Pub Date : 2022-10-28DOI: 10.37191/mapsci-2582-6549-3(2)-035
Kazim Khalid
Cytokines play a major role in the inflammatory and allo-specific components of allograft rejection, and in the migration of cells into graft tissue. IL-2 binding of sIL-2R plays a major role in T cell activation. It is suggested that high urinary sIL-2R (U/sIL-2R) in the first 3-5 post-transplant days identified the patient sub-group at risk of developing acute rejection (RX). However, it was difficult to distinguish between RX and infection (INFX) as both of these factors can potentially affect serum sIL-2R (S/sIL-2R) and U/sIL-2R concentrations independent of actual production rates. The aims of this study were to validate and extend previous findings of the use of sIL-2R in renal transplantation, to investigate other protein markers currently used such as serum C-reactive protein (CRP), serum cystatin C (cys. C), and serum and urine creatinine (S/creat. and UCRE) and attempt to differentiate RX from INFX. SIL-2R ELISA kit was validated and used to establish reference ranges in healthy donors, transplant (TX) recipients, and renal disease controls. These values were compared with serial estimations of S/sIL-2R and U/sIL-2R of patients post-TX. Levels of serum CRP, cys. C, S/creat. and UCRE were also investigated in the renal disease control and 21 TX subjects to determine if a panel of investigation would have enhanced clinical diagnosis. RX and INFX were determined retrospectively on an “intention to treat” basis. Results show that sIL-2R levels in normal serum and urine subjects are lower than in disease controls, that CRP and cys C are good indicators of RX as well as U/sIL-2R and S/sIL-2R, that UCRE is not a good marker of differentiation, and that stratifying levels of these markers according to treatment differentiated RX from INFX.
细胞因子在同种异体移植排斥反应的炎症和同种异体特异性成分以及细胞向移植组织的迁移中起主要作用。IL-2结合sIL-2R在T细胞活化中起重要作用。这表明,移植后最初3-5天的高尿sIL-2R (U/sIL-2R)可识别有发生急性排斥反应(RX)风险的患者亚组。然而,很难区分RX和感染(INFX),因为这两种因素都可能影响血清sIL-2R (S/sIL-2R)和U/sIL-2R浓度,而与实际生产速率无关。本研究的目的是验证和扩展sIL-2R在肾移植中使用的先前发现,研究目前使用的其他蛋白质标志物,如血清C-反应蛋白(CRP),血清胱抑素C (cys)。C),血清和尿肌酐(S/creat。和UCRE),并试图区分RX和INFX。对SIL-2R ELISA试剂盒进行验证,并用于建立健康供者、移植(TX)受者和肾脏疾病对照者的参考范围。将这些值与tx后患者S/sIL-2R和U/sIL-2R的序列估计值进行比较。血清CRP水平,cys。C, S /创造。和UCRE也在肾脏疾病控制和21 TX受试者中进行了调查,以确定调查小组是否会提高临床诊断。RX和INFX是在“治疗意向”的基础上回顾性确定的。结果显示,正常人血清和尿液中sIL-2R水平低于疾病对照组,CRP和cys C是RX的良好指标,U/sIL-2R和S/sIL-2R是RX的良好指标,UCRE不是分化的良好指标,根据治疗将这些标志物分层可区分RX和INFX。
{"title":"Clinical Significance Of Serum And Urine Soluble Interleukin 2 Receptor, C-Reactive Protein, Cystatin C, and Serum and Urine Creatinine in Renal Transplant Patients","authors":"Kazim Khalid","doi":"10.37191/mapsci-2582-6549-3(2)-035","DOIUrl":"https://doi.org/10.37191/mapsci-2582-6549-3(2)-035","url":null,"abstract":"Cytokines play a major role in the inflammatory and allo-specific components of allograft rejection, and in the migration of cells into graft tissue. IL-2 binding of sIL-2R plays a major role in T cell activation. It is suggested that high urinary sIL-2R (U/sIL-2R) in the first 3-5 post-transplant days identified the patient sub-group at risk of developing acute rejection (RX). However, it was difficult to distinguish between RX and infection (INFX) as both of these factors can potentially affect serum sIL-2R (S/sIL-2R) and U/sIL-2R concentrations independent of actual production rates. The aims of this study were to validate and extend previous findings of the use of sIL-2R in renal transplantation, to investigate other protein markers currently used such as serum C-reactive protein (CRP), serum cystatin C (cys. C), and serum and urine creatinine (S/creat. and UCRE) and attempt to differentiate RX from INFX. SIL-2R ELISA kit was validated and used to establish reference ranges in healthy donors, transplant (TX) recipients, and renal disease controls. These values were compared with serial estimations of S/sIL-2R and U/sIL-2R of patients post-TX. Levels of serum CRP, cys. C, S/creat. and UCRE were also investigated in the renal disease control and 21 TX subjects to determine if a panel of investigation would have enhanced clinical diagnosis. RX and INFX were determined retrospectively on an “intention to treat” basis. Results show that sIL-2R levels in normal serum and urine subjects are lower than in disease controls, that CRP and cys C are good indicators of RX as well as U/sIL-2R and S/sIL-2R, that UCRE is not a good marker of differentiation, and that stratifying levels of these markers according to treatment differentiated RX from INFX.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89994535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.37191/mapsci-2582-6549-3(2)-036
Kazim Khalid
Renal transplantation (TX) is widely used as a definitive therapy for chronic, end-stage organ failure. T cells are pivotal in rejection (RX), and RX is a process whereby donor tissue is recognized and destroyed by the host immune system. Within a rejecting graft it is likely that high concentrations of IL-2 are present. The binding of interleukin 2(IL-2) to its receptor (IL-2R) on human T cells constitutes the key regulatory event in the initiation and maintenance of the immune response. The receptor, IL-2R, is found in two forms: cellular and soluble. The surgical removal of a transplanted kidney following RX or failure can be hazardous. Two surgical techniques were applied: extracapsular and intracapsular removal. The technique of kidney transplant removal by either the intra- or extra-capsular route of the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure. The results of the report are a prospective study on 21 renal TX recipients, and show that nephrectomy of previous TX kidney will reduce the levels of four markers in serum and urine.
{"title":"Should the First Rejected Kidney Implant be Removed?","authors":"Kazim Khalid","doi":"10.37191/mapsci-2582-6549-3(2)-036","DOIUrl":"https://doi.org/10.37191/mapsci-2582-6549-3(2)-036","url":null,"abstract":"Renal transplantation (TX) is widely used as a definitive therapy for chronic, end-stage organ failure. T cells are pivotal in rejection (RX), and RX is a process whereby donor tissue is recognized and destroyed by the host immune system. Within a rejecting graft it is likely that high concentrations of IL-2 are present. The binding of interleukin 2(IL-2) to its receptor (IL-2R) on human T cells constitutes the key regulatory event in the initiation and maintenance of the immune response.\u0000\u0000The receptor, IL-2R, is found in two forms: cellular and soluble. The surgical removal of a transplanted kidney following RX or failure can be hazardous. Two surgical techniques were applied: extracapsular and intracapsular removal. The technique of kidney transplant removal by either the intra- or extra-capsular route of the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure.\u0000\u0000The results of the report are a prospective study on 21 renal TX recipients, and show that nephrectomy of previous TX kidney will reduce the levels of four markers in serum and urine.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82807879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosai–Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis that was first described as sinus histiocytosis with massive lymphadenopathy by Rosai and Dorfman in 1969. While classical/nodal RDD is typical, extranodal involvement is seen in up to 43% of all cases, with 23% showing only extranodal lesions. Here, we present a case of disseminated extranodal RDD, where the initial symptoms were cutaneous manifestations.
{"title":"A case of disseminated extranodal Rosai–Dorfman disease diagnosed by skin manifestations","authors":"Shintaro Saito MD, Akihiko Uchiyama MD, PhD, Yayoi Shibusawa MD, PhD, Sei-ichiro Motegi MD, PhD","doi":"10.1002/cia2.12286","DOIUrl":"10.1002/cia2.12286","url":null,"abstract":"<p>Rosai–Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis that was first described as sinus histiocytosis with massive lymphadenopathy by Rosai and Dorfman in 1969. While classical/nodal RDD is typical, extranodal involvement is seen in up to 43% of all cases, with 23% showing only extranodal lesions. Here, we present a case of disseminated extranodal RDD, where the initial symptoms were cutaneous manifestations.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46485252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a pediatric patient with acquired cold urticaria who developed a systemic reaction triggered by localized cold exposure. By determining the critical threshold temperature using TempTest®, we were able to minimize restriction in activities.