Labordiagnostik des Testosterons

Androgen-dependent immune modulation in parasitic infection

Parasitic infections modulate the immune system of the host, resulting in either immune tolerance or the induction of pro-inflammatory defense mechanisms against the pathogen. In both cases, sex hormones are involved in the regulation of the immune response, as they are present in the systemic circulation and can act on a wide variety of cell types, including immune cells. Men and women have a different milieu of sex hormones, and these hormones play a role in determining immune responses to parasitic infections. Men, who have higher plasma levels of androgens than women, are generally more susceptible to parasitic infections. Many immune cells express the androgen receptor (AR), and the immunologic functions of these cells can be modulated by androgens. In this review, we will highlight the immune cell types that are sensitive to male steroid hormones and describe their roles during three parasitic diseases, amebiasis, leishmaniasis, and helminthiasis.

Results of a BoNT/A antibody study in children and adolescents after onabotulinumtoxin A (Botox®) detrusor injection

BACKGROUND

Onabotulinumtoxin A (OnaBoNT/A, Botox®) is effective in the treatment of neurogenic detrusor overactivity, however this therapy can fail. In a prospective study, we analyzed patient serum for BoNT/A antibodies (BoNT/A-AB) as a possible cause of therapy failure.

METHODS

17 patients (average age 14.5 years) who had neurogenic detrusor overactivity were admitted for repeated OnaBoNT/A injection into the detrusor muscle. We analyzed their serum for BoNT/A-AB. The clinical findings were correlated with the incidence of BoNT/A-AB.

RESULTS

Positive BoNT/A-AB were clearly or marginally determined in 6 patients. Therapy had failed in all 6. In 4 of the 6, therapy might have failed because of a low-compliance bladder (3 patients) or tethered-cord syndrome (1), but BoNT/A-AB were found as the only possible cause in 2 patients. Thus, the incidence of BoNT/A-AB in the 17 patients was 35%, and the antibodies were clinically significant in 12%. All patients with BoNT/A-AB had a history of recurrent urinary tract infections.

CONCLUSIONS

Patients who show a failure of therapy after OnaBoNT/A injections for which no other causes can be determined should have their serum checked for BoNT/A-AB. Recurrent urinary tract infection might be a predisposing factor for BoNT/A-AB.