Two cases of cavitary lung cancer with concomitant chronic infectious disease

Tuberculosis reactivation at ileum following immune checkpoint inhibition with pembrolizumab for metastatic nasopharyngeal carcinoma: a case report

Background

Tuberculosis (TB) reactivation has been increasingly identified following immune checkpoint inhibitor (ICI) therapy for cancer patients. However there has been no report on TB reactivation in the gastrointestinal tract. In the report, we describe a patient who developed TB ileitis after pembrolizumab for her metastatic nasopharyngeal carcinoma (NPC). Rechallenge with pembrolizumab after its temporary interruption together with anti-TB therapy produced continuous tumor response but without further TB reactivation.

Case presentation

A 29-year-old lady with metastatic NPC involving the cervical nodes, lungs and bones started pembrolizumab after failure to multiple lines of chemotherapy. She complained of sudden onset of abdominal pain, vomiting and bloody diarrhea with mucus 21 months after pembrolizumab. Colonoscopy revealed terminal ileitis with multiple caseating granulomas with Langerhan cells. Serum interferon gamma release assay was strongly positive. She was treated with anti-TB medication and was later rechallenged with pembrolizumab for her progressive lung metastases without further TB relapse while her lung metastases were brought under control again.

Conclusion

To date, this is the first gastrointestinal TB reactivation after ICI therapy for cancer. Guidelines to screen for TB before initiation of ICIs in endemic areas should be established.

Development of a sustainable photocatalytic process for air purification

Nowadays, air pollution has become a global menace being responsible of a significant increase on the morbidity and mortality of human beings. In view of this, sustainable and efficient technologies for air purification are being sought. Air purification by photocatalytic treatment has received a lot of attention due to the unspecific and high oxidation capacity of the catalyst; however still some variables must be optimized to assure practical applications. In this work, visible light active TiO₂-Cu²⁺@perlite and Ag@TiO₂-Cu²⁺/perlite supported materials were fabricated. TiO₂-Cu²⁺ (2 at. %) were synthesized using a sol-gel procedure followed of the impregnation of the support by immersion. For Ag@TiO₂-Cu²⁺, silver deposition was conducted by chemical reduction using sodium citrate and sodium borohydride. The materials (powders and supported materials) were characterized by Scanning Electron Microscopy (SEM) to demonstrate their small size and adherence to the substrate. A prototype of a photocatalytic air purifier was built. The efficacy of the prototype was evaluated for the disinfection of indoor air (dentistry clinics). The photo-catalyst was activated using visible and UVA low-cost high-energy LEDs. The antibacterial activity of the air filter was evaluated. Ag@TiO₂-Cu²⁺ exerts better air disinfection activity at lower doses in comparison to TiO₂-Cu²⁺. Bacterial growth inhibitions up to 99% were achieved for both, Gram-negative and Gram-positive bacteria. The incorporation of Ag and Cu to TiO₂ improves the antibacterial activity of the materials due to enhanced photocatalytic activity and the synergic activity of TiO₂ and dopant elements (Ag, Cu) to inhibit microorganism's growth.