Biochemical profile of multiple myeloma about 50 cases

Multiple myeloma (MM) is a clonal proliferation of plasma cells invading the bone marrow and secreting monoclonal immunoglobulin. In order to study the epidemiological and biological and biochemical characteristics of MM, we carried out a retrospective work on a cohort of 50 cases collected at the Avicenna Military Hospital in Marrakesh, during a period of 5 years (from January 2013 to December 2017). Our study included 32 men (64%) and 18 women (36%), with an average age of 60.6 years, with extremes at 44 and 87 years. The circumstances of discovery were dominated by bone pain and alteration in general condition, which are revealing in more than 65% of cases. Biologically: the sedimentation rate was accelerated in 86% of cases, a monoclonal peak appearance was revealed on serum proteins electrophoresis in 88%of cases, most often located in the γ zone (64%), a predominance of the Ig G isotype (64%), and kappa light chains in 60% of cases, Bence Jones protein (BJP) was found in 7 patients, i.e. 14% of cases, and plasmacytosis over 10% was found on the myelograms in 90 % of cases.

SARS-CoV-2 vaccine effectiveness and breakthrough infections in maintenance dialysis patients

Background: SARS-CoV-2 vaccine effectiveness during the Delta period and immunogenicity threshold associated with protection against COVID-19 related hospitalization or death in the dialysis population is unknown. Methods: A retrospective, observational study assessed SARS-CoV-2 vaccine effectiveness and immunogenicity threshold in all adult maintenance dialysis patients without COVID-19 history treated between February 1 and October 2, 2021. All COVID-19 infections, composite of hospitalization or death following COVID-19 and available SARS-CoV-2 anti-spike immunoglobulin (Ig) G values were extracted from electronic medical record. COVID-19 cases per 10,000 days at risk and vaccine effectiveness during pre-Delta and Delta periods were determined. Results: Of 15,718 patients receiving dialysis during the study period, 11,191 (71%) were fully vaccinated, 733 (5%) were partially vaccinated and 3,794 (24%) were unvaccinated. 967 COVID-19 were cases identified: 511 (53%) occurred in unvaccinated patients and 579 (60%) occurred during the Delta period. COVID-19 related hospitalization or death was less likely among vaccinated versus unvaccinated patients for all vaccines (adjusted HR 0.19 [0.12, 0.30]) and for BNT162b2/Pfizer, mRNA-1273/Moderna, and Ad26.COV2.S/Janssen (adjusted HR=0.25 [0.16, 0.40], 0.14 [0.08, 0.22], and 0.34 [0.17, 0.68] respectively). Among those with anti-spike IgG levels, those with IgG level ≥ 7 had significantly lower risk of a COVID-19 diagnosis (HR=0.25 [0.15, 0.42]) and none experienced a COVID-related hospitalization or death. Conclusions: Among maintenance dialysis patients, SARS-CoV-2 vaccination was associated with a lower risk of COVID-19 diagnosis and associated hospitalization or death. Among vaccinated patients, low anti-spike IgG level is associated with worse COVID-19 related outcomes.

FcγR Genetic Variation and HIV-1 Vaccine Efficacy: Context And Considerations

Receptors for the crystallisable fragment (Fc) of immunoglobulin (Ig) G, Fcγ receptors (FcγRs), link the humoral and cellular arms of the immune response, providing a diverse armamentarium of antimicrobial effector functions. Findings from HIV-1 vaccine efficacy trials highlight the need for further study of Fc-FcR interactions in understanding what may constitute vaccine-induced protective immunity. These include host genetic correlates identified within the low affinity Fcγ-receptor locus in three HIV-1 efficacy trials – VAX004, RV144, and HVTN 505. This perspective summarizes our present knowledge of FcγR genetics in the context of findings from HIV-1 efficacy trials, and draws on genetic variation described in other contexts, such as mother-to-child HIV-1 transmission and HIV-1 disease progression, to explore the potential contribution of FcγR variability in modulating different HIV-1 vaccine efficacy outcomes. Appreciating the complexity and the importance of the collective contribution of variation within the FCGR gene locus is important for understanding the role of FcγRs in protection against HIV-1 acquisition.

Imaging aspect of neuromyelitis optica: a case report and review of the literature

The case report presents a neuromyelitis optica in a 19 years old male. Brain and spinal cord MRI showed bilateral optic neuropathy, multiphasic demyelinating process involving the cervical and thoracic spinal cord. Cerebrospinal fluid showed negative NMO Ig G. We will describe the radiological aspect of neuromyelitis optica with a review of the literature.

Особливості цитокінового профілю та імунного статусу у хворих на кондиломи аногенітальної ділянки

Мета роботи: вивчити зміни клітинного та гуморального імунітету у хворих на гострокінцеві кондиломи аногенітальної ділянки та визначити ступінь порушень; дослідити стан цитокінового профілю у хворих на ГК аногенітальної ділянки як факторів прогнозування перебігу післяопераційного періоду та ефективності лікування. Матеріали і методи. Обстежено 105 хворих на ГК аногенітальної ділянки: 63 (60 %) жінки та 42 (40 %) чоловіки. Вивчено стан клітинного та гуморального імунітету та рівень цитокінів TNFa, IL-4, IL-6, IL-8. Результати досліджень та їх обговорення. Частота хронічних соматичних захворювань склала 96 (91,43 %). Визначено достовірне зниження абсолютної та відносної кількості лімфоцитів та їх Т-популяцій. На тлі Т-лімфопенії визначено підвищення рівня В-лімфоцитів (CD22) в абсолютній та відносній кількості та Ig A та Ig G, що свідчить про наявність хронічного запального процесу та / або вірусного запалення з виснаженням Т-ланки імунітету. Рівень IL-4 був вищим, ніж у контрольній у 2,4 раза, та дорівнював (4,14 ± 0,24) пг/мл; IL-8 – у 1,9 – (29,82 ± 3,15) пг/мл; TNFa – у 3,0 – (7,64 ± 0,93) пг/мл; IL-6 – у 2,7 – (3,77 ± 0,45) пг/мл. Виявлено залежність рівня TNFa, IL-6, IL-4 та IL-8 від розповсюдження гострокінцевих кондилом та присутності супутнього перифокального запалення з найвищими значеннями при кондиломах Бушке–Левенштейна, тоді як у хворих на поодинокі гострокінцеві кондиломи цитокіновий профіль не відрізнявся від контрольної групи. У хворих на гострокінцеві кондиломи аногенітальної ділянки зсуви в ланках клітинного та гуморального імунітету характеризуються виснаженням ланки клітинного імунітету – загальною лімфопенією, Т-лімфопенією зі зниженням їхньої абсолютної та відносної кількості в усіх субпопуляціях, підвищенням рівня В-лімфоцитів, Ig G та Ig A. Підвищення рівня цитокінів IL-4, IL-6, IL-8 та TNFa у хворих на ГК аногенітальної ділянки відображає ступінь розповсюдження гострокінцевих кондилом та відповідає характеру перифокального запального процесу, що доцільно використовувати як фактор прогнозування перебігу післяопераційного періоду та ефективності лікування.

Previous COVID-19 Infection and Antibody Levels After Vaccination

Background: The emergence of new COVID-19 variants of concern coupled with a global inequity in vaccine access and distribution has prompted many public health authorities to circumvent the vaccine shortages by altering vaccination protocols and prioritizing persons at high risk. Individuals with previous COVID-19 infection may not have been prioritized due to existing humoral immunity.Objective: We aimed to study the association between previous COVID-19 infection and antibody levels after COVID-19 vaccination.Methods: A serological analysis to measure SARS-CoV-2 immunoglobulin (Ig)G, IgA, and neutralizing antibodies was performed on individuals who received one or two doses of either BNT162b2 or ChAdOx1 vaccines in Kuwait. A Student t-test was performed and followed by generalized linear regression models adjusted for individual characteristics and comorbidities were fitted to compare the average levels of IgG and neutralizing antibodies between vaccinated individuals with and without previous COVID-19 infection.Results: A total of 1,025 individuals were recruited. The mean levels of IgG, IgA, and neutralizing antibodies were higher in vaccinated subjects with previous COVID-19 infections than in those without previous infection. Regression analysis showed a steeper slope of decline for IgG and neutralizing antibodies in vaccinated individuals without previous COVID-19 infection compared to those with previous COVID-19 infection.Conclusion: Previous COVID-19 infection appeared to elicit robust and sustained levels of SARS-CoV-2 antibodies in vaccinated individuals. Given the inconsistent supply of COVID-19 vaccines in many countries due to inequities in global distribution, our results suggest that even greater efforts should be made to vaccinate more people, especially individuals without previous COVID-19 infection.

Modelling the concentration of anti-SARS-CoV-2 immunoglobulin G in intravenous immunoglobulin product batches

Background Plasma-derived intravenous immunoglobulin (IVIg) products contain a dynamic spectrum of immunoglobulin (Ig) G reactivities reflective of the donor population from which they are derived. We sought to model the concentration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG which could be expected in future plasma pool and final-product batches of CSL Behring’s immunoglobulin product Privigen. Study design and methods Data was extracted from accessible databases, including the incidence of coronavirus disease 2019 and SARS-CoV-2 vaccination status, antibody titre in convalescent and vaccinated groups and antibody half-life. Together, these parameters were used to create an integrated mathematical model that could be used to predict anti-SARS-CoV-2 antibody levels in future IVIg preparations. Results We predict that anti-SARS-CoV-2 IgG concentration will peak in batches produced in mid-October 2021, containing levels in the vicinity of 190-fold that of the mean convalescent (unvaccinated) plasma concentration. An elevated concentration (approximately 35-fold convalescent plasma) is anticipated to be retained in batches produced well into 2022. Measurement of several Privigen batches using the Phadia™ EliA™ SARS-CoV-2-Sp1 IgG binding assay confirmed the early phase of this model. Conclusion The work presented in this paper may have important implications for physicians and patients who use Privigen for indicated diseases.

Immunosupressive activity of opportunist pathogens of the infectious-inflammatory process in the urinary tract of men with calculous pyelonephritis

Objective - identification of pathogens of the infectious-inflammatory process of the urinary tract in men with calculous pyelonephritis, antilysozyme, anticomplementary, anti-immunoglobulin activity and inhibitory effect on the phagocytic activity of peripheral blood neutrophils.Material and methods. 34 strains of opportunistic taxa were isolated and identified by bacteriological method from 30 sick men aged 31 to 65 years (mean age 48.8 ± 4.27 years). These bacteria have antilysozyme, anti-complementary and anti-immunoglobulin activity, as well as the suppressive effect of supernatants of cultures of calculous pyelonephritis pathogens on the phagocytic activity of neutrophils in the peripheral blood of patients. The determination of the anti-complementary activity of bacteria was carried out using the principle, which includes testing the protective action of bacteria and their metabolic products against the growth of an indicator strain in the presence of a bactericidal substance (complement of blood serum). The antilysozyme activity of pathogens was investigated by a photometric method. Anti-immunoglobulin activity was studied by the method described in the work of I.S. Gaidash et al. Results. The majority of 27 (79.41%) isolated strains of Enterobacteriaceae (84%) and facultative anaerobic and aerobic gram-positive cocci (E. faecalis, S.saprophyticus) (66.67%) exhibit antilysozyme activity of varying degrees. The highest antilysozyme activity was found in the isolated strains of K. pneumoniae, 8.14% lower – in E. coli. Most (64.71%) of isolated strains of Enterobacteriaceae (68%) and gram-positive cocci (55.56%) from the urinary tract of men with calculous pyelonephritis exhibit anti-complementary activity. All isolated and identified taxa exhibit inhibitory activity against immunoglobulins of the main classes: Ig M, Ig G, and Ig A. K.pneumoniae inhibits immunoglobulins of all major classes, the concentration of Ig M decreases under the influence of this taxon by 22.36%, Ig G - by 26.88% and Ig A - by 19.61%.Conclusions. Opportunistic pathogens (E. coli, K. pneumoniae, P. mirabilis, E. cloaceae, S. marcescens, E. faecalis, S. saprophyticus) of the infectious-inflammatory process of the urinary tract in men with calculous pyelonephritis exhibit different levels of antilysozyme, anti-complementary activity; reduce the function of immunoglobulins Ig G (by 21.60%), Ig A (by 21.49%) and Ig M (by 14.30%), inhibit the phagocytic activity of neutrophilsby 15.74%, their capturing ability- by 22.59%.

Prevalence of Anti-Nuclear Antibodies and Anti-Phospholipid Antibodies in an Egyptian Cohort with Schizophrenia: A Case-Control Study

Background: Psychiatric disorders, including schizophrenia could herald other manifestation(s) of systemic lupus erythematosus (SLE) potentially hindering timely and optimal management. Moreover, schizophrenia is among the described ‘extra-criteria’ manifestations of anti-phospholipid syndrome (APS). Hence, screening schizophrenia patients for SLE and APS may pose diagnostic and therapeutic implications. Objectives: Examine schizophrenia patients with no overt connective tissue disease(s) manifestation(s) for clinical and/or serologic evidence of SLE and/or APS. Methods: The study included 92 schizophrenia patients [61 (66.3%) males] and 100 age- and gender-matched healthy controls. Both groups were tested for anti-nuclear antibodies (ANAs), anti-double stranded deoxyribonucleic acid (anti-dsDNA) antibodies, complement 3 (C3) and C4, and criteria anti-phospholipid antibodies (aPL) [anticardiolipin Immunoglobulin (Ig) G and IgM, anti-beta-2-glycoprotein I IgG and IgM, and lupus anticoagulant (LAC)]. Results: The patients’ mean age and disease duration were 28.8 ± 8.1 and 5.7 ± 2.2 years, respectively. The prevalence of ANA positivity, height of titre, and pattern was comparable between patients and controls (p = 0.9, p = 0.8 and p = 0.1, respectively). Anti-dsDNA antibodies and hypocomplementemia were absent in both groups. A significantly higher frequency of positive LAC was observed among patients compared with controls (7.6 % vs. 1 %, p = 0.02), whereas other aPL were comparable between both groups. None of the patients or controls demonstrated clinically meaningful (medium or high) aPL titres. Conclusion: In our study, schizophrenia was solely associated with LAC. Thus, in the absence of findings suggestive of SLE or APS, routine screening for both diseases is questionable.