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Yang X, Xia Q, Wang J. Acute thrombocytopenia during cesarean section. Int J Obstet Anesth 2023; 53:103612. [PMID: 36396546 DOI: 10.1016/j.ijoa.2022.103612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
We report a case of a healthy 29-year-old parturient with a normal pre-operative platelet count who received combined spinal-epidural anesthesia for cesarean section, and who suffered the sudden intra-operative onset of severe thrombocytopenia (platelet count 3 × 109/L). This event was likely due to cefoxitin administered for the prophylaxis of surgical infection.
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Affiliation(s)
- X Yang
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Xinshi District, Xinjiang Province, China
| | - Q Xia
- Department of Hematology, The First Affiliated Hospital of Xinjiang Medical University, Xinshi District, Xinjiang Province, China
| | - J Wang
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Xinshi District, Xinjiang Province, China.
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2
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Yamaguchi T, Lee JH, Lim AR, Sim JS, Yu EJ, Oh TJ. Bioconversion of Corticosterone into Corticosterone-Glucoside by Glucosyltransferase. Molecules 2018; 23:molecules23071783. [PMID: 30029555 PMCID: PMC6100193 DOI: 10.3390/molecules23071783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/17/2022] Open
Abstract
Glucosylation of the 21-hydroxyl group of glucocorticoid changes its solubility into hydrophilicity from hydrophobicity and, as with glucocorticoid glucuronides as a moving object in vivo, it is conceivable that it exhibits the same behavior. Therefore, glucosylation to the 21-hydroxyl group while maintaining the 11β-hydroxyl group is particularly important, and glucosylation of corticosterone was confirmed by high-resolution mass spectrometry and 1D (¹H and 13C) and 2D (COSY, ROESY, HSQC-DEPT and HMBC) NMR. Moreover, the difference in bioactivity between corticosterone and corticosterone 21-glucoside was investigated in vitro. Corticosterone 21-glucoside showed greater neuroprotective effects against H₂O₂-induced cell death and reactive oxygen species (ROS) compared with corticosterone. These results for the first time demonstrate that bioconversion of corticosterone through the region-selective glucosylation of a novel compound can present structural potential for developing new neuroprotective agents.
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Affiliation(s)
- Tokutaro Yamaguchi
- Department of Pharmaceutical Engineering and Biotechnology, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
- Genome-based BioIT Convergence Institute, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
- Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
| | - Joo-Ho Lee
- Genome-based BioIT Convergence Institute, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
| | - A-Rang Lim
- Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 305-811, Korea.
| | - Joon-Soo Sim
- Genomics Division, National Institute of Agricultural Science, RDA, Jeonju 54874, Korea.
| | - Eun-Ji Yu
- Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
| | - Tae-Jin Oh
- Department of Pharmaceutical Engineering and Biotechnology, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
- Genome-based BioIT Convergence Institute, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
- Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, Korea.
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3
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Hernandez DM, Goggs R, Behling-Kelly E. In vitro Inhibition of Canine Complement-Mediated Hemolysis. J Vet Intern Med 2017; 32:142-146. [PMID: 29171101 PMCID: PMC5787187 DOI: 10.1111/jvim.14871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/24/2017] [Accepted: 10/11/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Immune-mediated hemolytic anemia (IMHA) is the most common hematologic immune-mediated disease in dogs. Complement fixation on erythrocytes causes hemolysis. Complement inhibition decreases hemolysis in people with the hemolytic disease and also may prove effective in treating IMHA in dogs. HYPOTHESIS/OBJECTIVES Evaluate the in vitro efficacy of 2 complement inhibitors used in humans against canine complement. METHODS The inhibitory activity of the C3-inhibitor compstatin and recombinant human C1-esterase inhibitor (C1-INH) was evaluated using an in vitro hemolytic assay and spectrophotometric measurement of released hemoglobin. Dose-response curves for each inhibitor were generated. RESULTS Compstatin decreased approximately 50% of canine complement-mediated hemolysis in initial experiments. This inhibition largely was lost when a new lot of drug was purchased. C1-INH showed a dose-dependent inhibition. The highest concentration of C1-INH tested (500 μg/mL) decreased >80% of canine complement-mediated hemolysis, and the lowest concentration tested (31.25 μg/mL) decreased hemolysis >60%. CONCLUSIONS AND CLINICAL IMPORTANCE Human C1-INH is a robust inhibitor of canine complement-mediated hemolysis, whereas compstatin was minimally and variably effective. Human C1-INH may substantially decrease complement-mediated hemolysis in dogs with IMHA and warrants further investigation.
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Affiliation(s)
- D M Hernandez
- Department of Population Medicine and Diagnostic Sciences
| | - R Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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4
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Mackern-Oberti JP, Jara EL, Riedel CA, Kalergis AM. Hormonal Modulation of Dendritic Cells Differentiation, Maturation and Function: Implications for the Initiation and Progress of Systemic Autoimmunity. Arch Immunol Ther Exp (Warsz) 2016; 65:123-136. [PMID: 27585815 DOI: 10.1007/s00005-016-0418-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/04/2016] [Indexed: 01/09/2023]
Abstract
Hormonal homeostasis is crucial for keeping a competent and healthy immune function. Several hormones can modulate the function of various immune cells such as dendritic cells (DCs) by influencing the initiation of the immune response and the maintenance of peripheral tolerance to self-antigens. Hormones, such as estrogens, prolactin, progesterone and glucocorticoids may profoundly affect DCs differentiation, maturation and function leading to either a pro-inflammatory or an anti-inflammatory (or tolerogenic) phenotype. If not properly regulated, these processes can contribute to the pathogenesis of autoimmune disease. An unbalanced hormonal status may affect the production of pro-inflammatory cytokines, the expression of activating/inhibitory receptors and co-stimulatory molecules on conventional and plasmacytoid DCs (pDCs), conferring susceptibility to develop autoimmunity. Estrogen receptor (ER)-α signaling in conventional DCs can promote IFN-α and IL-6 production and induce the expression of CD40, CD86 and MHCII molecules. Furthermore, estrogen modulates the pDCs response to Toll-like receptor ligands enhancing T cell priming. During lupus pathogenesis, ER-α deficiency decreased the expression of MHC II on pDCs from the spleen. In contrast, estradiol administration to lupus-prone female mice increased the expression of co-stimulatory molecules, enhanced the immunogenicity and produced large amounts of IL-6, IL-12 and TNF-α by bone marrow-derived DCs. These data suggest that estradiol/ER signaling may play an active role during lupus pathology. Similarly, understanding hormonal modulation of DCs may favor the design of new therapeutic strategies based on autologous tolerogenic DCs transfer, especially in sex-biased systemic autoimmune diseases. In this review, we discuss recent data relative to the role of different hormones (estrogen, prolactin, progesterone and glucocorticoids) in DC function during systemic autoimmune pathogenesis.
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Affiliation(s)
- Juan Pablo Mackern-Oberti
- Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), CONICET, Mendoza, Argentina. .,Instituto de Fisiología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina. .,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Evelyn L Jara
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia A Riedel
- Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas y Facultad de Medicina, Millennium Institute of Immunology and Immunotherapy, Universidad Andrés Bello, Santiago, Chile
| | - Alexis M Kalergis
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile. .,Departamento de Endocrinología, Facultad de Medicina, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile. .,INSERM U1064, Nantes, France.
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5
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Sun P, Wu G, Gao RL, Liu S, Phillips WD, Liang SX. Rifampicin-dependent antibodies target glycoprotein IIb/IIIa and cause clearance of human platelets in NOD/SCID mice. Br J Haematol 2015; 172:137-40. [PMID: 25921553 DOI: 10.1111/bjh.13470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ping Sun
- Department of Haematology, the First Affiliated Hospital of Liaoning Medical University, Jinzhou, China
| | - Guangsheng Wu
- Department of Haematology, First Affiliated Hospital, Medical College of Shihezi University, Shihezi, China
| | - Rui-lan Gao
- Institution of Haematology Research, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shengyi Liu
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Liaoning Medical University, Jinzhou, China
| | - William D Phillips
- School of Medical Sciences (Physiology) and Bosch Institute, Anderson Stuart Bldg (F13), University of Sydney, Sydney, NSW, Australia
| | - Simon X Liang
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Liaoning Medical University, Jinzhou, China.
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6
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Sibley TA, Miller MM, Fogle JE. Human intravenous immunoglobulin (hIVIG) inhibits anti-CD32 antibody binding to canine DH82 cells and canine monocytes in vitro. Vet Immunol Immunopathol 2013; 151:229-34. [DOI: 10.1016/j.vetimm.2012.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 10/24/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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7
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Nakamura RK, Tompkins E, Bianco D. Therapeutic options for immune-mediated thrombocytopenia. J Vet Emerg Crit Care (San Antonio) 2012; 22:59-72. [DOI: 10.1111/j.1476-4431.2011.00705.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 11/25/2011] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Domenico Bianco
- Internal Medicine Department; Veterinary Specialists of the Valley; Woodland Hills; CA; 91364
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8
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Kuntz NL, Chabas D, Weinstock-Guttman B, Chitnis T, Yeh EA, Krupp L, Ness J, Rodriguez M, Waubant E. Treatment of multiple sclerosis in children and adolescents. Expert Opin Pharmacother 2010; 11:505-20. [DOI: 10.1517/14656560903527218] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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9
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Abstract
Corticosteroids (Cs) are widely used for treatment of multiple sclerosis (MS) acute relapses because of the potent immunosuppressive and anti-inflammatory properties. As for patients with relapsing-remitting (RR) MS, short-term administrations of Cs markedly less severity of symptoms and promote faster recovery of clinical attacks. Chronic administrations of Cs significantly diminish the formation of T1 hypointense lesions and the progression of brain atrophy. As for patients with secondary progressive MS treatment with Cs delays the time to onset of sustained disability. Finally the association between methylprednisolone and interferon beta (IFNbeta) leads the recovery of active lesions at greater extent and reduces the formation of neutralizing antibodies (NABs) against IFNbeta in patients with RRMS.
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Affiliation(s)
- Carlo Pozzilli
- Department of Neurological Sciences, La Sapienza University, V.le Università 30, 00185 Rome, Italy.
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10
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Abstract
IMHA is one of the most common causes of anemia in small animals. Although treatment may be rewarding, many patients do not respond adequately to glucocorticoids alone and require additional immunosuppressive therapy. Some patients may succumb to acute severe anemia and die within the first few weeks of treatment; even if they survive, relapses may occur. IMHA is the nemesis; as our understanding of this disease increases and treatment options expand, it is hoped that survival rates will finally improve.
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Affiliation(s)
- Sheila McCullough
- College of Veterinary Medicine, University of Illinois, 1008 West Hazelwood Drive, Urbana, IL 61801, USA.
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11
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Mason N, Duval D, Shofer FS, Giger U. Cyclophosphamide exerts no beneficial effect over prednisone alone in the initial treatment of acute immune-mediated hemolytic anemia in dogs: a randomized controlled clinical trial. J Vet Intern Med 2003; 17:206-12. [PMID: 12683622 DOI: 10.1111/j.1939-1676.2003.tb02435.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Cyclophosphamide is commonly used with prednisone in the initial treatment of severe idiopathic immune-mediated hemolytic anemia (IMHA) in dogs because retrospective reports suggest its benefit. This randomized controlled prospective clinicaltrial evaluated whether combined cyclophosphamide and prednisone therapy is more efficacious than prednisone therapy alone in the initial treatment of IMHA. Eighteen dogs with acute, severe idiopathic IMHA were randomly assigned to 1 of 2 treatment groups. The P group received prednisone therapy alone (1-2 mg/kg PO q12h), and the PC group received prednisone (1-2 mg/kg PO q12h) and cyclophosphamide (50 mg/m2 PO q24h for 4 consecutive days a week) for 4 weeks. The mortality rate in the P group was 20% (2 of 10), and in the PC group, the mortality rate was 38% (3 of 8). There was no difference in sequential CBC evaluations between the 2 groups. However, whereas dogs in the P group showed increases in reticulocyte count, reticulocytosis was suppressed in dogs in the PC group during the 1st week of therapy. Spherocytosis resolved more quickly in the P group (day 21) than in the PC group (day 28), but the time taken to achieve a negative Coombs' test result was comparable between groups. No difference was observed in the volume of packed red blood cells (pRBCs) given per transfusion between treatment groups, but more dogs in the PC group required a 2nd transfusion. The results of this limited study suggest that cyclophosphamide plus prednisone has no benefit over prednisone alone in the initial treatment of acute, severe idiopathic IMHA indogs.
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Affiliation(s)
- Nicola Mason
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA
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12
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Jeffery DR. Use of adrenocorticosteroid hormones in the treatment of multiple sclerosis. Expert Rev Neurother 2002; 2:859-66. [PMID: 19810919 DOI: 10.1586/14737175.2.6.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the fact that adrenocorticosteroid hormones have been used in the treatment of multiple sclerosis for over 50 years, the extent to which they affect clinical disease activity remains unclear. Their administration results in the modification of a host of immune functions, including the downregulation of inflammatory cytokines and adhesion molecules involved in the trafficking of lymphocytes and macrophages across the blood-brain barrier. This leads to a rapid suppression of inflammation in multiple sclerosis lesions and to the restoration of the integrity of the blood-brain barrier. Clinical studies of adrenocorticosteroids in the treatment of multiple sclerosis have demonstrated a more rapid resolution of relapse, but have not uniformly demonstrated an improvement in the extent of recovery. More recent studies suggest that adrenocorticosteroid hormones may bring about a dose-dependent decrease in MRI measures of disease activity lasting 6 months, delay the time to second relapse and delay the time to sustained progression in relapsing-remitting and secondary-progressive multiple sclerosis. Though it is clear that adrenocorticosteroid hormones may have greater effects than previously realized, their role in the treatment of multiple sclerosis remains controversial because significant methodological differences between studies have often led to conflicting results.
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Affiliation(s)
- Douglas R Jeffery
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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13
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Gomez F, Ruiz P, Bernal JA, Escobar M, Garcia-Egido A, Lopez-Saez JJ. Enhancement of splenic-macrophage Fcgamma receptor expression by treatment with estrogens. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:806-10. [PMID: 11427431 PMCID: PMC96147 DOI: 10.1128/cdli.8.4.806-810.2001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2001] [Accepted: 05/07/2001] [Indexed: 11/20/2022]
Abstract
Splenic-macrophage Fcgamma receptors (FcgammaRs) participate in the pathophysiologies of immune-complex diseases and in host defense against infection. Modulation of macrophage FcgammaR expression is an immuno-therapeutic target. Glucocorticoids, sex steroids, and dopaminergic drugs modulate macrophage FcgammaR expression. Previous data indicate that estradiol increases macrophage FcgammaR expression. Nevertheless, the effects of clinically used estrogens upon macrophage FcgammaR expression are unknown. We assessed the effects of treatment with commonly used estrogens on the expression of macrophage FcgammaRs using a guinea pig experimental model. Six estrogens have been studied: ethynylestradiol (Et), mestranol (M), chlortianisene (Ct), promestriene, 17-epiestriol, and 17beta-estradiol. Following in vivo treatment of guinea pigs, we determined the clearance of immunoglobulin G (IgG)-sensitized erythrocytes in vivo, the binding of IgG-sensitized erythrocytes by isolated splenic macrophages, and splenic-macrophage FcgammaR cell surface expression. Estrogens enhance the clearance of IgG-sensitized erythrocytes by increasing splenic-macrophage FcgammaR expression. Et, M, and Ct were more effective than the other estrogens. Flow cytometry and fluorescence microscopy with monoclonal antibodies demonstrated that estrogens increase the cell surface expression of FcgammaR1 and -2 more than that of FcgammaR2. These data indicate that treatment with commonly used estrogens enhances the clearance of IgG-sensitized cells by improving splenic-macrophage FcgammaR expression.
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Affiliation(s)
- F Gomez
- Hospital Universitario de Puerto Real/S.A.S. and Department of Medicine, School of Medicine, University of Cadiz, Cadiz, Spain.
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14
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Gomez F, Ruiz P, Lopez R, Rivera C, Romero S, Bernal JA. Effects of androgen treatment on expression of macrophage Fcgamma receptors. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2000; 7:682-6. [PMID: 10882672 PMCID: PMC95934 DOI: 10.1128/cdli.7.4.682-686.2000] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/1999] [Accepted: 04/24/2000] [Indexed: 11/20/2022]
Abstract
Macrophage Fcgamma receptors (FcgammaRs) play an important role in the host defense against infection and in the pathophysiology of immune cytopenias. Modulation of macrophage FcgammaR expression is a potential therapeutic approach to immune disorders. Glucocorticoids and progesterones decrease macrophage FcgammaR expression. We assessed the effect of treatment with androgens and antiandrogens on the expression of macrophage FcgammaRs using an experimental guinea pig model. Four androgens (testosterone, dihydrotestosterone, mesterolone, and danazol) and five antiandrogens (flutamide, nilutamide, cyproterone acetate, spironolactone, and finasteride) were studied. Following in vivo treatment of guinea pigs, we determined the clearance of immunoglobulin G (IgG)-sensitized erythrocytes in vivo, the binding of IgG-sensitized erythrocytes by isolated splenic macrophages, and splenic macrophage FcgammaR cell surface expression. All of the androgens impaired the clearance of IgG-sensitized erythrocytes by decreasing splenic macrophage FcgammaR expression. Dihydrotestosterone and mesterolone were more effective than testosterone or dihydrotestosterone. Flow cytometry and fluorescence microscopy with monoclonal antibodies demonstrated that the androgens decreased the cell surface expression of FcgammaR1,2 more than that of FcgammaR2. Antiandrogens did not significantly alter macrophage FcgammaR expression. Nevertheless, antiandrogens counteracted the effects of androgens on macrophage FcgammaR expression. These data indicate that androgens impair the clearance of IgG-coated cells by decreasing splenic macrophage FcgammaR expression. Thus, androgens other than danazol are candidate drugs for the treatment of immune disorders.
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Affiliation(s)
- F Gomez
- Hospital Universitario de Puerto Real/S.A.S., Department of Medicine, School of Medicine, University of Cadiz, Cadiz, Spain.
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15
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Abstract
Fcγ receptors convey to phagocytic cells the ability to recognize, bind, and internalize IgG-coated cells and microorganisms. The present study demonstrates the use of adenovirus (Ad)-mediated gene transfer of human Fcγ receptor IIA cDNA to convert normally nonphagocytic cells (hepatocytes) into functional equivalents of phagocytic cells. Ad vector in vitro transfer and expression of FcγRIIA cDNA in primary rat hepatocytes was confirmed by flow cytometry anti-FcγRIIA immunodetection, and the function of the receptor was demonstrated by enhanced binding and phagocytosis of 51Cr-labeled IgG-opsonized erythrocytes. After in vivo gene transfer to rats, expression of FcγRIIA cDNA in hepatocytes was confirmed by Northern analysis and immunohistochemistry. Rats infected with the Ad vector carrying the FcγRIIA cDNA demonstrated enhanced clearance of opsonized erythrocytes, but not nonopsonized erythrocytes, from the circulation with increased sequestration within the liver. Together, these data demonstrate that Ad-mediated FcγRIIA gene transfer can convert normally IgG-nonphagocytic cells into phagocytic cells capable of recognizing, binding, and ingesting an opsonized particulate antigen, suggesting that gene transfer strategies might be used to transiently augment host defense by enhancing the clearance of immune complexes.
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16
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Nomura S, Matsuzaki T, Yamaoka M, Ozaki Y, Nagahama M, Yoshimura C, Kagawa H, Nakayama S, Fukuhara S. Genetic analysis of HLA- and HPA-typing in idiopathic (autoimmune) thrombocytopenic purpura patients treated with cepharanthin. Autoimmunity 1999; 30:99-105. [PMID: 10435723 DOI: 10.3109/08916939908994767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We performed genetic analysis of human leukocyte antigen (HLA) and human platelet antigen (HPA) in 45 patients with cepharanthin-treated idiopathic thrombocytopenic purpura. HLA-typing was performed by the polymerase chain reaction-restriction fragment length polymorphism method, and HPA-typing by a polymerase chain reaction-sequence-specific primer method. There were 14 responders and 31 nonresponders. Responders included many patients who had already been treated with prednisolone. HLA-DRB1*0901 was significantly more common in responders than in nonresponders. In contrast, HLA-DRB1*0410 and DQB1*0401 were significantly more common in nonresponders. The a/b genotype of HPA-2a/2a (Ko(b)/Ko(b)) was significantly increased in responders. In contrast, HPA-2a/2b (Ko(b)/Ko(a)) and HPA-3a/3b (Bak(a)/Bak(b)) were significantly more common in nonresponders. These findings suggest that genetic studies of HLA and HPA can predict the response of idiopathic thrombocytopenic purpura to cepharanthin.
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MESH Headings
- Adult
- Aged
- Alkaloids/pharmacology
- Alkaloids/therapeutic use
- Anti-Inflammatory Agents/therapeutic use
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Antigens, Human Platelet/analysis
- Antigens, Human Platelet/genetics
- Autoantigens/genetics
- Autoantigens/immunology
- Autoimmune Diseases/drug therapy
- Autoimmune Diseases/genetics
- Autoimmune Diseases/immunology
- Autoimmune Diseases/therapy
- Benzylisoquinolines
- Blood Platelets/immunology
- Combined Modality Therapy
- Drug Resistance/genetics
- Endocytosis/drug effects
- Female
- Genetic Predisposition to Disease
- Genotype
- HLA Antigens/analysis
- HLA Antigens/genetics
- HLA-DQ Antigens/analysis
- HLA-DQ Antigens/genetics
- HLA-DQ beta-Chains
- HLA-DR Antigens/analysis
- HLA-DR Antigens/genetics
- HLA-DRB1 Chains
- Humans
- Male
- Middle Aged
- Polymerase Chain Reaction
- Polymorphism, Restriction Fragment Length
- Polymorphism, Single-Stranded Conformational
- Prednisolone/therapeutic use
- Purpura, Thrombocytopenic, Idiopathic/drug therapy
- Purpura, Thrombocytopenic, Idiopathic/genetics
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Splenectomy
- Treatment Outcome
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Affiliation(s)
- S Nomura
- The First Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan.
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17
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Abstract
A young female Somali cat was referred for investigation of chronic intermittent haematuria. Petechiae were found on the ears and ventral abdomen and further investigation revealed severe thrombocytopenia and megakaryocyte hyperplasia. Direct marrow immunohistochemistry detected anti-megakaryocyte autoantibody (Immunoglobulin G), but extensive investigation failed to find secondary causes of immune-mediated thrombocytopenia, so a diagnosis of primary (autoimmune) immune-mediated thrombocytopenia was concluded. Thrombocytopenia persisted despite aggressive immunosuppressive therapy (prednisolone, azathioprine and vincristine) but resolved after oral prednisolone was replaced with dexamethasone.
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Affiliation(s)
- S Tasker
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, University of Edinburgh
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18
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Gomez F, Ruiz P, Briceño F, Rivera C, Lopez R. Macrophage Fcgamma receptors expression is altered by treatment with dopaminergic drugs. Clin Immunol 1999; 90:375-87. [PMID: 10075867 DOI: 10.1006/clim.1998.4665] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Macrophage Fcgamma receptors have an important role in host defense and the pathophysiology of immune mediated disorders. Alteration of splenic macrophage Fcgamma receptors expression predisposes to severe infection. Inhibition or blockade of splenic macrophage Fcgamma receptors is one of the mechanisms by which immune cytopenias improve. Dopaminergic drugs have clinically significant regulatory functions on the immune response. Using an experimental model in the guinea pig we assessed the effect of commonly used dopaminergic drugs on the expression of macrophage Fcgamma receptors. Three dopa-antagonists, bromocryptine, leuprolide, and pergolide, and seven dopa-antagonists, chlorpromazine, SCH 23390, metochlopramide, sulpiride, veralipride, alizapride, and cisapride, were studied. Following guinea pig treatment with dopaminergic drugs, the clearance of IgG-sensitized RBCs in vivo, the in vitro binding of IgG-sensitized RBCs by isolated splenic macrophages and flow cytometry with monoclonal antibodies were performed. Treatment with dopa-agonists enhanced the clearance of IgG-sensitized RBCs, the in vitro binding of IgG-sensitized RBCs by isolated splenic macrophages, and the cell surface expression of both macrophage Fcgamma receptors, and vice versa, dopa-antagonists impaired macrophage Fcgamma receptors expression. Macrophage FcgammaR1,2 was more sensitive than FcgammaR2 to such dopaminergic effect. These alterations of macrophage Fcgamma receptors expression are mediated by both D1 and D2 dopamine receptors, with a major participation of D2 receptors. Dopaminergic drugs alter the clearance of IgG-coated cells by an effect at the expression of splenic macrophage Fcgamma receptors.
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Affiliation(s)
- F Gomez
- School of Medicine, Hospital Universitario de Puerto Real/S.A.S., University of Cadiz, School of Medicine, Spain
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19
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Gomez F, Ruiz P, Briceño F, Lopez R, Michan A. Treatment with progesterone analogues decreases macrophage Fcgamma receptors expression. CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY 1998; 89:231-9. [PMID: 9837693 DOI: 10.1006/clin.1998.4602] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Macrophage Fcgamma receptors (FcgammaRs) are critical for host defense against infection and have an important role in immune cytopenias. Modulation of macrophage FcgammaRs expression is a potential therapeutic approach to immune disorders. Glucocorticoids and synthetic progesterone analogues decrease macrophage FcgammaRs expression. We assessed the effect of treatment with commonly employed progestins on the expression of macrophage FcgammaRs using an experimental model in the guinea pig. Eight clinically available progesterones, medroxyprogesterone acetate (P3), megestrol acetate (P4), medrogestone (P5), alylestrenol (P6), linestrenol (P7), didrogesterone (P8), norethisterone (P9), and gestonorone caproate (P10) and two endogenous progesterones, progesterone (P1) and 17 alpha-hydroxyprogesterone (P2), were studied. Following in vivo treatment of guinea pigs, we determined the clearance of IgG-sensitized erythrocytes in vivo, the binding of IgG-sensitized erythrocytes by isolated splenic macrophages, and splenic macrophage Fcgamma receptor cell surface expression. All progesterones impaired the clearance of IgG-sensitized erythrocytes by decreasing splenic macrophage Fcgamma receptor expression. P5, P6, P7, and P8 were less effective. Flow cytometry and fluorescence microscopy with monoclonal antibodies demonstrated that progesterones decreased the cell surface expression of FcgammaR2 more than that of FcgammaR1,2. Clinically employed progestins impair the clearance of IgG-coated cells by decreasing splenic macrophage FcgammaRs expression. Thus, progesterones are candidate drugs for the treatment of immune disorders.
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Affiliation(s)
- F Gomez
- Department of Medicine, Hospital Universitario de Puerto Real/S.A.S., Spain
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20
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Zuckerman SH, Evans GF, Bryan N. Chronic administration of dexamethasone results in Fc receptor up-regulation and inhibition of class I antigen expression on macrophages from MRL/lpr autoimmune mice. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1997; 4:572-8. [PMID: 9302207 PMCID: PMC170598 DOI: 10.1128/cdli.4.5.572-578.1997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The MRL/lpr mouse develops, after approximately 8 weeks of age, a severe autoimmune syndrome with many features resembling human systemic lupus erythematosus, including autoantibodies against DNA and basement membranes resulting in immune complexes, vasculitis, and multiorgan disease. While this murine model of lupus has been used for the identification of therapeutics with potential efficacy in human autoimmune disease, the long-term impact of chronic immunosuppressive therapy on macrophage function in this paradigm is not understood. To this end, MRL/lpr mice were treated prophylactically with dexamethasone at 0.01, 0.1, and 1 mg/kg of body weight for 20 weeks or were allowed to develop autoimmune disease and, at 15 weeks of age, treated therapeutically with 1-mg/kg dexamethasone for 8 additional weeks. Analysis of surface antigens on resident peritoneal macrophages demonstrated a progressive loss in class I expression with a concomitant increase in Fc receptor expression. Neither phagocytosis nor CD11b expression was modulated with chronic steroid treatment. Furthermore, dexamethasone treatment was associated with a reduction in anti-DNA antibodies and total immunoglobulin G and yet an elevation in serum cholesterol due to an increase in high-density lipoproteins. Therefore, the MRL/lpr mouse serves not only as a small-animal model of autoimmune disease but also as one in which the negative and positive sequelae associated with chronic immunosuppression can be further understood.
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Affiliation(s)
- S H Zuckerman
- Division of Cardiovascular Research, Lilly Research Laboratories, Indianapolis, Indiana 46285, USA
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21
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Cohn LA. Glucocorticosteroids as immunosuppressive agents. SEMINARS IN VETERINARY MEDICINE AND SURGERY (SMALL ANIMAL) 1997; 12:150-6. [PMID: 9283238 DOI: 10.1016/s1096-2867(97)80026-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
When administered at pharmacological dosages, glucocorticosteroid hormones alter leukocyte kinetics, phagocytic cell function, cell-mediated immunity, and, to a lesser extent, humoral immunity. These properties are used to advantage in the treatment of immunologically mediated disease. Corticosteroids are used to suppress pathological immune responses associated with autoimmunity, inhibit rejection of allogenic tissues after organ transplantation, and to diminish inflammation associated with a wide variety of hypersensitivity disorders. The mechanisms by which corticosteroids relieve these conditions are still not completely understood but have recently become more comprehensible. By understanding how corticosteroids exert their effects, we can make better clinical decisions in the management of immune-mediated disease.
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Affiliation(s)
- L A Cohn
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA
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22
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MESH Headings
- Adult
- Blood Platelets/pathology
- Blood Platelets/physiology
- Female
- Glucocorticoids/therapeutic use
- Humans
- Infant, Newborn
- Male
- Prognosis
- Purpura, Thrombocytopenic, Idiopathic/blood
- Purpura, Thrombocytopenic, Idiopathic/diagnosis
- Purpura, Thrombocytopenic, Idiopathic/drug therapy
- Purpura, Thrombocytopenic, Idiopathic/physiopathology
- Purpura, Thrombocytopenic, Idiopathic/surgery
- Risk Factors
- Splenectomy
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Affiliation(s)
- S Karpatkin
- Department of Medicine, New York University Medical School, NY 10016, USA.
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Abstract
Canine idiopathic thrombocytopenic purpura (ITP) is a disease in which antibodies bound to the surface of platelets mediate premature platelet destruction by macrophages. ITP in dogs and chronic ITP in humans are analogous diseases. This article draws on information from the literature on ITP in dogs and in humans, and reviews the pathogenesis, diagnosis, and treatment of ITP in dogs.
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Affiliation(s)
- D C Lewis
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan 66506-5606, USA
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Vermeulen M, Palermo M, Giordano M. Neonatal pinealectomy impairs murine antibody-dependent cellular cytotoxicity. J Neuroimmunol 1993; 43:97-101. [PMID: 8458988 DOI: 10.1016/0165-5728(93)90079-e] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The pineal gland, through its principal hormone melatonin, is able to modulate different immune functions. We have previously demonstrated that exogenous melatonin induces a significant enhancement of murine antibody-dependent cellular cytotoxicity (ADCC). In order to determine whether the pineal gland plays a physiological role in ADCC regulation, we studied the influence of neonatal pinealectomy on this activity. The results presented here indicate that ablation of the pineal gland during the first week of life significantly reduces ADCC levels in adult mice. This impairment appears around 60 days of age, suggesting that sexual hormones may be involved in the pineal effect. Moreover, the administration of melatonin to pinealectomized mice restores ADCC levels regardless of the hour and seasonal time of injection. On the basis of the data reported here, a physiological regulation of ADCC by the pineal gland can be assumed.
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Affiliation(s)
- M Vermeulen
- Instituto de Investigaciones Hematolólogicas, Academia Nacional de Medicina, Buenos Aires, Argentina
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