scholarly journals Is Tolerance Broken in Autoimmunity?

2017 ◽  
Vol 10 ◽  
pp. 117955571771271
Author(s):  
Dama Laxminarayana
Keyword(s):  
Autoimmune Diseases ◽  
Molecular Mechanisms ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Cellular Events ◽  
Life Threatening ◽  
Benign Disorders ◽  
Autoimmune Pathogenesis ◽  
System Organ

Autoimmune diseases are classified into about 80 different types based on their specificity related to system, organ and/or tissue. About 5% of the western population is affected by this anomaly, but its worldwide incidence is unknown. Autoimmune diseases are heterogeneous in nature and clinical manifestations range from benign disorders to life-threatening conditions. Autoimmunity strikes at any stage of life, but age and/or gender also play role in onset of some of these anomalies. The autoimmune pathogenesis is initiated by the origination of autoantigens, which leads to the development of autoantibodies followed by auto-immunogenicity and the ultimate onset of autoimmunity. There is a lack of suitable therapies to treat autoimmune diseases, because mechanisms involved in the onset of these anomalies were poorly understood. Present therapies are limited to symptomatic treatment and come with severe side effects. Here, I described the molecular mechanisms and cellular events involved in the initiation of autoimmunity and proposed better strategies to modulate such molecular and cellular anomalies, which will help in preventing and/or controlling autoimmune pathogenesis and ultimately aid in enhancing the quality of life.

scholarly journals Fabry disease, a complex pathology not easy to diagnose

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Paolo Colomba ◽  
Simone Scalia ◽  
Giuseppe Cammarata ◽  
Carmela Zizzo ◽  
Daniele Francofonte ◽  
...  
Keyword(s):  
Fabry Disease ◽  
Vascular Endothelium ◽  
Clinical Manifestations ◽  
Premature Death ◽  
Lysosomal Storage ◽  
Familial Data ◽  
Enzyme Replacement ◽  
Cerebrovascular Complications ◽  
Cellular Events

Fabry disease is a multisystemic lysosomal storage disorder, inherited in an X-linked manner. It is a defect of metabolism of the glycosphingolipids, due to the reduction or absence of the activity of lysosomal enzyme α-galactosidase A. This reduction of activity causes the storage of globotriaosylceramide and derivatives in the lysosomes, triggering a cascade of cellular events, mainly in vascular endothelium. These events are the responsible for the systemic clinical manifestations and the renal, cardiac and cerebrovascular complications, or a combination of them. The symptomatology can lead to the premature death of patient between the fourth or fifth decade of life. The first symptoms can occur at different ages, generally in childhood, with different severity and course. Fabry disease is suspected on the basis of clinical and anamnestic-familial data, and it is confirmed by enzymatic and genetic assays. However, Fabry disease could be a pathology more complex than previously considered, and the diagnostic tests that are currently in use could be not always sufficient to confirm the clinical diagnosis. Probably, other factors could be also involved in the onset of symptomatology. In the last years, the knowledge of the disease is considerably increased but other studies are necessary to make a prompt and reliable diagnosis. An early diagnosis of Fabry disease is essential for the beginning of the enzyme replacement therapy, which can contribute to arrest its progression and improve the quality of life of patients.

Bowel Symptoms

2017 ◽  
Author(s):  
Kimberly Chow ◽  
Lauren Koranteng
Keyword(s):  
Bowel Obstruction ◽  
Clinical Manifestations ◽  
Advanced Practice ◽  
Comorbid Disease ◽  
Medication Treatment ◽  
Global Issues ◽  
Treatment Regimens ◽  
Bowel Symptoms ◽  
Life Threatening

Constipation, diarrhea, and bowel obstruction are three common and distressing symptoms in palliative care patients. These symptoms rarely occur without other clinical manifestations of disease, and their management must be considered in light of comorbid disease. Constipation, diarrhea, and bowel obstruction affect a person’s quality of life, eligibility for certain therapies, and may even be life-threatening. This chapter discusses the advanced practice registered nurse (APRN)’s role in the assessment, prevention, and management of these common bowel symptoms. as well as the global issues surrounding management. The causes and pharmacological treatment of these three bowel symptoms are discussed and detailed medication treatment regimens are presented in tabular form.

scholarly journals CTNI-28. A PROSPECTIVE, OBSERVATIONAL STUDY EVALUATING THE SAFETY AND QUALITY OF LIFE OF TUMOR TREATING FIELDS IN CHINESE GLIOBLASTOMA PATIENTS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii48-ii48
Author(s):  
Kevin Wong ◽  
Tao Jiang
Keyword(s):  
Quality Of Life ◽  
Adverse Reactions ◽  
Clinical Manifestations ◽  
Treatment Compliance ◽  
Symptomatic Treatment ◽  
Chinese Patients ◽  
Published Data ◽  
Newly Diagnosed ◽  
Tumor Treating Fields

Abstract OBJECTIVES Glioblastoma (GBM) is the most common and aggressive primary brain tumor with a median survival of 15 months. Adding Tumor Treating Fields (TTFields) to first-line therapy in GBM demonstrated improved survival in the EF-14 trial. This prospective study was designed to investigate the safety and effect on QoL of TTFields in Chinese patients with GBM. METHODS A total of 44 patients (29 newly diagnosed GBM, 15 recurrent GBM, median age 51.0 [24.0 - 81.0] years) who underwent TTFields following surgery, concurrent chemoradiotherapy were enrolled into the study. The primary endpoint was the incidence of TTFields-related skin adverse events; the secondary endpoint included quality of life (QoL), treatment adherence. RESULTS Of the 44 patients followed up for at least 3 months, 24 (54.5%) had skin adverse reactions, all of which were grade 1–2. Median time to skin AE was 1.2 months. The common skin AE were dermatitis (53.8%), ulcer (19.2%), infection (19.2%), and most of them could be resolved by symptomatic treatment (topical corticosteroid/antibiotics). In terms of QoL, noticeable improvement in overall health and clinical manifestations such as fatigue, nausea and vomiting were observed. The overall average treatment compliance was 91%: compliance (mean±SD), in newly diagnosed patients, 0.89±0.14, median 0.91; in recurrent patients, 0.86±0.13, median 0.93. CONCLUSIONS The incidence of skin adverse reactions (which could be effectively alleviated with treatment) in GBM patients treated with TTFields was acceptable. From our short follow up, TTFields appear to improve QoL and compliance in Chinese patients comparable to published data.

scholarly journals Viral Respiratory Pathogens and Lung Injury

2021 ◽  
Vol 34 (3) ◽  
Author(s):  
Nicola Clementi ◽  
Sreya Ghosh ◽  
Maria De Santis ◽  
Matteo Castelli ◽  
Elena Criscuolo ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Cell Damage ◽  
Clinical Manifestations ◽  
Upper Airway ◽  
Patient Specific ◽  
Respiratory Pathogens ◽  
Human Respiratory Tract ◽  
Immune Mediated ◽  
Life Threatening ◽  
Viral Respiratory

SUMMARY Several viruses target the human respiratory tract, causing different clinical manifestations spanning from mild upper airway involvement to life-threatening acute respiratory distress syndrome (ARDS). As dramatically evident in the ongoing SARS-CoV-2 pandemic, the clinical picture is not always easily predictable due to the combined effect of direct viral and indirect patient-specific immune-mediated damage. In this review, we discuss the main RNA (orthomyxoviruses, paramyxoviruses, and coronaviruses) and DNA (adenoviruses, herpesviruses, and bocaviruses) viruses with respiratory tropism and their mechanisms of direct and indirect cell damage. We analyze the thin line existing between a protective immune response, capable of limiting viral replication, and an unbalanced, dysregulated immune activation often leading to the most severe complication. Our comprehension of the molecular mechanisms involved is increasing and this should pave the way for the development and clinical use of new tailored immune-based antiviral strategies.

scholarly journals Chronic cough: differential diagnosis and treatment

2020 ◽  
pp. 124-131
Author(s):  
N. V. Orlova
Keyword(s):  
Chronic Cough ◽  
Whooping Cough ◽  
Symptomatic Treatment ◽  
Underlying Disease ◽  
European Respiratory Society ◽  
Life Threatening ◽  
Examination Methods ◽  
Peripheral Action ◽  
Antitussive Drugs

Cough is one of the most common symptoms and is present in diseases of the respiratory, cardiovascular, digestive, endocrine and other systems. Cough is a reflex act, therefore it is caused by stimulation of cough receptors due to pathological influences. The diagnosis takes into account the nature of the cough, its duration, the results of laboratory and instrumental examination methods. The most attention is required to diagnose chronic cough and exclude life-threatening causes. Symptoms of anxiety are hemoptysis, prolonged resistant cough, prolonged intoxication syndrome, weight loss, etc. In diagnostically unclear cases, the examination schedule must include computed tomography of the chest, magnetic resonance imaging and bronchoscopy. A dry, painful intense cough can lead to the development of complications: a decrease in the quality of life, hemorrhages, pneumothorax, etc., therefore, requires symptomatic treatment. A common cause of unproductive cough is viral diseases, whooping cough, diseases leading to overactive cough receptors. The variety of coughs determines a differentiated approach to its therapy. The main efforts should be directed to the treatment of the underlying disease. In the case of a productive cough, mucoactive drugs are used. To stop unproductive cough, antitussive drugs of central and peripheral action are used. The recommendations of the European Respiratory Society present the results of clinical trials assessing the efficacy and safety of antitussive drugs with morphine-like action. The study identified side effects that limit their use. One of the most effective and safe drugs is a non-opioid drug with a central action Sinekod. The effectiveness and safety of the drug is confirmed by clinical studies.

scholarly journals Cardiotoxicity of Novel Targeted Hematological Therapies

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 344
Author(s):  
Valentina Giudice ◽  
Carmine Vecchione ◽  
Carmine Selleri
Keyword(s):  
Targeted Therapies ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Standard Chemotherapy ◽  
Life Threatening ◽  
Myocardial Structure ◽  
Phosphoinositide 3 Kinase ◽  
Btk Inhibitors ◽  
Target Effects

Chemotherapy-related cardiac dysfunction, also known as cardiotoxicity, is a group of drug-related adverse events negatively affecting myocardial structure and functions in patients who received chemotherapy for cancer treatment. Clinical manifestations can vary from life-threatening arrythmias to chronic conditions, such as heart failure or hypertension, which dramatically reduce quality of life of cancer survivors. Standard chemotherapy exerts its toxic effect mainly by inducing oxidative stress and genomic instability, while new targeted therapies work by interfering with signaling pathways important not only in cancer cells but also in myocytes. For example, Bruton’s tyrosine kinase (BTK) inhibitors interfere with class I phosphoinositide 3-kinase isoforms involved in cardiac hypertrophy, contractility, and regulation of various channel forming proteins; thus, off-target effects of BTK inhibitors are associated with increased frequency of arrhythmias, such as atrial fibrillation, compared to standard chemotherapy. In this review, we summarize current knowledge of cardiotoxic effects of targeted therapies used in hematology.

scholarly journals Avocado–Soybean Unsaponifiables: A Panoply of Potentialities to Be Exploited

Biomolecules ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 130 ◽  
Author(s):  
Bahare Salehi ◽  
Antonio Rescigno ◽  
Tinuccia Dettori ◽  
Daniela Calina ◽  
Anca Oana Docea ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chemical Composition ◽  
Knee Osteoarthritis ◽  
Autoimmune Diseases ◽  
Adjuvant Treatment ◽  
Biological Effects ◽  
Symptomatic Treatment ◽  
Diffuse Scleroderma ◽  
Osteoarthritic Pain

Avocado and soybean unsaponifiables (ASU) constitute vegetable extracts made from fruits and seeds of avocado and soybean oil. Characterized by its potent anti-inflammatory effects, this ASU mixture is recommended to act as an adjuvant treatment for osteoarthritic pain and slow-acting symptomatic treatment of hip and knee osteoarthritis; autoimmune diseases; diffuse scleroderma and scleroderma-like states (e.g., morphea, sclerodactyly, scleroderma in bands). Besides, it was reported that it can improve the mood and quality of life of postmenopausal women in reducing menopause-related symptoms. This article aims to summarize the studies on biological effects of the avocado–soybean unsaponifiable, its chemical composition, pharmacotherapy as well as applications in autoimmune, osteoarticular and menopausal disorders. Finally, we will also discuss on its safety, toxicological and regulatory practices.

scholarly journals Animal Model of Severe Fever With Thrombocytopenia Syndrome Virus Infection

2022 ◽  
Vol 12 ◽  
Author(s):  
Jiawen Sun ◽  
Yuan-Qin Min ◽  
Yunjie Li ◽  
Xiulian Sun ◽  
Fei Deng ◽  
...  
Keyword(s):  
Animal Models ◽  
Molecular Mechanisms ◽  
Clinical Manifestations ◽  
Medical Problem ◽  
Future Research ◽  
Antiviral Therapies ◽  
Treatment And Prevention ◽  
Animal Infection ◽  
Life Threatening ◽  
Severe Fever

Severe fever with thrombocytopenia syndrome (SFTS), an emerging life-threatening infectious disease caused by SFTS bunyavirus (SFTSV; genus Bandavirus, family Phenuiviridae, order Bunyavirales), has been a significant medical problem. Currently, there are no licensed vaccines or specific therapeutic agents available and the viral pathogenesis remains largely unclear. Developing appropriate animal models capable of recapitulating SFTSV infection in humans is crucial for both the study of the viral pathogenic processes and the development of treatment and prevention strategies. Here, we review the current progress in animal models for SFTSV infection by summarizing susceptibility of various potential animal models to SFTSV challenge and the clinical manifestations and histopathological changes in these models. Together with exemplification of studies on SFTSV molecular mechanisms, vaccine candidates, and antiviral drugs, in which animal infection models are utilized, the strengths and limitations of the existing SFTSV animal models and some important directions for future research are also discussed. Further exploration and optimization of SFTSV animal models and the corresponding experimental methods will be undoubtedly valuable for elucidating the viral infection and pathogenesis and evaluating vaccines and antiviral therapies.

scholarly journals Regenerative Rehabilitation for COVID 19 Sequelae

2021 ◽  
Vol 7 (1) ◽  
pp. 1-4
Author(s):  
Santiago Saldarriaga-Gómez ◽  
Keyword(s):  
Quality Of Life ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Clinical Manifestations ◽  
Medical Conditions ◽  
Previous Knowledge ◽  
Life Threatening

COVID 19 pandemic has been with us for more than a year now and new insights in pathophysiology and clinical manifestations have emerged. Recent reports have shown that not only is acute COVID a life-threatening disease, but post COVID symptoms are more common than previously thought and may greatly affect quality of life. In this review, we explore the usefulness of regenerative rehabilitation with Mesenchymal Stem Cells (MSC) in post COVID symptoms based on previous knowledge in other medical conditions

scholarly journals Porphyrias in the Age of Targeted Therapies

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1795
Author(s):  
Angelika L. Erwin ◽  
Manisha Balwani
Keyword(s):  
Biosynthetic Pathway ◽  
Genetic Disorders ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Cellular Level ◽  
New Treatment ◽  
Tissue Site ◽  
Underlying Pathophysiology

The porphyrias are a group of eight rare genetic disorders, each caused by the deficiency of one of the enzymes in the heme biosynthetic pathway, resulting in the excess accumulation of heme precursors and porphyrins. Depending on the tissue site as well as the chemical characteristics of the accumulating substances, the clinical features of different porphyrias vary substantially. Heme precursors are neurotoxic, and their accumulation results in acute hepatic porphyria, while porphyrins are photoactive, and excess amounts cause cutaneous porphyrias, which present with photosensitivity. These disorders are clinically heterogeneous but can result in severe clinical manifestations, long-term complications and a significantly diminished quality of life. Medical management consists mostly of the avoidance of triggering factors and symptomatic treatment. With an improved understanding of the underlying pathophysiology and disease mechanisms, new treatment approaches have become available, which address the underlying defects at a molecular or cellular level, and promise significant improvement, symptom prevention and more effective treatment of acute and chronic disease manifestations.

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