1,721,100 research outputs found
Alpha-naphthyl acetate esterase activity in human lymphocytes: distribution in lymphocyte subpopulations and in mitogen-activated cells.
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Biologics for ANCA-associated vasculitis
No full textThe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of necrotizing vasculitides with a potential fatal outcome. Conventional therapy is based on the use of glucocorticoids (GCs) and cyclophosphamide (CYC), which is associated with severe toxic effects and is unable to control the disease activity in some refractory and relapsing cases. Several authors focused their efforts on the identification of safe and more efficient drugs, primarily investigating biological agents. Rituximab (RTX) demonstrated to be an alternative to CYC as remission-induction therapy for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in two clinical controlled randomized trials. Contrasting data emerged regarding anti-TNF-α agents, and their use should be limited to some selected refractory or relapsing cases. Mepolizumab (MPZ) and Omalizumab (OMZ) are potentially beneficial treatments for patients with eosinophilic granulomatosis with polyangiitis (EGPA). Hereby, we perform a review focused on the use of biological drugs for AAV treatment
Fungal allergy in asthma
No full textFungal exposure is universal and fungi can be linked to asthma in a variety of ways. Fungal allergy drives asthma severity and long-term or uncontrolled fungal infection are associated with a poor control of asthma, complications such as bronchiectasies and chronic pulmonary aspergillosis. The first evidence of the link between the severity of asthma and fungal sensitization dates 1978, when Schwartz et al. demonstrated a relationship between asthma severity and Aspergillus spp sensitization. Alternaria or Cladosporium spp were associated with asthma severity in the European Community Respiratory Health Survey. The term “Severe Asthma with Fungal Sensitization” (SAFS) was introduced by Denning et al. in 2006, to indicate those patients who have persistent severe asthma (despite standard treatment) and evidence of fungal sensitization, as defined by positive prick testing, or fungus or fungal antigen-specific blood IgE testing, and do not meet the criteria for Allergic Bronchopulmonary Aspergillosis (ABPA). Proposed classification by a European Academy of Allergy and Clinical Immunology (EAACI) Task Force sets the total IgE cutoff at 1000 IU/ml for ABPA. ABPA was accepted as an endotype, while SAFS was not and remains a pragmatic definition. ABPA may develop in asthmatics with a genetic predisposition and therefore SAFS may have the same background. Long-term antibiotic therapy may allow a reduction of exacerbations and recurrent infections, representing a cornerstone in the management of asthma and fungal sensitization
Raltegravir, tenofovir, and emtricitabine in an HIV-Infected patient with HCV chronic hepatitis, NNRTI intolerance and protease inhibitors-induced severe liver Toxicity
No full textAbstract Background in HIV-infected patients with HCV-related chronic hepatitis, liver impairment and drug toxicity may substantially reduce the number of possible therapeutic options. Case Description we here describe the case of an HCV-HIV coinfected woman who had repeated severe episodes of drug-related liver toxicity with indinavir, saquinavir, fosamprenavir, and darunavir, with minimal further therapeutic options left in this class. Previous treatment-limiting side effects with efavirenz and nevirapine also precluded use of non-nucleoside reverse transcriptase inhibitors. Introduction of an integrase-inhibitor regimen based on raltegravir, tenofovir, and emtricitabine allowed a prompt achievement of undetectable viral load and a substantial rise of CD4 count to high levels, with no subsequent episodes of hepatic toxicity, and no other side effects. Conclusions given the relatively common prevalence of HCV-related chronic hepatitis among people with HIV, raltegravir might represent an important alternative option for a substantial number of patients who cannot be treated with protease inhibitors or NNRTI because of drug-related hepatic toxicity.</p
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