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)

The associations among human immunodeficiency virus (HIV) infection, focal segmental glomerulosclerosis, and its variant, "collapsing glomerulopathy," often leading to chronic renal failure, are well described. HIV-seropositive patients may also develop a variety of immune complex-mediated glomerular diseases, including postinfectious glomerulonephritis, IgA nephropathy, and membranoproliferative glomerulonephritis. Herein we describe a case of pauci-immune necrotizing renal vasculitis in an HIV-seropositive patient, thereby expanding the differential diagnosis of acute renal failure in this setting.
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PMID:Renal vasculitis with HIV seropositivity: potential manifestation of cytomegalovirus infection. 929 73

Erythropoietin (Epo)-responsive anemia is a debilitating complication of chronic renal failure and human immunodeficiency virus (HIV) infection that effects more than 150,000 Americans. Patients with Epo-responsive anemias are currently treated with repeated injections of recombinant human Epo. In the studies described in this report, we have examined the safety and efficacy of using a single intramuscular (i.m.) injection of replication-defective adenoviral vectors (RDAd) encoding Epo for the treatment of Epo-responsive anemias in both mice and non-human primates. Our results demonstrate that there is a threshold dose of virus (2.5-8 x 10(7) pfu/gram of body weight) which is required to obtain long-term Epo expression and polycythemia in both species. A single i.m. injection of mice with 10(9) pfu of an RDAd encoding murine Epo (AdmEpo) resulted in elevations in hematocrits from control values of 49 +/- 0.9% to treated values of 81 +/- 3%, which were stable for more than 1 year. Similarly, a single i.m. injection of a monkey with 4 x 10(11) pfu of an RDAd-encoding simian Epo (AdsEpo) resulted in elevations of hematocrits from control levels of 40% to treated levels of > or =70%, which were stable for 84 days. Intramuscular injection of monkeys with AdsEpo appeared to be safe in that we did not detect abnormalities in chest X-rays, serum chemistries, hematologic, or clotting profiles (apart from elevated hematocrits) or organ histologies during the 84-day time course of the experiment. Taken together, these results suggest the feasibility of using i.m. injection of RDAd for the treatment of Epo-responsive anemias in humans.
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PMID:Long-term erythropoietin expression in rodents and non-human primates following intramuscular injection of a replication-defective adenoviral vector. 935 29

Measurements of the antithrombin III (AT III) activity in feline plasma with a thrombin dependent chromogenic substrate assay using an automatic analyzer showed a high within run precision. The coefficient of variance was 1.82% (normal AT III activity) or 3.19% (decreased AT III activity), respectively. In comparison with the feline pool plasma the AT III activity in canine plasma was similar (93.7%) and in human reference plasma was lower (71.7%). Respecting healthy cats aged more than three months no distinct influence could be demonstrated on the AT III activity neither of age nor of gender (p = 0.2180). Based on the 2.5%- and 97.5%- quantile the reference range was 83.5-122.5% respecting the total number of healthy cats (n = 138) or 82.6-121.5% concerning the 116 European Shorthair cats. AT III activity of cats infected with feline immunodeficiency virus (n = 37) or teline leukemia virus (n = 20) as well as of cats suffering from different solitary tumors (n = 8) was not distinctly different from the control group (p > 0.05). On the contrary, a significant decrease of AT III activity was found in traumatized cats (n = 20; median = 80.8%, p < 0.0001) as well as in animals with chronic renal failure (n = 20; median = 91.7%, p = 0.0228) which can be mainly attributed to a consumption reaction or excessive renal loss, respectively.
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PMID:[Antithrombin III activity in health cats and its changes in selected disease]. 945 44

In the submitted review the authors present basic information on immunization against viral hepatitis B (VHB) in patients with chronic renal failure. These patients have a significantly lower response to the vaccine against VHB, due in particular to secondary immunodeficiency. Possible correction of this adverse situation can be achieved by modification of the immunization pattern (type and dosage of vaccine, the period and early time of vaccination, route of administration) and adjuvant immunomodulating therapy.
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PMID:[Hepatitis B vaccination in patients with chronic renal failure]. 947 2

Recent studies of the growth hormone insulinlike growth factor I (IGFI) axis suggest that these hormones are involved in several physiologic processes, in addition to growth. Thus, several lines of evidence indicate an increasingly important role for recombinant human growth hormone as a part of the modern therapeutic armamentarium. In addition to the treatment of children with growth hormone deficiency, administration of growth hormone appears to be of considerable benefit to girls with Turner syndrome, children with chronic renal failure, and adults with growth hormone deficiency or human immunodeficiency virus (HIV) wasting syndrome. Moreover, its therapeutic use is being investigated in other conditions, such as children with idiopathic short stature, the healthy elderly, and the critically ill. However, long-term surveillance among growth hormone recipients is needed to fully evaluate its risk-benefit profile.
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PMID:Recombinant human growth hormone: old and novel uses. 968 21

This study was designed to determine whether there was any difference in the T-cell subset counts and serum immunoglobulin concentrations in patients with chronic renal failure as compared to normal controls. Ninety individuals participated in the study. These were divided into three groups as follows; (i) 30 subjects with normal renal function; (ii) 30 subjects with chronic renal failure (CRF)(creatinine clearance 10-50 mls/min), not requiring haemodialysis and; (iii) 30 subjects with end stage renal disease (creatinine clearance < 10 mls/min) on haemodialysis. The subjects in the three groups were matched for age and sex. In addition, it was ascertained that none of the subjects was on any medication or suffered from any ailment known to interfere with the immune system. The T-cell subset counts were carried out using flow cytometry while the serum concentration of immunoglobulins was measured using the radio-immunodiffusion method. Patients with CRF, whether on haemodialysis or not, had significantly lower lymphocyte counts as a proportion of total white cell count (19% and 19.2% respectively versus 39%) and low absolute CD4 cell counts per mm3 (337 +/- 94 and 449 +/- 116 respectively versus 891 +/- 360) and CD8 cell counts per mm3 (437 +/- 234 and 490 +/- 176 respectively versus 644 +/- 228) as compared to normals, with no statistically significant difference between the two groups with CRF. The CD4: CD8 ratios in the three groups studied were 1.487 +/- 0.233, 0.961 +/- 0.326 and 0.751 +/- 0.167 respectively, being significantly higher in normal controls than in any of the groups with CRF (p < 0.05) and in the group with CRF not requiring dialysis than in those requiring it (p < 0.05). The serum concentration of immunoglobulins in the two groups with CRF were similar to those in the group with normal renal function. It is concluded that CRF represents a state of immunodeficiency not significantly corrected by haemodialysis.
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PMID:T-cell subset counts and serum immunoglobulin concentrations in patients with chronic renal failure at the Kenyatta National Hospital. 974 96

We clinically investigated a total of 288 cases of bacteremia for the past ten years, from January 1986 to December 1995, at the Second Department of Internal Medicine in the jikei University Hospital. All of the subjects who had a positive reaction to blood culture or catheter tip culture were investigated for their basic disease, complications, and detected bacteria. Malignant tumors, chronic renal failure, diabetes mellitus, and hematologic disease were frequent by noted. The cases due to primary infection were mainly respiratory organ infection or urinary tract infection, which were 47.8% of the total. In 31.3% of the total, catheter tip cultures were positive. Except for catheter related infection, Gram-positive coccus were detected in 40.3%, which was most frequent. Methicillin resistant Staphylococcus aureus (MRSA) were 8.1% and Staphylococcus epidermidis were 11.2%. In catheter related infection, Gram-positive coccus were detected in 59.9%, which was most frequent amongst them, MRSA was 17.2%, S. epidermidis was 16.2%. The mortality of bacteremia was 12.5%, mainly from hematologic diseases, immunodeficiency due to long term steroid administration etc. Accordingly, the more the advance of chemotherapy, the better the prognosis of septicemia is. Appearance of catheter related infection was unexpected frequent. Increase of immunocompromised host is thought to be one of the main factors in the outbreak of bacteremia.
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PMID:[A clinical investigation of bacteremia for the past ten years at the Second Department of Internal Medicine, Jikei University Hospital]. 978 May 85

In 1986, Weiss et al reported a group of patients with nephrotic syndrome, progressive chronic renal failure, and the histopathologic features of glomerular capillary collapse. Similar lesions are often described in human immunodeficiency virus (HIV) nephropathy. We evaluated 893 consecutive nontransplant renal biopsies performed in our department and the follow-up of the patients at our outpatient service. Sixteen specimens were identified with the pathological features of collapsing glomerulopathy (focal segmental or global glomerular capillary collapse and visceral epithelial cell hyperplasia), with no evidence of HIV infection and/or intravenous drug abuse. Their clinical characteristics were analyzed and compared with a group of 29 patients with noncollapsing focal segmental glomerulosclerosis (FSGS). The follow-up period of both patient groups was 5 +/- 1.46 years. The Kaplan-Meier life table method was used to present survival of the patients. The age of both groups was similar, 34 +/- 4 years (mean +/- standard error of the mean) for patients with collapsing glomerulopathy and 35 +/- 3 years for those with FSGS. The serum creatinine level was greater in patients with collapsing glomerulopathy (183 +/- 31 micromol/L) compared with those with FSGS (115 +/- 18 micromol/L), but the difference was not significant (P = 0.0504). The difference in proteinuria was not significant (P = 0.7668); it was 5.83 +/- 0.74 g/d in patients with collapsing glomerulopathy and 5.42 +/- 0.84 g/d in those with focal sclerosing glomerulonephritis. The difference in systolic (P = 0.4) and diastolic blood pressure (P = 0.556) was also not significant. Survival of the patients with collapsing glomerulopathy was worse than that of patients with FSGS (P = 0.025). Renal function survived 5 years in 40% of the patients with FSGS, but patients with collapsing glomerulopathy had no renal function survival. Our data suggest that idiopathic collapsing glomerulopathy is a distinct clinicopathologic entity with similar clinical features to focal sclerosing glomerulonephritis, but a worse prognosis and a rapidly progressive course toward end-stage renal disease.
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PMID:Collapsing glomerulopathy: clinical characteristics and follow-up. 1019 29

CD40 and its ligand CD40L are key players in T cell-B cell interaction and T cell-antigen-presenting cell (APC) interaction. Inhibition of CD40-CD40L interaction leads to severe humoral and cellular immunodeficiency. In this study we examined the presence of soluble CD40 (sCD40) in the serum of haemodialysis (HD) patients, CAPD patients, chronic renal failure (CRF) patients and healthy donors in order to evaluate the possible involvement of CD40 in uraemic immunodeficiency. Soluble CD40 was detected in the serum of healthy donors (n = 41) with a mean of 0.14 +/- 0.12 ng/ml and in the urine of healthy donors with a mean of 1.80 +/- 0.74 ng/ml. Soluble CD40 was highly elevated in all patients with impaired renal function. HD patients (n = 22) had up to 100-fold elevated sCD40 levels with a mean concentration of 8.32 +/- 4.11 ng/ml, whereas CAPD patients (n = 10) had considerably lower levels of sCD40 with a mean of 3.58 +/- 2.40 ng/ml. A strong correlation between sCD40 and serum creatinine levels was noted in CRF patients (n = 66). The highly elevated levels of sCD40 may point to the involvement of CD40 and its ligand CD40L in the clinical manifestation of uraemic immunodeficiency.
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PMID:Soluble CD40 in the serum of healthy donors, patients with chronic renal failure, haemodialysis and chronic ambulatory peritoneal dialysis (CAPD) patients. 1040 29

The response to vaccination with recombinant hepatitis B virus (HBV) vaccine is poor in haemodialysis patients. A defect in the antigen-presenting cells may be responsible for this hyporesponsiveness. To overcome this and to improve the response to HBV vaccine in dialysis patients, we used granulocyte-macrophage colony-stimulating factor (GM-CSF) as a vaccine adjuvant. Fifteen consecutive patients with chronic renal failure (CRF), commenced on dialysis, were stratified to receive either 40microg HBV vaccine (Engerix-B) at 0, 1, 2 and 6 months (group A, n=9) or 3microg kg-1 GM-CSF (Leucomax) on day 1 followed by the vaccination schedule described above (group B, n=6). All patients were negative for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV) and human immunodeficiency virus (HIV) serology. Titres of antibody to HBsAg (HBsAb) were quantitatively assayed, using enzyme-linked immunosorbent assay (ELISA), at 1, 2, 6 and 7 months from the first dose of vaccination. Only 44% of the patients in group A developed protective antibody levels (mean HBsAb: 22 IU l-1) Fifty per cent of responders developed protective antibody levels (HBsAb >10 IU l-1) only after the fourth dose of vaccination. In contrast, all six patients (100%) in group B developed protective levels of HBsAb (mean HBsAb: 70 IU l-1) (P<0.02). Sixty-seven per cent of the responders were protected after only the second dose of vaccination (P=0.046). No serious adverse effects of GM-CSF were observed in group B. Hence, haemodialysis patients respond poorly to HBV vaccine. GM-CSF is a safe vaccine adjuvant capable of stimulating an earlier and a stronger antibody response to HBV vaccine in haemodialysis patients.
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PMID:Granulocyte-macrophage colony-stimulating factor enhances the efficacy of hepatitis B virus vaccine in previously unvaccinated haemodialysis patients. 1060 57


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