Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clofazimine is useful in the treatment of Hansen's disease (leprosy) and some dermatological disorders, and is currently being used in drug regimens for patients with human immunodeficiency viral infections who are also infected with Mycobacterium avium complex. After an oral dose, absorption is variable, but when given in an oil-wax suspension is approximately 70%. Administration with food appears to increase the peak plasma drug concentration and reduce the time to peak level. Data on the volume of distribution and percentage or type of protein binding are not available; however, the drug undergoes extensive tissue distribution. Clofazimine does not cross the blood-brain barrier, but does cross the placenta, and is found in human breast milk. To date 3 urinary metabolites have been identified in man, but their biological activity is unknown. A substantial portion of the unchanged drug is excreted in faeces. The elimination half-life is variable, with values as long as 70 days being quoted in the literature. Frequently reported side effects of clofazimine are hyperpigmentation of the skin and conjunctiva, and abdominal pain. These resolve upon cessation of therapy. Biochemical and haematological adverse effects have been reported, but are generally not clinically relevant. Pharmacokinetic drug interactions of potential clinical significance have been observed with dapsone, oestrogen, rifampicin and vitamin A.
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PMID:Clinical pharmacokinetics of clofazimine. A review. 265 45

Four rhesus monkeys (Macaca mulatta) were inoculated with a homogenate of a cutaneous lepromatous leprosy lesion from a mangabey monkey (Cercocebus atys). One died of B-cell lymphoma, and another died of an immunodeficiency syndrome. Cell suspensions prepared from the tumor and spleen of the monkey with lymphoma induced lymphoma or an immunodeficiency syndrome when inoculated into additional young rhesus monkeys. The immunodeficiency syndrome was similar to simian acquired immunodeficiency syndrome and consisted of opportunistic infections, lymphoid hyperplasia or atrophy, wasting, and syncytial cell formation. Mitogen responses and percentages of T4- and T8-positive lymphocytes were normal until the animals were moribund. Lymphoblastoid cell lines became established in vitro from tumor cell suspensions. These cells were infected with a herpesvirus related to Epstein-Barr virus. In addition, a retrovirus morphologically similar to human T-cell lymphotrophic virus type III (HTLV-III) and simian T-lymphotrophic virus type III (STLV-III) was isolated from one of the lymphoblastoid cell lines (LCL). Type D retroviruses could not be demonstrated in the monkeys in the transmission study; however, a retrovirus similar to that in the LCL was isolated from 4 animals by coculture of peripheral blood lymphocytes with the human cell line H9. These results suggest that this retrovirus, STLV-III/Delta, may be associated with the immunodeficiency syndrome in these macaques and may be of mangabey origin.
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PMID:Transmissible lymphoma and simian acquired immunodeficiency syndrome in rhesus monkeys. 301 95

Sera from 3500 individuals including patients of non-Hodgkin's lymphoma, patients with sexually transmitted diseases, leprosy, jail inmates, healthy laboratory workers and patients on hemodialysis were screened for antibodies against human immunodeficiency virus (HIV) as a sero surveillance exercise of one of the centers set up by the India Council of Medical Research at the Postgraduate Institute of Medical Education & Research, Candigarh. Three individuals were found to be strongly positive by ELISA using the Wellcozyme kit, with no background noise in the population studies. These three patients were also evaluated by the Western blot technique and showed strong antibody reaction to all the major gene products. It was also possible to ascertain the approximate incubation period of infection in a case who rapidly developed full blown AIDS and died of wasting syndrome. Comprehensive data of 14 cases was also collected from all the centers in India and in every case one could trace the contact outside India. None of the 3 cases studied at our center had Kaposi's sarcoma. These observations could be important landmarks in the epidemiology of AIDS in India.
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PMID:AIDS in India: a report of three cases with review of literatures. 304 89

Leprosy affects over 10 million people in the world. The disease is a model of graded cell-mediated immunity, in this case to the causative organism, Mycobacterium leprae. The clinical manifestations are due to (i) bacterial progression, (ii) immunologic responses of the host, (iii) peripheral nerve damage due to either or both bacterial progression and immunologic responses of the host, and (iv) preventable secondary deformities following nerve damage, which account for most of the stigma of the disease. Treatment modalities are now available to control or minimize the effects of bacterial progression, harmful immunologic responses of the host, peripheral nerve damage, and secondary deformities. Unique biochemical characteristics of M. leprae reside in the cell wall and associated macromolecules. Some of these molecules are potent immunogens in humans, while others constitute the structural integrity of the bacillus. Proteins of M. leprae are currently under intensive investigation as a result of deoxyribonucleic acid cloning of M. leprae genes. Structure-function and antigenic relationships of M. leprae proteins should become available by using recombinant deoxyribonucleic acid procedures coupled with T- and B-cell cloning to advance our understanding of the immunologic reactions encountered in Hansen's disease. Until recently, the study of the immunology of leprosy has been stymied by the lack of immunologically specific M. leprae antigens. The definition of specific antigens and production of recombinant and synthetic immunologic reagents have fostered state-of-the-art research efforts into new immunodiagnostic procedures and development of a leprosy vaccine. Also discussed is progress in understanding of the mechanism(s) underlying the M. leprae-specific immunodeficiency associated with lepromatous leprosy, including the role of suppressor T cells and defective macrophage function. Metabolic studies of M. leprae suggest intact catabolic pathways and energy generation with purine bases and catalase as possible growth factors. Special attention may also need to be given to biophysical parameters for eventual in vitro cultivation. Rapid in vitro systems, using quantitation of bacillary metabolic activity, may soon replace the lengthy mouse footpad test for determining the viability and drug susceptibility of the leprosy bacillus.
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PMID:Leprosy. 305 99

Monoclonal antibodies are now available to evaluate human T cell subsets by direct counting using indirect immunofluorescence analysis. The critical use of these antibodies has already permitted the delineation of the T cell imbalances present in a number of immunologically mediated diseases such as autoimmune haemolytic anaemia, chronic active hepatitis, myasthenia gravis, glomerulonephritides, multiple sclerosis, leprosy, or immunodeficiency syndromes. The potential diagnostic and therapeutic application of this new methodology are emphasized.
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PMID:The use of monoclonal anti-T cell antibodies to study T cell imbalances in human diseases. 646 43

For the evaluation of cancer risks associated with immunodeficiencies experienced by patients with Hansen's disease (leprosy) and for the assessment of possible adverse effects of dapsone therapy, a follow-up study was conducted of 1,678 patients admitted to the National Hansen's Disease Center in Carville, La., between 1939 and 1977. Overall, no substantial cancer mortality was observed (standardized mortality ratio = 1.3), nor was there any excess among patients exhibiting defects in cellular immunity by virtue of lepromatous forms of the disease. Notable was the absence of any significant excess of lymphoma (5 observed vs. 2.3 expected), despite the predominance of this tumor in certain other immunodeficiency states. Several cancer sites (oral, bladder, and kidney) occurred excessively, but reasons for the elevations were obscure. Although dapsone has been implicated as a carcinogen in laboratory animals, the use of sulfones, including dapsone, did not appear to affect significantly the risk of any cancers in this population.
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PMID:Cancer mortality among patients with Hansen's disease. 658 89

Since some previous studies have reported elevated total serum IgE levels in leprosy, that may be associated with the existence of a state of generalized T cell anergy, we undertook a carefully controlled study of this immunoglobulin in such patients before and after treatment with a Mycobacterium leprae-BCG vaccine. We found, firstly, that lepromatous leprosy patients suffering active disease had only a moderate elevation of IgE levels that was not statistically significant when compared to appropriate controls. In addition, multiple injections of the vaccine did not cause alterations in the concentration of this immunoglobulin. We were, therefore, unable to confirm the possible existence of a generalized immunodeficiency in lepromatous leprosy that could cause hyper-production of IgE.
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PMID:IgE in leprosy; effect of a Mycobacterium leprae-BCG vaccine. 668 43

The authors report a case of a forty-six year old woman suffering from generalized prurigo nodularis. This dermatosis was associated with a cellular immunodeficiency; therefore a clofazimine therapy 300 mg/a day was instituted for six months. Ten months after the cessation of the clofazimine therapy, there appeared a malabsorption syndrome that was temporarily improved by gluten--free diet the real etiology was only ascertained during laparotomy, when masses of crystals in the small intestine mucosa as well as in mesenteric lymph nodes were observed. Therefore when it is necessary to prescribe clofazimine to take advantage of become its immunoregulating properties, it must always become in mind that an intestinal complication may ensue: this is well recognized in articles appearing in journals devoted to leprosy.
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PMID:[Exudative enteropathy caused by clofazimine: apropos of a case]. 681 19

Women comprise the largest single grouping of human immunodeficiency virus (HIV)-infected persons under 30 years of age in Zambia--a phenomenon that reflects a complex interaction of economic, cultural, and psychosocial factors. Although women represented only 30.4% of clients presenting for HIV testing at a Lusaka site, 52.6% were seropositive compared to 35% of the male attendees. The low status of women in Zambia is perpetuated by early marriage and childbearing, low levels of education, unemployment or restriction to the informal sector, and polygamy. Only 2% of married Zambian women use condoms, and their financial dependence and low status render them unable to negotiate safe sex with partners. The Zambia National Acquired Immunodeficiency Syndrome (AIDS)/Sexually Transmitted Diseases (STD)/Tuberculosis and Leprosy Program's strategic plan for 1994-98 recognizes women's special vulnerability to HIV. It proposes educational interventions targeted at commercial sex workers and women attending prenatal and STD clinics as well as improved access to condoms. To achieve the sustained behavioral changes required to reduce HIV transmission, however, women's low status--particularly the lack of educational opportunities--must be addressed and women must be empowered to believe they can make choices about their sexual practices.
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PMID:Women and AIDS in Zambia: a review of the psychosocial factors implicated in the transmission of HIV. 757 11

During a large epidemiologic study in the Karonga District of northern Malawi, serum samples from 139 patients with incident leprosy, 124 with newly diagnosed leprosy, 277 patients with incident tuberculosis, and 2296 controls were tested for antibodies to human immunodeficiency virus. Sera were tested according to a four-test protocol using two ELISAs and two particle agglutination assays. Overall, 188 samples were considered positive, 2634 were considered negative, and 14 were indeterminate. All 18 available positive specimens from leprosy patients, a random sample of 14 positive specimens from tuberculosis patients, and 15 positive specimens from controls were tested by Western blot. There was no evidence of substantial numbers of ELISA false-positives in any patient group or among controls.
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PMID:Testing for antibody to human immunodeficiency virus type 1 in a population in which mycobacterial diseases are endemic. 762 1


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