Chronic Histologic Changes Are Present Regardless of HLA Mismatches

The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 ± 13.6 vs. 60 ± 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1.32, 95%CI 1.06–1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04–2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. ≤6 HLA-mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions.

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Alloreactive Immune Response Associated to Human Mesenchymal Stromal Cells Treatment: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10132991 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2991

Author(s):

Raquel Sanabria-de la Torre ◽

María I. Quiñones-Vico ◽

Ana Fernández-González ◽

Manuel Sánchez-Díaz ◽

Trinidad Montero-Vílchez ◽

...

Keyword(s):

Systematic Review ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Immune Rejection ◽

Human Mesenchymal Stromal Cells ◽

Immunological Profile ◽

Tolerability Data ◽

Donor Specific Antibodies ◽

The Impact ◽

Hla Mismatches

The well-known immunomodulatory and regenerative properties of mesenchymal stromal cells (MSCs) are the reason why they are being used for the treatment of many diseases. Because they are considered hypoimmunogenic, MSCs treatments are performed without considering histocompatibility barriers and without anticipating possible immune rejections. However, recent preclinical studies describe the generation of alloantibodies and the immune rejection of MSCs. This has led to an increasing number of clinical trials evaluating the immunological profile of patients after treatment with MSCs. The objective of this systematic review was to evaluate the generation of donor specific antibodies (DSA) after allogeneic MSC (allo-MSC) therapy and the impact on safety or tolerability. Data from 555 patients were included in the systematic review, 356 were treated with allo-MSC and the rest were treated with placebo or control drugs. A mean of 11.51% of allo-MSC-treated patients developed DSA. Specifically, 14.95% of these patients developed DSA and 6.33% of them developed cPRA. Neither the production of DSA after treatment nor the presence of DSA at baseline (presensitization) were correlated with safety and/or tolerability of the treatment. The number of doses administrated and human leucocyte antigen (HLA) mismatches between donor and recipient did not affect the production of DSA. The safety of allo-MSC therapy has been proved in all the studies and the generation of alloantibodies might not have clinical relevance. However, there are very few studies in the area. More studies with adequate designs are needed to confirm these results.

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Meningoencephalomyelitis in domestic cats: 3 cases of Pasteurella multocida infection and literature review

Journal of Veterinary Diagnostic Investigation ◽

10.1177/10406387211034484 ◽

2021 ◽

pp. 104063872110344

Author(s):

Bianca S. de Cecco ◽

Mariano Carossino ◽

Fabio Del Piero ◽

Nobuko Wakamatsu ◽

Maria S. Mitchell ◽

...

Keyword(s):

Pasteurella Multocida ◽

Case Series ◽

Infectious Agents ◽

Domestic Cats ◽

Neurologic Diseases ◽

Gram Negative ◽

The Central Nervous System ◽

Upper Respiratory ◽

Portal Of Entry ◽

Histologic Changes

Neurologic diseases are common in domestic cats, and infectious agents are suspected to be the primary cause in 30–45% of cases. Among infectious etiologies, those of bacterial origin are only sporadically characterized in the literature, with few of these reports correlating gross and histologic findings with confirmatory bacteriologic identification. Here, we describe bacterial meningitis and meningoencephalomyelitis associated with Pasteurella multocida in 3 domestic cats. Purulent exudate expanding the cerebral meninges was grossly evident in 2 of the cases. In all 3 cases, histologic changes included multifocal suppurative-to-necrosuppurative meningitis and/or meningoencephalomyelitis of variable severity. Intralesional colonies of gram-negative, short rod-shaped to coccobacillary bacteria were evident histologically in only 1 case. P. multocida was confirmed by routine bacteriologic culture in all cases. Based on our cases, we hypothesize that the upper respiratory system serves as the main portal of entry for P. multocida, leading to invasion of the central nervous system and possible systemic hematogenous dissemination. A case series of meningoencephalomyelitis associated with P. multocida infection in cats has not been reported previously, to our knowledge. We also review briefly other causes of meningoencephalomyelitis in cats.

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Intraductal Tetracycline Therapy for the Treatment of Chronic Recurrent Parotitis

Ear Nose & Throat Journal ◽

10.1177/014556139407300414 ◽

1994 ◽

Vol 73 (4) ◽

pp. 262-274 ◽

Cited By ~ 19

Author(s):

Lcdr David M. Bowling ◽

Steven D. Rauch ◽

Max L. Goodman

Keyword(s):

Radiation Therapy ◽

High Risk ◽

Success Rate ◽

Acute Inflammation ◽

Double Blind ◽

Cytotoxic Effects ◽

Therapeutic Implications ◽

Duct Ligation ◽

Chronic Recurrent Parotitis ◽

Histologic Changes

Chronic recurrent parotitis (CRP) is recurrent parotid inflammation with non-obstructive sialectasis. Therapies which produce acinar atrophy or remove the acini are effective in treating CRP. Parotidectomy, tympanic neurectomy, duct ligation, and radiation therapy have either a low success rate or a high risk of morbidity. Intraductal antibiotic instillation has been proposed as a possible method of treatment. We hypothesized that the cytotoxic effects of tetracycline could produce acinar atrophy. A double-blind experiment of intraductal tetracycline instillation was performed in ten rabbits. Acinar atrophy and acute inflammation were found in 40% of the tetracycline treated glands; controls had a complete absence of these histologic changes. These results support the use of tetracycline instillation to produce acinar atrophy and therefore, intraductal tetracycline may be an effective, low-risk therapy for CRP. The clinical features of CRP will be reviewed and therapeutic implications discussed.

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Cholecystectomy for Biliary Hyperkinesia

The American Surgeon ◽

10.1177/000313481908500232 ◽

2019 ◽

Vol 85 (2) ◽

pp. 219-222 ◽

Cited By ~ 2

Author(s):

Joshua Gazzetta ◽

Betty Fan ◽

Paul Bonner ◽

John Galante

Keyword(s):

Laparoscopic Cholecystectomy ◽

Chart Review ◽

Gallbladder Disease ◽

Retrospective Chart Review ◽

Biliary Colic ◽

Study Cohort ◽

Final Pathology ◽

Pathology Reports ◽

Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

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09:48 AM: Hearing Loss According to Histologic Changes of the Stapes

Otolaryngology ◽

10.1016/j.otohns.2006.06.653 ◽

2006 ◽

Vol 135 (2_suppl) ◽

pp. P181-P181

Author(s):

Michel Royer ◽

Carlos Stott Caro ◽

Leonor Moyano ◽

Constanza Jimena Valdes ◽

Leonor Moyano

Keyword(s):

Hearing Loss ◽

Histologic Changes

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