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    Cryoglobulinemia related to hepatitis C virus infection.

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    Abstract A causal link among hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia, cryoglobulinemic glomerulonephritis, and vasculitis is strongly supported. HCV triggers autoimmune response in predisposed individuals that manifests as organ-specific and non– organ-specific autoantibodies and as polyclonal/monoclonal rheumatoid factor, which has a central role in causing damaging cryoglobulin and immune complex tissue levels. Immunologic events are mainly induced by HCV infection persistence, with excessive immune stimulation. Humoral immune dysfunction leads to autoantibodies and rheumatoid factor production with cryoglobulinemia, glomerulonephritis, vasculitis, neuropathy, and probably thyroiditis, and arthritis in rare cases. Cellular immune dysfunction leads to lymphocytic infiltration, proliferation, and cytokine production. Pegylated (or not) interferon-alpha in combination with ribavirin appears to be the treatment of choice for patients with symptomatic essential mixed cryoglobulinemia with or without glomerulonephritis. Novel treatment with rituximab is promising

    Helicobacter pylori infection in shepherds, sheep and sheep-dogs

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    Objectives: Previous studies demonstrated a high prevalence of Helicobacter pylori infection among shepherds, sheep, sheep raw milk and children having contact with sheep, suggesting a model of transmission of infection at elevated frequency. The aim of this study was to examine whether H. pylori infection might be present in sheep-dogs. Material and Methods: Stool, serum, and wool were collected from sheep and sheep-dogs belonging to different flocks chosen because the shepherds had documented (13C-UBT) H. pylori infection. H. pylori status in the animals was evaluated using a homemade anti-H. pylori IgG enzyme-linked immunosorbent assay (ELISA) for sheep and sheep-dogs. Stool samples from sheep and sheep-dogs were also analyzed using the stool antigen test (HpSA) developed for humans. Results were expressed as optical density (OD450). PCR amplification was performed using primers specific for H. pylori [cagA, vacA (s and m region), iceA, babA2] as well as primers specific for Helicobacter species (16S rRNA) from the DNA extracted from sheep wool wash surrounding the mammalian glands. Results: 58 animals were studied (44 sheep, 8 lambs and 6 sheep-dogs). The H. pylori antigen test was positive in 82% (36/44) and in 100% of sheep and sheep-dogs stool samples, respectively. Lamb stool samples were weakly positive. High anti H. pylori IgG serum levels were detected in all 6 sheep-dogs and in 42 of 44 sheep. Genomic H. pylori and Helicobacter species DNA was not detected from any of the sheep wool samples collected. Conclusions: Although cross-reactivity cannot be excluded, the presence of the H. pylori antigen in stools obtained from sheep and from sheep-dogs, and the strong positivity for anti H. pylori IgG in both coupled with the ability to isolate H. pylori from sheep milk and stomachs, suggest that interaction between species may enhance the spread of bacteria in heavily contaminated settings

    Cryoglobulinemia Related to Hepatitis C Virus Infection

    No full text
    A causal link among hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia, cryoglobulinemic glomerulonephritis, and vasculitis is strongly supported. HCV triggers autoimmune response in predisposed individuals that manifests as organ-specific and non-organ-specific autoantibodies and as polyclonal/monoclonal rheumatoid factor, which has a central role in causing damaging cryoglobulin and immune complex tissue levels. Immunologic events are mainly induced by HCV infection persistence, with excessive immune stimulation. Humoral immune dysfunction leads to autoantibodies and rheumatoid factor production with cryoglobulinemia, glomerulonephritis, vasculitis, neuropathy, and probably thyroiditis, and arthritis in rare cases. Cellular immune dysfunction leads to lymphocytic infiltration, proliferation, and cytokine production. Pegylated (or not) interferon-alpha in combination with ribavirin appears to be the treatment of choice for patients with symptomatic essential mixed cryoglobulinemia with or without glomerulonephritis. Novel treatment with rituximab is promisin
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