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Abstract
Checkpoint inhibitors are increasingly being used in clinical practice. They can cause various gastrointestinal, hepatic and pancreatic side effects. As these side effects can be serious, appropriate management is essential. The different checkpoint inhibitors with their mechanisms of action and indications, as well as evaluation and management of gastrointestinal, hepatic and pancreatic side effects, are discussed in this article.
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Affiliation(s)
- Monjur Ahmed
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA 19107, United States
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Pereira NDS, Queiroga TBD, Nunes DF, Andrade CDM, Nascimento MSL, Do-Valle-Matta MA, da Câmara ACJ, Galvão LMDC, Guedes PMM, Chiari E. Innate immune receptors over expression correlate with chronic chagasic cardiomyopathy and digestive damage in patients. PLoS Negl Trop Dis 2018; 12:e0006589. [PMID: 30044791 PMCID: PMC6078325 DOI: 10.1371/journal.pntd.0006589] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 08/06/2018] [Accepted: 06/06/2018] [Indexed: 12/23/2022] Open
Abstract
Chronic chagasic cardiomyopathy (CCC) is observed in 30% to 50% of the individuals infected by Trypanosoma cruzi and heart failure is the important cause of death among patients in the chronic phase of Chagas disease. Although some studies have elucidated the role of adaptive immune responses involving T and B lymphocytes in cardiac pathogenesis, the role of innate immunity receptors such as Toll-like receptors (TLRs) and Nod-like receptors (NLRs) in CCC pathophysiology has not yet been determined. In this study, we evaluated the association among innate immune receptors (TLR1-9 and nucleotide-binding domain-like receptor protein 3/NLRP3), its adapter molecules (Myd88, TRIF, ASC and caspase-1) and cytokines (IL-1β, IL-6, IL-12, IL-18, IL-23, TNF-α, and IFN-β) with clinical manifestation, digestive and cardiac function in patients with different clinical forms of chronic Chagas disease. The TLR8 mRNA expression levels were enhanced in the peripheral blood mononuclear cells (PBMC) from digestive and cardiodigestive patients compared to indeterminate and cardiac patients. Furthermore, mRNA expression of IFN-β (cytokine produced after TLR8 activation) was higher in digestive and cardiodigestive patients when compared to indeterminate. Moreover, there was a positive correlation between TLR8 and IFN-β mRNA expression with sigmoid and rectum size. Cardiac and cardiodigestive patients presented higher TLR2, IL-12 and TNF-α mRNA expression than indeterminate and digestive patients. Moreover, cardiac patients also expressed higher levels of NLRP3, ASC and IL-1β mRNAs than indeterminate patients. In addition, we showed a negative correlation among TLR2, IL-1β, IL-12 and TNF-α levels with left ventricular ejection fraction, and positive correlation between NLRP3 with cardiothoracic index, and TLR2, IL-1β and IL-12 with left ventricular mass index. Together, our data suggest that high expression of innate immune receptors in cardiac and digestive patients may induce an enhancement of cytokine expression and participate of cardiac and digestive dysfunction.
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Affiliation(s)
- Nathalie de Sena Pereira
- Department of Parasitology, Federal University of Minas Gerais, Minas Gerais, Belo Horizonte, Brazil
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Natal, Brazil
- School of Health, Potiguar University, Natal, RN, Brazil
| | | | - Daniela Ferreira Nunes
- Department of Parasitology, Federal University of Minas Gerais, Minas Gerais, Belo Horizonte, Brazil
| | - Cléber de Mesquita Andrade
- Department of Biomedical Sciences, University of Rio Grande do Norte State, Rio Grande do Norte, Mossoró, Brazil
| | | | | | | | | | - Paulo Marcos Matta Guedes
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Natal, Brazil
| | - Egler Chiari
- Department of Parasitology, Federal University of Minas Gerais, Minas Gerais, Belo Horizonte, Brazil
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Ivashkinl VT, Sheptulina AF, Raĭkhelson KL, Losik EA, Ivashkin KV, Okhlobystin AV, Baranskaia EK, Polouvektova EA, Shifrin OS. [Autoimmune Diseases of Digestive System]. ACTA ACUST UNITED AC 2015:139-51. [PMID: 26234085 DOI: 10.15690/vramn.v70i2.1306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Autoimmune diseases of digestive system refer to pathological conditions, caused by autoimmune mechanisms, and their etiology remains unknown. This is a group of relatively rare diseases, however, during the last years a marked tendency towards the raise in incidence andprevalence is observed, which led to an increase in number of clinical investigations on etiology, pathogenesis, and, accordingly, development of new diagnostic methods and therapies. Results of such trials shown, for example, that the pathogenesis of chronic cholestatic liver diseases is associated with nuclear receptors function, while the main etiological and pathogenic factor of inflammatory bowel diseases represents gut microbiota. Despite new achievements in autoinmune diseases of digestive system research, therapies are low effective and are accompanied by a huge number of adverse events. The fact that these diseases may lead to malignant tumors is also worth noting. For example, patients with primary sclerosing cholangitis have a 160 times higher risk of cholangiocellular carcinoma, while 10-14% ofpatients with celiac disease may develop malignancies of esophagus, small and large intestine. Thus, these diseases require further investigation with a purpose of more accurate diagnostic methods for the detection of disease at early stages and new effective and safe therapies development.
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Sincu NI, Mocan S, Chiriac LC, Băţagă S. An endoscopic and pathological survey of digestive tract disorders in patients infected with human immunodeficiency virus monitored in the Clinic of Infectious Diseases from Tirgu Mures, Romania. Rom J Morphol Embryol 2014; 55:885-890. [PMID: 25329116] [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: 06/04/2023]
Abstract
UNLABELLED Gastrointestinal symptoms are among the most frequent complaints of patients infected with human immunodeficiency virus (HIV). PURPOSE An endoscopic and histopathological survey of digestive tract diseases among HIV-infected patients monitored in the Clinic of Infectious Diseases I from Tirgu Mures, Romania. MATERIALS AND METHODS Retrospective, observational study, on a group of 38 HIV-positive patients admitted to the Clinic of Infectious Diseases I from Tirgu Mures, Romania, during 2006-2013, undergoing upper/lower endoscopy. We collected data regarding the results of endoscopy and histopathological examination, CD4+ T-lymphocytes levels, microbiological examinations and outcome. Statistical analysis, performed by using Microsoft Office Excel 2007 and GraphPad Prism 5 programs, included contingency tables analysis and comparing means. RESULTS Our study depicted a variety of digestive disorders among HIV-infected patients, ranging from opportunistic infections to HIV enteropathy and non-HIV-associated conditions. The presence of Candida esophagitis implied significantly lower levels of CD4+ T-cells (p=0.0043). We found a statistically significant negative association between antiretroviral therapy and the presence of opportunistic infections (p=0.0375, OR=0.2030, 95% CI 0.0423-0.9741). Thirteen (34.21%) patients died, mostly due to tuberculosis and central nervous system infections. All were diagnosed with acquired immunodeficiency syndrome (AIDS). CONCLUSIONS HIV-infected patients experience a wide variety of digestive tract disorders, both AIDS-defining illnesses and non-HIV-associated conditions. Gastrointestinal opportunistic infections occur more often among patients with low CD4+ T-cells levels and in those not receiving antiretroviral therapy. Although digestive conditions did not represent direct causes of death in our study, they may predict an unfavorable outcome in AIDS-stage patients.
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Affiliation(s)
- Nina-Ioana Sincu
- Department of Infectious Diseases, University of Medicine and Pharmacy of Tirgu Mures, Romania;
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Dolgushina AI, Shaposhnik II, Volchegorskiĭ IA. [Clinical and immunological study of the relationship of the digestive system chronic diseases and atherosclerosis in the basin of the abdominal aorta in elderly patients]. Eksp Klin Gastroenterol 2014:19-24. [PMID: 25842658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Paper describes clinical and immunological study about the relationship between chronic diseases of the digestive system and atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age. There were revealed the structural and clinical features of the gastrointestinal tract diseases, depending on the extent of atherosclerosis in the basin of the abdominal aorta. Evaluation of the immune status included the determination of lymphocyte subpopulation composition, the functional state of neutrophils and cytokine levels. It is found that the progression of atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age with chronic diseases of the digestive system was accompanied by the activation of pro-inflammatory mechanisms of the immune system and the accompanying intensification of oxidative stress.
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Mondoulet L, Dioszeghy V, Larcher T, Ligouis M, Dhelft V, Puteaux E, Cherel Y, Letourneur F, Dupont C, Benhamou PH. Epicutaneous immunotherapy (EPIT) blocks the allergic esophago-gastro-enteropathy induced by sustained oral exposure to peanuts in sensitized mice. PLoS One 2012; 7:e31967. [PMID: 22363776 PMCID: PMC3283696 DOI: 10.1371/journal.pone.0031967] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/18/2012] [Indexed: 12/19/2022] Open
Abstract
Background Food allergy may affect the gastrointestinal tract and eosinophilia is often associated with allergic gastrointestinal disorders. Allergy to peanuts is a life-threatening condition and effective and safe treatments still need to be developed. The present study aimed to evaluate the effects of sustained oral exposure to peanuts on the esophageal and jejunal mucosa in sensitized mice. We also evaluated the effects of desensitization with epicutaneous immunotherapy (EPIT) on these processes. Methods Mice were sensitized by gavages with whole peanut protein extract (PPE) given with cholera toxin. Sensitized mice were subsequently exposed to peanuts via a specific regimen and were then analysed for eosinophilia in the esophagus and gut. We also assessed mRNA expression in the esophagus, antibody levels, and peripheral T-cell response. The effects of EPIT were tested when intercalated with sensitization and sustained oral peanut exposure. Results Sustained oral exposure to peanuts in sensitized mice led to severe esophageal eosinophilia and intestinal villus sub-atrophia, i.e. significantly increased influx of eosinophils into the esophageal mucosa (136 eosinophils/mm2) and reduced villus/crypt ratios (1.6±0.15). In the sera, specific IgE levels significantly increased as did secretion of Th2 cytokines by peanut-reactivated splenocytes. EPIT of sensitized mice significantly reduced Th2 immunological response (IgE response and splenocyte secretion of Th2 cytokines) as well as esophageal eosinophilia (50 eosinophils/mm2, p<0.05), mRNA expression of Th2 cytokines in tissue - eotaxin (p<0.05), IL-5 (p<0.05), and IL-13 (p<0.05) -, GATA-3 (p<0.05), and intestinal villus sub-atrophia (2.3±0.15). EPIT also increased specific IgG2a (p<0.05) and mRNA expression of Foxp3 (p<0.05) in the esophageal mucosa. Conclusions Gastro-intestinal lesions induced by sustained oral exposure in sensitized mice are efficaciously treated by allergen specific EPIT.
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Affiliation(s)
- Lucie Mondoulet
- DBV Technologies, Pépinière Santé Paris Cochin, Paris, France.
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Ren X, Wen X, Hong B, Liao Y, Ma W, Tang Y. [Effects of Sanren decoction on Th1/Th2 cytokines in rats with spleen-stomach damp-heat syndrome]. Nan Fang Yi Ke Da Xue Xue Bao 2012; 32:181-184. [PMID: 22381753] [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: 05/31/2023]
Abstract
OBJECTIVE To investigate the effects of Sanren decoction on the immune function of rats with spleen-stomach damp-heat (DHSS) syndrome. METHODS Fifty male SD rats were randomly allocated into normal control group, DHSS model group, and 3 Sanren decoction groups (high, medium and low doses). The effects of the decoction on the body mass, rectal temperature (RT), water and food intake, histopathological changes of the gastrointestinal mucosa and serum levels of interleukin (IL)-4 and interferon (IFN)-γ were evaluated. RESULTS The serum levels of IFN-γ and IL-4 in the model group significantly increased compared with those in the control group (P<0.01), with a slightly increased IFN-γ/IL-4 ratio (P>0.05). Sanren decoction obviously reduced the rectal temperature and significantly decreased the production of both cytokines. High-dose Sanren decoction caused more markedly decreased IL-4 level (P<0.05) to result in a significantly increased IFN-γ/IL-4 ratio (P<0.05). CONCLUSIONS A shift of Th1/Th2 balance toward Th1 immune response is demonstrated in rats with DHSS syndrome, and Sanren decoction produces a protective effect on the gastrointestinal mucosa by immunoregulation.
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Affiliation(s)
- Xi Ren
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
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Ishizuka T, Fukuzawa Y, Ando T, Goto H, Ohno Y, Hakamata Y, Matsumoto K, Usui Y, Morita H, Ohno Z. [Report from the 12th Tokai Chapter Educational Seminar: immunological abnormalities in disorders of internal medicine]. Nihon Naika Gakkai Zasshi 2011; 100:3373-3380. [PMID: 22250435 DOI: 10.2169/naika.100.3373] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Tatsuo Ishizuka
- Department of General Internal Medicine, Gifu University Graduate School of Medicine, Japan
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Hodgkinson L. Digestive Disease Week 2010. Turning Science into Medicine--part 2. IDrugs 2010; 13:424-426. [PMID: 20582861] [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: 05/29/2023]
Abstract
The Digestive Disease Week 2010 conference, held in New Orleans, included topics covering new therapeutic developments in the field of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. This conference report highlights selected presentations on the apolipoprotein E-mimetic peptide COG-112 (Cognosci Inc) for the potential treatment of Citrobacter rodentium-induced colitis; the inhibition of sphingosine kinase with ABC-294640 (Apogee Biotechnology Corp) to alleviate stress after hepatic ischemia-reperfusion injury; TLR4 targeting with NI-0101 (NovImmune SA) to prevent colitis-associated cancer; immunization against TNF with TNFalpha kinoid (Neovacs SA) for the treatment of patients with Crohn's disease; and preclinical studies with the anti-inflammatory agent minnelide (University of Minnesota) for the treatment of pancreatic cancer.
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Weber J. Ipilimumab: controversies in its development, utility and autoimmune adverse events. Cancer Immunol Immunother 2009; 58:823-30. [PMID: 19198837 PMCID: PMC11030858 DOI: 10.1007/s00262-008-0653-8] [Citation(s) in RCA: 177] [Impact Index Per Article: 11.8] [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] [Received: 12/02/2008] [Revised: 12/23/2008] [Accepted: 12/30/2008] [Indexed: 12/13/2022]
Abstract
A promising new class of anti-cancer drugs includes antibodies that mediate immune regulatory effects. It has become very clear over the last decade that different types of immune cells and different pathways serve to suppress anti-cancer immunity, particularly in the microenvironment of the tumor. The first examples of immune modulating antibodies are those directed against cytotoxic T lymphocyte antigen-4 (CTLA-4), a molecule present on activated T cells. Human antibodies that abrogate the function of CTLA-4 have been tested in the clinic and found to have clinical activity against melanoma. In this review, we discuss some of the controversies surrounding the potential clinical utility of one of those antibodies, ipilimumab, formerly MDX-010, from Medarex and Bristol Myers Squibb. The optimal dose and schedule of ipilimumab was derived in multiple clinical trials whose latest results are described below. Favorable survival in patients with stage IV melanoma were observed that appear to be associated with unique side effects of the drug called "immune-related adverse events". The management of these side effects is described, and the unusual kinetics of anti-tumor response with ipilimumab as well as a newly proposed schema for assessing anti-tumor responses in patients receiving biologic compounds like ipilimumab, which may supercede RECIST or WHO criteria, are addressed.
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Affiliation(s)
- Jeffrey Weber
- H. Lee Moffitt Cancer Center and Research Institute, Donald A. Adam Comprehensive Melanoma Research Center, Department of Oncologic Sciences, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Tsaregorodtseva TM, Serova TI, Vinnitskaia EV, Sabel'nikova EA, Berezina OV. [Autoimmune reactions in diseases of the digestive system organs]. TERAPEVT ARKH 2009; 81:68-71. [PMID: 19334495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM To examine content, diagnostic and prognostic role of autologous antibodies in gastrointestinal diseases (GID). MATERIAL AND METHODS Enzyme immunoassay was used to measure content of autologous antibodies to N+/K+ ATPase (Aab) of gastric parietal cells, mitochondria, microsomes, tissue transglutaminase in blood serum of 196 patients with gastric, gallbladder, small and large intestinal diseases. Aab relations with heterologous antibodies were studied with kits provided by Bektor-Best (Novosibirsk), DRG-Diagnostics, Orgentec (Germany) and others. RESULTS In GID high circulation of Aab to parietal cells (Ab-PC) was detected in 42% cases, mean content being 217 +/- 32.4 U/ml, 10 U/ml in the control. Maximal concentration (180 = 340 U/ml) occurred in hepatic cirrhosis, celiac disease, atrophic gastritis. In exacerbations of pancreatitis, colelithiasis and duodenal ulcer ab-PC concentration was 190-210 U/ml, in remission--6-12 U/ml. Minimal concentration (8-38 U/ml) was seen in polyps, gastric cancer, nonspecific ulcerative colitis. For primary biliary cirrhosis more typical was high A/ab concentration to mitochondria (in 83%; 200 U.ml), for autoimmune hepatitis--Aab to microsomes (in 81%; 170 U/ml), in celial disease--Aab to tissue transglutaminase (93%, 75 U/ml). High autoantibodies concentration in GID is accompanied with overcirculation of heteroantibodies to infectious-toxic agents confirming their role in development of autoimmune processes. CONCLUSION GID are associated with high circulation of autologous antibodies--markers of systemic humoral autoimmune reactions differing in duration, severity, site of lesion, form, stage, disease duration. Maximal detection rate and concentration of serum autologous antibodies were observed in hepatic cirrhosis, active hepatitis, celiac disease, atrophic gastritis, exacerbations of cholelithiasis, ulcer, pancreatitis. Estimation of Aab concentration is essential for diagnosis, prognosis of autoimmune diseases, it reflects intensity and duration of autoimmune reactions in GID.
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Shilova LN, Gontar' IP, Zborovskaia IA, Moskvitina OV. [Antibodies to enzymes of purine metabolism as a factor of gastrointestinal tract lesions in systemic scleroderma]. Eksp Klin Gastroenterol 2009:4-7. [PMID: 19551958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Antibodies to Adenosine Deaminase (AD) and Guanin Deaminase (GDA) were founded in sera of systemic sclerosis (SS) patients, their concentration positive correlated with activity of disease. Increased levels of antibodies to AD and GDA correlated with the severity of gastrointestinal tract injury (especially pancreatitis and hepatitis). It is shown that level of antibodies to AD and GDA differs reliable from contents of these antibodies, in sera of healthy persons. It is shown that AD enzymatic activity was decreased, while activity of GDA was increased. The antibodies to enzymes may be one of the possible causes of change of enzymes activity in sera of SS patients. The method of immunoenzyme determination of level of antibodies to AD, G on the basis of immobilized form of magnet sorbent was developed for immune diagnostics of SS.
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Cassinotti A, Birindelli S, Clerici M, Trabattoni D, Lazzaroni M, Ardizzone S, Colombo R, Rossi E, Porro GB. HLA and autoimmune digestive disease: a clinically oriented review for gastroenterologists. Am J Gastroenterol 2009; 104:195-217; quiz 194, 218. [PMID: 19098870 DOI: 10.1038/ajg.2008.10] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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: 12/11/2022]
Abstract
OBJECTIVES The human leukocyte antigen (HLA) system includes genes involved in graft-vs-host rejection and in immune response. The discovery that HLAs are associated with several diseases led to appealing developments both in basic biomedical research and in clinical medicine, and offered the opportunity to improve the understanding of pathogenesis and classification of diseases, as well as to provide diagnostic and prognostic indicators. The aim of this article is to review the association between HLA alleles and autoimmune digestive disease and its current relationship with modern HLA nomenclature and clinical practice. METHODS Articles dealing with the association between HLAs and autoimmune digestive disease (including celiac disease, inflammatory bowel disease, autoimmune hepatitis, sclerosing cholangitis and primary biliary cirrhosis) were searched for using Pubmed and SCOPUS databases from earliest records to January 2008. RESULTS The review has provided two sections. In the first, we explain the basic principles of HLA structure, function, and nomenclature, as an introduction to the second section, which describes current associations between HLA alleles and digestive diseases. The clinical implications of each HLA association are critically discussed. Actually, a clinical role for HLA typing is suggested for only a few conditions, e.g., celiac disease. CONCLUSIONS The knowledge of current HLA nomenclature and of its association with some digestive diseases such as celiac disease can be useful in clinical practice for diagnostic and prognostic purposes. This can avoid improper HLA typing as well as stressing the need for further studies on other possible clinical applications.
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Affiliation(s)
- Andrea Cassinotti
- Department of Clinical Science, Division of Gastroenterology, L. Sacco University Hospital, via G.B.Grassi 74, Milan, Italy.
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Gil'miiarova FN, Radomskaia VM, Gergel' NI, Gusiakova OA, Zubova IA, Sidorova IF, Sazonova OV, Kolesova TA. [Role of alimentary factors in development of digestive system diseases]. Vopr Pitan 2009; 78:62-66. [PMID: 19663306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In work the data are presented, which characterize the connection of a diet with disease of illnesses of digestive organs which rises in process of increase of products that contain gluten and meat reduction in diet. Immune reaction is found out, that shows the appearance of antibodies. A gladin and fabric transglutaminaze. Reaction characteristics are different in people with different blood groups.
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Abstract
IgA-nephropathy is the most common primary chronic glomerulonephritis worldwide. Beside the primary IgA-nephropathy (IgA-nephropathy with an unknown origin), there are more and more cases, which are associated with diseases of other organs. Although the causality is often not obvious, these forms are called secondary IgA-nephropathy. In this study, the authors cover only the secondary forms of IgA-nephropathy with relation to gastroenterology in a broader sense that includes the liver. They would like to draw the attention to the necessity of analyzing also the associate occurrence of gastrointestinal diseases (principally liver diseases, coeliac disease, Crohn's disease, ulcerative colitis) in patients with IgA-nephropathy, as well. They think that it would be expedient to organize a nationwide clinical analysis that would search the frequency of occurrence of IgA-nephropathy in the above mentioned gastrointestinal diseases.
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Affiliation(s)
- Nóra Szigeti
- Pécsi Tudományegyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika és Nefrológiai Centrum, Pécs.
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Tsaregorodtseva TM, Serova TI. [Diagnostic and prognostic value of humoral immune status indices for alimentary system diseases]. Eksp Klin Gastroenterol 2007:93-9, 144-5. [PMID: 17539352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The paper describes the results of studying the immune status of 1,960 patients with stomach, pancreas, liver, gall bladder, small and large intestine disorders, who were treated in the Central Research Institute of Gastroenterology. The results of the study demonstrate that alimentary system diseases are concomitant with changes in the functional activity of the immune system and development of the systemic immune response aimed at the neutralization and elimination of pathogenic agents. Impaired regulatory and efferent lymphocyte capacities, increased synthesis of cytokines, immunoglobulins, heterologous (anti-viral, anti-bacterial or antigliadin), autologous (to parietal cells, microsome mitochondria, tissue transglutaminase) antibodies, formation of immune complexes, autoimmune reactions and secondary immunodeficiency are specific immune mechanisms of the pathological process development, its synchronization and progression in patients with alimentary system diseases. Changes in the immunological status indices are expressed in varying degree depending on the organ involved, etiological factor, clinical course and stage of the disease, as well as treatment used. The immunological status indices have maximal values in cases of chronic hepatitis, hepatic cirrhosis, peptic or duodenal ulcer, cholelithiasis, chronic pancreatitis, gluten-sensitive enteropathy and minimal values in cases of chronic gastritis, gastroesophageal disease, steatohepatitis and irritable bowel syndrome. These data are sufficient for developing an algorithm of immune diagnostics for a number of alimentary system diseases. The study of immune status indices is of great diagnostic and prognostic value as it defines the etiological factor, intensity of inflammatory, infectious and autoimmune processes as well as disease stage and activity, its forecast and the efficacy of treatment of alimentary system diseases.
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Abstract
The intestinal microflora is a positive health asset that crucially influences the normal structural and functional development of the mucosal immune system. Mucosal immune responses to resident intestinal microflora require precise control and an immunosensory capacity for distinguishing commensal from pathogenic bacteria. In genetically susceptible individuals, some components of the flora can become a liability and contribute to the pathogenesis of various intestinal disorders, including inflammatory bowel diseases. It follows that manipulation of the flora to enhance the beneficial components represents a promising therapeutic strategy. The flora has a collective metabolic activity equal to a virtual organ within an organ, and the mechanisms underlying the conditioning influence of the bacteria on mucosal homeostasis and immune responses are beginning to be unravelled. An improved understanding of this hidden organ will reveal secrets that are relevant to human health and to several infectious, inflammatory and neoplastic disease processes.
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Affiliation(s)
- Ann M O'Hara
- Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
| | - Fergus Shanahan
- Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
- Department of Medicine, University College Cork, National University of Ireland, Cork, Ireland
- Tel: + 353 21 4901226; Fax: + 353 21 4345300
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Abstract
Food allergies are increasing in incidence, and the variety of triggering antigens is widening. There is also an increased recognition of the breadth of immunologically mediated responses to dietary antigens; the area of non-IgE-mediated food allergy is belatedly acquiring scientific respectability, aided by improved clinical recognition and basic scientific studies. The role of mucosal mast cells and eosinophils in intestinal allergic responses is now better recognized, and conditions such as eosinophilic oesophagitis are more prevalent than previously thought. However, the diagnostic difficulties of non-IgE-mediated allergies remain challenging.
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Affiliation(s)
- Simon H Murch
- Warwick Medical School, Clinical Sciences Research Institute, Coventry, UK.
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Korot'ko GF. [Modern problems of physiology and pathology of digestion]. Ross Fiziol Zh Im I M Sechenova 2003; 89:1582-4. [PMID: 14870497] [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: 04/28/2023]
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Abstract
BACKGROUND Sepsis is a major complication associated with increased morbidity and mortality in patients treated surgically for hepatobiliary and colorectal diseases. Impairment of immune function after surgery may be one of the mechanisms causing increased susceptibility to infection. From November 1999 to October 2001, the perioperative and postoperative immune responses of 20 patients who underwent laparoscopy were compared with those of 20 patients who underwent laparotomy. All the patients were affected by benign pathologies. The current study aimed to elucidate the differences between the immune responses induced by the two different surgical approaches. METHODS Immunologic function was assessed by a count of lymphocyte subsets (CD3, CD4, CD8, CD3-HLA-DR, CD19, CD16, CD57) and monocytes expressing human leukocyte antigen DR (HLA-DR). Blood samples were obtained 1 day before the surgical therapy, then 2 and 8 days after therapy. For statistical analysis, the continuous variables were compared using Student's t-test. Probability values less than 0.05 were considered significant. RESULTS With regard to T-lymphocyte function, a fall 2 days after surgery was assessed for both laparoscopy (p < 0.0005) and laparotomy (p < 0.00003) groups. At 8 days after surgery, these values had returned to the preoperative level on both groups. The activity of B-cells and natural killer cells was not significantly affected, whereas the number of monocytes expressing HLA-DR showed a long-lasting decrease after laparotomy (p < 0.011 2 days after surgery and p < 0.02 8 days after surgery), but not after laparoscopy. CONCLUSION Impairment of cell-mediated immune function after surgery was demonstrated especially in patients treated by laparotomy, as compared with those treated by laparoscopy.
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Affiliation(s)
- G Bolla
- Department of Surgery, Ospedale Civile of Dolo, Riviera 29 Aprile 2, 30031 Dolo, VE, Venice, Italy
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21
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Braham A, Safer L, Bdioui F, Lejmi A, Brahmi I, Ben Chabenne N, Ben Mimoun H, Saffar H. [Antiphospholipid antibodies in digestive diseases]. Presse Med 2001; 30:1890-7. [PMID: 11791401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
UNLABELLED DIAGNOSIS AND PROGNOSIS: Antiphospholipids comprise a very heterogeneous group of auto-antibodies including anticardiolipids demonstrated by immunological methods and lupus anticoagulants detected by coagulation tests. Antiphospholipids are encountered in various conditions other than dysimmune disease and are frequently involved in thrombotic manifestations. We discuss here the implications of these antibodies in digestive tract diseases and present an analysis of their diagnostic and prognostic value for optimal therapeutic and monitoring approaches. CLINICAL MANIFESTATIONS The risk of thrombosis is high in patients with cryptogenetic inflammatory bowel disease. The prevalence of antiphospholipid antibodies (AcAPL) is abnormally high in these patients, but their contribution to the development of thrombosis remains controversial. Patients with liver disease generally exhibit coagulation disorders, with paradoxical thrombotic manifestations. AcAPL are strongly implicated in the development of thrombosis, particularly in patients with alcoholic liver disease, hepatitis C, regenerative nodular hyperplasia, and cirrhosis, independently of the presence of an associated hepatocellular carcinoma. Antiphospholipid syndrome is considered to be the second leading cause of non-tumor-related Budd-Chiari syndrome, after myeproliferative syndromes. Likewise for portal or mesenteric vein thrombosis where antiphospholipid antibodies would be involved in the causal mechanism. UNDERLYING MECHANISMS Due to the diversity of these antibodies, it is unlikely that a unique mechanism could explain all the different thrombotic manifestations associated with their presence.
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Affiliation(s)
- A Braham
- Service de Gastro Hépato Entérologie, EPS Fattouma Bourguiba, Monastir 5000, Tunisie
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22
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Pár A. [Gastrointestinal immunology]. Orv Hetil 2001; 142:2357-67. [PMID: 11760453] [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: 02/23/2023]
Abstract
The paper is devoted to the actual questions of gastrointestinal immunology. In the first part, structure and function of gut-associated mucosal tissue (GALT), including the role of secretory immunoglobulins and importance of oral tolerance are shown. In the second part, the pathogenesis of unknown origin gastrointestinal and liver diseases (gluten sensitive enteropathy, inflammatory bowel diseases, autoimmune liver diseases, autoimmune pancreatitis) is described. Then the immunology of some gastrointestinal infections (Helicobacter pylori, hepatitis virus B and C, and HIV) and of alcoholic and drug induced, liver diseases is briefly summarized.
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Affiliation(s)
- A Pár
- Pécsi Tudományegyetem Altalános Orvostudományi Kar, I. Belgyógyászati Klinika
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23
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Abstract
One of the most significant extraintestinal manifestations of gastrointestinal diseases is rheumatologic disorders. The gastrointestinal diseases with rheumatologic manifestations can be divided into two major categories: intestinal disorders and disorders of the liver, biliary tree, and pancreas. The cause of diseases in each of these categories is different. Although intestinal permeability and immune responsiveness are frequently implicated in disorders of the intestine, diseases of the liver, biliary tree, and pancreas usually involve the production of autoantibodies, cytokines, or enzymes. Treatment of rheumatologic complications frequently involves therapy directed at the underlying gastrointestinal disease.
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Affiliation(s)
- J P Katz
- Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, USA
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24
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Haupt W, Zirngibl H, Klein P, Riese J, Hohenberger W. Reduced TNFalpha and IL-6 production in patients who mount a preoperative acute phase response. Langenbecks Arch Surg 1998; 383:71-4. [PMID: 9627174 DOI: 10.1007/s004230050094] [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: 02/07/2023]
Abstract
BACKGROUND/AIMS In some patients postoperative infective complications are related to a reduced resistance to the operative trauma and the perioperative microbiological challenge. To investigate preoperative alterations in the immune responses in patients who had mounted an acute-phase response before the operation, we measured the capacity of tumor necrosis factor alpha and interleukin-6 production in whole blood. PATIENTS/METHODS Serum concentrations of C-reactive protein, alpha1-antitrypsin, albumin, and prealbumin were measured in 89 patients submitted for major abdominal surgery on their admission to hospital. RESULTS In 23 patients (26%) we found concentrations of at least one, and in 16 patients (18%) of two or more of these variables beyond the reference range. Patients who mounted an acute-phase response released 37% less TNFalpha (1339 vs. 848 pg/ml) and 31% less IL-6 (24293 vs. 16900 pg/ml) when whole blood was stimulated with lipopolysaccharide 0.5 microg/ml. CONCLUSION Patients who mount an acute-phase response before operation may thus have a downregulated immune response at the level of proinflammatory cytokines. This is likely to alter their resistance to invasive micro-organisms in the perioperative period.
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Affiliation(s)
- W Haupt
- Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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25
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Abstract
As the immunocompromised patient population grows, the gastrointestinal surgeon is increasingly called upon to make complex diagnostic and therapeutic decisions. The surgeon should first identify the patient as immunocompromised and then categorize the probable degree of immunocompromise as mild, moderate, or severe. Mildly immunocompromised patients tend to present late and with minimal symptoms, but the disease entities are the same ones seen in the general population. Moderately and severely immunocompromised patients may also develop the usual surgical problems, but the differential diagnosis is expanded to include complications of the immunocompromised state or complications of the underlying problem which caused the immune compromise. The expanded differential diagnosis includes infections with atypical organisms, opportunistic neoplasms, neutropenic enterocolitis, complications of medications, and forms of biliary tract disease not seen in the general population. Advances in oncology, transplantation, and the treatment of AIDS, have extended the life expectancy of these patients and increased the immunocompromised population. Prompt appropriate operative therapy may be lifesaving when surgical complications develop.
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Affiliation(s)
- C E Scott-Conner
- Department of Surgery, University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1086, USA
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26
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Pezzilli R, Billi P, Fiocchi M, Beltrandi E, Cappelletti O, Sprovieri G, Miglioli M. Serum beta 2-microglobulin in chronic diseases of the pancreas. Int J Pancreatol 1995; 17:161-6. [PMID: 7622938 DOI: 10.1007/bf02788534] [Citation(s) in RCA: 7] [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: 01/26/2023]
Abstract
Elevated serum concentrations of beta 2-Microglobulin (beta 2-MG) has been reported in a variety of chronic diseases and solid tumors. We determined serum beta 2-MG concentrations in 140 subjects divided into five groups: group 1, 34 patients with proven chronic pancreatitis, 8 of whom were studied during a painful relapse; group 2, 40 patients with pancreatic cancer staged according to the Cubilla-Fitzgerald classification; group 3, 40 healthy subjects; group 4, 10 patients with digestive nonpancreatic carcinomas; group 5, 16 patients with benign digestive nonpancreatic diseases. Serum soluble interleukin-2 receptor (sIL-2R) was also determined in all patients with pancreatic diseases as an index of immune system activation. In addition, serum CA 19-9 was assayed in patients of groups 2 and 4, and C-reactive protein (CRP) of groups 1 and 5. Renal function, evaluated by serum creatinine determination, was normal in all subjects studied. Patients with pancreatic cancer and those with chronic pancreatitis had serum concentrations of beta 2-MG significantly higher than those of healthy subjects (p < 0.001 and p < 0.005, respectively). Patients with stage I and stage III pancreatic cancer had similar serum levels of beta 2-MG, and these concentrations were significantly lower than those of patients with stage II tumors (p < 0.002 and p < 0.05, respectively). In chronic pancreatitis patients, those studied during painful relapse of the disease had serum concentrations of beta 2-MG similar to those studied during clinical remission.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Pezzilli
- Laboratorio Centralizzato, Ospedale S. Orsola-M. Malpighi, Bologna, Italy
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27
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Luniakov AS, Shirina LI, Kruglik VI, Shatskaia NG. [Use of new domestic foodstuffs in the treatment of digestive system diseases with food intolerance]. Vopr Pitan 1993:25-7. [PMID: 8042307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A clinical trial has been performed of the food Unipit-3 and Laktanal based on cow milk proteins subjected to enzymic hydrolysis, dia- and ultrafiltration. A preliminary immunochemical assay of the above products protein component and its testing in anaphylactic shock reaction in animals demonstrated low sensitizing activity of this protein. The results of the trial of the above hypoallergenic foods in patients with food allergy showed their good tolerance and therapeutic efficacy.
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28
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Bychkova NG, Perederiĭ VG, Fomina AA. [The T- and B-immunity systems in patients with digestive organ diseases and exposure to internal radiation]. Vrach Delo 1991:17-20. [PMID: 1801424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Results are reported of an immunological examination of 534 patients with digestive diseases and 130 healthy persons. 282 patients subjected to radiation effects showed a marked and persistent T-lymphocytopenia, B-lymphocytosis, reduction of the content of T-helpers, T-suppressors, dysimmunoglobulinemia characterized by reduction of IgG content and excessive IgA secretion. These changes were observed during the period of exacerbation and remission requiring the use of immunocorrective agents.
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29
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Abstract
The serum levels of tumour marker CA 125 were measured in 162 patients with various digestive tract malignancies and in 155 patients with benign digestive tract diseases. The highest frequency of elevated CA 125 values (greater than 35 U ml-1) was found in patients with liver cancer (78%), but the level was equally often elevated in liver cirrhosis (78%). Two-thirds of the patients with biliary tract cancer had an increased CA 125 concentration, while four patients with benign biliary diseases had an elevated value. The serum level of CA 125 was elevated in only 20% of 60 patients with primary colorectal cancer, and in none of those with local disease (Dukes A or B). The CA 125 concentration seldom increased in patients with recurrent colorectal carcinoma. Twenty-three per cent of 44 patients with gastric cancer had an elevated CA 125 value. Two of 33 patients with benign colorectal and one of 68 patients with benign gastric diseases had an increased CA 125 concentration. The serum values of CA 125 showed no correlation with those of tumour markers alphafetoprotein (AFP), carcinoembryonic antigen (CEA) or CA 19-9. AFP was superior to the other markers in the diagnosis of liver diseases, while CA 19-9 showed the greatest accuracy in gastric diseases. In colorectal diseases, CEA had a higher sensitivity, but a lower specificity than CA 125 and CA 19-9. CA 125 and CA 19-9 had similar sensitivities for biliary tract cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C Haglund
- Fourth Department of Surgery, Children's Hospital, Helsinki University Central Hospital, Finland
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30
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Kuusela P, Haglund C, Roberts PJ. Comparison of a new tumour marker CA 242 with CA 19-9, CA 50 and carcinoembryonic antigen (CEA) in digestive tract diseases. Br J Cancer 1991; 63:636-40. [PMID: 2021550 PMCID: PMC1972369 DOI: 10.1038/bjc.1991.146] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The levels of CA 242, a new tumour marker of carbohydrate nature, were measured in sera of 185 patients with malignancies of the digestive tract and of 123 patients with benign digestive tract diseases. High percentages of elevated CA 242 levels (greater than 20 U ml-1) were recorded in patients with pancreatic and biliary cancers (68%). The sensitivity was somewhat lower than that of CA 19-9 (76%) and CA 50 (73%). On the other hand, in benign pancreatic and biliary tract diseases the CA 242 level was less frequently elevated than the CA 19-9 and CA 50 levels. The serum CA 242 concentration was increased in 55% of patients with colorectal cancer. CA 242 detected more Dukes A-B carcinomas (47%) than CEA (32%), whereas CEA was more often elevated (71% vs 59%) in Dukes C-D carcinomas. CA 242 was slightly elevated (ad 41 U ml-1) in 10% of patients with benign colorectal diseases. CA 50 and CA 19-9 had lower sensitivities than CA 242 using the recommended cut-off values. When cut-off levels based on relevant benign colorectal diseases were used, the sensitivities of these markers were similar and somewhat higher than that of CEA. Less than half of patients with gastric cancer (44%) had an elevated CA 242 serum level. CA 242 is a promising new tumour marker, that may be of additional value in the diagnosis of pancreatic and biliary, as well as colorectal cancer, and may be useful in monitoring cancer patients after radical surgery.
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Affiliation(s)
- P Kuusela
- Department of Bacteriology and Immunology, University of Helsinki, Finland
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31
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Motoo Y, Kawakami H, Watanabe H, Satomura Y, Ohta H, Okai T, Makino H, Toya D, Sawabu N. Serum sialyl-Tn antigen levels in patients with digestive cancers. Oncology 1991; 48:321-6. [PMID: 1891175 DOI: 10.1159/000226951] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [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: 12/29/2022]
Abstract
Serum levels of sialyl-Tn antigen (STN) were measured using a one-step radioimmunoassay kit in 257 patients with digestive cancers, 121 patients with benign digestive diseases, and in 64 healthy controls. With 45 U/ml regarded as the cutoff value, the positive rates of serum STN in digestive cancers were as follows: pancreas 40.0%, stomach 28.1, colon and rectum 27.8, biliary tract 25.0, liver 7.1, and esophagus 0%. In benign digestive diseases, the positive rate of STN was low (4.1%). In gastric and colorectal cancers, simultaneous measurements of STN and carcinoembryonic antigen (CEA) revealed that the positive rates of STN, CEA, and STN and/or CEA were 28, 42, and 55%, respectively. There was no significant correlation between STN and CEA in these cancers. STN may be a useful serum marker for digestive cancers, especially gastric and colorectal cancers.
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Affiliation(s)
- Y Motoo
- Department of Internal Medicine, Kanazawa University, Japan
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32
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[Clinical immunology in various field of medicine]. Nihon Rinsho 1990; 48 Suppl:282-569. [PMID: 2232227] [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: 12/30/2022]
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33
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Pakhomova EN, Bykov VL, Karaev EO. [Candidal carriage and the development of invasive candidiasis of the organs of the digestive tract during experimental immunodepression]. Zh Mikrobiol Epidemiol Immunobiol 1990:7-10. [PMID: 2220223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
After infecting healthy mice with Candida by their oral administration the fungi are rapidly eliminated from the digestive tract. In the animals, immunosuppressed by the injection of cyclophosphamide, the prolonged persistence of Candida in the digestive tract occurs, and the administration of Candida in considerable doses over prolonged periods in combination with the injections of high doses of immunosuppressing agents results in the development of profound invasive lesions, in some cases leading to the dissemination of the process.
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34
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Abstract
STUDY OBJECTIVE To determine the utility of the serologic marker CA19-9 in the diagnosis of pancreatic cancer in patients suspected of having a pancreatic disorder. DESIGN Blinded study of frozen pedigreed serum samples collected at time of diagnostic evaluation with follow-up review at a mean of 8 years. SETTING A general university teaching hospital serving both primary and referral patient populations. MEASUREMENTS AND MAIN RESULTS Sera collected prospectively from 1978 to 1980 from 261 patients undergoing imaging studies of the pancreas (ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography) for a variety of symptoms were assayed for CA19-9 levels, and the results were compared with earlier determinations of other potential markers for pancreatic cancer. In 54 patients ultimately shown to have pancreatic cancer, the CA19-9 assay showed a sensitivity of 70% with a median value of 349 u/mL (normal less than 70 u/mL) and range, 7.3 to 2,859,964 u/mL, whereas specificity of the marker in this population was 87%. The positive predictive value was 59%, and the negative predictive value was 92%. Results of CA19-9 testing in the small group of patients with definitive staging information showed no difference in sensitivity between patients with local/regional disease (n = 6) and those with distant metastases (n = 14), 50% compared with 71% (P = 0.613). CONCLUSION CA19-9 was found to be a more sensitive and specific marker of pancreatic cancer than other serologic markers and should be a useful test in the patient with suspected pancreatic disease.
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Affiliation(s)
- D K Pleskow
- New England Deaconess Hospital, Boston, Massachusetts
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35
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Immunology and immunopathology of the alimentary canal. Proceedings of the 11th International Convocation on Immunology. Buffalo, New York, 13-16 June 1988. Immunol Invest 1989; 18:I-XLIV, 1-650. [PMID: 2731968] [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: 01/02/2023]
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36
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Rak K. [Characteristics of polymorphic variants of the 3d component od the complement system. Association of C3F with various diseases]. Pol Arch Med Wewn 1988; 80:28-35. [PMID: 3078202] [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: 01/04/2023]
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37
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Myshkin KI, Myshkina AK, Duboshchina TB, Fedorov VE. [Immunologic reactions in surgical patients with concomitant diabetes mellitus]. Vestn Khir Im I I Grek 1987; 139:104-5. [PMID: 3441950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Reactions of the cell and humoral immunity in 40 emergent surgical patients with concomitant diabetes mellitus were studied which manifested themselves as a transitory immune reactions without immunization. The operative intervention eliminating mutual aggravation was shown to improve the indices of the cell and humoral immunity.
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38
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Sakamoto K, Haga Y, Yoshimura R, Egami H, Yokoyama Y, Akagi M. Comparative effectiveness of the tumour diagnostics, CA 19-9, CA 125 and carcinoembryonic antigen in patients with diseases of the digestive system. Gut 1987; 28:323-9. [PMID: 3471687 PMCID: PMC1432704 DOI: 10.1136/gut.28.3.323] [Citation(s) in RCA: 70] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Serum concentrations of CA 19-9, CA 125 and carcinoembryonic antigen (CEA) in 145 patients with gastrointestinal carcinomas and 89 with non-neoplastic diseases were determined to compare the clinical usefulness of these tumour markers. Significantly fewer positive cases were obtained with serum CA 19-9 (9%) and CA 125 (8%) tests than the CEA test (22%) (both p less than 0.05) in patients with benign diseases, while comparable sensitivities were achieved with the CA 19-9 (44%) test, the CA 125 (41%) test and the CEA test (47%) in those with a carcinoma. High incidences of raised concentrations of serum CA 19-9 and CA 125 were observed in case of cancer of the pancreas (CA 19-9: 87%, CA 125: 67%) and biliary tract (CA 19-9: 63%, CA 125: 48%). Combined tests of CA 19-9 and CA 125 revealed increments in the sensitivity (61%) and provided a higher specificity (87%) than that of the single CEA test (78%). These combined tests were most useful for a differential diagnosis of pancreatic carcinoma (97% positive) and biliary tract carcinoma (74%) from chronic pancreatitis (4%) and cholelithiasis (0%), respectively. Studies on the relations of clinical staging and serum concentrations of CA 19-9 and CA 125 revealed significant rises in cases of disseminated carcinoma. These results clearly show that serum CA 19-9 and CA 125 tests are most pertinent for diagnosing advanced carcinomas of organs in the digestive system.
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39
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Akiyoshi T, Koba F, Tsuji H. Activated killer cell activity in lymph nodes. J Clin Lab Immunol 1987; 22:91-5. [PMID: 3496459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The activated killer cell activity of cells from the perigastric lymph nodes (LNC) in patients with gastric carcinoma or benign lesions was assayed in comparison with that of peripheral blood mononuclear cells (PBM). The cytotoxic activity induced by phytohemagglutinin (PHA) activation in LNC from patients with either carcinoma or benign lesions was significantly decreased as compared to that in PBM, although the ability to produce interleukin 2 (IL 2) in LNC was significantly increased. Therefore, the ability to generate cytotoxic cells after activation with IL 2 was examined, and decreased capacity in LNC was observed. In LNC, the proportion of OKT3+ cells was similar to that in PBM, with a prevalence of OKT4+ cells over OKT8+ cells. Also, the percentage of Leu-11+ cells was remarkably reduced. The results indicated that decreased levels of the activated killer cell activity, which might be partially attributable to the composition of lymphocyte subsets, existed in lymph nodes, and this might facilitate tumor metastasis to the regional lymph nodes.
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40
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Nakad A, Jonard P, Geubel A, Warzee P, Coppens JP, Dehennin JP, Dive C. [CA 19-9 in neoplasms. Comparison with CEA]. Acta Gastroenterol Belg 1987; 50:36-44. [PMID: 3480669] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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41
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Markiewicz-Loskot G. [Evaluation of serum opsonization activity in infants with septicemia and infections of the digestive, respiratory and central nervous systems]. Pediatr Pol 1986; 61:784-9. [PMID: 3601482] [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: 01/06/2023]
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42
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Hermanowicz A, Gibson PR, Jeweli DP. [The role of phagocytes in diseases of the digestive system]. Pol Arch Med Wewn 1985; 74:288-93. [PMID: 3880300] [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: 01/07/2023]
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43
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Nogueira JM, Garcia-de-Lomas J, Buesa FJ, Prat J, Mir A, Camarena JJ. Effect of cutaneous and digestive colonization in the induction of anti-Candida albicans antibodies: experimental study. Mycopathologia 1985; 92:31-5. [PMID: 3906405 DOI: 10.1007/bf00442656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Candida albicans colonization induces antibodies, which must be taken into account in the serological diagnosis of candidiasis. In order to determine the degree of this effect, an experimental study in rabbits free of specific anti-Candida antibodies by cutaneous and digestive inoculation has been carried out. The evolution of humoral response was studied over 8 weeks by indirect immunofluorescence (IIF), direct agglutination (DA), counterimmunoelectrophoresis (CIE) and double diffusion (DD). The cutaneous colonization detectable by culture was maintained until the second week in 70% of the animals and the presence of antibodies detectable by IIF and DA was observed after the 2nd week. The highest antibody titre by IFF and DA was 1/64, and was reached in the 5th week, with a tendency to drop in the following weeks. Precipitins were only detected by CIE in 15% of the animals in the 7th week. Elimination of yeast in stools continued only in 20% of the animals in the 2nd week of the experiment. Antibodies were detected by IIF and DA after the 2nd week, with the highest titres detectable by IFF in the 5th week. Precipitant antibodies detectable by CIE appeared in 15% of the animals in the 8th week.
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44
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Rambaud JC, Jian R, Galian A, Seligmann M. [Alpha-chain disease]. Presse Med 1985; 14:1551-6. [PMID: 2932692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The pathological and clinical features of alpha-chain disease, its immunological diagnosis, the structural abnormalities of the abnormal immunoglobulin A compared with those of proteins of gamma and mu heavy chains diseases, the course of the disease and its present treatment, the epidemiological factors involved and their influence on pathogenesis and finally, the relationship with the "Mediterranean abdominal lymphoma" or IPSID are successively described. The stress has been placed on the latest data which refine but no not modify the first description of the disease. In the same way as studies on the synthesis and structure of proteins in heavy chain diseases will provide new data on the biosynthesis of normal immunoglobulins, so the elucidation of sequential events leading from a plasmocytic stage reversible by antibiotic therapy alone to a highly malignant immunoblastic stage should improve our knowledge of the genesis of human lymphomas.
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45
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Yoneshima M, Sawabu N, Kidani H, Takemori Y, Toya D, Okai T, Hattori N, Ogino T, Mai M. [Evaluation of the measurement of serum carcinoembryonic antigen (CEA) levels using monoclonal antibody]. Gan No Rinsho 1985; 31:1311-7. [PMID: 4057566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We measured serum carcinoembryonic antigen (CEA) levels in 164 cancer patients, 153 patients with benign diseases and 45 healthy controls using monoclonal antibody and compared CEA levels by monoclonal antibody (m-CEA) with those by polyclonal antibody (p-CEA). There was a good correlation between m-CEA and p-CEA, especially in cancer patients. The positively of m-CEA was almost the same as that of p-CEA in cancer patients. But, false-positive cases by m-CEA were less common than by p-CEA in non-cancerous patients. Thus, the measurement of m-CEA was not less useful than that of p-CEA.
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Liu YS, Tobias RJ, Zurawski VR. A more specific, simpler radioimmunoassay for carcinoembryonic antigen, with use of monoclonal antibodies. Clin Chem 1985; 31:191-5. [PMID: 3967348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A solid-phase, two-site monoclonal antibody radioimmunoassay for carcinoembryonic antigen in serum or plasma has been developed. Two monoclonal antibodies are used: 3d6, which is immobilized on polystyrene beads, reacts with high-molecular-mass CEA; the other, C4, with apparently restricted reactivity toward gastrointestinal tract and mammary carcinomas, is labeled with 125I. The assay consists of incubating 0.2 mL of serum both with 3d6-coated beads and 125I-labeled C4 at room temperature for 18 h. The CEA standard is calibrated against WHO international standard (73/601). Advantages of this assay include: (a) no heat or acid pre-treatment of samples; (b) linear response over a wider functional range, 0 to 150 micrograms/L, requiring fewer calibration points; and (c) no interference by glycosaminoglycans. Average inter- and intra-assay reproducibilities (CVs) are less than 10%; analytical recovery of CEA was 94 to 107%. CEA of less than 0.5 micrograms/L can be detected. The mean concentration of CEA in serum from healthy individuals is 0.97 (SD 1.18) micrograms/L; only 3% of the sera tested had concentrations greater than 3.0 micrograms/L. On comparing this assay with a polyclonal RIA, we found similar assay sensitivity for colorectal carcinoma but fewer false-positive results for sera from patients with benign liver and bowel diseases.
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Sheliapina VV, Fokina TV. [Changes in various immunologic indices in gastroduodenal and biliary pathology in children]. Pediatriia 1984:13-5. [PMID: 6514454] [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: 01/20/2023]
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Juszczyk J, Kryska A, Skorupska A. [Antibodies against hepatitis A virus in patients hospitalized with liver diseases and other diseases of the digestive system]. Pol Tyg Lek 1984; 39:1103-6. [PMID: 6095228] [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: 01/18/2023]
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Yamanaka T, Kitagawa Y, Seki H, Kimura K, Sakurabayashi I, Kawai T. [A new carbohydrate antigen CA19-9 associated with malignancies of digestive system. II. Serum levels of CA19-9 in various digestive diseases and their clinical significance]. Rinsho Byori 1984; 32:786-92. [PMID: 6594536] [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: 01/20/2023]
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50
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Baranov AA, Dorofeĭchuk VG. [Diet therapy in disorders of the protective mechanisms of the digestive tract in children]. Pediatriia 1984:73-5. [PMID: 6473004] [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: 01/20/2023]
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