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

Malignant tumors occur with greater frequency in patients with kidney transplants. Kaposi's sarcoma (KS), a rare vascular neoformation, represents approximately 3% of them. Its uncertain etiology appears to respond to: a chronic antigen stimulation by the transplanted tissue, to a depression of immune responsiveness, to the direct oncogenic action of the immunosuppressive agents, to the activation of oncogenic viruses or to a genetic predisposition of other possible factors. The clinical evolution is presented in two immunosuppressed kidney transplant patients with this pathology in the digestive tract. One had remission of the lesion following the suspension of the immunosuppressive agent. The relationship of this tumor with acquired immunodeficiency syndrome which occurred primarily (75%) in homosexuals shows a mortality rate of 30% due to KS. The first case showed signs of digestive hemorrhage and the typical nodule of KS was found in the esophagus on endoscopy. She also suffered a severe mixed infection due to Streptococcus faecalis and Cryptococcus neoformans with neurological complications and a new endoscopy 4 months after suspension of azathioprine showed the disappearance of the esophageal as well as the skin lesions. In the second patient, the suspicion of the digestive tract involvement could only be proved at autopsy. We insist on the importance of immunosuppression as a predisposing factor for the appearance of KS and infections in transplanted patients. It should also be remembered in cases with mucocutaneous lesions, that any digestive hemorrhage must primarily be attributed to KS and that the suspension of the immunosuppressive therapy constitutes the most effective treatment for the tumor.
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PMID:[Digestive Kaposi's sarcoma in patients with kidney transplantation--report of 2 cases]. 391 16

The acquired immunodeficiency syndrome (AIDS) is a new disease characterized by severe dysfunction of both the T cell and B cell systems, occurring in previously healthy individuals. Affected individuals may have recurrent and chronic opportunistic infections and/or Kaposi's sarcoma or other malignancy. Analysis of the cellular and subcellular components of immunity demonstrates a profound depression in the number and function of helper/inducer T cells bearing the OKT4 (Leu 3) differentiation antigen and a concomitant defect in the synthesis of the immuno-enhancing soluble growth factor, interleukin 2 (IL-2). Hypotheses to explain the etiology of the immunological dysfunction and implications for future therapy of AIDS are discussed.
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PMID:Characterization of the acquired immune deficiency syndrome at the cellular and molecular level. 609 6

Forty patients with acquired immunodeficiency syndrome (AIDS) were examined for ocular abnormalities. Twenty of these patients died and the eyes were obtained for culture and histopathologic examination. These patients have multiple opportunistic infections and neoplasms as the result of a severe depression of cellular immunity. Fifty percent of all patients with AIDS and 75% of the autopsy group have ocular signs attributable to AIDS. Ocular findings were confined to four major categories: cytomegalovirus retinitis (10 patients), retinal cotton wool spots (11 patients), conjunctival Kaposi's sarcoma (2 patients) and neuro-ophthalmic motility abnormalities (3 patients). Cytomegalovirus retinitis was a significant cause of visual loss. Seven of 40 autopsy eyes had hand motion or worse visual acuity prior to the patients' death because of CMV retinitis. This necrotic retinitis showed minimal inflammation and progressed to involve the entire retina in three to six months, resulting in a gliotic retinal membrane. Therapy with antiviral agents was not effective. Recognizing the ocular signs of AIDS may facilitate the diagnosis. The ophthalmologist also has a major role in the observation of progression or regression of these ocular manifestations, and can assist in the evaluation of therapy in patients with AIDS.
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PMID:Ophthalmic involvement in acquired immunodeficiency syndrome. 609 20

The acquired immune deficiency syndrome (AIDS) appeared in the United States in late 1978 and has spread at an epidemic rate through the four major coastal cities of this country. The disease appears to show the same epidemiologic distribution as hepatitis B virus infection, and for this reason, most investigators feel that this new disease is caused by a blood-borne sexually transmitted virus. A number of viral agents have been suggested as the cause of AIDS, but to date, no virus has been consistently isolated. The most likely candidate is a retrovirus that has recently been introduced into the human population and has found its way into two extremely high-risk groups, namely, promiscuous male homosexuals and intravenous drug abusers. The relationship between Kaposi's sarcoma and cytomegalovirus is still unclear, but evidence is mounting that cytomegalovirus may be the agent that initiates this multifocal malignancy. Multiple factors must be involved in this process. It is known that some immunosuppressed individuals develop Kaposi's sarcoma, which completely resolves when the immunosuppression is reversed; however, in individuals with classical Kaposi's sarcoma, the profound degree of helper T-cell depression that characterizes the acquired immune deficiency syndrome is not seen.
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PMID:Speculations on the viral etiology of acquired immune deficiency syndrome and Kaposi's sarcoma. 633 Feb 23

During the years from 1979 until 1983, 40 cases of CDC-defined AIDS were seen in Belgium. Only two patients were Belgian male homosexuals. The other patients were Central Africans who lived in Belgium or who had travelled to Belgium for medical care. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. The male:female ratio was 1.5. All patients had opportunistic infections. Five of them also had Kaposi's sarcoma. All patients tested had immunologic features of severe T-cell depression. The overall mortality was 42.5 percent. It is likely that AIDS is endemic now in Central Africa, and that the cases seen in Belgium represent only the tip of the iceberg.
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PMID:Acquired immune deficiency syndrome in Belgium and its relation to Central Africa. 639 49

Peripheral blood and bone marrow findings are presented for six homosexual males with Kaposi's sarcoma. Cytopenia in one or more cell lines was common in this group of patients, including two individuals with pancytopenia. Bone marrow findings in all patients, while not specific, were similar in that adequate numbers of normal appearing erythroid, myeloid, and megakaryocytic elements were present. Mild plasmacytosis as well as reticulin fiber increase were common findings. No patient, at time of study, demonstrated marrow involvement with Kaposi's sarcoma. We conclude that depression of peripheral blood counts in these patients was not due to marrow underproduction, and discuss possible mechanisms for increased blood cell destruction.
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PMID:Hematologic manifestations in homosexual men with Kaposi's sarcoma. 670 5

Two cases of Kaposi's sarcoma arising within intraparotid lymph nodes are presented. The tumor masses, clinically thought to be primary epithelial tumors of the parotid gland, were pathologically defined as Kaposi's sarcoma. No other evidence of this disease has been found elsewhere in either of the two patients studied. Immunologic studies performed in both patients demonstrated a depression of T-lymphocyte function and altered cell-mediated immunity in one. Search of the medical literature shows that these are the first two reported cases of Kaposi's sarcoma arising within lymph nodes of salivary glands.
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PMID:Primary lymph nodal Kaposi's sarcoma of the parotid gland. 688 7

Interferon-alpha (IFN-alpha) can inhibit human immunodeficiency virus (HIV-1) replication and is effective in treating Kaposi's sarcoma; interleukin-2 (IL-2) can increase circulating lymphocytes in HIV-1-infected patients. The safety of combination treatment with recombinant (r)IFN-alpha 2b and IL-2 was evaluated in HIV-1-infected patients with > 200 CD4+ T cells/mm3. A maximal tolerated dose of rIFN-alpha 2b was determined for 17 patients; then they received in combination 3, 6, or 12 x 10(6) IU/day rIL-2, given intravenously over 21 days. Twelve patients ultimately received the combination, 9 for the full 21 days. Significant toxicities included flu-like symptoms, anemia, transaminemia, and depression. Transient increases in CD4+ T cell percentages and spontaneous lymphocyte blast transformation were observed. Quantitative microcultures demonstrate a decline in HIV titers in patients receiving rIFN-alpha 2b (5/9) with a further decline on addition of rIL-2 (7/9). In summary, continuous rIL-2 at 6 x 10(6) IU/day in combination with rIFN-alpha 2b was reasonably tolerated and provided preliminary evidence of immunomodulatory and antiviral activity.
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PMID:A phase I study of interferon-alpha 2b in combination with interleukin-2 in patients with human immunodeficiency virus infection. 790 50

Two forms of recombinant interferon-alpha (IFN-alpha2a and IFN-alpha2b) have been approved by the Food and Drug Administration for a variety of clinical indications, including hairy cell leukemia, hepatitis, acquired immunodeficiency syndrome-related Kaposi's sarcoma, chronic myelogenous leukemia (IFN-alpha2a only), and adjuvant therapy for melanoma (IFN-alpha2b only), based on their proven clinical efficacy and acceptable safety profiles. The continued postmarketing monitoring of adverse reactions associated with IFN-alpha therapy has revealed some new toxicities. The most common adverse events associated with IFN-alpha therapy are flu-like symptoms, fatigue, anorexia, and central nervous system and psychiatric reactions. In particular, the incidence of depression has only recently been fully appreciated. Some of these side effects, particularly chronic fatigue, anorexia, and neuropsychiatric reactions, may become dose limiting. New approaches to minimize and manage the side effects of IFN-alpha therapy are needed.
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PMID:Safety profile of interferon-alpha therapy. 948 35

A number of studies are being conducted for HIV infections and opportunistic infections; these studies involve both new drugs and drugs currently in use, although administered differently or used for less traditional diseases. The studies include use of 1) foscarnet for treatment of early Kaposi's sarcoma; 2) tecogalen, an angiogenesis inhibitor, for more advanced Kaposi's sarcoma; 3) thalidomide for HIV infections, mouth ulcers, and wasting associated with HIV infection; 4) interleukin-2 for HIV infection; 5) testosterone for loss of sex drive secondary to depression in HIV infection; and 6) prozac for treating depression in HIV infection. Information is also given on a Spanish forum on approved and experimental treatments for AIDS and HIV. For further information on any of these studies, contact the Network at (800)734-7104.
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PMID:Treatment review. 1136 3


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