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Ryan K, Ozment C, Jahadi O, Bonadonna D, Murray J, Dykes J, Sleasman J, Yarlagadda V, Almond C. Moving Toward Uniform Criteria for Adverse Event Definitions Across Mechanical Circulatory Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Hall G, Burt T, Fisher K, Pittman R, Sleasman J, Buckley R, Cotten M, Mousallem T. A Single-Center Review of Severe Combined Immune Deficiency (SCID) Newborn Screening (NBS) Data in the Neonatal Intensive Care Unit (NICU). J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Csomos K, Ujhazi B, Blazso P, Herrera JL, Tipton CM, Kawai T, Gordon S, Ellison M, Wu K, Stowell M, Haynes L, Cruz R, Zakota B, Nguyen J, Altrich M, Geier CB, Sharapova S, Dasso JF, Leiding JW, Smith G, Al-Herz W, de Barros Dorna M, Fadugba O, Fronkova E, Kanderova V, Svaton M, Henrickson SE, Hernandez JD, Kuijpers T, Kandilarova SM, Naumova E, Milota T, Sediva A, Moshous D, Neven B, Saco T, Sargur R, Savic S, Sleasman J, Sunkersett G, Ward BR, Komatsu M, Pittaluga S, Kumanovics A, Butte MJ, Cancro MP, Pillai S, Meffre E, Notarangelo LD, Walter JE. Partial RAG deficiency in humans induces dysregulated peripheral lymphocyte development and humoral tolerance defect with accumulation of T-bet + B cells. Nat Immunol 2022; 23:1256-1272. [PMID: 35902638 PMCID: PMC9355881 DOI: 10.1038/s41590-022-01271-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/16/2022] [Indexed: 12/22/2022]
Abstract
The recombination-activating genes (RAG) 1 and 2 are indispensable for diversifying the primary B cell receptor repertoire and pruning self-reactive clones via receptor editing in the bone marrow; however, the impact of RAG1/RAG2 on peripheral tolerance is unknown. Partial RAG deficiency (pRD) manifesting with late-onset immune dysregulation represents an ‘experiment of nature’ to explore this conundrum. By studying B cell development and subset-specific repertoires in pRD, we demonstrate that reduced RAG activity impinges on peripheral tolerance through the generation of a restricted primary B cell repertoire, persistent antigenic stimulation and an inflammatory milieu with elevated B cell-activating factor. This unique environment gradually provokes profound B cell dysregulation with widespread activation, remarkable extrafollicular maturation and persistence, expansion and somatic diversification of self-reactive clones. Through the model of pRD, we reveal a RAG-dependent ‘domino effect’ that impacts stringency of tolerance and B cell fate in the periphery. Patients with partial recombination-activating gene (RAG) deficiency (pRD) present variable late-onset autoimmune clinical phenotypes. Walter and colleagues identified a restricted primary B cell antigen receptor repertoire enriched for autoreactivity and clonal persistence in pRD. They described dysregulated B cell maturation with expansion of T-bet+ B cells revealing how RAG impacts stringency of tolerance and B cell fate in the periphery.
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Affiliation(s)
- Krisztian Csomos
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
| | - Boglarka Ujhazi
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Peter Blazso
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.,Department of Pediatrics, University of Szeged, Szeged, Hungary
| | - Jose L Herrera
- Cancer and Blood Disorders Institute and Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.,Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher M Tipton
- Department of Medicine, Division of Rheumatology, Emory University, Atlanta, GA, USA
| | - Tomoki Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Sumai Gordon
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Maryssa Ellison
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Kevin Wu
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Matthew Stowell
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Lauren Haynes
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Rachel Cruz
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Bence Zakota
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Johnny Nguyen
- Department of Pathology & Laboratory Medicine, Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
| | | | | | | | - Joseph F Dasso
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Jennifer W Leiding
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Grace Smith
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Waleed Al-Herz
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Mayra de Barros Dorna
- Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Olajumoke Fadugba
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA
| | - Eva Fronkova
- Childhood Leukemia Investigation Prague, Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Veronika Kanderova
- Childhood Leukemia Investigation Prague, Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Michael Svaton
- Childhood Leukemia Investigation Prague, Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Sarah E Henrickson
- Allergy Immunology Division, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Institute for Immunology, the University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph D Hernandez
- Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, Stanford University, Stanford, CA, USA
| | - Taco Kuijpers
- Deptartment of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
| | | | - Elizaveta Naumova
- Department of Clinical Immunology, University Hospital Alexandrovska, Medical University, Sofia, Bulgaria
| | - Tomas Milota
- Department of Immunology, Second Faculty of Medicine Charles University and University Hospital Motol, Prague, Czech Republic
| | - Anna Sediva
- Department of Immunology, Second Faculty of Medicine Charles University and University Hospital Motol, Prague, Czech Republic
| | - Despina Moshous
- Université de Paris, Paris, France.,Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Enfants Malades Université Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Laboratory of Genome Dynamics in the Immune System, INSERM UMR1163, Institut Imagine, Paris, France
| | - Benedicte Neven
- Université de Paris, Paris, France.,Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Enfants Malades Université Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR1163, Institut Imagine, Paris, France
| | - Tara Saco
- Windom Allergy, Asthma and Sinus, Sarasota, FL, USA
| | - Ravishankar Sargur
- Department of Immunology and Allergy, Sheffield Teaching Hospitals, Sheffield, UK
| | - Sinisa Savic
- Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK.,National Institute for Health Research-Leeds Musculoskeletal Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, Leeds, UK
| | - John Sleasman
- Division of Allergy, Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Gauri Sunkersett
- Cancer and Blood Disorder Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Brant R Ward
- Division of Allergy and Immunology, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA, USA
| | - Masanobu Komatsu
- Cancer and Blood Disorders Institute and Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.,Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stefania Pittaluga
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Attila Kumanovics
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Manish J Butte
- Division of Immunology, Allergy, and Rheumatology, Department of Pediatrics and Jeffrey Modell Diagnostic and Research Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael P Cancro
- Department of Pathology, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA
| | - Shiv Pillai
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of technology and Harvard University, Cambridge, MA, USA
| | - Eric Meffre
- Department of Immunobiology, Yale University, New Haven, CT, USA.,Section of Rheumatology, Allergy and Clinical Immunology, Yale School of Medicine, New Haven, CT, USA
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Jolan E Walter
- Division of Pediatric Allergy/Immunology, University of South Florida at Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA. .,Division of Allergy and Immunology, Massachusetts General Hospital for Children, Boston, MA, USA.
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Wonnaparhown A, Curtis A, Fischer B, Venturi G, Walter J, Tarrant T, Sleasman J, De Paris K. T Cell Responses to SARS-CoV-2 Vaccination and Infection in Antibody Deficiency Diseases. J Allergy Clin Immunol 2022. [PMCID: PMC8804462 DOI: 10.1016/j.jaci.2021.12.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Affiliation(s)
- Jesse Crayle
- School of Medicine, Duke University, Durham, NC, USA
| | - Mai Elmallah
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Duke University, Durham, NC, USA, and
| | - John Sleasman
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Duke University, Durham, NC, USA, and
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Baloh C, Markert ML, Shashi V, Sleasman J. Predicting Autoimmunity Development in 22q11.2DS. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calabrese L, Geier C, Farmer J, Foldvari Z, Ujhazi B, Eibl M, Wolf H, Sleasman J, Parikh S, Dilley M, Pai SY, Henderson L, Hazen M, Neven B, Sharapova S, Mihailova S, Byram K, Fernandez J, Yankova P, Walter J. 174. VASCULITIS AS A MAJOR MORBIDITY FACTOR IN PATIENTS WITH HYPOMORPHIC RAG VARIANTS. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez060.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | - Boglarka Ujhazi
- Johns Hopkins All Children’s Hospital Saint Petersburg, FL USA
| | - Martha Eibl
- Immunology Outpatient Clinic Vienna, Austria
| | | | | | - Suhag Parikh
- Duke University School of Medicine Durham, NC USA
| | | | | | | | | | | | | | | | | | | | | | - Jolan Walter
- Johns Hopkins All Children’s Hospital Saint Petersburg, FL USA
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de la Morena MT, Leonard D, Torgerson TR, Cabral-Marques O, Slatter M, Aghamohammadi A, Chandra S, Murguia-Favela L, Bonilla FA, Kanariou M, Damrongwatanasuk R, Kuo CY, Dvorak CC, Meyts I, Chen K, Kobrynski L, Kapoor N, Richter D, DiGiovanni D, Dhalla F, Farmaki E, Speckmann C, Español T, Shcherbina A, Hanson IC, Litzman J, Routes JM, Wong M, Fuleihan R, Seneviratne SL, Small TN, Janda A, Bezrodnik L, Seger R, Raccio AG, Edgar JDM, Chou J, Abbott JK, van Montfrans J, González-Granado LI, Bunin N, Kutukculer N, Gray P, Seminario G, Pasic S, Aquino V, Wysocki C, Abolhassani H, Dorsey M, Cunningham-Rundles C, Knutsen AP, Sleasman J, Costa Carvalho BT, Condino-Neto A, Grunebaum E, Chapel H, Ochs HD, Filipovich A, Cowan M, Gennery A, Cant A, Notarangelo LD, Roifman CM. Long-term outcomes of 176 patients with X-linked hyper-IgM syndrome treated with or without hematopoietic cell transplantation. J Allergy Clin Immunol 2016; 139:1282-1292. [PMID: 27697500 DOI: 10.1016/j.jaci.2016.07.039] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/29/2016] [Accepted: 07/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND X-linked hyper-IgM syndrome (XHIGM) is a primary immunodeficiency with high morbidity and mortality compared with those seen in healthy subjects. Hematopoietic cell transplantation (HCT) has been considered a curative therapy, but the procedure has inherent complications and might not be available for all patients. OBJECTIVES We sought to collect data on the clinical presentation, treatment, and follow-up of a large sample of patients with XHIGM to (1) compare long-term overall survival and general well-being of patients treated with or without HCT along with clinical factors associated with mortality and (2) summarize clinical practice and risk factors in the subgroup of patients treated with HCT. METHODS Physicians caring for patients with primary immunodeficiency diseases were identified through the Jeffrey Modell Foundation, United States Immunodeficiency Network, Latin American Society for Immunodeficiency, and Primary Immune Deficiency Treatment Consortium. Data were collected with a Research Electronic Data Capture Web application. Survival from time of diagnosis or transplantation was estimated by using the Kaplan-Meier method compared with log-rank tests and modeled by using proportional hazards regression. RESULTS Twenty-eight clinical sites provided data on 189 patients given a diagnosis of XHIGM between 1964 and 2013; 176 had valid follow-up and vital status information. Sixty-seven (38%) patients received HCT. The average follow-up time was 8.5 ± 7.2 years (range, 0.1-36.2 years). No difference in overall survival was observed between patients treated with or without HCT (P = .671). However, risk associated with HCT decreased for diagnosis years 1987-1995; the hazard ratio was significantly less than 1 for diagnosis years 1995-1999. Liver disease was a significant predictor of overall survival (hazard ratio, 4.9; 95% confidence limits, 2.2-10.8; P < .001). Among survivors, those treated with HCT had higher median Karnofsky/Lansky scores than those treated without HCT (P < .001). Among patients receiving HCT, 27 (40%) had graft-versus-host disease, and most deaths occurred within 1 year of transplantation. CONCLUSION No difference in survival was observed between patients treated with or without HCT across all diagnosis years (1964-2013). However, survivors treated with HCT experienced somewhat greater well-being, and hazards associated with HCT decreased, reaching levels of significantly less risk in the late 1990s. Among patients treated with HCT, treatment at an early age is associated with improved survival. Optimism remains guarded as additional evidence accumulates.
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Affiliation(s)
- M Teresa de la Morena
- University of Texas Southwestern Medical Center and Children's Medical Center, Children's Health, Dallas, Tex.
| | - David Leonard
- University of Texas Southwestern Medical Center and Children's Medical Center, Children's Health, Dallas, Tex
| | - Troy R Torgerson
- University of Washington and Seattle Children's Research Institute, Seattle, Wash
| | | | - Mary Slatter
- Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Asghar Aghamohammadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharat Chandra
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | | | | | - Caroline Y Kuo
- Geffen SOM at David Geffen School of Medicine at UCLA, Los Angeles, Calif
| | | | | | - Karin Chen
- University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Neena Kapoor
- Children's Hospital Los Angeles, Keck School of Medicine, Los Angeles, Calif
| | | | | | | | | | - Carsten Speckmann
- Department of Pediatrics and Adolescent Medicine, Center for Chronic Immunodeficiency University Medical Center, Freiburg, Germany
| | | | - Anna Shcherbina
- Research and Clinical Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | | | - Jiri Litzman
- Department of Clinical Immunology and Allergology, St Anne's University Hospital in Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Melanie Wong
- Children's Hospital at Westmead, Sydney, Australia
| | - Ramsay Fuleihan
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Ill
| | | | - Trudy N Small
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Ales Janda
- University Hospital Motol, Prague, Czech Republic
| | | | | | | | | | - Janet Chou
- Children's Hospital Boston, Boston, Mass
| | | | - Joris van Montfrans
- Division Pediatrics, Pediatrische Immunologie en Infectieziekten, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Luis Ignacio González-Granado
- Unidad de Immunodeficiencias Primarias y la Unidad de Hematología y Oncología Pediátrica, Instituto de Investigacíon Hospital 12 de Octubre, Madrid, Spain
| | - Nancy Bunin
- Children's Hospital of Philadelphia, Philadelphia, Pa
| | | | - Paul Gray
- Sydney Children's Hospital, Randwick, Australia
| | | | - Srdjan Pasic
- Mother & Child Health Institute, Belgrade, Serbia
| | - Victor Aquino
- University of Texas Southwestern Medical Center and Children's Medical Center, Children's Health, Dallas, Tex
| | - Christian Wysocki
- University of Texas Southwestern Medical Center and Children's Medical Center, Children's Health, Dallas, Tex
| | - Hassan Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Beatriz Tavares Costa Carvalho
- Division of Allergy-Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Antonio Condino-Neto
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | | | - Hans D Ochs
- University of Washington and Seattle Children's Research Institute, Seattle, Wash
| | | | | | - Andrew Gennery
- Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Andrew Cant
- Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Luigi D Notarangelo
- Laboratory of Host Defenses, NIAID, National Institutes of Health, Bethesda, Md
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Ballow M, Pinciaro PJ, Craig T, Kleiner G, Moy J, Ochs HD, Sleasman J, Smits W. Flebogamma(®) 5 % DIF Intravenous Immunoglobulin for Replacement Therapy in Children with Primary Immunodeficiency Diseases. J Clin Immunol 2016; 36:583-9. [PMID: 27279130 DOI: 10.1007/s10875-016-0303-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/23/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The previous studies with Flebogamma(®) 5 % DIF intravenous immunoglobulin (IVIG) contained insufficient numbers of pediatric subjects to fully warrant a pediatric indication by the FDA. The objective of this study was to evaluate the efficacy, safety, and pharmacokinetics of Flebogamma® 5 % DIF for replacement therapy in children (age 2-16) with primary immunodeficiency diseases (PIDD). METHODS IVIG was administered at eight clinical sites to 24 subjects with well-defined PIDD at a dose of 300-800 mg/kg every 21-28 days for 12 months. The pharmacokinetics endpoint in this study was the dose-adjusted increment of the serum IgG trough levels. RESULTS The calculated serious bacterial infection rate was 0.05/subject/year. The incidence of adverse events considered potentially related to IVIG during or within 72 h after completing an infusion was within the FDA guidance threshold of <40 % at each time point. Dose-adjusted incremental IgG levels remained approximately equal to or slightly greater than pre-study IgG levels (between 800 and 1000 mg/dL throughout) when the subjects were treated with IVIG therapy other than Flebogamma(®) DIF 5 % indicating no evidence of a different pharmacokinetic profile in this pediatric population if compared to those profiles in previous Flebogamma studies in predominately adult populations. CONCLUSIONS Flebogamma(®) 5 % DIF is efficacious and safe, has adequate pharmacokinetic properties, is well-tolerated, and maintains the profile of Flebogamma(®) 5 % for the treatment of children with primary humoral immunodeficiency diseases.
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Affiliation(s)
- Mark Ballow
- The Children's Hospital of Buffalo, Buffalo, NY, USA.
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, 601 4th Street South, Saint Petersburg, FL, 3370, USA.
| | | | - Timothy Craig
- Penn State University Hershey Medical Center, Hershey, PA, USA
| | - Gary Kleiner
- Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies, University of Miami, Miami, FL, USA
| | - James Moy
- Allergy and Immunology, Rush University Medical Center, Chicago, IL, USA
| | - Hans D Ochs
- Seattle Children's Research Institute and University of Washington, Seattle, WA, USA
| | - John Sleasman
- Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, 601 4th Street South, Saint Petersburg, FL, 3370, USA
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Wilson LR, Gakpo R, Fischer B, Rudy B, Goodenow M, Aldrovandi G, Sleasman J. Lymphocyte Activation and Bone Turnover in HIV-Infected Young Adults; A Sub-Study of Adolescent Medicine Trials Network Protocol 061. J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pannaraj PS, Li F, Cerini C, Bender J, Bittinger K, Bailey A, Rollie A, Adisetiyo H, Santiskulvong C, Bushman F, Sleasman J, Aldrovandi G. Breastfeeding Influences Establishment and Development of the Infant Microbiome. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kubiak C, Jyonouchi S, Kuo C, Garcia-Lloret M, Dorsey MJ, Sleasman J, Zbrozek AS, Perez EE. Fiscal implications of newborn screening in the diagnosis of severe combined immunodeficiency. J Allergy Clin Immunol Pract 2014; 2:697-702. [PMID: 25439359 PMCID: PMC5911282 DOI: 10.1016/j.jaip.2014.05.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 03/25/2014] [Accepted: 05/06/2014] [Indexed: 12/31/2022]
Abstract
In the United States, newborn screening (NBS) is currently recommended for identification of 31 debilitating and potentially fatal conditions. However, individual states determine which of the recommended conditions are screened. The addition of severe combined immunodeficiency (SCID) screening to the recommended NBS panel has been fully instituted by 18 states, with another 11 states piloting programs or planning to begin screening in 2014. Untreated, SCID is uniformly fatal by 2 years of age. Hematopoietic stem cell transplantation usually is curative, but the success rate depends on the age at which the procedure is performed. Short-term implementation costs may be a barrier to adding SCID to states' NBS panels. A retrospective economic analysis was performed to determine the cost-effectiveness of NBS for early (<3.5 months) versus late (≥3.5 months) treatment of children with SCID at 3 centers over 5 years. The mean total charges at these centers for late treatment were 4 times greater than early treatment ($1.43 million vs $365,785, respectively). Mean charges for intensive care treatments were >5 times higher ($350,252 vs $66,379), and operating room-anesthesia charges were approximately 4 times higher ($57,105 vs $15,885). The cost-effectiveness of early treatment for SCID provides a strong economic rationale for the addition of SCID screening to NBS programs of other states.
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Affiliation(s)
- Catherine Kubiak
- Department of Pediatrics, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Soma Jyonouchi
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Caroline Kuo
- Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif
| | - Maria Garcia-Lloret
- Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif
| | - Morna J Dorsey
- Department of Pediatrics, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - John Sleasman
- Department of Pediatrics, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | | | - Elena E Perez
- Department of Pediatrics, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla.
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Routes J, Abinun M, Al-Herz W, Bustamante J, Condino-Neto A, De La Morena MT, Etzioni A, Gambineri E, Haddad E, Kobrynski L, Le Deist F, Nonoyama S, Oliveira JB, Perez E, Picard C, Rezaei N, Sleasman J, Sullivan KE, Torgerson T. ICON: the early diagnosis of congenital immunodeficiencies. J Clin Immunol 2014; 34:398-424. [PMID: 24619621 DOI: 10.1007/s10875-014-0003-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/17/2014] [Indexed: 01/27/2023]
Abstract
Primary immunodeficiencies are intrinsic defects in the immune system that result in a predisposition to infection and are frequently accompanied by a propensity to autoimmunity and/or immunedysregulation. Primary immunodeficiencies can be divided into innate immunodeficiencies, phagocytic deficiencies, complement deficiencies, disorders of T cells and B cells (combined immunodeficiencies), antibody deficiencies and immunodeficiencies associated with syndromes. Diseases of immune dysregulation and autoinflammatory disorder are many times also included although the immunodeficiency in these disorders are often secondary to the autoimmunity or immune dysregulation and/or secondary immunosuppression used to control these disorders. Congenital primary immunodeficiencies typically manifest early in life although delayed onset are increasingly recognized. The early diagnosis of congenital immunodeficiencies is essential for optimal management and improved outcomes. In this International Consensus (ICON) document, we provide the salient features of the most common congenital immunodeficiencies.
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Affiliation(s)
- John Routes
- Department of Pediatrics, Medical College of Wisconsin, and Children's Research Institute, Milwaukee, WI, 53226-4874, USA,
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Martinez DG, Funderburg NT, Cerissi A, Rifaie R, Aviles-Medina L, Llorens-Bonilla BJ, Sleasman J, Luciano AA. Lipopolysaccharide and soluble CD14 in cord blood plasma are associated with prematurity and chorioamnionitis. Pediatr Res 2014; 75:67-74. [PMID: 24135785 PMCID: PMC4116808 DOI: 10.1038/pr.2013.182] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/08/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Lipopolysaccharide (LPS), an endotoxin of Gram-negative bacteria, causes preterm birth in animals and has been implicated as a factor triggering preterm labor and systemic complications in humans. Little is known regarding LPS in the cord blood (CB) of term and preterm infants and its association with maternal and fetal characteristics. METHODS CB was obtained from term (n = 15) and preterm infants (n = 76) after delivery. Plasma levels of LPS, C-reactive protein (CRP), and soluble CD14 (sCD14) were measured using commercially available kits (limulus amebocyte lysate and enzyme-linked immunosorbent assay). Four linear regression models were created in order to identify independent variables that predict plasma LPS levels. RESULTS The analyte levels were significantly higher in preterm vs. term infant CB: LPS (24.48 vs. 1 pg/ml; P = 0.0009), CRP (87.9 vs. 47 ng/ml; P = 0.01), and sCD14 (0.32 vs.0.35 µg/ml; P = 0.013). There was a (significant) positive correlation between CB LPS levels and gestational age, birth weight, CRP levels, sCD14 levels, and association with both clinical and histological chorioamnionitis. CONCLUSION Our data suggest that LPS is associated with preterm labor and inflammation (CRP elevation and chorioamnionitis). These findings may be relevant to the understanding of the role of LPS in prematurity and its role in preterm morbidities.
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Affiliation(s)
- Denise G. Martinez
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Nicholas T. Funderburg
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Adam Cerissi
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Reema Rifaie
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Laura Aviles-Medina
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Braulio J. Llorens-Bonilla
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - John Sleasman
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Angel A. Luciano
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Kubiak C, Sleasman J, Dorsey MJ. MBL Polymorphisms in a US Cohort of Children with Recurrent Infection. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Brown J, Sleasman J, Dorsey MJ, Sriaroon P. Novel Interleukin-7Rα (IL-7Rα) Mutations Causing Delayed Onset Isolated T Cell Immunodeficiency Disease. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Damrongwatanasuk R, Sriaroon P, Sleasman J. Atopic Dermatitis in Patients with Agammaglobulinemia Is Associated with Cutaneous Staphylococcal Infections. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Mulligan K, Harris DR, Emmanuel P, Fielding RA, Worrell C, Kapogiannis BG, Monte D, Sleasman J, Wilson CM, Aldrovandi GM. Low bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B. Clin Infect Dis 2012; 55:461-8. [PMID: 22573848 PMCID: PMC3491777 DOI: 10.1093/cid/cis455] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 04/10/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Peak bone mass is achieved in adolescence/early adulthood and is the key determinant of bone mass in adulthood. We evaluated the association of bone mass with human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) during this critical period among behaviorally HIV-infected young men and seronegative controls. METHODS HIV-positive men (N = 199) and HIV-negative controls (N = 53), ages 14-25 years, were studied at 15 Adolescent Trials Network for HIV/AIDS Interventions sites. HIV-positive participants were recruited on the basis of ART status: ART-naive (N = 105) or on a regimen containing a nonnucleoside reverse transcriptase inhibitor (NNRTI; N = 52) or protease inhibitor (PI; N = 42). Bone mineral density (BMD) and content (BMC) and body composition were measured by dual-energy X-ray absorptiometry (DXA). Results were compared across groups by linear modeling. Bone results were adjusted for race, body mass index (BMI), and type of DXA (Hologic/Lunar). RESULTS The HIV-positive and HIV-negative groups had comparable median age (21 years) and racial/ethnic distribution. Median times since HIV diagnosis were 1.3, 1.9, and 2.2 years in the ART-naive, NNRTI, and PI groups, respectively (P = .01). Total and regional fat were significantly lower in the ART-naive group compared with seronegative controls. Mean BMD and Z scores were generally lower among HIV-positive participants on ART, particularly in the PI group. Average Z scores for the spine were below zero in all 4 groups, including controls. CONCLUSIONS Young men on ART with a relatively recent diagnosis of HIV infection have lower bone mass than controls. Longitudinal studies are required to determine the impact of impaired accrual or actual loss of bone during adolescence on subsequent fracture risk.
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Kubiak C, Sleasman J, Perez E, Dorsey M. Financial Impact of Late Diagnosis of Severe Combined Immunodeficiency: Why It is Fiscally Sound for States to Invest in the Implementation of Newborn Screening. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Wallet M, Guiulfo G, Wallet S, Sleasman J, Goodenow M. Activation of human macrophages by the endogenous toll-like receptor 4 ligand high molecular weight hyaluronan (101.20). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.101.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Rheumatoid arthritis [RA] is caused in part by cytokines secreted by classically activated synovial macrophages. We reported that IFNγ, typically produced by CD4 T cells within synovitis, primes macrophages for activation by high molecular weight hyaluronan [HMW-HA], a major component of joint synovial fluid. HMW-HA is a ligand for both toll-like receptor 4 [TLR4] and CD44. The purpose of this study was to compare the molecular mechanism of HMW-HA (endogenous TLR ligand) versus LPS (exogenous TLR ligand) induced macrophage activation. Transcriptome bioprofiles were determined by cDNA arrays, and the roles of CD44 and TLR4 were determined using blocking antibodies and cytokine measurement by Milliplex®. Significant differences in gene expression profiles were revealed when comparing IFNγ priming versus mock priming under both LPS and HMW-HA activating conditions, although nearly identical gene expression profiles were observed when comparing HMW-HA to LPS stimulation under both mock and IFNγ priming conditions. Blockade of CD44 enhanced inflammatory cytokine secretion while blockade of TLR4 inhibited inflammatory cytokine secretion in response to either HMW-HA or LPS. HMW-HA provides the stimulus required for classical macrophage activation when cells are primed with IFNγ in a response that is essentially identical to the LPS response. Type 1 T cells in proximity to endogenous TLR ligands may provide sufficient signals to initiate classical macrophage activation in RA.
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Affiliation(s)
- Mark Wallet
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Giorgio Guiulfo
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Shannon Wallet
- 3University of Florida, College of Dentistry, Gainesville, FL
| | - John Sleasman
- 2University of South Florida, All Childrens Hospital, St. Petersburg, FL
| | - Maureen Goodenow
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
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Wallet M, Appelberg S, Reist C, Guiulfo G, Sleasman J, Goodenow M. Reduction of HIV-1 innate immune activation by protease inhibitors (154.15). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.154.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
HIV-1-associated innate immune activation is caused by viral replication and/or microbial substances that leak from the gut lumen into the circulation (microbial translocation). Consequences of the ensuing HIV-1-associated inflammation range from neurocognitive impairment to cardiovascular disease where macrophages play a central role. HIV-1 therapy is evaluated based on suppression of viremia and restoration of CD4 T cells, while the effects of therapy on innate immune activation are rarely considered. The current study assessed the effects of protease inhibitors on macrophage activation ex vivo and in vivo. Nelfinavir [NFV] and tipranavir [TPV] inhibited LPS activation of human macrophages ex vivo as measured by reduced secretion of LPS-binding protein soluble CD14 [sCD14] and pro-inflammatory cytokines IL-6 and TNF. Cytokine secretion was inhibited prior to transcription by modulation of toll-like receptor signaling pathways. In vivo, NFV-treated HIV-1-infected patients presented with significantly reduced monocyte/macrophage activation as measured by a greater reduction in sCD14 plasma levels compared to those treated with indinavir or ritonavir. These data suggest that anti-inflammatory effects of NFV or TPV may augment efficacy of HIV-1 treatment by targeting HIV-1-assocated innate immune activation. Delineation of cellular targets of NFV or TPV will lead to novel approaches to suppress innate immune activation in HIV-1, other infectious diseases or autoimmunity.
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Affiliation(s)
- Mark Wallet
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Sofia Appelberg
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Caroline Reist
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Giorgio Guiulfo
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - John Sleasman
- 2University of South Florida, All Childrens Hospital, St. Petersburg, FL
| | - Maureen Goodenow
- 1Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
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Nguyen D, Kellner E, Hudey S, Dorsey M, Sriaroon P, Sleasman J, Perez E. Elevation of Soluble CD14 levels Supports Chronic Innate Immune Activation in Subjects with CVID, XLA, and SLE Compared to Healthy Subjects. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mulligan K, Harris DR, Monte D, Stoszek S, Emmanuel P, Hardin DS, Kapogiannis BG, Worrell C, Meyer WA, Sleasman J, Wilson CM, Aldrovandi GM. Obesity and dyslipidemia in behaviorally HIV-infected young women: Adolescent Trials Network study 021. Clin Infect Dis 2010; 50:106-14. [PMID: 19947855 DOI: 10.1086/648728] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The goal of this study was to determine the nature and prevalence of abnormalities in lipids, glucose metabolism, and body composition in behaviorally human immunodeficiency virus (HIV)-infected young women and the relationship of these abnormalities to different classes of antiretroviral therapy regimens. METHODS We conducted a cross-sectional, multicenter study involving 173 behaviorally HIV-infected women aged 14-24 years and 61 HIV-seronegative control subjects. HIV-infected women were categorized as follows: antiretroviral therapy naive (n=85), receiving a regimen containing a nonnucleoside reverse-transcriptase inhibitor (NNRTI; n=33), receiving a regimen containing a protease inhibitor (PI; n=36), or receiving a regimen not containing an NNRTI or a PI (n=19). Measurements included fasting lipid levels, glucose and insulin levels before and 2 hours after an oral glucose challenge, high-sensitivity C-reactive protein (hsCRP) levels, anthropometry, fat distribution (measured by dual energy X-ray absorptiometry), and antiretroviral therapy and medical histories. Race-adjusted results were compared across groups and within HIV-infected groups. RESULTS The median age of participants was 20 years. Of HIV-infected subjects, 77% were African American, 35% smoked cigarettes, and 32% reported exercising regularly. More than 40% had a body mass index > or =25. Triglycerides; total, high-density lipoprotein (HDL), and non-HDL cholesterol; and hsCRP levels differed significantly among groups, with higher levels being most common among those receiving antiretroviral therapy. Indices of glucose metabolism did not differ among groups. In general, cholesterol levels, hsCRP levels, and indices of glucose metabolism worsened as body mass index increased. CONCLUSIONS Obesity, dyslipidemia, and inflammation were prominent among HIV-infected adolescent women and, coupled with other risk factors, may accelerate the lifetime risk of cardiovascular disease and other adverse events. These results underscore the need for a multifaceted approach to addressing risk reduction in this population.
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Affiliation(s)
- Kathleen Mulligan
- University of California, San Francisco, San Francisco General Hospital Div. of Endocrinology, Bldg. 30, Rm. 3501K, 1001 Potrero Ave., San Francisco, CA 94110, USA.
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Caldwell J, Kellogg D, Isakson L, Watkins S, Reich A, Foss A, Sleasman J. Lyngbyatoxin A, A Cyanobacteria Dervived Aquatic Toxin, Induces Expression Of Pro-inflammatory Cytokines Including Il-4 And Il-5 By Human PBMC. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Eng W, Dorsey M, Sleasman J, Petrovic A, Westbrock W. A Novel Mutation CHS1 (LYST) Mutation: Osteomyelitis in a Child with Chediak-Higashi Syndrome. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Rudy BJ, Sleasman J, Kapogiannis B, Wilson CM, Bethel J, Serchuck L, Ahmad S, Cunningham CK. Short-cycle therapy in adolescents after continuous therapy with established viral suppression: the impact on viral load suppression. AIDS Res Hum Retroviruses 2009; 25:555-61. [PMID: 19534628 PMCID: PMC2853866 DOI: 10.1089/aid.2008.0203] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This was a proof-of-principle study to evaluate the impact of short cycle therapy (SCT; 4 days on/3 days off) in adolescents and young adults with good viral suppression on a protease inhibitor-based antiretroviral regimen. Subjects were recruited by the Adolescent Trials Network for HIV/AIDS Interventions and the Pediatric AIDS Clinical Trials Group. Subjects were infected either through perinatal/early childhood transmission or later via risk behaviors. All subjects were required to have at least 6 months of documented viral suppression below 400 copies/ml plus a preentry value below 200 copies/ml and an entry CD4+ T cell count above 350 cells/mm3. Of the 32 subjects enrolled, 12 (37.5%) had confirmed viral load rebound >400 copies, with 18 subjects (56%) coming off for any reason. The majority of subjects resuppressed when placed back onto continuous therapy using the same agents. Although no difference was found in virologic rebound rates between the early and later transmission groups, those infected early in life had higher rates of coming off SCT for any reason. There was no impact of SCT on the CD4+ T cell counts in those who remained on study or those who came off SCT for any reason. Subjects demonstrated good adherence to the SCT regimen. This study suggests that further evaluation of SCT may be warranted in some groups of adolescents and young adults infected with HIV.
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Affiliation(s)
- Bret J Rudy
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, 3535 Market Street, Suite 1517, Philadelphia, PA 19104, USA.
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27
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Pahwa S, Muresan P, Sleasman J, Fenton T, Moye J, Deveikis A, Wara D, Van Dyke R. Phase I/II trial of intermittent subcutaneous IL-2 administration in pediatric patients with moderate immune suppression: results of Pediatric AIDS Clinical Trials Study 402. J Allergy Clin Immunol 2007; 119:1538-41. [PMID: 17418382 DOI: 10.1016/j.jaci.2006.12.674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Revised: 12/26/2006] [Accepted: 12/28/2006] [Indexed: 10/23/2022]
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28
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Litherland SA, She JX, Schatz D, Fuller K, Hutson AD, Peng RH, Li Y, Grebe KM, Whittaker DS, Bahjat K, Hopkins D, Fang Q, Spies PD, North K, Wasserfall C, Cook R, Dennis MA, Crockett S, Sleasman J, Kocher J, Muir A, Silverstein J, Atkinson M, Clare-Salzler MJ. Aberrant monocyte prostaglandin synthase 2 (PGS2) expression in type 1 diabetes before and after disease onset. Pediatr Diabetes 2003; 4:10-8. [PMID: 14655518 DOI: 10.1034/j.1399-5448.2003.00042.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
METHODS We examined monocyte prostaglandin synthase 2 (PGS2/COX2) expression in individuals at risk for or with type 1 diabetes including: (i) 58 established type 1 and 2 diabetic patients; (ii) 34 autoantibody positive (AA+) children and adults; (iii) 164 infants and young children with insulin-dependent diabetes mellitus (IDDM) susceptibility human leukocyte antigen (HLA) alleles; and (iv) 37 healthy control individuals, over a 5-yr period. RESULTS Established type 1 diabetic patients (1 month to 30+ yr post-disease onset) had significantly higher PGS2 expression than healthy controls; by contrast, insulin-treated type 2 diabetic patients had significantly lower PGS2 expression than healthy controls. Longitudinal studies of AA+ subjects at risk for type 1 diabetes indicated that 73% (11/15) of individuals who developed this disease during the study period expressed high levels of PGS2 prior to or after onset. We also found high level PGS2 expression in genetically at-risk infants and young children that correlated with having a first-degree relative with type 1 diabetes, but not with age, gender, or HLA genotype. In this population, high level PGS2 expression coincided with or preceded autoantibody detection in 30% (3/10) of subjects. CONCLUSIONS These findings suggest that high level monocyte PGS2 expression, although subject to fluctuation, is present in at-risk subjects at an early age and is maintained during progression to and after type 1 diabetes onset.
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Affiliation(s)
- S A Litherland
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Box 100275, JHMHC, Gainesville, Florida 32610, USA
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Sáez-Llorens X, Nelson RP, Emmanuel P, Wiznia A, Mitchell C, Church JA, Sleasman J, Van Dyke R, Richardson CG, Cutrell A, Spreen W, Hetherington S. A randomized, double-blind study of triple nucleoside therapy of abacavir, lamivudine, and zidovudine versus lamivudine and zidovudine in previously treated human immunodeficiency virus type 1-infected children. The CNAA3006 Study Team. Pediatrics 2001; 107:E4. [PMID: 11134468 DOI: 10.1542/peds.107.1.e4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Abacavir (ABC) is a potent inhibitor of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase. We compared the efficacy, safety, and tolerability of combination therapy with ABC, lamivudine (3TC), and zidovudine (ZDV) versus 3TC and ZDV in antiretroviral experienced HIV-1-infected children over 48 weeks. METHODS Two hundred five HIV-1-infected children who had received previous antiretroviral therapy and had CD4(+) cell counts >/=100 cells/mm(3) were stratified by age and by previous treatment. Participants were randomly assigned to receive ABC (8 mg/kg twice daily [BID]) plus 3TC (4 mg/kg BID) and ZDV (180 mg/m(2) BID; ABC/3TC/ZDV group) or ABC placebo plus 3TC (4 mg/kg BID) and ZDV (180 mg/m(2); 3TC/ZDV group). Participants who met a protocol-defined switch criteria (plasma HIV-1 RNA >0.5 log(10) copies/mL above baseline at week 8 or >10 000 copies/mL after week 16) had the option to switch to open-label ABC plus any antiretroviral combination or continue randomized therapy or withdraw from the study. RESULTS The Kaplan-Meier estimates (95% confidence interval) of the proportion of participants who maintained HIV-1 RNA levels </=10 000 copies/mL for 48 weeks or more was significantly better in the ABC/3TC/ZDV group compared with the 3TC/ZDV group: 33% (23%-42%) versus 21% (13%-29%). At week 48, the proportions of participants with HIV-1 RNA </=10 000 copies/mL were 36% versus 26% for the ABC/3TC/ZDV and 3TC/ZDV groups, respectively, by intent-to-treat analysis. For the subgroup of participants with baseline HIV-1 RNA >10 000 copies/mL, a significantly higher proportion of participants in the ABC/3TC/ZDV group had HIV-1 RNA </=10 000 copies/mL compared with the 3TC/ZDV group (29% vs 12%) but no difference was observed in the subgroup of participants with baseline HIV-1 RNA </=10 000 copies/mL (78% vs 72%). The median changes from baseline in CD4(+) cell counts were greater in the ABC/3TC/ZDV group than in the 3TC/ZDV group. Few participants (3%) experienced abacavir-related hypersensitivity reaction. CONCLUSIONS ABC, in combination with 3TC and ZDV, provides additional antiretroviral activity over 48 weeks, compared with combination therapy with 3TC and ZDV in antiretroviral experienced HIV-1-infected children. ABC was safe and generally well-tolerated and should be considered an active component of combination antiretroviral therapy in this pediatric population.
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Affiliation(s)
- X Sáez-Llorens
- Hospital del Niño, Servicio de Infectologia, Panama City, Republic of Panama.
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30
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McIntosh K, Cooper E, Xu J, Mirochnick M, Lindsey J, Jacobus D, Mofenson L, Yogev R, Spector SA, Sullivan JL, Sacks H, Kovacs A, Nachman S, Sleasman J, Bonagura V, McNamara J. Toxicity and efficacy of daily vs. weekly dapsone for prevention of Pneumocystis carinii pneumonia in children infected with human immunodeficiency virus. ACTG 179 Study Team. AIDS Clinical Trials Group. Pediatr Infect Dis J 1999; 18:432-9. [PMID: 10353516 DOI: 10.1097/00006454-199905000-00007] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dapsone is an alternative drug for Pneumocystis carinii pneumonia (PCP) prophylaxis in individuals intolerant to trimethoprim-sulfamethoxazole (T/S). There are, however, few data on the pharmacokinetics, toxicity or efficacy of dapsone in children. Design. Randomized, multicenter trial comparing daily (1 or 2 mg/kg) with weekly (4 mg/kg) dapsone regimens in 94 HIV-infected children intolerant to T/S. METHODS Hematologic and hepatic toxicity was monitored, as well as the occurrence of skin rash, PCP or death. RESULTS Initial pharmacokinetic data indicated that adequate serum dapsone concentrations were not achieved with the daily 1-mg/kg regimen; the daily dose was then increased to 2 mg/kg. Both short and long term hematologic toxicities were marginally greater in children receiving the daily 2 mg/kg compared with the weekly regimen. Allergic skin rashes were similar in children receiving the daily and weekly regimens (17% in both) and were not associated with prior history of rash with T/S. PCP occurred most frequently with the daily 1-mg/kg regimen (22.0 cases/100 patient years), least frequently with the daily 2-mg/kg regimen (0 case/100 patient years) and at intermediate frequency with the weekly regimen (9.5 cases/100 patient years). More deaths were observed in patients receiving the daily than the weekly regimen (8 vs. 2, respectively), although the deaths were not directly attributable to dapsone treatment. CONCLUSION Although a weekly dapsone regimen of 4 mg/kg produced less hematologic toxicity than a daily regimen of 2 mg/kg, this advantage was offset by a trend toward higher breakthrough rates of PCP.
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Affiliation(s)
- K McIntosh
- Children's Hospital, Division of Infectious Diseases, Boston, MA 02115, USA.
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31
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Zeichner SL, Palumbo P, Feng Y, Xiao X, Gee D, Sleasman J, Goodenow M, Biggar R, Dimitrov D. Rapid telomere shortening in children. Blood 1999; 93:2824-30. [PMID: 10216076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Telomere shortening may reflect the total number of divisions experienced by a somatic cell and is associated with replicative senescence. We found that the average rate of telomere shortening in peripheral blood mononuclear cells (PBMCs) obtained longitudinally from nine different infants during the first 3 years of life (270 bp per year) is more than fourfold higher than in adults and does not correlate with telomerase activity. These results show that the rate of telomere loss changes during ontogeny, suggesting the existence of periods of accelerated cell division. Because human immunodeficiency virus (HIV) preferentially infects actively dividing cells, our observation suggesting accelerated cell division in children may provide an explanation for some of the distinctive pathogenic features of the HIV disease in infants, including higher viral loads and more rapid progression to acquired immunodeficiency syndrome (AIDS).
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Affiliation(s)
- S L Zeichner
- HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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32
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Mueller BU, Sleasman J, Nelson RP, Smith S, Deutsch PJ, Ju W, Steinberg SM, Balis FM, Jarosinski PF, Brouwers P, Mistry G, Winchell G, Zwerski S, Sei S, Wood LV, Zeichner S, Pizzo PA. A phase I/II study of the protease inhibitor indinavir in children with HIV infection. Pediatrics 1998; 102:101-9. [PMID: 9651421 DOI: 10.1542/peds.102.1.101] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Indinavir, an inhibitor of the human immunodeficiency virus type 1 (HIV-1) protease, is approved for the treatment of HIV infection in adults when antiretroviral therapy is indicated. We evaluated the safety and pharmacokinetic profile of the indinavir free-base liquid suspension and the sulfate salt dry-filled capsules in HIV-infected children, and studied its preliminary antiviral and clinical activity in this patient population. In addition, we evaluated the pharmacokinetic profile of a jet-milled suspension after a single dose. METHODS Previously untreated children or patients with progressive HIV disease despite antiretroviral therapy or with treatment-associated toxicity were eligible for this phase I/II study. Three dose levels (250 mg/m2, 350 mg/m2, and 500 mg/m2 per dose given orally every 8 h) were evaluated in 2 age groups (<12 years and >/=12 years). Indinavir was initially administered as monotherapy and then in combination with zidovudine and lamivudine after 16 weeks. RESULTS Fifty-four HIV-infected children (ages 3.1 to 18.9 years) were enrolled. The indinavir free-base suspension was less bioavailable than the dry-filled capsule formulation, and therapy was changed to capsules in all children. Hematuria was the most common side effect, occurring in 7 (13%) children, and associated with nephrolithiasis in 1 patient. The combination of indinavir, lamivudine, and zidovudine was well tolerated. The median CD4 cell count increased after 2 weeks of indinavir monotherapy by 64 cells/mm3, and this was sustained at all dose levels. Plasma ribonucleic acid levels decreased rapidly in a dose-dependent way, but increased toward baseline after a few weeks of indinavir monotherapy. CONCLUSIONS Indinavir dry-filled capsules are relatively well tolerated by children with HIV infection, although hematuria occurs at higher doses. Future studies need to evaluate the efficacy of indinavir when combined de novo with zidovudine and lamivudine.
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Affiliation(s)
- B U Mueller
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USA
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Mueller BU, Nelson RP, Sleasman J, Zuckerman J, Heath-Chiozzi M, Steinberg SM, Balis FM, Brouwers P, Hsu A, Saulis R, Sei S, Wood LV, Zeichner S, Katz TT, Higham C, Aker D, Edgerly M, Jarosinski P, Serchuck L, Whitcup SM, Pizzuti D, Pizzo PA. A phase I/II study of the protease inhibitor ritonavir in children with human immunodeficiency virus infection. Pediatrics 1998; 101:335-43. [PMID: 9480994 DOI: 10.1542/peds.101.3.335] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ritonavir, a potent antiretroviral protease inhibitor, has been approved for the treatment of adults and children with human immunodeficiency virus (HIV) infection. In a phase I/II study, we assessed the safety, tolerability, and pharmacokinetic profile of the oral solution of ritonavir in HIV-infected children and studied the preliminary antiviral and clinical effects. METHODS HIV-infected children between 6 months and 18 years of age were eligible. Four dose levels of ritonavir oral solution (250, 300, 350, and 400 mg/m given every 12 hours) were evaluated in two age groups (</=2 years, >2 years). Ritonavir was administered alone for the first 12 weeks and then in combination with zidovudine and/or didanosine. Clinical and laboratory parameters were monitored every 2 to 4 weeks. RESULTS A total of 48 children (median age, 7.7 years; range, 0.5 to 14.4 years) were included in this analysis. Dose-related nausea, diarrhea, and abdominal pain were the most common toxicities and resulted in discontinuation of ritonavir in 7 children. Ritonavir was well absorbed at all dose levels, and plasma concentrations reached a peak 2 to 4 hours after a dose. CD4 cells counts increased by a median of 79 cells/mm3 after 4 weeks of monotherapy and were maintained throughout the study. Plasma HIV RNA decreased by 1 to 2 log10 copies/mL within 4 to 8 weeks of ritonavir monotherapy, and this level was sustained in patients enrolled at the highest dose level of 400 mg/m for the 24-week period. CONCLUSIONS The oral solution of ritonavir has potent antiretroviral activity as a single agent and is relatively well tolerated by children when administered alone or in combination with zidovudine or didanosine.
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Affiliation(s)
- B U Mueller
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USA
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Neu J, Roig JC, Meetze WH, Veerman M, Carter C, Millsaps M, Bowling D, Dallas MJ, Sleasman J, Knight T, Auestad N. Enteral glutamine supplementation for very low birth weight infants decreases morbidity. J Pediatr 1997; 131:691-9. [PMID: 9403648 DOI: 10.1016/s0022-3476(97)70095-7] [Citation(s) in RCA: 193] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Glutamine, described as a "conditionally essential" amino acid for critically ill patients, has not been routinely added to parenteral amino acid formulations for critically ill neonates and is provided in only small quantities by the enteral route when enteral intake is low. We conducted a blinded, randomized study of enteral glutamine supplementation in 68 very low birth weight neonates randomly assigned to receive glutamine-supplemented premature formula versus premature formula alone between days 3 and 30 of life. Primary end points consisted of hospital-acquired sepsis, tolerance to subsequent enteral feedings (days with no oral intake), and duration of hospital stay. Hospital acquired sepsis was 30% (control group) and 11% (glutamine group). Logistic regression with birth weight as a covariate showed that: (1) feeding group was significant (p = 0.048) in determining the probability of developing proven sepsis over the course of hospitalization and (2) the estimated odds of developing sepsis were 3.8 times higher for infants in the control group than for those treated with glutamine. Glutamine-supplemented infants had better tolerance to enteral feedings as measured by percent of days on which feedings needed to be withheld (mean percentage of 8.8 vs 23.8, p = 0.007). Analysis of T cells demonstrated a blunting of the rise in HLA-DR+ and CD16 subsets in glutamine-supplemented infants. There were no differences in growth; in serum ammonia, urea, liver transaminase, or prealbumin concentrations; or in mean hospital stay. This study provides evidence for decreased morbidity in very-low-birth-weight neonates who receive enteral glutamine supplementation.
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Affiliation(s)
- J Neu
- Department of Pediatrics, University of Florida, Gainesville 32610, USA
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Abstract
Aminoglycosides have been reported to cause tetany by inducing renal wasting of magnesium and secondary hypocalcemia. A 9-year-old girl with AIDS was brought to the emergency department because of tetany. She had just finished a 3-week course of intravenous tobramycin for bronchiectasis and had an elevated serum tobramycin trough level 1 week before the onset of tetany. Hypomagnesemia, hypokalemia, and hypocalcemia had developed. The urine revealed inappropriately high levels of magnesium and potassium despite critically low serum levels, with an appropriately low urine calcium level. This pattern is suggestive of renal toxicity due to tobramycin. Over the next several months, she continued to require supplemental calcium, magnesium, potassium, and phosphorus. She also had nephrotic range proteinuria. Aminoglycoside renal mineral wasting has not previously been described in a child.
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Affiliation(s)
- W Slayton
- Department of Pediatrics, University of Florida College of Medicine, Gainesville 32610, USA
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Abstract
Hyponatremia has been recognized as a complication in adults with acquired immunodeficiency syndrome (AIDS). We did a retrospective study evaluating the medical records of 86 children (age 4 months to 21 years) with human immunodeficiency virus (HIV-1) infection to determine the frequency and clinical associations of hyponatremia. Twenty-two children (26%) developed hyponatremia (serum sodium < 135 mEq/L; range 104 to 134 mEq/L; mean 130 mEq/L). Fourteen were male; 18 of the 22 patients were black and 4 were white. At the time of hyponatremia, the children frequently had comorbid associations, including 8 (35%) with AIDS encephalopathy; 3 (14%) with cardiomyopathy; 3 (14%) using diuretics; 1 (5%) using pentamidine; 3 (14%) with bacterial pneumonia; 2 (9%) requiring gastric lavage feedings; 2 (9%) with tuberculosis meningitis; 2 (9%) with gastroenteritis; 1 (5%) with infection caused by Mycobacterium avium-intracellulare; 1 (5%) each with brain tumor and tumor metastasis to brain. The cause of hyponatremia was attributed to syndrome of inappropriate antidiuretic hormone in 8 children; poor sodium intake and/or excessive diarrheal losses in 5; and the use of diuretics in 3 patients. Mild hyponatremia with no identifiable cause was found in 5 patients.
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Affiliation(s)
- A Tolaymat
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville, USA
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37
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Matsuyama T, Yamada A, Deusch K, Sleasman J, Daley JF, Torimoto Y, Abe T. Cytochalasins enhance the proliferation of CD4 cells through the CD3-Ti antigen receptor complex or the CD2 molecule through an effect on early events of activation. J Immunol 1991; 146:3736-41. [PMID: 1709660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cytochalasins are known to inhibit or enhance the proliferation of T cells induced by mitogens in a concentration-dependent fashion. To clarify the mechanism by which cytochalasins enhance T cell proliferation, we examined which activation pathways and events in signal transduction were affected by cytochalasins. We also examined subsets of CD4 cells for a preferential response to cytochalasins. Cytochalasins enhanced the proliferation of CD4 cells induced by optimal doses of anti-CD3 antibody or suboptimal doses of anti-CD2 antibodies. Cytochalasins, at low concentrations, enhanced the rise in intracellular Ca2+ and production of IP3 in CD4 cells activated by anti-CD2 or CD3 antibodies. Cytochalasins also enhanced the modulation of CD3 induced by anti-CD3 antibody. These results suggest that cytochalasins enhance the proliferation of CD4 cells by affecting early events in signal transduction after activation through the CD3-Ti Ag-receptor complex or CD2 molecule. At the doses used, cytochalasins appear to interact with cytochalasin-binding sites in the cell membrane. Cytochalasins predominantly enhanced CD3-mediated proliferation in the CD29-subset of CD4 cells.
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Affiliation(s)
- T Matsuyama
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
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Matsuyama T, Yamada A, Deusch K, Sleasman J, Daley JF, Torimoto Y, Abe T. Cytochalasins enhance the proliferation of CD4 cells through the CD3-Ti antigen receptor complex or the CD2 molecule through an effect on early events of activation. The Journal of Immunology 1991. [DOI: 10.4049/jimmunol.146.11.3736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Cytochalasins are known to inhibit or enhance the proliferation of T cells induced by mitogens in a concentration-dependent fashion. To clarify the mechanism by which cytochalasins enhance T cell proliferation, we examined which activation pathways and events in signal transduction were affected by cytochalasins. We also examined subsets of CD4 cells for a preferential response to cytochalasins. Cytochalasins enhanced the proliferation of CD4 cells induced by optimal doses of anti-CD3 antibody or suboptimal doses of anti-CD2 antibodies. Cytochalasins, at low concentrations, enhanced the rise in intracellular Ca2+ and production of IP3 in CD4 cells activated by anti-CD2 or CD3 antibodies. Cytochalasins also enhanced the modulation of CD3 induced by anti-CD3 antibody. These results suggest that cytochalasins enhance the proliferation of CD4 cells by affecting early events in signal transduction after activation through the CD3-Ti Ag-receptor complex or CD2 molecule. At the doses used, cytochalasins appear to interact with cytochalasin-binding sites in the cell membrane. Cytochalasins predominantly enhanced CD3-mediated proliferation in the CD29-subset of CD4 cells.
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Affiliation(s)
- T Matsuyama
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - A Yamada
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - K Deusch
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - J Sleasman
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - J F Daley
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - Y Torimoto
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
| | - T Abe
- Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe City, Japan
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