Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Visceral leishmaniasis or kala-azar is characterized by a variety of immunopathological consequences in man. The most remarkable of these are the depression of cell-mediated immunity and polyclonal B cell activation. The consequences observed in man could be induced in a murine model by inoculating the causative agent, Leishmania donovani. The cell-mediated response was studied in this murine model in terms of the delayed-type hypersensitivity (DTH) response toward leishmania antigen in a progressive infection. BALB/b (H-2b) mice showed progressive enhancement in the DTH response, whereas BALB/c (H-2d) mice showed strong DTH at the onset which gradually disappeared (defined as DTH-negative phase) and reappeared again at the later stage of infection. Adoptive transfer of enriched populations of splenic T cells from infected BALB/c mice together with parasite antigen into the footpad of syngenic normal recipients produced a dramatic enhancement in the DTH response, except at the onset of the DTH-negative phase. These observations indicate that adherent cells have a role in suppression of the cell-mediated immune response and also that another mechanism operates at the onset of the DTH-negative phase. This DTH-negative phase was not caused by depletion of DTH-mediating cells from the repertoire, but rather by suppression mediated by a subset of T cell evolved in the course of infection. Characterization on the basis of lymphokine production of the T cells mediating the DTH response and of T cells mediating suppression of the DTH response showed them to be of Th1 and Th2 type, respectively. Studies also indicated that at the onset and the later stages of infection suppression was mediated by adherent cells, but at the onset of DTH-negative phase, in particular, suppression was mediated by Th2 cells. Furthermore, experiments also showed that adherent cells from infected mice gained another property, that of driving B cells, in a T cell-dependent manner.
 ...
PMID:Immunobiological studies on experimental visceral leishmaniasis. II. Adherent cell-mediated down-regulation of delayed-type hypersensitivity response and up-regulation of B cell activation. 138 13

We describe 40 HIV-seropositive patients who developed visceral leishmaniasis. All the patients lived in areas endemic for visceral leishmaniasis and belonged to groups at risk for AIDS. Twenty-three patients (57.2%) had definitive AIDS before or after diagnosis of leishmaniasis and 77.5% were classified as belonging to CDC group IV. Fever was present in 95% patients and enlargement of the liver and/or spleen in 92.5%. Lymphopenia was found in 78.3%, depression of the absolute number of CD4 lymphocytes in 90% and depression of the CD4 to CD8 ratio in all evaluated cases but leishmania antibodies were found in only 35.2%. Parasites were demonstrated in the bone marrow or liver in every case. Thirty patients (75%) showed an initial good response to antimonial drugs, although the leishmaniasis followed a chronic or relapsing course in 17 (42.5%). HIV-related mortality was 40%. A significant correlation was found only between the relapsing course of the disease and mortality. In a multivariate linear regression model, the relapsing course was the only variable that influenced mortality. Visceral leishmaniasis is an opportunistic disease that should be suspected in HIV-infected patients. We suggest that it should be included in the CDC group IV C-1 and considered as a disease indicative of AIDS.
 ...
PMID:Visceral leishmaniasis in patients infected with human immunodeficiency virus. Co-operative Group for the Study of Leishmaniasis in AIDS. 227 73

In an area endemic for visceral leishmaniasis, 16 patients with human immunodeficiency virus (HIV) infection developed the disease. All belonged to populations at risk for AIDS (15 were intravenous drug abusers). Five patients fulfilled the criteria for full-blown AIDS, and two more fulfilled them after diagnosis of leishmaniasis. All presented with the classic manifestations of visceral leishmaniasis, but leishmania serology was negative in 15 patients (93%). Leishmania donovani amastigotes were identified in the bone marrow in all cases. Most patients responded initially to treatment with pentavalent antimonial drugs, but seven (43%) followed a chronic course, with multiple relapses in five, despite alternative treatments. Visceral leishmaniasis occurred in patients with different levels of depression of the CD4 to CD8 lymphocyte ratio. Mortality was 37% (six patients) and was independent of the chronic-relapsing course of the disease. In no case was leishmaniasis the primary cause of death. Our data establish that visceral leishmaniasis is an opportunistic infection in HIV-infected patients, and we suggest that in endemic areas it should be considered an indicator disease for the diagnosis of AIDS.
 ...
PMID:Visceral leishmaniasis (kala-azar) as an opportunistic infection in patients infected with the human immunodeficiency virus in Spain. 210 72

Quantitation of immunoglobulins in patients with systemic leishmaniasis show a rise in IgM and IgG. Complement C3 levels in severely ill patients were very low, whereas generally within normal range in patients with uncomplicated recoveries. The cell mediated immune response of those kala-azar patients examined appeared to be depressed as measured by PHA skin tests. This depression was rapidly reversed following chemotherapy with Glucantim.
 ...
PMID:Immunological findings in kala-azar, Iran. 661 70

Delayed hypersensitivity by intracutaneous tests with leishmanin, tuberculin, trichophytin, oidiomycin, as well as sensitization with DNCB were assessed in ten patients with kala-azar. There was a significant depression of delayed hypersensitivity to leishmanin (Montenegro reaction) during the active phase of the disease. The response to ubiquitous microbial antigens and DNCB were also depressed as compared to controls.
 ...
PMID:Impaired cell-mediated immunity in patients with kala-azar. 729 74

Visceral leishmaniasis is associated with a marked depression of T cell responses, which has been characterized by the absence of IL-2 and IFN-gamma production by lymphocytes on in vitro stimulation with Leishmania Ag. The aim of this study was to evaluate both the mechanism of these immunologic abnormalities and the restoration of in vitro T cell responses to Leishmania Ags. A total of 15 untreated visceral leishmaniasis patients were evaluated. Although IFN-gamma and IL-4 levels in the supernatants of lymphocyte cultures were very low or absent, mRNA for these cytokines and for IL-10 were observed in PBMCs. Addition of IFN-gamma plus IL-2 enhanced lymphocyte proliferation by 158%. Restoration of T cell proliferative responses and IFN-gamma production was also observed by the addition of a neutralizing mAb alpha-IL-10. Neutralizing mAb alpha-IL-4 did not restore T cell responses but alpha-IL-10 and alpha-IL-4 mAbs had a synergistic effect on lymphocyte proliferation. The IFN-gamma levels in supernatants of lymphocyte cultures stimulated with Leishmania chagasi Ag or L. chagasi Ag plus alpha-IL-4, alpha-IL-10, or alpha-IL-4 plus alpha-IL-10 mAbs were 26 +/- 30 pg/ml, 41 +/- 18 pg/ml, 146 +/- 73 pg/ml, and 174 +/- 106 pg/ml, respectively. These data indicate that Th2 cell activation occurs in visceral leishmaniasis and that in vitro production of IFN-gamma and lymphocyte proliferation can be restored by blocking the inhibitory effect of the Th2 cytokines on mononuclear cells.
 ...
PMID:Restoration of IFN-gamma production and lymphocyte proliferation in visceral leishmaniasis. 820 20

Visceral leishmaniasis (VL) is characterized by a depression of the T helper cell type 1 immune response. Although mRNA expression for interleukin-4 (IL-4) is observed, evidence of the role of this cytokine in the pathogenesis of VL has been lacking. Since IL-4 is involved in IgE synthesis, we measured the total IgE and Leishmania antigen-specific IgE antibody levels in sera from patients with VL. Specific IgE antibodies detected by an ELISA technique after absorbing the sera with purified sheep IgG anti-human IgG were found in all 23 patients with VL and were not detected in subjects with subclinical Leishmania chagasi infection (n = 10), Chagas' disease (n = 10), atopic patients (n = 10), and healthy controls (n = 10). Levels of Leishmania-specific IgE (optical density values) before and after treatment were 0.100 +/- 0.03 (mean +/- SD) and 0.028 +/- 0.002, respectively (P < 0.05). These results indicate that a specific IgE response is useful in the diagnosis of active disease and to evaluate response to treatment.
 ...
PMID:Anti-leishmanial IgE antibodies: a marker of active disease in visceral leishmaniasis. 974 38

Visceral leishmaniasis (VL) is a zoonosis in most regions where it occurs. Dogs are the most important reservoir of the disease and are mainly responsible for the persistence of VL in the Paleartic and Neotropical regions. Canine leishmaniasis (CaL) is a viscerocutaneous, chronic infection with a worse prognosis than human disease. We now know that, as in man, there are some cases of asymptomatic infection. Former studies indicated that dog cutaneous parasitism becomes infectious to the insect vector in later periods of the disease, but recent studies performed by xenodiagnosis have shown that it is possible that transmission might occur earlier. The infected animal reacts with a great production of antibodies and depression of cellular immunity. Antibodies are not protective and resistance is related with active cellular immunity. The presence of Th 1 response in asymptomatic animals, sometimes without humoral response, means that the prevalence of CaL, found in epidemiological surveys by searching for antibodies, may be underestimated.
 ...
PMID:[Canine leishmaniasis. New concepts of epidemiology and immunopathology: their impact in the control of human visceral leishmaniasis]. 1002 81

The visceral and the different spectrum of cutaneous leishmaniases have been incriminated to be among the opportunistic infections co-existing with HIV/AIDS. In co-infections, leishmaniases surface in high prevalence, present frequently atypically, pose difficulties to be detected by routine diagnostic tests, most often result in an unfavorable response to treatment, frequent relapses and in premature deaths. Such presentations and management difficulties shall be highlighted in this review. To extract information on the scope of manifestations and responses to management, literature was surveyed utilizing the Pub Med electronic literature search. In due course, pertinent characteristics surfacing in HIV/AIDS and leishmaniasis co-infections comprising of clinical presentations and parasitological and serological findings were tracked. Investigation options, management approaches, outcomes of various treatment regimen and other intervention strategies were as well explored. Visceral leishmaniasis and HIV-1 are both associated with a depression of T cell response and similar disturbances of cytokine networks. The appearance of HIV has led to numerous atypical clinical manifestations of leishmaniasis among immunocompromised patients to include, recurrences, lingual, cervical, esophageal, mucocutaneous and presentations in other unusual sites. The common clinical presentations of the disease might not always be present being masked by other associated opportunistic infections. Spleen aspiration is more sensitive in immuno-competent visceral visceral leishmaniasis suspects, however, bone marrow aspirate remains the safest and the most frequently employed diagnostic technique in co-infected patients. Several species of Leishmania are incriminated in affecting HIV infected subjects, including formerly unknown zymodemes. In spite of the high number of reported cases of HIV-related VL, the treatment of choice, the best dosage and the duration of therapy appear not to be properly established. The pentavalent antimonials still remain the first line of therapy for co-infected cases. Amphotericin-B, especially the liposome formulation (Ambisome) was found to be relatively less toxic and more potent compared to pentamidine. A broad spectrum of other drugs have as well been used. The widespread use of HAART are envisaged to contribute to a progressive decrease in the morbidity and mortality of HIV-associated visceral leishmaniasis. There is no effective chemoprophylaxis or immuno-prophylaxis to prevent leishmanial infection. In the events of co-infections with HIV/AIDS, the need for policy provisions to control both diseases needs to be underlined. It is as well of a paramount importance that factors influencing co-infection are understood for effective treatment against leishmaniasis in co-infected patients. The need for improved diagnostic tests and new more effective and less toxic drugs is also apparent.
 ...
PMID:Leishmaniases and HIV/AIDS co-infections: review of common features and management experiences. 1280 30

Sikhism has millions of followers in India and among the Indian diaspora. As a religion it is relatively young but carries with it unique perspectives which are often not well known. The holy book of Sikhism, Guru Granth Sahib, is not only the last Guru, but also remained a key text for this religion. Using descriptions of the religion and its followers we attempt to understand the context of spirituality within this religion and attempt to apply it to clinical settings. We explored various texts to understand the notions of spirituality and ethics and directions for living one's life. We studied both the Gurumukhi version as well as the English translation of the Sikh holy text. In the context of history of the Sikhs, various descriptions related to mental well being were identified. In this paper we describe the history, development and the core values of the religion and we also review their role on psychiatric and mental health settings for managing Sikh patients. Guru Granth Sahib offers a very useful insight into what is understood by the term equivalent to depression and its phenomenology. The notions of dukh (loosely translated as pain, but can also mean sadness or suffering) and maya (illusion) and their role in daily living are also discussed. In this paper these descriptions are explored further and their importance explained.
 ...
PMID:Sikhism, spirituality and psychiatry. 2317 42


1 2 Next >>