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Radnay ZB, Udvardy M, Papp M, Hársfalvi J, Rejto L, Pál I, Illés Á, Kiss A. Evaluation of Mannose-Binding Lectin is a Useful Approach to Predict the Risk of Infectious Complications Following Autologous Hematopoietic Stem Cell Transplantation. Transplant Proc 2017; 48:3397-3405. [PMID: 27931588 DOI: 10.1016/j.transproceed.2016.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/27/2016] [Accepted: 08/22/2016] [Indexed: 01/03/2023]
Abstract
Hematopoietic stem cell transplantation (HSCT) associated immunocompromised state carries high risk of infectious complications. Mannose-binding lectin (MBL) is an acute phase protein involved in innate immune response. Serum MBL level is genetically determined and quite stable. According to literature, significant association was shown between low MBL concentrations and serious infections. The association between serum MBL level and frequency and severity of infections was studied in 186 patients following autologous HSCT. Double-monoclonal antibody sandwich enzyme-linked immunosorbent assay was used to determine MBL antigen level in sera. MBL levels were measured around 100 days following transplantation, in a period without active infection. Twenty-one patients (11%) were MBL deficient. The median time of first infection and number of infections during the first year post-transplantation were not significantly different between patients with MBL deficiency and those without MBL deficiency. The occurrence and number of infections after HSCT correlated with the MBL/C-reactive protein ratio. The number of severe infections was not higher among those with MBL deficiency. The occurrence of infections after the pre-engraftment period during the first year post-transplantation was significantly different in patient groups separated by MBL cut-off level. The MBL/C-reactive protein ratio might be a useful marker of infectious complications. MBL measurement may be helpful in antibiotic treatment. In case of MBL deficiency, earlier and more intensive treatment may be indicated.
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Affiliation(s)
- Z B Radnay
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - M Udvardy
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - M Papp
- Department of Gastroenterology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - J Hársfalvi
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Clinical Research Center, Faculty of Medicine, University of Debrecen, Hungary
| | - L Rejto
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I Pál
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Á Illés
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Kiss
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Länger F, Kreipe HH. [Immunodeficiency and immunocompromised patients. Opportunistic infection of the lungs]. DER PATHOLOGE 2011; 32:411-7. [PMID: 21935762 DOI: 10.1007/s00292-011-1497-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The number of patients suffering from innate, acquired or iatrogenic immunodeficiency is constantly rising. Thus the number of clinically relevant infections caused by rare or unusual pathogens is also increasing. Histopathological investigations allow the identification of difficult to culture infectious agents as well as the differentiation of tissue invasive infections from superficial colonization. In this review morphological reaction patterns and their differential diagnoses of the most common bacterial, viral and mycotic infections in the lungs of immunocompromised patients are discussed.
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Affiliation(s)
- F Länger
- Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Abstract
The Select Agents and Toxins List was created by the US Government to limit the possession of and access to particular microorganisms and toxins. Casadevall and Relman argue that this list, and others like it, could have the paradoxical effect of increasing our vulnerability to biological attack and natural epidemics. Anxiety about threats from the microbial world and about the deliberate misuse of microorganisms has led to efforts to define and control these dangers using lists and regulations. One list with tremendous legal implications and a potentially huge impact on research is the Select Agents and Toxins List, which was created by the US Government to limit the possession of and access to particular microorganisms and toxins. In this article, in addition to highlighting general problems with taxonomy-based, microorganism-centric lists, we discuss our view that such lists may have the paradoxical effect of increasing the societal vulnerability to biological attack and natural epidemics by interfering with the sharing of microbial samples and hindering research on vaccines and therapeutics.
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Conti HR, Shen F, Nayyar N, Stocum E, Sun JN, Lindemann MJ, Ho AW, Hai JH, Yu JJ, Jung JW, Filler SG, Masso-Welch P, Edgerton M, Gaffen SL. Th17 cells and IL-17 receptor signaling are essential for mucosal host defense against oral candidiasis. J Exp Med 2009; 206:299-311. [PMID: 19204111 PMCID: PMC2646568 DOI: 10.1084/jem.20081463] [Citation(s) in RCA: 755] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 01/07/2009] [Indexed: 12/14/2022] Open
Abstract
The commensal fungus Candida albicans causes oropharyngeal candidiasis (OPC; thrush) in settings of immunodeficiency. Although disseminated, vaginal, and oral candidiasis are all caused by C. albicans species, host defense against C. albicans varies by anatomical location. T helper 1 (Th1) cells have long been implicated in defense against candidiasis, whereas the role of Th17 cells remains controversial. IL-17 mediates inflammatory pathology in a gastric model of mucosal candidiasis, but is host protective in disseminated disease. Here, we directly compared Th1 and Th17 function in a model of OPC. Th17-deficient (IL-23p19(-/-)) and IL-17R-deficient (IL-17RA(-/-)) mice experienced severe OPC, whereas Th1-deficient (IL-12p35(-/-)) mice showed low fungal burdens and no overt disease. Neutrophil recruitment was impaired in IL-23p19(-/-) and IL-17RA(-/-), but not IL-12(-/-), mice, and TCR-alphabeta cells were more important than TCR-gammadelta cells. Surprisingly, mice deficient in the Th17 cytokine IL-22 were only mildly susceptible to OPC, indicating that IL-17 rather than IL-22 is vital in defense against oral candidiasis. Gene profiling of oral mucosal tissue showed strong induction of Th17 signature genes, including CXC chemokines and beta defensin-3. Saliva from Th17-deficient, but not Th1-deficient, mice exhibited reduced candidacidal activity. Thus, the Th17 lineage, acting largely through IL-17, confers the dominant response to oral candidiasis through neutrophils and antimicrobial factors.
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Affiliation(s)
- Heather R. Conti
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Fang Shen
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Namrata Nayyar
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Eileen Stocum
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Jianing N. Sun
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Matthew J. Lindemann
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Allen W. Ho
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Justine Hoda Hai
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Jeffrey J. Yu
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Ji Won Jung
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Scott G. Filler
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095
| | - Patricia Masso-Welch
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Mira Edgerton
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
| | - Sarah L. Gaffen
- Department of Oral Biology, School of Dental Medicine; Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences; Department of Biotechnology, University at Buffalo, State University of New York, Buffalo, NY 14201
- University of Pittsburgh Department of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA 15261
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