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East Meadow, NY, United States

Frieri M.,Nassau University Medical Center
Current Allergy and Asthma Reports | Year: 2012

In systemic lupus erythematosus (SLE) patients, the role of inflammatory mediators is relevant to the pathogenesis of accelerated atherosclerosis. CD40 ligand is increased on circulating lymphocytes, correlates with double-stranded DNA, and has an important role in predicting risk of cardiovascular disease. Vascular endothelial growth factor (VEGF) is a tightly regulated angiogenic cytokine in the kidney, and plasma levels have been associated with disease activity. It has been correlated with lupus nephritis, associated with higher mean carotid intima media thickness, and can be a novel cardiovascular risk factor in premature coronary atherosclerosis. VEGF has been demonstrated in cultured human aortic endothelial cells in the presence of simvastatin and in kidney biopsies in lupus nephritis. SLE patients have been shown to manifest disturbances in gene expression involved in lipid transport and atheroma promotion. This paper provides evidence of the immune system in accelerated atherosclerosis in SLE, the role of selected proinflammatory cytokines, and therapeutic approaches. © 2011 Springer Science+Business Media, LLC.

Leonardi G.P.,Nassau University Medical Center
American Journal of Clinical Pathology | Year: 2010

Identification of the 2009 H1N1 influenza A virus requires emergency use authorized (EUA) molecular reverse transcriptase-polymerase chain reaction. Laboratories lacking molecular capabilities outsource testing, which is costly and may delay result reporting. A fluorescent antibody (FA; D3 Ultra 2009 H1N1 influenza A virus ID Kit, Diagnostic Hybrids, Athens, OH) recently received Food and Drug Administration EUA status for 2009 H1N1 virus identification. The performance of this FA reagent was evaluated in this study. Influenza A-positive nasopharyngeal specimens (seasonal H1, H3, and 2009 H1N1) were prepared for culture and FA testing and were stained using influenza A antibodies and the 2009 H1N1 reagent. Other respiratory viruses were also evaluated. The FA reagent demonstrated 100% sensitivity and specificity. Bright, apple-green fluorescence was effortlessly identified in culture-positive cells, particularly around cell membrane perimeters. Laboratory-prepared slides were preferred over bedside-prepared specimens because background fluorescence obscured identification in the latter. The new FA reagent provides an accurate, rapid, and inexpensive assay for identifying the 2009 H1N1 virus in nonmolecular diagnostic laboratories. © American Society for Clinical Pathology.

Frieri M.,Nassau University Medical Center
Current allergy and asthma reports | Year: 2014

Good's syndrome and common variable immune deficiency (CVID) are associated with chronic rhinosinusitis. Good's syndrome is characterized by hypogammaglobulinemia, B-cell depletion, variable defects in cellular immunity and thymoma. Immunodeficiency and recurrent infections can initially present after thymectomy. The pathogenesis can involve cytokines from bone marrow along with genetic defects. Intravenous gamma globulin (IVIG) restores defective signaling and can reestablish immune homeostasis. IVIG at regular intervals is the most effective way to improve the clinical symptoms and reduce patient mortality. Increased awareness of the clinical and immunological profile of this syndrome may increase its early recognition. CVID patients have hypogammaglobulinemia, respond to IVIG and have a dysregulated antimicrobial peptide response to pathogenic bacteria in the upper respiratory tract. This article reviewed selected literature on Good's syndrome, described an unusual case of Good's syndrome, CVID including SAD related to chronic rhinosinusitis.

Hodak S.P.,University of Pittsburgh | Rosenthal D.S.,Nassau University Medical Center
Thyroid | Year: 2013

TSH receptor mRNA reverse transcription-polymerase chain reaction, the Veracyte and Asuragen commercial methods, and the noncommercial use of BRAF, RAS, RET/PTC, and PAX8/PPARγ testing have promising roles in the diagnosis and treatment of patients with nodular thyroid disease and thyroid cancer. However, at this time, experience with these molecular methods remains limited, and no test has perfect sensitivity and specificity. Peer-reviewed data evaluating the diagnostic performance of these tests are increasingly available. The American Thyroid Association (ATA) feels that until an expert consensus review of existing data (now underway by the ATA Guidelines Task Force) can be completed, no evidence-based recommendation for or against the use of these methods can be made. Clinicians are therefore advised to consider the use of these genetic diagnosis methods with appropriate caution, and to remain cognizant of the limitations of the data supporting their use. Patients who are interested in the use of these tests in their own care should discuss them thoroughly with their care providers. Until evidence-based recommendations are available, determining whether or not the limited data available support the use of these methods should be considered on a case-by-case basis. © 2013, Mary Ann Liebert, Inc.

Li Z.,Nassau University Medical Center | Ju Z.,Feinstein Institute for Medical Research | Frieri M.,Nassau University Medical Center
Allergy and Asthma Proceedings | Year: 2013

The T-cell immunoglobulin and mucin domain (Tim) gene family is a relatively newly discovered group of molecules with a conserved structure and important immunologic functions. Tim molecules express on many types of immune cells including T cells, B cells, dendritic cells, macrophages, and mast cells that have been shown to be involved in asthma, allergic rhinitis, food allergy, and autoimmunity. Tim-1-Tim-4 interaction promotes Th2 cytokine responses, and blocking this interaction can decrease airway inflammation in asthma and in allergic rhinitis. Tim-3 stimulates mast cells to produce Th2 cytokines, and anti-Tim-3 is able to dampen asthmatic inflammation. The Tim-3 ligand was shown to be greatly enhanced on intestinal epithelial cells in patients with food allergy and Tim-4 may play a role in maintaining oral tolerance and prevention of food allergy. Tim-3 deregulation plays a role in the pathogenesis of multiple sclerosis. Increased Tim-1 expression has been shown in mononuclear cells from systemic lupus erythematosus patients and Tim-3 may be involved in a protective role in rheumatoid arthritis. Copyright © 2013, OceanSide Publications, Inc., U.S.A.

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