Search results for "immunosuppression"

Enhanced Drug Delivery to the Skin Using Liposomes

2018

Background:. Enhancing drug delivery to the skin has importance in many therapeutic strategies. In particular, the outcome in vascularized composite allotransplantation mainly depends on systemic immunosuppression to prevent and treat episodes of transplant rejection. However, the side effects of systemic immunosuppression may introduce substantial risk to the patient and are weighed against the expected benefits. Successful enhancement of delivery of immunosuppressive agents to the most immunogenic tissues would allow for a reduction in systemic doses, thereby minimizing side effects. Nanoparticle-assisted transport by low temperature–sensitive liposomes (LTSLs) has shown some benefit in a…

CAR-T therapy in solid transplant recipients with post-transplant lymphoproliferative disease: case report and literature review

2021

Patients with postransplant lymphoproliferative disease (PTLD) who are refractory to rituximab-based regimens have extremely poor prognosis. Data is lacking in the setting of solid organ transplantation (SOT)-related PTLD treated with chimeric antigen receptor T-cell (CAR-T) therapy. Moreover, limited information is available on the influence of concomitant immunosuppressive drugs on CAR-T function. Here, we describe the clinical outcome in one PTLD patient and propose a strategy for tailoring immunosuppressive treatment and organ monitoring in patients with kidney allografts after CAR-T infusion. This report also reviews the limited published data in the setting of SOT-related PTLD treated…

The ins and outs of osteopontin.

2015

The continuous remodeling of progressing tumors demands non-physiologic production of extracellular matrix (ECM) proteins. Among them, osteopontin (OPN) has been largely involved in tumor progression and metastasis. We have recently discovered a new mechanism for OPN in the metastatic spread of mammary carcinoma providing local immunosuppression at the seeding site.

Four cases of progressive multifocal leukoencephalopathy in iatrogenic immunocompromised patients

2020

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by John Cunningham Virus (JCV). We report four PML cases in immunocompromised patients, respectively treated with (1) Natalizumab, (2) Rituximab, (3) autologous stem-cell transplantation, and (4) Tacrolimus. All patients underwent neurological examination, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), JCV-DNA research on biological samples, and lymphocytes subpopulation study. All cases presented with motor, behavioural, and cognitive disorders. Visual, sensitive, and cerebellar deficits developed in three cases. MRI revealed widespread progressiv…

2015

BACKGROUND Expensive pharmaceuticals are a major reason for cost intensive health care systems. Long-term immunosuppressive therapy plays a relevant role after organ transplantation. Patents of original drugs have expired and cheaper products are available. Little data are available regarding efficacy and safety of generic immunosuppressive agents. METHODS In this prospective study, 25 patients, who were clinically stable for a minimum of 2 years after liver transplantation, were converted from the original formulations of tacrolimus (TAC) and mycophenolate mofetil to the generics Tacpan (TAP) and Mowel (MOW). Patients were followed-up for 6 months. Results were compared retrospectively to …

α-Mannosyl-Functionalized Cationic Nanohydrogel Particles for Targeted Gene Knockdown in Immunosuppressive Macrophages

2019

Immunosuppressive M2 macrophages govern the immunophathogenic micromilieu in many severe diseases including cancer or fibrosis, thus, their re-polarization through RNA interference is a promising concept to support combinatorial therapies. For targeted siRNA delivery, however, safe and stable carriers are required that manage cell specific transport to M2 macrophages. Here, siRNA-loaded cationic nanogels are reported with α-mannosyl decorated surfaces that target and modify M2 macrophages selectively. Via amphiphilic precursor block copolymers bearing one single α-mannosyl moiety at their chain end mannosylated cationic nanohydrogel particles (ManNP) were obtained of 20 nm diameter determin…

Paraneoplastische limbische Enzephalitis bei kleinzelligem Bronchialkarzinom

2004

We report about a 63-year-old male patient who complained of a recent onset of confusion. A mediastinal mass had been detected in his chest X-ray three days before admission to our clinic. Surprisingly, a CT scan of the brain revealed no signs of cerebral masses or oedema. MRI demonstrated bright hyperintens signals in the medial aspect of both temporal lobes. Biopsy by mediastinoscopy showed small cell lung carcinoma (SCLC). No distant metastases were found by staging procedures. Cerebrospinal fluid and serum contained antineuronal antibodies (anti-Hu). The combination of symptoms, MRI findings and paraneoplastic antibodies established the diagnosis of paraneoplastic limbic encephalitis in…

469: Prospective, randomized, multicenter trial comparing conversion to a CNI-free regimen (MMF & sirolimus) vs. a CNI-reduced, MMF-based immunos…

2007

Demographic and clinical data in acquired hemophilia A

2012

Summary.  Background:  Acquired hemophilia A (AHA) is a rare autoimmune disease caused by autoantibodies against coagulation factor VIII and characterized by spontaneous hemorrhage in patients with no previous family or personal history of bleeding. Although data on several AHA cohorts have been collected, limited information is available on the optimal management of AHA. Objectives:  The European Acquired Hemophilia Registry (EACH2) was established to generate a prospective, large-scale, pan-European database on demographics, diagnosis, underlying disorders, bleeding characteristics, treatment and outcome of AHA patients. Results:  Five hundred and one (266 male, 235 female) patients from …

AISF position paper on liver transplantation and pregnancy: Women in Hepatology Group, Italian Association for the Study of the Liver (AISF)

2016

After the first successful pregnancy in a liver transplant recipient in 1978, much evidence has accumulated on the course, outcomes and management strategies of pregnancy following liver transplantation. Generally, liver transplantation restores sexual function and fertility as early as a few months after transplant. Considering that one third of all liver transplant recipients are women, that approximately one-third of them are of reproductive age (18-49 years), and that 15% of female liver transplant recipients are paediatric patients who have a >70% probability of reaching reproductive age, the issue of pregnancy after liver transplantation is rather relevant, and obstetricians, paedi…