1,721,000 research outputs found
Immunobiology of essential mixed cryoglobulinemia
Full text linkIntroduction
Mixed cryoglobulinemia (MC) is characterized by the production of monoclonal (type II MC) or polyclonal (type III MC) rheumatoid factors (RF), which form with endogenous IgG cold-precipitable immune complexes that cause small-vessel vasculitis and multi-organ damage. Hepatits C virus is the causative agent in 90% of MC patients, usually characterized by the expansion of an anergic B cell subpopulation called CD21low B cells. Only a minority of the patients has idiopathic or essential MC (EMC) and the B cell population has been scarcely investigated so far.
Objective: to characterize the phenotypical and functional proprieties of B cells in EMC and compare them with those of HCV-related MC and from healthy donors.
Method
The B cell phenotype and function was studied in 13 patients with EMC and compared to 24 patients with HCV-MC. The proliferative response of B cells was investigated through the CFSE assay, the intracellular pERK content was measured by the BD Phos-Flow system and apoptosis was measured through annexin/7AAD staining. All the analyses were performed by flow-cytometry.
Results
EMC patient showed significant lower absolute numbers of circulating B cells compared to HCV-MC (mean ± SD: 185/mm3 ± 236 vs 529/mm3 ± 795). Interestingly percentages and absolute numbers of CD21low B cells were significantly higher in EMC compare to HD but lower than HCV-MC patients. Similarly to CD21low B cells found in HCV MC, CD21low B cells in EMC proliferated poorly in response to TLR9 stimulation, displayed dysregulated pERK signaling and were apoptosis prone.
Conclusion
Similar features of virus-specific exhaustion and anergy induced by continual antigenic stimulation observed in B cells expanded in HCV-MC are found in B cells EMC. Our findings open the question of a possible role of a still yet unknown antigen responsible for the development of EMC
The last step to achieve barrier damage control
Full text linkHeterogeneity characterises inflammatory diseases and different phenotypes and endotypes have been identified. Both innate and adaptive immunity contribute to the immunopathological mechanism of these diseases and barrier damage plays a prominent role triggering type 2 inflammation through the alarmins system, such as anti-Thymic Stromal Lymphopoietin (TSLP). Treatment with anti-TSLP monoclonal antibodies showed efficacy in severe asthma and clinical trials for other eosinophilic diseases are ongoing. The aim of this perspective review is to analyse current advances and future applications of TSLP inhibition to control barrier damage
The Marginal Zone B Cells Clonally Expanded in Hepatitis C-Related Mixed Cryoglobulinemia Display the Functional and Molecular Signatures of Anergy Induced by Continual B Cell Receptor Signaling
No full text
Early benralizumab for eosinophilic myocarditis in eosinophilic granulomatosis with polyangiitis
Full text linkEosinophilic myocarditis is a life-threatening complication of eosinophilic syndromes including eosinophilic granulomatosis with polyangiitis (EGPA), undefined complex hypereosinophilic syndrome (HES), and drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. The in-hospital death rate for eosinophilic myocarditis due to any cause is about 20%,1 and is as high as 50% in its acute necrotizing form associated with DRESS.2 Conventional therapies including high-dose glucocorticoids and other immunosuppressants have variable efficacy and substantial toxic effects.1 Dilated cardiomyopathy is a frightening sequela but its incidence is unknown
Efficacy and safety of long-term treatment with low-dose rituximab for relapsing mixed cryoglobulinemia vasculitis
No full textThis study aims to evaluate the efficacy and safety of repeated treatments with low-dose rituximab for relapsing mixed cryoglobulinemia vasculitis. Thirty-seven patients with mixed cryoglobulinemia vasculitis refractory to standard of care treatment, 34 of which were HCV-positive, were treated with rituximab at the reduced dosage of 250 mg/m2 given twice 1 week apart per cycle. Thirty patients (81%) achieved a clinical response; 5 of them remain in remission, 3 were lost to follow-up or died, and 22 relapsed after a mean of 15.7 months. Eleven relapsers were retreated with one (6 patients), 2 (3 patients), or 3 (2 patients) additional rituximab cycles given at each relapse. Clinical and laboratory efficacy and side effects of long-term treatment were evaluated. Clinical response to retreatment was 91% (10/11) at the first relapse, 80% (4/5) at the second relapse, and 100% (2/2) at the third relapse. The mean (±SD) time to relapse was 17.1 ± 14.1 months in 30 patients who were treated with only one cycle (from first cycle to the first relapse) and 45.7 ± 30.6 months (from first cycle to the last observed relapse) in 11 patients treated with 2 or more cycles (p = 0.0037). Severe adverse reactions occurred in 3 patients, in 2 of whom at the first cycle. Our results suggest that repeated treatment of relapsing mixed cryoglobulinemia with a low-dose rituximab regimen is efficacious, safe, and cost-effective for the long-term management of this disorder
- …
