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Abraham RS, Basu A, Heimall JR, Dunn E, Yip A, Kapadia M, Kapoor N, Satter LF, Buckley R, O'Reilly R, Cuvelier GDE, Chandra S, Bednarski J, Chaudhury S, Moore TB, Haines H, Dávila Saldaña BJ, Chellapandian D, Rayes A, Chen K, Caywood E, Chandrakasan S, Lugt MTV, Ebens C, Teira P, Shereck E, Miller H, Aquino V, Eissa H, Yu LC, Gillio A, Madden L, Knutsen A, Shah AJ, DeSantes K, Barnum J, Broglie L, Joshi AY, Kleiner G, Dara J, Prockop S, Martinez C, Mousallem T, Oved J, Burroughs L, Marsh R, Torgerson TR, Leiding JW, Pai SY, Kohn DB, Pulsipher MA, Griffith LM, Notarangelo LD, Cowan MJ, Puck J, Dvorak CC, Haddad E. Relevance of lymphocyte proliferation to PHA in severe combined immunodeficiency (SCID) and T cell lymphopenia. Clin Immunol 2024; 261:109942. [PMID: 38367737 PMCID: PMC11018339 DOI: 10.1016/j.clim.2024.109942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/19/2024]
Abstract
Severe combined immunodeficiency (SCID) is characterized by a severe deficiency in T cell numbers. We analyzed data collected (n = 307) for PHA-based T cell proliferation from the PIDTC SCID protocol 6901, using either a radioactive or flow cytometry method. In comparing the two groups, a smaller number of the patients tested by flow cytometry had <10% of the lower limit of normal proliferation as compared to the radioactive method (p = 0.02). Further, in patients with CD3+ T cell counts between 51 and 300 cells/μL, there was a higher proliferative response with the PHA flow assay compared to the 3H-T assay (p < 0.0001), suggesting that the method of analysis influences the resolution and interpretation of PHA results. Importantly, we observed many SCID patients with profound T cell lymphopenia having normal T cell proliferation when assessed by flow cytometry. We recommend this test be considered only as supportive in the diagnosis of typical SCID.
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Affiliation(s)
- Roshini S Abraham
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, OH, USA.
| | - Amrita Basu
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, OH, USA
| | - Jennifer R Heimall
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, PA, USA
| | - Elizabeth Dunn
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Alison Yip
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Malika Kapadia
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, MA, USA
| | - Neena Kapoor
- Transplantation and Cellular Therapy Program, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lisa Forbes Satter
- Pediatrics, Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Rebecca Buckley
- Departments of Pediatrics and Immunology, Duke University Medical Center, Durham, NC, USA
| | - Richard O'Reilly
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Geoffrey D E Cuvelier
- Manitoba Blood and Marrow Transplant Program, CancerCare Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Sharat Chandra
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Bone Marrow Transplantation and Immune Deficiency, Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jeffrey Bednarski
- Division of Hematology and Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Sonali Chaudhury
- Division of Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago-Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Theodore B Moore
- Division of Hematology/Oncology, Mattel Children's Hospital at UCLA, Los Angeles, CA, USA
| | - Hilary Haines
- Division of Pediatric Hematology-Oncology and Bone Marrow Transplant, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Blachy J Dávila Saldaña
- Division of Blood and Marrow Transplantation, Children's National Hospital-George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | - Ahmad Rayes
- Division of Pediatric Hematology and Oncology, Intermountain Primary Childrens Hospital, Huntsman Cancer Institute, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Karin Chen
- Department of Pediatrics, University of Washington-Seattle Children's Hospital, Seattle, WA, USA
| | - Emi Caywood
- Nemours Children's Health Delaware, Thomas Jefferson University, Wilmington, DE, USA
| | - Shanmuganathan Chandrakasan
- Bone Marrow Transplantation Program, Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Christen Ebens
- Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Pierre Teira
- Pediatric Immunology and Rheumatology Division, CHU Sainte-Justine, Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Evan Shereck
- Division of Pediatric Hematology/Oncology, Oregon Health and Science University, Portland, OR, USA
| | | | - Victor Aquino
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hesham Eissa
- Division of Pediatric Hematology-Oncology-BMT, University of Colorado, Aurora, CO, USA
| | - Lolie C Yu
- Division of Pediatric Hematology-Oncology/HSCT, LSUHSC and Children's Hospital, New Orleans, LA, USA
| | - Alfred Gillio
- Institute for Pediatric Cancer and Blood Disorders, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Lisa Madden
- Pediatric Blood and Marrow Transplantation Program, Texas Transplant Institute, Methodist Children's Hospital, San Antonio, TX, USA
| | - Alan Knutsen
- Department of Pediatrics, Pediatric Allergy and Immunology Division, Saint Louis University, St Louis, MO, USA
| | - Ami J Shah
- Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, Stanford School of Medicine Pediatric Stem Cell Transplantation, Stanford University, Stanford, CA, USA
| | - Kenneth DeSantes
- American Family Children's Hospital, University of Wisconsin, Madison, WI, USA
| | - Jessie Barnum
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Larisa Broglie
- Division of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Avni Y Joshi
- Division of Pediatric and Adult Allergy and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Gary Kleiner
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jasmeen Dara
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Susan Prockop
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, MA, USA
| | - Caridad Martinez
- Pediatrics, Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Talal Mousallem
- Departments of Pediatrics and Immunology, Duke University Medical Center, Durham, NC, USA
| | - Joseph Oved
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lauri Burroughs
- Department of Pediatrics, University of Washington-Seattle Children's Hospital, Seattle, WA, USA
| | - Rebecca Marsh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Bone Marrow Transplantation and Immune Deficiency, Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Pharming Healthcare Inc, Warren, NJ, USA
| | - Troy R Torgerson
- Department of Pediatrics, University of Washington-Seattle Children's Hospital, Seattle, WA, USA
| | - Jennifer W Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University Baltimore, MD and Institute for Clinical and Translational Research, Johns Hopkins All Childrens Hospital, St. Petersburg, FL, USA
| | - Sung Yun Pai
- Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Donald B Kohn
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael A Pulsipher
- Division of Pediatric Hematology and Oncology, Intermountain Primary Childrens Hospital, Huntsman Cancer Institute, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Linda M Griffith
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Morton J Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Christopher C Dvorak
- Division of Allergy, Immunology, and Blood and Marrow Transplantation, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Elie Haddad
- Pediatric Immunology and Rheumatology Division, CHU Sainte-Justine, Department of Pediatrics, University of Montreal, Montreal, QC, Canada
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Xavier de Almeida A, Satnarine T, Gebbia J, Sampson HA, Kleiner G, Gans M. IgE Mediated Flaxseed Allergy in Non-Atopic Toddler Polysensitized to Tree Nuts but Tolerating Other Seeds. Eur Ann Allergy Clin Immunol 2023. [PMID: 37712400 DOI: 10.23822/eurannaci.1764-1489.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- A Xavier de Almeida
- Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami (FL), U.S.A
| | - T Satnarine
- Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami (FL), U.S.A
| | - J Gebbia
- Department of Pediatrics, Division of Allergy and Immunology, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami (FL), U.S.A
| | - H A Sampson
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York (NY), U.S.A
| | - G Kleiner
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami (FL), U.S.A
| | - M Gans
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami (FL), U.S.A
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Raj R, Gebbia J, Kleiner G, Gans M. A PATIENT WITH KABUKI SYNDROME AND HYPOGAMMAGLOBULINEMIA DEVELOPS BURKITT LYMPHOMA. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.888] [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: 11/11/2022]
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4
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Desai S, Gebbia J, Kleiner G, Gans M. STAT1 GOF DISEASE PRESENTING WITH RECURRENT CUTANEOUS CELLULITIS AND UNREMARKABLE BASIC IMMUNOLOGY LABORATORY VALUES. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.913] [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: 11/11/2022]
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5
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Narahari PG, Gebbia J, Alperstein W, Kleiner G, Gans M. Post-SARS-CoV-2 Atypical Inflammatory Syndrome in a Toddler with X-Linked Inhibitor of Apoptosis Deficiency After Stem Cell Transplant. J Clin Immunol 2022; 42:1600-1603. [PMID: 35821452 DOI: 10.1007/s10875-022-01316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/29/2021] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
A 10-month-old boy was diagnosed with X-linked lymphoproliferative syndrome type 2 due to X-linked inhibitor of apoptosis deficiency after presenting with failure to thrive and refractory inflammatory bowel disease. He underwent a matched unrelated donor stem cell transplant with reduced intensity conditioning at 16 months. At 27 months, he presented with an atypical inflammatory syndrome in the setting of recent COVID-19 infection, Epstein-Barr viremia, and low chimerism (7.3%). He recovered after treatment with intravenous immunoglobulin and steroids.
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Affiliation(s)
- Prasanth G Narahari
- Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1580 NW 10th Ave, Miami, FL, 33136, USA.
| | - Jennifer Gebbia
- Division of Allergy and Immunology, Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1580 NW 10th Ave, Miami, FL, 33136, USA
| | - Warren Alperstein
- Division of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, 33136, USA
| | - Gary Kleiner
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1580 NW 10th Ave, Miami, FL, 33136, USA
| | - Melissa Gans
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Holtz Children's Hospital at Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1580 NW 10th Ave, Miami, FL, 33136, USA
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6
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Muffly M, Perlin A, Rodriguez M, Gebbia J, Gans M, Kleiner G. Lupine allergy cross-reactivity with Fabaceae family. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.395] [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: 10/19/2022]
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7
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Hein N, Gebbia J, Alperstein W, Ziga E, Reichbach J, Estevez J, Fifi A, Hochberg J, Forges-Vogt C, Rodriguez M, Kleiner G. Refractory Pediatric Autoimmune Enteropathy Successfully Treated with Hematopoietic Stem Cell Transplant. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.421] [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: 11/27/2022]
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8
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Rush N, Gebbia J, Hein N, Lue J, Padron G, Kleiner G. 1) Prevalence of Peanut and Tree-nut Allergies Among Children in Florida. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.464] [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: 11/26/2022]
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9
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Anzilotti C, Swan DJ, Boisson B, Deobagkar-Lele M, Oliveira C, Chabosseau P, Engelhardt KR, Xu X, Chen R, Alvarez L, Berlinguer-Palmini R, Bull KR, Cawthorne E, Cribbs AP, Crockford TL, Dang TS, Fearn A, Fenech EJ, de Jong SJ, Lagerholm BC, Ma CS, Sims D, van den Berg B, Xu Y, Cant AJ, Kleiner G, Leahy TR, de la Morena MT, Puck JM, Shapiro RS, van der Burg M, Chapman JR, Christianson JC, Davies B, McGrath JA, Przyborski S, Santibanez Koref M, Tangye SG, Werner A, Rutter GA, Padilla-Parra S, Casanova JL, Cornall RJ, Conley ME, Hambleton S. An essential role for the Zn 2+ transporter ZIP7 in B cell development. Nat Immunol 2019; 20:350-361. [PMID: 30718914 PMCID: PMC6561116 DOI: 10.1038/s41590-018-0295-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 12/05/2018] [Indexed: 12/20/2022]
Abstract
Despite the known importance of zinc for human immunity, molecular insights into its roles have remained limited. Here we report a novel autosomal recessive disease characterized by absent B cells, agammaglobulinemia and early onset infections in five unrelated families. The immunodeficiency results from hypomorphic mutations of SLC39A7, which encodes the endoplasmic reticulum-to-cytoplasm zinc transporter ZIP7. Using CRISPR-Cas9 mutagenesis we have precisely modeled ZIP7 deficiency in mice. Homozygosity for a null allele caused embryonic death, but hypomorphic alleles reproduced the block in B cell development seen in patients. B cells from mutant mice exhibited a diminished concentration of cytoplasmic free zinc, increased phosphatase activity and decreased phosphorylation of signaling molecules downstream of the pre-B cell and B cell receptors. Our findings highlight a specific role for cytosolic Zn2+ in modulating B cell receptor signal strength and positive selection.
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Affiliation(s)
- Consuelo Anzilotti
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - David J Swan
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Bertrand Boisson
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163 Necker Hospital for Sick Children, Paris, France
- Paris Descartes University, Imagine Institute, Paris, France
| | - Mukta Deobagkar-Lele
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Catarina Oliveira
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Pauline Chabosseau
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Imperial College, London, UK
| | - Karin R Engelhardt
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Xijin Xu
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Rui Chen
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Luis Alvarez
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Katherine R Bull
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Eleanor Cawthorne
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Adam P Cribbs
- MRC WIMM Centre for Computational Biology, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Tanya L Crockford
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Tarana Singh Dang
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Amy Fearn
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Emma J Fenech
- Ludwig Institute for Cancer Research, University of Oxford, Oxford, UK
| | - Sarah J de Jong
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - B Christoffer Lagerholm
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Cindy S Ma
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of NSW, Darlinghurst, New South Wales, Australia
| | - David Sims
- MRC WIMM Centre for Computational Biology, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Bert van den Berg
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Yaobo Xu
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew J Cant
- Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Gary Kleiner
- Pediatric Allergy and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T Ronan Leahy
- Paediatric Immunology and Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - M Teresa de la Morena
- Division of Immunology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - Jennifer M Puck
- Department of Pediatrics, Division of Allergy, Immunology, and Blood and Bone Marrow Transplantation, University of California, San Francisco, CA, USA
- UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | | | - Mirjam van der Burg
- Department of Immunology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - J Ross Chapman
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Benjamin Davies
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - John A McGrath
- St John's Institute of Dermatology, King's College London, London, UK
| | | | | | - Stuart G Tangye
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of NSW, Darlinghurst, New South Wales, Australia
| | - Andreas Werner
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Guy A Rutter
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Imperial College, London, UK
| | - Sergi Padilla-Parra
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Dynamic Structural Virology Group, Biocruces Health Research Institute, Barakaldo, Spain
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Jean-Laurent Casanova
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163 Necker Hospital for Sick Children, Paris, France
- Paris Descartes University, Imagine Institute, Paris, France
- Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France
- Howard Hughes Medical Institute, New York, NY, USA
| | - Richard J Cornall
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
| | - Mary Ellen Conley
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
| | - Sophie Hambleton
- Primary Immunodeficiency Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
- Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Klopsch C, Skorska A, Lemcke H, Kleiner G, Gaebel R, Beyer M, Jaster R, Jockenhoevel S, Vollmar B, Dohmen P, David R, Steinhoff G. Epicardial Erythropoietin Preserves Heart Function after Myocardial Infarction through Synergistic Angiogenesis and TGF-beta/WNT Signaling Trigger in Cardiac Mesenchymal Stem Cells. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C. Klopsch
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - A. Skorska
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - H. Lemcke
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - G. Kleiner
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - R. Gaebel
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - M. Beyer
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - R. Jaster
- Division of Gastroenterology, Department of Medicine II, University of Rostock, Rostock, Germany
| | - S. Jockenhoevel
- Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - B. Vollmar
- Institute for Experimental Surgery, University of Rostock, Rostock, Germany
| | - P. Dohmen
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - R. David
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
| | - G. Steinhoff
- Department of Cardiac Surgery, University of Rostock, Rostock, Germany
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11
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Ballow M, Pinciaro PJ, Craig T, Kleiner G, Moy J, Ochs HD, Sleasman J, Smits W. Flebogamma(®) 5 % DIF Intravenous Immunoglobulin for Replacement Therapy in Children with Primary Immunodeficiency Diseases. J Clin Immunol 2016; 36:583-9. [PMID: 27279130 DOI: 10.1007/s10875-016-0303-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/23/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The previous studies with Flebogamma(®) 5 % DIF intravenous immunoglobulin (IVIG) contained insufficient numbers of pediatric subjects to fully warrant a pediatric indication by the FDA. The objective of this study was to evaluate the efficacy, safety, and pharmacokinetics of Flebogamma® 5 % DIF for replacement therapy in children (age 2-16) with primary immunodeficiency diseases (PIDD). METHODS IVIG was administered at eight clinical sites to 24 subjects with well-defined PIDD at a dose of 300-800 mg/kg every 21-28 days for 12 months. The pharmacokinetics endpoint in this study was the dose-adjusted increment of the serum IgG trough levels. RESULTS The calculated serious bacterial infection rate was 0.05/subject/year. The incidence of adverse events considered potentially related to IVIG during or within 72 h after completing an infusion was within the FDA guidance threshold of <40 % at each time point. Dose-adjusted incremental IgG levels remained approximately equal to or slightly greater than pre-study IgG levels (between 800 and 1000 mg/dL throughout) when the subjects were treated with IVIG therapy other than Flebogamma(®) DIF 5 % indicating no evidence of a different pharmacokinetic profile in this pediatric population if compared to those profiles in previous Flebogamma studies in predominately adult populations. CONCLUSIONS Flebogamma(®) 5 % DIF is efficacious and safe, has adequate pharmacokinetic properties, is well-tolerated, and maintains the profile of Flebogamma(®) 5 % for the treatment of children with primary humoral immunodeficiency diseases.
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Affiliation(s)
- Mark Ballow
- The Children's Hospital of Buffalo, Buffalo, NY, USA.
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, 601 4th Street South, Saint Petersburg, FL, 3370, USA.
| | | | - Timothy Craig
- Penn State University Hershey Medical Center, Hershey, PA, USA
| | - Gary Kleiner
- Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies, University of Miami, Miami, FL, USA
| | - James Moy
- Allergy and Immunology, Rush University Medical Center, Chicago, IL, USA
| | - Hans D Ochs
- Seattle Children's Research Institute and University of Washington, Seattle, WA, USA
| | - John Sleasman
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, 601 4th Street South, Saint Petersburg, FL, 3370, USA
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Klopsch C, Kleiner G, Skorska A, Ludwig M, Gaebel R, Mueller K, Mela P, Jockenhoevel S, David R, Steinhoff G. Epicardial Erythropoietin patch most efficiently improves myocardial regeneration and performance after infarction. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367267] [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: 10/25/2022]
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13
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Marcuzzi A, Tricarico PM, Piscianz E, Kleiner G, Vecchi Brumatti L, Crovella S. Lovastatin induces apoptosis through the mitochondrial pathway in an undifferentiated SH-SY5Y neuroblastoma cell line. Cell Death Dis 2013; 4:e585. [PMID: 23579272 PMCID: PMC3641335 DOI: 10.1038/cddis.2013.112] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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14
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Klopsch C, Kleiner G, Gaebel R, Lux C, Ludwig M, Mela P, Jockenhoevel S, Kaminski A, Steinhoff G. Local epicardial Erythropoietin-plus-fibrin patch application more efficiently improves cardiac functions than intramyocardial and systemic delivery of Erythropoietin in a rat myocardial infarction model. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332297] [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: 10/27/2022]
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15
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Berman DM, Willman MA, Han D, Kleiner G, Kenyon NM, Cabrera O, Karl JA, Wiseman RW, O'Connor DH, Bartholomew AM, Kenyon NS. Mesenchymal stem cells enhance allogeneic islet engraftment in nonhuman primates. Diabetes 2010; 59:2558-68. [PMID: 20622174 PMCID: PMC3279532 DOI: 10.2337/db10-0136] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To test the graft-promoting effects of mesenchymal stem cells (MSCs) in a cynomolgus monkey model of islet/bone marrow transplantation. RESEARCH DESIGN AND METHODS Cynomolgus MSCs were obtained from iliac crest aspirate and characterized through passage 11 for phenotype, gene expression, differentiation potential, and karyotype. Allogeneic donor MSCs were cotransplanted intraportally with islets on postoperative day (POD) 0 and intravenously with donor marrow on PODs 5 and 11. Recipients were followed for stabilization of blood glucose levels, reduction of exogenous insulin requirement (EIR), C-peptide levels, changes in peripheral blood T regulatory cells, and chimerism. Destabilization of glycemia and increases in EIR were used as signs of rejection; additional intravenous MSCs were administered to test the effect on reversal of rejection. RESULTS MSC phenotype and a normal karyotype were observed through passage 11. IL-6, IL-10, vascular endothelial growth factor, TGF-β, hepatocyte growth factor, and galectin-1 gene expression levels varied among donors. MSC treatment significantly enhanced islet engraftment and function at 1 month posttransplant (n = 8), as compared with animals that received islets without MSCs (n = 3). Additional infusions of donor or third-party MSCs resulted in reversal of rejection episodes and prolongation of islet function in two animals. Stable islet allograft function was associated with increased numbers of regulatory T-cells in peripheral blood. CONCLUSIONS MSCs may provide an important approach for enhancement of islet engraftment, thereby decreasing the numbers of islets needed to achieve insulin independence. Furthermore, MSCs may serve as a new, safe, and effective antirejection therapy.
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Affiliation(s)
- Dora M. Berman
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Melissa A. Willman
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Dongmei Han
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Gary Kleiner
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida
| | - Norman M. Kenyon
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Over Cabrera
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Julie A. Karl
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Roger W. Wiseman
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - David H. O'Connor
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Norma S. Kenyon
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Biomedical Engineering, University of Miami, Miami, Florida
- Corresponding author: Norma S. Kenyon,
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Renner ED, Hartl D, Rylaarsdam S, Young ML, Monaco-Shawver L, Kleiner G, Markert ML, Stiehm ER, Belohradsky BH, Upton MP, Torgerson TR, Orange JS, Ochs HD. Comèl-Netherton syndrome defined as primary immunodeficiency. J Allergy Clin Immunol 2009; 124:536-43. [PMID: 19683336 DOI: 10.1016/j.jaci.2009.06.009] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 05/12/2009] [Accepted: 06/02/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mutations in serine protease inhibitor Kazal-type 5 (SPINK5), encoding the serine protease inhibitor lympho-epithelial Kazal-type 5 related inhibitor (LEKTI), cause Comèl-Netherton syndrome, an autosomal-recessive disease characterized by congenital ichthyosis, bamboo hair, and atopic diathesis. Despite increased frequency of infections, the immunocompetence of patients with Comèl-Netherton syndrome has not been extensively investigated. OBJECTIVE To define Comèl-Netherton syndrome as a primary immunodeficiency disorder and to explore the benefit of intravenous immunoglobulin replacement therapy. METHODS We enrolled 9 patients with Comèl-Netherton syndrome, sequenced SPINK5, and analyzed LEKTI expression by immunohistochemistry. Immune function was assessed by measuring cognate immunity, serum cytokine levels, and natural killer cell cytotoxicity. RESULTS All patients presented with recurrent skin infections caused predominantly by Staphylococcus aureus. All but 1 reported recurrent respiratory tract infections; 78% had sepsis and/or pneumonia; 67% had recurrent gastrointestinal disease and failure to thrive. Mutations in SPINK5-including 6 novel mutations-were identified in 8 patients. LEKTI expression was decreased or absent in all patients. Immunologic evaluation revealed reduced memory B cells and defective responses to vaccination with Pneumovax and bacteriophage phiX174, characterized by impaired antibody amplification and class-switching. Immune dysregulation was suggested by a skewed T(h)1 phenotype and elevated proinflammatory cytokine levels, whereas serum concentrations of the chemokine (C-C motif) ligand 5 and natural killer cell cytotoxicity were decreased. Treatment with intravenous immunoglobulin resulted in remarkable clinical improvement and temporarily increased natural killer cell cytotoxicity. CONCLUSION These data provide new insights into the immunopathology of Comèl-Netherton syndrome and demonstrate that this multisystem disorder, characterized by lack of LEKTI expression in epithelial cells, is complicated by cognate and innate immunodeficiency that responds favorably to intravenous immunoglobulin therapy.
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Affiliation(s)
- Ellen D Renner
- Dr v Haunersches Kinderspital, Ludwig-Maximilians-Universität, Munich, Germany
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David AI, Szutan LA, Gaynor J, Ruiz P, Selvaggi G, Tryphonopoulos P, Kleiner G, Moon JI, Nishida S, Weppler D, Squenazi V, Conanan L, Levi DM, Kato T, Tzakis AG. [Critical value of citrulline for complications of intestinal transplant graft]. Rev Assoc Med Bras (1992) 2009; 54:426-9. [PMID: 18989563 DOI: 10.1590/s0104-42302008000500016] [Citation(s) in RCA: 2] [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] [Received: 09/20/2007] [Accepted: 04/15/2008] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE A biochemical marker for detection of acute cellular rejection following small intestine transplantation has been sought. Citrulline, a non- protein amino acid synthesized mainly by functioning enterocytes, has been proposed. Trial sensitivity has been reportedly high but with low specificity. Thus, the goal was to determine, in a sufficiently large analysis, the significant value of citrulline level in the post-transplant setting, which would correlate with complications such as rejection and infection. METHODS Since March, 2004 2,135 dried blood spot (DBS) citrulline samples were obtained from 57 small intestine transplant recipients three months or more after post-transplant, i.e., once the expected period of recovery in the citrulline levels had occurred. RESULTS Using a <13 vs. > 13 micromoles/L cut off point, sensitivity of DBS citrulline for the detection of moderate or severe ACR was extremely high (96.4%). Furthermore, specificity estimates (given the absence of ACR and these particular infections), while controlling for time-to-DBS sample were reasonably high (54%-74% in children and 83%-88% in adults), and the negative predictive value (NPV) was >99%. CONCLUSION Citrulline is a non-invasive marker to evaluate problems of the intestinal graft after three months post-transplant. Due to the high NPV, a moderate or severe ACR can be ruled out, based exclusively on knowledge of a high value for DBS citrulline.
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Affiliation(s)
- André Ibrahim David
- Departamento de Cirurgia da Irmandade, Santa Casa de Misericórdia de São Paulo, SP.
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18
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Kato T, Tzakis AG, Selvaggi G, Gaynor JJ, Takahashi H, Mathew J, Garcia-Morales R, Hernandez E, David A, Nishida S, Levi D, Moon J, Island E, Kleiner G, Ruiz P. Transplantation of the spleen: effect of splenic allograft in human multivisceral transplantation. Ann Surg 2007; 246:436-44; discussion 445-6. [PMID: 17717447 PMCID: PMC1959351 DOI: 10.1097/sla.0b013e3181485124] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To describe the effect of the splenic allograft in human multivisceral transplantation. SUMMARY BACKGROUND DATA We performed transplants of the spleen as part of a multivisceral graft in an attempt to decrease both the risk of infection from an asplenic state and the risk of rejection by a possible tolerogenic effect. To our knowledge, this is the first report of human splenic transplantation in a large series. METHODS All primary multivisceral recipients who received a donor spleen (N = 60) were compared with those who did not receive a spleen (N = 81). RESULTS Thirty-five of 60 (58%) are alive in the spleen group, and 39 of 81 (48%) are alive in control group (P = 0.98). In univariate analysis, splenic recipients showed superiority in freedom-from-any rejection (P = 0.02) and freedom-from-moderate or severe rejection (P = 0.007). No significant differences were observed in analyses of infectious complications between the spleen and control groups. Both platelet and leukocyte counts became normal in splenic patients, whereas these counts were significantly increased in nonsplenic recipients. Observed incidence of graft versus host disease (GVHD) was 8.25% (5 of 60) in the spleen group and 6.2% (5 of 81) in the control group (P = 0.70). Increased incidence of autoimmune hemolysis was observed in the spleen group. CONCLUSIONS Allograft spleen can be transplanted within a multivisceral graft without significantly increasing the risk of GVHD. The allogenic spleen seems to show a protective effect on small bowel rejection. Further investigation with longitudinal follow-up is required to precisely determine the immunologic and hematologic effects of the allograft spleen.
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Affiliation(s)
- Tomoaki Kato
- Departments of Surgery, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
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19
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Cirocco RE, Carreño MR, Mathew JM, Garcia-Morales RO, Fuller L, Esquenazi V, Ciancio G, Burke GW, Gaynor JJ, Blomberg BB, Rosen A, Kleiner G, Ricordi C, Miller J. FoxP3 mRNA transcripts and regulatory cells in renal transplant recipients 10 years after donor marrow infusion. Transplantation 2007; 83:1611-9. [PMID: 17589345 DOI: 10.1097/01.tp.0000266908.37446.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We update more favorable 10-year deceased donor kidney transplant survival in 63 recipients infused perioperatively with donor vertebral body bone marrow (DBMC-i) vs. 219 noninfused controls having equivalent immunosuppression and demographics. We questioned if this was associated with putatively regulatory FoxP3 mRNA and cell phenotypes (CD4+CD25+high percentages and high DC2:DC1 ratios) in DBMC-i vs. noninfused controls. METHODS Baseline studies were performed on peripheral blood lymphocytes (PBLs) vs. marrow in normal laboratory volunteers of CD4+CD25+high percentages and DC2:DC1 by flow cytometry, and FoxP3 mRNA in CD3+ cells by real-time polymerase chain reaction. Similar studies were performed on PBL of the majority of the 10-year patients remaining with graft function: 21 (of the remaining 37) DBMC-i vs. 55 (of the remaining 105) controls. RESULTS In normal subjects, all parameters were significantly higher in marrow than in PBL, supporting our previous reports of ex vivo DBMC immunoregulation. At 9.8+/-.02 years posttransplant in DBMC-i vs. controls, death-censored percent graft failure was 17.5% vs. 32.9% (P=0.02) with 247.6+/-24 vs. 79.9+/-3.1 (mean+/-SE) FoxP3 copies/5,000 CD3+ cells (P=0.0001). PBL CD4+CD25+high percentages were lower, but DC2:DC1 values higher in both recipient groups than in end-stage renal disease patients who had lower FoxP3 levels (40.8+/-5.9, P<0.0001), consistent with non-CD4+CD25+high T regulatory cells generated long-term posttransplant. Individual higher FoxP3 values correlated with higher iliac crest chimerism in DBMC-i, but not in controls (with 50-fold lower chimerism). In chronically rejecting controls, FoxP3 was further decreased. CONCLUSIONS Peritransplant DBMC-i has higher 10-year renal transplant acceptance, chimerism, and FoxP3 mRNA in thus-far unclarified regulatory cell phenotypes.
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Affiliation(s)
- Robert E Cirocco
- Department of Surgery, The Lillian Jean Kaplan Renal Transplant Center of the Division of Transplantation, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, USA.
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20
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Connelly EA, Aber C, Kleiner G, Nousari C, Charles C, Schachner LA. Generalized erythrodermic pemphigus foliaceus in a child and its successful response to rituximab treatment. Pediatr Dermatol 2007; 24:172-6. [PMID: 17461818 DOI: 10.1111/j.1525-1470.2007.00369.x] [Citation(s) in RCA: 26] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pemphigus foliaceus is an autoimmune disease that clinically manifests with cutaneous blisters of the superficial skin. The nonendemic or sporadic form of this entity is rare in children and typically presents with a milder, more localized rash that usually follows a benign course of short duration. We describe an affected patient atypical in both her young age and the severity of skin findings. Our patient presented with a full body exfoliative erythroderma at 21 months of age. After an extensive work-up to determine the etiology of her exfoliative erythroderma, direct and indirect immunofluorescence studies confirmed the diagnosis of pemphigus foliaceus. Rituximab therapy was initiated based on the patient's refractory disease course to multiple immunosuppressive agents. Rituximab is a therapeutic monoclonal antibody targeting CD20, an integral membrane protein highly expressed on the surface of pre-B lymphocytes and activated mature B lymphocytes. The patient's skin exhibited marked clinical improvement after the start of rituximab infusions over 12 weeks. Her initial desmoglein 1 antibody level was greater than 1:1280, which decreased to 1:16 after seven rituximab treatments. She has had no skin flares since initiating treatment with rituximab therapy. Based on this clinical and serologic response, the use of rituximab may be helpful in the treatment of pediatric pemphigus foliaceus refractory to mainstays of therapy.
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Affiliation(s)
- Elizabeth Alvarez Connelly
- Department of Dermatology and Cutaneous Surgery, Division of Pediatric Dermatology, University of Miami Miller School of Medicine, Miami, Florida 33125, USA
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21
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Gandia C, David A, Santiago S, Ruiz P, Tzakis A, Kleiner G. 193: Intestinal tissue engineering. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.197] [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: 11/26/2022]
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Abstract
BACKGROUND/OBJECTIVE Adipose-derived stem cells (ADSCs) are mesenchymal stem cells (MSCs) that can be extracted from adipose tissue and obtained by a less invasive method and in larger quantities compared with bone marrow-derived MSCs. The objective of this study was to harvest ADSCs from piglets and to explore their neuronal differentiation potential. METHODS Adipose tissue from piglet facial or abdominal fat was digested with collagenase type XI, followed by filter and centrifugation; the isolated adipose stromal cells were cultured in dishes. MSC markers were measured by flow cytometry; 2 to 5 passage cells were used for in vitro differentiation. Adipogenic, chondrogenic, osteogenic, and neuronal differentiation was induced by incubation of the ADSCs with different induction media. RESULTS ADSCs were easily expanded to beyond 15 passages, maintaining the undifferentiated state and exhibiting MSC characteristics and markers CD29, CD44, and CD90. ADSCs differentiated into other mesodermal cells including adipocytes, chondrocytes, and osteocytes. These cells were induced to differentiate into neuron-like cells as evidenced by neuronal morphology and the presence of neuronal markers including microtubule-associated protein 2, neuronal nuclear antigen, and beta-tubulin III. CONCLUSIONS ADSCs can be readily obtained from a small amount fat tissue and expanded in culture. Adipose tissue may be an alternative source of stem cell therapy for nervous system injury.
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Affiliation(s)
- Tingting Huang
- University of Miami School of Medicine, Miami, Florida
- Please address correspondence to John Kuluz, MD, Pediatric ICU, 6006 Holtz Center—JMH East Tower R131, Miami, FL 33136; phone: 303.243.3399; fax: 303.243.4607; (e-mail: )
| | - Dansha He
- University of Miami School of Medicine, Miami, Florida
| | - Gary Kleiner
- University of Miami School of Medicine, Miami, Florida
| | - John Kuluz
- University of Miami School of Medicine, Miami, Florida
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23
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Renner E, Rylaarsdam S, Anover S, Hartl D, Jayakumar A, Belohradsky B, Ermer U, Jin Y, Kleiner G, Nagel F, Zhu Q, Claymann G, Torgerson T, Ochs H. Comèl-Netherton Syndrome - New Insight Into The Molecular Basis of this Rare Syndrome Characterized by Atopic Diathesis and Immune Deficiency. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.060] [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: 10/23/2022]
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Cirocco RE, Carreno M, Mathew J, Vallone T, Rosen A, Hernandez A, Burke GW, Ciancio G, Kleiner G, Esquenazi V, Miller J. 127-P. Hum Immunol 2006. [DOI: 10.1016/j.humimm.2006.08.209] [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: 10/24/2022]
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25
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David AI, Gaynor JJ, Zis PP, Conanan L, Goldsmith L, Esquenazi V, Selvaggi G, Weppler D, Nishida S, Moon J, Madariaga JR, Ruiz P, Kato T, Levi DM, Kleiner G, Tryphonopoulos P, Tzakis AG. An association of lower serum citrulline levels within 30 days of acute rejection in patients following small intestine transplantation. Transplant Proc 2006; 38:1731-2. [PMID: 16908264 DOI: 10.1016/j.transproceed.2006.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION In a prospective protocol we studied whether serum citrulline level within 30 days of an acute rejection was predictive of the episode. METHODS An acute rejection episode was defined as the date of occurrence of any biopsy-proven rejection in which treatment was initiated until two successive biopsies showed no further rejection. We compared the mean citrulline level based on values determined within 30 days of the start of an acute rejection episode with the mean citrulline level measured on the same patient during a rejection-free period. Serum citrulline measurements were available immediately prior to the occurrence of rejection for 22 patients who experienced 37 episodes. RESULTS For the 12 episodes of mild rejection, the mean serum citrulline level +/- SE (standard error) was 15.0 + 2.3 micromol/L prior to rejection and 18.8 +/- 2.4 micromol/L during the rejection-free periods. A paired t test of the mean differences was not significant (P = 17). For the 25 episodes of moderate or severe rejection, the mean serum citrulline level was 12.4 +/- 1.1 micromol/L before rejection and 18.8 +/- 2.0 micromol/L during the rejection-free periods. A paired t test of the mean difference was statistically significant (P = .002). CONCLUSIONS Although further study of citrulline as a marker for the early detection of acute rejection episodes is needed, our hope is that its use will help to prevent some of these early episodes from evolving into full-blown moderate or severe grades of rejection.
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Affiliation(s)
- A I David
- Department of Surgery, Division of Liver and GI Transplant, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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26
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Kato T, Kleiner G, David A, Selvaggi G, Nishida S, Madariaga J, Thompson J, Ruiz P, Tzakis A. Inclusion of spleen in pediatric multivisceral transplantation. Transplant Proc 2006; 38:1709-10. [PMID: 16908256 DOI: 10.1016/j.transproceed.2006.05.059] [Citation(s) in RCA: 7] [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: 11/17/2022]
Abstract
Inclusion of the donor spleen may be beneficial for small children who receive multivisceral transplantation (MVT) because asplenia is associated with increased risk of bacterial sepsis. Beginning in 2003, the spleen was transplanted together with multivisceral transplantation in 17 children under daclizumab induction (spleen group). The results were compared to 23 children who received multivisceral transplantation without the spleen (control group) with the same immunosuppression regimen. Median age of 17 patients who received a spleen was 0.80 years (range 0.54-1.66). Platelet counts at 30 and 60 days posttransplant were significantly lower in the spleen group (average values: day 30: 399,000 vs 636,000, P = .015; day 60: 413,000 vs 622,000, P = .0056). WBC counts at 30 and 60 days posttransplant were also decreased in the spleen group but the difference was not statistically significant. Median rejection-free survival was 205 days in the spleen group and 101 days in the control group (P = NS). Median length of hospital stay was 39 days in the spleen group and 61 days in the control group. With a median follow-up of 398 days (spleen group) and 1232 days (control group), 3 of 17 (17%) in the spleen group developed graft versus host disease (GVHD), whereas 1 of 23 (4.5%) in control group did (P = NS). In one patient in each group, GVHD was fatal. No patient developed posttransplant lymphoproliferative disorder (PTLD) in the spleen group, whereas 4 of 23 (17%) in the control group developed PTLD. One-year patient survival was 84% in the spleen group and 86% in the control group. Recipients of the spleen as part of a multivisceral graft had significantly lower platelet counts. Rejection-free survival may be prolonged, but the risk of GVHD may be increased.
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Affiliation(s)
- T Kato
- Divisions of Transplant, Pediatric Gastroenterology, Pediatric Critical Care Medicine, and Immunopathology, University of Miami, School of Medicine, 1801 NW 9th Avenue, Miami, FL 33136, USA.
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Renner E, Rylaarsdam S, Anover S, Belohradsky B, Ermer U, Hackett M, Hornung R, Jin Y, Nagel F, Kleiner G, Stiehm R, Lu HM, Zhu Q, Torgerson T, Ochs H. Impaired Humoral Immune Response to a T-Cell-Dependent Neoantigen in Patients with ComèL-Netherton Syndrome. Clin Immunol 2006. [DOI: 10.1016/j.clim.2006.04.547] [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: 11/26/2022]
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Tryphonopoulos P, Tzakis AG, Weppler D, Garcia-Morales R, Kato T, Madariaga JR, Levi DM, Nishida S, Moon J, Selvaggi G, Regev A, Nery C, Bejarano P, Khaled A, Kleiner G, Esquenazi V, Miller J, Ruiz P, Ricordi C. The role of donor bone marrow infusions in withdrawal of immunosuppression in adult liver allotransplantation. Am J Transplant 2005; 5:608-13. [PMID: 15707417 DOI: 10.1111/j.1600-6143.2004.00743.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [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: 01/25/2023]
Abstract
We investigated the role of donor bone marrow cell (DBMC) infusions in immunosuppression withdrawal in adult liver transplantation. Patients enrolled were at least 3 years post-transplantation, with stable graft function. Forty-five (study group: G1) received DBMC, and 59 (control group: G2) did not. Immunosuppression was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year. Patient and graft survival were similar between the two groups. Although rejection episodes were significantly less in G1 the first 2 years of the study (35% vs. 57%, p = 0.016), there was no significant difference overall (74% vs. 81%, p = 0.14). Until February 2004, 20 patients, 10 in each group, were immunosuppression free for 1-3 years. Approximately 20% of long-term survivors of liver transplantation can successfully discontinue their immunosuppression. DBMC infusions, do not increase this likelihood.
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Affiliation(s)
- Panagiotis Tryphonopoulos
- Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, Florida, USA
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29
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Rodriguez M, Khimji I, Rhodd S, Lapage C, Zalesky L, Jimenez P, Barbouth D, Elsas L, Kleiner G. Combined home enzyme replacement therapy and unrelated cord blood transplantation for Hurler’s syndrome (MPSI) in a pediatric HSCT center. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.286] [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: 10/25/2022]
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30
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Pappas PA, Tzakis AG, Saudubray JM, Gaynor JJ, Carreno MR, Huijing F, Kleiner G, Rabier D, Kato T, Levi DM, Nishida S, Gelman B, Thompson JF, Mittal N, Ruiz P. Trends in serum citrulline and acute rejection among recipients of small bowel transplants. Transplant Proc 2004; 36:345-7. [PMID: 15050154 DOI: 10.1016/j.transproceed.2003.12.007] [Citation(s) in RCA: 23] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A test for detecting acute cellular rejection (ACR) of small intestinal transplants (ITx) would be a major advance. Small preliminary studies suggest that serum citrulline levels correlate with ACR. The results for a group of 26 isolated intestinal and multivisceral transplant recipients are summarized here. Serum citrulline concentrations were determined by ion exchange chromatography and compared to biopsy-based grade of ACR. Other factors considered included patient and donor age and sex, ischemia time, and serum creatinine. Straight-line fits were employed to describe how each patient's citrulline levels changed over time. Estimated times to achieve normal citrulline (>or=30 micromol/L) ranged from 1 to 730 days posttransplant for 21 patients demonstrating increasing citrulline levels over time. Using stepwise linear regression, patients' ranks for time required to achieve normal citrulline levels were the only independent predictors of both maximum ACR (P <.0001) and average ACR (P =.0059) after 14 days posttransplant. The rate and direction of change in citrulline over time may be an indicator of the risk of acute rejection. We plan to further examine the use of citrulline as a marker for rejection in larger prospective studies.
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Affiliation(s)
- P A Pappas
- Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida 33136, USA
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31
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Pappas PA, G Tzakis A, Gaynor JJ, Carreno MR, Ruiz P, Huijing F, Kleiner G, Rabier D, Kato T, Levi DM, Nishida S, Gelman B, Thompson JF, Mittal N, Saudubray JM. An analysis of the association between serum citrulline and acute rejection among 26 recipients of intestinal transplant. Am J Transplant 2004; 4:1124-32. [PMID: 15196071 DOI: 10.1111/j.1600-6143.2004.00469.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [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: 01/25/2023]
Abstract
Small preliminary studies suggest that serum citrulline levels may act as a marker for acute cellular rejection in small intestinal transplant recipients. The results comparing serum citrulline concentrations with biopsy-based grades of rejection are summarized here for an expanded group of 26 isolated intestinal and multivisceral transplant recipients. Other factors considered included patient and donor age and sex, ischemia time, serum creatinine, and type of transplant. Straight-line fits reasonably described how each patient's citrulline levels changed over time. Among 21 patients who demonstrated increasing citrulline levels over time, the estimated median time-to-achieve normal citrulline (>or=30 micromol/L) was 79 days post-transplant. Using stepwise linear regression, two characteristics were associated with a significantly higher maximum grade of rejection after 14 d post-transplant: longer time-to-achieve normal citrulline (using ranks, p < 0.00001) and the patient not receiving a multivisceral transplant (p = 0.0005). Only the latter characteristic was significantly associated with maximum grade of rejection during the first 14 d post-transplant (p = 0.01). Clearly, time-to-normalization of citrulline was delayed by the incidence of rejection, and in some cases with moderate-to-severe rejection, normalization of citrulline levels never occurred. We plan to further examine the use of citrulline as a marker for rejection in larger prospective studies.
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Affiliation(s)
- Peter A Pappas
- University of Miami/Jackson Memorial Hospital, Department of Surgery, Division of Transplantation, Miami, FL USA
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Abstract
The implantation of fragmented rat intestinal epithelium into the omentum of syngeneic animals results in the formation of a cyst containing neointestine. The purpose of our project was to study the evolution of this neointestine-containing cyst over time. Harvested jejunum and ileum of neonatal DA rats (6 to 8 days old) was digested with collagenase type XI and dispase at room temperature. The resulting organoid units, containing clusters of intestinal epithelium with stem cells were seeded onto a polyglactin polymer mesh (100000 units per mesh). The absorbable mesh was implanted in the omentum or peritoneal wall of an adult syngeneic animal. Animals were sacrificed at weekly intervals to harvest the neointestinal cysts. The lumen of the neointestine cysts was full of mucous while the wall of the cyst was covered by intestinal mucosa. H&E staining of the cyst demonstrated the morphology of intestinal epithelium; PAS staining identified goblet cells. The size of the cyst was maximal between 4 and 8 weeks postimplantation tending to regress thereafter. Neointestinal cysts are a consistent finding after implantation of intestinal epithelium organoids into the omentum or peritoneal wall in the rat model. The cysts reach a maximal size at 4 to 8 weeks postimplantation, tending to regress thereafter.
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Affiliation(s)
- W De Faria
- Department of Surgery, University of Miami School of Medicine, Miami, FL 33136, USA
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33
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Morafo V, Srivastava K, Huang CK, Kleiner G, Lee SY, Sampson HA, Li AM. Genetic susceptibility to food allergy is linked to differential TH2-TH1 responses in C3H/HeJ and BALB/c mice. J Allergy Clin Immunol 2003; 111:1122-8. [PMID: 12743580 DOI: 10.1067/mai.2003.1463] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although food allergy is a serious health problem in westernized countries, factors influencing the development of food allergy are largely unknown. Appropriate murine models of food allergy would be useful in understanding the mechanisms underlying food allergy in human subjects. OBJECTIVE We sought to determine the susceptibility of different strains of mice to food hypersensitivity. METHODS C3H/HeJ and BALB/c mice were sensitized to cow's milk (CM) or peanut by means of intragastric administration, with cholera toxin as a mucosal adjuvant. Mice were then challenged with CM or peanut. Antigen-specific IgE levels, anaphylactic symptoms, plasma histamine levels, and splenocyte cytokine profiles of these 2 strains were compared. RESULTS CM-specific IgE levels were significantly increased only in the C3H/HeJ strain, 87% of which exhibited systemic anaphylactic reactions accompanied by significantly increased plasma histamine levels in response to challenge. BALB/c mice exhibited no significant CM-specific IgE response, increased plasma histamine levels, or anaphylactic symptoms. After peanut challenge, 100% of peanut-sensitized C3H/HeJ mice exhibited high levels of peanut-specific IgE and anaphylactic symptoms. In contrast, no hypersensitivity reactions were detected in BALB/c mice, despite the presence of significant serum peanut-specific IgE levels. Splenocytes from CM- and peanut-sensitized C3H/HeJ mice exhibited significantly increased IL-4 and IL-10 secretion, whereas splenocytes from BALB/c mice exhibited significantly increased IFN-gamma secretion. CONCLUSION Induction of food-induced hypersensitivity reactions in mice is strain dependent, with C3H/HeJ mice being susceptible and BALB/c mice being resistant. This strain-dependent susceptibility to food allergy is associated with differential T(H)2-T(H)1 responses after intragastric food allergen sensitization.
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Affiliation(s)
- Vivian Morafo
- Department of Pediatrics, Mount Sinai School of Medicine, New York 10029-6574, USA
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Li XM, Kleiner G, Huang CK, Lee SY, Schofield B, Soter NA, Sampson HA. Murine model of atopic dermatitis associated with food hypersensitivity. J Allergy Clin Immunol 2001; 107:693-702. [PMID: 11295660 DOI: 10.1067/mai.2001.114110] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is an eczematous skin eruption that generally begins in early infancy and affects up to 12% of the population. The cause of this disorder is not fully understood, although it is frequently the first sign of atopic disease and is characterized by an elevated serum IgE level, eosinophilia, and histologic tissue changes characterized early by spongiosis and a CD4(+) T(H)2 cellular infiltrate. Hypersensitivity to foods has been implicated as one causative factor in up to 40% of children with moderate-to-severe AD. OBJECTIVE The purpose of this study was to establish a murine model of food-induced AD. METHODS Female C3H/HeJ mice were sensitized orally to cow's milk or peanut with a cholera toxin adjuvant and then subjected to low-grade allergen exposure. Histologic examination of skin lesions, allergen-specific serum Ig levels, and allergen-induced T-cell proliferation and cytokine production were examined. RESULTS An eczematous eruption developed in approximately one third of mice after low-grade exposure to milk or peanut proteins. Peripheral blood eosinophilia and elevated serum IgE levels were noted. Histologic examination of the lesional skin revealed spongiosis and a cellular infiltrate consisting of CD4(+) lymphocytes, eosinophils, and mast cells. IL-5 and IL-13 mRNA expression was elevated only in the skin of mice with the eczematous eruption. Treatment of the eruption with topical corticosteroids led to decreased pruritus and resolution of the cutaneous eruption. CONCLUSION This eczematous eruption resembles AD in human subjects and should provide a useful model for studying immunopathogenic mechanisms of food hypersensitivity in AD.
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Affiliation(s)
- X M Li
- Department of Pediatrics, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA
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35
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Rosenberg NM, Vergara TM, Kleiner G, Schubert CJ, Kunkel NC. Antibiotic conundrum. Pediatr Emerg Care 2000; 16:61-4. [PMID: 10698150 DOI: 10.1097/00006565-200002000-00020] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- N M Rosenberg
- Division of Emergency Services, Children's Hospital of Michigan, Detroit, USA
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36
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Auci DL, Kleiner G, Sheikh A, Acosta E, Athanassiadies TJ, Murali MR, Durkin HG. Cytokine-induced suppression and potentiation of hapten-specific immediate hypersensitivity responses. Immunol Invest 1993; 22:205-18. [PMID: 7685321 DOI: 10.3109/08820139309063403] [Citation(s) in RCA: 2] [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: 01/26/2023]
Abstract
The ability of subcutaneously (s.c.) injected cytokines (IL-4, IL-5, IL-6, IFN alpha, IFN gamma, GMCSF) to regulate the induction of hapten-specific immediate hypersensitivity (IH) responses was studied in BPO-KLH (benzylpenicilloyl-keyhole limpet hemocyanin) sensitized BALB/c mice at the peak of a hapten-specific IgE antibody forming cell (AFC) response. To induce IH responses, mice were injected in the right pinna with either BPO-BSA (benzylpenicilloyl-bovine serum albumin), BPO-KLH (0.01-1.0 micrograms/ml) or mcAb anti-IgE (0.001 - 1.0 micrograms/ml); and in the left pinna with an equal volume of saline (0.05 ml). Pinnae were measured 5 min to 4 hr later using a micrometer caliper. Treatment of mice with IL-4 or IFN gamma dramatically suppressed the induction of IH responses in dose dependent fashion. In contrast, treatment of mice with IL-6 and IFN alpha increased these responses in dose dependent fashion, while GMCSF and IL-5 had no effect. The suppression obtained with IL-4 and IFN gamma, and the increases seen with IL-6 and IFN alpha, were transient since these cytokines, as well as GMCSF and IL-5, had no effect on IH responses elicited 21 days after the peak of BPO-specific IgE AFC responses. The data suggest that cytokine mediated effects on IH responses occur via changes in serum levels of BPO-specific IgG1 or IgE, through direct or indirect effects of cytokines on mast cells or other cell types, or by affecting the ability of BPO-specific homocytotropic antibodies to bind to mast cell surfaces.
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Affiliation(s)
- D L Auci
- Department of Pathology, State University of New York Health Science Center, Brooklyn 11203
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37
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Kleiner G. [Family caring for family. Experiences with a discussion circle for nursing family members]. Dtsch Krankenpflegez 1991; 44:554-7. [PMID: 1914879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
We have characterized four IgG monoclonal antibodies (mAbs) derived from BALB/c mice that bind double-stranded DNA (dsDNA) with high affinity. The hydridomas were selected for expression of a member of the VHS107 family. Three of the four cell lines use the VH11 gene and one uses the VH1 gene. These antibodies exhibit many characteristics of pathogenic anti-DNA antibodies. They are high affinity and not broadly crossreactive. Unlike the anti-DNA antibodies in autoimmune mice, they exhibit no somatic mutation in their VH genes. These results demonstrate that somatic mutation of VHS107 genes is not necessary for generating high affinity dsDNA binding. The fact that such antibodies have not previously been reported suggests that they are rare and that their expression may be downregulated in both nonautoimmune and autoimmune individuals.
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Affiliation(s)
- R Shefner
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York 10461
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39
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Kleiner G, Greston WM. Inhibition of fibrinolysis and abruptio placentae. West J Med 1978. [DOI: 10.1136/bmj.2.6142.960] [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: 11/03/2022]
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40
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Abstract
The electrophoretic resolution of seven relatively polymorphic human gene-enzyme systems expressed in tissue culture cells can be used as a sensitive genetic monitor for intraspecific cell contamination. An identical genotype at each of the same allozyme loci provides a 95% (or greater) confindence estimate of the identity of two cultured lines, on the basis of the allelic frequencies of the seven enzyme loci in natural populations and in populations of independently derived cultured cells. Of 27 commonly used human cell lines examined, only one of 351 pairwise comparisons proved genetically indistinguishable.
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41
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Davis S, Boone CW, Radin R, Wade MJ, Kleiner G. Retention of significant antibody binding by surface antigens of feline leukemia cells (FLA) after fixation with formaldehyde and glutaraldehyde. Immunol Commun 1974; 3:189-96. [PMID: 4362771 DOI: 10.3109/08820137409055755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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42
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Kleiner G, Frenreisz S. Erythrozytenuntersuchungen bei Hyperthyreosen. Dtsch Med Wochenschr 1936. [DOI: 10.1055/s-0028-1141360] [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: 10/20/2022]
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