Necrotizing sarcoid granulomatosis mimicking lung cancer in a patient with a history of ulcerative colitis [Nekrotizující sarkoidní granulomatóza imitující karcinom plie u pacientky s ulcerózní kolitidou v anamnéze]
Hajna A.,Pneumologicka Klinika |
Marel M.,Pneumologicka Klinika |
Petrik F.,Pneumologicka Klinika |
Capkova L.,Ustav Patologie A Molekularni Mediciny |
Podrazil M.,Ustav Imunologie
Studia Pneumologica et Phthiseologica | Year: 2016
Necrotizing sarcoid granulomatosis is a rare systemic disease with a predilection for the lung parenchyma, considered a variant of nodular sarcoidosis by some authors. The diagnosis is based on histological examination; the disease has no characteristic clinical, radiological or laboratory findings. Studies found that patients with idiopathic inflammatory bowel diseases have more frequent lung involvement by idiopathic inflammations than the general population. Presented is a case of a young female with a history of ulcerative colitis suspected of having lung cancer based on a chest CT scan. A lung lobectomy was indicated but histological examination of the resected tissue failed to confirm lung cancer. After an infectious etiology was ruled out and immunological examination was carried out, necrotizing sarcoid granulomatosis was diagnosed. For more than 10 years, the patient had not needed treatment for ulcerative colitis and gastroenterological examination did not find active disease. It is uncertain whether the two conditions may be associated. However, a higher risk of lung involvement in patients with idiopathic inflammatory bowel diseases has been reported in the literature, suggesting a common immunopathological basis. During her follow-up, the patient was found to have an enlarged thymus, arousing suspicion of thymoma. Since she rejected surgery, the lesion characteristics or potential association with the above condition cannot be discussed.
Anti-HLA antibody monitoring and its relevance for the course and treatment of the patients after kidney transplantation [Vyznam monitorovanf anti-HLA protilatek pro prubeh a l£cbu pacientu potransplantaci ledviny]
Ambruzova Z.,Ustav imunologie |
Krejci K.,III interniklinika nefrologicka |
Zadrazll J.,III interniklinika nefrologicka |
Petrek M.,Ustav imunologie
Aktuality v Nefrologii | Year: 2016
Antibody mediated rejection significantly influences long-term graft survival and quality of life after kidney transplantation. Antibodies against HLA antigens of the donor, i.e. DSA (Donor-Specific Antibodies) preformed in the time of transplantation or produced de novo after transplantation are involved in the pathogenesis of rejection. More sensitive, current techniques for anti-HLA antibodies detection based on the ALBIA (Adressable Laser Bead ImmunoAssay) principle, enable detection of the wide spectrum of clinically potentially relevant antibodies (non-complement fixing, low titre or low affinity antibodies) whose real impact for transplantation outcome is still a matter of the intensive debate of transplant immunologists and nephrologists. Regular post-transplantation HLA antibodies monitoring can be used for early and non-invasive antibody-mediated rejection diagnostics, mainly in highly immunized recipients or re-transplanted patients. The aim of our work is 1) to characterize the possibility of anti-HLA antibodies post-transplantation monitoring by ALBIA assay (Luminex technology - HLA antigen-coated beads based flow cytomtery) and 2) to demonstrate interpretation of data for clinical nephrologists for their early therapy of humoral rejection and control of its effectiveness using representative case reports.
Liba-Vrabelova Z.,Klinika Detske Neurologie |
Kayserova J.,Ustav Imunologie |
Komarek V.,Klinika Detske Neurologie
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2013
Introduction: Europe is an important endemic area for infection with the Borrelia burgdorferi sensu lato complex that includes several genospecies. Incidence and symptoms vary between areas. B. garinii has high affinity to the central nervous system and is the main genospecies in the Czech Republic. Correct diagnosis of Lyme neuroborreliosis (LNB) is crucial for its therapy. Diagnosis may be difficult and the infection may become chronic. The aim of this study was to determine the incidence of LNB and to establish clinical and laboratory findings in our pediatric patients. Methods: Retrospective evaluation of clinical and laboratory data obtained over a two-year period on 286 children with neurological symptoms (unconsciousness, focal deficit, headache, meningeal syndrome etc.) who underwent a lumbar puncture to exclude neuroinflammation. Antibodies against borrelia (and neurotrophic viruses) in the cerebrospinal fluid (CSF) and serum were determined. Cytological, immunological and biochemical analysis of CSF were performed as well as the PCR for the presence of borrelial DNA. Results: An association between neurological symptoms and borrelial infection was confirmed in 58 children (median age 7.44 years; range 0.5-17.5 years). Tick-bite was reported in 53% of children only and skin erythema in none of them. LNB was confirmed with laboratory tests in 53 children. The other 5 children had no laboratory signs of inflammation in the CNS. The main presentations of LNB were peripheral facial nerve palsy (PFNP) in 69% and meningitis in 15%. PFNP of borrelial etiology formed 53% of all PFNP in the period analyzed. Conclusion: LNB in children in the Czech Republic is very common. Comprehensive diagnostic approach, including lumbar puncture, is crucial. Correct therapy at the right time may prevent the chronic course of the disease.
Vavrova K.,Ustav imunologie |
Bartunkova J.,Ustav imunologie |
Horvath R.,Ustav imunologie
Onkologie (Czech Republic) | Year: 2015
The aim of current immunotherapeutic approaches is to harness the individual's immune system towards a tumor tissue to eliminate or, at least, to control proliferation of the neoplastic cells. Among the cancer treatment strategies, the adoptive T cell transfer is progressively developing method that uses an ex vivo modified and expanded tumor-specific T cells as a tool to target and destroy the neoplastic tumor cells. The efficacy of the adoptive T cell therapy has significantly improved in recent years due to a better understanding of the molecular mechanisms that control the interactions of immune system and tumor cells. Promising results have already been achieved within the clinical trials in malignant melanoma, renal cancer and lymphoid leukemia. The adoptive T cell therapy is therefore gradually finding its place among the other immunotherapeutic strategies and expands the spectrum of available treatment options in cancer therapy.
Sobotkova M.,Ustav Imunologie |
Bartunkova J.,Ustav Imunologie
Alergie | Year: 2011
Wegener's granulomatosis is ANCA-associated small vessel vasculitis with extremely malignant prognosis. Cyclophosphamide, together with high-dose corticosteroids, are cornerstone for induction treatment in this diagnosis. Biologic therapy may offer another option with less adverse effects and could be efficient also in refractory cases. Due to the recent studies, rituximab seems to be most promissing. Many other biological drugs are also tested in this diagnosis with various success.
Vernerova E.,Ustav imunologie
Interni Medicina pro Praxi | Year: 2012
A dramatic increase in the prevalence of allergy and asthma has occurrred during the past few decades. Although the symptoms of many allergic disorders can be suppressed quite effectively by pharmacological interventions, these do not provide a curative solution and therefore involve lifelong use of medication. The pivotal role in the regulation and maintaining of allergen tolerance represent T cell subsets, particullary T regulatory cells (T reg). These cells represent targets in the treatment of allergic disorders.
Defects of Toll-like receptors function in children with pneumococcal infections and herpetic encefalitis [Poruchy funkce Toll-like receptorů u dětí s invazivní pneumokokovou infekcí a herpetickými encefalitidami]
Spisek R.,Ustav Imunologie |
Kralikova P.,Ustav Imunologie
Alergie | Year: 2012
Appropriate and efficient recognition of pathogens by the immune system represents the key step in the initiation of the immune response. Recognition of pathogen associated molecular patterns is mediated by the set of germ line encoded pattern recognition receptors. Toll-like receptors (TLRs) represent the most important member of pattern recognition receptors. It has been shown that defects in TLRs signalling pathways cause increased susceptibility to bacterial or viral infections. Defects in signaling molecules downstream of TLRs recognizing bacteria have been described in patients with severe invasive pneumococcal infections. Defects in TLRs responsible for the induction of an anti-viral immune response have been detected in children with necrotizing herpetic encephalitis.
Anti-HLA antibody monitoring and its relevance for the course and treatment of the patients after kidney transplantation [Význam monitorování anti-HLA protilátek pro pruůběh a léčbu pacientů po transplantaci ledviny]
Ambruzova Z.,UStav Imunologie |
Krejci K.,UStav Imunologie |
Zadrazil J.,UStav Imunologie |
Petrek M.,UStav Imunologie
Alergie | Year: 2016
Antibody mediated rejection significantly influences long-term graft survival and quality of life after kidney transplantation. Antibodies against HLA antigens of the donor, i.e. DSA (Donor-Specific Antibodies) preformed in the time of transplantation or produced de novo after transplantation are involved in the pathogenesis of rejection. More sensitive, current techniques for anti-HLA antibodies detection based on the ALBIA (Adressable Laser Bead ImmunoAssay) principle, enable detection of the wide spectrum of clinically potentially relevant antibodies (non-complement fixing, low titre or low affinity antibodies) whose real impact for transplantation outcome is still a matter of the intensive debate of transplant immunologists and nephrologists. Regular post-transplantation HLA antibodies monitoring can be used for early and non-invasive antibodymediated rejection diagnostics, mainly in highly immunized recipients or re-transplanted patients. The aim of our work is 1) to characterize the possibility of anti-HLA antibodies post-transplantation monitoring by ALBIA assay (Luminex technology - HLA antigen-coated beads based flow cytomtery) and 2) to demonstrate interpretation of data for clinical nephrologists for their early therapy of humoral rejection and control of its effectiveness using representative case reports.
PubMed | Ustav imunologie
Type: Journal Article | Journal: Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca | Year: 2015
Aseptic loosening (AL) and periprosthetic osteolysis (PPOL) in total hip (THA) and knee (TKA) arthroplasty are linked to an inflammatory process initiated by wear debris released from artificial joints. There is still limited information about the contribution of Toll-like receptors (TLRs) and distinct regulatory cytokines to AL/PPOL in both joints.In this study, we investigated mRNA expression of TLR-1,-2,-4 and cytokines/receptors (IL-2,-2R,-10,-10R, TGFb1) in pseudosynovial tissue obtained from 55 patients with aseptically failed THAs/TKAs and 37 control patients with hip/knee primary osteoarthritis (OA) using quantitative RT-PCR. Immunohistochemical staining was used to detect the corresponding proteins. Non-parametric Kruskal-Wallis and Mann-Whitney tests were used to determine differences between the patient groups.When comparing expression profiles between patients with aseptically failed THA and TKA, higher amounts of TLR-1,- 2,-4 and IL-2R mRNA transcripts were detected in THA patients. The mRNA expression of studied molecules (TLR-1,-2,-4, IL-2, IL-10, IL-2R, IL-10R, TGFb1) did not differ between THA and OA hip tissues. Lower mRNA expression of TLR-1,-2,- 4, IL-10, and IL-10R was detected in TKA when compared to control knee OA. Similar mRNA profiles of IL-2, IL-2R, and TGFb1 were observed in TKA and knee OA. Using immunohistochemistry, we detected low expression of TLR-1 protein in failed THA/TKA, whereas TLR-2 protein levels were higher in TKA/THA patients than in OA controls. High individual variability in TLR-4 protein levels was detected among patients with aseptically loosened THA and TKA. IL-10 protein levels were similar in THA and TKA patient subgroups and control subjects, whereas IL-10R protein level was higher in failed TKAs and OA controls than in THAs. No difference in IL-2 protein levels was detected between patients with THA/TKA and those with OA.Our data indicate close similarity between the expression patterns in aseptically failed THA and TKA. However, certain differences were observed which also suggest unique pathways associated with the end-stage of aseptic loosening in THA and TKA. For instance, differences in the size, shape and load of polyethylene particles between THA and TKA could play some role. The composition of THA and TKA and differences in terms of mechanical forces might also be involved.This is the fist study comparing the gene expression profile of a particular set of innate immunity regulatory molecules between tissues from aseptically failed THA and TKA. Low expression of TLR-1,-2,-4 and cytokines/receptors (IL-2, IL-2R, IL-10, IL-10R, and TGFb1) was observed in pseudosynovial tissues obtained from aseptically failed THAs and TKAs. Higher amount of TLR transcripts was detected in THA as compared to TKA. These findings indicate certain differences in the mechanism of aseptic loosening occurring at the site of THA and TKA. Further research is warranted.
Paukert J.,Detske oddeleni |
Kopelentova E.,Ustav imunologie |
Dvorakova L.,Detske oddeleni
Pediatrie pro Praxi | Year: 2015
Penicillin and other beta-lactams are among the most commonly prescribed antibiotic groups. It is also a group with most frequently reported allergic reacions. The majority od patients are classified as penicillin allergic based on clinical evaluation only without further additional testing. False diagnosis of a penicillin allergy then leads to overuse of alternative, usually broad spectrum antibiotics with a high rate of associated side effects, thus increasing microbial resistence and treatment cost. Thorough evalution of a suspected beta- -lactam allergy involves detailed patient history and examination, skin tests, laboratory tests and drug provocation tests. Suspected drug hypersensitivity can be safely excluded with detailed evaluation in a large number od cases. Where suspected beta-lactam allergy is confirmed, alternative antibiotic could be recommended.