Clinical Immunology Communications最新文献

Severe obesity is linked to a low-grade inflammatory process due to enlarged adipose tissue, resulting in elevated pro-inflammatory cytokines. Bariatric surgery induces anatomical changes, causing intestinal inflammation marked by anti-Saccharomyces cerevisiae (ASCA) antibodies. This study aimed to assess ASCA IgG/IgA levels preoperatively and 12 months post-surgery, correlating them with systemic inflammation markers (IL-6, CRP, MCP-1). Participants (BMI > 35 kg/m²) were recruited in South Brazil. Severe obesity individuals showed elevated IL-6 (p = 0.002), CRP (p<0.0001), and MCP-1 (p<0.0001) compared to lean controls. ASCA IgA was significantly higher in severe obesity (p = 0.0019). Post-surgery, ASCA IgG/IgA significantly decreased (p = 0.0046 and p<0.0001), along with IL-6, MCP-1, and CRP, confirming weight loss and reduced inflammation. Hypertrophic adipose tissue, producing pro-inflammatory cytokines, associates with increased intestinal inflammation. Bariatric surgery-induced anatomical changes contribute to long-term weight loss and reduced systemic and intestinal inflammation.

Background

The SARS-CoV2 pandemic required rapid development and expedited evaluation of vaccine efficacy. Initial evidence suggested waning immune response to SARS-CoV2 vaccination steadily over the first six months. This study evaluated duration of immunity in vaccinated patients at a single tertiary center in New York City during the pandemic.

Methods

We conducted a retrospective review of adult vaccinated patients admitted over a period of 3 months during the SARS-CoV2-Omicron variant and evaluated their immune response using the spike protein antibody titer. A total of 2476 patients were screened, and 1875 patients were included in the study. Secondary analysis of a cohort of patients with COVID-19 disease was also performed.

Results

Spike protein antibody was positive in 99 % of patients. Most patients received two doses of the Pfizer (42 %) or the Moderna (27 %) vaccines. There was a negative correlation between months since vaccination and spike protein antibody titer (Spearman's rank correlation –0.094, p <0.0001). Subgroup analysis of those who had received at least two doses of a vaccine series revealed similar negative correlations for both Pfizer (Spearman's rank correlation –0.14, p <0.0001) and Moderna vaccines (Spearman's rank correlation –0.11, p = 0.0043). Secondary analysis of patients admitted with a diagnosis of COVID-19 infection did not demonstrate any statistically significant difference in titer results over time.

Conclusions

Our study of patients admitted to a tertiary care center across a diverse patient population demonstrated that patients who were vaccinated against SARS-COV2 had a robust response in their spike protein antibody titer which was maintained well beyond six months after vaccination.

Cholangiocarcinoma (CCA) is a group of malignant digestive system tumors with a poor overall prognosis. Late diagnosis and limited treatment are the main problems of CCA. Immunotherapy is a promising method to improve the prognosis, but the immunosuppression of CCA tumor microenvironment hinders the development and implementation of immunotherapy. Therefore, a full understanding of the complex components of CCA and its tumor immune microenvironment (TiME) can better understand the pathogenesis and drug resistance mechanism of CCA and contribute to the discovery of new immunotherapy targets. This article reviews the TiME related research on CCA, comprehensively discusses the components of the immune microenvironment of cholangiocarcinoma, and introduces the research progress of immunotherapy and immune combination therapy for CCA.

As long as there is only symptomatic treatment against thick-borne encephalitis (TBE) available, vaccination is considered the only prevention against infection.

The national vaccination recommendations prescribe a booster vaccination every 5 years after a basic vaccination has been carried out. This study deals with the question if antibodies in sufficient concentration exist or not when the last immunization had been five years ago.

The TBE titer was determined in 168 subjects using indirect ELISA and the vaccination history was collected.

The results show that 97.3 % of the participants have a sufficient titer 5 years after the last booster vaccination. The time period since the last booster and the type of the vaccine influence the antibody level the most. In conclusion, it was found that by controlling the titer, it is possible to postpone a booster vaccination, if the immunization is still sufficient.

Management of Systemic lupus erythematosus is challenging due to its varied manifestations, relapses and problems associated with immunosuppressive therapy. This challenge is compounded in resource limited countries due to additional factors such as poor access to health care, limited income, out of pocket expenses for medical care and lack of financial independence of women. In the current review some of these issues have been highlighted in context of India, the most populous country of the world with current annual per capita income of around 2000 dollars.

Systemic lupus erythematosus (SLE) affects more severely non-White populations, which is also the case in Latin America; this is the result of a combination of genetic and non-genetic factors. Among the non-genetic factors, a limited income and a low educational level impact negatively on the course and outcome of the disease; in addition, lack of access to healthcare services deprives patients from the opportunity of being managed by specialists, making the availability of the newest drugs practically impossible. Taking together, these factors reduce the probability of patients achieving good outcomes, like remission, less damage accrual, a better survival and a better health-related quality of life, among others. Several strategies have been proposed to reduce these disparities, including peer education, educational activities for patients and primary care physicians, improving healthcare networks and generating cost-effectiveness analyses.

We report a case of an adult female with disseminated tuberculosis, cytomegalovirus viraemia and haemophagocytic-lymphohistiocystosis syndrome associated with neutralizing anti- interferon gamma (IFNγ) autoantibodies demonstrated by absent IFNγ stimulated STAT1 phosphorylation in the presence of patient sera. A brief review of immunodeficiency caused by anti-IFNγ autoantibodies is also described.

Goal of health policies is to protect and promote the health of communities. We examined COVID-19 policy outcomes of the 50 US states according to policymaker assumptions over time. With daily cumulative population mortality chosen as an indicator to evaluate and score outcomes of individual health policies, Hawaii had the best score and Arizona has the worst score. Our policy outcome analysis tool could identify and quantify policymakers’ faulty assumptions against COVID-19, and concludes that the more COVID-19 deaths, the greater the economic loss.

The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients and is defined by the acute onset of noncardiogenic pulmonary edema, hypoxemia, and the need for mechanical ventilation. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma, and is present in ∼10% of all intensive care unit patients worldwide. Pathologic specimens from patients with ARDS most frequently reveal diffuse alveolar damage, and laboratory studies have demonstrated both alveolar epithelial and lung endothelial injury, resulting in accumulation of protein-rich inflammatory edema fluid in the alveolar space. The current therapeutic regimen is comprised of supportive measures such as lung protective ventilation, restrictive fluid management, paralyzing drugs, and prone positioning. Although vast improvements have been made in ARDS-treatment during the last five decades, mortality among patients with severe ARDS remains at an unacceptable rate of 45%.This article reviews the evolution of the currently used definition, established pathophysiological mechanism, highlights the current best clinical practice to treat ARDS, gives a brief outlook on cutting edge trends in ARDS research and closes with an expert opinion on the subject. The ongoing digital revolution will help to individualize ARDS-treatment and will therefore presumably improve survival and quality of life.

Objectives

Elderly become more susceptible to lower respiratory tract infections, resulting in antibiotic prescriptions. Immunoglobulins (Ig) play an important role in host defense and protection against infections. Therefore, we aimed to investigate whether lower Ig levels are a risk factor for antibiotic use in the general elderly population.

Methods

After exclusion of current antibiotic users, Cox proportional-hazards regression models were performed to investigate the effect of stable serum IgM, IgG and IgA levels on time to first antibiotic prescription within the Rotterdam Study. Regression models were adjusted for age, sex, body mass index, smoking status and diabetes. We introduced quadratic terms and additionally categorized Igs to explore and quantify potential non-linearity of the association. The restricted cubic splines technique was used to plot the natural log of the hazard across Ig level.

Results

In total, 8,639 participants were included (mean age 64 years, 57% female, medium follow-up 3.2 years). No significant association between IgM and time to antibiotic prescription was observed. IgG and IgA levels (in g/L) showed a U-shaped relationship with time to antibiotic prescription (linear IgG HR 0.959, 95% CI 0.930–0.989; quadratic IgG² HR 1.002, 95% CI 1.000–1.003; linear IgA HR 0.949, 95% CI 0.910–0.990; quadratic IgA² HR 1.009, 95% CI 1.004–1.013).

Conclusion

Both low and high IgG and IgA levels were associated with a higher incidence of antibiotic prescriptions in stable middle-aged and older individuals. Increased awareness for the potential increased infection risk when persons have low or high Ig levels, even within the reference ranges, is needed.