and predictors for postsurgical outcomes in patients with nasal polyps stratified by local and systemic eosinophilia. Int Forum Allergy Rhinol 2020; 11:846-856. [PMID: 33012136 DOI: 10.1002/alr.22702] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/13/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND In this study we aimed to identify inflammatory patterns and predictors associated with clinical outcomes in chronic rhinosinusitis with nasal polyps (CRSwNP) patients with different blood and tissue eosinophilia. METHODS A total of 535 CRSwNP patients were enrolled, and the expression of 35 biomarkers, together with eosinophil and neutrophil counts in nasal polyps, were analyzed in a subset of 249 patients. Patients were stratified on the basis of blood (≥0.5 × 109 /L) and tissue (>10%) eosinophilia. Logistic regression models were applied to identify predictors of uncontrolled disease at least 1 year after surgery. Uncontrolled disease was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. RESULTS Among 535 patients, 38.5% showed inconsistent blood and tissue eosinophilia. In 249 CRSwNP patients, subjects with concomitant blood and tissue eosinophilia (group 1) showed marked mucosal type 2 inflammation, characterized by high levels of interleukin (IL)-5, IL-13, and eotaxin-1, whereas subjects with normal blood and tissue eosinophil levels (group 4) demonstrated significant local neutrophilic inflammation with high expression of granulocyte colony-stimulating factor and subjects with selective tissue eosinophilia (group 2) showed intermediate and mixed eosinophilic and neutrophilic inflammation. Subjects with isolated blood eosinophilia (group 3) showed low expression of vascular endothelial growth factor and IL-10. Asthma, prior sinus surgery, and blood eosinophilia were the top 3 predictors for postsurgical uncontrolled disease. For subgroup analysis, sex in group 1, asthma in group 2, tissue IL-10 and immunoglobulin E in group 3, and prior sinus surgery in group 4 were the strongest predictors of uncontrolled disease, respectively. CONCLUSION Different blood and tissue eosinophilia revealed distinct tissue inflammatory patterns in CRSwNP patients.
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Affiliation(s)
- Li Pan
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Bo Liao
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Cui-Lian Guo
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jin-Xin Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Heng Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Xiao-Bo Long
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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Matsunaga K, Harada M, Suizu J, Oishi K, Asami-Noyama M, Hirano T. Comorbid Conditions in Chronic Obstructive Pulmonary Disease: Potential Therapeutic Targets for Unmet Needs. J Clin Med 2020; 9:E3078. [PMID: 32987778 PMCID: PMC7598716 DOI: 10.3390/jcm9103078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022] Open
Abstract
The management of chronic obstructive pulmonary disease (COPD) has improved significantly due to advances in therapeutic agents, but it has also become apparent that there are issues that remain difficult to solve with the current treatment algorithm. COPD patients face a number of unmet needs concerning symptoms, exacerbations, and physical inactivity. There are various risk factors and triggers for these unmet needs, which can be roughly divided into two categories. One is the usual clinical characteristics for COPD patients, and the other is specific clinical characteristics in patients with comorbid conditions, such as asthma, cardiovascular disease, and bronchiectasis. These comorbidities, which are also associated with the diversity of COPD, can cause unmet needs resistance to usual care. However, treatable conditions that are not recognized as therapeutic targets may be latent in patients with COPD. We again realized that treatable traits should be assessed and treated as early as possible. In this article, we categorize potential therapeutic targets from the viewpoint of pulmonary and systemic comorbid conditions, and address recent data concerning the pathophysiological link with COPD and the impact of intervention on comorbid conditions in order to obtain evidence that could enable us to provide personalized COPD management.
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Affiliation(s)
- Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (M.H.); (J.S.); (M.A.-N.); (T.H.)
| | - Misa Harada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (M.H.); (J.S.); (M.A.-N.); (T.H.)
| | - Junki Suizu
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (M.H.); (J.S.); (M.A.-N.); (T.H.)
| | - Keiji Oishi
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan;
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (M.H.); (J.S.); (M.A.-N.); (T.H.)
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (M.H.); (J.S.); (M.A.-N.); (T.H.)
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Li R, Zhu WJ, Wang F, Tang X, Luo F. AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year-a retrospective cohort study with 522 cases. Arthritis Res Ther 2020; 22:202. [PMID: 32950060 PMCID: PMC7502203 DOI: 10.1186/s13075-020-02286-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). PATIENTS AND METHODS This was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008, to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91-1.26, 1.26-1.73, and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides, or low-density lipoprotein. RESULTS Higher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481-7.911, p = .004). Patients with higher DRR more often required the use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up. CONCLUSION Higher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation, and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.
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Affiliation(s)
- Renjiao Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China
| | - Wen-Jun Zhu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China
| | - Faping Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China
| | - Xiaoju Tang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China
| | - Fengming Luo
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
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Janeczek K, Emeryk A, Rachel M, Duma D, Zimmer Ł, Poleszak E. Polyvalent Mechanical Bacterial Lysate Administration Improves the Clinical Course of Grass Pollen-Induced Allergic Rhinitis in Children: A Randomized Controlled Trial. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:453-462. [PMID: 32858239 DOI: 10.1016/j.jaip.2020.08.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/23/2020] [Accepted: 08/11/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recent studies highlight the immunoregulatory potential of bacterial lysates, indicating their potential use in the prevention and treatment of allergic diseases. OBJECTIVE To investigate the clinical efficacy of polyvalent mechanical bacterial lysates (PMBLs) in children with grass pollen-induced allergic rhinitis. METHODS Seventy children with seasonal allergic rhinitis were enrolled to this study and were randomly assigned to the PMBL and placebo groups. Severity of seasonal allergic rhinitis symptoms was assessed by the total nasal symptom score, total ocular symptom score, and visual analogue scale. During 3 visits, peak nasal inspiratory flow was measured, and nasal smears for the presence of eosinophils and nasal lavage fluids for the presence of allergen-specific IgE against timothy grass pollen allergens were sampled. RESULTS A statistically significant decrease in total nasal symptom score (P = .001), total ocular symptom score (P = .04), and visual analogue scale score for nasal and eye symptoms (P < .001 and P < .001, respectively) and an increase in peak nasal inspiratory flow (P = .04) were observed in the PMBL group versus the placebo group. During the grass pollen season, an increase and then a decrease in the number of eosinophils in nasal smears was observed in both groups; however, the number of eosinophils was significantly lower in the PMBL group versus the placebo group. No significant changes in allergen-specific IgE concentrations were observed in the PMBL group, whereas in the placebo group a statistically significant increase in allergen-specific IgE concentration was observed. CONCLUSIONS Sublingual administration of PMBLs during the grass pollen season offers significant efficacy in alleviating seasonal allergic rhinitis symptoms in children sensitized to grass pollen allergens. PMBLs probably affect mucosal immunity, weakening the response of TH2 cells.
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Affiliation(s)
- Kamil Janeczek
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland.
| | - Andrzej Emeryk
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
| | - Marta Rachel
- Chair and Department of Human Physiology and Pathophysiology, University of Rzeszów, Rzeszów, Poland
| | - Dariusz Duma
- Department of Laboratory Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Łukasz Zimmer
- Department of Applied and Social Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Ewa Poleszak
- Department of Applied and Social Pharmacy, Medical University of Lublin, Lublin, Poland
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Hernández SA, Gabrie JA, Rodríguez CA, Matamoros G, Rueda MM, Canales M, Mergl R, Sanchez A. An Integrated Study of Toxocara Infection in Honduran Children: Human Seroepidemiology and Environmental Contamination in a Coastal Community. Trop Med Infect Dis 2020; 5:tropicalmed5030135. [PMID: 32842560 PMCID: PMC7559065 DOI: 10.3390/tropicalmed5030135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Infections caused by Toxocara canis and T. cati are considered zoonoses of global importance. Reports from North and South America indicate that human infections are widespread in both continents, but epidemiological information from Central America is still lacking. (2) Methodology: In the present cross-sectional multi-year study, we aimed to undertake the first seroepidemiological and environmental study on toxocariasis in Honduras. This included the determination of seroprevalence of anti-Toxocara spp. antibodies in children using a Toxocara spp. purified excretory-secretory antigens enzyme-linked immunosorbent assay (TES-ELISA) and a confirmatory Western blot. As well, through statistical analysis including logistic regression we aimed at identifying relevant biological and epidemiological factors associated with seropositivity. The study also entailed detection of parasites' eggs in the soil samples both through Sheather's concentration method and a nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. (3) Results: The study was undertaken in a coastal community of Honduras in 2 different years, 2015 and 2017. A total of 88 healthy schoolchildren completed the study, with participation of 79% (73/92) and 65% (46/71) of the student body in 2015 and 2017, respectively. Thirty-one children participated in both years (i.e., dual participants). Through both serological tests, seropositivity was confirmed in 88.6% (78/88) of children. Due to the high number of seropositives, logistic regression analysis was not possible for most socio-economic and epidemiological variables. Eosinophilia, on the other hand, was associated with seropositivity, independently of other intestinal helminthic infections. Continued seropositivity was observed in most of the dual participants, while seroconversion was determined in 8 of these children. Microscopic examination of soil samples did not yield any positive results. Through nested PCR-RFLP, 3 of the 50 samples (6%) were positive for Toxocara spp.; two were identified as T. canis and one as T. cati. (4) Conclusions: This work documents for the first time, high levels of human exposure to Toxocara spp. in Honduras. These findings, along with the country's favorable epidemiological conditions for this zoonosis, emphasize the need for more research to determine whether this infection is underreported in the country.
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Affiliation(s)
- Sergio A. Hernández
- Department of Health Sciences, Brock University, St. Catharines, ON L3S 2A1, Canada; (S.A.H.); (J.A.G.); (G.M.)
| | - José A. Gabrie
- Department of Health Sciences, Brock University, St. Catharines, ON L3S 2A1, Canada; (S.A.H.); (J.A.G.); (G.M.)
| | - Carol Anahelka Rodríguez
- Department of Parasitology, School of Microbiology and Institute of Microbiology Research, National Autonomous University of Honduras, Tegucigalpa, Honduras; (C.A.R.); (M.M.R.); (M.C.)
| | - Gabriela Matamoros
- Department of Health Sciences, Brock University, St. Catharines, ON L3S 2A1, Canada; (S.A.H.); (J.A.G.); (G.M.)
- Department of Parasitology, School of Microbiology and Institute of Microbiology Research, National Autonomous University of Honduras, Tegucigalpa, Honduras; (C.A.R.); (M.M.R.); (M.C.)
| | - María Mercedes Rueda
- Department of Parasitology, School of Microbiology and Institute of Microbiology Research, National Autonomous University of Honduras, Tegucigalpa, Honduras; (C.A.R.); (M.M.R.); (M.C.)
| | - Maritza Canales
- Department of Parasitology, School of Microbiology and Institute of Microbiology Research, National Autonomous University of Honduras, Tegucigalpa, Honduras; (C.A.R.); (M.M.R.); (M.C.)
| | - Ronald Mergl
- Niagara Falls Animal Medical Centre, Niagara Falls, ON L2E 6Z8, Canada;
| | - Ana Sanchez
- Department of Health Sciences, Brock University, St. Catharines, ON L3S 2A1, Canada; (S.A.H.); (J.A.G.); (G.M.)
- Department of Parasitology, School of Microbiology and Institute of Microbiology Research, National Autonomous University of Honduras, Tegucigalpa, Honduras; (C.A.R.); (M.M.R.); (M.C.)
- Correspondence:
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Oishi K, Matsunaga K, Shirai T, Hirai K, Gon Y. Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease. J Clin Med 2020; 9:jcm9082670. [PMID: 32824775 PMCID: PMC7464674 DOI: 10.3390/jcm9082670] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.
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Affiliation(s)
- Keiji Oishi
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Correspondence: ; Tel.: +81-836-22-2248
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan;
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka 420-8527, Japan;
| | - Keita Hirai
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka 422-8526, Japan;
- Laboratory of Clinical Pharmacogenomics, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8601, Japan;
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61
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Chan KH, Gibson P. Eosinophilic myocarditis presenting with hypoactive delirium and cardioembolic stroke. CMAJ 2020; 191:E1159-E1163. [PMID: 31636164 DOI: 10.1503/cmaj.190669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Ka Hong Chan
- Department of Medicine (Chan), University of British Columbia, Vancouver, BC; Department of Medicine (Gibson), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Paul Gibson
- Department of Medicine (Chan), University of British Columbia, Vancouver, BC; Department of Medicine (Gibson), Cumming School of Medicine, University of Calgary, Calgary, Alta.
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Šteňová E, Tarabčáková L, Babál P, Kašperová S. Hypereosinophilic syndrome-a rare adverse event of anti-cytokine treatment in rheumatoid arthritis resolved after Janus kinase inhibitor therapy. Clin Rheumatol 2020; 39:3507-3510. [PMID: 32495227 DOI: 10.1007/s10067-020-05134-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
Eosinophilia is uncommon in early rheumatoid arthritis (RA). The most frequent causes of hypereosinophilia during RA treatment are atopic eczema, allergy, helminth infection, haematological malignancy and drug-associated complications. The pathogenesis of this abnormality associated with anti-cytokine therapy is still unknown. We report the case of a young woman with RA and eosinophilia accompanied by systemic symptoms such as dyspnoea, fluid retention and eosinophilic vasculitis. An interesting observation was the persistence of eosinophilia during treatment with various biologics and its normalization after switching to the Janus kinase inhibitor baricitinib.
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Affiliation(s)
- Emőke Šteňová
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Staré Mesto, Mickiewiczova 13, 813 69, Bratislava, Slovakia.
| | - Lenka Tarabčáková
- Department of Rheumatology, Saint Michael's Hospital, Bratislava, Slovakia
| | - Pavel Babál
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Bratislava, Slovakia
| | - Stela Kašperová
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Staré Mesto, Mickiewiczova 13, 813 69, Bratislava, Slovakia
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Altrichter S, Frischbutter S, Fok JS, Kolkhir P, Jiao Q, Skov PS, Metz M, Church MK, Maurer M. The role of eosinophils in chronic spontaneous urticaria. J Allergy Clin Immunol 2020; 145:1510-1516. [DOI: 10.1016/j.jaci.2020.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 12/21/2022]
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Mull ES, Erdem G, Nicol K, Adler B, Shell R. Eosinophilic Pneumonia and Lymphadenopathy Associated With Vaping and Tetrahydrocannabinol Use. Pediatrics 2020; 145:peds.2019-3007. [PMID: 32217740 DOI: 10.1542/peds.2019-3007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2019] [Indexed: 11/24/2022] Open
Abstract
Idiopathic acute eosinophilic pneumonia is a rare and potentially life-threatening condition that is defined by bilateral pulmonary infiltrates and fever in the presence of pulmonary eosinophilia. It often presents acutely in previously healthy individuals and can be difficult to distinguish from infectious pneumonia. Although the exact etiology of idiopathic acute eosinophilic pneumonia remains unknown, an acute hypersensitivity reaction to an inhaled antigen is suggested, which is further supported by recent public health risks of vaping (electronic cigarette) use and the development of lung disease. In this case, a patient with a year-long history of vaping in conjunction with tetrahydrocannabinol cartridge use who was diagnosed with idiopathic acute eosinophilic pneumonia with associated bilateral hilar lymphadenopathy is described.
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Affiliation(s)
| | | | | | - Brent Adler
- Pathology, Nationwide Children's Hospital, Columbus, Ohio
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65
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Ohfuji S. Retrospective analysis of globule leukocytes in parasite-free rumens of cattle: a histopathological research with literature review. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s00580-020-03101-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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66
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Alhaddad O, Elsabaawy M, Abdelsameea E, Abdallah A, Shabaan A, Ehsan N, Elrefaey A, Elsabaawy D, Salama M. Presentations, Causes and Outcomes of Drug-Induced Liver Injury in Egypt. Sci Rep 2020; 10:5124. [PMID: 32198411 PMCID: PMC7083870 DOI: 10.1038/s41598-020-61872-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 02/26/2020] [Indexed: 02/07/2023] Open
Abstract
Drug-induced liver injury (DILI) is a frequent cause of liver injury and acute liver failure. We aimed to review all hospitalized DILI cases in a tertiary Egyptian center from January 2015 through January 2016. Cases with elevated alanine aminotransferase more than 3-fold and/or alkaline phosphatase more than 2-fold the upper limit of normal value were prospectively recruited and followed for one year. Drug history, liver biopsy whenever feasible and application of Roussel Uclaf Causality Assessment Method (RUCAM) were the diagnostic prerequisites after exclusion of other etiologies of acute liver injury. In order of frequency, the incriminated drugs were: Diclofenac (31 cases, 41.3%), amoxicillin-clavulanate (14 cases, 18.7%), halothane toxicity (8 cases, 10.7%), ibuprofen (4 cases, 5.3%), Khat (3 cases, 4%), tramadol (3 cases, 4%), Sofosbuvir with ribavirin (2 cases, 2.7%), and acetylsalicylic acid (2 cases, 2.7%) with one offending drug in 93.3% of cases. Forty-four cases (58.7%) were males; while 56 cases (74.7%) had HCV related chronic liver disease. Thirty-two cases (42.7%) presented with pattern of hepatocellular injury, while 23 cases (30.7%) were with cholestasis, and 20 cases (20.7%) with a mixed hepatocellular/cholestatic injury. One case received a transplant (0.75%), 7 cases died (9.3%), 23 cases (30.6%) developed liver decompensation (hepatic encephalopathy and ascites), and 44 cases completely resolved (58.7%). In conclusion, Diclofenac is the commonest offender in DILI occurrence in an Egyptian cohort. Age and prothrombin concentration were the only predictors of unfavorable outcomes of DILI.
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Affiliation(s)
- Omkolthoum Alhaddad
- Hepatology and gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Maha Elsabaawy
- Hepatology and gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Eman Abdelsameea
- Hepatology and gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.
| | - Ayat Abdallah
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Ahmed Shabaan
- Hepatology and gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Nermine Ehsan
- Pathology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Ahmed Elrefaey
- Pathology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Dalia Elsabaawy
- Clinical Pharmacy, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Mohsen Salama
- Hepatology and gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
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Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review. Clin Rev Allergy Immunol 2020; 57:194-212. [PMID: 30003499 DOI: 10.1007/s12016-018-8695-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hypereosinophilic syndrome and mastocytosis are relatively rare proliferative diseases encountered in the general population. However, allergists frequently consider these disorders in the differential of patients presenting with gastrointestinal, pulmonary, cutaneous, and allergic symptoms. Gastrointestinal symptoms are some of the most frequent and/or debilitating aspects of both disease states and in many cases lead to poor quality of life and functional limitation for the patient. They are the third most common clinical manifestation in hypereosinophilic syndrome and have been found to be the most distressful aspect of the disorder in those with systemic mastocytosis. Both eosinophils and mast cells play integral parts in normal gut physiology, but when and how exactly their effector functionality translates into clinically significant disease remains unclear, and the available literature regarding their pathophysiology remains sparse. Eosinophils and mast cells even, in fact, may not necessarily function in isolation from each other but can participate in bidirectional crosstalk. Both are affected by similar mediators and can also influence one another in a paracrine fashion. Their interactions include both production of soluble mediators for specific eosinophil and mast cell receptors (for example, eosinophil recruitment and activation by mast cells releasing histamine and eotaxin) as well as direct physical contact. The mechanistic relationship between clonal forms of hypereosinophilia and systemic mastocytosis has also been explored. The nature of gastrointestinal symptomatology in the setting of both hypereosinophilic syndrome and mast cell disease is frequently manifold, heterogeneous, and the lack of better targeted therapy makes diagnosis and management challenging, especially when faced with a substantial differential. Currently, the management of these gastrointestinal symptoms relies on the treatment of the overall disease process. In hypereosinophilia patients, systemic corticosteroids are mainstay, although steroid-sparing agents such as hydroxyurea, IFN-α, methotrexate, cyclosporine, imatinib, and mepolizumab have been utilized with varying success. In mastocytosis patients, anti-mediator therapy with antihistamines and mast cell stabilization with cromolyn sodium can be considered treatments of choice, followed by other therapies yet to be thoroughly studied, including the role of the low-histamine diet, corticosteroids, and treatment of associated IBS symptoms. Given that both eosinophils and mast cells may have joint pathophysiologic roles, they have the potential to be a combined target for therapeutic intervention in disease states exhibiting eosinophil or mast cell involvement.
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68
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Mohapatra S, Charilaou P, Sharma A, Singh DP, Sah RP, Murray D, Majumder S, Topazian MD, Chari ST. Significance of peripheral eosinophilia for diagnosis of IgG4-related disease in subjects with elevated serum IgG4 levels. Pancreatology 2020; 20:74-78. [PMID: 31791884 DOI: 10.1016/j.pan.2019.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/24/2019] [Accepted: 11/26/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES In this study, we aim to assess the diagnostic utility of elevated serum IgG4 (sIgG4) concentration alone and in combination with peripheral eosinophilia (PE) for IgG4-related disease (IgG4-RD). METHODS From the Mayo Clinic, Rochester electronic medical record database we identified 409 patients with above normal levels of sIgG4 (reference range 121-140 mg/dL) who had sIgG4 measured to differentiate IgG4-RD from another disease. RESULTS Among 409 patients with any elevation in sIgG4 levels, 129 (31.5%) had a definite diagnosis of IgG4-RD. The prevalence of PE increased with increasing sIgG4 levels and was more likely to be seen in subjects with IgG4-RD vs. non-IgG4-RD at ≥1X (n = 35/120, 29.2% vs. n = 23/258, 8.9%; p < 0.001), ≥2X (n = 23/64, 35.9% vs. n = 5/54,9.3%; p = 0.001) and ≥3X (n = 18/42, 42.9% vs. n = 0/9, 0%; p = 0.015) of sIgG4 upper limit of normal (ULN), respectively. After adjusting for gender and age, sIgG4 levels ≥ 2X ULN with PE as a predictor, had a higher positive predictive value in predicting IgG4-RD (72.2% vs. 65.9%) with an Area Under the Receiver Operatic Characteristic Curve (AUC) of 0.776, compared to sIgG4 ≥ 2X ULN without PE predictor (AUC = 0.74), p = 0.016. PE, sIgG4≥2X ULN, male gender, and age independently predicted the disease with odds ratio of 4.89 (95% CI:2.51-9.54), 3.78 (95% CI:2.27-6.28), 2.78 (95% CI:1.55-4.97), and 1.03 (95% CI:1.02-1.05), respectively. CONCLUSION Even in subjects in whom IgG4-RD is suspected, only a minority (∼30%) with elevated sIgG4 levels have IgG4-RD. sIgG4 by itself is more specific at higher levels, though never diagnostic. PE increases with increasing sIgG4 and adds diagnostic value at higher sIgG4 levels.
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Affiliation(s)
- Sonmoon Mohapatra
- Department of Gastroenterology and Hepatology, Saint Peter's University Hospital, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - Paris Charilaou
- Department of Gastroenterology and Hepatology, Saint Peter's University Hospital, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - Ayush Sharma
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Dhruv Pratap Singh
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Raghuwansh P Sah
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - David Murray
- Department of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Shounak Majumder
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mark D Topazian
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Suresh T Chari
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, USA.
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Association between eosinophil count and cholelithiasis among a population with Clonorchis sinensis infection in Foshan City, China. J Helminthol 2019; 94:e107. [PMID: 31779732 DOI: 10.1017/s0022149x19001019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The association between eosinophil count and cholelithiasis among people with Clonorchis sinensis infection is still uncertain. We conducted a cross-sectional study to investigate the associations among Clonorchis sinensis infection, eosinophil count and cholelithiasis. The study included 4628 participants from January to December 2018. The levels of eosinophil count were divided into four groups according to the quartiles of eosinophil count. Spearman's rank correlation was performed to assess the association between eosinophil counts and Clonorchis sinensis egg counts. Multiple regression analysis was performed to evaluate the relationships among C. sinensis infection, eosinophil count and cholelithiasis after adjusting for three models. The prevalence of C. sinensis infection was 38.72% (1792/4628), and the prevalence of cholelithiasis was 6.03% (279/4628). The infection rate of C. sinensis was higher in the cholelithiasis group than in the non-cholelithiasis group (63.08% vs. 37.16%, P < 0.001). Significant differences were found among various eosinophil count quartiles for C. sinensis infection, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltranspeptidase (γ-GT), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine (CRE), blood urea nitrogen (BUN), uric acid (UA) and non-alcoholic fatty liver disease (NAFLD) (all P < 0.001). A significant positive correlation was found between eosinophil count and log-transformed C. sinensis egg count (r = 0.9477, P < 0.001). Multiple logistic regression analysis revealed that light and moderate intensities of C. sinensis infection were associated with cholelithiasis (P < 0.01 and P < 0.001, respectively), and C. sinensis infection with eosinophil count ranging from 0.05 to 0.5 × 109/l were associated with cholelithiasis (P < 0.05). In conclusion, our findings suggest that the light and moderate infections of C. sinensis with eosinophil count ranging from 0.05 to 0.5 × 109/l may be associated with a higher risk of cholelithiasis.
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70
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Zhang X, Zhang P, Li J, He Y, Fei Y, Peng L, Shi Q, Zhang W, Zhao Y. Different clinical patterns of IgG4-RD patients with and without eosinophilia. Sci Rep 2019; 9:16483. [PMID: 31712579 PMCID: PMC6848131 DOI: 10.1038/s41598-019-52847-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/22/2019] [Indexed: 12/21/2022] Open
Abstract
It has been reported that patients with IgG4-related disease (IgG4-RD) showed an elevated incidence of eosinophilia. We aim to explore the clinical patterns of IgG4-RD patients with and without eosinophilia. Four hundred and twenty-five IgG4-RD patients referred to Peking Union Medical College Hospital were enrolled. Blood eosinophil count higher than 0.5 × 109/L was defined as eosinophilia. Clinical features of all the participants were collected and analyzed statistically. Eighty-seven patients (20%) with eosinophilia were found. As compared to those with a normal range of blood eosinophil count, male predominance, longer disease duration, increased prevalence of dacryoadenitis, sialadenitis, lymphadenopathy, and skin rash, higher IgG4-RD responder index, more organ involvement and higher levels of serum IgG4 (17.0 g/L vs 6.5 g/L, P < 0.001) was found in patients with eosinophilia. There was no significant difference in the incidence of allergic disease between the two groups. Peripheral eosinophil counts were positively correlated with disease duration, the number of involved organs, IgG4-RD responder index, and serum IgG4. Higher recurrence rate during follow-up period was found in patients with eosinophilia [28.6% (20/70) vs 17.1% (42/245), P = 0.034]. IgG4-RD patients with eosinophilia exhibited different clinical patterns from patients without. Eosinophilia appeared independent of allergies in IgG4-RD.
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Affiliation(s)
- Xia Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Panpan Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Jieqiong Li
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Yujie He
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunyun Fei
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Linyi Peng
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Qun Shi
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Wen Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
| | - Yan Zhao
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
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Intestinal Parasitic Infections in Internationally Adopted Children: A 10-Year Retrospective Study. Pediatr Infect Dis J 2019; 38:983-989. [PMID: 31460872 DOI: 10.1097/inf.0000000000002399] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) represent one of the leading causes of morbidity in the world. Children involved in international adoptions constitute a special group of subjects with specific problems and specific healthcare needs. Nevertheless, in current literature there are insufficient data on IPI in this subset of children. This study aims to evaluate the prevalence of IPI in a cohort of internationally adopted children and to investigate epidemiologic factors and clinical features related to IPIs. METHODS A retrospective study involving internationally adopted children <18 years old for which results from 3 fecal parasitologic tests were available, evaluated between September 1, 2008 and April 31, 2018 at a tertiary level university hospital in Rome. Univariate and multivariate logistic regression analyses were carried out to identify demographic factors and clinical features associated with IPIs. Two comparisons were performed, the first one according to the positivity of the parasitologic examination of the feces and the second one according to the pathogenicity of the identified strains. RESULTS Of 584 children evaluated, 346 (59.3%) had a positive parasitologic examination (143 pathogenic parasites and 203 nonpathogenic parasites) and 238 (40.8%) had a negative parasitologic examination. About 28.9% of children were positive for 2 or more parasites. A statistically significant positive association was found between IPIs and age, macroarea of origin (Africa and Latin America), living in institutions before adoption and vitamin D deficiency (P < 0.05). CONCLUSIONS Intestinal parasites represent a widespread infection among internationally adopted children, especially in school-age children and those from Latin America and Africa. Importantly, the parasites found in adopted children were not pathogenic in most cases and did not cause significant alterations in growth, major micronutrient deficits or malnutrition.
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Levin G, Cohen S, Springer C, Avital A, Picard E, Rottensctreich A. Factors Associated with Positive Adenosine Challenge Test in Young Children with Suspected Asthma. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2019; 32:103-108. [PMID: 32140278 DOI: 10.1089/ped.2019.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/29/2019] [Indexed: 11/12/2022]
Abstract
Background: To investigate the predictive factors associated with positive adenosine monophosphate challenge using the auscultation method (AMP-PCW) test results. Methods: This is a prospective study of young children with suspected asthma who underwent AMP-PCW test. Patients with a positive AMP-PCW test were compared with those with a negative AMP-PCW. A multivariate logistic regression model was performed to identify the independent determinants of positive AMP-PCW. Results: A total of 159 patients completed the AMP-PCW test. The median age was 53 months. In total, 54.0% of patients had a positive AMP-PCW. The prevalence of atopic dermatitis and family history of asthma and allergy were significantly higher among the positive AMP-PCW group (P = 0.04, P = 0.02, and P = 0.007, respectively), as were the prevalences of elevated immunoglobulin E (IgE), peripheral blood eosinophils percentage (P = 0.003, P < 0.001, respectively), and number of emergency department (ED) visits/hospitalizations before AMP-PCW test (P = 0.006). A significant inverse correlation exists between peripheral blood eosinophils percentage and serum IgE levels with the AMP end-point concentrations (r = -0.302, P = 0.001, and r = -0.312, P = 0.001, respectively). In multivariate logistic regression model, peripheral blood eosinophils percentage, IgE levels, and the number of ED visits/hospitalizations before the AMP-PCW test were found as independent predictors for positive AMP-PCW test result. Conclusions: Our results suggest that bronchial responsiveness to AMP-PCW is related to proxy markers of airway inflammation (elevated eosinophils and IgE levels) and clinical exacerbation of asthma before the test. This may support the role of AMP-PCW in detecting inflammatory changes and monitoring their trend among young children with suspected asthma.
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Affiliation(s)
- Gabriel Levin
- Department of Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel
| | - Shlomo Cohen
- Institute of Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Chaim Springer
- Institute of Pulmonology, Hadassah University Medical Center, Jerusalem, Israel
| | - Avraham Avital
- Institute of Pulmonology, Hadassah University Medical Center, Jerusalem, Israel
| | - Elie Picard
- Institute of Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amihai Rottensctreich
- Department of Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel
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Kroegel C, Foerster M, Quickert S, Slevogt H, Neumann T. [Vasculitides and eosinophilic pulmonary diseases]. Internist (Berl) 2019; 59:898-910. [PMID: 30140942 DOI: 10.1007/s00108-018-0479-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Eosinophilic granulocytes form peripheral effector cells controlled by Th2 lymphocytes, which cause local cell, tissue, and functional disorders of infiltrated organs via the release of cytotoxic basic proteins and oxygen radicals. Diseases associated with eosinophilia include systemic and organ-related forms. The lungs are involved in eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome), acute and chronic eosinophilic pneumonia, as well as in an organ manifestation in hypereosinophilic syndrome and certain parasitic diseases. In particular, the lungs are frequently affected in vasculitis of small vessels, including EGPA, granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Among these, EGPA is the most frequent pulmonary eosinophil vasculitis representative. In addition, there are various overlap syndromes in which characteristic features of EGPA can be detected in the context of other anti-neutrophil cytoplasmic antibody (ANCA-)associated vasculitides. Occasionally, non-ANCA-associated pulmonary vasculitides occur with eosinophilia (e.g., Schönlein-Henoch purpura, Kawasaki disease, drug-induced hypersensitivity, and paraneoplastic syndrome). Herein, the pulmonary vasculitides accompanying eosinophilia are presented with respect to both the lung manifestations and pulmonary eosinophilia.
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Affiliation(s)
- C Kroegel
- Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena, Am Klinikum 1, 07740, Jena, Deutschland.
| | - M Foerster
- Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena, Am Klinikum 1, 07740, Jena, Deutschland
| | - S Quickert
- Abt. Gastroenterologie, Hepatologie, Infektiologie, Klinik für Innere Medizin IV, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - H Slevogt
- AG Host Septomics, Universitätsklinikum Jena, Jena, Deutschland
| | - T Neumann
- Abt. für Rheumatologie, Immunologie und Rehabilitation, Kantonsspital St. Gallen, St. Gallen, Schweiz
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74
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Flores-Torres AS, Salinas-Carmona MC, Salinas E, Rosas-Taraco AG. Eosinophils and Respiratory Viruses. Viral Immunol 2019; 32:198-207. [PMID: 31140942 DOI: 10.1089/vim.2018.0150] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Eosinophils have been mainly associated with parasitic infection and pathologies such as asthma. Some patients with asthma present a high number of eosinophils in their airways. Since respiratory viruses are associated with asthma exacerbations, several studies have evaluated the role of eosinophils against respiratory viruses. Eosinophils contain and produce molecules with antiviral activity, including RNases and reactive nitrogen species. They can also participate in adaptive immunity, serving as antigen-presenting cells. Eosinophil antiviral response has been demonstrated against some respiratory viruses in vitro and in vivo, including respiratory syncytial virus and influenza. Given the implication of respiratory viruses in asthma, the eosinophil antiviral role might be an important factor to consider in this pathology.
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Affiliation(s)
- Armando S Flores-Torres
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
| | - Mario C Salinas-Carmona
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
| | - Eva Salinas
- 2 Department of Microbiology, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - Adrian G Rosas-Taraco
- 1 Department of Immunology, Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose E. Gonzalez," Monterrey, Nuevo León, Mexico
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75
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Rygula A, Fernandes RF, Grosicki M, Kukla B, Leszczenko P, Augustynska D, Cernescu A, Dorosz A, Malek K, Baranska M. Raman imaging highlights biochemical heterogeneity of human eosinophils versus human eosinophilic leukaemia cell line. Br J Haematol 2019; 186:685-694. [PMID: 31134616 DOI: 10.1111/bjh.15971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/19/2019] [Indexed: 01/21/2023]
Abstract
Eosinophils are acidophilic granulocytes that develop in the bone marrow. Although their population contributes only to approximately 1-6% of all leucocytes present in the human blood, they possess a wide range of specific functions. They play a key role in inflammation-regulating processes, when their numbers can increased to above 5 × 109 /l of peripheral blood. Their characteristic feature is the presence of granules containing eosinophil peroxidase (EPO), the release of which can trigger a cascade of events promoting oxidative stress, apoptosis or necrosis, leading finally to cell death. Raman spectroscopy is a powerful technique to detect EPO, which comprises a chromophore protoporphyrin IX. Another cell structure associated with inflammation processes are lipid bodies (lipid-rich organelles), also well recognized and imaged using high resolution confocal Raman spectroscopy. In this work, eosinophils isolated from the blood of a human donor were analysed versus their model, EoL-1 human eosinophilic leukaemia cell line, by Raman spectroscopic imaging. We showed that EPO was present only in primary cells and not found in the cell line. Eosinophils were activated using phorbol 12-myristate 13-acetate, which resulted in lipid bodies formation. An effect of cells stimulation was studied and compared for eosinophils and EoL-1.
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Affiliation(s)
- Anna Rygula
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland
| | - Rafaella F Fernandes
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Marek Grosicki
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland.,Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Bozena Kukla
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland
| | | | - Dominika Augustynska
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | | | - Aleksandra Dorosz
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland.,Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Kamilla Malek
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland.,Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - Malgorzata Baranska
- Faculty of Chemistry, Jagiellonian University, Krakow, Poland.,Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
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76
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Simmons RP, Dudzinski DM, Shepard JAO, Hurtado RM, Coffey KC. Case 16-2019: A 53-Year-Old Man with Cough and Eosinophilia. N Engl J Med 2019; 380:2052-2059. [PMID: 31116923 DOI: 10.1056/nejmcpc1900595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Rachel P Simmons
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - David M Dudzinski
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - Jo-Anne O Shepard
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - Rocio M Hurtado
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - K C Coffey
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
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77
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Ganapathineedi B, Mehta A, Dande S, Shinde A, Barsky G, Sebro N. Bullous Pemphigoid with Atypical Skin Lesions and Acute Interstitial Nephritis: A Case Report and Focused Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:212-218. [PMID: 30773528 PMCID: PMC6388647 DOI: 10.12659/ajcr.911422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 76 Final Diagnosis: Drug induced bullous pemphigoid Symptoms: Skin rash Medication: Cephalexin Clinical Procedure: Skin biopsy Specialty: General and Internal Medicine
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Affiliation(s)
| | - Alaap Mehta
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Susmitha Dande
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Anjali Shinde
- Department of Pathology, Mount Sinai Hospital, Chicago, IL, USA
| | - Gary Barsky
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Nadew Sebro
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
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78
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Khatun A, Sakurai M, Sakai Y, Tachibana M, Ohara N, Morimoto M. Mycobacterial infection induces eosinophilia and production of α-defensin by eosinophils in mice. J Vet Med Sci 2019; 81:138-142. [PMID: 30473572 PMCID: PMC6361637 DOI: 10.1292/jvms.18-0619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
It has been well known in humans that eosinophil infiltration into the site of inflammation and eosinophilia occur in mycobacterial infections. However, the role of eosinophils against the
mycobacterium is unclear. We showed in previous study that in situ mouse eosinophils infiltrated into tissues produce α-defensin, an anti-bacterial peptide. We investigated
in this study whether eosinophils reacting to mycobacteria produce α-defensin in mice and whether it can be used as a model. We showed that mycobacterial infection induced blood eosinophilia
and infiltration of α-defensin producing eosinophils that to surround mycobacteria at the site of infection. These findings were usually seen during human mycobacterial infection. We
established a good model to study host defense mechanism against mycobacteria through α-defensin via eosinophils.
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Affiliation(s)
- Afia Khatun
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8515, Japan
| | - Masashi Sakurai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8515, Japan
| | - Yusuke Sakai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8515, Japan
| | - Masato Tachibana
- Department of Oral Microbiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kita-ku, Okayama 700-8558, Japan
| | - Naoya Ohara
- Department of Oral Microbiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kita-ku, Okayama 700-8558, Japan
| | - Masahiro Morimoto
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8515, Japan
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79
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Yu JE, Sim DW, Koh YI. Etiologies and differential markers of eosinophilia-associated diseases in the Allergy Department of a single university hospital. ALLERGY ASTHMA & RESPIRATORY DISEASE 2019. [DOI: 10.4168/aard.2019.7.3.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Ji Eun Yu
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Da Woon Sim
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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80
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Khatun A, Sakurai M, Okada K, Sakai Y, Morimoto M. Detection of α-defensin in eosinophils in helminth-infected mouse model. J Vet Med Sci 2018; 80:1887-1894. [PMID: 30393268 PMCID: PMC6305521 DOI: 10.1292/jvms.18-0601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
α-defensin is a potent antimicrobial peptide secreted from intestinal mucosal epithelial
cells, such as Paneth cells, and affects not only bacteria but also parasites and fungi.
Recently, human eosinophils have also been shown to produce α-defensin, but no studies
have been done on other animals. In this study, we attempted to detect α-defensin protein
in mouse eosinophils infiltrating the intestinal mucosa during a helminth infection using
Zamboni fixation and immunohistochemistry. Most of the eosinophils infiltrating the
intestinal mucosa during helminth infection were positive for α-defensin. The expression
level of α-defensin mRNA was 50 fold that in the control. Meanwhile, the number of Paneth
cells was doubled, and their α-defensin fluorescence intensity was increased. These
results suggested that eosinophils are also important producers of α-defensin, such as
Paneth cells in mice, and that α-defensin produced from eosinophils might be involved in
defensive mechanisms against helminths. Moreover, the experimental system used in this
study is a good model to study the generation of α-defensin by eosinophils.
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Affiliation(s)
- Afia Khatun
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Masashi Sakurai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Kazuki Okada
- North Lab, 8-35 Hondori, 2-chome kita, Shiroishi-ku, Sapporo, Hokkaido 003-0027, Japan
| | - Yusuke Sakai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Masahiro Morimoto
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
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81
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Lin J, Huang X, Zhou W, Zhang S, Sun W, Wang Y, Ren K, Tian L, Xu J, Cao Z, Pu Z, Han X. Thrombosis in the portal venous system caused by hypereosinophilic syndrome: A case report. Medicine (Baltimore) 2018; 97:e13425. [PMID: 30508952 PMCID: PMC6283207 DOI: 10.1097/md.0000000000013425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Extensive thrombosis in the portal venous system caused by hypereosinophilic syndrome (HES) is rare, and there is no consensus on anticoagulant and thrombolytic treatments for arteriovenous thrombosis caused by HES. PATIENT CONCERNS The clinical data of a patient with extensive thrombosis in his portal venous system (superior mesenteric, splenic, hepatic, and portal veins), renal artery thrombosis, and mesenteric thrombosis caused by HES with secondary gastrointestinal bleeding and intestinal necrosis were retrospectively analyzed. Before admission, his eosinophil count increased to 7.47 × 10/L, and HES had been confirmed via bone marrow cytology. The patient experienced fever, cough, abdominal pain, massive hematemesis, and hematochezia that developed in succession. Abdominal computed tomography showed portal vein and superior mesenteric vein thromboses. DIAGNOSIS Hypereosinophilic syndrome; extensive thrombosis in the portal venous system; acute eosinophil-associated pneumonia; gastrointestinal bleeding; intestinal necrosis. INTERVENTIONS The patient was first treated with methylprednisolone, plasma exchange/hemofiltration, and single or combined use of unfractionated heparin and argatroban for anticoagulation. He was also administered alteplase and urokinase, successively, for thrombolytic treatment. Once the thromboses finally disappeared, the patient underwent surgery to excise a necrotic intestinal canal. OUTCOMES The thromboses disappeared with these treatments, and the patient recovered after the necrotic intestinal canal was excised. LESSONS The clinical manifestations of HES are complex and varied, and this condition can cause severe and extensive arteriovenous thrombosis. Anticoagulation therapy and thrombolysis are necessary interventions, and appear to be safe and effective.
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Affiliation(s)
- Jinfeng Lin
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Xiaoying Huang
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Weihua Zhou
- Department of Critical Care Medicine, Hai’an County People's Hospital, Nantong, China
| | - Suyan Zhang
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Weiwei Sun
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Yadong Wang
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Ke Ren
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Lijun Tian
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Junxian Xu
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Zhilong Cao
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
| | - Zunguo Pu
- Department of Critical Care Medicine, Hai’an County People's Hospital, Nantong, China
| | - Xudong Han
- Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University
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82
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Kroegel C, Foerster M, Quickert S, Slevogt H, Neumann T. [Vasculitides and eosinophilic pulmonary diseases]. Z Rheumatol 2018; 77:907-922. [PMID: 30367242 DOI: 10.1007/s00393-018-0561-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Eosinophilic granulocytes form peripheral effector cells controlled by Th2 lymphocytes, which cause local cell, tissue, and functional disorders of infiltrated organs via the release of cytotoxic basic proteins and oxygen radicals. Diseases associated with eosinophilia include systemic and organ-related forms. The lungs are involved in eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome), acute and chronic eosinophilic pneumonia, as well as in an organ manifestation in hypereosinophilic syndrome and certain parasitic diseases. In particular, the lungs are frequently affected in vasculitis of small vessels, including EGPA, granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Among these, EGPA is the most frequent pulmonary eosinophil vasculitis representative. In addition, there are various overlap syndromes in which characteristic features of EGPA can be detected in the context of other anti-neutrophil cytoplasmic antibody (ANCA-)associated vasculitides. Occasionally, non-ANCA-associated pulmonary vasculitides occur with eosinophilia (e.g., Schönlein-Henoch purpura, Kawasaki disease, drug-induced hypersensitivity, and paraneoplastic syndrome). Herein, the pulmonary vasculitides accompanying eosinophilia are presented with respect to both the lung manifestations and pulmonary eosinophilia.
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Affiliation(s)
- C Kroegel
- Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena, Am Klinikum 1, 07740, Jena, Deutschland.
| | - M Foerster
- Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena, Am Klinikum 1, 07740, Jena, Deutschland
| | - S Quickert
- Abt. Gastroenterologie, Hepatologie, Infektiologie, Klinik für Innere Medizin IV, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - H Slevogt
- AG Host Septomics, Universitätsklinikum Jena, Jena, Deutschland
| | - T Neumann
- Abt. für Rheumatologie, Immunologie und Rehabilitation, Kantonsspital St. Gallen, St. Gallen, Schweiz
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83
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Macháček T, Turjanicová L, Bulantová J, Hrdý J, Horák P, Mikeš L. Cercarial dermatitis: a systematic follow-up study of human cases with implications for diagnostics. Parasitol Res 2018; 117:3881-3895. [PMID: 30302587 DOI: 10.1007/s00436-018-6095-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022]
Abstract
Cercarial dermatitis (CD) is an allergic skin disease that rises in consequence of infection by invasive stages (cercariae) of trematodes of the family Schistosomatidae. CD has been considered a re-emerging disease, human cases have been reported from all continents, and tourism-threatening outbreaks occur even in frequented recreational areas. Although the symptoms of CD are generally known, the data on immune response in human patients are sporadic and incomprehensive. In the present study, we attempted to correlate the symptoms, personal history, and time course of CD in human patients with differential cell counts, dynamics of selected cytokines, and dynamics and quality of antibody response. By a systematic follow-up, we obtained a uniquely complex dataset from ten persons accidentally and concurrently infected by the same parasite species in the same locality. The onset of CD was significantly faster, and the symptoms were heavier in participants with a history of CD if compared to naive ones, who, however, also developed some of the symptoms. The repeatedly infected persons had elevated proportion of eosinophils 1 week post exposure (p.e.) and a stronger specific IgG but not IgM response, whereas specific IgE response was not observed. Increased serum levels of IL-4 occurred 1 and 3 week(s) p.e. in all participants. There was high variability in individual immunoblot patterns of IgG response, and no antigen with a universal diagnostic potential was confirmed. The presented analyses suggested that a complex approach can improve the accuracy of the diagnosis of CD, but component data should be interpreted carefully.
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Affiliation(s)
- Tomáš Macháček
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, 12844, Prague 2, Czech Republic
| | - Libuše Turjanicová
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, 12844, Prague 2, Czech Republic
| | - Jana Bulantová
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, 12844, Prague 2, Czech Republic
| | - Jiří Hrdý
- Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 7, 12800, Prague 2, Czech Republic
| | - Petr Horák
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, 12844, Prague 2, Czech Republic
| | - Libor Mikeš
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, 12844, Prague 2, Czech Republic.
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84
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Arango-Franco CA, Moncada-Vélez M, Beltrán CP, Berrío I, Mogollón C, Restrepo A, Trujillo M, Osorio SD, Castro L, Gómez LV, Muñoz AM, Molina V, Del Río Cobaleda DY, Ruiz AC, Garcés C, Alzate JF, Cabarcas F, Orrego JC, Casanova JL, Bustamante J, Puel A, Arias AA, Franco JL. Early-Onset Invasive Infection Due to Corynespora cassiicola Associated with Compound Heterozygous CARD9 Mutations in a Colombian Patient. J Clin Immunol 2018; 38:794-803. [PMID: 30264381 DOI: 10.1007/s10875-018-0549-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/11/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE CARD9 deficiency is an inborn error of immunity that predisposes otherwise healthy humans to mucocutaneous and invasive fungal infections, mostly caused by Candida, but also by dermatophytes, Aspergillus, and other fungi. Phaeohyphomycosis are an emerging group of fungal infections caused by dematiaceous fungi (phaeohyphomycetes) and are being increasingly identified in patients with CARD9 deficiency. The Corynespora genus belongs to phaeohyphomycetes and only one adult patient with CARD9 deficiency has been reported to suffer from invasive disease caused by C. cassiicola. We identified a Colombian child with an early-onset, deep, and destructive mucocutaneous infection due to C. cassiicola and we searched for mutations in CARD9. METHODS We reviewed the medical records and immunological findings in the patient. Microbiologic tests and biopsies were performed. Whole-exome sequencing (WES) was made and Sanger sequencing was used to confirm the CARD9 mutations in the patient and her family. Finally, CARD9 protein expression was evaluated in peripheral blood mononuclear cells (PBMC) by western blotting. RESULTS The patient was affected by a large, indurated, foul-smelling, and verrucous ulcerated lesion on the left side of the face with extensive necrosis and crusting, due to a C. cassiicola infectious disease. WES led to the identification of compound heterozygous mutations in the patient consisting of the previously reported p.Q289* nonsense (c.865C > T, exon 6) mutation, and a novel deletion (c.23_29del; p.Asp8Alafs10*) leading to a frameshift and a premature stop codon in exon 2. CARD9 protein expression was absent in peripheral blood mononuclear cells from the patient. CONCLUSION We describe here compound heterozygous loss-of-expression mutations in CARD9 leading to severe deep and destructive mucocutaneous phaeohyphomycosis due to C. cassiicola in a Colombian child.
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Affiliation(s)
- Carlos A Arango-Franco
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Marcela Moncada-Vélez
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Claudia Patricia Beltrán
- Departamento de Pediatría, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Indira Berrío
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia.,Hospital General de Medellín "Luz Castro de Gutiérrez" ESE, Medellín, Colombia
| | - Cristian Mogollón
- Infectología, Hospital Universitario Fernando Troconnis, Santa Marta, Colombia
| | | | | | - Sara Daniela Osorio
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Lorena Castro
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Lina Vanessa Gómez
- Hospital Pablo Tobón Uribe, Medellín, Colombia.,Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Ana María Muñoz
- Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Verónica Molina
- Hospital Pablo Tobón Uribe, Medellín, Colombia.,Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | - Carlos Garcés
- Departamento de Pediatría, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Juan Fernando Alzate
- Centro Nacional de Secuenciación Genómica CNSG, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Felipe Cabarcas
- Centro Nacional de Secuenciación Genómica CNSG, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia.,Grupo SISTEMIC, Facultad de Ingeniería, Universidad de Antioquia UdeA , Calle 70 No 52-21, Medellín, Colombia
| | - Julio Cesar Orrego
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France.,Howard Hughes Medical Institute, New York, NY, USA
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, EU, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Andrés Augusto Arias
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia. .,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.
| | - José Luis Franco
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
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85
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Brunet BA, Sugg RM, Stewart P. Hypereosinophilic syndrome presenting acutely with neurologic signs. Ann Allergy Asthma Immunol 2018; 120:461-464. [PMID: 29501486 DOI: 10.1016/j.anai.2018.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Barbara A Brunet
- Department of Medicine, Division of Clinical Immunology and Allergy, University of Mississippi Medical Center, Jackson, Mississippi.
| | - Rebecca M Sugg
- Department of Neurology, University of Mississippi Medical Center, Jackson, Mississippi; Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi; Department of Radiology, University of Mississippi Medical Center, Jackson, Mississippi; Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi
| | - Patricia Stewart
- Department of Medicine, Division of Clinical Immunology and Allergy, University of Mississippi Medical Center, Jackson, Mississippi
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86
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Shigematsu Y, Kanda H, Nagasaki T, Ishizawa T, Inoue Y, Takahashi S. Hepatic Eosinophilic Abscess Associated with Sigmoid Colon Cancer. Intern Med 2018; 57:1405-1409. [PMID: 29760319 PMCID: PMC5995723 DOI: 10.2169/internalmedicine.0083-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The clinical course of hepatic eosinophilic abscess (HEA) induced by malignant tumors is not well-known; however, it is considered to be a benign hepatic lesion. HEA is difficult to diagnose by imaging alone and a pathological examination is generally needed, particularly in patients with malignant tumors, because the radiological findings can be similar to those of metastasis. We report a case of multiple HEAs with eosinophilia and sigmoid colon cancer that was difficult to diagnose without a pathological examination. After the resection of the sigmoid colon cancer, the patient's eosinophilia was quickly ameliorated and the HEAs disappeared within 6 months.
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Affiliation(s)
- Yasuyuki Shigematsu
- Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research (JFCR), Japan
- Division of General Oncology, The Cancer Institute Hospital of JFCR, Japan
| | - Hiroaki Kanda
- Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research (JFCR), Japan
| | - Toshiya Nagasaki
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Takeaki Ishizawa
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Yosuke Inoue
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Shunji Takahashi
- Division of General Oncology, The Cancer Institute Hospital of JFCR, Japan
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87
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Karakonstantis S, Kalemaki D, Tzagkarakis E, Lydakis C. Pitfalls in studies of eosinopenia and neutrophil-to-lymphocyte count ratio. Infect Dis (Lond) 2017; 50:163-174. [PMID: 29070003 DOI: 10.1080/23744235.2017.1388537] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
There is a number of publications evaluating the eosinophil count and the neutrophil-to-lymphocyte count ratio for diagnosis, prognosis or monitoring of patients. Of special interest is the use of these parameters for discrimination between the different causes of fever (e.g. bacterial versus viral vs. non-infectious causes of fever) and for monitoring the efficacy of therapy and predict the course of the patient. However, pitfalls in previous study designs prevent applicability to clinical practice. Here, we provide a short review of the relevant literature and summarize important factors that should be taken into account when designing studies, with special attention to the selection of a proper and clinically meaningful study population and the effects of the stress response and of corticosteroids.
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Affiliation(s)
- Stamatis Karakonstantis
- a Resident of Internal Medicine, Second Department of Internal Medicine , General Hospital of Heraklion 'Venizeleio-Pananeio' , Heraklion , Greece
| | - Dimitra Kalemaki
- b Resident of General Medicine , University Hospital of Heraklion, Voutes , Heraklion , Greece
| | - Emmanouil Tzagkarakis
- c Consultant in Internal Medicine. Second Department of Internal Medicine , General Hospital of Heraklion 'Venizeleio-Pananeio' , Heraklion , Greece
| | - Charalampos Lydakis
- d Head of the Second Department of Internal Medicine , Second Department of Internal Medicine, General Hospital of Heraklion 'Venizeleio-Pananeio' , Heraklion , Greece
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88
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Salzer HJF, Rolling T, Vinnemeier CD, Tannich E, Schmiedel S, Addo MM, Cramer JP. Helminthic infections in returning travelers and migrants with eosinophilia: Diagnostic value of medical history, eosinophil count and IgE. Travel Med Infect Dis 2017; 20:49-55. [PMID: 28882532 DOI: 10.1016/j.tmaid.2017.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/26/2017] [Accepted: 09/01/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Eosinophilia in travelers and migrants returning from the tropics is often associated with invasive helminthic infections. Total IgE is considered a useful additional diagnostic parameter; however, both parameters are also increased in various other non-helminthic diseases. METHODS We retrospectively evaluated travelers and migrants seen at our department between September 2007 and May 2014. Patients with an absolute eosinophil count ≥500 cells/μl were considered for further analyses. RESULTS Among 6618 returned travelers and migrants, 154 (2.3%) had a total eosinophil count ≥500 cells/μL. Of these, 71 patients (46%) were diagnosed with helminthic infection. In an additional 62 patients (40%) with eosinophilia a final diagnosis was found, including non-helminthic infections in 34 patients and non-infectious causes in 28 patients, while in 21 patients (14%) no diagnosis was made. Patients with helminthic infections had higher eosinophil counts than travelers and migrants with other diagnoses (median 981 vs. 710 cells/μl; p = 0.001), while total IgE levels (n = 70; 172 vs. 152 kU/l; p = 0.731) were similar in both groups. CONCLUSION Eosinophil count but not total IgE levels are associated with helminthic infections in returning travelers and migrants with eosinophilia. Our results do not support the use of total IgE to differentiate helminthic infections from other causes of eosinophilia in this population.
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Affiliation(s)
- Helmut J F Salzer
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel Borstel, Germany.
| | - Thierry Rolling
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Christof D Vinnemeier
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Egbert Tannich
- Department of Molecular Parasitology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany; National Reference Centre for Tropical Infections, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Stefan Schmiedel
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marylyn M Addo
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Jakob P Cramer
- Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
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89
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Peinhaupt M, Sturm EM, Heinemann A. Prostaglandins and Their Receptors in Eosinophil Function and As Therapeutic Targets. Front Med (Lausanne) 2017; 4:104. [PMID: 28770200 PMCID: PMC5515835 DOI: 10.3389/fmed.2017.00104] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/27/2017] [Indexed: 02/06/2023] Open
Abstract
Of the known prostanoid receptors, human eosinophils express the prostaglandin D2 (PGD2) receptors DP1 [also D-type prostanoid (DP)] and DP2 (also chemoattractant receptor homologous molecule, expressed on Th2 cells), the prostaglandin E2 receptors EP2 and EP4, and the prostacyclin (PGI2) receptor IP. Prostanoids can bind to either one or multiple receptors, characteristically have a short half-life in vivo, and are quickly degraded into metabolites with altered affinity and specificity for a given receptor subtype. Prostanoid receptors signal mainly through G proteins and naturally activate signal transduction pathways according to the G protein subtype that they preferentially interact with. This can lead to the activation of sometimes opposing signaling pathways. In addition, prostanoid signaling is often cell-type specific and also the combination of expressed receptors can influence the outcome of the prostanoid impulse. Accordingly, it is assumed that eosinophils and their (patho-)physiological functions are governed by a sensitive prostanoid signaling network. In this review, we specifically focus on the functions of PGD2, PGE2, and PGI2 and their receptors on eosinophils. We discuss their significance in allergic and non-allergic diseases and summarize potential targets for drug intervention.
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Affiliation(s)
- Miriam Peinhaupt
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - Eva M Sturm
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - Akos Heinemann
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
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90
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Braga FG, Ruas LP, Pereira RM, Lima XT, Antunes E, Mamoni RL, Blotta MHSL. Functional and phenotypic evaluation of eosinophils from patients with the acute form of paracoccidioidomycosis. PLoS Negl Trop Dis 2017; 11:e0005601. [PMID: 28489854 PMCID: PMC5439957 DOI: 10.1371/journal.pntd.0005601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 05/22/2017] [Accepted: 04/26/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Eosinophilia is a typical finding of the acute/juvenile form of paracoccidioidomycosis (PCM), a systemic mycosis endemic in Latin America. This clinical form is characterized by depressed cellular immune response and production of Th2 cytokines. Moreover, it has been shown that the increased number of eosinophils in peripheral blood of patients returns to normal values after antifungal treatment. However, the role of eosinophils in PCM has never been evaluated. This study aimed to assess the phenotypic and functional characteristics of eosinophils in PCM. METHODS/PRINCIPAL FINDINGS In 15 patients with the acute form of the disease, we detected expression of MBP, CCL5 (RANTES) and CCL11 (eotaxin) in biopsies of lymph nodes and liver. In addition, there were higher levels of chemokines and granule proteins in the peripheral blood of patients compared to controls. Isolation of eosinophils from blood revealed a higher frequency of CD69+ and TLR2+ eosinophils in patients compared to controls, and a lower population of CD80+ cells. We also evaluated the fungicidal capacity of eosinophils in vitro. Our results revealed that eosinophils from PCM patients and controls exhibit similar ability to kill P. brasiliensis yeast cells, although eosinophils of patients were less responsive to IL-5 stimulation than controls. CONCLUSION/PRINCIPAL FINDINGS In conclusion, we suggest that eosinophils might play a role in the host response to fungi and in the pathophysiology of PCM by inducing an intense and systemic inflammatory response in the initial phase of the infection.
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Affiliation(s)
- Fernanda Gambogi Braga
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Luciana Pereira Ruas
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Ricardo Mendes Pereira
- Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Xinaida Taligare Lima
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Ronei Luciano Mamoni
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
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91
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Diny NL, Rose NR, Čiháková D. Eosinophils in Autoimmune Diseases. Front Immunol 2017; 8:484. [PMID: 28496445 PMCID: PMC5406413 DOI: 10.3389/fimmu.2017.00484] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/07/2017] [Indexed: 12/15/2022] Open
Abstract
Eosinophils are multifunctional granulocytes that contribute to initiation and modulation of inflammation. Their role in asthma and parasitic infections has long been recognized. Growing evidence now reveals a role for eosinophils in autoimmune diseases. In this review, we summarize the function of eosinophils in inflammatory bowel diseases, neuromyelitis optica, bullous pemphigoid, autoimmune myocarditis, primary biliary cirrhosis, eosinophilic granulomatosis with polyangiitis, and other autoimmune diseases. Clinical studies, eosinophil-targeted therapies, and experimental models have contributed to our understanding of the regulation and function of eosinophils in these diseases. By examining the role of eosinophils in autoimmune diseases of different organs, we can identify common pathogenic mechanisms. These include degranulation of cytotoxic granule proteins, induction of antibody-dependent cell-mediated cytotoxicity, release of proteases degrading extracellular matrix, immune modulation through cytokines, antigen presentation, and prothrombotic functions. The association of eosinophilic diseases with autoimmune diseases is also examined, showing a possible increase in autoimmune diseases in patients with eosinophilic esophagitis, hypereosinophilic syndrome, and non-allergic asthma. Finally, we summarize key future research needs.
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Affiliation(s)
- Nicola L Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noel R Rose
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniela Čiháková
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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