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Casulo C, Day B, Dawson KL, Zhou X, Flowers CR, Farber CM, Hainsworth JD, Cerhan JR, Link BK, Zelenetz AD, Friedberg JW. Disease characteristics, treatment patterns, and outcomes of follicular lymphoma in patients 40 years of age and younger: an analysis from the National Lymphocare Study†. Ann Oncol 2015; 26:2311-7. [PMID: 26362568 DOI: 10.1093/annonc/mdv375] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma, with median age at diagnosis in the seventh decade. FL in young adults (YAs), defined as diagnosis at ≤40 years, is uncommon. No standard approaches exist guiding the treatment of YA FL, and little is known about their disease characteristics and outcomes. To gain further insights into YA FL, we analyzed the National LymphoCare Study (NLCS) to describe characteristics, initial treatments, and outcomes in this population versus patients aged >40 years. PATIENTS AND METHODS Using the NLCS database, we stratified FL patients by age: 18-40 (YA), 41-60, 61-70, 71-80, and >80 years. Survival probability was estimated using Kaplan-Meier methodology. We examined associations between age and survival using hazard ratios and 95% confidence intervals (CIs) from multivariable Cox models. RESULTS Of 2652 eligible FL patients in the NLCS, 164 (6%) were YAs. Of YA patients, 69% had advanced disease, 80% had low-grade histology, and 50% had good-risk disease according to the Follicular Lymphoma International Prognostic Index (FLIPI). Nineteen percent underwent observation, 12% received rituximab monotherapy, and 46% received chemoimmunotherapy [in 59% of these: R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone)]. With a median follow-up of 8 years, overall survival (OS) at 2, 5, and 8 years was 98% (95% CI 93-99), 94% (95% CI 89-97), and 90% (95% CI 83-94), respectively. Median progression-free survival (PFS) was 7.3 years (95% CI 5.6-not reached). CONCLUSIONS In one of the largest cohorts of YA FL patients treated in the rituximab era, disease characteristics and outcomes were similar to patients aged 41-60 years, with favorable OS and PFS in YAs. Longer-term outcomes and YA-specific survivorship concerns should be considered when defining management. These data may not support the need for more aggressive therapies in YA FL. CLINICAL TRIAL NUMBER Roche/Genentech ML01377 (U2963n).
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Affiliation(s)
- C Casulo
- James P. Wilmot Cancer Center, University of Rochester, Rochester
| | - B Day
- Genentech, Inc., South San Francisco
| | | | - X Zhou
- RTI Health Solutions, Research Triangle Park, Durham
| | - C R Flowers
- Department of Medicine, Emory University, Atlanta
| | - C M Farber
- Carol G. Simon Cancer Center, Morristown
| | | | - J R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester
| | | | - A D Zelenetz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - J W Friedberg
- James P. Wilmot Cancer Center, University of Rochester, Rochester
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Abstract
New applications are always being developed for immunoglobulins; new recommendations are regularly published. We wished to know the indications used in a large hospital. A hundred and thirty-six adult patients were prescribed immunoglobulins from January to December 2008. Three preparations in intravenous immunoglobulins were available (one liquid, 2 freeze-dried). Fourteen charts were rejected for clerical errors. A hundred and twenty two charts were available for statistical study. Thirty-six patients were on immunoglobulins for antibody deficiency, 19 were followed in haematology for chronic lymphoid leukaemia or multiple myeloma, 19 were treated after lung transplantation, 17 had received a kidney transplant, 1 after heart transplantation: these indications were substitution. Twenty for Guillain Barré and chronic demyelinating polyneuropathy, 10 in immune thrombocytopenic purpura: this was for immunomodulation. Recommendations were followed by the prescribers; charts were reviewed in March and November 2009. Side-effects were rare. (0.6%) (1).
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Affiliation(s)
- C M Farber
- Immunodeficiency Treatment Unit, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Brussels, Belgium.
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3
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Delforge M, Farber CM, Spath P, Kaveri S, Witte T, Misbah SA, Hübner R, Haerynck F, Latinne D, Muylle L, Toungouz M, Deneys V. Recommended indications for the administration of polyclonal immunoglobulin preparations. Acta Clin Belg 2012; 66:346-60. [PMID: 22145269 DOI: 10.2143/acb.66.5.2062586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The following recommendations, which aim at standardising and rationalising the clinical indications for administering polyclonal immunoglobulins in Belgium, were drawn up by a working group of the Superior Health Council. To this end, the Superior Health Council organised an expert meeting devoted to"Guidelines for the use of immunoglobulins". The experts discussed the indications for immunoglobulin use, the'ideal'immunoglobulin preparation, its mechanisms of action, the practical issues involved in administering immunoglobulins and their potential side effects. The recommendations formulated by the experts were validated by the Superior Health Council working group with the purpose of harmonising immunoglobulin use in Belgium
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Affiliation(s)
- M Delforge
- Afdeling Hematologie, Universitaire Ziekenhuizen Leuven (KUL), Leuven, Belgium.
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Farber CM, Wanders JAW, Goffard JC, Parma J. A woman with recurrent "infections" since birth--a new mevalonate kinase mutation. Acta Clin Belg 2011; 66:129-31. [PMID: 21630610 DOI: 10.2143/acb.66.2.2062531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A tired 32-year-old woman complaining of tiredness was referred for work-up of a possible immune deficiency. She had a history of recurrent infections since birth, which usually responded to antibiotics within a few days. Her mother, a nurse, had reported that early charts had disappeared. Munchausen's by proxy was suspected for years. Careful anamnesis indicated possible recurrent fever. Serum IgD levels were high, which led us to suspect Hyper IgD Syndrome. Sequencing of the mevalonate kinase gene revealed 2 mutations, leading to amino acid substitutions: one already described (V3771) and R40W: never reported before. Mevalonate kinase activity was very low in the patient's peripheral blood cells. We used the "Poly Phen" prediction program successfully. Our experiments confirmed the diagnosis of mevalonate kinase deficiency. We used steroids to abort recurrent crises.
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Affiliation(s)
- C M Farber
- Unité de Traitement des Immunodéficiences, Hôpital Erasme, Bruxelles, Belgique.
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5
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Mohammed Rafiyath S, Farber CM, Onyemeke NO, Bustami R. Retrospective review of modified-R-CHOP (MRCHOP), substituting liposome-encapsulated doxorubicin (LED) for doxorubicin in high-risk patients with aggressive B-cell lymphoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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6
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Allen SL, Rai KR, Elstrom R, Negrea OG, Farber CM, Abbasi R, Teoh N, Horne H, Wegener WA, Goldenberg DM. Subcutaneous injections of low doses of veltuzumab (humanized anti-CD20 antibody): Objective responses in B-cell malignancies. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8530 Background: Low IV doses of veltuzumab, a second-generation anti-CD20 monoclonal antibody with structure-function differences from chimeric rituximab, have shown clinical activity, thus justifying subcutaneous (SC) injections. Methods: A phase I/II study was initiated in patients (pts) with previously untreated or relapsed CD20+ indolent NHL or CLL who received 4 SC injections of veltuzumab 2 weeks apart at dose levels of 80, 160, or 320 mg. Efficacy was assessed by CT-based IWG (NHL) or hematology-based NCI/IWCLL (CLL) criteria 4 and 12 weeks later, with responding pts continuing follow-up. Other evaluations included AEs, safety laboratories, B-cell blood levels (CD19), serum veltuzumab levels, and human anti-veltuzumab antibody (HAHA) titers. Results: Nineteen pts (8M/11F, median age 63), including 14 NHL pts (11 follicular, 3 other indolent NHL; 5 treatment naive) most with stage III or IV disease (11/14) and 5 CLL pts (4 treatment naïve) all with Rai stage II or III disease, have now received SC veltuzumab at 80 mg (3 NHL, 3 CLL), 160 mg (9 NHL, 2 CLL) or 320 mg (2 NHL) dose levels. Pre-treatment with antihistamines or steroids has not been required, and SC veltuzumab was well tolerated with only mild, transient injection site reactions and tenderness. To date, all HAHA results have been negative. In NHL pts, SC veltuzumab demonstrates good bio-availability, with a slow release pattern over several days and depletion of circulating B cells starting after 1st injection. Initial response information is currently available for 10 pts. For 7 NHL pts, 4 weeks after treatment with 80 or 160 mg doses, 2 pts had partial responses, 3 pts showed stable disease, and 2 pts had disease progression. For 3 CLL pts who received 80 mg doses, serum veltuzumab levels were lower, but all pts still achieved 65–75% decreases in circulating leukemic cells over the course of treatment. Conclusions: SC administration of veltuzumab is well tolerated, achieves slow but efficient delivery into the blood, and is pharmacologically active. The low doses currently evaluated in B-cell malignancies show evidence of therapeutic activity, achieving objective responses in NHL and notable reductions in circulating leukemic cells in CLL. [Table: see text]
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Affiliation(s)
- S. L. Allen
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - K. R. Rai
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - R. Elstrom
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - O. G. Negrea
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - C. M. Farber
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - R. Abbasi
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - N. Teoh
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - H. Horne
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - W. A. Wegener
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
| | - D. M. Goldenberg
- North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Weill Medical College of Cornell/New York Hospital, New York, NY; Low Country Cancer Care, Savannah, GA; Hematology Oncology Associates Northern New Jersey, Morristown, NJ; Hematology Oncology Specialists, Denville, NJ; Immunomedics, Inc., Morris Plains, NJ
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Berenson JR, Yellin O, Crowley J, Makary A, Gravenor DS, Yang HH, Upadhyaya GH, Flinn IW, Staszewski H, Tiffany NM, Sanani S, Farber CM, Morganstein N, Duvivier H, Nassir Y, Sefaradi A, Shamouelian A, Swift RA. A088 Overall Survival Among Patients with Multiple Myeloma (MM) Treated with Zoledronic Acid (ZOL). ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1557-9190(11)70454-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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8
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Demols P, Claes CA, Farber CM, Rasquin F. Macular CMV retinitis: a case report. Bull Soc Belge Ophtalmol 2004:17-21. [PMID: 15510719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection associated with AIDS. It usually affects the peripheral retina, sparing the macula. We describe an atypical CMV retinitis exclusively confined to the macula. METHODS A 43-year-old man with the diagnosis of AIDS developed a white retinal lesion confined to the macula of the right eye. Two weeks later, a more typical granular appearance was observed leading to presumption of CMV retinitis. RESULTS The patient was treated with ganciclovir without success. With foscarnet, a good response was obtained, leading to total healing of the lesion. CONCLUSIONS CMV retinitis has to be taken into consideration in all lesions confined to the macula in immunodepressed patients. An early diagnosis is crucial to avoid blindness.
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Affiliation(s)
- P Demols
- Department of Ophthalmology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
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9
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Van Vooren JP, Farber CM. [The immunodeficiency treatment unit]. Rev Med Brux 2003; 23 Suppl 2:85-6. [PMID: 12584919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Physicians of the unit have first taken care of patients with acquired Immunodeficiency in 1981. We have become an independent "Reference Centre" in 1998. The multidisciplinary team follows more than 300 patients on a regular basis. AIDS has been amply publicized, but other immuno-deficiencies have not. Primary immunodeficiencies are "orphan" diseases; they can be as serious, or more severe even, than AIDS. About 60 patients with "PID" are followed by the team. We are involved in research, and have participated in the identification of a mutation of an HIV co receptor that protects against HIV infection. We also studied the pathogenesis of Kaposi's sarcoma, and the immunological basis of adverse reactions to intravenous gammaglobulins.
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10
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Kentos A, Vekemans M, Van Vooren JP, Lambermont M, Liesnard C, Feremans W, Farber CM. High-dose chemotherapy and autologous CD34-positive blood stem cell transplantation for multiple myeloma in an HIV carrier. Bone Marrow Transplant 2002; 29:273-5. [PMID: 11859402 DOI: 10.1038/sj.bmt.1703348] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2001] [Accepted: 11/01/2001] [Indexed: 11/08/2022]
Abstract
The epidemiology and clinical outcome of multiple myeloma in human immunodeficiency virus (HIV)-positive patients is poorly documented. There are uncertainties concerning the optimal management of this rare disorder. We report on the use of myeloablative chemotherapy with autologous stem cell transplantation in an HIV-positive patient with multiple myeloma.
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Affiliation(s)
- A Kentos
- Clinique d'Hématologie, ULB-Hôpital Erasme, Free University of Brussels, Brussels, Belgium
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11
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Dieye TN, Sow PS, Simonart T, Guèye-Ndiaye A, Popper SJ, Delforge ML, Dieye A, Sarr AD, Crusiaux A, Van Vooren JP, Devleeschouwer M, Kanki P, Mboup S, Diakhate L, Farber CM. Immunologic and virologic response after tetanus toxoid booster among HIV-1- and HIV-2-infected Senegalese individuals. Vaccine 2001; 20:905-13. [PMID: 11738756 DOI: 10.1016/s0264-410x(01)00383-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Twelve HIV-1-infected, nine HIV-2-infected patients and eight HIV-negative subjects were given a 40IU booster dose of tetanus toxoid (TT). Blood was collected on days 0, 7 and 30 after immunization. Changes in HIV-1 or HIV-2 RNA load were evaluated by nested PCR. TT-IgG antibody levels were quantified by ELISA. CD4 cell counts as well as activation, memory and maturation markers of T lymphocyte subsets were determined by flow cytometry. The induction of apoptosis was investigated using 7-aminoactinomycin D (AAD) and propidium iodide (PI) staining. Proliferative responses to TT and pokeweed mitogen (PWM) were determined by the level of [(3)H] thymidine incorporation. Seven and 30 days after immunization, there was no detectable increase in HIV-1 or HIV-2 plasma load. There were also no changes in CD4 cell counts, CD69, HLA-DR and memory CD45RO or naive CD45RA antigens. Immunization did not increase the spontaneous apoptosis of peripheral blood mononuclear cells (PBMCs), CD4+ and CD8+ T cells subsets neither in controls nor in HIV-infected patients. Similarly, apoptosis induced in vitro by PWM or by the specific TT recall antigen did not vary during the study period. The proliferative response to PWM and to the TT recall antigen was decreased both in HIV-1- and HIV-2-infected patients compared to HIV-negative controls. Immunization significantly increased the TT-IgG levels in healthy controls and in HIV-infected patients. However, the anti-TT-IgG response, as measured by the fold-increase index between days 0 and 30, was significantly higher in healthy controls than in HIV-1- (P=0.036) and HIV-2-infected patients (P=0.003). In conclusion, we found no deleterious immunologic or virologic effect was detected in healthy HIV-1- and HIV-2-infected individuals after antigenic challenge with a TT booster. However, the response to TT vaccination was lower in HIV-1- and in HIV-2-infected individuals than in healthy HIV-negative controls.
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Affiliation(s)
- T N Dieye
- Immunodeficiency Unit, Erasme Hospital, ULB, Brussels, Belgium
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12
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Farber CM, Benoit Y, Boven K, De Baets F, Ferster A, Hoyoux C, Mascart F, Otten J, Philippet P, Van Lierde S, Van Vooren JP, Vermylen C. [Immune deficiencies: diagnosis, management, some perspectives]. Rev Med Brux 2001; 22:73-82. [PMID: 11388026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Severe primary immunodeficiencies (PID) are rare; their global incidence is comparable to that of childhood leukemia; they include more than 100 different entities. Clinical manifestations are: unusually severe or frequent infections or infections that do not respond to adequate treatment; an increased risk of certain malignancies; sometimes auto-immune manifestations. Delayed diagnosis and management of PID can lead to severe and irreversible complications or to death. PID can become manifest only in the adult; in common variable immune deficiency, the median age at diagnosis is between the 2nd and the 3rd decade of life. PID are often transmitted genetically; recent progresses in molecular biology have allowed more precise and earlier, including antenatal, diagnosis. Molecular treatment of 3 infants with a severe immunodeficiency has recently been achieved in April 2000. Those progresses were mostly based on the study of immunodeficiency databases. We present here the work of a Belgian group specialized in PID; meetings have started in June 1997. This group establishes guidelines for the diagnosis and treatment of PID, adapted to the local situation. The elaboration of a national register of PID is also underway; this has to provide all guaranties of anonymity to patients and families. Such a register already exists at the European level; it has provided the basis for new diagnostic and therapeutic possibilities. The inclusion of Belgian data in this register should allow essential progresses essential for our patients.
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Affiliation(s)
- C M Farber
- Hôpital Erasme Unité de Traitement des Immunodéficiences Route de Lennik 808 1070 Bruxelles
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14
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Dieye TN, Van Vooren JP, Delforge ML, Liesnard C, Devleeschouwer M, Farber CM. Spontaneous apoptosis and highly active antiretroviral therapy (HAART). Biomed Pharmacother 2000; 54:16-20. [PMID: 10721458 DOI: 10.1016/s0753-3322(00)88636-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Increased programmed cell death (PCD) or apoptosis has been detected in the T cells of HIV-infected subjects; it is held partially responsible for the continuous loss of CD4+ T cells during the natural course of HIV infection. Highly active antiretroviral therapy (HAART) decreases the viral load and leads to an increase of CD4+ count in vivo. In this study we evaluated PCD in total peripheral blood mononuclear cells, CD8+ and CD4+ lymphocytes before and four weeks after initiation of HAART. Seven HIV-1-infected patients were investigated. Viral load was assessed by RT-polymerase chain reaction and PCD by flow cytometry using apoptosis by 7 amino actinomycin D (7AAD) and propidium iodide (PI). After four weeks of HAART, CD4+ T and CD8+ T cell levels were stable, and plasma HIV-RNA copies were significantly decreased. In four of the patients (4/7), HIV-RNA levels were reduced to undetectable levels (fewer than 400 copies per milliliter). A statistically significant reduction of apoptosis among CD4+ cells was observed (P < 0.03), though neither in the CD8+ T cell population nor in peripheral blood mononuclear cells (PBMCS). These results demonstrate the beneficial effect of HAART on apoptosis of CD4+ cells in the early treatment stage.
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Affiliation(s)
- T N Dieye
- Centre National de Transfusion Sanguine du Sénégal, Dakar
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15
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Delforge ML, Farber CM, De Leener F, Caroyer JM, Liesnard C, Van Vooren JP. Foscarnet activity on human immunodeficiency virus type 1 in the central nervous system. Clin Infect Dis 1999; 28:931. [PMID: 10825078 DOI: 10.1086/517256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- M L Delforge
- Virology and AIDS Reference Laboratory, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
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16
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Simonart T, Noel JC, Andrei G, Parent D, Van Vooren JP, Hermans P, Lunardi-Yskandar Y, Lambert C, Dieye T, Farber CM, Liesnard C, Snoeck R, Heenen M, Boelaert JR. Iron as a potential co-factor in the pathogenesis of Kaposi's sarcoma? Int J Cancer 1998; 78:720-6. [PMID: 9833765 DOI: 10.1002/(sici)1097-0215(19981209)78:6<720::aid-ijc9>3.0.co;2-f] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The role of iron in the pathogenesis of several tumours is being increasingly investigated. In particular, its involvement in the pathogenesis of Kaposi's sarcoma (KS) is suggested by the distribution of the endemic form of KS corresponding to continental rifts and associated iron-oxide-rich volcanic clays. We investigated in vitro to what extent iron supplementation or withdrawal could affect the growth of KS-derived cells, by analysing the effects of adding iron salts (iron chloride and ferric nitrilotriacetate) and/or reducing iron by iron chelators (desferrioxamine) on KS-derived cell cultures. The addition of iron salts strongly stimulated the growth of KS cells, as reflected by increase in thymidine incorporation and cell number. Conversely, desferrioxamine and deferiprone inhibited cell growth. The inhibitory effect of iron chelation was more pronounced on rapidly dividing basic fibroblast-growth-factor-stimulated cells. These results may point to a novel therapeutic approach to KS.
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Affiliation(s)
- T Simonart
- Department of Dermatology, Hôpital Universitaire Erasme, Brussels, Belgium
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17
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Binet H, Simonart T, Van Vooren JP, Heenen M, Liesnard C, Delforge ML, Farber CM, Parent D. Porphyria cutanea tarda in a human immunodeficiency virus-infected patient: treatment with N-acetyl-cysteine. Int J Dermatol 1998; 37:718-9. [PMID: 9762833 DOI: 10.1046/j.1365-4362.1998.00481.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Delforge ML, Farine S, Liesnard C, Gulbis B, De Maertelaer V, Clumeck N, Farber CM, Van Vooren JP. Nutritional status and antiprotease therapy. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 18:393-4. [PMID: 9704948 DOI: 10.1097/00042560-199808010-00015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blankaert D, Simonart T, Van Vooren JP, Parent D, Liesnard C, Farber CM, Marique T, Werenne J. Constitutive release of metalloproteinase-9 (92-kd type IV collagenase) by Kaposi's sarcoma cells. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 18:203-9. [PMID: 9665496 DOI: 10.1097/00042560-199807010-00002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Kaposi's sarcoma (KS) is an angioproliferative disease characterized by proliferating spindle-shaped cells, angiogenesis, and inflammatory cell infiltration. Several lines of evidence suggest that KS is a multifocal cytokine-mediated disease of vascular origin. Because metalloproteinases (MMPs) are important enzymes involved in angiogenesis, we studied their activity in five different KS-derived cell lines and compared these data with those obtained with human umbilical vein endothelial cells (HUVEC). We focused on the activity of the 72- and 92-kd type IV collagenases because these enzymes are thought to play an important role in the process of tumoral invasion. Nonstimulated HUVEC released a weak 72-kd collagenase activity and no 92-kd collagenase activity, as determined by zymographic analysis. Stimulation of HUVEC with phorbol myristate acetate (PMA) or TNF-alpha increased the 72-kd collagenase activity and also induced a 92-kd collagenase activity. By contrast, KS-derived cells constitutively released significant 72- and 92-kd collagenase activities. The basal release of these enzymes by KS cells was further enhanced by TNF-alpha or PMA. Conversely after in vivo exposure to chemotherapy, KS-derived cells showed a downregulation of the production of MMPS that could be reversed by the addition of TNF or PMA. These results suggest that KS cells have constitutive features of activated cells that have an invasive and metastasizing potential.
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Affiliation(s)
- D Blankaert
- Laboratory of Cell Biotechnology, Université Libre de Bruxelles, Brussels, Belgium
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20
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Simonart T, Parent D, Heenen M, Farber CM, Van Vooren JP. Skin testing in AIDS patients with cutaneous trimethoprim-sulfamethoxazole hypersensitivity. Clin Exp Dermatol 1998; 23:47. [PMID: 9667114 DOI: 10.1046/j.1365-2230.1998.00279.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Schneider E, Lambermont M, Van Vooren JP, Bastin G, Feremans W, Kentos A, Lemoine F, Liesnard C, Delforge ML, Crenier L, Capel P, Farber CM. Autologous stem cell infusion for acute myeloblastic leukemia in an HIV-1 carrier. Bone Marrow Transplant 1997; 20:611-2. [PMID: 9337065 DOI: 10.1038/sj.bmt.1700930] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We present the case of an asymptomatic HIV carrier, who presented with acute myeloblastic leukemia in third relapse and successfully underwent autologous stem cell transplantation as a rescue treatment. This observation supports the conclusion that tolerance of autologous bone marrow or stem cell transplant in patients with HIV may correlate with a low viral burden and relatively good immune function.
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Affiliation(s)
- E Schneider
- Clinic of Haematology, Hôpital Erasme, Brussels, Belgium
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22
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Tourne L, Durez P, Van Vooren JP, Farber CM, Liesnard C, Heenen M, Parent D. Alleviation of HIV-associated psoriasis and psoriatic arthritis with cyclosporine. J Am Acad Dermatol 1997; 37:501-2. [PMID: 9308575 DOI: 10.1016/s0190-9622(97)70160-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- L Tourne
- Division of Dermatology, Erasmus Hospital, University of Brussels, Belgium
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23
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Galle C, Struelens M, Liesnard C, Godfroid J, Maes N, Dewitte O, Farber CM, Clevenbergh P, Van Vooren JP. Brucella melitensis osteitis following craniotomy in a patient with AIDS. Clin Infect Dis 1997; 24:1012. [PMID: 9142817 DOI: 10.1093/clinids/24.5.1012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- C Galle
- Département de Microbiologie, Hôpital Erasme, Brussels, Belgium
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24
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Steinfeld S, Galle C, Struelens M, De Gheldre Y, Farber CM, Appelboom T, Van Vooren JP. Pyogenic arthritis caused by streptococcus equisimilis (group-C streptococcus) in a patient with AIDS. Clin Rheumatol 1997; 16:314-6. [PMID: 9184272 DOI: 10.1007/bf02238970] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A patient with the Acquired ImmunoDeficiency Syndrome (AIDS) treated with a daily low dose of corticosteroids for chronic atopic dermatitis experienced a sudden episode of unilateral knee arthritis. Culture of the purulent synovial liquid yielded a pure culture of Streptococcus Equisimilis. A four week period of intravenous antibiotherapy combined with repeated drainages allowed a complete recovery of articular function.
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Affiliation(s)
- S Steinfeld
- Dept of Rheumatology, Erasmus Hospital, Free University of Brussels, Belgium
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25
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Simonart T, Van Vooren JP, Noel JC, Liesnard C, Farber CM, Parent D. High prevalence of cutaneous viral infections in AIDS patients with Kaposi's sarcoma: insight into the role of human herpesvirus 8? AIDS 1997; 11:824-6. [PMID: 9143620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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26
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Abstract
Human myeloid leukemia cells (HL-60) transport only the oxidized form of vitamin C (dehydroascorbic acid) and accumulate the vitamin in the reduced form, ascorbic acid. We performed a detailed study of the role of glutathione in the intracellular trapping/accumulation of ascorbic acid in HL-60 cells. Uptake studies using HL-60 cells depleted of glutathione by treatment with L-buthionine-(S,R) sulfoximine and diethyl maleate, revealed no changes in the cells' ability to transport dehydroascorbic acid and accumulate ascorbic acid. Similar transport and accumulation rates were obtained using HL-60 cells containing intracellular glutathione concentrations from 6 mM to 1 microM. HL-60 cells, containing as little as 5 microM glutathione, were able to accumulate up to 150 mM ascorbic acid intracellularly when incubated with dehydroascorbic acid. Glutathione was capable of reducing dehydroascorbic acid by a direct chemical reaction, but only when present in a greater than 10-fold stoichiometric excess over dehydroascorbic acid. The accumulation of ascorbic acid by HL-60 cells was strongly temperature-dependent and was very inefficient at 16 degrees C. On the other hand, the direct chemical reduction of dehydroascorbic acid by excess glutathione proceeded efficiently at temperatures of 16 degrees C. Our data indicate that glutathione-dependent reductases in HL-60 cells are not responsible for the ability of these cells to accumulate millimolar concentrations of ascorbic acid. These findings indicate that alternative enzymatic mechanisms are involved in the cellular reduction of dehydroascorbic acid.
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Affiliation(s)
- V H Guaiquil
- Program in Molecular Pharmacology and Therapeutics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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27
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Liesnard C, Delforge ML, Tchetcheroff M, De Maertelaer V, Farber CM, Van Vooren JP. Importance of method in the determination of syncytium-inducing phenotype of human immunodeficiency virus type 1 clinical isolates. J Virol Methods 1997; 64:137-45. [PMID: 9079760 DOI: 10.1016/s0166-0934(96)02152-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The in vitro syncytium induction capacity of human immunodeficiency virus type 1 (HIV1) isolates is an important marker in the progression of the disease. Two methods have been widely used to determine the biological phenotype of HIV1. These two methods, the direct MT-2 assay and the supernatant assay, were compared for the detection of syncytium-inducing (SI) variants on 275 blood samples obtained from 87 HIV infected patients during a 13 month follow-up period. A SI virus was detected in 152 blood samples. In 44 blood samples, the HIV isolate was found to be SI by only one method, but was SI by both methods in another blood sample of the follow up. Among SI carriers discordant results between the methods were more frequent when the patient was on antiretroviral therapy, and a transient reversion to a non syncytium-inducing (NSI) strain confirmed by both assays was sometimes observed. The supernatant assay has a 93% sensitivity and the direct MT-2 assay has a 78% sensitivity for detection of the SI phenotype. The supernatant assay is as rapid as and less tedious than the MT-2 assay. Antiretroviral therapy could have some effects in decreasing or even suppressing the SI part of the virus population of patients with SI phenotype.
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Affiliation(s)
- C Liesnard
- Laboratoire de Référence SIDA, Hôpital Erasme, Brussels, Belgium
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28
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Schneider E, Farber CM, Struelens MJ, Van Vooren JP. Long survival of a patient with AIDS in spite of previous Rhodococcus equi infection. Acta Clin Belg 1997; 52:50. [PMID: 9085620 DOI: 10.1080/17843286.1997.11718551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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29
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Delpire P, Farber CM, Portaels F, Struelens M, Clevenbergh P, Dargent JL, Delpace J, Mehdi A, Van Vooren JP. Splenectomy in a patients with AIDS, generalized Mycobacterium genavense infection and severe pancytopenia. Tuber Lung Dis 1996; 77:569-70. [PMID: 9039454 DOI: 10.1016/s0962-8479(96)90059-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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30
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Simonart TH, Parent D, Heenen M, Farber CM, Van Vooren JP. Decreased skin reactivity to codeine in patients with the acquired immunodeficiency syndrome. Clin Immunol Immunopathol 1996; 81:12-5. [PMID: 8808635 DOI: 10.1006/clin.1996.0150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To evaluate the skin reactivity and the mast cell releasibility in the acquired immunodeficiency syndrome (AIDS), 24 patients with AIDS were skin tested with histamine (1 mg/ml) and codeine phosphate (0.9, 0.09, and 0.009 mg/ml), a mast cell degranulating agent. They were compared to 12 HIV-negative healthy volunteers and 16 urticaria-prone subjects. Reactivity to codeine phosphate was lower in patients with AIDS than in HIV-negative subjects. This difference in skin reactivity was the more significant when the AIDS group was compared to the urticaria-prone group. There was no correlation between the reactivity to codeine and the IgE levels. Possible explanations to the decreased skin reacting to codeine in patients with AIDS include a decrease of local mast cell density or releasibility. This suggests that a mechanism related to urticaria and involving mast cells is quite unlikely to be at the origin of the hypersensitivity reactions observed in AIDS.
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Affiliation(s)
- T h Simonart
- Department of Dermatology, Erasme Hospital, University Hospital, Brussels, Belgium
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31
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32
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Samson M, Libert F, Doranz BJ, Rucker J, Liesnard C, Farber CM, Saragosti S, Lapoumeroulie C, Cognaux J, Forceille C, Muyldermans G, Verhofstede C, Burtonboy G, Georges M, Imai T, Rana S, Yi Y, Smyth RJ, Collman RG, Doms RW, Vassart G, Parmentier M. Resistance to HIV-1 infection in caucasian individuals bearing mutant alleles of the CCR-5 chemokine receptor gene. Nature 1996; 382:722-5. [PMID: 8751444 DOI: 10.1038/382722a0] [Citation(s) in RCA: 2027] [Impact Index Per Article: 72.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
HIV-1 and related viruses require co-receptors, in addition to CD4, to infect target cells. The chemokine receptor CCR-5 (ref.1) was recently demonstrated to be a co-receptor for macrophage-tropic (M-tropic) HIV-1 strains, and the orphan receptor LESTR (also called fusin) allows infection by strains adapted for growth in transformed T-cell lines (T-tropic strains). Here we show that a mutant allele of CCR-5 is present at a high frequency in caucasian populations (allele frequency, 0.092), but is absent in black populations from Western and Central Africa and Japanese populations. A 32-base-pair deletion within the coding region results in a frame shift, and generates a non-functional receptor that does not support membrane fusion or infection by macrophage- and dual-tropic HIV-1 strains. In a cohort of HIV-1 infected caucasian subjects, no individual homozygous for the mutation was found, and the frequency of heterozygotes was 35% lower than in the general population. White blood cells from an individual homozygous for the null allele were found to be highly resistant to infection by M-tropic HIV-1 viruses, confirming that CCR-5 is the major co-receptor for primary HIV-1 strains. The lower frequency of heterozygotes in seropositive patients may indicate partial resistance.
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MESH Headings
- Alleles
- Amino Acid Sequence
- Base Sequence
- Cloning, Molecular
- Cohort Studies
- DNA Primers
- Frameshift Mutation
- Gene Frequency
- Genotype
- HIV Infections/genetics
- HIV Infections/immunology
- HIV Seropositivity/genetics
- HIV Seropositivity/immunology
- HIV-1/immunology
- Humans
- Immunity, Innate/genetics
- Immunity, Innate/immunology
- Membrane Fusion
- Molecular Sequence Data
- Polymerase Chain Reaction
- Protein Conformation
- Receptors, CCR5
- Receptors, Cytokine/chemistry
- Receptors, Cytokine/genetics
- Receptors, Cytokine/immunology
- Receptors, HIV/chemistry
- Receptors, HIV/genetics
- Receptors, HIV/immunology
- White People/genetics
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Affiliation(s)
- M Samson
- IRIBHN and Services de Genetique Medicale, Virologie and Immunodeficiences, Universite Libre de Bruxelles, Belgium
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33
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Fauville-Dufaux M, Waelbroeck A, De Mol P, Vanfleteren B, Levy J, Debusschere P, Farber CM. Contribution of the polymerase chain reaction to the diagnosis of tuberculous infections in children. Eur J Pediatr 1996; 155:106-11. [PMID: 8775224 DOI: 10.1007/bf02075761] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED The purpose of the study was to evaluate the contribution of polymerase chain reaction (PCR) to the diagnosis of tuberculous infection in children. Two different PCR techniques were compared to the standard bacteriological methods for the detection of Mycobacterium tuberculosis in 157 specimens obtained from the respiratory system of 51 children. Patients were classified in three groups: 12 patients with active disease (57 specimens), 12 patients with silent tuberculous infection (23 specimens) and 27 patients without tuberculosis (77 specimens). One PCR method (PCR/Ag85) used amplification of a fragment of the genes coding for the mycobacterial antigen 85 followed by hybridization of a probe specific for M. tuberculosis on the Southern blot of amplified DNA. The other PCR technique was a nested PCR (NPCR) using double amplification of a fragment of the insertion element IS6110 only present in the M. tuberculosis genome. The sensitivities of the different techniques, compared to the clinical diagnosis, were 7.0% for acid fast staining, 22.8% for culture, 24.6% for PCR/Ag85 and 44.9% for NPCR in active disease, 4.3% for culture, 8.7% for PCR/Ag85 and 28.6% for NPCR in silent tuberculous infection. The specificities were 100% for culture, 94.8% for PCR/Ag85 and 87.9% for NPCR. Among the 12 children clinically considered as having active tuberculosis, 1 had smear positive samples, 4 had at least one positive culture, 7 at least one positive PCR/Ag85 and 9 at least one NPCR positive sample. Among the 12 children having silent tuberculous infection, none had positive smears, 1 had one positive culture, 2 had at least one positive PCR/Ag85 and 5 at least one NPCR positive sample. CONCLUSION Our study suggests that both PCR techniques, and especially NPCR, are able to detect M. tuberculosis DNA in specimens containing few micro-organisms. PCR methods are more sensitive than culture and the results are available more quickly. Testing multiple samples from the same individual increased the sensitivity. In view of occasional false-positive results, cultures remain the gold standard to establish definitive diagnosis of primary tuberculous infection in children.
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Affiliation(s)
- M Fauville-Dufaux
- Laboratory of Tuberculosis and Mycobacteria, Institut Pasteur-Bruxelles, Brus
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34
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Simonart T, Noel JC, Liesnard C, Parent D, Heenen M, Brancart F, Van Vooren JP, Farber CM, Blankaert D, Werenne J. Kaposi's sarcoma and herpesvirus 8: a word of caution. Dermatology 1996; 193:272. [PMID: 8944361 DOI: 10.1159/000246267] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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35
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Estaquier J, Idziorek T, Zou W, Emilie D, Farber CM, Bourez JM, Ameisen JC. T helper type 1/T helper type 2 cytokines and T cell death: preventive effect of interleukin 12 on activation-induced and CD95 (FAS/APO-1)-mediated apoptosis of CD4+ T cells from human immunodeficiency virus-infected persons. J Exp Med 1995; 182:1759-67. [PMID: 7500020 PMCID: PMC2192228 DOI: 10.1084/jem.182.6.1759] [Citation(s) in RCA: 220] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection leads to a progressive loss of CD4+ T helper (Th) type 1 cell-mediated immunity that is associated with defective in vitro CD4+ T cell proliferation and abnormal T cell death by apoptosis in response to T cell receptor (TCR) stimulation. Quantification of interleukin (IL)-2, interferon gamma, IL-4, IL-5, and IL-10 secretion by immunoassays, and of interferon gamma, IL-4 and IL-10 messenger RNA expression by competitive reverse transcriptase polymerase chain reaction after in vitro stimulation of the TCR revealed a similar Th1 cytokine profile in T cells from HIV-infected persons and from controls. These data indicated that the loss of CD4+ Th1 cell function in HIV-infected persons is not related to a Th1 to Th2 cytokine switch as previously proposed, but to a process of activation-induced death of CD4+ Th1 cells. Despite the absence of elevated levels of Th2 cytokines, apoptosis of CD4+ T cells, but not of CD8+ T cells, was prevented in vitro by antibodies to IL-10 or IL-4, two Th2 cytokines that downregulate Th1 cell responses, or by the addition of recombinant IL-12, a cytokine that upregulates Th1 functions. TCR-induced apoptosis of T cell hybridomas and preactivated T cells has been shown to involve the CD95 (Fas/Apo-1) molecule. CD4+ and CD8+ T cells from HIV-infected persons expressed high levels of the CD95 molecule, and, in contrast to T cells from controls, were highly sensitive to antibody-mediated CD95 ligation, which induced apoptosis in a percentage of T cells similar to that induced by TCR stimulation. As TCR-induced apoptosis, CD95-mediated apoptosis of CD4+ T cells, but not of CD8+ T cells, was prevented by the addition of recombinant IL-12. Together, these findings suggest that apoptosis of CD4+ T cells from HIV-infected persons involves an abnormal sensitivity to CD95 ligation, and to TCR stimulation in the presence of normal levels of Th2 cytokines. The preventive effect of IL-12 on both mechanisms has potential implications for the design of immunotherapy strategies aimed at the upregulation of CD4+ Th1 cell functions in AIDS.
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Affiliation(s)
- J Estaquier
- Institut National de la Santé et de la Recherche Médicale (INSERM) U 415, Institut Pasteur, Lille, France
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Brohée P, Farber CM, Van Vooren JP, Clumeck N, Hildebrand J. Rapidly developing neurological symptoms in a 40-year-old man with AIDS. Acta Neurol Belg 1995; 95:239-43. [PMID: 8553798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- P Brohée
- Department of Neurology, Hôpital Erasme, Belgium
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37
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Van Vooren JP, Farber CM, Daelemans P, Delforge ML, Liesnard C. Acute Sjögren-like syndrome as the first manifestation of a generalized CMV infection in a patient with AIDS. J Laryngol Otol 1995; 109:1113-4. [PMID: 8551135 DOI: 10.1017/s0022215100132177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report the first case of generalized cytomegalovirus (CMV) disease in an AIDS patient who presented with an acute Sjögren-like syndrome and was diagnosed by parotid gland biopsy. All symptoms disappeared after a few days of intravenous ganciclovir therapy.
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Affiliation(s)
- J P Van Vooren
- Department of Immunodeficiency, Université Libre de Bruxelles, Hopital Erasme, Belgium
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38
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Van Vooren JP, Renard M, Dargent JL, Capel P, Feremans WW, Farber CM. Cardiac tamponade: the first manifestation of a generalized lymphoma in a patient with HIV infection. Eur J Haematol Suppl 1995; 55:274. [PMID: 7589348 DOI: 10.1111/j.1600-0609.1995.tb00275.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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39
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Delforge ML, Liesnard C, Debaisieux L, Tchetcheroff M, Farber CM, Van Vooren JP. In vivo inhibition of syncytium-inducing variants of HIV in patients treated with didanosine. AIDS 1995; 9:89-90. [PMID: 7893446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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40
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Baras L, Farber CM, Van Vooren JP, Parent D. Herpes simplex virus tracheitis in a patient with the acquired immunodeficiency syndrome. Eur Respir J 1994; 7:2091-3. [PMID: 7875288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Herpetic tracheobronchitis and pneumonia occur basically in immunodepressed patients, but have rarely been reported in patients with the acquired immunodeficiency syndrome (AIDS). Some large reviews on pulmonary manifestations in AIDS report a small number of herpetic pulmonary infections, without determining any prevalence of this particular viral involvement. Predisposing factors are alteration of cell-mediated immunity and invasive procedures (such as endotracheal tube use) in debilitated patients. The case we report illustrates the occurrence of a herpetic tracheitis in an HIV-infected patient with severe P. carinii pneumonia, needing systemic corticotherapy and mechanical ventilation. It illustrates the risk of dissemination of herpes simplex virus (HSV) from a herpetic stomatitis to the lower respiratory tract, even after the endotracheal cannula has been removed.
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Affiliation(s)
- L Baras
- Dept of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Belgium
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41
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Baras L, Farber CM, Van Vooren JP, Parent D. Herpes simplex virus tracheitis in a patient with the acquired immunodeficiency syndrome. Eur Respir J 1994. [DOI: 10.1183/09031936.94.07112091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Herpetic tracheobronchitis and pneumonia occur basically in immunodepressed patients, but have rarely been reported in patients with the acquired immunodeficiency syndrome (AIDS). Some large reviews on pulmonary manifestations in AIDS report a small number of herpetic pulmonary infections, without determining any prevalence of this particular viral involvement. Predisposing factors are alteration of cell-mediated immunity and invasive procedures (such as endotracheal tube use) in debilitated patients. The case we report illustrates the occurrence of a herpetic tracheitis in an HIV-infected patient with severe P. carinii pneumonia, needing systemic corticotherapy and mechanical ventilation. It illustrates the risk of dissemination of herpes simplex virus (HSV) from a herpetic stomatitis to the lower respiratory tract, even after the endotracheal cannula has been removed.
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42
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Vera JC, Rivas CI, Zhang RH, Farber CM, Golde DW. Human HL-60 myeloid leukemia cells transport dehydroascorbic acid via the glucose transporters and accumulate reduced ascorbic acid. Blood 1994; 84:1628-34. [PMID: 8068952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The cellular accumulation of vitamin C, a substance critical to human physiology, is mediated by transporters located at the cell membrane, and is regulated in a cell-specific manner. Neoplastic cells may have special needs for vitamin C. Therefore, we investigated the transport of vitamin C in a human myeloid leukemia cell line (HL-60). The HL-60 cells lacked the capacity to transport the reduced form of vitamin C, ascorbic acid, but they showed a remarkable ability to transport the oxidized form of vitamin C, dehydroascorbic acid (DHA). Uptake-accumulation studies indicated that the HL-60 cells accumulated ascorbic acid when provided with DHA. Kinetic analysis showed the presence of two functional activities involved in the uptake of DHA, one with low affinity and one with high affinity. Cytochalasin B and phloretin, which inhibit the passage of glucose through the facilitative glucose transporters, also inhibited the transport of DHA by HL-60 cells. Transport of DHA was completed by D- but not L-hexoses, and was sensitive to D-hexose-dependent counter transport acceleration. These data support the concept that HL-60 myeloid leukemic cells transport DHA through the facilitative hexose transporters (glucose transporters) and accumulate the reduced form of ascorbic acid.
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Affiliation(s)
- J C Vera
- Program in Molecular Pharmacology and Therapeutics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
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Farber CM, Crusiaux A, Schandené L, van Vooren JP, Goldman M, Dupont E, Tasiaux N. Tumor necrosis factor and intravenous gammaglobulins in common variable immunodeficiency. Clin Immunol Immunopathol 1994; 72:233-6. [PMID: 8050197 DOI: 10.1006/clin.1994.1136] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Common variable immunodeficiency (CVI) patients require regular intravenous immunoglobulin substitution therapy (IVGG). We studied eight patients; four of whom had adverse reactions to IVGG, and found that those coincided with elevated tumor necrosis factor-alpha (TNF-alpha) levels during infusion. Those reactions and TNF production were abolished by switching from one IVGG preparation to another in two patients. Reappearance of adverse reactions after switching preparation was preceded by a progressive rise in peak TNF levels in one patient.
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Affiliation(s)
- C M Farber
- Cliniques Universitaires de Bruxelles, Hopital Erasme, Bruxelles, Belgium
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Michils A, Farber CM, Van Vooren JP, Yernault JC, Duchateau J. Sustained benefit of interferon-alpha therapy and oral hyposensitization in severe atopic dermatitis. Br J Dermatol 1994; 130:134-5. [PMID: 8305310 DOI: 10.1111/j.1365-2133.1994.tb06908.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Vandenbruaene M, Colebunders R, Goeman J, Alary M, Farber CM, Kestens L, van Ham G, Van den Ende J, Van Gompel A, Van den Enden E. Evaluation of two staging systems for HIV infection for use in developing countries. AIDS 1993; 7:1613-5. [PMID: 7904453 DOI: 10.1097/00002030-199312000-00011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the clinical axis of the World Health Organization (WHO) clinical staging system and the modified WHO staging system proposed by Montaner et al. using the lymphocyte strata > 1500, 1500-1000 and < 1000 cells x 10(6)/l. DESIGN Cross-sectional study. PATIENTS Four hundred and fifteen consecutive patients with HIV infection attending three HIV reference centres in Belgium. METHODS Absolute CD4 lymphocyte counts were compared between stages within the two staging systems. RESULTS Median CD4 lymphocyte counts decreased with increasing stage of disease in both staging systems. Differences in median CD4 lymphocyte counts between stages of each staging system were statistically significant (Kruskal-Wallis one-way analysis of variance, P < 0.001). The WHO clinical stage 1 and the modified WHO stage I had positive predictive values of 56 and 58%, respectively, for identifying patients with CD4 lymphocyte levels > 500 cells x 10(6)/l. The WHO clinical stage 4 and the modified WHO stage IV had positive predictive values of 79 and 80%, respectively, for identifying patients with CD4 lymphocyte levels < 200 cells x 10(6)/l. CONCLUSIONS The WHO clinical staging system or a modified version of this system using lymphocytes stratification may be a good alternative in developing countries to the CD4 lymphocyte count-based HIV staging system used in the developed world. Cohort studies in developing countries are needed to assess their prognostic value.
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Colebunders R, Kintin D, Fleerackers Y, Demeulenaere T, Vandenbruaene M, Goeman J, Kestens L, Farber CM, Soete F. Surveillance case definition for AIDS in resource-poor countries. Lancet 1993; 342:864-5. [PMID: 8104289 DOI: 10.1016/0140-6736(93)92723-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Silber R, Farber CM, Papadopoulos E, Nevrla D, Liebes L, Bruck M, Brown R, Canellakis ZN. Glutathione depletion in chronic lymphocytic leukemia B lymphocytes. Blood 1992; 80:2038-43. [PMID: 1356514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Glutathione (GSH) content may be the major determinant of a cell's sensitivity to cytotoxic alkylating agents. In the present study, the GSH concentration was determined in lymphocytes isolated from the blood of normal subjects and patients with chronic lymphocytic leukemia (CLL). Comparable levels were found in both types of cells. Incubation for 20 hours led to a decrease in GSH to 51% of baseline values in CLL B cells. Under the same conditions, normal B- or T-lymphocyte GSH content remained constant. GSH depletion was shown to be a characteristic of the B-CLL B lymphocyte. It was not found in the T cells of patients with B-CLL or in cells from patients with T-CLL. Chlorambucil (CLB) contributes to the decrease in GSH in B-CLL lymphocytes; after incubation with the drug, lower levels of GSH were found than in the normal B or T lymphocytes, B-CLL T cells, or T-CLL (CD4 or CD8) cells. GSH depletion of CLL B lymphocytes may be related to the greater therapeutic efficacy of CLB in B-CLL than in T-CLL.
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Affiliation(s)
- R Silber
- Harry and Gussie Wallerstein Hematology Laboratory, Department of Medicine, New York University School of Medicine, NY 10016
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Drowart A, Selleslaghs J, Yernault JC, Valcke C, De Bruyn J, Huygen K, Farber CM, Van Vooren JP. The humoral immune response after BCG vaccination: an immunoblotting study using two purified antigens. Tuber Lung Dis 1992; 73:137-40. [PMID: 1421345 DOI: 10.1016/0962-8479(92)90146-b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The specific IgG response induced by BCG vaccination was investigated in 27 adults using two purified BCG antigens in a dot immunoblotting assay. The reflectance values increased significantly after vaccination when P64 but not when P32 was used as the antigen. The values measured after vaccination were compared with those obtained when testing sera from patients with tuberculosis. We observed that the level of anti-P64 IgG reached after BCG immunization was high enough to preclude a serological differential diagnosis with tuberculosis.
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Affiliation(s)
- A Drowart
- Université libre de Bruxelles, Belgium
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Dussaussois L, Stallenberg B, Farber CM, Gevenois PA. [Hemophilia and arthralgia. Hemophiliac arthropathies, acute of the ankle and chronic of the knee]. Rev Med Brux 1992; 13:74-7. [PMID: 1561504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- L Dussaussois
- Service de Radiologie, Université Libre de Bruxelles, Hôpital Erasme
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